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Bullying and Suicidal Ideation and Behaviors: A Meta-Analysis
Open accessAbstract
BACKGROUND AND OBJECTIVES: Over the last decade there has been increased attention to the association between bullying involvement (as a victim, perpetrator, or bully-victim) and suicidal ideation/behaviors. We conducted a meta-analysis to estimate the association between bullying involvement and suicidal ideation and behaviors. METHODS: We searched multiple online databases and reviewed reference sections of articles derived from searches to identify cross-sectional studies published through July 2013. Using search terms associated with bullying, suicide, and youth, 47 studies (38.3% from the United States, 61.7% in non-US samples) met inclusion criteria. Seven observers independently coded studies and met in pairs to reach consensus. RESULTS: Six different meta-analyses were conducted by using 3 predictors (bullying victimization, bullying perpetration, and bully/victim status) and 2 outcomes (suicidal ideation and suicidal behaviors). A total of 280 effect sizes were extracted and multilevel, random effects meta-analyses were performed. Results indicated that each of the predictors were associated with risk for suicidal ideation and behavior (range, 2.12 [95% confidence interval (CI), 1.67–2.69] to 4.02 [95% CI, 2.39–6.76]). Significant heterogeneity remained across each analysis. The bullying perpetration and suicidal behavior effect sizes were moderated by the study’s country of origin; the bully/victim status and suicidal ideation results were moderated by bullying assessment method. CONCLUSIONS: Findings demonstrated that involvement in bullying in any capacity is associated with suicidal ideation and behavior. Future research should address mental health implications of bullying involvement to prevent suicidal ideation/behavior.
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“One review (Holt et al., 2015) found a significant moderating effect from the country of origin of the study in both bullying perpetration and victimization.”
From Risk and Protective Factors of Self-harm and Suicidality in Adolescents: An Umbrella Review with Meta-Analysis (2024) · cites this paper as Holt et al., 2015
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“Holt et al. (2015) and Van Geel et al. (2014) explored bullying victimization as a risk for suicidal ideation from 23 and 24 individual studies, respectively; the pooled OR was 2.23 and 2.34 for the overall relationship between bullying victimization and suicide ideation.”
From Risk and Protective Factors of Self-harm and Suicidality in Adolescents: An Umbrella Review with Meta-Analysis (2024) · cites this paper as Holt et al., 2015
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“They found a significant OR of 2.62 (95% CI, 1.51–4.55), indicating a 1.62-fold higher risk of suicidal behavior for youth who perpetrated bullying (Table 1).”
From Risk and Protective Factors of Self-harm and Suicidality in Adolescents: An Umbrella Review with Meta-Analysis (2024) · cites this paper as Holt et al., 2015
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“The OR ranged from 2.78 to 3.26 for the overall relationship between bullying victimization and suicidal behavior.”
From Risk and Protective Factors of Self-harm and Suicidality in Adolescents: An Umbrella Review with Meta-Analysis (2024) · cites this paper as Holt et al., 2015
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
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“The meta-analysis included two reviews of 24 studies (Holt et al., 2015; Van Geel et al., 2014) and one school global health survey (Koyanagi et al., 2019) resulted in a pooled OR of bully victimization to suicide attempts being 2.97 (95% C.I. 2.53–3.49, p < 0.0001) (Fig. 1).”
From Risk and Protective Factors of Self-harm and Suicidality in Adolescents: An Umbrella Review with Meta-Analysis (2024) · cites this paper as Holt et al., 2015
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“Holt et al. (2015) reviewed studies that assessed the relationship between bullying perpetration and suicidal ideation and found a pooled OR of 2.12.”
From Risk and Protective Factors of Self-harm and Suicidality in Adolescents: An Umbrella Review with Meta-Analysis (2024) · cites this paper as Holt et al., 2015
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“Gender was reported in individual studies as a moderator to associations between bullying and suicidality (Klomek et al., 2009) but not significant in Holt’s meta-analysis.”
From Risk and Protective Factors of Self-harm and Suicidality in Adolescents: An Umbrella Review with Meta-Analysis (2024) · cites this paper as Holt et al., 2015
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Cites
Preferred Reporting Items for Systematic Reviews and Meta-Analyses: the PRISMA statement
Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G., & for the PRISMA Group (2009) · BMJ · doi:10.1136/bmj.b2535 · Cited by 83,823
Preferred reporting items for systematic reviews and meta-analyses: the PRISMA Statement.
(2009) · PubMed Central · Cited by 44,859
Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement
Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G., & the PRISMA Group* (2009) · Annals of Internal Medicine · doi:10.7326/0003-4819-151-4-200908180-00135 · Cited by 37,554
Conducting Meta-Analyses in R with the metafor Package
Viechtbauer, W. (2010) · Journal of Statistical Software · doi:10.18637/jss.v036.i03 · Cited by 20,464
Borenstein, M., Hedges, L. V., Higgins, J. P. T., & Rothstein, H. R. (2009) · doi:10.1002/9780470743386 · Cited by 14,225
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Borenstein, M., Hedges, L. V., Higgins, J. P. T., & Rothstein, H. R. (2021) · doi:10.1002/9781119558378 · Cited by 9,799
Bullying at school: what we know and what we can do
(1994) · Choice Reviews Online · doi:10.5860/choice.32-1080 · Cited by 4,755
Bullying, Cyberbullying, and Suicide
Hinduja, S., & Patchin, J. W. (2010) · Archives of Suicide Research · doi:10.1080/13811118.2010.494133 · Cited by 2,078
Predictors of bullying and victimization in childhood and adolescence: A meta-analytic investigation
Cook, C. R., Williams, K. R., Guerra, N. G., Kim, T. E., & Sadek, S. (2010) · School Psychology Quarterly · doi:10.1037/a0020149 · Cited by 1,758
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Moore, S. E., Norman, R. E., Suetani, S., Thomas, H. J., Sly, P. D., & Scott, J. G. (2017) · World Journal of Psychiatry · doi:10.5498/wjp.v7.i1.60 · Cited by 1,320
Bullying in schools: the state of knowledge and effective interventions
Menesini, E., & Salmivalli, C. (2017) · Psychology Health & Medicine · doi:10.1080/13548506.2017.1279740 · Cited by 1,080
Gaffney, H., Ttofi, M. M., & Farrington, D. P. (2018) · Aggression and Violent Behavior · doi:10.1016/j.avb.2018.07.001 · Cited by 642
Recent increases in depressive symptoms among US adolescents: trends from 1991 to 2018
Keyes, K. M., Gary, D., O’Malley, P. M., Hamilton, A., & Schulenberg, J. (2019) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-019-01697-8 · Cited by 465
Zych, I., Ortega-Ruiz, R., & Del Rey, R. (2015) · Aggression and Violent Behavior · doi:10.1016/j.avb.2015.10.001 · Cited by 439
Metadata
- Authors
- Holt, M. K., Vivolo-Kantor, A. M., Polanin, J. R., Holland, K. M., DeGue, S., Matjasko, J. L., Wolfe, M., & Reid, G.
- Affiliations
- Boston University (US)
- Centers for Disease Control and Prevention (US)
- Vanderbilt University (US)
- ORCID
- Venue
- Pediatrics
- Publisher
- American Academy of Pediatrics (AAP)
- Published
- 2015-02-01
- Volume
- 135
- Issue
- 2
- Pages
- e496-e509
- ISSN
- 0031-4005 (ISSN-L)
- 1098-4275
- PMC
- PMC4702491
- OpenAlex
- W2046705515
- Cited by
- 675
- References
- 77
- Citations by year
- 2026: 45 · 2025: 67 · 2024: 52 · 2023: 77 · 2022: 81 · 2021: 80 · 2020: 70 · 2019: 67 · 2018: 70 · 2017: 32 · 2016: 17 · 2015: 14
- FWCI
- 6.91
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- PEDIATRICS (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (CC999999)
- Topics
- Social Sciences › Psychology › Social Psychology › Bullying, Victimization, and Aggression
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Social Sciences › Business, Management and Accounting › Organizational Behavior and Human Resource Management › Workplace Violence and Bullying
- Keywords
- bullying, suicidal ideation, suicidal behavior, bullying victimization, bullying perpetration, youth, suicide prevention
- MeSH terms
- Adolescent, Child, Child, Preschool, Female, Humans, Male, Suicide, Suicide, Attempted, Precipitating Factors, Bullying, Suicidal Ideation
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