Cyberbullying, Risky Sex Hike Teen Suicide Risk

SAN FRANCISCO - Adolescents who reported being victims of "cyberbullying" or engaging in high-risk sexual behaviors were more likely to have considered or attempted suicide, researchers said here.

Data from the federal Youth Risk Behavior Survey (YRBS), involving more than 15,000 teens in the 13-17 age group, suggested that cyberbullying -- denigration and threats communicated via Internet technology -- was a greater contributor to suicidal ideation than in-person bullying at school, Kristi Kindrick, MD, of the University of Arkansas for Medical Sciences in Little Rock, said at the annual meeting of the American Psychiatric Association.

A separate analysis of YRBS data, led by her husband William Kindrick, MD, at the same institution,

found that teenagers with four or more previous sex partners, those starting to have sex before age 13, and those who said they had been forced into sex all showed much higher rates of suicidal ideation or attempts than the general high-school-age population.

The highest rates of self-reported suicidality in the latter study -- topping 40% for ideation and 30% for actual attempts -- were seen in respondents who said they had been forced into intercourse. The next greatest risk factor for suicidality in the study was a sexual debut prior to age 13.

Both researchers said their findings highlight the vulnerability of teenagers to suicidality when under severe stress. William Kindrick told MedPage Today that the risky sex behaviors examined in the study are very often an outgrowth of depression and low self-esteem, so the association with suicidality was not a surprise.

In the cyberbullying study, Kristi Kindrick and colleagues analyzed responses from 15,425 YRBS participants to questions about suicidal thoughts and acts, including ideation, detailed plans, attempts, and attempts requiring medical treatment. The survey also included two questions about bullying -- that occurring at school and that communicated via websites, social media, online chat rooms, and instant messaging.

Overall, 10.5% of the sample (after weighting to reflect national demographics) reported suicidal ideation, 8.3% reported having made suicide plans, 4.6% had made attempts, and 1.5% had been treated for an attempt.

Those percentages were vastly higher, though, for the 3,416 respondents who said they had been bullying victims. For example, among the 1,367 reporting being bullied at school only, 23.2% said they had considered suicide, 19.4% had made plans, and 9.5% had made attempts.

For the 930 reporting cyberbullying only, 28.9% had thoughts of suicide, 22.2% had made plans, and 14.7% had made attempts.

And, among 1,119 participants who said they were bullied both at school and online, 39.5% had considered suicide, 32.7% had made plans, and 21.1% had made attempts. The adjusted odds ratio for attempts in this group was 4.3 (95% CI 3.4-5.4) compared with the nonbullied portion of the sample.

Attempts with or without the need for treatment remained significantly more common among those experiencing both cyber-based and school bullying even when the data were adjusted for participants' reports of recent sadness or hopelessness, Kindrick said.

The researchers found that girls were nearly twice as likely as boys to experience cyberbullying, and that it was far more common among white girls than those of other ethnicities. Kindrick, referring to a 2004 film starring Lindsay Lohan, said the findings indicated that the "Mean Girls" phenomenon is a reality in many high schools.

She suggested that screening instruments for adolescents with depressive symptoms should include questions about bullying, including cyberbullying.

Results were similar in the study by William Kindrick, except that the reports of risky sexual behaviors likely included substantial overlap -- that is, many participants reporting early sexual debut were likely among those with four or more sex partners and with a history of unwilling sex.

With 15,212 YRBS participants responding to the relevant questions (not necessarily the same ones as in the cyberbullying analysis), the analysis found that approximately 42% of those who said they had been forced into sex had thought of suicide, 37% had made plans, 32% had made suicide attempts, and 15% had made attempts requiring treatment.

In comparison, 16% of the overall sample reported suicidal ideation, 12% had made plans, 8% had made attempts, and 2% had made attempts requiring treatment.

These with a sexual debut prior to age 13 reported suicidal ideation at a rate of 29%, plans among 25%, attempts in 22%, and serious attempts in 9%.

Respondents reporting four or more partners showed rates of suicidality lower than these figures, but still higher than the overall sample.

William Kindrick noted that the reported rates of forced sex and early debut were surprisingly high -- 8% and 6%, respectively. These prevalences "need to be addressed by parents, clinicians, and educators," he suggested.

Jeffrey Borenstein, MD, of the Brain and Behavior Research Foundation, who moderated a press briefing featuring the cyberbullying study, said clinicians' first responsibility in dealing with potentially suicidal teens is to make them safe.

But they can also take steps to reduce the external risk factors, he said. In the case of bullying, he said, clinicians can encourage and support victims, parents, and school officials in identifying perpetrators and creating a non-bullying culture.

At the briefing, Kristi Kindrick highlighted a finding in her study that 6.5% of respondents said they don't feel safe at school.

She noted that, if such an atmosphere prevailed in an adult workplace, "it would be called harassment" and would not be tolerated.

"Unfortunately, we can overlook that in kids," she said.

Source: Cyberbullying, Risky Sex Hike Teen Suicide Risk