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Meta-Analysis
. 2015 Feb;135(2):e496-509.
doi: 10.1542/peds.2014-1864. Epub 2015 Jan 5.

Bullying and suicidal ideation and behaviors: a meta-analysis

Melissa K Holt  1 , Alana M Vivolo-Kantor  2 , Joshua R Polanin  3 , Kristin M Holland  2 , Sarah DeGue  2 , Jennifer L Matjasko  2 , Misty Wolfe  2 , Gerald Reid  4
Affiliations
Meta-Analysis

Bullying and suicidal ideation and behaviors: a meta-analysis

Melissa K Holt et al. Pediatrics. 2015 Feb.

Abstract

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.

Keywords: bullying; meta-analysis; suicidal behaviors; suicidal ideation; suicidality; victimization; youth.

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Conflict of interest statement

POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose.

Figures

FIGURE 1
FIGURE 1
PRISMA flow diagram.
FIGURE 2
FIGURE 2
Bullying victimization-suicidal ideation forest plot. Estimates represent log odds ratios; boxes represent weights; bars around the boxes represent the 95% CIs; effect sizes aggregated to the study-level for ease of presentation.
FIGURE 3
FIGURE 3
Bullying victimization-suicidal behavior forest plot. Estimates represent log odds ratios; boxes represent weights; bars around the boxes represent the 95% CI; effect sizes aggregated to the study-level for ease of presentation.
FIGURE 4
FIGURE 4
Bullying perpetration-suicidal ideation forest plot. Estimates represent log odds ratios; boxes represent weights; bars around the boxes represent the 95% CIs; effect sizes aggregated to the study-level for ease of presentation.
FIGURE 5
FIGURE 5
Bullying perpetration-suicidal behavior forest plot. Estimates represent log odds ratios; boxes represent weights; bars around the boxes represent the 95% CIs; effect sizes aggregated to the study-level for ease of presentation.
FIGURE 6
FIGURE 6
Bully-victim-suicidal ideation forest plot. Estimates represent log odds ratios; boxes represent weights; bars around the boxes represent the 95% CIs; effect sizes aggregated to the study-level for ease of presentation.
FIGURE 7
FIGURE 7
Bully-victim-suicidal behavior forest plot. Estimates represent log odds ratios; boxes represent weights; bars around the boxes represent the 95% CIs; effect sizes aggregated to the study-level for ease of presentation.
See this image and copyright information in PMC

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