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Original Investigation |

Relationship Between Peer Victimization, Cyberbullying, and Suicide in Children and Adolescents:  A Meta-analysis

Mitch van Geel, PhD1; Paul Vedder, PhD1; Jenny Tanilon, PhD2
[+] Author Affiliations
1Institute of Education and Child Studies, Leiden University, Leiden, the Netherlands
2Department of Hospitality Research, Hotelschool, The Hague, the Netherlands
JAMA Pediatr. 2014;168(5):435-442. doi:10.1001/jamapediatrics.2013.4143.
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Importance  Peer victimization is related to an increased chance of suicidal ideation and suicide attempts among children and adolescents.

Objective  To examine the relationship between peer victimization and suicidal ideation or suicide attempts using meta-analysis.

Data Sources  Ovid MEDLINE, PsycINFO, and Web of Science were searched for articles from 1910 to 2013. The search terms were bully*, teas*, victim*, mobbing, ragging, and harassment in combination with the term suic*. Of the 491 studies identified, 34 reported on the relationship between peer victimization and suicidal ideation, with a total of 284 375 participants. Nine studies reported on the relationship between peer victimization and suicide attempts, with a total of 70 102 participants.

Study Selection  Studies were eligible for inclusion if they reported an effect size on the relationship between peer victimization and suicidal ideation or suicide attempt in children or adolescents.

Data Extraction and Synthesis  Two observers independently coded the effect sizes from the articles. Data were pooled using a random effects model.

Main Outcomes and Measures  This study focused on suicidal ideation and suicide attempts. Peer victimization was hypothesized to be related to suicidal ideation and suicide attempts.

Results  Peer victimization was found to be related to both suicidal ideation (odds ratio, 2.23 [95% CI, 2.10-2.37]) and suicide attempts (2.55 [1.95 -3.34]) among children and adolescents. Analyses indicated that these results were not attributable to publication bias. Results were not moderated by sex, age, or study quality. Cyberbullying was more strongly related to suicidal ideation compared with traditional bullying.

Conclusions and Relevance  Peer victimization is a risk factor for child and adolescent suicidal ideation and attempts. Schools should use evidence-based practices to reduce bullying.

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Figure 1.
Flow Diagram of All Stages of the Literature Search

All stages of the literature search are detailed, from the number of records identified through the number of studies included in the meta-analysis.

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Figure 2.
Forest Plot of the Effect Sizes Between Peer Victimization and Suicidal Ideation

Data were pooled under the assumption of a random-effects model. YRBS indicates Youth Risk Behavior Survey.

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Figure 3.
Forest Plot of the Effect Sizes Between Peer Victimization and Suicide Attempts

Data were pooled under the assumption of a random-effects model. YRBS indicates Youth Risk Behavior Survey.

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