BALTIMORE – Acutely suicidal adolescents who also were bullies had a heightened prevalence of suicidal ideation, substance use, and functional impairment, compared with similar suicidal adolescents who were not bullies, a review of more than 400 American teenagers has shown.
Results from a post hoc analysis of a suicide intervention trial also showed that the bullying behaviors in most study participants resolved over the course of 1 year.
"These findings highlight the importance of specifically assessing for and targeting bullying behavior when treating suicidal adolescents," Cheryl A. King, Ph.D., reported in a poster at the meeting. "The coinciding improvement in mental health suggests that targeting bullying perpetrators for treatment could improve outcomes for both the bullies as well as potential victims," said Dr. King, professor of psychology and director of the institute for human adjustment at the University of Michigan in Ann Arbor.
The post hoc analysis she and her associates ran included 433 of the 448 hospitalized, suicidal adolescents, aged 13-17, who participated in the Youth-Nominated Support Team–Version II intervention study (J. Consulting Clin. Psychology 2009;77:880-93). The investigators randomized suicidal teenagers in a psychiatric hospital to receive either usual care or usual care plus the Youth-Nominated Support Team–Version II intervention, a 3-month treatment based on social support and healthy behavior models. Results from the primary analysis showed very limited positive effects from this intervention, with no effect on suicide attempts and no enduring effect on suicidal ideation scores.
"These findings highlight the importance of specifically assessing for and targeting bullying behavior when treating suicidal adolescents."
For the post hoc analysis, the researchers evaluated 433 of the participating adolescents at baseline on a bullying scale that rated each participant by six criteria: teasing, physical attacks, meanness to others, destroying belongings of others, threats to hurt others, and getting into many fights. Fifty-four (12%) of the adolescents included in this analysis met the assessment’s threshold for being bullies.
The bully subgroup had significantly higher levels of suicidal ideation, substance use, and functional impairment, compared with the other teens in the study who did not meet the bully criteria.
One year after their first assessment, 4 of the original 54 teens who met the bullying criteria continued to have scores that classified them as bullies. In addition, 12 other adolescents who initially had not met the bullying criteria did so when they underwent reassessment at 12 months. Most of those initially identified as bullies showed improvements in their suicidal ideation and substance use during the following 12 months. However, they continued to have greater functional impairment than the nonbullies at 12 months.
The total group of 16 adolescents who met the bullying criteria at 1 year again showed higher levels of suicidal ideation and other suicide risk factors, compared with the nonbullies.
The factors that shape the fluctuating trajectories of bullying in this study population might help identify targets for intervention that could decrease bullying and suicidal behaviors among adolescents, Dr. King and her associates concluded.
Dr. King said she had no relevant financial disclosures.