School of Education, Boston University, Boston, Massachusetts;
Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia; and.
Pediatrics. 2015 Feb;135(2):e496-509. doi: 10.1542/peds.2014-1864. Epub 2015 Jan 5.
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.
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.
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.
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.
在过去十年中，人们越来越关注欺凌行为（作为受害者、施害者或欺凌受害者）与自杀意念/行为之间的关系。我们进行了一项荟萃分析，以评估欺凌行为与自杀意念和行为之间的关联。
我们搜索了多个在线数据库，并查阅了从搜索中获得的文章的参考文献部分，以确定截至 2013 年 7 月发表的横断面研究。使用与欺凌、自杀和青年相关的搜索词，有 47 项研究（38.3%来自美国，61.7%来自非美国样本）符合纳入标准。七名观察者独立对研究进行编码，并分组进行协商以达成共识。
使用 3 个预测指标（欺凌受害、欺凌施害和欺凌受害者身份）和 2 个结果（自杀意念和自杀行为）进行了 6 项不同的荟萃分析。共提取了 280 个效应量，并进行了多层次、随机效应荟萃分析。结果表明，每个预测指标都与自杀意念和行为的风险相关（范围为 2.12[95%置信区间（CI），1.67-2.69]至 4.02[95% CI，2.39-6.76]）。每项分析仍存在显著的异质性。欺凌施害和自杀行为的效应量受到研究来源国的调节；欺凌受害者身份和自杀意念的结果受到欺凌评估方法的调节。
研究结果表明，任何形式的欺凌行为都与自杀意念和行为有关。未来的研究应该解决欺凌行为对心理健康的影响，以预防自杀意念/行为。
