Suicidal Thoughts Common Among Victimized Youth

Pam Harrison

October 23, 2012

Suicidal ideation is significantly more common among adolescents who have experienced any form of victimization compared with those who have not, new research shows.

Heather Turner, PhD, from the University of New Hampshire, in Durham, and colleagues found that the risk for suicidal ideation was 2.4 times greater among youth who experienced peer victimization in the past year compared with youth who had not experienced bullying.

Thoughts of suicide were also 3.4 times greater among youth who were sexually assaulted and 4.4 times greater among youth who had been mistreated by parents or caregivers.

Youth who had been exposed to 7 or more types of victimization in the past year were almost 6 times as likely to report suicidal ideation as nonexposed youth.

"We know that many adolescents are exposed to several different types of victimization, often within a fairly short period of time, so one of the important advantages of our survey is that it is a more comprehensive assessment of victimization exposure than usual," Dr. Turner told Medscape Medical News.

"And I think the findings emphasize the need to include comprehensive victim assessment that takes in a wide array of different types of victimization when considering suicide intervention and prevention efforts in general."

The study was published online October 22 in Archives of Pediatric and Adolescent Medicine.

All Types of Victimization

Because earlier studies investigating the effect of victimization on suicidal ideation have typically focused on only 1 form of victimization, researchers used 2 waves of longitudinal data to examine the effects of several forms of victimization on suicidal ideation.

The wave 1 survey was conducted between January and May, 2008; the second wave was conducted approximately 2 years later.

An enhanced version of the Juvenile Victimization Questionnaire was used in both waves of the study, and 1 item from the Trauma Symptoms Checklist for Children was used to assess suicidal ideation.

Results showed that 4.3% of the total sample of 1186 children and adolescents between the ages of 10 to 17 years in wave 1 experienced suicidal ideation in the month preceding the interview, with females reporting ideation rates almost twice those of males.

The forms of victimization associated with the greatest percentage of youth reporting ideation included maltreatment, with over 16% of maltreated youth reporting suicidal ideation compared with 2.7% of adolescents who had not been maltreated.

Some 23% of sexually assaulted youth also reported suicidal ideation vs 3.7% of those who had not been sexually assaulted.

Almost 16% of adolescents who had been exposed to 7 or more individual types of victimization reported suicidal ideation in the past month, investigators add.

There was also a "substantial" association between suicidal ideation and living in a household with a stepparent or unmarried parent partner.

Victimization exposure did not fully explain this association, as investigators point out, and the particularly strong association between suicidal ideation and stepfamily households is both "worrisome" and warrants more attention, researchers suggest.

"I think it's important to recognize that we're talking about the kinds of victimization many adolescents experience," Dr. Turner said.

"So this is about the accumulation of different types of victimization episodes across multiple domains in adolescence, and this accumulation is what creates the greatest risk of suicidal ideation.

"Our findings show how important it is to take a more holistic youth-centered approach in promoting youth health and well-being and reducing suicidal risk."

Beyond Mood Disorders

Peter A. Wyman, PhD, from the University of Rochester Medical Center in New York, told Medscape Medical News that what this study adds is the finding that multiple victimization episodes have an effect on suicidal ideation "above and beyond" a diagnosis of mood disorder.

"It also underscores the fact that some youth are vulnerable to multiple forms of victimization, particularly when from very adverse family environments," he added.

Dr. Wyman also noted that the suicide prevention field typically emphasizes the role of mood problems along with other psychiatric and substance use disorders in suicide risk.

This focus usually translates into strategies to identify youth with these specific disorders before making a referral for treatment.

"Far less attention has been given to clarifying the contributions of adolescents' social environment and experiences such as being victims of bullying," Dr. Wyman said.

"So this study draws attention to considering doing an assessment of at-risk youth by asking about peers and events that happen in families as well as exposure to violence, as they can have added risk beyond a single event."

The authors and Dr. Wyman have disclosed no relevant financial relationships.

Arch Pediatr Adolesc Med. Published online October 22, 2012. Abstract