title: Acutely suicidal adolescents who engage in bullying behavior: 1-year trajectories.
abstract: OBJECTIVE
  Prospective longitudinal research is needed to examine associations between bullying behaviors and trajectories of suicidal ideation and behavior and overall functional impairment. The specific aims of the present study are to: (1) characterize differences in baseline functioning between acutely suicidal adolescents who are classified into bullying perpetrator and non-bully groups and (2) examine the 1-year trajectories of these two groups of adolescents.
  
  
  METHODS
  Participants were 433 psychiatrically hospitalized suicidal adolescents (72% female), ages 13 to 17 years. Participants reported suicidal ideation, depression, anxiety, substance use, adaptive functioning, and bullying behavior. Six items from the Youth Self-Report were used to classify adolescents into bullying perpetrator (n = 54) and non-bully (n = 379) groups. Follow-up assessments were conducted at 6 weeks, 3 months, 6 months, and 12 months.
  
  
  RESULTS
  At hospitalization, adolescents in the bully group reported significantly higher levels of suicidal ideation, substance use, and functional impairment. Suicidal ideation differences remitted at six weeks. The elevated functional impairment of the bullying perpetrator group persisted across the 12-month period.
  
  
  CONCLUSIONS
  Adolescents who met bullying perpetrator group criteria were characterized by more severe suicidal ideation and higher levels of proximal risk factors for suicide. Bullying behavior was not stable over time but was associated with elevated suicide risk when present. These findings highlight the importance of specifically assessing for and targeting bullying behavior at multiple time points when treating suicidal adolescents.
authors.affiliation: Department of Psychiatry, University of Michigan Depression Center, Ann Arbor, MI, USA. kingca@umich.edu
authors.forename: Cheryl A
authors.initials: CA
authors.lastname: King
authors.forename: Adam
authors.initials: A
authors.lastname: Horwitz
authors.forename: Johnny
authors.initials: J
authors.lastname: Berona
authors.forename: Qingmei
authors.initials: Q
authors.lastname: Jiang
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D001007:Anxiety / Q000453:epidemiology; D058445:Bullying / Q000523:psychology*; D003863:Depression / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D011581:Psychological Tests; D019966:Substance-Related Disorders / Q000453:epidemiology; D059020:Suicidal Ideation