title: Bullying and suicidal ideation and behaviors: a meta-analysis.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: School of Education, Boston University, Boston, Massachusetts; holtm@bu.edu.
authors.forename: Melissa K
authors.initials: MK
authors.lastname: Holt
authors.affiliation: Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia; and.
authors.forename: Alana M
authors.initials: AM
authors.lastname: Vivolo-Kantor
authors.affiliation: Peabody Research Institute, Vanderbilt University, Nashville, Tennessee.
authors.forename: Joshua R
authors.initials: JR
authors.lastname: Polanin
authors.affiliation: Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia; and.
authors.forename: Kristin M
authors.initials: KM
authors.lastname: Holland
authors.affiliation: Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia; and.
authors.forename: Sarah
authors.initials: S
authors.lastname: DeGue
authors.affiliation: Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia; and.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Matjasko
authors.affiliation: Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia; and.
authors.forename: Misty
authors.initials: M
authors.lastname: Wolfe
authors.affiliation: School of Education, Boston University, Boston, Massachusetts;
authors.forename: Gerald
authors.initials: G
authors.lastname: Reid
mesh_terms: D000293:Adolescent; D058445:Bullying / Q000523:psychology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D015985:Precipitating Factors; D059020:Suicidal Ideation; D013405:Suicide / Q000523:psychology*; D013406:Suicide, Attempted / Q000523:psychology*
keywords: bullying; meta-analysis; suicidal behaviors; suicidal ideation; suicidality; victimization; youth