title: Internal resilience, peer victimization, and suicidal ideation among adolescents.
abstract: OBJECTIVE
  Our goal was to examine the association between peer victimization (PV) and suicidal ideation (SI), and the degree to which internal resilience moderates this association.
  
  
  METHODS
  We examined the independent associations between PV frequency and type (verbal, cyber, physical, and relational), internal resilience, and the risk of SI within the last 12 months among 9th and 11th grade students participating in the California Healthy Kids Survey (CHKS) (n=42,594; 55.2% female; 72.2% non-white).
  
  
  RESULTS
  Odds ratios (OR) of SI associated with very low- (at least 1 PV type 1 time, but none more than 1 time), low- (at least 1 PV type 2-3 times, but none more than 2-3 times), and moderate/high- (at least 1 PV type 4 times or more) frequency PV compared with no PV were 1.30 (95% CI=1.15-1.45), 1.70 (95% CI=1.51-1.90) and 2.47 (95% CI=1.23-2.73), respectively. Any exposure to physical (OR=1.31; 95% CI=1.19-1.44), relational (OR=1.26; 95% CI=1.15-1.38), verbal (OR=1.38; 95% CI=1.27-1.50), or cyber (OR=1.26; 95% CI=1.15-1.39) PV was associated with increased odds of SI compared with no PV. Internal resilience was associated with lower odds of SI (OR=0.98, 95% CI=0.98-0.99), regardless of PV exposure. The slope between internal resilience and SI was significantly steeper for those subjects who experienced verbal PV (OR interaction=0.99; 95% CI=0.98-1.00).
  
  
  CONCLUSIONS
  Even infrequent PV was found to be associated with increased risk for SI. Internal resilience was associated with reduced SI, particularly for verbal forms of PV. Our results suggested that efforts to decrease SI among adolescents should be directed toward both preventing PV and strengthening internal resilience.
authors.forename: Matthew E
authors.initials: ME
authors.lastname: Hirschtritt
authors.forename: Anna E
authors.initials: AE
authors.lastname: Ordóñez
authors.forename: Yvette C
authors.initials: YC
authors.lastname: Rico
authors.forename: Kaja Z
authors.initials: KZ
authors.lastname: LeWinn
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D002140:California / Q000453:epidemiology; D019548:Crime Victims / Q000145:classification / Q000523:psychology* / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D004522:Educational Status; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D016017:Odds Ratio; D010379:Peer Group; D065840:Protective Factors; D055500:Resilience, Psychological; D012307:Risk Factors; D012574:Schools; D017678:Sex Distribution; D012944:Social Support; D013334:Students / Q000523:psychology / Q000706:statistics & numerical data; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000523:psychology*; D059020:Suicidal Ideation