title: Associations of childhood bullying victimization with lifetime suicidal behaviors among new U.S. Army soldiers.
abstract: Prior studies have documented associations of childhood bullying victimization with suicidal behaviors. However, many failed to adjust for concomitant risk factors and none investigated this relationship in military personnel. This study aimed to estimate independent associations of childhood bullying victimization with suicidal behaviors among U.S. Army soldiers.
  
  
  
  Soldiers reporting for basic training completed a cross-sectional survey assessing mental disorders, suicidal behaviors, and childhood adversities including two types of bullying victimization: (1) Physical Assault/Theft and (2) Bullying Comments/Behaviors. Associations of childhood bullying experiences with suicidal behaviors were estimated using discrete-time survival analysis of person-year data from 30,436 soldiers. Models adjusted for sociodemographic factors, childhood maltreatment by adults, and mental disorders.
  
  
  
  After comprehensive adjustment for other risk factors, more frequent Physical Assault/Theft by peers during childhood was associated with increased odds of lifetime suicidal ideation (adjusted odds ratio [AOR] = 1.18, 95% CI: 1.11-1.26, P < .001) and attempt (AOR = 1.30, 95% CI: 1.13-1.50, P < .001). More frequent Bullying Comments/Behaviors were associated with increased risk of ideation (AOR = 1.30, 95% CI: 1.26-1.35, P < .001), plan (AOR = 1.44, 95% CI: 1.35-1.54, P < .001), attempt (AOR = 1.24, 95% CI: 1.15-1.33, P < .001), and onset of plan among ideators (AOR = 1.09, 95% CI: 1.03-1.15, P = .002). Relative to no bullying victimization, exposure to the most persistent bullying was associated with two- to fourfold increase in risk for suicidal behaviors.
  
  
  
  Childhood bullying victimization is associated with lifetime suicidal behaviors among new soldiers. Exposure to Bullying Comments/Behaviors during childhood is associated with progression from suicidal ideation to plan. Improved recognition of these relationships may inform risk mitigation interventions for soldiers.
authors.affiliation: Department of Psychiatry, University of California San Diego, La Jolla, CA, USA.
authors.forename: Laura
authors.initials: L
authors.lastname: Campbell-Sills
authors.affiliation: Department of Health Care Policy, Harvard Medical School, Boston, MA, USA.
authors.forename: Ronald C
authors.initials: RC
authors.lastname: Kessler
authors.affiliation: Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Ursano
authors.affiliation: Department of Health Care Policy, Harvard Medical School, Boston, MA, USA.
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Rosellini
authors.affiliation: Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
authors.forename: Tracie O
authors.initials: TO
authors.lastname: Afifi
authors.affiliation: National Institute of Mental Health, Bethesda, MD, USA.
authors.forename: Lisa J
authors.initials: LJ
authors.lastname: Colpe
authors.affiliation: Institute for Social Research, University of Michigan, Ann Arbor, MI, USA.
authors.forename: Steven G
authors.initials: SG
authors.lastname: Heeringa
authors.affiliation: Department of Psychology, Harvard University, Cambridge, MA, USA.
authors.forename: Matthew K
authors.initials: MK
authors.lastname: Nock
authors.affiliation: Department of Health Care Policy, Harvard Medical School, Boston, MA, USA.
authors.forename: Nancy A
authors.initials: NA
authors.lastname: Sampson
authors.affiliation: Departments of Psychiatry, Psychology, and Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
authors.forename: Jitender
authors.initials: J
authors.lastname: Sareen
authors.affiliation: National Institute of Mental Health, Bethesda, MD, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Schoenbaum
authors.affiliation: Department of Family Medicine and Public Health, University of California San Diego, La Jolla, CA, USA.
authors.forename: Xiaoying
authors.initials: X
authors.lastname: Sun
authors.affiliation: Department of Family Medicine and Public Health, University of California San Diego, La Jolla, CA, USA.
authors.forename: Sonia
authors.initials: S
authors.lastname: Jain
authors.affiliation: Department of Psychiatry, University of California San Diego, La Jolla, CA, USA.|Department of Family Medicine and Public Health, University of California San Diego, La Jolla, CA, USA.|VA San Diego Healthcare System, San Diego, CA, USA.
authors.forename: Murray B
authors.initials: MB
authors.lastname: Stein
mesh_terms: D000328:Adult; D000069586:Adult Survivors of Child Adverse Events / Q000706:statistics & numerical data*; D058445:Bullying / Q000706:statistics & numerical data*; D019548:Crime Victims / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008889:Military Personnel / Q000706:statistics & numerical data*; D013405:Suicide / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology
keywords: bullying; child maltreatment; military personnel; suicidal ideation; suicide attempt