title: Bullying Victimization and Suicide Ideation and Behavior Among Adolescents in Europe: A 10-Country Study.
abstract: OBJECTIVE
  To examine risk and protective factors moderating the associations between three types of bullying victimization (physical, verbal, and relational bullying) with suicide ideation/attempts in a large representative sample of European adolescents.
  
  
  METHODS
  We analyzed cross-sectional data on 11,110 students (mean age = 14.9, standard deviation = .89) recruited from 168 schools in 10 European Union countries involved in the Saving and Empowering Young Lives in Europe study. A self-report questionnaire was used to measure victimization types, depression, anxiety, parental and peer support, and suicide ideation and attempts. For each outcome, we applied hierarchical nonlinear models controlling for sociodemographics.
  
  
  RESULTS
  Prevalence of victimization was 9.4% physical, 36.1% verbal, and 33.0% relational. Boys were more likely to be physically and verbally victimized, whereas girls were more prone to relational victimization. Physical victimization was associated with suicide ideation, and relational victimization was associated with suicide attempts. Other associations between victimization and suicidality (ideation/attempts) were identified through analysis of interactions with additional risk and protective factors. Specifically, verbal victimization was associated with suicide ideation among adolescents with depression who perceived low parental support. Similarly, low peer support increased the associations between verbal victimization and suicide ideation. Verbal victimization was associated with suicide attempts among adolescents with anxiety who perceived low parental support.
  
  
  CONCLUSIONS
  Findings support the development of prevention strategies for adolescent victims of bullying who may be at elevated risk for suicide ideation/behavior, by taking into account gender, the type of bullying, symptomatology, and availability of interpersonal support.
authors.affiliation: Feinberg Child Study Centre, Schneider Children's Medical Centre, Tel Aviv University, Tel Aviv, Israel; Child and Adolescent Psychiatry, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel Hashomer, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Shira
authors.initials: S
authors.lastname: Barzilay
authors.affiliation: Feinberg Child Study Centre, Schneider Children's Medical Centre, Tel Aviv University, Tel Aviv, Israel; Baruch Ivcher School of Psychology, Interdisciplinary Center (IDC), Herzliya, Israel. Electronic address: bkanat@idc.ac.il.
authors.forename: Anat
authors.initials: A
authors.lastname: Brunstein Klomek
authors.affiliation: Feinberg Child Study Centre, Schneider Children's Medical Centre, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Alan
authors.initials: A
authors.lastname: Apter
authors.affiliation: National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP), Karolinska Institute, Stockholm, Sweden.
authors.forename: Vladimir
authors.initials: V
authors.lastname: Carli
authors.affiliation: National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP), Karolinska Institute, Stockholm, Sweden; Department of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, New York.
authors.forename: Camilla
authors.initials: C
authors.lastname: Wasserman
authors.affiliation: National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP), Karolinska Institute, Stockholm, Sweden.
authors.forename: Gergö
authors.initials: G
authors.lastname: Hadlaczky
authors.affiliation: Department of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, New York; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York.
authors.forename: Christina W
authors.initials: CW
authors.lastname: Hoven
authors.affiliation: Department of Health Sciences, University of Molise, Campobasso, Italy; National Institute for Health, Migration and Poverty, Rome, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Sarchiapone
authors.affiliation: Vadaskert Child Psychiatry Hospital, Budapest, Hungary; Institute of Psychology Eotvos Lorand University, Budapest, Hungary.
authors.forename: Judit
authors.initials: J
authors.lastname: Balazs
authors.affiliation: Institute of Psychology Eotvos Lorand University, Budapest, Hungary.
authors.forename: Agnes
authors.initials: A
authors.lastname: Kereszteny
authors.affiliation: Clinic of Child and Adolescent Psychiatry, Centre of Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany.
authors.forename: Romuald
authors.initials: R
authors.lastname: Brunner
authors.affiliation: Clinic of Child and Adolescent Psychiatry, Centre of Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Kaess
authors.affiliation: Department of Psychiatry, School of Medicine, Centro de Investigacion Biomedica en Red de Salud Mental, CIBERSAM, University of Oviedo, Oviedo, Spain.
authors.forename: Julio
authors.initials: J
authors.lastname: Bobes
authors.affiliation: Department of Psychiatry, School of Medicine, Centro de Investigacion Biomedica en Red de Salud Mental, CIBERSAM, University of Oviedo, Oviedo, Spain.
authors.forename: Pilar
authors.initials: P
authors.lastname: Saiz
authors.affiliation: Clinical Psychology Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.
authors.forename: Doina
authors.initials: D
authors.lastname: Cosman
authors.affiliation: Research Division for Mental Health, University for Medical Information Technology (UMIT), Hall in Tirol, Austria.
authors.forename: Christian
authors.initials: C
authors.lastname: Haring
authors.affiliation: Addiction help services B.I.N., Innsbruck, Austria.
authors.forename: Raphaela
authors.initials: R
authors.lastname: Banzer
authors.affiliation: National Suicide Research Foundation, Cork, Ireland.
authors.forename: Paul
authors.initials: P
authors.lastname: Corcoran
authors.affiliation: Department of Psychiatry and Clinical Psychology, Centre Hospitalo-Universitaire (CHU) de Nancy, Universite de Lorraine, Nancy, France.
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Kahn
authors.affiliation: Slovene Center for Suicide Research, UP IAM, University of Primorska, Koper, Slovenia.
authors.forename: Vita
authors.initials: V
authors.lastname: Postuvan
authors.affiliation: Slovene Center for Suicide Research, UP IAM, University of Primorska, Koper, Slovenia.
authors.forename: Tina
authors.initials: T
authors.lastname: Podlogar
authors.affiliation: Estonian-Swedish Mental Health and Suicidology Institute (ERSI), Tallinn, Estonia; School of Governance, Law and Society, Tallinn University, Tallinn, Estonia.
authors.forename: Merike
authors.initials: M
authors.lastname: Sisask
authors.affiliation: Estonian-Swedish Mental Health and Suicidology Institute (ERSI), Tallinn, Estonia; School of Natural Sciences and Health, Tallinn University, Tallinn, Estonia.
authors.forename: Airi
authors.initials: A
authors.lastname: Varnik
authors.affiliation: National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP), Karolinska Institute, Stockholm, Sweden.
authors.forename: Danuta
authors.initials: D
authors.lastname: Wasserman
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D058445:Bullying / Q000706:statistics & numerical data*; D019548:Crime Victims / Q000706:statistics & numerical data*; D005060:Europe; D005260:Female; D006801:Humans; D008297:Male; D015995:Prevalence; D065840:Protective Factors; D057566:Self Report; D013405:Suicide / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires
keywords: Adolescence; Bullying; Ideation; SEYLE; Suicide; Suicide attempt; Victimization