Online Program

Resilience moderates the effect of bullying on suicide ideation: Results from the California healthy kids survey

Monday, November 4, 2013

Matthew Hirschtritt, B.A., Department of Psychiatry, University of California, San Francisco, San Francisco, CA
Anna Ordóñez, M.D., Department of Psychiatry, University of California, San Francisco, San Francisco
Yvette Rico, B.A., Department of Psychiatry, University of California, San Francisco, San Francisco, CA
Kaja LeWinn, Sc.D., M.S., Department of Psychiatry, University of California, San Francisco, San Francisco, CA
Background: Previous research has demonstrated that bullying is a precipitant of suicidal ideation (SI). However, less is known about the moderating effect of resilience in this association. Objective: To assess whether bullying and resilience independently predict suicide ideation, and the extent to which resilience moderates the association between bullying and SI. Methods: We analyzed cross-sectional data from the 2009-2010 California Healthy Kids Survey (CHKS). Using binary logistic regression, we predicted endorsement of SI by bullying frequency or bullying type and internal resilience level, measured by an 18-item scale, and their interaction. Covariates included demographics, depressive symptoms, and other clinical variables. Results: Students (n = 52,989; 54.9% female) in grades 9 (50.6%) and 11 (49.4%) were primarily Caucasian (65.8%). In main effect models, internal resilience was significantly protective against SI (OR=.988, 95% CI=.985-.991) and low and high bullying frequency (compared to no bullying) were risk factors for SI (OR=1.517 [1.422-1.618], OR=2.536 [2.368-2.715], respectively). Similarly, physical (OR=1.293 [1.215-1.376]), relational (OR=1.283 [1.205-1.365]), verbal (OR=1.399 [1.320-1.482]), and cyberbullying (OR=1.292 [1.211-1.377]) were all risk factors for SI. A significant interaction between bullying frequency and resilience in the final model suggests the slope for students with low bullying is less steep (B=.003; p<.05) than for those with no (reference group) or high bullying (B=.003; p>.05). Conclusions: Resilience may act as an effect modifier for students who are bullied. To reduce risk of SI among students, schools should focus on bullying prevention as well as resilience enhancement.

Learning Areas:

Planning of health education strategies, interventions, and programs
Public health or related public policy
Social and behavioral sciences

Learning Objectives:
Explain the independent roles of bullying and resilience on suicidal ideation (SI) among adolescents. Describe the effect-modifying role of resilience in the association between bullying and SI. Identify implications of these findings to school administrators and policy makers.

Keyword(s): Adolescent Health, Psychiatric Epidemiology

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I was the lead investigator on the research study discussed in this presentation. I was involved in the design and data analysis processes.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.