Summary:
Background: Suicidal behavior and self-injury are common especially in adolescence and are associated with increased psychopathology, suicide risk and increased needs for mental health services. At the same time, traditional and cyber bullying among adolescents is a public health issue, and such experiences hide a risk of self-injurious and suicidal behaviors.
Objectives: Highlight the rates of occurrence of self-injurious non-suicidal and suicidal behaviors in high school students and investigate correlation between these behaviors and the experiences of traditional and cyber bullying.
Method: The study was carried out as part of the Global Child and Adolescents Mental Health Study (GCAMHS), regarding the psychosocial burden of adolescents following the COVID-19 pandemic. 5711 adolescents aged 13.43±0.97 years participated (3110 girls, 2502 boys, 99 other) from 51 school units in 6 regional units of Greece. The data was collected with the Strengths and Difficulties Questionnaire (SDQ) and with questions about the frequency of "Negative Thoughts and Behaviors", "Seeking External Help" and "Experiences of Traditional and Cyberbullying".
Results: 26.3% of the students displayed self-injurious non-suicidal behaviors, 28.9% displayed suicidal thoughts and 9% made at least one suicide attempt. 26.2% of students reported that they experienced traditional bullying, 21.3% of them as victims, 10.4% as perpetrators and 5.2% as perpetrator-victims. The rates for cyberbullying experiences were 16.5%, 11.6% as victims, 8.4% as perpetrators and 3.5% as perpetrator-victims. Regarding the occurrence of non-suicidal self-injurious behaviors, gender "other" (OR:3.573, CI 95%:2.099-6.081, P-value<.001), gender "boy" (OR:0.725, CI 95%:0.618-0.850 , P-value<.001), experiences of traditional bullying as a perpetrator (OR:1.556, CI 95%:1.149-2.107, P-value=0.004) and as a victim (OR:1.852, CI 95%:1.545-2.219, P-value<.001) and cyberbullying experiences as a victim (OR:1.591, CI 95%:1.259-2.010, P-value<.001), living with biological parents (OR:0.714, CI 95%: 0.592-0.862, P-value<.001), living in an urban area (OR:1.885, CI 95%:1.584-2.243, P-value<.001), the need for external assistance (OR:2.138, CI 95 %:1.837-2.488, P-value<.001) and a higher overall score on the Strengths and Difficulties Scale (OR:1.129, CI 95%:1.115-2.144, P-value<.001) appeared to predict the likelihood of non-suicidal self-injury behaviors. Similarly, for suicidal thoughts, gender "other" (OR:4.539, CI 95%:2.541-8.109, P-value<.001), gender "boy" (OR:0.664, CI 95%:0.568-0.778 , P-value<.001), experiences of traditional bullying as a victim (OR:2.205, CI 95%:1.840-2.643, P-value<.001) and experiences of cyberbullying as a perpetrator (OR:1.702, CI 95% :1.239-2.338, P-value<.001) and being a victim (OR:1.687, CI 95%:1.328-2.142, P-value<.001), living with biological parents (OR:0.726, CI 95% :0.601-0.876, P-value<.001), living in an urban area (OR:1.886, CI 95%:1.589-2.239, P-value<.001), the need for outside help (OR:2.193, CI 95%:1.890-2.545, P-value<.001) and higher total score on the Strengths and Difficulties Scale (OR:1.136, CI 95%:1.122-2.151, P-value<.001) appeared to predict the occurrence of suicidal thoughts. Finally, regarding suicide attempts, gender "other" (OR:2.742, CI 95%:1.649-4.560, P-value<.001), experiences of traditional bullying as a perpetrator (OR:2.458, CI 95%:1.652- 3.657, P-value<.001) and as a victim (OR:2.061, CI 95%:1.602-2.652, P-value<.001) and cyberbullying experiences as a victim (OR:1.625, CI 95%:1.178- 2.712, P-value<.001), living with biological parents (OR:0.683, CI 95%:0.531-0.877, P-value=0.003), living in an urban area (OR:1.713, CI 95%: 1.320-2.223, P-value<.001), the need for external help (OR:2.258, CI 95%:1.744-2.922, P-value<.001) and the highest overall score on the Strengths and Difficulties Scale (OR: 1.125, CI 95%:1.104-1.147, P-value<.001) appeared to predict suicide attempts.
Conclusions: From the literature review, as well as the results from the present research, the importance of the phenomenon of self-injurious and suicidal behaviors and the fact that bullying experiences work predictively for the appearance of these behaviors emerge. It is recommended to utilize the above data in order to create programs for the prevention and treatment of self-injurious and suicidal behaviors.
