Exposure to Violence in the School Setting and Suicidal Ideation and Attempts Among United States High School Students: 2003-2013 CDC Youth Risk Behavior Survey. Open Access

Benzo, Sarah Marie (2016)

Permanent URL: https://etd.library.emory.edu/concern/etds/2801ph009?locale=en
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Abstract

BACKGROUND: Suicide is a serious public health problem that affects millions of individuals worldwide. Suicide and suicidal behaviors are complex phenomena that arise from numerous risk factors. Current research has examined the impact of violence exposure on mental health and behavior, but little research has focused specifically on the impact of violence experienced in the school setting and suicidal behaviors among adolescents.

METHODS: This study utilized data from the CDC Youth Risk Behavior Survey combined dataset that contained data from the YRBS surveys conducted from 1991-2013. Using this data analysis was conducted to assess the association between suicidal behavior and violence within the school setting from 2003-2013. From this data, logistic regression analysis was utilized to estimate the association between suicidal behavior (considered suicide, made a suicide plan, and attempted suicide) and violence within the school setting (having been in a physical fight on school property, having been threatened or injured at school with a weapon, and having been bullied on school property). Logistic regression was used to assess the crude and adjusted associations between each school violence exposure variable and each suicidal behavior. Adjusted models also tested whether there was interaction between the school violence exposures and any of the covariates of interest. Trend analysis was also conducted on this National data over the time period of 2003-2013. All analyses were weighted to account for the complex survey design.

RESULTS: Overall, 15.8 % of students reported having considered suicide, 13% of students reported having made a suicide plan, and 7.6% of students reported having attempted suicide within the past 12 month. After controlling for potential confounders, a significant association was found between school violence exposure (having been in a physical fight on school property, having been threatened or injured at school with a weapon, and having been bullied on school property), and students who considered suicide, made a suicide plan, and attempted suicide. However, the association between exposure to school violence and suicidal ideation and attempts varied by age, race/ethnicity, and feelings of sadness or hopelessness.

CONCLUSIONS: This study identified a signification association between exposure to violence within the school setting and considering suicide, making a suicide plan, and attempting suicide among students in grades 9-12. These findings are essential in developing suicide prevention efforts within the school systems. Follow-up studies are needed to better understand the association, and direction of causality between school violence and suicide behaviors among this population.

Table of Contents

Introduction.......................................................................................................1

Epidemiology of Suicide......................................................................................1

Suicide and Violence...........................................................................................2

Suicide and Violence Experienced in the School Setting.........................................4

Methods.............................................................................................................6

Data Source........................................................................................................6

Classification of Variables....................................................................................7

Statistical Analysis..............................................................................................9

Results..............................................................................................................11

Descriptive Analysis...........................................................................................11

Unadjusted Analysis...........................................................................................12

Multivariate Analysis.........................................................................................14

Trend Analysis..................................................................................................20

Discussion........................................................................................................21

Findings...........................................................................................................21

Strengths and Limitations..................................................................................27

Public Health Implications and Direction for Future Research..............................29

Conclusions......................................................................................................31

References........................................................................................................33

Tables..............................................................................................................35

Appendix I: YRBS Questionnaire Characteristics.................................................39

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