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Sampasa-Kanyinga, H., Roumeliotis, P., & Xu, H. (2014). Associations between cyberbullying and school bullying victimization and suicidal ideation, plans and attempts among Canadian schoolchildren. PLoS ONE, 9,e102145.

Suicide is the second leading cause of death for Canadian youth aged 10–24. Experience of bullying is one of many possible determinants of suicidal ideation and behaviors. Cyberbullying has been defined as the use of email, cell phones, text messages, and Internet sites to threaten, harass, embarrass, or socially exclude; it is more pervasive than traditional bullying. The inability for victims to have any control over acts of cyberbullying may result in feelings of powerlessness in the victim. As a result, the damage experienced in cyberbullying may be largely social and emotional in nature. Several studies have shown that traditional bullying among youths is associated with depression and suicidal ideation, and several correlates have been identified among victims of cyberbullying, such as increased depression, suicidal ideation, and suicide attempts. The purpose of the current study was to examine the association between cyberbullying and school bullying victimization with suicidal ideation, plans and attempts among middle and high school students and test whether the presence of depression mediates these associations. The researchers hypothesized that cyberbullying and school bullying victimization results in higher likelihood of suicidal ideation, plans and attempts, and that depression would mediate these relationships.

Method:
The data collected between November 2010 and March 2011 from the Eastern Ontario Youth Risk Behavior Survey (YRBS), a regional cross-sectional school-based survey, was utilized in this study. A total of 3,509 students in grades 7 to 12 were the target population of the survey (54.9% females). 49 schools participated in the survey. Students were asked about school bullying and cyberbullying victimization in the past 12 months by the following questions: ‘‘During the past 12 months, have you ever been bullied or threatened by someone while on school property?’’ and ‘‘During the past 12 months, have you ever experienced cyberbullying, that is, being bullied by email, text messaging, instant messaging, social networking or another website?’’ Responses included ‘‘Yes’’ (coded as 1) or ‘‘No’’ (coded as 0). Depression was assessed by the following question: ‘‘During the past 12 months, did you ever feel so sad or hopeless almost every day for 2 weeks or more in a row that you stopped doing some usual activities?’’ (Yes or No). Suicidal ideation, plans, and attempts were measured by the following questions, asked of all students: (1) ‘‘During the past 12 months, did you ever seriously consider attempting suicide?’’ (Yes or No); (2) ‘‘During the past 12 months, did you make a plan about how you would attempt suicide?’’ (Yes or No); and (3) ‘‘If you attempted suicide during the past 12 months, did any attempt result in injury, poisoning, or overdose that had to be treated by a doctor or nurse?’’ Response options included ‘‘I did not attempt suicide during the past 12 months’’ (coded as 0), Yes (equates to‘‘attempted suicide that required medical attention’’; coded as 1) or No (equates to ‘‘attempted suicide that did not require medical attention’’; coded as 1).

Results:
17.4% of students were victims of cyberbullying and 25.2% were victims of school bullying. Girls were twice as likely to experience cyberbullying victimization as boys, and students who were in lower grades were more likely to be victims of school bullying. Participants who reported spending a lot of time on the computer reported cyberbullying victimization more often than those who used computers for less time. The prevalence of suicidal ideation, plans and attempts was 10.5%, 10.7%, and 10.9%; girls were more likely to report suicidal ideation and plan than boys. Victims of cyberbullying and school bullying incurred a significantly higher risk of suicidal ideation, plans, and attempts compared to those who were not victims. Effects of cyberbullying victimization on suicidal ideation, plans and attempts were fully mediated by depression. Depression also fully mediated the relationship between school bullying victimization and suicide attempts, but partially mediated the relationship between school bullying victimization and both suicidal ideation and plans.

Discussion:
These findings suggest that cyberbullying and school bullying victims are at risk of psychological distress, suicidal ideation and suicidal behavior. Mishna et al. reported a significant lack of knowledge regarding Internet safety among youths. Enhancing awareness among schoolchildren is therefore a crucial step towards preventing cyberbullying victimization. This could be tackled by parents and schools discussing Internet safety and cyberbullying with children. The mediating role of depression justifies the need for addressing depression among victims of both forms of bullying to prevent the risk of subsequent suicidal behaviors. It is crucial to provide suicide prevention training to teachers and parents to help them identify symptoms or changes in behavior related to depression. Girls may have experienced more cyberbullying due to the fact that cyberbullying is text-based, and girls communicate more often using text messaging than boys.