Child and Adolescent Social Work Journal

, Volume 32, Issue 3, pp 257–268 | Cite as

Peer Victimization and Adolescent Suicide: The Mediating Effect of Risk Behaviors

  • Sung Seek Moon
  • Alexis Karlson
  • Yi Jin Kim


This study explored the impact of three risk behaviors (risky sexual behaviors, aggression, and substance use) on the peer victimization–suicide relationship. A hypothesized model was developed using an integrated conceptual model based on social cognitive theory and escape theory of suicide. This model was then tested using structural equation modeling. The participants were 7,656 males (49.8 %) and 7,708 females (50.2 %) from the 2011 Youth Risk Behavior Survey ranged in age from 12 years or less to over 18 years (mean = 16.1 years, SD = 1.24). Results demonstrated that peer victimization has a significant direct effect on suicidal behavior. Aggression, and substance use, but not risky sexual behavior, mediated the risk of suicide. Also, substance use has a significant direct effect on aggression that affects suicidal behavior. Findings were discussed within the context of the empirical and theoretical review and implications for social work practice were considered.


Peer victimization Suicide Risky sexual behavior Aggression Substance use 


  1. Agirdag, O., Demanet, J., Van Houtte, M., & Van-Avermaet, P. (2011). Ethnic school composition and peer victimization: A focus on the interethnic school climate. International Journal of Intercultural Relations, 35(4), 465–473. doi: 10.1016/j.ijintrel.2010.09.009.CrossRefGoogle Scholar
  2. Aldwin, C., & Revenson, T. (1987). Does coping help? A re-examination of the relation between coping and mental health. Journal of Personality and Social Psychology, 53(2), 337–348. doi: 10.1037/0022-3514.53.2.337.CrossRefPubMedGoogle Scholar
  3. American Foundation for Suicide Prevention. (2014). Facts and figures: Suicide deaths. Retrieved from
  4. Andreou, E. (2001). Bully/victim problems and their association with coping behaviour in conflictual peer interactions among school-age children. Educational Psychology, 21(1), 59–66.CrossRefGoogle Scholar
  5. Baechler, J. (1980). A strategic theory. Suicide and Life-Threatening Behavior, 10(2), 70–99. doi: 10.1111/j.1943-278X.1980.tb00768.x.PubMedGoogle Scholar
  6. Bandura, A. (1986). Social foundations of thought and action: A social cognitive theory. Englewood Cliffs, NJ: Prentice-Hall.Google Scholar
  7. Bandura, A. (1991). Self-efficacy mechanism in physiological activation and health-promoting behavior. In J. Madden IV (Ed.), Neurobiology of learning, emotion and affect (pp. 229–270). New York: Raven.Google Scholar
  8. Baron, R. M., & Kenny, D. A. (1986). The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology, 51, 1173–1182. doi: 10.1037/0022-3514.51.6.1173.CrossRefPubMedGoogle Scholar
  9. Baumeister, R. F. (1990). Suicide as escape from self. Psychological Review, 97(1), 90–113.CrossRefPubMedGoogle Scholar
  10. Baumeister, R. F., Dewall, C. N., Ciarocco, N. J., & Twenge, J. M. (2005). Social exclusion impairs self-regulation. Journal of Personality and Social Psychology, 88(4), 589–604. doi: 10.1037/0022-3514.88.4.589.CrossRefPubMedGoogle Scholar
  11. Bentler, P. M. (1990). Comparative fit indices in structural models. Psychological Bulletin, 107, 238–246. doi: 10.1037/0033-2909.107.2.238.CrossRefPubMedGoogle Scholar
  12. Bollen, K. (1989). Structural equations with latent variables. New York: Wiley.CrossRefGoogle Scholar
  13. Borowsky, I. W., Ireland, M., & Resnick, M. D. (2001). Adolescent suicide attempts: Risks and protectors. Pediatrics, 107(3), 485–493.CrossRefPubMedGoogle Scholar
  14. Brotheridge, C. M., Lee, R. T., & Power, J. L. (2012). Am I my own worst enemy? The experiences of bullying targets who are also aggressors. Career Development International, 17(4), 358–374. doi: 10.1108/13620431211255833.CrossRefGoogle Scholar
  15. Brown, G. K., Ten Have, T., Henriques, G. R., Xie, S. X., Hollander, J. E., & Beck, A. T. (2005). Cognitive therapy for the prevention of suicide attempts: A randomized controlled trial. Journal of the American Medical Association, 294(5), 563–570.CrossRefPubMedGoogle Scholar
  16. Centers for Disease Control and Prevention (CDC). (2010). 10 Leading causes of death by age group, United States2010. Retrieved from
  17. Centers for Disease Control and Prevention (CDC). (2011). 2011YRBS data user’s guide. Retrieved from
  18. Centers for Disease Control and Prevention (CDC). (2014). Trends in suicide rates among persons ages 10 years and older, by sex, United States, 19912009. Retrieved from
  19. Chen, X., & Tse, H. (2008). Social functioning and adjustment in Canadian-born children with Chinese and European backgrounds. Developmental Psychology, 44(4), 1184–1189. doi: 10.1037/0012-1649.44.4.1184.CrossRefPubMedGoogle Scholar
  20. Choi, H., Meininger, J., & Roberts, R. (2006). Ethnic differences in adolescents’ mental distress, social stress, and resources. Adolescence, 21(162), 263–283.Google Scholar
  21. Craig, W. M., & Pepler, D. J. (2007). Understanding bullying: From research to practice. Canadian Psychology, 48, 86–93.CrossRefGoogle Scholar
  22. Demaray, M. K., & Malecki, C. K. (2003). Perceptions of the frequency and importance of social support by students classified as victims, bullies, and bully/victims in an urban middle school. School Psychology Review, 32(3), 471–489.Google Scholar
  23. DeWall, C. N., Twenge, J. M., Gitter, S. A., & Baumeister, R. F. (2009). It’s the thought that counts: The role of hostile cognition in shaping aggressive responses to social exclusion. Journal of Personality and Social Psychology, 96(1), 45–59. doi: 10.1037/a0013196.CrossRefPubMedCentralPubMedGoogle Scholar
  24. Doran, N., Luczak, S. E., Bekman, N., Koutsenok, I., & Brown, S. A. (2012). Adolescent substance use and aggression: A review. Criminal Justice and Behavior, 39(6), 748–769. doi: 10.1177/0093854812437022.CrossRefGoogle Scholar
  25. Dunn, M. S., Ilapogu, V., Taylor, L., Naney, C. C., Blackwell, R., Wilder, R., & Givens, C. C. (2008). Self-reported substance use and sexual behaviors among adolescents in a rural state. Journal of School Health, 78(11), 587–593.CrossRefPubMedGoogle Scholar
  26. Espelage, D., & Holt, M. (2007). Dating violence and sexual harassment across the bully-victim continuum among middle and high school students. Journal of Youth and Adolescence, 36(6), 799–811.CrossRefGoogle Scholar
  27. Fagan, J. (1990). Intoxication and aggression. In M. Tonry & J. Q. Wilson (Eds.), Drugs and crime. Crime and justice: A review of research (Vol. 13, pp. 241–320). Chicago, IL: University of Chicago Press.Google Scholar
  28. Felix, E. D., & McMahon, S. D. (2007). The role of gender in peer victimization among youth: A study of incidence, interrelations, and social cognitive, correlates. Journal of School Violence, 6(3), 27–44. doi: 10.1300/J202v06n03_03.CrossRefGoogle Scholar
  29. Fox, C., & Boulton, M. (2006). Longitudinal associations between submissive/nonassertive social behavior and different types of peer victimization. Violence and Victims, 21(3), 383–400.CrossRefPubMedGoogle Scholar
  30. Francis, S. A., & Thorpe, R. J. (2010). Using the primary socialization theory to predict substance use and sexual risk behaviors between Black and White Adolescents. Substance Use and Misuse, 45(13), 2113–2129.CrossRefPubMedCentralPubMedGoogle Scholar
  31. Frisén, A., Hasselblad, T., & Holmqvist, K. (2012). What actually makes bullying stop? Reports from former victims. Journal of Adolescence, 35(4), 981–990.CrossRefPubMedGoogle Scholar
  32. Giletta, M., Scholte, R., Engels, R., Ciairano, S., & Prinstein, M. (2012). Adolescent non-suicidal self-injury: A cross-national study of community samples from Italy, the Netherlands and the United States. Psychiatry Research, 197(1–2), 66–72.CrossRefPubMedCentralPubMedGoogle Scholar
  33. Graham, S., & Bellmore, A. D. (2007). Peer victimization and mental health during early adolescence. Theory into Practice, 46(2), 138–146. doi: 10.1080/00405840701233081.CrossRefGoogle Scholar
  34. Hallfors, D., Hyunsan, C., Brodish, P. H., Flewelling, R., & Khatapoush, S. (2006). Identifying high school students “at risk” for substance us and other behavioral problems: Implications for prevention. Substance Use and Misuse, 41(1), 1–15. doi: 10.1080/10826080500318509.CrossRefPubMedGoogle Scholar
  35. Hawker, D. J., & Boulton, M. J. (2000). Twenty years’ research on peer victimization and psychosocial maladjustment: A meta-analytic review of cross-sectional studies. Journal of Child Psychology and Psychiatry, 41(4), 441–455. doi: 10.1111/1469-7610.00629.CrossRefPubMedGoogle Scholar
  36. Heilbron, N., & Prinstein, M. J. (2010). Adolescent peer victimization, peer status, suicidal ideation, and nonsuicidal self-injury: Examining concurrent and longitudinal associations. Journal of Developmental Psychology, 56(3), 388–419.Google Scholar
  37. Hollander, D. (2001). Health risks after dating violence. Family Planning Perspectives, 33(6), 242–244.Google Scholar
  38. Hu, L., & Bentler, P. (1999). Cutoff criteria for fit indexes in covariance structural analysis: Conventional criteria versus new alternatives. Structural Equation Modeling, 6(1), 1–55.CrossRefGoogle Scholar
  39. Joiner, T. E., & Rudd, M. (2002). Suicide science: Expanding the boundaries. New York: Springer.Google Scholar
  40. Kaminski, J. W., & Fang, X. (2009). Victimization by peers and adolescent suicide in three US samples. The Journal of Pediatrics, 155(5), 683–688. doi: 10.1016/j.jpeds.2009.04.061.CrossRefPubMedGoogle Scholar
  41. Kim, Y. J., Moon, S. S., & Kim, M. J. (2011). Physical and psycho-social predictors of adolescents’ suicide behaviors. Child and Adolescent Social Work Journal, 28(6), 421–438. doi: 10.1007/s10560-011-0241-1.CrossRefGoogle Scholar
  42. Klassen, A., & Wilsnack, S. (1986). Sexual experience and drinking among women in a U.S. national survey. Archives of Sexual Behavior, 15(5), 363–392.CrossRefPubMedGoogle Scholar
  43. Kochel, K., Ladd, G., & Rudolph, K. (2012). Longitudinal associations among youth depressive symptoms, peer victimization, and low peer acceptance: an interpersonal process perspective. Child Development, 83(2), 637–650. doi: 10.1111/j.1467-8624.2011.01722.x.PubMedCentralPubMedGoogle Scholar
  44. Kochenderfer-Ladd, B. B., & Pelletier, M. E. (2008). Teachers’ views and beliefs about bullying: Influences on classroom management strategies and students’ coping with peer victimization. Journal of School Psychology, 46(4), 431–453.CrossRefPubMedGoogle Scholar
  45. Kochenderfer-Ladd, B. B., & Skinner, K. (2002). Children’s coping strategies: Moderators of the effects of peer victimization? Developmental Psychology, 38(2), 267–278.CrossRefPubMedGoogle Scholar
  46. Laflamme, L., Möller, J., Hallqvist, J., & Enström, K. (2008). Peer victimization and intentional injuries: Quantitative and qualitative accounts of injurious physical interactions between students. International Journal of Adolescent Medicine & Health, 20(2), 201–208.CrossRefGoogle Scholar
  47. Lazarus, R. S., & Folkman, S. (1984). Stress, appraisal, and coping. New York: Springer.Google Scholar
  48. Lee, R. (1993). Doing research on sensitive topics. London: Sage.Google Scholar
  49. Liang, H., Flisher, A., & Chalton, D. (2003). Violence and substance use in adolescents with increasing severity of suicidal behavior. Archives of Suicide Research, 7(1), 29–40.CrossRefGoogle Scholar
  50. Litt, M. D., Kadden, R. M., & Tennen, H. (2011). The nature of coping in treatment for marijuana dependence: Latent structure and validation of the coping strategies scale. Psychology of Addictive Behaviors, 26(4), 791–800. doi: 10.1037/a0026207.CrossRefPubMedCentralPubMedGoogle Scholar
  51. Luncheon, C., Bae, S., Lurie, S., & Singh, K. (2008). Drug use among Hispanic female adolescents who are at risk for suicide. American Journal of Health Studies, 23(3), 108–115.Google Scholar
  52. Marston, E. G., Hare, A., & Allen, J. P. (2010). Rejection sensitivity in late adolescence: Social and emotional sequelae. Journal of Research on Adolescence, 20(4), 959–982. doi: 10.1111/j.1532-7795.2010.00675.x.CrossRefPubMedCentralPubMedGoogle Scholar
  53. McDonald, R. P., & Ho, M. H. R. (2002). Principle and practice in reporting structural equation analyses. Psychological Methods, 7(1), 64–82. doi: 10.1037/1082-989X.7.1.64.CrossRefPubMedGoogle Scholar
  54. McGee, Z., Barber, A., Joseph, E., Dudley, J., & Howell, R. (2005). Delinquent behavior, violent victimization, and coping strategies among Latino adolescents. Journal of Offender Rehabilitation, 42(3), 41–56.CrossRefGoogle Scholar
  55. Menzer, M. M., Oh, W., McDonald, K. L., Rubin, K. H., & Dashiell-Aje, E. (2010). Behavioral correlates of peer exclusion and victimization of East Asian American and European American young adolescents. Asian American Journal of Psychology, 1(4), 290–302. doi: 10.1037/a0022085.CrossRefGoogle Scholar
  56. Muula, A., Rudatsikira, E., & Siziya, S. (2008). Correlates of weapon carrying among high school students in the United States. Annals of General Psychiatry, 7, 1–8. doi: 10.1186/1744-859X-7-8.CrossRefGoogle Scholar
  57. Nickerson, A. B., & Slater, E. D. (2009). School and community violence and victimization as predictors of adolescent suicidal behavior. School Psychology Review, 38(2), 218–232.Google Scholar
  58. Nrugham, L., Holen, A., & Sund, A. (2012). Suicide attempters and repeaters: Depression and coping: A prospective study of early adolescents followed up as young adults. Journal of Nervous & Mental Disease, 200(3), 197–203.CrossRefGoogle Scholar
  59. Ohene, S. A., Ireland, M., & Blum, R. W. (2005). The clustering of risk behaviors among Caribbean youth. Maternal and Child Health Journal, 9(1), 91–100. doi: 10.1007/s10995-005-2452-6.CrossRefPubMedGoogle Scholar
  60. Perren, S., & Alsaker, F. D. (2006). Social behavior and peer relationships of victims, bully-victims, and bullies in kindergarten. Journal of Child Psychology and Psychiatry, 47(1), 45–57. doi: 10.1111/j.1469-7610.2005.01445.x.CrossRefPubMedGoogle Scholar
  61. Peskin, M. F., Tortolero, S. R., & Markham, C. M. (2006). Bullying and victimization among Black and Hispanic adolescents. Adolescence, 41(163), 467–484.PubMedGoogle Scholar
  62. Pihl, R. O., & Sutton, R. (2009). Drugs and aggression readily mix; So what now? Substance Use and Misuse, 44(9/10), 1188–1203.CrossRefPubMedGoogle Scholar
  63. Robinson, S. (2006). Victimization of obese adolescents. The Journal of School Nursing, 22(4), 201–206. doi: 10.1177/10598405050220040301.CrossRefPubMedGoogle Scholar
  64. Rudatsikira, E., Muula, A., & Siziya, S. (2008). Variables associated with physical fighting among US high school students. Clinical Practice and Epidemiology in Mental Health, 4, 1–8.CrossRefGoogle Scholar
  65. Rudolph, K. D., Troop-Gordon, W., Hessel, E. T., & Schmidt, J. D. (2011). A latent growth curve analysis of early and increasing peer victimization as predictors of mental health across elementary school. Journal of Clinical Child and Adolescent Psychology, 40(1), 111–122.CrossRefPubMedCentralPubMedGoogle Scholar
  66. Rulison, K. L., Gest, S. D., Loken, E., & Welsh, J. A. (2010). Rejection, feeling bad, and being hurt: Using multilevel modeling to clarify the link between peer group aggression and adjustment. Journal of Adolescence, 33(6), 787–800. doi: 10.1016/j.adolescence.2010.07.005.CrossRefPubMedCentralPubMedGoogle Scholar
  67. Sharaf, A., Thompson, E. A., & Walsh, E. (2009). Protective effects of self-esteem and family support on suicide risk behaviors among at-risk adolescents. Journal of Child & Adolescent Psychiatric Nursing, 22(3), 160–168. doi: 10.1111/j.1744-6171.2009.00194.CrossRefGoogle Scholar
  68. Sontag, L. M., & Graber, J. A. (2010). Coping with perceived peer stress: Gender-specific and common pathways to symptoms of psychopathology. Developmental Psychology, 46(6), 1605–1620.CrossRefPubMedGoogle Scholar
  69. Spirito, A., Esposito-Smythers, C., Weismoore, J., & Miller, A. (2012). Adolescent suicidal behavior. In P. C. Kendall (Ed.), Child and adolescent therapy: Cognitive-behavioral procedures (4th ed., pp. 234–256). New York, NY: Guilford Press.Google Scholar
  70. Spriggs, A. L., Iannotti, R. J., Nansel, T. R., & Haynie, D. L. (2007). Adolescent bullying involvement and perceived family, peer and school relations: Commonalities and differences across race/ethnicity. The Journal of Adolescent Health: Official Publication of the Society for Adolescent Medicine, 41(3), 283–293. doi: 10.1016/j.jadohealth.2007.04.009.CrossRefGoogle Scholar
  71. Thatcher, W. G., Reininger, B. M., & Drane, J. W. (2002). Using path analysis to examine adolescent suicide attempts, life satisfaction, and health risk behavior. Journal of School Health, 72(2), 71–76.CrossRefPubMedGoogle Scholar
  72. Thompson, E., Connelly, C., Thomas-Jones, D., & Eggert, L. (2013). School difficulties and co-occurring health risk factors: Substance use, aggression, depression, and suicidal behaviors. Journal of Child and Adolescent Psychiatric Nursing, 26(1), 74–84. doi: 10.1111/jcap.12026.CrossRefPubMedGoogle Scholar
  73. Twenge, J. M., Baumeister, R. F., Tice, D. M., & Stucke, T. S. (2001). If you can’t join them, beat them: Effects of social exclusion on aggressive behavior. Journal of Personality and Social Psychology, 81(6), 1058–1069. doi: 10.1037/0022-3514.81.6.1058.CrossRefPubMedGoogle Scholar
  74. Twenge, J. M., Cantanese, K. R., & Baumeister, R. F. (2002). Social exclusion causes self-defeating behavior. Journal of Personality and Social Psychology, 83(3), 606–615. doi: 10.1037/0022-3514.83.3.606.CrossRefPubMedGoogle Scholar
  75. Twenge, J. M., Cantanese, K. R., & Baumeister, R. F. (2003). Social exclusion and the deconstructed state: Time perception, meaninglessness, lethargy, lack of emotion, and self-awareness. Journal of Personality and Social Psychology, 85(3), 409–423.CrossRefPubMedGoogle Scholar
  76. U.S. Department of Education. (2008). Student victimization in US schools: Results from the 2005 school crime supplement to the national crime victimization survey. Retrieved from
  77. Viljoen, J. L., O’Neill, M. L., & Sidhu, A. (2005). Bullying behaviors in female and male adolescent offenders: Prevalence, types, and association with psychosocial adjustment. Aggressive Behavior, 31(6), 521–536. doi: 10.1002/ab.20036.CrossRefGoogle Scholar
  78. Waldrop, A. E., Hanson, R. F., Resnick, H. S., Kilpatrick, D. G., Naugle, A. E., & Saunders, B. F. (2007). Risk factors for suicidal behavior among a national sample of adolescents: Implications for prevention. Journal of Traumatic Stress, 20(5), 869–879. doi: 10.1002/jts.20291.CrossRefPubMedGoogle Scholar
  79. Watson, J., & Nesdale, D. (2012). Rejection sensitivity, social withdrawal, and loneliness in young adults. Journal of Applied Social Psychology, 42(8), 1984–2005. doi: 10.1111/j.1559-1816.2012.00927.x.CrossRefGoogle Scholar
  80. Wei, S., & Williams, J. (2009). Maladjustment among Taiwanese seventh-graders. Social Work Research, 33(4), 231–242.CrossRefGoogle Scholar
  81. Winsper, C., Lereya, T., Zanarini, M., & Wolke, D. (2012). Involvement in bullying and suicide-related behavior at 11 years: A prospective birth cohort study. Journal of the American Academy of Child and Adolescent Psychiatry, 51(3), 271–282.CrossRefPubMedGoogle Scholar
  82. Zayas, L. H., Lester, R. J., Cabassa, L. J., & Fortuna, L. R. (2005). Why do so many Latina teens attempt suicide? A conceptual model for research. American Journal of Orthopsychiatry, 75(2), 275–587.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  1. 1.College of Social WorkUniversity of South CarolinaColumbiaUSA
  2. 2.School of Social WorkIndiana University South BendSouth BendUSA

Personalised recommendations