_______________________________________________________________________ Depression and Suicide
ADVERSE EXPERIENCES AND SUICIDALITY AMONG HETEROSEXUAL AND SEXUAL MINORITY HIGH-SCHOOL STUDENTS
Percentage of Students Reporting Experience a Heterosexual Gay, Lesbian, or Bisexual
Adverse Experience
Threatened or injured with weapon (e.g., gun, knife, club) on school property
5.1%
10.0%
Avoided school because of safety concerns b
4.6%
12.5% 28.0% 34.2% 17.8% 17.5% 22.7% 60.4% 42.8% 38.2% 29.4%
Cyberbullied
14.2% 18.8%
Bullied on school property
Forced to have sexual intercourse c
5.4% 8.3% 9.1%
Physical dating violence Sexual dating violence
Probable major depressive episode Seriously considered attempting suicide
26.4% 14.8% 11.9%
Made a suicide plan Attempted suicide
6.4% 2.0%
Suicide attempt received medical care
9.4%
a All rates are past-year unless otherwise stated. b In the past 30 days c Over the lifetime Source: [389]
Table 7
Bullying and Cyberbullying Adults are not immune to victimization from bullying or cyberbullying, but the bulk of research has focused on adoles- cent and young adult age groups. Bullying is defined as the use of power and aggression to control and distress another [394]. Intentionality, repetition, and abuse of power primar- ily distinguish bullying from other forms of aggression [395]. Cyberbullying does not induce distress through physical aggression and harm, but through the reach of Internet and social media. The emotional harm can be severe, in part from the ease that humiliating or threatening information, photos, and other content are spread, and by recruitment of other cyberbullying participants [396]. A study of 15,425 high-school students found higher rates of girls being bullied (31.3%) or cyberbullied (22.0%) compared with boys (22.9% and 10.8%, respectively). Suicide attempts were made by 4.6% of those never-bullied, 9.5% of those bullied at school, 14.7% of those cyberbullied, and 21.1% of those victimized both at school and online [397]. Peer victimization in childhood or adolescence can have long- lasting adverse effects. Among 30,436 U.S. soldiers in basic training, more frequent physical assault/theft by childhood peers was associated with increased odds of lifetime suicidal ideation and attempts; more frequent bullying comments/ behaviors was associated with increased risk of ideation, plan- ning, and attempts among ideators. Relative to non-exposure, exposure to the most persistent bullying carried a two- to fourfold increase in risk of suicidality [398].
Gender and Sexual Minority Adults In Western countries, the lifetime prevalence of suicide attempts is 4% among heterosexuals and 17% among sexual minorities [399]. Among sexual minority populations, a his- tory of suicide attempts increases subsequent risk of repeat attempts and fatal outcomes [377; 400]. Reports suggest high suicide attempt rates among gay/bisexual African Americans, gay/bisexual men of lower socioeconomic status, and sexual minority Latinos [401; 402; 403]. Suicidality disproportionately affects gender minorities, who may represent up to 0.5% of the adult population. Transgender men and women are roughly 5 times more likely to attempt suicide and 19 times more likely to die by suicide than cisgender adults [404]. The suicide attempt prevalence in trans popula- tions is 22% to 43% for lifetime and 9% to 11.2% for past-year [405]. Violent victimization, experienced by 43% to 60% of transgender persons, predicts a fourfold increase in suicide risk [404]. Physical assault increases the odds of attempting suicide, but physical abuse directed at gender identity or expression has greater relative impact on suicidal behavior [404]. Experienc- ing fewer transphobia events has been associated with a 66% reduction in ideation and a 76% reduction in suicide attempts among ideators [405].
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