Abstract

This study aimed to examine whether being bullied, fighting, and injury, regarded in terms of frequency and nature, were significantly associated with psychological distress and suicidal behavior, independent of substance abuse and parental support in adolescents. Secondary analysis of data from the Global School-based Student Health Survey from Kiribati, the Solomon Islands, and Vanuatu was conducted. Binomial logistic regression analysis was used to examine the association of being bullied, fighting and injury with psychological health outcomes (loneliness, insomnia, suicidal ideation and suicide attempt) at a 5% level of significance. A total of 4122 students were included; 45.5% were male, and 52.0% were 14 years of age or younger. Of the total, 9.3% felt lonely and 9.5% had insomnia most of the time over the last 12 months; 27.6% had suicidal ideation, and 30.9% reported at least one suicide attempt in the last 12 months. Multivariable logistic regression analysis showed that being bullied, fighting and injury were significantly associated with psychological health outcomes; adjusted odds ratios (AORs) of loneliness, insomnia, suicidal ideation and suicide attempt increased with increased exposure to bullying, fighting, and injury compared to non-exposed group. Among the types of bullying victimization, the highest AORs of insomnia and suicide attempt were among students who were left out of activities, compared to the non-bullied. Among the causes of injury, adolescents injured due to a physical attack were the most likely to report the highest AORs of loneliness, insomnia and suicidal ideation compared to those not injured. Preventing violence and injury among adolescents might contribute to better mental health and reduction of suicidal behavior.

Highlights

  • Suicidal behavior in adolescents is a common problem in low-income and middle-income countries [1]

  • The study revealed that being bullied, fighting, and injury, in terms of frequency and nature, were significantly associated with loneliness, insomnia and suicidal behavior, independent of substance abuse and parental support in adolescents in three Western Pacific Island countries

  • adjusted odds ratios (AORs) of loneliness, insomnia, suicidal ideation and suicide attempt usually increased with increased exposure to bullying, fighting and injury compared to the non-exposed group

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Summary

Introduction

Suicidal behavior in adolescents is a common problem in low-income and middle-income countries [1]. World Health Organization (WHO) states that the suicide rate dropped by 47% between 2000 and 2012 in low- and middle-income countries in the Western Pacific Region [2], the literature reports that suicide was more common in the Western Pacific Region and the Western Pacific Island countries, especially in the countries with faster growing populations, including Papua New Guinea, Kiribati, Vanuatu, and Solomon Islands etc. Loneliness and insomnia are two indicators of psychological distress in adolescents that are significantly associated with suicidal and other health risk behaviors, and poor health outcomes [5,6,7,8].

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