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Background <p>The progression from suicidal ideation to attempt is a multi-stage process, yet it is unknown how different victimization contexts contribute uniquely to each stage. We compared the associations of school-based peer bullying and family-based childhood maltreatment with suicidal ideation, suicide planning, and suicide attempts in adolescents to identify the primary intervention target for halting suicidality at each step.</p> Methods <p>A multicenter, school-based survey of 18,910 Chinese students aged 12–22 years was conducted. Participants were categorized into four groups: none, peer bullying only, childhood maltreatment only, and both. Logistic regression and population attributable fraction analyses were applied.</p> Results <p>Overall, 10.9% reported peer bullying only, 18.7% maltreatment only, and 8.9% both. Peer bullying showed a stronger association with suicidal ideation than maltreatment (<i>OR</i> 1.35; 95% <i>CI</i>:1.14<b>–</b>1.60), particularly among females &lt; 15 years (<i>OR</i> 1.68; 95% <i>CI</i>:1.21–2.32). Childhood maltreatment had a stronger link to suicide attempts (<i>OR</i> 1.34; 95% <i>CI</i>: 1.06<b>–</b>1.70) and a higher PAF (13% vs. 2% for peer bullying). Among ideators, maltreatment increased progression to attempts (<i>OR</i> 1.70, 95% <i>CI</i>: 1.32–2.19). Notably, co-exposure sharply raised the risk of suicide attempts (PAF: 25%).</p>

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Differential roles of peer bullying and childhood maltreatment in suicidal ideation and attempts among Chinese adolescents

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年5月28日

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  • Zixuan Xu,
  • Wenhua An,
  • Jie Hu,
  • Ziyan Yin,
  • Chenxi Zhang,
  • Lengyi Zhang,
  • Yuqin Dai,
  • Yanmei Zhang,
  • Yizhen Yu

摘要

Background

The progression from suicidal ideation to attempt is a multi-stage process, yet it is unknown how different victimization contexts contribute uniquely to each stage. We compared the associations of school-based peer bullying and family-based childhood maltreatment with suicidal ideation, suicide planning, and suicide attempts in adolescents to identify the primary intervention target for halting suicidality at each step.

Methods

A multicenter, school-based survey of 18,910 Chinese students aged 12–22 years was conducted. Participants were categorized into four groups: none, peer bullying only, childhood maltreatment only, and both. Logistic regression and population attributable fraction analyses were applied.

Results

Overall, 10.9% reported peer bullying only, 18.7% maltreatment only, and 8.9% both. Peer bullying showed a stronger association with suicidal ideation than maltreatment (OR 1.35; 95% CI:1.14–1.60), particularly among females < 15 years (OR 1.68; 95% CI:1.21–2.32). Childhood maltreatment had a stronger link to suicide attempts (OR 1.34; 95% CI: 1.06–1.70) and a higher PAF (13% vs. 2% for peer bullying). Among ideators, maltreatment increased progression to attempts (OR 1.70, 95% CI: 1.32–2.19). Notably, co-exposure sharply raised the risk of suicide attempts (PAF: 25%).