Recent studies examine how bullying, social media use, and antidepressant treatment influence suicide risk and mental health in adolescents and young adults.

By Richard Sears

This week, Mad in America examines research around increased suicide risk in children and adolescents related to bullying in high-school and the use of selective serotonin reuptake inhibitors (SSRIs), and the impact of reducing social media use on the mental health of young adults.

Bullying and Suicide Attempts Among US High School Students

A recently published research letter in JAMA Network Open finds high-school students that experience bullying at school are more likely to attempt suicide. This research, led by Khushboo R. Agarwal from the City University of New York, also finds that the link between being bullied and attempting suicide is stronger in female high-school students.

The goal of the current work was to examine the relationship between bullying and suicide attempts in US high-school students. The authors used data collected by the 2023 Youth Risk Behavior Surveillance System (YRBSS), an anonymous, self-report survey conducted each year in all 50 US states.

Exposure to bullying was measured using a single question: “During the past 12 months, have you ever been bullied on school property?” Suicide attempts were measured by asking participants if they had attempted suicide in the past 12 months. The authors used YRBSS data on age, sex, race, ethnicity, sexual identity, and gender identity to access how these factors affected the relationship between bullying and suicide attempts.

Non-bullied males served as the comparator group in the current research due to their lower number of suicide attempts. The authors note that although males attempt suicide less often than females, males complete suicide significantly more frequently. In total, the current work examined data from 20,103 high-school students.

Nineteen-point-two percent of participants reported experiencing bullying on school property and 9.5% reported a suicide attempt in the past year. Transgender students (42.6%) and those reporting uncertainty about their gender identity (38.8%) were much more likely to be bullied at school compared to other groups. Female (21.9%), white (23.2%), multiracial (21.5%), and LGBQ+ (28.7%) students, as well as those between 12 – 14 years old (23.5%), also reported higher rates of bullying.

Overall, students that reported bullying were 3.58 times more likely than non-bullied males to attempt suicide. Bullied females were most likely to attempt suicide, and did so 5.65 times more often than non-bullied males. Bullied males (3.25) and non-bullied females (1.5) were also more likely to attempt suicide.

This study had several limitations. The authors did not measure the severity of bullying. This research also did not include teens that completed suicide. As males complete suicide at much higher rates than females, some of the sex differences observed may have been biased by this exclusion. The self report nature of the survey could also bias the data through participants misremembering or providing socially acceptable, rather than true, answers. As the sample was self-selected and exclusively from the United States, generalizability to other populations is limited.

Social Media Detox and Youth Mental Health

A new study published in JAMA Network Open finds that reducing social media use improves symptoms of depression, anxiety, and insomnia in young adults. However, reducing social media use did not improve feelings of loneliness. The current work, led by Elombe Calvert from the Beth Israel Deaconess Medical Center, also did not find significant behavioral changes linked to social media reduction.

This study had three goals: (1) to investigate social media’s impact on the mental health of young adults, (2) to explore the effect of abstaining from social media for one week on symptoms of anxiety, depression, insomnia, and loneliness, and (3) to determine whether reducing social media use was linked to mental health states or behavioral changes.

The authors recruited US based participants online through an app called ResearchMatch. Participants had to be between 18 to 24 years old, own a smartphone that was compatible with mindLAMP (a data collection app), speak English, and have the ability to provide informed consent and complete virtual study visits. A data collection app provided the authors with information on mobility, screen time, and incoming and outgoing calls and texts. Race and ethnicity were self-reported.

Participants answered self-report surveys on mental health and social media use at three virtual meetings. The first meeting was a baseline measure, the second meeting occurred after two weeks of monitoring, and the third meeting after some participants opted into a week long social media detox targeting five social media platforms: Facebook, Instagram, Snapchat, TikTok, and Twitter.

Mental health symptoms were measured using the Patient Health Questionnaire-9 (depression), Generalized Anxiety Disorder-7, Insomnia Severity Index, UCLA Loneliness Scale, and the Rosenberg Self-esteem Scale. Social media use was measured using the Problematic Use of Social Networks Scale, Bergen Social Media Addiction Scale, and the Negative Social Media Comparison Scale. Three-hundred and seventy-three participants completed the baseline surveys and 295 completed the one week social media detox.

Ninety-three point eight percent of participants used at least one of the included social media platforms during the baseline measure, averaging 1.9 hours per day on these platforms. Females had higher daily social media use (2 hours per day) compared to males (1.3 hours per day). During the one week detox, participants spent an average of 0.5 hours per day on the included social media platforms.

Participants that completed the one week detox reported reduced symptoms of anxiety (16.1%), depression (24.8%), and insomnia (14.5%). Some small behavioral changes were observed during the detox period, with participants slightly increasing their overall screen time and time at home. However, the authors note that these changes were small compared to the day-to-day variability in these behaviors.

The authors acknowledge several limitations to this research. The participants were mostly female and college educated, limiting generalizability to other populations. The sample was nonclinical, meaning they did not have a mental health diagnosis. The self-report nature of the surveys means the data was susceptible to bias due to misremembering and giving socially acceptable, rather than true, answers. Participants could have been accessing social media platforms on other devices. Participant behavior could have been affected by being monitored rather than as a reaction to reduced social media use. There were no follow up visits with participants after the initial post detox visit, meaning the long-term changes to mental health symptoms was not measured.

Selective Serotonin Reuptake Inhibitors (SSRIs), Childhood and Adolescent Depression, and Suicidality Following the FDA’s 2004 Black Box Warning: A Systematized Literature Review

#James Donaldson notes:Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticleFind out more about the work I do on my 501c3 non-profit foundationwebsite www.yourgiftoflife.org Order your copy of James Donaldson's latest book,#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

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A new literature review published in Springer Nature: Cureus finds that SSRI use by children and adolescents is linked to increased risk of suicide. This review, led by Harlin Kaur from Creighton University School of Medicine, additionally finds that the increase in suicide risk is especially high during the initial treatment period.

The goal of the current work was to examine the link between SSRI use in children and adolescents to increased risk of suicide. To accomplish this goal, the authors decided to review studies that examined this relationship. To be included in the current review, studies had to examine service users under the age of 18 with a major depressive disorder (MDD) diagnosis that were taking SSRIs. The included studies were peer-reviewed, published in English, and examined increased suicide risk linked to SSRI use. In total, eight studies were included in the current review.

Two of the four randomized control trials (RCTs) revealed a link between SSRI use in children and adolescents with an MDD diagnosis that were taking SSRIs, and three of the four observational studies did so. The RCTs reported that cognitive behavioral therapy may lessen the increased risk of suicide associated with SSRI use.

“This systematized literature review found a measurable association between SSRI use for the treatment of adolescent major MDD and an increased risk of suicidality,” the researchers concluded. https://standingabovethecrowd.com/?p=16405