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Suicide is one of the leading causes of death in adolescents and help-seeking behaviour for suicidal behaviour is low. School-based screenings can identify adolescents at risk for suicidal behaviour and might have the potential to facilitate service use and reduce suicidal behaviour. The aim of this study was to assess associations of a two-stage school-based screening with service use and suicidality in adolescents (aged 15 ± 0.9 years) from 11 European countries after one year. Students participating in the 'Saving and Empowering Young Lives in Europe' (SEYLE) study completed a self-report questionnaire including items on suicidal behaviour. Those screening positive for current suicidality (first screening stage) were invited to an interview with a mental health professional (second stage) who referred them for treatment, if necessary. At 12-month follow-up, students completed the same self-report questionnaire including questions on service use within the past year. Of the N = 12,395 SEYLE participants, 516 (4.2%) screened positive for current suicidality and were invited to the interview. Of these, 362 completed the 12-month follow-up with 136 (37.6%) self-selecting to attend the interview (screening completers). The majority of both screening completers (81.9%) and non-completers (91.6%) had not received professional treatment within one year, with completers being slightly more likely to receive it (χ2(1) = 8.948, V = 0.157, p ≤ 0.01). Screening completion was associated with higher service use (OR 2.695, se 1.017, p ≤ 0.01) and lower suicidality at follow-up (OR 0.505, se 0.114, p ≤ 0.01) after controlling for potential confounders. This school-based screening offered limited evidence for the improvement of service use for suicidality. Similar future programmes might improve interview attendance rate and address adolescents' barriers to care. [ABSTRACT FROM AUTHOR]

Peer victimization is a major stressor adolescents often face in the school environment, and has been linked to depression and suicidal risk. This study analyzed the associations between three behavioral coping strategies (avoidance, seeking social support from adults/peers, and retaliation) and depression and suicidal ideation. Participants included 4,254 victimized students who were part of the Saving and Empowering Young Lives in Europe (SEYLE) study that compared three school-based prevention interventions and collected information on health risk behaviors in adolescents from 11 European countries. Results showed behavioral avoidance to be associated with an increase in levels of depression, as compared to the other coping strategies (adult social support, peer social support, retaliation). Seeking social support from adults was associated with lower depression and suicidal ideation rates. A more than 25% increase in suicidal ideation was associated with behavioral avoidance, compared to seeking social support from adults. By contrast, retaliation to peer victimization was not found to be associated with increased depression or suicidal ideation. The findings support the Coping Deficit model and may suggest that abstaining by doing nothing when victimized can be associated with certain adverse emotional outcomes. [ABSTRACT FROM AUTHOR]

Background: Predictions of two different models for suicide attempts (SA) over 12 months, as differentially impacted by specific school‐based suicide prevention interventions, were compared. These were as follows: (a) interpersonal theory (IPTS) and (b) a two‐pathway model, one path associated with externalizing symptoms and continuum of self‐harm behaviors, and the other with internalizing symptoms. Methods: Self‐report questionnaires were completed by 11,110 high school students from ten EU countries enrolled in the Saving and Empowering Young Lives in Europe (SEYLE) study. Baseline measures included perceived burdensomeness, thwarted belongingness from parents and peers, health risk behaviors, self‐injury, suicide ideation (SI), and attempts (SA). SI and SA were reassessed at 12‐month follow‐up. Each model's predictions of SI and SA groups over time (i.e., repeated SA, remitted SA, SA onset, and no SA) were estimated in the no intervention/control group. The superior model was estimated across intervention groups. Results: Interpersonal theory showed better fit compared to the two‐pathway model. In partial agreement with IPTS predictions, parental low belongingness but not peer belongingness or burdensomeness predicted greater likelihood of SI. The likelihood of repeated SA versus no SA was higher among adolescents who reported SI, self‐injury, risk behaviors, and particularly both SI and self‐injury. All three interventions attenuated the combined effect of SI and self‐injury. Youth Aware of Mental Health Program (YAM) additionally decreased the effect of risk behaviors on the likelihood of repeated SA. Conclusions: Interpersonal theory assumptions were partially supported. Perceived interpersonal difficulties with parents were primarily related with SI, and risk behaviors and self‐injury were important predictors of SA. Suicide prevention interventions may be effective by mitigating the hazardous effect of varying self‐harm behaviors and may be further advanced by increasing parental involvement. [ABSTRACT FROM AUTHOR]

Background: The association between bullying victimization and depression, suicide ideation and suicide attempts has been studied mainly in cross‐sectional studies. This study aims to test the bidirectional effect and the chronicity versus sporadic effect of physical, verbal, and relational bullying victimization on suicidal ideation/attempts and depression. Methods: Longitudinal assessments with an interval of 3‐ and 12‐months were performed within a sample of 2,933 adolescents (56.1% females; mean age 14.78, SD = .89) from 10 European countries, participating in the Saving and Empowering Young Lives in Europe (SEYLE) school‐based multicenter control sample. Multilevel Structural Equation Models were used, controlling for sociodemographic variables. Victimization was considered chronic when a student was victimized in the first two time points and sporadic when it was reported only at one point but not in another. Results: Bidirectional prospective association between all types of victimization and depression were found. Among participants, who reported victimization once (but not twice), physical victimization, but not verbal and relational, was associated with later suicidal ideation and attempts. Chronic victimization of any type increased likelihood for later depression compared with sporadic and no‐victimization. Chronic relational victimization increased the likelihood of later suicidal ideation, and chronic physical victimization increased the likelihood for suicidal attempts. Conclusions: The results support the bidirectional effect of victimization and depression and indicate that there are complex longitudinal associations between victimization and suicidal ideation/attempts. Physical victimization may especially carry effect on suicidal risk over time. Interventions should focus on victimization as a cause of distress but also aim to prevent vulnerable adolescents from becoming targets of victimization. [ABSTRACT FROM AUTHOR]

Purpose To examine risk and protective factors moderating the associations between three types of bullying victimization (physical, verbal, and relational bullying) with suicide ideation/attempts in a large representative sample of European adolescents. Methods We analyzed cross-sectional data on 11,110 students (mean age = 14.9, standard deviation = .89) recruited from 168 schools in 10 European Union countries involved in the Saving and Empowering Young Lives in Europe study. A self-report questionnaire was used to measure victimization types, depression, anxiety, parental and peer support, and suicide ideation and attempts. For each outcome, we applied hierarchical nonlinear models controlling for sociodemographics. Results Prevalence of victimization was 9.4% physical, 36.1% verbal, and 33.0% relational. Boys were more likely to be physically and verbally victimized, whereas girls were more prone to relational victimization. Physical victimization was associated with suicide ideation, and relational victimization was associated with suicide attempts. Other associations between victimization and suicidality (ideation/attempts) were identified through analysis of interactions with additional risk and protective factors. Specifically, verbal victimization was associated with suicide ideation among adolescents with depression who perceived low parental support. Similarly, low peer support increased the associations between verbal victimization and suicide ideation. Verbal victimization was associated with suicide attempts among adolescents with anxiety who perceived low parental support. Conclusions Findings support the development of prevention strategies for adolescent victims of bullying who may be at elevated risk for suicide ideation/behavior, by taking into account gender, the type of bullying, symptomatology, and availability of interpersonal support. [ABSTRACT FROM AUTHOR]