Bullying Victimization and Suicide Among US High School Adolescents: The Mediating Role of Depressive Symptoms and the Moderating Effects of Physical Activity and Sex

This study examined associations between bullying victimization and suicidal behaviors among US high school adolescents using seven waves of Youth Risk Behavior Surveillance System data (2011–2023; N = 110,409). Logistic regression analyses showed that bullying victimization and depressive symptoms significantly increased the odds of suicidal behaviors. In contrast, higher grade level and physical activity (PA) were associated with lower odds of suicidal behaviors. Moderated mediation analyses demonstrated that depressive symptoms mediated the effects of bullying victimization on suicidal behaviors, while PA buffered the indirect effects of school bullying on suicidal behaviors through depressive symptoms. Sex moderated direct effects, with stronger associations observed among females. These findings emphasize the importance of interventions that address bullying victimization, depressive symptoms, and PA to reduce suicidal behaviors among US high school adolescents.