Sex Differences In the Association between Dating Violence and Suicide Attempts Among U.S. High Schoolers

Background and Purpose

Teen dating violence remains a significant issue globally, with about 1 in 5 of adolescents reporting experiences of physical dating violence and 1 in 10 reporting experiences of sexual dating violence. Dating violence demonstrates a significant relationship with suicidal ideation and attempts, increasing the likelihood of suicidal behaviors by 6 to 9 times.

The current study examines the likelihood of suicide attempt based on physical and dating violence experiences, including interaction of sex, while controlling for age, ethnicity, and depression. The study hypothesizes that those with dating violence experiences will have a higher odds of a suicide attempt than those without any dating violence exposure, and that this relationship will depend on sex.

Methods

This study is a secondary data analysis from the 2023 Youth Risk Behavior Survey (YRBS), a cross-sectional, national survey conducted by the Centers for Disease Control and Prevention. YRBS uses a three-stage cluster sample design that provides representative data of 9th-12th grade students at public and private schools. The analytic sample included only participants who reported dating. A binary logistic regression was completed to examine the associations between suicide attempts and physical and sexual dating violence experiences, adjusting for age, sex, ethnicity, and depression, and including interaction terms between sex and dating violence. All assumptions were assessed and met; despite substantial missingness in sexual dating violence, multiple imputation analyses produced results consistent with full model. Sensitivity analysis demonstrate consistency across methods.

Results

The analytic sample included 8,851 high school students in grades 9-12^th within the United States. Descriptive analyses show that the analytic sample is split almost evenly between males (49.6%) and females (50.4%), with the majority of students being non-Hispanic (77.5%) and between the ages of 15-17 (77.6%). Almost half of the sample report feeling sad or hopeless for at least 2 weeks over the past year (45.8%). Slightly less than 10% report a history of dating violence (physical = 9.7%; sexual = 9.4%) and about 12% report at least one suicide attempt (12.6%) in the last year.

Both physical and sexual dating violence experiences were significant predictors of a suicide attempt, where students who experienced sexual dating violence were almost 2x more likely to attempt suicide (OR = 1.80, [1.46, 2.21], p < .001) and those who experienced physical dating violence were almost 3x more likely (OR = 2.65 [2.10, 3.32], p <.001). Sex was a significant moderator for sexual dating violence but for not physical dating violence. The association between sexual dating violence and suicide attempts was approximately two times stronger among males compared to females (OR = 2.04, [1.34, 3.10], p = .001).

Conclusions and Implications

Given that suicide is the second leading cause of death among adolescents, understanding specific risk factors is necessary for early intervention within the field of social work. Findings of this study highlight the importance of early intervention for those who have experienced dating violence, especially among males with sexual dating violence exposure, to mitigate the potential negative consequence of suicidal behaviors.