Page 134 - GHES-3-3

Global Health Economics and
Sustainability
Polyvictimization and suicidal behaviors

2023). Even youth who have experienced various types 2. Methods
of interpersonal victimization (e.g., childhood abuse,
sexual victimization, bullying, and Internet victimization) 2.1. Participants and data collection procedures
in their lives but also have higher levels of resilience are Samples were collected from four universities across the
likely to seek family support and tend to employ positive midwestern, south-central, and southern regions of the
reappraisal compared with those with lower resilience to United States using a cross-sectional study and convenience
polyvictimization (Kirchner et al., 2020). sampling. Upon receiving approval letters from the
Social support includes emotional and physical support institutional review boards of each school, the research team
from interpersonal relationships, including family, friends, recruited college students who were aged at least 18 years
neighbors, or support groups, to cope with an individual’s and whose primary language was English. The survey was
biological, psychological, and social stress (House et al., distributed through students’ emails and included detailed
1988; Jolly et al., 2021). The literature has recognized that information about the study, a consent statement, and an
social support plays a protective role in buffering negative explanation of confidentiality on the survey’s first page.
outcomes from severely stressful situations (Guerra et al., Students could start the survey voluntarily after agreeing to
2016; Guerra et al., 2019; Holfeld & Baitz, 2020; Hsieh et al., the consent letter. The self-administered online survey was
2022; Setti et al., 2016); thus, social support is significantly conducted using Qualtrics from November 2022 to January
related to well-being (Stronge et al., 2019; Wilson et al., 2023. Upon completing the survey, participants were
2020). If individuals have experienced childhood abuse eligible to enter raffles for compensation. After excluding
and bullying victimization, they may not have relational incomplete survey questionnaires, 790 samples were used
social support (e.g., family or peers). Moreover, perceived from a total of 878 participants for data analysis. For the
social support concerns individuals’ positive thoughts main analysis, the expectation-maximization imputation
and feelings about themselves (Ioannou et al., 2019). method was applied to address missing values, as the
Therefore, despite the stressful nature of polyvictimization selected variables’ missing rates ranged from 0.0% to 30%
experiences throughout their lifetime, individuals may (Thulare et al., 2021). The participants’ ages ranged from
perceive their surrounding social support positively. Such 18 to 31 years (M = 21.56); of these, 184 (28%) were male,
a positive perception of social support from one’s family, 474 (71%) were female, and 10 preferred not to disclose
school, and community can act as a buffer against suicidal their gender. Their racial demographics included White
ideation and behaviors (Hou et al., 2022; Standley & (472; 55%), African American (128; 17%), Hispanic (94;
Foster‐Fishman, 2021). While perceived social support 12%), and others (i.e., Asian, Native American, Eskimo, or
serves as a protective factor against subsequent adverse mixed races; 125; 16%).
health outcomes for polyvictims, the moderating role 2.2. Measures
of perceived social support in the association between
polyvictimization and suicidal ideation/behaviors has not 2.2.1. Suicidal thoughts/behaviors
been examined among college students. Suicidal thoughts/behaviors were measured using five items
adopted from the Suicidal Ideation Attributes Scale (van
1.3. The current study
Spijker et al., 2014). Questions reflecting these attributes
This study examined how the association between in the past month included the following: “How often have
polyvictimization and suicidal thoughts/behaviors can you had thoughts about suicide?” and “How close have you
be explained by college students’ resilience and whether come to making a suicide attempt?” The response options
perceived social support can moderate the association ranged from “Never” (0) to “Always” (10), with unlabeled
between polyvictimization and suicidal thoughts/ points 1 – 9 between the two values. The Cronbach’s alpha
behaviors. The specific hypotheses that this study tested for this scale in the current sample was 0.91. This scale
are as follows: is one of the most commonly utilized measures and has
Hypothesis 1: Polyvictimization is positively associated demonstrated good reliability and validity with adolescents
with suicidal ideation/behaviors among college and adults in previous studies (Han et al., 2017; Harris
students. et al., 2021; van Spijker et al., 2014).
Hypothesis 2: Resilience has an indirect relationship 2.2.2. Polyvictimization
between polyvictimization and suicidal ideation/behaviors. Polyvictimization was assessed using the Adverse
Hypothesis 3: Perceived social support moderates the Childhood Experiences International Questionnaire
relationship between polyvictimization and suicidal (ACE-IQ; Felitti et al., 2019) and the Multidimensional
ideation/behaviors. Peer-Victimization Scale (Mynard & Joseph, 2000). In

Volume 3 Issue 3 (2025) 126 https://doi.org/10.36922/ghes.3737