Findings from the 2023 YRBSS: Examining the risk factors of social media use, alcohol use, bullying and adolescent suicide.

BACKGROUND

Adolescent mental health concerns in the U.S. continue to rise, with suicide remaining the second leading cause of death among youth. Identifying factors associated with suicidal thoughts and behaviors is critical for prevention efforts.

METHODS

We analyzed data from the 2023 Youth Risk Behavior Surveillance Survey (YRBSS), a nationally representative survey of U.S. high school students. Multivariate logistic regression models assessed associations between self-reported frequency of social media use, school-based bullying, cyberbullying, and 30-day alcohol consumption with five risk markers of suicide risk, adjusting for sex, race/ethnicity, and grade level. Complete case analyses were conducted to address variable missingness, resulting in variation in sample size across models.

RESULTS

School-based bullying, cyberbullying, and recent alcohol use were each significantly associated with four suicide risk markers. Social media use showed a modest associated with one marker: feelings of sadness or hopelessness.

CONCLUSION

This cross-sectional study identifies bullying, alcohol use, and social media exposure as important correlates of adolescent suicide risk markers; however causal or temporal relationships cannot be inferred. Longitudinal research is needed to clarify how these factors interact over time and whether they contribute to or result from suicidal ideation. Future studies should also examine potential interaction effects among these risk factors. While schools may consider these associations when refining existing prevention efforts, comprehensive, evidence-based programs addressing bullying, online behaviors, and substance use should be informed by robust longitudinal evidence.