A Gender-Based Approach to Peer Victimization, Depression, and Sexual Risk Behaviors Among High School Youth in the United States

Background and Purpose
Although the associations between peer victimization, depression and sexual risk behaviors among adolescents have been documented in previous research, we lack research examining how different types of peer victimization predict sexual risk behaviors, and how depression may mediate the relationship between types of peer victimization and such risk behaviors. In addition, little is known about how these direct and indirect associations differ between females and males. Therefore, the purpose of this study is to examine gender differences in the direct and joint associations among four types of peer victimization (victims of school bullying, cyber-bullying, physical dating violence, and sexual dating violence), depression, and sexual risk behaviors among high school students in the United States.

Methods
Data were drawn from the 2015 Youth Risk Behavior System Survey, collected by the U.S. Centers for Disease Control and Prevention. This study included only high school students who had ever engaged in sexual intercourse (N=5,288). The dependent variable was sexual risk behavior. No condom use, engaging in sex while using alcohol or drug, and multiple sex partners were combined to create the sexual risk behavior variable. The independent variables were victimization through school bullying, cyber-bullying, physical dating violence, and sexual dating violence. The mediating variable was depressive symptoms. Path analyses were conducted to test the effects of each type of peer victimization on sexual risk behavior, mediated by depressive symptoms, using Mplus 7.4. In addition, we tested for group invariance to compare the direct and indirect associations between male and female students. 

Results
Each type of peer victimization variable positively predicted depressive symptoms for both females and males. In addition, the direct effects of physical dating violence and sexual dating violence were associated with an increase in sexual risk behavior for females and males. However, school-bullying victimization did not significantly predict sexual risk behavior for either females or males. Cyber-bullying victimization significantly predicted an increase in sexual risk behavior only for males, not for females. In terms of indirect effects, depression positively mediated the relationship between cyber-bullying victimization and sexual risk behaviors only for males. This path model indicated good model fit [CFI=1, TLI=1, χ2=697.45 (p<.001), RMSEA=0.00, 90% CI (.00, .00)].

Conclusions and Implications
Results suggest that being a victim of bullying or violence during adolescence is linked directly to depression; for male adolescents, both are associated with increased health risk behaviors, and depression mediates this relationship for male victims of cyber-bullying. Future research may consider further parsing out gender differences in bullying and its consequences. Among practitioners, prevention efforts can focus on how to mitigate depression among bullying victims in order to reduce future negative outcomes. In addition, our findings highlight the need to pay particular attention to male adolescents victims, who may be ashamed to self-identify and who may be hard to detect when the bullying occurs online.