Differential Moderation by Aerobic and Muscle‐Strengthening Physical Activity of the Violence Victimization‐Suicidal Ideation Association in Korean Adolescents
Youngjun LeeABSTRACT
Purpose
Violence victimization is a known risk factor for adolescent suicidal ideation, yet moderating factors remain poorly understood. This study examined whether aerobic and muscle‐strengthening physical activity (PA) differentially moderated the violence victimization–suicidal ideation association.
Methods
Four waves of the Korea Youth Risk Behavior Survey (KYRBS 2021–2024; n = 214,218) were analyzed using complex sample logistic regression. Aerobic PA (0–7 days/week) and muscle‐strengthening PA (0–5+ days/week) were modeled continuously, with linear and quadratic terms to test interactions with violence victimization, adjusting for psychosocial and sociodemographic covariates. Sex‐ and SES‐stratified analyses and formal three‐way interaction tests were conducted.
Results
Overall, 13.3% reported suicidal ideation, versus 38.9% among violence‐victimized adolescents (OR = 3.43). Aerobic PA showed a non‐monotonic interaction with violence: odds of suicidal ideation were elevated at 1–3 days/week (ORs 1.4–1.8) but attenuated at ≥ 4 days/week, a pattern nominally strongest among males. Muscle‐strengthening PA showed elevated odds at higher frequencies (≥ 3 days/week; ORs 1.4–1.9) rather than low frequencies, though this association was not statistically significant in continuous models.
Discussion
Both PA types showed frequency‐dependent, nonlinear associations inconsistent with single‐threshold framing. Findings are associational and hypothesis‐generating, requiring prospective confirmation.