Weight Status and School Bullying Experiences in Urban China: The Difference Between Boys and Girls

The prevalence and association of traditional bullying and cyber bullying with mental health among adolescent and youth students in China: a study after the lifting of COVID-19 restrictions

BACKGROUND

Although bullying may affect students' mental health, its prevalence and impact on mental health among students in China after the lifting of COVID-19 restrictions remains unclear. This study aimed to explored the prevalence and association of traditional and cyber bullying with mental health among Chinese adolescent and youth students post-COVID-19 restrictions.

METHODS

An online survey included 82,873 students from various educational levels in Sichuan Province, China, assessing traditional and cyber victimization, cyber perpetration, COVID-19 experiences, insomnia, anxiety, depression, and post-traumatic stress disorder (PTSD). Logistic regression analyses were conducted to explore the associations between bullying and mental health problems.

RESULTS

A total of 28.3% of students reported experiencing bullying, with 23.2% traditional victimization, 17.7% cyber victimization, and 8.1% cyber perpetration. Males had significantly higher prevalence of bullying, while females had significantly higher prevalence of mental health problems. All forms of bullying significantly increased the risk of mental health problems, with traditional bullying showing the strongest association. Students who experienced all three types of bullying had significantly higher risks of insomnia (adjusted odds ratio [aOR] 4.89 [95% CI, 4.57-5.23]), anxiety (aOR 11.42, [95% CI, 10.55-12.36]), depression (aOR 11.52, [95% CI, 10.58-12.53]), and PTSD (aOR 15.48, [95% CI, 14.17-16.92]).

CONCLUSION

This study highlights the high prevalence of bullying, as well as its cumulative impact on mental health problems among adolescent and youth students. Addressing and preventing bullying is crucial to promote positive mental well-being in adolescent and youth students.

Relations between school climates and bullying behaviors in Chinese adolescents: The mediating role of prosocial tendency

This research investigated the relationships between school climates and bullying behaviors in Chinese adolescents, and tested the mediating effect of prosocial tendency according to the seesaw effect. School climates were operationalized using three constructs: subjective diversity of student development goals, teacher support, and peer trust. Bullying behaviors included traditional (i.e., physical, nonphysical, and relational) and cyber bullying behaviors. We recruited 538 adolescents from three schools in Beijing, China (286 girls, 252 boys; average age = 12.47) and asked them to fill out the surveys measuring school climates and prosocial tendency at the outset and to report school bullying behaviors three months later. The results showed that subjective diversity of student development goals and peer trust were directly associated with less cyber bullying behavior. Moreover, teacher support and peer trust were indirectly associated with less traditional bullying behaviors via prosocial tendency. Our findings extend the existing literature on the relationships between school climates and bullying behaviors by incorporating different types of bullying behaviors, concentrating on Chinese adolescents from a cultural viewpoint, and tapping into the underlying mechanism via revealing prosocial tendency as a mediator. Theoretical and empirical contributions of this study, as well as practical implications are discussed.

Traditional bullying, cyberbullying, and quality of life among adolescents in 35 countries: Do cultural values matter?

RATIONALE

Substantial evidence indicates that involvement in school bullying has been linked to lower quality of life (QoL). Yet there is little information elucidating the link between bullying involvement and QoL in different cultures.

OBJECTIVE

This study investigated the associations between different types of bullying involvement and QoL among adolescents. The moderating roles of cultural values in the relationship between bullying involvement and QoL were examined.

METHODS

This study included representative samples from 35 countries (N = 184,017) using data from the 2017/2018 Health Behavior in School-Aged Children (HBSC) survey and the new 2023 World Cultural Map Scores from the World Values Survey Wave 7 (2017/2021). Multilevel mixed-effects analysis was employed to examine individual-level and country-level effects simultaneously.

RESULTS

All types of bullying involvement were associated with lower QoL, with being a victim having the lowest QoL. Adolescents in societies that prioritize higher self-expression values exhibited a reduced propensity to engage in school bullying. In countries with higher self-expression values, there was a more pronounced negative association between bullying involvement and QoL. Traditional/Secular-rational values had no significant and consistent moderating effect on the association between bullying involvement and QoL. Those results were quite similar for both traditional bullying and cyberbullying.

CONCLUSION

These findings imply that cultural values are closely intertwined with adolescent bullying and quality of life. Therefore, prevention and intervention programs should pay more attention to addressing bullying and promoting the QoL of adolescents according to various cultural values.

Association of Friendly School and Family Contexts and Reducing Health Risk Behaviors Among Adolescents: A Cross-National Study in Europe, North America, and China

BACKGROUND

Social factors play an important role in adolescents' behaviors. This study aims to understand percentages of health risk behaviors across country in Europe, North America, and China; explore the associations between friendly school and family contexts and involvement for several health risk behaviors among adolescents.

METHODS

Data derived from health behavior in school-aged children cross-sectional surveys and China Education Panel Survey in 2014-2015. Hierarchical generalized linear modeling was used to analyze data.

RESULTS

The highest percentages of health risk behaviors including unhealthy diet, smoking or alcohol, screen-based sedentary behaviors, and violent behaviors across country ranged from 28.62% to 65.24%. National classmate friendliness was negatively associated with 5 out of 9 health risk behaviors prevalence rates in 41 countries (p < 0.05). Adolescents' perceived peer friendly and helpful were common protective factor for engaging in several health risk behaviors (p < 0.01). Individual family contexts were associated with 3 types of health risk behaviors involvement (p < 0.001).

SCHOOL HEALTH POLICY IMPLICATIONS

Health risk behaviors among adolescents reducing was associated with the implementation of friendly school and family contexts, emphasizing the significance of the goals of embedding friendly adolescents, along with the home-school collaboration.

CONCLUSIONS

Public health strategies should promote national climate of friendship and individual perceived friendly school contexts to reduce health risk behaviors.

Prevalence and associated factors of depressive and anxiety symptoms among Chinese secondary school students

BACKGROUND

Depressive and anxiety symptoms affect about one-fourth of Chinese secondary school students. However, the prevalence and correlates of mental distress among secondary school students from Western China remain largely unexplored. This study aimed to examine the prevalence and associations of depressive and anxiety symptoms with demographic, family, school, life, and behavior factors in a large, representative sample of secondary school students in Zigong, a city in Western China.

METHODS

Secondary school students were recruited using cluster sampling. The 9-item Patient Health Questionnaire, the 7-item Generalized Anxiety Disorder Questionnaire, Multidimensional Peer-Victimization Scale, the Pittsburgh Sleep Quality Index, and Nine-Item Internet Gaming Disorder Scale-Short Form were used. Descriptive statistic was used to describe the sociodemographic characteristics of participants. The clustering effect was adjusted by the "survey" package of R to calculate weighted prevalence. Univariate and multivariate logistic regression were used to explore associated factors of depression and anxiety, respectively.

RESULTS

A total of 63,205 participants were involved, in which the weighted prevalence of depression in all subjects was 23.0% (95% CI: 19.6- 27.0%), and the weighted prevalence of anxiety was 13.9% (95% CI: 11.2- 17.0%). Logistic regression results showed girls, being single-child, non-nuclear family, peer bullying, sleep disturbance, and internet gaming disorder symptoms were positively associated with depressive and anxiety symptoms.

CONCLUSION

Depressive and anxiety symptoms were prevalent among secondary school students in Western China. Our results can guide policy strategies for the assessment, prevention, and intervention of psychological status among Chinese secondary school students.

Prevalence and associated factors of bullying victimization among Chinese high school students in Shandong, China

BACKGROUND

Bullying is a growing concern worldwide. However, there is insufficient research on the prevalence and factors associated with different forms of bullying in a large sample of Chinese adolescents. This study aims to investigate the prevalence and associated factors of bullying victimization among Chinese high school students.

METHODS

Data from the 2020-2021 cross-sectional survey of the DYH program were used. A total of 8203 high school students were randomly selected from all 17 cities in Shandong Province, China. Bullying victimization was measured using two separate questions and identified into three types: school bullying victims, cyberbullying victims, and combined bullying victims. The multinomial logit model was used to explore the factors related to bullying victimization.

RESULTS

The prevalence of bullying victimization was 11.59 %, with 4.04 % of school bullying, 3.37 % of cyberbullying, and 4.18 % of combined bullying. Smoking was negatively associated with bullying victimizations. Male, physical exercise, peer relationships, and obsessive-compulsive symptoms were significantly associated with school bullying victims and combined victims. Watching TV was an influencing factor for school bullying victims and cyberbullying victims. Single-child households, family economic status, drinking alcohol, parent-child relationships, and paranoia were correlated with different types of bullying victimization.

LIMITATIONS

The cross-sectional design limited the examination of causal inferences.

CONCLUSION

We should pay more attention to cyberbullying victimization, which has become as common as school bullying victimization among high school students. The associated factors explored in this study may contribute to understanding bullying victimizations and designing bullying intervention strategies among high school students in China.

Association between weight status and bullying experiences among children and adolescents in schools: An updated meta-analysis

BACKGROUND

The association between weight status and bullying experience is well established, but little is known about the association between overweight or obesity and bullying behaviors among children and adolescents.

OBJECTIVE

The aim of this study was to provide updated evidence on the association between weight status and exposure to bullying among school children and adolescents.

METHODS

All literature published not later than December 12, 2019 was obtained from PubMed, Web of Science, Embase, and PsycINFO databases. The odds ratios (ORs) and corresponding 95 % confidence intervals (CIs) were used to measure the effect size. Results were combined using random-effects or fixed-effects meta-analysis, and sensitivity analysis was conducted to explore potential heterogeneity moderator factors.

RESULTS

This meta-analysis included 26 studies on the association between obesity overweight and bullying. Overall, children and adolescents with obesity had greater odds of experiencing bullying than their counterparts with healthy weight. Children and adolescents with obesity (OR = 1.46, 95 % CI:1.31-1.62), and overweight (OR = 1.24, 95 % CI: 1.17-1.32) were more likely to experience bullying than their normal weight peers. With regards to gender, boys with obesity experienced an increased risk of bullying behaviors than girls with obesity (OR = 1.40, 95 % CI: 1.30-1.50). Similarly, boys with overweight experienced an increased risk of bullying behaviors than girls with overweight (OR = 1.19, 95 % CI:1.06-1.34).

CONCLUSIONS

The present results suggest that children and adolescents must be protected from bullying, especially those that are children and adolescents with obesity overweight and effective strategies are needed to reduce bullying behaviors among children and adolescents in schools.

Associations between school bullying and anxiety in children and adolescents from an ethnic autonomous county in China

School bullying is a widespread public health issue that negatively impacts the mental health of children and adolescents. This study aimed to investigate associations between school bullying involvement and anxiety of children and adolescents. A survey covering all types of pre-college schools (primary, middle, high, and vocational school) was conducted in an ethnic autonomous county in China. 1,943 students participated in this study. Being a victim of verbal (OR=3.08, 95%CI = [2.43,3.91]), physical (OR=3.24, 95%CI = [2.46,4.27]), relational (OR=3.72, 95%CI = [2.90,4.76]), or cyberbullying (OR=3.47, 95%CI = [2.61,4.61]) were associated with increased symptoms of generalized anxiety. Similarly, being a perpetrator of verbal (OR=2.12, 95%CI = [1.45,3.10]), physical (OR=1.85, 95%CI = [1.22,2.79]), relational (OR=1.78, 95%CI = [1.15,2.74]), or cyber-bullying (OR=1.59, 95%CI = [1.08,2.33]) were related to a higher degree of anxiety. Moreover, in both victims and perpetrators higher levels of anxiety were associated with a greater number of types of bullying they were involved in, suggesting a dose-response relation between school bullying involvement and anxiety. Therefore, both bullying victims and perpetrators need mental health support and anti-bullying strategies should address different forms of bullying evenhandedly.

Nomogram predicting bullying victimization in adolescents

OBJECTIVE

The purpose of this study was to construct a cross-sectional study to predict the risk of bullying victimization among adolescents.

METHODS

The study recruited 17,365 Chinese adolescents using stratified random cluster sampling method. The classical regression methods (logistic regression and Lasso regression) and machine learning model were combined to identify the most significant predictors of bullying victimization. Nomogram was built based on multivariable logistic regression model. The discrimination, calibration and generalization of nomogram were evaluated by the receiver operating characteristic curves (ROC), the calibration curve and a high-quality external validation.

RESULTS

Grade, gender, peer violence, family violence, body mass index, family structure, depressive symptoms and Internet addiction, recognized as the best combination, were included in the multivariable regression. The nomogram established based on the non-overfitting multivariable model was verified by internal validation (Area Under Curve: 0.749) and external validation (Area Under Curve: 0.755), showing decent prediction of discrimination, calibration and generalization.

CONCLUSION

Comprehensive nomogram constructed in this study was a useful and convenient tool to evaluate the risk of bullying victimization of adolescents. It is helpful for health-care professionals to assess the risk of bullying victimization among adolescents, and to identify high-risk groups and take more effective preventive measures.

Prevalence and associated factors of school bullying among Chinese college students in Changsha, China

BACKGROUND

School bullying has attracted worldwide attention for its adverse outcomes; however, there is still a lack of research among college students. The aim of this study was to investigate the prevalence of school bullying victimization and the associated factors among Chinese college students.

METHODS

8098 Chinese college students from two universities in Hunan province were recruited in this cross-sectional study, and data on participants' demographic information, bullying history, suicidal behaviors, anxiety (Self-Rating Anxiety Scale) and depression (Self-reporting Depression Scale) were collected. Binary logistic regression was used to analyze the independent correlates of school bullying.

RESULTS

The prevalence of school bullying was 8.03% in our study. Gender (OR,0.792;95%CI[0.660,0.950]; p = 0.012); depression (OR,1.979; 95%CI[1.359,2.883]; p < 0.001); anxiety (OR,1.996; 95%CI[1.388, 2.869]; p < 0.001); suicidal ideation (OR,1.353;95%CI[1.087,1.684]; p = 0.007); suicide attempts (OR,1.772;95%CI[1.306,2.403]; p < 0.001); family income between 30,000 and 70,000/year (yuan) (OR,0.763;95% CI[0.627,0.929]; p = 0.007) and family income more than 70,000/year (yuan) (OR,0.578;95%CI[0.461,0.725]; p < 0.001) were independent correlates of school bullying. The bullying score was positively correlated with physical or mental disorder history, family history of mental disorder, suicidal ideation, suicide plans, suicide attempts, anxiety, depression, smoking and drinking alcohol (all p < 0.05), and negatively correlated with right-handedness, good relationship with parents and family income (all p < 0.05).

LIMITATIONS

No causal relationship could be drawn due to the cross-sectional design.

CONCLUSION

School bullying is quite common among college students. In order to improve students' mental health and prevent suicide, we should pay attention to the negative effects of bullying victimization such as depression, anxiety, suicidal behaviors and so on, apart from putting in place anti-bullying interventions.

Relationship between Weight Status and Health-Related Quality of Life in a Sample of Early Adolescents from Central and Northern Italy: A Cross-Sectional Study of the AVATAR Project Participants

Among the various factors that could influence health-related quality of life (HRQoL) in adolescence, body mass index (BMI) seems to play a key role as a main anthropometric parameter. The aim of this cross-sectional study was to determine, in a sample of Italian adolescents, whether HRQoL is associated with the different weight status categories (underweight, normal weight, overweight, obese), according to BMI cut-off points for children, even considering sex differences. Data were collected from 1707 adolescents (n = 828 males) in seven schools. HRQoL was analyzed using the Italian version of KIDSCREEN-52. Males were more overweight and obese than females (13% vs. 10% and 4% vs. 2%, p < 0.05, respectively). In females, BMI categories are associated with physical well-being (p < 0.05), emotion/mood (p < 0.05), self-perception (p < 0.001), financial resources (p < 0.05), and bullying behavior (p < 0.05). In males, weight status is linked to physical well-being dimension (p < 0.001) and perception of self (p < 0.05). Our results may suggest that there is an association between weight status categories and HRQoL, more pronounced in females than in males. Interestingly, the weight status correlated more with the psychological dimension mainly in females, whereas in males, a stronger association between weight and physical status was observed, suggesting that given the complex, multifaceted, and dynamic nature of relationship between health-related quality of life and weight status in adolescents, multiple factors must be considered.

Bullying Victimization and Life Satisfaction Among Rural Left-Behind Children in China: A Cross-Sectional Study

Objectives: This study aimed to evaluate the associations between bullying victimization and life satisfaction in primary school children and also investigate the interactive effects of left-behind status and bullying victimization on life satisfaction. Materials and Methods: Bullying victimization was measured using the Chinese version of the revised Olweus Bully/Victim Questionnaire. Life satisfaction was assessed using the Multidimensional Students' Life Satisfaction Scale (MSLSS). Life satisfaction is composed of five domains, namely, family, school, friends, environment, and self-satisfaction. Left-behind status of rural children was defined as one or both their parents migrating to working in cities. The data were analyzed using Mann-Whitney U tests, Chi-square tests, and multivariate linear and logistic regression analyses. Results: A total of 810 primary school children were involved, of which 8.5% reported bullying victimization, and 44.3% were left-behind children (LBC). We found that bullying victimization was negatively associated with all domains of life satisfaction (all p < 0.05). With further left-behind status-stratified analysis, we found that negative association between bullying victimization and friend satisfaction was more profound in the LBC group than in the non-LBC group [b(SE)= -0.133 (0.03) vs. -0.061 (0.026) for LBC and non-LBC, respectively, p < 0.05]. When further interaction analysis was conducted, we identified interaction effects between left-behind status and bullying victimization on friend satisfaction (p interaction = 0.048). Similar interaction effect between bullying victimization and left-behind status on school satisfaction was also found (p interaction = 0.004). Conclusions: Bullying victimization was associated with low life satisfaction (including lower family, friends, school, self, and environment satisfaction). There were significant interactions between left-behind status and bullying victimization on friend satisfaction, as well as school satisfaction. Left-behind status of children may exaggerate the impact of bullying victimization on friends/school satisfaction rating.

Cyberbullying Involvement, Resilient Coping, and Loneliness of Adolescents During Covid-19 in Rural China

Cyberbullying involvement can lead to internal health issues, especially mental health problems. Different coping strategies may reduce or enhance the strengths between cyberbullying experience and mental health problems. In this study, we examined the correlations between cyberbullying involvement and loneliness among a group of children and adolescents during the Covid-19 pandemic in China, focusing on investigating the protecting effect of the resilient coping strategy. The results demonstrated that 86.68% of the students were not involved in cyberbullying activities, 8.19% were victims only, 1.89% was perpetrators only, and 3.24% were both victims and perpetrators. Compared with the non-involved, the victims-only group had a significantly higher degree of reported loneliness and a lower score of resilient coping, while the differences of the other groups were not significant. Resilient coping strategy can significantly reduce loneliness and play a mediating role between cyberbullying victimization and loneliness, but such mitigating effect was relatively weak. Besides, peer relations were the primary protective factors, and age was the primary risk factor of loneliness among the controlled variables. This study can enrich current knowledge of cyberbullying involvement and the psychological health among children and adolescents, especially in the context of the pandemic.