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

The mediating role of childhood maltreatment in the association between being left-behind and adolescent anxiety

BACKGROUNDS

Left-behind and separated from parents are common among Chinese adolescents and many developing countries, which may cause maltreatment and mental disorders, especially anxiety. Nevertheless, the comprehensive study in the prevalence of childhood maltreatment and its role in anxiety among left-behind adolescents is still insufficient.

METHODS

A nationally representative middle school sample of 32,620 adolescents participated the pen-paper survey regarding demographics, left-behind status and the source of abuse. The Generalized Anxiety Disorder-7 and Chinese version of the Childhood Trauma Questionnaire were used to assess anxiety symptoms and maltreatment experience. The analyses in prevalence, risk factors and mediating effects were preformed in SPSS 27.

RESULTS

30,174 valid questionnaires were collected, of which 2748 were left-behind adolescents. 46.4 % of left-behind and 35.6 % of non-left-behind adolescents reported anxiety, and left-behind increased risk of anxiety (OR = 1.180, 95%CI: 1.180-1.286, p < 0.001). In left-behind adolescents, female sex, older age, and maltreatment experience were risk factors of anxiety. Additionally, left-behind adolescents were more likely to suffer serious abuse and all abuse subtypes. The maltreatment almost completely mediated the association between left-behind and anxiety (0.857, 95%bootstrap CI = 0.743, 0.976), of which emotional abuse played the largest role (0.648, CI = 0.547, 0.751), followed by physical neglect, emotional neglect, and sexual abuse.

CONCLUSION

This study revealed the prevalence of anxiety and maltreatment in Chinese left-behind adolescents, and suggested that the maltreatment might significantly mediate the anxiety of left-behind adolescents. This may shed a light on other developing countries where the phenomenon of left-behind adolescents exists.

Comparison of bullying victimization and depression symptoms among Chinese adolescents before and after the end of the dynamic zero-COVID-19 policy: a repeated cross-sectional study

BACKGROUND

The COVID-19 pandemic has had a significant impact on the physical and mental health of human beings. Most adolescents in mainland of China have been infected with COVID-19 after the adjustment of the dynamic zero-COVID-19 policy. This study aims to analyze the relationship between the COVID-19 pandemic effect and depressive symptoms among adolescents in mainland China.

METHODS

This school-based repeated cross-sectional study was conducted on students aged 11-19 years from September to October 2022 and September to October 2023 in Ningbo, Zhejiang Province, China, using a stratified cluster, multistage sampling method. Data analysis occurred from January to June 2024. Depression symptoms and bullying victimization, exclusion of cyberbullying, were assessed using the 20-item Center for Epidemiological Studies Depression Scale (CES-D) and Bully/Victim Questionnaire, respectively.

RESULTS

In the first survey wave in 2022 during the dynamic zero-COVID-19 policy period in Mainland China, 10,224 participants completed the questionnaires. In wave 2 survey in 2023 which was the first year after lifting of the dynamic zero-COVID-19 policy, 11,604 participants completed the questionnaires. This resulted in a sample of 10,224 in wave 1 and 11,604 in wave 2. The mean age in wave 1 was 15.2 (SD = 1.7) and 15.1 (SD = 1.8) in wave 2. The prevalence of depression symptoms in adolescents in wave 2 was higher than in wave 1 (17.0% vs. 14.6%, P < 0.05). The prevalence of bullying victimization and types of bullying victimization in school among adolescents were higher in 2023 than in 2022. A total of 3.2% of the 2023 participants and 1.7% of the 2022 participants experienced bullying victimization in school (P < 0.05). The odds ratio of experiencing depression (CES-D Score ≧ 16) and bullying victimization in school were 1.18 (95% CI, 1.10-1.28) and 1.86 (95% CI, 1.55-2.24) times higher, respectively, in 2023 than in 2022 (P < 0.01). The mediated regression analysis revealed that after lifting of the dynamic zero-COVID-19 had a significant association with an increase in depression symptoms, which was partially mediated by bullying victimization in school (total association:β = 0.175; SE = 0.038; P < 0.001; direct association:β = 0.138; SE = 0.039; P < 0.001; indirect association: a*b = 0.037; P < 0.001; the proportion of mediation: 20.88%, P < 0.001).

CONCLUSIONS

The findings of this repeated cross-sectional study suggest that an increased risk of depression symptoms or bullying victimization has been associated with the COVID-19 pandemic in mainland China after lifting the dynamic zero-COVID-19 policy. In addition, bullying victimization may play a mediating role in the associations between the pandemic and depression symptoms. These findings indicated that additional support should be offered to Chinese adolescents in the period of post-pandemic COVID-19.

CLINICAL TRIAL NUMBER

Not applicable.

Family affluence and bullying victimisation affect life satisfaction in large-bodied adolescents: Evidence from 37 high-income countries

BACKGROUND

Adolescents with large body sizes often experience bullying which likely affects their overall well-being. Yet, there is limited research on how bullying victimisation affects overall life satisfaction among this cohort of adolescents, and how family affluence moderates this relationship.

OBJECTIVE

This study investigates the moderation effects of family affluence in the association between bullying victimisation and life satisfaction among adolescents with large bodies.

SETTING AND PARTICIPANTS

This research involved 16,240 adolescents with large bodies based on the World Health Organization's Body Mass Index Chart/Classification for ages 13 to 15 years from 37 high-income countries in Europe and North America.

DESIGN

The study used data from the Health Behaviour in School-aged Children (HBSC) survey, a cross-national study of adolescent health and well-being. Hypotheses were assessed through mixed effects binary logit models with random intercepts, accounting for data clustering and variations across regions.

RESULTS

After controlling for covariates, both cyberbullying (AOR = 1.72; 95 % CI = 1.48-2.00) and traditional bullying (AOR = 1.74, 95 % CI: 1.53-1.99) were significantly associated with lower life satisfaction compared with no bullying experience among participants. Family affluence partly moderated these associations, wherein the highest level of affluence reduced the effects of cyberbullying (AOR = 1.57, 95 % CI: 1.09-2.27) and traditional bullying (AOR = 1.41, 95 % CI: 1.02-1.96) on life satisfaction compared to lower levels.

CONCLUSION

Both traditional and cyberbullying significantly reduced life satisfaction among adolescents with large body sizes. However, higher family affluence moderates (reduces) these negative effects, suggesting a protective role of socioeconomic status. These findings highlight the need for targeted interventions to support bullied adolescents, particularly those with large bodies and from lower socioeconomic backgrounds.

The Prevalence and Severity of School Bullying among Left-Behind Children: A Meta-Analysis

The involvement of left-behind children (LBC) in school bullying has raised concern in China. However, the susceptibility of LBC to engage in bullying is controversial, and comprehensive, representative studies covering the entire country are lacking. The purpose of this study was to evaluate the prevalence and severity of school bullying among LBC. The Chinese National Knowledge Network, WanFang, VIP, PubMed, Web of Science, EMBASE, and EBSCO databases were searched for literature on being left-behind and bullying before April 2022. The effect size was measured by odds ratio (ORs), standard mean difference (SMD), and 95% confidence interval (CI). Random-effects or fixed-effects models were selected for meta-analysis, and subgroup analysis was used to explore the sources of heterogeneity. The meta-analysis included 25 studies of school bullying among LBC and non-LBC (NLBC). The prevalence of bullying perpetration and victimization among LBC were 18.58% (95% CI [3.72%, 33.44%], p < .05) and 40.62% (95% CI [25.47%, 55.78%], p < .05), respectively. Compared with NLBC, the risk of bullying perpetration and victimization among LBC increased 1.97 times (OR = 1.97, 95% CI [1.77, 2.20], p < .05) and 2.17 times (OR = 2.17, 95% CI [1.43, 3.29], p < .05), respectively. The severity of bullying experienced by LBC was higher than that of NLBC (SMD = 0.49, 95% CI [0.20, 0.79], p < .05). The prevalence and severity of school bullying were higher in LBC than in NLBC, and left-behindness was positively associated with school bullying. LBC are a crucial population to protect when developing bullying interventions.

Parental migration and cyberbullying victimization among Chinese left-behind children: understanding the association and mediating factors

Introduction

Parental absence is greatly associated with school bullying victimization of left-behind children (LBC) in migrant families. With the increasing popularity of the Internet, little is known about the association between parental migration and cyberbullying victimization, and potential mediators.

Methods

We conducted a cross-sectional study in Anhui and Zhejiang Province, China, in 2020. With a sample of 792 currently left-behind children (CLBC), 541 previously left-behind children (PLBC), and 628 never left-behind children (NLBC), path analysis was used to explore the association between parental migration and cyberbullying victimization among children, while considering the independent and sequential mediating roles of parent-child communication, and time spent online.

Results

The prevalence of cyberbullying victimization was 29.3% among CLBC, 29.2% among PLBC, and 23.4% among NLBC. Path analysis showed that current left-behind status was positively associated with cyberbullying victimization among children (p = 0.024). Furthermore, current left-behind status was associated with worse parent-child communication, which, in turn, predicted a higher prevalence of cyberbullying victimization [95% CI = (0.007, 0.036)]. Similarly, the previous left-behind experience was associated with worse parent-child communication, which, in turn, predicted a higher prevalence of cyberbullying victimization [95% CI = (0.013, 0.043)]. Current left-behind status was associated with increased time spent online, which, in turn, predicted a higher prevalence of cyberbullying victimization [95% CI = (0.013, 0.038)]. Additionally, the current left-behind status positively predicted cyberbullying victimization among children through the serial mediating roles of parent-child communication and time spent online [95% CI = (0.001, 0.006)]. Similarly, previous left-behind experience positively predicted cyberbullying victimization among children through the serial mediating roles of parent-child communication and time spent online [95% CI = (0.002, 0.007)].

Discussion

We propose that to protect CLBC and PLBC from cyberbullying victimization, it is of great importance for migrant parents to regulate children's time spent online and promote daily parent-child communication.

The interaction effects of social support and four types of bullying on sleep quality in Chinese adolescents

OBJECTIVES

The aims of this study were to examine the association of verbal, social, physical, and cyber bullying victimizations with sleep quality while taking social support as a moderator and to further examine gender and grade differences in the moderating effects of social support on bullying-associated sleep quality among Chinese adolescents.

METHODS

An online cross-sectional survey was conducted in a province of northwestern China. A total of 20,320 students were included in our analyses. Multivariable linear regression analyses were conducted to examine the association between bullying victimization and sleep quality as well as the moderating effects of social support on these relationships.

RESULTS

After adjusting for confounding variables, four types of bullying victimization were significantly associated with sleep quality. Social support only moderated the relationship of verbal, physical, and social bullying with sleep quality. Moreover, these positive moderating effects were found only for girls and, in terms of grade difference, only for primary students. Some reversed moderating effects of social support were also observed in the relationship of cyber, physical bullying with sleep quality.

LIMITATIONS

This was a cross-sectional study, limiting the causal inference.

CONCLUSIONS

This study revealed that bullying is a risk factor for poor sleep quality among adolescents in northwestern China. Furthermore, social support moderated the relationship between bullying and sleep quality in different ways depending on grade, gender, and type of bullying. More efforts are needed to prevent bullying and improve both school climate and students' sleep quality.

Video game addiction in psychiatric adolescent population: A hospital-based study on the role of individualism from South China

BACKGROUND

For decades, video game-related behaviors have been investigated in different psychologic research, much of whose attention has been paid to video game addiction (VGA), while the differences between VGA and social media addiction (SMA) should have deserved more attention. In addition to detecting common risk factors of VGA, one core question is whether social inclination (individualism or collectivism) matters.

OBJECT

The objectives of this study were to clarify the prevalence of VGA and SMA,, identify the influencing factors of VGA, and clarify the relationships between VGA and adolescents' individualism-collectivism inclination.

METHOD

The survey was conducted among 110 adolescent psychiatric patients. For each interviewee, psychological scales were filled face to face. Path analysis was used to examine the causation structure of the childhood trauma-related symptoms.

RESULT

The prevalence of VGA was 40.9% (45 out of 110), and it was 41.8% for SMA (46 out of 110); childhood trauma, social media addiction, the individualistic inclination, and the rate of homosexuality were observed to be independent indicators for video game addiction (r2  = 0.46).

CONCLUSION

Psychological counseling on patients' internet-related behaviors may focus on the individualistic personality and possible childhood trauma, which are two important risk factors of video game addiction. It is recommended to distinguish between video game addiction and social addiction in clinical practice.

Symptoms mediate the relationship between childhood trauma and non-suicidal self-injury: A hospital-based study of adolescents with mood disorder

BACKGROUND

Childhood trauma has a significant impact on the development of adolescents, which may lead to interpersonal and psychological problems. Determining the incidence and consequences of childhood trauma in psychiatric clinical practice is of great significance.

METHODS

A survey was conducted among adolescents with mood disorders. Childhood Trauma Questionnaire (CTQ), the Adolescent Non-Suicidal-Self-Injury Behavior Function Assessment Scale (ANBFAS) and a series of psychological scales were filled face to face. Path analysis was used to examine the causation structure of childhood trauma-related symptoms.

RESULTS

A total of 117 participants (74.5%) had experienced at least one type of trauma. Interpersonal and psychological features of adolescent patients with childhood trauma were detailed in this study. The path analysis model showed that the relationships between childhood trauma and NSSI were mediated by depressive symptoms and thinking disorders, respectively, whereas depressive symptoms individually mediated the correlation between childhood trauma and sleep disturbances in adolescent patients with psychiatric disorders (χ2 /df = 1.23).

CONCLUSION

For adolescent patients with childhood trauma, psychological counseling for interpersonal relationships should start with families and peers. It is important to treat their depressive symptoms and thinking disorders and alleviate NSSI behavior and sleep disorders.

Association between bullying victimization, coping style, and mental health problems among Chinese adolescents

BACKGROUND

This study aimed to examine the association of bullying victimization with anxiety and depressive symptoms among Chinese adolescents and explored the role of coping styles in the foregoing associations.

METHOD

Data were drawn from the 2019 School-based Chinses Adolescents Health Survey (n = 19,809). Information about bullying victimization, coping styles, anxiety symptoms, and depressive symptoms were measured. Linear mixed-effects models were performed.

RESULTS

After adjusting for covariates, verbal victimization (β = 1.94 for anxiety symptoms; β = 4.62 for depressive symptoms), relational victimization (β = 3.40 for anxiety symptoms; β = 8.37 for depressive symptoms), physical victimization (β = 2.63 for anxiety symptoms; β = 6.07 for depressive symptoms) and cyber victimization (β = 4.68 for anxiety symptoms; β = 10.72 for depressive symptoms) were associated with anxiety and depressive symptoms. Moreover, the severity of anxiety and depressive symptoms tended to increase with the number of victimization types. The interaction effects between bullying victimization and coping style on anxiety and depressive symptoms were significant. Further stratified analyses by coping styles indicated that the association of relational and cyber victimization on anxiety and depressive symptoms were significantly stronger in adolescents with negative coping style than in those with positive coping style.

LIMITATIONS

Causal inference is limited due to the cross-sectional design.

CONCLUSION

Bullying victimization is associated with anxiety and depressive symptoms, and coping styles may play a moderate role in these associations. Interventions to promote mental health could focus on developing positive coping styles, particularly among adolescents with bullying victimization.

Establishment and validation of a nomogram for suicidality in Chinese secondary school students

BACKGROUND

Accurately identifying high-risk of suicide groups and conducting appropriate interventions are important to reduce the risk of suicide. In this study, a nomogram technique was used to develop a predictive model for the suicidality of secondary school students based on four aspects: individual characteristics; health risk behaviors; family factors; and school factors.

METHODS

A total of 9338 secondary school students were surveyed using the stratified cluster sampling method, and subjects were randomly divided into a training set (n = 6366) and a validation set (n = 2728). In the former, the results of the lasso regression and random forest were combined, from which 7 optimal predictors of suicidality were determined. These were used to construct a nomogram. This nomogram's discrimination, calibration, clinical applicability, and generalization were assessed using receiver operating characteristic curves (ROC), calibration curves, decision curve analysis (DCA), and internal validation.

RESULTS

Gender, depression symptoms, self-injury, running away from home, parents' relationship, relationship with father, and academic stress were found to be significant predictors of suicidality. The area under the curve (AUC) of the training set was 0.806, while that of the validation data was 0.792. The calibration curve of the nomogram was close to the diagonal, and the DCA showed the nomogram was clinically beneficial across a range of thresholds of 9-89 %.

LIMITATIONS

Causal inference is limited due to the cross-sectional design.

CONCLUSION

An effective tool was constructed for predicting suicidality among secondary school students, which should help school healthcare personnel assess this information about students and also identify high-risk groups.

School victimization and Internet addiction among Chinese adolescents: The mediating roles of life satisfaction and loneliness

The present study investigated the possibility of life satisfaction and loneliness mediating the link between school victimization and Internet addiction. A total of 3,363 middle/high school students (45% males; M_age  = 15.67 years old, SD = 1.58) completed a series of self-report questionnaires, which included school victimization, life satisfaction, loneliness, and Internet addiction. The findings demonstrated a positive relationship between school victimization and Internet addiction. In addition, life satisfaction and loneliness mediated the link between school victimization and Internet addiction. Overall, these findings contribute to a better understanding of the association between school victimization and Internet addiction. They also extended the GST, providing suggestions for preventing and managing adolescents' Internet addiction.

Effects of Parental Migration on Dental Caries of Six- to Eight-Year-Old Children Using Structural Equation Modeling

This cross-sectional study aimed to document the relationship between dental caries, oral health behaviors, and the duration of parental migration in rural Yunnan, China, from September to December 2020. Seven rural primary schools with high parental migration were studied. The oral health status of 500 six- to eight-year-old students was assessed using clinical examination and caregivers' interviews. A total of 51.8% of the children had at least one parent absent for at least 6 months (left-behind children). Among those children with parental migration <6 months, 40.0% consumed sugar twice or more daily and 82.8% of those with parental migration from 6 to 12 months brushed once a day or less. The percentage of daily sugar consumption twice or more and brushing once or less among those without parental migration were 36.0% and 68.6%. Prevalence of caries in permanent teeth (DMFT) in children without parental migration and those whose parental migration <6 months, 6 to <12 months, and ≤12 months were 30.9%, 20.0%, 28.7% and 19.8%, respectively. Out of several other causal pathways between parental migration and dental caries, our structural equation model delineated that sugar consumption is the important mediator variable. Special education programs may be needed to educate caregivers on sugar consumption for the left-behind children in rural areas.

School assets and bullying in Chinese youth: A multiple mediation model of intentional self-regulation and internet gaming disorder

Bullying is a severe social problem affecting young people all over the world. Previous studies suggested that engagement in bullying had massive effects on teenagers' physical and psychological development. It is critical and necessary to investigate the antecedents and underlying mechanisms of this phenomenon among young generations. The present study, based on the positive youth development perspective and the developmental assets theory, attempts to explore the positive factors in the school subsystem that could effectively prevent adolescents from bullying, as well as the multiple mediation effects of intentional self-regulation (ISR) and internet gaming disorder (IGD). In this study, we adopted a two-wave design and recruited a sample of 768 Chinese adolescents using a randomized cluster sampling method in the post-pandemic era. The results revealed that T1 school assets significantly and negatively predicted T2 adolescent bullying. Furthermore, T2 ISR and T2 IGD mediated the association between T1 school assets and T2 bullying separately and sequentially. Overall, school resources play a protective role in adolescent development and could effectively prevent them from negative outcomes. These current findings contribute to the literature by providing a further understanding of the direct and indirect protective effects of school assets on adolescent bullying. Moreover, practitioners could also benefit from these findings in preventing and intervening in bullying in the school subsystem.

Pathways of Adolescent Life Satisfaction Association with Family Support, Structure and Affluence: A Cross-National Comparative Analysis

Background and Objectives: Despite the importance of life satisfaction for health and well-being, there is a paucity of cross-national comparative studies in life satisfaction related to the family environment. The present research examined the pathways of life satisfaction association with perceived family support and other family environment variables among adolescents aged from 11 to 15 years in 45 countries. Materials and Methods: Samples from the Health Behaviour in School-aged Children (HBSC) survey in 2017/2018 were analysed (n = 188,619). Path analysis was applied to evaluate the associations among the study variables. Results: A positive association between the life satisfaction score and high family support was identified in all 45 countries (standardized regression weight ranged from 0.067 to 0.420, p < 0.05). In majority of countries, living with both parents and higher levels of family affluence had a positive effect on adolescent life satisfaction both directly and indirectly through family support. In the described path model, the proportion of life satisfaction score variance that was accounted for by family support, family structure, family affluence, gender and age was up to 25.3%. The path models made it possible to group the participating countries into two clusters. In the first cluster (10 countries) the Eastern and Southern European countries dominated, while the second cluster (35 countries) united the countries of Western and Central Europe. Conclusions: There is evidence that countries with high level of adolescent life satisfaction differ in the high rate of intact family structure and the strong relation between family support and perceived life satisfaction.