Relationship between school bullying and mental health status of adolescent students in China: A nationwide cross-sectional study

Adolescent Patients'experiences of Mental Disorders Related to School Bullying

Objective

The purpose of this study was to explore the real inner experience and nursing needs of adolescent patients who suffered from school bullying, and to develop a treatment plan to restore adolescent mental health.

Methods

Using the maximum difference sampling method, 15 adolescent patients were interviewed by psychologists and nurses, and the interview results were analyzed by topic induction.

Results

Among the 15 participants, 12 (80%) felt helpless, 13 (86.7%) had serious negative emotions, and 10 (66.7%) felt anxious about personal growth. Based on the semi-structured interviews, the psychological states of participants were summarized into three themes: Helplessness, Severe negative emotions, and Anxiety about personal growth. Under the theme of serious negative emotions, it was further divided into three sub-themes: Frustration and Distrust, Rebellion, Insecurity and depression. These themes reflected the significant impact of school bullying on the psychological status of the participants.

Conclusion

The internal experience of adolescent patients with mental disorders caused by school bullying mainly includes helplessness, serious negative emotions and anxiety about personal growth. It is recommended to evaluate and diagnose patients' existing and potential health problems individually during clinical treatment and care. On the basis of comprehensive assessment, psychological counseling should be provided and support from family and school should be sought to promote positive mental health and personal growth of adolescents.

Perceived school bullying and psychotic-like experiences in sexual minority adolescents: the mediating and moderating roles of resilience

AIMS

This two-wave, longitudinal study aimed to examine the potential moderating and mediating effects of resilience on the association between perceived school bullying and psychotic-like experiences among Chinese sexual minority adolescents.

METHODS

A total of 4192 senior high students were included and 984 (23.5%) of them were identified as a sexual minority (mean age = 16.68 years, SD = 0.71). Participants completed two online surveys during April 21 to May 12, 2021 and December 17 to 26, 2021, respectively, as well as completed self-report measures of sample characteristics, perceived school bullying, resilience, and psychotic-like experiences (including two dimensions: delusional experiences and hallucinatory experiences).

RESULTS

Perceived school bullying and resilience were associated with psychotic-like experiences in sexual minority adolescents. Resilience mediated the relationship between perceived school bullying and subsequent psychotic-like experiences (b = 0.03, 95% CI = 0.01 ~ 0.04)/ delusional experiences (b = 0.03, 95% CI = 0.01 ~ 0.04)/ hallucinatory experiences (b = 0.02, 95% CI = 0.01 ~ 0.03). Additionally, resilience only moderated the associations of perceived school bullying with hallucinatory experiences (b = -0.06, 95% CI = -0.12 ~ -0.01).

CONCLUSIONS

These findings indicated that resilience plays a crucial role in mediating or moderating the relationship between perceived school bullying and psychotic-like experiences. Assessing and reducing school bullying, as well as promoting resilience, may have important clinical implications for reducing the risk of psychotic-like experiences in sexual minority adolescents.

Analysis of the current situation and factors influencing bullying in junior high schools in backward areas of Western, China & A case study of Qingyang City in Gasu

BACKGROUND

Qingyang is located in the northwest of China. By analyzing the current situation and risk factors of bullying in junior high schools in Qingyang City, and identify relevant data for formulating prevention and control measures of bullying in western backward areas.

METHODS

Qingyang City is divided into four regions based on economic level and population quality. One junior high school is randomly selected from each region, a total of 1200 students from 4 junior high schools of different levels in Qingyang City were randomly selected, and the "Questionnaire on Middle School Students' School bullying" was administered between December 2021 and February 2022.

RESULTS

The reporting rate of bullying in junior high schools in Qingyang was 47.35%. The incidence of campus bullying among urban-rural integration junior high schools, senior students, and male students is higher than that of municipal -level junior high schools, junior students, and female students (P< 0.05). The results of binary logistic regression showed that the second grade of junior high school (OR = 1.39,95% CI: 1.022-1.894), poor student performance (OR = 1.744,95% CI: 1.09-2.743), external dissatisfaction (OR = 2.09,95% CI: 1.177-3.427), mother working in an enterprise (OR = 1.623,95% CI: 1.074-2.453), and urban-rural integration middle school (OR = 3.631,95% CI: 2.547-5.177) were factors affecting bullying in junior high school campus.

CONCLUSION

The reporting rate of bullying in junior high schools in Qingyang City was relatively high, mostly occurring in places lacking supervision and after-school hours.

TRIAL REGISTRATION

Not applicable.

Association between social dominance hierarchy and PACAP expression in the extended amygdala, corticosterone, and behavior in C57BL/6 male mice

The natural alignment of animals into social dominance hierarchies produces adaptive, and potentially maladaptive, changes in the brain that influence health and behavior. Aggressive and submissive behaviors assumed by animals through dominance interactions engage stress-dependent neural and hormonal systems that have been shown to correspond with social rank. Here, we examined the association between social dominance hierarchy status established within cages of group-housed mice and the expression of the stress peptide PACAP in the bed nucleus of the stria terminalis (BNST) and central nucleus of the amygdala (CeA). We also examined the relationship between social dominance rank and blood corticosterone (CORT) levels, body weight, motor coordination (rotorod) and acoustic startle. Male C57BL/6 mice were ranked as either Dominant, Submissive, or Intermediate based on counts of aggressive/submissive encounters assessed at 12 weeks-old following a change in homecage conditions. PACAP expression was significantly higher in the BNST, but not the CeA, of Submissive mice compared to the other groups. CORT levels were lowest in Submissive mice and appeared to reflect a blunted response following events where dominance status is recapitulated. Together, these data reveal changes in specific neural/neuroendocrine systems that are predominant in animals of lowest social dominance rank, and implicate PACAP in brain adaptations that occur through the development of social dominance hierarchies.

Bidirectional Longitudinal Associations between Parental Psychological Control and Peer Victimization among Chinese Adolescents: The Mediating Role of Basic Psychological Need Satisfaction

Despite evidence indicating a connection between inappropriate parenting styles and peer victimization, the dynamic processes and mechanisms underlying this link and whether it is consistent across genders and different developmental stages have yet to be explored. To address these gaps, the current 2-year longitudinal study explored the potential bidirectional associations between parental psychological control and peer victimization, as well as the mediating role of adolescent basic psychological need satisfaction. A total of 4,990 adolescents (49.4% boys, Mage T1 = 12.21 years, SDage T1 = 2.60) across different developmental stages (early adolescents, N = 1,819, 49.2% boys, Mage T1 = 9.34 years, SDage T1 = 0.62; middle adolescents, N = 1,525, 50.75% boys, Mage T1 = 12.47 years, SDage T1 = 0.69; late adolescents, N = 1,646, 46.5% boys, Mage T1 = 15.26 years, SDage T1 = 0.50) participated in this three-wave longitudinal survey. The results revealed that parental psychological control was bidirectionally associated with peer victimization. Additionally, basic psychological need satisfaction played the meditating role in this vicious cycle. Further analysis demonstrated interesting developmental differences. Parental psychological control was directly associated with subsequent peer victimization at all three developmental stages, and peer victimization was only directly associated with subsequent parental psychological control in the next year among early adolescents and middle adolescents. The mutual mediating role of basic psychological need satisfaction between parental psychological control and peer victimization was observed exclusively in early adolescents. Both male and female adolescents could be equally affected by these dynamics. This research underscores the reciprocal dynamics inherent in parent-child interactions, intervening in either of these processes (i.e., family, peers, and adolescent basic psychological need satisfaction) may break this destructive cycle.

The Protective Roles of Self-Compassion and Parental Autonomy Support Against Depressive Symptoms in Peer-Victimized Chinese Adolescent Girls: A Longitudinal Study

Peer victimization (PV) is a common and serious problem in school contexts, which hinders adolescents' emotional development and social adaptation. The present study aimed to test the longitudinal relationship between PV and the increase of depressive symptoms (DSs) among Chinese mid-late adolescents using a two-wave longitudinal design and examine the buffering effects of self-compassion (SC) and parental autonomy support (PAS) on this relationship. A relatively large sample of Chinese high school students (N = 722, 52.1% boys; age at Time 2 = 16.23 years old, SD = 0.79) were surveyed annually at two time points. The results showed that PV at Time 1 positively predicted DSs at Time 2 after controlling for the DSs at Time 1. In addition, SC and PAS moderated the longitudinal relationship between PV and the development of DSs, while such moderating effects only existed in girls but not in boys. Specifically, the positive relationship between PV and DSs was non-significant among girls with higher levels of SC or PAS. Our findings highlighted that SC and PAS might be important protective factors buffering against DSs for victimized girls.

An Analysis of the Association between School Bullying Prevention and Control Measures and Secondary School Students' Bullying Behavior in Jiangsu Province

(1) Background: China released regulations on school bullying prevention and control in 2017; however, current research on school bullying in China focuses on exploring influencing factors and lacks empirical research on the effectiveness of anti-bullying policies in schools. The objective of this study was to use an empirical model to explore the association between bullying prevention and control measures and secondary school students' bullying victimization and multiple bullying victimization in Chinese schools. (2) Methods: Data were derived from the 2019 Surveillance of Common Diseases and Health Influencing Factors among Students in Jiangsu Province. The school's bullying prevention and control measures, which was the independent variable, were obtained in the form of a self-report questionnaire and consisted of five measures: the establishment of bullying governance committees, thematic education for students, thematic training for parents, special investigations on bullying, and a bullying disposal process. Bullying victimization and multiple bullying victimization, which was the dependent variable, were obtained through a modified version of the Olweus bullying victimization questionnaire. In order to better explain the differences in the results, this study constructed multilevel logistic regression models to test the association between school bullying prevention and control measures and the rates of bullying victimization and multiple bullying victimization among secondary school students at both the school level and the student level. Meanwhile, this study constructed five models based on the null model by sequentially incorporating demographic variables, physical and mental health variables, lifestyle variables, and bullying prevention and control measures in schools to verify this association. (3) Results: A total of 25,739 students were included in the analysis. The range of bullying victimization rates for students in the different secondary schools in this study was between 6.8% and 37.3%, and the range of multiple bullying victimization rates was between 0.9% and 14.8%. The establishment of bullying disposal procedures was strongly associated with a reduction in bullying victimization (OR = 0.83, 95%CI: 0.71-0.99, p < 0.05). Establishing bullying disposal procedures was not significantly associated with multiple bullying victimization rates (OR = 0.89, 95%CI: 0.73-1.09, p > 0.05). The establishment of a bullying governance committee, thematic education for students, thematic training for parents, and special surveys on bullying were not significantly associated with bullying victimization rates or multiple bullying victimization rates (all p > 0.05). (4) Conclusions: Among the current bullying prevention and control measures for secondary school students in China, the establishment of a bullying disposal process was conducive to reducing the rate of bullying victimization, but it was ineffective in reducing the rate of multiple bullying victimization, and the other preventive and control measures did not achieve the purpose of anti-bullying in schools.

Effectiveness of a localised and systematically developed gatekeeper training program in preventing suicide among Chinese adolescents

To combat the pressing issue of contemporary suicide rates, an effective Life Gatekeeper training program was developed to educate school teachers in identifying and intervening with at-risk students. Two single-arm sequential studies evaluated the program's effectiveness, spanning implementation science stages from design to refinement. The initial study employed face-to-face training (FTF), followed by a standardized video-based 'Train-the-trainer' (TTT) approach. In Study 1, post-intervention and one-month follow-up results showed improved suicide literacy, reduced stigma, and increased willingness to intervene among gatekeepers. The revised TTT program (study 2) also yielded reduced stigmatization and improved intervention competence. In addition, six out of twenty teachers exhibited gatekeeper behaviors. In conclusion, both delivery methods proved effective, particularly the practical application of the TTT version, although further research is warranted to examine long-term effectiveness of the program.

Does having vulnerable friends help vulnerable youth? The co-evolution of friendships, victimization, and depressive symptoms in Chinese adolescents' social networks

This study examined whether having vulnerable friends helps or hurts victimized and depressed (i.e., vulnerable) adolescents and whether this depends on classroom supportive norms. Students (n = 1461, 46.7% girls, 93.4% Han nationality) were surveyed four times from seventh and eighth grade (Mage  = 13 years) in 2015 and 2016 in Central China. Longitudinal social network analyses indicated that having vulnerable friends can both hurt and help vulnerable adolescents. Depressed adolescents with depressed friends increased in victimization over time. Victimized adolescents with victimized friends increased in victimization but decreased in depressive symptoms. These processes were most likely in classrooms with high supportive norms. Having friends and a supportive classroom may hurt vulnerable adolescents' social position but help victims' emotional development.

Longitudinal correlates of bullying victimization among Chinese early adolescents: A cross-lagged panel network analysis

BACKGROUND

Bullying victimization is a major public health issue often faced by adolescents. This highlights the need to identify the relevant risk factors to inform intervention. Based on the ecological systems theory and applied cross-lagged panel network analysis, this study explored the longitudinal correlates of bullying victimization among Chinese early adolescents.

METHODS

A total of 1686 early adolescents (60.4 % were boys) from the Chinese Early Adolescent Cohort study were included in this study. Bullying victimization and its associated factors were assessed using the self-report questionnaires, which was administered from 2019 (T1), 2021 (T2), and 2022 (T3). The longitudinal relationships between bullying victimization and its correlates were examined using a cross-lagged panel network analysis.

RESULTS

27.0 %, 14.9 %, and 13.2 % of the participants reported being bullied by peers at T1, T2, and T3, respectively. The temporal network suggested that individual-level (sex, depression, and anxiety), family-level (child abuse), school-level (satisfaction with classmates), and social-level (satisfaction with society) factors were associated with bullying victimization. The node with the greatest centrality strength was anxiety. Notably, relationship with teachers and classmates were the unique nodes in the T2 → T3 replication network.

LIMITATIONS

The sample is unrepresentative, as it is from only one middle school.

CONCLUSIONS

The findings provide important insights into bullying victimization prevention and intervention among Chinese early adolescents: 1) highlighting the importance of joint interventions across multiple departments; 2) focusing on the most central factors of bullying victimization; and 3) considering the effect of time when exploring the correlates of bullying victimization.

The Role of Coping Styles in Mediating the Dark Triad and Bullying: An Analysis of Gender Difference

Recently, the phenomenon of school bullying has gradually become a primary focus of social attention. To reduce the occurrence of bullying, it is important that we explore the psychological mechanisms of students with bullying tendencies. We conducted mediation models through a multi-group analysis to verify the mediating effect of coping styles on the relationship between dark personality traits and bullying, and further explored the differences in this mechanism between male and female groups. The participants were 772 high school students recruited from a middle school in Tianjin, China. They completed a set of self-reported measurements including the Dirty Dozen (DD), Simplified Coping Style Questionnaire (SCSQ), Buss-Perry Aggression Questionnaire (BPAQ), and Reactive-Proactive Aggression Questionnaire (RPQ). All the measurement instruments have acceptable reliability and validity. The results of the multi-group multiple models indicated that (1) there are significant gender differences in bullying behavior, with males scoring significantly higher than females. Moreover, the gender difference was only reflected in proactive aggression, in which males had higher scores than females; there was no significant gender difference in reactive aggression. (2) In the group of females, both negative and positive coping styles partially moderated the relationship between the Dark Triad and bullying. However, in the group of males, only negative coping styles partially mediated the relationship between the Dark Triad and bullying. (3) The above results also held for proactive aggression. In conclusion, our study highlights the gender differences in the mediating effect of coping styles on the relationship between the Dark Triad and bullying and proactive aggression. These findings contribute to better shared understanding of gender-related aspects in school bullying.

Impact of social dominance hierarchy on PACAP expression in the extended amygdala, corticosterone, and behavior in C57BL/6 male mice

The natural alignment of animals into social dominance hierarchies produces adaptive, and potentially maladaptive, changes in the brain that influence health and behavior. Aggressive and submissive behaviors assumed by animals through dominance interactions engage stress-dependent neural and hormonal systems that have been shown to correspond with social rank. Here, we examined the impact of social dominance hierarchies established within cages of group-housed laboratory mice on expression of the stress peptide pituitary adenylate cyclase-activating polypeptide (PACAP) in areas of the extended amygdala comprising the bed nucleus of the stria terminalis (BNST) and central nucleus of the amygdala (CeA). We also quantified the impact of dominance rank on corticosterone (CORT), body weight, and behavior including rotorod and acoustic startle response. Weight-matched male C57BL/6 mice, group-housed (4/cage) starting at 3 weeks of age, were ranked as either most-dominant (Dominant), least-dominant (Submissive) or in-between rank (Intermediate) based on counts of aggressive and submissive encounters assessed at 12 weeks-old following a change in homecage conditions. We found that PACAP expression was significantly higher in the BNST, but not the CeA, of Submissive mice compared to the other two groups. CORT levels were lowest in Submissive mice and appeared to reflect a blunted response following social dominance interactions. Body weight, motor coordination, and acoustic startle were not significantly different between the groups. Together, these data reveal changes in specific neural/neuroendocrine systems that are predominant in animals of lowest social dominance rank, and implicate PACAP in brain adaptations that occur through the development of social dominance hierarchies.

Effects of stress on school bullying behavior among secondary school students: Moderating effects of gender and grade level

This study investigated the effects of stress on school bullying behaviors among middle school students, and the moderating role of gender and grade level in this relationship. To this end, the Olweus Child Bullying Questionnaire (OBVQ) secondary school version of the child bullying questionnaire and the stressor scale for secondary school students were used to survey 3,566 secondary school students in Guizhou Province, and the data were statistically analyzed. Results showed that stress was significantly and positively associated with school bullying among secondary school students. Furthermore, both gender and grade moderated the relationship between stress and school bullying, showing that boys and middle school children are more likely to engage in bullying than girls and high school students, respectively. The results of the study provide a theoretical basis for the prevention and intervention of school bullying behaviors among middle 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.

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.

Analysis of Influencing Factors of Psychological Intervention on International Students in China after COVID-19: Hainan Province, China

Objectives: In the post-covid-19 era, students face numerous mental health-related effects. Returning to Chinese institutions, international students in China experienced mental health issues (anxiety and stress). These overseas students' psychological issues are obstacles to their academic performance in China. Students' fear restructured their ability to think critically and execute effectively. Consequently, the framework of this study is intended to emphasize the beneficial effects of offline activities, physical activity, and classroom activities on reducing anxiety among international students in China. Methods: This study is predicated on survey data acquired using a five-point Likert scale. 317 responses were received from overseas students enrolled in Hainan universities. Results: The findings show that offline, physical, and classroom activities substantially impact the anxiety reduction of overseas students in China. The study's contribution to the literature is a fresh concept that previous research has not addressed. In addition, this research has significant theoretical and practical consequences for both knowledge and findings. Conclusion: The study has given a paradigm for relieving anxiety among overseas students in China by addressing a research gap. Meanwhile, this study's limitations provide a roadmap for researching further areas of literature in the future.

Does Friend Support Matter? The Association between Gender Role Attitudes and School Bullying among Male Adolescents in China

This study investigated the association between gender role attitudes, perceived friend support, and school bullying among male adolescents from 11 schools in two cities in China. A total of 3172 Chinese adolescents between 12 and 20 years of age (48.80% girls and 51.20% boys) completed questionnaires that included measures of bullying, gender role attitudes, and perceived social support. In terms of outcome measures, the Chinese version of the Illinois Bully Scale (IBS), Attitudes toward Women Scale for Adolescents (AWSA), and Multidimensional Scale of Perceived Social Support (MSPSS) were used to assess bullying perpetration, gender role attitudes, and perceived friend support, respectively. Based on masculinity theories and the stress-buffering theory, the study found that male adolescents held more traditional gender role attitudes (t = 30.78, p < 0.001) and reported higher prevalence of bullying behaviors (36.02%) than girls (31.20%). In addition, boys’ bullying behaviors were significantly predicted by gender role attitudes through perceived friend support. That is, male youth with more conservative gender role attitudes reported less perceived friend support (adjusted OR = 1.055; SE = 0.013), which elevated their risks of bullying perpetration (adjusted OR = 2.082; SE = 0.302). These findings have critical implications for bullying intervention and prevention through gender equity education.

Factor structure of the Chinese version of the Screen for Adult Anxiety Related Disorders (SCARRED)

The aim of this study was to translate and validate the Screen for Adult Anxiety Related Emotional Disorders (SCAARED). The original SCAARED was translated into Chinese and administered 6371 Chinese college students (45.4% females, mean age 18.64 ± 0.89) aged 17-28. The factor structure of SCAARED in Chinese was examined by confirmatory factor analysis and exploratory structural equation modeling (ESEM). Internal consistency and criterion-related validity were also evaluated. The four-factor structure of the SCAARED (generalizing anxiety disorder, separation anxiety disorder, social anxiety disorder and panic disorder) fit the sample well. The SCAARED and its each dimension demonstrated good internal consistency, split-half reliability and criterion-related validity. Similar to other versions of SCAARED, Chinese version of the SCAARED showed that excellent psychometric properties. These findings support that the SCAARED is a reliable and valid anxiety disorder screening instrument in Chinese college students. Future replication studies are warranted in diverse samples and clinical populations.

The Relationship between the Outdoor School Violence Distribution and the Outdoor Campus Environment: An Empirical Study from China

It is widely believed that outdoor environmental design contributes to outdoor violence prevention. To enhance the effectiveness of environmental design, the intrinsic link between the outdoor school violence distribution (OSVD) and the outdoor campus environment (OCE) should be fully considered. For this purpose, this study investigated boarding school L, located in southern Zhejiang Province of China, through a questionnaire and Spatial Syntax theory. Based on the questionnaire marker method (N = 338, 50.59% female), the OSVD was mapped using the kernel density estimation in ArcGIS, including four types of teacher-student conflict: verbal bullying, physical conflict, and external intrusion. The spatial analysis of the OCE (spatial configuration and spatial visibility) then was generated by the DepthmapX, involving four spatial attributes such as integration, mean depth, connectivity, and visibility connectivity. Statistical analysis results indicated the correlation between the OSVD and both the spatial configuration and spatial visibility of the OCE. For the different violence types, there were differences in the impact relationships, with integration being a significant predictor of teacher-student conflict and physical conflict (p < 0.01) and a general predictor of verbal bullying (p < 0.05), while mean depth was a significant predictor of physical conflict (p < 0.01), but not recommended as a predictor of external intrusion. This study explores and predicts the relationship between the OSVD and the OCE, providing guidance and evidence for school violence prevention environmental design. It is a novel attempt, but still challenging and requires more research to refine.

The association between violent video game exposure and sub-types of school bullying in Chinese adolescents

BACKGROUND

School bullying among adolescents has been a worldwide public health issue. It has been observed that adolescents who are exposed to violent video games (VVGs) are often more aggressive. However, research on the association between violent video game exposure (VVGE) and different types of school bullying is limited in the Chinese context.

OBJECTIVE

The purpose of this study was to explore whether VVGE is linked to school bullying behaviors among Chinese adolescents and to examine the relationship between different levels of violent game exposure and four sub-types (physical, verbal, relational, and cyber) of school bullying involvement.

METHODS

This was a cross-sectional study of 1,992 Chinese students (55.02% boys and 44.98% girls) with the average age of 15.84 ± 1.62 years. Sub-types of school bullying victimization and perpetration, Internet addiction, and VVGE were measured by using a self-administrated questionnaire. The association was examined by multiple logistic regression analysis, adjusting for covariates.

RESULTS

Physical, verbal, relational, and cyber school bullying victimization were reported by 18.12, 60.34, 11.75, and 12.05% of the adolescents, and physical, verbal, relational, and cyber school bullying perpetration were reported by 16.62, 54.62, 21.49, and 8.23% of them. Of the students, 1,398 (70.18%) were normal Internet users, 514 (25.80%) showed moderate Internet addictive behaviors, and 31 (1.56%) of the students showed severe Internet addictive behaviors. The prevalence of no VVGE, low-level VVGE, medium-level VVGE, and high-level of VVGE were 27.70, 24.10, 24.20, and 24.00%, respectively. The risk of physical victimization and physical perpetration significantly increased with the increasing degree of violent video game exposure (P for trend < 0.001), with the highest adjusted odds ratios (ORs) of 2.251 (95% CI 1.501-3.375) and 2.554 (95% CI 1.685-3.870), when comparing high-level VVGE with no VVGE.

CONCLUSION

These findings highlight the specific association between different sub-types of school bullying involvement and violent video game exposure. Physical school bullying prevention and intervention programs should be conducted after adolescents are exposed to violent video games.