Association of peer bullying, life satisfaction with self-harm among junior high school students
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摘要:
目的 探究青少年遭受同伴欺凌、生活满意度和自伤行为之间的关联，为预防青少年自伤行为提供科学依据。 方法 于2022年10月，采用多阶段分层随机整群抽样的方法，抽取安徽省宣城市、合肥市和淮北市共5 724名初中生，使用自编的青少年心理行为问卷进行调查。 结果 青少年遭受同伴欺凌检出率为30.0%，高致命性自伤、低致命性自伤、无明显组织损伤的自伤、潜在损伤的自伤以及心理伤害的自伤检出率分别为10.2%，25.8%，35.5%，20.8%和28.2%。多因素Logistic回归分析结果显示，遭受同伴欺凌与5种自伤行为(OR=2.52~3.21)之间均呈正向关联，生活满意度与5种自伤行为(OR=0.19~0.33)之间均呈负向关联(P值均 < 0.01)。青少年生活满意度在遭受同伴欺凌与高致命性自伤、低致命性自伤、无明显组织损伤的自伤和潜在损伤的自伤之间有调节作用(OR值分别为1.53，1.42，1.30，1.39，P值均 < 0.05)，在遭受同伴欺凌与心理伤害的自伤之间没有调节作用(P>0.05)。 结论 青少年遭受同伴欺凌可能增加自伤行为的发生风险，提高生活满意度有助于缓解同伴欺凌对青少年自伤行为的负面影响。 Abstract:Objective To explore the association between adolescent peer bullying, life satisfaction and self-harm, so as to provide intervention support for the prevention of adolescent self-harm behaviors. Methods In October 2022, 5 724 junior high school students from Xuancheng, Hefei, Huaibei in Anhui Province were selected by multistage stratified random cluster sampling, and a self-administered adolescent mental health behavior questionnaire was used to conduct the survey. Results The detection rate of peer bullying among adolescents was 30.0%, and the detection rates of the five self-harm behaviors including highly lethal self-harm, less lethal self-harm with visible tissue damage, self-harm without visible tissue damage, self-harm with latency damage, and psychological self-harm were 10.2%, 25.8%, 35.5%, 20.8% and 28.2%, respectively. Logistic regression model results showed a positive association between exposure to peer bullying and the five self-harmful behaviors (OR=2.52-3.21, P < 0.01), and a negative association between life satisfaction and the five self-harmful behaviors (OR=0.19-0.33, P < 0.01). Adolescent life satisfaction had a moderating effect between exposure to peer bullying and highly lethal self-harm, less lethal self-harm with visible tissue damage, self-harm without visible tissue damage, and self-harm with latency damage (OR=1.53, 1.42, 1.30, 1.39, P < 0.05), and no moderating effect between exposure to peer bullying and psychological self-harm (P>0.05). Conclusion Peer bullying among adolescents may increase the risk of self-harm behavior. Improvement of life satisfaction can effectively mitigate the negative effects of peer bullying on adolescent self-harm. -
Key words:
- Violence /
- Quality of life /
- Self-injurious behavior /
- Mental health /
- Regression analysis /
- Adolescent
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表 1 不同人口统计学特征青少年遭受同伴欺凌和自伤检出率比较
Table 1. Comparison ofdetection rates of peer bullying and self-harm in adolescents with different demographic characteristics
人口统计学指标 选项 人数 统计值 同伴欺凌 高致命性自伤 潜在损伤的自伤 低致命性自伤 无明显组织损伤的自伤 心理伤害的自伤 性别 男 3 006 985(32.8) 218(7.3) 597(19.9) 577(19.2) 958(31.9) 699(23.3) 女 2 718 730(26.9) 366(13.5) 593(21.8) 902(33.2) 1 072(39.4) 914(33.6) χ2值 23.76 60.15 3.32 145.82 35.75 75.90 P值 < 0.01 < 0.01 0.07 < 0.01 < 0.01 < 0.01 是否为独生子女 是 1 942 617(31.8) 178(9.2) 403(20.8) 487(25.1) 699(36.0) 520(26.8) 否 3 782 1 098(29.0) 406(10.7) 787(20.8) 992(26.2) 1 331(35.2) 1 093(28.9) χ2值 4.59 3.45 0.01 0.89 3.93 2.86 P值 0.03 0.06 0.96 0.35 0.05 0.09 自评家庭经济 中等以下 499 228(45.7) 85(17.0) 148(29.7) 173(34.7) 237(47.5) 199(39.9) 中等 4 277 1 228(28.7) 422(9.9) 874(20.4) 1 108(25.9) 1 518(35.5) 1 215(28.4) 中等以上 948 259(27.3) 77(8.1) 168(17.7) 198(20.9) 275(29.0) 199(21.0) χ2值 65.17 30.42 153.06 32.45 48.82 58.06 P值 < 0.01 < 0.01 < 0.01 < 0.01 < 0.01 < 0.01 母亲受教育程度 小学及以下 1 245 395(31.7) 118(9.5) 270(21.7) 311(25.0) 441(35.4) 371(29.8) 初中 2 640 794(30.1) 274(10.4) 537(20.3) 697(26.4) 920(34.8) 748(28.3) 高中及以上 1 839 526(28.6) 192(10.4) 383(20.8) 471(25.6) 669(36.4) 494(26.9) χ2值 3.48 0.92 0.93 0.96 1.11 3.22 P值 0.18 0.63 0.63 0.62 0.57 0.20 父亲受教育程度 小学及以下 746 224(30.0) 77(10.3) 166(22.3) 187(25.1) 257(34.5) 212(28.4) 初中 2 674 832(31.1) 279(10.4) 556(20.8) 709(26.5) 953(35.6) 760(28.4) 高中及以上 2 304 659(28.6) 228(9.9) 468(20.3) 583(25.3) 820(35.6) 641(27.8) χ2值 3.72 0.40 1.29 1.21 0.39 0.25 P值 0.16 0.82 0.53 0.55 0.82 0.89 合计 5 724 1 715(30.0) 584(10.2) 1 190(20.8) 1 479(25.8) 2 030(35.5) 1 613(28.2) 注：()内数字为检出率/%。 
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表 2 青少年同伴欺凌和生活满意度与自伤行为关联的Logistic回归分析(n=5 724)
Table 2. Logistic regression analysis of the relationship of peer bullying and life satisfaction with self-harm behaviors among adolescents(n=5 724)
因变量 自变量 单因素 多因素 β值 标准误 Wald χ2值 OR值(95%CI) P值 β值 标准误 Wald χ2值 OR值(95%CI) P值 高致命性自伤行为 同伴欺凌 1.13 0.09 160.83 3.08(2.59~3.66) < 0.01 1.17 0.09 165.03 3.21(2.69~3.84) < 0.01 生活满意度 -1.73 0.10 294.31 0.18(0.15~0.22) < 0.01 -1.66 0.10 260.53 0.19(0.16~0.23) < 0.01 潜在损伤的自伤行为 同伴欺凌 0.97 0.08 205.25 2.62(2.30~2.99) < 0.01 0.95 0.07 196.17 2.60(2.27~2.97) < 0.01 生活满意度 -1.24 0.07 331.30 0.29(0.25~0.33) < 0.01 -1.21 0.07 306.70 0.30(0.26~0.34) < 0.01 低致命性自伤行为 同伴欺凌 1.00 0.06 249.19 2.71(2.40~3.07) < 0.01 1.07 0.07 266.33 2.92(2.57~3.32) < 0.01 生活满意度 -1.41 0.06 489.92 0.24(0.22~0.28) < 0.01 -1.36 0.07 430.49 0.26(0.23~0.29) < 0.01 无明显组织损伤的自伤行为 同伴欺凌 0.91 0.06 233.75 2.48(2.21~2.79) < 0.01 0.92 0.06 230.45 2.52(2.23~2.83) < 0.01 生活满意度 -1.16 0.06 405.03 0.31(0.28~0.35) < 0.01 -1.11 0.06 358.07 0.33(0.29~0.37) < 0.01 心理伤害的自伤行为 同伴欺凌 1.02 0.06 271.85 2.78(2.46~3.14) < 0.01 1.06 0.06 275.71 2.88(2.54~3.27) < 0.01 生活满意度 -1.61 0.06 646.13 0.20(0.17~0.23) < 0.01 -1.55 0.06 579.25 0.21(0.19~0.24) < 0.01
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表 3 青少年生活满意度对同伴欺凌与自伤行为关联中的调节效应[OR值(95%CI), n = 5 724]
Table 3. Moderating effects of life satisfaction between peer bullying and self-harm behaviors among adolescents [OR(95%CI), n = 5 724]
因变量 自变量 模型1 模型2 模型3 高致命性自伤行为 同伴欺凌 3.21(2.69~3.84)** 2.45(2.04~2.95)** 2.18(1.76~2.70)** 生活满意度 0.23(0.18~0.28)** 0.19(0.14~0.25)** 交互项 1.53(1.02~2.28)* 潜在损伤的自伤行为 同伴欺凌 2.60(2.27~2.97)** 2.14(1.86~2.45)** 1.87(1.56~2.23)** 生活满意度 0.34(0.30~0.39)** 0.30(0.25~0.36)** 交互项 1.39(1.06~1.84)* 低致命性自伤行为 同伴欺凌 2.92(2.57~3.32)** 2.38(2.08~2.72)** 2.05(1.72~2.44)** 生活满意度 0.30(0.26~0.34)** 0.26(0.22~0.31)** 交互项 1.42(1.09~1.85)** 无明显组织损伤的自伤行为 同伴欺凌 2.52(2.23~2.83)** 2.11(1.87~2.39)** 1.86(1.57~2.21)** 生活满意度 0.37(0.33~0.42)** 0.34(0.30~0.39)** 交互项 1.30(1.02~1.65)* 心理伤害的自伤行为 同伴欺凌 2.88(2.54~3.27)** 2.30(2.02~2.63)** 2.23(1.88~2.65)** 生活满意度 0.24(0.21~0.27)** 0.24(0.20~0.28)** 交互项 1.07(0.83~1.40) 注：模型1在调整性别、独生子女、自评家庭经济和父母亲受教育程度的基础上，添加了遭受同伴欺凌；模型2在模型1基础上添加生活满意度；模型3在模型2的基础上添加同伴欺凌与生活满意度交互项。*P < 0.05，**P < 0.01。
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[1] SKEGG K. Self-harm[J]. Lancet, 2005, 366(9495): 1471-1483. doi: 10.1016/S0140-6736(05)67600-3 [2] LANG J, YAO Y. Prevalence of nonsuicidal self-injury in Chinese middle school and high school students: a Meta-analysis[J]. Medicine, 2018, 97(42): e12916. doi: 10.1097/MD.0000000000012916 [3] LIANG Y, CHEN J, XIONG Y, et al. Profiles and transitions of non-suicidal self-injury and depressive symptoms among adolescent boys and girls: predictive role of bullying victimization[J]. J Youth Adolesc, 2023, 52(8): 1705-1720. doi: 10.1007/s10964-023-01779-6 [4] JOHNSON J A, WILLIAMS D J, FEINSTEIN J A, et al. Positive predictive value of ICD-10 codes to identify acute suicidal and self harm behaviors[J]. Hosp Pediatr, 2023, 13(8): e207-e210. doi: 10.1542/hpeds.2023-007220 [5] PLENER P L, KAPUSTA N D, KÖLCH M G, et al. Non-suicidal self-injury as autonomous diagnosis-implications for research and clinic of the DSM-5 proposal to establish the diagnosis of Non-Suicidal Self-Injury in adolescents[J]. Z Kinder Jugendpsychiatr Psychother, 2012, 40(2): 113-120. doi: 10.1024/1422-4917/a000158 [6] LI Y, LI Y H, HE Y, et al. Psychological resilience mediates the association between childhood maltreatment and self-harm phenotype in Chinese early adolescents[J]. Child Psychiatry Hum Dev, 2022. DOI: 10.1007/s10578-022-01471-z. [7] HAN A, WANG G, XU G, et al. A self-harm series and its relationship with childhood adversity among adolescents in mainland China: a cross-sectional study[J]. BMC Psychiatry, 2018, 18(1): 28. doi: 10.1186/s12888-018-1607-0 [8] 季成叶. 现代儿童少年卫生学[M]. 2版. 北京: 人民卫生出版社, 2010: 661-665.JI C Y. Modern child and adolescent hygiene[M]. 2 th ed. Beijing: People's Medical Publishing House, 2010: 661-665. (in Chinese) [9] 陶芳标. 中华医学百科全书(公共卫生学儿童少年卫生学)[M]. 北京: 中国协和医科大学出版社, 2017: 150-151.TAO F B. Chinese medical encyclopedia (public health, child and adolescent health)[M]. Beijing: China Union Medical College Press, 2017: 150-151. (in Chinese) [10] PENG Z, KLOMEK A B, LI L, et al. Associations between Chinese adolescents subjected to traditional and cyber bullying and suicidal ideation, self-harm and suicide attempts[J]. BMC Psychiatry, 2019, 19(1): 324. doi: 10.1186/s12888-019-2319-9 [11] ARNARSSON A, NYGREN J, NYHOLM M, et al. Cyberbullying and traditional bullying among Nordic adolescents and their impact on life satisfaction[J]. Scand J Public Health, 2020, 48(5): 502-510. doi: 10.1177/1403494818817411 [12] CHANG Q, XING J, HO R T H, et al. Cyberbullying and suicide ideation among Hong Kong adolescents: the mitigating effects of life satisfaction with family, classmates and academic results[J]. Psychiatry Res, 2019, 274: 269-273. doi: 10.1016/j.psychres.2019.02.054 [13] DOROL-BEAUROY-EUSTACHE O, MISHARA B L. Systematic review of risk and protective factors for suicidal and self-harm behaviors among children and adolescents involved with cyberbullying[J]. Prev Med, 2021, 152(Pt 1): 106684. [14] HE Y, CHEN S S, XIE G D, et al. Bidirectional associations among school bullying, depressive symptoms and sleep problems in adolescents: a cross-lagged longitudinal approach[J]. J Affect Disord, 2022, 298(PtA): 590-598. [15] SU P Y, WANG G F, HE H, et al. Is involvement in school bullying associated with increased risk of murderous ideation and behaviours among adolescent students in China?[J]. BMC Psychiatry, 2019, 19(1): 121. doi: 10.1186/s12888-019-2108-5 [16] WANG G F, JIANG L, WANG L H, et al. Examining childhood maltreatment and school bullying among adolescents: a cross-sectional study from Anhui Province in China[J]. J Interper Viol, 2019, 34(5): 980-999. doi: 10.1177/0886260516647000 [17] BENRUD-LARSON L M, SANDRONI P, SCHRAG A, et al. Depressive symptoms and life satisfaction in patients with multiple system atrophy[J]. Mov Disord, 2005, 20(8): 951-957. doi: 10.1002/mds.20450 [18] 苏普玉, 郝加虎, 黄朝辉, 等. 2 713名大学生自伤行为及其与自杀心理行为的关联研究[J]. 中华流行病学杂志, 2010, 31(11): 1267-1271.SU P Y, HAO J H, HUANG Z H, et al. An investigation on self-harm episodes and their relationship with suicidal psychology and behaviors in 2 713 college students[J]. Chin J Epidemiol, 2021, 31(11): 1267-1271. (in Chinese) [19] YUAN M Y, LI Y H, CHANG J J, et al. Suicidal and homicidal ideation among Chinese undergraduates with precollege school bullying experiences: sensitive periods and exposure trajectories[J]. Asian J Psychiatr, 2022, 70: 103047. doi: 10.1016/j.ajp.2022.103047 [20] ZHANG M Z, TANG R, RAO W M, et al. Body mass index and the risk of suicidal ideation and suicide attempt among youth in 45 low-and middle-income countries[J]. J Affect Disord, 2022, 298(PtA): 357-363. [21] LIANG K, ZHAO L, LEI Y, et al. Non-suicidal self-injury behaviour in a city of China and its association with family environment, media use and psychopathology[J]. Compr Psychiatry, 2022, 115: 152311. doi: 10.1016/j.comppsych.2022.152311 [22] XIAO W, RONG F, LI S, et al. Co-occurrence patterns of adverse childhood experiences and their associations with non-suicidal self-injury and suicidal behaviors and gender difference among middle school students: a three-city survey in China[J]. J Affect Disord, 2023, 320: 140-147. doi: 10.1016/j.jad.2022.09.124 [23] MYKLESTAD I, STRAITON M. The relationship between self-harm and bullying behaviour: results from a population based study of adolescents[J]. BMC Public Health, 2021, 21(1): 524. doi: 10.1186/s12889-021-10555-9 [24] LIANG S W, LIU L L, PENG X D, et al. Prevalence and associated factors of suicidal ideation among college students during the COVID-19 pandemic in China: a 3-wave repeated survey[J]. BMC Psychiatry, 2022, 22(1): 336. doi: 10.1186/s12888-022-03968-2 [25] AZPIAZU IZAGUIRRE L, FERNANDEZ A R, PALACIOS E G. Adolescent life satisfaction explained by social support, emotion regulation, and resilience[J]. Front Psychol, 2021, 12: 694183. doi: 10.3389/fpsyg.2021.694183 [26] RAN H, CAI L, HE X, et al. Resilience mediates the association between school bullying victimization and self-harm in Chinese adolescents[J]. J Affect Disord, 2020, 277: 115-120. doi: 10.1016/j.jad.2020.07.136 -
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