初中生不同类型同伴欺凌行为与精神病性体验的关联

张婷婷; 李泳汉; 苏普玉

doi:10.16835/j.cnki.1000-9817.2025197

初中生不同类型同伴欺凌行为与精神病性体验的关联

doi: 10.16835/j.cnki.1000-9817.2025197

1.
中国人民解放军联勤保障部队第九〇一医院临床学院, 安徽合肥 230031
2.
安徽医科大学公共卫生学院儿少卫生与妇幼保健学系/出生人口健康教育部重点实验室/人口健康与优生安徽省重点实验室

基金项目:

国家自然科学基金面上项目 82173539

详细信息

作者简介:
张婷婷(1988-), 女, 安徽肥东人, 硕士, 主管技师, 主要研究方向为儿童青少年发育与行为医学

通讯作者:
苏普玉, E-mail: supuyu@ahmu.edu.cn

利益冲突声明 所有作者声明无利益冲突。
中图分类号: R179 C913.5 G444
计量
- 文章访问数: 16
- HTML全文浏览量: 8
- PDF下载量: 1
- 被引次数: 0
出版历程
- 收稿日期: 2025-03-12
- 修回日期: 2025-04-28
- 网络出版日期: 2025-08-02
- 刊出日期: 2025-07-25

Association between different types of peer victimization and psychotic-like experiences among junior high school students

1.
Clinical College, the 901st Hospital of PLA Joint Logistics Support Force, Heifei 230031, Anhui Province, China

摘要

摘要: 目的探讨初中生同伴欺凌行为与精神病性体验(PLEs)的关联，为有效防控青少年PLEs提供科学依据。方法 2024年1月，利用方便抽样与整群抽样相结合的方法从皖南地区(安庆市宿松县)选取2所普通初级中学2 760名学生进行调查，采用社区精神病性评估问卷(CAPE)和中学生同伴欺凌问卷调查初中生不同症状PLEs以及同伴欺凌中言语欺凌、躯体欺凌、关系欺凌和网络欺凌行为的发生情况。采用多因素Logistic回归模型探讨初中生不同类型同伴欺凌行为与不同症状PLEs的关联。结果初中生PLEs检出率为17.5%，妄想体验和幻觉体验检出率分别为15.4%和7.4%。同伴欺凌行为总体报告率为51.3%，遭受欺凌和欺凌他人报告率分别为49.6%和19.5%，其中遭受言语欺凌和言语欺凌他人报告率均最高(42.4%，15.5%)，遭受网络欺凌和网络欺凌他人报告率均最低(6.0%，1.9%)。相比没有经历欺凌行为的学生，经历过欺凌行为的初中生妄想体验、幻觉体验和PLEs检出率均较高(χ²值分别为29.09~127.22，27.23~72.29，34.32~127.25，P值均 < 0.01)。多因素Logistic回归模型结果显示，调整相关混杂因素后，初中生遭受言语欺凌与妄想体验(OR=1.59，95%CI=1.22~2.09)、幻觉体验(OR=1.94，95%CI=1.33~2.84)和PLEs(OR=1.62，95%CI=1.26~2.09)风险均正向相关，遭受关系欺凌与妄想体验(OR=1.83，95%CI=1.40~2.39)、PLEs(OR=1.65，95%CI=1.28~2.13)风险均正向相关，遭受躯体欺凌与幻觉体验(OR=1.64，95%CI=1.12~2.40)、PLEs(OR=1.41，95%CI=1.06~1.87)风险均正向相关(P值均 < 0.05)。结论初中生不同类型遭受欺凌行为与不同症状PLEs之间存在关联，其中遭受关系欺凌与PLEs的关联性较强。
- 暴力 /
- 精神卫生 /
- 回归分析 /
- 学生
Abstract: Objective To explore the association between peer victimization and psychotic-like experiences (PLEs) among junior high school students, so as to provide a scientific basis for preventing adolescent PLEs. Methods In January 2024, a method of combining convenient sampling with cluster sampling was used to survey 2 760 students from two ordinary junior high schools in southern Anhui Province (Susong Country, Anqing City). The Community Assessment of Psychic Experiences (CAPE) and the Adolescent Peer Bullying Scale were employed to assess PLEs with different symptoms and peer victimization (verbal, physical, relational, and cyberbullying). Multivariate Logistic regression models analyzed the associations of different types peer victimization and PLEs with different symptoms. Results The prevalence of PLEs was 17.5%, with delusional (15.4%) and hallucinatory (7.4%) symptoms being most common. Peer victimization was reported by 51.3% of students (49.6% victims, 19.5% perpetrators), with verbal victimization being most frequent (42.4% victims, 15.5% perpetrators) and cyberbullying least frequent (6.0% victims, 1.9% perpetrators). Compared to students without bullying, students exposed to bullying showed significantly higher rates of delusional (χ²=29.09-127.22), hallucinatory (χ²=27.23-72.29), and overall PLEs (χ²=34.32-127.25) (all P < 0.01). After adjusting for relevant confounding factors, the multiple Logistic regression model revealed verbal victimization increased risks of delusions (OR=1.59, 95%CI=1.22-2.09), hallucinations (OR=1.94, 95%CI=1.33-2.84), and overall PLEs (OR=1.62, 95%CI=1.26-2.09); relational victimization was associated with delusions (OR=1.83, 95%CI=1.40-2.39) and PLEs (OR=1.65, 95%CI=1.28-2.13); physical victimization correlated with hallucinations (OR=1.64, 95%CI=1.12-2.40) and PLEs (OR=1.41, 95%CI=1.06-1.87) (all P < 0.05). Conclusion Specific types of peer victimization are differentially associated with PLEs, with relational victimization demonstrating the strongest association.
- Violence /
- Mental health /
- Regression analysis /
- Students
注释:

1) 利益冲突声明 所有作者声明无利益冲突。

HTML全文

表 1 不同人口统计学特征初中生PLEs检出率比较

Table 1. Comparison of detection rates of PLEs among junior high school students with different demographic characteristics

特征	选项	人数	统计值	妄想体验	幻觉体验	PLEs
性别	男	1 523		220(14.4)	111(7.3)	254(16.7)
	女	1 237		205(16.6)	92(7.4)	229(18.5)
			χ²值	2.37	0.02	1.59
			P值	0.12	0.88	0.21
年级	初一	1 381		172(12.5)	74(5.4)	194(14.0)
	初二	1 379		253(18.3)	129(9.4)	289(21.0)
			χ²值	18.39	16.17	22.82
			P值	< 0.01	< 0.01	< 0.01
户籍	城市	1 102		162(14.7)	78(7.1)	182(16.5)
	农村	1 658		263(15.9)	125(7.5)	301(18.2)
			χ²值	0.69	0.21	1.23
			P值	0.41	0.65	0.27
家庭类型^*	核心家庭	1 193		172(14.4)	76(6.4)	197(16.5)
	大家庭	888		125(14.1)	69(7.8)	147(16.6)
	单亲家庭	268		48(17.9)	21(7.8)	51(19.0)
	其他	411		80(19.5)	37(9.0)	88(21.4)
			χ²值	8.59	3.65	6.15
			P值	0.04	0.30	0.11
家庭经济状况	较差	269		49(18.2)	26(9.7)	57(21.2)
	一般	2 079		312(15.0)	150(7.2)	354(17.0)
	较好	412		64(15.5)	27(6.6)	72(17.5)
			χ²值	1.89	2.56	2.86
			P值	0.39	0.28	0.24
与母亲关系	较差	133		50(37.6)	24(18.0)	52(39.1)
	一般	826		157(19.0)	76(9.2)	180(21.8)
	较好	1 801		218(12.1)	103(5.7)	251(13.9)
			χ²值	73.55	33.51	69.35
			P值	< 0.01	< 0.01	< 0.01
母亲教育方式	专制型	299		80(26.8)	48(16.1)	95(31.8)
	权威型	2 408		340(14.1)	150(6.2)	380(15.8)
	溺爱型	53		5(9.4)	5(9.4)	8(15.1)
			χ²值	34.08	38.02	47.33
			P值	< 0.01	< 0.01	< 0.01
与父亲关系	较差	197		67(34.0)	37(18.8)	73(37.1)
	一般	1 218		207(17.0)	99(8.1)	242(19.9)
	较好	1 345		151(11.2)	67(5.0)	168(12.5)
			χ²值	72.73	49.94	80.29
			P值	< 0.01	< 0.01	< 0.01
父亲教育方式	专制型	342		87(25.4)	53(15.5)	98(28.7)
	权威型	2 323		316(13.6)	137(5.9)	361(15.5)
	溺爱型	95		22(23.2)	13(13.7)	24(25.3)
			χ²值	36.60	46.10	39.62
			P值	< 0.01	< 0.01	< 0.01
留守状态	是	503		89(17.7)	52(10.3)	102(20.3)
	否	2 257		336(14.9)	151(6.7)	381(16.9)
			χ²值	2.49	8.03	3.29
			P值	0.12	< 0.01	0.07
注：()内数字为检出率/%；^*核心家庭指父母双方与子女，大家庭指父母双方与子女和祖父母或外祖父母，单亲家庭指父亲或母亲一方与子女，其他类型指父亲或母亲一方与子女和祖父母或外祖父母。

下载: 导出CSV

表 2 不同类型同伴欺凌行为初中生PLEs检出率比较

Table 2. Comparison of the detection rate of PLEs among junior high school students in different types of peer bullying behaviors groups

欺凌行为	选项	人数	统计值	妄想体验	幻觉体验	PLEs
遭受言语欺凌	无	1 591		154(9.7)	62(3.9)	177(11.1)
	有	1 169		271(23.2)	141(12.1)	306(26.2)
			χ²值	94.31	65.92	105.74
			P值	< 0.01	< 0.01	< 0.01
遭受关系欺凌	无	2 044		221(10.8)	103(5.0)	259(12.7)
	有	716		204(28.5)	100(14.0)	224(31.3)
			χ²值	127.22	62.02	127.25
			P值	< 0.01	< 0.01	< 0.01
遭受躯体欺凌	无	2 338		300(12.8)	130(5.6)	340(14.5)
	有	422		125(29.6)	73(17.3)	143(33.9)
			χ²值	77.35	72.29	92.65
			P值	< 0.01	< 0.01	< 0.01
遭受网络欺凌	无	2 595		363(14.0)	167(6.4)	414(16.0)
	有	165		62(37.6)	36(21.8)	69(41.8)
			χ²值	66.25	53.87	71.88
			P值	< 0.01	< 0.01	< 0.01
言语欺凌他人	无	2 331		308(13.2)	140(6.0)	351(15.1)
	有	429		117(27.3)	63(14.7)	132(30.8)
			χ²值	54.98	40.06	61.95
			P值	< 0.01	< 0.01	< 0.01
关系欺凌他人	无	2 620		381(14.5)	177(6.8)	432(16.5)
	有	140		44(31.4)	26(18.6)	51(36.4)
			χ²值	29.09	27.23	36.60
			P值	< 0.01	< 0.01	< 0.01
躯体欺凌他人	无	2 608		372(14.3)	174(6.7)	423(16.2)
	有	152		53(34.9)	29(19.1)	60(39.5)
			χ²值	46.81	32.45	53.80
			P值	< 0.01	< 0.01	< 0.01
网络欺凌他人	无	2 708		403(14.9)	186(6.9)	458(16.9)
	有	52		22(42.3)	17(32.7)	25(48.1)
			χ²值	29.46	49.93	34.32
			P值	< 0.01	< 0.01	< 0.01
注：()内数字为检出率/%。

下载: 导出CSV

表 3 初中生不同类型同伴欺凌行为与PLEs关联的多因素Logistic回归分析[OR值(95%CI)，n=2 760]

Table 3. Multiple Logistic regression of the relationship between different types of peer bullying behaviors and PLEs among junior high school students[OR(95%CI), n=2 760]

自变量	妄想体验	幻觉体验	PLEs
遭受欺凌
言语欺凌	1.59(1.22~2.09)^**	1.94(1.33~2.84)^**	1.62(1.26~2.09)^**
关系欺凌	1.83(1.40~2.39)^**	1.32(0.92~1.91)	1.65(1.28~2.13)^**
躯体欺凌	1.30(0.96~1.74)	1.64(1.12~2.40)^*	1.41(1.06~1.87)^*
网络欺凌	1.39(0.91~2.11)	1.22(0.72~2.05)	1.39(0.92~2.09)
欺凌他人
言语欺凌	1.34(0.99~1.81)	1.27(0.86~1.89)	1.33(0.99~1.78)
关系欺凌	0.95(0.60~1.49)	1.02(0.57~1.83)	1.02(0.66~1.59)
躯体欺凌	1.34(0.88~2.05)	1.13(0.66~1.91)	1.35(0.90~2.04)
网络欺凌	1.10(0.54~2.25)	1.91(0.87~4.22)	1.15(0.57~2.31)
注：控制性别、年级、户籍、与父/母亲关系、父/母亲教育方式等因素；自变量均以无欺凌行为为参照组；^P < 0.05，^*P < 0.01。

下载: 导出CSV

参考文献(26)

[1]	LEE K W, CHAN K W, CHANG W C, et al. A systematic review on definitions and assessments of psychotic-like experiences[J]. Early Interv Psychiatry, 2016, 10(1): 3-16.
[2]	MCGRATH J J, SAHA S, AL-HAMZAWI A, et al. Psychotic experiences in the general population: a cross-national analysis based on 31 261 respondents from 18 countries[J]. JAMA Psychiatry, 2015, 72(7): 697.
[3]	LINSCOTT R J, VAN O J. An updated and conservative systematic review and Meta-analysis of epidemiological evidence on psychotic experiences in children and adults: on the pathway from proneness to persistence to dimensional expression across mental disorders[J]. Psychol Med, 2013, 43(6): 1133-1149.
[4]	HINTERBUCHINGER B, MOSSAHEB N. Psychotic-like experiences: a challenge in definition and assessment[J]. Front Psychiatry, 2021, 12: 582392.
[5]	MAIJER K, BEGEMANN M J H, PALMEN S J M C, et al. Auditory hallucinations across the lifespan: a systematic review and Meta-analysis[J]. Psychol Med, 2018, 48(6): 879-888.
[6]	王东方, 张雯, 王思思, 等. 青少年精神病性体验及其社会影响因素: 基于城乡差异的实证分析[J]. 中国临床心理学杂志, 2019, 27(2): 302-305, 355. WANG D F, ZHANG W, WANG S S, et al. Psychotic-like experiences and associated socio-demographic factors among adolescents: comparison between urban and rural areas[J]. Chin J Clin Psychol, 2019, 27(2): 302-305, 355. (in Chinese)
[7]	OLWEUS D. School bullying: development and some important challenges[J]. Annu Rev Clin Psychol, 2013, 9: 751-780.
[8]	CHEN L H, TIMOTHEA T. Pathways linking school bullying and ps-ychotic experiences: multiple mediation analysis in Chinese adolescents and young adults[J]. Front Psychiatry, 2022, 13: 1007348.
[9]	YE Z X, WU D M, HE X Y, et al. Meta-analysis of the relationship between bullying and depressive symptoms in children and adolescents[J]. BMC Psychiatry, 2023, 23(1): 215.
[10]	MICHAEL T M, LEAH K, ALEXANDRA M. A revised and extended systematic review and Meta-analysis of the relationship between childhood adversity and adult psychiatric disorder[J]. J Psychiatr Res, 2022, 156: 268-283.
[11]	DANIEL S, SYUDO Y, SHUNTARO A, et al. The role of bullying victimization in the pathway between autistic traits and psychotic experiences in adolescence: data from the Tokyo teen cohort study[J]. Schizophr Res, 2022, 239: 111-115.
[12]	LIU X Q, MOSES G, LIN X L, et al. The association between sibling bullying and psychotic-like experiences among children age 11-16 years in China[J]. J Affect Disord, 2021, 284: 31-37.
[13]	ARSENEAULT L, CANNON M, FISHER H L, et al. Childhood tra-uma and children's emerging psychotic symptoms: a genetically sensitive longitudinal cohort study[J]. Am J Psychiatry, 2011, 168(1): 65-72.
[14]	MARK W, TOULOPOULOU T. Validation of the Chinese version of Community Assessment of Psychic Experiences (CAPE) in an adolescent general population[J]. Asian J Psychiatr, 2017, 26: 58-65.
[15]	张婷婷, 李泳汉, 袁梦园, 等. 中学生急性应激反应与同伴欺凌行为的关联[J]. 中国学校卫生, 2022, 43(10): 1462-1466, 1471. doi: 10.16835/j.cnki.1000-9817.2022.10.005 ZHANG T T, LI Y H, YUAN M Y, et al. Association between acute stress response and peer bullying behaviors among middle school students[J]. Chin J Sch Health, 2022, 43(10): 1462-1466, 1471. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2022.10.005
[16]	WANG D F, CHEN X Y, ANDREW S, et al. Perceived school bullying and psychotic-like experiences in sexual minority adolescents: the mediating and moderating roles of resilience[J]. Child Adolesc Psychiatry Ment Health, 2024, 18(1): 55.
[17]	池上新, 范婷, 曾文茜. 双重防护: 初中生的社会资本对校园欺凌的影响: 以深圳市S中学为例[J]. 中国青年社会科学, 2022, 41(1): 98-106. CHI S X, FAN T, ZENG W Q. Double protection: the influence of social capital of junior high school students on school bullying: takes Shenzhen S middle school as an example[J]. Chin J Youth Soc Sci, 2022, 41(1): 98-106. (in Chinese)
[18]	李洪杰, 杨晓蕾, 钱学艳, 等. 父母教养方式对大学生精神病性体验的影响[J]. 中国校医, 2024, 38(6): 405-408. LI H J, YANG X L, QIAN X Y, et al. Influence of parenting styles on psychotic-like experiences among college students[J]. Chin J School Doctor, 2024, 38(6): 405-408. (in Chinese)
[19]	王俊霞, 叶建武, 张丽虹, 等. 丽水城区单亲家庭中学生心理健康状况[J]. 中国学校卫生, 2022, 43(2): 265-267, 273. doi: 10.16835/j.cnki.1000-9817.2022.02.024 WANG J X, YE J W, ZHANG L H, et al. Mental health status of middle school students from single parent families in urban area of Lishui City[J]. Chin J Sch Health, 2022, 43(2): 265-267, 273. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2022.02.024
[20]	朱素平, 王艺橙, 李潇潼, 等. 农村留守儿童处境不利与不良行为: 有调节的中介模型[J]. 中国临床心理学杂志, 2025, 33(1): 112-116. ZHU S P, WANG Y C, LI X T, et al. The left-behind adversity and delinquency among left-behind children in rural China: a moderated mediated model[J]. Chin J Clin Psychol, 2025, 33(1): 112-116. (in Chinese)
[21]	MCKAY M T, CANNON M, CHAMBERS D. Childhood trauma and adult psychiatric disorder: a systematic review and Meta-analysis of longitudinal cohort studies[J]. Acta Psychiatr Scand, 2021, 143(3): 189-205.
[22]	LISA R S, HENNING T, KOEN B, et al. Peer-reported bullying, rejection and hallucinatory experiences in childhood[J]. Acta Psychiatr Scand, 2021, 143(6): 503-512.
[23]	YANG J P. Bullying victimization, nonsuicidal selfinjury, and psychotic-like experiences in Chinese rural adolescents: exploring transactional associations[J]. Res Child Adolesc Psychopathol, 2025, 53(1): 125-136.
[24]	DANTCHEV S, ZAMMIT S, WOLKE D. Sibling bullying in middle childhood and psychotic disorder at 18 years: a prospective cohort study[J]. Psychol Med, 2018, 48(14): 2321-2328.
[25]	GENNARO C, STEVEN M, ELIZABETH K, et al. Bullying victimization and risk of psychotic phenomena: analyses of British national survey data[J]. Lancet Psychiatry, 2015, 2(7): 618-624.
[26]	FETEN F R, EYA L, ALEXANDRE A L. The relationship between Internet gaming disorder and psychotic experiences: cyberbullying and insomnia severity as mediators[J]. BMC Psychiatry, 2023, 23(1): 857.