Investigating the Impact of Traditional Bullying and Cyberbullying on Suicidal Attempts in Chinese Youth: A Prospective Cohort Study

Abstract

Aims: It is unknown whether bullying exposure is independently associated with suicide attempts incidence. This study aims to investigate the association between traditional bullying, cyberbullying, and subsequent risk of suicide attempts among Chinese adolescents. Methods: In this prospective cohort study, 1162 participants (mean age, 12.59, 54.5% male) were recruited from November 2020 to December 2020 in Changsha Hunan Province. In total, 782 of them completed the follow-up in May and June 2021 and were included in the final analysis. Logistic regression was utilized to calculate the odds ratio (OR) with 95% confidence intervals (95% CIs). Gender differences in these associations were further explored by stratified analysis. Results: Adolescents who engaged in bullying perpetration (BP) and experienced cyberbullying victimization (CV) were significantly associated with an increased risk of suicide attempts in the 6-month follow-up even after adjusting for age, ethnicity, single child, depression, anxiety, and stress in the baseline (BP: adjusted OR [aOR] = 3.337, 95% CI: 1.463-7.611, p=0.004; CV: aOR = 3.338, 95% CI: 1.468-7.590, p=0.004). Furthermore, the association between BP and suicide attempts was found to be statistically significant only among male adolescents (aOR = 6.692, 95% CI: 1.566-28.601, p=0.01), while CV was significantly associated with a heightened risk of suicide attempts among female adolescents (aOR = 4.452, 95% CI: 1.684-11.771, p=0.003). Conclusions: BP and CV were longitudinally associated with an increased risk of suicide attempts in Chinese youth, and these associations vary across genders.

Keywords: bullying; cyberbullying; mental health; prospective study; suicide.

Figure 1

The number of participants involved in different types of bullying.

Figure 2

The odds ratio (OR) and 95% confidence intervals (95% CIs) of the associations between bullying involvement and suicide attempts. Model 1: unadjusted. Model 2: adjusted for age, ethnicity, and single child. Model 3: adjusted for age, ethnicity, single child, and depression, anxiety, and stress at baseline.

Figure 3

The odds ratio (OR) and 95% confidence intervals (95% CIs) of the associations between bullying involvement and suicide attempts stratified by gender. Model 1: unadjusted. Model 2: adjusted for age, ethnicity, and single child. Model 3: adjusted for age, ethnicity, single child, and depression, anxiety, and stress at baseline.