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. 2025 Aug 15;25(1):2785.
doi: 10.1186/s12889-025-24140-x.

Associations between unintentional injuries and bullying victimization in adolescents: evidence from a large-scale cross-sectional study in China

Yawen Xuan  1 , Wenkang Zhou  2 , Shuting Kong  2 , Xudong Zhou  1   3 , Hui Zhu  4 , Jingjing Lu  5
Affiliations

Associations between unintentional injuries and bullying victimization in adolescents: evidence from a large-scale cross-sectional study in China

Yawen Xuan et al. BMC Public Health. .

Abstract

Background: Little is known about the associations between unintentional injuries from the perspective of parents and their children's bullying victimization. This study aimed to examine the links between parent-reported unintentional injury subtypes and student-reported experiences of bullying victimization from a school-based large-scale survey.

Methods: A total of 30,386 students from 35 primary schools, 27 middle schools, and 6 high schools with available data on unintentional injuries, school bullying victimization, and covariates were included in this study. Multivariable and multinomial logistic regression analyses were used to scrutinize the association of 12 types of unintentional injuries with any type of school bullying victimization, as well as multiple types of bullying experienced concurrently.

Results: 10 out of 12 types of unintentional injuries were found to be associated with elevated risks of bullying victimization, with children and adolescents whose parents reported being struck by thrown, projected, or falling objects demonstrating the greatest vulnerability to school bullying victimization, followed by accidental drowning and submersion, contact with sharp instrument, etc. And there was also a positive association between the number of unintentional injuries and bullying victimization. The associations varied among children and adolescents who reported the presence of multiple bullying.

Conclusions: Certain types and cumulative circumstances of unintentional injuries of children and adolescents necessitate vigilant attention from parents due to the potential indication of bullying. Subsequent research should delve into the underlying mechanisms linking unintentional injuries to school bullying victimization, focusing on specific injury types to provide more targeted guidance for identifying bullying.

Keywords: A large-scale cross-sectional study; Children and adolescents; Parental perspective; School bullying victimization; Unintentional injury.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: The study was approved by the ethics committee of the School of Public Health, Zhejiang University (ZGL202108-1) and was conducted in accordance with the ethical standards in the Declaration of Helsinki of 1964 and its later amendments. Passive informed consent procedure was used and the students and their parents could withdraw consent at any time. Consent for publication: Not applicable. Competing interests: The authors declare that they have no competing interests.

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