رفتارهای زورگویی در میان جوانان در سن مدرسه در چین:عوامل شیوع و مطالعه در استان گوانگدونگ

Abstract Bullying among school-aged youth is a common issue worldwide and is increasingly being recognized as an important problem affecting both victims and perpetrators. Most of the bullying studies have been conducted in western countries, and their implications in other regions are limited due to different cultural contexts. The goal of our study is to identify the prevalence of bullying and its correlates school-aged youth in Guangdong province. In total, 1098 (7.1%) students reported having bullied other students, 744 (4.8%) students reported having been bullied by other students and 396 (2.6%) students reported having both bullied other students and been bullied by other students. There was a strong association between bullying others as well as being bullied and suicidal ideations, suicidal attempts, and self-harm behaviors. The prevalence of bullying and its associations with delinquent behaviors warrant the importance of school facility based preventive intervention taking into account both victims and perpetrators.

1. Introduction Bullying among school-aged youth is a common issue worldwide and is increasingly being recognized as an important problem affecting the well-being and social functioning of the victims as well as the perpetrators. Numerous studies have reported that victims of frequent bullying experience a myriad of psychological, psychosomatic and behavioral symptoms, including anxiety, low self-esteem, low self-worth (Malhi et al., 2014 and Stapinski et al., 2014), considerable mental health problems (Turcotte Benedict et al., 2014), sleeping difficulties, bed wetting, feelings of sadness and common headaches and learning difficulties (Williams et al., 1996, Bijttebier and Vertommen, 1998 and Sesar et al., 2012). They are also more likely to be unhappy and depressed (Fitzpatrick et al., 2010). Bullying not only affects victims but also harms those who bully. Youths that bully others are more likely to dislike school and to engage in unhealthy behaviors, such as smoking and drinking alcohol to excess (Shetgiri et al., 2012). In addition, being a bully during childhood and adolescence is associated with delinquency in adulthood (Kaltiala-Heino et al., 1999). Therefore, bullying is a double-edged sword. Bullying hurts both the bully and the recipient of the bullying. Bullying among school children is a well-established phenomenon. The fact that some children are frequently harassed and attacked by other children has been described in various reports (Olweus, 1993, O’Connell et al., 1999 and Dake et al., 2003), and many adults have personal experience with bullying from their own adolescence and youth. Although people have been acquainted with the problem of bullying for a long time, it did not receive sufficient attention from scientists until the early 1970s (Olweus, 1973 and Olweus, 1978). After that, considerable variability in the prevalence of bullying among different countries and regions has been reported. Salmivalli et al. (2013) reported 11.6% middle-school students were victims of traditional bullying in Finland. In Ireland, 19.4% of schoolboys reported having been a victim of school bullying at some point in their lives (McMahon et al., 2010). A recent US national study reported a bullying prevalence of 29.9% among a population of school-aged youth (Nansel et al., 2001). The variation in the reported prevalence of bullying could be due to differences in measurement methods, different origins of the studied students and different cultural contexts. Therefore, studies of bullying in a specific region do not automatically apply to other regions. Currently, most of the researches on bullying have been conducted in Europe the United States. The studies in western countries (van der Wal et al., 2003, Kim et al., 2009 and McMahon et al., 2010; Nansel et al., 2012) have provided a foundation for an understanding of the bullying problem and lead to series of intervention efforts in those areas (Ttofi and Farrington, 2011 and Roland and Midthassel, 2012). However, it is insufficient to guide intervention and policy development in China because of different cultural perceptions towards bullying (Griffin and Gross, 2004 and Chen and Avi Astor, 2010). The purpose of this study is to describe the prevalence of bullying in Guangdong province using a sample of Chinese youth in grades 7–12. In addition, the relationships between bullying behaviors (bullying others, being bullied and both) and possible correlates are explored.

3. Results 3.1. Demographic characteristics Table 1 summarizes the demographic of our sample. Overall, a total of 15,686 students finished the questionnaire and returned it. Participating students in sampled classes were excluded if they did not respond to the bullying questions (n=239 students) or if the grade is unknown (n=39 students), yielding a final cohort of 15,408 students. In this cohort, 54.5% of the participants were female. There were 7032 (45.6%) students from secondary school, 5650 (36.7%) from high school and 2726 (17.7%) from occupational school. More than 11,011 (71.5%) participants reported having at least one sibling. 9410 (61.1%) students reported their family social economic status as the medium. The proportions of self-reported academic performance below the 25th percentile, between the 25th and 75th percentile and above the 75th percentile were 28.6%, 36.6% and 34.9%, respectively. The majority of the participants׳ parents had an education level equivalent to secondary school (i.e., 7–12 years). Table 1 presents more detailed demographic information. Table 1. Socio-demographic characteristics of sampled school-aged youths (n=15,408), 2013. Characteristics Male Female Total N % N % N % Grades Secondary school 3463 49.4 3569 42.5 7032 45.6 High school 2389 34.1 3261 38.8 5650 36.7 Occupational school 1161 16.5 1565 18.7 2726 17.7 Siblings 0 2344 33.4 2053 24.5 4397 28.5 1 2838 40.5 3431 40.8 6269 40.7 2 1095 15.6 1736 20.7 2831 18.4 3 or more 736 10.5 1175 14.0 1911 12.4 Family socioeconomic status Low 1046 14.9 1062 12.7 2108 13.7 Medium 4077 58.1 5333 63.5 9410 61.1 High 1890 27.0 2000 23.8 3890 25.2 Academic performance Bad (75th percentile) 2390 34.1 2012 24.0 4402 28.6 Medium (25th–75th percentile) 2296 32.7 3336 39.7 5632 36.5 Good (25th percentile) 2327 33.2 3047 36.3 5374 34.9 Father׳s education ≤6 years 798 11.3 977 11.6 1775 11.5 7–12 years 4787 68.3 5953 70.9 10,740 69.7 ≥13 years 1428 20.4 1462 17.5 2890 18.8 Mother׳s education ≤6 years 1393 19.9 1829 21.8 3222 20.9 7–12 years 4561 65.0 5520 65.7 10,081 65.5 ≥13 years 1057 15.1 1046 12.5 2103 13.6 Table options 3.2. Psychological and behavioral characteristics Table 2 describes the psychological and behavioral characteristics of participants. 2440 (34.8%) male students and 2223 (26.5%) female students reported that they did not have frequent communication with their parents. A total of 3768 (24.5%) students had at least one absence from school in the 30 days prior to the survey. The proportions of school absence in the 30 days prior to the survey were 25% for males and 24% for females. In total, 3842 (26.7%) participants reported having ever used alcohol, of those who ever used alcohol; the proportion of males is significantly higher than that of females. There were 4126 (29.8%) participants reported having ever used tobacco, of those who ever used tobacco, the proportion of males is also significantly higher than that of females. Of the students, 10,489 (68.1%) reported having experienced loneliness. The proportion of feeling loneliness was higher among female participants (73%) than among male participants (62.2%). A total of 1618 (10.5%) students have performed self-harm behaviors, and self-harm behaviors were more common among male students (11.5%) than among female students (9.6%). Of the surveyed students, 2365 (15.3%) had suicidal ideas. Suicidal ideations were more common among female students (16.7%) than among male students (13.8%). In total, 436 (2.8%) students have attempted suicide, and suicide attempts were more common among male (3.1%) than female (2.6%) students. Table 2. Behavioral characteristics of sampled school-aged youths (n=15,408), 2013. Characteristics Male Female Total N % N % N % Communication with parent Frequent communication with parents 4572 65.2 6171 73.5 10,743 69.7 Infrequent communication with parents 2440 34.8 2223 26.5 4663 30.3 School absence in past 30 days (days) 0 5261 75.0 6379 76.0 11,640 75.5 1–2 1390 19.8 1703 20.3 3093 20.1 3–4 195 2.8 179 2.1 374 2.4 5 or more 167 2.4 134 1.6 301 2.0 Alcohol use Never 4306 67.3 6221 78.1 10,527 73.3 Less than once a week 1464 22.9 1463 18.4 2927 17.4 Once or twice a week 309 4.8 145 1.8 454 2.2 Three or more times a week 320 5.0 141 1.8 461 2.0 Tobacco use Never 5793 52.2 7123 81.3 9730 70.2 Less than once a week 3133 34.9 1309 14.9 3155 17.4 Once or twice a week 737 6.0 167 1.9 467 2.2 Three or more times a week 1117 6.9 159 1.8 504 2.0 Loneliness Never 2646 37.7 2268 27.0 4914 31.9 Occasional 3100 44.3 4783 57.0 7883 51.2 Sometimes 455 6.5 627 7.5 1082 7.0 Frequent 808 11.5 716 8.5 1524 9.9 Self-harm behaviors Never 6201 88.4 7587 90.4 13,788 89.5 Occasional 546 7.8 641 7.6 1187 7.7 Sometimes 120 1.7 107 1.3 227 1.5 Frequent 144 2.1 60 0.7 204 1.3 Suicidal ideation No 6047 86.2 6996 83.3 13,043 84.7 Yes 966 13.8 1399 16.7 2365 15.3 Suicide attempt No 6796 96.9 8176 97.4 14,972 97.2 Yes 217 3.1 219 2.6 436 2.8 Regular physical exercise No 3824 54.5 6601 78.6 10,425 67.7 Yes 3186 45.5 1794 21.4 4980 32.3 Table options 3.3. Bullying types and stratified analysis Table 3 presents the distribution of social and behavioral variables stratified by bullying types. Of the students, 1098 (7.1%) reported having bullied other students, 744 (4.8%) reported having been bullied by other students and 396 (2.6%) reported having both bullied other students and been bullied by other students. We also analyzed the bullying types after stratifying by certain characteristics and potential confounders. Generally, male students were more likely to bully (8.1% of all male students), to be bullied (6.5% of all male students) and to both bully and be bullied (3.4% of all male students) than female students (bully: 6.3%, be bullied: 3.5% and both bully and be bullied: 1.9%). Students who reported low family socioeconomic status were more likely to bully (8.9%), to be bullied (5.8%) and to both bully and be bullied (4.2%) than the other corresponding two groups. Students whose academic performance was below the 25th percentile were more likely to bully (8.9%), to be bullied (6.5%) and to both bully and be bullied (3.4%) than those whose academic performance was above the 75th percentile. Students with 5 or more school absences in the past 30 days had significantly higher rates of engaging in all types of bullying behaviors. Alcohol use and tobacco use have complicated relationships with bullying behaviors. A higher proportions of students who reported alcohol use less than once a week or once or twice a week engaged in bullying others compared with students who abstain from alcohol. However, a lower proportion of students who use alcohol more than 3 times a week engaged in bullying others compared with students who abstain from alcohol. Students who consume alcohol more frequently were more likely to be bullied. Students who feel lonely were more likely to engage in all types of bullying behaviors. Students who either have suicidal ideations or have attempted suicide were more likely to engage in all three types of bullying behaviors. Table 3. Bullying distributions in a sample of school-aged youths (n=15,408), 2013. Characteristics Neither bullying nor bullied Bullying Bullied Both bullying and bullied N % N % N % N % Gender Male 5749 82.0 571 8.1 453 6.5 240 3.4 Female 7421 88.4 527 6.3 291 3.5 156 1.9 Family socioeconomic status Low 1712 81.1 188 8.9 122 5.8 88 4.2 Medium 8144 86.5 647 6.9 410 4.4 215 2.3 High 3321 85.4 264 6.8 212 5.4 93 2.4 Academic performance Bad (75th percentile) 3571 81.1 394 8.9 287 6.5 151 3.4 Medium (25th–75th percentile) 4914 87.2 361 6.4 229 4.1 133 2.4 Good (25th percentile) 4692 87.3 344 6.4 228 4.2 112 2.1 School absence in past 30 days (days) 0 10,072 86.5 791 6.8 518 4.4 265 2.3 1–2 2588 83.6 251 8.1 162 5.2 94 3.0 3–4 312 83.4 24 6.4 26 7.0 12 3.2 5 or more 205 68.1 33 11.0 38 12.6 25 8.3 Alcohol use Never 9362 86.9 726 6.7 457 4.2 232 2.2 Less than once a week 2366 80.5 246 8.4 215 7.3 114 3.9 Once or twice a week 246 76.8 24 7.5 40 12.6 10 3.1 Three or more times a week 255 77.4 19 5.7 40 12.3 15 4.6 Tobacco use Never 5793 79.8 541 7.5 553 7.6 369 5.1 Less than once a week 3133 76.6 357 8.7 415 10.1 184 4.5 Once or twice a week 737 71.1 35 3.3 207 20.0 58 5.6 Three or more times a week 1117 75.8 92 6.3 207 14.1 58 3.9 Loneliness Never 4460 90.7 197 4.0 204 4.1 55 1.1 Occasional 6760 85.7 592 7.5 357 4.5 179 2.3 Sometimes 817 75.4 136 12.6 79 7.3 51 4.7 Frequent 1137 74.6 173 11.4 103 6.8 111 7.3 Self-harm behaviors Never 12,070 87.5 855 6.2 594 4.3 276 2.0 Occasional 840 70.7 181 15.2 103 8.7 64 5.4 Sometimes 167 73.6 25 11.0 22 9.7 13 5.7 Frequent 98 48.0 38 18.6 25 12.3 43 21.1 Suicidal ideation No 11,500 88.1 760 5.8 562 4.3 227 1.7 Yes 1677 70.8 339 14.3 182 7.7 169 7.1 Suicide attempt No 12,931 86.3 1018 6.8 703 4.7 328 2.2 Yes 246 56.4 81 18.6 41 9.4 68 15.6 Regular physical exercise No 9015 86.4 726 7.0 442 4.2 248 2.4 Yes 4159 83.5 373 7.5 302 6.1 148 3.0 Table options 3.4. Multinomial logistic regression results Table 4 presents the results from the multinomial logistic regression of students who bullied, were bullied and both were bullied and bullied others. We used the group of students who reported having never been bullied nor bullying other students as the reference group. Table 4. Correlates of bullying using multinomial logistic regression models (n=15,408), 2013. Characteristics Bullies Bullied Both bullying and bullied OR 95% CI ORa 95% CI OR 95% CI ORa 95% CI OR 95% CI ORa 95% CI Gender Female 1 1 1 1 1 1 Male 1.40 1.24, 1.58 1.38 1.18, 1.61 2.00 1.73, 2.34 1.70 1.42, 2.04 1.99 1.62, 2.44 2.10 1.63, 2.71 Family socioeconomic status Low 1 1 1 1 1 1 Medium 0.72 0.61, 0.88 0.92 0.75, 1.13 0.71 0.57, 0.87 0.86 0.68, 1.10 0.51 0.40, 0.66 0.92 0.67, 1.28 High 0.72 0.60, 0.88 0.90 0.71, 1.15 0.90 0.71, 1,13 1.03 0.79, 1.34 0.54 0.40, 0.73 1.02 0.70, 1.47 Academic performance Bad (75th percentile) 1 1 1 1 1 1 Medium (25th–75th percentile) 0.67 0.57, 0.77 0.77 0.65, 0.92 0.58 0.58, 0.69 0.69 0.56, 0.85 0.64 0.50, 0.81 0.77 0.58, 1.02 Good (25th percentile) 0.66 0.57, 0.77 0.80 0.67, 0.97 0.60 0.51, 0.72 0.73 0.60, 0.90 0.56 0.44, 0.72 0.69 0.52, 0.93 School absence in past 30 days (days) 0 1 1 1 1 1 1 1–2 1.23 1.06, 1.43 1.07 0.90, 1.28 1.22 1.01, 1.46 1.03 0.84, 1.27 1.38 1.09, 1.75 1.02 0.77, 1.36 3–4 0.98 0.64, 1.49 0.71 0.43, 1.16 1.62 1.08, 2.44 1.15 0.72, 1.82 1.46 0.81, 2.64 0.87 0.44, 1.72 5 or more 2.05 1.41, 2.98 1.23 0.76, 2.00 3.60 2.52, 5.15 2.13 1.38, 3.28 4.64 3.01, 7.14 1.32 0.69, 2.54 Alcohol use Never 1 1 1 1 1 1 Less than once a week 0.96 0.56, 1.63 1.15 0.97, 1.37 1.86 1.54, 2.25 1.59 1.31, 1.93 1.94 1.50, 2.50 1.50 1.15, 1.95 Once or twice a week 1.26 0.78, 2.03 0.95 0.58, 1.55 3.36 2.28, 4.95 2.43 1.63, 3.63 1.65 0.80, 3.40 0.92 0.43, 1.94 Three or more times per week 1.34 1.13, 1.59 0.77 0.44, 1.32 3.24 2.20, 4.78 2.49 1.67, 3.72 2.39 1.31, 4.36 1.53 0.81, 2.88 Tobacco use Never 1 1 1 Less than once a week 1.22 0.76, 1.97 NA 1.39 0.88, 2.19 NA 0.92 0.50, 1.72 NA Once or twice a week 0.50 0.15, 1.66 NA 2.95 1.62, 5.38 NA 1.23 0.46, 3.26 NA Three or more times per week 0.88 0.40, 1.93 NA 1.94 1.08, 3.49 NA 0.81 0.31, 2.13 NA Loneliness Never 1 1 1 1 1 1 Occasional 1.98 1.68, 2.34 1.93 1.58, 2.35 1.15 0.97, 1.38 1.19 0.97, 1.46 2.15 1.58, 2.91 2.36 1.64, 3.40 Sometimes 3.77 2.99, 4.75 2.76 2.08, 3.06 2.11 1.61, 2.77 1.85 1.36, 2.52 5.06 3.43, 7.46 3.51 2.18, 5.66 Frequent 3.44 2.78, 4.27 2.08 1.58, 2.74 1.98 1.55, 2.53 1.21 0.89, 1.64 7.92 5.69, 11.01 3.62 2.36, 5.57 Self-harm behaviors Never 1 1 1 1 1 1 Occasional 3.04 2.55, 3.62 1.93 1.58, 2.39 2.49 2.00, 3.11 1.63 1.25, 2.12 3.33 2.52, 4.41 1.47 1.04, 2.08 Sometimes 2.11 1.38, 3.24 1.14 0.70, 1.85 2.68 1.70, 4.21 1.08 0.60, 1.92 3.40 1.91, 6.06 0.84 0.41, 1.75 Frequent 5.47 3.74, 8.01 1.30 0.73, 2.31 5.18 3.32, 8.10 1.78 0.99, 3.20 19.19 13.15, 28.00 1.96 1.06, 3.64 Suicidal ideation No 1 1 1 1 1 1 Yes 3.06 2.66, 3.51 1.97 1.64, 2.38 2.22 1.86, 2.65 1.73 1.39, 2.17 5.11 4.16, 6.27 2.70 2.03, 3.60 Suicide attempt No 1 1 1 1 1 1 Yes 4.18 3.23, 5.42 1.47 1.02, 2.11 3.07 2.18, 4.30 1.01 0.64, 1.61 10.90 8.15, 14.56 2.35 1.50, 3.68 Regular physical exercise No 1 1 1 1 1 1 Yes 1.11 0.98, 1.27 1.18 1.00, 1.38 1.48 1.27, 1.72 1.36 1.14, 1.62 1.29 1.05, 1.59 1.09 0.84, 1.41 The reference group is students who neither bullied nor were bullies; NA: Not applicable a Adjusted OR. Table options 3.4.1. Bullies After adjusting for potential confounders, significantly more boys than girls were bullies (OR=1.38, 95% CI: 1.18, 1.61). Better academic performance was inversely associated with bullies. Self-reported loneliness and self-harm behaviors were positively associated with bullies. Either suicidal ideations or suicide attempts were also positively associated with bullies. One interesting finding is that regular exercise was also positively associated with bullies. 3.4.2. Be bullied After adjusting for potential confounders, boys were more likely to be bullied than girls (OR=1.70, 95% CI: 1.42, 2.04). Similar to bullies, better academic performance was a protective factor for being bullied. School absence for more than 5 days in the prior 30 days was positively associated with being bullied (OR=2.13, 95% CI: 1.38, 3.28). However, this relationship was not statistically significant for categories with fewer school absences. Alcohol use was positively associated with being bullied by others. Suicidal ideations were significantly associated with being bullied. Again, regular exercise was also positively associated with being bullied. 3.4.3. Bullied students who also bullied others Students who both bullied and were bullied by others were significantly more likely to be boys, experience loneliness and have suicidal ideations and suicide attempts. Students who reported alcohol use of less than once a week were also more likely to both be bullied by and bully others. For more detailed information can be found in Table 4.