School bullying and its association with psychological wellbeing: Findings of the Fujian Adolescent Mental Wellness Study (FAMWeS)

BACKGROUND: School bullying is becoming a prevalent phenomenon in China, posing a growing threat to the psychological well-being of children and adolescents. This study aims to examine bullying victimization and bullying behavior using data from FAMWeS (the Fujian Adolescent Mental Wellness Study), and how they impact emotional state and psychological distress.

METHOD: The study conducted in entire Fujian Province, China, involved a cross-sectional questionnaire survey on adolescent students from secondary and high schools, employing multi-stage stratified cluster sampling methods from May to July 2023. Primary outcome measures were bullying victimization and bullying behavior. Emotional state was evaluated using the Depression, Anxiety, and Stress Scale for Youth (DASS-Y), and psychological distress was assessed using the General Health Questionnaire-12 (GHQ-12).

RESULTS: Analysis of 53,157 valid responses revealed that 19.4% of respondents reported being victims of bullying, 9.9% reported engaging in bullying behavior, and 8.2% reported experiencing both bullying victimization and engaging in bullying themselves. A minority were found to have depressive (19.1%), anxiety (22.0%), and stress (9.2%) symptoms. The presence of psychological distress was observed in 54.4% of the participants (GHQ score of 3-12). Significant associations were found between bullying victimization and the DASS-Y subscales of depression, anxiety, and stress. Odds ratios indicated a 1.73 times higher likelihood for depression (OR 1.73, 95% CI 1.521.96), 2.24 times higher for anxiety (OR 2.24, 95% CI 1.96-2.55), and 1.59 times higher for stress (OR 1.59, 95% CI 1.38-1.84). Similarly, psychological distress measured by the GHQ was significantly associated with bullying victimization (OR 1.77, 95% CI 1.68-1.86). Bullying behavior also showed significant associations with all DASS-Y subscales and psychological distress. Geographic disparities revealed varying rates across districts, while factors such as age, academic performance, and parental education emerged as significant influences on bullying victimization and behavior.

CONCLUSION: The findings underscore a concerning prevalence of bullying victimization and behavior, highlighting the critical need for comprehensive anti-bullying strategies that address both victimization and perpetration dynamics. There is also a clear need for interventions targeting socio-economic disparities across various geographic regions.