Suqian Duan: Suzhou Guangji Hospital, Affiliated Guangji Hospital of Soochow University, Soochow University, Suzhou, China; Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
Zhizhou Duan: The National Clinical Research Center for Mental Disorders, Beijing Key Laboratory of Mental Disorders & Advanced Innovation Center for Human Brain Protection, Beijing Anding Hospital, Capital Medical University, Beijing, China; School of Public Health, Wuhan University, Wuhan, China.
Runsen Chen: The National Clinical Research Center for Mental Disorders, Beijing Key Laboratory of Mental Disorders & Advanced Innovation Center for Human Brain Protection, Beijing Anding Hospital, Capital Medical University, Beijing, China; Department of Psychiatry, University of Oxford, Oxford, UK. Electronic address: runsen.chen@psych.ox.ac.uk.
INTRODUCTION: Prior work suggests that involvement in bullying was associated with a higher suicide risk among adolescents. However, the mechanisms of this association remain unclear. The present study aimed to understand the relationship between direct and indirect involvement in bullying (bullying victimization, bullying perpetration and bullying witnessing) and suicide risk by examining the serial mediation of negative coping styles and depressive symptoms. METHODS: 12,354 Chinese adolescents (mean age = 15.00, 54% male) were recruited from December 2018 to January 2019 in 18 secondary schools. Participants completed questionnaires that measured their direct and indirect involvement in bullying, negative coping styles, depressive symptoms, and suicide risk. RESULTS: The relationship between involvement in bullying and suicide risk was mediated by negative coping styles, depressive symptoms, and also serially mediated by negative coping styles and depressive symptoms. Similar findings were obtained for both direct and indirect involvement in bullying. LIMITATIONS: The present study is limited by a cross-sectional design. Future studies could examine longitudinal changes in the outcome measures CONCLUSIONS: Given the urgent need to reduce the high suicide rate among adolescents in China, our findings suggest that having a less negative coping style is an important protective factor. These results provide direction for the development of prevention strategies and targeted interventions within this population. Additionally, it is essential to develop prevention strategies and interventions not only for those who have been a victim or perpetrator of bullying, but also for those who have witnessed bullying.
