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Association Between Bullying and Suicidal Behavior Among Chinese Adolescents: An Analysis of Gender Differences

Authors Yang T, Guo L, Hong F, Wang Z, Yu Y, Lu C

Received 20 August 2019

Accepted for publication 3 December 2019

Published 17 January 2020 Volume 2020:13 Pages 89—96


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Professor Igor Elman

Tingting Yang, 1 Lan Guo, 2 Feng Hong, 1 Ziyun Wang, 1 Yao Yu, 3 Ciyong Lu 2

1School of Public Health, The Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang 550025, People’s Republic of China; 2Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, People’s Republic of China; 3The Affiliated Hospital of Guizhou Medical University, Guiyang 550004, People’s Republic of China

Correspondence: Ciyong Lu
Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, People’s Republic of China
Tel +86-20-87332477

Background: Suicide has become the leading cause of death among 15– 34 years old in China, and more attention should be paid to risk factors and prevention of suicidal ideation and suicide attempts. The school-based survey was conducted to test the associations of bullying behavior with suicidal ideation and suicide attempts, and to assess whether the biological gender can moderate these associations.
Methods: A multistage stratified cluster sampling method was used to recruit participants from high schools in Guizhou, China, and univariate and multivariate logistic regression models were fitted.
Results: A total of 23,392 students were included in the analysis, and 45.4% were boys. The mean age of the students was 15.2 (SD: 1.9) years. Overall, 3.8% (882) of the students were victims, 4.9% (1144) were bullies, and 3.2% (736) were bully-victims. A total of 18.9% of students reported having suicidal ideation, and 3.9% reported having suicide attempts. Victims (adjusted odds ratio [AOR]=2.15, 95% CI=1.84– 2.51), bullies (AOR=3.17, 95% CI=2.78– 3.62), and bully-victims (AOR=3.18, 95% CI=2.71– 3.73) were at an elevated risk of suicidal ideation than neutrals; similar associations can be found in the associations between bullying behavior and suicide attempts. Further stratification analyses showed that the associations of being bullied or bullying others with suicidal ideation and suicide attempts were slightly stronger in girls than in boys.
Conclusion: Prevention or intervention programs are recommended to take the biological gender into consideration, and future studies are also warranted to investigate the reasons of differences by gender in the association of bullying and suicidal behavior.

Keywords: bullying behavior, suicidal ideation, Chinese adolescents, gender difference

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