Association between bullying behaviors and risk of non-suicidal self-injuries among adolescents: a meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

TANG Hanmei ¹ ^# , CHEN Xiaolong ¹ ^# , LU Feiteng ² , FU Yanyan ¹ , HU Wang ¹ , ZHAN Wenyun ³ ,  HUANG Peng ^1,4

1. Department of Epidemiology, School of Public Health, Nanchang University, Nanchang, 330006, P.R.China;
2. The Second Clinical Medical College, Nanchang University, Nanchang, 330006, P.R.China;
3. School of Nursing, Jiangxi University of Technology, Nanchang, 330098, P.R.China;
4. Jiangxi Province Key Laboratory of Preventive Medicine, Nanchang, 330006, P.R.China;

Corresponding author：

HUANG Peng, Email: huangpengncu@163.com

Keywords：

Bullying; Non-suicidal self-injury; Adolescents; Meta-analysis

DOI：

10.7507/1672-2531.201711070

Video：

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ObjectivesTo systematically review the association between bullying and risk of non-suicidal self-injury among adolescents.MethodsPubMed, MEDLINE, EMbase, The Cochrane Library, CNKI and WanFang Data were searched from inception to September 1^st 2017 to collect studies on the association between bullying and non-suicidal self-injuries. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies by Agency for Healthcare Research and Quality (AHRQ). Then, meta-analysis was performed using CMA 2.2 software.ResultsA total of 23 studies involving 18 819 participates were finally included. The results of meta-analysis showed that bullying victims reported more NSSI than uninvolved adolescents (OR=2.41, 95%CI 1.96 to 2.96, P<0.001). The bullying perpetrators reported more NSSI than uninvolved adolescents (OR=2.26, 95%CI 1.39 to 3.68,P=0.001). Individuals acting as both victims and perpetrators could also increase risks of NSSI (OR=2.76, 95%CI 1.17 to 6.51, P=0.02). Using meta-regression, it was found that the relation between NSSI and bullying victimization was significantly moderated by age, with studies in which respondents were younger reporting larger effect sizes than studies in which respondents were older (B=–0.33, 95%CI –0.38 –0.28, P<0.001).ConclusionsThe current study demonstrates that involvement in bullying in any capacity is associated with non-suicidal self-injuries. Due to the limitation of research, more studies are required to verify above conclusions.

Citation： TANG Hanmei, CHEN Xiaolong, LU Feiteng, FU Yanyan, HU Wang, ZHAN Wenyun, HUANG Peng. Association between bullying behaviors and risk of non-suicidal self-injuries among adolescents: a meta-analysis. Chinese Journal of Evidence-Based Medicine, 2018, 18(7): 707-714. doi: 10.7507/1672-2531.201711070 Copy

1.	Kocsis RN. Diagnostic and statistical manual of mental disorders fifth edition (DSM-V). Int J Offender Ther Comp Criminol, 2013, 57(12): 1546-1548.
2.	Cassels M, Wilkinson P. Non-suicidal self-injury in adolescence. Paediatr Child Health, 2016, 26(12): 554-558.
3.	Swannell SV, Martin GE, Page A, et al. Prevalence of nonsuicidal self-injury in nonclinical samples: systematic review, meta-analysis and meta-regression. Suicide Life Threat Behav, 2014, 44(3): 273-303.
4.	梁素改, 闫敬, 朱翠珍, 等. 非自杀性自伤与自杀未遂的中学生人格特征分析. 四川大学学报∙医学版, 2014, 45(6): 970-973.
5.	梁素改, 闫敬, 朱翠珍, 等. 中学生非自杀性自伤的危险因素研究. 中华行为医学与脑科学杂志, 2014, 23(11): 1013-1016.
6.	王蕾, 孙月吉, 林媛, 等. 大连市 1463 名初中生非自杀自我伤害行为的流行病学调查. 中华行为医学与脑科学杂志, 2012, 21(2): 177-180.
7.	闫敬, 朱翠珍, 司徒明镜, 等. 四川省 1312 名中学生非自杀性自伤行为检出率及其危险因素研究. 中华流行病学杂志, 2012, 33(1): 46-49.
8.	Salmivalli C. Bullying and the peer group: a review. Aggress Violent Behav, 2010, 15(2): 112-120.
9.	Reynolds P. Agency for healthcare research and quality. Am J Phys Med Rehabil, 2005, 84(12): 1034-1035.
10.	Hay C, Meldrum R. Bullying victimization and adolescent self-harm: testing hypotheses from general strain theory. J Youth Adolesc, 2010, 39(5): 446-459.
11.	张欣艺. 卷入欺负与自我伤害行为初中生的注意偏向和攻击性研究. 济宁: 曲阜师范大学, 2016.
12.	Annerback EM, Sahlqvist L, Wingren G. A cross-sectional study of victimisation of bullying among schoolchildren in Sweden: background factors and self-reported health complaints. Scand J Public Health, 2014, 42(3): 270-277.
13.	Baiden P, Stewart SL, Fallon B. The mediating effect of depressive symptoms on the relationship between bullying victimization and non-suicidal self-injury among adolescents: Findings from community and inpatient mental health settings in Ontario, Canada. Psychiatry Res, 2017, 255: 238-247.
14.	Bakken NW, Gunter WD. Self-cutting and suicidal ideation among adolescents: gender differences in the causes and correlates of self-injury. Deviant Behavior, 2012, 33(5): 339-356.
15.	Christoffersen MN, Mohl B, Depanfilis D, et al. Non-suicidal self-injury-does social support make a difference? An epidemiological investigation of a Danish national sample. Child Abuse Negl, 2015, 44: 106-116.
16.	Claes L, Luyckx K, Baetens I, et al. Bullying and victimization, depressive mood, and non-suicidal self-injury in adolescents: the moderating role of parental support. J Child Fam Stud, 2015, 24(11): 3363-3371.
17.	Eisenberg ME, Mcmorris BJ, Gower AL, et al. Bullying victimization and emotional distress: is there strength in numbers for vulnerable youth? J Psychosom Res, 2016, 86: 13-19.
18.	Giletta M, Scholte RH, Engels RC, et al. Adolescent non-suicidal self-injury: a cross-national study of community samples from Italy, the Netherlands and the United States. Psychiatry Res, 2012, 197(1): 66-72.
19.	Hamada S, Kaneko H, Ogura M, et al. Association between bullying behavior, perceived school safety, and self-cutting: a Japanese population-based school survey. Child Adolesc Ment Health, 2016, 13(1): 1-7.
20.	Jantzer V, Haffner J, Parzer P, et al. Does parental monitoring moderate the relationship between bullying and adolescent nonsuicidal self-injury and suicidal behavior? A community-based self-report study of adolescents in Germany. BMC Public Health, 2015, 15: 583-591.
21.	Jiang Y, You J, Hou Y, et al. Buffering the effects of peer victimization on adolescent non-suicidal self-injury: The role of self-compassion and family cohesion. J Adolesc, 2016, 53: 107-115.
22.	Junker A, Bjorngaard JH, Bjerkeset O. Adolescent health and subsequent risk of self-harm hospitalisation: a 15-year follow-up of the Young-HUNT cohort. Child Adolesc Psychiatry Ment Health, 2017, 11: 25-33.
23.	Jutengren G, Kerr M, Stattin H. Adolescents' deliberate self-harm, interpersonal stress, and the moderating effects of self-regulation: a two-wave longitudinal analysis. J Sch Psychol, 2011, 49(2): 249-264.
24.	Landstedt E, Gillander Gadin K. Deliberate self-harm and associated factors in 17-year-old Swedish students. Scand J Public Health, 2011, 39(1): 17-25.
25.	Mccauley HL, Montano G, Miller E. Bullying and childhood adversity as predictors of non-suicidal self-Injury among sexual minority adolescents in the healthy allegheny teen survey. J Adolesc Health, 2016, 58(2): S105-S106.
26.	Mcmahon EM, Reulbach U, Keeley H, et al. Bullying victimisation, self harm and associated factors in Irish adolescent boys. Soc Sci Med, 2010, 71(7): 1300-1307.
27.	Noble RN, Sornberger MJ, Toste JR, et al. Safety first: the role of trust and school safety in non-suicidal self-injury. McGill J Educ, 2011, 46(3): 423-443.
28.	O'connor RC, Rasmussen S, Hawton K. Adolescent self-harm: a school-based study in Northern Ireland. J Affect Disord, 2014, 159: 46-52.
29.	O'connor RC, Rasmussen S, Miles J, et al. Self-harm in adolescents: self-report survey in schools in Scotland. Br J Psychiatry, 2009, 194(1): 68-72.
30.	Thomas HJ, Connor JP, Lawrence DM, et al. Prevalence and correlates of bullying victimisation and perpetration in a nationally representative sample of Australian youth. Aust N Z J Psychiatry, 2017, 51(9): 909-920.
31.	Wu J, He Y, Lu C, et al. Bullying behaviors among Chinese school-aged youth: a prevalence and correlates study in Guangdong Province. Psychiatry Res, 2015, 225(3): 716-722.
32.	Xavier A, Pinto-Gouveia J, Cunha M, et al. Self-criticism and depressive symptoms mediate the relationship between emotional experiences with family and peers and self-injury in adolescence. J Psychol, 2016, 0(0): 1-16.
33.	Vrouva I, Fonagy P, Fearon PR, et al. The risk-taking and self-harm inventory for adolescents: development and psychometric evaluation. Psychol Assess, 2010, 22(4): 852-865.
34.	Sansone RA, Wiederman MW, Sansone LA. The self-harm inventory (SHI): development of a scale for identifying self-destructive behaviors and borderline personality disorder. J Clin Psychol, 1998, 54(7): 973-983.
35.	Lundh LG, Karim J, Quilisch E. Deliberate self-harm in 15-year-old adolescents: a pilot study with a modified version of the deliberate self-harm inventory. Scand J Psychol, 2007, 48(1): 33-41.
36.	冯玉. 青少年自我伤害行为与个体情绪因素和家庭环境因素的关系. 武汉: 华中师范大学, 2008.
37.	Fox KR, Franklin JC, Ribeiro JD, et al. Meta-analysis of risk factors for nonsuicidal self-injury. Clin Psychol Rev, 2015, 42: 156-167.
38.	Muehlenkamp J, Brausch A, Quigley K, et al. Interpersonal features and functions of nonsuicidal self-injury. Suicide Life Threat Behav, 2013, 43(1): 67-80.
39.	Malhi P, Bharti B, Sidhu M. Aggression in schools: psychosocial outcomes of bullying among Indian adolescents. Indian J Pediatr, 2014, 81(11): 1171-1176.
40.	Scholte RH, Burkn WJ, Overbeek, G. Divergence in self- and peer-reported victimization and its association to concurrent and prospective adjustment. J Youth Adolesc, 2013, 42(12): 1789-1800.
41.	van Geel M, Goemans A, Vedder P. A meta-analysis on the relation between peer victimization and adolescent non-suicidal self-injury. Psychiatry Res, 2015, 230(2): 364-368.

1. Kocsis RN. Diagnostic and statistical manual of mental disorders fifth edition (DSM-V). Int J Offender Ther Comp Criminol, 2013, 57(12): 1546-1548.
2. Cassels M, Wilkinson P. Non-suicidal self-injury in adolescence. Paediatr Child Health, 2016, 26(12): 554-558.
3. Swannell SV, Martin GE, Page A, et al. Prevalence of nonsuicidal self-injury in nonclinical samples: systematic review, meta-analysis and meta-regression. Suicide Life Threat Behav, 2014, 44(3): 273-303.
4. 梁素改, 闫敬, 朱翠珍, 等. 非自杀性自伤与自杀未遂的中学生人格特征分析. 四川大学学报∙医学版, 2014, 45(6): 970-973.
5. 梁素改, 闫敬, 朱翠珍, 等. 中学生非自杀性自伤的危险因素研究. 中华行为医学与脑科学杂志, 2014, 23(11): 1013-1016.
6. 王蕾, 孙月吉, 林媛, 等. 大连市 1463 名初中生非自杀自我伤害行为的流行病学调查. 中华行为医学与脑科学杂志, 2012, 21(2): 177-180.
7. 闫敬, 朱翠珍, 司徒明镜, 等. 四川省 1312 名中学生非自杀性自伤行为检出率及其危险因素研究. 中华流行病学杂志, 2012, 33(1): 46-49.
8. Salmivalli C. Bullying and the peer group: a review. Aggress Violent Behav, 2010, 15(2): 112-120.
9. Reynolds P. Agency for healthcare research and quality. Am J Phys Med Rehabil, 2005, 84(12): 1034-1035.
10. Hay C, Meldrum R. Bullying victimization and adolescent self-harm: testing hypotheses from general strain theory. J Youth Adolesc, 2010, 39(5): 446-459.
11. 张欣艺. 卷入欺负与自我伤害行为初中生的注意偏向和攻击性研究. 济宁: 曲阜师范大学, 2016.
12. Annerback EM, Sahlqvist L, Wingren G. A cross-sectional study of victimisation of bullying among schoolchildren in Sweden: background factors and self-reported health complaints. Scand J Public Health, 2014, 42(3): 270-277.
13. Baiden P, Stewart SL, Fallon B. The mediating effect of depressive symptoms on the relationship between bullying victimization and non-suicidal self-injury among adolescents: Findings from community and inpatient mental health settings in Ontario, Canada. Psychiatry Res, 2017, 255: 238-247.
14. Bakken NW, Gunter WD. Self-cutting and suicidal ideation among adolescents: gender differences in the causes and correlates of self-injury. Deviant Behavior, 2012, 33(5): 339-356.
15. Christoffersen MN, Mohl B, Depanfilis D, et al. Non-suicidal self-injury-does social support make a difference? An epidemiological investigation of a Danish national sample. Child Abuse Negl, 2015, 44: 106-116.
16. Claes L, Luyckx K, Baetens I, et al. Bullying and victimization, depressive mood, and non-suicidal self-injury in adolescents: the moderating role of parental support. J Child Fam Stud, 2015, 24(11): 3363-3371.
17. Eisenberg ME, Mcmorris BJ, Gower AL, et al. Bullying victimization and emotional distress: is there strength in numbers for vulnerable youth? J Psychosom Res, 2016, 86: 13-19.
18. Giletta M, Scholte RH, Engels RC, et al. Adolescent non-suicidal self-injury: a cross-national study of community samples from Italy, the Netherlands and the United States. Psychiatry Res, 2012, 197(1): 66-72.
19. Hamada S, Kaneko H, Ogura M, et al. Association between bullying behavior, perceived school safety, and self-cutting: a Japanese population-based school survey. Child Adolesc Ment Health, 2016, 13(1): 1-7.
20. Jantzer V, Haffner J, Parzer P, et al. Does parental monitoring moderate the relationship between bullying and adolescent nonsuicidal self-injury and suicidal behavior? A community-based self-report study of adolescents in Germany. BMC Public Health, 2015, 15: 583-591.
21. Jiang Y, You J, Hou Y, et al. Buffering the effects of peer victimization on adolescent non-suicidal self-injury: The role of self-compassion and family cohesion. J Adolesc, 2016, 53: 107-115.
22. Junker A, Bjorngaard JH, Bjerkeset O. Adolescent health and subsequent risk of self-harm hospitalisation: a 15-year follow-up of the Young-HUNT cohort. Child Adolesc Psychiatry Ment Health, 2017, 11: 25-33.
23. Jutengren G, Kerr M, Stattin H. Adolescents' deliberate self-harm, interpersonal stress, and the moderating effects of self-regulation: a two-wave longitudinal analysis. J Sch Psychol, 2011, 49(2): 249-264.
24. Landstedt E, Gillander Gadin K. Deliberate self-harm and associated factors in 17-year-old Swedish students. Scand J Public Health, 2011, 39(1): 17-25.
25. Mccauley HL, Montano G, Miller E. Bullying and childhood adversity as predictors of non-suicidal self-Injury among sexual minority adolescents in the healthy allegheny teen survey. J Adolesc Health, 2016, 58(2): S105-S106.
26. Mcmahon EM, Reulbach U, Keeley H, et al. Bullying victimisation, self harm and associated factors in Irish adolescent boys. Soc Sci Med, 2010, 71(7): 1300-1307.
27. Noble RN, Sornberger MJ, Toste JR, et al. Safety first: the role of trust and school safety in non-suicidal self-injury. McGill J Educ, 2011, 46(3): 423-443.
28. O'connor RC, Rasmussen S, Hawton K. Adolescent self-harm: a school-based study in Northern Ireland. J Affect Disord, 2014, 159: 46-52.
29. O'connor RC, Rasmussen S, Miles J, et al. Self-harm in adolescents: self-report survey in schools in Scotland. Br J Psychiatry, 2009, 194(1): 68-72.
30. Thomas HJ, Connor JP, Lawrence DM, et al. Prevalence and correlates of bullying victimisation and perpetration in a nationally representative sample of Australian youth. Aust N Z J Psychiatry, 2017, 51(9): 909-920.
31. Wu J, He Y, Lu C, et al. Bullying behaviors among Chinese school-aged youth: a prevalence and correlates study in Guangdong Province. Psychiatry Res, 2015, 225(3): 716-722.
32. Xavier A, Pinto-Gouveia J, Cunha M, et al. Self-criticism and depressive symptoms mediate the relationship between emotional experiences with family and peers and self-injury in adolescence. J Psychol, 2016, 0(0): 1-16.
33. Vrouva I, Fonagy P, Fearon PR, et al. The risk-taking and self-harm inventory for adolescents: development and psychometric evaluation. Psychol Assess, 2010, 22(4): 852-865.
34. Sansone RA, Wiederman MW, Sansone LA. The self-harm inventory (SHI): development of a scale for identifying self-destructive behaviors and borderline personality disorder. J Clin Psychol, 1998, 54(7): 973-983.
35. Lundh LG, Karim J, Quilisch E. Deliberate self-harm in 15-year-old adolescents: a pilot study with a modified version of the deliberate self-harm inventory. Scand J Psychol, 2007, 48(1): 33-41.
36. 冯玉. 青少年自我伤害行为与个体情绪因素和家庭环境因素的关系. 武汉: 华中师范大学, 2008.
37. Fox KR, Franklin JC, Ribeiro JD, et al. Meta-analysis of risk factors for nonsuicidal self-injury. Clin Psychol Rev, 2015, 42: 156-167.
38. Muehlenkamp J, Brausch A, Quigley K, et al. Interpersonal features and functions of nonsuicidal self-injury. Suicide Life Threat Behav, 2013, 43(1): 67-80.
39. Malhi P, Bharti B, Sidhu M. Aggression in schools: psychosocial outcomes of bullying among Indian adolescents. Indian J Pediatr, 2014, 81(11): 1171-1176.
40. Scholte RH, Burkn WJ, Overbeek, G. Divergence in self- and peer-reported victimization and its association to concurrent and prospective adjustment. J Youth Adolesc, 2013, 42(12): 1789-1800.
41. van Geel M, Goemans A, Vedder P. A meta-analysis on the relation between peer victimization and adolescent non-suicidal self-injury. Psychiatry Res, 2015, 230(2): 364-368.

Chinese Journal of Evidence-Based Medicine

Association between bullying behaviors and risk of non-suicidal self-injuries among adolescents: a meta-analysis

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