Sensitive periods for the effect of bullying victimization on suicidal behaviors among university students in China: The roles of timing and chronicity.

OBJECTIVE

To examine whether timing and chronicity of bullying victimization (BV) play a significant role in linking exposure to BV to suicidal behaviors in university students.

METHODS

A multistage stratification sampling method was used to select a sample of 4034 university students (18-23 years, mean age 20.38±1.35 years, 41.9% female). We used latent class analysis and developmental-stage-based characterizations of BV timing and chronicity to explore the sensitive periods for the effect of BV on suicidal behaviors.

RESULTS

The prevalence rates of suicidal ideation, plans and attempts among our study participants were 9.9%, 3.0% and 1.3%, respectively. BV during primary school (OR = 2.12, 95% CI: 1.55-2.90) and secondary school (OR = 2.65, 95% CI: 1.80-3.90) was associated with suicidal ideation among university students. We identified four classes of life-course BV experiences (low BV, 73.8%; moderate BV, 18.6%; secondary school BV, 4.4% and persistent BV, 3.2%). Persistent BV was associated with 2.50 times (95% CI: 1.56-3.98), 2.98 times (95% CI: 1.48-6.02), and 6.13 times (95% CI: 2.48-15.14) higher risk of suicide ideation, plans, and attempts, respectively. Both moderate BV (OR = 1.75, 95% CI: 1.35-2.26) and secondary school BV (OR=2.01, 95% CI: 1.29-3.12) were positively correlated with suicidal ideation. Furthermore, there was a dose-response relationship between the number of periods of BV and suicidal behaviors.

LIMITATIONS

This study was a cross-sectional study based on self-reported measures, especially BV experiences in each school stage.

CONCLUSIONS

This study identifies sensitive periods for the effect of BV on suicidal behaviors among university students in China.