Department of Health Service & Population Research, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
ESRC Centre for Society and Mental Health, King's College London, London, UK.
J Adolesc. 2023 Jan;95(1):5-33. doi: 10.1002/jad.12097. Epub 2022 Oct 9.
Bullying victimization has consistently been highlighted as a risk factor for self-injurious thoughts and behaviors (SITBs) in young people. This systematic review of prospective, community-based studies explored associations between bullying victimization (traditional/face-to-face and cyber) across the full spectrum of self-harm and suicidality, in children and young people aged up to (and including) 25 years. Importantly, associations by sex/gender were explored.
MEDLINE, Embase, PsycINFO, CINAHL and Scopus were searched for articles meeting the inclusion criteria. Articles were screened by title, abstract and full text. Quality appraisal was performed using the Newcastle-Ottawa Scale for cohort studies. Data were synthesized narratively. The protocol is registered on PROSPERO (CRD42021261916) and followed PRISMA 2020 guidelines.
A total of 35 papers were included, across 17 countries. Results were presented by bullying type: traditional/face-to-face (n = 25), cyber (n = 7) and/or an aggregate of both types (n = 7). Outcomes included suicidal ideation (n = 17), self-harm (n = 10), suicide attempt (n = 4), NSSI (n = 4), other (n = 7). Studies measured outcomes in under 18s (n = 24), 18-25-year-olds (n = 8) and both under 18s and 18-25-year-olds (n = 3). Studies exploring the role of sex/gender (20%) found some interesting nuances.
Some weak to strong associations between bullying and SITBs were found yet conclusions are tentative due to study heterogeneity (e.g., methods used, conceptualizations and operationalisations of exposures/outcomes). Future research should address methodological issues raised in this review, and further explore gender differences in bullying, including by bullying sub-types (e.g., overt or relational) and victim status (e.g., victim or bully-victim).
欺凌受害一直被强调为年轻人自残思想和行为（SITBs）的风险因素。本项针对前瞻性、基于社区的研究的系统综述探讨了在儿童和 25 岁以下年轻人中，欺凌受害（传统/面对面和网络）与各种自残和自杀风险之间的关联。重要的是，还探讨了按性别/性别划分的关联。
通过 MEDLINE、Embase、PsycINFO、CINAHL 和 Scopus 搜索符合纳入标准的文章。文章通过标题、摘要和全文进行筛选。使用纽卡斯尔-渥太华量表对队列研究进行质量评估。数据以叙述方式进行综合。该方案已在 PROSPERO（CRD42021261916）上注册，并遵循 PRISMA 2020 指南。
共纳入 35 篇文章，来自 17 个国家。结果按欺凌类型呈现：传统/面对面（n=25）、网络（n=7）和/或两者的综合类型（n=7）。结果包括自杀意念（n=17）、自残（n=10）、自杀企图（n=4）、非自杀性自伤（NSSI）（n=4）、其他（n=7）。研究在 18 岁以下（n=24）、18-25 岁（n=8）以及 18 岁以下和 18-25 岁（n=3）的人群中测量了结果。探索性别/性别作用的研究（20%）发现了一些有趣的细微差别。
虽然发现了欺凌与 SITBs 之间存在一些强弱关联，但由于研究的异质性（例如，使用的方法、暴露和结果的概念化和操作化），结论仍不确定。未来的研究应解决本综述中提出的方法学问题，并进一步探讨欺凌中的性别差异，包括通过欺凌亚类型（例如，公开或关系）和受害者地位（例如，受害者或欺凌受害者）。
