School of Public Health, Medical College of Soochow University, Suzhou, China.
Mental Health Center, West China Hospital, Sichuan University, Chengdu, China.
Front Public Health. 2023 Feb 22;11:1064731. doi: 10.3389/fpubh.2023.1064731. eCollection 2023.
Suicide is the fourth leading cause of death for adolescents, and globally, over 75% of completed suicides occur in low- and middle-income countries (LMICs). Bullying has been proven to be closely related to suicide attempts. However, further understanding of the mechanisms underlying the relationship between bullying and adolescents' suicide attempts is urgently needed.
We used data from the Global School-based Student Health Survey (GSHS) (2010-2017) from 41 LMICs or regions. This study was based on questions assessing bullying victimization, suicide attempts, sleep deprivation, and body mass. Chi-square tests were used to explore the correlations among the main variables. The mediating role of sleep deprivation and the moderating role of body mass index (BMI) were analyzed using PROCESS.
The results showed a positive association between bullying victimization and suicide attempts. Sleep deprivation partially mediated the relationship between the frequency of being bullied and suicide attempts. In addition, sleep deprivation played a full or partial mediating role in the relationship between different types of bullying and suicide attempts. BMI moderated the relationships between the frequency of being bullied and suicide attempts, between being made fun of about one's body and sleep deprivation, and between sleep deprivation and suicide attempts.
Being bullied has a positive effect on suicide attempts, which is mediated by sleep deprivation and moderated by body mass. The results of this study are consistent with the stress-diathesis model of suicide, suggesting that being bullied is one of the stressors of suicide in adolescents, while sleep deprivation and body mass are susceptibility diatheses of suicide. The results are conducive to identifying adolescents at a high risk of suicide, suggesting that there is a need to pay more attention to bullied adolescents, especially their sleep quality and body mass, and design effective intervention measures to improve the current situation of adolescent suicide in LMICs.
自杀是青少年的第四大死因，在全球范围内，超过 75%的自杀行为发生在中低收入国家（LMICs）。欺凌已被证明与自杀未遂密切相关。然而，迫切需要进一步了解欺凌与青少年自杀未遂之间关系的潜在机制。
我们使用了来自 41 个 LMICs 或地区的全球学校学生健康调查（GSHS）（2010-2017 年）的数据。这项研究基于评估欺凌受害、自杀未遂、睡眠不足和体重的问题。卡方检验用于探索主要变量之间的相关性。使用 PROCESS 分析睡眠不足的中介作用和体重指数（BMI）的调节作用。
研究结果表明，欺凌受害与自杀未遂呈正相关。睡眠不足部分中介了被欺凌频率与自杀未遂之间的关系。此外，睡眠不足在不同类型的欺凌与自杀未遂之间的关系中发挥了完全或部分中介作用。BMI 调节了被欺凌频率与自杀未遂之间、因身材被嘲笑与睡眠不足之间以及睡眠不足与自杀未遂之间的关系。
被欺凌对自杀未遂有正向影响，这种影响是由睡眠不足介导的，同时受到体重的调节。本研究结果与自杀的应激素质模型一致，表明被欺凌是青少年自杀的应激源之一，而睡眠不足和体重是自杀的易患素质。研究结果有助于识别自杀风险较高的青少年，提示需要更加关注被欺凌的青少年，特别是他们的睡眠质量和体重，并设计有效的干预措施来改善 LMICs 青少年自杀的现状。
