Sun Weidi, Gu Fang, Tan Boren, Tang Shanshan, Tang Ke, Meng Jia, Shen Yu, Gao Lei, Li Juanjuan, Shan Shiyi, Li Shuting, Xiao Wenhan, Zhang Ronghua, Song Peige
Center for Clinical Big Data and Statistics of the Second Affiliated Hospital, School of Public Health, Zhejiang University School of Medicine, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
Department of Nutrition and Food Safety, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, 310051, Zhejiang, China.
BMC Public Health. 2025 May 26;25(1):1944. doi: 10.1186/s12889-025-23129-w.
Bullying is a rising social concern and public health challenge, threatening the mental health of the youth. Existing evidence lacks comprehensive insight into the gender disparities in such association. This cross-sectional study aimed to elucidate the gender differences in the association between bullying victimization and depressive symptoms among children and adolescents.
A total of 21,654 fourth-grade and above students were recruited from the annual school-based survey "China Common Disease and Risk Factor Surveillance among Students" in Zhejiang Province, China, conducted in 2021. Six forms of bullying victimization were assessed with a self-administered questionnaire and further categorized into three subtypes, including physical, verbal, and relational bullying victimization. Depressive symptoms were measured with the Center for Epidemiologic Studies Depression Scale. A multilevel generalized linear model was employed to analyze the gender-specific association of bullying victimization (in specific forms, subtypes, and cumulative measures) with depressive symptoms. Gender differences were tested by the girls-to-boys ratios of odds ratios (RORs) and the 95% confidential intervals (CIs).
The median age of recruited children and adolescents was 15.07 years. All specific forms of bullying victimization were significantly associated with increased odds of depressive symptoms. Girls who were mocked or teased (ROR = 1.27, 95% CI = 1.05-1.56), body-shamed (ROR = 1.39, 95% CI = 1.05-1.85) and experienced the subtype of verbal bullying (ROR = 1.22, 95% CI = 1.01-1.46) exhibited greater depressive symptoms than boys. Concerning cumulative effects, girls who experienced two or more forms of bullying victimization (ROR = 1.42, 95% CI = 1.09-1.84), all three subtypes of bullying victimization (ROR = 1.89, 95% CI = 1.10-3.24) had more prominently increased odds of depressive symptoms than boys.
Bullied girls exhibited a higher susceptibility to depressive symptoms than boys with the same experience, especially when exposed to multiple bullying incidents. These findings underscore the need for developing gender-specific strategies to protect children from bullying, with an emphasis on safeguarding girls.
欺凌是一个日益严重的社会问题和公共卫生挑战，威胁着青少年的心理健康。现有证据缺乏对这种关联中性别差异的全面洞察。这项横断面研究旨在阐明儿童和青少年中欺凌受害与抑郁症状之间关联的性别差异。
从2021年在浙江省开展的年度学校“中国学生常见疾病及危险因素监测”调查中招募了总共21,654名四年级及以上学生。通过自填问卷评估六种形式的欺凌受害情况，并进一步分为三种亚型，包括身体欺凌受害、言语欺凌受害和关系欺凌受害。使用流行病学研究中心抑郁量表测量抑郁症状。采用多水平广义线性模型分析欺凌受害（具体形式、亚型和累积测量）与抑郁症状的性别特异性关联。通过比值比（ROR）的女孩与男孩比值以及95%置信区间（CI）检验性别差异。
招募的儿童和青少年的中位年龄为15.07岁。所有特定形式的欺凌受害均与抑郁症状几率增加显著相关。遭受嘲笑或戏弄（ROR = 1.27，95%CI = 1.05 - 1.56）、身体羞辱（ROR = 1.39，95%CI = 1.05 - 1.85）以及经历言语欺凌亚型（ROR = 1.22，95%CI = 1.01 - 1.46）的女孩比男孩表现出更严重的抑郁症状。关于累积效应，经历两种或更多形式欺凌受害（ROR = 1.42，95%CI = 1.09 - 1.84）、所有三种欺凌受害亚型（ROR = 1.89，95%CI = 1.10 - 3.24）的女孩比男孩抑郁症状几率增加更为显著。
与有相同经历的男孩相比，受欺凌女孩表现出更高的抑郁症状易感性，尤其是在遭受多次欺凌事件时。这些发现强调需要制定针对性别的策略来保护儿童免受欺凌，重点是保护女孩。
