Pulse Brain · Growing Health Evidence Index
Tier 3 — Observational / field trialPeer-reviewed

Influence of academic stress and school bullying on self-harm behaviors among Chinese middle school students: The mediation effect of depression and anxiety

Hui Chen, Huijuan Guo, Haiyan Chen, Xia Cao, Jiali Liu, Xianliang Chen, Yusheng Tian, Huajia Tang, Xiaoping Wang, Jiansong Zhou

Frontiers in Public Health · 2023

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Summary

This cross-sectional study of 1,313 Chinese middle school students explored pathways linking academic stress and school bullying to self-harm behaviours, with depression and anxiety as potential mediators. Both depressive and anxiety symptoms were associated with increased odds of self-injury and suicide attempts; depression partially mediated associations for both bullying and academic stress with self-harm outcomes, whilst anxiety mediated effects on non-suicidal self-injury only. The findings suggest that reducing academic pressure and school bullying, alongside screening for and intervention on mood symptoms, may reduce self-harm risk in this population.

UK applicability

Whilst the study was conducted in a Chinese middle school context, the underlying relationships between academic stress, bullying, and self-harm are likely relevant to UK adolescent mental health. However, differences in educational systems, cultural stressors, and mental health service availability mean direct translation of findings requires caution; UK-specific research would strengthen evidence for local policy and prevention.

Key measures

Patient Health Questionnaire-9 (PHQ-9) for depression severity; Generalized Anxiety Disorder-7 (GAD-7) for anxiety severity; self-reported measures of bullying experience, academic stress, suicide attempts, and non-suicidal self-injury (NSSI); odds ratios (OR) with 95% confidence intervals

Outcomes reported

The study measured prevalence of suicide attempts (3.40%) and non-suicidal self-injury (4.10%) among middle school students, and examined associations with academic stress, school bullying, depression, and anxiety symptoms.

Theme
General food systems / other
Subject
Other / interdisciplinary
Study type
Research
Study design
Observational cohort
Source type
Peer-reviewed study
Status
Published
Geography
China
System type
Other
DOI
10.3389/fpubh.2022.1049051
Catalogue ID
SNmojmgojl-c2sza0

Topic tags

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