Association between victimization by bullying and direct self injurious behavior among adolescence in Europe: a ten-country study

Abstract

Previous studies have examined the association between victimization by bullying and both suicide ideation and suicide attempts. The current study examined the association between victimization by bullying and direct-self-injurious behavior (D-SIB) among a large representative sample of male and female adolescents in Europe. This study is part of the Saving and Empowering Young Lives in Europe (SEYLE) study and includes 168 schools, with 11,110 students (mean age = 14.9, SD = 0.89). Students were administered a self-report survey within the classroom, in which they were asked about three types of victimization by bullying (physical, verbal and relational) as well as direct self-injurious behavior (D-SIB). Additional risk factors (symptoms of depression and anxiety, suicide ideation, suicide attempts, loneliness, alcohol consumption, drug consumption), and protective factors (parent support, peer support, pro-social behavior) were included. The three types of victimization examined were associated with D-SIB. Examination of gender as moderator of the association between victimization (relational, verbal, and physical) and D-SIB yielded no significant results. As for the risk factors, depression, but not anxiety, partially mediated the effect of relational victimization and verbal victimization on D-SIB. As for the protective factors, students with parent and peer support and those with pro-social behaviors were at significantly lower risk of engaging in D-SIB after being victimized compared to students without support/pro-social behaviors. This large-scale study has clearly demonstrated the cross-sectional association between specific types of victimization with self-injurious behavior among adolescents and what may be part of the risk and protective factors in this complex association.

Appendix

Scale	Question	Items	Response alternatives
Victimization	In the past 12 months have others often… (please put a cross in one or more of the relevant box/s)	10 items	Yes/no
		Physical victimization: others pushed, hit or kicked you
		Verbal victimization: others teased you, called you names, made fun of how you look or talk
		Relational victimization: others spread rumors about you, deliberately left you out of activities, taken money, property or food from you, made you work for other pupils or people, take advantage of you, controlled you
D-SIB	Mark the number of times you’ve EVER done the act during your life?	1. Have you ever intentionally cut your wrist, arms, or other area(s) of your body, or stuck sharp objects into your skin such as needles, pins, staples (not including tattoos, ear piercing, needles used for drugs, or body piercing)?	The scale was from never to 5 times or more
		2. Have you ever intentionally burned yourself with a cigarette, lighter or match?
		3. Have you ever intentionally carved words, pictures, designs or other markings into your skin, or scratched yourself to the extent that scarring or bleeding occurred?
		4. Have you ever intentionally prevented wounds from healing, or bit yourself to the extent that it broke skin?
		5. Have you ever intentionally banged your head or punched yourself thereby causing a bruise?
		6. Have you ever intentionally hurt yourself in any of the above-mentioned ways so that it led to hospitalization or injury severe enough to require medical treatment?
Depression	Beck Depression Inventory	BDI II
Anxiety	The Zung Self-Rating Anxiety Scale (SAS)
Suicide ideation/plan	During the past two weeks, have you reached the point where you seriously considered taking your life or perhaps made plans how you would go about doing it?		The range was from (0) never to (5) always
Suicide attempts	Have you ever tried to take your own life?		The options were yes, during the past 2 weeks; yes, during the past 6 months or longer; no, never
Loneliness	During the past 12 months, how often have you felt lonely?		Never, rarely, sometimes, most of the time, always
Alcohol consumption	How often do you have a drink containing alcohol? For example, 0.33 l beer or cider; glass of wine or 4 cl of strong alcohol		Never, once a month or less, 2 to 4 times a month, 2 to 3 times a week, 4 or more times a week, every day, several times a day
Drugs consumption	During your life, how many times have you ever used drugs?		Never, 1 or 2 times, 3 to 9 times, 10 or more times
Parental support	First three items: during the past 2 weeks		Never, rarely, sometimes, most of the time, always
	1. How often did your parents or guardians check to see if your homework was done?
	2. During the past 2 weeks, how often did your parents or guardians understand your problems and worries?		Other questions: never or almost never, sometimes and often
	3. During the past 2 weeks, how often did your parents or guardians really know what you were doing with your free time?
	Other items were: how often do your parents/guardians… (please put a cross in the relevant box)?
	Help you make important decisions; Take time to talk with you about things that happened to you; come to see you when you do some special activity like being in a play, a sport, or you give some sort of a performance; pay attention to your opinion or what you say
Social support	Three items		Rarely or never, sometimes, often or all the time, rarely or never, sometimes, often or all the time
	1. You get along well with people your age
	2. You feel you belong to a group
	3. People your age like having you in the group
Prosocial behavior SDQ	Please give your answers on the basis of how things have been for you over the last 6 months	1. I try to be nice to other people	Not true, somewhat true or certainly true
		2. I care about their feelings
		3. I usually share with others (food, games, pens etc.)
		4. I am helpful if someone is hurt, upset or feeling ill
		5. I am kind to younger children
		6. I often volunteer to help others (parents, teachers, children)