Abstract
BACKGROUND: Although bullying may affect students' mental health, its prevalence and impact on mental health among students in China after the lifting of COVID-19 restrictions remains unclear. This study aimed to explored the prevalence and association of traditional and cyber bullying with mental health among Chinese adolescent and youth students post-COVID-19 restrictions. METHODS: An online survey included 82,873 students from various educational levels in Sichuan Province, China, assessing traditional and cyber victimization, cyber perpetration, COVID-19 experiences, insomnia, anxiety, depression, and post-traumatic stress disorder (PTSD). Logistic regression analyses were conducted to explore the associations between bullying and mental health problems. RESULTS: A total of 28.3% of students reported experiencing bullying, with 23.2% traditional victimization, 17.7% cyber victimization, and 8.1% cyber perpetration. Males had significantly higher prevalence of bullying, while females had significantly higher prevalence of mental health problems. All forms of bullying significantly increased the risk of mental health problems, with traditional bullying showing the strongest association. Students who experienced all three types of bullying had significantly higher risks of insomnia (adjusted odds ratio [aOR] 4.89 [95% CI, 4.57-5.23]), anxiety (aOR 11.42, [95% CI, 10.55-12.36]), depression (aOR 11.52, [95% CI, 10.58-12.53]), and PTSD (aOR 15.48, [95% CI, 14.17-16.92]). CONCLUSION: This study highlights the high prevalence of bullying, as well as its cumulative impact on mental health problems among adolescent and youth students. Addressing and preventing bullying is crucial to promote positive mental well-being in adolescent and youth students.