| Objectives: School bullying victimization is associated with increased risk of depression and anxiety in children and adolescents.However,little is known about the role of resilience in this association.This study investigated the association between resilience,school bullying victimization and symptoms of depressive/anxiety/depressive-anxiety symptoms in children and adolescents.It also explores whether resilience and its dimensions have mediating and moderating effects on the association between school bullying victimization and depressive/anxiety/depressiveanxiety symptoms.To provide a theoretical basis and feasible intervention strategies for reducing the incidence of depression and anxiety associated with bullying victimization in children and adolescents.Methods: A population-based cross-sectional study adopting two-stage simple random cluster sampling of 9545 was implemented in Yunnan province.Of all respondents,the final 9102 were included in the analysis and explored in terms of three outcomes: depressive,anxiety,and depressive-anxiety symptoms.The Chinese version of the Olweus bully/victim questionnaire(OBVQ),the Patient Health Questionnaire-9(PHQ-9),the Generalized Anxiety Disorder-7(GAD-7)and the Resilience Scale for Chinese Adolescents(RSCA)were used to measure bullying victimization,depressive symptoms,anxiety symptoms and resilience in children and adolescents respectively.Univariate and multivariate Logistic regression models were adopted to estimate crude and adjusted associations among bullying victimization,depressive/anxiety/depressive-anxiety symptoms,and resilience.The moderating effect of resilience was evaluated through multivariate Logistic regression models.A path model was used to analyze the hypothesized mediation by resilience in the association between bullying victimization and depressive/anxiety/depression-anxiety symptoms.Results: The school bullying victimization prevalence was 13.16%,the prevalence of depressive,anxiety,and depressive-anxiety symptoms was 19.26%,6.61% and 32.40%.A comparison between groups revealed that girls had a higher prevalence of depression,anxiety and depressive-anxiety symptoms than boys.The prevalence of depression,anxiety and depressive-anxiety symptoms were all significantly higher among those who had experienced bullying victimization than those who had not.The results of the multivariate Logistic regression models showed that bullying victimization in children and adolescents was associated with depressive/anxiety/depression-anxiety symptoms,however,moderating effect of resilience has not been found.Bullying victims were more likely to have symptoms of depression(OR=2.95,95%CI:2.51-3.45),anxiety(OR=2.41,95%CI:1.85-3.12)and depressive-anxiety symptoms(OR=3.80,95%CI:3.17-4.56)compared to those who had not experienced bullying victimization.The path analysis model showed that resilience mediated the association between bullying victimization and depressive/anxiety/depression-anxiety symptoms.The highest percentage of mediators was found among those with symptoms of depression-anxiety,at 32.71%,followed by those with depressive symptoms,at 16.44%,and finally those with anxiety symptoms,at 14.17%.Further analysis showed that of the five dimensions of resilience,emotion regulation mediated the strongest effect in all populations,followed by interpersonal assistance and family support.Conclusions: The findings suggest that resilience has a significant mediating role in the association between bullying victimization and depressive/anxiety/depressiveanxiety symptoms.Among the dimensions of resilience,the emotional regulation,interpersonal assistance and family support dimensions,in particular,played an important mediating role.Our major findings highlighted the promising role of resilience-based intervention measures in reducing the risk of depressive/anxiety/depression-anxiety associated with school bullying victimization in children and adolescents. |
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