Association between bullying victimization, coping style, and mental health problems among Chinese adolescents

Background: This study aimed to examine the association of bullying victimization with anxiety and depressive symptoms among Chinese adolescents and explored the role of coping styles in the foregoing associations.Method: Data were drawn from the 2019 School-based Chinses Adolescents Health Survey (n = 19,809). Infor-mation about bullying victimization, coping styles, anxiety symptoms, and depressive symptoms were measured. Linear mixed-effects models were performed.Results: After adjusting for covariates, verbal victimization (beta = 1.94 for anxiety symptoms; beta = 4.62 for depressive symptoms), relational victimization (beta = 3.40 for anxiety symptoms; beta = 8.37 for depressive symp-toms), physical victimization (beta = 2.63 for anxiety symptoms; beta = 6.07 for depressive symptoms) and cyber victimization (beta = 4.68 for anxiety symptoms; beta = 10.72 for depressive symptoms) were associated with anxiety and depressive symptoms. Moreover, the severity of anxiety and depressive symptoms tended to increase with the number of victimization types. The interaction effects between bullying victimization and coping style on anxiety and depressive symptoms were significant. Further stratified analyses by coping styles indicated that the association of relational and cyber victimization on anxiety and depressive symptoms were significantly stronger in adolescents with negative coping style than in those with positive coping style.Limitations: Causal inference is limited due to the cross-sectional design. Conclusion: Bullying victimization is associated with anxiety and depressive symptoms, and coping styles may play a moderate role in these associations. Interventions to promote mental health could focus on developing positive coping styles, particularly among adolescents with bullying victimization.