Background
Bullying involvement is a significant risk factor for self-injurious thoughts and behaviours (SITBs), yet how its association with SITBs evolves before, across, and in the aftermath of the COVID-19 pandemic remains underexplored.
Methods
Data were collected from seven annual population-representative cross-sectional surveys conducted in Hong Kong, encompassing three COVID-19 pandemic phases: before (2018-2019), during (2020-2022), and after (2023-2024). The surveys included 10,532 persons aged 11-35. We calculated weighted prevalence estimates for SITBs and bullying involvement. Multivariable logistic regression models, adjusted for potential confounders, examined the associations between bullying involvement and SITBs. To explore demographic heterogeneity, we conducted subgroup analyses by age group, gender, and main occupation type.
Results
SITBs prevalence in the general young population increased from 13.6% in 2020 to 27.9% in 2024. Bullying involvement declined initially (9.0% to 6.7% in 2020-2021) but steadily rose to 31.5% by 2024. Association between bullying involvement and SITBs strengthened during the pandemic, peaking in 2022, and remained stronger in post-pandemic times (aOR = 33.32 [95% CI: 22.74-48.81] in 2023 and 12.47 [95% CI: 9.24-16.83] in 2024) compared to 2020. Association was stronger among young people (aged 11-24) and students during the pandemic, but otherwise among young adults (aged 25-35) and employed persons. Females generally exhibited higher odds than males.
Conclusion
Effective deployment of resources to safeguard the young population’s mental wellbeing is even more critical today. Anti-bullying programs and suicide prevention efforts could be tailored to different demographic subgroups through customizing modules for educational and workplace settings.