Moderation of sex in the Association between School Bullying Behaviors and problematic gaming among Chinese adolescents: a cross-sectional study.

Abstract

Problematic gaming (PG) is a serious issue among adolescents worldwide, and there is evidence suggesting that school bullying behaviors may be associated with increased rates of PG. This study aimed to examine the associations between school bullying behaviors and PG among adolescents, with a focus on sex effects. A total of 20,197 participants were recruited from the 2023 School-based Chinese Adolescents Health Survey. Information about school bullying behaviors and PG was measured. Sampling weights were utilized to estimate the prevalence, and weighted logistic regression models were executed. Stratified analyses by sex were performed. Among Chinese adolescents, the weighted prevalence of PG was 4.2%, 8.1% were identified as victims, 1.8% as bullies, and 3.4% as bully-victims. A higher frequency of school bullying behaviors corresponds to a higher prevalence of PG. After adjusting for covariates, victims (AOR = 1.34, 95% CI = 1.03-1.73), bullies (AOR = 2.08, 95% CI = 1.39-3.11), and bully-victims (AOR = 2.75, 95% CI = 2.09-3.61) were associated with PG. Moreover, the severity of PG tended to increase with the number of involved in school bullying behaviors. The interaction terms of bully-victims and sex were significant. Further stratified analyses by sex indicated that the association of school bullying behaviors with PG was stronger for females than males, especially those identified as bully-victims. School bullying behaviors are associated with PG among adolescents, with a stronger association found in female adolescents, particularly those identified as bully-victims. These findings suggest that implementing prevention and control measures for school bullying could help reduce PG among adolescents.