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programs should be conducted to focus on developing mental health status of those children and adolescents who are involved in multiple sub-types of sibling victimization or perpetration.

Background: Bullying tends to peak during adolescence, and it is an important risk factor of self-harm and suicide. However, research on the specific effect of different sub-types of bullying is limited.Objective: The purpose of this study is to examine the associations between four common forms of bullying (verbal, physical, relational, and cyber) and self-harm, suicidal ideation (SI), and suicide attempts (SA).Method: This was a cross-sectional study of a sample including 4,241 Chinese students (55.8% boys) aged 11 to 18 years. Bullying involvement, self-harm, SI, and SA were measured via The Juvenile Campus Violence Questionnaire (JCVQ). The association was examined through multinomial logistic regression analysis, adjusted for demographic characteristics and psychological distress.Results: Bullying victimization and perpetration were reported by 18.0 and 10.7% of participants. The prevalence of self-harm, SI, and SA were 11.8, 11.8, and 7.1%, respectively. Relational bullying victimization and perpetration were significantly associated with SI only, SI plus self-harm, and SA. Physical bullying victimization and perpetration were risk factors of self-harm only and SA. Verbal victimization was significantly associated with SI only. Cyber perpetration was a risk factor of SA.Conclusions: The findings highlight the different effects of sub-types of bullying on self-harm and suicidal risk. Anti-bullying intervention and suicide prevention efforts should be prior to adolescents who are involved in physical and relational bullying.

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