Prevalence of School Violence and Its Association with Depression, Anxiety, and Stress among Female Middle School Students in a Mountainous Province of Northern Vietnam: A Cross-Sectional Descriptive Study

Authors

  • Quang Viet Nguyen Faculty of public health, Thai Nguyen University of Medicine and Pharmacy, University Thai Nguyen, Thai Nguyen, Vietnam
  • Son Duc Nguyen National Institute of Medical Device and Construction, Vietnam
  • Hoa Quynh Thi Nguyen Faculty of public health, Thai Nguyen University of Medicine and Pharmacy, University Thai Nguyen, Thai Nguyen, Vietnam
  • Duong Thuy Thi Truong Faculty of public health, Thai Nguyen University of Medicine and Pharmacy, University Thai Nguyen, Thai Nguyen, Vietnam
  • Thu Hoai Le Faculty of public health, Thai Nguyen University of Medicine and Pharmacy, University Thai Nguyen, Thai Nguyen, Vietnam

DOI:

https://doi.org/10.55489/njcm.170620266634

Keywords:

Mental health, Adolescent, Violence, Students, Vietnam

Abstract

Background: School violence remains a public health concern in Vietnam, yet evidence from Northern mountainous regions is limited. The objectives were to assess school violence prevalence and its association with mental health outcomes among female middle school students.

Methods: A cross-sectional study was conducted among 699 students. Data collection occurred Jan–Jun 2025, with analysis through Jan 2026. Validated questionnaires and DASS-21 were used. Multivariate logistic regression estimated adjusted Odds Ratios (aOR) while controlling for age, ethnicity, area, and lifestyle.

Results: Violence prevalence was 71.5%, with psychological (68.2%), economic (35.5%), and physical (32.9%) modalities recorded. Anxiety was most frequent (28.5%), followed by depression (21.3%) and stress (10.6%). Physical violence was a consistent independent predictor for depression (aOR=2.55), anxiety (aOR=2.22), and stress (aOR=2.47). Additionally, insufficient sleep was associated with depression and stress; prolonged social media usage (>3 hours/day) with anxiety and stress; and lack of physical exercise with increased odds of depression.

Conclusion: Female students face a significant prevalence of victimization and emotional impairment. Interventions should integrate violence prevention with promotion of healthy sleep and exercise habits to safeguard student mental health.

References

Vietnam Government. Decree No. 80/2017/ND-CP dated July 17, 2017: Regulations on safe, healthy, and friendly educa-tional environments, and the prevention and control of school violence. Hanoi: Government of Vietnam; 2017 Jul 17.

Sawyer SM, Afifi RA, Bearinger LH, Blakemore SJ, Dick B, Ezeh AC, et al. Adolescence: a foundation for future health. Lancet. 2012 Apr 28;379(9826):1630-1640. DOI: https://doi.org/10.1016/S0140-6736(12)60072-5 PMid:22538178

Sawyer SM, Azzopardi PS, Wickremarathne D, Patton GC. The age of adolescence. Lancet Child Adolesc Health. 2018 Mar;2(3):223-228. DOI: https://doi.org/10.1016/S2352-4642(18)30022-1 PMid:30169257

United Nations Children’s Fund (UNICEF) Vietnam. Compre-hensive study on school-related factors impacting mental health and well-being of adolescent boys and girls in Viet Nam. 2022:23-24. [cited 2026 Mar 11]. Available from: https://www.unicef.org/vietnam/media/9831/file/Study%20on%20school-relat-ed%20factors%20impacting%20mental%20health%20and%20well-being%20of%20adolescents%20in%20Viet%20Nam.pdf

Barnawi MM, Sonbaa AM, Barnawi MM, Alqahtani AH, Fairaq BA. Prevalence and Determinants of Depression, Anxiety, and Stress Among Secondary School Students. Cureus. 2023 Aug 26;15(8):e44182. DOI: https://doi.org/10.7759/cureus.44182 PMID: 37641721 PMCID: PMC10460469

Jackson J, Hamwey M, Stratton N, Vasan A. Persistent Sadness, Violence, and Bullying and Associations With Screen Time Among New York City Public High School Students, 2021. Am J Public Health. 2025 Sep;115(9):1397-1407. DOI: https://doi.org/10.2105/AJPH.2025.308051 PMid:40440655 PMCid:PMC12332309

Nguyen MH, Thanh NM, Tran BN, Nguyen MQ, Tran TNH, Nguyen HA. School bullying and mental health of junior high school students in Hanoi. Vietnam Med J. 2023;532(2):259-262. DOI: https://doi.org/10.51298/vmj.v532i2.7625

Lee E. Effects of School Violence on Depression and Suicidal Ideation in Multicultural Adolescents. Iran J Public Health. 2019;48(2):262-269. PMID: 31205880; PMCID: PMC6556187

Le MTH, Tran TD, Holton S, Nguyen HT, Wolfe R, Fisher J. Re-liability, convergent validity and factor structure of the DASS-21 in a sample of Vietnamese adolescents. PLoS One. 2017 Jul 19;12(7):e0180557. DOI: https://doi.org/10.1371/journal.pone.0180557 PMid:28723909 PMCid:PMC5516980

Luo J, Xian G, Yao C, Jin J, Zhao J, Song X, Gong J. Further validat-ing of the Depression Anxiety Stress Scales-21 (Dass-21) in Chinese adolescents: factor structure and measurement in-variance. BMC Public Health. 2025 Jun 4;25(1):2073. DOI: https://doi.org/10.1186/s12889-025-23287-x PMid:40468260 PMCid:PMC12135228

Betts LR, Houston JE, Steer OL. Development of the Multidi-mensional Peer Victimization Scale-Revised (MPVS-R) and the Multidimensional Peer Bullying Scale (MPVS-RB). J Genet Psychol. 2015;176(1-2):3-109. DOI: https://doi.org/10.1080/00221325.2015.1007915 PMid:25775213

Gaete J, Valenzuela D, Godoy MI, Rojas-Barahona CA, Salmival-li C, Araya R. Validation of the Revised Olweus Bully/Victim Questionnaire (OBVQ-R) Among Adolescents in Chile. Front Psychol. 2021 Apr 12;12:578661. DOI: https://doi.org/10.3389/fpsyg.2021.578661 PMid:33912096 PMCid:PMC8072054

Nguyen PTH, My Le D, Phuong Le LT. An Investigation into Causes of Violence at Secondary Schools in Da Nang, Vietnam. International Journal of Pharmaceutical Research and Allied Sciences. 2021;10(3):112-119. DOI: https://doi.org/10.51847/hF5h5nzXgn

Le THH, Nguyen TH, Tran QT, et al. Validity and reliability of traditional and cyber bullying victimization scale: Findings from a school-based survey in urban areas of Ha Noi and Hai Duong. Vietnamese Journal of Public Health. 2016;(40):198-204. https://vjol.info.vn/TTCC/article/view/29086/24804

Plan International. Are schools safe and equal places for girls and boys in Asia? Research Findings on School-Related Gen-der-Based Violence [Internet]. Woking, UK: Plan Internation-al; 2015 [cited 2026 Mar 11]. Available from: https://plan-internation-al.org/uploads/2022/01/2015_are_schools_safe_and_equal_places_for_girls_and_boys_in_asia_en.pdf

Karmaliani R, Mcfarlane J, Somani R, Khuwaja HMA, Bhamani SS, Ali TS, et al. Peer violence perpetration and victimization: Prevalence, associated factors and pathways among 1752 sixth grade boys and girls in schools in Pakistan. PLoS One. 2017 Aug 17;12(8):e0180833. DOI: https://doi.org/10.1371/journal.pone.0180833 PMid:28817565 PMCid:PMC5560651

Arhuis-Inca W, Ipanaqué-Zapata M, Bazalar-Palacios J, Gaete J. Space Analysis of School Violence in the Educational Setting of Peru, 2019. Int J Environ Res Public Health. 2022 Nov 30;19(23):16044. DOI: https://doi.org/10.3390/ijerph192316044 PMid:36498116 PMCid:PMC9736996

Merikangas KR, He JP, Burstein M, Swanson SA, Avenevoli S, Cui L, et al. Lifetime prevalence of mental disorders in U.S. adolescents: results from the National Comorbidity Survey Replication--Adolescent Supplement (NCS-A). J Am Acad Child Adolesc Psychiatry. 2010 Oct;49(10):980-989. DOI: https://doi.org/10.1016/j.jaac.2010.05.017 PMid:20855043 PMCid:PMC2946114

Dong T, Wang Y, Lin Y. Prevalence and determinants of de-pression, anxiety, and stress among secondary school stu-dents. PLoS One. 2025;20(9):0328785. DOI: https://doi.org/10.1371/journal.pone.0328785 PMid:40901810 PMCid:PMC12407422

Durbeej N, Hared YA, Ahmed AM, Hassan HM, Flacking R, Joffer J, et al. The Experience of Abuse and Depressive Symp-toms Among Adolescents in a Post-Conflict Setting: A Cross-Sectional Study. Adolescents. 2025;5(3):42. DOI: https://doi.org/10.3390/adolescents5030042

Wang X, Di J, Zhao G, Wang L, Zhang X. Association of Nighttime Sleep Duration with Depressive Symptoms and Its Interaction with Regular Physical Activity among Chinese Adolescent Girls. Int J Environ Res Public Health. 2021 Oct 25;18(21):11199. DOI: https://doi.org/10.3390/ijerph182111199 PMid:34769716 PMCid:PMC8583044

Pueyo Gutiérrez-Rivas P, Lozano D, Roso-Moliner A et al. Correlation Between Physical Activity and Psychological Problems in Secondary School Students in Spain. Sports (Ba-sel). 2025;13(10):362. DOI: https://doi.org/10.3390/sports13100362 PMid:41150497 PMCid:PMC12567635

Javier Guzmán Murillo, José Marcelo Torres Ortega, William Niebles. Relationship between Anxiety and School Violence: Econometric Analysis in Secondary School Students. Journal of Ecohumanism. 2024;3(4):3614-3622. DOI: https://doi.org/10.62754/joe.v3i4.6043

Hoang The Hai, Le Van Hien, Le Thi Hien. The relationship be-tween school bullying and the level of psychological stress of junior high school students in Da Nang city. Journal of Science and Technology - University of Da Nang. 2020;18(10):24-27.

Luo S, Ban Y, Qiu T et al. Effects of stress on school bullying behavior among secondary school students: Moderating ef-fects of gender and grade level. Front Psychol. 2023:14:1074476. DOI: https://doi.org/10.3389/fpsyg.2023.1074476 PMid:37008878 PMCid:PMC10050707

Downloads

Published

2026-06-01

How to Cite

1.
Nguyen QV, Nguyen SD, Nguyen HQT, Truong DTT, Le TH. Prevalence of School Violence and Its Association with Depression, Anxiety, and Stress among Female Middle School Students in a Mountainous Province of Northern Vietnam: A Cross-Sectional Descriptive Study. Natl J Community Med [Internet]. 2026 Jun. 1 [cited 2026 Jun. 1];17(06):459-67. Available from: https://njcmindia.com/index.php/file/article/view/6634

Issue

Section

Original Research Articles

Similar Articles

<< < 22 23 24 25 26 27 28 29 30 31 > >> 

You may also start an advanced similarity search for this article.