J Multidiscip Healthc. 2026 Aug 27;19:628304. doi: 10.2147/JMDH.S628304. eCollection 2026.
ABSTRACT
INTRODUCTION: The rapid expansion of digital technology has increased adolescents’ exposure to online risks, including cyberbullying victimization (CBV) and Online Gaming Addiction (OGA), which may be associated with self-harming behavior (SHB). This study examined regional disparities in digital risk exposure and SHB among Indonesian adolescents.
METHODS: A cross-sectional study was conducted among 1742 adolescents aged 11-16 years from five regions of Indonesia: Sumatera, Java, Kalimantan, Sulawesi, and Papua. Participants were recruited using multistage cluster sampling. Data were collected using demographic questionnaires, the Indonesian Online Game Addiction Questionnaire, the Cyberbullying and Online Aggression Survey Instrument, and the Self-Harm Inventory (SHI). Regional differences were examined using chi-square tests, and multivariable logistic regression was used to identify factors associated with lifetime SHB.
RESULTS: The prevalence of lifetime SHB was 55.0% and varied significantly across regions, ranging from 34.3% in Java to 84.6% in Sulawesi. OGA and CBV were most prevalent in Java (67.9% and 81.2%, respectively), followed by Sulawesi. In adjusted analyses, adolescents in Sulawesi had higher odds of lifetime SHB, whereas those in Java had lower odds compared with adolescents in Papua. Older age, male sex, longer internet use, and CBV were significantly associated with higher odds of lifetime SHB, while OGA was not significantly associated with SHB.
DISCUSSION: Regional differences in lifetime SHB were not fully explained by digital risk exposure alone and may reflect broader psychosocial and contextual factors that warrant further investigation. These findings highlight the importance of considering regional context and CBV in adolescent SHB prevention and mental health strategies. Region-specific approaches addressing digital safety, psychosocial support, and equitable access to adolescent mental health services may be warranted.
PMID:42677222 | PMC:PMC13528657 | DOI:10.2147/JMDH.S628304
