*This piece is republished from the West Hudson Psychiatric Society July 2023 eSynapse

As part of our ongoing commitment to behavioral health, PRMS is pleased to feature Dr. Faraz Mohammed, West Hudson Psychiatric Society President and Child and Adolescent Psychiatrist, as a guest blogger this month. Dr. Mohammed shares more about the scary effects of cyberbullying, as well as the statistics on the number of children and adolescents affected by it.

Cyberbullying is a relatively new form of violence expressed through electronic media, and it has been researched a lot these days because of its effects on children's and adolescents' mental health. Cyberbullying is derived from traditional bullying behaviors that occur repeatedly and systematically against an individual who fails to or cannot defend him or her self. Cyberbullying involves the use of electronic media with the intention of causing harm, humiliation, suffering, fear, and despair for the individual who is the target of aggression (1,2). These actions can be carried out via email, chat rooms, online voting booths, cell phones, and instant messaging. Studies suggest that 20-40% of teenagers will have at least one cyberbullying experience during adolescence and that the number of cyber victims is increasing. Cyberbullying may achieve a greater audience than traditional bullying since it occurs in virtual spaces where free expression is allowed, without social control. Dehue et al. suggest three conditions that must be met for a behavior to be considered "cyberbullying": the attack must be intentional, occur repeatedly, and cause psychological distress. The direct damage caused by cyberbullying harms the victim's reputation, with repercussions that may be even greater than those observed in traditional bullying (3).

Victimization related to cyberbullying has been associated with social and behavioral problems. The prevalence of cyberbullying varies between 6.8% to 35.4%. Between-group comparisons showed that a higher proportion of cyber victims came from single-parent families, had psychosomatic problems (headache, abdominal pain, and sleep problems), presented higher levels of perceived difficulties, emotional problems, peer and social difficulties, as well as not feeling safe at school and not feeling adequately looked after by teachers. The following factors were related to being a cyberbully: headache; high levels of perceived difficulties; not feeling safe in school and not feeling adequately looked after by teachers; behavior problems; hyperactivity; smoking; frequent drunkenness; and reduced pro-social behavior (4).

Cyberbullying has been associated with depressive symptomatology in several studies. In three studies, the likelihood of reporting harassment through the Internet was significantly higher among adolescents who presented more severe depressive symptomatology than those who presented mild or absent depressive symptomatology (5, 6, 7). The following types of cyberbullying were significantly related to a three-fold increased risk of emotional distress: episodes in which the aggressor was an adult; publication of a picture of the child or adolescent; and episodes accompanied by aggressive contacts off-line, like receiving a telephone call or when the aggressor went to the victim's house (8).

Cyberbullying was a predictor of suicide attempts, especially among those who suffer cyber victimization: 1.9 times compared to 1.5 times among the cyberbullying perpetrators (8). Besides depressive symptomatology from moderate to severe intensity, use of substances, suicidal thoughts, and suicide attempts were also associated with cyberbullying (9,10).

Adolescents who were victims of cyberbullying and traditional school bullying reported more depressive symptoms, and higher scores on the suicidal ideation and suicidal behavior scale, as well as more suicide attempts that demanded medical treatment (11). Hinduja & Patching's study showed that the likelihood of attempting suicide was twice as high among victims and aggressors compared to those not involved in cyberbullying.

Online communication has become a centerpiece in the life of adolescents, offering many opportunities for psychosocial development and the construction of intimate relationships. However, in this context, violent interactions such as cyberbullying may occur. Cyberbullying is associated with emotional stress, social anxiety, substance use, depressive symptoms, suicidal ideation, and suicide attempts. Psychiatrists, parents, and educators should know the risks of online communication and promote dialogue about the topic, helping adolescents find effective ways to deal with such incidents.

References:

1. Suzuki K, Asaga R, Sourander A, Hover CW, Mandel D. Cyberbullying and adolescent mental health. Int J Adolesc Med Health 2012; 24:27-35.
2. Monks C, Smith PK. Definitions of "bullying": age differences in understanding of the term and the role of experience. Br J Dev Psychol 2006; 24: 801-21.
3. Dehue F, Bolman C, Vollink, T. Cyberbullying: youngsters' experiences and parental perception. Cyberpsychol Behav 2008; 11:217-23.
4. Sourander A, Brunstein Klomek A, Ikonen M, Lindroos J, Luntamo T, Koskelainen M, et al. Psychosocial risk factors associated with cyberbullying among adolescents: a population-based study. Arch Gen Psychiatry 2010; 67:720-8.
5. 5.Ybarra ML. Linkages between depressive symptomatology and internet harassment among young regular internet users. Cyberpsychol Behav 2004; 7:247-57.
6. Chang FC, Lee CM, Chiu CH, Hsi WY, Huang TF, Pan YC. Relationships among cyberbullying, school bullying, and mental health in Taiwanese adolescents. J Sch Health 2013; 83:454-62.
7. Schneider SK, O'Donnell L, Stueve A, Coulter RWS. Cyberbullying, school bullying, and psychological distress: a regional census of high school students. Am J Public Health 2012; 102:171-7.
8. Hinduja S, Patchin JW. Bullying, cyberbullying, and suicide. Arch Suicide Res 2010; 14:206-21.
9. Ybarra ML, Mitchell KJ, Wolak J, Finkelhor D. Examining characteristics and associated distress related to internet harassment: findings from the Second Youth Internet Safety Survey. Pediatrics 2006; 118:1169-77.
10. Wang J, Nansel TR, Iannotti RJ. Cyber and traditional bullying: differential association with depression. J Adolesc Health 2011; 48:415-7.
11. Litwiller B, Brausch A. Cyber bullying and physical bullying in adolescent suicide: the role of violent behavior and substance use. J Youth Adolesc 2013; 42:675-84.

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