Bullying can take many forms from physical violence, to verbal insults, spreading rumours and excluding people from activities. It takes a physical and emotional toll on victims, the effects of which can persist after the bullying itself stops.

Surveys in the UK indicate that up to half of primary school pupils and one in 10 secondary school students have been bullied (Royal College of Psychiatrists).

The proliferation of social media and other forms of communication, such as texting, have created a new medium for bullying, which is termed “cyberbullying”. It is estimated that around 38% of young people have experienced cyberbullying (NSPCC).

A new survey by North American researchers, published in JAMA Pediatrics, sought to identify the association of cyberbullying with mental health and substance misuse. Additionally authors sought to determine the protective effect of family support, in particular through family meals, for young people exposed to cyberbullying.

Methods

The survey was distributed electronically to 20,385 young people in 49 middle- and high-schools in a Mid-Western US state. Participation was voluntary and anonymous. Parents were informed about the survey 4 weeks in advance so that they could review the survey and could opt out. The survey response rate was high, with 90% of students in most districts participating.

The survey measured:

• The frequency of cyberbullying and “traditional” face-to-face bullying victimisation
• “Internalising” problems: anxiety, depression, self-harm and suicide attempt in the past 12 months, and suicidal thoughts in the past 30 day
• “Externalising” problems: physical fighting or vandalising property in the past 30 days
• Substance use problems that may represent coping mechanisms: ≥3 episodes of drunkenness or binge drinking in the previous 30 days, prescription or over-the-counter (OTC) drug misuse in the previous 12 months
• The number of times evening meals were eaten with their family
• Demographic information about respondents’ age, sex and eligibility for free or reduced-cost school meals (indicating low income households)

Ordinal regression was used to analyse the contribution of demographic factors to cyberbullying victimisation. Odd ratios (ORs) were calculated using logistic regression to examine the association between mental health and substance abuse with cyberbullying exposure. Negative binomial regressions were used to test the direct and indirect effects of cyberbullying victimisation and family dinners on internalising and externalising problems, alcohol and substance misuse and health problems.

Results

The final sample included 18,834 participants. 1,551 cases were excluded where complete cyberbullying data was unavailable. Compared with the remaining sample, excluded cases were slightly older (15.3 vs 15.0 years; p=<0.001), included fewer girls (35.9% vs 50.5%; p=<0.001) and included fewer low-income students (10.1% vs 19.2%, p=<0.001). The removal of these cases did not affect the overall demographic of the final sample. Due to technical problems, the drunkenness and binge drinking questions were only administered to 6,454 students, but this subsample did not differ from the remaining sample on demographics.

• 6% of respondents had experienced cyberbullying in the past 12 months
• Cyberbullying incidence was:
  • More common in girls (OR 2.95, 95% Confidence Interval 2.54 to 3.44)
  • Increased with every additional year of age (OR 1.07, 95% CI 1.03 to 1.11)
  • Increased by involvement in traditional face-to-face bullying:
    • As a target (OR 1.37, 95% CI 1.33 to 1.40)
    • As the perpetrator (OR 1.12, 95% CI 1.08 to 1.16)
• The OR for all outcomes relating to mental health problems, alcohol and substance misuse, self-harm, and suicidal thoughts and suicide attempts increased as the frequency of cyberbullying increased. These associations persisted even when analyses were adjusted to control for the co-occurrence of face-to-face bullying
• Family dinners were negatively related to the frequency of cyberbullying and all health outcomes, this association was strengthened as cyberbullying became more frequent

Conclusions

The authors concluded that:

Cyberbullying uniquely relates to internalizing, externalizing, and substance use problems in adolescents. The associations are not explained by involvement in traditional (face-to-face) forms of bullying. However, their strength is moderated by the frequency of family dinners.

Health care professionals should be aware of the potential health risks associated with cyberbullying and the benefits associated with regular and frequent family contact.

Further study is needed to identify other paths through which social support can protect adolescents from the risks associated with online bullying.

Summary

• This large survey provides data on the amount of cyberbullying that takes place, its relationship to “traditional” face-to-face bullying and demonstrates the various negative effects that cyberbullying has on its targets.
• Authors acknowledge the limitations of the survey, especially regarding some of the measurements used and that they were not able to detect potential underreporting of cyberbullying amongst boys.
• The health impact of cyberbullying persisted even when it was controlled for co-occurrence of “traditional” bullying, therefore authors suggest cyberbullying is a worthwhile target for preventive interventions.
• Family dinners provide an opportunity for interaction, but are likely part of a wider set of family characteristics which are conducive to creating an environment that has a positive effect on young people’s overall mental health.
• As this was a survey, it cannot conclusively say that its findings prove a causative link, but it nonetheless provides interesting findings and directions for further research.

Bullying myths

The independent not-for-profit organisation Child Trends is keen to dispel some myths about bullying:

• Statistics do not show that bullying is on the rise
• Although cyberbullying attracts headlines, “traditional” face-to-face bullying remains more prevalent
• Bullying can potentially be a contributory factor in suicide, but it is unlikely to be the sole cause
• Witnesses and perpetrators are also affected by bullying, as well as those who are the targets of bullying
• Criminalising bullying may not help and efforts should be concentrated on dealing with and preventing bullying

Support if you are experiencing cyberbullying

The NSPCC and Royal College of Psychiatrists provide advice to parents on how they can encourage their child to talk to them about cyberbullying. Chatdanger and NHS Choices provide information on how to prevent and respond to cyberbullying. Childline and the NSPCC provide 24 hour telephone advice lines that parents and young people can use to get advice about cyberbullying.

If you need help

If you need help and support now and you live in the UK or the Republic of Ireland, please call the Samaritans on 116 123.

If you live elsewhere, we recommend finding a local Crisis Centre on the IASP website.

We also highly recommend that you visit the Connecting with People: Staying Safe resource.

Links

Elgar FJ, Napoletano A, Saul G, Dirks MA, Craig W, Poteat VP, Holt M, Koenig BW. Cyberbullying Victimization and Mental Health in Adolescents and the Moderating Role of Family Dinners. JAMA Pediatr. 2014;168(11):-. doi:10.1001/jamapediatrics.2014.1223 [PubMed abstract]

Childline. Cyber bullying (online bullying). http://www.childline.org.uk/Explore/Bullying/Pages/online-bullying.aspx

National Society for the Prevention of Child Cruelty (NSPCC). Cyberbullying. http://www.nspcc.org.uk/help-and-advice/for-parents/online-safety/cyberbullying/cyberbullying_wda99645.html

NSPCC (2013). Statistics on bullying. http://www.nspcc.org.uk/Inform/resourcesforprofessionals/bullying/bullying_statistics_wda85732.html

Royal College of Psychiatrists (RCPSYCH). The emotional cost of bullying: information for parents, carers and anyone who works with young people. http://www.rcpsych.ac.uk/healthadvice/parentsandyouthinfo/parentscarers/bullyingandemotion.aspx

NHS Choices (2013) Coping with cyberbullying. http://www.nhs.uk/Livewell/Bullying/Pages/Cyberbullying.aspx

Chatdanger. http://www.chatdanger.com/

Five things to know about bullying (email newsletter). Child Trends, 8 Oct 2014.