Cyberbullying -- bullying online rather than face to face -- is linked to various types of post traumatic stress disorder (PTSD) symptoms, both for victims and perpetrators, suggests the first study of its kind, published online in the Archives of Disease in Childhood.
Their findings prompt the researchers to suggest that asking about cyberbullying should become a routine part of any children's mental health or psychological assessment.
The prevalence of cyberbullying among teens is thought to be between 10% and 40% and to pose specific risks because it can be done day and night, in various contexts, is rapid, anonymous, and reaches a wide audience, say the researchers.
It has been suggested that there may be some overlap between traditional bullying and cyberbullying.
To explore this further, and find out what the mental health impact of cyberbullying might be, the researchers questioned 2218 pupils aged between 11 and 19 from four secondary schools in London about their experiences of bullying.
They used The Olweus Bully/Victim Questionnaire to find out what type of bullying the teens had been involved with, how often this had happened, and for how long it had lasted.
And they screened for PTSD symptoms using the Children Revised Impact of Events Scale (CRIES), which has two dimensions: intrusive thoughts and avoidance behaviours.
Just over half the teens were girls (55%). Around a third (34%) were of white ethnicity; two thirds were of black, Asian and other minority ethnic backgrounds. Most of the children (80%) had been born in the UK.
The survey responses showed that nearly half (46%) of all the pupils reported a history of any type of bullying: 17% as victims; 12% as perpetrators; and 4% as both.
But involvement in traditional bullying (1 in 3 of the teens) was more common than involvement in cyberbullying (1 in 4).
Some 13% of the teens had been cyberbullied; 8.5% had bullied others online; and 4% had been both victim and perpetrator. Some 16% of the teens had been bullied in person; 12% had bullied others in person; and 6.5% had been both victim and perpetrator.
There was some overlap between both types of bullying, although pure cyberbullies were less likely to also be traditional bullies.
Half of those involved in a specific role in cyberbullying were also involved in the same role in traditional bullying: 52% of cyber victims were also traditional victims; 45.5% of cyber victims were also traditional bully victims; and 48% of the cyberbullies were also traditional bullies.
Around 72% (1516) of the teens completed the CRIES assessment. More than a third of cyber victims (35%), more than one in four (29%) of the cyberbullies, and a similar proportion (28%) of those who were both, scored above the threshold for clinically significant PTSD symptoms.
Further analysis indicated that cyber victims displayed significantly more PTSD symptoms than did cyberbullies, and they experienced more intrusive thoughts and avoidance behaviours.
Cyberbullies also had significantly more PTSD symptoms than teens who weren't involved in any form of bullying.
This is an observational study, so can't establish cause and effect. It also relied on subjective reports, and it didn't include a full clinical assessment of suspected PTSD symptoms.
And while the sample was representative of UK urban teens, the findings may not be applicable to other regions or countries, caution the researchers.
Nevertheless, they suggest their findings have important implications. "Parents, teachers and health professionals need to be aware of possible PTSD symptoms in young people involved in cyberbullying," they write.
And they note: "Despite cyberbullying being less frequent than traditional bullying, it is noteworthy that more than a third of the cyberbullies were not involved in traditional bullying, whereas a huge majority of the cyberbully victims were involved in traditional bullying, mainly as traditional victims or [as both victim and perpetrator].
"This suggests that the anonymity provided to perpetrators online may constitute a new platform for bullying to occur, though this finding requires further study."
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