Friday, August 23, 2013

Depression and Cyberbullying - Evidenced Based Research from US NIH

Parry Aftab, WiredSafety’s founder and privacy and security lawyer, hates when she is asked during an interview to contrast the risks of cyberbullying with those of offline bullying. “Both are hurtful and unacceptable,” she responds whenever asked.

While physical bullying involves physical pain and fear, often the protracted nature of a cyberbullying campaign and its persistence long after the cyberbullies have ceased their attacks leads to higher rates of depression for victims. Over the eighteen years since WiredSafety’s volunteers began their work assisting victims of cyberbullying and cyberharassment, the charity had substantial anecdotal evidence of this fact. But until recently, no credible research existed to support this premise.

Reprinted below, with permission from the US Department of Health and Human Services, are  the results of research conducted at the National Institute of Health demonstrating higher depression rates among victims of cyberbullying than with victims of traditional offline bullying.

The research was conducted using survey responses received in 2005/2006. It is important to note that this predated the explosion of social networking use by teens and Facebook’s opening its use to more than university students. Parry Aftab suspects that if this research were conducted with fresher data, the differences between cyberbullying and traditional bullying victims’ depression rates would be even more marked.

Why? There are many reasons why cyberbullying can lead to more depression than offline bullying. And when a campaign involves both offline and cyberbullying, it represents the worst of both worlds. Anonymity is probably the worst culprit, when students feel that they can do things and hide behind the cyber-mask and rarely risk being identified. Another big problem is the lack of digital literacy and digital hygiene skills.

Passwords are easily guessed and frequently shared. Privacy settings are not used effectively or at all. They don’t screen for malware or use firewalls and often share devices. They share too much, don’t think before they click and misinterpret others’ communications. There is no escape. No changing neighborhoods, schools or cliques can avoid it. It follows the victim to grandma’s house and back again, to the mall, the gym, school, home and camp. But there’s more.

When asked to identify the main reasons cyberbullying results in higher incidents and levels of depression, Parry and WiredSafety’s “KidDoc”, pediatrician and Vanderbilt University faculty member, Dr. Deanna Guy agreed:

1. It is persistent. Once posted or shared, digital communications and content have a life of their own. Parry’s most frequently repeated quote, “what you post online stays online – forever” underscores the caching, publication, and viral nature of digital information.
2. Victims tend to revisit the scene of the cybercrime, re-reading text messages, logging in to view hijacked accounts, viewing hurtful images and seeing the latest postings. Each time they do, they are being revictimized. Each time is a renewed hurt.
3. The written or multimedia message has tremendous power. It enables a single post to spread to thousands of students.
4. It brings groups together. Messages among students at the victim’s old school come to the attention of students at the new school. Teens from camp connect with teens from church. What was private to a few becomes public and never-ending.
5. It is credible. After having read and re-read the messages and view and reviewed the images, the victim starts to believe that the cyberbullies have merit.
6. This is especially the case when a “mean girls” cyberbullying campaign gains traction with active posses, bystanders and rumor-mongers joining in. These campaigns persist long after the original cyberbullies have lost interest.
7. Cyberbullying is a renewable resource. New groups or individuals pick up the campaign when the victim comes to their attention, and old cyberbullying campaign members renew it when bored or the victim does something noteworthy.
8. The anonymity of cyberbullying (more than 2/3s of cyberbullying occurs anonymously or through the use of fake accounts or accounts that have been taken over by the cyberbullies) contributes to the problem in two ways – more students cyberbully knowing that there is a limited risk of being exposed and the victims don’t know if the cyberbully is their best friend or worst enemy. They become paranoid about not knowing whom can be trusted. This isolates them further.
9. There is no safe place to escape to; no place to hide from cyberbullies. Offline bullies need offline environments to do their damage - playgrounds, the walks to school, school buses, locker rooms or hallways. The devices and technologies used by teens to cyberbully others are designed to provide access to users 24/7/365. It can come at victims in the middle of the night, on vacation or in the security of their bedroom.
10. Cyberbullies often pose as a trustworthy friend, causing conflict and further isolating the victim from those who could help them address the attacks. Students have told Parry that they don’t know if the cyberbully is their best friend or worst enemy – they become paranoid.
11. Parents are rarely effective in helping students handle offline bullying, largely because it is hidden from them. But even those parents who learn of the cyberbullying are rarely prepared to address cyberbullying.
One student told Parry that she wouldn’t bother telling her parents since they would be “clueless” about the issue and “worthless” in providing help or support.

Sadly, the same digital communication tools and devices that allow the students to stay in touch and receive support from their friends are now seen as a source of pain.

The problem is exacerbated by the fact that there are more cyberbullies than bullies.

Cyberbullying attracts equal opportunity offenders. Everyone can be a cyberbully, no matter how small, shy or physically-challenged they are. They can act out their fantasies. They can act on impulse with technologies designed to be used impulsively. They aren’t really mean and nasty students, just playing one online. They can masquerade as others harassing friends of that student, providing two victims for the price of one. It is entertainment. It’s fun. It’s empowering. And it rarely involves serious risk of exposure.

With all of this, the NIH findings are not surprising at all. (the report is copied below)

Depression high among youth victims of school cyber bullying, NIH researchers report
Finding underscores need to monitor, obtain treatment for recipients of cyberbullying
Unlike traditional forms of bullying, youth who are the targets of cyber bullying at school are at greater risk for depression than are the youth who bully them, according to a survey conducted by researchers at the National Institutes of Health.
The new finding is in contrast to earlier studies of traditional bullying, which found that the highest depression scores were reported by another category of youth involved in bullying-bully victims. Past studies on traditional bullying show that bully-victims — those who both bully others and are bullied themselves — are more likely to report feelings of depression than are other groups.
Traditional forms of bullying involve physical violence, verbal taunts, or social exclusion. Cyber bullying, or electronic aggression, involves aggressive behaviors communicated over a computer or a cell phone.
"Notably, cyber victims reported higher depression than cyber bullies or bully-victims, which was not found in any other form of bullying," the study authors wrote in the Journal of Adolescent Health. "…unlike traditional bullying which usually involves a face-to-face confrontation, cyber victims may not see or identify their harasser; as such, cyber victims may be more likely to feel isolated, dehumanized or helpless at the time of the attack."
The analysis, of 6th through 10th grade students, was conducted by Jing Wang, Ph.D., Tonja R. Nansel, Ph.D., and Ronald J. Iannotti, Ph.D., all of the Division of Epidemiology, Statistics and Prevention Research at NIH's Eunice Kennedy Shriver National Institute of Child Health and Human Development.
Dr. Iannotti noted that, although bullies are less likely to report feelings of depression than are bully-victims or victims, they are more likely to report depression than are youth not involved with any bullying behaviors — either traditional bullying or cyber bullying.
Being bullied interferes with scholastic achievement, development of social skills, and general feelings of well being, explained Dr. Iannotti, the study's senior author. In a study published last year, he and study coauthors reported that the prevalence of bullying is high, with 20.8 percent of U.S. adolescents in school having been bullied physically at least once in the last two months, 53.6 percent having been bullied verbally, and 51.4 percent bullied socially (excluded or ostracized), and 13.6 percent having been bullied electronically (
The U.S. Health Resources and Services Administration advises parents to encourage children to tell them immediately if they are victims of cyberbullying or other troublesome online behaviors. The agency also lists a number of steps that parents can take to help prevent cyber bullying and how to respond to it, at The site also includes extensive information on preventing and dealing with traditional forms of bullying. The Center for Disease Control also provides information on electronic aggression for parents, educators, and researchers at
In the current study, the research team sought to examine the association between depression and cyber bullying, which has not been studied extensively.
To conduct the study, the researchers analyzed data on American students collected in the 2005/2006 Health Behavior in School-aged Children Study, an international study of adolescents in 43 countries ( The researchers measured depression by gauging responses to six survey items. Students were asked to indicate, if, within the past 30 days, they felt very sad; grouchy or irritable, or in a bad mood; hopeless about the future; felt like not eating or eating more than usual; slept a lot more or a lot less than usual; and had difficulty concentrating on their school work. Students ranked their response according to a five item scale ranging from "never" to "always."
They were also asked to indicate whether they were involved with bullying behaviors, whether as perpetrators or victims. Survey questions were designed to measure the following forms of bullying: physical (hitting), verbal (such as name calling), relational (social isolation and spreading false rumors), and cyber (using computers or cell phones). The researchers classified bullying others or being bullied "two or three times a month" as frequent, and "only once or twice" as occasional. Respondents were further classified as either not involved with bullying (either as bullies or victims), bullies, victims, or bully-victims (who had bullied others and also been bullied themselves).
Compared to students who were not involved with bullying, adolescents who were bullies, bully victims, or victims tended to score higher on the measures of depression. Those frequently involved with physical, verbal, and relational bullying, whether victims or perpetrators, reported higher levels of depression than did students only occasionally involved in these behaviors.

The researchers found that youth who were frequently involved with bullying behaviors, regardless of the type of bullying involved, reported higher depression scores than did youth only occasionally involved with such behaviors.
For physical violence, no differences were found in depression scores among bullies, victims, or bully-victims. For verbal and relational bullying, victims and bully-victims reported higher levels of depression than bullies.
For cyber bullying, however, frequent victims reported significantly higher levels of depression than frequent bullies and marginally higher depression than frequent bully-victims. The finding that victims of cyber bullying reported higher depression scores than bully victims was distinct from traditional forms of bullying and merited further study.

Victims of cyber bullying scored higher for feelings of depression than did bully-victims, a finding not seen with any other category of bullying.
Because of the association between bullying and depression, bullies, bully-victims, and victims are candidates for evaluation by a mental health professional, Dr. Wang said.
Information about depression and its treatment is available from the National Institute of Mental Health, at
Dr. Wang noted that in their earlier study, she and her coworkers had found that students were less likely to bully or to be victimized if they felt they had strong parental support—feeling that their parents helped them as much as they needed, were loving, understood their problems and worries, and helped them to feel better when they were upset.
The NICHD sponsors research on development, before and after birth; maternal, child, and family health; reproductive biology and population issues; and medical rehabilitation. For more information, visit the Institute’s Web site at
The National Institutes of Health (NIH) — The Nation's Medical Research Agency — includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. It is the primary federal agency for conducting and supporting basic, clinical and translational medical research, and it investigates the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit