October 30, 2014

Cyberbullying: Notes from the Field

Ellen Selkie, MD, MPH
Adolescent Medicine Fellow, University of Washington/Seattle Children’s
As an adolescent medicine provider, I’m constantly working to keep up with media trends—a great conversation with my patients is often started when I ask what websites they use, or their favorite platform for staying connected with friends.   However, I’ve also seen peer relationships turn sour through media—particularly when it comes to cyberbullying.  
The CDC defines bullying as “unwanted aggressive behavior(s) by another youth or group of youths who are not siblings or current dating partners that involves an observed or perceived power imbalance and is repeated multiple times or is highly likely to be repeated.” Notably, bullying falls on the spectrums of aggression and violence, but not all violent or aggressive behaviors are necessarily bullying.  
How does this definition fit cyberbullying?  Well, we certainly see unwanted aggressive behaviors online—name calling and rumor spreading can be easily done by commenting or posting on social media, and text messaging is a quick way to threaten someone else.  The “power imbalance” may not be a physical one, but having secrets about a peer can be very powerful…especially if you decide to talk about them online without permission. For some teens, it may be “easier” to bully others online because of the anonymity that the Internet can offer as well as the potential for a large audience to see nasty messages quickly.  
It’s important to note that most kids who experience cyberbullying are also being bullied in person (“traditional” bullying).  They usually have some idea of who is cyberbullying them, though not always a specific person.  In fact, many studies show that cyberbullying is less common in prevalence than traditional bullying.  But whereas bullying that happens in person is usually limited by the timing and place of the school environment, cyberbullying can happen anywhere, at any time.  I’ve had multiple patients tell me that they check their Instagram at 2 or 3 in the morning “just in case” someone has posted a mean comment, so that they can delete it before too many people see it.
 The potential permanency of messages on the Internet calls into question whether a single post, while not “repeated multiple times,” would still constitute bullying behavior.  I think this is where we get into the topic of why we care about bullying in general.  We know that bullying, both as a bully and a victim, is associated with poor mental health, suicidality, school failure, and other negative health outcomes.  Cyberbullying has also been associated with these negative outcomes, and in some studies is more strongly associated with suicidality than traditional bullying alone.  It’s unclear why this might be, and further research is needed in this area.  But if a single mean post on Facebook is hurtful enough, and a teen can look at it over and over, might that not lead to distress, poor sleep, depression, or other negative consequences?
Regardless, I’m making sure to ask my patients about both in-person bullying AND cyberbullying, and most importantly, how they are coping if they are experiencing bullying.   While some teens view these aggressive behaviors as “drama” that is easily ignored, others take their peers’ online comments to heart.  Knowing each individual teen and their support system is key to identifying those most at risk.  
For more resources on these topics, visit StopBullying.gov and the Cyberbullying Research Center for further information.