Until not that long ago, being bullied by others was often considered as a normal rite of passage. The past decade has seen the publication of dozens of prospective studies on being bullied and health problems with follow-up now reaching into adulthood. There is now convincing evidence that being bullied as a child or as an adolescent shows a causal relation to the development of mental health issues, in particular anxiety, depression, and non-suicidal self-injury; suicide attempts; suicide ideation; and general poor health. The adverse effects of being bullied are as detrimental or might even exceed those of childhood maltreatment by adults.
Recent years has seen a flourish of studies looking at cyberbullying, which is defined as bullying that takes place using electronic technology. Electronic devices, such as smart phones, have become so common that nearly 100% of adolescents in high-income countries use them daily, often checking their phone hundreds of times and for hours per day. Girls spend more time on devices and on social network sites than do boys. Electronic devices are also used to be mean, attack, exclude, or spread nasty rumours and ridicule. There have been high profile anecdotal reports of suicides after being bullied online. But has cyberbullying reached epidemic proportions and is it now the major route of being bullied?
In The Lancet Child and Adolescent Health, Andrew K Przybylski and Lucy Bowes report on the largest survey of cyberbullying and traditional bullying to date done in the UK. The What about Youth Study undertaken by the Health and Social Care Information Centre (now National Health Service Digital) in 2014–15 included some 120 000 youths aged 15 years in 150 local authorities in England. There are three major findings. First, despite widespread antibullying policies in schools in the UK, still 29 302 (27%) of adolescents reported to be regular victims of physical, verbal, or relational (ie, traditional) bullying. Second, hardly any new cases of bullying victimisation occurred by cybervictimisation only (406 [<1%] total, 130 [<1%] boys, 276 [<1%] girls). Most cybervictimisation occurred together with traditional bullying (3655 [3%] involved traditional and cybervictimisation). Third, a much higher percentage of variance in poor mental well-being (5% of well-being variability) was explained by traditional bullying compared with cybervictimisation (<1%).
These findings add to those of other recent studies that both assessed traditional and cyberbullying: cybervictimisation on its own creates very few new victims of bullying and that traditional bullying is still the major factor leading to poor mental health. Much has been made about cyberbullying despite it being a rare event on its own. Why is there thus such a large gulf between the empirical evidence and the perception of cyberbullying being epidemic? First, cases of suicides related to cyberbullying have received attention in the media but the empirical evidence indicates that they are rare compared with those associated with traditional bullying or both. Second, several research reports and reviews of cyberbullying have been methodologically flawed but widely reported. These reports falsely attributed the adverse effects on mental health to cybervictimisation, although 85–90% of cybervictimisation occurs alongside traditional victimisation. Thus, cyberbullying is another tool in the toolbox of bullies but it has not replaced traditional bullying.
The findings from this study are consistent with an evolutionary view of bullying. The social, schooling, and individual factors related to cyberbullying and traditional bullying are mostly the same. Bullying is a strategy to access resources by being dominant and powerful and being perceived as such. Thus, bullies (who bully others but never get bullied themselves) are usually highly popular, socially skilled, but callous in the pursuit of resources, such as dating opportunities, by using strategies to reduce the value and popularity of others while enhancing their own. Thus, bullies mostly target the same peers using electronic means that they also target using traditional means. Occasionally, a victim of traditional bullying who might not be mentally and physically strong enough to retaliate face-to-face might use the anonymity of online attacks.
The findings by Przybylski and Bowes and others have several important implications. Any intervention to reduce bullying and the adverse mental health effects caused by victimisation must include efforts to reduce traditional bullying. This could be by new innovative interventions in schools including online resources and learning or considering approaches involving primary health-care professionals. Furthermore, any study or review of the effects of cybervictimisation must take into account the effects of traditional bullying. The association of bullying victimisation on mental health shows a clear dose–response relationship—the more often (by whatever mean) or the longer children or adolescents have been bullied, the worse the mental health outcomes.