Abstract
Background
Scholars have argued that cyberbullying should be characterized as an Adverse Childhood Experience (ACE) given its potential for traumatic impacts on youth development. Considering the current attention surrounding mental health and well-being among adolescents, it seems critical to empirically measure this relationship, and also determine if some types have a stronger negative influence.
Methods
Data utilized in this study were derived from a survey conducted on a nationally-representative sample in 2023 involving 2,697 English-speaking middle and high school students aged 13 to 17 residing within the United States.
Results
We identified a strong positive relationship between PTSD symptoms and experience with cyberbullying. Surprisingly, exclusion and rejection were just as harmful as overt threats when it comes to inducing trauma. Gossip and malicious comments were as detrimental as targeting someone based on their identity.
Conclusion
By becoming more trauma-informed and implementing school-based specific measures, those who work with youth can better safeguard and support them in the face of cyberbullying.
Keywords: Cyberbullying, Trauma, Teens, Adverse childhood experiences, Cyberviolence
Background
Around the world, there has been a growing movement to view bullying and cyberbullying through the lens of trauma [1, 2]. Trauma results from “an event, series of events, or set of circumstances that is experienced by an individual as physically or emotionally harmful or life threatening and that has lasting adverse effects on the individual’s functioning and mental, physical, social, emotional, or spiritual well-being” [3, 11]. Bullying, widely considered a pernicious form of school violence, often occurs as a stressor that over time can have traumatic effects [4]. Indeed, bullying is being proposed by researchers as a type of Adverse Childhood Experience (ACE) [5, 6], and has been strongly and consistently linked (as is the case with many other ACEs) to poor outcomes later in life [7–10].
Similarly, scholars in recent years have argued that cyberbullying should be characterized as an ACE [11] given its potential for long-term traumatic impacts on healthy youth development. This conceptualization aligns with a growing body of research that demonstrates the interconnectedness between cyberbullying and other established ACEs [7, 12, 13]. Moreover, we understand that the tenuous developmental stages of childhood and adolescence are uniquely susceptible to certain risk factors that compromise health and well-being, and that ACEs are not only frequently experienced during this time but have a pronounced effect in both the short term and long term [14–16]. It appears, then, that considering the full spectrum of traumatic experiences in both offline and online contexts is necessary to mitigate negative health outcomes for this population.
Additional formal inquiry on this topic also is warranted given the heightened state of affairs in the United States where health professionals have suggested youth are entrenched in a mental health crisis [17–19]. Experts have proffered that the COVID-19 pandemic [20–22] and the ubiquity of social media use among teens [23] may be exacerbating factors. Any efforts to reduce the stressors that youth are facing, and more fully understanding the impact severity of such harms should compel and mobilize an urgent response. This seems especially critical given that bullying was largely dismissed as a normative component of growing up until Dan Olweus’s [24, 25] pioneering empirical efforts among Scandinavian youth in the 1970s catalyzed a shift in how many societies across the world considered and responded to peer-based aggression. Fully appreciating the scope and seriousness of impact stemming from cyberbullying victimization is essential to marshaling and implementing the most appropriate interventions and supports.
In the following text, we first provide an updated picture of the frequency, scope, and outcomes associated with cyberbullying. Then, we detail what has been discovered thus far in the literature base regarding the link between bullying experiences and traumatic outcomes. Next, we empirically explore this proposed relationship among a national sample of youth from the United States (US). After detailing the results, we offer some focal points and strategies to consider when building a trauma-informed approach to optimally assist those who have been bullied online in a way that mitigates the emotional, psychological, physiological, and even behavioral fallout that occurs.
Bullying and cyberbullying
The Centers for Disease Control and Prevention (CDC) defines bullying as “any 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” [26, 7]. The United Nations has identified that 32% of all students around the world have been bullied in some form by their school peers in the past month [27]. In the United States, self-report survey data from the CDC’s Youth Risk Behavior Surveillance System (YRBSS) in 2021 revealed that 15% of high schoolers were bullied at school over the last year [28]. Experience with bullying victimization has been linked to anxiety [29–31], depression [32–34], mental disorders [35–38], emotional and psychological struggles [39–42], physical health problems [43–45], and academic issues [46–48]. Generally speaking, bullying victims tend to consider suicide and attempt suicide more often than nonvictims [49–51]. Indeed, a meta-analytic work encompassing 47 studies from the US found consistent associations between bullying and suicidal ideation and behavior [52].
Cyberbullying has been defined as “willful and repeated harm inflicted through computers, cell phones, and other electronic devices” [53:10]. This form of bullying typically manifests through the dissemination of malicious, humiliating, or threatening content via social media platforms, gaming interfaces, and chat environments. A report by UNICEF [54] revealed that one-third of young people from the ages of 13 and 24 across 30 countries said they had been bullied online. YRBSS data from the US in 2021 show slightly lower prevalence rates, with approximately 16% of high school students reporting they were victims of cyberbullying in the past year [28].
Extensive research has indicated that cyberbullied youth are more likely to suffer academically, emotionally, psychologically, and even behaviorally [51, 53, 55–57]. Specifically, targets have struggled with substance use and abuse [58–60], negative affect [61–64], depression [65, 66], self-harm [67, 68], suicidal ideation [57, 69–71] and other psychosocial problems [72, 73]. Associations have also been found with lower academic achievement [65, 74, 75], lower self-esteem [70, 76–78], lower life satisfaction and well-being [40, 79], conduct problems [80], hostility and aggression [70, 81], and traditional bullying and interpersonal violence towards other youth [64, 82, 83].
Traumatic outcomes
Outside of these sequelae, chronic exposure to bullying has been linked to greater emotional, psychological, and physical distress, symptomatology, and pathology in children [36, 84–86]. Indeed, studies have shown that these social and emotional disturbances can have long-term consequences on targets into their adult years [87–89]. This leads us to the growing body of research showing that the effects of bullying resemble that of post-traumatic stress disorder (PTSD), and that the two are correlated [36, 86, 90–92]. For instance, 37% of British adolescents who were bullied indicated clinically significant levels of posttraumatic stress [93]. As another example, 25% of adults studied still experienced symptoms of PTSD, including intrusive memories of bullying, many years after they had finished their schooling [94]. In a meta-analysis of 29 cross-sectional studies, 57% of bullying targets on average reported symptoms of PTSD above thresholds for caseness (i.e., enough to formally classify it as trauma) [36].
Finally, emerging research largely involving non-representative school-based samples is confirming the expected link between online bullying and post-traumatic stress symptomatology [95–97] as well as increased psychiatric symptom severity [98]. An examination of 5,058 Italian students between the ages of 11 and 18 identified that those who had been cyberbullied reported significantly high levels of post-traumatic stress compared to their peers [97]. Relatedly, a study involving 2,218 students between the ages of 11 and 19 across four secondary schools in London found that 28.6% of cyberbullying victims presented clinically significant PTSD symptoms [96]. Longitudinal research in China involving 661 adolescents ages 12–17 found that cyberbullying victimization was positively associated with PTSD over time [99]. Finally, a study of 353 adolescents aged 13–17 who presented to the emergency department in a primary children’s hospital in the northeastern US identified that 61% of those who self-reported PTSD symptomatology also reported being cyberbullied in the past year [95].
Current study
In the present study, we propose three primary hypotheses regarding the relationship between cyberbullying experiences and traumatic outcomes among youth. First, we hypothesize a positive relationship between the frequency of cyberbullying experiences and the manifestation of PTSD outcomes. That is, the more cyberbullying that a youth experiences, the greater the number of PTSD indicators that will be observed. Second, we anticipate significant demographic differences in this relationship, and hypothesize that gender and age will play differentiating roles. Specifically, we predict that girls and younger adolescents will exhibit a higher likelihood of experiencing traumatic outcomes compared to boys and older adolescents, respectively. Third, we believe that the extent of traumatic outcomes will vary depending on the type of cyberbullying experienced. We predict that threats, privacy violations, and identity-based cyberbullying will be associated with more severe traumatic outcomes compared to other forms of cyberbullying (i.e., indirect cyberbullying and exclusion). This hypothesis is grounded in the argument that these particular forms of cyberbullying more directly impact an individual’s sense of safety, security, and identity– each of which are fundamental components of psychological well-being, and core human needs [100, 101].
Methodological approach
Data utilized in this study were derived from a survey conducted on a nationally-representative sample of 5,005 English-speaking middle and high school students aged 13 to 17 residing within the United States in 2023. Informed consent was obtained from the parents, and assent was secured from the children prior to their participation in the study. A marketing research firm was commissioned to distribute the survey instrument via email invitations, a cost-effective strategy that has been employed by other scholars over the years [102–104]. Of the individuals sampled for this study, 51% met established age, race, gender, and region criteria, and 15% of these chose to complete the survey, which took an average of 23 min to complete. The final sample for this analysis was n = 2,697 (53.9% of youth in the full sample who had been cyberbullied at least once).
Measures
Demographic controls
Age, gender, and race were included as controls in the models to account for any influence they might have on trauma associated with experiencing cyberbullying (see Table 1). Age was included as a continuous variable representing the respondent’s age in years (range 13–17; mean = 15.1). Gender represents the student’s self-reported gender (boy or girl– other genders were excluded from this analysis). The sample consisted of 57.5% girls and 42.5% boys. Race was a categorical variable where 1 = White, 2 = African American, 3 = Hispanic, 4 = Asian, 5 = American Indian or Alaskan Native, 6 = multiracial, and 7 = Other. Comparable to the population of early adolescents in the US [105], 66% of the sample was White/Caucasian, 8.6% was African American, 9.6% was Hispanic/Latin American, 2.0% was Asian, 0.8% was Native American, 11.3% was multiracial, and 1.7% was another race. For the multivariate models, race was dichotomized where 1 = Non-white and 0 = White.
Table 1.
Sample demographic characteristics of those who had been cyberbullied (N = 2,697)
| Percent | ||
|---|---|---|
| Gender | ||
| Girl | 57.5 | |
| Boy | 42.5 | |
| Age (mean = 15.1) | ||
| 13 | 18.1 | |
| 14 | 19.4 | |
| 15 | 19.8 | |
| 16 | 20.3 | |
| 17 | 22.5 | |
| Race | ||
| White/Caucasian | 66.0 | |
| Hispanic or Latin American | 9.6 | |
| Black/African American | 8.6 | |
| Asian | 2.0 | |
| American Indian or Native | 0.8 | |
| Multiracial | 11.3 | |
| Other | 1.7 | |
Cyberbullying
Experience with cyberbullying was measured using an 18-item scale that includes a variety of forms it can take (see Table 2). The varieties therein were developed during several studies over the previous twenty years [53, 106]. We define cyberbullying to research participants in the following manner: “…when someone repeatedly and intentionally harasses, mistreats, or makes fun of another person online or while using cell phones or other electronic devices.” Respondents are then asked how many times in the last 30 days they experienced each of the [listed] behaviors, with response options including: (0) never, (1) once, (2) a few times, and (3) many times. Therefore, higher values on the cyberbullying scale represent more experience with cyberbullying (Mean = 9.4; SD = 10.4). Cronbach’s Alpha for the cyberbullying scale was 0.914.
Table 2.
Types of cyberbullying experienced (Total alpha: 0.914)
| Percent | |
|---|---|
| Threats (Alpha: 0.786; Mean: 0.59) | |
| Someone threatened to hurt me through texts or direct messages | 38.2 |
| Someone threatened to hurt me online | 34.2 |
| Identity-Based (Alpha: 0.685; Mean: 0.40) | |
| Someone posted mean names, comments, or gestures about me with a sexual meaning | 29.4 |
| Someone posted mean names or comments online about my race or color | 26.4 |
| Someone posted mean names or comments online about my religion | 16.2 |
| Privacy Violations (Alpha: 0.799; Mean: 0.44) | |
| Someone repeatedly contacted me via text or online after I told them to stop | 41.6 |
| Someone stalked me online | 25.8 |
| Someone shared my personal information online without my permission | 23.8 |
| Someone pretended to be me online and acted in a way that was mean or hurtful to me | 23.1 |
| Someone tracked or monitored my location or activities after I told them to stop | 18.2 |
| Indirect Harassment (Alpha: 0.783; Mean: 0.36) | |
| Someone posted mean or hurtful comments about me online | 56.3 |
| Someone spread rumors about me online | 52.5 |
| Someone embarrassed or humiliated me online | 49.8 |
| Someone shared a mean or hurtful picture online of me | 28.1 |
| Someone shared a mean or hurtful video online of me | 18.7 |
| Someone created a mean or hurtful web page about me | 13.3 |
| Exclusion (Alpha: 0.588; Mean: 0.44) | |
| Someone intentionally excluded me from a group text or group chat | 53.4 |
| Someone encouraged others to gang up on me online | 35.1 |
| Any of the above | 87.2 |
PTSD
To measure trauma outcomes developed after exposure to cyberbullying, respondents were asked 9 items comprising the Posttraumatic Stress clinical scale component of the original 54-item Trauma Symptom Checklist for Children [107]. Youth were asked whether their experience with cyberbullying specifically affected them in a variety of ways, including: “Feeling very upset when something reminded you of it?“; “Loss of interest in activities that you used to enjoy?“; “Having strong physical reactions when something reminded you of it (for example, heart pounding, trouble breathing, sweating)?“; “Having strong negative belief about yourself (there is something wrong with me)?“; “Having difficulty concentrating?“; “Trouble falling or staying asleep?“; “Hurt your schoolwork?“; and “Negatively impacted friendships?” Response choices ranged on a 5-point Likert scale including 0 = not at all, 1 = a little bit, 2 = moderately, 3 = quite a bit, and to 4 = extremely. The nine items were combined into a mean scale ranging from 0 to 4, with higher values representing more PTSD (Mean = 1.24; SD = 1.02). Cronbach’s Alpha for the PTSD scale was 0.936.
Procedure
Statistical analyses were conducted using IBM SPSS (version 29.0). We begin by displaying the percentage of youth who experienced each of the 18 types of cyberbullying in the scale. Next, we use Ordinary Least-Squares (OLS) Regression to analyze the relationship between frequency of cyberbullying victimization and trauma, controlling for age, gender, and race. Finally, again using OLS Regression, we assess whether different forms of cyberbullying are more or less likely to be associated with traumatic responses. We estimated models for five different subgroups of cyberbullying (threats, identity-based cyberbullying, privacy violations, indirect cyberbullying, and exclusion).
This approach of stratifying specific behaviors into these five categories is logical and coheres with existing research on cyberbullying, online harassment, and general peer-based victimization via electronic technologies. First, the Threats category focuses on direct threats of physical harm, a distinct and severe form of cyberbullying which implicates a fear for one’s own safety or property. Research is clear that threats can significantly harm individuals who are targeted online [108–110]. Identity-based Cyberbullying focuses on bullying based on protected personal characteristics core to one’s self. Studies have shown that youth who belong to marginalized or minority identity groups (e.g., gender, race, religion) are disproportionately targeted and impacted by bullying and cyberbullying [111–114].
Third, Privacy Violations focus on those actions by others that invade one’s personal boundaries and violate their feelings of security, control over their private information, and overall ability to freely be themselves. Examples involve cyberstalking, impersonation, doxing, and repeated unwanted contact [115–119], and affect a nontrivial proportion of youth and young adults. Indirect Cyberbullying relates to the various types of online harm that damage the target’s reputation and social relationships, such as rumors, the posting of hurtful comments, and the sharing of embarrassing pictures or videos [106, 120, 121]. Finally, behaviors in the Exclusion category are done with the intent of undermining the target’s sense of value and belonging. Exclusionary behaviors have powerful negative effects on young people [122–124], especially during a season of life where peer relationships often are inextricably tied to one’s self-worth, self-esteem, and happiness [125–127].
Results
Table 2 displays the 18 cyberbullying items, grouped into the five different forms, along with prevalence rates for each. Indirect forms of harassment were among the most commonly-experienced types of cyberbullying, with 56.3% of students saying someone posted mean or hurtful comments about them online and 52.5% reporting that someone had spread rumors about them online. Exclusion was also common, with 53.4% of students reporting that someone intentionally excluded them from a group text or group chat. Less commonly-reported were cyberbullying through a web page (13.3%) or based on religion (16.2%). Overall, 87.2% of the sample had experienced one or more of these types of cyberbullying in the last 30 days. To be clear, this does not mean that 87.2% of youth in the US have been cyberbullied in the last 30 days, but that 87.2% of those who were cyberbullied had experienced the types noted in the table.
Table 3 displays the results of the regression analysis examining the relationship between cyberbullying and trauma. We began by first running a model with only the control variables. As shown in Table 3, boys who experienced cyberbullying scored significantly lower than girls on the trauma scale (Beta=-0.23, p <.001). Moreover, older youth who were cyberbullied reported less trauma than younger students (Beta=-0.05, p <.05). There was no relationship with regard to race. Overall, the control variables only accounted for about 1% of the variation in trauma. When the cyberbullying summary scale was added to the model, the control variables largely stayed the same (age became statistically insignificant). The more cyberbullying a youth experienced, the more trauma they experienced (Beta = 0.56, p <.001). Notably, adding the cyberbullying summary scale resulted in a model that explained 32% of the variation in trauma.
Table 3.
OLS Regression– Frequency of cyberbullying and relationship to trauma
| Controls | Cyberbullying Scale | |
|---|---|---|
| B (SE) Beta |
B (SE) Beta |
|
| Boys |
-0.23 (0.04)*** -0.11 |
-0.18 (0.03)*** -0.08 |
| Age |
-0.03 (0.01)* -0.05 |
-0.01 (0.01) -0.02 |
| Non-white |
-0.03 (0.04) -0.02 |
-0.04 (0.03) -0.02 |
| Cyberbullying Summary Scale |
0.05 (0.00)*** 0.56 |
|
| Constant | 1.86 (0.21)*** | 1.00 (0.18)*** |
| Adjusted R2 | 0.013 | 0.322 |
*p <.05; ***p <.001 (two-tailed)
Finally, Table 4 shows the results of five different regression models that utilize the various forms of cyberbullying. Not surprisingly, each was significantly related to experiencing trauma, with Beta coefficients ranging from 0.41 to 0.48 and adjusted R2s ranging from 0.18 to 0.25. Overall, there is no clear difference from one model to the next. That is, type of cyberbullying does not seem to matter when it comes to the extent to which trauma could result.
Table 4.
OLS Regression– Type of cyberbullying and trauma
| Indirect Cyberbullying |
Threats | Identity-based Cyberbullying |
Privacy-based Cyberbullying |
Exclusion | |
|---|---|---|---|---|---|
| B (SE) Beta |
B (SE) Beta |
B (SE) Beta |
B (SE) Beta |
B (SE) Beta |
|
| Boys |
-0.18 (0.04)*** -0.09 |
-0.24 (0.04)*** -0.12 |
-0.21 (0.04)*** -0.10 |
-0.17 (0.04)*** -0.08 |
-0.19 (0.04)*** -0.09 |
| Age |
-0.01 (0.01) -0.02 |
-0.03 (0.01) -0.04 |
-0.02 (0.01) -0.03 |
-0.03 (0.01)* -0.04 |
-0.01 (0.01) -0.01 |
| Non-white |
-0.00 (0.04) -0.00 |
-0.04 (0.04) -0.02 |
-0.12 (0.04)** -0.06 |
-0.03 (0.04) -0.01 |
0.02 (0.04) 0.01 |
| Indirect Cyberbullying |
1.56 (0.06)*** 0.48 |
||||
| Threats |
0.56 (0.04)*** 0.45 |
||||
| Identity-based Cyberbullying |
0.71 (0.03)*** 0.44 |
||||
| Privacy-based Cyberbullying |
0.77 (0.03)*** 0.48 |
||||
| Exclusion |
1.03 (0.04)*** 0.41 |
||||
| Constant | 0.91 (0.19)*** | 1.42 (0.19)*** | 1.38 (0.19)*** | 1.45 (0.19)*** | 1.01 (0.20)*** |
| Adjusted R2 | 0.238 | 0.218 | 0.201 | 0.245 | 0.182 |
*p <.05; **p <.01; ***p <.001 (two-tailed)
Discussion
The current research found that experience with cyberbullying was significantly associated with trauma. The more cyberbullying a student experienced, the more traumatic outcomes they reported. There were no differences when examining different forms of cyberbullying; all forms were significantly related to trauma. This latter finding is particularly important given the perception among some that relatively minor forms of cyberbullying (e.g., indirect cyberbullying or exclusion) are less consequential than more serious forms (e.g., threats or privacy violations). Even seemingly minor forms of mistreatment online can have significant impacts on youth.
Results from the current research are important insofar as they illuminate what was commonly believed regarding the consequences of cyberbullying. Future research should explore whether there are any particular protective factors that could help minimize the trauma experienced by youth who have been cyberbullied. For example, youth with strong family connections or peer relationships may be less impacted by cyberbullying [128]. Similarly, youth who have enhanced levels of resilience may be able to brush off their experience with cyberbullying more easily [129]. Additional scholarly inquiry should also explore the long-term consequences of cyberbullying victimization. It would be important to know whether the trauma experienced is relatively short-lived (a few months), or whether it persists for many years (e.g., some research has shown the effects of school bullying to last well into the adult years [88, 130, 131]).
Limitations
Certain methodological limitations of our study warrant acknowledgment and consideration. Given that we utilized a cross-sectional research design which asked students about their experiences at one point in time, we are unable to ensure proper temporal ordering of the independent and dependent variables. We minimized this concern by specifically asking respondents to report trauma associated with their cyberbullying experience(s). As such, we can assume the cyberbullying occurred before the trauma.
Second, caution must always be used when interpreting results from self-reported experiences of youth. Students may not be fully forthcoming about their experiences or could mis-remember when—or even if—a specific event occurred [132–134]. We sought to minimize this concern by asking youth about recent experiences with cyberbullying (within the most recent 30 days). We reason that if a child was cyberbullied within the previous 30 days, they likely remember it well.
Policy implications
Given the empirical link between cyberbullying and trauma, a goal in every school should be to move towards trauma-informed care [135–137] - also known as a trauma-informed approach or becoming trauma sensitive. This requires educators and other youth-serving adults to be familiar with (1) the research about the prevalence, trends, and impact of trauma on youth and (2) know the best practices and methods to support children and families who have experienced trauma [138]. Inherent in this approach is the prioritization of specific care leading to better outcomes especially when considering the heavy costs, burdens, and negative impact of trauma when untreated or otherwise unaddressed [139].
Many students who are bullied engage in avoidant coping, where they repress the intrusive thoughts or feelings that arise specific to the abuse they have experienced [140]. This manifests in a blunt affect, a general numbness, and the avoidance of any stimuli that may potentially trigger traumatic thoughts [141]. What appears most productive, then, is a solution-focused approach that revolves around providing emotional and practical support, as well as developing productive coping mechanisms to manage anxiety and traumatic symptoms [85, 142, 143].
The National Institute for Trauma and Loss in Children offers educators a number of steps to become a trauma-informed school [144]. Ultimately, a school may not be able to completely prevent a traumatic event but can cultivate skills and strategies within their students to appreciably reduce the impact of those events when they happen. To begin, schools should provide childhood trauma awareness training and understanding of how trauma impacts children’s learning and behavior [145]. It does not matter what one’s professional background or role in a school is. Administrators should provide opportunities for every adult in the school to grow in their knowledge of how stress and trauma affect students [146]. What is more, those adults should avail themselves of the knowledge to better serve those under their care. In addition, educators would do well to view trauma as an experience rather than an incident or a diagnostic category. Youth-serving adults must not get caught up in personal perceptions of what leads to trauma and what does not. It is not possible to fully know how a certain event might affect a child within a certain context, and so educators must focus on their experience [147]. If they cannot readily articulate their experience, school personnel must be inquisitive and care enough to ask and find out.
Relatedly, educators should believe the link between private logic and behavior. Students think a certain way because of the collective impact and influence of their past (and current) experiences (which may be traumatic in nature). How they act may not be in line with what one thinks is logical, but it is logical given their unique past. Moreover, school personnel must firmly establish the experience of physical, emotional, and psychological safety. When students feel safe at school, they do so much better academically, socially, and relationally [148, 149]. Safety is not only about preventing violence, but also about creating an environment marked by clarity, structure, consistency, hope, empowerment, and autonomy. Students must believe that their perspectives are welcomed (e.g., when they convey to administration that they do not feel safe) and will not be disregarded, their experiences matter and will not be trivialized or thought of as the result of a joke [53, 55, 150].
Additionally, to reduce the impact of trauma intense hyper-arousal (an atypical heightened state of anxiety) must be lowered while improving the ability to regulate emotions [151–154]. When stress affects the body, numerous responses are triggered on a neurological, cognitive, emotional, and physical (somatic) level. As such, adolescents and youth-serving adults need to learn how to sense and understand what exactly is happening in these situations in order to temper or even forestall their negative impact. One way this can happen is through experiential grounding. Also known as centering, this is where those who have experienced trauma practice certain techniques to keep them in the present, instead of being swept away in more autonomic outcomes like withdrawal, rumination, panic, disassociation, defensiveness, and denial [155–158].
Third, it is incumbent upon all youth-serving organizations to develop a Crisis Intervention Plan. Essentially, this involves the proactive establishment of an “emotional first aid” response to traumatic incidents [159, 160]. This plan is formulated by a team composed of key administration, mental health associates or liaisons, and other relevant staff members [161, 162]. The team prepares email templates, protocols, flowcharts, resource dissemination strategies, and more. It is important to recognize that schools are not only grappling with typical tragedies (e.g., suicides, natural disasters like hurricanes, illnesses) but also the additional strain of new historical events (e.g., the COVID-19 pandemic, the Israel-Hamas war, the Ukraine-Russia war) that affect certain subpopulations of youth. Therefore, the creation and implementation of a crisis plan is of paramount importance to forestall significant emotional and psychological fallout among adolescents today.
Conclusion
Our research revealed a strong link between cyberbullying victimization and traumatic outcomes in youth. Contrary to our hypotheses, we found no significant differentiation in the severity of traumatic outcomes across subgroups of cyberbullying. Said another way, no single type of cyberbullying emerged as more detrimental than the others in terms of producing traumatic responses. Given the uniformity of trauma risk across all forms of cyberbullying, it seems vital to avoid prioritizing or trivializing any particular type over another. Exclusion and rejection are just as harmful as overt threats when it comes to causing trauma. Similarly, gossip and malicious comments can be as traumatic as targeting someone based on their identity characteristics.
Enhancing physical, emotional, and psychological safety measures for youth at school and in the community, incorporating experiential grounding activities, and developing comprehensive crisis intervention plans are key intervention strategies to consider in response. By becoming more trauma-informed and implementing such measures, those who work with youth can better safeguard and support them in the face of cyberbullying, and can help them move forward without greatly compromising their health.
Acknowledgements
Not applicable.
Authors’ contributions
Sameer Hinduja: Funding acquisition, Investigation, Project administration, Conceptualization, Writing– original draft, Writing– review & editing.
Justin W. Patchin: Funding acquisition, Data curation, Conceptualization, Formal analysis, Methodology, Investigation, Writing– original draft, Writing– review & editing.
Funding
This project was supported by an unrestricted research grant from Facebook Research.
Data availability
The data that support the findings of this study are available from the corresponding author upon reasonable request.
Declarations
Ethics approval and consent to participate
The study was approved by the Institutional Review Board at the University of Wisconsin-Eau Claire. This research was conducted in full accordance with the ethical principles outlined in the Declaration of Helsinki for research involving human subjects. All participants provided informed consent prior to enrollment, and appropriate precautions were taken to minimize potential risks.
Consent for publication
Not applicable.
Competing interests
The authors declare that they have no competing interests.
Ethical considerations
The study was approved by the Institutional Review Board at the University of Wisconsin-Eau Claire. Informed consent/assent has been appropriately obtained.
Footnotes
Publisher’s note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
References
- 1.Finkelhor D. Trends in adverse childhood experiences (ACEs) in the united States. Child Abuse Negl. 2020;108:104641. [DOI] [PubMed] [Google Scholar]
- 2.Centers for Disease Control. About Bullying [Internet]. Youth Violence Prevention. 2024. Available from: https://www.cdc.gov/violenceprevention/youthviolence/bullyingresearch/fastfact.html
- 3.SAMHSA. SAMHSA’s concept of trauma and guidance for a trauma-informed approach. HHS Publication No(SMA) 14–4884. 2014.
- 4.Cantor D. School crime patterns a National profile of US public high schools using rates of crime reported to police: report on the study of school violence. and prevention: DIANE Publishing; 2002. [Google Scholar]
- 5.Finkelhor D, Shattuck A, Turner H, Hamby S. Improving the adverse childhood experiences study scale. JAMA Pediatr. 2013;167:70–5. [DOI] [PubMed] [Google Scholar]
- 6.Karatekin C, Hill M. Expanding the original definition of adverse childhood experiences (ACEs). J Child Adolesc Trauma. 2019;12:289–306. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 7.Trompeter N, Testa A, Raney JH, Jackson DB, Al-Shoaibi AA, Ganson KT, et al. The association between adverse childhood experiences (ACEs), bullying victimization, and internalizing and externalizing problems among early adolescents: examining cumulative and interactive associations. J Youth Adolesc. 2024;53:744–52. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 8.Merrin GJ, Wang JH, Kiefer SM, Jackson JL, Pascarella LA, Huckaby PL et al. Adverse childhood experiences and bullying during adolescence: A systematic literature review of two decades. Adolesc Res Rev 2023:1–29.
- 9.Ballard E, Van Eck K, Musci RJ, Hart S, Storr C, Breslau N, et al. Latent classes of childhood trauma exposure predict the development of behavioral health outcomes in adolescence and young adulthood. Psychol Med. 2015;45:3305–16. [DOI] [PubMed] [Google Scholar]
- 10.Quinn K, Boone L, Scheidell JD, Mateu-Gelabert P, McGorray SP, Beharie N, et al. The relationships of childhood trauma and adulthood prescription pain reliever misuse and injection drug use. Drug Alcohol Depend. 2016;169:190–98. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 11.Lillestolen T, de La Guardia MA, Omar H. Cyberbullying and its implications as an adverse childhood experience (ACE): A literature review. Dynamics Hum Health 2024;11.
- 12.Nagata JM, Trompeter N, Singh G, Raney J, Ganson KT, Testa A, et al. Adverse childhood experiences and early adolescent cyberbullying in the united States. J Adolesc. 2023;95:609–16. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 13.Nova FF, Pfafman R, Kardys K, Kerrigan C, Guha S, Pater J. Uncovering adverse childhood experiences (aces) from clinical narratives within the electronic health record. Proceedings of the ACM on Human-Computer Interaction. 2022;6:1–29.
- 14.Fisher HL, Jones PB, Fearon P, Craig TK, Dazzan P, Morgan K, et al. The varying impact of type, timing and frequency of exposure to childhood adversity on its association with adult psychotic disorder. Psychol Med. 2010;40:1967–78. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 15.Kieling C, Buchweitz C, Caye A, Silvani J, Ameis SH, Brunoni AR, et al. Worldwide prevalence and disability from mental disorders across childhood and adolescence: evidence from the global burden of disease study. JAMA Psychiatry. 2024;81:347–56. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 16.Solmi M, Radua J, Olivola M, Croce E, Soardo L, Salazar de Pablo G, et al. Age at onset of mental disorders worldwide: large-scale meta-analysis of 192 epidemiological studies. Mol Psychiatry. 2022;27:281–95. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 17.Shim R, Szilagyi M, Perrin JM. Epidemic rates of child and adolescent mental health disorders require an urgent response. Pediatrics 2022;149. [DOI] [PubMed]
- 18.Slomski A. Teen girls are faring worse than boys on nearly all mental health Measures—Here’s why. JAMA. 2023;329:1243–45. [DOI] [PubMed] [Google Scholar]
- 19.Walters AS. The mental health crisis: new data on teen girls. Brown Univ Child Adolesc Behav Letter. 2023;39:8–8. [Google Scholar]
- 20.Breuner CC, Bell DL. Adolescent mental and behavioral health: COVID-19 exacerbation of a prevailing crisis. Pediatrics 2023;151. [DOI] [PubMed]
- 21.Santaniello CM, Lubniewski KL, Kamei A, Pompeo-Fargnoli A. Impacts of the COVID-19 pandemic: the mental health crisis for children and adolescents. Case Rep Res Practices Med. 2022;2:45–53. [Google Scholar]
- 22.Marinoni C, Rizzo M, Zanetti MA. Social media, online gaming, and cyberbullying during the COVID-19 pandemic: the mediation effect of time spent online. Adolescents. 2024;4:297–310. [Google Scholar]
- 23.Office of the Surgeon General (OSG). Social Media and Youth Mental Health: The U.S. Surgeon General’s Advisory [Internet]. PubMed. Washington (DC): US Department of Health and Human Services. 2023. Available from: https://pubmed.ncbi.nlm.nih.gov/37721985/ [PubMed]
- 24.Olweus D. Aggression in the schools. Bullies and whipping boys. Washington, DC: Hemisphere Press (Wiley); 1978. [Google Scholar]
- 25.Olweus D, Limber SP. The Olweus bullying prevention program: Implementation and evaluation over two decades. Handbook of bullying in schools: Routledge; 2009:377– 99.
- 26.Gladden RMV-K, Hamburger AM, Lumpkin ME. CD. Bullying Surveillance among Youths: Uniform Definitions for Public Health and Recommended Data Elements. Version 1.0, in National Center for Injury Prevention and Control, Centers for Disease Control and Prevention and US Department of Education2014: Atlanta, GA.
- 27.UNESCO. Behind the numbers: ending school violence and bullying [Internet]. Unesco.org. 2019. Available from: https://unesdoc.unesco.org/ark:/48223/pf0000366483
- 28.Centers for Disease Control and Prevention. Youth risk behavior survey [Internet]. cdc.gov. 2021. Available from: https://www.cdc.gov/healthyyouth/data/yrbs/pdf/YRBS_Data-Summary-Trends_Report2023_508.pdfychology
- 29.Lee KS, Vaillancourt T. A four-year prospective study of bullying, anxiety, and disordered eating behavior across early adolescence. Child Psychiatry Hum Dev. 2019;50:815–25. [DOI] [PubMed] [Google Scholar]
- 30.Lee J. Pathways from childhood bullying victimization to young adult depressive and anxiety symptoms. Child Psychiatry Hum Dev. 2021;52:129–40. [DOI] [PubMed] [Google Scholar]
- 31.Jadambaa A, Thomas HJ, Scott JG, Graves N, Brain D, Pacella R. The contribution of bullying victimisation to the burden of anxiety and depressive disorders in Australia. Epidemiol Psychiatric Sci. 2020;29:e54. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 32.Park IY, Speer R, Whitfield DL, Kattari L, Walls EN, Christensen C. Predictors of bullying, depression, and suicide attempts among youth: the intersection of race/ethnicity by gender identity. Child Youth Serv Rev. 2022;139:106536. [Google Scholar]
- 33.He Y, Chen S-S, Xie G-D, Chen L-R, Zhang T-T, Yuan M-Y, et al. Bidirectional associations among school bullying, depressive symptoms and sleep problems in adolescents: A cross-lagged longitudinal approach. J Affect Disord. 2022;298:590–98. [DOI] [PubMed] [Google Scholar]
- 34.Strohacker E, Wright LE, Watts SJ. Gender, bullying victimization, depressive symptoms, and suicidality. Int J Offender Ther Comp Criminol. 2021;65:1123–42. [DOI] [PubMed] [Google Scholar]
- 35.Turcotte Benedict F, Vivier PM, Gjelsvik A. Mental health and bullying in the united States among children aged 6 to 17 years. J Interpers Violence. 2015;30:782–95. [DOI] [PubMed] [Google Scholar]
- 36.Nielsen MB, Tangen T, Idsoe T, Matthiesen SB, Magerøy N. Post-traumatic stress disorder as a consequence of bullying at work and at school. A literature review and meta-analysis. Aggress Violent Beh. 2015;21:17–24. [Google Scholar]
- 37.Arseneault L. The long-term impact of bullying victimization on mental health. World Psychiatry. 2017;16:27–8. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 38.Evans-Lacko S, Takizawa R, Brimblecombe N, King D, Knapp M, Maughan B, et al. Childhood bullying victimization is associated with use of mental health services over five decades: a longitudinal nationally representative cohort study. Psychol Med. 2017;47:127–35. [DOI] [PubMed] [Google Scholar]
- 39.Garaigordobil M, Machimbarrena JM. Victimization and perpetration of bullying/cyberbullying: connections with emotional and behavioral problems and childhood stress. Psychosocial Intervention. 2019;28:67–73. [Google Scholar]
- 40.Carvalho M, Branquinho C, de Matos MG. Cyberbullying and bullying: impact on psychological symptoms and well-being. Child Indic Res. 2021;14:435–52. [Google Scholar]
- 41.Arslan G, Allen K-A, Tanhan A. School bullying, mental health, and wellbeing in adolescents: mediating impact of positive psychological orientations. Child Indic Res. 2021;14:1007–26. [Google Scholar]
- 42.Cañas E, Estévez E, Martínez-Monteagudo MC, Delgado B. Emotional adjustment in victims and perpetrators of cyberbullying and traditional bullying. Soc Psychol Educ. 2020;23:917–42. [Google Scholar]
- 43.Zarate-Garza PP, Biggs BK, Croarkin P, Morath B, Leffler J, Cuellar-Barboza A, et al. How well do we understand the long-term health implications of childhood bullying? Harv Rev Psychiatry. 2017;25:89–95. [DOI] [PubMed] [Google Scholar]
- 44.Hamilton LD, Newman ML, Delville CL, Delville Y. Physiological stress response of young adults exposed to bullying during adolescence. Physiol Behav. 2008;95:617–24. [DOI] [PubMed] [Google Scholar]
- 45.Camodeca M, Nava E. The long-term effects of bullying, victimization, and bystander behavior on emotion regulation and its physiological correlates. J Interpers Violence. 2022;37:NP2056–75. [DOI] [PubMed] [Google Scholar]
- 46.Hosozawa M, Bann D, Fink E, Elsden E, Baba S, Iso H et al. Bullying victimisation in adolescence: prevalence and inequalities by gender, socioeconomic status and academic performance across 71 countries. EClinicalMedicine 2021;41. [DOI] [PMC free article] [PubMed]
- 47.Riffle LN, Kelly KM, Demaray ML, Malecki CE, Santuzzi AM, Rodriguez-Harris DJ, et al. Associations among bullying role behaviors and academic performance over the course of an academic year for boys and girls. J Sch Psychol. 2021;86:49–63. [DOI] [PubMed] [Google Scholar]
- 48.Huang L. Exploring the relationship between school bullying and academic performance: the mediating role of students’ sense of belonging at school. Educational Stud. 2022;48:216–32. [Google Scholar]
- 49.Peprah P, Asare BY-A, Nyadanu SD, Asare-Doku W, Adu C, Peprah J, et al. Bullying victimization and suicidal behavior among adolescents in 28 countries and territories: a moderated mediation model. J Adolesc Health. 2023;73:110–17. [DOI] [PubMed] [Google Scholar]
- 50.Geoffroy M-C, Arseneault L, Girard A, Ouellet-Morin I, Power C. Association of childhood bullying victimisation with suicide deaths: findings from a 50-year nationwide cohort study. Psychol Med 2022:1–8. [DOI] [PMC free article] [PubMed]
- 51.Hinduja S, Patchin JW. Connecting adolescent suicide to the severity of bullying and cyberbullying. J School Violence 2018:1–14.
- 52.Holt MK, Vivolo-Kantor AM, Polanin JR, Holland KM, DeGue S, Matjasko JL, et al. Bullying and suicidal ideation and behaviors: A meta-analysis. Pediatrics. 2015;135:e496–509. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 53.Hinduja S, Patchin JW. Bullying beyond the schoolyard: preventing and responding to cyberbullying. 3rd ed. Thousand Oaks, CA: Sage; 2024. [Google Scholar]
- 54.UNICEF.org. UNICEF poll: More than a Third of Young People in 30 Countries Report Being a Victim of Online Bullying [Internet]. 2019. Available from: https://www.unicef.org/press-releases/unicef-poll-more-third-young-people-30-countriesreport-being-victim-online-bullying
- 55.Patchin JW, Hinduja S. Bullying today: bullet points and best practices. Thousand Oaks, CA: Sage; 2016. [Google Scholar]
- 56.Kwan I, Dickson K, Richardson M, MacDowall W, Burchett H, Stansfield C, et al. Cyberbullying and children and young People’s mental health: a systematic map of systematic reviews. Cyberpsychology. Behav Social Netw. 2020;23:72–82. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 57.Hamm MP, Newton AS, Chisholm A, Shulhan J, Milne A, Sundar P, et al. Prevalence and effect of cyberbullying on children and young people: A scoping review of social media studies. JAMA Pediatr. 2015;169:770–77. [DOI] [PubMed] [Google Scholar]
- 58.Gámez-Guadix M, Orue I, Smith PK, Calvete E. Longitudinal and reciprocal relations of cyberbullying with depression, substance use, and problematic internet use among adolescents. J Adolesc Health. 2013;53:446–52. [DOI] [PubMed] [Google Scholar]
- 59.Yoon Y, Lee JO, Cho J, Bello MS, Khoddam R, Riggs NR, et al. Association of cyberbullying involvement with subsequent substance use among adolescents. J Adolesc Health. 2019;65:613–20. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 60.Pichel R, Feijóo S, Isorna M, Varela J, Rial A. Analysis of the relationship between school bullying, cyberbullying, and substance use. Child Youth Serv Rev. 2022;134:106369. [Google Scholar]
- 61.Hinduja S, Patchin JW. Cyberbullying: offenders and victims. In: Thio A, Calhoun TC, Conyers A, editors. Readings in deviant behavior. Boston: Allyn and Bacon; 2010. [Google Scholar]
- 62.Brighi A, Melotti G, Guarini A, Genta ML, Ortega R, Mora-Merchán J, et al. Self-esteem and loneliness in relation to cyberbullying in three European countries. In: Li Q, Cross D, Smith PK, editors. Cyberbullying in the global playground: research from international perspectives. Chichester: Wiley Blackwell Publishing; 2012. pp. 32–56. [Google Scholar]
- 63.Wang X, McClung SR. Toward a detailed Understanding of illegal digital downloading intentions: an extended theory of planned behavior approach. New Media Soc. 2011;13:663–77. [Google Scholar]
- 64.Kowalski RM, Limber SP. Psychological, physical, and academic correlates of cyberbullying and traditional bullying. J Adolesc Health. 2013;53:S13–20. [DOI] [PubMed] [Google Scholar]
- 65.Okumu M, Kim YK, Sanders JE, Makubuya T, Small E, Hong JS. Gender-specific pathways between face-to-face and cyber bullying victimization, depressive symptoms, and academic performance among US adolescents. Child Indic Res. 2020;13:2205–23. [Google Scholar]
- 66.Hu Y, Bai Y, Pan Y, Li S. Cyberbullying victimization and depression among adolescents: A meta-analysis. Psychiatry Res. 2021;305:114198. [DOI] [PubMed] [Google Scholar]
- 67.Dorol O, Mishara BL. Systematic review of risk and protective factors for suicidal and self-harm behaviors among children and adolescents involved with cyberbullying. Prev Med. 2021;152:106684. [DOI] [PubMed] [Google Scholar]
- 68.Yang B, Wang B, Sun N, Xu F, Wang L, Chen J, et al. The consequences of cyberbullying and traditional bullying victimization among adolescents: gender differences in psychological symptoms, self-harm and suicidality. Psychiatry Res. 2021;306:114219. [DOI] [PubMed] [Google Scholar]
- 69.Bai Q, Huang S, Hsueh F-H, Zhang T. Cyberbullying victimization and suicide ideation: A crumbled belief in a just world. Comput Hum Behav. 2021;120:106679. [Google Scholar]
- 70.Fisher BW, Gardella JH, Teurbe-Tolon AR. Peer cybervictimization among adolescents and the associated internalizing and externalizing problems: A meta-analysis. J Youth Adolesc. 2016;45:1727–43. [DOI] [PubMed] [Google Scholar]
- 71.John A, Glendenning AC, Marchant A, Montgomery P, Stewart A, Wood S, et al. Self-harm, suicidal behaviours, and cyberbullying in children and young people: systematic review. J Med Internet Res. 2018;20:e9044. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 72.Juvonen J, Gross EF. Extending the school grounds?—Bullying experiences in cyberspace. J Sch Health. 2008;78:496–505. [DOI] [PubMed] [Google Scholar]
- 73.Didden R, Scholte RH, Korzilius H, De Moor JM, Vermeulen A, O’Reilly M, et al. Cyberbullying among students with intellectual and developmental disability in special education settings. Dev Neurorehabilitation. 2009;12:146–51. [DOI] [PubMed] [Google Scholar]
- 74.Halliday S, Taylor A, Turnbull D, Gregory T. The relationship between early adolescent cyberbullying victimization and later emotional wellbeing and academic achievement. Psychology in the Schools 2023.
- 75.Torres CE, D’Alessio SJ, Stolzenberg L. The effect of social, verbal, physical, and cyberbullying victimization on academic performance. Victims Offenders. 2020;15:1–21. [Google Scholar]
- 76.Lei H, Mao W, Cheong CM, Wen Y, Cui Y, Cai Z. The relationship between self-esteem and cyberbullying: A meta-analysis of children and youth students. Current Psychology. 2020;39,:830–842
- 77.Foody M, Samara M, O’Higgins Norman J. Bullying and cyberbullying studies in the school-aged population on the Island of Ireland: A meta‐analysis. Br J Educ Psychol. 2017;87:535–57. [DOI] [PubMed] [Google Scholar]
- 78.Chen L, Ho SS, Lwin MO. A meta-analysis of factors predicting cyberbullying perpetration and victimization: from the social cognitive and media effects approach. New Media Soc. 2017;19:1194–213. [Google Scholar]
- 79.Giumetti GW, Kowalski RM. Cyberbullying via social media and well-being. Curr Opin Psychol. 2022;45:101314. [DOI] [PubMed] [Google Scholar]
- 80.Hay C, Meldrum R, Mann K. Traditional bullying, cyber bullying, and deviance: A general strain theory approach. J Contemp Crim Justice. 2010;26:130–47. [Google Scholar]
- 81.Abreu RL, Kenny MC. Cyberbullying and LGBTQ youth: A systematic literature review and recommendations for prevention and intervention. J Child Adolesc Trauma. 2018;11:81–97. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 82.Guo S. A meta-analysis of the predictors of cyberbullying perpetration and victimization. Psychol Sch. 2016;53:432–53. [Google Scholar]
- 83.Patchin JW, Hinduja S. Cyberbullying and Self-Esteem. J Sch Health. 2010;80:616–23. [DOI] [PubMed] [Google Scholar]
- 84.Gladstone GL, Parker GB, Malhi GS. Do bullied children become anxious and depressed adults? A cross-sectional investigation of the correlates of bullying and anxious depression. J Nerv Ment Dis. 2006;194:201–08. [DOI] [PubMed] [Google Scholar]
- 85.Tenenbaum LS, Varjas K, Meyers J, Parris L. Coping strategies and perceived effectiveness in fourth through eighth grade victims of bullying. School Psychol Int. 2011;32:263–87. [Google Scholar]
- 86.Tehrani N. Bullying: a source of chronic post traumatic stress? Br J Guidance Couns. 2004;32:357–66. [Google Scholar]
- 87.Wolke D, Copeland WE, Angold A, Costello EJ. Impact of bullying in childhood on adult health, wealth, crime, and social outcomes. Psychol Sci. 2013;24:1958–70. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 88.Klomek AB, Sourander A, Elonheimo H. Bullying by peers in childhood and effects on psychopathology, suicidality, and criminality in adulthood. Lancet Psychiatry. 2015;2:930–41. [DOI] [PubMed] [Google Scholar]
- 89.Klomek AB, Sourander A, Gould M. The association of suicide and bullying in childhood to young adulthood: A review of cross-sectional and longitudinal research findings. Can J Psychiatry. 2010;55:282–88. [DOI] [PubMed] [Google Scholar]
- 90.McKenney K, Pepler D, Craig W, Connolly J. Psychosocial consequences of peer victimization in elementary and high school: an examination of posttraumatic stress disorder symptomatology. Child victimization: maltreatment, bullying and dating violence, prevention and intervention 2005:15– 2.
- 91.Veenstra R, Lindenberg S, Oldehinkel AJ, De Winter AF, Verhulst FC, Ormel J. Bullying and victimization in elementary schools: a comparison of bullies, victims, bully/victims, and uninvolved preadolescents. Dev Psychol. 2005;41:672. [DOI] [PubMed] [Google Scholar]
- 92.Plexousakis SS, Kourkoutas E, Giovazolias T, Chatira K, Nikolopoulos D. School bullying and post-traumatic stress disorder symptoms: the role of parental bonding. Front Public Health. 2019;7:75. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 93.Mynard H, Joseph S, Alexander J. Peer-victimisation and posttraumatic stress in adolescents. Pers Indiv Differ. 2000;29:815–21. [Google Scholar]
- 94.Rivers I. Recollections of bullying at school and their long-term implications for lesbians, gay men, and bisexuals. Crisis. 2004;25:169–75. [DOI] [PubMed] [Google Scholar]
- 95.Ranney ML, Patena JV, Nugent N, Spirito A, Boyer E, Zatzick D, et al. PTSD, cyberbullying and peer violence: prevalence and correlates among adolescent emergency department patients. Gen Hosp Psychiatry. 2016;39:32–8. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 96.Mateu A, Pascual-Sánchez A, Martinez-Herves M, Hickey N, Nicholls D, Kramer T. Cyberbullying and post-traumatic stress symptoms in UK adolescents. Arch Dis Child. 2020;105:951–56. [DOI] [PubMed] [Google Scholar]
- 97.Baldry AC, Sorrentino A, Farrington DP. Post-traumatic stress symptoms among Italian preadolescents involved in school and cyber bullying and victimization. J Child Fam Stud. 2019;28:2358–64. [Google Scholar]
- 98.Nobles MR, Reyns BW, Fox KA, Fisher BS. Protection against pursuit: A conceptual and empirical comparison of cyberstalking and stalking victimization among a National sample. Justice Q. 2014;31:986–1014. [Google Scholar]
- 99.Liu C, Liu Z, Yuan G. The longitudinal influence of cyberbullying victimization on depression and posttraumatic stress symptoms: the mediation role of rumination. Arch Psychiatr Nurs. 2020;34:206–10. [DOI] [PubMed] [Google Scholar]
- 100.Maslow AH. A theory of human motivation. Psychol Rev. 1943;50:370. [Google Scholar]
- 101.Erikson EH, Identity. Youth and crisis. New York: W.W. Norton & Company; 1968. [Google Scholar]
- 102.Lenhart A, Anderson M, Smith A, Teens. Technology and Romantic Relationships [Internet]. Pew Research Center: Internet, Science & Tech; 2015. Available from: https://www.pewresearch.org/internet/2015/10/01/teens-technology-and-romantic-relationships/
- 103.Saleh A, Bista K. Examining factors impacting online survey response rates in educational research: perceptions of graduate students. Online Submiss. 2017;13:63–74. [Google Scholar]
- 104.Daikeler J, Bošnjak M, Lozar Manfreda K. Web versus other survey modes: an updated and extended meta-analysis comparing response rates. J Surv Stat Methodol. 2020;8:513–39. [Google Scholar]
- 105.America’s Diverse Adolescents| HHS Office of Population Affairs [Internet]. opa.hhs.gov. Available from: https://opa.hhs.gov/adolescent-health/adolescent-health-data/americas-diverse-adolescents
- 106.Patchin JW, Hinduja S. Measuring cyberbullying: implications for research. Aggress Violent Beh. 2015;23:69–74. [Google Scholar]
- 107.Briere J. Trauma symptom checklist for children. Odessa, FL: Psychological Assessment Resources 1996:00253-8.
- 108.Goyal N, Park L, Vasserman L. You have to prove the threat is real: Understanding the needs of Female Journalists and Activists to Document and Report Online Harassment. In: Proceedings of Proceedings of the 2022 CHI Conference on Human Factors in Computing Systems. 2022.
- 109.Sobieraj S. Credible threat: attacks against women online and the future of democracy. Oxford University Press; 2020.
- 110.Ortega R, Elipe P, Mora-Merchán JA, Genta ML, Brighi A, Guarini A, et al. The emotional impact of bullying and cyberbullying on victims: A European cross‐national study. Aggressive Behav. 2012;38:342–56. [DOI] [PubMed] [Google Scholar]
- 111.Obermaier M, Schmuck D. Youths as targets: factors of online hate speech victimization among adolescents and young adults. J Computer-Mediated Communication 2022;27.
- 112.Bliuc A-M, Faulkner N, Jakubowicz A, McGarty C. Online networks of Racial Hate: A systematic review of 10 years of research on cyber-racism. Comput Hum Behav. 2018;87:75–86. [Google Scholar]
- 113.Keighley R. Hate hurts: exploring the impact of online hate on LGBTQ + young people. Women Criminal Justice. 2022;32:29–48. [Google Scholar]
- 114.Hinduja S, Patchin JW. Bullying, cyberbullying, and LGBTQ students. Cyberbullying Research Center. 2020. Available from: https://ed.buffalo.edu/content/dam/ed/alberti/docs/Bullying-Cyberbullying-LGBTQ-Students.pdf
- 115.Wright MF. Cyberstalking victimization, depression, and academic performance: the role of perceived social support from parents. Cyberpsychology Behav Social Netw. 2018;21:110–16. [DOI] [PubMed] [Google Scholar]
- 116.Walsh WA, Finkelhor D, Turner H. Characteristics and dynamics of cyberstalking victimization among juveniles and young adults. Violence against Women 2024:10778012231225238. [DOI] [PubMed]
- 117.Chen M, Cheung ASY, Chan KL, Doxing. What adolescents look for and their intentions. Int J Environ Res Public Health. 2019;16:218. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 118.Chen Q, Chan KL, Cheung ASY. Doxing victimization and emotional problems among secondary school students in Hong Kong. Int J Environ Res Public Health. 2018;15:2665. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 119.Wu B, Doxxed. Impact of online threats on women including private details being exposed and swatting. Plus Greg Lukianoff on balancing offence and free speech. Index Censorsh. 2015;44:46–9. [Google Scholar]
- 120.1.Patchin J, Hinduja S. Tween cyberbullying in 2020. [Internet]. 2020. Cyberbullying Research Center and Carton Network. Available from: https://i.cartoonnetwork.com/stop-bullying/pdfs/CN_Stop_Bullying_Cyber_Bullying_Report_9.30.20.pdf
- 121.Patchin JW, Hinduja S. Words wound: Delete cyberbullying and make kindness go viral. Minneapolis, MN: Free Spirit; 2014. [Google Scholar]
- 122.Killen M, Mulvey KL, Hitti A. Social exclusion in childhood: A developmental intergroup perspective. Child Dev. 2013;84:772–90. [DOI] [PubMed] [Google Scholar]
- 123.Masten CL, Eisenberger NI, Borofsky LA, Pfeifer JH, McNealy K, Mazziotta JC, et al. Neural correlates of social exclusion during adolescence: Understanding the distress of peer rejection. Soc Cognit Affect Neurosci. 2009;4:143–57. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 124.Lev-Wiesel R, Nuttman-Shwartz O, Sternberg R. Peer rejection during adolescence: psychological long-term effects—A brief report. J Loss Trauma. 2006;11:131–42. [Google Scholar]
- 125.Zhang Y, Qin P. Comprehensive review: Understanding adolescent identity. Stud Psychol Sci. 2023;1:17–31. [Google Scholar]
- 126.Scholte RH, Van Aken MA. Peer relations in adolescence. Handbook of adolescent development: Psychology; 2020. pp. 175–99. [Google Scholar]
- 127.Bagwell CL, Kochel KP, Schmidt ME. Friendship and happiness in adolescence. Friendship and happiness: across the life-span and cultures 2015:99–116.
- 128.Sapouna M, Wolke D. Resilience to bullying victimization: the role of individual, family and peer characteristics. Child Abuse Negl. 2013;37:997–1006. [DOI] [PubMed] [Google Scholar]
- 129.Hinduja S, Patchin JW. Cultivating youth resilience to prevent bullying and cyberbullying victimization. Child Abuse Negl. 2017;73:51–62. [DOI] [PubMed] [Google Scholar]
- 130.Winding TN, Skouenborg LA, Mortensen VL, Andersen JH. Is bullying in adolescence associated with the development of depressive symptoms in adulthood? A longitudinal cohort study. BMC Psychol. 2020;8:1–9. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 131.Boden JM, van Stockum S, Horwood LJ, Fergusson DM. Bullying victimization in adolescence and psychotic symptomatology in adulthood: evidence from a 35-year study. Psychol Med. 2016;46:1311–20. [DOI] [PubMed] [Google Scholar]
- 132.Morgenstern R, Barrett N. The retrospective bias in unemployment reporting by sex, race and age. J Am Stat Assoc. 1974;69:355–57. [Google Scholar]
- 133.Horvath F. Forgotten Unemployment: Recall Bias in Retrospective Data, in Monthly Labor Review1982, Superintendent of Documents, U.S. Government Printing Office: Washington, DC. 40–43.
- 134.Brenner PS, DeLamater JD. Social desirability bias in self-reports of physical activity: is an exercise identity the culprit? Soc Indic Res. 2014;117:489–504. [Google Scholar]
- 135.Reeves E. A synthesis of the literature on trauma-informed care. Issues Ment Health Nurs. 2015;36:698–709. [DOI] [PubMed] [Google Scholar]
- 136.Oral R, Ramirez M, Coohey C, Nakada S, Walz A, Kuntz A, et al. Adverse childhood experiences and trauma informed care: the future of health care. Pediatr Res. 2016;79:227–33. [DOI] [PubMed] [Google Scholar]
- 137.Bath H. The three pillars of trauma-informed care. Reclaiming Child Youth. 2008;17:17–21. [Google Scholar]
- 138.Hanson RF, Lang J. A critical look at trauma-informed care among agencies and systems serving maltreated youth and their families. Child Maltreat. 2016;21:95–100. [DOI] [PubMed] [Google Scholar]
- 139.Dye H. The impact and long-term effects of childhood trauma. J Hum Behav Social Environ. 2018;28:381–92. [Google Scholar]
- 140.Carney JV. Perceptions of bullying and associated trauma during adolescence. Prof School Couns. 2008;11:2156759X0801100304. [Google Scholar]
- 141.Davidson LM, Inslicht SS, Baum A. Traumatic stress and posttraumatic stress disorder among children and adolescents. Handbook of developmental psychopathology: Springer; 2000. pp. 723–37. [Google Scholar]
- 142.Perfect MM, Turley MR, Carlson JS, Yohanna J, Saint Gilles MP. School-related outcomes of traumatic event exposure and traumatic stress symptoms in students: A systematic review of research from 1990 to 2015. School Mental Health. 2016;8:7–43. [Google Scholar]
- 143.Bell H, Limberg D, Robinson EM III. Recognizing trauma in the classroom: A practical guide for educators. Child Educ. 2013;89:139–45. [Google Scholar]
- 144.Soma C. 10 Steps Every Educator Needs to Know to Create a Trauma Informed School - Starr Commonwealth [Internet]. Starr Commonwealth. 2017 [cited 2025 Mar 28]. Available from: https://starr.org/2017/10-steps-every-educator-needs-to-know-to-create-a-trauma-informed-school/
- 145.L’Estrange L, Howard J. Trauma-informed initial teacher education training: A necessary step in a system-wide response to addressing childhood trauma. In: Proceedings of Frontiers in Education. Frontiers Media SA. 2022.
- 146.Garay B, Lasarte G, Corres-Medrano I, Santamaría-Goicuria I. Why should educators receive training in childhood trauma?? Trends Psychol 2022:1–28.
- 147.Honsinger C, Brown MH. Preparing Trauma-Sensitive teachers: strategies for teacher educators. Teacher Educators’ J. 2019;12:129–52. [Google Scholar]
- 148.Kutsyuruba B, Klinger DA, Hussain A. Relationships among school climate, school safety, and student achievement and well-being: a review of the literature. Rev Educ. 2015;3:103–35. [Google Scholar]
- 149.Konold T, Cornell D, Shukla K, Huang F. Racial/ethnic differences in perceptions of school climate and its association with student engagement and peer aggression. J Youth Adolesc. 2017;46:1289–303. [DOI] [PubMed] [Google Scholar]
- 150.Maftei A, Măirean C. Not so funny after all! Humor, parents, peers, and their link with cyberbullying experiences. Comput Hum Behav. 2023;138:107448. [Google Scholar]
- 151.Heller L, LaPierre A. Healing developmental trauma: how early trauma affects self-regulation, self-image, and the capacity for relationship. North Atlantic Books; 2012.
- 152.Blaustein ME, Kinniburgh KM. Treating traumatic stress in children and adolescents: how to foster resilience through attachment, self-regulation, and competency. Guilford; 2018.
- 153.Van der Kolk BA. The neurobiology of childhood trauma and abuse. Child Adolesc Psychiatric Clin. 2003;12:293–317. [DOI] [PubMed] [Google Scholar]
- 154.Ford JD, Russo E. Trauma-focused, present-centered, emotional self-regulation approach to integrated treatment for posttraumatic stress and addiction: trauma adaptive recovery group education and therapy (TARGET). Am J Psychother. 2006;60:335–55. [DOI] [PubMed] [Google Scholar]
- 155.de Tord P, Bräuninger I, Grounding. Theoretical application and practice in dance movement therapy. Arts Psychother. 2015;43:16–22. [Google Scholar]
- 156.Covington S. Beyond trauma. Center City. MN: Hazeldon; 2003. [Google Scholar]
- 157.Miller NA, Najavits LM. Creating trauma-informed correctional care: A balance of goals and environment. Eur J Psychotraumatology. 2012;3:17246. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 158.Fisher J. The work of stabilization in trauma treatment. Trauma Center Lecture Series, Boston, Massachusetts. 1999. Available from: https://www.complextrauma.uk/uploads/2/3/9/4/23949705/the_work_on_stabilization_in_trauma_work.pdf
- 159.Allen M, Burt K, Bryan E, Carter D, Orsi R, Durkan L. School counselors’ Preparation for and participation in crisis intervention. Prof School Couns. 2002;6:96–102. [Google Scholar]
- 160.Sokol RL, Heinze J, Doan J, Normand M, Grodzinski A, Pomerantz N, et al. Crisis interventions in schools: A systematic review. J School Violence. 2021;20:241–60. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 161.Jimerson SR, Brock SE, Pletcher SW. An integrated model of school crisis preparedness and intervention: A shared foundation to facilitate international crisis intervention. School Psychol Int. 2005;26:275–96. [Google Scholar]
- 162.Knox KS, Roberts AR. Crisis intervention and crisis team models in schools. Child Schools. 2005;27:93–100. [Google Scholar]
Associated Data
This section collects any data citations, data availability statements, or supplementary materials included in this article.
Data Availability Statement
The data that support the findings of this study are available from the corresponding author upon reasonable request.
