摘要：Objectives. Using data from a regional census of high school students, we have documented the prevalence of cyberbullying and school bullying victimization and their associations with psychological distress. Methods. In the fall of 2008, 20 406 ninth- through twelfth-grade students in MetroWest Massachusetts completed surveys assessing their bullying victimization and psychological distress, including depressive symptoms, self-injury, and suicidality. Results. A total of 15.8% of students reported cyberbullying and 25.9% reported school bullying in the past 12 months. A majority (59.7%) of cyberbullying victims were also school bullying victims; 36.3% of school bullying victims were also cyberbullying victims. Victimization was higher among nonheterosexually identified youths. Victims report lower school performance and school attachment. Controlled analyses indicated that distress was highest among victims of both cyberbullying and school bullying (adjusted odds ratios [AORs] were from 4.38 for depressive symptoms to 5.35 for suicide attempts requiring medical treatment). Victims of either form of bullying alone also reported elevated levels of distress. Conclusions. Our findings confirm the need for prevention efforts that address both forms of bullying and their relation to school performance and mental health. Recent national attention to several cases of suicide among youth victims of cyberbullying 1,2 has raised concerns about its prevalence and psychological impact. Most states now have legislation in place that requires schools to address electronic harassment in their antibullying policies, 3 yet schools lack information about cyberbullying correlates and consequences and how they may differ from those of school bullying. To inform schools’ efforts, research is needed that examines the overlap between cyberbullying and school bullying and identifies which youths are targeted with either or both types of bullying. It is also necessary to understand whether the psychological correlates of cyberbullying are similar to those of school bullying and whether students targeted with both forms of bullying are at increased risk of psychological harm. With reports indicating that 93% of teens are active users of the Internet and 75% own a cell phone, up from 45% in 2004, 4 there is great potential for cyberbullying among youths. Yet the extent of cyberbullying victimization and its prevalence relative to school bullying is unclear. Studies have found that anywhere from 9% to 40% of students are victims of cyberbullying, 5–7 and most suggest that online victimization is less prevalent than are school bullying and other forms of offline victimization. 8,9 Strikingly few reports provide information on youths’ involvements in bullying both online and on school property. Cyberbullying has several unique characteristics that distinguish it from school bullying. Electronic communications allow cyberbullying perpetrators to maintain anonymity and give them the capacity to post messages to a wide audience. 10 In addition, perpetrators may feel reduced responsibility and accountability when online compared with face-to-face situations. 11,12 These features suggest that youths who may not be vulnerable to school bullying could, in fact, be targeted online through covert methods. The limited number of studies that address the overlap between school and cyberbullying victimization has wide variation in findings, indicating that anywhere from about one third to more than three quarters of youths bullied online are also bullied at school. 11,13,14 The distinct features of cyberbullying have led to questions about the sociodemographic characteristics of cyberbullying victims compared with those of school bullying victims. Although numerous studies of school bullying have found that boys are more likely to be victims, 15,16 the extent of gender differences in cyberbullying is unclear. 5 Some studies have found that girls are more likely to be victims of cyberbullying, 9,10 yet other studies have found no gender differences. 8,17,18 Age is another characteristic in which cyberbullying patterns may differ from traditional bullying. Although there is a decreasing prevalence of traditional bullying from middle to high school, 16 some studies suggest that cyberbullying victimization increases during the middle school years, 8,10 and others have found no consistent relationship between cyberbullying and age. 11,19 Sexual orientation has been consistently linked with traditional bullying. 20–22 Despite recent media attention to cases of suicide among sexual minority youths who have been cyberbullied, 23 accounts of the relationship between cyberbullying and sexual orientation are primarily anecdotal, with little documentation of the extent to which nonheterosexual youths are victimized. The wide range of definitions and time frames used to assess cyberbullying complicates the comparison of the prevalence and correlates of cyberbullying across studies, and rapid advances in communications technology render it difficult to establish a comprehensive and static definition. Furthermore, there is wide variation in the age and other demographic characteristics of the samples, with many studies employing small, nonrepresentative samples. In addition to comparing the sociodemographics of cyberbullying victims with those of school bullying victims, it is important to understand whether cyberbullying is linked with negative school experiences, as is the case with school bullying. School bullying is widely known to be associated with many negative indicators, including lower academic achievement, lower school satisfaction, and lower levels of attachment and commitment to school, known as school bonding. 24,25 Because most cyberbullying occurs outside school, 19,26 it is uncertain whether a similar relationship exists for cyberbullying. A few studies have linked cyberbullying to negative school experiences, such as lower academic performance 27 and negative perceptions of school climate. 8 Although these studies suggest that cyberbullying may be a contributing factor, more research is needed to determine the extent to which school attachment and performance are related to cyberbullying experiences. The known link between school bullying and psychological harm, including depression and suicidality 28–31 has also raised concerns about how cyberbullying is related to various forms of psychological distress. An emerging body of research has begun to identify psychological correlates of cyberbullying that are similar to the consequences of traditional bullying, including increased anxiety and emotional distress. 6,11,32 There are also reports that online victimization may be linked with more serious distress, including major depression, 33,34 self-harm, and suicide. 31,35,36 Although studies consistently identify a relationship between cyberbullying and psychological distress, it is not known whether reports of psychological distress are similar among cyberbullying and school bullying victims or what levels of distress are experienced by those who report being victimized both online and at school. In this study, we used data collected from more than 20 000 students from the second wave of the MetroWest Adolescent Health Survey to examine patterns and correlates of bullying victimization. We first examined the prevalence of cyberbullying and school bullying and the degree of overlap between the 2 forms of victimization. Next, looking at youths who experienced cyberbullying only, school bullying only, or both types of bullying, we identified sociodemographic and individual-level school characteristics associated with each type of victimization. Finally, we analyzed the relationship between type of bullying victimization and multiple indicators of psychological distress, ranging from depressive symptoms to suicide attempts.
