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Cyberbullying is a topic covered in the 5-Minute Clinical Consult.

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  • Cyberbullying or online aggression: behavior via electronic or digital media that communicates hostile or aggressive messages intended to harm or discomfort others; includes threats, stalking, spreading rumors, harassment, sexually explicit or embarrassing images, impersonation, and exclusion
    • All can be carried out through social media, e-mail, online forums, apps, or instant messaging.
    • Can occur between strangers (3/4 of victims report knowing their bully)
  • Popular media focuses on reporting high-profile cases, but minor, common episodes are pervasive and corrosive and may have greater effects on the mental health of victims. Minor incidents may precede major bullying and take an additive toll on emotional health.
  • Compared with traditional bullying, cyberbullying can be anonymous, opportunistic, free from supervision, and easily accessible. Power differentials may be absent, unlike traditional bullying.
  • Large overlap between traditional bullies and victims and cyberbullies and victims; but youth not engaged in traditional bullying may participate due to limited consequences, lack of perceived harm to victims due to the ability to use a false name, or assume someone else’s on-screen identity.
  • Intervention is difficult because cyberbullying does not occur in spaces monitored by school staff or supervisory adults in nonschool settings.
  • Infrequently reported, usually to a friend (30%), parent (<10%), rarely to school personnel (<5%)
  • Cyberbullying creates a permanent record that can cause lasting emotional and social harm; the number of witnesses is unlimited.
  • Most common mediums for cyberbullying: Facebook, Twitter, YouTube, Snapchat, Instagram, and texting
  • Anonymity can facilitate disinhibition, for example, allowing students to post inappropriate evaluations of teachers on Web sites such as http://www.ratemyteachers.com/.
  • Commonly, a pediatric or early adult issue; but cyberbullying can occur anywhere, at any age, such as at work or in college between students or student bullying of professors on anonymous course evaluations. Adult-on-child cyberbullying is less uncommon.
  • Types of cyberbullying:
    • Direct: text, call, instant message, e-mail. Like traditional bullying, cyberbullying can be where an individual contacts his or her victim directly.
    • Indirect: commenting on public Web sites, posting pictures/videos to public forums
    • Microepidemics: multiple bullies—a contagion of peer-group bullying (e.g., sports teams)—piling on a single victim or group
    • Technology-facilitated sexual violence (TFSV) refers to a range of behaviors where digital technologies are used to facilitate both virtual and face-to-face sexually based harms. Many popular interactive video games portray systemic violence against women, male social dominance, hypermasculinity. This behavior has been shown to increase real world tolerance to sexual harassment.
    • Workplace: repeated and enduring negative behavior in the workplace that occurs via technology (1)
    • Cybertrolling—deliberate provocation of others by deceptive, harmful behavior, often causing large emotional reactions and disruption of communication. Prototypical troll is male, high in psychopathy, sadism, and low in empathy. Cybertrolling is distinguishable from cyberbullying by the pointlessness and disruptiveness of behavior.


According to the U.S. High School Youth Risk Behavior survey in 2015, 15.5% of high schoolers reported being electronically bullied in the last 12 months (2)[A].

  • Cyberbullying is pervasive; globally, between 20% and 40% of adolescents report cyber victimization. Studies vary in reporting relative prevalence of cyberbullying compared to traditional bullying.
  • 60% of online victims were also bullied; 1/2 of middle and high schoolers report being targeted; 1/3 cyberbullied others.
  • Bullying behavior peaks in middle school.
  • 1/4 of adults experience cyberbullying.
  • Due to Internet openness, much bullying is witnessed by third parties. Data suggest <25% of U.S. teens have witnessed traditional bullying versus >75% who were bystanders of cyberbullying.

Risk Factors

  • For victims
    • Previous victims of traditional bullying
    • Frequent Internet or social media use
    • Previous online harassment
    • Psychosomatic, emotional, or peer problems
    • Families with structures other than two biologic parents
    • Greater female correlation with depression and cyber victimization
    • Males are more likely to stand up to bullies.
    • Targets may be perceived as different—physical or mental disability, race/ethnicity, socioeconomic class, gender expression, or sexual preference.
      • Bullying for sexual orientation—higher risk of depression, suicidality than bullying for other reasons
  • For cyberbullies
    • Males are three times more likely to cyberbully.
    • Hyperactivity, conduct disorder
    • Substance use, including nicotine
    • Not feeling safe at school
    • Low prosocial behavior (limited empathy)
    • Exposure to media portraying antisocial or at-risk behavior
    • Disorganized attachment styles with caregivers
    • Previous victims of traditional bullying
    • Younger children may unintentionally bully, viewing the Internet similarly to a video game, where there are no consequences.
    • Intend online content as jokes.
    • Youths who both bully and victimize have higher rates of severe psychiatric illness.

General Prevention

Recommendations to parents/guardians

  • Communicate with children about online use.
    • Discuss positive and negative aspects of social media and Internet usage.
    • Learn about technologies children use.
  • Teach children that jokes may be difficult to interpret when not in person. When they poke fun or criticize, they may unwittingly offend.
  • Encourage children to report cyberbullying and resist pressure to reinforce bullying.
  • Form an online-use plan with children.
    • Reduce time online or on social media sites.
    • Negotiate policies that fit desires and needs of both parents and children.
  • Check privacy settings and supervise online activities.
    • Understand limitations of software monitoring to assess Internet use.
    • Parental Internet monitoring more effective than simple Internet restriction (3)
    • Remember that adolescents may know how to circumvent parental restriction software.
  • Workplace:
    • Bystander reporting training
    • Updating company policies to create explicit expectations for employees
    • Technologic cyberbullying defense applications can detect, intervene, prevent cyberbullying. Example: MCDefender—smartphone application prewarns perpetrators attempting to bully others before a message is sent and prevents bullying messaging (4).

Commonly Associated Conditions

  • Traditional bullying
  • Behavioral health comorbidities
  • Internet/video game addiction
  • Bully victims are more likely to bring guns to school and engage in school violence. Half of adolescents expressing shooting threats online had prepared to carry out threats.
  • Victims report more depressive symptoms; bullies report more problems with substance use.

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Stephens, Mark B., et al., editors. "Cyberbullying." 5-Minute Clinical Consult, 27th ed., Wolters Kluwer, 2019. Medicine Central, im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816218/all/Cyberbullying.
Cyberbullying. In: Stephens MB, Golding J, Baldor RA, et al, eds. 5-Minute Clinical Consult. 27th ed. Wolters Kluwer; 2019. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816218/all/Cyberbullying. Accessed April 18, 2019.
Cyberbullying. (2019). In Stephens, M. B., Golding, J., Baldor, R. A., & Domino, F. J. (Eds.), 5-Minute Clinical Consult. Available from https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816218/all/Cyberbullying
Cyberbullying [Internet]. In: Stephens MB, Golding J, Baldor RA, Domino FJ, editors. 5-Minute Clinical Consult. Wolters Kluwer; 2019. [cited 2019 April 18]. Available from: https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816218/all/Cyberbullying.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Cyberbullying ID - 816218 ED - Stephens,Mark B, ED - Golding,Jeremy, ED - Baldor,Robert A, ED - Domino,Frank J, BT - 5-Minute Clinical Consult, Updating UR - https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816218/all/Cyberbullying PB - Wolters Kluwer ET - 27 DB - Medicine Central DP - Unbound Medicine ER -