Caroline Helwick

October 20, 2012

October 20, 2012 (New Orleans, Louisiana) — A new analysis of 41 cases of suicide related to "cyberbullying" revealed a complex picture of mental health status and victimization.

Many of the victims of cyberbullying also endured traditional bullying tactics, and a high percentage of these teenagers were struggling with mood disorders or depression.

The anonymity of the online mode of harassment affords great power, John C. LeBlanc, MD, of Dalhousie University in Halifax, Nova Scotia, Canada, concludes, and, he says, "future research should explore the role of these anonymous postings in the severity and impact of these messages."

Dr. LeBlanc reported these findings at the 2012 American Academy of Pediatrics (AAP) National Conference and Exhibition. For his work, he received the "Best Abstract" award from the AAP Council on School Health Programs.

Distance Between Bully and Target

Cyberbullying is defined as bullying using electronic means — primarily the Web and text messaging. It is an extension of traditional bullying, but with the additional element of electronic media, which creates some distance between the bully and his or her target, Dr. LeBlanc said.

He and his colleagues conducted an electronic search using Google and Factiva to investigate cases of suicide related to cyberbullying between January 2003 and May 2012. They excluded cases of suicide in which cyberbullying was deemed to not be a factor, or for which information was insufficient.

An exploratory analysis evaluated demographics, dates and locations of the suicides, the mental status of the victim (as assessed independently by 2 investigators), the co-occurrence of cyberbullying and traditional bullying, and the type of media used to convey aggression.

"We wanted to see what else might be going on in the lives of these people," he said.

The researchers identified 41 individuals — 24 female and 17 male — whose mean age was 15 years (range, 13 to 18 years). Their search uncovered no adults who had committed suicide as a result of cyberbullying.

These suicides had occurred in the United States (n = 26), Australia (n = 6), the United Kingdom (n = 5), and Canada (n = 4).

The study found that 24% of teenagers in this population were the victims of homophobic bullying, including the 12% who were identified as homosexual and another 12% who were identified as heterosexual or of unknown sexual preference.

A marked increase was noted in cyberbullying-related suicides in recent years. Only 2 or fewer cases occurred per year between 2003 and 2007; this jumped to 6 in 2008, peaked at 13 in 2011, and was reported at 5 for the first 3 months of 2012, Dr. LeBlanc said.

In fact, 44% of all suicides occurred recently — between January 2011 and April 2012; 56% occurred between 2003 and 2010.

The month with the highest incidence was January (n = 7), followed by September (n = 6) and April (n = 5). "The start of the school year and the winter term may be associated with increased risk, although this was not statistically significant in this small sample, and it could have occurred by chance," he said.

The investigators determined that 32% of the teenagers had a reported diagnosis of a mood disorder, and 15% had symptoms of depression.

"There was a high level of coexisting mental illness," he said. "Many of the families described the bullying as the 'tipping point.' "

However, exceptions were noted: 37% of the individuals studied "were reported to have been acting normally immediately prior to the suicide, so their suicide came as a surprise," he added.

Pattern of Bullying

In many of the cases, cyberbullying was not the only form of harassment. Only 17% of the adolescents who committed suicide were bullied only via electronic means; 78% were bullied both at school and online, Dr. LeBlanc reported.

In describing social and electronic media modes of bullying, he said that Facebook and Formspring were specifically mentioned in 21 cases, and MySpace was commonly used only before 2011. Text or video messaging was noted in 14 cases.

Formspring is a lesser known site — where "you can post whatever you want" — and this figured prominently in these suicides as well, he said.

Harold Magalnick, MD, of Phoenix, Arizona, commented on the findings. At the AAP meeting, Dr. Magalnick was the recipient of the Milton Senn Award, which honors a community-based pediatrician for collaboration with and service to his or her local school system.

The need to deal with cyberbullying has increased in his practice, Dr. Magalnick said, noting that the problem is seen not in adolescents alone, but increasingly among younger children. "By third grade, many children have cell phones, which give even more opportunities for bullying," he said.

All these children are dealing with this experience at a vulnerable period of psychosocial development, he added, and are being "hit with an issue they don't know how to deal with."

He said the anonymity of cyberbullying has fueled the impact of this form of aggression. "The bully used to be a particular kid at school, but now it's anonymous. This is more of a threat because the kids don't know who they are going up against any more," he said.

At this point, no interventions have been proven to prevent cyberbullying, Dr. LeBlanc added in his presentation. "We need to test interventions that specifically target this," he said.

Dr. LeBlanc and Dr. Magalnick have disclosed no relevant financial relationships.

The American Academy of Pediatrics 2012 National Conference and Exhibition: Abstract 18782. Presented October 20, 2012.