Cyberbullying: A 21st Century Health Care Phenomenon

Jemica Carter, PhD, RN; Feleta L. Wilson, PhD, RN, FAAN


Pediatr Nurs. 2015;41(3):115-125. 

In This Article


The results of this study provided insight into the phenomena of traditional bullying and cyberbullying in adolescents. Participants overwhelmingly indicated they had access to a variety of technologies that could increase their risk for becoming cyberbullies and/or cybervictims, including devices that could be used with limited parental supervision, such as cell phones, laptop computers, and computers in the bedroom. Between 80% and 90% had access to computers, email accounts, and social networking accounts; approximately 80% possessed a cell phone and were skillful at text messaging. According to Mishna, Cook, Gadalla, Daciuk, and Solomon (2010), frequent technology use (e.g., Internet and other communication tools) may increase an adolescent's risk of being bullied online. In their survey of urban Canadian juveniles (N = 2,186), Mishna et al. (2010) found that 99% had daily access to a computer, and 55% used a cell phone for daily communication with friends; nearly half (49.5%) had been bullied online in the previous three months. Similarly, an anonymous Internet survey conducted in the U.S. (Juvonen & Gross, 2008) found that 94% of youth aged 12 to 17 years had home access to the Internet, and 72% reported at least one instance of cyberbullying within the past year. Li (2007a) identified technology use as a contributing factor for cyberbullying, emphasizing, "It is reasonable to assume that if students have limited opportunities to access technology, they should have fewer opportunities to be involved in cyber harassments" (p. 436).

In the present study, 16.9% (n = 62) of the students had been victims of cyberbullying, with slightly under half experiencing one or more incidents within the past 30 days. This finding supports other evidence, indicating that the prevalence of cyberbullying in adolescents ranges from 9% to 25% (Kowalski & Limber, 2007; Li, 2007b; Williams & Guerra, 2007), although a small study (Raskauskas & Stoltz, 2007) (N = 84) reported higher percentage for cybervictims and bullies (48.8% and 21.4%, respectively). Approximately one-third (33.9%, n = 19) of the students in the present study who had experienced cyberbullying had also cyberbullied others; this number may have been higher if participants who perpetrated traditional bullying (25.1%, n = 91) reported their cyberbullying history. In the study by Juvonen and Gross (2008), paired t-tests revealed a link between in-school bullying and online bullying. According to the National Crime Prevention Council (n.d.), increased access to technology "has allowed some teens to take the bullying that thrives in school hallways into cyberspace" (p. 1).

The students of the present study may have been reluctant to reveal their cyberbullying history to the researchers. Juvonen and Gross (2008) reported that 90% of their sample indicated they do not tell an adult about cyberbullying. This is similar to findings from Patchin and Hinduja (2006), who reported that less than 9% of the cyberbullying victims in their sample told an adult about the experience. Researchers have noted that adolescents fear losing technology privileges if they disclose negative aggression problems to their parents and teachers (Agatson et al., 2007; Kowalski & Limber, 2007; Mishna et al., 2010). It is possible, too, that adolescents consider cyberspace "their world," and are simply not psychologically prepared to share it with adults, even in the face of danger. In discussing the reliability of findings from their anonymous Internet survey (N = 571), Patchin and Hinduja (2006) noted "demographic data obtained may not be completely accurate because of a lack of trust in our research project, mischief, or purposeful obfuscation" (p. 158). In the present study, the researchers took care to connect with students about the topic by reading each survey question aloud.

Other findings of the present study can be noted in relation to the literature. Seventy percent (n = 42) of cyberbullying victims named "students inside the school" as perpetrators of the aggression, indicating they had some idea of the identity of the cyberbully. In a study by Mishna and colleagues (2010), a vast majority (89%) of the sample reported knowing the identity of the cyberbully, often indicating a fellow student or an acquaintance from another school. It is possible that in spite of the anonymous character of cyberbullying, victims can "guess" the identity of the aggressor, perhaps through the type of information shared or media used.

Other relations with the literature are dissimilar. In their anonymous Internet survey, Juvonen and Gross (2008) found that cyberbullying experiences occurred most frequently through instant messaging (IM) and message boards, and least frequently through social networking (i.e., social profile) sites (4%), while participants in Raskauskas and Stoltz's (2012) study cited text messaging as the most common media used for cyberbullying. In our study, cyberbullying victims named social networking sites (e.g., MySpace™, Facebook™, Twitter™) as the most common media used for the aggression (68%). Further, all cyberbullies in our sample admitted to using social networking sites to bully online. Twyman, Saylor, Taylor, and Comeaux (2010) also found that participants with cyberbullying experience were more likely to have a MySpace™ (i.e., social networking) account. According to Langos (2012), cyberbullying that takes place in a more public forum (i.e., website vs. email) can establish harm at its first instance due to the immediate wide audience. Further research is needed to determine types of media used for cyberbullying in order to plan collaborative interventions and education programs that involve parents, school personnel, nurses, and community leaders.

The logistic regression analyses did not reveal statistically significant findings for the personal and demographic variables, including data collection site (urban or suburban), participant age or grade in school, gender, ethnicity, academic grades and citizenship, family size, and birth order (see Table 5 and Table 6). A few U.S. studies (Kowalski & Limber, 2007; Raskauskas & Stoltz, 2007; Williams & Guerra, 2007) have differentiated their sample among urban, suburban, and rural areas, although site was not included as a variable in these studies. It is possible that community settlement plays a non-significant role in the cyberbullying phenomenon, given that most adolescents today have access to communicative technologies. The relation between age and cyberbullying has shown mixed findings in the literature. Wang, Iannotti, and Nansel (2009) found no differences in the cyberbullying phenomenon among 6th graders and 7th and 8th graders, and fewer self-reports of cyberbullying among 9th and 10th graders. Williams and Guerra (2007) found that engagement in Internet bullying increased from 5th to 8th grade, and then declined slightly among high school adolescents. It is possible that in the present study, the school and organization settings played a role in the prevalence of cyberbullying among all age groups. Simil ar to reports in the literature (Wang et al., 2011; Williams & Guerra, 2007), gender played no significant role in cyberbullying victim experience in the present study. Kowalski and Limber (2007) reported that girls were more likely to be engaged in electronic bullying than boys, although differences in gender were not significant across the methods of electronic bullying. In the present study, the larger prevalence of cyberbullying via social profiling websites may have contributed to the lack of significant difference in the experiences between male and female participants.

Few U.S. studies have explored the phenomenon of cyberbullying with race/ethnicity as a factor (Wang et al., 2009). In fact, a few authors have acknowledged the ethnic homogeneity of their participants due to convenience sampling (Kowalski & Limber, 2007) or the audience appeal of particular websites used for electronic surveying (Patchin & Hinduja, 2006). The majority of participants of the present study reported they were African American; this makeup may have been a result of the school setting. In 2007, Li explored cyberbullying among a diverse sample of middle school students (69.7% white participants, 9% Asian, and 20% are black, Hispanic Aboriginal, or other ethnic participants). Li (2007b) found that white participants were more likely to experience cyberbullying. In future studies, a more diverse sample may determine if race or ethnicity plays a role in the cyberbullying.

To the best of our knowledge, only one study has explored cyberbullying with academic grades as a factor. Li (2007b) explored the phenomenon among middle school students in Canada and found that academic achievement did not relate significantly to cyberbullying.

Limitations were identified in this research study. The use of a nonrandomized convenience sample may have affected the outcomes. The researchers were required to obtain permission from the schools and community organizations and then from the parents. Many schools we contacted were reluctant to allow data collection from students because it might detract attention from classroom instruction. In particular, the researchers encountered difficulties when attempting to gain access to a larger sample, representing various demographic characteristics, enrolled in the local public school system. We found that charter school administrators generally were more cooperative in allowing researchers to distribute surveys to their students; thus, many of the participants were attending charter schools. The majority of the charter school participants self-reported being African American. The large number of African Americans in the sample may have an impact on the findings of this paper.

Another potential limitation of the study was respondent bias from the use of self-report instruments. No attempt was made to verify the responses of the students to the survey questions regarding use of technology and experiences with cyberbullying. The students may have responded to survey items as they thought the researcher would expect instead of providing their true feelings about the questions being asked. Lastly, the participants were drawn from urban and suburban areas in a large metropolitan area. The results may not be generalizable to adolescents in rural areas.