Among adolescents receiving treatment in an acute inpatient psychiatric unit, those who experienced cyberbullying had elevated hyperresponse and higher rates of posttraumatic stress disorder (PTSD), depersonalization, and depression, according to a study published in the Journal of Clinical Psychiatry. A history of emotional abuse and recent cyberbullying were also correlated, suggesting that adolescents with a history of childhood trauma may be more vulnerable to continued abuse.
This questionnaire-based study assessed recent cyberbullying, current symptoms, and trauma in adolescents (13 to 17 years) admitted to inpatient psychiatric services at a suburban New York psychiatric hospital. Participants completed 3 questionnaires: the Childhood Trauma Questionnaire (CTQ), the Trauma Symptom Checklist for Children (TSCC), and a cyberbullying questionnaire, which was modified to reflect changes in social media technologies.
Among the 50 participants, rates of access to and engagement with internet-based communication and/or social media were high, with most participants (96%) indicating access to a cell phone and social media sites, and most participants engaging in at least 1 social media activity per day. There were no diagnostic differences between the participants who had experienced cyberbullying and those who had not, or in frequency of social media usage (χ25, 10.48; P =.063).
Twenty percent of participants experienced cyberbullying. Adolescents who had been cyberbullied had significantly higher scores on TSCC scales for PTSD, anger, depression, and fantasy dissociation (P <.05 for all). They also had clinically significant elevations (t score >65) in hyperresponses, dissociation, and overt dissociation that were not seen in nonbullied participants. Adolescents who experienced cyberbullying had significantly higher CTQ emotional abuse scores compared with those who were not bullied; however, levels of other types of trauma (emotional or physical neglect; sexual or physical abuse) did not differ significantly between groups. Cyberbullied participants were significantly more likely to meet clinical criteria for a lifetime history of emotional abuse (χ21, 4.01; P <.05).
In the final analysis, investigators used emotional abuse severity and cyberbullying status to predict depression and PTSD, as these symptoms showed the largest differences between bullied and nonbullied participants. Both regressions showed overall significance (depression: F₂,₄₇, 4.02; P =.024; PTSD: F₂,₄₇, 4.19; P =.021). Cyberbullying status predicted depression severity (t₄₈, 2.34; P =.024; R², 0.10), and emotional abuse was the only predictor for PTSD symptoms (t₄₈, 2.30, P =.021, R², 0.11).
Despite the limitations of the small sample size, study investigators conclude that adding questions on cyberbullying “to the clinical evaluation of adolescents may bring to light symptoms that may have otherwise been ignored and factors that may be causing or contributing to those symptoms.” They added, “These findings suggest that careful assessments of both bullying experiences and early life trauma should be a part of the clinical assessment of any identified or at-risk children and adolescents.”
Saltz SB, Rozon M, Pogge DL, Harvey PD. Cyberbullying and its relationship to current symptoms and history of early life trauma: A study of adolescents in an acute inpatient psychiatric unit. J Clin Psychiatry. 2020;81(1):18m12170.