Adverse Impacts of Cyberbullying Victimization on Health and Mental Health Among Adolescents in China: An Investigation of a Representative Sample

Background: Cyberbullying is an indirect type of bulling behavior that takes place via cyberspace. Cyber bullies harm victims psychologically and emotionally without face-to-face encounter. Cyberbullying victimization is associated with negative consequences that can adversely affect adolescents’ development. With the increase of Internet access, cyberbullying has become to a public health concern in China. This study examined prevalence rates of cyberbullying victimization using a representative sample of adolescents in China. In addition, it explored the effects of cyberbullying victimization on adolescents’ health, mental health, and substance use behaviors.

Methods: A three-stage stratified random sampling method was used to obtain a representative sample from all high school students in Xi’an, a large, highly populated city in Western China. Cross-sectional data were collected from 3,232 adolescents (Mage = 15.8, SD = 0.9) using self-administered survey. Slightly more than half of the sample (52.3%) was female. Adolescents’ cyberbullying victimization, self-esteem, post-traumatic stress disorder (PTSD) symptoms, depression, anti-social personality symptoms, borderline personality symptoms, and parent-child attachment were assessed using standardized, self-report measurement instruments. Further, questions were developed specifically for this survey to assess adolescents’ substance misuse and gambling, and sociodemographic information, including their parents’ marital status and employment status, and family economic status. 

Descriptive analysis was used to estimate the prevalence rates of cyberbullying victimization in this sample. Bivariate tests were conducted to examine the differences in sociodemographic characteristics and psychosocial factors between cyberbullying victims and non-victims. OLS and binary logistic regressions were conducted to examine the effects of cyberbullying victimization on adolescents’ health and mental health (e.g., depression, PTSD, substance misuse) after controlling for sociodemographic factors (e.g., age, gender, parents’ marital status, family income) and parent-child attachment. Missing data was handled using 10 iterations multivariate imputation by chain equations.

Results: A total of 21.9% of the sample reported having experienced cyberbullying victimization during their lifetime. Three binary logistic regressions revealed that cyberbullying victims were 33.7% more likely to engage in gambling for money (p < .05), 64.2% more likely to engage in problem drinking (p < .001), and 69.3% more likely to smoke cigarettes (p < .001) compared to their non-victim peers after controlling for adolescents’ sociodemographic factors and parent-child attachment. Five OLS regressions indicated that cyberbullying victimization had significant effects on adolescents’ health (β = -.85, p < .01), depression (β = 3.74, p < .001), PTSD (β = 7.17, p < .001), antisocial personality symptoms (β = .50, p < .01), and borderline personality symptoms (β = 1.40, p < .001) after controlling for adolescents’ sociodemographic factors and parent-child attachment.

Conclusions and Implications: Cyberbullying victimization is prevalent among adolescents in China. Findings regarding sociodemographic profiles of adolescents who are more likely to experience cyberbullying victimization have implications for service providers. Further, we found that cyberbullying victimization was associated with a number of adverse health and mental health consequences. Thus, effective prevention and intervention programs for cyberbullying that are tailored to Chinese adolescents is an urgent need. Findings and implications for research and practice will be discussed in detail.