Impact of Cyberbullying Victimization on Suicide Risk Among Adolescents: The Mediator Role of Mental Health during the COVID-19 Pandemic

Background and Purpose

Recently, cyberbullying has become a serious social problem in the U.S., particularly among adolescents. The COVID-19 pandemic increased social media usage, with 23.2% of U.S. teenagers reporting they had been cyberbullied in 2021. Previous studies have shown a link between cyberbullying and suicide, making addressing the problem and identifying potential protective and risk factors necessary. This study aimed to investigate the association between cyberbullying victimization (CV) and suicide risk, including suicidal ideation (SI), plan (SP), and attempt (SA), and to assess the potential mediation effects of poor mental health (PMH) and poor mental health during the pandemic (PMHP) among adolescents.

Methods

This study used data from the 2021 Adolescent Behaviors and Experiences Survey (ABES), which was conducted to provide nationally representative data during a time when many students were attending school virtually due to COVID-19. A total of 7,998 students submitted surveys of which 7,689 had complete data. CV was the primary independent variable. Dependent variables were dichotomized SI, SP, and SA, assessed by asking if participants considered, made a plan, or attempted suicide during the past year. Data were weighted according to ABES analytic guidelines. We estimated OLS and binary logistic models to regress CV and PMH/PMHP on suicide risk. Mediation effects were assessed using the Sobel-Goodman test with bootstrapped standard errors.

Results

Of 7,689 adolescents, 13.8% experienced CV. Both PMH and PMHP partially mediated the associations between CV and SI, SP, and SA. CV adolescents were more likely to have SI compared to non-CV that decomposed into a direct effect of CV (aOR=2.16, p<.001) and an indirect effect of PMH (aOR=1.60, p<.001), indicating there was a 60% increase in the odds of SI caused by the indirect effect of CV, mediated through its effects on PMH. Thirty eight percent of the total effect of CV on SI was mediated by its effect on PMH. The effect of CV on SI was also mediated by PMHP (aOR=1.57, p<.001), with thirty seven percent of the total effect of CV on SI mediated by PMHP.

Similarly, CV adolescents were more likely to make SP (aOR=2.66, 2.75, p<.001) with an indirect effect of PMH (aOR=1.51, p<.001) and PMHP (aOR=1.52, p<.001) each. About a third of the effect of CV on SP was mediated by its effect on PMH or PMHP. CV adolescents were also more likely to attempt suicide (aOR=2.97, 3.00, p<.001), again mediated through the indirect effect of PMH (aOR=1.54, p<.001) and PMHP (aOR=1.45, p<.001).

Conclusions and Implications

CV significantly increased the odds of SI, SP, and SA directly as well as indirectly through worsening or exacerbating PMH/PMHP. Adolescence is a critical period for development, and PMH in adolescence may adversely affect long-term development and mental health. Therefore, intervening and preventing CV is critical for teenagers' mental well-being and development, particularly given findings on suicide risk. During the pandemic, students had limited access to school-based help. Subsequent continued use of online teaching warrants development and implementation of a system to provide appropriate interventions even in non-face-to-face situations.