Adolescent victims and perpetrators of electronic bullying appear more likely to report having psychiatric and physical symptoms and problems, according to a report in the July issue of Archives of General Psychiatry, one of the JAMA/Archives journals.

Cyberbullying is defined as an aggressive, intentional, repeated act using mobile phones, computers or other electronic forms of contact against victims who cannot easily defend themselves, according to background information in the article. "There are several special features regarding cyberbullying when compared with traditional physical, verbal or indirect bullying such as the difficulty of escaping from it, the breadth of the potential audience and the anonymity of the perpetrator," the authors write.

Andre Sourander, M.D., Ph.D., of Turku University, Turku, Finland, and colleagues distributed questionnaires to 2,438 Finnish adolescents in seventh and ninth grade (age range, 13 years to 16 years). Of those, 2,215 (90.9 percent) were returned with sufficient information for analysis. In addition to information about cyberbullying and cybervictimization, the teens were asked to report their demographic information, general health, substance use, traditional bullying behavior and psychosomatic symptoms, such as headache and abdominal pain.

In the six months prior to the survey, 4.8 percent of the participants were only victims of cyberbullying, 7.4 percent were cyberbullies only and 5.4 percent were both victims and perpetrators of cyberbullying.

Being a cybervictim only was associated with living in a family with other than two biological parents; perceived difficulties in emotions, concentration, behavior, or getting along with other people; headache; recurrent abdominal pain; sleeping difficulties and not feeling safe at school. Being a cyberbully only was associated with perceived difficulties in emotions, concentration, behavior, or getting along with other people; hyperactivity; conduct problems; infrequent helping behaviors; frequently smoking or getting drunk; headache and not feeling safe at school. Being both cyberbully and cybervictim was associated with all of these conditions.

"Of those who had been victimized, one in four reported that it had resulted in fear for their safety," the authors write. "The feeling of being unsafe is probably worse in cyberbullying compared with traditional bullying. Traditional bullying typically occurs on school grounds, so victims are safe at least within their homes. With cyberbullying, victims are accessible 24 hours a day, seven days a week."

The results suggest that cyberbullying is an increasingly important type of harmful behavior, the authors note. "There is a need to create cyberenvironments and supervision that provide clear and consistent norms for healthy cyberbehavior. Clinicians working in child and adolescent health services should be aware that cyberbullying is potentially traumatizing," they conclude. "Policy makers, educators, parents and adolescents themselves should be aware of the potentially harmful effects of cyberbullying."

This study was supported by a grant from the Pediatric Research Foundation, Finland, and by the Finnish-Swedish Medical Association.