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What Counts?: A Qualitative Study of Adolescents’ Lived Experience With Online Victimization and Cyberbullying
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What Counts?: A Qualitative Study of Adolescents’ Lived Experience with Online Victimization and Cyberbullying Megan L. Ranney MD MPH , Sarah K. Pittman , Alison Riese MD MPH , Christopher Koehler BA , Michele Ybarra PhD , Rebecca Cunningham MD , Anthony Spirito PhD , Rochelle K. Rosen PhD PII: DOI: Reference:
S1876-2859(19)30450-4 https://doi.org/10.1016/j.acap.2019.11.001 ACAP 1432
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Academic Pediatrics
Received date: Accepted date:
21 February 2019 2 November 2019
Please cite this article as: Megan L. Ranney MD MPH , Sarah K. Pittman , Alison Riese MD MPH , Christopher Koehler BA , Michele Ybarra PhD , Rebecca Cunningham MD , Anthony Spirito PhD , Rochelle K. Rosen PhD , What Counts?: A Qualitative Study of Adolescents’ Lived Experience with Online Victimization and Cyberbullying, Academic Pediatrics (2019), doi: https://doi.org/10.1016/j.acap.2019.11.001
This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. © 2019 Published by Elsevier Inc. on behalf of Academic Pediatric Association
Title: What Counts?: A Qualitative Study of Adolescents' Lived Experience with Online Victimization and Cyberbullying Authors and Affiliations: Megan L. Ranney, MD MPH a, b Sarah K. Pittman b Alison Riese, MD MPH b, c Christopher Koehler BA a Michele Ybarra, PhD d Rebecca Cunningham MD e Anthony Spirito PhD f Rochelle K. Rosen, PhD g a
Department of Emergency Medicine, Alpert Medical School of Brown University 55 Claverick Street 2nd Floor, Providence, RI 02903, United States of America [email protected] b
Rhode Island Hospital 593 Eddy Street, Providence, RI 02903, United States of America [email protected] c
Department of Pediatrics, Alpert Medical School of Brown University Box G-RIH Hasbro 129, Providence, RI 02903, United States of America [email protected] d
Center for Innovative Public Health Research 555 N. El Camino Real #A347, San Clemente, CA 92672, United States of America [email protected] e
Department of Emergency Medicine, University of Michigan 1500 East Medical Center Drive, Ann Arbor, MI 48109, United States of America [email protected] f
Department of Psychiatry and Human Behavior, Brown University 700 Butler Drive, Providence, RI 02906, United States of America [email protected] g
Department of Behavioral and Social Sciences, Brown University Box G-5121-4, Providence, RI 02912, United States of America [email protected] Corresponding Author: Megan L. Ranney Address: 55 Claverick Street, 2nd Floor, Providence, RI 02903, United States of America Email: [email protected] Phone: 401-444-2557
Fax: 401-444-2249 Declarations of interests: none Funding: This work was supported by the National Institutes of Health [R21HD088739]. Keywords: (5/5) Cyberbullying; adolescent; violence; qualitative; intervention development What’s New (37/40) Youth – even those with a history of cyberbullying – describe online conflict (“drama”) as part of a larger spectrum of peer violence. Discussion of “drama” and “bystander interventions” may be more acceptable to at-risk youth than cyberbullying-focused interventions. Abstract: (244/250) Objective: To inform development of cyberbullying interventions that are both accurate and meaningful to all adolescents, this qualitative analysis examines experiences of online peer victimization among a sample of predominately minority and low-income youth. Methods: Adolescents ages 13-17 years who reported past-year cyberbullying on a previously validated survey were recruited from an urban pediatric clinic to complete semi-structured interviews. Interview topics included definitions of cyberbullying, prior cyberbullying experiences, and strategies to reduce cyberbullying and its consequences. Interviews were audiorecorded and transcribed verbatim. Using thematic analysis, study team members applied both structural and emergent codes to transcripts. Results: Saturation was reached after 23 interviews (mean age 14.8 years; 65% female, 47.8% Hispanic, 35% Black, 74% low socioeconomic status). Four main themes emerged: 1) Teens avoided the term “cyberbullying,” due to its association with suicidality and severe depression; they preferentially described experiences (even those meeting criteria for repetition, power differential, etc.) as “online conflict”. 2) In-person bullying categories (bully, victim, bullyvictim, bystander) apply to online conflict. Few identify purely as victims. 3) Cyberbullying is
part of a larger continuum of peer violence, including physical fights and in-person bullying. 4) Teens want to help victims of cyberbullying; they desire more guidance in so doing. Conclusions: These youth rarely acknowledge presence of cyberbullying; instead, they describe online conflict as part of a larger spectrum of peer violence. Clinicians may consider prevention of a range of conflict-related behaviors (rather than focusing exclusively on cyberbullying), and may considerengaging adolescent bystanders in prevention of online conflict.
Introduction Estimates of the prevalence of adolescent cyberbullying vary immensely, with reported rates of victimization ranging from 2% to 72% 1-3. This range partly reflects a lack of consistency about what, exactly, constitutes cyberbullying 4,5. For instance, experts disagree about the degree to which traditional elements of bullying, such as existence of a power differential, matter in the online world 6-8; whether the word “bullying” is needed in queries about cyberbullying prevalence 6 ; and whether cyber-harassment is qualitatively different from cyber-bullying 9. There is also uncertainty as to whether the categories of involvement in traditional bullying (e.g, bully perpetrators, victims, bully-victims, and bystanders) extend to cyberbullying 4, and whether the prevalence of youth in each category differs because of the wide-reach of the Internet and social media 2. Finally, there is disagreement as to whether the presence of negative outcomes (such as substance use, depressive symptoms, and suicidality) are required in order to label an experience as being cyberbullying 7,12. Underlying these expert debates about cyberbullying categorization is the absence of knowledge about the first-hand or “lived” experiences of adolescents experiencing online victimization 15. The “lived experience” of an event includes how it is defined, how it is
experienced, and how it is perceived to impact one’s life. The lack of knowledge about youth’s lived experiences of online conflict is particularly notable for low-income and minority youth. Despite their reported experience of cyberbullying at similar rates as majority and high-income youth 16, little is known about how online conflict fits into these adolescent’s greater world of social, emotional, and physical conflict
6,13,14,17
. It is also unknown whether minority and low-
income youth have unique concerns about online conflict. Ideally, cyberbullying interventions and assessments should be both accurate and meaningful to adolescents of all strata of society. To advance this goal, this qualitative study recruited from a sample of predominantly lower-income and non-white adolescents 18. We used applied thematic analysis to examine current experiences and perceptions of online peer victimization 19.
Methods Screening and Recruitment Participants presenting to a pediatric clinic in an urban teaching hospital in New England were eligible for screening if they were being seen for a well-child or sick-child visit, were between the ages of 13 and 17 years, spoke English, had an English-speaking parent or guardian present, and were able to assent. After parental verbal consent and participant verbal assent, participants completed a brief screening survey administered using a HIPAA compliant web-based data collection tool (REDcap) 20. All participants completing the survey were compensated with a small item (e.g. gum, pens). Participants were eligible for the hour-long semi-structured interview if they endorsed any past-year cyberbullying victimization experiences (e.g., “How often does another kid
pretended to be you and send or post something that damages your reputation or friendships?”) on the Cyberbullying Scale, a previously validated 16-question self-report measure with excellent internal consistency (Cronbach’s 0.94) and construct validity 21. Additional quantitative measures, used to assist with analysis, asked about demographic characteristics (e.g., age, socioeconomic status (SES), race, ethnicity, gender identity, sexual orientation)
22-24
, in-person
bullying (the Illinois Bullying Scale 25,26), and past year fights (a single question from the Youth Risk Behavior Surveillance Survey 27). We sought to recruit a sample of adolescents who were representative of the diversity of youth seeking care in our clinic. We iteratively recruited, interviewed, and analyzed until saturation was reached on multiple topics. Written consent and assent were obtained in the clinic; interviews were scheduled after the visit, to minimize conflict with clinical care. Participants were compensated with a $25 gift card. The study was approved by the hospital institutional review board. Interviews Semi-structured interviews were conducted by a single research assistant (RA) with a background in psychology and extensive qualitative facilitation training (supervised by RKR and MLR), using an iteratively revised interview guide; the RA was aware of participants’ survey responses but these were not discussed in the interview. Participants were asked open-ended questions about social media habits, experiences with online conflict, and strategies they and their friends use to avoid and cope with online conflict. Participants were asked to define or describe cyberbullying in their own words. Participants who had trouble defining cyberbullying in their own words, were offered commonly used definitions of cyberbullying, and asked to reflect on their accuracy and applicability to the participant’s life 28,29. Participants were then asked about personal and friends’ experiences with cyberbullying and online conflict or
victimization. Each online conflict experience was probed for further information (e.g., electronic medium used, who was involved, what the participant thought and felt about the experience). All interviews were recorded, transcribed verbatim, and checked for accuracy. A written debrief was completed by the RA after each interview, to inform iterative changes in the interview guide, allow “member checking” (in which emergent concepts were tested by presenting them to future participants), and to reflect on and develop facilitation skills. Analysis Members of the research team used applied thematic analysis to approach the data 19. Structural codes were derived from the interview agenda, research questions, and expert knowledge of the field; emergent codes were derived from iterative review of data that emerged during interviews 30. Interviews were independently coded by three team members until coding scheme stability was reached. Subsequent interviews were coded independently by two team members who met to discuss codes and resolve disagreements, with the primary investigator arbitrating if needed; as all codes were applied through consensus, kappa values were not calculated. Agreed upon codes were entered into NVivo 10 31. After thematic saturation was reached, the research team read the content of codes in aggregate, summarizing main concepts within each code. We used self-reported demographics and bullying experiences in NVivo to stratify codes and inform analysis (e.g., examining the frequency of codes and emergent themes according to gender). Coding summaries were reviewed by the team, organized, and summarized to develop the four themes presented here.
Results Forty-eight of 142 screened adolescents reported at least “sometimes” having a past-year cyberbullying experience (e.g., getting online messages that make you scared for your safety) on the CBS screen. After 23 interviews and a review of the interview debriefs, the coding team felt that saturation had been reached on the key research topics, and recruitment was stopped 32,33. Participants who did not complete the interview refused consent/assent (N=12), were unable to be scheduled (N = 5), lost interest (N = 4), had a parent who changed their mind (N = 1), or became too busy to participate (N = 3). Eligible youth who did and did not participate were demographically similar; participant demographics also mirror the clinic at large. Participants’ mean age was 14.8 years (SD = 1.03), with 65% female, 48% Hispanic, 74% low SES, and 35% Black or African American. The average cyberbullying score was 7.36 (SD = 5.51; range: 2-20. Four main themes about online conflict and violence were identified, as described below. The components of each theme are identified and illustrative participant quotes for each are presented in Tables 1 and 2. Theme A: Defining cyberbullying is complicated Participants were generally uncomfortable with the word “cyberbullying.” Most participants said cyberbullying was identified not by what happened during a conflict, nor by how it made them feel, but rather by the severity of its consequences. Many participants spontaneously defined cyberbullying as occurring only when it caused suicidality or severe depression (theme A1). Almost all participants verbally described experiencing online conflict (such as having lies told about them online or having fake pictures posted of them) and described negative emotional consequences to these events. Yet only two participants explicitly identified these
events as having been “cyberbullying.” Instead, most participants described their experiences as online “drama” or “conflict,” and used these terms interchangeably. Most participants said this online drama exists on a continuum of acceptability, ranging from joking to truly hurtful. Boundaries between what is acceptable or funny online, and what is hurtful, were difficult to define. A few participants specifically mentioned that joking could turn into hurtful drama, without the perpetrator necessarily being aware of their hurtfulness (theme A2). Even though they did not self-identify as victims of cyberbullying (see also theme B1), most participants described online drama using terms and concepts similar to existing definitions of cyberbullying (e.g., occurring over and over, being associated with a loss or lack of power, being associated with anxiety or hopelessness) (theme A3). For instance, participants described online conflict as reoccurring or dragging on for days. Some online conflict was perpetrated by an adolescent of greater status or popularity; some experiences of hurtful online conflict were described as one-time incidents; some were reportedly perpetrated by a peer of equal or lesser status than the “victim”. One participant said that online drama sometimes provided an outlet for teens of lesser status to express their anger. Many teens specifically said that online drama had more severe emotional consequences than in-person conflict; a few teens said that conflict that occurs exclusively online is easier to ignore. Finally, participants also expressed weariness with the label of cyberbullying. They said that the term cyberbullying was overapplied by adults (theme A4); they also felt that adults often assumed that cyberbullying was happening, when it wasn’t. Theme B: “Sometimes you don’t know that you’re bullying”
Our participants – all of whom had endorsed victimization on the quantitative screening measure – spontaneously described multiple, overlapping types of online experiences of bullying “drama”. We found that these experiences fell into four categories. The first experiential category was online victimization (theme B1). Most participants provided examples of family members, friends, or peers who had been online victims. Victimization was described as a situation where other teens were “helpless,” did not fight back, and were emotionally affected by the conflict. Notably, none of our participants described themselves exclusively as an online victim. The second category of involvement was online bullying of others (without concomitant victimization) (theme B2). Only a few participants exclusively shared stories of perpetrating online bullying behaviors towards peers. As one of these participants explained, “we don’t really say it out loud that we [cyber]bullied someone,” and – just as few self-identified as online “victims” - few self-identified as online “bullies”. Other participants commented that it was often difficult to identify who was the perpetrator of online conflict, as teens frequently traded roles in the cycle of online violence. A third category was being an online bully-victim (theme B3); these adolescents were both victims and perpetrators of online bullying. Many participants described personal experiences that matched this categorization. They commonly described their online actions as “fighting back” or “defending themselves or their friends.” They also (as described further in Theme C) were likely to describe pervasive drama or conflict throughout all aspects of their life. Some teens said that they only harassed other people online if they were “asking for it [online conflict].”
The final type of involvement with online conflict was as a bystander (theme B4). Almost all interviewed participants reported having seen multiple incidents of online bullying of others in the past year during the interview, in addition to potentially fitting in the other categories of involvement in online conflict. Although about half the interviewees initially said they’d only been bystanders to online conflict (e.g., never experiencing it themselves), with probing many of the self-identified bystanders reported prior involvement as both online victims and online bullies. These participants said their prior experiences allowed them to develop coping skills and strategies that helped prevent current involvement in cyberbullying and online drama. Theme C: It’s all violence, regardless of where it happens Descriptions of online conflict rarely stopped at the boundaries of the online world. Many youth reported concurrent online bullying, in-person bullying, and physical fights. The overlap between physical fights and online drama was bidirectional (theme C1). Sometimes online conflict led to physical fights, particularly for participants who saw fights as a means of self-defense against online conflict. Sometimes, cyberbullying or online drama was a result of inperson physical fights. For instance, two teens separately recounted stories of videos of physical fights being posted online to engage other teens in conflict. This direct extension of physical conflict into the online world was described as widening the reach, duration, and consequences of peer violence. For most interviewees, the medium by which conflict or drama occurred (whether online or in-person) was not important. When asked about “online drama” or “cyberbullying”, participants would describe both online and in-person components of an episode (theme C1). They frequently conflated terms, using the term “bullying” (but not “cyberbullying”) whether
they were referring to online or in-person conflict. Youth who qualitatively described more frequent involvement with online conflict, drama, and bullying also had higher quantitative scores for in-person bullying and in-person fights (see also Table 1). These teens said that if they could not fight in person, they used online media to engage with others. That said, teens did acknowledge that some drama and violence occurred exclusively online (theme C2), and that online drama could be uniquely amplified and spread around social media. Adolescents also reported that online drama sometimes occurred with people they would ordinarily not have a conflict with because of distance; through social media, they now engage in conflict despite geographical separation. This theme buttressed the findings in Theme A. Theme D: Teens Can– –And Want to– Help A teen’s conception of where they fell in the continuum of online conflict influenced their opinions about potential ways to stop cyberbullying. Most of the participants who selfdescribed as bystanders suggested that instilling empathy in other teens would be the most effective strategy for getting a cyberbully to stop bullying. These teens said bystanders needed to be persuaded to intervene and support victims (theme D1). In contrast, teens who described being online bullies or bully-victims were more likely to suggest violence – either physical or online - as their preferred method of resolving online conflict (see also theme C1). Almost all interviewees – even the bullies - expressed the desire to help friends who were victimized online. Many told stories of previously helping friends; the rest said they would help if presented with the opportunity. The bullies and bully-victims described “helping” by aggressing against others on behalf of their friends. Others described more gentle bystander interventions (see Table 1). However, some participants expressed hesitation about spontaneously reaching out to victims of online conflict (theme D2). When asked why, these
hesitant participants said they were afraid they would get dragged into the drama, felt like it was not their place to intervene, or were unsure of how to help a peer. In terms of helping victims (theme D3), many teens suggested changing the victim’s perception of online conflict or bullying. Participants said it was important to identify realistic actions that match adolescents’ goals and that fit with their online lifestyle. Some encouraged teaching teens to fight back. Participants’ opinions on involving adults varied (theme D4). Some participants reported strong relationships with an adult, such as a parent, and reported that they would talk to an adult about any conflict they experienced. Many said that they preferred to handle conflicts on their own, without the help of adults. Some even thought that involving an adult would make the situation worse. Yet all participants said that going to an adult would be beneficial in extreme situations, such as when they were feeling physically threatened by someone, or if they or a peer was threatening suicide.
Discussion This qualitative analysis provides novel perspectives on adolescents’ lived experience, definitions, and solutions to online conflict (see Table 3 for a summary of main findings and their corresponding implications). This paper is unique both in presenting the experiences of a primarily minority and low-income sample, who are often left out of discussions of online conflict, and in comparatively examining adolescents’ experiences and researchers’ definitions of cyberbullying. Most importantly, adolescents strongly disliked the word “cyberbullying” and were reluctant to label themselves a cyber-victim (despite all interviewees having reported past-year cyber-victimization on a quantitative screening survey) or a cyber-bully. Teens defined
“cyberbullying” as online conflict that causes severe consequences, particularly suicidality. Although many described personal experiences that experts would label as online “bullying” (based on frequency and power differentials), teens called these incidents of online “drama” or “conflict.” Our data therefore suggest that youth may tune out interventions or questions that use the word cyberbullying. Assuming they have not experienced cyberbullying, simply because their online experiences did not make them feel suicidal, adolescents may dismiss cyberbullyingspecific content as not relevant to their own experiences or social media interaction. This disparity between lived experiences and identification with a label is similar to that seen in other types of violence. For instance, validated measures of intimate partner violence and physical fights use lists of specific incidents 34,35, rather than asking about whether someone has “been a victim of domestic violence”. Our findings therefore suggest that researchers and clinicians should be similarly specific in the ways that they ask youth about experiences with online conflict. Clinicians and interventionists may engage youth more effectively by discussing unambiguous occurrences (such as having others spread lies online) and the consequences of these episodes (such as how it makes them feel), than by discussing “cyberbullying”. Teens may also be more open to discussions of online “drama” or “conflict” 9. Second, our study highlighted the overlap between online and in-person conflict. Some prior research suggests that in-person and online victimization, bullying, and physical fights may have distinct etiologies and consequences 36,37. We found however, that teens elided these categories both in their descriptions of others’ conflict and in their own experiences: one form of conflict informed, and often worsened, another. Because multiple-victimized teens are at greatest risk of negative outcomes 1, an exclusive focus on cyber-violence may be misguided 6,13,14. This finding also reinforces the importance of interviewing a diverse sample of adolescents, as
minority youth may be more likely to experience physical violence 38. Future hypothesis-testing and intervention development work should likely include measurements and interventions for multiple types of violence. Third, our analysis highlights the importance of addressing bystanders’ role in online conflict. Youth commonly described being witnesses or bystanders 2. Many adolescents who witness online conflict have also previously experienced or perpetrated online conflict; they too, are at risk of suffering negative consequences of cyberbullying 1. Our findings suggest that bystander interventions may be more acceptable to youth than interventions that focus on online victimization or bullying. For instance, as articulated by our interviewees, good online communication skills may allow youth to better articulate when someone has “crossed a line” between joking and bullying online, and may enhance self-efficacy in standing up for peers. Our findings also highlight the importance of de-emphasizing “fighting back” as a solution. Some early evidence suggests that encouraging bystander intervention may prevent future episodes of online conflict 41. The differences in perspective between the professional community that works in the area of cyberbullying, and the adolescents who experience cyberbullying, also suggests that the professional community should actively engage adolescents as collaborators to develop interventions. Finally, our qualitative findings highlight the wide spectrum of online conflict. The lower end of the online victimization continuum is teens joking around or “cracking on” friends; the upper extremes result in severe emotional harm. Teens only see this upper extreme as problematic. Yet, seemingly minor online conflict may also be a warning sign for future severe bullying, just as verbal partner violence is a marker of risk for future, life-threatening physical violence 39, and seemingly minor school scuffles can serve as a marker of risk for future serious
assaults and homicide 40. Future work could examine the temporal trajectory by which online conflict progresses from mild or minimally impairing, to severe, as well as personality traits and coping styles that predict trajectories in the wake of online conflict.
Limitations This study is qualitative, and thus provides guidance for future work rather than definitive causal conclusions. Although we had a relatively small number of participants from one pediatric clinic, our data was saturated and we believe the sample adequately describes the opinions and experiences of teens, with both agreement on several topics and some diversity in opinion. However, transferability of these findings to other adolescent populations are to be determined. The majority of our participants were low-income and of minority race or ethnicity; however, prior work suggests that racial, ethnic, and socioeconomic minority youth are equally likely to be harassed or bullied online 16.
Conclusion This qualitative study found that teens dislike the term cyberbullying, associating it with only the most severe incidents of online conflict. Nonetheless, teens described a great deal of online conflict, as well as negative consequences to this conflict. Being a bystander to online conflict was very commonly reported. Online and physical violence strongly overlapped for our interviewees. Future intervention programs may best engage youth by not focusing on cyberbullying per se, but instead by engaging youth in prosocial responses to, and avoidance of, all types of adolescent conflict, ranging from the physical to the online world.
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Table 1: Self-described online conflict experiences by demographic characteristics SelfDescribed Online Experiences
Online Victim
Online Bully
Online Bullyvictim
Online Bystander
Exemplar Quotes of Online Experience "My friend, she actually started cutting herself. She started feelin’ sad about herself. She stopped eating and all that because the [online] bully was tellin’ her that she was fat, she was ugly, and that nobody wants her, and that she needs to kill herself because nobody would care what she does.” “The bully could be somebody who sits at home, do nothing. The bully could be the shyest kid in school, but once you get behind a screen, that’s a whole different person inside of you, and I know that for a fact because when I was younger, I used to like, not exactly bully people, but like I would always like get myself into people’s drama and then I’ll text that person and be like, “Oh, you’re a B I T C H. Why are you doin’ this,” dah, dah, dah, dah? “I just like wanted her to feel bad about herself because of what she did [online], or like if—because of what she did to me. And it—I like—after that, I felt so bad about it. [Laughter] ...I don’t know. I just like felt like—I felt awful. It didn’t make me feel better at all. I mean it didn’t change anything. I was still like mad at her, but at the same time, I was mad more at myself for being so stu—going down to her level.” “He just looked wrong. Like, I spent every day with this kid, and I've never seen him, like, that upset. ... And so that, like, it hurt me, and I was like, "Who did it?" And he was like, "It was this kid." And what ended up happening was I went on his [social media] account, and I was, like, I’m serious, like, "You can't do this. Like, that's not cool."
Number of Participants
Mean Age
Female (%)
CBS* Mean (SD)
IBS* Mean (SD)
Physical Fights* Mean (SD)
3
15
33
8 (5.2)
5.3 (5.1)
0 (0)
3
15
66
8.3 (4.7)
18 (8.9)
1.5 (2.1)
7
15
57
10.7 (6.6)
13 (11)
1 (1.4)
22
15
62
7.2 (5.6)
9.4 (8.7)
0.45 (1.1)
* CBS = Cyberbullying Scale (measures past-year online victimization); IBS = Illinois Bullying Scale (measures past-year in-person victimization and bullying); Physical Fights = Youth Risk Behavior Surveillance Survey (measures past-year physical fights)
Table 2: Quotes from participants supporting themes and subthemes Theme A: Defining cyberbullying is complicated A1: Cyberbullying is defined by being associated with severe mental health consequences
And people who are cyberbullied, they get very depressed and like wanna end their lives. [Participant 18] Yeah, like, I feel like cyberbullying is different than drama. Like, they both are unneeded, but it’s like cyberbullying is—it takes a—it has a different impact on people. Like, it might make someone, like, be suicidal or things like that. And drama’s just like to make people angry. [Participant 10] …like, they would be joking around. But like, I think that— that's something that you kinda have to be careful with cuz, like, the other person can take it really seriously. [Participant 16]
A2: Drama can still be hurtful; online conflict can have similar components and health outcomes as traditional bullying
A3: Cyberbullying and online drama sometimes – but not always – can be defined using traditional elements of bullying (e.g., presence of power differential, repetitiveness)
A4: Adults overapply the label of “cyberbullying”
I used to have a lotta friends, and I wanted to make more friends, but as I went on, it kinda was just happening a bit, people sharing my secrets [online]… [Interviewer: How did that make you feel?] Really bad. [Participant 12] … [online drama] is all the time because it's online, in school. Like, that must be so much worse than just having to deal with it in school and an hour after school. Like, they might not be gettin' physically hurt, but sometimes emotionally is where it's at. [Participant 20] Like, um, if they’re jealous of the person or something, they’ll start [cyber-] bullying them. [Participant 3] The [cyber-] bully could be somebody who sits at home, do nothing. The [cyber-] bully could be the shyest kid in school, but once you get behind a screen, that’s a whole different person inside of you. [Participant 9] Cyberbullying is when someone would, like, they will text you on purpose to make you feel bad and it doesn't have to be nonstop, but most of the time, it'll be nonstop. [Participant 20] But I feel like that’s like—not that cyber bullying is expected of our generation, but it’s common in the way that society sees it. But I feel like it’s not always like that. It’s like oh, you can be with your friends, and it’s like—not all friends do this, but me
and my friends, we make jokes about each other, we crack on each other. [Participant 19] Theme B: “Sometimes you don’t know that you’re bullying”
B1: Cybervictims
B2: Cyberbullies
[a girl] sent pictures to someone that she trusted, and then it got on—it got all over Facebook and every other social media... And like people was calling her names and all that stuff. And I felt bad, because I knew her and I got to know her and she’s really a nice person. And people would be saying a lot of stuff about her. [Participant 21] So if we were being the [cyber]bully, we don’t really like say it out loud that we bullied somebody cuz sometimes you don’t know that you’re bullying somebody. [Participant 7] We will see like before pictures … [and] will just comment like, ‘Damn, you were mad fat’. [Participant 19] One girl would say one thing. The other girl would respond back… they were both trying to do one thing, and that was make the other person feel, like, terrible… They were both bullying each other. [Participant 6]
B3: Cyberbully-victims
B4: Bystander
But um, it’s like, some people—not that they set themselves up for cyberbullying, but it’s like they follow that path. They’ll do something and then be offended when somebody else says something back... they think like everyone is bullying them and everyone is against them. It’s really like that they set themselves up for it, since they already started the problem. [Participant 19] I’ve seen, like, cyberbullying before, but it’s never happened to me. [Participant 3] So I try to, like, keep my distance, like—like I try not to get involved. [Participant 22]
Theme C: It’s all just violence, regardless of where it happens
C1: The relationship between in-person and online violence, drama, and cyberbullying is bidirectional
Then it went back Twitter, and then it became an internet brawl between people subbing1 each other, and it just went bad… Cuz they got suspended, so they couldn't do it no longer in person, so then it went back to online… I'd say maybe about—each girl had five friends [who got involved]. [Participant 6] I’ve personally never been cyberbullied because I always have either a comeback or it’s like, if it gets to a point where fighting is needed, then I will do that. [Participant 19] It was more like an in-person thing that was brought to online. [Participant 20]
C2: Some forms of violence occurred
…if somebody bully [sic] you—like, I'm right here and somebody's in Puerto Rico like, somebody bully [sic] me from
exclusively online; teens had mixed feelings about the impact of these forms of violence
there, like, it's not possible that I could fight with him unless I get a flight. [Participant 1] Like, if it's a chat room, I'll just leave the chat room, or if it's on a online game, I'll just leave the game and join another one. [Participant 12]
Theme D: Teens can – and want to - help D1: Instilling empathy in teens would persuade them to intervene D2: Some teens express hesitation to intervening in peers’ online conflict
D3: How to help victims
D4: Teens had mixed thoughts about involving adults
Or if—if you’re the—in the middle, and you see somebody bullying, what are you gonna say? Because, yeah, exactly, what if you was that person being bullied?… I always feel like, since I went through that, and now I don’t go through that, I always try to help the people who do go through that. [Participant 7] It's kind of corny to say, but, like, I'm a girl, so I shouldn't get in between the boy drama. [Participant 11] It’s not my place to tell you, like, what to do. [Participant 16] Don’t take everything always to the heart. If it’s something you can brush off your shoulders, brush it off your shoulders. If it’s something bad, I don’t know, tell somebody. [Participant 9] I know people just say, "Oh, just close the laptop” or whatever. It's just that—the thing is, other people wanna stay on the internet without being pushed around. [Participant 8] If you tell an adult, that person's just gonna hit you probably twenty times harder. [Participant 8] My mom is my rock and she is the reason I got through [online] bullying. [Participant 6]
Table 3: Summary of main findings Main Finding Teens actively dislike the term “cyberbullying” Teens associate the term with only very severe [mental health] consequences Teens’ definitions of severe experiences differ from those in the cyberbullying literature
Implication for Interventions and Future Research When discussing cyberbullying or online conflict/violence with teens, provide a clear definition and give examples of experiences, especially less severe experiences that constitute conflict/violence
Terms used in discussing online experiences may make teens ignore relevant discussions if they feel the experiences don’t relate to their own social media use
Use language and examples that teens relate to/have experienced; offer strategies and advice that fit with their social media use and are easily actionable
Teens are most likely to describe themselves as bystanders to online conflict
Include bystanders in future studies; develop interventions that encourage bystanders actively help peers and boost their coping skills to prevent mental health consequences
Teens’ experiences of online conflict blend into in-person conflict
Researchers and clinicians should consider discussion of the multitude of formats in which teens can be harassed, bullied, or engaged in violence
What Counts?: A Qualitative Study of Adolescents’ Lived Experience with Online Victimization and Cyberbullying Megan L. Ranney MD MPH , Sarah K. Pittman , Alison Riese MD MPH , Christopher Koehler BA , Michele Ybarra PhD , Rebecca Cunningham MD , Anthony Spirito PhD , Rochelle K. Rosen PhD PII: DOI: Reference:
S1876-2859(19)30450-4 https://doi.org/10.1016/j.acap.2019.11.001 ACAP 1432
To appear in:
Academic Pediatrics
Received date: Accepted date:
21 February 2019 2 November 2019
Please cite this article as: Megan L. Ranney MD MPH , Sarah K. Pittman , Alison Riese MD MPH , Christopher Koehler BA , Michele Ybarra PhD , Rebecca Cunningham MD , Anthony Spirito PhD , Rochelle K. Rosen PhD , What Counts?: A Qualitative Study of Adolescents’ Lived Experience with Online Victimization and Cyberbullying, Academic Pediatrics (2019), doi: https://doi.org/10.1016/j.acap.2019.11.001
This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. © 2019 Published by Elsevier Inc. on behalf of Academic Pediatric Association
Title: What Counts?: A Qualitative Study of Adolescents' Lived Experience with Online Victimization and Cyberbullying Authors and Affiliations: Megan L. Ranney, MD MPH a, b Sarah K. Pittman b Alison Riese, MD MPH b, c Christopher Koehler BA a Michele Ybarra, PhD d Rebecca Cunningham MD e Anthony Spirito PhD f Rochelle K. Rosen, PhD g a
Department of Emergency Medicine, Alpert Medical School of Brown University 55 Claverick Street 2nd Floor, Providence, RI 02903, United States of America [email protected] b
Rhode Island Hospital 593 Eddy Street, Providence, RI 02903, United States of America [email protected] c
Department of Pediatrics, Alpert Medical School of Brown University Box G-RIH Hasbro 129, Providence, RI 02903, United States of America [email protected] d
Center for Innovative Public Health Research 555 N. El Camino Real #A347, San Clemente, CA 92672, United States of America [email protected] e
Department of Emergency Medicine, University of Michigan 1500 East Medical Center Drive, Ann Arbor, MI 48109, United States of America [email protected] f
Department of Psychiatry and Human Behavior, Brown University 700 Butler Drive, Providence, RI 02906, United States of America [email protected] g
Department of Behavioral and Social Sciences, Brown University Box G-5121-4, Providence, RI 02912, United States of America [email protected] Corresponding Author: Megan L. Ranney Address: 55 Claverick Street, 2nd Floor, Providence, RI 02903, United States of America Email: [email protected] Phone: 401-444-2557
Fax: 401-444-2249 Declarations of interests: none Funding: This work was supported by the National Institutes of Health [R21HD088739]. Keywords: (5/5) Cyberbullying; adolescent; violence; qualitative; intervention development What’s New (37/40) Youth – even those with a history of cyberbullying – describe online conflict (“drama”) as part of a larger spectrum of peer violence. Discussion of “drama” and “bystander interventions” may be more acceptable to at-risk youth than cyberbullying-focused interventions. Abstract: (244/250) Objective: To inform development of cyberbullying interventions that are both accurate and meaningful to all adolescents, this qualitative analysis examines experiences of online peer victimization among a sample of predominately minority and low-income youth. Methods: Adolescents ages 13-17 years who reported past-year cyberbullying on a previously validated survey were recruited from an urban pediatric clinic to complete semi-structured interviews. Interview topics included definitions of cyberbullying, prior cyberbullying experiences, and strategies to reduce cyberbullying and its consequences. Interviews were audiorecorded and transcribed verbatim. Using thematic analysis, study team members applied both structural and emergent codes to transcripts. Results: Saturation was reached after 23 interviews (mean age 14.8 years; 65% female, 47.8% Hispanic, 35% Black, 74% low socioeconomic status). Four main themes emerged: 1) Teens avoided the term “cyberbullying,” due to its association with suicidality and severe depression; they preferentially described experiences (even those meeting criteria for repetition, power differential, etc.) as “online conflict”. 2) In-person bullying categories (bully, victim, bullyvictim, bystander) apply to online conflict. Few identify purely as victims. 3) Cyberbullying is
part of a larger continuum of peer violence, including physical fights and in-person bullying. 4) Teens want to help victims of cyberbullying; they desire more guidance in so doing. Conclusions: These youth rarely acknowledge presence of cyberbullying; instead, they describe online conflict as part of a larger spectrum of peer violence. Clinicians may consider prevention of a range of conflict-related behaviors (rather than focusing exclusively on cyberbullying), and may considerengaging adolescent bystanders in prevention of online conflict.
Introduction Estimates of the prevalence of adolescent cyberbullying vary immensely, with reported rates of victimization ranging from 2% to 72% 1-3. This range partly reflects a lack of consistency about what, exactly, constitutes cyberbullying 4,5. For instance, experts disagree about the degree to which traditional elements of bullying, such as existence of a power differential, matter in the online world 6-8; whether the word “bullying” is needed in queries about cyberbullying prevalence 6 ; and whether cyber-harassment is qualitatively different from cyber-bullying 9. There is also uncertainty as to whether the categories of involvement in traditional bullying (e.g, bully perpetrators, victims, bully-victims, and bystanders) extend to cyberbullying 4, and whether the prevalence of youth in each category differs because of the wide-reach of the Internet and social media 2. Finally, there is disagreement as to whether the presence of negative outcomes (such as substance use, depressive symptoms, and suicidality) are required in order to label an experience as being cyberbullying 7,12. Underlying these expert debates about cyberbullying categorization is the absence of knowledge about the first-hand or “lived” experiences of adolescents experiencing online victimization 15. The “lived experience” of an event includes how it is defined, how it is
experienced, and how it is perceived to impact one’s life. The lack of knowledge about youth’s lived experiences of online conflict is particularly notable for low-income and minority youth. Despite their reported experience of cyberbullying at similar rates as majority and high-income youth 16, little is known about how online conflict fits into these adolescent’s greater world of social, emotional, and physical conflict
6,13,14,17
. It is also unknown whether minority and low-
income youth have unique concerns about online conflict. Ideally, cyberbullying interventions and assessments should be both accurate and meaningful to adolescents of all strata of society. To advance this goal, this qualitative study recruited from a sample of predominantly lower-income and non-white adolescents 18. We used applied thematic analysis to examine current experiences and perceptions of online peer victimization 19.
Methods Screening and Recruitment Participants presenting to a pediatric clinic in an urban teaching hospital in New England were eligible for screening if they were being seen for a well-child or sick-child visit, were between the ages of 13 and 17 years, spoke English, had an English-speaking parent or guardian present, and were able to assent. After parental verbal consent and participant verbal assent, participants completed a brief screening survey administered using a HIPAA compliant web-based data collection tool (REDcap) 20. All participants completing the survey were compensated with a small item (e.g. gum, pens). Participants were eligible for the hour-long semi-structured interview if they endorsed any past-year cyberbullying victimization experiences (e.g., “How often does another kid
pretended to be you and send or post something that damages your reputation or friendships?”) on the Cyberbullying Scale, a previously validated 16-question self-report measure with excellent internal consistency (Cronbach’s 0.94) and construct validity 21. Additional quantitative measures, used to assist with analysis, asked about demographic characteristics (e.g., age, socioeconomic status (SES), race, ethnicity, gender identity, sexual orientation)
22-24
, in-person
bullying (the Illinois Bullying Scale 25,26), and past year fights (a single question from the Youth Risk Behavior Surveillance Survey 27). We sought to recruit a sample of adolescents who were representative of the diversity of youth seeking care in our clinic. We iteratively recruited, interviewed, and analyzed until saturation was reached on multiple topics. Written consent and assent were obtained in the clinic; interviews were scheduled after the visit, to minimize conflict with clinical care. Participants were compensated with a $25 gift card. The study was approved by the hospital institutional review board. Interviews Semi-structured interviews were conducted by a single research assistant (RA) with a background in psychology and extensive qualitative facilitation training (supervised by RKR and MLR), using an iteratively revised interview guide; the RA was aware of participants’ survey responses but these were not discussed in the interview. Participants were asked open-ended questions about social media habits, experiences with online conflict, and strategies they and their friends use to avoid and cope with online conflict. Participants were asked to define or describe cyberbullying in their own words. Participants who had trouble defining cyberbullying in their own words, were offered commonly used definitions of cyberbullying, and asked to reflect on their accuracy and applicability to the participant’s life 28,29. Participants were then asked about personal and friends’ experiences with cyberbullying and online conflict or
victimization. Each online conflict experience was probed for further information (e.g., electronic medium used, who was involved, what the participant thought and felt about the experience). All interviews were recorded, transcribed verbatim, and checked for accuracy. A written debrief was completed by the RA after each interview, to inform iterative changes in the interview guide, allow “member checking” (in which emergent concepts were tested by presenting them to future participants), and to reflect on and develop facilitation skills. Analysis Members of the research team used applied thematic analysis to approach the data 19. Structural codes were derived from the interview agenda, research questions, and expert knowledge of the field; emergent codes were derived from iterative review of data that emerged during interviews 30. Interviews were independently coded by three team members until coding scheme stability was reached. Subsequent interviews were coded independently by two team members who met to discuss codes and resolve disagreements, with the primary investigator arbitrating if needed; as all codes were applied through consensus, kappa values were not calculated. Agreed upon codes were entered into NVivo 10 31. After thematic saturation was reached, the research team read the content of codes in aggregate, summarizing main concepts within each code. We used self-reported demographics and bullying experiences in NVivo to stratify codes and inform analysis (e.g., examining the frequency of codes and emergent themes according to gender). Coding summaries were reviewed by the team, organized, and summarized to develop the four themes presented here.
Results Forty-eight of 142 screened adolescents reported at least “sometimes” having a past-year cyberbullying experience (e.g., getting online messages that make you scared for your safety) on the CBS screen. After 23 interviews and a review of the interview debriefs, the coding team felt that saturation had been reached on the key research topics, and recruitment was stopped 32,33. Participants who did not complete the interview refused consent/assent (N=12), were unable to be scheduled (N = 5), lost interest (N = 4), had a parent who changed their mind (N = 1), or became too busy to participate (N = 3). Eligible youth who did and did not participate were demographically similar; participant demographics also mirror the clinic at large. Participants’ mean age was 14.8 years (SD = 1.03), with 65% female, 48% Hispanic, 74% low SES, and 35% Black or African American. The average cyberbullying score was 7.36 (SD = 5.51; range: 2-20. Four main themes about online conflict and violence were identified, as described below. The components of each theme are identified and illustrative participant quotes for each are presented in Tables 1 and 2. Theme A: Defining cyberbullying is complicated Participants were generally uncomfortable with the word “cyberbullying.” Most participants said cyberbullying was identified not by what happened during a conflict, nor by how it made them feel, but rather by the severity of its consequences. Many participants spontaneously defined cyberbullying as occurring only when it caused suicidality or severe depression (theme A1). Almost all participants verbally described experiencing online conflict (such as having lies told about them online or having fake pictures posted of them) and described negative emotional consequences to these events. Yet only two participants explicitly identified these
events as having been “cyberbullying.” Instead, most participants described their experiences as online “drama” or “conflict,” and used these terms interchangeably. Most participants said this online drama exists on a continuum of acceptability, ranging from joking to truly hurtful. Boundaries between what is acceptable or funny online, and what is hurtful, were difficult to define. A few participants specifically mentioned that joking could turn into hurtful drama, without the perpetrator necessarily being aware of their hurtfulness (theme A2). Even though they did not self-identify as victims of cyberbullying (see also theme B1), most participants described online drama using terms and concepts similar to existing definitions of cyberbullying (e.g., occurring over and over, being associated with a loss or lack of power, being associated with anxiety or hopelessness) (theme A3). For instance, participants described online conflict as reoccurring or dragging on for days. Some online conflict was perpetrated by an adolescent of greater status or popularity; some experiences of hurtful online conflict were described as one-time incidents; some were reportedly perpetrated by a peer of equal or lesser status than the “victim”. One participant said that online drama sometimes provided an outlet for teens of lesser status to express their anger. Many teens specifically said that online drama had more severe emotional consequences than in-person conflict; a few teens said that conflict that occurs exclusively online is easier to ignore. Finally, participants also expressed weariness with the label of cyberbullying. They said that the term cyberbullying was overapplied by adults (theme A4); they also felt that adults often assumed that cyberbullying was happening, when it wasn’t. Theme B: “Sometimes you don’t know that you’re bullying”
Our participants – all of whom had endorsed victimization on the quantitative screening measure – spontaneously described multiple, overlapping types of online experiences of bullying “drama”. We found that these experiences fell into four categories. The first experiential category was online victimization (theme B1). Most participants provided examples of family members, friends, or peers who had been online victims. Victimization was described as a situation where other teens were “helpless,” did not fight back, and were emotionally affected by the conflict. Notably, none of our participants described themselves exclusively as an online victim. The second category of involvement was online bullying of others (without concomitant victimization) (theme B2). Only a few participants exclusively shared stories of perpetrating online bullying behaviors towards peers. As one of these participants explained, “we don’t really say it out loud that we [cyber]bullied someone,” and – just as few self-identified as online “victims” - few self-identified as online “bullies”. Other participants commented that it was often difficult to identify who was the perpetrator of online conflict, as teens frequently traded roles in the cycle of online violence. A third category was being an online bully-victim (theme B3); these adolescents were both victims and perpetrators of online bullying. Many participants described personal experiences that matched this categorization. They commonly described their online actions as “fighting back” or “defending themselves or their friends.” They also (as described further in Theme C) were likely to describe pervasive drama or conflict throughout all aspects of their life. Some teens said that they only harassed other people online if they were “asking for it [online conflict].”
The final type of involvement with online conflict was as a bystander (theme B4). Almost all interviewed participants reported having seen multiple incidents of online bullying of others in the past year during the interview, in addition to potentially fitting in the other categories of involvement in online conflict. Although about half the interviewees initially said they’d only been bystanders to online conflict (e.g., never experiencing it themselves), with probing many of the self-identified bystanders reported prior involvement as both online victims and online bullies. These participants said their prior experiences allowed them to develop coping skills and strategies that helped prevent current involvement in cyberbullying and online drama. Theme C: It’s all violence, regardless of where it happens Descriptions of online conflict rarely stopped at the boundaries of the online world. Many youth reported concurrent online bullying, in-person bullying, and physical fights. The overlap between physical fights and online drama was bidirectional (theme C1). Sometimes online conflict led to physical fights, particularly for participants who saw fights as a means of self-defense against online conflict. Sometimes, cyberbullying or online drama was a result of inperson physical fights. For instance, two teens separately recounted stories of videos of physical fights being posted online to engage other teens in conflict. This direct extension of physical conflict into the online world was described as widening the reach, duration, and consequences of peer violence. For most interviewees, the medium by which conflict or drama occurred (whether online or in-person) was not important. When asked about “online drama” or “cyberbullying”, participants would describe both online and in-person components of an episode (theme C1). They frequently conflated terms, using the term “bullying” (but not “cyberbullying”) whether
they were referring to online or in-person conflict. Youth who qualitatively described more frequent involvement with online conflict, drama, and bullying also had higher quantitative scores for in-person bullying and in-person fights (see also Table 1). These teens said that if they could not fight in person, they used online media to engage with others. That said, teens did acknowledge that some drama and violence occurred exclusively online (theme C2), and that online drama could be uniquely amplified and spread around social media. Adolescents also reported that online drama sometimes occurred with people they would ordinarily not have a conflict with because of distance; through social media, they now engage in conflict despite geographical separation. This theme buttressed the findings in Theme A. Theme D: Teens Can– –And Want to– Help A teen’s conception of where they fell in the continuum of online conflict influenced their opinions about potential ways to stop cyberbullying. Most of the participants who selfdescribed as bystanders suggested that instilling empathy in other teens would be the most effective strategy for getting a cyberbully to stop bullying. These teens said bystanders needed to be persuaded to intervene and support victims (theme D1). In contrast, teens who described being online bullies or bully-victims were more likely to suggest violence – either physical or online - as their preferred method of resolving online conflict (see also theme C1). Almost all interviewees – even the bullies - expressed the desire to help friends who were victimized online. Many told stories of previously helping friends; the rest said they would help if presented with the opportunity. The bullies and bully-victims described “helping” by aggressing against others on behalf of their friends. Others described more gentle bystander interventions (see Table 1). However, some participants expressed hesitation about spontaneously reaching out to victims of online conflict (theme D2). When asked why, these
hesitant participants said they were afraid they would get dragged into the drama, felt like it was not their place to intervene, or were unsure of how to help a peer. In terms of helping victims (theme D3), many teens suggested changing the victim’s perception of online conflict or bullying. Participants said it was important to identify realistic actions that match adolescents’ goals and that fit with their online lifestyle. Some encouraged teaching teens to fight back. Participants’ opinions on involving adults varied (theme D4). Some participants reported strong relationships with an adult, such as a parent, and reported that they would talk to an adult about any conflict they experienced. Many said that they preferred to handle conflicts on their own, without the help of adults. Some even thought that involving an adult would make the situation worse. Yet all participants said that going to an adult would be beneficial in extreme situations, such as when they were feeling physically threatened by someone, or if they or a peer was threatening suicide.
Discussion This qualitative analysis provides novel perspectives on adolescents’ lived experience, definitions, and solutions to online conflict (see Table 3 for a summary of main findings and their corresponding implications). This paper is unique both in presenting the experiences of a primarily minority and low-income sample, who are often left out of discussions of online conflict, and in comparatively examining adolescents’ experiences and researchers’ definitions of cyberbullying. Most importantly, adolescents strongly disliked the word “cyberbullying” and were reluctant to label themselves a cyber-victim (despite all interviewees having reported past-year cyber-victimization on a quantitative screening survey) or a cyber-bully. Teens defined
“cyberbullying” as online conflict that causes severe consequences, particularly suicidality. Although many described personal experiences that experts would label as online “bullying” (based on frequency and power differentials), teens called these incidents of online “drama” or “conflict.” Our data therefore suggest that youth may tune out interventions or questions that use the word cyberbullying. Assuming they have not experienced cyberbullying, simply because their online experiences did not make them feel suicidal, adolescents may dismiss cyberbullyingspecific content as not relevant to their own experiences or social media interaction. This disparity between lived experiences and identification with a label is similar to that seen in other types of violence. For instance, validated measures of intimate partner violence and physical fights use lists of specific incidents 34,35, rather than asking about whether someone has “been a victim of domestic violence”. Our findings therefore suggest that researchers and clinicians should be similarly specific in the ways that they ask youth about experiences with online conflict. Clinicians and interventionists may engage youth more effectively by discussing unambiguous occurrences (such as having others spread lies online) and the consequences of these episodes (such as how it makes them feel), than by discussing “cyberbullying”. Teens may also be more open to discussions of online “drama” or “conflict” 9. Second, our study highlighted the overlap between online and in-person conflict. Some prior research suggests that in-person and online victimization, bullying, and physical fights may have distinct etiologies and consequences 36,37. We found however, that teens elided these categories both in their descriptions of others’ conflict and in their own experiences: one form of conflict informed, and often worsened, another. Because multiple-victimized teens are at greatest risk of negative outcomes 1, an exclusive focus on cyber-violence may be misguided 6,13,14. This finding also reinforces the importance of interviewing a diverse sample of adolescents, as
minority youth may be more likely to experience physical violence 38. Future hypothesis-testing and intervention development work should likely include measurements and interventions for multiple types of violence. Third, our analysis highlights the importance of addressing bystanders’ role in online conflict. Youth commonly described being witnesses or bystanders 2. Many adolescents who witness online conflict have also previously experienced or perpetrated online conflict; they too, are at risk of suffering negative consequences of cyberbullying 1. Our findings suggest that bystander interventions may be more acceptable to youth than interventions that focus on online victimization or bullying. For instance, as articulated by our interviewees, good online communication skills may allow youth to better articulate when someone has “crossed a line” between joking and bullying online, and may enhance self-efficacy in standing up for peers. Our findings also highlight the importance of de-emphasizing “fighting back” as a solution. Some early evidence suggests that encouraging bystander intervention may prevent future episodes of online conflict 41. The differences in perspective between the professional community that works in the area of cyberbullying, and the adolescents who experience cyberbullying, also suggests that the professional community should actively engage adolescents as collaborators to develop interventions. Finally, our qualitative findings highlight the wide spectrum of online conflict. The lower end of the online victimization continuum is teens joking around or “cracking on” friends; the upper extremes result in severe emotional harm. Teens only see this upper extreme as problematic. Yet, seemingly minor online conflict may also be a warning sign for future severe bullying, just as verbal partner violence is a marker of risk for future, life-threatening physical violence 39, and seemingly minor school scuffles can serve as a marker of risk for future serious
assaults and homicide 40. Future work could examine the temporal trajectory by which online conflict progresses from mild or minimally impairing, to severe, as well as personality traits and coping styles that predict trajectories in the wake of online conflict.
Limitations This study is qualitative, and thus provides guidance for future work rather than definitive causal conclusions. Although we had a relatively small number of participants from one pediatric clinic, our data was saturated and we believe the sample adequately describes the opinions and experiences of teens, with both agreement on several topics and some diversity in opinion. However, transferability of these findings to other adolescent populations are to be determined. The majority of our participants were low-income and of minority race or ethnicity; however, prior work suggests that racial, ethnic, and socioeconomic minority youth are equally likely to be harassed or bullied online 16.
Conclusion This qualitative study found that teens dislike the term cyberbullying, associating it with only the most severe incidents of online conflict. Nonetheless, teens described a great deal of online conflict, as well as negative consequences to this conflict. Being a bystander to online conflict was very commonly reported. Online and physical violence strongly overlapped for our interviewees. Future intervention programs may best engage youth by not focusing on cyberbullying per se, but instead by engaging youth in prosocial responses to, and avoidance of, all types of adolescent conflict, ranging from the physical to the online world.
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Table 1: Self-described online conflict experiences by demographic characteristics SelfDescribed Online Experiences
Online Victim
Online Bully
Online Bullyvictim
Online Bystander
Exemplar Quotes of Online Experience "My friend, she actually started cutting herself. She started feelin’ sad about herself. She stopped eating and all that because the [online] bully was tellin’ her that she was fat, she was ugly, and that nobody wants her, and that she needs to kill herself because nobody would care what she does.” “The bully could be somebody who sits at home, do nothing. The bully could be the shyest kid in school, but once you get behind a screen, that’s a whole different person inside of you, and I know that for a fact because when I was younger, I used to like, not exactly bully people, but like I would always like get myself into people’s drama and then I’ll text that person and be like, “Oh, you’re a B I T C H. Why are you doin’ this,” dah, dah, dah, dah? “I just like wanted her to feel bad about herself because of what she did [online], or like if—because of what she did to me. And it—I like—after that, I felt so bad about it. [Laughter] ...I don’t know. I just like felt like—I felt awful. It didn’t make me feel better at all. I mean it didn’t change anything. I was still like mad at her, but at the same time, I was mad more at myself for being so stu—going down to her level.” “He just looked wrong. Like, I spent every day with this kid, and I've never seen him, like, that upset. ... And so that, like, it hurt me, and I was like, "Who did it?" And he was like, "It was this kid." And what ended up happening was I went on his [social media] account, and I was, like, I’m serious, like, "You can't do this. Like, that's not cool."
Number of Participants
Mean Age
Female (%)
CBS* Mean (SD)
IBS* Mean (SD)
Physical Fights* Mean (SD)
3
15
33
8 (5.2)
5.3 (5.1)
0 (0)
3
15
66
8.3 (4.7)
18 (8.9)
1.5 (2.1)
7
15
57
10.7 (6.6)
13 (11)
1 (1.4)
22
15
62
7.2 (5.6)
9.4 (8.7)
0.45 (1.1)
* CBS = Cyberbullying Scale (measures past-year online victimization); IBS = Illinois Bullying Scale (measures past-year in-person victimization and bullying); Physical Fights = Youth Risk Behavior Surveillance Survey (measures past-year physical fights)
Table 2: Quotes from participants supporting themes and subthemes Theme A: Defining cyberbullying is complicated A1: Cyberbullying is defined by being associated with severe mental health consequences
And people who are cyberbullied, they get very depressed and like wanna end their lives. [Participant 18] Yeah, like, I feel like cyberbullying is different than drama. Like, they both are unneeded, but it’s like cyberbullying is—it takes a—it has a different impact on people. Like, it might make someone, like, be suicidal or things like that. And drama’s just like to make people angry. [Participant 10] …like, they would be joking around. But like, I think that— that's something that you kinda have to be careful with cuz, like, the other person can take it really seriously. [Participant 16]
A2: Drama can still be hurtful; online conflict can have similar components and health outcomes as traditional bullying
A3: Cyberbullying and online drama sometimes – but not always – can be defined using traditional elements of bullying (e.g., presence of power differential, repetitiveness)
A4: Adults overapply the label of “cyberbullying”
I used to have a lotta friends, and I wanted to make more friends, but as I went on, it kinda was just happening a bit, people sharing my secrets [online]… [Interviewer: How did that make you feel?] Really bad. [Participant 12] … [online drama] is all the time because it's online, in school. Like, that must be so much worse than just having to deal with it in school and an hour after school. Like, they might not be gettin' physically hurt, but sometimes emotionally is where it's at. [Participant 20] Like, um, if they’re jealous of the person or something, they’ll start [cyber-] bullying them. [Participant 3] The [cyber-] bully could be somebody who sits at home, do nothing. The [cyber-] bully could be the shyest kid in school, but once you get behind a screen, that’s a whole different person inside of you. [Participant 9] Cyberbullying is when someone would, like, they will text you on purpose to make you feel bad and it doesn't have to be nonstop, but most of the time, it'll be nonstop. [Participant 20] But I feel like that’s like—not that cyber bullying is expected of our generation, but it’s common in the way that society sees it. But I feel like it’s not always like that. It’s like oh, you can be with your friends, and it’s like—not all friends do this, but me
and my friends, we make jokes about each other, we crack on each other. [Participant 19] Theme B: “Sometimes you don’t know that you’re bullying”
B1: Cybervictims
B2: Cyberbullies
[a girl] sent pictures to someone that she trusted, and then it got on—it got all over Facebook and every other social media... And like people was calling her names and all that stuff. And I felt bad, because I knew her and I got to know her and she’s really a nice person. And people would be saying a lot of stuff about her. [Participant 21] So if we were being the [cyber]bully, we don’t really like say it out loud that we bullied somebody cuz sometimes you don’t know that you’re bullying somebody. [Participant 7] We will see like before pictures … [and] will just comment like, ‘Damn, you were mad fat’. [Participant 19] One girl would say one thing. The other girl would respond back… they were both trying to do one thing, and that was make the other person feel, like, terrible… They were both bullying each other. [Participant 6]
B3: Cyberbully-victims
B4: Bystander
But um, it’s like, some people—not that they set themselves up for cyberbullying, but it’s like they follow that path. They’ll do something and then be offended when somebody else says something back... they think like everyone is bullying them and everyone is against them. It’s really like that they set themselves up for it, since they already started the problem. [Participant 19] I’ve seen, like, cyberbullying before, but it’s never happened to me. [Participant 3] So I try to, like, keep my distance, like—like I try not to get involved. [Participant 22]
Theme C: It’s all just violence, regardless of where it happens
C1: The relationship between in-person and online violence, drama, and cyberbullying is bidirectional
Then it went back Twitter, and then it became an internet brawl between people subbing1 each other, and it just went bad… Cuz they got suspended, so they couldn't do it no longer in person, so then it went back to online… I'd say maybe about—each girl had five friends [who got involved]. [Participant 6] I’ve personally never been cyberbullied because I always have either a comeback or it’s like, if it gets to a point where fighting is needed, then I will do that. [Participant 19] It was more like an in-person thing that was brought to online. [Participant 20]
C2: Some forms of violence occurred
…if somebody bully [sic] you—like, I'm right here and somebody's in Puerto Rico like, somebody bully [sic] me from
exclusively online; teens had mixed feelings about the impact of these forms of violence
there, like, it's not possible that I could fight with him unless I get a flight. [Participant 1] Like, if it's a chat room, I'll just leave the chat room, or if it's on a online game, I'll just leave the game and join another one. [Participant 12]
Theme D: Teens can – and want to - help D1: Instilling empathy in teens would persuade them to intervene D2: Some teens express hesitation to intervening in peers’ online conflict
D3: How to help victims
D4: Teens had mixed thoughts about involving adults
Or if—if you’re the—in the middle, and you see somebody bullying, what are you gonna say? Because, yeah, exactly, what if you was that person being bullied?… I always feel like, since I went through that, and now I don’t go through that, I always try to help the people who do go through that. [Participant 7] It's kind of corny to say, but, like, I'm a girl, so I shouldn't get in between the boy drama. [Participant 11] It’s not my place to tell you, like, what to do. [Participant 16] Don’t take everything always to the heart. If it’s something you can brush off your shoulders, brush it off your shoulders. If it’s something bad, I don’t know, tell somebody. [Participant 9] I know people just say, "Oh, just close the laptop” or whatever. It's just that—the thing is, other people wanna stay on the internet without being pushed around. [Participant 8] If you tell an adult, that person's just gonna hit you probably twenty times harder. [Participant 8] My mom is my rock and she is the reason I got through [online] bullying. [Participant 6]
Table 3: Summary of main findings Main Finding Teens actively dislike the term “cyberbullying” Teens associate the term with only very severe [mental health] consequences Teens’ definitions of severe experiences differ from those in the cyberbullying literature
Implication for Interventions and Future Research When discussing cyberbullying or online conflict/violence with teens, provide a clear definition and give examples of experiences, especially less severe experiences that constitute conflict/violence
Terms used in discussing online experiences may make teens ignore relevant discussions if they feel the experiences don’t relate to their own social media use
Use language and examples that teens relate to/have experienced; offer strategies and advice that fit with their social media use and are easily actionable
Teens are most likely to describe themselves as bystanders to online conflict
Include bystanders in future studies; develop interventions that encourage bystanders actively help peers and boost their coping skills to prevent mental health consequences
Teens’ experiences of online conflict blend into in-person conflict
Researchers and clinicians should consider discussion of the multitude of formats in which teens can be harassed, bullied, or engaged in violence