Associations between self-injury and involvement in cyberbullying among mentally distressed adolescents in Scania, Sweden

Aims: To investigate associations between self-injury and involvement in cyberbullying as a bully, victim or bully-victim among mentally distressed adolescents.

Methods: Data from the public health survey of children and adolescents in Scania, Sweden 2016 were used. A questionnaire was answered anonymously in school by 9143 students in 9th grade compulsory school (response rate 77%) and 7949 students in 2nd grade of upper secondary school (response rate 73%). Students with past year (broadly defined) mental distress at least 2 weeks in a row (33% of boys and 63% of girls) were asked if they had performed self-injury (i.e. cut, superficially cut or otherwise injured themselves) past year, and those with data on self-injury and cyberbullying were included in the present study ( n=6841). Associations between self-injury and cyberbullying were investigated by multiadjusted logistic regression analysis.

Results: Among mentally distressed students, self-injury was reported by 11.7% of boys and 25.9% of girls. Age-adjusted analysis showed increasingly higher odds of self-injury among cyberbullies, cybervictims and cyberbully-victims, using non-involved as reference group (OR boys: 1.8, 2.3, 3.0; girls: 2.1, 3.2, 4.8). Associations weakened after adjustment for several potential confounders but remained significant for all cyberbullying groups except male cyberbullies, among whom significance was lost after adjustment for smoking, alcohol and narcotics.

Conclusions: Peer victimization in cyber space is associated with self-injury, especially among victims and bully-victims. Decreasing peer victimization is a priority, and school and health professionals need to be aware of the associations between cyberbullying and self-injury among mentally distressed adolescents.