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The study compared levels of depression among bullies, victims and bully-victims of traditional (physical, verbal and relational) and cyber bullying, and examined the association between depression and frequency of involvement in each form of bullying.
A U.S. nationally-representative sample of students in grades 6 to 10 (N = 7313) completed the bullying and depression items in the Health Behavior in School-Aged Children (HBSC) 2005 Survey.
Depression was associated with each of four forms of bullying. Cyber victims reported higher depression than bullies or bully-victims, a finding not observed in other forms of bullying. For physical, verbal and relational bullies, victims and bully victims, the frequently-involved group reported significantly higher level of depression than the corresponding occasionally-involved group. For cyber bullying, differences were found only between occasional and frequent victims.
Findings indicate the importance of further study of cyber bullying as its association with depression is distinct from traditional forms of bullying.
Bullying is a pervasive problem among children and adolescents, and may take various forms including physical (e.g., hitting), verbal (e.g., name-calling), relational (e.g., social isolation), or occurring in cyber space [1, 2]. Previous studies have consistently shown that depression is associated with exposure to bullying . Bully-victims, a group of individuals who are both bullies and victims, are a distinct group at highest risk for psychosocial problems . However, few studies have examined the association between depression and different forms of bullying . In addition, because research on cyber bullying is still in its early stage, little is known about how level of depression differs in cyber bullies, victims, and bully-victims. The current study: (1) examines the association between depression and frequency of involvement in physical, verbal, relational and cyber forms of bullying and victimization; and (2) compares levels of depression among bullies, victims and bully-victims of each form.
A U.S. nationally-representative sample of adolescents in grade 6 through 10 was assessed in the 2005/2006 Health Behavior in School-aged Children study, using a three-stage stratified design . Youth assent and parental consent were obtained as required by participating school districts. The study protocol was reviewed and approved by the Institutional Review Board of the Eunice Kennedy Shriver National Institute of Child Health and Human Development.
Among the 7,508 adolescents who completed the anonymous paper survey, 195 (2.6%) were excluded due to missing information. The analytic sample (N = 7,313) consisted of 48.0% males, 42.3% Caucasian Americans, 18.5% African-Americans, and 26.4% Hispanic Americans. The mean age of the sample was 14.2 years (SD 1.42).
Measures included gender, grade, race/ethnicity (Caucasian, African-American, Hispanic, and others) and family affluence .
Six items from the Center for Epidemiologic Studies Depression Scale (CES-D)  assessed depressive feelings and behaviors in the past 30 days : (1) very sad; (2) grouchy or irritable, or in a bad mood; (3) hopeless about the future; (4) felt like not eating or eating more than usual; (5) slept a lot more or a lot less than usual; and (6) had difficulty concentrating on their school work. Responses were coded one to five: never, seldom, sometimes, often, and always. This scale showed desirable reliability (Cronbach's alpha =.80).
Olweus’ revised bully/victim instrument  was used to measure physical (1 item, e.g., hitting), verbal (3 items, e.g., calling mean name) and relational bullying (2 items, i.e., social isolation and spreading false rumors), with added items measuring cyber bullying (2 items, i.e, using computers or using cell phones) . For each item, two parallel questions asked frequency of bullying (bullying others) and victimization (being bullied) in the past couple of months at school. Following the recommendations of previous studies, the cutoff point was “two or three times a month” for frequent involvement and “only once or twice” for occasional involvement. Co-occurrence of bullying and victimization were examined, generating eight mutually exclusive groups: 1) non-involved, 2) occasional bullies, 3) occasional victims, 4) occasional bully-victims, 5) frequent bullies, 6) frequent victims, 7) frequent bully-victims, and 8) mixed frequency (individuals reporting both bullying and victimization but with different frequency levels).
For each form of bullying, a regression analysis was conducted with depression as the outcome, the categorized measure of bullying and victimization as predictor, and socio-demographic variables as covariates. To test if the association between depression and bullying differed by gender, a gender by bullying interaction term was also included. Two sets of contrasts were tested in each regression model, with one comparing frequency levels and the other comparing bullies, victims, and bully-victims (see Figure 1). All analyses were conducted using STATA, version 9  and an alpha of .05 as the significance level.
The percentages of those never, occasionally or frequently involved in bullying and victimization, as well as the percentages in the eight bullying/victimization groups are reported in Table 1. The prevalence of involvement in physical, verbal, relational and cyber bullying was 21.2%, 53.7%, 51.6% and 13.8%, respectively.
Compared to the non-involved group, adolescents with any involvement in bullying or victimization reported higher level of depression across all four forms of bullying. The interaction of gender and involvement in bullying was not significant. The R2 of the four regression models were .115, .170, .189, and .107 for physical, verbal, relational, and cyber bullying, respectively.
Two sets of planned comparisons were conducted (Figure 1). For physical, verbal and relational bullying, the frequently-involved group reported significantly higher level of depression than the corresponding occasionally-involved group. For cyber bullying, differences were found only between occasional and frequent victims. For verbal and relational bullying, victims and bully-victims reported higher level of depression than bullies (both occasional and frequent groups). For cyber bullying, frequent victims reported significantly higher level of depression than frequent bullies. In addition, the difference between frequent cyber victims and frequent cyber bully-victims approached significance (p < .10).
This study examined associations between depression and four forms of bullying: three traditional (physical, verbal, and relational) and a relatively new form (cyber). For traditional bullying, the associations between depression and frequency of involvement within bullies, victims, and bully-victims were consistent with previous studies . For cyber bullying, on the other hand, these associations were not found for bullies or bully-victims. In addition, the comparisons of bullies, victims, and bully-victims showed different results across forms of bullying. Notably, cyber victims reported higher depression than bullies or bully-victims, which was not found in any other form of bullying. This may be explained by some distinct characteristics of cyber bullying . For example, unlike traditional victims, cyber victims may experience an anonymous attacker who instantly disperses fabricated photos throughout a large social network; as such, cyber victims may be more likely to feel isolated, dehumanized or helpless at the time of the attack . Findings indicate the importance of further study of cyber bullying as its association with depression is distinct from traditional forms of bullying.
This research was supported by the Intramural Research Program of the Eunice Kennedy Shriver National Institute of Child Health and Human Development and the Maternal and Child Health Bureau of the Health Resources and Services Administration.
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