Acoso cibernético y la salud mental de los adolescentes: revisión sistemática

Bottino, Sara Mota Borges; Bottino, Cássio M. C.; Regina, Caroline Gomez; Correia, Aline Villa Lobo; Ribeiro, Wagner Silva

doi:10.1590/0102-311X00036114

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Review • Cad. Saúde Pública 31 (3) • Mar 2015 • https://doi.org/10.1590/0102-311X00036114 copiar

Acoso cibernético y la salud mental de los adolescentes: revisión sistemática

Autoria SCIMAGO INSTITUTIONS RANKINGS

Cyberbullying, uma nova forma de violência expressa por meio da mídia eletrônica, tem preocupado pais, educadores e pesquisadores. A associação entre cyberbullying e a saúde mental dos adolescentes será revisada. Revisão sistemática em duas bases de dados: PubMed e a Biblioteca Virtual em Saúde (BVS). A prevalência do cyberbullying variou entre 6,5% a 35,4%. Bullying tradicional prévio ou atual estava associado às vítimas e agressores do cyberbullying. Uso diário de três ou mais horas de Internet, web câmera, mensagens de texto, postar informações pessoais e assediar outros online estavam associados ao cyberbullying. "Cybervítimas" e cyberbullies tinham mais problemas emocionais, psicossomáticos, dificuldades sociais, e não se sentiam seguros e cuidados na escola. O cyberbullying estava associado à sintomatologia depressiva moderada e grave, uso de substâncias, ideação e tentativas de suicídio. Profissionais de saúde devem conhecer as interações de natureza violenta que ocorrem no ambiente virtual e de seus agravos para a saúde mental dos adolescentes.

Bullying; Adolescente; Saúde Mental

Reference	Country	Study design	Sample characteristics	Participants	Participation rate	Cyberbullying measurements	Quality of studies
Ybarra ¹³	USA	Cross-sectional populational-based. Randomly selected phone numbers. Telephone survey	Regular Internet urban users (i.e., at least six times in the previous six months). One young person and one caregiver	N = 1,501. Age: 10-17 years. 47% girls and 53% boys.	82%	(1) Whether the respondent felt worried or threatened because of someone else bothering or harassing him or her while online (yes/no) and (2) whether the respondent felt threatened or embarrassed because someone had posted or sent a message about the young person for other people to see (yes/no)	Strong
Ybarra et al. ¹⁶	USA	Cross-sectional populational-based. Randomly selected phone numbers. Telephone survey	Regular Internet urban users (i.e., at least six times in the previous six months). One youth and one caregiver	N = 1,500. Age: 10-17 years. 51% girls and 49% boys	45%	(1) In the past year did you ever feel worried or threatened because someone was bothering or harassing you on-line? (2) In the past year did anyone ever use the Internet to threaten or embarrass you by posting or sending messages about you for other people to see?	Strong
Juvonen & Gross ¹⁵	USA	Cross-sectional. Anonymous web-based survey	Participants from 55 states recruited through a popular teen web site	N = 1,454. Age: 12-17 years. 75% girls and 25% boys	NI	9 questions about aggressive behavior on the Internet	Weak
Hinduja & Patchin ²¹	USA	Cross-sectional, randomized. Self-reported questionnaire	36 middle schools from the largest school district of USA. Representative sample	N = 1,963. 6^th-8^th grades. 48% girls and 52% boys	96%	14 questions: 9 questions about cybervictimization and 5 question about cyberbullying offending	Moderate
Sourander et al. ¹⁷	Finland	Cross-sectional populational-based. Self-reported questionnaire	Two cities in north and south of Finland. All children attending the seventh and ninth grade, except for children attending classes for the physically or mentally disabled	N = 2,215. 7^th-9^th grades. 50% girls and 50% boys	90.9%	Two general questions about cyberbullying, defined as: “cyberbullying is when someone repeatedly makes fun of another person online or repeatedly picks on another person through e-mail or text messages or when someone posts something online about another person that they don’t like”: (1) During the past 6 months, how often have you been cyberbullied? (2) During the past 6 months, how often have you cyberbullied others	Strong
Wang et al. ¹⁹	USA	Cross-sectional populational-based. Self reported questionnaire	A U.S. nationally-representative sample of adolescents	N = 7,313. 6^th-10^th grades. 42.3% girls and 56.7% boys	NI	Two questions about: (1) having suffered bullying through computer: messages or photos; (2) having suffered bullying through cellular	Strong
Ortega et al. ²²	Italy, Spain, England	Cross-sectional, multicentric. Self-reported questionnaire	Urban students.Representative sample	N = 5,862. Age: 12-16 years. 8^th-, 10^th and 12^th grades. 48.8% girls and 52.2% boys	NI	12 questions to cellular phone; 12 questions to internet; DAPHNE questionnaire (Genta et al. ³³)	Moderate
Schneider et al. ¹⁸	USA	Census: (86%) of Boston metropolitan area. Self-reported questionnaire	22 high school urban students, middle and upper-middle class families	N = 20,406. 9^th to 12^th grades. 50.4% girls and 49.6% boys	88.1%	One question: “How many times someone used the internet, cellular or other means of electronic communication to intimidate, provoke or threaten you?”	Strong
Litwiller & Brausch ²⁰	USA	Cross-sectional, randomized.Self-reported questionnaire	27 high schools public students, from seven-county region. Representative sample. Rural Midwest region	N = 4,693. 9^th-12^th grades. 47% girls and 53% boys	65%	Three questions about cyberbullying: (1) someone spread rumors about you online in chats, website, by emails or text messages?; (2) someone posted compromising or inappropriate photos of you online?; (3) someone sent you aggressive messages or messages with threats by e-mail or text	Strong
Chang et al. ¹⁴	Taiwan	Cross-sectional, randomized. Self-reported questionnaire	26 urban high schools, two cities. Representative sample	N = 2,992. 10^th grade. 48% girls and 52% boys	80%	12 questions: six cybervictimization (how often has someone: posted rude comments; embarrassing photos; spread rumours; threatening comments; talked about sex online) and six cyberbullying (how often have you ever: posted rude comments; sent embarrassing photos; spread rumours; made threatening comments; talked about sex online)	Strong

Authors	Prevalence of cyberbullying	Risk factors related to cyberbullying	Measures of mental health problems	Mental health problems related to cyberbullying
Ybarra ¹³	6.5%	Male gender: Depressive sintomatology (OR = 3.38; CI: 1.78-6.45); Daily use of the internet for three or more hours (OR = 4.34; CI: 2.12-8.89); Harasser of others online (OR = 4.19; CI: 2.06-8.50); Interpersonal victimization (OR = 3.07; CI: 0.57-6.00). Female gender: Daily use of the internet for three or more hours (OR = 3.67; CI: 1.53-8.8); Daily use of internet for two hours a day (OR = 2.34; CI: 1.16-4.73); Using the Internet most frequently for instant messaging (OR = 2.92; CI: 1.19-7.79) or e-mail (OR = 2.75; CI: 1.20-6.26); Harasser of others online (OR = 2.82; CI: 1.43-5.50)	Depressive symptoms of DSM-IV ³⁴	Symptoms of major depression (OR = 3.38; CI: 1.78-6.45)
Ybarra et al. ¹⁶	9%	Harassing others online (OR = 3.6; CI: 2.3-5.7); Using internet for instant messaging, blogging, and chat room (OR = 3.4; CI: 0.9-6.3); Borderline/clinically significant social problems (OR = 2.4; CI: 1.2-4.4); Interpersonal victimization (OR = 1.5; CI: 1.0-2.2)	Youth Self-Report of Child Behavior Checklist (Achenbach ³⁵)	Emotional distress: 38% of the harassed youth reported distress associated; Characteristics associated with emotional distress among targets of harassment incident: preadolescence (OR = 0.5.5; CI: 1.5-19.3), adult harasser (OR = 4.1; CI: 1.4-11.6); Being asked to send a picture of oneself (OR = 3.2; CI: 1.2-8.4); Aggressive offline contact (OR = 3.9; CI: 1.5-10.1)
Juvonen & Gross ¹⁵	72%	School bullying (OR = 6.87; CI: 4.90-9.62); Daily use of the internet for three hours or more (OR = 1.45; CI: 1.04-2.02); Instant messaging (OR = 2.84; CI: 1.08-7.49); Webcam (OR = 1.50; CI: 1.04-2.14)	Social anxiety scale with 5 items (La Greca & Lopez ³⁶)	Social anxiety (β = 0.31; p < 0.01)
Hinduja & Patchin ²¹	Cy-v: 5.7-18.3%. Cy-b: 9-23.1%	Not found	Four items about suicide attempt and suicide adapted from American School Health Associations ³⁷	Suicidal ideation: Cybervictim (OR = 1.94; p < 0.001); Cyberbully (OR = 1.49; p < 0.05)
Sourander et al. ¹⁷	17.6%. Cy-v: 4.8%. Cy-b: 7.4%. Cy-v/b: 5.4%	Cybervictimization: not living with both biological parents; perceived difficulties; emotional problems and peer problems; headache, abdominal pain, sleeping problems, not feeling safe at school and uncared about by teachers. Traditional victimization and school bullying. Cyberbullies: high level of perceived difficulties, hyperactivity, conduct problems, and lowprosocial behavior. Traditional bullying. Cybervictim and cyberbully were associated with all these risk factors above	Strengths and Difficulties Questionnaire – SDQ (Goodman ³⁸)	Cyberbully: Hyperactivity problems (OR = 2.4; 95%CI: 1.4-3.9); Behavior problems (OR = 2.6; 95%CI: 1.5-4.5); Low prosocial behavior (OR = 2.3; 95%CI: 1.5-3.4); Emotional problems (OR = 2.1; 95%CI: 1.1-3.6); Peer problems (OR = 4.8; 95%CI: 2.9-7.7); Cybervictim: Behavior problem (OR = 2.6; 95%CI: 1.5-4.5); Hyperactivity problems (OR = 2.4; 95%CI: 1.4-3.9); Emotional problems (OR = 2.2; 95%CI: 1.2-3.9); Peer problems (OR = 4.8; 95%CI: 2.9-7.7)
Wang et al. ¹⁹	10.1%	Male-gender. 6-8 grade	Depression: Six items: sadness; irritation, bad mood; hopelessness; changes in appetite; sleep; concentration problems in the past 30 days (Dahlberg et al. ³⁹)	Depression, medically attended injuries, medicine use for sleeping problems and nervousness *
Ortega et al. ²²	England: 2.0% mobile phone, 2.6% Internet; Italy: 2.2% mobile phone; 1.9% Internet; Spain: 0.5% mobile phone 1.3% Internet	NI	DAPHNE questionnaire (Genta et al. ³³)	Mobile phone cyberbullying: angry – 35.8%; not bothered – 25.4%;worried – 19.5%; upset – 18.3%; stressed – 13.3%; afraid – 13.3%; depressed – 10.7% Internet cyberbullying: not bothered – 35.7%; angry – 33.7%; upset – 19.5%; worried – 15.5%; afraid – 12.8%; depressed – 10.3%
Schneider et al. ¹⁸	15.8%	Female gender; non-white/mixed race; non heterosexuality identified; lower school performance; lower school attachment	Centers for Disease Control and Prevention ⁴⁰; Health and Risk Behaviors of Massachusetts Youth ⁴¹	Distress: Depressive symptoms (OR= 4.38; 99%CI: 3.76-5.10); Self-injury (OR = 4.79; 99%CI: 4.06-5.65); Suicidal ideation (OR = 3.35; 99%CI: 2.71-4.13); Suicide attempt (OR = 5.04; 99%CI: 3.88-6.55); Suicide attempt that required medical treatment (OR = 5.42; 99%CI: 3.56-8.26)
Litwiller & Brausch ²⁰	23%	Not founded	Suicidal behavior: Center for Disease and Control ⁴⁰; Substance use: 17 items from Monitoring the Future Survey (Johnston ⁴²); Violent behavior: 4 items from Center for Disease and Control, 2008 ⁴⁰; Sexual behavior: 5 items from Center for Disease and Control ⁴⁰	Substance use (estimate = 0.33; 95%CI: 0.28-0.35); Violent behavior (estimate = 0.16; 95%CI: 0.14-0.19); Non safe sex behavior (estimate = 0.005; 95%CI: 0.00-0.15); Suicidal behavior R²adj = 0.67
Chang et al. ¹⁴	35.4%. Cy-v: 18.4%; Cy-b: 5.4%; Cy-v/Cy-b: 11.2%	Male (OR = 1.57; 95%CI: 1.15-2.16); Lower academic performance (OR = 1.69; 95%CI: 1.34-2.15). Internet risks behaviors: Posting personal information photos and using a webcam to chat with strangers: Cy-b (OR = 1.87; 95%CI: 1.28-2.73); Cy-v (OR = 1.58; 95%CI: 1.28-1.96); Cy-v/Cy-b (OR = 4.28; 95%CI: 3.00-6.10)	Rosenberg Self-esteem Scale (Rosenberg ⁴³); Depression CES-D (Radloff ⁴⁴)	Low self-esteem scores and high depression scores *: Cy-v: low self-esteem scores and high depression scores; Cy-b: high depression scores; Cy-b/Cy-v: low self-esteem and high depression scores

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[1] Correspondence S. M. B. Bottino Universidade Federal de São Paulo. Rua Cônego Eugênio Leite 933, cj. 93, São Paulo, SP 05414-012, Brasil. sarabottino@uol.com.br