Is cyberbullying essentially the same as bullying, or is it a qualitatively different activity? The lack of a consensual, nuanced definition has limited the field’s ability to examine these issues. Evidence suggests that being a perpetrator of one is related to being a perpetrator of the other; furthermore, strong relationships can also be noted between being a victim of either type of attack. It also seems that both types of social cruelty have a psychological impact, although the effects of being cyberbullied may be worse than those of being bullied in a traditional sense (evidence here is by no means definitive). A complicating factor is that the 3 characteristics that define bullying (intent, repetition, and power imbalance) do not always translate well into digital behaviors. Qualities specific to digital environments often render cyberbullying and bullying different in circumstances, motivations, and outcomes. To make significant progress in addressing cyberbullying, certain key research questions need to be addressed. These are as follows: How can we define, distinguish between, and understand the nature of cyberbullying and other forms of digital conflict and cruelty, including online harassment and sexual harassment? Once we have a functional taxonomy of the different types of digital cruelty, what are the short- and long-term effects of exposure to or participation in these social behaviors? What are the idiosyncratic characteristics of digital communication that users can be taught? Finally, how can we apply this information to develop and evaluate effective prevention programs?

The term “cyberbullying” is used broadly, both in colloquial and formal use. First coined in 1999, there is no general consensus on a definition, although different versions usually include the use of digital technology to inflict harm repeatedly or to bully.1,4 In 2006, Patchin and Hinduja2 defined cyberbullying as “willful and repeated harm inflicted through the use of computers, cell phones, or other electronic devices.” Kowalski et al5 defined it in 2014 as “the use of electronic communication technologies to bully others.” The use of different operational definitions has affected a great deal of the research, including reported prevalence rates, which show wide variation.6 

Most definitions of cyberbullying have modeled themselves on the more widely agreed-upon definition of traditional bullying, and it seems clear that there is some overlap between bullying and cyberbullying.7 Bullying and cyberbullying are reliably correlated.5 Yet, it has been argued that cyberbullying requires its own, separate scrutiny; several studies suggest it can cause harm above and beyond traditional bullying.8 Behaviors that are likely to be related to cyberbullying, such as online harassment and online sexual harassment, appear to be harmful and deserving of study.9 In addition, effective programming to reduce cyberbullying continues to elude researchers and other stakeholders.9,10 

The study of traditional bullying benefits significantly from a useful and operational definition that describes 3 core characteristics of bullying behaviors (intention, repetition, and power imbalance).11 Assessing these 3 characteristics of an aggressor helps predict greater negative impact upon the target.12 Some researchers have defined cyberbullying as simply bullying that occurs through electronic or digital means.3,5 Several studies have found significant correlations between the 2 behaviors.5,13,14 A majority of cyberbullying perpetrators and victims are also bullying perpetrators and victims, respectively.15 Cyberbullying interacts with in-school encounters; it may be triggered by events at school and may result in problems in school.16 Targets can often identify their perpetrators as peers from school; they typically know each other in “real life.”17,18 These findings all suggest that cyberbullying may simply be bullying in another realm.

Other researchers have adopted definitions that are similar but not identical to traditional bullying. For example, Patchin and Hinduja2 omitted the term “bullying” and its characteristic power imbalance to define cyberbullying as “willful and repeated harm through the use of computers, cell phones, or other electronic devices.” The use of slightly different definitions may reflect the fact that important differences between the 2 behaviors have been identified.

First, the use of digital technology clearly impacts communication. In a digital environment, cruelty can occur with or without the aggressor’s specific intent to make it repetitive or focused upon a less powerful target. For example, a user’s single online comment can easily spread beyond the initial posting. Assessing for intent to harm, intentional repetition, and power can be challenging in a digital environment. At other times, power imbalances between aggressors and targets can be measured through differences in technological expertise or the use of anonymity.19 (We note here that assessing for these factors can be challenging in any environment, traditional or online. But online interactions, which may lack nuances in communication, can be particularly difficult to judge.)

A second difference is the widespread use of digital devices, which means that cyberbullying is likely to happen outside of school (whereas traditional bullying most often happens in school), and cyberbullies may draw power from certain characteristics of the digital environment (notably anonymity).20 Victims of cyberbullying may feel unable to escape the cruelty, whereas traditional bullying does not typically carry over into the home setting.21 The motivations for cyberbullying may also be different online; qualitative research has suggested that how youth perceive digital communications may differ from how they perceive traditional communications.22 For example, digital technology can alter a user’s perception of the conformity of their attitudes to a majority, which can in turn change their willingness to express extreme or controversial opinions.

Third, cyberbullying seems to cause its own psychological harm to victims. Kowalski20 points out that cyberbullying accounts for some of the variance in psychological harm above and beyond that of traditional bullying. Compared with traditional harassment, online harassment may be more strongly linked than bullying to substance abuse and depression.23 One longitudinal study found that cyberbullying victimization predicted depression and substance abuse 6 months later, although researchers did not compare it to traditional bullying.24 Overall, cyberbullying seems to have a strong emotional impact that is independent of traditional bullying.8 

The characteristics of digital technology and the unique impact of cyberbullying do suggest that it is not a precise counterpart to traditional bullying, but important questions remain. Whether widespread online access to personally harmful material is particularly psychologically impactful remains largely unexplored. The hypothesis that online repetition through forwarding or sharing materials, for example, is as damaging as the repetition inherent in traditional bullying has not been studied.25 

As with traditional bullying versus harassment, differences between perpetrators and victims of cyberbullying and other types of online harassment or conflict have not been thoroughly clarified; online harassment typically involves harmful behaviors that lack either repetition or a power imbalance.26 Ybarra and Chen26 point out that online harassment may be less prevalent than cyberbullying and may result in less severe outcomes. On the other hand, online sexual harassment has been linked with more serious problems, including depression and substance abuse, and these effects are compounded when youth are also bullied in person.23 Online sexual harassment may contribute to cyberbullying by making nude or sexual images available to bullies, who may exploit them.27 Sexual maturation has been linked to both traditional bullying and digital behaviors associated with cyberbullying.9 Longitudinal research is lacking, and it is needed to help establish a sequence for these outcomes and others.20,25 

Finally, programming to prevent traditional bullying has been, in many cases, adapted to include digital technology. Concerns have been raised about the appropriateness of this approach and the lack of data supporting efficacy.9,28 Programs addressing cyberbullying and digital behaviors may need to address issues not typically addressed in existing prevention programs, such as content credibility and perceptual changes that can impact sharing.29 

  • Ask patients to describe their experiences with digital technology. Do they find it a primarily positive experience?

  • Ask patients if they have seen their peers having problems online. What types of problems have they seen, and what is their opinion about what they saw?

  • Ask patients to describe the types of social media applications being used.

  • If a child has had a negative experience, ask, “Do you know who you could go to for help and support?”

  • Ask your patients if their schools engage in any education about cyberbullying, the use of social media, and digital technology.

  • Ask your patients’ parents if they have access to educational materials about cyberbullying, digital devices, and sexting (Note: There are free research-based downloads for parents at http://www.marccenter.org).

  • Encourage parents to talk regularly to their children about what they’re doing online, what digital activities they enjoy, and what (if any) problems they’re having.

  • Encourage parents to ask children to explain or demonstrate some digital activity. Kids often enjoy showing their skills to their parents.

  • Encourage parents to respond to social problems with supportive actions, such as listening, being supportive, and sometimes providing a different perspective. Direct actions are not always possible or necessary.

  • Explain to parents that if a social problem persists, they can notify the Web site or application maker about the problem. Either you or they can also notify a child’s school, where the adults can keep an eye on interactions and support a targeted child.

  • Encourage parents to create a Family Media Plan as per recent recommendations from the American Academy of Pediatrics.30 

Dr Englander authored the initial draft of the document, drawing upon the work of the other authors listed below, and contributed to the final draft; Drs Kowalski, Lin, and Parti authored a section of the White Paper on which the summary is based, contributed conceptually to the White Paper regarding similarities and differences between cyberbullying and traditional bullying, and reviewed and revised the manuscript; Dr Donnerstein participated in the writing of sections on the long-term health implications of cyberbullying; and all authors approved the final manuscript as submitted.

The analysis, conclusions, and recommendations contained in each article are solely a product of the individual workgroup and are not the policy or opinions of, nor do they represent an endorsement by Children and Screens: Institute of Digital Media and Child Development or the American Academy of Pediatrics.

FUNDING: This special supplement, “Children, Adolescents, and Screens: What We Know and What We Need to Learn,” was made possible through the financial support of Children and Screens: Institute of Digital Media and Child Development.

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Competing Interests

POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose.

FINANCIAL DISCLOSURE: The authors have indicated they have no financial relationships relevant to this article to disclose.