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APNA 30th Annual Conference Session 2026: October 20, 2016 Hutson 1

The Newest Risk Factor for Pediatric Depression, Anxiety, and Suicidal Ideation: Cyberbullying

Elizabeth Hutson PMHNP-BC

Disclosures

The speaker has no conflicts of interest to disclose

Learning Objectives

• Upon completion of this presentation,

participants will be able to:

– Define cyberbullying – Discuss evidence-based treatment strategies for children who have developed depression, anxiety, and/or suicidal ideation as a consequence of victimization of cyberbullying – Identify ineffective coping skills for victims of cyberbullying

APNA 30th Annual Conference Session 2026: October 20, 2016 Hutson 2 Definition of Cyberbullying

“Willful and repeated harm inflicted through aggressive actions through the use of computers, cell phones, and other electronic devices”

Hutson, 2016

Defining Attributes of Cyberbullying

• Aggressive Action
• Electronic mean of contact
• Intent
• Harm
• Repetition

Not included: Power Differential

24/7

Hutson, 2016

Background

• Victim of Cyberbullying
• 25% of children
• Perpetrator of Cyberbullying
• 16% of children
• 40% - 55% of students are involved in

some way

• as victims, perpetrators, or
• bservers/bystanders

Palladino, Nocentini, & Menesini, 2012

APNA 30th Annual Conference Session 2026: October 20, 2016 Hutson 3

Consequences (and Antecedents) of Cyberbullying

• Depression
• Anxiety
• Suicidal Ideation

Is Cyberbullying Worse than Tradition Bullying?

• Certain types of cyberbullying lead to greater

emotional distress

• When an adult is involved as perpetrator
• When pictures are posted
• When the bullying carries over into traditional

bullying

• Suicidal Ideation
• More prevalent from cyberbullying versus traditional

bullying

• Victims are 8X more likely to bring a weapon to

school

Bottino et al., 2015; Ybarra, Diener-West, & Leaf, 2007

Case Study

• 13-year-old female who presents with

depression, social anxiety, NSSI and SI

• First bullied in person in 5th grade
• Kids would call her “Crusty” or “Pizza”
• Cyberbullied in 7th grade on Instagram
• Created a fake account with her picture
• Switched schools, but the in-person and

cyberbullying continued

APNA 30th Annual Conference Session 2026: October 20, 2016 Hutson 4 What do you think she should do?

• Tell her teachers or school administrators 😦
• Tell her parents 😄
• Take away/take a break from electronics 😄
• Tell a friend 😦
• Tell the police
• Ignore the behavior 😦
• Confront the bully 😦
• Go to counseling 😄

19 articles selected with 14 unique programs

31 Articles

281 Abstracts

1800 Titles

PUBMED, CINAHL, Psychinfo, Eric, Medline, Communication and Mass Media Complete: Cyberbullying + Intervention OR Treatment OR Therapy OR Program

What does the evidence say she should do?

Empathy Social Skills Coping Skills Peer Mentors Bystanders Psychoeducation Legal Consequences Parent Education Talking to an Adult you trust Digital Citizenship Collaborative with students Teacher Involvement in incidents

NoTrap!

X X X X X X X

Media Heros

X X X X X X X X X

Tabby

X X X X X X X X X

CFSP

X X X X X X X X X X

Cyberprogram 2.0

X X X X X X

ViSC

X X X X X X

ConRed

X X X X X X X X

KiVa

X X X X X X X X X X X

P4C

X X X

SDPaCB

X X X X

WebQuest

X X X X

Arizona A.G.

X X X

iZ Heros

X X X X

School‐Based

X X X

APNA 30th Annual Conference Session 2026: October 20, 2016 Hutson 5 EBP: Schools

• Whole school approach
• Specific guidelines for teachers to

address bullying incidents

• Collaboration between students
• Peer Mentoring
• Bystanders

EBP: Individuals

Things to teach individuals:

• Coping Skills
• Psychoeducation
• Empathy Training
• Social Skills
• Digital Citizenship
• Legal Consequences

EBP: Parents

• Parent Psychoeducation
• Talking to an adult you trust

APNA 30th Annual Conference Session 2026: October 20, 2016 Hutson 6 EBP: Healthcare Practitioners

None were found

Theoretical approaches from CBT

• Thinking, Feeling, Behaving Triangle
• Cognitive Restructuring of Distortions
• ABCs
• Positive Self-Talk

Melnyk, 2016

(Likely) ineffective coping strategies

• Ignoring
• Confronting the bully
• Telling an unhelpful adult
• Taking away electronic devices

Fenaughty & Harré, 2013

APNA 30th Annual Conference Session 2026: October 20, 2016 Hutson 7 Future Recommendations

• Treatment programs in school that

specifically target depression, anxiety, and SI using CBT

• Treatment programs that can be

implemented in the healthcare provider’s

• ffice