Bullying, Cyberbullying, and Recent Poor Mental Health Among U.S. High School Students: A Cross-Sectional Indirect-Association Analysis

Abstract

Background: Cyberbullying victimization is associated with recent poor mental health among adolescents, but the roles of digital and offline contextual indicators require careful interpretation. Objective: Guided primarily by Stress Process Theory and secondarily by bounded routine activity concepts, this study examined cross-sectional associations among traditional school bullying, cyberbullying, social media use, physical activity frequency, and recent poor mental health among U.S. high school students. Methods: Complete-case 2023 Youth Risk Behavior Survey data for U.S. high school students (N = 10,295; 49.5% female; 42.7% White, 21.9% Hispanic/Latino, 11.2% Black or African American, and 24.2% all other races) were analyzed in two non-survey-weighted, model-based indirect-association specifications using PROCESS Model 6. Both models adjusted for sex, grade, sexual identity, race/ethnicity, and the alternate bullying indicator. Results: Traditional bullying and cyberbullying were each positively associated with more frequent recent poor mental health after mutual adjustment (β = 0.113 and β = 0.111, respectively). No indirect associations were statistically supported in the traditional bullying model. In the cyberbullying model, the indirect association through social media use was statistically supported but small, and the sequential indirect association through social media use and physical activity frequency was statistically supported but extremely small. Conclusions: Findings support a cautious, cross-sectional interpretation in which bullying victimization is treated as peer-related strain and social media use and physical activity frequency are contextual indicators rather than causal mediators.