Amy Seery MD Via Christi Medical Center Family Medicine Residency

1. Bullying in the Digital Age Amy Seery MD Via Christi Medical Center Family Medicine Residency September 2013

2. Objectives • Is avoiding technology the answer? • Is this really affecting my child? • How does cyberbullying occur? • Is cyberbullying really that harmful for anyone? • What if my child is the victim? Or the bully?

3. Do we need this technology? CulturalInertia

4. Exposure, Not Saturation

5. “Just Ignore It!” WRONG!

6. Bullying defined… • Overt • Physical (hitting, kicking, gym aggression, having personal items stolen) • Verbal (name calling, mocking, teasing) • Relational • Social exclusion, spreading rumors • Cyberbullying

7. Cyberbullying defined… • "Cyberbullying" is when a child, preteen or teen is tormented, threatened, harassed, humiliated, embarrassed or otherwise targeted by another child, preteen or teen using the Internet, interactive and digital technologies or mobile phones. • Adult involvement is “cyber-harassment” or “cyber-stalking” Stopcyberbullying.org

8. Bullying has changed… • Cyberbullying is different from “traditional” face-to-face aggression because of the anonymityof the mediums used. • The distance between the perpetrator and the victim prevents the perpetrator from seeing the harmful consequences of their actions or to experience any sympathy/empathy for their victim.

9. Broken Feedback Loop

10. Escalation Phenomenon

11. Does this really include my child?

12. Mean 24.4

13. Victims Bullies

14. The Real Online Predators…

16. Cyberbullying & School Violence

17. Ryan Halligan, 13 years old October 2003 • He was repeatedly sent instant messages from middle school classmates accusing him of being gay, and was "threatened, taunted and insulted incessantly" • Bullying on the internet "amplified and accelerated the hurt and pain he was trying to deal with, that started in the real world". Growing Up Online (Chapter 6: "Cyberbullying"). [Television production]. Boston: PBS. January 22, 2008. Event occurs at 0:08:16–0:08:30. http://www.pbs.org/frontline/video/share.html?s=frol02n3b7q4e. Retrieved 2010-10-27.

18. Megan Meier, 13 years old October 2006 • Witnesses testified that the women intended to use Meier’s e-mails with "Josh" to get information about her and later humiliate her, in retribution for her allegedly spreading gossip about Drew's daughter Steinhauer, Jennifer (November 26, 2008). "Verdict in MySpace Suicide Case". New York Times. http://www.nytimes.com/2008/11/27/us/27myspace.html?_r=1&hp. Retrieved 2010-10-27.

19. Jesse Logan, 18 years old July 2008 • She had sent nude pictures of herself to a boyfriend. When they broke up, he sent them to other high school girls. The girls were harassing her, calling her a slut and a whore. She was miserable and depressed, afraid even to go to school. Celizic, Mike (March 6, 2009). “Her teen committed suicide over ‘sexing’". Today Parenting- MSNBC. http://today.msnbc.msn.com/id/29546030. Retrieved 2010-10-27.

20. JaheemHarrera, 11 years old April 2009 • "There is name-calling, there is teasing, but I will tell you that it is almost always done outside the presence of adults. There is a code of silence among the students." Time Magazine. Bullying: Suicides Highlight a Schoolyard Problem By Paige BowersWednesday, May. 20, 2009

21. Seth Walsh, 13 years old September 2010 • The bullying took every form. "It was eye to eye, over the telephone, personal, over the Internet. He spent a lot of his life frightened." Time Magazine. The Bullying of Seth Walsh: Requiem for a Small-Town Boy By Bryan Alexander / Tehachapi Saturday, Oct. 02, 2010

22. Tyler Clementi, 18 years old September 2010 • His roommate had secretly recorded a video of Clementi kissing a guy; the video went up on YouTube. On Facebook, Clementi offered a final status update: "jumping off gw bridge sorry." Jonathan Lemire, Michael J. Feeney And Larry Mcshane (1 October 2010). "He Wanted Roomie Out Rutgers Suicide Complained Of Video Voyeur Before Fatal Fall". Daily News (New York): p. 2. Retrieved 2010-10-27.

23. Rhianna Lynn Morawitz, 14 yr old September 21st 2011- Freshman at NE High • "We never even thought in a million years this would happen. It was a complete shock," Morawitz said. • "We knew she was being bullied and that some crap was going on at school. . . . We tried to make the school aware of it. They knew what was going on, but they didn't do anything about it."

24. The How… A continuum of cyberbullying:

25. 1. Instant Messaging/ Text Messaging Harassment

26. 2. Stealing Passwords / Impersonation

27. 3. Blogs / Online Journals

28. 4. Sending Pictures or Videos through E-mail and Cell Phones

29. Revenge Pornography • Minors involved = illegal • Taken without consent = illegal • Taken by the subject and handed over freely ≠ illegal

30. 5. Memes

31. 6. Internet Polling

32. 7. Interactive Gaming

33. 8. Sending Malicious Code / Spyware

34. 9. Sending Porn to Online Accounts

35. (aka: cyberbullying-by-proxy) 10. Targeting the victim for harassment by a third party

36. The Harmful Effects of Bullying and Cyberbullying

37. People who bully others- Are more likely to- • Abuse alcohol and other drugs in adolescence and as adults. • Get into fights, vandalize property, and drop out of school. • Engage in early sexual activity. • Have criminal convictions and traffic citations as adults. In one study, 60% of boys who bullied others in middle school had a criminal conviction by age 24. • Be abusive toward their romantic partners, spouses or children as adults.

38. People who witness bullying- • Have increased use of tobacco, alcohol or other drugs. • Have increased mental health problems, including depression and anxiety. • Are more likely to miss or skip school.

39. Emotional Reactions to Being the Cyberbully • Did not feel anything 41% • They felt they were funny 25% • Guilty 21% • Powerful 9% • Popular 6% • Better than others 4% Mishna F, et al. Cyber Bullying Behaviors Among Middle and High School Students. American Journal of Orthopsychiatry. 2010. Vol 8, No 3, 362-374

40. The Why… • Anger, revenge, frustration, jealousy • Vengeance for the wronged friend • Entertainment • Boredom • Ego booster • Readily accessible • Revenge of the Nerd- victim becomes the bully • Impersonal nature of a screen

41. So what’s happening to the cyberbullying victims?

42. Don’t tell… • 58% have not told their parents or an adult about something mean or hurtful that happened to them online. • Cyberbullying is rarely reported • Fear of retaliation or worsening of the bullying • A major barrier is fear of losing internet or phone privileges. isafe.org Kowalski R, et al. Electronic bullying among middle school students. Journal of Adolescent Health, 41, S22-S30. 2007.

43. Digital Isolation One of the most damaging effects is that a victim begins to avoid friends and activities, often the very intention of the cyberbully.

44. Digital isolation becomes physical / social / emotional isolation • In general, peer harassment leads to: • Depression • Decreased self- • worth • Hopelessness • Loneliness • Lower GPA / Grad • rates • Poor sleep patterns • Emotionally labile • Withdrawal • Avoidance of • media • Lying • Poor health (up to • 3 yr) • Use of violence in • confrontations Hinduja S, et al. Bullying, Cyberbullying, and Suicide. Archives of Suicide Research. 14:206-221, 2010.

45. Suicide • CDC: suicide was the 2nd leading cause of death among 10-24 year olds in 2010. • Even though suicide rates have decreased between 1990-2000 among young people, there has been an upward trend in 10- to 20-year olds from 2000-2010. Baldry A, et al. Direct and vicarious victimization at school and at home as risk factors for suicidal cognition among Italian adolescents. Journal of Adolescence. 26(6). 703-716. 2003. Centers for Disease Control and Prevention. 2007. Morbidity and Mortality Weekly Report, 56(35), 905-908.

46. Suicide and Bullying • Youth who are bullied are at an elevated risk for suicidal ideation, attempts, and completion of suicides. • Among boys who were frequently bullied (at least once per week) 4% had severe suicidal ideation versus 1% in boys not bullied. • In girls, of those bullied 8% had severe SI versus 1% in those not. • Of those who bullied othersat least once per week both boys and girls showed 8% increase of severe SI. Kaltiala-Heino R, et al. Bullying, depression, and suicidal ideation in Finnish adolescents: School Survey. British Medical Journal. 319(7206). 348-351. 1999.

47. Suicide and Cyberbullying • Youth who experienced traditional bullying or cyberbullying, as either offender or victim, scored higher on suicidal ideation scales. • Cyberbullying victimization was a stronger predictor of suicidal ideation than bullying or cyberbullying offending. Hinduja S, et al. Bullying, Cyberbullying, and Suicide. Archives of Suicide Research. 14:206-221, 2010.

48. Helping Victims and Bullies as a Parent

49. Making a difference • Recognize the importance of online relationships for children and adolescents • Counsel and demonstrate internet safety and responsibility • Encourage efforts by schools and lawmakers • Ask about your child’s screen time (cell, tv, games, computer, etc.) • Talk about your child’s “online life” • Talk about suicide with your child • Encourage open communication between your child and their teachers, physician, and other trusted adults Be a Role Model Start Asking

50. Privacy vs. Protection • Is it okay to “snoop”? • Play-date analogy • Use parental monitoring software and site filters • Do NOT rely on these methods only • An opportunity to reward good behavior • Keep passwords for emergencies • Check your child’s internet History