Cyberbullying among 4,200 Brazilian teens almost always came with bullying at school

Six percent of roughly 4,200 students is about 252 adolescents ^[14], and the study's strongest finding rests on that small group. Among them, 52.4% showed psychological symptoms at a clinically significant level. The figure for students with no involvement in bullying was 12.5% ^[7]. The ratio is about 4.2 to 1 ^[15]. In head counts, the 52.4% is around 130 young people ^[16].

The case for calling cyberbullying an extension of school aggression comes from the shape of the profiles, published in Psychiatry Research ^[5]. None of the three groups is defined by online bullying alone ^[17]. Students bullied often at school were rarely involved in cyberbullying. Online aggression turned up in the small group that was also in conflict in person and moved between the two settings [c5, c6]. A profile analysis groups behaviours that occur together in the same students. On its own, it does not show which came first. "The research shows that violence against the same young person occurs both at school and online, indicating that cyberbullying is often an extension of in-person conflict," said Zila Sanchez, head of Unifesp's Department of Preventive Medicine and coordinator of the study [c9, c11].

The choice of comparison group matters for the claim about risk. The authors describe the 6% as the most vulnerable group ^[3], but the distress figure compares them with students who had no involvement at all ^[7]. A fairer test of whether bullying in several settings adds harm would use the 46% group bullied mainly at school ^[2]. The phys.org report of the study does not give that group's rate of clinical symptoms.

The alcohol figure for the victim-perpetrators is lifetime use ^[8]. That is a broad measure in a sample that runs up to the third year of high school ^[6], and the cigarette comparison is the more informative of the two. Both carry the same limit. The group is defined by being target and aggressor at once ^[3], so the data cannot separate harm from being bullied from whatever leads a student to bully. Distress and drinking could pull a teenager into conflict or follow from it. The authors' own phrase for the link is "strongly associated" ^[13].

Sanchez draws her school-policy conclusion from the overlap. "This study reinforces the evidence that in Brazil, it isn't possible to have one program focused solely on mental health, another on drug prevention and a third against bullying, as is often seen in schools. Everything is connected," she said ^[10].