The study’s central methodological innovation was its use of latent class analysis, a statistical technique that identifies probabilistic clusters within a population rather than forcing adolescents into isolated, predefined categories such as “online victim” or “physical aggressor.” Most previous research on bullying has examined these categories separately, using distinct data sets and analytical frames. By contrast, the Unifesp team analyzed associations between violent involvement, psychological symptoms, drug use, and sociodemographic factors simultaneously, allowing the data to reveal how different forms of violence tend to co-occur in the same young person.

The analysis identified three distinct profiles. The largest group, comprising 48 percent of the sample, showed no significant association with any type of violence. The second group, representing 46 percent, consisted of adolescents who are frequently bullied at school and sometimes engage in bullying themselves, but who rarely participate in cyberbullying. The third and smallest group, just 6 percent of the sample, proved to be the most complex and the most vulnerable: so-called victim-perpetrators who both experience and perpetrate aggression across multiple contexts, moving frequently between physical school environments and online spaces.

Although this third group is numerically small, its members carry a disproportionate burden of harm. More than half of the adolescents classified as victim-perpetrators in multiple contexts — 52.4 percent — exhibited psychological symptoms at a clinically significant level, compared with 12.5 percent of those not involved in bullying at all. That difference translates into an elevenfold higher likelihood of psychological distress. The pattern extended to substance use as well: seven out of ten members of this group had consumed alcohol at some point in their lives, and their rate of cigarette use was nearly three times higher than that of peers uninvolved in bullying incidents.

“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,” says Professor Zila Sanchez, head of the Department of Preventive Medicine at Unifesp and coordinator of the study. “We have to look very closely at these young people involved in multiple contexts. It isn’t just bullying. It includes mental health issues and the use of alcohol and other drugs. There’s no way to separate them.” Sanchez argues that the findings reinforce a growing body of evidence that fragmented interventions — one program for mental health, another for drug prevention, a third against bullying — fail to address the interconnected reality of adolescent risk in Brazil.

The demographic breakdown of the high-risk group adds a further layer of concern. Girls were more likely to be victims of bullying, while boys predominated in the multiple-context victim-perpetrator group. Younger adolescents and Black and Brown students were also more likely to fall into the highest-risk category, a finding the researchers say underscores the importance of building social and racial inequalities into the design of prevention strategies rather than treating bullying as a uniformly distributed phenomenon.

One of the study’s most counterintuitive findings concerned screen time. Despite widespread public anxiety about how many hours teenagers spend online, the researchers found that screen time did not distinguish between the risk groups, even though most students in the sample spent four or more hours online each day. “We were unable to distinguish, based on the number of hours, any differences in impact between those exposed to cyberbullying and those not exposed to any type of violence,” Sanchez explains. “It has much more to do with the group they interact with on WhatsApp, for example, which is generally the same as their school group. Parents often think that keeping their children away from screens protects them. Protection isn’t just about limiting screen time; it’s also about what teenagers are doing, who they’re interacting with, and what’s happening.”

For parents and educators seeking warning signs, Sanchez draws a distinction between ordinary adolescent turbulence and genuine cause for alarm. Typical behavioral changes tend to be temporary, but isolation, aggression, irritability, or disruptive behavior become red flags when they are frequent and begin to interfere with a young person’s studies, social life, or other domains. She also stresses that bullying extends far beyond physical violence, which accounts for only a minority of cases and is the form schools most readily intervene against. Bullying can involve social exclusion, humiliation, hiding belongings, or repeated comments about physical appearance. “Cases range from frequently excluding a student from games or conversations to the point where they would rather stay in the classroom during recess to insults about their appearance, weight, and other characteristics,” she says. “That often goes undiagnosed by the school.”

The study arrives amid a shifting legal and statistical landscape in Brazil. Since 2024, bullying and cyberbullying have been classified as crimes under Law No. 14.811, defined as “systematic intimidation” and “systematic virtual intimidation” involving intentional, repetitive physical or psychological violence, with penalties on conviction ranging from a fine to up to four years of imprisonment. The 20th Brazilian Yearbook of Public Safety, produced by the Brazilian Forum on Public Safety, recorded 4,549 police reports of bullying against children and adolescents in 2025, a 68.2 percent increase over the previous year, alongside 677 reports of cyberbullying, up 61.4 percent. Experts caution that these figures largely reflect the most serious cases that extend beyond school walls, and that the sharp rise stems primarily from the new law’s implementation rather than a sudden surge in violence. Meanwhile, the National School Health Survey (PeNSE 2024), conducted by the Brazilian Institute of Geography and Statistics, shows the percentage of students reporting being bullied rising from 23 percent in 2019 to 27 percent in 2024, meaning four in ten students aged 13 to 17 now report having been victims of bullying at school.

The research is already shaping public policy. It forms part of Prev.Action, a thematic project funded by the São Paulo Research Foundation (FAPESP) that evaluates strategies for preventing alcohol use among adolescents in four municipalities in the interior of São Paulo state, and its findings contributed directly to the creation of Prisma, a program launched in 2026 for eighth- and ninth-grade elementary students. Prisma is currently being tested in 36 state schools across six cities, with nearly 5,000 adolescents participating. Teachers receive training, materials, and implementation support, while students complete twelve lessons covering drug prevention, bullying, cyberbullying, and emotional education, with initial results expected after an end-of-year follow-up. “The seed is being planted with this FAPESP-funded study so that we can develop a program in partnership with the state,” says Sanchez, who is also coordinating the program. “The research made it possible to test a public policy in the field. The study identified gaps, guided the refinement of interventions, and translated its findings into school-based practice.” The study’s first author is biomedical researcher Augusto Henrique Roiz Druziani, supported by a FAPESP doctoral scholarship, with postdoctoral fellow Luís Eduardo Soares dos Santos among the co-authors. Taken together, the findings deliver a clear message to schools, families, and policymakers: the digital and physical worlds of adolescent violence are one continuous ecosystem, and effective prevention must treat it that way.

Subject of Research: Patterns of bullying and cyberbullying involvement and their links to mental health and substance use among Brazilian adolescents

Article Title: Cyberbullying rarely occurs in isolation; it functions as an extension of school violence

Article References: Cyberbullying rarely occurs in isolation; it functions as an extension of school violence. (n.d.). Original publication

Image Credits: AI Generated

DOI: Not provided

Keywords: cyberbullying, bullying, adolescents, school violence, mental health, substance use, latent class analysis, Brazil, victim-perpetrators, prevention programs, Unifesp, FAPESP