Bullying and Cyberbullying in Childhood and Adolescence: A Narrative Review and Proposed Clinical Response Framework

Abstract

Background: Existing reviews establish that bullying and cyberbullying are associated with substantial health burden, but they rarely integrate conceptual distinctions, evidence strength, and healthcare response. Objective: To synthesize evidence on traditional bullying, peer victimization, and cyberbullying among children and adolescents and to identify clinically defensible implications and research priorities. Methods: A structured narrative review informed by SANRA addressed three questions concerning construct boundaries, health consequences and modifiers, and healthcare response. PubMed/MEDLINE was searched through 29 August 2026; Google Scholar supported citation tracing and the retrieval of named institutional reports. Eligibility, selection, charting, and narrative evidence-characterization procedures are reported. The final synthesis included 61 sources (53 journal articles and eight institutional reports, guidance documents, or books). Results: Cross-national surveillance estimated 11% repeated school bullying and 15% cybervictimization under different frequency thresholds. Meta-analytic estimates were 25% for victimization and 16% each for perpetration and bully–victim involvement. A longitudinal meta-analysis of 27 studies (13,497 participants) found a small prospective association between cybervictimization and later mental-health symptoms. School programs reduced perpetration by approximately 18–19% and victimization by 15–16%; cyberbullying effects were small (g = −0.18 and −0.13, respectively). The evidence was strongest for associations with internalizing symptoms, suicidality, psychosomatic complaints, sleep disruption, and impaired functioning but bidirectionality and residual confounding limit causal inference. Conclusions: Symptom- or risk-triggered, behavior-specific inquiry and coordinated safety assessment are justified; evidence is insufficient to recommend universal clinical screening. BV-CARE is presented as an author-developed, hypothesis-generating framework requiring stakeholder co-design, feasibility testing, and prospective validation before routine use.