Cyberbullying Exposure, Sleep Disturbance, and Heart Rate Variability Among Adolescents: A Cross-Sectional Study

Nia Aprilia, Alini Alini, Ayu Dekawaty, Tengku Mohd Saifuddin Tengku Kamarulbah

Abstract


Introduction: Cyberbullying has emerged as a major adolescent health concern in the digital era. Although its psychological consequences are well documented, less is known about how cyberbullying relates simultaneously to sleep disturbance and physiological stress responses. Understanding these interconnected effects is important for developing comprehensive adolescent health assessment and intervention strategies. Objective: This study aimed to analyze the association between cyberbullying exposure, sleep disturbance, perceived stress, and physiological stress responses among adolescents. Methods: : A cross-sectional analytical study was conducted among 150 adolescents aged 15–18 years enrolled in senior high schools in West Java, Indonesia. Participants were selected using multistage cluster sampling. Cyberbullying exposure was assessed using the Cyberbullying Victimization Scale, sleep quality using the Pittsburgh Sleep Quality Index, and perceived stress using the Perceived Stress Scale-10. Physiological stress response was measured using resting heart rate variability (HRV) obtained under standardized resting conditions. Data were analyzed using IBM SPSS Statistics version 26.0 and AMOS version 24.0 through descriptive statistics, Pearson correlation, multiple linear regression, and structural equation modeling. Results: Participants reported moderate cyberbullying exposure (mean = 24.36, SD = 7.12), poor sleep quality (mean PSQI = 7.48, SD = 3.05), moderate perceived stress (mean = 18.92, SD = 5.64), and reduced HRV (mean = 42.15, SD = 10.83). Cyberbullying was positively correlated with sleep disturbance (r = .46, p < .01) and perceived stress (r = .52, p < .01), and negatively correlated with HRV (r = −.41, p < .01). Structural modeling indicated that cyberbullying was associated with HRV both directly and through pathways involving sleep disturbance and perceived stress. Conclusion: Cyberbullying is significantly associated with behavioral, psychological, and physiological stress responses in adolescents. Early multidimensional assessment is needed to reduce its long-term health consequence

Keywords


adolescents; cyberbullying; heart rate variability; perceived stress; sleep disturbance.

References


Álvarez-Marín, I., Pérez-Albéniz, A., Lucas-Molina, B., Martínez-Valderrey, V., & Fonseca-Pedrero, E. (2022). Assessing Cyberbullying in Adolescence: New Evidence for the Spanish Version of the European Cyberbullying Intervention Project Questionnaire (ECIP-Q). International journal of environmental research and public health, 19(21), 14196. https://doi.org/10.3390/ijerph192114196

Bansal, S., Garg, N., Singh, J., & Van Der Walt, F. (2023). Cyberbullying and mental health: Past, present and future. Frontiers in Psychology, 14, 1279234. https://doi.org/10.3389/fpsyg.2023.1279234

Borualogo, I. S., Kusdiyati, S., & Wahyudi, H. (2023). Translation and adaptation of cyberbullying victimization and perpetration scales for Indonesian contexts. KnE Life Sciences, 8(18), 287–297. https://doi.org/10.18502/kss.v8i18.14227

Buysse, D. J., Reynolds, C. F., Monk, T. H., Berman, S. R., & Kupfer, D. J. (1989). The Pittsburgh Sleep Quality Index: A new instrument for psychiatric practice and research. Psychiatry Research, 28(2), 193–213. https://doi.org/10.1016/0165-1781(89)90047-4

Camodeca, M., & Nava, E. (2022). The long-term effects of bullying, victimization, and bystander behavior on emotion regulation and its physiological correlates. Journal of interpersonal violence, 37(3-4), NP2056-NP2075.

Centofanti, S. A., Dorrian, J., & Banks, S. (2024). Nighttime phone use, cyberbullying, sleep, and psychological wellbeing in adolescents. Adolescent Health, Medicine and Therapeutics, 15, 45–56. https://doi.org/10.3390/youth4030025

Craig, W., Boniel-Nissim, M., King, N., Walsh, S. D., Boer, M., Donnelly, P., Harel-Fisch, Y., Malinowska-Cieślik, M., Gaspar de Matos, M., Cosma, A., & Pickett, W. (2020). Social media use and cyber-bullying: A cross-national analysis of young people in 42 countries. Journal of Adolescent Health, 66(6), S100–S108. https://doi.org/10.1016/j.jadohealth.2020.03.006

Gini, G., & Pozzoli, T. (2013). Bullied children and psychosomatic problems: a meta-analysis. Pediatrics, 132(4), 720–729. https://doi.org/10.1542/peds.2013-0614

Haddad, C., Sacre, H., Bou Malhab, S., Malaeb, D., Saadeh, D., Abou Tayeh, C., & Salameh, P. (2021). A cross-sectional study of COVID-19-related bullying in a sample of Lebanese adults: scale validation, correlates, and mediating effect of fear and anxiety. BMC psychology, 9(1), 137. https://doi.org/10.1186/s40359-021-00643-1

Harris, K. M., Gaffey, A. E., Schwartz, J. E., Krantz, D. S., & Burg, M. M. (2023). The Perceived Stress Scale as a Measure of Stress: Decomposing Score Variance in Longitudinal Behavioral Medicine Studies. Annals of behavioral medicine : a publication of the Society of Behavioral Medicine, 57(10), 846–854. https://doi.org/10.1093/abm/kaad015

John, A., Glendenning, A. C., Marchant, A., Montgomery, P., Stewart, A., Wood, S., Lloyd, K., & Hawton, K. (2018). Self-Harm, Suicidal Behaviours, and Cyberbullying in Children and Young People: Systematic Review. Journal of medical Internet research, 20(4), e129. https://doi.org/10.2196/jmir.9044

Latino, F., et al. (2025). Understanding the psycho-physiological impact of bullying: Heart rate variability and stress responses in adolescents. Education Sciences, 15(5), 521. https://doi.org/10.3390/educsci15050521

Lee, J., Choo, H., Zhang, Y., Cheung, H. S., Zhang, Q., & Ang, R. P. (2025). Cyberbullying victimization and mental health symptoms among children and adolescents: A meta-analysis of longitudinal studies. Trauma, Violence, & Abuse. https://doi.org/10.1177/15248380241313051

Man, X., Liu, J., & Li, Y. (2022). Effects of bullying forms on adolescent mental health and protective factors. Frontiers in Psychiatry, 13, 845134. https://doi.org/10.3389/fpsyt.2022.845134

Nagata, J. M., Li, E. J., Huang, O. H., Ricklefs, C., Ganson, K. T., Testa, A., Scheffler, A., Sugrue, L., & Baker, F. C. (2026). Cyberbullying and sleep disturbances in adolescents: An updated evidence review. Academic Pediatrics, 26(1), 103149. https://doi.org/10.1016/j.acap.2025.103149

Qi, K., et al. (2025). School bullying and sleep disorders among adolescents: A longitudinal study. Acta Paediatrica, 114(2), 345-353. https://doi.org/10.1111/apa.17030

Real, A. G., et al. (2025). Victimization and sleep duration among diverse adolescents. Sleep Health, 11(1), 12-20. https://doi.org/10.1016/j.sleh.2024.10.004

Setyowati, A., & Chung, M. H. (2021). Validity and reliability of the Indonesian version of the Pittsburgh Sleep Quality Index in adolescents. International journal of nursing practice, 27(5), e12856. https://doi.org/10.1111/ijn.12856

Simpson, D. M. (2025). A pilot study investigating heart rate variability as a measure of stress in healthy school children responding to experimental stressors (Doctoral dissertation, University of Essex (United Kingdom)).

Stefanaki, C., Michos, A., Latsios, G., Tousoulis, D., Peppa, M., Zosi, P., ... & Bacopoulou, F. (2020). Sexual dimorphism of heart rate variability in adolescence: a case-control study on depression, anxiety, stress levels, body composition, and heart rate variability in adolescents with impaired fasting glucose. International Journal of Environmental Research and Public Health, 17(8), 2688.

Sun, J., Ban, Y., & Liu, J. (2024). Relationship between bullying victimization and suicide ideation among Chinese adolescents: A moderated chain mediation model. Children and Youth Services Review, 156, 107304. https://doi.org/10.1016/j.childyouth.2023.107304

Umar, N. F., Nurdin, N. H., Zulfiqri, Z., & Rafli, M. (2025). Validity and reliability of the Indonesian version of the cyber bullying perpetration (CBP) and victimization (CBV) instrument. Professional Guidance and Counseling Journal, 6(1), 13–22.

Viner, R. M., Aswathikutty-Gireesh, A., Stiglic, N., Hudson, L. D., Goddings, A. L., Ward, J. L., & Nicholls, D. E. (2019). Roles of cyberbullying, sleep, and physical activity in mediating the effects of social media use on mental health and wellbeing among young people. The Lancet Child & Adolescent Health, 3(10), 685–696. https://doi.org/10.1016/S2352-4642(19)30186-5

Zhu, C., Huang, S., Evans, R., & Zhang, W. (2021). Cyberbullying among adolescents and children: A comprehensive review of global prevalence and prevention. Frontiers in Public Health, 9, 634909. https://doi.org/10.3389/fpubh.2021.634909




DOI: https://doi.org/10.17509/jpki.v12i1.100053

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