Loneliness and nervousness mediate the association between alcohol use and cyberbullying victimization among school-aged adolescents: a two-year longitudinal study

BACKGROUND: Adolescent alcohol use and cyberbullying victimization represent significant global public health concerns. This two-year longitudinal study examined the prospective association between alcohol use and cyberbullying victimization among school-aged adolescents and explored the potential mediating roles of loneliness, sadness, and nervousness. METHODS: We utilized data from 1,902 adolescents (mean age 12.2 ± 0.47 years; 51.3% boys) in the Ningbo Youth Risk Behavior Survey (2016-2018). Self-reported baseline data included alcohol use, lifestyle factors (physical activity, screen time, smoking status, and diet), and demographics. Cyberbullying victimization was assessed at follow-up. Multivariable logistic regression, adjusted for key covariates, was used to evaluate the association between alcohol and cyberbullying. Sensitivity analyses were performed to test the consistency of this association across subgroups stratified by sex, age of drinking initiation, and alcohol consumption frequency. Subgroup and mediation analyses were performed to examine potential effect modifiers and the indirect effects of loneliness, sadness, and nervousness. RESULTS: At baseline, 40.6% (n = 773) of the adolescents reported alcohol use. The incidence of cyberbullying victimization at follow-up was 11.4% (n = 217). After adjusting for confounders, baseline alcohol use was significantly associated with increased odds of subsequent cyberbullying victimization (adjusted odds ratio [AOR] = 1.45, 95% CI: 1.06 to 2.00). Sensitivity analyses revealed that this association was stronger in boys (AOR = 1.63, 95% CI: 1.10 to 2.42), those who initiated drinking at age ≥ 11 years (AOR = 1.80, 95% CI: 1.23 to 2.61), and those with higher drinking frequency (1-2 days/month: AOR = 1.71, 95% CI: 1.09 to 2.63; 3-30 days/month: AOR = 2.41, 95% CI: 1.24 to 4.50). Mediation analyses indicated that loneliness and nervousness partially mediated the relationship between alcohol use and cyberbullying victimization, accounting for 11.59% and 7.25% of the total effect, respectively. Sadness did not have a significant mediating effect. CONCLUSIONS: Alcohol use is an independent predictor of subsequent cyberbullying victimization among adolescents, with a more pronounced effect among boys. This association is partially mediated by increased feelings of loneliness and nervousness. These findings suggest that interventions targeting alcohol use, in addition to efforts to reduce loneliness and nervousness, may help mitigate the risk of cyberbullying victimization in this population.