Substance Use among Cyberbullying Victims During the COVID-19 Pandemic: A Moderated Mediation Model of Mental Health Problems and Telemedicine Services Use

The usage of substances among adolescents remains a prominent social concern, especially during COVID-19. In parallel, cyberbullying has emerged as another significant challenge, affecting the well-being and health of students as they spend more time online. We investigated the correlation between cyberbullying victimization and substance use in adolescents-and considered the potential mediating effect of mental health problems and the moderating effect of telemedicine services. We used data from the Adolescent Behaviors and Experiences Survey (n = 6,237), a nationally representative study administered by the CDC of the United States. Binary logistic regression and Ordinary Least Squares regression models were employed to examine the associations, and moderated mediation models were performed. The results showed that cyberbullying victimization significantly and directly correlated with increased substance use in adolescents. Mental health problems were found to partially mediate the link between cyber victimization and substance use. Furthermore, telemedicine services exhibited a protective effect on these associations. Specifically, cyber victimization significantly and positively predicted augmented mental health problems and substance use for students who did not use telemedicine services, whereas these associations became non-significant for those who used telemedicine services. This study contributes valuable insights into the impact of disasters, cyberbullying, and adolescent substance use, and it also underscores the importance of adopting a comprehensive prevention approach that addresses both cyberbullying and addictions simultaneously.