Cyber bullying is linked to self-harm among children and teenagers in Singapore, newly released research suggests.
The Singapore Children's Society (SCS) and Institute of Mental Health studied data involving more than 3,000 students aged between 12 and 17 in 2014, in a survey on cyber bullying and Internet addiction.
Among other things, participants were asked if they had ever hurt themselves deliberately, for example, by cutting themselves.
The findings of the study, which were released to The Straits Times last week, concluded: "Being involved in cyber bullying - whether as a victim or as those who are both bullies and victims of bullying - was associated with a higher level of reported self-harm, than reported by those not involved in cyber bullying."
But the researchers added that cyber bullying does not necessarily lead to self-harm, as it could be that youngsters who already do so have characteristics that make them vulnerable to online or offline bullying.
Psychologists and youth counsellors said youngsters could be more prone to self-harm in the event of trauma or distress because of hyper-sensitivity and a tendency to hide their emotions from adults.
Psychologist Daniel Koh, from Insights Mind Centre, said online hostility could fuel such trauma.
He said: "Negative comments on social media have the power to reinforce whatever negative thoughts a person might have, which makes it more difficult to cope. They may not be able to deal with the situation in a positive manner and hence are responding to the distress by self-harming." He said he has come across five cases of depression caused by cyber bullying in the past year.
"There could be more of such cases, but it's just that they tend to go unreported. If the depression is not detected, it may lead to more serious cases of self-harm or even suicide," said Mr Koh.
An increasing number of secondary school students were found to have felt they are on the receiving end of hostile acts online.
In a separate study, Cyber wellness firm Kingmaker Consultancy conducted a survey of 2,600 students aged between 13 and 15 last year, and found an increase of up to 7 percentage points in the types of bullying, such as spreading rumours or sending offensive messages, compared with 2013.
About 43 per cent of male students said they were made fun of by others who posted pictures or jokes about them online, compared with 36 per cent in 2013. About 32 per cent of female students also reported the same in the latest survey, up from 28 per cent previously.
SCS senior director for youth services Carol Balhetchet said that for cyber bullying, warning signs include situations when children go quiet and go into their own worlds. After a distressing event that disturbs a young person's sense of safety, they want to quickly get back into a "safe space", she said.
"They will try to isolate themselves from shame or guilt and withdraw into their own world, or refuse to talk about their problems."
This creates a vicious circle, where they might resort to extreme behaviour - such as self-harming, abusing substances or getting into fights - to exert some sense of control over their emotions.
"The problem might seem like it's a lot bigger because they don't talk about it and, in the end, it's the situation that controls them, not the other way round," said Dr Balhetchet.
Children take time to develop skills to deal with their social environments, so when they do react, they tend to be hyper-sensitive.
Dr Raymond Cheong from Children/Youth Learning and Counselling Clinic said that in these instances, parents should listen to their children and not talk down to them. "When they start to talk to you, don't interrupt but keep listening. Sometimes, they don't want a solution, but just want parents to listen to them first."
If their condition does not improve, parents should seek professional help, he added.