title: Social networking sites and mental health problems in adolescents: The mediating role of cyberbullying victimization.
abstract: BACKGROUND
  Previous research has suggested an association between the use of social networking sites (SNSs) and mental health problems such as psychological distress, suicidal ideation and attempts in adolescents. However, little is known about the factors that might mediate these relationships. The present study examined the link between the use of social networking sites and psychological distress, suicidal ideation and suicide attempts, and tested the mediating role of cyberbullying victimization on these associations in adolescents.
  
  
  METHODS
  The sample consisted of a group of 11-to-20-year-old individuals (n=5126, 48% females; mean±SD age: 15.2±1.9 years) who completed the mental health portion of the Ontario Student Drug Use and Health Survey (OSDUHS) in 2013. Multiple logistic regression analyses were used to test the mediation models.
  
  
  RESULTS
  After adjustment for age, sex, ethnicity, subjective socioeconomic status (SES), and parental education, use of SNSs was associated with psychological distress (adjusted odds ratio, 95% confidence interval=2.03, 1.22-3.37), suicidal ideation (3.44, 1.54-7.66) and attempts (5.10, 1.45-17.88). Cyberbullying victimization was found to fully mediate the relationships between the use of SNSs with psychological distress and attempts; whereas, it partially mediated the link between the use of SNSs and suicidal ideation.
  
  
  CONCLUSIONS
  Findings provide supporting evidence that addressing cyberbullying victimization and the use of SNSs among adolescents may help reduce the risk of mental health problems.
authors.affiliation: Ottawa Public Health, 100, Constellation Crescent, K2G 6J8 Ottawa, Canada. Electronic address: hugues.sampasa@ottawa.ca.
authors.forename: H
authors.initials: H
authors.lastname: Sampasa-Kanyinga
authors.affiliation: Centre for Addiction and Mental Health, 33, Russell St., Toronto, Canada; Department of Psychiatry, University of Toronto, Toronto, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
authors.forename: H A
authors.initials: HA
authors.lastname: Hamilton
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D058445:Bullying / Q000517:prevention & control*; D002648:Child; D019548:Crime Victims / Q000523:psychology*; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008603:Mental Health / Q000706:statistics & numerical data; D016017:Odds Ratio; D009864:Ontario; D060756:Social Networking; D013315:Stress, Psychological / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control; D013334:Students / Q000523:psychology; D019966:Substance-Related Disorders / Q000209:etiology / Q000523:psychology; D059020:Suicidal Ideation; D013405:Suicide / Q000523:psychology; D055815:Young Adult; D000092864:Suicide Prevention
keywords: Adolescent psychiatry; Epidemiology; Suicide; Violence