Treatment interventions for people who experience or perpetrate cyber violence: a systematic review
Systematic review
|Published
Digital platforms have become an arena for cyber violence. Our knowledge of effective treatment alternatives for perpetrators and victims of cyber violence is limited. The aim of this systematic review was to summarize evidence for the effects of available treatments for these groups.
Key message
Digital platforms have become an arena for cyber violence. Our knowledge of effective treatment alternatives for perpetrators and victims of cyber violence is limited. The aim of this systematic review was to summarize evidence for the effects of available treatments for these groups.
We searched the literature for randomized and non-randomized controlled trials. We excluded studies that investigated prevention of cyber violence. We assessed the risk of bias of the reported results and their certainty.
We included two small studies: One randomized controlled trial published in 2019 investigating a cognitive-behavioral social work intervention with 42 young adults exposed to cyber violence in Iran and one controlled trial with pre-post design from 2020 investigating whether a solution-focused intervention among 12 high-school students in Indonesia altered their aggressive behavior online.
The results showed that:
- It is uncertain whether cognitive-behavioral social work intervention will reduce the risk of revictimization in young adults who are exposed to cyber violence.
- It is uncertain whether solution-focused brief intervention will reduce online aggression in high-school students who perpetrate cyber violence.
The certainty of these results is very low.
The current evidence base for treatment effects of interventions for perpetrators and victims of cyber violence is scarce.
Summary
Background
Cyber violence is a generic term for abuse occurring via mobile and internet services. A decade ago the incidence of cyber violence in Norway was relatively low, but has grown with the increasing use of digital services especially in the adult and elderly population, but also among children and adolescents.
Our knowledge of the health problems cyber violence may cause is still limited. Both perpetrators and victims of cyber violence may be at higher risk of mental illness compared to peers not involved in cyberbullying. Traditional and cyber violence may have similar psychological consequences, such as anxiety and depression.
In 2019, NIPH published an evidence and gap map of systematic reviews on treatment alternatives for violence and sexual abuse. The authors identified, among other findings, that therapies for cyber violence were understudied. Whether therapies for traditional violence may be effective in treating cyber violence is poorly understood.
Objective
This systematic review summarizes the current evidence base for the following scientific questions: What are the effects of treatment interventions for 1) victims of cyber violence and 2) perpetrators of cyber violence?
Method
We followed the methodology described in NIPH’s methods handbook (1) as outlined in our protocol (2). We searched for controlled studies (both randomized and non-randomized) with participants of all ages who were either victims or perpetrators of cyber violence. We included all types of treatment interventions for the study populations as defined by our selection criteria. We did not limit our literature searches by language, geography or year of publication. We excluded studies investigating prophylactic interventions. We assessed the risk of bias and certainty of the results for each outcome.
Results
We identified 10,708 references through systematic literature searches in relevant databases. We found an additional six potentially relevant references by reading research papers, including review articles. We were unable to translate one of the papers. We selected and read 40 references in full text and excluded 34 of these. Of the six remaining studies, three were study protocols without published results. Two original research papers and one protocol described two published studies that met our inclusion criteria.
Because the two included studies investigated distinct populations, we did not pool the results in a meta-analysis and present a narrative summary of the results.
One randomized controlled trial examined whether cognitive-behavioural intervention reduced the incidence of cyber victimization in 42 young adults in Tehran, Iran. Another controlled study conducted at a vocational high school in Indonesia applied solution-focused brief intervention aimed at reducing aggressive online behaviour among twelve students.
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Table 2. Reported effects and certainty of findings of the included studies (3-5) |
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Outcome |
Anticipated absolute effects |
Relativ |
Number of participants (study type) |
Certainty |
Comments |
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Risk with control group |
Risk with intervention group |
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Revictimization |
952 per 1000 |
381 per 1000 |
RR 0.40 |
42 |
⊕⊖⊖⊖ |
It is uncertain whether a cognitive-behavioral social work intervention has any effect on revictimization. |
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Online aggression |
Mean OAS |
MD 7,4 lower OAS |
Not applicable |
12
|
⊕⊖⊖⊖ |
It is uncertain whether a solution-focused brief intervention has any effect on online aggression. |
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CI: confidence interval; MD: mean difference; OAS: online aggression score; RR: risk ratio |
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a We assess the risk of bias as very serious because participants and staff were not blinded to the intervention. b We assess the imprecision of the outcome as serious because of few study participants. c We assess the risk of bias as very serious because it is unclear whether participants were comparable in terms of important background factors at study initiation. It is unclear how participants were assigned to study groups. |
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Discussion
The two included studies have methodological limitations and the reported results are highly uncertain. It is therefore difficult to conclude with certainty on the effect of the interventions. Furthermore, it is unclear whether putative differences between patients in Indonesia or Iran and Norway in the context of cyber violence might affect treatment outcomes. The two interventions investigated were adapted from established treatment methods for traditional violence. It is plausible that these therapies are applicable to clinical practice in Norway, but the existing evidence base is too uncertain to inform current medical practice. We do not currently know whether therapies for traditional violence may be effective in treating cyber violence.
Conclusion
This systematic review found a lack of research-based evidence for the effect of treatments for perpetrators and victims of cyber violence. We need more high-quality research studies on effective treatment options for people with health problems related to cyber violence. Current scientific evidence is too scarce to assess treatment effects on perpetrators and victims of cyber violence.
