Published in BMC Psychiatry, the research identifies subclinical psychotic symptoms as a key factor that suicide prevention programs have largely been missing.
Most conversations about cyberbullying and mental health follow a familiar script. Bullying leads to depression. Depression raises suicide risk. Intervene on the bullying, address the depression, reduce the risk. It is a logical framework — and an incomplete one.
A study published in BMC Psychiatry in February 2024, co-authored by Souheil Hallit of the Psychology Department at Effat University‘s College of Humanities, makes the case that the picture is more complex than that. The research, part of the PEARLS project — a large binational cross-cultural study conducted across Lebanon and Tunisia — investigated whether psychotic experiences play a role in the pathway from cyberbullying to suicidal ideation in healthy young adults, and found that they do.
The Study
The sample consisted of 3,103 healthy community participants from Lebanon, surveyed between June and September 2022. The mean age was 21.73 years, 63.6% were female, and all participants had no prior history of diagnosed mental illness or antipsychotic medication use — a deliberate design choice, focused specifically on what happens in otherwise healthy individuals when they are exposed to cyberbullying. Of the full sample, 18.8% reported experiencing suicidal ideation.
Psychotic experiences — subclinical symptoms that fall below the threshold of a formal psychotic disorder, including unusual perceptions in the positive dimension and emotional withdrawal in the negative dimension — were tested as mediators in the relationship between cyberbullying and suicidal ideation. Both perpetration and victimization were assessed separately, using validated instruments alongside established measures of suicidal ideation and psychotic experiences.
The mediation analysis confirmed the hypothesis. Both positive and negative psychotic experiences partially mediated the path from cyberbullying to suicidal ideation — in both directions, whether the young person was the one doing the bullying or the one being targeted. Greater cyberbullying involvement was linked to more severe psychotic experiences, and more severe psychotic experiences were in turn linked to higher levels of suicidal ideation. A direct link between cyberbullying and suicidal ideation also held up independently of the mediation pathways.
What Current Prevention Frameworks Are Missing
The study’s practical contribution is in what it suggests about how suicide prevention programs should be designed. The researchers point out that attempting to eliminate cyberbullying is an unrealistic primary prevention strategy — it is too widespread and too embedded in the digital environments that young people inhabit to be controlled in any comprehensive way. A more viable approach, they argue, is to identify and address the psychological vulnerabilities that convert cyberbullying exposure into elevated suicide risk.
Chief among those vulnerabilities, this research suggests, is the presence of attenuated psychotic symptoms in otherwise healthy individuals. The study calls for the assessment of subclinical psychotic experiences to become a standard component of suicide risk evaluation — something that current protocols, which tend to focus on depression, anxiety, and perceived stress as primary mediating factors, largely overlook.
Alongside individual-level screening, the researchers advocate for multilevel prevention approaches — combining school-based, community-level, and clinical interventions — that address both the environmental reality of cyberbullying and the internal psychological factors that make some young people more vulnerable to its effects. Targeted programs covering digital citizenship, empathy, coping skills, and communication are identified as evidence-based tools for reducing suicide risk in this population.
Context and Limitations
The study situates itself within a region where both the stakes and the research gaps are particularly pronounced. Across the Middle East and North Africa, suicide is considered significantly underreported — in part because deaths by suicide are frequently classified differently due to the social stigma attached to them. Cyberbullying, meanwhile, has grown rapidly among Arab youth alongside expanding digital access, yet research addressing the intersection of these two issues from within the region remains limited.
The researchers are candid about the constraints of their findings. The cross-sectional design prevents any causal conclusions from being drawn, and the sample — skewed toward female, unmarried, and highly educated participants living with family — cannot be treated as representative of the broader population. Future longitudinal studies in larger and more diverse samples are identified as the necessary next step.
