Cyber interpersonal violence: Adolescent perspectives and digital practices

Ci a ion: Machado, B.; de Fa ia, P.L.; A aújo, I.; Ca idade, S. Cybe In e pe sonal Violence: Adolescen Pe spec i es and Digi al P ac ices. In . J. En i on. Res. Public Heal h 2024,21, 832. h ps://doi.o g/10.3390/ ije ph21070832 Academic Edi o : Michelle F. W igh Recei ed: 24 May 2024 Re ised: 22 June 2024 Accep ed: 24 June 2024 Published: 26 June 2024 Copy igh : © 2024 by he au ho s. Licensee MDPI, Basel, Swi ze land. This a icle is an open access a icle dis ibu ed unde he e ms and condi ions o he C ea i e Commons A ibu ion (CC BY) license (h ps:// c ea i ecommons.o g/licenses/by/ 4.0/). In e na ional Jou nal o En i onmen al Resea ch and Public Heal h A icle Cybe In e pe sonal Violence: Adolescen Pe spec i es and Digi al P ac ices Bá ba a Machado 1,*, Paula Loba o de Fa ia 2, Isabel A aújo 3and Sónia Ca idade 4 1NOVA Na ional School o Public Heal h, NOVA Uni e si y o Lisboa, 1600-560 Lisboa, Po ugal 2 In e disciplina y Cen e o Social Sciences (CICS), Comp ehensi e Heal h Resea ch Cen e (CHRC), Na ional School o Public Heal h, NOVA Uni e si y, 1600-560 Lisboa, Po ugal; [email p o ec ed] 3The A i icial In elligence and Heal h Resea ch Uni , Poly echnic Uni e si y o Heal h, CESPU, 4760-409 Vila No a de Famalicão, Po ugal; [email p o ec ed] 4Psychology Resea ch Cen e, School o Psychology, Uni e si y o Minho, 4710-057 B aga, Po ugal; [email p o ec ed] *Co espondence: [email p o ec ed] Abs ac : Backg ound: The pe asi e use o echnology, especially among adolescen s, has enabled cybe communica ion and b ough many ad an ages bu also led o po en ial iolence. The issue o cybe in e pe sonal iolence (CIV) impac ing young indi iduals is inc easingly ecognized as a ma e o public heal h; howe e , li le is known abou adolescen s’ pe spec i es o he phenomenon. This s udy explo es adolescen s’ pe spec i es on CIV. I seeks o unde s and hei in e p e a ions o abuse, ic im impac and eac ions, iolence escala ion, gende issues, ic imiza ion and pe pe a ion pa e ns, and bys ande oles. Me hods: This quali a i e s udy used i een ocus g oups o ga he elemen a y school pa icipan s’ pe spec i es on cybe in e pe sonal iolence. F om ou Po uguese schools, 108 pa icipan s (M= 12.87 and SD = 0.31) pa icipa ed in he s udy. A hema ic analysis unco e ed h ee hemes. The esul s e idenced adolescen s’ pe spec i es abou CIV. Due o he amoun o ime spen online, adolescen s egula ly encoun e cybe ha assmen and ecognize he impo ance o help-seeking. Men al heal h p oblems and hei in luence on he social and educa ional li es o adolescen s is a ising as a CIV p oblem. Conclusions: Pa en s play a c ucial ole in mi iga ing CIV as well as bys ande s. Fu u e p og ams should p omo e heal hy ela ionships, aise CIV awa eness, in ol e s akeholde s, guide pa en s, in eg a e pe pe a o s in o p og ams, and os e e ec i e ne wo king. Keywo ds: adolescen s; cybe iolence; in e pe sonal iolence; digi al p ac ices; public heal h; men al heal h 1. In oduc ion Young people and adolescen s a e aking he lead in adop ing new echnologies, as social ne wo ks and ins an messaging se ices ha e become common i ual pla o ms in ou cul u e. This new gene a ion is named “digi al na i es” because hey we e bo n in o and aised in he digi al e a [ 1 ]. The e m “digi al na i e” i s appea ed in he li e a u e in he la e 1990s and is c edi ed o P ensky [ 2 , 3 ] and Tapsco [ 4 ]. Digi al na i es a e indi iduals bo n be ween 1980 and 1994, ep esen ing he i s gene a ion o g ow up wi h new echnology. They spen mos o hei li es ha ing access o digi al communica ion echnology [ 5 ]. P ensky [ 2 ] men ions indi iduals who we e no bo n in o he digi al wo ld bu adap ed o i la e in li e as “digi al immig an s”. La e , o he au ho s [ 5 , 6 ] c ea ed an ex a uni ying concep and labelled i as “digi al lea ne s”. New social ela ionships and beha io s a e g owing and e ol ing because child en and eenage s ha e access o compu e s and o he elec onic de ices con inually [ 7 ]. They canno pic u e in e ac ion in a wo ld whe e such de ices do no exis . Adolescence is a long pe iod and can be In . J. En i on. Res. Public Heal h 2024,21, 832. h ps://doi.o g/10.3390/ije ph21070832 h ps://www.mdpi.com/jou nal/ije ph In . J. En i on. Res. Public Heal h 2024,21, 832 2 o 22 subdi ided in o ou pa s: p eadolescence (ages 11–13), ea ly adolescence (ages 13–15), middle adolescence (ages 15–17), and la e adolescence (ages 17–19) [8]. S udies [ 9 , 10 ] indica e ha a ound nine ou o en Po uguese adolescen s aged 9–17 use mobile phones o access he in e ne daily, like o he Eu opean coun ies [ 10 ]. Due o he explosion in he a ailabili y o elec onic ools among young people, many o hei social and communica ion in e ac ion skills ha e been los [ 11 ]. These digi al beha io s aise he possibili y o encoun e ing cybe in e pe sonal iolence (CIV), as mo e and mo e people can access global, c oss-bo de digi al communica ion. CIV was i s de ined as ac s in ended o damage a ic im’s in e pe sonal connec ions o sel -concep , such as sha ing in ima e pho os o he ic im online wi hou pe mission [ 10 ]. Al hough, adolescen s’ social p ocesses bene i signi ican ly om he use o digi al ools, hese same p ac ices also expose hem o mo e in e pe sonal in usion, inc easing hei isk o expe iencing cybe da ing abuse (CDA), cybe s alking, cybe bullying, and sex ing [ 12 , 13 ]. CDA concen a es on da ing ela ionships and is an eme gen o m o da ing abuse ha can be a ha m ul expe ience o adolescen s, igge ing psychological damage in i s ic ims [ 14 , 15 ]. Cybe bullying is de ined as he use o elec onic de ices o in en ionally suppo epea ed and hos ile beha io by an indi idual o g oup, aiming o ha m o he s [ 16 ]. Nowadays, wi h he ise o new echnology ields, cybe bullying is de ined as su e ing o some conside a ion by esea che s [17]. Despi e hese ypes o abuse, we unde s and ha adolescen s in his gene a ion ha e access o mo e educa ional oppo uni ies, a g ea e amoun o in o ma ion abou en e ainmen , heal h, and o he opics, and a libe a ing pla o m o exp ess hemsel es, make iends, and o m social bonds hanks o communica ion echnologies [ 18 ]. Howe e , hey also ha e o deal wi h he po en ially ha m ul side e ec s o he digi al en i onmen ’s e olu ion, such as unsa e in e ne usage [ 19 , 20 ]. Despi e es ic ions o young child en on popula social media pla o ms, hei use can s ill endange child en’s psychological and physical well-being. A s udy o 14 social media companies’ policies and in e iews wi h hei ep esen a i es ound ha cybe bullying con inues despi e hese measu es [ 21 ]. Some pla o ms ha e imp o ed by allowing use s o epo cybe bullying and equi ing eal names [22]. Da a om se e al a eas show us ha CIV has inc eased. In Ko ea, di e en s udies e ealed ha he a es o cybe ic imiza ion ose om 19% in 2019 o 19.7% in 2020 [ 23 ], wi h he highes p e alence inc easing om 25.8% in 2019 o 32.7% in 2020 among elemen a y school s uden s [ 24 ]. In Aus alia, om 2015 o 2020 [ 25 ], he e was an inc ease in he endency o cybe ic imiza ion o e ime, wi h highe a es in 2017 and 2019 compa ed o 2015; CIV a es in 2020 we e also highe han hose s a ed in 2015 and 2019. In Po ugal, a s udy among adolescen s shows ha 23% o esponden s epo ed ha ing had a si ua ion ha bo he ed hem in he las yea , and o 5% his happened a leas once a mon h [ 26 ]. Also, he p opo ion o Po uguese adolescen s ha assed online inc eased om 7% in 2000 o 10% in 2014 [ 27 ]; by 2022, mo e han 60% o Po uguese adolescen s epo ed being cybe ic ims [ 28 ]. Managing he ad e se e ec s o CIV calls o a hough ul heo e ical explo a ion o i s oo s. Li es yle- ou ine ac i i ies heo y (L-RAT) unde lines beha io al and con ex ual isk ac o s, con empla es o ganiza ional chance as a causal mechanism o CIV ic imiza ion, and allows iden i ica ion o he cybe ou ines ha inc ease o dec ease such isks, di ec ly e ealing oppo uni ies o si ua ional p e en ion and in e en ion [ 29 ]. Al hough adolescen s a e bo n and aised wi h socio and in e ne skills, hei naï e use o echnology, hei high isk o exposu e o CIV, and a gene al de ici o coping skills o such expe iences make hem ulne able [ 10 , 30 ]. Vale e al. [ 28 ] epo ed ha olde adolescen s who published pho og aphs online, including ex s, music, and ideos sha ed wi h s ange s, and who had pa en s wi h less knowledge o hei online ac i i ies we e a high isk o being ic imized. The sex o adolescen s was no conside ed a p edic i e cha ac e is ic. Gi en hese po en ial isks, pa en s play a c ucial ole in p o ec ing hei adolescen s online. They can do his by implemen ing educa ional media ion s a egies (such as supe ision, deba ing con en , co- iewing, and encou agemen o solu ion-o ien ed communica ion) and aking a p e en i e app oach (including con ols, se ing ules, es ic i e sc een ime, and es ic ed con en ). These measu es no only sa egua d child en bu also os e hei sel - In . J. En i on. Res. Public Heal h 2024,21, 832 3 o 22 su iciency and sel - egula ion [ 30 ]. Po uguese adolescen s could bene i om he eassu ing suppo o he Po uguese Sa e In e ne Cen e’s ee helpline, wi h p o essionals ha p o ide ic ims suppo in online c imes, such as in o ma ion, emo ional suppo , and legal suppo , as hey can epo o au ho i ies [ 29 ]. Adolescen s can ind guidance in na ional awa eness campaigns (e.g., Po uguese Associa ion o Vic im Suppo , an i-cybe bullying campaign in schools, Segu aNe ) and media campaigns [ 30 ]. Finally, adolescen s can alk wi h psychologis s in schools and nu ses om ca e cen e s who isi schools pe iodically. They can also discuss hese ma e s wi h eache s, who may p o ide some aining acco ding o hei own ini ia i e o , a imes, he school’s ini ia i e. L-RAT s udies [31,32] ound ha e ealing p i a e in o ma ion also con ibu ed o becoming a ic im. Mo e ex ensi e social ne wo ks, esul ing in many iends on social media, appea o be a sha ed isk ac o . Connec ion wi h s ange s can p o ide access o p i a e in o ma ion, such as daily ou ines o physical appea ance. Adolescen s ealize he impo ance o no alking wi h s ange s as a p e en i e measu e. They also conside pa en al moni o ing o hei kids’ ac i i ies an essen ial p o ec i e measu e [ 33 ]. Pa en s should y o adop pa en al con ol and media ion s a egies o hei child en’s online ac i i ies [ 30 ]. Conside ing he echnical di icul ies ha pa en s can ace, p e en ion p og ams should in eg a e in e ne opics in ended o pa en s. The me a-analysis conduc ed by Ca idade and B aga [ 15 ] emphasized h ee c i ical con ex s o isk ac o s o you h CIV: indi iduals, in ima e ela ionships, and pee s. Young people who ha e expe ienced ic imiza ion and s uggle wi h men al heal h issues, use alcohol and d ugs, o ha e pee s who use and a e in ol ed in o line domes ic iolence a e conside ed a high- isk g oup. Despi e hei sociodemog aphic cha ac e is ics, p e en ion p og ams could ocus on his speci ic g oup [ 15 ]. This me a-analysis also p oposes ha he impac o pee s as a isk elemen needs conside a ion when add essing Cybe Da ing Violence (CDV) pe pe a ion. Aligning wi h social lea ning p ocesses, i is c ucial o os- e app op ia e and posi i e social ole models wi hin in ima e and pee ela ionships o dis up he cycle o iolence. Addi ionally, his s udy e ealed ha indi idual sociodemo- g aphic ac o s like gende , age, and e hnici y showed no co ela ion wi h you h CDV [ 15 ]. Taylo and Xia, in hei sys ema ic e iew, con i med ha bo h men and women engage in CDV a simila a es, emphasizing he signi icance o ecognizing dis inc demog aphic aspec s in p e en ion s a egies [34]. Exis ing p og ams ha e ocused on indi idual and pee isk ac o s, which, in ou iew, should emain a p io i y [ 35 ]. I is also c ucial o design p og ams using inno a i e s a egies, such as he bys ande app oach [ 36 ], which has shown p omise, o example, in p e en ing da ing iolence [ 37 ]. This me hod aims o empowe young people o in e ene and dis up po en ially abusi e si ua ions hey wi ness, wi h a ocus on he in luence o pee s and o he social ci cles. While aising awa eness is i al o p e en ing CIV, i alone is no enough o add ess he complexi y o his issue. E ec i e p e en ion equi es sus ained e o s ha in ol e a mul idimensional and mul i-agen app oach, inco po a ing skill-building componen s [35]. P esen S udy This s udy aims o analyze pe spec i es on CIV in a g oup o Po uguese p eado- lescen s and adolescen s. I is also in ended o unde s and he de ini ions a ibu ed by pa icipan s on he subjec : meanings a ibu ed o abuse, impac on he ic im and eac- ions, he e olu ion o iolence, gende issues, si ua ions o ic imiza ion, si ua ions o pe pe a ion, and he ole o bys ande s. CIV deep comp ehension is essen ial o sa egua ding young people’s well-being, p o- mo ing heal hy digi al in e ac ions, and de eloping e ec i e p e en ion s a egies. By unde - s anding he dynamics o CIV, we can wo k owa ds c ea ing sa e online spaces o e e yone. Howe e , he e is li le esea ch on he meaning ha adolescen s a ibu e o such phenom- ena [ 38 ], al hough his pe spec i e is c ucial o de eloping p og ams ha adjus o hei eali y. This is why a quali a i e app oach, wi h i s unique abili y o explo e he nuances and complexi- ies o he issue, is essen ial o be e mapping he p oblem among adolescen s. I allows us In . J. En i on. Res. Public Heal h 2024,21, 832 4 o 22 o unde s and in a mo e in-dep h and holis ic way he meanings hey a ibu e o his ype o abuse. In Po ugal, as in o he coun ies, mos s udies in his a ea a e based on a quan i a i e app oach [ 38 , 39 ], which does no allow o he deep unde s anding o CIV ha we aim o achie e in his s udy on na ional pe spec i es o young s uden s. 2. Ma e ials and Me hods 2.1. Pa icipan s The esea ch pa icipan s we e (N= 108) 42 boys and 66 gi ls aged 11–15 (M= 12.87 and SD = 0.31) om 4 schools ac oss no he n egions o Po ugal. The selec ion o schools was based on he ollowing inclusion c i e ia: adolescen s be ween 6 h g ade and 9 h g ade (middle and high school). 2.2. P ocedu es A quali a i e non-expe imen al in es iga ion was planned. Pa icipa ion was olun a y, and pa icipan s could wi hd aw om he ocus g oup a any ime. To main ain con iden iali y and due o he sensi i e na u e o he esea ch, pa icipan s we e asked no o use people’s names when discussing inciden s in ol ing o he s and o a oid linking desc ip ions o beha io s o speci ic indi iduals. Pa icipan s we e ee o pa icipa e in he ocus g oup om any loca ion hey p e e ed, and hey we e ne e di ec ly ques ioned one by one. The schools in ol ed we e all public. Fi s , he headmas e o each selec ed school was con ac ed o de e mine he school’s in e es in pa icipa ing in he s udy. I he esponse was a i ma i e, a eache was designa ed o acili a e all p ocesses be ween he school and he esea che s. This eache con i med which s uden s we e in e es ed in pa icipa ing in he s udy and checked whe he hei pa en s ag eed. I hey did, he esea che s con ac ed he s uden s’ pa en s/gua dians and p o ided hem wi h he necessa y in o ma ion abou he s udy. A e ob aining he pa en s’ in o med consen , he esea che s con ac ed he pa icipan s o ask o hei consen and scheduled he ocus g oup in e iew i consen was gi en. Pa icipan s ag eed o pa icipa e in he ocus g oup and o ha e i eco ded. In hei consen o ms, pa en s we e in o med ha he ocus g oup would be eco ded and ha he da a would be used o his in es iga ion. In o ma ion, consen , and ec ui men ma e ials we e de eloped and app o ed wi hin a s ic e hical p ocedu e ha included app o al by he E hical Commi ee o he Na ional School o Public Heal h, NOVA Uni e si y (numbe 3/2021), he consen o he Minis y o Educa ion—Moni o ing School Su eys (numbe 0789800001), and in o med consen by he pa en (s)/gua dian(s) o pa icipan s. Gua an ees we e gi en o p ese e and dissemina e esea ch ma e ials in a manne ha gua ded esponden s’ con iden iali y. The me hod o semi-s uc u ed in e iews was applied in ocus g oups. The s udy used a quali a i e me hodology o explo e CIV om he speci ic con ex ualized pa icipan s’ pe spec- i e [ 40 ]. In es iga ing CIV om he pe spec i e o human in e ac ions in a speci ic place, such as schools, and i s cul u al con ex is possible wi h a quali a i e s udy design [ 41 ]. Th oughou he semi-s uc u ed in e iew, we pu sued co e ing all he abo e hemes. The sc ip o he in e iew had mac o a eas o discussion, such as he de ini ion o CIV and ypologies, mean- ings a ibu ed o abuse, impac on he ic im and hei eac ion, gende issues, con ac wi h agg ession, ic imiza ion, and bys ande si ua ions. The mode a o adop ed a neu al a i ude o ensu e he esponden s’ sa e y and open- ness. They discussed hei expe iences wi h ex emely sensi i e hemes and abs ained om judgmen s and in e p e a ions du ing he ocus g oup. The leading esea che mode a ed he ocus g oup. Focus g oups ollowed he es ablished c i e ia, such as ha ing only boys o gi ls om se e al g ades, all picked andomly, o analyze whe he he e we e di e ences in g oups cons i u ed by gi ls and boys. The es o he g oups included he emaining pa icipan s, also dis ibu ed in an alea o y way. Focus g oups we e conduc ed in May 2022, du ing a e noons o mo nings wi hou eaching ac i i y, in class ooms p o ided by he schools, in an en i onmen whe e p i acy was gua an eed. The du a ion o he ac i i y anged om 45 min o 1 h, In . J. En i on. Res. Public Heal h 2024,21, 832 5 o 22 depending on he willingness and eadiness o he esponden s. As we we e dealing wi h p eadolescen s, i was essen ial o educe he isk o inducing nega i e emo ions in pa icipan s a e asking hem o ecall episodes o CIV hey migh ha e expe ienced. The e o e, pa icipan s we e in o med ha hey could be e e ed o he school psychologis whene e necessa y. Addi ionally, con ac in o ma ion o a ious suppo ins i u ions, such as he Po uguese Vic im Suppo Associa ion, was p o ided and made a ailable. 2.3. Da a Analysis The ocus g oup discussion was audio eco ded, e ba im ansc ibed, and e i ied as accu a e. The double e iew me hod was used, in which wo esea ch eam membe s e iewed each ansc ip independen ly. This helped o iden i y and co ec possible ansc ip ion e o s. To unco e pa e ns and hemes in he da a, a hema ic analysis was conduc ed using an induc i e me hodology, allowing conclusions o be d awn di ec ly om he da a, as p oposed by Ba din [ 42 ]. The esea che s comple ed se e al eadings o he ansc ip s o c ea e ini ial codes, which we e hen e ined by mo e eadings, e lexi e jou naling, mind mapping, and memo w i ing, o a ange he codes in o meaning ul g oupings o disco e o e a ching hemes. Themes and sub- hemes we e discussed and ag eed upon wi h he esea ch eam. Du ing ini ial and subsequen eadings, seman ic and open codes we e gene a ed un il sa u a ion. Fo da a alida ion, he esea che s p oceeded o a de ailed desc ip ion, and a co-codi ica ion o he da a was unde aken. Coding was as inclusi e as possible o a oid obscu ing any po en ially signi ican ex ac s in he heme. The NVi o 14.0 so wa e was used o o ganize, code, and in e p e he da a. Valida ion was ca ied ou o ensu e he eliabili y and c edibili y o he esul s. Thus, wo independen esea che s wi h expe ience in quali a i e da a analysis me hods and who did no know he pa icipan s coded he ansc ibed in e iews. One o he esea che s independen ly coded he en i e sample, and he o he esea che 20% o he sample ( ou ocal g oups in e iews), ob aining 89% ag eemen o he hemes. A senio esea che audi ed he en i e coding p ocess. 3. Resul s In a global analysis, and conside ing he ca ego ies wi h an excellen ep esen a ion, i e s and ou : 1. Cybe In e pe sonal Violence (CIV); 2. con ac s wi h cases o ic imiza ion; 3. bys ande s; 4. isk ac o s o cybe in e pe sonal iolence; 5. impac o cybe in e - pe sonal iolence, and 6. cybe in e pe sonal iolence and gende . Se e al subca ego ies eme ged om hese ca ego ies, which will be shown below. 3.1. Cybe In e pe sonal Violence Ele en subca ego ies eme ged h ough he pa icipan s’ epo s abou cybe in e pe - sonal iolence (Table 1). Table 1. Sys ems o ca ego ies, subca ego ies, and speci ic ca ego ies ega ding cybe in e pe sonal iolence. Ca ego ies Subca ego ies Speci ic Ca ego ies Cybe In e pe sonal iolence Abusi e o ms Emo ional abuse Sexual abuse Physical abuse Abuse ypologies Cybe bullying Cybe da ing abuse Cybe s alking Mo i a ion Fun Punishmen Disc imina ion Jealously In . J. En i on. Res. Public Heal h 2024,21, 832 6 o 22 Table 1. Con . Ca ego ies Subca ego ies Speci ic Ca ego ies Violence acili a o s Digi al p ac ices Indi idual cha ac e is ics Lack o pa en al con ol/supe ision Abusi e beha io s Telling lies Sp eading umo s F aming Pos ing and sha ing pho os, ideos, and nudes Hacking Show o p i a e li e Image manipula ion Th ea s Insul Take pho os Violence p oli e a ion Recidi ism Escala ion o iolence Agg esso p o ile Gende (male) Social s a us Pe sonal cha ac e is ics Vic im p o ile Sociodemog aphic cha ac e is ics (gende , sexual o ien a ion, e hnici y) Physical cha ac e is ics Psychological cha ac e is ics Social unc ioning Vic im eac ions Main ain ela ionship Talking wi h iends Being passi e Con on a ion Lea ing he g oup P i a e accoun s Show no ea ! Ask o help Help ypologies In o mal help (pee s, amily. . .) Fo mal help (police, p o esso s, heal h p o essionals. . .) Sel -p o ec i e beha io s Do no in e ac wi h s ange s Do no sha e in o ma ion Limi age o access o social ne wo ks Pa en al con ol Pa en al educa ion School educa ion Limi ed con en Cybe secu i y Specialized o ices Censu ed con en Do no ake nudes Child en’s educa ion Reliable pe son In . J. En i on. Res. Public Heal h 2024,21, 832 7 o 22 Pa icipan s desc ibed se e al o ms o cybe in e pe sonal iolence, highligh ing h ee abusi e s a es, namely emo ional, physical, and sexual abuse. Pa icipan s o en said ha hey had su e ed o assis ed in all hese o ms, which can be p ac iced in isola ion o in conjunc ion wi h one ano he (“Many kids insul people ia ex o email”—P1; “Many imes, we saw agg essi e and mean commen s in cha s o on social media”—P2; “Sp ead umo s abou he pe son”—P3; “Sp ead ake news”—P4). Sexual abuse was less common bu also men ioned by he pa icipan s (“A gi l om school had e e yone sha e a nude o he ; i was ho ible”—P5; “The gi ls a e e y mean o each o he and commen on each o he ’s bodies on social media, o assaul each o he ”—P1 ). Pa icipan s also no e ha “Online h ea s a e o en me in pe son, wi h physical agg ession”—P6. They also epo se e al abuse ypologies, namely cybe bullying (“I hink he mos common a e insul s h ough digi al media; hey happen all he ime hese days”—P7; “Many people pos pho os o o he s wi hou pe mission and e en make un o hem”—P8); Cybe da ing abuse (“Some young people da e each o he and exchange insul ing messages wi h each o he ”—P7; “Some imes gi ls da e boys, sha e in ima e pho os wi h hem, and hey pos hem o e e yone o see”—P9), and cybe s alking (“A gi l was s alked by a boy online. He was always bo he ing he , and e en i she old him o s op, he would no s op. One day a e school, he e en ollowed he home”—P10). Conce ning CIV, pa icipan s conside ha he e a e some mo i a ions o p ac ice hese ac s, such as un (“Some people enjoy making un o o he s”—P11), punishmen (“Some imes people a e hu by some pas si ua ion and y o ge e enge”—P12), disc im- ina ion (“Cybe bullying o en happens due o disc imina ion, skin colo , way o d essing and e en sexual o ien a ion”—P13), and jealously (“They a e o en jealous o ha pe son and y o pu him/he down”—P14). They also conside he e a e some acili a o s o implemen his kind o iolence, such as digi al p ac ices (“Nowadays almos all young people ha e access o he in e ne e e ywhe e, bo h a school and a home”—P1; “We ha e he in e ne on mobile phones, so i is always a ailable”—P14; “A school, we all ha e cell phones o compu e s. Many also ha e able s and o he elec onic de ices whe e cybe iolence can be commi ed”—P19; “E en in games, wi h he PlayS a ion, we can be agg esso s o ic ims”—P20) and indi idual cha ac e is ics (“Young people s ay a home mo e, especially in big ci ies, so hey use digi al media mo e han in he old days when ou pa en s used o play in he s ee ”—P17; “Child en ha e social ne wo ks e y ea ly on and some imes hey do no e en ealize he p oblems hey a e ge ing in o”—P18; “We all ha e social ne wo ks, and we can pos hings in eal ime, hings ha a e o en bad and ha hu o he people”—P2). Many pa icipan s also no e ha nowadays, he lack o pa en al con ol is a iolence acili a o (“Pa en s do no ha e ime and do no con ol hei child en’s ac i i ies, so hey do no know i hey a e agg esso s o ic ims”—P22; “Young people now ha e much eedom, hey can do wha e e hey wan and he e is no much con ol”—P5; “We ha e much eedom, we can alk o whome e we wan ”—P15), associa ed wi h he wo ldwide in o ma ion sp ead (“Things a e exposed igh away, and i is all e y as . And he wo s pa is ha i s ays o e e , once published he e is no way o dele e i ”—P23). In his ca ego y, a subca ego y o abusi e beha io s su aced, whe e he pa icipan s iden i ied a ious ac ions. These include lying (“Lying is a se ious ma e ”—P27), dis- semina ing umo s (“Ci cula ing umo s o alse in o ma ion abou us is e y se ious and ha m ul”—P28), aming o he s (“Implica ing someone in cybe -a acks”—P29), and pos ing pho os o ideos wi hou consen (“Uploading o he people’s pho os wi hou pe - mission is e y se ious”—P5; “Sha ing ideos and pho os is also se ious, no jus pos ing hem. I hey a e explici , i becomes e en mo e se ious”—P11; “I belie e ha bo h pos ing and sha ing pho os and ideos a e se ious ac ions”—P30). O he s iden i ied ac ions like hacking (“In il a ing social ne wo ks, as we discussed in ha case, is e y se ious”—P31), exposing someone’s p i a e li e (“Re ealing aspec s o someone’s p i a e li e is se ious”—P32), manipula ing images (“I ’s also e y se ious when In . J. En i on. Res. Public Heal h 2024,21, 832 8 o 22 indi iduals c ea e pho o collages and hen pos hem”—P15), making h ea s (“Th ea ening he indi idual o hei amily is e y se ious”—P22), hu ling insul s (“Insul s a e less se e e because i ’s easie o igno e he pe son”—P33), and aking pho os wi hou consen (“Taking pho os o he pe son is less se ious as long as hey a en’ pos ed”—P34). Pa icipan s we e also conce ned abou iolence p oli e a ion. They men ion ecidi ism (“No mally, cybe iolence does no happen jus once, i epea s i sel o e ime”—P35; “The ic im is a ic im se e al imes because iolence is epea ed”—P36) and he escala ion o iolence (“I hink i usually s a s mild, hen o e ime i ge s wo se. Some imes i s a s wi h insul s and hen hey s a pos ing mo e in ima e hings abou he ic im”—P1). P o iles o bo h he ic im and he agg esso we e also discussed. The p o iles o he agg esso and he ic im we e o en associa ed wi h gende (“I ’s mo e common o gi ls o be ic ims and boys o be agg esso s”—P36; “When he agg esso is a gi l, i ’s usually gi l agains gi l”—P37; “I ’s mo e common o gi ls o be ic ims and boys o be agg esso s”—P32). The p o ile o he agg esso is also linked o social s a us (“Bullies a e no always he popula ones. Some imes hey sha e cha ac e is ics wi h he ic ims, and hey ac his way o eel supe io ”—P38) and pe sonal ai s (“Bullies a e no always he popula ones. Some imes hey sha e cha ac e is ics wi h he ic ims, like being shy, and hey ac his way o eel supe io ”—P38). Rega ding he ic im p o ile, i also included physical cha ac e is ics (“People who wea glasses o ha e a disabili y a e also subjec ed o mean commen s”—P39; “Young peo- ple wi h acne a e also made un o ”—P40; “I we a e oo sho , hey make un o ou pho os on social ne wo ks, bu i we a e oo all, oo”—P41), psychological cha ac e is ics (“Ve y shy people a e also easy a ge s because hey don’ complain o ell anyone, hey usually su e in silence”—P27), sociodemog aphic cha ac e is ics (“People who a e ic ims a e also ic ims because hey e eal on social ne wo ks ha hey a e, o example, homosexuals, ha hey a e no Ch is ians and some imes ha e e hnici ies ha a e di e en om ou s”—P42; “Being a o eigne can also lead o cybe iolence, wi h mean commen s because people don’ exp ess hemsel es so well in ou language”—P43), and social unc ioning (“The ac ha hey always ake pic u es wi h he same clo hes, because hey a e poo , can al eady make he pe son a possible cybe ic im”—P11). Re e ing o CIV, ic im eac ions we e also ci ed, such as main aining a ela ionship (“Mos ic ims a i s do no hing, hey y o igno e i and see i he agg esso s ops”—P33) and being passi e. Some no ed ac ing (“When i was wi h me, I old my pa en s, and hey helped o esol e he si ua ion”. “I old my mo he and my mo he spoke o he police”—P7), alking wi h iends (“Some ic ims wen o hei iends”—P44), alking o eache s (“When his happens he e a school, we alk o eache X, and he sol es he si ua ion”—P45), con on a ion (“The ic im should alk o he abuse o y o unde s and why he/she is doing ha ”—P4), and lea ing he g oup (“Many imes, when i happens in a Wha sApp g oup, he ic im simply lea es he g oup”—P46). Pa icipan s also men ioned hey c ea e p i a e accoun s (“Ha e p i a e accoun s ( . . . )”—P50), show no ea (“As i is online, i is easie o he ic im no o show ea , which can de e he agg esso ”—P21), and ask o help (“People should always ask o help, e en i i akes ime o hey hink i will no do any good because some imes i wo ks and p oblems a e sol ed”—P44). In he ma e ela ed o asking o help, o he subca ego ies eme ged, including in o mal help such as alking wi h an adul (“Talk o pa en s”. “Fi s , hey should alk o a close ela i e”—P1) o alking wi h pee s (“I old my bes iend wha was happening so she could ind a way o help me”—P42). Some also no ed o mal help, which includes alking o a p o essional (“Tell he school psychologis , and he/she migh be able o help”—P48), o a police o ice (“I i is an ex eme case wi h h ea s and exposu e o pho os, I hink we should alk o he police”—P5), and o school s a (“Talk o he class di ec o ”—P17; “Tell he eache s”—P22; “Tell he ope a ional assis an s”—P35). The las heme ha eme ged was ela ed o sel -p o ec i e beha io s, such as do no in e ac wi h s ange s (“I p e e o play online wi h people I know because i ’s sa e ”—P47; “Some imes playing online wi h people we al eady know can lead o iolence as e , because In . J. En i on. Res. Public Heal h 2024,21, 832 9 o 22 hey know us be e and so hey know how o a ack us wi h insul s o example”—P48), do no sha e in o ma ion (“Do no sha e ou passwo ds wi h o he people”—P49; “No sha ing in o ma ion abou ou li es wi h people we only mee online”—P8), limi he age o access o social ne wo ks (“Limi he age o access o child en o social ne wo ks”—P32), pa en al con ol (“Pa en s mus con ol wha hei child en do online”—P2), pa en al and school educa ion, espec i ely (“Pa en s should alk o hei child en abou cybe iolence and each hem how o de end hemsel es”—P40; “We should hea mo e abou hese ma e s a school”. “The school could p omo e mo e lec u es on his opic”—P40), limi ed con en (“We sha e e y li le o ou s u on social media, o example, we shouldn’ e en pos pic u es o ou sel es”—P38), cybe secu i y (“Ha ing an an i i us ins alled on ou compu e , so hey don’ hack ou accoun s”—P50), specialized o ices (“In schools, c ea e o ices wi h p o essionals such as psychologis s and eache s o deal wi h hese ma e s”— P17), censu ed con en (“The people who manage he social ne wo ks should censo his con en , so ha i doesn’ sp ead”—P1), do no ake nudes (“Ne e ake nudes, so he e is no isk o hem being sha ed”—P43), child en’s educa ion (“Educa ing child en no o be mean o o he people, eaching hem ha cybe iolence is some hing e y bad and ha i can do a lo o ha m o someone else’s li e”—P3) and exis ence o a eliable pe son (“C ea e a e e ence pe son in schools ha all pa icipan s know hey can u n o in hese si ua ions”—P52). 3.2. Con ac s wi h Cases o Vic imiza ion Pa icipan s epo ed se e al con ac s wi h cases o ic imiza ion in hei daily li es (c . Table 2) , which can be di ided in o ypes o ic imiza ion ha include sexual ic im- iza ion, whe e he mos men ioned kind was “nudes” (“When I was in 5 h g ade, a gi l in my class sen nudes o a boy and he sp ead hem all o e he school”—P45), cybe bul- lying wi h pho o sha ing (“This yea he e was a case in my class wi h a 7 h-g ade gi l. I all s a ed wi h ange , hen e e yone made un o he and eco ded ideos and ook pic u es and hen pos ed hem online, in g oups, on social ne wo ks”—P8), meme c ea ion (“I happened he e a school, a g oup o pa icipan s c ea ed memes o o he pa icipan s and e en eache s and sp ead hem on Ins ag am, in he class g oup”—P1), sexual o ien- a ion disc imina ion (“I was a boy who in a g oup called him gay. Then hey s a ed o pu i on his social ne wo ks and in o he g oups he was in and make un o him”—P53), sp eading umo s (“I happened o me, hey s a ed w i ing alse in o ma ion abou me on Twi e and Ins ag am and sp eading lies”—P48), hacked accoun s (“Du ing he pandemic, a gi l in my class educed he numbe o gues s o he bi hday pa y. A boy, because he was no in i ed, hacked he Ins ag am accoun , and s a ed pos ing emba assing hings in he name”—P15; “In ou class, a pe son has al eady hacked ano he colleague’s email accoun and sen emails wi h e ible hings o all con ac s”—P22), gaming iolence (“I ha e su e ed om iolence while playing ideo games. They s a ed insul ing me in messages, and hen hey eco ded he game and made un o me in Wha sApp g oups saying I was a agile playe ”—P54), and sexual ha assmen (“A boy om ano he class made many commen s o a sexual cha ac e on Messenge o a gi l. He e en ha assed he and e en ollowed he home.”—P36). In his s udy, pa icipan s only had con ac wi h CIV as ic ims (“I happened o me, hey s a ed w i ing alse in o ma ion abou me on Twi e and Ins ag am and sp eading lies”—P18) o bys ande s (“I happened he e a school, a g oup o pa icipan s c ea ed memes o o he pa icipan s”—P27). In bo h cases, hey s a e ha a eques o help is necessa y. Tha help could be om a p o essional (“She wen o ell he psychologis ( . . . )”—P13; “We old eache X, and he ook ca e o he si ua ion”—P1; “We wen o alk o he school boa d ( . . . )”—P33), which pa icipan s men ioned being a psychologis , a eache , and an ope a ional assis an , among o he s; om pa en s (“I old my mo he ( . . . )”—P25; “The a he saw he con e sa ion on Wha sApp ( . . . )”—P55); om he police (“My mo he wen o ell he police wha was going on ( . . . )”—P25); o om pee g oup (“The gi l old he iends, who epo ed i ”—P56). Howe e , i was ecognized ha some imes he e is In . J. En i on. Res. Public Heal h 2024,21, 832 16 o 22 mobile de ice o li , plead, o exp ess desi e is known as sex ing [ 68 ]. Many o he ic ims said ha hey s a ed exchanging messages wi h someone hey knew, and he asked o send sexual pic u es a e a ew yea s o con e sa ion and mu ual in e es . The li e a u e s a es ha sex ing is equen ly used as a lead-up o ac ual sexual ac i i y, as i can be seen as an ex- ension o concu en sexual con ac o p omo e bonding and communica ion a ac ion [ 54 ]. This cha ac e is ic sugges s ha ic ims need assis ance in ully unde s anding he isks o sending online sexual con en . Ou pa icipan s ela ed o his conce ning eali y because a conside able numbe o hem admi ed o ha ing ecei ed o sen semi-nude pic u es by message, a eali y also epo ed in ano he s udy [ 69 ]. Sex ing can gene a e eelings in adolescen s such as amusemen , en husiasm, ulne abili y, humilia ion, and dis ess. Many o hem ecognize ha when his ype o pic u e comes o public a en ion, adolescen s ha e a e ible ime; hey mo e om one school o ano he school o a oid colleagues ha ha e seen he pic u e, hey eel e y ashamed, sad, anxious, and exposed, and some also mo e o ano he ci y. Pa icipan s a e awa e ha his ype o publica ion leads, many imes, o child en commi ing suicide o ha ing men al heal h p oblems, such as dep ession. Adolescen s ecognize sex ing and e enge po n as wo o he mos impac ul o ms o CIV due o hei emo ional changes in ic ims. Mos o hem we e eminded o he ic ims hey knew when hey men ioned he impac o CIV, namely emo ional changes (e.g., ea , insecu i y, sel -es eem p oblems) and beha io changes (e.g., suicide, social isola ion, ea ing diso de s). 4.6. Bys ande s’ Role in CIV Adolescen s belie e ha he ole o bys ande s is o suppo he ic im and epo o alk o he agg esso in o de o s op he iolence ci cle. Howe e , many esponden s also ecognized ha bys ande s o en igno e hese si ua ions because hey do no belie e hey ha e any hing o do wi h hem and do no wan o ge in ol ed. A ecen sys ema ic e iew ound ha in 100% o he s udies, he ole o a cybe - ic im was iden i ied; in 39%, he ole o a cybe -agg esso ; in 16%, he ole o a cybe -obse e [ 70 ]. 4.7. Reques o Help Adolescen s eques o mal and in o mal help, and help-seeking is conside ed one o he mos common coping s a egies among ic ims [ 38 ]. Howe e , a smalle numbe o cybe ic ims seek help when compa ed o ic ims in eal space [ 71 ], e en hough mos o hem unde s and i is a help ul s a egy in con olling he impac o CIV and s opping he iolence cycle [ 72 ], as ecognized by pa icipan s. They seek assis ance om p o essionals such as psychologis s, eache s, school boa ds, and ope a ional assis an s. They also men ioned con ac ing police o ice s. On he o he hand, hey seek in o mal help om pa en s and pee g oups. A leas some adolescen s ecognize ha some imes hey do no seek help because hey a e being mocked. These da a align wi h he li e a u e, which says less han 30% o people who expe ienced echnology- acili a ed abuse sough p o essional help [ 73 ]. Ou esul s a e a li le bi di e en om o he esul s, as pa icipan s men ioned ha adolescen s eques in o mal (e.g., pa en s, iends) and o mal help (e.g., eache s , police o ice s), wi hou any p e e ence [ 74 , 75 ]. These esul s could be because many o he pa icipan s men ioned being bys ande s. As a esul , hey ecognize he impo ance o seeking help om au ho i ies, o example, due o he e ec i eness o his in s opping CIV. In his line, pa icipan s e e o ic ims’ eac ions o CIV, and mos o hem a e desc ibed as passi e (e.g., main aining he ela ionship o simply doing no hing). In con as , o he s a e ac i e (e.g., alking wi h iends, lea ing he agg essi e g oup, showing no ea , asking o help). 4.8. Sel -P o ec i e Beha io s Pa icipan s also men ioned some sel -p o ec i e beha io s ha could be implemen ed o educe CIV. They iden i ied he need o hea mo e abou he subjec a school. A s udy showed [ 76 ] ha mos pa icipan s discussed he alue o a con inuous educa ion campaign In . J. En i on. Res. Public Heal h 2024,21, 832 17 o 22 and aising awa eness abou CIV as a p ope p e en a i e s a egy ha should in eg a e and con inue o educa e kids in all g ades. In he same s udy, a school counsello exp essed simila iews ega ding he e ec o educa ion on his subjec and how educa ional p o- g amming has aised awa eness and communica ion ega ding CIV. He also men ioned ha some school p og ams ha e been bene icial in ge ing hings ou in he open and ge ing people o alk abou cybe bullying, o example. I was also no ed ha hose who engage in CIV should be awa e o he legal consequences, which a e poo ly add essed in school p og ams [ 76 ]. The ollowing a e also conside ed necessa y p o ec i e measu es: do no in e ac wi h s ange s and ins ead limi in e ac ion o iends; do no sha e in o - ma ion such as passwo ds, and do no ake and sha e nudes. Finally, many pa icipan s epo ed he need o pa en al con ol as a p o ec i e measu e as well as pa en al educa ion. They belie e ha pa en s should con ol hei kids’ digi al p ac ices and limi access o inapp op ia e con en . In he cu en li e a u e, pa en al in ol emen wi h echnology is no ed as c ucial in p e en ing CIV. Pa en s a e an essen ial esou ce o minimizing and esol ing you h CIV issues, namely because adolescen s a e mos likely o alk abou pa en al echnology use, pa icula ly as a ac ic o s op o s ep in when cybe bullying occu s [ 76 ]. Pa icipan s also no e ha pa en s a e esponsible o child en’s educa ion and should each hem o be kind o one ano he and ecognize se e al o ms o iolence o p o ec hemsel es agains . In he end, pa icipan s alked abou he possibili y o c ea ing specialized o ices in school wi h a mul idisciplina y eam ha is able o suppo hem in he case o CIV, as ic ims, bys ande s, o e en agg esso s. This o ice could also include a poin pe son o whom adolescen s could go o suppo . We also e i ied ha some schools al eady ha e his pe son, e en in an in o mal o m. Fo una ely, o he s akeholde s in he li e a u e appea eady o emb ace such educa- ional endea o s in hei schools. G adinge e al. [ 77 ] examined he opinions o eache s and pa en s abou cybe bullying p e en ion and disco e ed ha 95% o pa en s and 90% o eache s ha e posi i e iews ega ding acili a ing and pa icipa ing in an i-bully educa ion s a egies. Consequen ly, eache s and pa en s would likely be suppo i e and in es ed in implemen ing such educa ional p og amming [ 77 ]. O he esea ch has documen ed ha eache s and educa ional suppo p o essionals ha e indica ed a desi e o ecei e addi ional aining ela ed o CIV in e en ions [ 78 ]. Addi ionally, a s udy in es iga ed he e ec i e- ness o such p og ams and acknowledged he alue o implemen ing such educa ional p og ams [ 79 ]. The esul s o his s udy speak o hose sugges ions, as CIV awa eness, digi- al ci izenship aining, empa hy, espec , and con lic managemen exe cises can be easily implemen ed as new modules wi hin exis ing p og ams on he speci ic ma e s o CIV, such as cybe bullying and cybe da ing iolence. A las , Yu dakul and Ayhan’s s udy [ 80 ] concluded ha he Cybe bullying Awa eness P og am success ully enhanced he unde - s anding and coping abili ies o eenage s in he in e en ion g oup owa ds cybe bullying. Based on hese indings, ecommenda ions a e pu o h o educa o s and policymake s, as men ioned abo e by o he au ho s. Policymake s a e ad ised o inco po a e p e en ion p og ams wi h ega d o cybe bullying in o na ional cu iculums. This would help o aise eenage s’ awa eness abou cybe bullying and s eng hen hei esilience. Educa o s should also deli e hese p og ams o child en and eenage s na ionwide. 5. P ac ical Implica ions Pa icipan s iden i ied emo ional, physical, and sexual abuse ela ed o CDA, cybe - bullying, and cybe s alking. Adolescen digi al p ac ices, jealousy, and a lack o pa en al con ol con ibu e o he sp ead o CIV. Pos ing, sha ing pho os and ideos, and elling lies a e some o he abusi e beha io s ha adolescen s p ac ice o su e om. Vic ims should seek help, especially o mal help, and he bys ande ’s ole in s opping he cycle o iolence should be ecognized. Pa en al con ol, child en’s educa ion, and sa e digi al p ac ices a e some p o ec i e measu es o be conside ed. CIV has a signi ican impac on adolescen s’ men al heal h, wi h emo ional changes (e.g., sadness, ea , ange ) ha can lead o social isola ion o e en suicide. Conside ing his, ou esea ch emphasizes he need o In . J. En i on. Res. Public Heal h 2024,21, 832 18 o 22 p e en ion h ough educa ion. Resea ch has highligh ed ha less han hal o he p og ams de eloped o comba CIV inco po a e educa ional con en o pa en s. Howe e , such p og ams a e among he mos success ul a educing cybe ic imiza ion [ 81 ]. So, schools mus ha e a clea objec i e and policy o gua d agains he many cybe h ea s ha young people encoun e nowadays. Schools mus also ha e a p og am in eg a ing CIV as a mul idimensional and mul idisciplina y issue di ec ed a pa en s, ic ims, agg esso s, and bys ande s. Resea che s should explo e bys ande s’ oles in s opping CIV, as hey can be allies in he igh agains CIV, o en as in o mal suppo s o whom ic ims and e en agg esso s u n. Heal h p o essionals, such as psychologis s, school nu ses, and o he s, mus suppo and counsel adolescen s, as he mos epo ed as he o mal help o whom ic ims and e en bys ande s u n when looking o ad ice. Taking in o conside a ion he e idence-based suppo p o ided by his s udy, we sugges ha u u e educa ional and in e en ion p o- g ams emphasize he ollowing: (1) p omo ion o heal hy ela ionships; (2) disclosu e o media campaigns; (3) awa eness abou he na u e and consequences o CIV; (4) he inclu- sion o pa en s, eache s, and o he s akeholde s; (5) p o iding guidance and in o ma ic assis ance o pa en s; (6) in eg a ing agg esso s in educa ion and es uc u ing p og ams; and (7) e ec i e ne wo king (e.g., amilies, educa ion, legal, heal h). 6. Limi a ions and Fu u e Resea ch This s udy has limi a ions, al hough i s indings ha e subs an ial implica ions lead- ing o se e al impo an ecommenda ions. This s udy b ings a Po uguese pe spec i e p o ided by adolescen s on he CIV opic. Howe e , he indings o his s udy a e based on a sample om a limi ed geog aphical a ea ( he no he n egion o he coun y). The e- o e, samples o adolescen s in o he pa s o he coun y should be also in es iga ed o unde s and his phenomenon o e a wide ho izon. Addi ionally, he sample size is limi ed and hus only pa ially ep esen a i e o some adolescen s in schools; o example, we did no in e iew pa icipan s om p i a e schools. Fu he mo e, he leading esea che also mode a ed he in e iews. In u u e s udies, an addi ional obse e could be p esen o be e cap u e and analyze pa icipan s’ beha io s. One u u e di ec ion could be o use he esul s o his s udy o c ea e a su ey o check hese conclusions wi h a b oade sample. Fu u e esea ch should con inue o ask adolescen s and o he s akeholde s (e.g., police o ice s, eache s, and amily suppo p o essionals) abou o he ypes o po en ial school suppo a ailable in hei geog aphic a ea, as he esponses may p o ide di e en sugges ions o solu ions. Fu u e esea ch may also include he ic im’s pe spec i e as well as ha o he o ende s. 7. Conclusions This s udy complemen s he cu en li e a u e by p o iding e idence abou adoles- cen s’ pe spec i es on CIV. Fu he mo e, one o he mos ele an con ibu ions o his s udy abou CIV is he pe spec i e o he phenomenon om he iew o subjec s who li e his eali y in he i s pe son. Mo eo e , his s udy demons a es ha he ole o pa en s is inc easingly c ucial in p o ec ing and educa ing hei child en h ough supe ision and e- educa ion ega ding hei digi al p ac ices. This s udy also indica es ha he e a e speci ic cha ac e is ics, such as amily issues and gende issues, speci ic o ic ims and agg esso s and ha he e a e a ia ions in he se e i y and he episodes o CIV. These ac o s can be used o ecognize mo e suscep ible adolescen s and agg esso s, who pose a g ea e isk o se ious CIV, esul ing in damage o ic ims. Finally, his s udy in eg a es he bys ande ’s posi ion on in e ening in CIV as a media o , in e ene , o s oppe o he cycle o iolence. Au ho Con ibu ions: Concep ualiza ion, B.M., S.C., I.A. and P.L.d.F.; me hodology, B.M. and S.C.; alida ion, B.M., S.C. and P.L.d.F.; o mal analysis, B.M. and S.C.; in es iga ion, B.M.; esou ces, B.M.; da a cu a ion, B.M.; w i ing—o iginal d a p epa a ion, B.M.; w i ing— e iew and edi ing, B.M., S.C., I.A. and P.L.d.F.; isualiza ion, B.M.; supe ision, S.C., I.A. and P.L.d.F.; p ojec adminis a ion, B.M.; unding acquisi ion, S.C. All au ho s ha e ead and ag eed o he published e sion o he manusc ip . In . J. En i on. Res. Public Heal h 2024,21, 832 19 o 22 Funding: This s udy was conduc ed a he Psychology Resea ch Cen e (PSI/01662), School o Psychology, Uni e si y o Minho, suppo ed by he Founda ion o Science and Technology (FCT) h ough he Po uguese S a e Budge (Re .: UID/01662/2020). Ins i u ional Re iew Boa d S a emen : The s udy was conduc ed in acco dance wi h he Decla a ion o Helsinki and app o ed by he E hics Commi ee o he Na ional School o Public Heal h, NOVA Uni e si y (numbe 3/2021) and wi h consen o he Minis y o Educa ion (numbe 0789800001). In o med Consen S a emen : In o med consen was ob ained om all subjec s in ol ed in he s udy. Da a A ailabili y S a emen : The da ase s p esen ed in his a icle a e no eadily a ailable because his p ojec emains in p og ess, and da a analysis is ongoing. Reques s o access he da ase s should be di ec ed o [email p o ec ed]. Con lic s o In e es : The au ho s decla e no con lic s o in e es . Re e ences 1. Ball, C.; F ancis, J.; Huang, K.-T.; Kadylak, T.; Co en, S.R.; Rika d, R.V. The Physical–Digi al Di ide: Explo ing he Social Gap be ween Digi al Na i es and Physical Na i es. J. Appl. Ge on ol. 2019,38, 1167–1184. [C ossRe ] 2. P ensky, M. Digi al Na i es, Digi al Immig an s Pa 1. Ho izon 2001,9, 1–6. [C ossRe ] 3. P ensky, M. Digi al Na i es, Digi al Immig an s Pa 2: Do They Really Think Di e en ly? Ho izon 2001,9, 1–6. [C ossRe ] 4. Egna o , W.J.; Tapsco , D. G owing Up Digi al. The Rise o he Ne Gene a ion. New Yo k: McG aw Hill. Xii+338. ISSN 0-07-063361-4. Web Si e: www.g owingupdigi al.com. Educ. In . Technol. 1999,4, 203–205. [C ossRe ] 5. Galla do-Echenique, E.E.; Ma qués-Molías, L.; Bullen, M.; S ijbos, J.-W. Le ’s Talk abou Digi al Lea ne s in he Digi al E a. In . Re . Res. Open Dis ib. Lea n. 2015,16, 156–187. 6. Benne , S.; Ma on, K.; Ke in, L. The ‘Digi al Na i es’ Deba e: A C i ical Re iew o he E idence. B . J. Educ. Technol. 2008,39, 775–786. [C ossRe ] 7. Hülü , G.; Macdonald, B. Re hinking Social Rela ionships in Old Age: Digi aliza ion and he Social Li es o Olde Adul s. Am. Psychol. 2020,75, 554. [C ossRe ] [PubMed] 8. Cola usso, C.A.; Cola usso, C.A. Adolescence (Ages 12–20). In Child and Adul De elopmen ; C i ical Issues in Psychia y; Sp inge : Bos on, MA, USA, 1992; pp. 91–105. 9. Smahel, D.; Machacko a, H.; Masche oni, G.; Dedko a, L.; S aks ud, E.; Óla sson, K.; Li ings one, S.; Haseb ink, U. EU Kids Online 2020: Su ey Resul s om 19 Coun ies. 2020. A ailable online: h ps://www.eukidsonline.ch/ iles/Eu-kids-online-2020 -in e na ional- epo .pd (accessed on 9 Feb ua y 2024). 10. Pon e, C.; Ba is a, S. EU Kids Online Po ugal: Usos, Compe ências, Riscos e Mediações Da In e ne Repo ados Po C ianças e Jo ens (9–17 Anos); Faculdade de Ciências Sociais e Humanas da Uni e sidade No a de Lisboa: Lisboa, Po ugal, 2019. 11. Reed, L.A.; Tolman, R.M.; Wa d, L.M. Snooping and Sex ing: Digi al Media as a Con ex o Da ing Agg ession and Abuse among College S uden s. Violence Agains Women 2016,22, 1556–1576. [C ossRe ] [PubMed] 12. Ca idade, S.; B aga, T.; Bo ajo, E. Cybe Da ing Abuse (CDA): E idence om a Sys ema ic Re iew. Agg ess. Violen Beha . 2019, 48, 152–168. [C ossRe ] 13. Jun, W. A S udy on he Cause Analysis o Cybe bullying in Ko ean Adolescen s. In . J. En i on. Res. Public Heal h 2020,17, 4648. [C ossRe ] [PubMed] 14. Fe ne , M.; Lapie e, A.; Hébe , M.; Cousineau, M.-M. A Sys ema ic Re iew o Li e a u e on Cybe In ima e Pa ne Vic imiza ion in Adolescen Gi ls and Women. Compu . Hum. Beha . 2019,100, 11–25. [C ossRe ] 15. Ca idade, S.M.M.; B aga, T. You h Cybe Da ing Abuse: A Me a-Analysis o Risk and P o ec i e Fac o s. Cybe psychol. J. Psychosoc. Res. Cybe sp. 2020,14, 2. [C ossRe ] 16. Hinduja, S.; Pa chin, J.W. Cybe bullying: Iden i ica ion, P e en ion, & Response; Cybe bullying Resea ch Cen e : Suga loa Key, FL, USA, 2014. 17. Co co an, L.; Mc Guckin, C.; P en ice, G. Cybe bullying o Cybe Agg ession?: A Re iew o Exis ing De ini ions o Cybe -Based Pee - o-Pee Agg ession. Socie ies 2015,5, 245–255. [C ossRe ] 18. Bo ca, G.; Bina, M.; Kelle , P.S.; Gilbe , L.R.; Bego i, T. In e ne Use and De elopmen al Tasks: Adolescen s’ Poin o View. Compu . Hum. Beha . 2015,52, 49–58. [C ossRe ] 19. Machimba ena, J.M.; Cal e e, E.; Fe nández-González, L.; Ál a ez-Ba dón, A.; Ál a ez-Fe nández, L.; González-Cab e a, J. In e ne Risks: An O e iew o Vic imiza ion in Cybe bullying, Cybe Da ing Abuse, Sex ing, Online G ooming and P oblema ic In e ne Use. In . J. En i on. Res. Public Heal h 2018,15, 2471. [C ossRe ] [PubMed] 20. Cosma, A.; Walsh, S.D.; Ches e , K.L.; Callaghan, M.; Molcho, M.; C aig, W.; Picke , W. Bullying Vic imiza ion: Time T ends and he O e lap be ween T adi ional and Cybe bullying ac oss Coun ies in Eu ope and No h Ame ica. In . J. Public Heal h 2020,65, 75–85. [C ossRe ] [PubMed] 21. Milose ic, T. Social Media Companies’ Cybe bullying Policies. In . J. Commun. 2016,10, 22. 22. Ba le , C.P.; DeWi , C.C.; Ma onna, B.; Johnson, K. Social Media Use as a Tool o Facili a e o Reduce Cybe bullying Pe pe a ion: A Re iew Focusing on Anonymous and Nonanonymous Social Media Pla o ms. Violence Gend. 2018,5, 147–152. [C ossRe ] In . J. En i on. Res. Public Heal h 2024,21, 832 20 o 22 23. Shin, S.Y.; Choi, Y.-J. Compa ison o Cybe bullying be o e and a e he COVID-19 Pandemic in Ko ea. In . J. En i on. Res. Public Heal h 2021,18, 10085. [C ossRe ] 24. Choi, Y.-J.; Shin, S.Y.; Lee, J. Change in Fac o s A ec ing Cybe bullying o Ko ean Elemen a y School S uden s du ing he COVID-19 Pandemic. In . J. En i on. Res. Public Heal h 2022,19, 11046. [C ossRe ] 25. T ompe e , N.; Jackson, E.; Sheanoda, V.; Luo, A.; Allison, K.; Bussey, K. Cybe bullying P e alence in Aus alian Adolescen s: Time T ends 2015–2020. J. Sch. Violence 2022,21, 252–265. [C ossRe ] 26. Machado, B.; Ca idade, S.; A aújo, I.; Fa ia, P.L. Mapping he Cybe In e pe sonal Violence among Young Popula ions: A Scoping Re iew. Soc. Sci. 2022,11, 207. [C ossRe ] 27. Simões, J.A.; Pon e, C.; Fe ei a, E.; Do e o, J.; Aze edo, C. C ianças e Meios Digi ais Mó eis Em Po ugal: Resul ados Nacionais Do P oje o Ne Child en Go Mobile; Cesno a: Lisboa, Po ugal, 2014. 28. Vale, M.; Pe ei a, F.; Spi zbe g, B.H.; Ma os, M. Cybe -ha assmen Vic imiza ion o Po uguese Adolescen s: A Li es yle- ou ine Ac i i ies Theo y App oach. Beha . Sci. Law 2022,40, 604–618. [C ossRe ] [PubMed] 29. Leuk eld , E.R.; Ya , M. Applying Rou ine Ac i i y Theo y o Cybe c ime: A Theo e ical and Empi ical Analysis. De ian Beha . 2016,37, 263–280. [C ossRe ] 30. Vale, A.; Pe ei a, F.; Gonçal es, M.; Ma os, M. Cybe -Agg ession in Adolescence and In e ne Pa en ing S yles: A S udy wi h Vic ims, Pe pe a o s and Vic im-Pe pe a o s. Child. You h Se . Re . 2018,93, 88–99. [C ossRe ] 31. Akgül, G. Rou ine Ac i i ies Theo y in Cybe Vic imiza ion and Cybe bullying Expe iences o Tu kish Adolescen s. In . J. Sch. Educ. Psychol. 2023,11, 135–144. [C ossRe ] 32. Choi, K.-S.; Cho, S.; Lee, J.R. Impac s o Online Risky Beha io s and Cybe secu i y Managemen on Cybe bullying and T adi ional Bullying Vic imiza ion among Ko ean You h: Applica ion o Cybe -Rou ine Ac i i ies Theo y wi h La en Class Analysis. Compu . Hum. Beha . 2019,100, 1–10. [C ossRe ] 33. Agapi o, D.; B i o, P.Q. A Dyadic App oach o Adolescen s’ Risky Online Beha io s. J. Spa . O gan. Dyn. 2020,8, 244–267. 34. Taylo , S.; Xia, Y. Cybe Pa ne Abuse: A Sys ema ic Re iew. Violence Vic . 2018,33, 983–1011. [C ossRe ] [PubMed] 35. De La Rue, L.; Polanin, J.R.; Espelage, D.L.; Pigo , T.D. A Me a-Analysis o School-Based In e en ions Aimed o P e en o Reduce Violence in Teen Da ing Rela ionships. Re . Educ. Res. 2017,87, 7–34. [C ossRe ] 36. S o e , H.L.; Casey, E.; He enkohl, T. E icacy o Bys ande P og ams o P e en Da ing Abuse among You h and Young Adul s: A Re iew o he Li e a u e. T auma Violence Abus. 2016,17, 256–269. [C ossRe ] [PubMed] 37. dos San os, K.B.; Mu a, S.G. Pee s as Agen s o Da ing Violence P e en ion: Feasibili y Analysis o an In e en ion. T ends Psychol. 2019,27, 631–646. [C ossRe ] 38. Pe ei a, F.; Spi zbe g, B.H.; Ma os, M. Cybe -Ha assmen Vic imiza ion in Po ugal: P e alence, Fea and Help-Seeking among Adolescen s. Compu . Hum. Beha . 2016,62, 136–146. [C ossRe ] 39. No o, F.; Pe ei a, F.; Ma os, M. Cybe -Agg ession in Adolescence and Pa en al In ol emen : F om Pe pe a ion o Supe ision. In . J. Cybe C iminol. 2014,8, 94–110. 40. C eswell, J.W.; Po h, C.N. Quali a i e Inqui y and Resea ch Design: Choosing among Fi e App oaches; Sage Publica ions: Thousand Oaks, CA, USA, 2016; ISBN 1506330193. 41. Py˙ zalski, J.; Plich a, P.; Szus e , A.; Ba li´nska, J. Cybe bullying Cha ac e is ics and P e en ion—Wha Can We Lea n om Na a i es P o ided by Adolescen s and Thei Teache s? In . J. En i on. Res. Public Heal h 2022,19, 11589. [C ossRe ] [PubMed] 42. Ba din, L. Analise de Con eúdo; Re is a e Ampliada: São Paulo, B azil, 2011. 43. Bo ajo, E.; Gámez-Guadix, M.; Cal e e, E. Cybe Da ing Abuse: P e alence, Con ex , and Rela ionship wi h O line Da ing Agg ession. Psychol. Rep. 2015,116, 565–585. [C ossRe ] [PubMed] 44. So o, A.M.; Lopez-del Bu go, C.; Albe os, A.; Ibabe, I. Cybe Da ing Abuse in Adolescen s: My hs o Roman ic Lo e, Sex ing P ac ices and Bullying. Compu . Hum. Beha . 2024,150, 108001. [C ossRe ] 45. Li, J.; Ran, G.; Zhang, Q.; He, X. The P e alence o Cybe Da ing Abuse among Adolescen s and Eme ging Adul s: A Me a- Analysis. Compu . Hum. Beha . 2023,144, 107726. [C ossRe ] 46. Ma ínez So o, A.; Ibabe E os a be, I. Cybe Da ing Abuse: Concep ualiza ion and Me a-Analysis o P e alence Ra es. Anu. Psicol. Ju ídica 2024,34, 133–144. [C ossRe ] 47. S ickland, M.L.; Lo e, H.; Kimmes, J. The In e ac ion Be ween Adolescen Cybe Da ing Abuse and Pa en ing on Men al Heal h Ou comes. J. Child Fam. S ud. 2023,32, 769–780. [C ossRe ] 48. ¸Sahin, S.S.; Ayaz-Alkaya, S. P e alence and P edisposing Fac o s o Pee Bullying and Cybe bullying among Adolescen s: A C oss-Sec ional S udy. Child. You h Se . Re . 2023,155, 107216. [C ossRe ] 49. Gohal, G.; Alqassim, A.; El yeb, E.; Rayyani, A.; Hakami, B.; Al Faqih, A.; Hakami, A.; Qad i, A.; Mah ouz, M. P e alence and Rela ed Risks o Cybe bullying and I s E ec s on Adolescen . BMC Psychia y 2023,23, 39. [C ossRe ] [PubMed] 50. Naga a, J.M.; T ompe e , N.; Singh, G.; Raney, J.; Ganson, K.T.; Tes a, A.; Jackson, D.B.; Mu ay, S.B.; Bake , F.C. Ad e se Childhood Expe iences and Ea ly Adolescen Cybe bullying in he Uni ed S a es. J. Adolesc. 2023,95, 609–616. [C ossRe ] [PubMed] 51. Li, J.; Wu, Y.; Heske h, T. In e ne Use and Cybe bullying: Impac s on Psychosocial and Psychosoma ic Wellbeing among Chinese Adolescen s. Compu . Hum. Beha . 2023,138, 107461. [C ossRe ] 52. Olson, C.; Bellmo e, A.; Mo eno, M.A. Elucida ing College S uden s’ Cybe s alking Vic imiza ion Expe iences. Cybe psychol. Beha . Soc. Ne w. 2024,27, 208–213. [C ossRe ] [PubMed] In . J. En i on. Res. Public Heal h 2024,21, 832 21 o 22 53. Mish a, S.; Mish a, A.; Rawa , R. A s udy o impac o social media on college s uden s. Clea In . J. Res. Comme . Manag. 2015,6, 27. 54. Paa , Y.-F.; Ma kham, C. Digi al C ime, T auma, and Abuse: In e ne Sa e y and Cybe Risks o Adolescen s and Eme ging Adul s in he 21s Cen u y. Soc. Wo k Men . Heal h 2021,19, 18–40. [C ossRe ] 55. Flach, R.M.D.; Deslandes, S.F. Abuso Digi al Nos Relacionamen os A e i o-Sexuais: Uma Análise Bibliog á ica. Cad. Saude Publica 2017,33, e00138516. [PubMed] 56. B own, C.; Hega y, K. Digi al Da ing Abuse Measu es: A C i ical Re iew. Agg ess. Violen Beha . 2018,40, 44–59. [C ossRe ] 57. Bake , C.K.; Ca eño, P.K. Unde s anding he Role o Technology in Adolescen Da ing and Da ing Violence. J. Child Fam. S ud. 2016,25, 308–320. [C ossRe ] 58. S ona d, K.E. “Technology Was Designed o This”: Adolescen s’ Pe cep ions o he Role and Impac o he Use o Technology in Cybe Da ing Violence. Compu . Hum. Beha . 2020,105, 106211. [C ossRe ] 59. Temple, J.R.; Choi, H.J.; B em, M.; Wol o d-Cle enge , C.; S ua , G.L.; Peskin, M.F.; Elmquis , J. The Tempo al Associa ion be ween T adi ional and Cybe Da ing Abuse among Adolescen s. J. You h Adolesc. 2016,45, 340–349. [C ossRe ] [PubMed] 60. Washing on, E.T. An O e iew o Cybe bullying in Highe Educa ion. Adul Lea n. 2015,26, 21–27. [C ossRe ] 61. Ande son, M. A Majo i y o Teens Ha e Expe ienced Some Fo m o Cybe bullying. 2018. A ailable online: h ps: //li emo esc eenless.o g/blog/ esou ce/a-majo i y-o - eens-ha e-expe ienced-some- o m-o -cybe bullying/ (accessed on 1 Ap il 2024). 62. Tzani-Pepelasi, C.; Ioannou, M.; Synno , J.; Ash on, S.-A. Compa ing Fac o s Rela ed o School-Bullying and Cybe -Bullying. In Re iewing C ime Psychology; Rou ledge: London, UK, 2020; pp. 267–291. 63. Bas iaensens, S.; Pabian, S.; Vandebosch, H.; Poels, K.; Van Cleempu , K.; DeSme , A.; De Bou deaudhuij, I. F om No ma i e In luence o Social P essu e: How Rele an O he s A ec whe he Bys ande s Join in Cybe bullying. Soc. De . 2016,25, 193–211. [C ossRe ] 64. Nixon, C.L. Cu en Pe spec i es: The Impac o Cybe bullying on Adolescen Heal h. Adolesc. Heal h Med. The . 2014,5, 143. [C ossRe ] [PubMed] 65. Quin ana-O s, C.; Rey, L.; Ne o, F. Beyond Cybe bullying: In es iga ing when and How Cybe ic imiza ion P edic s Suicidal Idea ion. J. In e pe s. Violence 2022,37, 935–957. [C ossRe ] [PubMed] 66. Skilb ed-Fjeld, S.; Reme, S.E.; Mossige, S. Cybe bullying In ol emen and Men al Heal h P oblems among La e Adolescen s. Cybe psychol. J. Psychosoc. Res. Cybe sp. 2020,14, 5. [C ossRe ] 67. Na a o, R.; Yube o, S.; La añaga, E.; Ma ínez, V. Child en’s Cybe bullying Vic imiza ion: Associa ions wi h Social Anxie y and Social Compe ence in a Spanish Sample. Child Indic. Res. 2012,5, 281–295. [C ossRe ] 68. Mi chell, K.J.; Finkelho , D.; Jones, L.M.; Wolak, J. P e alence and Cha ac e is ics o You h Sex ing: A Na ional S udy. Pedia ics 2012,129, 13–20. [C ossRe ] [PubMed] 69. Mo i, C.; Cooke, J.E.; Temple, J.R.; Ly, A.; Lu, Y.; Ande son, N.; Rash, C.; Madigan, S. The P e alence o Sex ing Beha io s among Eme ging Adul s: A Me a-Analysis. A ch. Sex. Beha . 2020,49, 1103–1119. [C ossRe ] [PubMed] 70. Ma ín, A.R.; Cab é, R.B.; Ne i, E.M. Cibe acoso y Ansiedad Social En Adolescen es: Una Re isión Sis emá ica. Re . Psicol. Clínica Con Niños Adolesc. 2019,6, 9–15. 71. Dooley, J.J.; G adinge , P.; S ohmeie , D.; C oss, D.; Spiel, C. Cybe -Vic imisa ion: The Associa ion be ween Help-Seeking Beha iou s and Sel -Repo ed Emo ional Symp oms in Aus alia and Aus ia. J. Psychol. Couns. Sch. 2010,20, 194–209. [C ossRe ] 72. Machacko a, H.; Ce na, A.; Se ciko a, A.; Dedko a, L.; Daneback, K. E ec i eness o Coping S a egies o Vic ims o Cybe bul- lying. Cybe psychol. J. Psychosoc. Res. Cybe sp. 2013,7, 1–12. [C ossRe ] 73. Mum o d, E.A.; Ro hman, E.F.; Mai a, P.; She idan-Johnson, J. US Young Adul s’ P o essional Help-Seeking in Response o Technology-Facili a ed Abuse. J. In e pe s. Violence 2023,38, 7063–7088. [C ossRe ] [PubMed] 74. Lachman, P.; Zweig, J.; Dank, M.; Yahne , J. Pa e ns o Help-seeking Beha io among Vic ims o Teen Da ing Violence and Abuse: Va ia ions among Boys and Gi ls. J. Sch. Heal h 2019,89, 791–799. [C ossRe ] 75. Jony, M.D.M.I.; Bosh a, S.J.; Islam, M.D.K.; Rahman, M.; Rahman, M.; Shah ia , M.A. A Su ey on Sha ed Pe cep ions, Help Seeking Pa e ns and Awa eness o Cybe Bullying Among Bangladeshi Ci izens. In P oceedings o he 2023 IEEE In e na ional Con e ence on Blockchain and Dis ibu ed Sys ems Secu i y (ICBDS), New Raipu , India, 6–8 Oc obe 2023; pp. 1–5. 76. Hend y, B.P.; Hells en, L.-A.M.; McIn y e, L.J.; Smi h, B.R.R. Recommenda ions o Cybe bullying P e en ion and In e en ion: A Wes e n Canadian Pe spec i e om Key S akeholde s. F on . Psychol. 2023,14, 1067484. [C ossRe ] [PubMed] 77. G adinge , P.; S ohmeie , D.; Spiel, C. Pa en s’ and Teache s’ Opinions on Bullying and Cybe bullying P e en ion. Z. Psychol. 2017,25, 76–84. [C ossRe ] 78. B adshaw, C.P.; Waasdo p, T.E.; O’B ennan, L.M.; Guleme o a, M. Teache s’ and Educa ion Suppo P o essionals’ Pe spec i es on Bullying and P e en ion: Findings om a Na ional Educa ion Associa ion S udy. Sch. Psych. Re . 2013,42, 280–297. [C ossRe ] 79. Yanagida, T.; S ohmeie , D.; Spiel, C.; Yanagida, T.; S ohmeie , D. Dynamic Change o Agg essi e Beha io and Vic imiza ion Among Adolescen s: E ec i eness o he ViSC P og am. J. Clin. Child. Adolesc. Psychol. 2019,48, S90–S104. [C ossRe ] [PubMed] In . J. En i on. Res. Public Heal h 2024,21, 832 22 o 22 80. Yu dakul, Y.; Ayhan, A.B. The E ec o he Cybe bullying Awa eness P og am on Adolescen s’ Awa eness o Cybe bullying and Thei Coping Skills. Cu . Psychol. 2023,42, 24208–24222. [C ossRe ] [PubMed] 81. Hu son, E.; Kelly, S.; Mili ello, L.K. Sys ema ic Re iew o Cybe bullying In e en ions o You h and Pa en s wi h Implica ions o E idence-based P ac ice. Wo ld iews E id.-Based Nu s. 2018,15, 72–79. [C ossRe ] [PubMed] Disclaime /Publishe ’s No e: The s a emen s, opinions and da a con ained in all publica ions a e solely hose o he indi idual au ho (s) and con ibu o (s) and no o MDPI and/o he edi o (s). MDPI and/o he edi o (s) disclaim esponsibili y o any inju y o people o p ope y esul ing om any ideas, me hods, ins uc ions o p oduc s e e ed o in he con en .