Recent national attention to several cases of suicide among youth victims of cyberbullying 1,2 has raised concerns about its prevalence and psychological impact. Most states now have legislation in place that requires schools to address electronic harassment in their antibullying policies, 3 yet schools lack information about cyberbullying correlates and consequences and how they may differ from those of school bullying. To inform schools' efforts, research is needed that examines the overlap between cyberbullying and school bullying and identifies which youths are targeted with either or both types of bullying. It is also necessary to understand whether the psychological correlates of cyberbullying are similar to those of school bullying and whether students targeted with both forms of bullying are at increased risk of psychological harm.With reports indicating that 93% of teens are active users of the Internet and 75% own a cell phone, up from 45% in 2004,4 there is great potential for cyberbullying among youths. Yet the extent of cyberbullying victimization and its prevalence relative to school bullying is unclear. Studies have found that anywhere from 9% to 40% of students are victims of cyberbullying, 5---7 and most suggest that online victimization is less prevalent than are school bullying and other forms of offline victimization. 8,9 Strikingly few reports provide information on youths' involvements in bullying both online and on school property. Cyberbullying has several unique characteristics that distinguish it from school bullying. Electronic communications allow cyberbullying perpetrators to maintain anonymity and give them the capacity to post messages to a wide audience.10 In addition, perpetrators may feel reduced responsibility and accountability when online compared with face-to-face situations. 11,12 These features suggest that youths who may not be vulnerable to school bullying could, in fact, be targeted online through covert methods. The limited number of studies that address the overlap between school and cyberbullying victimization has wide variation in findings, indicating that anywhere from about one third to more than three quarters of youths bullied online are also bullied at school. In addition to comparing the sociodemographics of cyberbullying victims with those of school bullying victims, it is important to understand whether cyberbullying is linked with Objectives. Using data from a regional census of high school students, we have documented the prevalence of cyberbullying and school bullying victimization and their associations with psychological distress.Methods. In the fall of 2008, 20 406 ninth-through twelfth-grade students in MetroWest Massachusetts completed surveys assessing their bullying victimization and psychological distress, including depressive symptoms, self-injury, and suicidality.Results. A total of 15.8% of students reported cyberbullying and 25.9% reported school bullying in the past 12 months. A majority (59.7%) of cyberbullying victims were also school bully...