State of the art report on bullying at the workplace in the Nordic countries

State of the art report on

bullying at the workplace in

the Nordic countries

Åse Marie Hansen and the Nordic bullying network group

State of the art report on bullying at the workplace in the Nordic countries

TemaNord 2011:515

© Nordic Council of Ministers, Copenhagen 2011

ISBN 978-92-893-2203-4

This publication has been published with financial support by the Nordic Council of Ministers. But the contents of this publication do not necessarily reflect the views, policies or recommendations of the Nordic Council of Ministers.

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Content

Introduction to the project ... 13

Scope of the network... 13

1. Risk factors and antecedent of bullying at the workplace... 15

1.1 Risk factors in the working environment... 15

1.2 Leadership ... 15

1.3 Intrapersonal/individual risk factors... 20

1.4 Discussion on risk factor of bullying... 23

2. Health consequences of workplace bullying... 29

2.1 Depression and anxiety ... 30

2.2 Post-Traumatic Stress Disorder... 31

2.3 Sleep problems ... 31

2.4 Physiological reactions... 32

2.5 Sickness absence ... 32

2.6 Personality disorders ... 32

2.7 The long-term consequences ... 33

2.8 Other health consequences ... 34

2.9 Final conclusion on health effects ... 34

2.10 Future research ... 36

3. How is bullying prioritized in each of the Nordic countries in terms of legislation?.... 41

3.1 The European Framework Agreement on harassment and violence at work... 41

3.2 How is bullying prioritized in the Nordic countries?... 43

3.3 Discussion ... 51

4. Interventions for workplace bullying... 55

4.1 Policy ... 55

4.2 Organization/employer level interventions... 56

4.3 Workplace/group/task level interventions ... 57

4.4 Individual level interventions ... 60

4.4.1 Interventions in other European countries ... 60

4.5 Discussion and conclusion ... 60

4.5.1 Future interventions... 61

5. Ongoing studies in Sweden Appendix 1... 63

5.1 Bullying in the Workplace – An Evaluation of Processes and Results... 63

5.2 The bullying narrative –about co-production and production of the stories narrated by bullied. ... 64

5.3 Whistleblowing processes in Swedish public organizations – complaints and consequences... 66

7. Ongoing studies in Finland Appendix 3...69

7.1 “I wish I had...”: Target reflections on coping with workplace mistreatment (with Marie-Elène Roberge, Aino Salimäki, & Jennifer Berdahl)...69

7.2 Perceptions and conceptualisations of workplace bullying as a gendered phenomenon ...70

8. Ongoing studies in Denmark Appendix 4 ...71

8.1 A 3-year prospective study on bullying in Danish workplaces ...71

8.2. MODENA project...74

8.3 Rehabilitation of employees exposed to workplace bullying – an early intervention...75

8.4 Ongoing studies in Denmark...75

9. Litterature...79

Previous studies in Sweden Appendix 5 ...79

Previous studies in Norway Appendix 6 ...79

Previous studies in Iceland Appendix 7 ...84

Previous studies in Finland Appendix 8...85

Previous studies in Denmark Appendix 9 ...87

Foreword

Unfortunately, workplace bullying seems to flourish in all kinds of sectors and types of organisations. All Nordic countries have laws where the indi-vidual has the right to a safe working environment, requiring the employer to prevent bullying from occurring and to handle bullying firmly when a complaint is being made. Yet, research has shown that the security granted the individual worker by law is not necessarily enforced by employers or health and safety authorities in the respective countries.

This is the first Nordic report on the current scientific state of art of pre-vention activities regarding workplace bullying in the Nordic countries. Dur-ing the last 20 years the Nordic countries have been among the leadDur-ing ones regarding research on this important workplace stressor. Common features among the Nordic countries made it possible to eventually compare the Nor-dic countries’ national data on both measurements, risk factors, consequences and the prevention of bullying at the work place. Hence, after these first 20 years of pioneering research a Nordic bullying network consisting of the lead-ing research institutions in this field within the Nordic countries was estab-lished a few years ago with the aim to coordinate research efforts and existing knowledge combined with increased cross-national collaboration and fertiliza-tion in this field. Furthermore, the network aims to contribute to establishing a joint Nordic theoretical, empirical, conceptual and methodological platform for science and for the prevention of bullying at the workplace.

This report of the network concludes that in order to reduce the negative consequences workplace bullying may have on individuals and work places it is important for all organisations to implement anti-bullying policies by focussing on interventions at all levels: e.g. by improvement of the general psychosocial climate at work, the leadership practices, and the procedures for conflict management; by developing fair complaints procedures; and by developing counselling and therapeutic interventions for those already vic-timized at work.

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I welcome this first Nordic report on such an important aspect of our working lives which we need to bring out in the open and face directly with the most efficient preventive measures we have at our disposal. To this end, the establishment of the Nordic bullying network and the platform for the development of such preventive measures that it provides is very useful. I am confident that the efforts of the network could in the years to come pro-vide important contributions to reducing bullying at workplaces in the Nor-dic countries.

Halldór Ásgrímsson Secretary General

Preface

The project has been planned and carried out in the Nordic bullying network group consisting of the following research institutions and members:

Denmark: Annie Høgh, Associate professor Department of Psychology, University of Copenhagen Annie.Hogh@psy.ku.dk

Eva Gemzøe Mikkelsen,

researcher

CRECEA Horsens egemzoe@hotmail.com

Charlotte Bloch,

associate professor

Department of Sociology, University of Copenhagen

Charlotte.Bloch@sociology.ku.dk

Åse Marie Hansen,

senior researcher

National Research Centre for the Working Environment

aamh@nrcwe.dk

PhD students:

Carolina Magdalene Maier, Maria Gullander

University of Copenhagen

Tine Eriksen-Jensen University of Aarhus

Referents: Lilie Darsø, Louise Bang Olesen, Maj Wissing, Iris Olafsdottir Finland:

Maarit Vartia,

senior specialist

Finnish Institute of Occupational Health Centre of Expertise for Work Organizationsmaarit

vartia@ttl.fi

Denise Salin,

associate professor

Department: Management and Organi-sation, Hanken School of Economics

denise.salin@hanken.fi

Island:

Gudbjörg Linda Rafnsdóttir,

MA, Fil.dr, professor

University of Iceland glr@hi.is

Kristinn Tómasson,

Administration of

Occupational Safety and Health in Iceland kristinn@ver.is Norway: Ståle Einarsen, professor Faculty of Psychology, University of Bergen Stale.Einarsen@psysp.uib.no

Stig Berge Matthiesen,

professor Faculty of Psychology, University of Bergen stig@uib.no Anders Skogstad, professor Faculty of Psychology, University of Bergen anders.skogstad@psysp.uib.no Lars Glasø, associate professor Faculty of Psychology, University of Bergen Lars.glaso@psysp.uib.no PhD students:

Lars Johan Hauge, Morten Birkeland Nielsen, Brita Bjørkelo,

Guy Notelars, Tina Løkke Vie

all University of Bergen.

Sweden:

Margaretha Strandmark,

professor

University of Karlstad Margaretha.strandmark@kau.se

Lillemor Hallberg,

professor

Department of Health and Society, Halmstad University

lillemor.hallberg@hos.hh.se

Ph.D students:

Louise Svensson Helena Blomberg

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This state-of-the-art report is a product of the contributions and discussion that took place at four meetings in the network group during 2008–2010.

Summary

This report gives a state-of-the-art on workplace bullying in the Nordic countries and is based on a summary of previous peer-reviewed papers, the presentations at the workshop, and the discussions at the meetings. An in-troductory meeting was held in April 2008 for the Network members. We decided to conduct workshops with the following topics:

 Risk factors of workplace bullying (November 2008).  Health consequences of workplace bullying (June 2009).  How is bullying prioritized in each country (June 2009).  How much information is available?

 Intervention studies and prevention of bullying at the workplace (September 2010).

At each workshop the participants were asked to prepare an abstract and give a presentation. State-of-the-art on workplace bullying is based on papers from the participants or institutions included in the network. The articles on the list are written in English, Norwegian, Swedish or Danish. Previous and on-going research activities are included in appendixes 1–10 which include peer- re-viewed papers, book chapters and magazine articles. Further a total of 10 PhD students attended the meetings and presented their projects.

Risk factors

Workplace bulling seems to flourish in all kinds of sectors and types of or-ganisations. Stressful and poorly organized work environments as well as deficiencies in leadership may, however, facilitate work-related bullying either directly or by creating a negative work climate. Working under ad-verse physical or mental conditions are stressors that are likely to cause or result in an increased sense of stress or a nervous feeling among those ex-posed leading to both increased aggressiveness and vulnerability. It is im-portant to recognize that the psychosocial working environment changes over time. Hence, it was discussed how often screening of the psychosocial working environment may be carried out to detect bullying or its risk factors at the workplace.

Health consequences

A vast amount of evidence exists regarding the negative consequences bul-lying may have on those targeted. The most robust finding for the psycho-logical consequences of bullying at work is that it is a risk factor of

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ing depression. Other observed outcomes are burn-out, anxiety and nervous-ness, reduced job satisfaction and reduced general well-being. Regarding the physical consequences, the most consistent consequences associated with bullying at work are cardiovascular disease and fibromyalgia. In addition to these, a number of factors may be of importance. The bully victims experi-ence feelings of guilt, shame, and diminished self-esteem.

Legislation

An important insight from the overall discussion of the phenomenon of bul-lying revealed that legally, bulbul-lying is viewed somewhat differently in the different Nordic countries. However, all the Nordic countries have enacted legislation and guidance for handling workplace bullying. All countries seem to have a law where the individual has the right to a safe working envi-ronment, requiring the employer to prevent bullying from occurring and to handle bullying firmly when a complaint is being made. Yet, research has shown that the security granted the individual worker by law is not necessar-ily enforced by employers or health and safety authorities in the respective countries.

Prevention of bullying

The regulations against bullying aim to motivate initiatives against bullying in organizations and the introduction of local organizational anti-bullying policies and guidelines. A distinction is commonly made between primary, secondary and tertiary intervention on the one hand, and between policy, organization/employer, workplace/group/task and individual levels on the other hand. Some workplaces do have anti-bullying policies including pro-cedures for prevention and management of harassment. Yet, this is not yet fully enforced in the different countries. However, it is important for all organisations to implement anti-bullying policies, by focussing on both pri-mary intervention (e.g. improvement of the general psychosocial climate at work, improved leadership practices, and improved procedures for conflict management), secondary intervention (e.g. by developing fair complaints procedures), and tertiary level of intervention (e.g. by developing counsel-ling and therapeutic interventions for those already victimized at work).

Introduction to the project

A number of studies stress that bullying at the workplace has severe conse-quences, both for the organisation, those targeted as well as for employees being bystanders. Bullying at work, according to most definitions, takes place when someone, repeatedly over a longer period of time (usually 6 months), is exposed to negative acts from one or several others, in a situa-tion where he or she for different reasons may have difficulties defending him- or herself against these actions. Bullying may take different forms. Yet, also single incidents or shorter intermezzos of harassment and inappropriate behaviour at work may create stress and inefficiency at work, as well as being explicitly forbidden by law (e.g. in Norway). Direct bullying is ag-gressive acts that are aimed directly at the target, as for example teasing, scolding, spreading rumours, and threats. Indirect bullying may take the form of social isolation or withdrawal of necessary information. This social process of bullying is described as being rejected and ostracised at or even from the workplace. Repeated slander, deceit, insults and unjust treatment seem in the worst cases to lead up to a rejection and expulsion of the target of bullying. Bullying may be work-related in its nature (e.g. acts that make it difficult for the target to do his/her work) or personal in nature (e.g. offend-ing teasoffend-ing, rumours, slander, or sexual harassment) (1).

Research on bullying at work started in the 1980s in Sweden and soon spread to both Finland and Norway, with Denmark and Iceland catching up during the late 1990s. During the last 20 years the Nordic countries have been among the leading ones regarding research on this important workplace stressor. Common features among the Nordic countries make it possible to coordinate data on both measurement, risk factors, consequences and the pre-vention of bullying at the workplace. Hence, a coordination of research efforts and existing knowledge combined with increased cross-national collaboration and fertilization in this field was important after these first 20 years of pio-neering research. This report describes the activities of a Nordic network in this field, as well as summarising the current scientific state of art. In addition, the report and its content may be an example of how collaboration in a Nordic network can develop this kind of knowledge-base within an emerging re-search field.

Scope of the network

The overall purpose of the network is to get an overview of the knowledge on bullying at the workplace in the Nordic countries. Further the network aims to contribute to establish a joint Nordic theoretical, empirical,

concep-State of the art report on bullying at the workplace in the Nordic countries

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tual and methodological platform for science and for the prevention of bul-lying at the workplace.

In addition to the overall aims described above, the specific aims of the project were:

 To establish a Nordic scientific network on bullying at the workplace including scientific workshops and seminars.

 To prepare a Nordic “state of the art” report on the current research activities in the Nordic countries on bullying at the workplace.  To prepare a Nordic “state of the art” report on the current

international research and activities in the Nordic countries on prevention of bullying at the workplace (intervention studies).  To improve the knowledge on qualitative and quantitative scientific

methods across the area.

 To make an overview of laws and regulations concerning bullying at the workplace and how these laws and regulations are enforced  To draw on the experience in the field between the qualitative and

quantitative scientific methods.

 To produce a pamphlet covering the main findings and the future perspectives. The target group of the pamphlet is practitioners and political decision makers.

 Establish a platform for holding visits of PhD students from the participating institutions.

1. Risk factors and antecedent of

bullying at the workplace

Fifteen studies concerning risk factors and antecedents of bullying at the workplace were identified by the network members. Seven studies addressed poor leadership (2–8), three studies addressed personality (9–11), and 5 studies addressed gender and age (12–16). Two of these studies were quali-tative studies.

1.1 Risk factors in the working environment

Stressful and poorly organized work environments as well as deficiencies in leadership may facilitate work-related bullying either directly or by creating a work climate in which bullying can flourish (3;17–21). Studies have shown that bullying is more frequent in organisations with a negative psy-chosocial work environment characterised by a negative social climate, many conflicts, a low level of information and control, a high level of role ambiguity and role conflicts (22). When workplace stressors and interper-sonal problems are not dealt with, they may escalate into bullying, resulting in high levels of psychological distress among those involved and even among those observing the bullying (6). A total of 17 studies concerning risk factors and antecedents of bullying at the workplace were identified. Five of these studies addressed poor leadership (2;3;6;8;12) and manage-ment style (8), six studies addressed organizational climate (4;15;21;23) or organizational changes (5;7), two studies addressed conflicts at work (24) (22), two studies addressed personality (9;10) and two studies addressed gender and bullying at the workplace (13;14). Fifteen studies were cross-sectional studies. Due to the fact that most/all studies are cross-cross-sectional, it is not possible to determine the direction of cause and effect, if bullying is a consequence of factors in the psychosocial work environment or if a poor psychosocial working environment promotes bullying. Further, longitudinal studies showed that previous bullying is a risk factor for bullying (22;23).

1.2 Leadership

The management style may directly or indirectly contribute to a higher level of bullying (8;22). Work-related harassment is most strongly connected with dissatisfaction with supervisors and leaders, while personal derogation and social exclusion correlate most strongly with dissatisfaction with co-worker

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interaction (12). The relationships between leaders and subordinates are strongly marked by affective experiences during interaction such as moods, emotions and emotion-laden judgement. Four similar emotional factors are revealed for subordinates and leaders, labelled recognition, frustration, vio-lation, and uncertainty. These factors seem to be specific to leader-subordinate relationships and to remain stable across positions, gender, and the public and private sectors, as well as occurring in both positive and negative relationship (2). Hence, violation that is the resentment from inter-action with others (such as feelings of mistreatment and harassment) is an emotional factor in all leader-subordinate relationships. Hence, both parties in this dyad are predisposed to react to negative behaviours by the other. Research has also documented how some leaders, supervisors and managers behave in a destructive manner, be it towards their subordinates, towards the organisation itself, or towards both (25–28). Strong associations have been found between exposure to destructive leadership and impaired health and well-being among subordinates (6;29;30). Hence, destructive leadership is a risk factor in the psychosocial work environment.

Destructive leadership can be defined as; “the illegal, or repeated behav-iour by a leader, supervisor or manager that violate the legitimate interest of the organisation by undermining and/or sabotaging the organisation’s goals, tasks, resources, and effectiveness and/or the motivation, well-being or job satisfaction of his/her subordinates.” (26).

Fig 1. A model of destructive and constructive leadership

From Einarsen et al, 2007, p. 211. (26).

Generally, leadership research focuses only on effective and constructive aspects of leadership, neglecting the fact that leaders may also misbehave. Research conducted by members of our network has therefore made impor-tant contributions to nuance the picture of leaders normally portrayed in the scholarly literature. In a model of destructive and constructive leadership

State of the art report on bullying at the workplace in the Nordic countries 17

(26),four types of destructive leadership are defined and included (Fig 1). The four groups of leadership behaviours include active (tyrannical, de-railed, and supportive-disloyal) as well as passive forms (laissez-faire) of destructive leadership behaviours. Further, two of them consist of construc-tive as well as destrucconstruc-tive elements. That is, tyrannical leadership is anti-subordinate as well as pro-organizational, while supportive-disloyal leader-ship is pro-subordinate as well as anti-organizational. Hence, leaders may be both “good” and “bad” at the same time, making it difficult for the organi-sation and its management to intervene in case of e.g. bullying. Leaders may also face dilemmas of doing important things for the organisation while simultaneously mistreating their subordinates.

In relationship to workplace bullying, both Laissez-faire leadership and tyrannical and derailed leadership are known risk factors documented in many studies. Yet, one study showed how witnesses perceived autocratic leadership to be the risk, employees exposed to bullying themselves report that non-contingent leadership is the biggest risk, i.e. leadership practices where the leaders act in an inconsistent manner punishing subordinates in an arbitrary manner. High levels of laissez-faire leadership are associated with high levels of workplace stressors, hence possible being a root factor for bullying. Studies have also shown how laissez-faire leadership increases the negative relationship between role stressors and bullying, hence being a moderator of the stressor-bullying relationship.

As regards potential precursors of destructive leadership behaviours, there is a lack of studies regarding situational factors. In the light of studies con-cerning precursors of counterproductive work behaviours (cf., (31)) there are more good candidates, such as role stressors, organizational injustice and lack of autonomy and participative decision making. These should be investigated in relation to destructive leadership among leaders in prospective studies.

Studies of destructive leadership behaviours belong to a rather new re-search field containing many important rere-search questions, and methodo-logical issues are still to be addressed. Among them are how strong impact components of destructive leadership behaviour can have on health com-pared to other factors such as role stressors and social climate (6)? 1.2.1 Conflicts and power struggle in the workplace

As noted above, a stressful and poorly organized work environment as well as deficiencies in leadership may facilitate work-related bullying either di-rectly or by creating a work climate in which bullying can flourish. In addi-tion, a poor psychosocial working environment may contribute to role con-flicts and interpersonal concon-flicts which are both strongly associated with bullying if unresolved (22;32). Overall, conflicts with the supervisor have the highest association with reports of workplace bullying. Long-standing struggles for power can precede systematic bullying at the workplace. These power struggles may emanate from conflicting values at the workplace

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caused by the interplay between poor organisational conditions, weak or indistinct leadership and the involved parties’ personalities and work-related expectations(24).

An un-published PhD study aimed to identify and discuss expressions of relationship conflict at work in two different organisations. Preliminary results show that a number of expressions can be linked to intergroup conflicts at work. These were a wish for involvement in the solution of conflicts, a non-confronting approach to conflict solution, emotions that “take over”, hidden or indirect communication and slander. The study also indicated that some of these expressions may be antecedents to workplace bullying. Placing the find-ings in a micro sociological framework inspired by Goffman (33), the study argued that employees who experience relationship conflicts at work found themselves in roles they did not approve of themselves. Therefore they seek moral redress in order to save their faces (34), again showing what a range of quantitative studies have shown; a strong association between reports of role stressors and exposure as well as enactment of workplace bullying.

1.2.2 The organization/ the environment/ the structure

In addition to risk factors of bullying at work found in the psychological work environment and the organizational climate of the organisation, bully-ing also seems to flourish in hectic and competitive environments, where employees are willing to sabotage the work performance of colleagues and to expel unwanted colleagues and subordinates in order to improve their own position (35). Workplace bullying may in some cases be a form of or-ganisational politics, i.e. a deliberate, competitive strategy from the perspec-tive of the individual perpetrator. Globalisation, increased pressures for effi-ciency, and restructuring, contributes to increased internal competition, and may potentially lead to more bullying (4). In general, victims of bullying report that envy, a weak superior, competition for tasks or advancement, and competition for the supervisor’s favour and approval are the most common reasons for bullying. The results concerning the communication climate demonstrate the importance of discussions, listening, and tolerance (7) for preventing bullying. To gain a broader understanding, bullying factors out-side the organization must also be taken into conout-sideration. An examination of societal forces and changes that enable, motivate and trigger bullying is thus an important venue for further research in the area.

Workplace bullying within the organization may also be associated with the structures and processes in the work environment. Salin (2008) identified three groups, i.e. enabling structures or necessary antecedents (e.g. perceived power imbalances, low perceived costs, and dissatisfaction and frustration), motivating structures or incentives (e.g. internal competition, reward systems, and expected benefits), and precipitating processes or triggering circum-stances (e.g. downsizing and restructuring, organisational changes, changes in the composition of the workgroup). The authors concluded that bullying often

State of the art report on bullying at the workplace in the Nordic countries 19

occurred in an interaction between structures and processes from all three groupings (36)(fig 2).

Fig. 2. Disenabling factors acting as a filter in the working environment.

From Salin, 2008, p. 223 (37).

1.2.3 Whistleblowing and power struggle

Whistleblowing is when a former or current employee discloses misconduct that is under his/her employers control to someone that may be able to do something about it (38). According to power theory, whistleblowing may be seen as a potential power struggle in which the dominant coalition accept or turn down the employees initiative by either terminating the wrongdoing, or balancing the power struggle by retaliating against the whistleblower (39). Exposure to bullying behaviours after whistleblowing may function as an organization’s way to sanction an employee, to punish the person, but also to send out a warning signal to the surroundings. However, in line with Hirsch-man’s notion of voice (1970) in his voice-exit model, reporting behaviour may also be a reaction to problematic events at work, such as bullying behav-iours. Thus, the association may be turned around; bullying behaviours may also function as an antecedent of whistleblowing (40). Studies have shown that whistleblowing is related to bullying at work (41) and that retaliation after whistleblowing can develop into workplace bullying (42). One of the most common reasons for reporting wrongdoing at work is the bullying of a colleague at work (41).

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1.3 Intrapersonal/individual risk factors

Leymann claimed that there is no association between workplace bullying and personality (20;43). An empirical study (44) also showed that there is no such thing as a general victim personality profile indicating vulnerability, at least when measured among employees that previously have been bullied at work and who are still working. Other studies on the personalities and emo-tional stability of persons who previously have been bullied at work have, however, shown that they as a group report higher scores on neuroticism, irritability (aggressiveness dimension) as well as impulsiveness (extraver-sion dimen(extraver-sion), when compared to their non-bullied work colleagues. These characteristics can illustrate a self-image dominated by mistrust and embitterment as well as irritability and impulsiveness (44). Glasø et al. (9), however, found that the major part of the victims is quite like non-victims as far as personality is concerned. However, in the study of Glasø et al., one-third of the victims tended to be more neurotic and less agreeable, conscien-tious and extravert than non-victims. Further, emotional instability and in-troversion are associated with exposure to bullying as measured by the Negative Acts Questionnaire. Hence, the findings of the study confirm the notion that personality should not be neglected being an important factor in understanding the bullying phenomenon. Yet, personality does not easily differentiate targets from non-targets. The authors conclude that the main focus when intervening in order to prevent bullying in organizations must be on organizational factors more than on the personality of victims. A qualita-tive study (24) also showed that extra vulnerable as well as extra qualified persons make targets of workplace bullying. Accordingly, everybody can probably be bullied.

Taken together, these research findings may indicate that employees that have been bullied at work may become more neurotic and introvert than other employees as a consequence of bullying. However, we lack longitudi-nal studies to establish the direction of these relationships. It may be the case that different personality traits provoke different types of bullying. In order to prevent bullying in organizations, the main focus when intervening must be on organizational factors more than on the personality of victims (9). 1.3.2 Demographic risk factors

Some demographical risk factors for bullying seem to exist, although bully-ing can be directed at all kinds of employees in all kinds of organisations. A representative study from Norway showed very few such risk factors. A strong correlation between age and work-related harassment was, however, found in one study (12) where younger workers experienced more bullying behaviours.

State of the art report on bullying at the workplace in the Nordic countries 21

Gender is also important when you discuss the relation between the per-petrator and the bullied – woman to woman, man to man, man to woman, or woman to man (45). For instance, the persons bullying female officers are usually co-workers, whereas men are bullied by co-workers and supervisors equally often. Unsatisfactory features of work and poor social climate were, however, significant predictors of bullying among both men and women. Bullying had also similar effects on the feelings of stress, mental health, and job satisfaction of both men and women (16). Furthermore, the culture at typically female or male dominated workplaces seems to be an antecedent to workplace bullying. Among employees working with things (male-dominated occupations) or with clients/patients (female-(male-dominated occupa-tions), there is a higher prevalence of bullying than among employees work-ing with symbols or customers. One example of this is a study suggestwork-ing that types of work and gender ratio are risk factors in the onset of workplace bullying (46). Further, belonging to a gender minority has been shown to be a risk factor for exposure to bullying at work. In one study, male assistant nurses were for instance more often exposed to bullying at work than their female colleagues (13).

A recent study focussed on gender differences among highly educated pro-fessionals. Approx. 8.8% of the respondents classified themselves as bullied and the respondents reported high levels of work-related negative acts. There are significant differences in self-labelling between men and women. Men and women also provided different explanations for bullying while men empha-size the role of the victim and women emphaempha-size the role of the perpetrator or group processes. In addition, there is a positive relationship between organiza-tional politics and bullying. The stories written by observers of bullying also showed that bullying was sometimes seen as a deliberate attempt to get rid of unwanted people, e.g. employees who were considered as threats or a burden (37). Further, organizational changes and the diversity of the work force were directly related to exposure to bullying (5).

Highly educated employees seem to have a lower risk than lower edu-cated employees. Further, employees working in the food industry and the manufacturing industry are more at risk than employees in the service indus-try (47). These results were supported by a study of Ortega (46), which shows that unskilled workers also report the highest prevalence of bullying, while managers/supervisors reported the lowest prevalence (46).

Being an immigrant, especially of Non-western origin, also poses a higher risk of bullying at work, as shown by a Danish study of health-care workers (48).

The risks are everywhere. Individual risk factors may be irrelevant as bullying takes place everywhere. Bullying may be a part of being part of a group. A high exposure rate is not necessarily a sign of victimisation. Health care workers experience a lot of aggression from clients and patients but not always bullying. Some bullied persons can have a healthy life after having

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experienced bullying. However, this is not the case for all bullied. It is all about the coping strategy which is why research is needed in this area. 1.3.3 Self-labelling of bullying

What about self-labelling of bullying? The presentation of a definition of bullying before answering a questionnaire has a large impact of the number of reported incidents of bullying. In fact you get the lowest prevalence of bullying if you ask with a definition (49). Over exposure of workplace bul-lying can create so much focus on bulbul-lying, that people start feeling bullied even though this is not the case. So how do we handle passing along infor-mation on workplace bullying without making it a risk factor.

Different measurement procedures can also influence on the identifica-tion of demographical risk groups in survey research on workplace bullying. The results from a study of 2,539 Norwegian employees, demographical risk groups were assessed with four different method (self-labelling, behavioural experiences with operational criterion (50), behavioural experiences with latent class cluster analysis, and behavioural experiences measured as a con-tinuous variable (51)). The results showed that the self-labelling approach identified one risk group variable, whereas five risk group variables were identified with the continuous variable approach. Using the cluster ap-proach, four risk group variables were identified, whereas three such vari-ables were found with the operational criterion method. The authors con-cluded that the number of risk groups identified in survey research on work-place bullying is heavily dependent on the measurement procedure utilised.

Can the bullied victims benefit from being bullied? Sometimes the bul-lied person can benefit by labelling him- or herself as bulbul-lied, but it depends on how far along the bullying process is, because the personal consequences of bullying are so severe. This is one of the reasons why we need to investi-gate the impact of self-labelling more thoroughly in the future.

1.3.4 Previous experience of bullying at college and during training Some empirical findings indicate that persons who were victimized at school are more likely to be victimized in the workplace (10). This indicates that previous experience of bullying at college and during training can influence later exposure to bullying at work. Since bullying at work by definition is characterised by repeated exposure to negative behaviour, which is often detrimental to the health and well-being of the target, a reasonable assump-tion might be that having been exposed to bullying earlier in life increases the risk of future exposure. A Danish study among health care workers aimed to test whether previous bullying increased the risk of bullying during the first year after finishing college (52). It was found that previous expo-sure to bullying constitutes a risk of future bullying. However, the magni-tude of the risk depends on when the previous bullying took place (48).

State of the art report on bullying at the workplace in the Nordic countries 23

Thus, there is a very high risk of being exposed to bullying in the first job after finishing college among those who had been bullied during their edu-cation. This suggests that preventive measures should be included in the school programme. Another study indicates that persons who were victim-ized at school are more likely to be victimvictim-ized in the workplace (10). 1.3.5 Stress as a risk factor

A longitudinal study from Finland investigated whether susceptibility to workplace bullying is associated with psychological distress. The results showed that employees high on psychological distress had a higher risk of becoming bullied compared with those with a low level of psychological distress. The odds ratio of high psychological distress was 1.93 (95% CI 1.46 to 2.56) adjusted for gender. The study suggests that psychological distress can sometimes make an employee susceptible to bullying at work (7). A longitudinal study from Iceland showed that bullying at work has adverse effects on psychological health. Interestingly, the study shows that a reverse causal relationship is also possible, i.e. depressed individuals may be at higher risk than non-depressed individuals to be exposed to bullying at work. This implies that individual factors must be taken into account, along with environmental factors, when efforts are made to prevent bullying at work (23).

1.4 Discussion on risk factor of bullying

As described above, stressful and poorly organized work environments as well as deficiencies in leadership may facilitate work-related bullying either directly or by creating a negative work climate. Working under adverse physical or mental conditions is a stressor that is likely to cause or result in an increased sense of stress or a nervous feeling among those exposed. It is important to recognize that the psychosocial working environment changes over time. Hence, it was discussed how often screening of the psychosocial working environment may be carried out to detect bullying at the workplace. Leadership for instance changes over time. It should therefore be considered what the optimal interval for measuring leadership behaviours at work is.

Topics that were mentioned to be of great value to focus on were factors that may facilitate bullying:

 Leadership (which probably differs between cultures).

 Conflicts, not handling of conflicts, and climate for handling conflicts  Power struggle

 Whistleblowing

State of the art report on bullying at the workplace in the Nordic countries

24

If you make a distinction between targets and victims of bullying and com-pare them to the people that never experience any bullying, some risk fac-tors will occur. But if you take the complex work environment into account, other demographic risk factors will disappear. One factor alone is not a risk factor, several events or factors have to be present at the same time; often being a combination of a troublesome working environment and lack of appropriate leadership practices, combined with a culture that directly of indirectly rewards or at least accepts bullying.

Few demographic factors and personality profiles are systematically as-sociated with bullying at work, at least when measured at one point in time. However, age, gender, marital status can be risk factors in some instances.

The research field mainly consists of cross-sectional studies which may be a weakness for the results. Therefore, more longitudinal studies should be performed in the future.

Table 1. Stu d ies on risk fact ors and a n tec e de nt s to bull y ing a n d to w h at exten t w o rk cultures p romo te b u ll y ing Ref Stud y design* and pu rpose Number of part icipan ts (m en/ w o m en) M easure s and analy s is R e sult s Discuss ion/conc lusi on (as st at ed in t h e art ic le, no o w n comment s or idea s) (8)

C & QUAN To inv

e stiga te r e lati onship s betw een bully ing and o ther p s y c hoso c ial w o rk env ironment fa ctor s w ithin a p a rti c ular organiza tion al se tti ng. 186 blue -coll a r ( 1 4 0 men and 46 w omen) ANOVA an d Chi-sq uare w e re used to ex ami ne associa tion s betw een bully ing, psy c ho social fac tor s. Signifi can t d ifferen ces i n bul lied and no n-bullied employ ees’ rati ngs of p s y c hoso c ial factors su ch as j ob con trol , man agement sty le, role clari ty , s o cial c limat e, s o cial c onta c t an d w o rk cen tral ity .

The results did

not prov ide suppor t for the hy pothesi s that a genera lly poor p s y c hoso c ial w o rk env ironment crea

tes the cond

itio ns for bully ing. Non ethele s s, they do sugge st that ma nagement sty le may directly or indirectly hav e contributed to a highe r l e v e l of bully ing. (12) C & QUAN An ex ploratory and descrip tiv e inv e sti-gation of the prev alence and sev e rity of harassment among men. Resp onden ts w e re introdu ced to a de finiti on o f bully -ing. 460 male indu strial w o rkers, superv isor s and manage rs. A prin cipal compon ent analy s is w ith v a rimax rota tion, Cronba ch’ s al pha, Pearson s produ ct-m oment correla tion s. On a w eekly or dail y basis, 6 .7% (n=3 1) o f the men had been su bj ecte d to one or mor e of the behav iours o f pe rsonal der ogati on. The stronge st corre lation w a s found be tw een age and w o rk-rela ted hara s sment, w h ich sug-gests th at y ounger men ex perience more v ic-timiza tion than o lde r men. Men ex periencing h arassment a t w ork report low ered ov

erall job sati

sfacti on. W o rk-related h a rassment i s most stron g ly conn ecte d w ith d issa tisfacti on w ith superv isor s and lea ders, w h ile per sona l deroga tion and soci al ex clu s io n co rrela ted most strongly w ith dissati s faction w ith co-w orker inte ractio n. Thi s may indica te tha t sup e rvisor s a nd collea gue s u s e di ffer ent means of hara s sment. (2) C & QUAN To ex plore the emo tion s , mood s an d emotion-lad en ju dg ements that lead er s and subordin a te s e x perience during intera ction. 270 leade rs and 54 2 subordin a te s (36% men and 64 % w o men). Frequency analy s is, correl a -tion analy s is, an d a prin cipal componen t a naly s is w e re perform ed on th e d a ta. The rela tion ship s b e tw een leader s a n d sub o rdi-nate s ar e strongly marked by affe ctiv e ex peri-ence s . The affe cts tha t sco red low e st among b o th subordin a te s and le aders carried stron g per-sonal or nega tiv e connota tion s , such a s “j eal-ousy ”, “ full of ha tre d ” or “hara s sed” . Leadership i s an e m otionally char ged proce s s. Four similar emotio nal fa cto rs w e re rev ealed for subordi -nate s an d lea der s, l abelled r e co gniti on, fru s tra tion, v iolation and uncertainty , and co nsi s tin g of emo tion s , moods and emo tio n-laden j udgemen ts. These fa ctor s seem to be spe c if ic to l eade r-subordin ate relationships and to r emain stabl e across po sitio ns, gender, and the public and priv ate secto rs, as w e ll as o ccu rring in both posi tiv e and nega ti v e relationships. (3)

C & QUAN To inv

e stiga te the i m portan c e of a broad spe c trum o f str e ssor s at w o rk in conne cti on w ith different measures o f w o rkplace b u lly ing. 2539 re spond ents. 48% men and 52% w omen. Data screening was per-formed follo wi ng the recom-mendati ons of Taba chnick and Fid e ll (2 007). All bully ing mea s ur es w e re found to co rrelate signi ficantly w ith th e w o rk env ironment v a ri-ables. The ov erall stronge st correla te s w e re found fo r ty rannical leader ship , laisse z-faire leadersh ip, in terper sonal co nfli cts, and role conflict.

The results sub

s tan tiate that bully ing a t w o rk a ffe cts much l a rger w o rkin g popula tion s than those dire ctly ex posed to it. By sta nders to bully ing re ported their w o rk env ironment a s be ing nearly as stressful a s employ ees dire ctly ex posed to bully ing, he nce v a lidat-ing the r epor ts mad e by targe ts. (6) C & QUAN To te st the as sum p tion tha t lais se z-fair e leadersh ip b ehav iour i s no t a ty pe of zero-le ader ship, bu t a ty pe o f de stru c-tiv e leadership b e h a v iour that show s sy stemati c rela tion ship s w ith w o rkpla c e str e ssor s, bully ing at w o rk, an d p s y c ho-logical di str e ss. 2273 Norw egian employ ees. 50 % m en and 50% w o men. Correlation analy s e s an d partial correla tion s w e re ex ecuted. W L S w a s u s ed due to s u bs ta nt ia l d e v ia ti on s f ro m normality . The mean w a s 0.5 2 , r e fle c ting the fact tha t the majority of w o rkers ex perienced a low lev e l of laissez-fair e le ader ship . The stronge st corre lation w a s found be tw een laissez-fair e le ader ship and bully ing. H igh lev e ls of la isse z-faire lead ership w e re asso ci ated w ith high lev e ls o f w o rk plac e st ress ors. W hen w o rkpla c e stressor s and in terpe rsonal probl ems are no t dealt w ith, they ma y escala te i n to bully ing, resul ting in high levels of p s y c hological distre ss amon g those inv o lv ed and ev en among tho s e observ ing th e bully ing.

Ref Stud y design* and pu rpose Number of part icipan ts (m en/ w o m en) M easure s and analy s is R e sult s Discuss ion/conc lusi on (as st at ed in t h e art ic le, no o w n comment s or idea s) (11)

C & QUAL To inv

e stiga te the manner in w h ich bully ing is i n itia ted at w o rkpla c e s i n th e public serv ice secto r in order to facilita te w o rkplace b u lly ing prev ention. 22 in form an ts ; (7 men/15 w omen) Grounded th eory methodol-ogy Four ca tego ries ge nerated from the da ta: “po-tenti a l a rena for co nfli cts” , “p erso nal strength or v u lnerability ”, “professional and per so nal v a lue conflicts” a nd “ s trug gling for pow er” as the core cate gory . A long-standing str uggle for pow er pre c ede s sy stem-atic bully ing a t the w o rkplace i n the pu blic se ctor. The pow er strug g le emanate s from con fli cting v a lues a t the w o rkplace cau s ed by the in terplay betw een poor organisa tion al cond ition s , w eak or indi stinct leader ship and the i nv ol v ed partie s ’ p erso nalities and w ork-related ex pecta tion s. (4)

C & QUAN To empirically

test that ther e i s in fa ct a relation ship be tw een a high degree of perceiv ed organi sa tional pol iti c s and th e occurren c e of bully ing. Re spond ents w e re presen ted to a de finiti on o f bully -ing. 385 bu sine ss pro fe s -sional s 57.3 % w o men and 42 .7% men. Percep tion s of Poli tics Scale (PO PS): Cro nbach’ s alpha w a s 0 .88 , Sp earman correla tion coef fi cie n ts W o rk pla c e bully ing can in some ca se s be a form of o rgani sati onal po liti c s, i .e ., a deliber ate, competitiv e stra teg y from the per spe c ti v e of th e indiv

idual perpetrator. The

finding s imply that globalisation , incre a sed pre ssu res for effi cien cy , and re structurin g, contribu te to in crea sed in ter-nal competi tion , an d may lead to more bully ing. Bully ing seems to fl ourish in he cti c and compe ti tiv e env ironments, w here employ ees ar e w illing to sabo -tage the w o rk pe rfo rmance of colleagu es a nd to ex pel unw anted co lleagu es a nd subor dina te s in ord e r to improv e their ow n p o sition. (15) C, QUAN & QUA L To describe the pre v alence of bully ing ex perienced by business p rofe s sional s and to fur ther the u nderstanding o f bully ing. Respon de nts w e re pre s en ted to a de fini tion of bul ly ing. 385 bu sine ss pro fe s -sional s(42 .7% men/57.3% w o men). Percep tion s of Poli tics Scale (PO PS): Cro nbach’ s alpha w a s 0 .88 , N’ Viv o sof tw a re 8.8% of the resp on dents re ported tha t they had been bull ied d u ring the past 12 mon th s . 30 .4% reported that they had ob serv ed bully ing in thei r ow n w o rkplace . 11.6% o f the w ome n as compared to 5 % o f the men cl assi fied the m selv es a s bei ng b u llied. Bully ing is a w idesp read and v isible pro b lem among highly educa ted p ro fessiona ls. Men an d w omen prov ide diffe rent ex planation s fo r bul ly ing, w ith men emphasi z ing the rol e of the v ictim and w omen empha-sizing the role of th e perpe tra tor or gro up pro c e sse s. The study indica te s a p o si tiv e relati onship be tw een organiza tion al po liti c s and bully ing. (7)

C & QUAN To identify

the w o rk-related ri sks o f bully ing in th e p s y c hologica l w o rk env ironment and th e organi za tional climate . Respo nde nts w e re pre s en ted to a de fini tion of bul ly ing. 949 publi c employ ees. (85% w omen and 15% men) . Pearson s Produ ct-m oment Correlation s, Mul tip le Regression Analy s is 10.1% felt bullied . Gender and age d id no t ex plain bully ing. The v ictims o f bul ly ing fel t tha t envy , a w eak su per ior, compe ti tion for tasks o r adv ancement, and competition for the superv i-sor’ s fav our and ap prov al w e re the mo st com-mon rea s on s for bu lly ing. Risk fa ctor s o f bully ing a t w o rk can be found in the psy c hological w o rk env ironment and or ganiza tional climate .

The results con

c er ning the communi cation clima te demonstrate the importan c e of di scussions, li stening , and toleran c e . (5)

C & QUAN Direct a

s w e ll a s i n direct r e lati onsh ips betw een organi za ti onal change s and ex posure to bully ing at w o rk a re inv e sti-gated . 2408 employ ees (4 8% men/52% w omen) Frequencie s analy s es, des crip tiv e sta ti s ti c s , reli-ability analy s es, cor relation analy s es, ANOVA , ex plora-tory factor analy s is and regression analy s is w e re condu cted. Differe nt organi za ti onal change s are p o sitiv e ly associa ted w ith ex posure to task-r elate d and person-related w o rkpla c e b u lly ing, an d th at being ex posed to m o re orga niza tiona l changes increa se s the li kelih ood o f be ing ex posed to bully

ing. The rel

a tio n ship s a re stronge st be -tw een organi zati on al change s a nd ta sk-rela ted bully ing. The find ings o f the presen t study indicate tha t organ-izational cha nges a re dire ctly related to ex posure to bully ing, and tha t changes in w o rk tasks and the compo s ition o f the w o rk for c e esp e cial ly influence bully ing.

Ref Stud y design* and pu rpose Number of part icipan ts (m en/ w o m en) M easure s and analy s is R e sult s Discuss ion/conc lusi on (as st at ed in t h e art ic le, no o w n comment s or idea s) (9) C & QUAN To ex amine differe n ce s in per sonal ity betw een a gr oup of bullied v ictims and a non-bu llied group . Re sponden ts w e re introdu ced to a de fi nition of bully ing. 72 bulli ed (21 m en/ 51 wom en) and 72 r e fe r-ences (21 men/51 wo men), w ith adm ini-stration/e x ecuti v e or healthcare work. Frequency analy s is, t-test, univ ariate analy s is of v a riance, Tw oStep clu s ter analy s is, and co rrel a tion analy s is. Emotional in sta b ility and introv ersion seem to be associa ted w ith ex posure to bully ing be hav iour. T w o differen t pe rso nality group s amon g th e v ictims: Cluster 2 ( 36%) di ffered si gnifican tly from the co ntro l gro up and te nded to b e si gnifi -cantly less ex trov ert, agree able, con sci entiou s and open to ex peri ence , bu t more emotionally unstable than the v ictim s i n clu s te r 1 (6 4%).

The results indi

cate the re i s no su ch thi ng a s a gene ral v ictim per sonali ty profile indi cating v u lnerability . Victims are , o r be come as a conse que nce of bully ing, more neuro ti c a nd i n trov ert than non-v ictim s. Differe nt per sonali ty traits o f v ictim s m a y pro v oke diffe rent ty pes o f b u lly

ing. The main

fo cus w hen interv ening in order to prev ent b u lly ing in organi za tion s must be on organi zational factor s mor e th an on the personal ity of v icti m s. (10)

C & QUAN To inv

estiga te w hether targe ts and perpetra tor s of bull y ing at w o rk po rtray cer tain personali ty chara c teristi c s. 2215 employ ees: 5 3% men and 47% w o m en. The foll ow ing analyses w ere performed : One-w a y ANOVA, reliabi lity analy s is w ith Cronbach’ s alp ha, cro ss-tab analy s is for cate gori c al data , an d fr e-quency stati s tics. About 16% o f the sample may be cate gorized a s either perpe tra tor s (5.4%) , prov ocativ e v ictims (2.1%) , or as targets o f bully ing (8.3 %) . Mo st prov ocativ e v ictims and mo st perpe tra tors w e re males. Re sponden ts w ith n o ex perience of bully ing w e re used as a compari s on gr oup (n=1,838) . Empirical finding s i ndica te tha t person s w ho w e re v ictimized at schoo l are more l ikely to b e v ictim ize d in the w o rkpla c e . Indiv idual differe nces ex ist w hen perp etra tors and targe ts o f bu lly ing are compared . B u llie d v ictims can be div ided in to a t le ast tw o groups: tar gets o f b u lly ing and prov ocativ e v ic tims. The prov ocati v e v ictims deserv e more a tten tion. (16)

C & QUAN To inv

e stiga te g end er di ffer ences in faci ng a nd ex perien c ing bully ing at w o rk in a v iolent, mal e d o minated w o rking env ironment, name ly prisons. Re spon-dents w e re in trodu ced to a de fini tion of bully ing. 773 male and 123 fem a le pris on o ffice rs. Hierarchi c al regre s sion analy s is, MANOVA 20% o f the re spond ents per ceiv ed the m selv es as v ictim s of bully ing. Female v ictims h ad been subje c ts of sex ual harassment signi ficantly more ofte n than the ir mal e co lleague s. The p e rson s bully ing female offi cer s w e re u s ually co-w orkers, w hereas men w e re bullied by co -w orkers and superv isor s equ ally often . U n sati s fac tory fea tures of w o rk an d p oor social clima te w e re signifi can t pre d ictors o f b u lly ing among bo th men and w o men. Bul ly in g had simila r e ffects on the feel -ings of stre ss, men tal heal th , and job satisfa c ti on o f both men an d w omen. (13)

C & QUAN To inv

e stiga te w hether bein g di fferen t i n a w o rk grou p simpl y in terms o f o ne’s gender, may be a ri sk factor fo r ex po-sure to bully ing a t w o rk. 6485 nur se s (247 men/6234 w o men) Reliability analy s es, chi-square tests, Fishe r’s ex act tests, and logi sti c r egres-sion analy s es w e re use d . A larger pro portio n

of males than femal

e

s

re-ported that the

y had been e x p o sed to bull y ing (10.2% v s . 4.3%). M a

les reported less often high

commitm

ent to the work unit, and

w e re less likel y to be bothered b y lo ng-term he alth prob le ms. In con c lu sion , the study suppor ts the h y pothesis th at belonging to a gen der minori ty is a ri sk fa ctor for ex posure to bully ing at w o rk, ina s much as male a ssi s-tant nur se s are mor e often ex posed to bully ing at w o rk than thei r female colleague s. (14)

C & QUAN To estimate

the pre v alence of bully ing and to id enti fy risk groups in a repre-sentativ e popula tio n samp le. Resp on-dents w e re in trodu ced to a de fini tion of bully ing. 3,429 employ ees (52.4% w o men) T e st s o f null-hy poth e si s, Chi-square test 1.6% of the sample repor ted daily to weekly bully ing. Unskilled w o rkers re ported th e highe st prev alence o f bul ly ing, w h ile manag -ers/sup e rv isors the low e st prev alence . People w o rking w ith th ings (mal-dominate d o c cupa-tion s) a nd pe ople working w ith clien ts/p a tien ts (female-domin ated occ upati ons) re ported highe r prev alence o f bul ly ing than p eople w o rking w ith sy mbols or cu stom ers. The find ings sugge st that ty pes of w o rk an d ge nder ratio are ri sk fa ctor s in the onse t of w o rkpla c e bully ing. F u ture s tudie s sho u ld ta ke in to ac cou n t the ty pe of w o rk and the gend er ra tio of th e or gan ization.

Ref Stud y design* and pu rpose Number of part icipan ts (m en/ w o m en) M easure s and analy s is R e sult s Discuss ion/conc lusi on (as st at ed in t h e art ic le, no o w n comment s or idea s) (23) L To (a)a sse ss the pr ev alence of bully ing in an Iceland ic ho spital tru s t a nd (b ) to determine the in flu ence of nega tiv e affe ctiv ity (NA) on b u lly ing self-repor ts. Bully ing w a s deter mined v ia 21-item sca le a s sessing pa rticipan ts’ ex posure to p e rsi s ten t bully ing behav iours. 708 ho spi tal emplo y -ees; 105 men and 603 w o men in Iceland . Prev alence ra te s w e re assessed th rough frequency analy s is (p ropor tion of parti cipan ts rep o rti ng bully ing ex periences in the past 12 mon ths) . Influ ence o f negative affe c-tiv ity w a s asse sse d thr ough correla tion and regr ession analy s is. 28% o f employ ees reported ex posure to bully ing (persi stent bully ing behav iours) a t w o rk in the past 12 mon ths. So me 34% had w itnessed the bully ing of o ther s. T y pes of bully

ing most

fre-quently repor ted w e re w o rk-rela ted bu lly ing, personal der ogati o n and isolati on. Mal e and female parti cipa nts w e re just a s li kely to repor t bully ing at w o rk. A signi fi c ant , y e t l o w , correla -tion w as fou nd b etw een bully

ing reports and

negativ e affe ctiv ity . W or k ing in hospital s may place peo ple at grea t risk of being bul lied. O ther Scandinav ian studi es h av e pointed to hig h lev e ls o f bully ing in hospital s . A cco rd-ing to the cu rren t study , negativ e affe ctiv it y (defined as mood-dispo s it ional dimension , refle c tin g nega tiv e emotionali ty and se lf-concept) doe s no t play a cri ti c al role in bully ing self-reports. Thi s findin g , combined w ith the findi ng tha t 34 % had w itnessed b u lly ing at w o rk, i s importan t sin c e it suggests that bully ing at w o rk i s not purely a sub jectiv e phenomenon but a real in terper -sonal stre ssor. (21) C To asse ss the a s so ciation b e tw een w e ll-being, w o rk en v ironment and health among empl oy ees in sav ings- and o ther ban k b ra n che s in Ice land w ith referen c e to w heth e r they had been ex posed to bully ing at w o rk. All employ ees (N=1847) in sav ings- and o ther ban k b ra n -che s in Icel and i n the spring o f 200 2. A que sti onnaire ba sed on the General Nordi c Ques-tionnaire for Psy c h o logical and So cial Factor s at W o rk w a s sen t to all emp loy ees. The data w as an alyzed using th e SP SS sta tisti cal package . Respon se r a te 80 %. 8% (N0110) had ex peri-enced bully ing. The v ictims of bully ing w e re more li kely to h a v e poor p s y c hoso c ial w o rk env ironment and were le ss li kely to ha v e e x peri-enced a posi tiv e rel a tion ship w ith supe rv isors and o ther sta ff. In the ligh t o f the a s sociatio n be tw een w o rk organi

za-tion and bully

ing, it is o f impor tance tha t superv isor s and employ ers are w e ll v e rsified in co mmunicati on ski lls per taining to staff rela tion s and re cogni zing psy c hoso c ial ri sk fa cto rs in the employ ees? w o rk env ironment???. (48) L To ex plore w hether (a) immigrant hea lth care w o rkers (HC W ) are more at ri sk o f bully ing at w o rk tha n Danish staff m e m bers, (b) this a sso cia tion i s in -crea sed by prev iou s ex posure to bu lly -ing and , (c) immigr ants ex perience more bully ing from superv isor s , co l-legues and clients/r e siden ts. Health care stud ents (N=5,696, 10 .4 % immigrants) Follow -up: one y ear (N=3,109, 9 ,1 % immigrants). A que sti onnaire in cl uding socio-demograo hic factor s, w o rking con d itio ns, phy sical and p s y c hologica l health . Only one que stio n about bully ing w a s includ ed abou t ex posure to bully ing. At follow -up, 9.1 % of the to tal cohor t h ad been ex posed to bully ing at w o rk du ring thei r fi rst y ear of empl oy ment, her eof 1.8 % frequen cy . “Non-W e ste rn” immigr ants ha d a signi fica ntly higher risk o f ex posure to bully ing at w o rk dur ing follow -up than the Dani sh respond ents indep endent of prev ious ex perience w ith bully ing (OR = 1.85 (1.18–2 .93)) . Danish and immigran t he alth car e w o rkers w e re more ex posed to bully ing fr om co-w o rkers than fr om superv isor s w ith no sta tisti-cally signi fi cant di ff erence be tw een th e Danes and the immigr

ant groups. Both

“ W e s tern’’ and “non-W e stern’’ re sp ondents w e re more at ri sk o f bully ing from clien ts/r e sid ents than the Danish respond ents. The attempt o f the presen t study w a s not to “‘blame the v ictim’’ bu t to lo ok a t potenti a l di ffer ence s in ex po-sure to bully ing am ong di ffe rent immig rant group s and to di scu s s po ssible reason s for these d iffe rences. Thi s might b e u s e ful for prev entiv e interv entions. The implica tion s for not doing any thing agai nst bully ing might b e hig h dr op out rate s among students a nd new employ ees. To prev ent futur e r e -ex posure, it i s im portan t tha t targe ts o f bu lly ing get h e lp a nd suppo rt on how to cope w ith the ef fe ct of bu lly ing so tha t thi s d oes not t u rn into a nega tiv e cir c le . L= long it udi nal , C = cr os s secti o n a l, I= in te rv enti on, QU AN = Qua n ti tati v e , QU A L = Q ual it a ti v e

2. Health consequences of

workplace bullying

In summary 17 studies concerning health consequences of workplace bullying were identified. Thirteen of these discussed bullying and psychological health consequences, such as stress and PTSD symptoms (53–56), burnout (57), depression (58), lack of psychological well-being (59) 17394–95, psychologi-cal trauma (60), psychologipsychologi-cal and somatic stress symptoms (23;49;61;62). Also cardiovascular diseases (58) and fibromyalgia (63) were discussed as well as changes in salivary cortisol (64;65).

An interview study with 20 targets found that they usually developed psychological and psychosomatic symptoms already a few months after the bullying started. At first, the symptoms only appeared when the targets were at work. However, over time the symptoms became more chronic. The tar-gets described a number of psychological symptoms (i.e. inability to concen-trate, mood swings, anxiety, sleep problems, fear and depressive symptoms) as well as psychosomatic symptoms (i.e. headaches, respiratory and cardiac complaints, hypertension and hypersensitivity to sounds, etc.) If the targets had a chronic disease, the symptoms often became worse (60).

Over the past three decades, research into the consequences of bullying at work in the Nordic countries have shown that exposure to systematic nega-tive behaviour at work such as bullying or mobbing may have devastating effects on the health and well-being of the exposed individuals. Most re-search on the consequences of bullying at work has been cross-sectional studies, a few case-control studies and clinical interviews with those tar-geted. Only a few longitudinal studies have been published. Correlation studies have found associations between exposure to bullying and chronic fatigue, psychosomatic, psychological and physical symptoms, general stress, insomnia, and mental stress reactions etc. (see e.g. for reviews (66– 68)). Common symptoms such as muscular-skeletal complaints, anxiety, irritability and depression were reported by targets in different European countries (69–72). Some victims displayed symptoms analogue to Posttrau-matic Stress Disorder (PTSD) (42;43;73–75). Self-hatred and suicidal thoughts have also been reported ((76;77). Qualitative studies (29;60;71;77– 79) have demonstrated consequences such as reduced self-confidence, low self-worth, shyness, an increased sense of vulnerability as well as feelings of guilt and self-contempt. The bullies blame the problems at the workplace on the bully victims. When the victims bring this guilt inside themselves, they experience feelings of shame because they are not worth more than to be bullied (60). Indeed, many targets reported that their physical health and mental well-being had been permanently damaged (49). Not surprisingly,