June 2nd, 2014

Workplace bullying and psychological distress after 5 years

New longitudinal study documents long-term mental health consequences

Einarsen, S. & Nielsen, M.B. (2014) Workplace bullying as an antecedent of mental health problems: A five-year prospective and representative study. International Archives of Occupational & Environmental Health, May 20, 2014. DOI 10.1007/s00420-014-0944-7

Professor Stale Einarsen, colleagues and students conduct cutting-edge research into workplace bullying at the University of Bergen, Norway. This new study employees a longitudinal design. That is, it follows a group of people over 5 years, longer than the typical 12-24 months follow-up in other longitudinal works. Over time, the researcher has the chance to see an escalation of the bullying and the relative permanence of its effects on bullied individuals.

Einarsen cites three theoretical approaches to the link between bullying and mental health problems. First, is the Janoff-Bulman model that explains trauma from the shattering of a person’s expectations for safety and security in social relationships. When, instead, abuse is experienced instead of a benevolent world, strong stress responses and a possible long-lasting state of fear, anxiety, depression and confusion result. Second, Williams’ work in ostracism and social exclusion can lead to a “social death” when the bullied target is the focus of sustained negative attention from peers. The third theoretical thread explored is the notion that people already depressed at work may underperform or not engage in social activity with coworkers and “perceive” they are bullied or mistreated. In other words, mental health problems can lead to exclusion instead of bullying leading to mental health problems. — a form of reverse causation, targets cause their own fate.

Of the 2,539 Norwegians who had participated in a 2005 national survey 1,613 did so again in 2010; women comprised 54% of the sample. The behavioral measure of workplace bullying were scores on Einarsen’s NAQ-R (Negative Acts Questionnaire) which is the gold standard used by academic researchers. Respondents check off which of 22 behaviors were directed against them and how frequently. The experience tells whether or not the person has been objectively bullied.

In addition, respondents were asked if they considered themselves victims of workplace bullying by answering “yes” to the question: “Bullying takes place when one or more persons systematically and over time feel that they have been subjected to negative treatment on the part of one or more persons, in a situation in which the person(s) exposed to the treatment have difficulty in defending themselves against them. It is not bullying when two equally strong opponents are in conflict with each other.”

Researchers measured psychological distress using the Hopkins Symptoms Checklist items related to anxiety and depression. Based on a threshold average score, the need for psychological treatment of respondents was calculated.

in 2005, 13.4% of the sample surveyed were sufficiently distressed as to warrant treatment; in 2010, it was 11.4% (n = 183 respondents) — a higher percentage for women. In 2005, 12.5% were bullied according to the NAQ score; 9.2% in 2010 (n = 148 respondents). In Pam Lutgen-Sandvik’s work, individuals tend to self-report being bullied less frequently than the behavioral NAQ scores indicated. In this study, the effect was the same, only 4.6% self-labeled as victims of bullying in 2005, 4.1% in 2010. They are not whiners. If anything, bullied targets are more likely to suffer in silence.

Important findings emerged. the significant predictors for experiencing psychological distress five years later were prior distress, being young, and exposure to bullying behaviors. The significant association between bullying behaviors in 2005 and distress in 2010 was found only with men, not for women. These predictions were found when several variables were held constant: leadership responsibility, and demands and decision latitude (control over one’s tasks) within jobs.

However, exposure to bullying behaviors in 2010 was predicted by psychological distress in 2005 for men, not for women. Self-labeled victimization, saying you felt bullied, in 2010 was predicted by exposure to bullying behaviors and self-labeling in 2005. For men only, exposure to bullying behaviors (according to the NAQ) did lead to self-labeling as victim in 2005.

Anxiety experience in 2010 was significantly related to bullying behaviors in 2005. For women, anxiety in 2005 was the only significant predictor of anxiety in 2010. For men, anxiety in 2010 was predicted by anxiety, being bullied and self-report as a victim in 2005.

For women, depression in 2010 was unrelated to bullying or felling bullied in 2005. For men, 2010 depression was predicted by depression and feeling bullied in 2005. Being bullied in 2010 (according to the NAQ) was predicted by being bullied and being anxious, but not depressed, in 2005. Feeling victimized in 2010 was predicted by that same feeling and actually being bullied in 2005.

Researchers did find evidence of psychological distress five years after prior bullying experiences. And it was in the direction of bullying lead to, causing, distress. The gender differences were unique to this study and are significant. For men, the evidence suggests that men are the more vulnerable workers. Over time, distressed men may draw more rejection from peers than do women. The only support from the findings for the reverse causation model was limited to men targets and only with respect to anxiety.

The researchers’ complaint about their own study’s limitation is that only two measurement periods in time were used — five years apart. The effects on women of bullying may have dissipated sometime during those years, but researchers were unable to pinpoint when. With annual measurements, better estimates of how long effects of prior bullying have on bullied targets could be made. Finally, the women who participated in the second wave of research in 2010 were still in the workforce and relatively healthy. Severely bullied women may have been removed and on disability and not participated in the study. This may explain why many of the predicted long-term effects of bullying on psychological distress held for only men, a quirky aspect of the survey sample.

Another major critique is that the subsets of individuals who were distressed and bullied or both were less than 150, a small sample by any standard.

The authors make two strong conclusions:

“preventive measures against bullying should be directed at situational factors rather than individual ones” … “it is important for practitioners (therapists) to make victims understand that their exposure to bullying has little to do with them as persons”


Einarsen, S. & Nielsen, M.B. (2014) Workplace bullying as an antecedent of mental health problems: A five-year prospective and representative study. International Archives of Occupational & Environmental Health, May 20, 2014. DOI 10.1007/s00420-014-0944-7


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