In the past 20 years, bullying in the workplace has been brought to public attention through media reports and research findings. The term «bullying» refers to a situation in which a person repeatedly and over time is subjected to negative behaviours by one or several others in the workplace, and in which the person concerned does not manage to defend him/herself against these behaviours (1). Bullying is therefore a matter of prolonged harassment, not of isolated episodes of conflict. Differences in the balance of power between the bully and the victim of bullying may have their basis in both formal positions and informal psychological power relations.
Bullying may manifest itself in numerous different ways, but the research literature commonly distinguishes between direct and indirect bullying (1). The former denotes openly abusive behaviours such as verbal abuse, inappropriate remarks at the victim’s expense and unjustified criticism of the person’s work performance. Indirect bullying denotes behaviours such as social exclusion and rumours. It is also usual to distinguish between person-related and work-related bullying. Person-related bullying is manifested through behaviours that impinge on an employee’s personal integrity. Examples of work-related bullying are being allocated work that is beneath the person’s level of competence and withholding of information necessary to perform work assignments.
From a legal standpoint, behaviours that can be considered legitimate within the framework of legislation and foreseeable within a given employment relationship cannot be considered as bullying, even though they may be subjectively experienced as abusive by an employee (2). In most studies a subjective approach is taken – since they are based on the employee’s experiences only (3).
In the research literature, bullying has been surveyed using two methodologies. The exposure method investigates the respondents’ exposure to specific bullying behaviours. The self-evaluation method entails asking the respondents whether they think they have been subjected to bullying or not, generally after having presented a definition of the term «bullying». In line with these methods, nationally representative figures show that approximately 14 % of Norwegian employees have been subjected to systematic bullying. A total of 4.6 % have perceived themselves as bullied during the last six months (4).
Given that bullying in the workplace is a prolonged and systematic form of harassment within an important area of life, it is reasonable to assume that it has health-related consequences. This is supported by results from cross-sectional studies that show that exposure to bullying is positively associated with both physical and mental health problems. In a meta-analysis of cross-sectional studies an average correlation of 0.34 was found between bullying and mental health problems while a correlation of 0.28 was found between bullying and somatic symptoms (3). These correlations demonstrate that high exposure to bullying is consistently associated with a high degree of health problems.
However, cross-sectional studies provide no information on the causal direction of the associations observed, and therefore do not tell us whether bullying leads to increased health problems or if it is the case that persons with already existing health problems are more exposed to being bullied. For example persons with mental health problems may more easily experience negative events such as bullying, as they may easily behave in a way that triggers aggression in others.
Compared to cross-sectional studies, prospective research designs have the advantage that they provide information on the direction of associations over time. They will therefore give better indications of how exposure to bullying is linked to health problems. The purpose of this article is to summarise results from the research literature on prospective associations between bullying and health problems.