title: Exposure to bullying behaviors as a predictor of mental health problems among Norwegian nurses: results from the prospective SUSSH-survey.
abstract: BACKGROUND
  The relationship between workplace bullying and mental health problems are well documented in previous cross-sectional studies, but knowledge on how this relationship develops over time is still scarce.
  
  
  OBJECTIVE
  The aim of this study was to explore the prospective relationship between exposure to bullying behaviors at baseline, and increased symptoms of mental health problems (anxiety, depression, fatigue) one year later. Furthermore, the reverse relationship was investigated.
  
  
  METHODS
  This is a prospective longitudinal study, where members of the Norwegian Nurses Organization answered identical questions regarding workplace bullying and mental health problems, at baseline (2008-2009) and follow-up (2010).
  
  
  METHODS
  Altogether, 1582 nurses completed both questionnaires.
  
  
  RESULTS
  Hierarchical regression analyses indicated that exposure to bullying behaviors at baseline predicted subsequent increased symptoms of anxiety and fatigue, after adjusting for baseline symptoms of anxiety and fatigue respectively, age, gender, night work and job demands. Moreover, symptoms of anxiety, depression and fatigue at baseline predicted increased exposure to bullying behaviors one year later, after adjusting for exposure to bullying behaviors at baseline, age, gender, night work and job demands.
  
  
  CONCLUSIONS
  In this study we find support for a reciprocal relationship between exposure to bullying behaviors and symptoms of anxiety and fatigue, respectively. Thus, the results may indicate a vicious circle where workplace bullying and mental health problems mutually affect each other negatively.
authors.affiliation: Department of Psychosocial Science, University of Bergen, Norway. Electronic address: Iselin.Reknes@psysp.uib.no.
authors.forename: Iselin
authors.initials: I
authors.lastname: Reknes
authors.affiliation: Department of Psychosocial Science, University of Bergen, Norway; Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway.
authors.forename: Ståle
authors.initials: S
authors.lastname: Pallesen
authors.affiliation: Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway; Department of Psychosocial Science, University of Bergen, Norway.
authors.forename: Nils
authors.initials: N
authors.lastname: Magerøy
authors.affiliation: Department of Global Public Health and Primary Care, University of Bergen, Norway.
authors.forename: Bente Elisabeth
authors.initials: BE
authors.lastname: Moen
authors.affiliation: Department of Global Public Health and Primary Care, University of Bergen, Norway; Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway.
authors.forename: Bjørn
authors.initials: B
authors.lastname: Bjorvatn
authors.affiliation: Department of Psychosocial Science, University of Bergen, Norway.
authors.forename: Ståle
authors.initials: S
authors.lastname: Einarsen
mesh_terms: D000328:Adult; D058445:Bullying; D003625:Data Collection; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000209:etiology* / Q000523:psychology; D009664:Norway; D009740:Nursing Staff / Q000523:psychology*; D011446:Prospective Studies; D012956:Societies, Nursing
keywords: Longitudinal; Mental health; Norway; Nurses; Workplace bullying