Literature-1.edited.edited.docx

1.Workplace bullying Workplace bullying, defined as repeated negative behavior carried out over a period of time towards one or more individual(s) who cannot easily defend themselves (2,3), is recognized as a problem worldwide and does not respect national boundaries(1,2). According to the literature, the term “bullying’ is used in English-speaking countries and “harassment” in French-speaking countries while “mobbing” in other European countries (3). The phenomenon of bullying has three essential components(3). First, the behavior perpetrated against the target is unwanted and viewed as harassing and offending by the target. Second, the persistence of this behavior over time in terms of frequency (at least twice a week) and duration (for a minimum of six months)(3). If such behavior infrequently occurs or in isolation, then it is categorized as an uncivil behavior or a conflict, which is opposed to bullying. Third, occurring of this negative behavior is systematic and planned so that the target may perceive themselves as helpless and lacking any recourse or escape from the harmful act(4). This helplessness perceived because of real, or perceived power imbalance between target and perpetrator(5). The power imbalance is because of formal power (e.g., higher organizational positions(6) or informal power (e.g., networks of people)(7,8). The perpetration runs from supervisor to subordinate (downwards bullying) or subordinate to a supervisor (upwards bullying) o pr peer to peer (horizontal bullying) or external customer to an employee(9,10). In other words, these components can divided into five crucial elements: the target's experience of negative behavior(s), persistence of such behaviors, the target's experience of psychological and or physical harm, a power imbalance between the target and the perpetrator(11), and finally, the target's perception of being bullied(11). Specifically, workplace bullying behaviors classified into three categories as per the Revised Negative Acts Questionnaire (NAQ-R)(6): work-related, person-related and physical intimidation. Examples of work-related acts are such as withholding information, ignorance of opinions, imposing unreasonable deadlines, excessive monitoring of work, pressure not to claim entitlements, and unmanageable workloads(12). Whereas, person-related bullying includes being humiliated or ridiculed in relation to work, having critical areas of responsibility removed or replaced, doing gossip or spreading rumors, insulting or making offensive remarks or allegations, ignoring or isolating, or encouraged to quit, or the target of practical jokes, or the subject of excessive testing and sarcasm(12). Finally, physically intimidation includes being shouted at, being the target of uncontrollable aggression or pointing finger or invasion in personal space or blocking or threatening of or actual physical violence and abuse(12). All these kinds of offline bullying behavior also occur in cyberspace(12), which is described later as workplace cyberbullying.

1.1 Workplace cyberbullying – an online form of workplace bullying 1.1.1 Concept Workplace bullying can occur both in cyberspace (i.e., online) and face-to-face (i.e., offline)(12). The cyberspace bullying (also known as cyber abuse, cyber harassment, online bullying, online harassment, online abuse, electronic bullying, electronic harassment, and electronic abuse) now emerged as a new form of workplace bullying(13,14). Workplace cyberbullying includes insulting, threatening, or intimidating others, occurs through different information and

communication technologies (ICT) such as the Internet, email, mobile phones, and computers. Because technology is prevalent in most aspects of our lives, both public and private, targets are continuously available and cannot escape from these negative behaviors(2,15). Some specific examples of cyberbullying at work are purposely deleting someone’s work files, forwarding someone’s emails to third parties to harm him or her, and ignoring someone’s e-mails at work. Furthermore, new technologies allow access to personal information that might be inaccessible in face-to-face bullying(15). The emergence of workplace cyberbullying because of the increasing use of information and communication technologies and devices (ICTDs) at the workplace(13,14,16). ICTDs allow people to be bullied anywhere and anytime beyond the office premises and work time, unlike traditional bullying where the problem restricted to the physical presence of target(17). Indeed, given the unavoidable reliance of workplaces on these technologies and devices, escape from such negative fall-outs for members of the workforce is impossible - on the contrary, such experiences can be expected to increase due to growing electronic communication, information sharing and increasing online social interaction via email, Facebook, Instagram, What’s app and many more(14,18). As Borstoff, Graham and Marker 2007 assert, cyberbullying is emerging as the preferred form of harassment among employees despite the safeguard of organizational antibullying policies(14).

1.1.2 Definition Workplace cyberbullying defined as all negative acts stemming from working relationships and occurring through ICTs(2). These acts are either (a) carried out repeatedly over a period of time or (b) conducted at least once and intrusive into one's personal life, with the potential of exposing private information to a vast online audience(11). Workplace cyberbullying causes targets to feel helpless and unable to defend themselves. Workplace cyberbullying includes three types of behavior, similar to offline workplace bullying: (a) person-related, (b) work-related, and (c) intrusive(11). Person-related and work-related negative behaviors are acts that, respectively, target a person (e.g., gossiping, spreading rumors, or insulting a person) and make someone’s job difficult to perform (e.g., withholding information, ignoring opinions, or giving excessive workloads). The third category, intrusiveness, refers to behaviors that invade someone’s personal life and make individuals feel pursued (e.g., sharing embarrassing pictures online, hacking into personal information)(2). The target is always accessible online, and private information can be widely shared and viewed countless times(13,16). Intrusiveness differentiates workplace cyberbullying from workplace bullying because of its inherence to the online environment(2).

1.1.3 Characteristics Though the workplace cyberbullying is a type of workplace bullying, it has some additional features that make it unique from traditional bullying(12). On the part of perpetrators, they may be less aware of the injury of targets caused by their cyberbullying behaviors because they do not have to see and feel the pain and fear directly from the targets(19). On the part of targets, it is hard for them to escape the bullying because they have to receive email or text messages for their work and cannot merely "defriend" or ignore messages from superiors, colleagues or subordinates(15). Moreover, some bullying behaviors may reach a much larger audience, for example, uploading an inappropriate picture of someone in social media or spreading rumors about some colleague in the company forum. Such acts are more damaging to the targets because the picture or the rumors are visible by more employees than traditional bullying (e.g., face-toface bullying)(7).

Moreover, AVG Technologies 2014 with using digital diaries found that cyberbullying could be carried forward from childhood or adolescent to adulthood and into their working life(20). A study about antecedents of workplace bullying found that the neutralization techniques (denial of responsibility, denial of injury, denial of victim, appeal to higher loyalties and the metaphor of the ledger) increase the intention of workplace cyberbullying(7). This model of neutralization justifies harmful behavior. Based on this model, though employees are aware of the deterrence of cyberbullying behaviors at work, they may still conduct such behaviors because they may use neutralization techniques to legitimize those behaviors(7). Cyberbullying perpetration found associated with ex-partner relationships, friends, acquaintances and work colleagues(21).

1.2 Prevalence 1.2.1 Workplace bullying prevalence In general, workplace bullying assessed by two standard methods: the self –labeling approach and the behavioral experience method (22). In the literature, the prevalence rate found different as per operational definitions likewise about 11% rate, if using the self-labeling with definition method (in which, the definition presented earlier and asked the respondents to label themselves as bullied or not), while about 15% with using the behavioral experience method (in which, using questionnaire consisting of a list of bullying behaviors. Moreover, up to 18% rate if the self-labeling without definition method (in which, without telling definition, only asked respondents to label themselves bullied or not) (3,22). Therefore, this difference in prevalence may result from different measurement approaches. The prevalence of workplace bullying is about 3% to 15% in Europe(22), such that between 3% to 4% of the European employees experience weekly bullying behavior (=serious bullying), while 9% to 15% may experience monthly bullying behaviors(=occasionally bullying)(3). The prevalence of workplace bullying in Belgium noted in several studies. A study by Notelaers showed that about 27.2% of employees had work criticism, 20.8% had negative encounters, 8.3% reported occasionally bullied, 9.5% reported moderately work-related bullying, and 3.6% reported being targets of severe workplace bullying(23).

1.2.2 Workplace cyberbullying prevalence The prevalence of workplace cyberbullying reported to range from 3.7% to 46.2%(2). According to the literature, this range presumably results from the work environment hypothesis. Therefore, it is because of the prevalence of workplace cyberbullying can vary among different working contexts and settings. There are some following studies have described the prevalence of workplace cyberbullying. Australian study among employees of the manufacturing sector found that about 89.3% have experience of at least one negative act average (being 8.9 negative acts) either face-to-face or by e-mail, SMS or telephone at least on a "now and then" basis for six months(12,13). The types of activity over email were withholding the information, spreading gossip, subjected to allegations against them, and exposure to unmanageable workloads, behavior, which is similar as the list compiled by Einarsen(3) and Felblinger(24). One of the studies, using Leymann’s operational definition of workplace bullying(25), reported about half of these respondents had experienced negative acts via e-mail or telephone or both at least ‘now and then' (12). Farley et al. study found that about 46.2% of doctors had once the experience of cyberbullying in last six months(26), whereas the study by Gardner et al. reported only about 2.8% workers had cyberbullied in past six months in New Zeeland(27). Coyne et al. have studied regarding workplace

cyberbullying and their consequences through disempowerment approach. In their study, about 79.3% of participants had exposure to at least one negative act during the last six months, and 18.0% were victims of cyberbullying using Leymann's definition. The CNAQ (cyber version of negative act questionnaires) items most frequently experienced were having your views or opinions ignored (54% of the sample), being exposed to an unmanageable workload (42%), being ignored or excluded (41%) and provided tasks with unreasonable or impossible targets or deadlines (40%). They found that the significant correlations between cyberbullying and general mental strain, NA, interpersonal justice and job satisfaction(28). A recent UK (United Kingdom) based study conducted among British University employees found that eight out of ten had experience of workplace bullying at least once in last six months and 14% to 20% had experience of these acts at least weekly basis in last six months. (29). Baruch study in 2005 has concluded that medium of communication makes no difference to the experience of bullying(16). That study among employees of an MNC (multinational corporation) in the UK found bullying via email to be at the same level as bullying via traditional face-to-face contact, meetings, letters and phone conversations such that its negative individual and organizational outcomes like reduced job satisfaction, lower performance, increased absenteeism and higher intention to leave existed regardless of the mode involved(16). As above, this apparent inconsistency for the prevalence of workplace cyberbullying(30), because of the different assessment methods for such behaviors (subjective or objective)(3), and work environment in which the research was conducted(12,13). However, there is a visible gap in the knowledge regarding risk factors related to workplace cyberbullying. In most of the studies, the point prevalence rate of events found with the use of cross-sectional survey method, which can give the frequency of the listed behavior of workplace cyberbullying. In the existing literature, workplace cyberbullying has not received as much consideration as its offline counterpart. The prevalence of workplace cyberbullying yet not investigated in Belgium. However, recent studies suggest that cyberbullying is present in workplaces, but further research is needed to determine at-risk working populations(2). For the measurement of workplace cyberbullying prevalence, recent research was conducted to construct and validate the inventory of cyberbullying acts at work (ICW) in Belgium(2). This inventory includes ten items in the context of work-related, person-related and intrusion to determine bullying acts through emails, Internet, telephone, tablet within a duration of the last six months. This inventory is constructed on the basis negative acts questionnaire(6) to measure workplace cyberbullying(2). Therefore, our study will use this inventory to find the extent of workplace cyberbullying and associated work-related factors.

1.3 Antecedents of workplace (cyber) bullying There are many studies focused recently to understand the phenomenon of cyberbullying by knowing their predictive factors. These predictive factors can be individual and organizational factors. In general, factors such as frequency of Internet use, aggression, risky online behavior, hyperactivity, narcissism, moral disengagement, normative belief about aggression, the experience of cyber victimization, the experience of traditional bullying perpetration and victimization(31,32) are related to the occurrence of cyberbullying. In the line of this knowledge, Kubiszewski et al study revealed that internalizing problems (such as insomnia, perceived social disintegration, psychological distress) are the characteristics of cyber-victims and cyberbully/victims while externalizing problems (such as general aggressiveness, antisocial behavior)

can be prevalent in cyber-bullies and cyber-bully/victims(7). Besides, low body esteem and low social support are associated with cyber victimization(33) while the use of drugs and alcohol problem found related to cyberbullying perpetration(31). There is considerable overlap in predictors of experience and enactment of workplace bullying because of shifting roles of perpetrators and targets of workplace cyberbullying(11,34,35). Workplace bullying emerges from a set of individual, organizational, and contextual factors(36). A study found the distinctive features of the harassed employee within the public sector with age, full-time work, the greater nighttime associated with public service professions, and a lower level of motivation. Moreover, workplace bullying decreases if job demands are limited and job resources are increased(36). Further, there are few theories about antecedents of workplace cyberbullying. The affective events theory explains how affective work events can arise from different work attitudes and affect-driven behaviors elicited by different emotional experiences (e.g., anger, fear)(11). Another theory is the emotional reaction model, which states that the presence of work stressors can elicit emotions that fuel workplace cyberbullying. This model applies to both victimization and perpetration phenomena (11). Earlier studies mentioned that workplace bullying mainly originates from the work environment caused by job-related stressors (2,37,38), team-related stressors (2,39), and organizational stressors (2,40). Specifically, work-related factors such as workload, role conflicts, job insecurity, autocratic leadership, and interpersonal conflicts are of concern (2,38,41). Work stressors refer to work-related environmental conditions that can decrease the health and well-being of workers (11). Workplace stressors (related to the job, team, and organization) are predictive of cyberbullying perpetration and victimization. For example, job-related factors such as role conflicts, role ambiguity, and workload (11,37,40), team-related factors such as conflicts and leadership (11,39), and organizational factors such as organizational change and social climate (11,40) have been found to predict workplace bullying. Stressful work environment stimulates workplace bullying to occur (42), which is explained by the model of Baillien et al. study. In that the three paths that may lead to the strains (low strain vs. high strain), conflicts (low conflict vs. high conflict), and aspects within the team or the organization which directly related to bullying (7,42). The association between those work stressors and exposure to bullying mediated by the Work Environment Hypothesis and the General Strain Theory: a poor psychosocial work environment (i.e., work stressors) may trigger exposure to bullying because it depletes employees' energy, causing strain (38). Strained employees have difficulties in defending themselves against bullying acts and offer little resistance. Consequently, they become an "easy target" for exposure to workplace bullying(38). As traditional bullying and cyberbullying have a common core (i.e., negative interpersonal behavior that causes targets to feel helpless), the stressor-strain theory can be used to predict incidences of workplace bullying/cyberbullying. The stressor-strain theory states that exposure to stressful work conditions (e.g., role conflicts) leads to physical (e.g., somatic complaints), psychological (e.g., anxiety), and behavioral (e.g., aggression) strain(11). This work environment hypothesis justifies the theoretical framework for the occurrence of offline and online variance workplace bullying. In addition to a poor work environment, lack of organizational support and less effective organizational strategies are also found as positively associated with workplace bullying (2,27). Workplace bullying refers to prolonged exposure to various hostile behaviors at work, which can lead to severe stress reactions. Christian Balducci et al. study in Italy, they performed structural equation modeling and found that job demands (workload and role conflict) and job resources

(decision authority, co-worker support and salary/promotion prospects) were related to bullying over and above neuroticism, and that bullying mediated the relationship between job demands and post-traumatic stress disorder symptoms. In general, bullying is considered a strain phenomenon, which initiated by both environmental and personality factors(43). Norwegian study with the baseline and follow up result supported that the role conflict and role ambiguity, independently, predict subsequent exposure to workplace bullying(44). Through structural equation models, a multicenter study among 696 employees from 66 centers confirms the relationship between workplace bullying and some variables that are considered antecedents (interpersonal conflict, role ambiguity, role conflict, and workplace social support) or consequences (health complains and inclination to absenteeism from work) of this phenomenon(45). This study results found the mediating effect of workplace bullying between certain work conditions and health complains(45). The negative consequence of workplace bullying has inspired the researcher to find the sources of workplace bullying. The focus was on the individual and work-related antecedents and the process of the relationship between antecedents and workplace bullying. For the antecedents on the task level, role conflicts, workload, and job insecurity are of importance. The association of workload and workplace bullying found confirmed through a prospective study. The factors which are resources are autonomy, role clarity, feedback, social support of colleagues and manager. The association with autonomy also found confirmed in a previous longitudinal study. Finally, at an organizational level, there are different factors such as a type of management and organizational change, anti-bullying policies, communication in the organization(46). There is three process relationship of antecedents with workplace bullying, known as ‘three-way – explanation model(driewegs-verklaringsmodel)(42)'. The first process at the level of task: The different work-related antecedents creates strains. These strains weaken the target to defend him/her self from such negative acts (General strain theory). These strains also force the employee to take a distance from the work. The employee chooses to spend more time on the given task, instead of the unclear task, which makes him/her more away from work. Ultimately, he/she becomes isolated from a group of colleagues from work. Other employees notice such behavior and develop a negative attitude towards their stressed colleague and start bullying because of dissatisfaction or revenge. In line with this stress process, wellknown stress models such as the Job Demand-Control ('JDC') Model (Karasek, 1979) successfully applied to the workplace bullying (Baillien, 2011; Notelaers, 2011; Tuckey, 2009). The second process (at the team level), the different work-related antecedents causes workplace bullying because they produce conflicts. This conflict process is in line with Leymann's (1996) idea of bullying as an escalated conflict. A third process is at the level of the organization. The various work-related antecedents can give rise to bullying because they encourage, allow or directly provoke this behavior. In this way, the organization indicates that bullying at work arises, as is the case with a highly competitive culture, a gossip culture or with a lack of anti-bullying policies in the organization. The antecedents, in this case, respond to how people deal with each other at work and contribute to an environment in which too little attention paid to respectful social relationships(46).

1.4 Effects of workplace (cyber) bullying Bullying process includes four phases (Einarsen, 2000). In the first phase, this negative behavior is indirect and subtle. Where in the second phase, this negative behavior becomes direct and the target becomes socially isolated, humiliation and socially isolated. In the third phase, target perceives difficult to defense to such negative behavior and progressively gets isolated from the surrounding society and not able to reverse the perception of being a victim (stigmatization). In

the fourth phase, further, increase social isolation with negativism. Finally, there is a chance that silent permission from senior management to leave a job (expulsion). This self-withdrawal is through voluntary or forced dismissal or due to long-term illness. In past studies, there is clear evidence of the outcomes of longtime exposure to workplace bullying. After six months, lower dedication to the job, then after one year, it lowers job satisfaction. There is also a considerable increase in cardiovascular diseases, depression. They also have symptoms like weight gain, eating disorders, migraine, and myalgia (Brousse et al., 2008). Workplace Bullying associated with decreasing in work efficiency, productivity and increase turnover intention as well as turnover (46). Targets of bullying are thinking more and more need for the recuperation. Also, low sleep quality. They have higher chances for burnout and also suicidal ideation. Some clinical studies showed that the targets of bullying have typical symptoms of post-traumatic stress syndrome. Prevalence of workplace bullying found as per the self-perception approach (1% to 4%) lower as compared to objective measurement approach (8% - 15%). (46) Different study results have indicated the severe work-related consequences for victims of workplace bullying(7). In the following theoretical model, workplace bullying activates the affective outcomes (job satisfaction, commitment, intent to leave) as well as health & well-being outcomes (mental health problems, physical health problems, somatization, posttraumatic stress, burnout, sleep, strain, core self-evaluations). These outcomes change with the moderators such as coping strategies and individual personality factors. These both, affective outcomes and health & wellbeing outcomes, may finally lead to behavioral outcomes (performance, absenteeism). Moreover, again, this behavioral outcome starts a new cycle of workplace bullying. This reciprocal relationship is known as a vicious cycle of victim-bully behavior(47).

FIGURE 1 THEORETICAL MODEL: RELATIONSHIPS BETWEEN THE OUTCOMES OF WORKPLACE BULLYING

Added to this, another model (below) for the relationship between bullying, job attitudes and performance emerged from path analysis in Baruch et al. study(16). That found that bullying is directly correlated with anxiety and indirectly with absenteeism and intent to leave. Bullying also negatively correlated with job satisfaction, intent to leave, and finally decreases performance. These findings supported by the qualitative study among employees of three industries, workplace bullying found directly correlated with poor organizational commitment and high turnover intentions(7). Similar evidence also reported by another study that absence from work due to sickness was 1.5 times higher for bullying targets. Different studies also described

outcomes of workplace bullying for individual level such as anxiety(48), feeling of fatigue(49), emotional exhaustion, concentration problems(50), adverse effect on emotional intelligence and ability of self-management(51), burnout(52), depression(48,49), suicidal ideation and behavior(53). In short, workplace bullying leads to different types of consequences for individual level and organizational level. Outcomes of workplace bullying: A theoretical framework : In response to the lack of a theoretical basis, building on transactional theories of stress (Lazarus & Folkman, 1984), the Affective Events Theory (AET; Weiss & Cropanzano, 1996), and the Cognitive Activation Theory of Stress (CATS; Ursin & Eriksen, 2004), the model presented shows how workplace bullying related with individual outcomes. In line with psychological stress theories in general, the point of departure for our model is that exposure to systematic and prolonged aggression negatively affects the targeted individual. The inherent psychological nature of workplace bullying behavior and the subjective interpretation of being a victim of such treatment indicate that cognitive mechanisms can explain the effects of exposure to bullying. Hence, as a way of explaining how these adverse effects arise, we suggest a process in which the prolonged duration of a bullying experience develops into repeated and chronic cognitive activation. Building on the core assumptions of CATS, this kind of sustained cognitive activation could, over time, lead to prolonged physiological activation, which subsequently manifests through impairment of health and wellbeing(Ursin & Eriksen, 2004). According to empirical evidence has shown that the consequences of bullying vary between individuals with considering the moderating factors. According to transactional stress models (Lazarus & Folkman, 1984), the nature and severity of reactions following exposure to a given stressor are functions of a dynamic interplay between event characteristics and individual appraisal and coping processes. Adopting this perspective, we propose that the severity of outcomes of workplace bullying is dependent upon the interaction between the severity and nature of the bullying behavior and individual characteristics and coping mechanisms. Initially, activation following exposure to bullying viewed as a normal and healthy response that occurs when there is a discrepancy between what one expects and what happens (Eriksen & Ursin, 2004). In cases where the individual sees this discrepancy as manageable and expects to cope reasonably well with the situation, activation subsides and does not develop into a health risk. However, when the individual is unable to cope and perceives the discrepancy as unmanageable, the level of cognitive and physical activation may be sustained. An extensive body of research has shown that this kind of cognitive dissonance is associated with persistent high-stress levels and pathology, such as decreased sleep quality, increased cortisol levels, elevated heart rate, and increased mortality (Eriksen & Ursin, 2004; Meurs & Perrewe, 2011). In light of this, adverse outcomes of exposure to workplace bullying can be seen as the individual' s inability to cope with, and therefore prevent and deter, the unwanted social behavior of others at work. This idea of failure to cope further supported by research, which suggests the cognitive incongruity between how one perceives oneself and how bullies treat one is strongly related to reported health problems among targets of bullying (Mikkelsen & Einarsen, 2002a; Nielsen, Matthiesen, & Einarsen, 2008). Building on the AET, it has also been proposed that the failure to cope with exposure to bullying triggers adverse and lasting affective and attitudinal reactions (Glasø, Vie, Holmdal, & Einarsen, 2011). As shown in Figure 1, we further propose that the adverse effects of bullying on health effects and attitudes have secondary and indirect consequences for behavioral

outcomes in that reduced health and well-being leads to increased absenteeism and reduced performance. Moreover, as indicated by the feedback loops from the outcome categories pointing to exposure to bullying, it is suggested that potential outcomes of bullying have reversed effects on subsequent exposure to, or at least the reporting of, bullying — this latter association described in detail in Study 2. Morten Birkeland Nielsen & Ståle Einarsen (2012): Outcomes of exposure to workplace bullying: A meta-analytic review, Work & Stress: An International Journal of Work, Health & Organisations, 26:4, 309-332 http://dx.doi.org/10.1080/02678373.2012.734709

FIGURE 2 ASSOCIATION OF WORKPLACE BULLYING AND ITS OUTCOME

In past studies, there is enormous evidence that any bullying has deleterious impacts on the victims, the witnesses and the organization(12). However, there is little scientific evidence regarding the specific consequences of workplace cyberbullying(28,54). Zhang et al., study mentioned that workplace cyberbullying might have similar consequences as workplace bullying because of more comfortable way to cyberbully than to bully (for example, one does not have to direct contact with the target) and therefore, there might be even higher rates of cyberbullying than non-cyber forms of bullying(7). Few recent studies also narrated that workplace cyberbullying, in general, affects an individual's mental, physical and emotional health(2,54). Usually, any threatening or challenging situation leads to stress as a human response, but excessive or prolonged stress can result in adverse health outcomes(20). Here, it shows that stress can be an outcome of once challenging situation like workplace cyberbullying act but if it persists then, it can act as a risk factor for adverse health consequences like impairment of cognitive function (or presenteeism), intent on escaping situation or place (through absenteeism, intent to leave job), burnout, depression Addition to these, negative emotions on organizational perception and satisfaction due to workplace cyberbullying increases the rate of job dissatisfaction(28), intent to leave, absenteeism, .manpower turnover(16). Coyne et al., the study in 2016 through hierarchical regression analysis found that cyberbullying is positively related to general mental strain. Furthermore, the target individual might develop posttraumatic stress disorder(55), depression, anxiety, loneliness, psychosomatic symptoms, behavioral problems, cognitive problems, sense of helplessness, suicidal ideation(32,56,57). General wellbeing of the individual can be measured using the General Health Questionnaire (GHQ) which was developed by Goldberg(58). The GHQ-12 used to find three underlying factors: psychological distress, social and emotional dysfunction, and cognitive

disorder(58). Different research has also found that stress could negatively impact on an employee's motivation, task performance, concentration, and energy level(20). Organizations, in which bullying problem exists, might have a higher level of health problems and a higher level of absenteeism(12). Moreover, with the significant use of technology at the workplace, increases workplace cyberbullying which may have an additional impact on workplace bullying impacts such as decreased job satisfaction and turnover(25). Bullying, either offline/online, problem leads to financial damage to the organization through absenteeism, turnover and legal actions(4). Job satisfaction is important to integrate an organization. In other words, satisfied employees participate in and help to build an organization's success(59). Workplace cyberbullying affects job satisfaction among employees more than traditional workplace bullying, observed by Sprigg et al. study(29). Their findings also supported by Farley et al. study(20). These studies found that cyberbullying detrimentally affects a worker's psychological and physical well-being, which results in lower job satisfaction and higher stress(20). Similarly, a study by Baruch 2005, which investigated whether cyberbullying can affect employees' job satisfaction, found a highly significant negative relationship between cyberbullying and job outcomes. The experience of cyberbullying resulted in an increased intention to leave the organizations, higher anxiety level, and lower job satisfaction as per Baruch study in 2005(16). This study has measured job outcomes (job satisfaction, anxiety, productivity, absenteeism and intention to leave job) with using single items inventory such as "I am satisfied with my job", "I feel subject to a high level of stress", "I am a very productive employee", "I am frequently absent from work on sick leave", "I am considering quitting my job at multinational company (MNC)", respectively(16). Some researches even suggest that the impact of bullying spreads to the individuals who witness such behavior(4). Similarly, Hoel, Einarsen and Cooper 2003 study reported that one in five individuals who witnessed bullying considered leaving their organization because of having witnessed such abusive behavior(4). Previous research shows that lower levels of job satisfaction and higher levels of stress and feelings of guilt and fear, insomnia, and headaches reported among witness of cyberbullying(4). These researchers also found that bullying associated with higher turnover and intention to leave(4). In the cross-sectional study by Janssens H et al. in Belgium has mentioned that presenteeism at workplace not only due to the health condition of workers but also due to their psychosocial conditions at work like bullying at the workplace(60). Bullying significantly predicted the risk of disability retirement. Bullied employees have a higher risk of disability than non-bullied employees both bullied men and women had a higher risk of disability than non-bullied employees(61).

1.4.1 Burnout Burnout is a psychological syndrome that occurs due to prolonged engagement in work situations that are emotionally demanding(62). Two core dimensions of burnout are emotional exhaustion and detachment. Emotional exhaustion refers to a profound feeling of fatigue and lack of emotional and mental energy required to meet job demands and is considered the most visible manifestation of burnout. Detachment, "and the associated dimension of cynicism," represents a cynical and indifferent approach toward other people which results from an attempt to distance oneself from work(62) emotionally. The persistent harassment by managers or co‐ workers leads to uncertainty and anxiety because of continuous thought about whether it will continue and how it will affect their position in the organization(62). Therefore, Workplace bullying creates unsafe working conditions, characterized by high job demands and low job

resources(62). Thus, as a form of continuous aggressive behavior at work, workplace bullying could become a significant job demand for the targeted individuals, leading to excessive effort investment, and consequently, burnout, depression, and job dissatisfaction(62). From an organizational perspective, workplace bullying associated with employee turnover, reduced motivation, and organizational commitment, reduced functioning, and productivity loss(47,62). Burnout that consists of 3 dimensions – emotional exhaustion, depersonalization and reduced professional efficacy(62) – is a widespread health-related problem in the current working life and develops as a prolonged response to chronic emotional and interpersonal stressors that repeatedly occur in the working environment(62). Some studies have confirmed that high job demands result in the occupation burnout which, in turn, leads to health problems in various occupational groups, including teachers(62). The study results indicated the cumulative effects of exposure to several stressors, including workplace bullying and psychosocial job characteristics (high demands, low control, and low social support at work) that contributed to the victimization and development of mental health problems(62). Recent investigations directed towards the understanding of possible interconnections between bullying and burnout, showing that bullying found positively associated with burnout among nurses(62). Another recent study on nurses has indicated that workplace bullying does not affect health directly, but only indirectly, via the mediation of burnout(62). According to the GHQ-12 assessment results, a quarter (25%) of all respondents classified as sufferers from psychological distress(63) — high emotional exhaustion found in 25.6%, high depersonalization in 10.6%. The workplace bullying was prevalent at the rates of 8.3% for occasional and 2.9% for severe bullying. A quarter (25%) of Kaunas teachers suffered from psychological distress(63). Our study revealed that occasional and severe bullying were strong predictors for psychological distress after adjustment to adverse psychosocial job characteristics and burnout(63). Workplace bullying and burnout found independently associated with poor mental health among teachers. Since adverse psychosocial working conditions lead teachers to poorer mental health, which in turn affects the educational process of new generations, preventive measures again workplace bullying can improve employees wellbeing(63). A study among teachers in Lithuania in 2014 found the association between psychological stress (measured by GHQ -12), burnout (measured by Maslach burnout inventory (MBI) and workplace bullying (measured by 22 items negative acts questionnaire(63). Workplace bullying was prevalent among Kaunas teachers (occasional 8.3%, severe 2.9%). The results showed that twenty-five percent of teachers suffered from psychological distress and 25.6% had high emotional exhaustion, 10.6% had high depersonalization, and 33.7% had low personal achievement in 33.7% of cases(63). Occasional and severe bullying found associated with psychological distress, after adjusting to factors such as job strain, social support, emotional exhaustion, depersonalization and personal accomplishment)(63).

1.4.2 Psychological stress A prospective study among Norwegian workers with 5-year time lag with the purpose of exploring a long-term relationship between exposure to workplace bullying and psychological health outcomes in the form of anxiety and depression(64). Workplace bullying poses a severe long-term threat to the health and wellbeing of workers, at least for men. The results of the study pointed out the importance of prevention of workplace bullying and subsequently preserving the mental wellbeing of the workers(64). Another cross-sectional study among 50 organizations in Japan also followed the mediation analysis by Baron and Kenny and showed the mediating effect of workplace bullying for job

strain, and symptoms of depression and sleep disturbance. They concluded that workplace bullying seems to play essential roles in the relationships of job strain with depression or sleep disturbance in both genders(65). A cross-sectional study among 342 new graduate nurses, working in acute care hospitals in Ontario, Canada, purposed to test a model linking authentic leadership to new graduate nurses experiences of workplace bullying and burnout, and eventually job satisfaction and intent to leave their job(66). They did path analysis within structural equation modeling. They found that authentic leadership had a direct adverse effect on workplace bullying, which in turn had a direct positive direct effect on emotional exhaustion(66). The findings from this study demonstrate the fundamental importance of authentic leadership in creating supportive working environments(66). An authentic leadership style may reduce the probability of a unit culture of workplace bullying developing, contributing to a nursing workforce that is less burned out, more satisfied with their job, and ultimately, less likely to leave their position(66). Adverse psychosocial work conditions may influence the motivation of employees to adhere to their job(67). A cross-sectional study among 1809 Danish hospital employees, about the relationship between psychosocial work environment (job demands, job resources, management quality and exposure to workplace bullying) and intention to quit the job(67), Six factors were identified as independently associated with the wish to quit or not: self-assessed health status, meaningfulness of the job, quality of collaboration between colleagues, age, the trustworthiness of closest superior(s) and exposure to bullying(67). They applied logistic regression model and found that 50% or more would quit if this were economically possible(67). They concluded that psychosocial work conditions independently associated with intention to quit the job if economically possible(67). Consequences of workplace bullying linked to intent to leave, turnover, and harmful emotional and physical effects. An exploratory, descriptive, online survey among nurse managers in acute care settings across the United States to explore relationships between authentic leadership style, global social power, job demand, job control, and workplace bullying of the nurse. This study found that 35% of nurse managers reported nurse managers are recipients of workplace bullying (severity ranging from occasional to severe) emanating from executive nurse leaders, clinical nurses, and their nurse manager peers(68). In the restaurant sector, a study regarding potential consequences of workplace bullying indicated that bullying prevails in the restaurant industry, with apprentices as a risk group(69). Bullying was negatively related to job satisfaction, commitment, employees' perceptions of creative behavior, and external evaluations of restaurant creativity level, and positively related to burnout and intention to leave the job(69). They also found with mediation testing, where bullying was a predictor for intention to leave a job, and job satisfaction, commitment, and burnout were a mediator(69). An online survey was conducted by newly licensed registered nurses in South Korea. They used The Copenhagen Psychosocial Questionnaire II was used to measure violence and nurse job outcomes(70). Multiple linear and logistic regression analyses conducted. Verbal abuse was most prevalent (59.6%), followed by threats of violence (36.9%), physical violence (27.6%), bullying (25.6%), and sexual harassment (22.4%)(70). Approximately three-quarters of the nurses had experienced at least one type of violence. The main perpetrators were patients and nurse colleagues, although the distribution of perpetrators varied depending on the type of violence(70). Bullying had a significant relationship with all four job outcomes (job satisfaction,

burnout, commitment to the workplace, and intent to leave), while verbal abuse found associated with all job outcomes except for intent to leave(70). A longitudinal study over 12 months performed among 699 nurses about the role of the psychological need satisfaction concerning workplace bullying and employee functioning (burnout, work engagement, and turnover intention). The results from cross-lagged analyses show that workplace bullying thwarts the satisfaction of employees' basic psychological needs and fosters burnout after 12 months later. Besides, when taking into account the cross-lagged effect of workplace bullying on employee functioning, need satisfaction fosters work engagement and hinders turnover intention over time(71). A Palestinian study, among 343 nurses in the Hebron district, has examined cross-sectional associations between exposure to workplace aggression and the occurrence of psychological distress and job satisfaction(72). The participants responded to questions about their sociodemographic status, workplace aggression (WHO questionnaires), psychological distress (General Health Questionnaire, GHQ-30), and job satisfaction (Generic Job Satisfaction Scale) (72). The result showed that about 7.3% reported exposure to bullying and colleagues were the primary source of bullying. Males reported a higher prevalence of bullying than females — workplace bullying associated with lower job satisfaction(72). Bullying is a kind of psychological terror that takes place in the form of repeated attacks among workers, as well as by the manager on the employees, aiming to instill stress, job dissatisfaction, and exhaustion on the employees(73). It has been put forth especially by recent studies that the leadership styles of the managers are highly influential on bullying(73). The study was carried out with 1189 forest engineers working at 25 different Regional Directorates of Forestry in Turkey(73). The status of the employee and the type of leadership style found associated with workplace bullying(73). A quantitative research study, among a total of 308 radiation therapists, findings indicate a need for evaluation of the radiation therapy workplace, to identify the effects of workplace bullying in the radiation therapy department on job performance and explore the environment and morale of individuals who work with a bully(74). Participants indicated that working in a hostile environment led to forgetfulness, ineffective communication, and perceived discrepancies in promotion and treatment by management. This study concluded that any bullying behavior contributes to an overall toxic work environment, which is unhealthy and unsafe for the employees(74). Cross-Sectional research investigated the current state of face-to-face bullying and cyberbullying among nurses in the workplace(75). Electronic communication by computer or smartphone widely used as a prompt and efficient means of facilitating nursing work; however, this leads to the possibility of cyberbullying as well as face-to-face bullying among nurses. A total of 226 staff nurses working in one of five tertiary hospitals in Korea with a career of 10 years or shorter were surveyed using a self-reported questionnaire(75). The mean face-to-face bullying score was 1.32±0.53and the cyberbullying score was 1.14±0.37 (possible range: 1-5); most were workrelated negative experiences(75). The explanatory power of nursing organizational culture for face-to-face bullying was 6.3%, and relation-oriented culture and hierarchy-oriented culture were significant factors affecting face-to-face bullying(75). The explanatory power of nursing organizational culture for cyberbullying was 4.3%, and relation-oriented culture was a significant factor affecting cyberbullying(75). The relation-oriented culture had a significant effect on both face-to-face bullying and cyberbullying. This study suggested that cyberbullying should consider

as an essential type of workplace bullying in nursing, which occurs via various information and communication devices(75). The negative effects of in-person workplace bullying (WB) are well established(27). Less known about cyber-bullying (CB), in which negative behaviors mediated by technology(27). Giving on the conservation of resources theory, online research survey examined how individual and organizational factors were related to WB and CB at two-time points three months apart among 826 participants(27). 15% of participants had bullied, and 2.8% of participants had been cyberbullied within the last six months(27). Women reported more WB, but not more CB, than men. Worse physical health, higher strain, more destructive leadership, more team conflict, and less effective organizational strategies associated with more WB. Managerial employees experienced more CB than non-managerial employees(27). Poor physical health, less organizational support, and less effective organizational strategies found associated with more CB(27). Rates of CB were lower than those of WB, and very few participants reported experiencing CB without also experiencing WB. Both forms of bullying were related to poorer work environments(27). Workplace bullying is an occupational hazard for trainee doctors. However, little known about their experiences of cyberbullying at work(26). This study examines the impact of cyberbullying among trainee doctors, and how attributions of blame for cyberbullying influence individual and work-related outcomes. A study, among trainee doctors at over six months, was asked to complete an online survey that included measures of cyberbullying, blame attribution, negative emotion, job satisfaction, interactional justice, and mental strain. A total of 158 trainee doctors completed the survey(26). Overall, 46.2% of respondents had experienced at least one act of cyberbullying. Cyberbullying adversely impacted on job satisfaction (β = - 0.19; p < 0.05) and mental strain (β = 0.22; p < 0.001), although attributions of blame for the cyberbullying influenced its impact and the path of mediation(26). Negative emotion mediated the relationship between self-blame for a cyber-bullying act and mental strain, whereas interactional injustice mediated the association between blaming the perpetrator and job dissatisfaction. This study concluded that the acts of cyberbullying had been experienced by nearly half of the sample during their training and were found to significantly relate to ill health and job dissatisfaction(26).

1.4.3 Study need There are fewer studies available about workplace cyberbullying in the literature. This study conducted to explore the extent of the workplace (cyber) bullying and its relation with work stressors and different consequences because of work stressors, which would enrich the existing knowledge about bullying behavior in the workplace. For the summery, most of the research about workplace cyberbullying are conducted using a cross-sectional study method, as (cyber) bullying considered a sensitive problem. Most of the conclusions and results are derived from quantitative data by an online survey. Few of the studies are qualitative studies to reach out the depth of workplace cyberbullying phenomenon, but there is a question of generalizability of conclusion. There is a knowledge gap about risk factors associated with workplace cyberbullying in the literature. There is a necessity to explore prevalence and risk factors, looking at the effects of workplace cyberbullying on employee's health and the organization. In summary, there is increasing research on workplace cyberbullying but limited data on variables specifically associated with workplace cyberbullying. Our study will examine the association of socio-demographic variables and work-related variables with workplace

cyberbullying. Most previous studies have used a cross-sectional study design, which may be because bullying (especially cyberbullying) is considered a sensitive problem. Most conclusions had derived from quantitative data collected through online surveys. Although a small number of studies with qualitative examinations of workplace cyberbullying, the generalizability of their conclusions is unclear. This study conducted using a cross-sectional study, as bullying is a sensitive issue. This study will explore the co-occurrence of workplace bullying and workplace cyberbullying and also mediating role of workplace (cyber) bullying in the association between work stressors and outcomes (emotional exhaustion, detachment, general unwell-being, intention to leave job and job satisfaction). This analysis will enrich the existing literature and will assist policymakers and preventive advisors in enacting preventive measures among employees and employers to improve wellbeing in the workplace.