Validation of the Bullying Scale for Adults - Results of the PRONIA-study

https://doi.org/10.1016/j.jpsychires.2020.04.004Get rights and content

Highlights

  • BSA assesses bullying retrospectively throughout school and working life.

  • Bullying was significantly less frequent in healthy controls than in patients.

  • No differences between patient groups regarding bullying.

  • High item scale discrimination and very good internal consistency.

  • Good concurrent validity.

Abstract

Background

Bullying as a specific subtype of adverse life events is a major risk factor for poor mental health. Although many questionnaires on bullying are available, so far none covers bullying retrospectively throughout school and working life. To close this gap, the Bullying Scale for Adults (BSA) was designed.

Methods

Based on data of 622 participants from five European countries collected in the prospective multicenter Personalized Prognostic Tools for Early Psychosis Management (PRONIA) study, we investigated whether the BSA is a reliable and valid measurement for bullying and whether there is a difference across different diagnostic groups of early mental disorders (recent onset depressive/ psychotic patients, patients at clinical high-risk of psychosis) and healthy controls.

Results

Bullying experiences were significantly less frequent in healthy controls than in patient groups, with no significant differences between the three clinical groups. The BSA exhibited a high item scale discrimination (r > .3) and very good internal consistency (Cronbach's α = .93). Four factors were identified: 1. Sexual harassment, 2. Emotional Abuse, 3. Physical Abuse, 4. Problems at school. The highly significant correlation between bullying, and childhood adversities and trauma (r = .645, p < .001) indicated good concurrent validity.

Discussion

The BSA is the first validated questionnaire that, in retrospective, reliably records various aspects of bullying (incl. its consequences) not only throughout childhood but also working life. It can be used to assess bullying as a transdiagnostic risk factor of mental disorders in different mental disorders, esp. psychosis and depression.

Introduction

Mental disorders are one of the main causes of disability worldwide and, therefore, are associated with enormous social costs (Gustavsson et al., 2011; Reeves et al., 2011; Whiteford et al., 2013). In Europe, depression and psychosis are among the three most expensive brain disorders (Gustavsson et al., 2011). To prevent these, modifiable disorder-specific as well as important transdiagnostic risk factors need to be identified. Childhood adversities and traumatic experiences (CAT) have been repeatedly reported to be such important transdiagnostic risk factors (Iffland et al., 2013; Read et al., 2007; Saed et al., 2013; Salokangas et al., 2019; Schussler-Fiorenza Rose et al., 2016). Within the context of CAT, childhood bullying is an important aspect, related in itself to poor mental health and reduced adaptation to adult roles (Copeland et al., 2013; Moffa et al., 2017; Nansel et al., 2004; Niedhammer et al., 2006; Nolfe et al., 2007; Rigby, 1999; Trotta et al., 2013; Valmaggia et al., 2015; Wolke and Lereya, 2015). In addition, in adulthood, a connection between workplace bullying and poor mental health was repeatedly shown (Einarsen and Nielsen, 2015; Finne et al., 2011; Leach et al., 2017; Nielsen and Einarsen, 2012; Nielsen et al., 2010; Rugulies et al., 2012; Verkuil et al., 2015). A meta-analysis (Lahelma et al., 2012) reported that victims of workplace bullying had a 68% increased probability of subsequent poor mental health compared to people not experiencing workplace bullying; and that exposure to workspace bullying predicted mental health problems 5–7 years later. In doing so, the association between workplace bullying and poor mental health was independent of the influence of other common workplace psychosocial adversities (Hauge et al., 2010; Lahelma et al., 2012). In addition, bullying significantly impacted on job satisfaction, workforce retention, and work quality (Vessey et al., 2010). In the light of these results, it seems important to not only record bullying experiences in childhood but also in current occupation.

With regard to bullying in childhood and adolescence, reported prevalence rates greatly differ, which is most likely due to differences in the operationalization of bullying (Menesini and Nocentini, 2009). A recent review (Juvonen and Graham, 2014) estimated the prevalence of bullying in youth at 20–25%, while a meta-analysis with a total sample of 335.519 young people (12–18 years) reported a mean prevalence of traditional bullying of 35%, while the prevalence of workplace bullying in 70 studies was 14.6% (Modecki et al., 2014).

The term “bullying” was defined by Olweus (1991) as the repeated exposure over time to negative actions (physical and verbal) of one or more other pupils. Leymann (1996) complemented Olweus’ definition by a time criterion of a minimum duration of six months and a minimum frequency of one event per week. The term “mobbing” is often used synonymously but was originally conceived for the behavior of a group but not a single person against an individual (Heinemann, 1972; Olweus, 1973).

Commonly, the various questionnaires on bullying (Einarsen, 2001; Felix et al., 2011; Finkelhor et al., 2005; Leymann, 1990; Swearer, 2016), incl. the most established one, the Bully-/Victim-Questionnaire (Cornell and Bandyopadhyay, 2009; Olweus, 1996), exclusively cover either school or working life but not both. To close this coverage gap, Ruhrmann and Kaiser developed the Bullying Scale (BSA) (Ruhrmann and Kaiser, 2013), which is based on the Bully Survey (Swearer, 2016). With 21 items, the BSA is significantly shorter than the 46-item school period-focused Bully Survey and, additionally, covers working life. Other than the Bully Survey, the BSA records duration and frequency of bullying as well as the kind of perpetrator. Just as the Bully Survey, the BSA is complemented by a list of the most frequent consequences of bullying experiences. Furthermore, similar to the Bully Survey but in contrast to other bullying scales, the BSA asks for both own bullying experiences and own bullying activities.

In this study, the psychometric properties, validity and reliability, of the BSA were investigated in a large European sample that was recruited within the multicenter Personalized Prognostic Tools for Early Psychosis Management (PRONIA) study (Koutsouleris et al., 2018) (see www.pronia.eu), which allowed the evaluation of the BSA in five different European countries and four different languages. Additionally, the prevalence of bullying in this young European sample was examined and compared across language regions.

Section snippets

Sample

Participants were recruited within the PRONIA study, a prospective project funded by the European Union under the 7th Framework Program (grant agreement n° 602152). Seven clinical centers (German region: Munich (LMU), Bale (UBS) and Cologne (UKK); Finnish region: Turku; English region: Birmingham (BHAM); Italian region: Udine and Milan) in five European countries participated. Three clinical groups, i.e., patients clinically at high-risk of psychosis (CHR), patients with a recent onset

Sample characteristics

Baseline data of 706 participants were included (Table 1). After excluding 82 subjects, 622 persons remained for further analyses (n = 383 (61.58%) German region, n = 99 (15.92%) Italian region, n = 60 (9.65%) Finland, n = 80 (12.86%) England). Throughout the entire sample, the HCs were the largest group (n = 251 (40.35%)) and 52.6% (n = 327) were female. The average age was 24.91 years (SD = 5.98). HCs were also the largest group within the individual countries. The sizes of the patient groups

Discussion

Within PRONIA, the BSA was developed as a brief self-report scale of bullying experiences, covering bullying in both childhood and the current living situation. The aim of the present study was to examine the major psychometric properties of the BSA and to compare bulling and childhood adversities and trauma measured by the CTQ.

Conclusion

Overall, the BSA can be regarded as a reliable and valid instrument for the measurement of bullying. However, the results from the BSA may only be compared with caution to other bullying research and a further evaluation of the questionnaire seems worthwhile. To the best of our knowledge, it is the first questionnaire that covers past and current bullying as well the own engagement in it as a perpetrator. Moreover, it is an extremely economic questionnaire that has the potential to be used in a

Funding Sources

PRONIA is a Collaborative Project funded by the European Union under the 7th Framework Programme under grant agreement n° 602152. CP was supported by NHMRC Senior Principal Research Fellowship (628386 & 1105825) and EU-NHMRC grant (1075379).

Role of Funding Sources

The funding organizations stated above were not involved in the design and conduct of the study; the collection, management, analysis, and interpretation of the data; the preparation, review, or approval of the manuscript; and decision

CRediT authorship contribution statement

Theresa Katharina Haidl: Conceptualization, Methodology, Formal analysis, Writing - original draft. Nicole Schneider: Methodology, Formal analysis, Data curation. Kim Dickmann: Methodology, Formal analysis, Data curation. Stephan Ruhrmann: Supervision, Writing - review & editing. Nathalie Kaiser: Project administration, Conceptualization, Validation. Marlene Rosen: Project administration, Validation. Mauro Seves: Investigation, Validation. Thorsten Lichtenstein: Investigation, Software,

Declaration of competing interest

Christos Pantelis has participated on Advisory Boards for Janssen-Cilag, Astra-Zeneca, Lundbeck, and Servier. He has received honoraria for talks presented at educational meetings organised by Astra-Zeneca, Janssen-Cilag, Eli-Lilly, Pfizer, Lundbeck and Shire.

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