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Examining the role of self-conscious emotions and perfectionistic self-presentation in workplace bullying among Korean nurses: a cross-sectional study

BMC Nursing volume 24, Article number: 528 (2025) Cite this article

Abstract

Background

There is a lack of systematic evaluations of the diversity and effectiveness of interventions to prevent workplace bullying. This cross-sectional study aimed to investigate the relationships among self-conscious emotions, perfectionistic self-presentation, and workplace bullying, focusing on both victim and perpetrator roles among nurses in South Korea.

Methods

Data from 522 nurses working in tertiary hospitals in South Korea were analyzed. Self-conscious emotions, perfectionistic self-presentation, and workplace bullying were assessed using the Test of Self-conscious Affect version 3 Short, the Perfectionistic Self-Presentation and Psychological Distress Scale, the Negative Acts Questionnaire-Revised, and the Negative Acts Questionnaire-Revised-Perpetrator.

Results

Among victims, shame-proneness was the most significant factor, followed by anti-bullying training, subjective health status, externalization, current working unit, and total years of experience. Among perpetrators, shame-proneness was also the most significant factor, followed by guilt-proneness, anti-bullying training, externalization, perfectionistic self-presentation, current working unit, detachment/unconcern, subjective health status, and religion.

Conclusions

While the influencing factors differed between victims and perpetrators, self-conscious emotions and perfectionistic self-presentation were key contributors to workplace bullying. Understanding these factors can support the development of interventions to prevent workplace bullying from both victim and perpetrator aspects. Trait-focused interventions, such as enhancing shame resilience, may help nurses manage aggressive behaviors, thereby reducing workplace bullying. Recognizing personality traits, including self-conscious emotions and perfectionistic self-presentation, may help nurses better understand their own and others’ behaviors in the workplace. Nurse managers and administrators should consider these traits when addressing conflicts among nurses.

Clinical trial number

Not applicable.

Peer Review reports

Background

Workplace bullying refers to harmful behaviors that are intentionally and repeatedly carried out to humiliate, offend, or distress another person [1]. Workplace bullying can take various forms, including verbal abuse, physical threats, public disrespect, and excessive workloads [2]. In nursing, workplace bullying not only causes mental and physical health problems, negatively impacting nurses’ well-being [3], but also affects nursing practices and patient outcomes [3, 4]. Workplace bullying arises from a combination of personal factors, such as sex, marital status, education level, and negative emotional dispositions, and organizational factors, including managerial and organizational characteristics and a lack of coworker support [3]. Although various influencing factors have been analyzed and interventions have been developed, they remain insufficiently understood. Furthermore, systematic evaluations of the diversity and effectiveness of interventions to prevent workplace bullying remain limited [5].

Among personal characteristics, personality encompasses the ways individuals think, feel, and behave, which become stable over time and across situations, distinguishing them from others [6]. A nurse’s personality influences how they perceive their work environment, plays a key role in their sense of pride and dignity in nursing [7], and affects their experience of workplace bullying [8, 9]. The same situation may be perceived differently based on individual personality traits. Self-conscious emotions, defined as “a personality trait associated with the tendency to reflect on or think about oneself [10],” can be categorized into shame- and guilt-proneness, depending on whether the emotional focus is on the self or the specific behaviors [11]. These emotions, shaped through the process of self-evaluation based on self-awareness and self-representation [12], represent stable traits that lead to differences in cognitive, emotional, and behavioral responses to personal transgressions [13]. For instance, individuals with high shame-proneness tend to attribute failures to their own incompetence, whereas those with high guilt-proneness view failures as a consequence of their lack of effort [13]. Consequently, individuals prone to shame may struggle to overcome negative events, as their self-esteem is disrupted [14]. They may also express their distress through aggressive behavior and anger [15], which can be associated with workplace bullying. Given that nursing is a profession with little tolerance for mistakes and high expectations for accountability, such tendencies can intensify self-doubt, fear of failure, impostor feelings, and burnout among nurses [16], potentially exacerbating workplace bullying. To mitigate the effects of shame, promoting shame resilience among nurses may be an effective intervention [17].

Perfectionistic self-presentation refers to the desire to be perceived as perfect by others [18]. It involves portraying oneself as flawless rather than genuinely striving for perfection [19]. Individuals with high perfectionistic self-presentation are more likely to exhibit behaviors they believe will make them appear perfect, while concealing behaviors that may be perceived as flawed [19]. This trait contributes to psychological distress and maladjustment, including depression, loneliness, despair, and social anxiety [20]. Perfectionistic self-presentation is also a significant predictor of workplace bullying (victim aspect) [9]. Furthermore, individuals with high perfectionistic self-presentation may avoid negative evaluations and conceal their imperfections [19], making them more vulnerable to negative judgments or criticism when mistakes occur in nursing practice. Additionally, these individuals tend to avoid engaging in workplace bullying owing to their concerns about how they will be perceived by others [18]. According to the Perfectionism Social Disconnection Model, perfectionistic self-presentation involves defensive interpersonal behaviors aimed at securing others’ love and respect while avoiding shame and rejection [21]. Interventions targeting perfectionistic self-presentation could reduce vulnerability to negative evaluations and criticism in nursing practice, thereby helping alleviate social anxiety, depression, and vulnerable narcissism [22].

This study hypothesized that shame-proneness and perfectionistic self-presentation—traits that involve self-blame when things go wrong rather than focusing on the events themselves—are significantly associated with workplace bullying as key contributing factors. Furthermore, as highlighted in a recent systematic review on future research agendas [23], it is essential to analyze workplace bullying-related factors from both victim and perpetrator aspects. While most research has focused on victims, few studies have explored the behavioral characteristics and contributing factors of perpetrators. Effective workplace bullying interventions should not only support victims but also incorporate strategies targeting perpetrators. Research has shown that experiences of workplace bullying can be associated with reciprocal perpetration [24], and in line with the concept of a vicious cycle of workplace bullying, individuals can become either victims or perpetrators [5]. In addition, Jang et al. [25] simultaneously examined the experiences of both victims and perpetrators in their research, suggesting the need for a multifaceted analysis of workplace bullying among nurses. Accordingly, this study aimed to investigate the relationships between workplace bullying, nurses’ self-conscious emotions, and perfectionistic self-presentation, considering both victim and perpetrator aspects.

Methods

Design

A cross-sectional study design was employed.

Participants and data collection

The inclusion criteria for this study were as follows: (1) nurses working in a tertiary hospital in South Korea and (2) nurses who had worked for at least three months, corresponding to the probationary period. The exclusion criteria were as follows: (1) nurses working in departments with only one nurse, (2) nurses in non-direct nursing roles, such as administrative positions, and (3) nurses diagnosed with or receiving treatment for mental health conditions.

A convenience sampling method was employed. Data were collected through an online survey conducted between February 15 and February 26, 2023. The sample size for multiple regression analysis was calculated using G*power 3.1.9.7. Based on a two-tailed test with a significance level of 0.05, a power of 0.95, 20 predictors, and an effect size of f2 = 0.15, the minimum required sample size was 346. To account for a 20% dropout rate, the target sample size was set at approximately 450 participants.

Recruitment was conducted via an open invitation posted on the groupware bulletin board of a tertiary hospital and in an online community primarily used by hospital nurses. A total of 568 questionnaires were collected. After excluding 46 responses that met the exclusion criteria (22 nurses not working in tertiary hospitals, 21 nurses diagnosed with or receiving treatment for a mental health condition, and three nurses in non-direct nursing roles), the final sample included 522 nurses for analysis. The study adhered to the STROBE reporting guidelines.

Measurements

Based on previous studies [9], a self-report questionnaire was developed to collect information on the participants’ general and work-related characteristics. The tools used to evaluate self-conscious emotions, perfectionistic self-presentation, and workplace bullying (from both victim and perpetrator aspects) are described below.

Self-conscious emotions

Self-conscious emotions were measured using the Test of Self-conscious Affect version 3 Short (TOSCA-3 S) [26]. The TOSCA-3 S presents 11 scenarios depicting negative situations encountered in daily life. The participants rated their responses for shame-proneness, guilt-proneness, detachment/unconcern, and externalization on a five-point Likert scale (1: Not likely, 5: Likely). Each scenario includes items for all four domains, with 11 questions per domain, totaling 44 items. Higher scores indicate greater proneness to the respective self-conscious emotion [26]. Cronbach’s α for the TOSCA-3 S ranged from 0.77 to 0.88 in the original study [26], whereas in this study, it ranged from 0.67 to 0.83.

Perfectionistic self-presentation

Perfectionistic self-presentation was measured using the Korean version [19] of the Perfectionistic Self-Presentation and Psychological Distress Scale [18]. This tool consists of 19 items rated on a seven-point Likert scale (1: Never, 7: Always) and is divided into three subscales: perfectionistic self-promotion (8 items), non-display of imperfection (5 items), and non-disclosure of imperfection (6 items). The original tool reported Cronbach’s α between 0.91 and 0.95 [18], while the Korean version demonstrated a reliability of 0.85 (ranging from 0.75 to 0.88) [19]. In this study, Cronbach’s α was 0.86, with subscale reliabilities ranging from 0.70 to 0.78.

Workplace bullying (victim and perpetrator aspects)

The victim aspect of workplace bullying was assessed using the Korean version [27] of the Negative Acts Questionnaire-Revised (NAQ-R) [28]. This tool consists of 22 items rated on a five-point Likert scale, with total scores ranging from 22 to 110. Cronbach’s α was 0.93 in both the original study [28] and the Korean version [27], and in this study, it was 0.92.

The perpetrator aspect of workplace bullying was assessed using the Negative Acts Questionnaire-Perpetrator (NAQ-P), which was adapted from the NAQ-R [28] to focus on perpetrator behaviors. The NAQ-P consists of 22 items rated on a five-point Likert scale, with total scores ranging from 22 to 110. The tool’s reliability and validity were previously confirmed, with a Cronbach’s α value of 0.97 at the time of development and 0.93 in this study.

Data analysis

Data were analyzed using SPSS Statistics version 26.0. Differences in workplace bullying (both victim and perpetrator aspects) based on the participants’ general and work-related characteristics were analyzed by conducting independent t-tests and one-way analysis of variance. Post-hoc comparisons were made by conducting Scheffe’s test to identify significant group differences. Pearson’s correlation coefficient was used to examine correlations between self-conscious emotions, perfectionistic self-presentation, and workplace bullying (victim and perpetrator aspects). Multiple linear regression analysis was performed to identify factors influencing workplace bullying. The Kolmogorov–Smirnov test was used to assess normality, while the Breusch–Pagan test was conducted to check for homoscedasticity of residuals.

Ethical considerations

The study was conducted after obtaining approval from the Institutional Review Board of Chung-Ang University (No. 1041078-202208-HR-173, Approval date: September 5, 2022). Participants who accessed the study via a link to the posted research advertisement were provided with an informed consent form explaining the study’s purpose, methods, anonymity, and their right to withdraw at any time. After obtaining informed consent, the survey link to complete the questionnaires was provided to those who voluntarily chose to participate in this study.

Results

Participant characteristics and workplace bullying experiences

The mean age of the participants was 31.23 years (standard deviation = 5.61), with an average of 7.09 years (standard deviation = 5.02) of total work experience. Among the 522 participants, 495 (94.8%) were female, 329 (63.0%) were single, and 444 (85.1%) held a bachelor’s degree. A total of 316 participants (60.5%) were working in a ward, and 437 (83.7%) were staff nurses. Additionally, 260 participants (49.8%) had completed anti-bullying training within the past year. In Table 1, the experiences of workplace bullying (victim, perpetrator, and bystander) reported by the participants represent dichotomous results derived from the participants’ subjectively perceived experiences over the past year. Of the total number of participants, 165 (31.6%) reported being victims of workplace bullying, 45 (8.6%) admitted to perpetrating bullying, and 226 (43.3%) had witnessed workplace bullying.

Table 1 Participants’ characteristics and workplace bullying experiences (N = 522)
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Comparison of workplace bullying by general and work-related characteristics

Workplace bullying (victim aspect) scores were significantly higher among the participants who identified themselves as religious, those working in wards (compared to outpatient or other units), staff nurses, those reporting poor health status, and those who had not completed anti-bullying training within the past year. In contrast, workplace bullying (perpetrator aspect) scores were higher for the female participants, those identifying as religious, and those working in wards or intensive care units (compared to outpatient or other units). Additionally, those with poor health status and those who had not completed anti-bullying training within the past year had higher perpetrator scores than those in better health or who had undergone training (Table 2).

Table 2 Comparison of workplace bullying based on general and work-related characteristics (N = 522)
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Correlations among age, working years, self-conscious emotions, perfectionistic self-presentation, and workplace bullying (victim and perpetrator aspects)

Workplace bullying (victim aspect) was positively correlated with self-conscious emotions, including shame-proneness, detachment/unconcern, and externalization (except guilt-proneness), and negatively correlated with age and total working years. Workplace bullying (perpetrator aspect) was positively correlated with shame-proneness, detachment/unconcern, and externalization but negatively correlated with age, total work experience, perfectionistic self-presentation, and guilt-proneness. Moreover, a significant positive correlation was observed between the victim and perpetrator aspects of workplace bullying (Table 3).

Table 3 Correlations among working years, self-conscious emotions, perfectionistic self-presentation, and workplace bullying (victim and perpetrator aspects) (N = 522)
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Factors influencing workplace bullying

Victim aspect

The variables that were significant in the test of differences in workplace bullying (victim aspect) (religion, current working units, position, subjective health status, and completion of anti-bullying training) and the main independent variables (self-conscious emotions and perfectionistic self-presentation) were included in the regression model. No multicollinearity was observed among the independent variables (variance inflation factor: 1.02–1.54). A Durbin–Watson index of 1.95 confirmed the independence of error terms, fulfilling the assumptions for regression analysis, with the normality of residuals (Z = 0.06, p = .078) and homoscedasticity (χ2 = 6.37, p = .383) verified. This regression model explained 31.0% of the variance in workplace bullying (victim aspect). The most significant factor influencing workplace bullying (victim aspect) was shame-proneness (β = 0.29, p < .001), followed by anti-bullying training (β=-. 19, p < .001), subjective health status (β = 0.19, p < .001), externalization (β = 0.17, p < .001), current working unit (ward) (β = 0.13, p < .001), and total working years (β=-0.11, p = .004). Higher workplace bullying (victim aspect) scores were associated with poor subjective health, fewer years of work experience, working in a ward, lack of anti-bullying training, higher shame-proneness, and higher externalization (Table 4).

Table 4 Factors influencing workplace bullying (victim aspect) (N = 522)
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Perpetrator aspect

The variables that were significant in the test of differences in workplace bullying (perpetrator aspect) (sex, religion, current working unit, subjective health status, and completion of anti-bullying training) and the main independent variables (self-conscious emotions and perfectionistic self-presentation) were included in the regression model. No multicollinearity was found among the independent variables (variance inflation factor: 1.03–2.64). The Durbin–Watson index of 2.05 confirmed the independence of error terms, meeting the assumptions for regression analysis. Normality (Z = 0.05, p = .116) and homoscedasticity of residuals (χ2 = 12.23, p = .201) were also verified. This model explained 39.2% of the variance in workplace bullying (perpetrator aspect). The most significant predictor of workplace bullying was shame-proneness (β = 0.34, p < .001), followed by guilt-proneness, anti-bullying training, externalization, perfectionistic self-presentation, current working unit, detachment/unconcern, subjective health status, and religion. Higher workplace bullying (perpetrator aspect) scores were associated with those participants who were religious, had poor subjective health, had not completed anti-bullying training, had higher shame-proneness, lower guilt-proneness, higher detachment/unconcern, higher externalization, and lower perfectionistic self-presentation. Those working in outpatient departments had lower workplace bullying (perpetrator aspect) scores than those in other units (Table 5).

Table 5 Factors influencing workplace bullying (perpetrator aspect) (N = 522)
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Discussion

This study aimed to examine the factors influencing workplace bullying among nurses, focusing on both the victim and perpetrator aspects, and to identify the role of self-conscious emotions, perfectionistic self-presentation, and work experience in shaping these experiences. Shame-proneness emerged as the most influential factor in the victim aspect of workplace bullying among nurses. Shame involves a negative feeling about oneself [15], leading to a degrading self-evaluation, perceiving oneself as defective [29], and attributing failure to one’s own incompetence [13]. Shame-proneness is associated with maladaptive emotions [30] and low self-esteem [31], both of which can make it more difficult for individuals to overcome challenging situations [14]. This, in turn, can negatively influence their ability to cope with workplace bullying (victim aspect). Prior research has also highlighted poor shame management in relation to the victim aspect [32], along with its contribution to psychological distress and reduced functioning [33]. Considering the limited research on nurses, addressing shame-proneness in this population is essential. Interventions such as promoting shame resilience [17] and providing anti-bullying training may help mitigate the effects of shame-proneness.

Another significant factor in the victim aspect was externalization, which involves attributing blame for situations to external circumstances rather than internal factors. This strategy can help preserve self-esteem [14]. Given that externalizing problems are associated with trait anger [34], which has been associated with experiences of being bullied [35], externalization may play a role in workplace bullying (victim aspect). While coping mechanisms can sometimes reduce the negative effects of workplace bullying, avoidance or inaction can intensify its psychological impact [36]. Externalization may serve as a coping mechanism to improve the psychological well-being of the victim aspect of workplace bullying. However, research on externalization as a coping strategy remains limited, and further studies are needed to clarify its role.

Shame-proneness also emerged as the most significant factor influencing the perpetrator aspect of workplace bullying among nurses. Individuals with high shame-proneness tend to internalize negative feelings about themselves rather than focusing on specific behaviors [37]. This often leads to psychological problems, interpersonal problems, anger, hostility, social anxiety, reduced empathy, and a tendency to blame others [38]. Furthermore, these individuals may express their anger and engage in aggressive behaviors to regain a sense of control [15]. Since expressing hostility or aggression can serve as a defense mechanism to avoid the painful emotions associated with shame [37], it is crucial to examine the self-esteem of nurses with high shame-proneness and provide them with training on expressing their difficulties without resorting to hostility or aggression. These individuals often struggle with resolving interpersonal conflicts [38] and may experience shame in their relationships with others [39]. Therefore, providing specific training that focuses on improving their interactions with others, rather than solely focusing on the individual nurse, may be more effective.

The second significant factor affecting the perpetrator aspect of workplace bullying was guilt-proneness. In contrast to shame-proneness, guilt-proneness focuses on specific behaviors rather than the self. Individuals with high guilt-proneness tend to take responsibility for their actions and are more likely to correct their behavior or take moral action [13]. This allows them to manage anger more constructively and communicate their frustrations without hostility, leading to positive long-term outcomes [37]. Studies have found a direct negative relationship between guilt-proneness and aggression [15], supporting the findings of this study that guilt-proneness influences the perpetrator aspect of workplace bullying. According to Jacobson et al. [40], guilt-proneness, when combined with high self-esteem, leads to a greater tendency for reparative actions and reduces involvement in bullying. Thus, interventions aimed at enhancing self-esteem in nurses with guilt-proneness may help mitigate workplace bullying.

Detachment/unconcern, another influencing factor, refers to an individual’s tendency to emotionally detach or remain indifferent in situations that trigger self-conscious emotions [26]. Research suggests a negative relationship between detachment/unconcern and guilt-proneness [41]. Guilt-proneness, which focuses on specific behaviors rather than the self, encourages individuals to avoid negative actions such as bullying [37] and to work toward resolving difficulties in interpersonal relationships [38]. Despite limited research on detachment/unconcern, its established relationship with guilt-proneness aligns with the findings of this study. However, detachment/unconcern is also characterized by openness to new experiences and a willingness to change behaviors quickly to achieve rewards [42], which should be considered when designing interventions for the perpetrator aspect of workplace bullying. Despite these insights, the relationship between detachment/unconcern and workplace bullying remains largely unexplored, highlighting the need for further research.

The externalization of self-conscious emotions was also identified as a factor influencing the perpetrator aspect of workplace bullying. Externalization involves defensively attributing the pain of a shameful experience to external sources and is associated with shame-proneness [15]. It is associated with hostility and avoidance of intimacy [43], indirectly shaping the relationship between aggression and other self-conscious emotions, such as shame-proneness and guilt-proneness [15]. Given that externalization can cause interpersonal difficulties [44] by leading individuals to blame others without engaging in self-improvement [14], it likely contributes to the perpetrator aspect of workplace bullying. However, research on the relationship between externalization and workplace bullying in the context of self-conscious emotions remains limited. Given that externalization can negatively impact physical and mental health [3], as well as nursing outcomes [3, 4], addressing this issue should be a priority. Further research exploring these relationships will be valuable for developing effective interventions.

In this study, lower levels of perfectionistic self-presentation were associated with higher scores in the perpetrator aspect of workplace bullying. A previous study found that the relationship between perfectionism and hostility varies by type: certain types are linked to social disconnection and hostility, while perfectionistic self-presentation is not [45]. According to Jang et al. [9], perfectionistic self-presentation in intensive care unit nurses negatively influences the perpetrator aspect of workplace bullying, aligning with the findings of this study. Individuals with high perfectionistic self-presentation are more concerned with how they appear to others and may avoid engaging in workplace bullying to prevent negative social impressions [18]. While this study showed an association between perfectionistic self-presentation and the perpetrator aspect of workplace bullying, other studies have linked it to the victim [9] or reported contrasting findings [46]. Given that perfectionistic self-presentation also contributes to psychological distress [18], further research is needed to clarify its role in the perpetrator aspect of workplace bullying among nurses. Considering the potential for social desirability bias, qualitative studies could offer deeper insights into how workplace bullying perpetration develops over time.

Some self-conscious emotions identified in this study, such as shame-proneness, were found to influence both the victim and perpetrator aspects of workplace bullying. However, this study did not assess whether varying levels of shame-proneness are associated with the victim or perpetrator aspect—an area that could be explored in future research. According to previous research, perfectionistic self-presentation can influence both victim and perpetrator roles [9], whereas this study found a significant effect only on the perpetrator aspect. The same traits may not consistently influence workplace bullying, as victims of workplace bullying may also become perpetrators and vice versa [47]. Additionally, the effects of personality traits on workplace bullying may manifest over time [35], complicating the distinction between victim and perpetrator roles. This study found that subjective health status, current working unit, and participation in anti-bullying training influenced both the victim and perpetrator aspects of workplace bullying. Given the complexity of workplace bullying [48], addressing not only nurses’ personal characteristics but also their work environment and educational needs is essential.

Limitations

Although the present study reveals important findings, it has some limitations. First, it was a cross-sectional study; thus, the causal relationships between the variables could not be established. Longitudinal studies are needed to examine the causal links between self-conscious emotions, perfectionistic self-presentation, and workplace bullying. Second, the study relied on data from nurses working in tertiary hospitals in Korea, collected through convenience sampling. The sample was not evenly distributed across demographic and occupational characteristics, which limits the generalizability of the findings. Additionally, since the data were collected through an online open-call invitation, self-selection bias could not be avoided. To address these limitations, future studies should employ random cluster sampling and conduct multilevel analyses to enhance the robustness and generalizability of the findings. Third, the use of self-reported questionnaires introduces the possibility of social desirability bias. Finally, the identified influencing factors explained 31% of the variance in the victim aspect and 39% of the variance in the perpetrator aspect of workplace bullying. This study focused solely on self-conscious emotions and perfectionistic self-presentation, and other relevant variables may have been overlooked. Future studies should explore additional factors, such as self-esteem and support from co-workers or nurse managers, and examine how they interact with self-conscious emotions and perfectionistic self-presentation to provide a more comprehensive understanding of workplace bullying.

Implications for practice and research

Nurses can exhibit traits that may lead them to become either victims or perpetrators of workplace bullying, even when they share certain characteristics. By identifying their specific personality traits, nurses can better understand their own strengths and weaknesses, as well as the behaviors and attitudes of their colleagues. Nurse managers and administrators can offer more personalized, trait-focused support to address conflicts among staff nurses. Developing interventions to enhance shame resilience in interpersonal situations could help nurses express negative emotions or aggressive tendencies more constructively, reducing the likelihood of blaming others. These efforts could foster a positive workplace culture that embraces personality differences, ultimately improving teamwork and nursing outcomes.

While interest in how personal characteristics influence workplace bullying is growing, research on the associations between self-conscious emotions, self-presentation, and both the victim and perpetrator aspects of workplace bullying remains limited. Further research on this topic could provide valuable insights into the mechanisms underlying workplace bullying and inform the development of more effective interventions.

Conclusion

This study explored the associations between self-conscious emotions, perfectionistic self-presentation, and both the victim and perpetrator aspects of workplace bullying among Korean nurses. The findings revealed that self-conscious emotions and perfectionistic self-presentation are key factors influencing both victims and perpetrators, although the specific factors influencing each group differed. Understanding the personal characteristics of nurses can empower them to better manage challenging situations, such as workplace bullying. For nurse managers and administrators, these insights offer a foundation for developing more effective interventions to address and prevent workplace bullying.

Data availability

The data presented in this study are available upon reasonable request from the corresponding author, subject to approval by the Institutional Review Board of Chung-Ang University.

Abbreviations

TOSCA-3S:

Test of Self-conscious Affect version 3 Short

NAQ-R:

Negative Acts Questionnaire-Revised

NAQ-P:

Negative Acts Questionnaire-Perpetrator

References

  1. Wilson JL. An exploration of bullying behaviours in nursing: a review of the literature. Br J Nurs. 2016;25:303–6. https://doiorg.publicaciones.saludcastillayleon.es/10.12968/bjon.2016.25.6.303.

    Article  PubMed  Google Scholar 

  2. Lee Y, Lee M. Development and validity of workplace bullying in nursing-type inventory (WPBN-TI). J Korean Acad Nurs. 2014;44:209–18. https://doiorg.publicaciones.saludcastillayleon.es/10.4040/jkan.2014.44.2.209.

    Article  PubMed  Google Scholar 

  3. Serafin L, Sak-Dankosky N, Czarkowska‐Pączek B. Bullying in nursing evaluated by the negative acts Questionnaire‐revised: a systematic review and meta‐analysis. J Adv Nurs. 2020;76:1320–33. https://doiorg.publicaciones.saludcastillayleon.es/10.1111/jan.14331.

    Article  PubMed  Google Scholar 

  4. Johnson AH, Benham-Hutchins M. The influence of bullying on nursing practice errors: a systematic review. AORN J. 2020;111:199–210. https://doiorg.publicaciones.saludcastillayleon.es/10.1002/aorn.12923.

    Article  PubMed  Google Scholar 

  5. Jang SJ, Son YJ, Lee H. Intervention types and their effects on workplace bullying among nurses: a systematic review. J Nurs Manag. 2022;30:1788–800. https://doiorg.publicaciones.saludcastillayleon.es/10.1111/jonm.13655.

    Article  PubMed  Google Scholar 

  6. Pervin LA. Personality: a view of the future based on a look at the past. J Res Pers. 1996;30:309–18. https://doiorg.publicaciones.saludcastillayleon.es/10.1006/jrpe.1996.0021.

    Article  Google Scholar 

  7. Song HS, Lim SH, Min JS. Comparison of job satisfaction, nursing professionalism, turnover intention by Nurse’s personality type. Asia Pac J Multimedia Serv Converg Art Humanit Sociol. 2019;9:687–96. https://doiorg.publicaciones.saludcastillayleon.es/10.21742/AJMAHS.2019.02.67.

    Article  Google Scholar 

  8. Choi MR, Ha JH. The effect of workplace bullying on suicidal ideation of hospital nurses: moderated mediation effect of socially prescribed perfectionism and self-criticism. Korean J Woman Psychol. 2019;24:193–216.

    Google Scholar 

  9. Jang SJ, Kim E, Lee H. Effects of personality traits and mentalization on workplace bullying experiences among intensive care unit nurses. J Nurs Manag. 2023;2023:5360734. https://doiorg.publicaciones.saludcastillayleon.es/10.1155/2023/5360734.

    Article  PubMed  PubMed Central  Google Scholar 

  10. American Psychological Association. Self-consciousness [Internet]. Washington (DC): APA Dictionary of Psychology. 2018. https://dictionary.apa.org/self-consciousness

  11. Cândea DM, Szentagotai-Tătar A. Shame-proneness, guilt-proneness and anxiety symptoms: a meta-analysis. J Anxiety Disord. 2018;58:78–106. https://doiorg.publicaciones.saludcastillayleon.es/10.1016/j.janxdis.2018.07.005.

    Article  PubMed  Google Scholar 

  12. Tracy JL, Robins RW. Putting the self into self-conscious emotions: A theoretical model. Psychol Inq. 2004;15:103–25. https://doiorg.publicaciones.saludcastillayleon.es/10.1207/s15327965pli1502_01.

    Article  Google Scholar 

  13. Tangney JP, Dearing RL. Shame and guilt. New York: Guilford Press; 2002.

    Google Scholar 

  14. Uji M, Nagata T, Kitamura T. Narcissism: its function in modulating self-conscious emotions. Bull Menninger Clin. 2012;76:211–34. https://doiorg.publicaciones.saludcastillayleon.es/10.1521/bumc.2012.76.3.211.

    Article  PubMed  Google Scholar 

  15. Stuewig J, Tangney JP, Heigel C, Harty L, McCloskey L. Shaming, blaming, and maiming: functional links among the moral emotions, externalization of blame, and aggression. J Res Pers. 2010;44:91–102. https://doiorg.publicaciones.saludcastillayleon.es/10.1016/j.jrp.2009.12.005.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Edwards-Maddox S. Burnout and impostor phenomenon in nursing and newly licensed registered nurses: a scoping review. J Clin Nurs. 2023;32:653–65. https://doiorg.publicaciones.saludcastillayleon.es/10.1111/jocn.16475.

    Article  PubMed  Google Scholar 

  17. Alvarez DV. Using shame resilience to decrease depressive symptoms in an adult intensive outpatient population. Perspect Psychiatr Care. 2020;56:363–70. https://doiorg.publicaciones.saludcastillayleon.es/10.1111/ppc.12443.

    Article  PubMed  Google Scholar 

  18. Hewitt PL, Flett GL, Sherry SB, Habke M, Parkin M, Lam RW, et al. The interpersonal expression of perfection: perfectionistic self-presentation and psychological distress. J Pers Soc Psychol. 2003;84:1303–25. https://doiorg.publicaciones.saludcastillayleon.es/10.1037/0022-3514.84.6.1303.

    Article  PubMed  Google Scholar 

  19. Ha JH. Development and validation study of perfectionistic self-presentation scale-Korean version. Korea J Couns. 2011;12:1211–30. https://doiorg.publicaciones.saludcastillayleon.es/10.15703/kjc.12.4.201108.1211.

    Article  Google Scholar 

  20. Rnic K, Hewitt PL, Chen C, Jopling E, Lemoult J, Flett GL. Examining the link between multidimensional perfectionism and depression: a longitudinal study of the intervening effects of social Disconnection. J Soc Clin Psychol. 2021;40:277–303. https://doiorg.publicaciones.saludcastillayleon.es/10.1521/jscp.2021.40.4.277.

    Article  Google Scholar 

  21. Hewitt PL, Flett GL, Mikail SF, Kealy D, Zhang LC. Perfectionism in the therapeutic context: the perfectionism social Disconnection model. The psychology of perfectionism. Routledge; 2017. pp. 306–30.

  22. Casale S, Svicher A, Fioravanti G, Hewitt PL, Flett GL, Pozza A. Perfectionistic self-presentation and psychopathology: a systematic review and meta‐analysis. Clin Psychol Psychother. 2024;31:e2966. https://doiorg.publicaciones.saludcastillayleon.es/10.1002/cpp.2966.

    Article  PubMed  Google Scholar 

  23. Gupta P, Gupta U, Wadhwa S. Known and unknown aspects of workplace bullying: a systematic review of recent literature and future research agenda. Hum Resour Dev Rev. 2020;19:263–308. https://doiorg.publicaciones.saludcastillayleon.es/10.1177/1534484320936812.

    Article  Google Scholar 

  24. Lee J, Steigerwald N, Jex S, Rada-Bayne A, Holden C. Perpetrator-targeted reciprocated incivility: the investigation of the incivility spiral and the effects of agreeableness as a moderator. Basic Appl Soc Psych. 2024;46:19–31. https://doiorg.publicaciones.saludcastillayleon.es/10.1080/01973533.2023.2275071.

    Article  Google Scholar 

  25. Jang I, Jang SJ, Chang SJ. Factors influencing hospital nurses’ workplace bullying experiences focusing on meritocracy belief, emotional intelligence, and organizational culture: A cross-sectional study. J Nurs Manag. 2024;2024:1637066. https://doiorg.publicaciones.saludcastillayleon.es/10.1155/2024/1637066.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Tangney JP, Dearing R, Wagner P, Gramzow R. The test of self-conscious affect (TOSCA-3). Fairfax: George Mason University; 2000.

    Google Scholar 

  27. Nam W, Kim JW, Kim YK, Koo JW, Park CY. The reliability and validity of the negative acts Questionnaire-Revised (NAQ-R) for nurses for the assessment of workplace bullying. Korean J Occup Environ Med. 2010;22:129–39. https://doiorg.publicaciones.saludcastillayleon.es/10.35371/kjoem.2010.22.2.129.

    Article  Google Scholar 

  28. Einarsen S, Hoel H, Notelaers G. Measuring exposure to bullying and harassment at work: validity, factor structure and psychometric properties of the negative acts Questionnaire-Revised. Work Stress. 2009;23:24–44. https://doiorg.publicaciones.saludcastillayleon.es/10.1080/02678370902815673.

    Article  Google Scholar 

  29. Woien SL, Ernst HA, Patock-Peckham JA, Nagoshi CT. Validation of the TOSCA to measure shame and guilt. Pers Individ Dif. 2003;35:313–26.

    Article  Google Scholar 

  30. Robins RW, Noftle EE, Tracy JL. Assessing self-conscious emotions. The self-conscious emotions: theory and research. New York: Guilford Press; 2007. pp. 443–67.

    Google Scholar 

  31. Budiarto Y, Helmi AF. Shame and self-esteem: a meta-analysis. Eur J Psychol. 2021;17:131–45. https://doiorg.publicaciones.saludcastillayleon.es/10.5964/ejop.2115.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Braithwaite V, Ahmed E. Looking beneath the iceberg: can shame and pride be handled restoratively in cases of workplace bullying. Int J Restor Justice. 2019;2:209–34. https://doiorg.publicaciones.saludcastillayleon.es/10.5553/IJRJ/258908912019002002003.

    Article  Google Scholar 

  33. Wu X, Qi J, Zhen R. Bullying victimization and adolescents’ social anxiety: roles of shame and self-esteem. Child Indic Res. 2021;14:769–81. https://doiorg.publicaciones.saludcastillayleon.es/10.1007/s12187-020-09777-x.

    Article  Google Scholar 

  34. Li N, Hein S, Ye L, Liu Y. Social decision making mediates the association between anger and externalising problems in Chinese adolescents. Int J Psychol. 2019;54:501–9. https://doiorg.publicaciones.saludcastillayleon.es/10.1002/ijop.12489.

    Article  PubMed  Google Scholar 

  35. Reknes I, Notelaers G, Iliescu D, Einarsen SV. The influence of target personality in the development of workplace bullying. J Occup Health Psychol. 2021;26:291–303. https://doiorg.publicaciones.saludcastillayleon.es/10.1037/ocp0000272.

    Article  PubMed  Google Scholar 

  36. Van den Brande W, Bernstein C, Reknes I, Baillien E. The moderating effects of coping mechanisms and resources in the context of workplace bullying, emotional abuse and harassment. In: D’Cruz P, Noronha E, Baillien E, Catley B, Harlos K, Høgh A, editors. Pathways of job-related negative behaviour. Singapore: Springer; 2021. pp. 153–76. https://doiorg.publicaciones.saludcastillayleon.es/10.1007/978-981-13-0935-9_7.

    Chapter  Google Scholar 

  37. Tangney JP. Constructive and destructive aspects of shame and guilt. In: Bohart AC, Stipek DJ, editors. Constructive & destructive behavior: implications for family, school, & society. American Psychological Association; 2001. pp. 127–45. https://doiorg.publicaciones.saludcastillayleon.es/10.1037/10433-006.

  38. Covert MV, Tangney JP, Maddux JE, Heleno NM. Shame-proneness, guilt-proneness, and interpersonal problem solving: a social cognitive analysis. J Soc Clin Psychol. 2003;22:1–12. https://doiorg.publicaciones.saludcastillayleon.es/10.1521/jscp.22.1.1.22765.

    Article  Google Scholar 

  39. Leeming D, Boyle M. Managing shame: an interpersonal perspective. Br J Soc Psychol. 2013;52:140–60. https://doiorg.publicaciones.saludcastillayleon.es/10.1111/j.2044-8309.2011.02061.x.

    Article  PubMed  Google Scholar 

  40. Jacobson RP, Hood JN, Jacobson KJ. The effects of moral emotional traits on workplace bullying perpetration. Ethics Behav. 2017;27:527–46. https://doiorg.publicaciones.saludcastillayleon.es/10.1080/10508422.2016.1182026.

    Article  Google Scholar 

  41. Hasui C, Kitamura T, Tamaki A, Takahashi M, Masuda S, Ozeki N. The test of self-conscious affect-3 in Japanese university students. J Nerv Ment Dis. 2009;197:458–60. https://doiorg.publicaciones.saludcastillayleon.es/10.1097/NMD.0b013e3181a61f52.

    Article  PubMed  Google Scholar 

  42. Watson S, Gomez R. TOSCA-3 shame, guilt, externalization, and detachment: associations with revised reinforcement sensitivity theory constructs. J Explor Psychol Behav Health. 2023;2:1–7.

    Google Scholar 

  43. Gouva M, Kaltsouda A, Paschou A. Psychometric evaluation of the Greek version of TOSCA-3 to measure shame and guilt, 4. Interscientific Health Care; 2012. pp. 105–13.

  44. Kitamura T, Hada A, Usui Y, Ohashi Y. Development of the Japanese version of the test of self-conscious affect-3 (TOSCA-3): a study among student and parent population. Behav Sci (Basel). 2024;14:576. https://doiorg.publicaciones.saludcastillayleon.es/10.3390/bs14070576.

    Article  PubMed  Google Scholar 

  45. Stoeber J, Noland AB, Mawenu TW, Henderson TM, Kent DN. Perfectionism, social disconnection, and interpersonal hostility: not all perfectionists don’t play nicely with others. Pers Individ Dif. 2017;119:112–7. https://doiorg.publicaciones.saludcastillayleon.es/10.1016/j.paid.2017.07.008.

    Article  Google Scholar 

  46. Hussain MA, Chen L, Wu L. Your care mitigates my ego depletion: why and when perfectionists show incivility toward coworkers. Front Psychol. 2021;12:746205. https://doiorg.publicaciones.saludcastillayleon.es/10.3389/fpsyg.2021.746205.

    Article  PubMed  PubMed Central  Google Scholar 

  47. Vranjes I, Salin D, Baillien E. Being the bigger person: investigating the relationship between workplace bullying exposure and enactment and the role of coping in ending the bullying spiral. Work Stress. 2022;36:183–201. https://doiorg.publicaciones.saludcastillayleon.es/10.1080/02678373.2021.1969477.

    Article  Google Scholar 

  48. Matsson A, Jordan T. Workplace bullying investigations. Organ Dyn. 2022;51:100840. https://doiorg.publicaciones.saludcastillayleon.es/10.1016/j.orgdyn.2021.100840.

    Article  Google Scholar 

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Funding

This work was supported by the New Faculty Startup Fund from Seoul National University and the Basic Science Research Program through the National Research Foundation of Korea (NRF) (Grant No. 2022R1F1A1063441).

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Authors and Affiliations

  1. College of Nursing, The Research Institute of Nursing Science, Seoul National University, Seoul, Republic of Korea

    Sun Joo Jang

  2. Red Cross College of Nursing, Chung-Ang University, Seoul, Republic of Korea

    Haeyoung Lee & Sophia J. Chung

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Contributions

SJJ: conceptualization, methodology, formal analysis, writing-original draft, writing-review and editing; HL: conceptualization, writing-original draft, writing-review and editing; SJC: conceptualization, writing-original draft, writing-review and editing. All authors approved the final version of the manuscript.

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Correspondence to Sophia J. Chung.

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Ethics approval and consent to participate

This study was conducted after obtaining approval from the Institutional Review Board of Chung-Ang University, where the researchers are affiliated (No. 1041078-202208-HR-173, Approval date: September 5, 2022). Informed consent for participation was obtained from all participants. The study was conducted in accordance with the Declaration of Helsinki.

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The authors declare no competing interests.

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Jang, S.J., Lee, H. & Chung, S.J. Examining the role of self-conscious emotions and perfectionistic self-presentation in workplace bullying among Korean nurses: a cross-sectional study. BMC Nurs 24, 528 (2025). https://doiorg.publicaciones.saludcastillayleon.es/10.1186/s12912-025-03176-9

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BMC Nursing

ISSN: 1472-6955

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