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Association Between Bullying Exposure and Depression, Anxiety and Stress Among Dental Students: A Two-Centre
Sefa Çolak1, Aras Erdil2, Göksal Keldal1
1Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Tokat Gaziosmanpaşa University, Tokat, Türkiye.
Introduction:
Bullying-related behaviours in dental education may negatively affect students' psychological well-being; however, evidence regarding their association with depressive, anxiety and stress symptoms among clinical-year dental students remains limited. This study aimed to assess exposure to bullying-related behaviours and its association with psychological distress among undergraduate dental students in Türkiye.
Materials And Methods:
This two-centre cross-sectional survey included 414 fourth- and fifth-year dental students from two universities in Türkiye. Data were collected using a structured questionnaire including demographic items, a 30-item bullying questionnaire adapted from AbuAlula et al. and the Depression Anxiety Stress Scale-21 (DASS-21). Associations between bullying total score and DASS-21 scores were assessed using correlation analyses. Multivariable linear regression models with HC3 robust standard errors were used to examine the independent associations between bullying total score and depressive, anxiety and stress symptoms after adjustment for age, gender, grade and university.
Results:
Exposure to at least one bullying-related behaviour was reported by 99.3% of participants. Mean raw DASS-21 scores were 8.26 ± 5.75 for depression, 8.45 ± 5.09 for anxiety and 9.01 ± 5.30 for stress. At least mild symptom severity was observed in 70.3% for depressive symptoms, 82.1% for anxiety symptoms and 57.7% for stress symptoms. Bullying total score was positively correlated with depression, anxiety, stress and DASS total score (all p < 0.001). In adjusted analyses, bullying total score remained independently associated with higher depression, anxiety and stress scores (all p < 0.001).
Conclusion:
Reported exposure to at least one bullying-related behaviour was common among clinical-year dental students and was independently associated with greater psychological distress. Given the broad operational definition used, this finding should not be interpreted as the prevalence of persistent, severe or repetitive bullying victimisation. These findings highlight the importance of supportive learning environments and institutional strategies aimed at reducing bullying-related behaviours in dental education.
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