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181. Experiences of Bullying among College Students and Implications for


Teacher Formation Programmes: From Bullied to Bully

Article  in  Journal of Adolescent Health · February 2020


DOI: 10.1016/j.jadohealth.2019.11.184

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DE GRUYTER International Journal of Adolescent Medicine and Health. 2019; 20190087

Ugyen Choden1 / Kezang Sherab1 / John Howard2

Experience of bullying among Bhutanese college


students: implications for teacher formation
programmes
1 Paro College of Education, Royal University of Bhutan, Paro, Bhutan, E-mail: kezangsherab.pce@rub.edu.bt
2 National Drug and Alcohol Research Centre, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia

Abstract:
Bullying in schools and colleges/universities has significant negative impacts on individuals and learning en-
vironments. Much of the evidence comes from school studies. This study, the first of its kind in Bhutan, ex-
plores the experience of bullying among college students. The study employed a self-administered survey to
a representative sample of 2471 (male = 1242 and female = 1191) college students with mean age 21.5 years,
from eight of the 11 college campuses across Bhutan. The findings indicate that bullying is not an uncommon
experience amongst the college students; both as victims and victimizers. Implications for relevant stakehold-
ers in Bhutan, and elsewhere, and recommendations to address the issues are presented, especially as they
relate to teacher formation (teacher training programs). Although teacher formation is largely dependent on
a pre-service teacher’s beliefs and prior learning experiences, teacher preparation programs play a vital role.
Recommendations for further research are also provided.
Keywords: bullying, caring, college student, compassion, teacher formation
DOI: 10.1515/ijamh-2019-0087
Received: April 24, 2019; Accepted: May 30, 2019

Introduction
Bullying is common in schools and colleges. The experience of bullying is associated with numerous negative
outcomes, including bullying others [1], [2], [3], [4], [5], [6], [7], [8], [9], [10], [11], [12], [13], [14], [15]. Being
bullied by peers or their teachers may have impacts on the development and mental health of school students.
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Likewise, being bullied by teachers or peers in college is likely to have similar negative impacts.
Much of what is known derives from research with school students. Little is known about the experience of
bullying among college students, an important sub-group of adolescents and young people ages 18–24, other
than in relation to cyberbullying. College students who are in teacher formation programs (teacher training
courses) are of particular interest, as they will become responsible for the education, development and wellbe-
ing of the young people in their care, and regarded by many students and other stakeholders as role models
especially in the Bhutanese context [16]. While teacher formation is largely dependent on the student’s be-
liefs and prior learning experiences, teacher preparation programs play a vital role [17]. It is important that
pre-service teachers are trained to become caring and compassionate teachers. Issues associated with being
bullied, being a bully, or both, may have significant implications as to how they undertake their professional
roles post-graduation. Those bullied may become bullies when in positions of power, such as teaching. Edu-
cation is recognized as a protective factor, especially so for young people from disadvantaged and or abusive
family backgrounds, offering a pathway out of deprivation, and an opportunity to benefit from positive and
safe interactions with teachers and fellow students.
This study, the first of its kind in Bhutan, reports on the experiences of bullying among a sample of Bhutanese
college students, and highlights concerns about how bullying might be addressed within curricula, and student
via services.

Kezang Sherab is the corresponding author.


© 2019 Walter de Gruyter GmbH, Berlin/Boston.

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Bullying and its impacts


The majority of violent acts experienced by children are committed by people who are a part of their life: parents,
siblings, peers, teachers, employers, boyfriends, girlfriends, spouses and extended family members [1]. Some
of this violence is termed ‘bullying’. While there appears to be no universally accepted definition of bullying,
it is generally characterized by four criteria [2], [3], [4], [5], [6]:

– hostile intent (i.e. the harm caused by bullying is deliberate, not accidental);
– imbalance of power (i.e. bullying includes a real or perceived power inequity between the bully and the
victim);
– repetition over a period of time (i.e. more than once with the potential to occur multiple times); and
– victim distress (victim suffers mild to severe psychological, social or physical trauma).

Bullying occurs in most schools and colleges. It may be directly physical (hitting, poking, hair pulling, inap-
propriate touching), verbal (name calling, teasing, gossip), emotional (rejecting, defaming, humiliating, ma-
nipulating friends, peer pressure), sexual (sexual harassment, sexual propositioning, exhibitionism) [2], [7] or
“cyber” via social media and other Internet platforms [8], [9]. Indirect bullying can be similar to emotional and
verbal bullying, and usually involves exclusion from groups and activities, spreading rumors about character
or reputation, making faces or obscene gestures behind someone’s back, and manipulating friendships or other
relationships, often via use of online social media, chatrooms and blogs.
Prior research has shown that between 15 and 35% of people may experience bullying in their lifetime, with
up to 30% reporting being involved in bullying others [2], [7], [10], [11], [12], [13], [14], [15]. People from minority
groups and those with diverse sexual and gender orientations experience higher rates of bullying [6], [18], [19].
The cyberbullying rate is higher than the traditional type of bullying [20]. Up to 50% of victims seek assistance,
often of little or no impact. Those who do not seek assistance, often cite fear of stigma, embarrassment, being
seen as ‘weak’, or feel that the problem is not serious enough to seek help [13].
Gender and social norms play a role, for example, social norms that support the authority of teachers over
students may legitimize the use of violence to maintain discipline and control [14]. Schools themselves can
‘teach’ children to be violent. This can occur through teacher led or modeled gender discrimination, or tolerance
of, or not effectively managing, bullying by students or school personnel that can lead students to feel unwanted
or unimportant and traumatized.
Schools and tertiary education systems (hereafter, colleges) are not isolated from the broader community
and social contexts within which they exist. Norms of communities that do not protect young people from
violence, bullying, discrimination, stigmatization, and the marginalization of certain sub-groups, are usually
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reflected in the ‘culture’ of educational settings unless carefully and effectively managed. Unsafe learning envi-
ronments are of no benefit. They are characterized by fear and insecurity, beliefs that teachers and the ‘system’
do not care about, and are incapable of, ensuring student wellbeing and safety, all of which have impacts on
the student wellbeing and the quality of education.
The impacts of bullying from fellow students and/or teachers are extensive, and include depression, anxi-
ety, stress, insecurity, post-traumatic stress disorder (PTSD), lack of trust, feelings of rejection, isolation, loneli-
ness, suicidal ideation, suicidal attempts, psychosomatic symptoms, sleep difficulties, enuresis, substance use,
relationship difficulties, violence, decline in concentration, performance, participation in activities, truancy and
fear of attending school [3], [4], [6], [18], [19], [21], [22], [23]. Also, there may be feelings of anger and a desire for
vengeance. A meta-analysis confirmed that both in the United States and internationally, bullying is strongly
associated to suicidal ideation and the other negative behaviors discussed which could have lifelong impact
on youths [3]. These impacts can be associated with young people not meeting their potential, having poorer
learning outcomes, reduced participation in further education and vocational preparation, and lower employ-
ment prospects. Duncan (2, p. 272) argues, “ignoring any of the [bullying] behaviors can be dangerous because
the less serious actions may easily escalate to more severe behavior”.
In addition, there are impacts on “bystanders” (fellow students and teachers) who witness the bullying,
and who attempt to intervene or not [24]. These include guilt, shame, anger, and are similar to the impacts
on victims. Likewise, there are impacts on the perpetrators, which, again, may mimic those of their victims,
and/or the development of traits of antisocial personality disorder. Bullies may be popular students, who do
not encounter a great deal of social stigma from their aggression, or unpopular and who may be rejected by
other students [24].
There is some lack of clarity as to whether the impacts of bullying endure. The Twins Early Development
Study in England and Wales followed 11,108 twins (5894 girls and 5314 boys) of mean age 11.3 years at first and
16.3 at last assessment [19]. It was found exposure to bullying was associated with higher anxiety, depression,

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hyperactivity and impulsivity, inattention and conduct problems. Pre-existing and multiple vulnerabilities were
significant, however, some effects dissipated over time, demonstrating a potential for resilience.

The Bhutan situation


Although there is limited research in the Bhutanese context, the frequent appearance of newspaper articles
related to bullying, discrimination, sexual harassment and youth suicide indicate that Bhutan has been experi-
encing such issues [25], [26], [27]. However, two recent studies give an indication of the extent of the experience
of bullying among school students, and more broadly via a national survey. The World Health Organization
Regional Office for South East Asia [15] Global School-based Student Health Survey administered to 7576 stu-
dents across Bhutan, found that 27% of the young people surveyed reported that they had been bullied at school
on 1 or more days during the 30 days prior to the survey. Of those who reported being bullied, 2.4% had been
bullied 10 or more times. More boarding students (31%) than day scholars (24%) reported being bullied.
The National Commission for Women and Children and the United Nation’s Children’s Emergency Fund
Bhutan commissioned Child Frontiers Ltd to undertake a literature review in 2013, a qualitative study in 2014
and a national survey in 2015 on violence against children and youth in Bhutan. In addition, there were 49 work-
shops with 428 children aged 8–17 years, youth testimonies, group discussions with 368 adult stakeholders, and
29 interviews with relevant government representatives, community leaders, non-governmental organizations
(NGOs) and counsellors [28], [29], [30], [31], [32].
The qualitative study on what makes Bhutanese children happy revealed that their happiness is fundamen-
tally linked to the wellbeing of their families, experiences at school, ability to contribute to others’ happiness
and their own physical, emotional and social wellbeing (31, p. 10). While violence at schools was seen to be
reducing, it remained prevalent and “…school was not a safe place’”. Despite a ban in corporal punishment
in 2008, school children in Bhutan experienced “light” to “severe” beatings by their teachers and principals
or by matrons and wardens in their hostels. The children reported that they were beaten sometimes “for no
reason”, or when the teachers were “stressed or drunk”. Sexual violence was experienced from other students
and teachers, as well as at home and in the community [31].
About half the sample experienced emotional violence at school such as scolding, screaming, humiliation,
intimidation and threats, putting down and discriminating against the less abled/performing and/or poor
students, and on the basis of “caste” and/or disability [31]. The national survey of 3187 children and young
people (aged 13–17 and 18–24 years) revealed more than 64.1% experienced physical violence, usually before
the age of 13; 43.7% experienced it from parents, relatives or other caregivers; 54.5% by teachers in day schools;
and about 25% from peers; with 12.8% reporting sexual violence (but greater for males 17.1%). About 50% of
the sexual violence occurred at school, and was mainly “touching” [29].
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In Monasteries, child monks reported being bullied by older monks and regularly beaten by the kudrung
(discipline master) with a teycha (leather whip) or other adult monks for committing “offences”, such as being
late to prayers. However, child nuns reported only “light beatings” by their kudrung or “adult nuns” (31, pp.
vii–viii), albeit these remain acts of violence.

Bullying and college students


Existing research suggest that if bullying is not addressed at the school level, it will continue into colleges and
also later in the workplace [2]. While there is extensive research on bullying at the school level, not much is
known about bullying at the college level, other than for cyberbullying [8], [9]. However, a recent study found
that sexual harassment is common amongst Bhutanese college students [27].
Given the significant gap in the literature in relation to college students, there is limited research to guide
stakeholders as to factors that are associated with bullying in colleges. Some variables of interest include,
whether students live with their parents, in hostels or independently, their age, year of study, and type of college
they attend – i.e. science and technology, education, health sciences, business studies, and natural resources.
Education colleges are of particular interest, as they train future teachers, who could perpetuate bullying in
their schools. It is important that the pre-service teachers undergo meaningful and constructive experiences.
This study sought to attempt to provide greater insight into the Bhutanese college students’ experiences of
bullying, and to provide guidance to key stakeholders in Bhutan and elsewhere.

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Research questions
This paper aimed at addressing the following research questions:

– What is the prevalence of the experience of being bullied and bullying others?
– Are there any significant differences in being bullied and bullying others, in terms of gender, year of study,
type of accommodation, age, and college?

Materials and methods


The study employed a self-administered survey to a representative sample of 2471 college students, of mean
age 21.5 years (ranging from 18 to 36 years), from eight of the 11 college campuses across Bhutan. One of
the colleges refused to participate, one was not reachable, and the other was a small college. This equates to
about approximately 20% of all college students in Bhutan. The survey instrument canvassed: substance use,
reasons for substance use, perceptions of the safety of various substances, sexual orientation, sexual behavior
and mental health using the Kessler 6 scale [33]. This paper focuses on the bullying aspects of the broader study.
Key variables of interest were age, gender, college, accommodation (home, hostel or independent), and year in
course. These variables were of interest to explore and gain greater insight into bullying amongst different
categories of college students.
The survey included two scales that measured whether the respondent had: (1) been a victim of bullying;
(2) bullied others and used a 4-point Likert type scale (0 = No; 1 = Sometimes; 2 = Once a week; 3 = Several
times a week).
The management of all the 11 colleges in Bhutan were approached to seek permission to carry out this study.
After a review by the appropriate authorities, the eight colleges that participated in this study granted ethics
approval. Individual students were informed to return the survey on a voluntary basis. Informed consent was
obtained from all participants in the study.
Principal component analyses (PCA) were conducted to identify subsets of items measuring a common sub-
construct for each of the three measurement scales. PCA helped to condense the number of items and also to
establish construct validity of the Likert-type items. The “victim of bullying” scale produced three components
– victim of verbal bullying, victim of bullying through influencing others, and victim of physical bullying. The “bullying
others” scale produced two components – bullying others verbally, and bullying others physically.
Four one-way multivariate analysis of variances (MANOVAs) were conducted between the five components:
(i) victim of verbal bullying; (ii) victim of bullying through influencing others; (iii) victim of physical bullying; (iv) bullying
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others verbally; and (v) bullying others physically as dependent variables (DVs) and four demographic variables
(gender, year of study, accommodation, and college) as independent variables (IVs) to explore if there were any
statistically significant differences in their experiences.
Inspection of a multivariate Box’s M test showed significance in terms of all four demographic variables. This
indicated that the homogeneity of covariance matrices of all the DVs was not equal across groups. Levene’s tests
for each of the DVs were undertaken to check the homogeneity of variances. All six DVs showed significance
(p > 0.05) for each MANOVA indicating that there were differences between the groups of variables. However,
inspection of standard deviations (SDs) for these DVs revealed relatively small differences (less than one scale
unit of SD) between the various groups.

Results
The results of this study are presented as they relate to the research questions posed, preceded by demographic
information.

Demographic characteristics
Relevant demographic information is presented in Table 1.

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Table 1: Demographic characteristics (n = 2471).


Characteristic Category n %a
Gender Female 1191 48.2
Male 1242 50.3
1st year 907 36.7
Year of study 2nd year 763 30.9
3rd year 450 18.2
4th year 300 12.1
Accommodation in the college College hostel 2151 87.0
Day scholar 278 11.3
18–19 442 17.9
Age 20 515 20.8
21 466 18.9
22 400 16.2
23 275 11.1
24–36 326 13.2
1 268 10.8
2 345 14.0
College 3 310 12.5
4 292 11.8
5 324 13.1
6 222 9.0
7 406 16.4
8 304 12.3
a Percentages do not add up to 100 due to missing values.

Prevalence of bullying

Up to 36% of students surveyed reported experiencing at least one form of bullying (Table 2), with the most
frequent being having lies told about them (45.2%), other students made to get peers to dislike them and being
called names, made fun of and teased (36.1%). However, far fewer reported bullying others, with the most
frequent being excluding others (18.1%).
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Table 2: Prevalence of bullying (n = 2471).


%
Being victimized
 Hit, kicked or pushed 14.0
 Locked indoors 14.0
 Money/things taken/destroyed 11.9
 Lies told about 45.2
 Others made to dislike me 36.1
 Left out, excluded, ignored 35.1
 Called names, made fun of, teased 36.1
 Threatened to do things did not want to 13.5
 Bullied with names with sexual meanings 8.1
 Bullied with names about race/color 12.8
Bullying others
 Stole money/destroyed things 4.5
 Hit, kicked, pushed other students 8.7
 Locked others indoors 3.2
 Spread false rumors 8.0
 Made others dislike others 9.0
 Left others out, excluded, ignored 18.1
Threatened/forced others to do things they did not want to 9.1
 Bullied others with names about race/color 9.1
 Called other names, made fun of, teased them 16.2
 Called others names with sexual meanings 5.9

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Student experiences of bullying

A greater number of college students appear to be a victim of bullying through peers influencing each other (M =
0.44; SD = 0.52), followed by bullying others verbally (M = 0.14; SD = 0.28), and being a victim of verbal bullying (M
= 0.14; SD = 0.34) (see Table 3).

Table 3: Bullying components with mean and SD.


Component n Mean SD
Victim of verbal bullying 2329 0.14 0.34
Victim of bullying through influencing others 2335 0.44 0.52
Victim of physical bullying 2331 0.12 0.28
Bullying others verbally 2303 0.14 0.28
Bullying others physically 2307 0.06 0.23

SD, standard deviation.

Comparison of the six components in terms of demographic variables

The overall multivariate F-tests showed that gender (Wilk’s lambda = 0.972, MV F (6, 2226) = 10.672, p < 0.05,
partial η2 = 0.028), college (Wilk’s lambda = 0.973, MV F (6, 2260) = 10.257, p < 0.05, partial η2 = 0.027) and year
of study (Wilk’s lambda = 0.975, MV F (18, 6259) = 3.066, p < 0.05, partial η2 = 0.008) were significantly different.
The multivariate F-test showed no significant difference for accommodation.
Following the significant multivariate F-tests for gender, college and year of study, univariate F-tests were
examined to identify which of the components contributed to the significance. For IVs with more than two cat-
egories, posthoc Tukey multiple comparisons tests were examined to identify significant differences between
the categories of students.
According to the results of univariate F-tests, gender showed statistically significant differences (p < 0.05)
on three components, college showed statistically significant differences (p < 0.05) on four components, and
year of study showed statistically significant differences (p < 0.05) and marginally significant differences on two
components each (see Table 4).
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Table 4: Tests of between-subjects’ effects.


MANOVA Dependent variable df Error F Sig. Partial Eta squared
effect

Gender Victim of verbal bullying 1 2231 21.955 0.001 0.010


Bullying others verbally 1 2232 25.307 0.001 0.011
Bullying others physically 1 2231 36.318 0.001 0.016
College Victim of verbal bullying 1 2265 37.292 0.001 0.016
Victim of bullying through influencing 1 2265 35.639 0.001 0.015
others
Victim of physical bullying 1 2265 22.364 0.001 0.01
Bullying others verbally 1 2265 21.504 0.001 0.009
Year of study Victim of verbal bullying 3 2218 6.412 0.001 0.009
Victim of bullying through influencing 3 2218 6.092 0.001 0.008
others
Victim of physical bullying 3 2218 4.809 0.002 0.006
Bullying others verbally 3 2218 4.321 0.005 0.006

The examination of effect size, as measured by partial Eta squared, generally explained a small portion of
variability of scores for each grouping of variables (see Table 4). Examination of means and SD for each of the
group of variables showed the following:
In terms of gender, means for male students for all three components (victim of verbal bullying; bullying others
verbally; and bullying others physically were significantly higher than female student means. In terms of college,
means for teacher education colleges for all four components (victim of verbal bullying; victim of bullying through

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influencing others; victim of physical bullying; bullying others verbally) were significantly higher than other college
means (see Table 5).

Table 5: Mean comparison in terms of gender and college.


Component Gender College
Male Female Education Others
M SD M SD M SD M SD
Victim of verbal bullying 0.17 0.37 0.10 0.28 0.21 0.40 0.11 0.30
Bullying others verbally 0.17 0.31 0.11 0.22 0.19 0.30 0.13 0.27
Bullying other physically 0.09 0.26 0.03 0.14
Victim of bullying through influencing others 0.55 0.53 0.40 0.51
Victim of physical bullying 0.16 0.32 0.10 0.26

SD, standard deviation.

In terms of year of study, consultation of posthoc Tukey multiple comparison tests showed several significant
and marginally significant differences (see Table 6). The overall pattern for all components showed that senior
student means are significantly and marginally significantly higher compared to their junior counterparts.

Table 6: Posthoc Tukey multiple comparison tests on year of study.


Component Significant difference Marginal significance Mean and SD comparison

Victim of verbal bullying 1st year vs. 4th year 1st (M = 0.12, SD = 0.28)
2nd year vs. 4th year 2nd (M = 0.12, SD = 0.30)
4th (M = 0.21. SD = 0.42)
Victim of bullying through 1st year vs. 3rd year 1st (M = 0.39, SD = 0.48)
influencing others 1st year vs. 4th year 3rd (M = 0.50, SD = 0.57)
4th (M = 0.52, SD = 0.58)
Victim of physical bullying 2nd year vs. 4th year 2nd (M = 0.10, SD = 0.26)
3rd year vs. 4th year 3rd (M = 0.10, SD = 0.26)
4th (M = 0.17, SD = 0.34)
Bullying others verbally 1st year vs. 4th year 1st (M = 0.12, SD = 0.25)
4th (M = 0.18, SD = 0.33)
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M, mean; SD, standard deviation.

Findings and discussion


This study revealed that over a third (36%) of the Bhutanese college students surveyed had experienced bully-
ing at some point in their lives. The level of reported bullying was similar to that in the international studies
reported (15–35%) [2], [7], [10], [11], [12], [13], [14]. The findings, together with the WHO Bhutan school survey
(27%) [15], and the similarity to research in many countries, warrant attention.
It was found that the males in the sample were more likely to be victims of verbal bullying as well as per-
petrators of physical and verbal bullying. Some were called names with sexual references or related to their
race or color, threatened to do things that they did not want to, had other students being influenced to dislike
them, had lies told about them, were left out/excluded from activities, or ignored, locked indoors, had been
hit, kicked, or pushed, and had money or other things taken away from them. As demonstrated in the existing
literature, such bullying is a form of violence [2], [3], [7] that can have negative impact on children, adolescents
and young people. There is increased risk that they may become aggressive adults. However, it is unclear as to
why the males in the sample were more often victims of both verbal and physical bullying. This is something
that requires further exploration.
The findings also suggest that the college students who are in teacher preparation courses were more likely
to be victims of all types of bullying, and verbally bullied others in the form of lack of courtesy, lack of respect,
name calling, insults, and harassment. In addition, the situation for the senior college students appeared to
be more problematic. While it is beyond the scope of this study to provide a reasonable explanation for this
situation, it warrants further investigation. It may be related to their personal experience, what they are taught,

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or exposed to, in the college environment by peers and academic staff, or what they observe during in-school
placements.
Education college students are future teachers who are role models for those they teach, especially in smaller
communities. Earlier research has shown that more than what teachers teach, students are influenced by the be-
havior and conduct of their teachers [16], [34]. Good teachers create and maintain a safe learning environment,
and demonstrate that they care for their students to assist their growth as kind and caring adults.
Despite the Bhutanese Ministry of Education’s ban on corporal punishment since 2008, it appears that cor-
poral punishment still occurs in schools across the country, as it does in monasteries for both monks and nuns
[31]. Past research indicates that if Bhutanese teachers and principals, and senior monks and nuns, continue to
make use of corporal punishment [31] and continue to threaten their students emotionally [16]. It is likely to
have a negative impact on them, and is inconsistent with the national philosophy of Gross National Happiness
(GNH). Opening up a respectful and culturally sensitive conversation about the impacts of corporal punish-
ment and cycles of violence is necessary. In a GNH society, teachers, and monks, should model compassion,
care, honesty, and a positive attitude towards life.

Implications and conclusion


The findings of this study have salience for Bhutan and internationally. It is apparent that there needs to be thor-
ough reflection on the college environment, including any bullying on campus or in student accommodation,
the attitudes and behavior of staff, and whether there are effective policies and practices in place to confront,
reduce and eliminate bullying. This should occur within curricula and via student support services, opportu-
nities to address personal experience of being bullied and/or being a bully can and should be provided. As the
bullied often become bullies, it is crucial to have in place structures so that students do not perpetuate cycles of
verbal and physical violence, in particular those who will take up teaching posts.
In addition, students in health care courses, for example, nursing, public health, and counselling, could
also benefit from greater attention the physical and mental health sequelae of bulling, and on preventive and
treatment interventions. Like teachers, they hold position of influence and power and are role models.
Traditional beliefs have been implicated in previous studies [31]. The engagement of culture bearers and
religious leaders in developing and implementing evidence informed strategies that focus on physical and
mental wellbeing is essential; especially for Bhutan with its national goal of ensuring and maintaining GNH.
Parent education, via schools and community programs may need to reinforce strategies for more effective,
and less harmful, parenting and behavior regulation approaches. Likewise, more attention may be required to
effectively address use of alcohol as a factor in violence at home and at school.
More research is required to gain a greater depth of understanding on the issues raised by the current study,
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particularly on the prevalence, nature, frequency and impact of school and college bullying. Further research is
required to explore if the increasing rate of sexual harassments and youth suicide have any correlation to bul-
lying. Likewise, given the cultural pervasiveness of violence and bullying, qualitative studies of perpetuation
of violence by those bullied would be helpful.
Notwithstanding these research gaps, relevant stakeholders need to initiate programs and develop re-
sources that increase the knowledge and understanding of the nature and causes of bullying and harassment,
the negative impacts of all forms of bullying, and to interrupt any cycles of being a victim of bullying to becom-
ing a bully; especially for those in teacher formation programs.
Many countries have implemented anti-bullying programs in schools, as part of curricula and in school
policies and structure [1], [15]. There appears to be less activity at the college level. Colleges that not already
do so could draw on the developments in the school sector, and reflect on the design and implementation of
bullying prevention policies, and reinforce procedures for reporting and investigating such acts. Appropriate
supports need to be provided for the victims through the enhancement or establishment of counselling services
with trained and accredited counsellors on college campuses.
In addition, there appears to be a need for programs and research to reconsider the use of the term “bul-
lying”, where much of what comes within its ambit is actual violence – that is, behavior punishable under
criminal codes. “Bullying” has possibly become a softer term than physical and emotional violence. Greater
attention is required to recognize the significant, and often under-recognized, impacts of emotional and psy-
chological abuse. Teachers, for example, can use words to control, regulate and demean students, as well as
praise, support and encourage.
Research on the protective influence of the WHO’s “health promoting schools” approach, adopted by num-
ber of European countries, Australia, New Zealand, the USA, and Canada, has continued since the late 1980s

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and has identified mostly positive outcomes [35]. The approach might usefully be deployed in developing
“health promoting colleges”, where such a concept is not already enshrined in guiding principles.

Limitations
This report is based on a part of the larger study that explored “legal and illegal drug use, mental health con-
cerns and sexuality among college students in Bhutan”. The sample obtained represents about 20% of college
students in Bhutan, and while representative, the findings might require cautious interpretation.

Acknowledgment

We would like to thank UNFPA, Bhutan for the funding support and Paro College of Education for adminis-
trative support.

Compliance with ethical standards: All procedures performed in studies involving human participants were
in accordance with the ethical standards of the institutional and/or national research committee and with the
1964 Helsinki declaration and its later amendments or comparable ethical standards.
Conflict of interest: The authors declare that they have no conflict of interest.

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