Striving or surviving? Influence of bullying on psychological well-being and coping approaches among undergraduate dental students.

OBJECTIVES: To assess the frequency of bullying and its association with depression, anxiety, stress, and coping strategies among undergraduate dental students. METHODOLOGY: A cross-sectional study was conducted among 124 dental undergraduates at Bibi Aseefa Dental College, Larkana, Pakistan (August 2025-January 2026). Bullying exposure was assessed using an adapted 15-item Negative Acts Questionnaire-Revised (NAQ-R), while psychological distress was measured using the 21 items Depression, Anxiety, and Stress Scale (DASS-21), Coping strategies were evaluated using the 24 items Brief-COPE inventory and were categorized as adaptive and maladaptive. Data were analyzed using descriptive statistics, Chi-square tests, and Spearman's correlation, with a p-value < 0.05 considered statistically significant. RESULTS: Most students reported high bullying exposure (74.2%). Moderate to extremely severe depression was observed in 50.8%, severe to extremely severe anxiety in 54.0%, and moderate to severe stress in 29.9% of participants. Bullying exposure was significantly associated with depression (χ² = 18.2, p = 0.020), stress (χ² = 16.6, p = 0.035), and anxiety (χ² = 29.2, p < 0.001). Spearman's correlation revealed that bullying was positively correlated with anxiety (ρ = 0.427, p < 0.001) and maladaptive coping (ρ = 0.403, p < 0.001), while maladaptive coping strongly correlated with anxiety (ρ = 0.648, p < 0.001). Adaptive coping showed weaker positive correlations with anxiety, suggesting increased coping efforts in response to distress. Multivariable analysis identified high bullying exposure (OR ≈6.0, p<0.001) and maladaptive coping (OR ≈ 1.18, p<0.001) as significant independent predictors of moderate to severe anxiety. CONCLUSION: Bullying is highly prevalent among dental students and strongly associated with anxiety, depression, and maladaptive coping. Targeted interventions, including bullying prevention, mental health support, and resilience training, are essential to safeguard student well-being.