As with all human behavior, multiple interacting biopsychosocial elements are intertwined within various layers of this phenomenon. Superficial descriptions of victims have been used to justify social rejection, such as arrogant, clingy, rude, aggressive, shy, tattling, meddling, ignorant, and dull-looking. In more psychological terms, the victims exhibit low self-esteem, distorted self-image, poor social skills, and low self-assertiveness. Both perpetrators and victims are known to be overprotective, and have poor parent-child relationships, discipline problems, and frequent exposure to family violence (3). However, it is not clear whether these elements are the causes or effects of social rejection. In the medico-psychiatric realm, victims' innate vulnerabilities should not be ignored, as children and adolescents with chronic mental and physical conditions are more likely to become victims of this destructive relationship. For example, anxiety, depression, attention deficit hyperactivity disorder, and tic disorders are positively associated with a higher incidence of victimization. Young people with developmental problems, such as language disorders and autism spectrum disorder, are also easy targets for victimization. In addition, physical and motor problems including cerebral palsy, epilepsy, asthma, eczema, diabetes, underweight/overweight, and obesity are reported to be associated with a higher risk of victimization (4). Some reports have suggested that individuals with chronic conditions are victimized because they are regarded as "different" from the perspective of their peers. However, there may be mediating factors between the above conditions and victimization, such as poor social skills and unacceptable behavior as symptoms of mental health issues. It is also noteworthy that victims are at a higher risk of mental health problems such as depression, anxiety, post-traumatic stress disorder, and even self-injurious and suicidal behavior as a result of Wang-tta; these problem behaviors aggravate the vicious cycle of victimization and rejection.

There may also be a troubling interpretation in the context of the unique characteristics of Korean society and culture. At a general level, massive academic pressure and a value system centered on academic achievement have been used as justification for bullying behavior and blamed for the lack of guilt expressed by perpetrators. However, attention should be paid to the pattern of victimization in Korea, which is quite different from that in other countries. For example, in contrast to Western societies, which may involve an older student with more physical power harming younger children, peer aggression in Korea typically involves a group of young people targeting a particular peer (3), and the majority of the aggression originates in a particular classroom (5). In contrast to the physical aggression perpetrated by boys in Western countries, the involvement of girls is common in Korea. Further, isolation of a targeted peer in cyber space, including through mobile messaging systems (i.e., "Kakao-talk") or human trafficking for snacks, game items, or even Wi-Fi for their cellular phones, is common and difficult for the third party to prove. Although peer victimization is not a phenomenon unique to Korea, it may have been molded within the framework of the cultural atmosphere. It has also been hypothesized that the strong group conformity, collectivism, bonding, and integrity emphasized in Korean culture could influence the formation of the nature of wang-tta, similar to Ijime in Japan (5). That is to say, in more individualized cultures, choosing the target of bullying is more individualized and takes place in a small group rather than an entire class. In other words, it is one of the signs of pathological and distorted interpersonal relationships in the entire culture. This notion is supported by the fact that the peer victimization phenomenon is not confined to the classroom; rather, it is widespread, even among students' parents (6) and in the workplace.

What could be the solution? As many causative factors are interacting in this phenomenon on individual, cultural, and even moral/philosophical levels, there is probably no single solution. The first step is to acknowledge that social rejection or peer victimization is a serious problem for all group members involved. Although school violence committees and a firm punishment system can manage active violence toward peers, these are not sufficient for dealing with cyberbullying and more subtle exclusion from relationships. Prior to establishing a punishment system, it is essential to define the school's attitudes and responsibilities; it should be explicitly declared that peer victimization will be taken seriously and prohibited in the school. Many studies have reported that holistic school-based intervention programs are effective in reducing peer victimization. Common elements of successful prevention and intervention programs include considering multiple levels of the systems surrounding students, particularly the macro-system, which includes school-parent co-operation and interventions to improve students' individual peer relationships and home environments (1). The medical professional's role is also important; they should be open to requests for help, and co-operate with schools to deal with the vulnerabilities of potential victims. Social rejection or peer victimization is typically related to mental health issues, but it is important for every medical professional to participate actively in reducing the stigma of chronic illness in children and adolescents, because it may trigger discrimination and peer rejection. Moreover, the value system of society as a whole should be re-examined; this may be very difficult and painful, but the key may be in the revision of attitudes regarding respect for individual differences and fostering co-existence with vulnerable individuals within the community.