Background: Counterproductive work behaviors, such as violence, and anti-social behaviors, such as bullying, are serious issues in healthcare. It can lead to poor patient care outcomes, loss of staff morale, and a decline in the organization’s performance. This study explored nursing personality traits (Big Five Inventory [BFI]), primary and secondary psychopathy, and demographic data to determine whether victims and perpetrators of counterproductive behaviors have specific characteristics that distinguish them from others. Design: A cross-sectional, self-administered online survey was conducted with nurses in a Saudi tertiary healthcare organization. Methods: This study included all nursing staff (2400) with a simple random sample of n = 824. Participants completed an online self-report survey that included demographic information, followed by questionnaires to measure personality traits and primary and secondary psychopaths. Results: 46.5% of the nurses in the study were exposed to violence, 54.2% were exposed to anti-social behaviors such as bullying, and 16.7% were perpetrators of counterproductive behavior. Perpetrators had significantly lower agreeableness scores than other staff members, odds ratios (OR) 3.00 [95% confidence interval (CI) 2.17-4.15], and significantly higher openness scores (OR) 0.52 [95% confidence interval (CI) 0.35-0.79]. Victims of anti-social behaviors such as bullying had significantly lower scores for primary psychopathy (OR) 1.04 [95% confidence interval (CI) 1.02-1.06] and significantly higher scores for second psychopathy (OR) 0.96 [95% confidence interval (CI) 0.92-0.99], neuroticism (OR) 0.73 [95% confidence interval (CI) 0.57-0.95], and openness (OR) 0.66 [95% confidence interval (CI) 0.50-0.88] Conclusion: The study was unique in that it examined perceptions, actual behavior, and predictors using personality and psychopathy traits. Perpetrators had significantly lower scores in agreeableness compared to other staff, and they shared significantly high scores in openness traits with the victims. Victims, on the other hand, had significantly high scores in secondary psychopathy and neuroticism. This study offered a global leadership solution through the effective use of a behavior committee.