Anger, personality traits and psychopathological symptoms in subjects exposed to negative interpersonal actions in workplaces: an observational study in a large sample attending a Center for Occupational Stress

OBJECTIVE

The association between adverse working conditions and mental disorders is well established. In addition to psychopathological symptoms, this study aimed at investigating anger and personality traits in a clinical sample of subjects referring negative interpersonal experiences in workplaces.

METHODS

1676 workers attending a Centre for Occupational Stress in Milan (from 2014 to 2016) were administered an assessment protocol including SCL-90 for general psychopathology, STAXI for anger intensity and expression, and MMPI-2 for personality traits. A qualitative checklist was used to collect negative experiences in workplaces.

RESULTS

Patients reported they were exposed to "threats to the task or the professional career" more than to "attacks to the person". Over 80% scored above the cutoff in all the subscales of the SCL-90, with highest scores in Depression, Obsessive-Compulsive Disorder, Anxiety, Somatization and Paranoia. 60% scored above the 90th percentile in the AX/in subscale, showing intense anger feelings that they mostly suppress. Abnormal elevations at the MMPI scales of Hypochondria, Depression, Hysteria, and Paranoia were found in over 50% of the sample. Women reported higher psychological difficulties and internalized anger than men. Anger towards objects and people, instead, was more common in males. No differences were observed by work sector or employment status.

CONCLUSIONS

In addition to severe psychological difficulties, individuals reporting negative interpersonal experiences in workplaces have high levels of internalized anger and a distinctive profile of personality traits. While a deeper investigation is needed, anger expression should be considered in future treatment programs.

The last resort: Workplace bullying and the consequences of changing jobs

This study investigated the consequences of changing jobs for employees subjected to workplace bullying. First, we hypothesized that bullied employees would be more likely to change jobs than non‐bullied employees. Moreover, we hypothesized that changing jobs would result in a reduction of exposure to bullying behaviors and an alleviation of mental health problems for those bullied at baseline. The study was based on a longitudinal probability sample of the whole Swedish workforce (n = 1,095). The time lag was 18 months. The results supported all hypotheses except one. Those employees who were bullied at baseline were more likely to have changed jobs at follow‐up. Also, for the changers there was a reduction in exposure to subsequent bullying. The actual drop in exposure to bullying behaviors was significant and substantial. This gives further support for the work environment hypothesis, suggesting the work context may be a more important cause than individual characteristics. As for mental health problems, the association between bullying and subsequent anxiety was not significant for those changing jobs, suggesting that leaving a toxic workplace may reduce anxiety relatively quickly. However, depression symptoms were not affected by the change of jobs, and the association between bullying and subsequent depression was the same 18 months later. The conclusion is that changing jobs can be a useful, last resort on an individual level, improving the situation for the victim of bullying. However, it is important to note that it does not solve any underlying organizational problems and risk factors.

Bullying, Discrimination, Harassment, Sexual Harassment, and the Fear of Retaliation During Surgical Residency Training: A Systematic Review

BACKGROUND

The negative effects of bullying, discrimination, harassment, and sexual harassment (BDHS) on well-being and productivity of surgical residents in training have been well documented. Despite this, little has changed over the past decade and these behaviors continue. The purpose of this study was to determine the prevalence of each abusive behavior experienced by residents, identify the perpetrators, and examine the reporting tendency.

METHODS

A systematic review of articles published between 2010 and 2020 in the MEDLINE, EMBASE, and Cochrane databases was performed following PRISMA guidelines. The following search terms were used: bullying, harassment, sexual harassment, discrimination, abuse, residency, surgery, orthopedic surgery, general surgery, otolaryngology, obstetrics, gynecology, urology, plastic surgery, and training.

RESULTS

Twenty-five studies with 29,980 surgical residents were included. Sixty-three percent, 43, 29, and 27% of surgical residents experienced BDHS, respectively. Female residents reported experiencing all BDHS behaviors more often. Thirty-seven percent of resident respondents reported burnout, and 33% reported anxiety/depression. Attending surgeons, followed by senior co-residents, were the most common perpetrators. Seventy-one percent did not report the behavior to their institution. Fifty-one percent stated this was due to fear of retaliation. Of those who reported their experiences, 56% stated they had a negative experience reporting.

CONCLUSION

Our review demonstrates high prevalence rates of BDHS experienced by residents during surgical training, which have been associated with burnout, anxiety, and depression. The majority of residents did not report BDHS due to fear of retaliation. Residency programs need to devise methods to have a platform for residents to safely voice their complaints.

Workplace bullying increases the risk of anxiety through a stress-induced β2-adrenergic receptor mechanism: a multisource study employing an animal model, cell culture experiments and human data

OBJECTIVES

Several studies show that severe social stressors, e.g., in the form of exposure to workplace bullying in humans, is associated with negative mental health effects such as depression and anxiety among those targeted. However, the understanding of the underlying biological mechanisms that may explain the relationship between exposure to bullying and such negative health outcomes is scarce. The analyses presented here focus on understanding the role of the β2-adrenergic receptors (ADRB2) on this association.

METHODS

First, a resident-intruder paradigm was used to investigate changes in circulating norepinephrine (NE) in rat serum induced by repeated social defeat and its relationship with subsequent social behavior. Second, the direct effects of the stress-hormones NE and cortisol, i.e., synthetic dexamethasone (DEX), on the ADRB2 expression (qPCR) and monocyte chemoattractant protein-1 (MCP-1) release (immunoassay) was examined in cultured EL-1 cells. Third, in a probability sample of 1052 Norwegian employees, the 9-item short version of the Negative Acts Questionnaire-Revised (S-NAQ) inventory, Hopkins Symptom Checklist and genotyping (SNP TaqMan assay) were used to examine the association between social stress in the form of workplace bullying and anxiety moderated by the ADRB2 genotype (rs1042714) in humans.

RESULTS

The present study showed a clear association between reduced social interaction and increased level of circulating NE in rats previously exposed to repeated social defeat. Parallel cell culture work, which was performed to examine the direct effects of NE and DEX on ADRB2, demonstrated ADRB2 downregulation and MCP-1 upregulation in cultured EL-1 cells. Genotyping with regard to the ADRB2 genotype; rs1042714 CC vs CG/GG, on human saliva samples, showed that individuals with CC reported more anxiety following exposure to bullying behaviors as compared to the G carriers.

CONCLUSION

We conclude that workplace bullying promotes anxiety and threaten well-being through an ADRB2 associated mechanism.

The Associations Between Workplace Bullying and Physical or Psychological Negative Symptoms: Anxiety and Depression as Mediators

Workplace bullying is a critical issue for its negative consequences on victims' health and well-being. This study aimed at examining the intermediate roles of anxiety and depression, in the relations between workplace bullying as a predictor, and physical and psychological negative symptoms as outcomes. In particular, it was hypothesized that workplace bullying would be associated with higher anxiety and depression and, through them, with higher physical and psychological negative symptoms. We sampled 151 Italian employees, who called on a workplace bullying public clinical center as victims and filled a paper-and-pencil questionnaire. Results of bootstrapped regressions showed that only anxiety mediated the association of workplace bullying with negative physical symptoms while both anxiety and depression mediated its association with negative psychological symptoms. The results have implications for the development of appropriate intervention strategies for both prevention and clinical treatment. In particular, timely diagnosing and treating anxiety and depression could prevent subsequent problems related to psychological and physical symptoms such as colitis, headache, tiredness, nervousness, etc. Organizational interventions in terms of primary prevention are also discussed. From an empirical standpoint, the study contributed to disentangling the differential roles of anxiety and depression with respect to physical and psychological symptoms; moreover, overcoming a common limit of workplace bullying research, the current study was carried out on actual victims.

Medicine's Shame Problem

BACKGROUND

Physician mental health is an increasingly discussed topic. Despite the progress made regarding the discussion of physician mental health, these issues remain concerning. In particular, the discussion as to why these issues are so problematic remains limited. Contributors can include bullying, the "hidden curriculum" of medicine, how the medical culture handles errors, and importantly, shame.

OBJECTIVE

This narrative review evaluates the literature on bullying and abuse in medicine, how abuse can exacerbate shame, how the handling of medical errors can exacerbate shame, how shame can negatively affect mental health, and how the medical community and leaders can mitigate these issues.

DISCUSSION

Physician mental health remains an important issue. Job-related stressors, bullying, medicine's hidden curriculum, medical error, traumatic patient encounters, and perfectionism can contribute to physician depression and burnout. Shame may underlie these factors. Shame is a universal emotion that leads to poor self-esteem, depression, eating disorders, abuse, and addiction. However, shame can be addressed and overcome, especially via acknowledgment, vulnerability, and empathy. The medical community can provide some of these techniques by encouraging environments of kindness and respect, giving constructive rather than destructive feedback, providing empathy and support after a medical error, and encouraging mutual learning environments where questions are asked with respect in order to enhance learning. This is opposed to hierarchies and "pimping," where questions are asked with intimidation and disrespect.

CONCLUSIONS

Shame is likely a contributor to physician mental health issues. For shame resilience to occur, it must not be kept secret and mutual support should be provided. By addressing the possible causes behind physician mental health concerns, including shame, more solutions can be proposed.

Occupational exposure factors for mental and behavioral disorders at work: The FOREC thesaurus

Background

Mental disorders in the workplace are a major public health problem. Knowledge of the impact of the psychosocial work environment on mental and behavioral disorders can assist occupational physicians in the identification and description of occupational risk situations, and help to define priority actions. However, no classification for occupational exposure factors is currently available. We aimed to build a thesaurus of “Organizational, Relational, Ethical and other Contributing Factors” (FOREC) linked with the onset of mental and behavioral disorders.

Methods

The French Agency for Food, Environmental and Occupational Health and Safety (ANSES) initiated and supervised a multidisciplinary working group consisting of the representatives of the main French occupational and public health actors. All decisions were accepted on a consensus basis. This collaborative work led to the classification of occupational exposure factors for mental and behavioral disorders in the workplace. To test this thesaurus in clinical practice, a French multicenter study was implemented. Patients were workers referred to the Occupational Disease Centers for mental health issues at work. Factors contributing to mental and behavioral disorders among workers were identified and coded retrospectively from the worker’s point of view using the FOREC thesaurus.

Results

We recruited 323 workers, aged 44.9±9.2 years, of which 31.3% were men. The most commonly encountered disorders were generalized anxiety disorders (106 workers, 32.8%) and moderate depressive episodes (86 workers, 26.7%). We identified 1357 factors, i.e. an average of 4.2 factors per worker. Among them, 575 (42.4%) were relational and 515 (37.9%) were organizational. All factors identified during consultations were described in the thesaurus.

Conclusions

We built the first thesaurus of “Organizational, Relational, Ethical and other Contributing Factors” (FOREC) that may help to generate profiles of mental and behavioral disorders at work. Encoding and describing these exposure factors, as well as using a worldwide standardized and shared terminology, will help to identify specific workplace prevention programs.

‘The fact that she just looked at me…’ – Narrations on shame in South African workplaces

Orientation: Shame has been internationally researched in various cultural and societal contexts as well as across cultures in the workplace, schools and institutions of higher education. It is an emotional signal that refers to experienced incongruence of identity goals and the judgement of others.Research purpose: The purpose of this study was to focus on experiences of shame in the South African (SA) workplace, to provide emic, in-depth insights into the experiences of shame of employees.Motivation for the study: Shame in the workplace often occurs and might impact negatively on mental health and well-being, capability, freedom and human rights. This article aims at gaining some in-depth understanding of shame experiences in SA workplaces. Building on this understanding the aim is to develop awareness in Industrial and Organisational Psychologists (IOPs), employees and organisations to cope with shame constructively in addition to add to the apparent void in the body of knowledge on shame in SA workplaces.Research design, approach and method: An interpretative hermeneutical research paradigm, based on Dilthey’s modern hermeneutics was applied. Data were collected through semistructured interviews of 11 employees narrating their experiences from various workplaces, including the military, consulting organisations and higher education institutions. Content analysis was used for data analysis and interpretation.Main findings: The major themes around which shameful experiences evolved included loss of face, mistreatment by others, low work quality, exclusion, lifestyle and internalised shame on failure in the workplace. Shame is experienced as a disturbing emotion that impacts negatively on the self within the work context. It is also experienced as reducing mental health and well-being at work.Practical/managerial implications: SA organisations need to be more aware of shame in the workplace, to address the potential negative effects of shame on employees, particularly if they are not prepared to reframe shame into a constructively and positively used emotion. Safe spaces should be made available to talk about shame. Strategies should be applied to deal with shame constructively.Contribution/value-add: This article expands an in-depth understanding of shame from emic and culture-specific perspectives within SA workplaces. The findings are beneficial to IOPs and organisations to understand what shame is from the perspective of SA employees across cultural groups. The article thereby adds value to theory and practice, offering IOPs a deeper understanding of shame in the work context.

Workplace bullying and the association with suicidal ideation/thoughts and behaviour: a systematic review

The established links between workplace bullying and poor mental health provide a prima facie reason to expect that workplace bullying increases the risk of suicidal ideation (thoughts) and behaviours. Until now, there has been no systematic summary of the available evidence. This systematic review summarises published studies reporting data on workplace bullying and suicidal ideation, or behaviour. The review sought to ascertain the nature of this association and highlight future research directions. 5 electronic databases were searched. 2 reviewers independently selected the articles for inclusion, and extracted information about study characteristics (sample, recruitment method, assessment and measures) and data reporting the association of workplace bullying with suicidal ideation and behaviour. 12 studies were included in the final review-8 reported estimates of a positive association between workplace bullying and suicidal ideation, and a further 4 provided descriptive information about the prevalence of suicidal ideation in targets of bullying. Only 1 non-representative cross-sectional study examined the association between workplace bullying and suicidal behaviour. The results show an absence of high-quality epidemiological studies (eg, prospective cohort studies, which controlled for workplace characteristics and baseline psychiatric morbidity). While the available literature (predominantly cross-sectional) suggests that there is a positive association between workplace bullying and suicidal ideation, the low quality of studies prevents ruling out alternative explanations. Further longitudinal, population-based research, adjusting for potential covariates (within and outside the workplace), is needed to determine the level of risk that workplace bullying independently contributes to suicidal ideation and behaviour.

Workplace Harassment and Morbidity Among US Adults: Results from the National Health Interview Survey

Most research on workplace harassment originates from European countries.Prevalence of workplace harassment and associated morbidity has not been well studied in the United States. The purpose of this study was to assess in a sample of US workers the prevalence of workplace harassment and the psychological and physical health consequences of workplace harassment. The 2010 National Health Interview Survey data were analyzed in 2014 for this study. We computed the prevalence of workplace harassment, assessed the demographic and background characteristics of victims of harassment, and tested the association between harassment and selected health risk factors by using logistic regression analysis. Statistical significance was established as p < 0.01. A total of 17,524 adults were included in our study (51.5% females and 74.9% Whites). A little <1 in 10 (8.1%) reported being harassed in the workplace in the past 12 months. The odds of harassment were significantly higher for females (OR 1.47, p < 0.001),multiracial individuals (OR 2.30, p < 0.001), and divorced or separated individuals (OR 1.88, p < 0.001). Victims of harassment were significantly more likely to: be obese, sleep less, and smoke more. In addition, harassment was associated with psychosocial distress, pain disorders, work loss, bed days, and worsening health of employees in the past 12 months. Analysis was stratified by gender and distinct health risk patterns for men and women victims were observed. Workplace harassment in the US is associated with significant health risk factors and morbidity. Workplace policies and protocols can play a significant role in reducing harassment and the associated negative health outcomes.

Workplace bullying and subsequent health problems

BACKGROUND

Cross-sectional studies demonstrate that exposure to bullying in the workplace is positively correlated with self-reported health problems. However, these studies do not provide a basis to draw conclusions on the extent to which bullying leads to increased health problems or whether health problems increase the risk of being bullied. To provide better indications of a causal relationship, knowledge from prospective studies on the association between bullying in the workplace and health outcomes is therefore summarised.

MATERIAL AND METHOD

We conducted a systematic literature review of original articles from central literature databases on longitudinal associations between bullying in the workplace and health. Average associations between bullying and health outcomes are calculated using meta-analysis.

RESULTS

A consistent finding across the studies is that exposure to bullying is significantly positively related to mental health problems (OR =1.68; 95% KI 1.35-2.09) and somatic symptoms (OR = 1.77; 95% KI 1.41-2.22) over time. Mental health problems are also associated with subsequent exposure to bullying (OR = 1.74; 95% KI 1.44-2.12).

INTERPRETATION

Bullying is positively related to mental health problems and somatic symptoms. The association between mental health problems and subsequent bullying indicates a self-reinforcing process between mental health and bullying. The methodological quality of the studies that were conducted is relatively sound. However, based on the existing knowledge base there are no grounds for conclusions regarding an unambiguous causal relationship between bullying and health.

Novel mechanistic insights into treadmill exercise based rescue of social defeat-induced anxiety-like behavior and memory impairment in rats

Social defeat (SD) induced stress causes physiological and behavioral deficits in rodents, including depression and anxiety-like behaviors, as well as memory impairment. Anxiolytic and mood elevating effects of physical exercise are also known. However, rescue effect of physical exercise in social defeat-induced anxiety, depression or memory impairment has not been addressed. The role of epigenetic mechanisms that potentially contribute to these rescue or protective effects is also not known. The present study investigated the effect of moderate treadmill exercise on anxiety-like behavior and memory function in rats subjected to SD using a modified version of the resident-intruder model for social stress (defeat). Changes in histone acetylation and histone-modifying enzymes were examined in hippocampus, amygdala and frontal cortex which are considered critical for anxiety, depression and cognition. Sprague Dawley rats were randomly assigned in four groups; control, exercised, social defeat, social defeat and exercise. At the end of the SD or control exposure lasting 30 min daily for 7 days, one group of SD rats was subjected to treadmill exercise for 2 weeks, whereas the other SD group was handled without exercise. Anxiety-like behavior tests and radial arm water maze test suggested that moderate treadmill exercise rescued social defeat induced anxiety-like behavior and memory impairment. Moreover, exercise normalized SD-induced increase in oxidative stress, most likely by adjusting antioxidant response. Our data suggests involvement of epigenetic mechanisms including histone acetylation of H3 and modulation of methyl-CpG-binding in the hippocampus that might contribute to the rescue effects of exercise in SD-induced behavioral deficits in rats.

Selbstregulation von Emotionen als Schutzfaktor gegen gesundheitliche Auswirkungen von Mobbing

Hintergrund: Der Zusammenhang zwischen Gesundheitsbeeinträchtigungen und Mobbing ist vielfach untersucht. Wenige Erkenntnisse liegen über die Bedeutung von selbstregulatorischen Mechanismen für die Gesundheit von Mobbingbetroffenen vor. Fragestellung: Unterscheiden sich niedrig handlungsorientierte Mobbingbetroffene hinsichtlich der Stärke gesundheitlicher Symptome von hoch handlungsorientierten? Methode: An der Untersuchung nahmen 35 von Mobbing betroffene Patienten einer psychosomatischen Fachklinik teil. Variablen wurden mit standardisierten Verfahren (Mobbingfragebogen, Hakemp, SCL-90-R) untersucht. Ergebnisse: Eine höhere Vielfalt konkreter Mobbinghandlungen bei niedriger selbstregulatorischer Kompetenz (Lageorientierung) ging mit einer signifikant erhöhten allgemeinen Symptombelastung einher. Bei hoher selbstregulatorischer Kompetenz (Handlungsorientierung) zeigte sich demgegenüber unabhängig von der Mobbingvielfalt eine vergleichsweise niedrige allgemeine Symptombelastung. Schlussfolgerungen: Die Fähigkeit zur selbstgesteuerten Regulation von Emotionen scheint vor den gesundheitlichen Beeinträchtigungen, die mit einem sozialen Stressor wie Mobbing assoziiert sind, zu schützen.

Exposure to bullying behaviors as a predictor of mental health problems among Norwegian nurses: results from the prospective SUSSH-survey

BACKGROUND

The relationship between workplace bullying and mental health problems are well documented in previous cross-sectional studies, but knowledge on how this relationship develops over time is still scarce.

OBJECTIVES

The aim of this study was to explore the prospective relationship between exposure to bullying behaviors at baseline, and increased symptoms of mental health problems (anxiety, depression, fatigue) one year later. Furthermore, the reverse relationship was investigated.

DESIGN

This is a prospective longitudinal study, where members of the Norwegian Nurses Organization answered identical questions regarding workplace bullying and mental health problems, at baseline (2008-2009) and follow-up (2010).

PARTICIPANTS

Altogether, 1582 nurses completed both questionnaires.

RESULTS

Hierarchical regression analyses indicated that exposure to bullying behaviors at baseline predicted subsequent increased symptoms of anxiety and fatigue, after adjusting for baseline symptoms of anxiety and fatigue respectively, age, gender, night work and job demands. Moreover, symptoms of anxiety, depression and fatigue at baseline predicted increased exposure to bullying behaviors one year later, after adjusting for exposure to bullying behaviors at baseline, age, gender, night work and job demands.

CONCLUSION

In this study we find support for a reciprocal relationship between exposure to bullying behaviors and symptoms of anxiety and fatigue, respectively. Thus, the results may indicate a vicious circle where workplace bullying and mental health problems mutually affect each other negatively.

MMPI-2 personality profiles and suicidal ideation and behavior in victims of bullying at work: a follow-up study

The main aim of this study was to investigate longitudinally the personality profile and suicidal ideation and behavior in victims of bullying at work in relation to the evolution of the victimization. Forty-eight victims were evaluated by means of medical and psychological assessment including the Minnesota Multiphasic Personality Inventory-2 (MMPI-2). A follow up session was carried out after an average of 22 months. At first evaluation, the average MMPI-2 personality profile of victims showed abnormal elevations on scales Hs (Hypochondria), D (Depression), Hy (Hysteria), and Pa (Paranoia), which were strikingly similar to that found in previous studies. Furthermore, suicidal ideation and behavior were common among victims. At follow-up, 26 victims reported that the degree of bullying had remained the same or had even worsened, whereas 22 said that the situation had improved or had been resolved. Although there was a trend toward normalization in the MMPI-2 profile for all victims, the profile of the "static" group was still abnormal at follow up. On the contrary, the profile of the "improved" group was entirely within normal range. Suicidal ideation and behavior decreased in all victims, but only to a significant degree in the improved group. Results are discussed in the light of the bullying process.

Sex composition of the workplace and mortality risk

This study uses Swedish occupational register data to examine whether the proportion of men in administrative workplaces in the Swedish public service affects all-cause mortality risks amongst both males and females of working age. Using piecewise constant survival models to analyse occupational data from the Swedish administrative registers from 1995 to 2007, it was found that for males, a 1% increase in the proportion of males was associated with a 1.3% increase in mortality risk (hazard ratio, HR 1.013, 95% CI 1.007-1.020, p<0.001), but no association was found for females (HR 1.004, 95% CI 0.996-1.012, p=0.297). Adjustments were made for age, family status, education, occupational status, occupational segregation by sex, the total number of individuals in the workplace, level of government, region, period and variables reflecting the workplace structure by age, age by sex, occupation and education. A higher proportion of males may be related to (i) an increased exposure to risky health behaviours such as alcohol consumption and unhealthy dietary patterns, (ii) a tendency towards sickness presenteeism, and (iii) an increase in the levels of several well-established emotional stressors in the workplace, leading to an increased level of psychosocial stress. The findings and potential extensions of this research are discussed.

The impact of bystanding to workplace bullying on symptoms of depression among women and men in industry in Sweden: an empirical and theoretical longitudinal study

Background

Prospective studies on bystanding to workplace bullying and the health outcomes are scarce.

Aim

To investigate the work environmental risk factors of depressive symptoms among bystanders to bullying in both women and men in four large industrial organizations in Sweden.

Method

The number of respondents at four large industrial enterprises with more than one year at the workplace at T1: n = 2,563 (Women: n = 342; Men: n = 2,227). Bystanders to bullying at T1: n = 305 (Women: n = 30; Men: n = 275). The total number of those with symptoms of depression at T2: Women: n = 30; Men: n = 161. Two thousand one hundred and seventy-seven employees answered the questionnaire on T1 and T2 with an 18-month interval. “To have depressive symptoms” was defined as not having depressive symptoms at T1 but having depressive symptoms at T2.

Results

The number of men who were bystanders to bullying was larger compared to women. However, the proportion of women who were bystanders to bullying and developed depressive symptoms 18 months later was higher in comparison with men (33.3 and 16.4 %, respectively). Further, “Being a bystander to bullying” 1.69 (1.13–2.53), “Rumors of changes in the workplace” 1.53 (1.10–2.14), “Reduced role clarity” 2.30 (1.21–4.32), “Lack of appreciation of being in the group” 1.76 (1.22–2.53) increased the risk of future symptoms of depression. “Job Strain” was not an adjusted risk factor for depression.

Conclusion

Our results support previous findings that bystanding to workplace bullying is related to future depressive symptoms.

Saliva DHEAS changes in patients suffering from psychopathological disorders arising from bullying at work

BACKGROUND

Psychological disorders arising from bullying at work (BW) are common. The relationship between these disorders and putative markers is not well established.

AIMS

To measure saliva dehydroepiandrosterone sulphate (DHEAS) and saliva cortisol as putative markers in individuals suffering from BW.

METHODS

Forty one subjects suffering from BW were screened for mental distress at the institute of occupational health in Clermont-Ferrand, France. They were compared with 28 psychologically healthy controls (group C). The conditions causing BW were recorded. The hospital anxiety and depression (HAD) scale, the Beech questionnaire and the visual analogic scale (VAS) of stress were used to determine the psychological consequences of BW. Saliva samples were collected at awakening (7 am), 30 and 60 min after awakening, and then every 2 h until bed time (11 pm).

RESULTS

The BW group had significantly higher scores on the HAD scale, higher stress on the VAS, and a higher score on the Beech questionnaire. They also had a significantly higher saliva concentration of DHEAS. There was no significant difference between groups in cortisol levels at any time, nor in area under the curve (AUC) and cortisol awakening response (CAR). There was a significant positive correlation between HAD and VAS scores and DHEAS levels, but not between cortisol levels or AUC or CAR.

CONCLUSION

In contrast to saliva cortisol levels, saliva DHEAS levels are modified after psychological distress arising from BW. This discrepancy probably arises from the stability conferred by the very long half life of DHEAS of about 15 h.

An ecological model of workplace bullying: a guide for intervention and research

The origins and outcomes of workplace bullying can be understood through the use of a conceptual model which is based on the ecological perspective. This model portrays the work environment as a series of nested, interconnected layers that exist within society as a whole. These layers are society (macrosystem), the corporation (exosystem), the co-workers and managers of the bully and target (mesosystem), and the bully and target (microsystem). Workplace bullying does not occur in isolation. Elements at each of these levels serve as antecedents to bullying, and the outcomes of bullying are manifested at each of these levels. These antecedents and outcomes need to be considered when developing interventions that target workplace bullying. The model can be used as a theoretical framework to guide intervention planning and evaluation, and can also be used to guide the formulation of questions for empirical research.

Social defeat promotes specific cytokine variations within the prefrontal cortex upon subsequent aggressive or endotoxin challenges

Stressful experiences typically have short-lived neuroendocrine and neurochemical effects, but the processes leading to these biological alterations may be sensitized so that later challenges promote exaggerated responses. As stressors and immunogenic insults have both been associated with inflammatory immune variations within the brain, we assessed whether a social defeat stressor would result in augmented corticosterone release and mRNA expression of pro-inflammatory cytokines within the prefrontal cortex (PFC) upon later social defeat (sensitization) or endotoxin (lipopolysaccharide: LPS) challenges (cross-sensitization). In the absence of a prior stressor experience, the social defeat challenge did not affect prefrontal interleukin (IL)-1β or tumor necrosis factor (TNF)-α mRNA expression, but increased that of IL-6, whereas LPS increased the expression of each cytokine. Among mice that had initially been repeatedly defeated, IL-1β and TNF-α expression was enhanced after the social defeat challenge, whereas this was not evident in response to the LPS challenge. In contrast, the initial social defeat stressor had protracted effects in that increase of IL-6 expression was limited upon subsequent challenge with either social defeat or LPS. Previous social stressor experiences also limited the corticosterone rise ordinarily elicited by either social defeat or LPS treatment. It seems that a powerful stressor, such as social defeat, may have persistent effects on later corticosterone and cytokine responses to different types of stressful insults (social versus systemic challenges), but the nature of the effects varies with the specific process assessed.

Interfaces LER/Saúde Mental: a experiência de um Centro de Referência em Saúde do Trabalhador do Estado de São Paulo

Este relato apresenta demandas que cada vez mais chegam aos Cerests desafiando as equipes multidisciplinares para o desenvolvimento de novas modalidades de abordagem diagnóstica e terapêutica. A experiência é de um Cerest do interior de São Paulo na última década. Construída a partir do relato de trabalhadores, visitas a locais de trabalho, discussão com representantes de empresas e atuação de equipe plurinstitucional de LER, ilustra situações de trabalho potencialmente adoecedoras, em especial do sistema musculoesquelético (LER/DORT). Trabalhadores de cinco empresas de quatro diferentes ramos relatam pressão para produção, sobrecarga física e competitividade, situações de humilhação ou constrangimento como forma de ajustá-los aos padrões da empresa, além da exposição pública e da "punição pelo adoecimento" dos acometidos pelos agravos que retornam ao trabalho. Verifica-se que há ainda grande deficiência no reconhecimento das situações em que o trabalho contribui para o adoecimento mental. Os profissionais da área da Saúde do Trabalhador devem estar especialmente atentos para identificar os casos de sofrimento mental nos portadores de LER/DORT e notificá-los. Recomenda-se que as informações geradas sejam reunidas, analisadas e divulgadas, de modo que possam ser instrumento para sensibilização dos profissionais de saúde em geral e gerar formas de intervenção mais eficazes à proteção à saúde dos trabalhadores.

Health outcomes and self-labeling as a victim of workplace bullying

OBJECTIVE

This study investigated the extent to which self-labeling as a victim of workplace bullying mediates or moderates the relationship between exposure to bullying and the target's health outcomes.

METHODS

Data were collected by means of anonymous self-report questionnaires. A total of 1024 employees in a transport organization participated in the study, among whom 116 self-labeled victims were identified. Exposure to bullying was measured by a short version of the Negative Acts Questionnaire, while the respondents' health outcomes were measured by the Bergen Health Checklist.

RESULTS

The findings showed that self-labeling both moderated and partially mediated the relationship between exposure to bullying and the targets' health. However, the moderator analyses indicate that self-labeling only acts as moderator in cases of low exposure. Intense exposure to bullying behaviors is related to increased levels of health complaints regardless of the target's subjective appraisal of being a victim or not.

CONCLUSION

Self-labeling as a victim plays an important role in the victimizing process, although persistent exposure to workplace bullying seems to have considerable harmful effects on the target's health independently of whether the experience is labeled as bullying or not.

Exploring risk groups workplace bullying with categorical data

In this study, we first explore whether different exposure groups of workplace bullying exist, employing a large, heterogeneous sample. The results show six different exposure groups: almost 30.5% is not bullied since they report hardly any negative act at work at all, 27.2% face some limited work criticism, 20.8% face limited negative encounters, 8.3% is occasionally bullied, 9.5% are predominately work related bullied, and a total of 3.6% can be seen victims of severe workplace bullying. In a second step, the relationship between the identified target groups and social demographics were investigated using multinomial logistic regression to identify risk groups of workplace bullying. Employees between the age of 35 and 54, public servants, blue-collar workers, as well as employees working in the food and manufacturing industries have a significantly elevated risk to be victims of workplace bullying. In contrast, employees younger than 25, employees with a temporary contract, teachers, nurses and assistant nurses are those least likely at risk. These findings are important for policymakers at the national and organisational level as they assist in focussing towards possible avenues to prevent workplace bullying.

Assessment of workplace bullying and harassment: reliability and validity of a Japanese version of the negative acts questionnaire

OBJECTIVES

Interest in workplace bullying and harassment has been increasing in Japan. At present, the Negative Acts Questionnaire (NAQ) is one of the most frequently used questionnaires for assessing these issues. The purpose of this study was to develop a Japanese version of the NAQ.

METHODS

We translated the original version of the NAQ using a back-translation method. Participants in this study were recruited from 737 workers at a manufacturing company in Japan. Data were obtained from questionnaires completed by 517 respondents (response rate: 70.1%).

RESULTS

We used a cross-validation approach. A three-factor model was obtained from exploratory factor analyses. The confirmatory factor analysis for this model revealed values of 0.94, 0.91, 0.95, and 0.054 for the goodness-of-fit index, the adjusted goodness-of-fit index, the comparative fit index, and the root mean square error of approximation, respectively. Pearson's correlation coefficients for the NAQ scores with the Job Content Questionnaire (JCQ) support scores and the Effort-Reward Imbalance Questionnaire scores for respect and job security were significant (p<0.001) and the direction of these associations were consistent with our expectations, with the exceptions of the correlations between the NAQ sexual harassment score and the JCQ support scores. Cronbach's alpha coefficients for the scores on the entire NAQ scale and on three subscales (person-related bullying, work-related bullying, and sexual harassment) were 0.90, 0.84, 0.60, and 0.60, respectively.

CONCLUSIONS

A Japanese version of the NAQ was developed and it appears to have acceptable levels of internal consistency reliability and factor- and construct-validity.