Work-related exposure to violence or threats and risk of mental disorders and symptoms: a systematic review and meta-analysis

Abstract

Objective This review aimed to examine systematically the epidemiological evidence linking work-related exposure to violence and threats thereof with risk of mental disorders and mental ill-health symptoms. Methods We searched PubMed, EMBASE, PsycINFO and Web of Science to identify original studies that provide quantitative risk estimates. The evidence was weighted according to completeness of reporting, potential common method bias, and bias due to differential selection and drop out, selective reporting, and misclassification of exposure and outcome. Results We identified 14 cross-sectional and 10 cohort studies with eligible risk estimates, of which 4 examined depressive disorder and reported an elevated risk among the exposed [pooled relative risk (RR) 1.42, 95% confidence interval (CI) 1.31–1.54, I 2 =0%]. The occurrence of depressive and anxiety symptoms, burnout and psychological distress was examined in 17 studies (pooled RR 2.33, 95% CI 3.17, I 2 =42%), and 3 studies examined risk of sleep disturbance (pooled RR 1.22, 95% CI 1.09–1.37, I 2 =0%). In most studies, common method bias and confounding could not be ruled out with confidence and strong heterogeneity in most outcome definitions invalidate the strict interpretation of most pooled risk estimates. Conclusion The reviewed studies consistently indicate associations between workplace violence and mental health problems. However, due to methodological limitations the causal associations (if any) may be stronger or weaker than the ones reported in this study. Prospective studies with independent and validated reporting of exposure and outcome and repeated follow-up with relevant intervals are highly warranted.

Cross-sectional study of aggression against Spanish nursing personnel and effects on somatisation of physical symptoms

“…Exposure to severely violent situations is considered an antecedent traumatic event for stressful factors that promote development of PTSD, depression and anxiety 44. Even though violence and threats in the workplace are usually not as severe, they are often prolonged or repeated, which can contribute to increasing the risk of mental disorders 45 46. The appearance of episodes of violence in the workplace has been specifically related to development of PTSD symptoms,47 48 as well as presence of anxiety, physical symptoms and sleep impairment in healthcare professionals 49 50.…”

Organizational Prevention and Management Strategies for Workplace Aggression Among Child Protection Workers: A Project Protocol for the Oslo Workplace Aggression Survey (OWAS)

“…Firstly, by using behavioral inventories to assess specific forms of physical and psychological aggression, the findings will provide prevalence estimates as well as an in-depth understanding of how these forms of aggression influence individuals and organizations. Secondly, whereas previous studies on workplace aggression have mainly used cross-sectional data (Neall and Tuckey, 2014;Rudkjoebing et al, 2020), the present project is based on longitudinal research designs, including a quantitative diary study, which is a novel approach within this field of research. Thirdly, by examining mediating and moderating variables in the relationship between aggression and outcomes, this project will generate novel knowledge important for extending and developing the theoretical basis of our understanding of workplace aggression, which is critical in order to adequately design upcoming studies.…”

“…In order to understand the health effects of workplace aggression, it is also important to identify the mechanisms that determine how workplace aggression creates health problems. To this date, only a few studies, mainly based on cross-sectional self-report data from small and specific samples, have examined such explanatory variables (Neall and Tuckey, 2014;Nielsen and Einarsen, 2018;Rudkjoebing et al, 2020). In this project, we will therefore examine these mechanisms applying longitudinal data.…”

“…As for specific health consequences following workplace aggression, several systematic reviews and meta-analyses show that those exposed are at significantly higher risk of developing mental and somatic health complaints ( Lanctot and Guay, 2014 ; Nielsen et al, 2014 ; Rudkjoebing et al, 2020 ), symptoms of posttraumatic stress ( Jacobowitz, 2013 ; Nielsen et al, 2015b ), and suicidal ideation ( Leach et al, 2017 ). Targets also report higher turnover and lower affective commitment ( LeBlanc and Barling, 2004 ; Bowling and Beehr, 2006 ), lower productivity ( Bowling and Beehr, 2006 ), reduced work ability as manifested through higher sickness absence rates ( Nielsen et al, 2016 ), and risk of disability retirement ( Nielsen et al, 2017a ).…”

“…In this project, we will therefore examine these mechanisms applying longitudinal data. These kinds of prospective studies have been requested in the literature on workplace aggression ( Rudkjoebing et al, 2020 ). Based on the theory of shattered basic assumptions described above ( Janoff-Bulman, 1989 ; Mikkelsen and Einarsen, 2002 ; Nielsen and Einarsen, 2018 ), it is likely that workplace aggression influences the health and well-being of those exposed through factors such as worrying ( Rosario-Hernández et al, 2018 ; Demsky et al, 2019 ), job dissatisfaction ( Devonish, 2013 ), psychological detachment ( Demsky et al, 2014 , 2019 ), and job engagement ( Einarsen et al, 2018 ).…”