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Work-related threats and violence and post-traumatic symptoms in four high-risk occupations: short- and long-term symptoms

  • Lars Peter AndersenEmail author
  • Annie Hogh
  • Ask Elklit
  • Johan Hviid Andersen
  • Karin Biering
Original Article

Abstract

Objectives

To examine the associations between exposure to work-related violence and threats and subsequent PTSD among males and females in four high-risk occupations in human service work. Furthermore, we examined the modifying effect of coping style and self-efficacy.

Methods

Questionnaire data were collected in 2011 and in 2015 from 2678 employees working in psychiatric wards, in the elder sector, in special schools and in the Prison and Probation Service (PPS). Exposure to work-related violence and threats was measured in 2011, while PTSD was measured in 2011 and 2015 by the Impact of Event Scale-Revised. To assess the associations, logistic regression was conducted, adjusted for bullying, sexual harassment, negative acts, conflicts at work, other private traumas and baseline PTSD.

Results

There was an association between work-related threats and PTSD in 2011 and 2015. Furthermore, there was an association between work-related violence and PTSD in 2011. The associations were strongest in the PPS. Male staff had a higher risk for PTSD. Neither coping style nor self-efficacy did modify the associations between exposure to work-related violence and threats and subsequent PTSD.

Conclusion

The prevention of PTSD following work-related violence and threats should first of all be based on reducing the risk of work-related violence. In addition, supervisors should be trained to detect symptoms of PTSD after exposure to traumatic events.

Keywords

Work-related violence and threats PTSD Self-efficacy Coping Human service sectors 

Notes

Funding

This work was supported by the Danish Environmental Research Fund (grant number 14-2014-03).

Compliance with ethical standards

Conflict of interest

All authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors. This study was conducted based on approval from the Danish Data Protection Agency, journal # 2014-331-0925 and under their rules of data protection.

References

  1. Abualrub RF, Al-Asmar AH (2011) Physical violence in the workplace among Jordanian hospital nurses. J Transcult Nurs 22(2):157–165Google Scholar
  2. Andersen LP, Hogh A, Gadegaard C (2016) Risk factors for work-related threats and violence. Arbejdsmiljøforskningsfonden—The Danish Work Environment Fund, CopenhagenGoogle Scholar
  3. Andersen LP, Hogh A, Biering K, Gadegaard CA (2018) Work-related threats and violence in human service sectors: the importance of the psycho-social work environment examined in a multilevel prospective study. Work 59(1):141–154Google Scholar
  4. Arnetz JE, Arnetz BB, Petterson IL (1996) Violence in the nursing profession: Occupational and lifestyle risk factors in Swedish nurses. Work Stress 10(2):119–127Google Scholar
  5. Arnetz JE, Hamblin L, Russell J, Upfal MJ, Luborsky M, Janisse J et al (2017) Preventing patient-to-worker violence in hospitals: Outcome of a randomized controlled intervention. J Occup Environ Med 59(1):18–27Google Scholar
  6. Asukai N, Kato H, Kawamura N, Kim Y, Yamamoto K, Kishimoto J et al (2002) Reliability and validity of the Japanese-language version of the impact of event scale-revised (IES-R-J): Four studies of different traumatic events. J Nerv Ment Dis 190(3):175–182Google Scholar
  7. Benight CC, Bandura A (2004) Social cognitive theory of posttraumatic recovery: The role of perceived self-efficacy. Behav Res Ther 42(10):1129–1148Google Scholar
  8. Bonde J, Utzon-Frank N, Bertelsen M, Borritz M, Eller N, Nordentoft M et al (2013) A scientific review addressing delayed onset posttraumatic stress disorder and posttraumatic depression. National Reseach Centre for Working Environment, KøbenhavnGoogle Scholar
  9. Breslau N, Davis GC (1992) Posttraumatic stress disorder in an urban population of young adults: risk factors for chronicity. Am J Psychiatry 149(5):671–675Google Scholar
  10. Briere J, Agee E, Dietrich A (2016) Cumulative trauma and current posttraumatic stress disorder status in general population and inmate samples. Psychol Trauma Theory Res Pract Policy 8(4):439Google Scholar
  11. Brown J, Mulhern G, Joseph S (2002) Incident-related stressors, locus of control, coping, and psychological distress among firefighters in northern Ireland. J Trauma Stress 15(2):161–168Google Scholar
  12. Budd T (1999) Violence at work: findings from the British crime survey. Home Office, LondonGoogle Scholar
  13. Caldwell MF (1992) Incidence of PTSD among staff victims of patient violence. Hosp Commun Psychiatry 43(8):838–839Google Scholar
  14. Carlier IV, Lamberts RD, Gersons BP (1997) Risk factors for posttraumatic stress symptomatology in police officers: a prospective analysis. J Nerv Ment Dis 185(8):498–506Google Scholar
  15. Carmel H, Hunter M (1989) Staff injuries from inpatient violence. Hosp Commun Psychiatry 40(1):41–46Google Scholar
  16. Carver CS (1997) You want to measure coping but your protocol’s too long: consider the brief COPE. Int J Behav Medi 4(1):92–100Google Scholar
  17. Chen G, Gully SM, Eden D (2001) Validation of a new general self-efficacy scale. Organ Res Methods 4(1):62–83Google Scholar
  18. Chen W, Hwu H, Kung S, Chiu H, Wang J (2008) Prevalence and determinants of workplace violence of health care workers in a psychiatric hospital in Taiwan. J Occup Health 50(3):288–293Google Scholar
  19. Clausen T, Hogh A, Borg V (2012) Acts of offensive behaviour and risk of long-term sickness absence in the Danish elder-care services: a prospective analysis of register-based outcomes. Int Arch Occup Environ Health 85(4):381–387Google Scholar
  20. Cohn A, Hodson S, Crane M (2010) Resilience training in the Australian defense force. InPsych Bull Austr Psychol Soc Ltd 32(2):16Google Scholar
  21. Creamer M, Bell R, Failla S (2003) Psychometric properties of the impact of event ScaleΓÇöRevised. Behav Res Ther 41(12):1489–1496Google Scholar
  22. Dijkema MB, Grievink L, Stellato RK, Roorda J, Van der Velden PG (2005) Determinants of response in a longitudinal health study following the firework-disaster in Enschede, the Netherlands. Eur J Epidemiol 20(10):839–847Google Scholar
  23. Einarsen S, Hoel H, Notelaers G (2009) Measuring exposure to bullying and harassment at work: validity, factor structure and psychometric properties of the negative acts questionnaire-revised. Work Stress 23(1):24–44Google Scholar
  24. Engelhard IM, van den Hout MA, Kindt M (2003) The relationship between neuroticism, pre-traumatic stress, and post-traumatic stress: a prospective study. Personal Individ Differ 35(2):381–388Google Scholar
  25. Evans J, Frank B (2003) Contradictions and tensions: exploring relations of masculinities in the numerically female-dominated nursing profession. J Men’s Stud 11(3):277Google Scholar
  26. Fikretoglu D, Brunet A, Poundja J, Guay S, Pedlar D (2006) Validation of the deployment risk and resilience inventory in French-Canadian veterans: Findings on the relation between deployment experiences and post deployment health. Can J Psychiatry 51(12):755–763Google Scholar
  27. Flannery RB, LeVitre V, Rego S, Walker AP (2011) Characteristics of staff victims of psychiatric patient assaults: 20-year analysis of the assaulted staff action program. Psychiatr Q 82(1):11–21Google Scholar
  28. Folkman S (2013) Stress: appraisal and coping. Springer, New YorkGoogle Scholar
  29. Friborg O, Emaus N, Rosenvinge JH, Bilden U, Olsen JA, Pettersen G (2015) Violence affects physical and mental health differently: the general population based Tromsø study. PLoS One 10(8):e0136588Google Scholar
  30. Friis K, Larsen FB, Lasgaard M (2017) Physical violence at work predicts health-related absence from the labor market: a 10-year population-based follow-up study. Psychol Violence.  https://doi.org/10.1037/vio0000137 Google Scholar
  31. Gates DM, Ross CS, McQueen L (2006) Violence against emergency department workers. J Emerg Med 31(3):331–337Google Scholar
  32. Gates DM, Gillespie GL, Succop P (2011) Violence against nurses and its impact on stress and productivity. Nurs Econ 29(2):59–67Google Scholar
  33. Gillespie GL, Gates DM, Miller M, Howard PK (2010) Violence against healthcare workers in a pediatric emergency department. Adv Emerg Nurs J 32(1):68–82Google Scholar
  34. Gries CJ, Engelberg RA, Kross EK, Zatzick D, Nielsen EL, Downey L et al (2010) Predictors of symptoms of posttraumatic stress and depression in family members after patient death in the ICU. Chest J 137(2):280–287Google Scholar
  35. Isenhardt A, Hostettler U (2016) Inmate violence and correctional staff burnout: The role of sense of security, gender, and job characteristics. J Interpers Violence.  https://doi.org/10.1177/0886260516681156 Google Scholar
  36. Jacobowitz W (2013) PTSD in psychiatric nurses and other mental health providers: a review of the literature. Issues Ment Health Nurs 34(11):787–795Google Scholar
  37. Kessler RC, Sonnega A, Bromet E, Hughes M, Nelson CB (1995) Posttraumatic stress disorder in the national comorbidity survey. Arch Gen Psychiatry 52(12):1048–1060Google Scholar
  38. Kristensen TS, Hannerz H, Hogh A, Borg V (2005) The Copenhagen psychosocial questionnaire. A tool for the assessment and improvement of the psychosocial work environment. Scand J Work Environ Health 31(6):438–449Google Scholar
  39. Lanctôt N, Guay S (2014) The aftermath of workplace violence among healthcare workers: a systematic literature review of the consequences. Aggress Violent Behav 19(5):492–501Google Scholar
  40. Laposa JM, Alden LE, Fullerton LM (2003) Work stress and posttraumatic stress disorder in ED nurses/personnel (CE). J Emerg Nurs 29(1):23–28Google Scholar
  41. Leather P, Lawrence C, Beale D, Cox T, Dickson R (1998) Exposure to occupational violence and the buffering effects of intra-organizational support. Work Stress 12(2):161–178Google Scholar
  42. Littleton H, Horsley S, John S, Nelson DV (2007) Trauma coping strategies and psychological distress: a meta-analysis. J Trauma Stress 20(6):977–988Google Scholar
  43. Luszczynska A, Benight CC, Cieslak R (2009) Self-efficacy and health-related outcomes of collective trauma. Eur Psychol 14(1):51–62Google Scholar
  44. Matthiesen SB, Einarsen S (2004) Psychiatric distress and symptoms of PTSD among victims of bullying at work. Br J Guid Couns 32(3):335–356Google Scholar
  45. Menckel E, Viitasara E (2002) Threats and violence in Swedish care and welfare. magnitude of the problem and impact on municipal personnel. Scand J Caring Sci 16(4):376–385Google Scholar
  46. Nachreiner NM, Hansen HE, Okano A, Gerberich SG, Ryan AD, McGovern PM et al (2007) Difference in work-related violence by nurse license type. J Prof Nurs 23(5):290–300Google Scholar
  47. Nielsen MB, Tangen T, Idsoe T, Matthiesen SB, Magerøy N (2015) Post-traumatic stress disorder as a consequence of bullying at work and at school. A literature review and meta-analysis. Aggress Violent Beh 21:17–24Google Scholar
  48. Ozer EJ, Best SR, Lipsey TL, Weiss DS (2008) Predictors of posttraumatic stress disorder and symptoms in adults: a meta-analysis. Psychol Trauma Theory Res Pract Policy S(1):3–36Google Scholar
  49. Pai H, Lee S (2011) Risk factors for workplace violence in clinical registered nurses in Taiwan. J Clin Nurs 20(9):1405–1412Google Scholar
  50. Peñalba V, McGuire H, Leite JR (2008) Psychosocial interventions for prevention of psychological disorders in law enforcement officers. Cochrane Database of Syst Rev 2008(3):CD005601Google Scholar
  51. Perrin M, Vandeleur CL, Castelao E, Rothen S, Glaus J, Vollenweider P et al (2014) Determinants of the development of post-traumatic stress disorder, in the general population. Soc Psychiatry Psychiatr Epidemiol 49(3):447–457Google Scholar
  52. Rash CJ, Coffey SF, Baschnagel JS, Drobes DJ, Saladin ME (2008) Psychometric properties of the IES-R in traumatized substance dependent individuals with and without PTSD. Addict Behav 33(8):1039–1047Google Scholar
  53. Rasmussen CA, Hogh A, Andersen LP (2013) Threats and physical violence in the workplace: a comparative study of four areas of human service work. J Interpers Violence 28(13):2749–2769Google Scholar
  54. Richter D, Berger K (2006) Post-traumatic stress disorder following patient assaults among staff members of mental health hospitals: a prospective longitudinal study. BMC Psychiatry 6(1):15Google Scholar
  55. Rugulies R, Bultmann U, Aust B, Burr H (2006) Psychosocial work environment and incidence of severe depressive symptoms: prospective findings from a 5-year follow-up of the danish work environment cohort study. Am J Epidemiol 163(10):877–887Google Scholar
  56. Saeki K, Okamoto N, Tomioka K, Obayashi K, Nishioka H, Ohara K et al (2011) Work-related aggression and violence committed by patients and its psychological influence on doctors. J Occup Health 53(5):356–364Google Scholar
  57. Schat ACH, Kelloway EK (2003) Reducing the adverse consequences of workplace aggression and violence: the buffering effects of organizational support. J Occup Health Psychol 8(2):110–122Google Scholar
  58. Schnider KR, Elhai JD, Gray MJ (2007) Coping style use predicts posttraumatic stress and complicated grief symptom severity among college students reporting a traumatic loss. J Counseling Psychol 54(3):344Google Scholar
  59. Shin KM, Chang HY, Cho S, Kim NH, Kim KA, Chung YK (2015) Avoidance symptoms and delayed verbal memory are associated with post-traumatic stress symptoms in female victims of sexual violence. J Affect Disord 184:145–148Google Scholar
  60. Skeffington PM, Rees CS, Mazzucchelli T (2017) Trauma exposure and post-traumatic stress disorder within fire and emergency services in western Australia. Austr J Psychol 69:20–28Google Scholar
  61. Skogstad M, Skorstad M, Lie A, Conradi HS, Heir T, Weisæth L (2013) Work-related post-traumatic stress disorder. Occup Med 63(3):175–182Google Scholar
  62. Somville FJ, De Gucht V, Maes S (2016) The impact of occupational hazards and traumatic events among belgian emergency physicians. Scand J Trauma Resusc Emerg Med 24(1):59Google Scholar
  63. Spector PE, Zhou ZE, Che XX (2014) Nurse exposure to physical and nonphysical violence, bullying, and sexual harassment: a quantitative review. Int J Nurs Stud 51(1):72–84Google Scholar
  64. Speroni KG, Fitch T, Dawson E, Dugan L, Atherton M (2014) Incidence and cost of nurse workplace violence perpetrated by hospital patients or patient visitors. J Emerg Nurs 40(3):218–228Google Scholar
  65. Spinaris CG, Denhof MD, Kellaway JA (2012a) Posttraumatic stress disorder in united states corrections professionals: prevalence and impact on health and functioning. Desert Waters Correctional Outreach, Florence, pp 1–32Google Scholar
  66. Spinaris CG, Denhof MD, Kellaway JA (2012b) Posttraumatic stress disorder in united states corrections professionals: prevalence and impact on health and functioning (Retrieved from /z-wcorg/) Google Scholar
  67. Spinaris C, Denhof M, Morton G (2013) Impact of traumatic exposure on corrections professionals. Desert Waters Correctional Outreach, FlorenceGoogle Scholar
  68. Tanielian T, Haycox LH, Schell TL, Marshall GN, Burnam MA, Eibner C et al (2008) Invisible wounds of war. Summary and recommendations for addressing psychological and cognitive injuries. Rand Cooperation, Santa Monica, CA, pp 1–67Google Scholar
  69. Tolin DF, Foa EB (2006) Sex differences in trauma and posttraumatic stress disorder: a quantitative review of 25 years of research. Psychol Bull 132(6):959–992Google Scholar
  70. Torkelson DJ, Seed MS (2011) Gender differences in the roles and functions of inpatient psychiatric nurses. J Psychosoc Nurs Ment Health Serv 49(3):34–41Google Scholar
  71. van der Ploeg E, Kleber RJ (2003) Acute and chronic job stressors among ambulance personnel: Predictors of health symptoms. Occup Environ Med 60(Suppl 1):i40–i46Google Scholar
  72. Vidal-Martí C, Pérez-Testor C (2015) Patient assaults on professionals. type II workplace violence: a known phenomenon in barcelona nursing homes. Work 51(4):879–886Google Scholar
  73. Vogt DS, Tanner LR (2007) Risk and resilience factors for posttraumatic stress symptomatology in gulf war I veterans. J Trauma Stress 20(1):27–38Google Scholar
  74. Walsh BR, Clarke E (2003) Post-trauma symptoms in health workers following physical and verbal aggression. Work Stress 17(2):170–181Google Scholar
  75. Weiss DS, Marmar CR (1997) The impact of event scale—revised. Guilford Press, New York, pp 399–411Google Scholar
  76. Willness CR, Steel P, Lee K (2007) A metaanalysis of the antecedents and consequences of workplace sexual harassment. Pers Psychol 60(1):127–162Google Scholar
  77. Wohlfarth TD, van den Brink W, Winkel FW, & ter Smitten M (2003) Screening for posttraumatic stress disorder: an evaluation of two self-report scales among crime victims. Psychol Assess 15(1):101Google Scholar
  78. Wykes T, Whittington R (1998) Prevalence and predictors of early traumatic stress reactions in assaulted psychiatric nurses. J Forensic Psychiatry 9(3):643–658Google Scholar
  79. Wynne R, Clarkin N, Cox T, Griffeths A (1997) Guidance on the prevention of violence at work. European Commision, DG-V, LuxembourgGoogle Scholar
  80. Zlotnick C, Franklin CL, Zimmerman M (2002) Does “subthreshold” posttraumatic stress disorder have any clinical relevance? Compr Psychiatry 43(6):413–419Google Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Occupational MedicineRegional Hospital West JutlandHerningDenmark

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