Does leadership support buffer the effect of workplace bullying on the risk of disability pensioning? An analysis of register-based outcomes using pooled survey data from 24,538 employees

  • Thomas ClausenEmail author
  • Paul Maurice Conway
  • Hermann Burr
  • Tage S. Kristensen
  • Åse Marie Hansen
  • Anne Helene Garde
  • Annie Hogh
Original Article



To investigate whether self-reported exposure to workplace bullying predicts the risk of disability pensioning among employees in two occupational groups—(1) employees working with clients or customers and (2) office workers and manual workers—and whether leadership support and occupational group moderates that association.


Survey data from 24,538 employees (112,889 person years) were fitted to a national register containing information on disability-pension payments. Using multi-adjusted Cox-regression analysis, observations were followed in the register to assess the risk of disability pensioning. The average follow-up time was 4.6 years (standard deviation [SD] = 1.5).


Self-reported exposure to workplace bullying predicted an increased risk of disability pensioning (hazard ratio [HR] = 1.46; 95% confidence interval [CI]: 1.15–1.86). This association was moderated by leadership support: the association between workplace bullying and disability pensioning was significantly different for respondents who reported low leadership support (HR = 1.97; 95% CI: 1.38–2.80) compared to respondents who reported medium (HR = 1.03; 95% CI: 0.60–1.76) or high leadership support (HR = 1.08; 95% CI: 0.60–1.95). Further analyses showed similar associations between workplace bullying and the risk of disability pensioning among the two occupational groups.


Self-reported workplace bullying increases the risk of disability pensioning, and this association is buffered by leadership support. Workplace bullying should be considered an important workplace stressor. This study indicates that workplaces may enhance worker retention by actively promoting measures to eliminate the occurrence of workplace bullying and to enhance leadership support.


Longitudinal study Psychosocial work environment Workplace mistreatment Harassment Early retirement Quality of leadership 



This work was supported by the Danish Working Environment Research Fund (Grant no. 20100019956) and the Danish Council for Independent Research (Grant no. 1319-00092). The funding bodies played no role in the data collection, the formulation of study hypothesis, the analyses, or the interpretation of findings. The authors also wish to thank two anonymous reviewers for their helpful comments to an earlier version of this manuscript.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest to report.


  1. Albertsen K, Lund T, Christensen KB, Kristensen TS, Villadsen E (2007) Predictors of disability pension over a 10-year period for men and women. Scand J Pub Health 35:78–85CrossRefGoogle Scholar
  2. Ankestyrelsen [National Social Appeals Board] (2017), Førtidspension. Årsstatistik 2016 [Disability Pension. Annual Statistics 2016], Ankestyrelsen [National Social Appeals Board], CopenhagenGoogle Scholar
  3. Clausen T, Borg V (2011) Job demands, job resources and meaning at work. J Manag Psychol 26(8):665–681CrossRefGoogle Scholar
  4. 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):381–387CrossRefGoogle Scholar
  5. Clausen T, Hogh A, Carneiro IG, Borg V (2013) Does psychological wellbeing mediate the association between acts of offensive behaviour and turnover among care workers? A longitudinal analysis. J Adv Nurs 69(6):1301–1313Google Scholar
  6. Clausen T, Burr H, Borg V (2014) Do psychosocial work conditions predict risk of disability pensioning? An analysis of register-based outcomes using pooled data on 40,554 observations. Scand J Pub Health 42(4):377–384CrossRefGoogle Scholar
  7. Clausen T, Madsen I, Christensen K, Bjørner J, Poulsen O, Maltesen T, Pedersen J, Borg V, Rugulies R (2017) Dansk Psykosocialt Spørgeskema—Et spørgeskema om psykosocialt arbejdsmiljø. Dokumentationsrapport [Danish Psychosocial Questionnaire—a questionnaire on the psychosocial working environment. Documentation report], Det Nationale Forskningscenter for Arbejdsmiljø [National Research Centre for the Working Environment], København [Copenhagen]Google Scholar
  8. Dellve L, Lagerström M, Hagberg M (2003) Work-system risk factors for permanent disability among home-care workers: a case control study. Int Arch Occup Environ Health 76:216–226Google Scholar
  9. Feveile H, Olsen O, Burr H, Bach E (2007) The Danish work environment cohort study 2005: from idea to sampling design. Stat Transit 8(3):441–458Google Scholar
  10. Feveile H, Olsen O, Hogh A (2007) A randomized trial of mailed questionnaires versus telephone interviews: response patterns in a survey. BMC Med Res Methodol 26(7):27CrossRefGoogle Scholar
  11. Francioli L, Conway PM, Hansen AM, Holten A, Grynderup MB, Persson R, Mikkelsen EG, Hogh A (2015) Quality of leadership and workplace bullying: the mediating role of social community at work in a two-year follow-up study. J Bus Ethics 19:1–11 (Pub online) Google Scholar
  12. Grynderup M, Nabe-Nielsen K, Lange T et al (2016) Does perceived stress mediate the association between workplace bullying and long-term sickness absence. J Occup Environ Med 58(6):226–230CrossRefGoogle Scholar
  13. Hjollund NH, Larsen FB, Andersen JH (2007) Register-based follow-up of social benefits and other transfer payments: accuracy and degree of completeness in a Danish interdepartmental administrative database compared with a population-based survey. Scand J Public Health 35(5):497–502CrossRefGoogle Scholar
  14. Hogh A, Mikkelsen EG, Hansen AM (2011) Individual consequences of workplace bullying/mobbing. In: Einarsen S, et al. (eds) Workplace bullying: development in theory, research and practice, 2nd edn. Taylor & Francis, London, pp 107–128Google Scholar
  15. Hogh A, Giver H, Hannerz H, Pedersen BH (2012) Bullying or violence during training and the risk of dropout from the eldercare sector 2 years later. Scand J Caring Sci 26(4):730–737CrossRefGoogle Scholar
  16. Katsahian S, Latouche A, Mary J (2008) Practical methodology of meta-analysis of individual patient data using a survival outcome. Contemp Clin Trials 29(2):220–230CrossRefGoogle Scholar
  17. Keyes CLM (2007) Promoting and protecting mental health as flourishing: a complementary strategy for improving national mental health. Am Psychol 62(2):95–108CrossRefGoogle Scholar
  18. Kivimäki M, Virtanen M, Vartia M, Elovainio M, Vahtera J, Keltikangas-Järvinen L (2003) Workplace bullying and the risk of cardiovascular disease and depression. Occup Environ Med 60(10):779–783CrossRefGoogle Scholar
  19. Knardahl S, Johannessen H, Sterud T, Härmä M, Rugulies R, Seitsamo J, Borg V (2017) The contribution from psychological, social and organizational work factors to risk of disability retirement: a systematic review with meta-analyses. BMC Public Health 17(1):176CrossRefGoogle Scholar
  20. Leymann H (1990) Mobbing and psychological terror at workplaces. Violence Vict 5(2):119–126CrossRefGoogle Scholar
  21. Mikkelsen EG, Einarsen S (2001) Bullying in Danish work-life: prevalence and health correlates. Eur J Work Org Psychol 10(4):393–413CrossRefGoogle Scholar
  22. Nabe-Nielsen K, Grynderup MB, Conway PM, Clausen T, Bonde JP, Garde AH, Hogh A, Kaerlev L, Torok E, Hansen AM (2017) The role of psychological stress reactions in the longitudinal relation between workplace bullying and turnover. J Occup Environ Med 59(7):665–672CrossRefGoogle Scholar
  23. Nielsen M, Einarsen S (2012) Outcomes of exposure to workplace bullying: a meta-analytic review. Work Stress 26(309):332Google Scholar
  24. Nielsen M, Notelaers G, Einarsen S (2011) Measuring exposure to workplace bullying. In: Einarsen S, et al. (eds) Bullying and harassment in the workplace: developments in theory, research and practice, 2nd edn. CRC Press, Boca Raton, pp 149–174Google Scholar
  25. Nielsen M, Emberland J, Knardahl S (2017) Workplace bullying as a predictor of disability retirement: a prospective registry study of Norwegian employees. J Occup Environ Med 59:609–614CrossRefGoogle Scholar
  26. Pejtersen JH, Kristensen TS, Borg V, Bjorner JB (2010) The second version of Copenhagen Psychosocial Questionnaire (COPSOQII). Scand J Public Health 38(suppl 3):8–24CrossRefGoogle Scholar
  27. Podsakoff PM, MacKenzie SB, Lee JY, Podsakoff NP (2003) Common method biases in behavioral research: a critical review of the literature and recommended remedies. J Appl Psychol 88(5):879–903CrossRefGoogle Scholar
  28. Rugulies R, Aust B, Pejtersen JH (2010) Do psychosocial work environment factors measured with scales from the Copenhagen Psychosocial Questionnaire predict register-based sickness absence of 3 or more weeks in Denmark? Scand J Public Health 38(suppl 3):42–50CrossRefGoogle Scholar
  29. Rugulies R, Madsen IE, Hjarsbech PU, Hogh A, Borg V, Carneiro IG, Aust B (2012) Bullying at work and onset of a major depressive episode among Danish female eldercare workers. Scand J Work Environ Health 38(3):218–227CrossRefGoogle Scholar
  30. Semmer N, Jacobshagen N, Meier L, Elfering A (2007) Occupational stress research: the ‘stress-as-offense-to-self’ perspective. In: Houdmont J, McIntyre S (eds) Occupational health psychology. Nottingham University Press, Nottingham, pp 43–59Google Scholar
  31. Theorell T, Hammarström A, Aronsson G, Bendz LT, Grape T, Hogstedt C, Marteinsdotti C, Skoog I, Hall C (2015) A systematic review including meta-analysis of work environment and depressive symptoms. BMC Public Health 15:738CrossRefGoogle Scholar
  32. Thoits P (1986) Social support as coping assistance. J Consult Clin Assist 54:416–423CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.National Research Centre for the Working EnvironmentCopenhagenDenmark
  2. 2.Department of PsychologyUniversity of CopenhagenCopenhagenDenmark
  3. 3.Federal Institute for Occupational Safety and Health (BAuA)BerlinGermany
  4. 4.Task ConsultGillelejeDenmark
  5. 5.Department of Public HealthUniversity of CopenhagenCopenhagenDenmark

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