Health Consequences of Workplace Bullying: Physiological Responses and Sleep as Pathways to Disease

  • Åse Marie Hansen
  • Anne Helene Garde
  • Kirsten Nabe-Nielsen
  • Matias Brødsgaard Grynderup
  • Annie Høgh
Living reference work entry
Part of the Handbooks of Workplace Bullying, Emotional Abuse and Harassment book series (HWBEAH, volume 2)


This chapter summarizes the current knowledge on physiological stress reactions as possible pathways between workplace bullying and disease. Being exposed to workplace bullying may create a highly stressful situation for the target that may be characterized by lack of control. Feelings of control and predictability are important characteristics of the individual’s appraisal processes and may be an important factor to understand how workplace bullying “gets under the skin”.

Theoretically, there are several potential mechanisms through which physiological stress reactions may affect health, for example, by a direct biological, prolonged physiological activation and lack of restitution or through changes in life style and health behaviours. We briefly present the following models: cognitive activation theory of stress (CATS) model; effort-recovery model; stressor-detachment model; and allostatic load model, including the acute and chronic stress response.

The current knowledge on workplace bullying and salivary cortisol is presented and shown in five out of six studies that salivary cortisol was lower among individuals that reported workplace bullying.

The state of the art on the prospective association between workplace bullying and sleep problems was also included and showed that employees exposed to workplace bullying have increased risk of having sleep problems 1–5 years later.

Using long-term sickness absence (LTSA) as a global measure of health, we provided knowledge on possible mechanisms on workplace bullying leading to LTSA. Only a few studies have investigated possible mechanisms of how workplace bullying may lead to LTSA. One study found that perceived stress accounted for up to 13% of the association between workplace bullying and LTSA 2 years after the reports of workplace bullying. Another study found that sleep mediated 4–12% of the association. Finally, one study did not find salivary cortisol to be a part of the pathway.


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Copyright information

© Springer Nature Singapore Pte Ltd. 2018

Authors and Affiliations

  • Åse Marie Hansen
    • 1
    • 2
  • Anne Helene Garde
    • 1
    • 2
  • Kirsten Nabe-Nielsen
    • 1
  • Matias Brødsgaard Grynderup
    • 1
    • 3
  • Annie Høgh
    • 4
  1. 1.Department of Public HealthUniversity of CopenhagenCopenhagenDenmark
  2. 2.National Research Centre for the working EnvironmentCopenhagenDenmark
  3. 3.Department of NeurologyNordsjællands Hospital – HillerødHillerødDenmark
  4. 4.Department of PsychologyUniversity of CopenhagenCopenhagenDenmark

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