Leaders as the targets of workplace bullying - prevalence and outcomes.

PURPOSE: Bullying of leaders is an underexplored topic in organizational research. To fill this knowledge gap, the aims of this study were to determine the prevalence of bullying of leaders and to examine whether holding a formal leadership position influences the relationships between exposure to bullying and the outcomes job satisfaction and depression. METHODS: Data from two separate surveys were employed: (1) A cross-sectional occupation specific sample comprising 678 Norwegian child welfare social workers; (2) A nationally representative probability sample of 1,608 Norwegian employees with two time-points (6 months' time-lag). RESULTS: Analyzing multiple indicators of workplace bullying, holding a formal leadership position had no impact on the initial risk of being bullied. Analyses of prospective data showed that leaders report a somewhat stronger increase in levels of bullying over time compared to non-leaders, although the effect size was small. With exception of a small buffering effect on the cross-sectional association between exposure to bullying behaviors and job satisfaction in the second sample, holding a leadership position had no effect on the strength of the association between bullying and outcomes. CONCLUSION: The findings show that leaders have the same risk of being bullied and are influenced by bullying in roughly the same manner as non-leaders. Organizational measures and interventions against bullying should therefore consider leaders as a risk group in line with other employees.

Impact of psychosocial work factors on risk of medically certified sick leave due to common mental disorders: a nationwide prospective cohort study of Norwegian home care workers.

BACKGROUND: The Norwegian home care services experience a high level of sick leave, a large proportion of which is due to common mental disorders. A substantial number of such cases can be attributed to psychosocial factors at work, but more knowledge about occupation-specific risk factors is needed to develop targeted preventive measures to reduce sick leave levels. The aim of this study is to identify the most prominent psychosocial work factors influencing the risk of sick leave spells due to common mental disorders. METHODS: Employees from a random sample of 130 Norwegian home care services (N = 1.819) completed a baseline survey on 15 psychosocial work factors. Participants were subsequently followed up for 26 months using registry data on sick leave. The outcome measure was the number of medically certified sick leave spells due to common mental disorders during follow-up in the Norwegian social insurance database. Incidence risk ratios (IRR) and 95% confidence intervals (CIs) were calculated using negative binomial regression with robust standard errors. RESULTS: Emotional dissonance (IRR 1.30, 95% CI 1.05-1.60) and emotional demands (IRR 1.35, 95% CI 1.14-1.58) were associated with an excess risk of sick leave, while control over work pacing (IRR 0.78, 95% CI 0.62-0.98) was associated with a reduced risk. An estimated 30% (95% CI 8.73-48.82) of sick leave cases were attributable to emotional dissonance and 27% (95% CI 4.80-46.33) were attributable to emotional demands. Control over work pacing was estimated to have prevented 20% (95% CI 1.32-37.78) of the sick leave cases. CONCLUSIONS: This study found that emotional dissonance and emotional demands were robust risk factors for sick leave due to common mental disorders, and that control of work pacing constituted a robust protective factor against sick leave.

Simulated quick returns in a laboratory context and effects on sleep and pre-sleep arousal between shifts: a crossover controlled trial.

This trial presents a laboratory model investigating the effect of quick returns (QRs, <11 h time off between shifts) on sleep and pre-sleep arousal. Using a crossover design, 63 participants worked a simulated QR condition (8 h time off between consecutive evening- and day shifts) and a day-day (DD) condition (16 h time off between consecutive day shifts). Participants slept at home and sleep was measured using a sleep diary and sleep radar. Compared to the DD condition, the QR condition reduced subjective and objective total sleep time by approximately one hour (both p < .001), reduced time in light- (p < .001), deep- (p = .004), rapid eye movement (REM, p < .001), percentage of REM sleep (p = .023), and subjective sleep quality (p < .001). Remaining sleep parameters and subjective pre-sleep arousal showed no differences between conditions. Results corroborate previous field studies, validating the QR model and indicating causal effects of short rest between shifts on common sleep parameters and sleep architecture.

This trial proposes a laboratory model to investigate the consequences of quick returns (QRs, <11h time off between shifts) on subjective/objective sleep and pre-sleep arousal. QRs reduced total sleep time, light-, deep-, REM sleep, whereas pre-sleep arousal was unaffected. Results emphasise the importance of ensuring sufficient rest time between shifts.Abbreviation: QR: Quick return; DD: Day-day; NREM: Non-rapid eye movement; REM: Rapid eye movement; PSG: Polysomnography; TIB: Time in bed; SOL: Sleep onset latency; WASO: Wake after sleep onset; TST: Total sleep time; EMA: Early morning awakening; PSAS: Pre-Sleep Arousal Scale; MEQ: Morning-Evening Questionnaire; LMM: Linear mixed model; EMM: Estimated marginal mean; SD: Standard deviation; SE: Standard error; d: Cohens' d; h: hours; m: minutes.

Workplace mistreatment and insomnia: a prospective study of child welfare workers.

OBJECTIVE: This study examines how workplace mistreatment relates to insomnia among child welfare workers. The main aim was to determine the impact of three different forms of mistreatment, namely client perpetrated violence, cyber harassment, and colleague perpetrated bullying, on changes in levels of insomnia over time. A secondary aim was to examine whether these three forms of mistreatment represent overlapping or distinct and unique phenomena. METHODS: The study was based on a probability sampled prospective survey of 424 Norwegian child welfare workers. Time lag between baseline and follow-up was six months. A confirmatory factor analysis determined the dimensionality of the indicators of mistreatment. TwoStep cluster analysis was used to examine patterns of exposure. Between and within group changes in insomnia was determined with linear regression analyses and repeated measures ANOVA. Dominance analysis was used to investigate the relative impact the predictor variables had on insomnia. RESULTS: Client perpetrated violence and colleague perpetrated bullying were associated with increased levels of insomnia over time. Exposure to bullying was established as the most prominent predictor. Client perpetrated violence, cyber harassment, and colleague perpetrated bullying represent unique and distinct constructs. Child welfare workers mainly report exposure to one form of mistreatment rather than a combination of different types. CONCLUSIONS: Client perpetrated violence and colleague perpetrated bullying were established as risk factors for insomnia among child welfare workers. Employers and human resource personnel should prioritize developing effective primary, secondary, and tertiary strategies to prevent and handle these hazards and thereby reduce the risk of insomnia among workers.

Associations between workplace bullying and later benefit recipiency among workers with common mental disorders.

OBJECTIVE: In this study, we examined exposure to workplace bullying as a predictor of registry-based benefit recipiency among workers struggling with work participation due to common mental disorders. Further, we examined if the experience of receiving social support moderated the association between workplace bullying and benefit recipiency. DESIGN: Secondary analyses of a randomized controlled trial. PATIENTS: People struggling with work participation due to common mental disorders (CMD). METHODS: Study participants (n = 1193) were from a randomized controlled trial (The At Work and Coping trial (AWaC), trial registration http://www. CLINICALTRIALS: gov NCT01146730), and self-reported CMD as a main obstacle for work participation. Participants were at risk of sickness absence, currently on sickness absence or on long-term benefits. Benefit recipiency indicated sickness absence and/or long-term benefits (i.e., disability pension) at 6-month follow-up. RESULTS: Of the 1193 participants, 36% reported exposure to workplace bullying. Workplace bullying was significantly associated with benefit recipiency at 6-month follow-up (OR 1.41, CI 1.11-1.79). Social support did not moderate the association between bullying and benefit recipiency. CONCLUSIONS: The finding that workplace bullying increases the risk of later benefit recipiency suggest that bullying is a significant obstacle for work participation.

Spinal pain in employees exposed to abusive supervision: Evidence of a sex and CRHR1 CTC haplotype interaction.

Previous findings suggest that exposure to social stress in the form of abusive supervision may increase the risk of musculoskeletal disorders. In the present study, we examined the link between abusive supervision, the CRHR1 genotype and spinal pain. The data were collected through a national survey drawn from the National Central Employee Register by Statistics Norway. A total of 1226 individuals returned both the questionnaire and the saliva kit. Abusive supervision was measured by a 5-item version of the Tepper's 2000 scale. Spinal pain was measured by 3 items (neck-, upper and low back pain). Genotyping with regard to CRHR1 rs242941, rs242939 and rs1876828 was carried out using Taqman assay, and Phase v.2.1.1 was used to define the CRHR1 allele combinations. The analyses revealed that abusive supervision was associated with spinal pain. In particular, we observed a strong effect of abusive supervision on spinal pain in female +CTC/+CTC carriers (p = 0.002). Moreover, using +CTC/+CTC as a reference, +CTC/-CTC and -CTC/-CTC both showed protective effects (p = 0.024, p = 0.002, respectively). Also, our data demonstrated a clear sex and CRHR1 CTC haplotype interaction (p = 0.013). No such gene-environment interaction was seen in men. Our data demonstrated that the CRHR1 CTC haplotype may exacerbate the effect of abusive supervision on spinal pain in female employees. Hence, the present study supports the theory that both gender and the CRHR1 genotype, may moderate the pain responses to social stressors.

Killing two birds with one stone: how intervening when witnessing bullying at the workplace may help both target and the acting observer.

OBJECTIVE: This study examines under which conditions being an observer of bullying can be detrimental to health and well-being. It was hypothesized that health-related problems following observations of bullying are determined by (1) whether the observer has been exposed to bullying her/himself and (2) whether the observer have tried to intervene in the bullying situation that they witnessed. METHODS: The study was based on a longitudinal probability survey of the Swedish workforce, with an 18-month time lag between assessment points (N = 1096). RESULTS: Witnessing bullying at work were associated with an increase in subsequent levels of mental distress among the observers, although this association became insignificant when adjusting for the observers' own exposure to bullying. Intervening against bullying moderated the relationship between observations of bullying and mental health problems. Observers who did not try to intervene reported a significant increase in mental health problems at follow-up, whereas there were no significant changes in levels of mental health problems among those who did intervene. CONCLUSIONS: the findings suggest that observer interventions against bullying may be highly beneficial for both the targets and observers of bullying. Organizations should therefore invest in ways to increase constructive bystander behavior in negative social situations at the workplace.

Workplace bullying increases the risk of anxiety through a stress-induced ß2-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 ß2-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.

Associations between exposure to workplace bullying and insomnia: a cross-lagged prospective study of causal directions.

OBJECTIVE: Workplace bullying has been established as a significant correlate of sleep problems. However, little is known regarding the causal direction between bullying and sleep. The aim of this study was to examine temporal relationships between bullying and symptoms of insomnia. METHODS: Reciprocal and prospective associations between exposure to workplace bullying and symptoms of insomnia were investigated in a national probability sample comprising 1149 Norwegian employees. Data stemmed from a two-wave full panel survey study with a 6-month time interval between the baseline and follow-up assessments. Models with stabilities, forward-, reverse-, and reciprocal associations were tested and compared using Structural Equation Modelling. Analyses were adjusted for age, gender, and the stability in the outcome variables over time. Workplace bullying was assessed with the nine-item Short Negative Acts Questionnaire. Insomnia was assessed with a previously validated three item scale reflecting problems with sleep onset, sleep maintenance, and early morning awakening. RESULTS: The forward association model, which showed that exposure to workplace bullying prospectively increased levels of insomnia (b = 0.08; p < 0.001), had best fit with the data [CFI = 0.94; TLI = 0.93; RMSEA = 0.049 (0.046-0.052)]. The reverse association model where insomnia influences risk of being subjected to bullying was not supported. CONCLUSION: Workplace bullying is a risk factor for later insomnia. There is a need for further studies on moderating and mediating variables that can explain how and when bullying influence sleep.

Repeated social defeat promotes persistent inflammatory changes in splenic myeloid cells; decreased expression of ß-arrestin-2 (ARRB2) and increased expression of interleukin-6 (IL-6).

BACKGROUND: Previous studies suggest that persistent exposure to social stress in mammals may be associated with multiple physiological effects. Here, we examine the effects of social stress in rats, i.e. repeated social defeat, on behavior, hypothalamic-pituitary-adrenal (HPA)-axis and immune system. METHODS: A resident-intruder paradigm, where an intruder rat was exposed to social stress by a dominant resident rat for 1 hour each day for 7 consecutive days was used. The day after the last stress exposure in the paradigm the data were analyzed. Variation in social interaction was observed manually, whereas locomotion was analyzed off-line by a purpose-made software. Gene expression in the pituitary gland, adrenal gland and myeloid cells isolated from the spleen was measured by qPCR. RESULTS: The exposure to social stress induced decreased weight gain and increased locomotion. An increased nuclear receptor subfamily group C number 1 (NR3C1) expression in the pituitary gland was also shown. In myeloid cells harvested from the spleen, we observed decreased expression of the ß2-adrenergic receptor (ADRB2) and ß-arrestin-2 (ARRB2), but increased expression of interleukin-6 (IL-6). Subsequent analyses in the same cells showed that ARRB2 was negatively correlated with IL-6 following the stress exposure. CONCLUSION: Our results show that that the experience of social stress in the form of repeated social defeat in rats is a potent stressor that in myeloid cells in the spleen promotes persistent inflammatory changes. Future research is needed to examine whether similar inflammatory changes also can explain the impact of social stress, such as bullying and harassment, among humans.

Exposure to workplace bullying, microRNAs and pain; evidence of a moderating effect of miR-30c rs928508 and miR-223 rs3848900.

Prolonged exposure to bullying behaviors may give rise to symptoms such as anxiety, depression and chronic pain. Earlier data suggest that these symptoms often are associated with stress-induced low-grade systemic inflammation. Here, using data from both animals and humans, we examined the moderating role of microRNAs (miRNAs, miRs) in this process. In the present study, a resident-intruder paradigm, blood samples, tissue harvesting and subsequent qPCR analyses were used to screen for stress-induced changes in circulating miRNAs in rats. The negative acts questionnaire (NAQ), TaqMan assays and a numeric rating scale (NRS) for pain intensity were then used to examine the associations among bullying behaviors, relevant miRNA polymorphisms and pain in a probability sample of 996 Norwegian employees. In rats, inhibited weight gain, reduced pituitary POMC expression, adrenal Nr3c1 mRNA downregulation, as well as increased miR-146a, miR-30c and miR-223 in plasma were observed following 1 week of repeated exposure to social stress. When following up the miRNA findings from the animal study in the human working population, a stronger relationship between NAQ and NRS scores was observed in subjects with the miR-30c GG genotype (rs928508) compared to other subjects. A stronger relationship between NAQ and NRS scores was also seen in men with the miR-223 G genotype (rs3848900) as compared to other men. Our findings show that social stress may induce many physiological changes including changed expression of miRNAs. We conclude that the miR-30c GG genotype in men and women, and the miR-223 G genotype in men, amplify the association between exposure to bullying behaviors and pain.Lay summaryUsing an animal model of social stress, we identified miR-146a, miR-30c and miR-223 as potentially important gene regulatory molecules that may be involved in the stress response. Interestingly, human genotypes affecting the expression of mature miR-30c and miR-223 had a moderating effect on the association between exposure to bullying and pain. Subjects with the miR-30c rs928508 GG genotype had a significantly stronger association between exposure to bullying behaviors and pain than other subjects. The same was observed in men with the miR-223 rs3848900 G genotype, as compared to other men.

Workplace bullying, mental distress, and sickness absence: the protective role of social support.

PURPOSE: This study examined the protective effects of supervisor, colleague, and non-work-related social support on the associations between workplace bullying, mental distress, and medically certified sickness absence. We hypothesized that social support moderated the direct association between workplace bullying and mental distress as well as the indirect association between bullying and sickness absence through mental distress. We also hypothesized that the protective effects of social support were stronger among women than among men. METHODS: A sample of 10,627 employees was recruited from 96 Norwegian organizations. Workplace bullying, mental distress, and social support were assessed through a questionnaire survey and responses were linked to official registry data on medically certified sickness absence for the year following the survey assessment. RESULTS: The results showed that all three investigated sources of social support moderated the direct association between workplace bullying and mental distress. Supervisor support moderated the indirect association between workplace bullying and sickness absence through mental distress among both male and female respondents, whereas colleague support moderated this indirect association among women only. Non-work-related support had no protective effect on the indirect association. CONCLUSIONS: The findings suggest that social support, and especially supervisor support, is beneficial with regard to reducing the negative impact of workplace bullying on health and work ability of those exposed. Organizations should, therefore, include social support in interventions targeting bullying.

Effects of exposure to workplace terrorism on subsequent doctor certified sickness absence, and the modifying role of psychological and social work factors: a combined survey and register study.

BACKGROUND: Studies have shown that terrorist attacks affect the mental and physical health of persons exposed to terrorism. When terror strikes at the workplace where people spend much time, and should feel safe, the health consequences for those affected might be severe. The aim of the study was to determine whether psychological and social work factors moderates effects of exposure to a workplace terrorist attack on subsequent doctor-certified sickness absence. METHODS: The study design combined survey data with register data on sickness absence. Data on exposure to the attack, and psychosocial working conditions were collected by a web-based questionnaire 10 months after the attack. Survey data was linked to registry data on doctor-certified sickness absence over the one-year time period following baseline. The survey response rate was 56% (n = 1974), where 80.6% (1591) gave consent to link survey data to data on sickness absence. Exposure to the attack was assessed as "Directly-", or "Indirectly exposed". Psychological and social work factors were measured by the General Questionnaire for Psychological and Social factors at Work (QPSNordic). Data were analyzed with negative binominal hurdle regressions. RESULTS: Direct exposure to the attack increased the odds of becoming sick-listed if role clarity was average (OR = 1.50) or high (OR = 2.13), but not if low (OR = 1.17). Direct exposure was associated with higher sickness absence rates if control over work pace was low (RR = 1.61). Role conflict, support from co-workers, and -superior showed weaker evidence of moderating effects of exposure on sickness absence. CONCLUSIONS: Exposure to the bomb explosion, as well as psychosocial working conditions affect the risk of employee sickness absence. Psychosocial working conditions seems to moderate effects of exposure to workplace terrorism on subsequent sickness absence. Organizations would benefit from striving for good psychological and social working conditions both as preventions against illness and sickness absence, and as measures in the aftermath of a workplace terrorist attack.

Psychosomatic symptoms among Palestinian nurses exposed to workplace aggression.

BACKGROUND: The study examined associations between workplace aggression (WPA) and psychosomatic symptoms in Palestinian nurses. METHODS: The 341 nurses, (62% females and 38% males), answered a WHO questionnaire and a psychosomatic symptoms checklist. RESULTS: A total of 27.3% of the nurses reported exposure to WPA of any kind within the last 12 months. After adjusting for covariates, female nurses exposed to WPA of any kind and those exposed to verbal aggression reported a higher symptom score: (1.5; 95% confidence interval [CI]: 0.3, 2.7), and (1.4; 95%CI 0.2, 2.6), respectively, than unexposed females. Male nurses exposed to bullying reported a higher symptom score: (3.2; 95%CI 1.0, 5.5) than unexposed males. CONCLUSIONS: Exposure to WPA was associated with higher occurrences of psychosomatic symptoms for both sexes. The female nurses reacted most strongly to verbal aggression or to WPA of any type, while bullying was associated with the male nurses' symptoms.

Alcohol Use and Psychosocial Stressors in the Norwegian Workforce.

BACKGROUND: Although alcohol use can have detrimental effects for employees, little is known about the prevalence, distribution, and correlates in the Norwegian workforce. AIMS: To determine the overall and the work-related prevalence of weekly alcohol use, and to establish associations between psychosocial work stressors and alcohol use among Norwegian employees. METHODS: Data were from a 2015 national probability sample of 1,608 Norwegian employees (response rate 32%). Job demands, lack of job control, role expectations, workplace bullying, and leadership were examined as correlates of several dimensions of alcohol use. RESULTS: Average weekly alcohol consumption was 4.28 units (SD = 7.91). Male workers reported significantly higher consumption than female workers. Also, 2.6% of male and 2.0% of female workers reported problematic alcohol use. Only 0.1% of workers reported weekly alcohol use before the workday, 0.4% reported weekly use during the workday, 20.1% reported weekly use after ending the work day, and 80% reported use during weekends/days off. Alcohol intake increased with age, but was not related to marital status, educational level, work schedule, or leadership position. Problematic alcohol use was related to job demands and workplace bullying. Alcohol use after work was positively related to lack of job control and role ambiguity and negatively related to bullying. Conclusions/importance: Weekly alcohol use before and during the workday is not prevalent among Norwegian workers. Interventions to reduce job demands and workplace bullying may reduce problematic alcohol intake, whereas increasing job control and reducing role ambiguity may reduce after work use.

Psychological, social, and mechanical work exposures and disability retirement: a prospective registry study.

BACKGROUND: Relations between several occupational psychological and social factors and disability retirement remain largely unexplored. Knowledge of which specific aspects of the work environment that affect risk of disability is a prerequisite for the success of organizational interventions aiming to prevent premature work force exit. The objective of the present study was to determine contributions to registered disability retirement by a broad range of psychological and social work exposures while taking into account effects of mechanical exposure. METHODS: Written consent was obtained from 13 012 employees (96 organizations) representing a wide range of occupations, to link their survey responses to data from the Norwegian national registry of disability compensation. Median follow-up time was 5.8 years. To determine effects of self-reported work exposures on risk of disability retirement hazard ratios (HR) and 99% confidence intervals (99% CI) were calculated with Cox regression analysis. Effects of sex, age group, skill level, sickness absence in the last three years, and work exposures estimated to be confounders were accounted for. Post hoc stratification by sex was conducted to explore if identified predictors affected risk of disability retirement differently in men compared to women. RESULTS: Contributors to higher risk of disability retirement were "role conflict" (high level HR 1.55 99% CI 1.07 to 2.24) and "physical workload" (high level HR 1.93 99% CI 1.39 to 2.68). Contributors to lower risk of disability retirement were "positive challenge" (high level HR 0.56 99% CI 0.34 to 0.93), "fair leadership" (high level HR 0.56 99% CI 0.39 to 0.81), and "control over work intensity" (high level HR 0.62, 99% CI 0.47 to 0.82). Direction of effects was not dependent on sex in any of the five identified predictors. CONCLUSIONS: Several specific psychological and social work factors are independent contributors to risk of disability retirement. In order to prevent premature work force exit workplace interventions should consider targeting the predictors identified by the present study.

Emotional dissonance and sickness absence: a prospective study of employees working with clients.

PURPOSE: (1) Determine the relationship between emotional dissonance and medically certified sickness absence among employees working with clients and (2) compare the impact of emotional dissonance on medically certified sickness absence with the impact of other psychological and social work factors. METHODS: A sample of 7758 employees was recruited from 96 Norwegian organizations in the period 2004 to 2014, all working with clients. The study design was prospective with emotional dissonance measured at baseline and then linked to official registry data of medically certified sickness absence for the year following the survey assessment. Quantitative demands, decision demands, role clarity, role conflict, control over work intensity, and decision control were included as additional work exposures. The impact of the study variables on the presence and duration of medically certified sickness absence was investigated with a negative binomial hurdle model. RESULTS: In the fully adjusted model, emotional dissonance and role conflict significantly predicted the presence of medically certified sickness absence. Control over work intensity and decision control were negatively related to presence of sickness absence. Only role conflict was a risk factor for the duration of sickness absence when all factors were analysed simultaneously. CONCLUSION: Emotional dissonance is a risk factor for the presence of medically certified sickness absence in client-driven work environments. Theoretical models of sickness absence, as well as interventions aiming to prevent sickness absence in such environments, should be aware of the effect emotional dissonance may have on employees.

Victimization from workplace bullying after a traumatic event: time-lagged relationships with symptoms of posttraumatic stress.

OBJECTIVE: This study examined relationships between victimization from bullying and symptoms of posttraumatic stress (PTSS) after exposure to a terror attack at the workplace. It was hypothesized that (1) victims of bullying report higher and more stable levels of PTSS over time compared to their non-bullied colleagues and (2) that PTSS provides an increased risk of subsequent victimization from bullying. METHODS: The hypotheses were tested in a two-wave prospective sample comprising 2337 employees from Norwegian governmental ministries who were exposed to the 2011 Oslo terror attack. The two waves of data collection were conducted 10 and 22 months after the terror attack. RESULTS: Hypothesis 1 was partially supported: victims of bullying reported significantly higher levels of PTSS than non-bullied employees at both measurement points, but bullying was not related to the stability in PTSS over time. In support of hypothesis 2, PTSS at 10 months was significantly associated with an increased risk of feeling victimized by bullying 1 year later. CONCLUSIONS: The results indicate that victimization from bullying is associated with elevated levels of PTSS in the aftermath of a workplace terror attack, but that bullying does not have any impact on the long-term development of PTSS. PTSS may be a potential antecedent of bullying. These findings suggest that organizations must give high priority to the psychosocial work environment of traumatized employees to prevent further detrimental health consequences.

The healthy worker effect: Do health problems predict participation rates in, and the results of, a follow-up survey?

PURPOSE: To determine the impact of the healthy worker effect (HWE) as a bias for the external and internal validity of the follow-up assessment in prospective survey research. Specifically, the study examined (1) whether the health status of respondents at the baseline measurement influenced response at the follow-up survey (external validity) and (2) whether HWE is a threat to internal validity by differential attrition, i.e., whether associations between work and health at baseline differ between stayers and dropouts. METHODS: In a two-wave questionnaire survey with a 2-year time lag comprising 6283 persons, 4392 responded at both time points (response rate 70%). Mental distress and somatic symptoms served as indicators of health. Role conflict and role clarity were indicators of work factors. RESULTS: There were few differences in response rate at follow-up between persons with and without health complaints at the baseline measurement. As response rate increased incrementally with educational level, there seems to be a socio-educational bias, rather than a HWE bias on survey participation. Baseline relationships between work factors and health indicators were equal in magnitude among stayers and dropouts. CONCLUSION: The health status of participants at baseline seems to have little impact on the external and internal validity of the follow-up assessment in prospective survey research. Hence, the findings provide little support to the HWE as a potential bias in prospective studies within occupational health research. A limitation of the study is that the findings do not inform about the impact of the HWE on participation in the baseline assessment.

Time-lagged relationships between leadership behaviors and psychological distress after a workplace terrorist attack.

PURPOSE: The impact of leadership practices on employee health may be especially evident after extreme events that have physical, psychological, or material consequences for the members of an organization. In this prospective study, we aimed to examine the association between leadership behavior and psychological distress in employees who had experienced a workplace terror attack. METHODS: Ten and 22 months after the 2011 Oslo bombing attack targeting their workplace, ministerial employees (n = 2272) responded to a questionnaire assessing fair, empowering, supportive, and laissez-faire leadership, as well as psychological distress. Cross-sectional and time-lagged associations between the constructs were tested using structural equation modeling. RESULTS: Cross-sectionally, higher levels of supportive leadership were associated with lower levels of psychological distress. Longitudinally, negative relationships were found between psychological distress and subsequent ratings of fair and empowering leadership. CONCLUSIONS: Supportive leadership was associated with employees' psychological health after trauma, but seems not to have long-term effects on subsequent psychological distress. Rather, psychological distress may lead the employees to perceive their leaders as more negative across time.