Joseph A. Flaherty

Sexual harassment and generalized workplace abuse among university employees : Prevalence and mental health correlates

OBJECTIVES This study hypothesized that interpersonal workplace stressors involving sexual harassment and generalized workplace abuse are highly prevalent and significantly linked with mental health outcomes including symptomatic distress, the use and abuse of alcohol, and other drug use. METHODS Employees in 4 university occupational groups (faculty, student, clerical, and service workers; n = 2492) were surveyed by means of a mailed self-report instrument. Cross-tabular and ordinary least squares and logistic regression analyses examined the prevalence of harassment and abuse and their association with mental health status. RESULTS The data show high rates of harassment and abuse. Among faculty, females were subjected to higher rates; among clerical and service workers, males were subjected to higher rates. Male and female clerical and service workers experienced higher levels of particularly severe mistreatment. Generalized abuse was more prevalent than harassment for all groups. Both harassment and abuse were significantly linked to most mental health outcomes for men and women. CONCLUSIONS Interpersonally abusive workplace dynamics constitute a significant public health problem that merits increased intervention and prevention strategies.

Gender differences in the perception and utilization of social support: Theoretical perspectives and an empirical test

The authors contend that women are the more supportive, nurturing and affectively-connected sex. They argue that these gender differences result from socialization experiences which may be modified by social and occupational roles. Theoretical perspectives and research addressing this proposition are reviewed. Empirical data on support-eliciting and support-providing behaviors in a cohort of medical students are then provided to test their thesis. The data suggest that women have developed a greater sensitivity to the needs of themselves and others, leading to a greater capacity to provide support and a greater dependence upon social support for psychological well-being. Personality and developmental factors that may account for these differences are examined. The implications of these findings for gender differences in mental health are discussed.

The Measurement of Social Support: The Social Support Network Inventory

HE PLURALISTIC OR BIOPYSCHOSOCIAL model of illness acknowledges that social factors play a role in the development of physical and emotional illness. Or, in Cassel’s language, that there is a “contribution of the social environment to host resistance.“’ Research continues to explore those social variables which directly or indirectly contribute to pathophysiologic processes, vulnerability to illness, symptom formation, and treatment response. One major area of research concerns the influence of stress and life events beginning with early writings of Cannon2 and Adolf Meyer.-’ Since the development of quantitative instruments for measuring life events, pioneered by Holmes and Rahe,4 there has been a flurry of studies examining the relationship between this variable and a variety of dependent symptom variables. Unfortunately, life events have rarely accounted for more than 15% and frequently less than 10% of the variance in any psychiatric outcome measures. Cognizant of the limits of a parsimonious theory linking stressful life events to illness, Caplan5 and others have suggested that social supports or social networks may be an intermediary variable serving to buffer the potentially negative effects of stress. Subsequently, a variety of investigators have shown an inverse association between specific aspects of social support and the development of depression in the general population6 and in recent widows;’ an inverse relationship between social support and symptom severity has also been shown in unipolar populations. R.9 Components of social support have also been examined in relationship to schizophrenia,‘O anxiety,” and psychosomatic disorders.r2 In most of these studies, social support has emerged as a better predictor of outcome than life events, causing speculation that there is a direct effect in addition to that of buffering stress. Although the use of specific questions on aspects of social support (eg, number of friends, relatives in the immediate geographic area, presence of a close contidante) are useful, it became clear by the mid-70’s that quantitative instruments were needed to reliably assess social support in research investigations and clinicians. This report presents the rationale, design, and psychometric testing of one instrument-the Social Support Network Inventory (SSNI)--which the authors began developing in 1979. It should be noted that other investigators such as Pattison” began developing similar instruments at that time; an excellent review of the methodology of these instruments has been provided by Lin.13

Workplace harassment, active coping, and alcohol-related outcomes

PURPOSE While sexual harassment and generalized workplace abuse (GWA) have been linked with alcohol use and abuse, active problem-focused coping has been shown to lessen vulnerability to deleterious mental health consequences of varied social stressors. At the same time, active coping is relatively more efficacious in response to stressors, which are amenable to change by personal actions. However, the moderating role that coping plays in relation to harassment and drinking is unknown. METHOD Using data from a two-wave survey of university employees (N=2038), we addressed the extent to which (1) active coping was utilized by harassed and abused employees, (2) whether coping impacted on the continuation or cessation of harassment and abuse, and (3) the extent to which nonsuccessful coping was predictive of alcohol use and abuse. RESULTS Active coping had no significant impact on the ability to end harassing or abusive experiences. Moreover, the use of problem-focused coping that was unsuccessful predicted some drinking outcomes for both men and women, controlling for Wave I drinking and sociodemographic characteristics. IMPLICATIONS The data suggest that increased institutional attention to the prevention of workplace harassment and abuse might impact on decreasing alcohol use and abuse.

Demoralization in Soviet-Jewish immigrants to the United States and Israel ☆

Two hundred seventy-two recent Soviet-Jewish immigrants to the United States were compared with 412 Soviet-Jewish immigrants to Israel for the purpose of determining which country was more likely to lead to the development of demoralization. Even when differences in age and marital state were accounted for, the immigrants to the United States were significantly more demoralized. Individuals with low social support, older immigrants, women, and divorced or widowed individuals were more likely to be demoralized in both countries. Self-selection and host reception factors are explored to explain the differences between the two groups of immigrants.

A biopsychosocial treatment approach to the management of diabetes mellitus

The relationship among recent life stress, social support, a patients locus of control, and the control of blood glucose is evaluated in persons with diabetes mellitus, using objective measures of these psychosocial variables. Short-term [fasting blood sugar (FBS)] and long-term [glycosylated hemoglobin (Hgb A-1C)] control measures are taken at two points in time in order to evaluate the effects of the psychosocial variables on change in diabetes control. For life events, a significant positive association was found between the number of recent life events and blood glucose control. Decrease in social support predicted a worsening of longer-term (Hgb A-1C) control over time. An external locus of control within the patient was associated both with poor short-term control at time one and prediction of poorer long-term control over time. The implications of these findings are discussed in support of a biopsychosocial approach to the management of diabetes mellitus.

Adult psychosocial assets and depressive mood over time. Effects of internalized childhood attachments.

This paper discusses contrasting assumptions in psychiatric epidemiological research regarding the relative significance of childhood and adult social experiences as etiological factors in adult psychopathology. It delineates a set of hypotheses that relate internal parental representations to subsequent depressed mood and to psychosocial assets assumed to mediate the relationships between parental representations and mood states. These hypotheses were prospectively tested using a cohort of medical students surveyed at medical school entrance and 7 months later. The data show that earlier paternal affectivity perceived at time 1 is inversely predictive of time 2 depressed mood, holding time 1 mood constant, whereas earlier maternal and paternal overprotection perceived at time 1 are directly predictive of time 2 depressed mood, holding time 1 mood constant. In addition, parental representations at time 1 are significantly linked to particular personality characteristics at time 1 and 2. However, it is not clear whether these personality characteristics are antecedents or consequences of depressed mood. The paper concludes with a discussion of theoretical and methodological issues involved in the retrospective assessment of remote social experiences as etiological factors in adult psychopathology.

Somatic Symptoms Among Older Soviet Immigrants: an Exploratory Study

This exploratory study investigates the overlap of somatization and depressive symp toms among older Jewish-Soviet immigrants to the United States. It has been sug gested that this group has depression often masked by somatic complaints. In order to test this hypothesis fifty-five respondents completed the Symptom Checklist 90, PERI Demoralization Scale and the Social Support Network Inventory. The somatiza tion subscale was found to be significantly higher among older Soviet immigrants than in a depressed group, yet the depression subscale was significantly lower. Com pared to a group of normal controls both the depression and somatization subscales were significantly elevated. Somatization, depression, and demoralization were elevated in Soviet immigrants. The results of this study are discussed in the context of the available literature on cross-cultural psychiatry and somatization. The clinical relevance of these findings is highlighted.

Gender differences in medical student distress : contributions of prior socialization and current role-related stress

Gender differences in psychological distress among future physicians are addressed from contrasting role-related stress and socialization-based vulnerability perspectives. A medical student cohort was surveyed at medical school entrance and after one year of training, focusing on earlier familial relationships, personality and social support resources, perceived medical school stressors and alcohol consumption and depressive and anxiety symptomatology. Relative to socialization perspectives, the sexes manifested more similarities than differences at time 1, although the females manifested lower overall psychopathology, but greater perceived paternal overprotection in childhood. Relative to role stress perspectives, both sexes reported increased psychopathology by the time 2 point. The sexes did not differ in perceived medical school-related stressors, while females manifested better social supports at time 2. The psychosocial predictors of increased subjective distress for both sexes included perceived earlier familial relationships and medical school stressors. The only predictor of increased drinking (by males) was time 1 drinking level. Future research on gender roles and distress should assess both male and female modes of psychopathology and should address antecedents of role entrance in addition to the (presumed) consequences of role incumbency.

Effects on Alcohol Use and Anxiety of the September 11, 2001, Attacks and Chronic Work Stressors: A Longitudinal Cohort Study

OBJECTIVES We hypothesized that chronic stressors associated with an everyday social role (work) would interact with a traumatic macrosocial stressor (the terrorist attacks of September 11, 2001) in predicting mental health status (during the fall of 2001). METHODS We used mail surveys returned as part of wave 3 of a workplace cohort study, both before and after September 11, 2001, to assess decision latitude, sexual harassment, generalized workplace abuse, psychological distress, and alcohol use. We also used regression analyses to assess the main effect of September 11 and interactions between September 11 and stressors, after control for baseline mental health. RESULTS The main effect of September 11 on elevated alcohol use was significant for women but not for men. For women, work stressors significantly interacted with experiencing the events of September 11 to affect alcohol use and anxiety outcomes. CONCLUSIONS Women experiencing chronic work stressors were most vulnerable to elevated psychological distress and alcohol use after September 11, 2001.