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Mobbing Psychiatric impacts and psycho-social outcomes

Mobbing Psychiatric impacts and psycho-social outcomes. Professor Philippe Corten Van Driette Y., Dewell P., From L., Friedrich A., Tiv Ph., Pelc I. Clinique du Stress - 2005. Mobbing was described by H. Leymann M-F. Hirigoyen Ch. Dejours As a moral ill-treatment at work.

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Mobbing Psychiatric impacts and psycho-social outcomes

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  1. MobbingPsychiatric impacts and psycho-social outcomes Professor Philippe Corten Van Driette Y., Dewell P., From L., Friedrich A., Tiv Ph., Pelc I. Clinique du Stress - 2005

  2. Mobbing was described by H. Leymann M-F. Hirigoyen Ch. Dejours As a moral ill-treatment at work Mobbing (Bullying) definition: Repetitive and abusive attitudes at work (=harassment) The behaviors separately considered are insignificants H. Leymann process: To isolate the victim To prevent her to ask help or to express oneself To bring her into disrepute toward colleagues or hierarchy To hit the victim in his dignity (humiliations) To compromise the health of the victim Goal: Destruction of the moral integrity Mobbing: Background

  3. Mobbing:Aim and hypothesis • Has mobbing severe psychiatric consequences? • Has mobbing severe psycho-social outcomes? • What are the characteristics of the victims?

  4. Design: retrospective study Sample: Source: outpatients of the “clinique du stress” CHU-Brugmann, Brussels since September 2002 to august 2005. Inclusive criteria: Step 1: All patients who met the definition of a pathological chronic stress were assessed (N= 395) Definition of a chronic pathological stress: A persistent state of tension negatively perceived Where someone is or feels unable to answer adequately to the task Where this inability may have significant consequences With psychological, physical and/or functional impact Mobbing: Methodology

  5. Inclusive criteria Step 2: Only patients who attribute the main source of stress to the job were maintained in the sample (N= 341) Step 3: Following the H. Leymann criteria the sample was divided in 2 subgroups Perceived mobbing N= 101 Stressed patients without perceived mobbing N=228 Mobbing: Methodology

  6. Tools Clinical assessment: GHQ-28 of D. Goldberg (General Health Questionnaire) with 4 subscales Anxiety Depression Summarizations Disability Beck Depression Inventory Perceived stress of Cohen and Williamson Stress at work of Legeron Maslach Burn Out Inventory Attitudes and behaviors toward stress Locus of control Copings Assertivity Alexythymia (TAS-20) Clinical interview and follow-up by psychologists and/or psychiatrists Anamnesis data Sociologic data Treatment Drugs Psychotherapy Medical disablement to work Mobbing: Methodology

  7. Mobbing: results1- Has mobbing severe psychiatric consequences?

  8. Mobbing: results1- Has mobbing severe psychiatric consequences?

  9. Mobbing: results1- Has mobbing severe psychiatric consequences?

  10. Mobbing: results1- Has mobbing severe psychiatric consequences?

  11. Mobbing: results1- Has mobbing severe psychiatric consequences?

  12. Mobbing: results2- What are the outcomes? • Length of follow-up: NS • Mobbing: 10,09 months sd 8,91 • Stress: 9,03 months sd 8,12

  13. Mobbing: results2- What are the outcomes?

  14. Mobbing: results2- What are the outcomes?

  15. Locus of control Internality (0 to 6) Mobbing: Mean 2,52 sd 1,54 Stress: Mean 3,09 sd 1,65 Anova p=.0038 Externality (0 to 6) Mobbing: Mean 1,95 sd 1,4 Stress: Mean 1,71 sd 1,45 Anova NS => Less internality Copings => Nearly same or better Mobbing: results3- Characteristicsa) Attitudes toward stress

  16. Emotions Bad perceptions (0 to 35, cutting point 14) Mobbing: 19,8 sd 6,35 Stress: 21,49 sd 6,65 Anova NS Bad verbalizations (0 to 25, cutting point 10) Mobbing: 13,76 sd 4,66 Stress: 16,05 sd 4,94 Anova p=.0014 Avoidance of emotions (0 to 40, cutting point 16) Mobbing: 14,39 sd 4,81 Stress: 15,38 sd 4,78 => Bad perceptions and verbalizations but similar or better than stressed patients without mobbing Assertivity => similar Mobbing: results3- Characteristicsa) Attitudes toward stress

  17. Mobbing: results3- Characteristicsb) Sociological data • Age : NS mean 42 years sd 8,55 • Gender: mobbing 60% female vs 48% stressed (Chi Square p=.0351) • Life milieu: NS 65% founded home • Civil status: mobbing 21% divorced vs 7% (Chi Square p=.0111) • Education: NS 56% University or High School

  18. Mobbing: results3- Characteristicsc) complaints

  19. Mobbing: discussionLegal prosecution • In Belgium two procedures are recognized to prosecute an harassing people • Internal procedure inside the company • Justice procedure

  20. Mobbing: discussionPost Traumatic Stress Disorder (PTSD) ? Symptoms: Reviviscence Avoidance Hyper arousal

  21. Mobbing: discussionPTSD ? • 43% of the victims have all the symptoms • Is mobbing a life threatening situation? • From the witnesses: NO • From the victim: YES • Spontaneously they compare mobbing to the most life frightful situations “The XYZ company, it is Guantanamo in Brussels” “When I gona better, I saw my inner city and what I look was Hiroshima” “For me to be victim of mobbing is like to be a concentration camp survival: the same difficulties to speak about, the same incredible story, the same silence …” • Should we include in the definition of life threatening situation, the destruction of the moral integrity also?

  22. Mobbing: Conclusions • Mobbing has severe psychiatric consequences (GHQ-28 = 21) • Outcomes • Long time disablement (mean 9 months for 76% of them) • 2/3 anti depressive drugs, 60% supportive therapy, ½ specified psychotherapy • only 27% return to the same job after treatment, 33% are sacked • Characteristics • Similar or better attitude toward stress • More female and divorced • Neck tensions, decrease of libido, loose of weight, diarrhea, bruxism + Tiredness & early wake up • Prosecutions • 2/3 with no prosecution • PTSD • 43% have all the symptoms => extension of the life threatening definition?

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