Workplace Violence, Risk of Depression, Musings about Trauma

This is no big surprise, although I did not expect the magnitude of the
effect:

href="http://www.eurekalert.org/pub_releases/2006-08/bsj-vaw080806.php">Violence
at work significantly boosts clinical depression risk

Work-related violence and threats and the risk of
depression and stress disorders



Employees subjected to real or threatened violence at work run a major
risk of becoming clinically depressed, indicates research in the
Journal of Epidemiology and Community Health.



The magnitude of the risk was in direct proportion to the amount of
workplace violence experienced, the study shows.



The findings are based on the occupations of more than 14,000 hospital
patients between the ages of 18 and 65, who were being treated for
depression or stress related disorders between 1995 and 1998...



...Exposure to violence boosted the risk of depression by 45% in women
and 48% in men, compared with those in workplaces without any risk of
violence.



Stress related disorders were around a third more likely in women and
55% more likely in men.



Threatening behaviour boosted the likelihood of depression by 48% in
women and stress related disorders by almost 60% in men...

This is an extract from J Epidemiol Community Health
2006; 60: 771-5, which apparently is not on line yet.



It is difficult to know how generalizable the findings are, though.
 They looked at patients who had been hospitalized for
depression or stress-related conditions, so it is not at all
representative of the general population.  

I do wonder about confounding variables.   I am tempted to
assume that workplaces that have a risk of violence or, in general,
less desirable places to work.  Perhaps persons who work is
such places are disadvantaged, economically or otherwise.
 Perhaps they feel trapped in a job they don't really want.
 



Even allowing for the selection bias, and the possible confounds, the
increase in risk is impressive.



It brings to mind one of those private hypotheses that I have;
something I tend to think is true, even though I can't prove it.
 That is, I think that violence is more damaging to a person,
if it is perpetrated by someone whom you ought to be able to trust.
 



I think that two otherwise identical assaults, one carried out by a
total stranger, and one carried out by a client or coworker, are likely
to be experienced differently.  The one carried out by by the
acquaintance will be more traumatic.  That, I think, has to do
with the violation of trust that occurs with acquaintance violence.




Women I've seen who have experienced so-called date rape sometimes feel
guilty about how traumatized they are, as though they "shouldn't" be as
traumatized as victims of rape by a stranger.  But violation
of trust is a serious matter.  It has a deeply unsettling
effect upon one's sense of order in the universe, among other things.
 



As it happens, though, it is not possible to do the experiment that
would be necessary to test my hypothesis.  It is plainly
impossible to do a randomized trial comparing the effects of the two
types of assault. Moreover, there is no way to do it under double-blind
conditions.  



So I am just going to go on believing what I believe, even though it
cannot be tested or proved.