Workplace bullying: is there a difference by enterprise size?

OBJECTIVE: While relationships between working conditions, bullying and health issues have been proven, most studies have investigated these relationships in large enterprises (> 250 employees). Indeed, only a few studies have analyzed this issue in small firms, despite the fact that the latter differ from the former at multiple levels. Therefore, our objective was twofold: to assess whether the size of a firm had an impact on the frequency of workplace bullying and to identify whether the effects of bullying on workers' health differed according to the size of the company. METHOD: Data from the 2010 SUMER French periodical cross-sectional survey were analyzed (N = 31,420 for the present study). Bullying at work was measured based on nine possible hostile attitudes derived from the French version of the Leymann Inventory of Psychological Terror. Two other questions measured colleague-to-colleague verbal violence and sexual or physical assaults. Anxious or depressive episodes were measured using the Hospital Anxiety and Depression scale (HAD). Other health issues were: perceived health status, sickness absence (at least one absence lasting more than eight days), and work injuries. RESULTS: Our findings show that bullying at work was less frequent in micro enterprises (< 10 employees). Anxiety/depression, perceived health status, sickness absence (at least one lasting more than eight days) were significantly associated with workplace bullying, but the effects of bullying were significantly higher in micro enterprises (statistical interaction). CONCLUSION: This study highlights how a firm's size influences workplace bullying and, in particular, the prevalence and consequences of bullying in micro enterprises. The implication and guidelines for practice are discussed.

[Suicide among the French National Police forces: Implication of life events and life trajectories]. / Suicide dans la Police nationale française : trajectoires de vie et facteurs associés.

OBJECTIVES: Research indicates that suicide rates are high among members of law enforcement. Our objectives were: (1) to determine life events implicated in suicide mortality among French law enforcement; and (2) to describe the different life trajectories of police officers who deceased by suicide. METHODS: All suicides of police officers which occurred during 2008 (n=49) were explored using the psychological autopsy method. Key informants were: a supervisor, a colleague and a member of the family or a close friend. Each of them were interviewed by trained psychologists using standardized questionnaires exploring: sociodemographic characteristics, life events, social integration and support, health service use, mental health with the Composite International Diagnostic Interview short form (CIDI-SF), occupational stress with the Spielberger Inventory, impulsiveness with the Barratt Impulsiveness Scale and aggressiveness with the Brown-Goodwin Lifetime Aggression Scale. Information was then summarized in a timetable life trajectory of all life areas. All cases were finally appraised by at least two experts in order to identify the determinants of the suicide and to determine psychiatric diagnoses. For each period of time, a burdensomeness score was determined, from 6 (no adversity) to 1 (adversities in each sphere of life). RESULTS: Of the 49 cases of suicide, two were excluded and 39 were investigated and appraised (response rate: 39/47=83%). Eighty-two percent of the suicide cases were men and the mean age at death was 35years. In more than half of the cases, police officers used their service weapon to commit suicide. All deceased police officers were suffering from mental health symptoms (primarily depression). Of them, two thirds had used healthcare for this distress. The main other cause of suicide was problems in the married life (70% of the cases). Four distinct types of life trajectories of adversities could be identified by a qualitative analysis. DISCUSSION: It is the first time such a study was performed in France, and results are concordant with those of the literature. This study showed that all deceased police officers were suffering from mental disorders and that there was not one single profile of life trajectory: screening and support of police officers in distress need to be prioritized. Moreover, results suggested that the availability of the service weapon during off-duty periods should be reconsidered. This study helped the Home ministry to elaborate and improve strategies to prevent suicide among police officers.

Cognitive hostility and suicide.

OBJECTIVE: To determine whether a specific component of hostility (i.e. cognitive or behavioural) may predict suicide in a prospective design, controlling for depressive mood. METHOD: In 1993, 14,752 members of the 'GAZ et ELectricité' (GAZEL) cohort (10,819 men, mean age=49.0 years; 3933 women, mean age=46.2 years) completed the Center for Epidemiologic Studies Depression Scale and at least one subscale (i.e. cognitive or behavioural hostility) of the Buss and Durkee Hostility Inventory. Dates and causes of death were obtained annually. RESULTS: During a mean follow-up of 15.7 years, 28 participants completed suicide (24 men, four women). Suicide was predicted by depressive mood [relative index of inequality (RII) (95% CI)=8.16 (1.97-33.85)] and cognitive hostility [RII (95% CI)=10.76 (2.50-46.42)], but not behavioural hostility [RII (95% CI)=1.37 (0.38-4.97)]. These associations remained significant after adjustment for potential confounders. After mutual adjustment, however, suicide remained significantly associated with cognitive hostility [RII (95% CI)=8.87 (1.52-51.71)] (RII reduction: 34.6%), but no longer with depressive mood [RII (95% CI)=2.03 (0.41-10.07)] (RII reduction: 79.1%). CONCLUSION: Cognitive rather than behavioural hostility is associated with an increased risk of suicide, independently of baseline depressive mood.

Disruptive symptoms in childhood and adolescence and early initiation of tobacco and cannabis use: the Gazel Youth study.

PURPOSE: To examine the link between symptoms of hyperactivity-inattention and conduct disorder in childhood, and the initiation of tobacco and cannabis use, controlling for other behavioral symptoms, temperament and environmental risk factors. METHOD: The sample (N=1107 participants, aged 4 to 18 years at baseline) was recruited from the population-based longitudinal Gazel Youth study with a follow-up assessment 8 years later. Psychopathology, temperament, environmental variables, and initiation of tobacco and cannabis use were self-reported. Event time analyses were performed to assess the effects of childhood disruptive symptoms on age at first use of tobacco and cannabis. RESULTS: Proportional hazard models revealed that participants with high levels of childhood symptoms of both hyperactivity-inattention and conduct disorder were at highest risk of early tobacco initiation (in males: hazard ratio [HR]=2.05; confidence interval [CI]: 1.24-3.38; in females: HR=2.01; CI: 1.31-3.09), and, in males, of early cannabis initiation (HR=1.95; CI: 1.04-3.64). Temperament, through activity in both males and females and negative emotionality in females, was also associated to early substance use initiation. CONCLUSIONS: Children who simultaneously have high levels of symptoms of hyperactivity-inattention and conduct disorder are at increased risk for early substance initiation. These associations may guide childhood health professionals to consider the liability for early substance initiation in high-risk groups.

Hyperactivity-inattention symptoms in childhood and suicidal behaviors in adolescence: the Youth Gazel Cohort.

OBJECTIVE: Although a link has been suggested between attention deficit/hyperactivity disorder (ADHD) and completed suicide, little is known about the association with suicidal behaviors in community settings. This study addresses the relationship between childhood hyperactivity-inattention symptoms (HI-s) and subsequent suicidal behaviors. METHOD: Nine hundred sixteen subjects aged 7-18 were recruited from the general population and surveyed in 1991 and 1999. Parent and adolescent self-reports provided psychopathology and suicidal behavior pattern measures. Multivariate modeling was used to evaluate the effects of childhood HI-s and other risk factors on adolescent suicidal behaviors. RESULTS: In males, HI-s independently accounted for the risk of lifetime suicide plans/attempts (OR=3.25, P = 0.02) and adolescent 12-month prevalence rates of suicide plans/attempts (OR=5.46, P = 0.03). In females, HI-s did not independently heighten the likelihood of suicidal behaviors. CONCLUSION: This survey suggests a possible specific link between HI-s and suicide plans/attempts in males.

Examining the influence of drop-outs in a follow-up of maintained opiate users.

INTRODUCTION: In most longitudinal studies of problem opiate users, drop-outs are frequent, but not taken into account. However, missing data can induce important bias in parameters estimates. OBJECTIVE: The aim of this study was to examine the influence of drop-outs in the statistical analysis of a follow-up of opiate users in maintenance treatment. METHODS: Participants were 519 patients who had sought maintenance treatment between 1994 and 2001. Drug use was studied using the drug composite score of the Addiction Severity Index. A classical data analysis (linear mixed effects model for repeated measurements) was compared with a selection model, which consists, in this case, of a joint modelling of the score and of the drop-out probability in order to reduce bias induced by drop-outs. RESULTS: At 18 months, 38% of the patients were available for evaluation. Drop-outs were associated with low drug use and were informative. Each model showed that the score decreased over time and that it was associated with psychiatric problems. Unlike the classical method, the joint model showed no significant association between the score and age or treatment setting. CONCLUSIONS: These results show the importance of accounting for informative drop-outs in data analysis before drawing conclusions from such studies.