ABSTRACT
BACKGROUND: This study examined associations between anxiety and work-related outcomes in an anxiety disorders clinic population, examining both pretreatment links and the impact of anxiety change over 12 weeks of treatment on work outcomes. Four validated instruments were used to also allow examination of their psychometric properties, with the goal of improving measurement of work-related quality of life in this population. METHODS: Newly enrolled adult patients seeking treatment in a university-based anxiety clinic were administered four work performance measures: Work Limitations Questionnaire (WLQ), Work Productivity and Activity Impairment Questionnaire (WPAI), Endicott Work Productivity Scale (EWPS), and Functional Status Questionnaire Work Performance Scale (WPS). Anxiety severity was determined using the Beck Anxiety Inventory (BAI). The Clinical Global Impressions, Global Improvement Scale (CGI-I) was completed by patients to evaluate symptom change at a 12-week follow-up. Two severity groups (minimal/mild vs. moderate/severe, based on baseline BAI score) were compared to each other on work measures. RESULTS: Eighty-one patients provided complete baseline data. Anxiety severity groups did not differ in job type, time on job, job satisfaction, or job choice. Patients with greater anxiety generally showed lower work performance on all instruments. Job advancement was impaired for the moderate/severe group. The multi-item performance scales demonstrated better validity and internal consistency. The WLQ and the WPAI detected change with symptom improvement. CONCLUSION: Level of work performance was generally associated with severity of anxiety. Of the instruments tested, the WLQ and the WPAI questionnaire demonstrated acceptable validity and internal reliability.
Subject(s)
Anxiety Disorders/rehabilitation , Rehabilitation, Vocational , Absenteeism , Adult , Anxiety Disorders/diagnosis , Anxiety Disorders/psychology , Career Choice , Career Mobility , Disability Evaluation , Female , Follow-Up Studies , Humans , Job Satisfaction , Male , Middle Aged , Obsessive-Compulsive Disorder/diagnosis , Obsessive-Compulsive Disorder/psychology , Obsessive-Compulsive Disorder/rehabilitation , Panic Disorder/diagnosis , Panic Disorder/psychology , Panic Disorder/rehabilitation , Personality Inventory/statistics & numerical data , Phobic Disorders/diagnosis , Phobic Disorders/psychology , Phobic Disorders/rehabilitation , Psychometrics , Quality of Life/psychologyABSTRACT
OBJECTIVE: Studies in clinical and community samples have documented that social anxiety disorder is common, disabling, and costly. It reduces educational attainment and job success, and thus it may undermine economic self-sufficiency. The authors examined whether social anxiety disorder was an obstacle to successful employment in a longitudinal epidemiological study of women receiving welfare in an urban Michigan county. The hypothesis that social anxiety disorder would predict reduced work attainment was examined. METHODS: Psychiatric diagnoses were established with the Composite International Diagnostic Interview-Short Form. The authors conducted a linear fixed-effects regression analysis for survey data with 609 respondents who completed at least the third wave of the Women's Employment Study in order to explore obstacles to employment among mothers on welfare. RESULTS: Analyses demonstrated that compared with respondents without social anxiety disorder, those with this disorder worked fewer months. The impact of social anxiety disorder was independent of and more striking than the effects of depression. CONCLUSIONS: By undermining efforts to obtain or maintain employment, social anxiety disorder poses a significant, unrecognized impediment to efforts to reduce welfare reliance and to help recipients achieve economic self-sufficiency. Because recipients may lose benefits if they fail to enter the workforce rapidly and if they exceed time limits for support, those with social anxiety disorder are at risk of extreme economic hardship. Improved access to effective treatments in this population could have significant public health and economic benefits.
