Workplace Harassment, Macro-Level Stressors, Substance Use and Health Outcomes: A Long-Term Follow Up

工作场所骚扰、宏观压力源、药物使用和健康结果：长期随访

基本信息

批准号：
10210237
负责人：
KATHLEEN M ROSPENDA
金额：
$ 54.75万
依托单位：
UNIVERSITY OF ILLINOIS AT CHICAGO
依托单位国家：
美国
项目类别：
财政年份：
2019
资助国家：
美国
起止时间：
2019-07-01 至 2024-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10210237
关键词：
Address Adult Adverse effects Affect Alcohols Anxiety Awareness Behavioral CD2 gene Cause of Death Cessation of life Chronic Chronic Disease Cognitive Coupled Cox Proportional Hazards Models DSM-V Data Data Set Development Distal Distress Drug abuse Drug usage Effectiveness Equation Ethnic Origin Event Exposure to Follow-Up Studies Gender Goals Health Individual Intervention Interview Joints Link Long-Term Effects Longitudinal Studies Longterm Follow-up Mediating Mediator of activation protein Mental Health Modeling Morbidity - disease rate Organizational Models Outcome Participant Policies Prevalence Prevention Prevention strategy Psychopathology Race Reaction Recording of previous events Records Religion and Spirituality Reporting Research Risk Risk Factors Role Sampling Studies Services Sexual Harassment Stress Structural Models Structure Substance abuse problem Surveys Symptoms Testing Time Work Workplace alcohol related consequences base bullying cohort contextual factors coping design drinking behavior experience follow-up indexing innovation mortality mortality risk physical health service prevent prospective protective factors psychologic public health relevance social stressor substance use theories treatment strategy

项目摘要

Workplace harassment (WH) is a traumatic stressor that is consistently linked to substance use and abuse, poor mental health, and health symptoms. However, long-term risk for serious psychopathology, morbidity, and mortality remains unstudied. Building on our prior work on WH and substance use, we focus on four aims: 1) delineate long-term consequences of WH on morbidity and mortality over a 25 year period; 2) using three approaches, test the role of substance abuse, psychological and cognitive mediators (distress, alienation, and rumination), and stress sensitization, and the possible integration of these factors, to explain the long-term effects of WH on psychopathology and adverse health outcomes, including mortality, in the context of other stressors and key work-related structural and contextual factors; 3) examine risk and protective factors (services use, coping and coping effectiveness, gender and race/ethnicity) modifying the relationships between prior and current stressors and substance abuse, psychopathology, and adverse health outcomes, and 4) examine the reliability of long-term recall of prior WH experiences and substance use by comparing current recall to prior reports. A central innovation of the proposed study is delineating how WH, a micro-level stressor, may sensitize reactions to later micro- and macro-level stressors, increasing long-term risk for substance abuse, psychopathology, and adverse health outcomes. Capitalizing on an existing 8-wave dataset spanning 10 years, this follow-up study will a) re-survey at 3 one-year intervals a cohort of adults first surveyed while employed in 1996 (N=2478); b) supplement the survey with structured interviews to assess presence and timing of current and past psychopathology and substance abuse as per DSM-5 criteria, long-term recall of WH and substance abuse, and work-related structural and contextual factors that contribute to WH; and c) use the National Death Index to ascertain mortality, including date and cause of death, on mortality occurring since the end of the prior study. This design will allow us to test longitudinal models of the effects of WH on morbidity and mortality, incorporating both proximal and distal mechanisms, and incorporating intrapsychic factors, behavioral factors, and work-related structural/contextual factors in models to explain long-term effects of WH on outcomes. This will be the first study of long-term risk for mortality associated with WH. Given the wealth of previous data characterizing the sample, this study presents a unique opportunity to inform viable strategies to prevent and address WH-related substance abuse, psychopathology, chronic health issues, and mortality, and to inform targeted, timely treatment and prevention strategies to ameliorate negative health-related effects of WH at individual, workplace, and policy levels.

工作场所骚扰 (WH) 是一种创伤性压力源，始终与药物使用和滥用相关，心理健康状况不佳，并出现健康症状。然而，严重的精神病理学、发病率和死亡率仍未得到研究。基于我们之前在 WH 和物质使用方面的工作，我们重点关注四个目标：1) 描述 25 年期间 WH 对发病率和死亡率的长期影响； 2）使用三个方法，测试药物滥用、心理和认知调节因素（苦恼、疏远和沉思）和压力敏化，以及这些因素的可能整合，以解释长期的在其他情况下，WH 对精神病理学和不良健康结果（包括死亡率）的影响压力源以及与工作相关的关键结构和背景因素； 3）检查风险和保护因素（服务使用、应对和应对有效性、性别和种族/民族）改变之间的关系先前和当前的压力源和药物滥用、精神病理学和不良健康结果，以及 4) 通过比较当前的 WH 经历和物质使用来检查长期回忆的可靠性回顾之前的报告。拟议研究的一个核心创新是描述 WH（一种微观层面的压力源）如何可能会使对随后的微观和宏观压力源的反应敏感，从而增加物质的长期风险虐待、精神病理学和不良健康结果。利用现有的 8 波数据集 10 年内，这项后续研究将 a) 以一年为间隔 3 次重新调查一组首次接受调查的成年人 1996 年就业（N=2478）； b) 通过结构化访谈来补充调查，以评估存在感和根据 DSM-5 标准，当前和过去的精神病理学和药物滥用的时间安排，WH 的长期回忆药物滥用，以及导致 WH 的与工作相关的结构和背景因素； c) 使用国家死亡指数，用于确定自该日期以来发生的死亡率，包括死亡日期和原因之前的研究结束。该设计将使我们能够测试 WH 对发病率影响的纵向模型和死亡率，结合近端和远端机制，并结合内心因素，模型中的行为因素和与工作相关的结构/背景因素来解释 WH 的长期影响关于结果。这将是第一项针对与 WH 相关的长期死亡风险的研究。鉴于财富以前的数据表征了样本，这项研究提供了一个独特的机会来告知可行的策略预防和解决与 WH 相关的药物滥用、精神病理学、慢性健康问题和死亡率，以及提供有针对性的、及时的治疗和预防策略，以改善与健康相关的负面影响个人、工作场所和政策层面的 WH。