A Prospective Twin Study Investigating the Role of Genetics, Early Environment and Neuroticism in the Association Between Exposure to Work-Related Offensive Behaviours and Sickness Absence due to Common Mental Disorders

• Introduction: Sickness absence (SA) has been shown to be associated with several negative consequences, both for the affected individual as well as for society on the whole, in terms of economic loss. The most common reason for SA is SA due to common mental disorders (CMDs). Previous studies have indicated that there is an association between exposure to work-related offensive behaviours, such as harassment, bullying, violence and threats of different kinds and CMDs. However, the mechanistic pathway in this association is still largely unknown. For example, the associations between exposure to offensive or abusive behaviours and health outcomes may partially be explained by individual characteristics, including genetic predispositions and early experiences. The aim of the present study was to investigate the role of familial factors (genetics and shared early-life environment) and neuroticism in the associations between exposure to work-related violence/threats and harassment/bullying, and SA due to CMDs.Method: The study sample included 8795 twin individuals from the Swedish Twin project of Disability pension and Sickness absence (STODS), including survey data from the Study of Twin Adults: Genes and Environment (STAGE) linked to national register data. Self-reported work-related violence and/or threats and work-related harassment including bullying and register data on SA due to CMDs were analysed using logistic regression on the whole sample, and conditional logistic regression among complete same-sex twin pairs discordant on exposures. Individuals were followed for a maximum of 13 years or until their first incident SA spell due to CMD. Interactions between neuroticism and exposures were assessed using both multiplicative and additive interaction analyses.Results: Exposure to work-related violence/threats were associated with higher odds of SA due to CMDs when adjusting for age, sex, marital status, children living at home, education, type of residential area, work characteristics, and symptoms of depression and burnout (OR 2.11, 95% CI 1.52-2.95). Higher odds of SA due to CMDs were also found for exposure to harassment/bullying (OR 1.52, 95% CI 1.10-2.11) and a combined indicator of exposure to either of the kinds of exposure or exposure to both kinds, i.e. violence/threats and/or harassment/bullying (OR 1.98 95% CI 1.52-2.59), compared with the unexposed. Analyses of twin pairs discordant on exposure, using the unexposed twin sibling as reference, showed somewhat reduced ORs that were no longer statistically significant for all exposures. No multiplicative interaction was found between neuroticism and exposure to work-related violence/threats, or harassment. However, a statistically significant additive interaction was found between neuroticism and exposure to violence/threats, with higher odds of SA due to CMDs in the group scoring lower on neuroticism.Conclusion: Exposure to work-related offensive behaviours were associated with SA due to CMDs. The results of the matched twin pair analysis indicated that these associations may be confounded by familial factors. In addition, an interaction effect between violence/threats and neuroticism was found. Thus, future studies investigating associations and causality between offensive behaviours at work and mental health-related outcomes should, when possible, consider familial factors and neuroticism.

Ämnesord

SAMHÄLLSVETENSKAP  -- Psykologi (hsv//swe)

SOCIAL SCIENCES  -- Psychology (hsv//eng)

Nyckelord

sickness absence

common mental disorders

harassment

bullying

violence

threats

twin study

genetics

psykologi

Psychology

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