Employment
Stress and DSM IV Psychological Disorders
A
structural way of categorising employment-related psychological
disorders was highlighted as being crucial to reliably and validly
identify the extent and severity of work-related adverse events (Koch
+ Bracey, 2006). A simple typology of adverse events at work was
illustrated and is shown below:-
Work-Related
Adverse Events |
Specific |
Sustained |
| |
|
Work
Accident |
Work
Place Discrimination |
Work
Assault |
Work
Place Stress (Bullying, Harassment, Relationship-Conflict and
Workload-Related) |
Driving
Accident |
|
| |
|
The
diagnostic and statistical manual of mental disorders (DSM IV TR)
(APA 2000) provides a classification of the main types of
psychological disorder recognised worldwide. Applying these to the
above adverse events, the typical disorders which are considered in a
“range of opinions” for work-related problems are shown
in the table below:
Depressive
Disorders (Episodic, Persistent, Chronic)
Anxiety
Disorders (Phobic, Generalised)
Adjustment
Disorders (Anxiety and/or Depression based)
Sleep
Disorders
Stress
Disorders (Acute and “in extremis” PTSD)
Addictive
Disorders (Alcohol, Cannabis, other)
Pain
and Somataform Disorders |
These
disorders account for a significant amount of the variability of
psychological reaction to work difficulties. However, although not
officially categorised within DSM IV, this system does allow for
“other conditions” which occasional are a “better
fit” for the psychological reactions seen emanating from
organisations. These include:
Relationship
problems (e.g., difficulties with co-workers)
Adult
antisocial behaviour
Age-related
cognitive decline
Occupational
problem (e.g., job dissatisfaction, job role uncertainty)
Acculturation
problem (e.g., adjustment to different industrial culture)
Phase
of life problem (e.g., starting or changing career) |
At
present, employment litigation allows, in practice, for both types of
classification to be utilised in debating how an individual employee
has or has not been affected or “disabled” within the
work place. Both systems need further refinement and elaboration to
enhance their utility both in quantum assessment terms and in
treatment and prognosis terms.
A
third system which is implicit in employment litigation itself but
appears elusive to scrutiny and fair resolution is one which attempts
to classify “Responsibility for disability”. Such a
system includes:
Employee
Responsibility
Live
Manager Responsibility
Department
Head Responsibility
Organisation
(prevailing culture) Responsibility
Colleagues
Responsibility |
Litigation
typically contrasts employee and “the rest” (i.e.,
employer). The variability typically found in evidence is not
accounted for sufficiently by this dichotomous approach. It would be
useful to all concerned to elaborate all three systems in a
structured and logical way to form the basis of future employment
stress debates.
Ref:
Koch HCH + Ron Bracey R (2006) Employment + Injury. Legal and
Medical 13.
|
