職場上中階管理者的焦慮程度最高


  【24drs.com】新研究認為,職場的分層結構中,以中階主管的焦慮程度最高,而憂鬱程度較小。
  
  第一作者、紐約市哥倫比亞大學Mailman公衛學院流行病學系博士前研究員Seth Prins表示,給醫師們的關鍵訊息是,重點在於要能瞭解社會背景,或流行病學家所謂的「健康的社會決定因素」。
  
  顯然地,心理健康專家無法開一張職務晉升的處方,但是,忽略病人的社會經濟背景、或個人特徵等治療因素之下,那或許也不是最佳方法。
  
  這些研究結果線上發表於8月3日健康與病痛社會學期刊。
  
  研究顯示,社會經濟階層較低與職場階層較低者的心理與生理疾病風險增加,不過,有一些證據認為,中階者的內化障礙如憂鬱症和焦慮症之風險比較高,相較於低或高階員工,中階員工對於工作職責和控制面臨著獨特的壓力。
  
  為了更妥善地評估這個理論,研究者評估了21,859名全職勞工的資料,這些人參與了2001-2002年的「酒精與相關情況之全國流行病學調查(National Epidemiologic Survey on Alcohol and Related Conditions)」,這項全國代表性調查的對象是18歲以上的美國人,進行個別訪查。
  
  他們檢視了三類受訪者:企業主,定義為自營人士,年收入超過71,500美元;經理和主管,擔任高階行政或管理職務者;各種職業的職工,包括農民和勞工。
  
  他們發現,在終身與12個月的憂鬱與焦慮評估中,職位屬社會經濟中階之勞工,特別是主管職者,焦慮程度顯著高於低階與高階勞工,而憂鬱發生率的研究結果則是不一致。
  
  舉例來說,主管的所有疾病發生率都高於低階勞工,終身內患有憂鬱(風險比[OR]為1.75;95%信賴區間[CI]為1.58 - 1.93)、終身內患有焦慮(OR, 2.33;CI, 1.97 - 2.75)、12個月內患有憂鬱(OR, 1.19;CI, 1.03 - 1.37)以及12個月內患有焦慮(OR, 1.76;CI, 1.39 - 2.23)的風險都較高。
  
  在所有疾病中,經理的發生率次高,相較於低階勞工,經理終身內患有憂鬱(OR, 1.2;CI, 1.06 - 1.35)和終身內患有焦慮(OR, 1.36;CI, 1.19 - 1.57)的風險較高。
  
  與私人企業的企業主相比,主管職位者終身內患有憂鬱(OR, 1.86;CI, 1.5 - 2.31)和12個月內患有憂鬱(OR, 1.4;CI, 0.9 - 2.16)的風險較高,且他們終身內患有焦慮(OR, 5.13;CI, 3.1- 8.6)和12個月內患有焦慮(OR, 9.39; CI, 7.76 - 11.35)的風險更高出許多。
  
  Prins解釋,研究結果強調了中階管理職位的獨特壓力,這可能包括居高不下的壓力與較低的位階。
  
  他解釋,我們懷疑,中階管理者的[壓力源]來自於其雙重角色—在預計執行的政策中,他們很少有發言權,還要面臨著下屬的對立。換句話說,中階管理者要面臨來自上司與下屬雙方的砲火。
  
  Prins指出,而較低階的勞工可能會造成失控的外在因素而引起壓力,主管可能將更傾向於內化壓力的工作環境,並將其歸因於個人的失敗。他表示,研究一致顯示,外在歸因可對抗低自尊與憂鬱等內化異常。
  
  在這些方面,相較於對管理階層,對第一線勞工可能有更堅實的社會支持,這些也是我們希望進行後續探討的問題。
  
  組織與職業精神病學院院長、波士頓警察署首席心理醫師Andrew O. Brown醫師表示,如同在許多壓力情況下,中階管理者的焦慮情況可能會惡化自我忽視的問題。
  
  他表示,如果有人擔心失業且正處於壓力鍋型的情況,他們真的需要對基本的自我照護與運動等議題投注更多關注。
  
  Brown醫師強調,在這種情況下的人,需要尋求有能力之心理健康專家的幫助。
  
  他表示,與瞭解患者個人在工作上之壓力經驗的治療師合作,積極幫助決策與提供有建設性的建議。
  
  藉由美國精神病學協會基金會的「職場心理健康夥伴(Partnership for Workplace Mental Health)」,雇主也可以積極協助解決各階層勞工的工作壓力。
  
  這個夥伴計畫為雇主提供在職場提高有關心理健康議題警覺的計畫,且鼓勵具有支持性的職場文化,讓勞工感到舒適且在需要時可以求援。
  
  資料來源:http://www.24drs.com/
  
  Native link:Anxiety Levels Highest at Mid Management in Workplace

Anxiety Levels Highest at Mid Management in Workplace

By Nancy A. Melville
Medscape Medical News

In the hierarchy of the workplace, it is those in the middle, not necessarily the bottom, particularly supervisors, who show the highest levels of anxiety and, to a lesser degree, depression, new research suggests.

"The key message for clinicians is to appreciate that social context, or what epidemiologists call the social determinants of health, matters," said lead author Seth Prins, MPH, a predoctoral fellow in the Department of Epidemiology at Columbia University's Mailman School of Public Health, in New York City.

"Obviously, a mental health professional can't prescribe a job promotion, but ignoring the socioeconomic context of their patients, or treating such factors as individual characteristics, probably isn't the best idea either," he told Medscape Medical News.

The findings were published online August 3 in the journal Sociology of Health and Illness.

Middle Ranks

Research has shown an increased risk for mental and physical illness among those in lower socioeconomic classes and in the lower ranks of the workplace. However, some evidence suggests a higher risk of internalizing disorders, such as depression and anxiety, in middle social ranks, where employees can face unique pressures with regard to job responsibilities and control, compared with lower or higher ranks.

To better evaluate the theory, the researchers evaluated data on 21,859 fulltime workers who were respondents in the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions, a nationally representative survey of the US population aged 18 years and older who were interviewed in person.

They identified respondents in three categories: business owners identified as self-employed and earning more than $71,500; managers and supervisors who held executive, administrative, or managerial positions; and workers of various occupations, including farmers and laborers.

They found that in estimates of lifetime and 12-month depression and anxiety, workers in positions in the middle socioeconomic classes, particularly supervisors, had significantly higher levels of anxiety compared with workers in lower and higher classes. Rates of depression were less consistent.

For example, the prevalence of all disorders was higher among supervisors than among lower-ranking workers, with higher odds of lifetime depression (odds ratio [OR], 1.75; 95% confidence interval [CI], 1.58 - 1.93), lifetime anxiety (OR, 2.33; CI, 1.97 - 2.75), 12-month depression (OR, 1.19; CI, 1.03 - 1.37), and 12-month anxiety (OR, 1.76; CI, 1.39 - 2.23).

Managers had the next highest levels in terms of all disorders. Compared with lower-ranking workers, they had higher odds of lifetime depression (OR, 1.2; CI, 1.06 - 1.35) and lifetime anxiety (OR, 1.36; CI, 1.19 - 1.57).

Compared with those above them ─ business owners in the private sector ─ supervisors had the highest odds of lifetime depression (OR, 1.86; CI, 1.5 - 2.31) and 12-month depression (OR, 1.4; CI, 0.9 - 2.16), and they had much higher odds of lifetime anxiety (OR, 5.13; CI, 3.1- 8.6) and 12-month anxiety (OR, 9.39; CI, 7.76 - 11.35).

The results underscore the unique pressures of middle management positions, which can involve higher levels of stress than lower-ranking positions, Prins explained.

"We suspect the [stress contributor] is this dual role of middle management — being expected to enforce policies in which they have little say, but also facing antagonism of subordinates," he explained.

"In other words, middle managers have to take flak from the top down as well as from the bottom up," he said.

Whereas lower-ranking workers may be able to attribute conditions causing stress to external factors that are out of their control, supervisors may be more prone to internalizing stressful work conditions and attributing them to personal failure, Prins added.

"Research has consistently shown that external attributions are protective against low self-esteem and internalizing disorders such as depression," he said.

"Along these lines, there may be more solidarity and social support among frontline workers than among the managerial class. These are questions that we hope to explore in future research."

As in many stressful situations, people in middle management positions who experience anxiety may exacerbate the problem with self-neglect, said Andrew O. Brown, MD, lead psychiatrist with the Boston Police Department and president of the Academy of Organizational and Occupational Psychiatry.

"If someone is worried about losing their job and is in a pressure-cooker type of situation, they really have to devote more attention rather than less to basic self-care and issues such as physical exercise," he told Medscape Medical News.

Dr Brown underscored the need for people in such situations to seek help from capable mental health professionals.

"It's important to work with a therapist who is capable of understanding how the patient's personal history applies to the stressful experience at work and who can take an active role in helping with decision making and constructive advice," he said.

Employers can also take an active role in addressing workplace stress at any level with programs offered through the American Psychiatry Association Foundation's Partnership for Workplace Mental Health.

The partnership works to provide employers with programs to raise awareness about mental health issues in the workplace and encourage a supportive culture in which workers can feel comfortable in reaching out for help if needed.

The study was supported by the National Institute of Mental Health. Seth Prins and Dr Brown have disclosed no relevant financial relationships.

Sociol Health Illn. Published online August 3, 2015.

    
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