Victims of mobbing show behavioral and social inhibition; less skilled to face environmental challenges

A study by Naples investigators published in the current issue of Psychotherapy and Psychosomatics reports on what happens in the axis which controls the secretion of cortisol in victims of mobbing.

Mobbing (bullying at the workplace) is a severe form of work related psychological distress resulting from repeated hostile communications or acts directed in a systematic manner by one or more individuals toward one subjects, who is in a situation where he/she may have difficulties defending him/herself against these actions. Being subjected to violence at the workplace is expected to generate stress reactions, which may have severe consequences for both physical and emotional health.

Stress is associated with activation of the hypothalamo-pituitary-adrenal (HPA) axis, and there is evidence that personality traits may influence the HPA response to stressful situations. To assess whether the stressful load of workplace bullying affects HPA activity and whether character and temperament characteristics have a role in the determinism of the HPA activity of bullied subjects, daytime saliva cortisol levels and personality characteristics of bullied individuals as compared to controls who had not been bullied were measured.

Ten bullied patients (6 men, 4 women) and 10 age- (within 3 years) and sex-matched healthy controls were recruited for the study. Two patients were working in public companies while the remainder were working in private companies. Cases of bullying were defined according to Leymann's definition by using a self-administered questionnaire, which included the 45-item inventory of workplace bullying elaborated by Leymann, frequency and duration of bullying, and a self-report of being exposed to bullying. The duration of bullying exposure ranged from 9 to 78 months. Control subjects were mentally healthy as assessed by the SCID-I non-patient edition and did not significantly differ from patients at education and occupational levels. All subjects were drug-free for at least 6 weeks and were physically healthy. The self-administered Temperament and Character Inventory-Revised (TCI-R) of Cloninger was used to assess subjects' character and temperament characteristics. Subjects were asked to go to sleep at their habitual sleep time and to awake at 06.00 a.m.; they collected saliva samples immediately after awakening and at 08.00, 12.00, 16.00 and 20.00 h of the day. Participants  collected saliva at home into Salivette tubes that were stored in home freezers before being returned to the lab. Saliva cortisol concentrations were determined by ELISA method, using a commercial kit (Biochem Immunosystem, Milan, Italy).

Two-way analysis of variance (ANOVA) with repeated measures, one-way ANOVA, the post-hoc Tukey's test, the Pearson's correlation test and the stepwise multiple regression were used where appropriate.

At the end of the investigation, bullied subjects exhibited significantly higher levels of harm avoidance (p = 0.004) and lower levels of self-directedness (p = 0.0004) as compared to controls. As for saliva cortisol levels, two-way ANOVA with repeated measures showed significant effects for group (p =0.0008) and time (p< 0.00001) and a significant group X time interaction (p = 0.001). In the bullied group, saliva cortisol concentrations at 06.00 and 08.00 a.m. and the whole daytime cortisol secretion, evaluated as the area under the curve (AUC), were significantly lower than in controls.

In bullied subjects, diurnal cortisol AUC significantly correlated positively with self-directedness (p = 0.04), and negatively with harm avoidance (p = 0.02) and duration of bullying exposure (r = -087; p< 0.001). The stepwise multiple regression showed that duration of bullying exposure was significantly associated with saliva cortisol AUC (p = 0.001), explaining 76% of the variability in saliva cortisol concentrations. After removing this effect, harm avoidance resulted still significantly associated to saliva cortisol AUC (p = 0.0007) and explained a further 11% of the variability in saliva cortisol concentrations. After removing this effect, self-directedness was no longer associated with cortisol AUC. As compared to normal controls, individuals bullied at the workplace exhibited higher harm avoidance, lower self-directedness and decreased diurnal secretion of saliva cortisol.

This study shows that victims of mobbing are characterized by behavioral and social inhibition and seem to be less skilled to face environmental challenges, which may impair their ability to cope with the work-related psychological violence. In conclusion, victims of mobbing are characterized by a reduced tonic activity of the HPA axis, which seems to be related to both the chronicity of being exposed to workplace bullying and increased levels of harm avoidance.