Are frequency and severity of workplace violence etiologic factors of posttraumatic stress disorder? A 1-year prospective study of 1,763 social educators.

Although cross-sectional studies have associated workplace violence (WPV) with posttraumatic stress disorder (PTSD), prospective studies are needed to ascertain the exposure leading to the development of PTSD. Using a 1-year prospective survey design, with monthly measures of violence, and 1,763 participants, we investigated whether frequency and/or severity of WPV could be considered etiological factors for PTSD. Binary logistic regression models were used, with subclinical and clinical PTSD as outcomes. The models were adjusted for demographic, lifestyle, and trauma-related factors, as well as strain in the work environment. Compared with the nonexposed group, frequency of WPV increased the risk of PTSD in an exposure-response pattern: low frequency OR ⫽ 4.0, 95% confidence intervals [CI] [1.0, 16.3], medium frequency OR ⫽ 5.9, 95% CI [1.4, 24.3], and high frequency OR ⫽ 6.5, 95% CI [1.6, 25.6]. We also found that when threat was the most severe incident of WPV, the risk of PTSD increased, OR ⫽ 5.4, 95% CI [1.2, 24.2]. In addition, severe incidents of WPV increased the risk of PTSD, OR ⫽ 6.5, 95% CI [1.6, 26.0]. This prospective study consolidates existing cross-sectional studies, which have indicated that frequency of WPV is an etiological factor for PTSD. The study underlines the need for integrating an understanding of the pattern and characteristics of WPV in future research. Specifically, we propose the use of frequency of WPV as an additional factor in targeting employees at risk of developing PTSD.