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Background: Research on the impacts of exposure to workplace harassment (WH) is largely cross-sectional, and existing prospective studies generally are between two and five years of follow-up, with the longest US study being 10 years. However, the effects of exposure to WH may persist longer, particularly if exposure has been chronic. This study fills this gap by examining effects of prior exposure to chronic sexual and generalized WH on psychological distress and alcohol misuse over an approximately 25 year study period., Methods: Individuals originally recruited from a university-employed sample in the United States were surveyed at 8 time points from 1996-2007 and again in 2020-2021. A series of hybrid path analyses were tested on a sample of 2352 individuals, regressing recent outcomes on latent classes of harassment derived from earlier survey waves, controlling baseline outcomes and demographics. Model fit was assessed using a variety of fit statistics, and standardized regression coefficients were used to assess significance of individual pathways., Results: Prior exposure to chronic sexual harassment had significant direct associations with psychological distress, alcohol misuse, and recent stressors at follow-up. Prior exposure to chronic generalized harassment had significant direct associations with lower income and alcohol misuse. Both forms of WH were significantly indirectly associated with psychological distress through recent stressors at follow-up., Conclusions: Exposure to chronic WH is associated with long-term effects on psychological distress and alcohol misuse in a sample representing a wide variety of job types and racial/ethnic identities. Enforcement of anti-sexual harassment law and policies and enactment of policies and laws to prevent generalized harassment/workplace bullying are imperative for the protection of worker health., (© 2023. The Author(s).)

While most research has examined the long-term effects of alcohol consumption on health, the current study examines how health status impacts on drinking behavior. Using data from a national study conducted between 2010 and 2011 to assess the impact of the recession on drinking behavior, this study examines how economic hardships linked to the recent economic recession affect physical health, and how physical health may in turn affect alcohol use. Structural equation models were used to test the predicted associations. The data demonstrate that many of the economic stressors linked to the recession are associated with increased somatic symptoms. Somatic symptoms are also associated with increased drinking for men, but not for women. These findings suggest that men may use alcohol to self medicate somatic symptomatology. The current findings are consistent with gender role-based explanations that account for gender disparities in the utilization of medical care., (Copyright © 2012 Elsevier Ltd. All rights reserved.)

Although harassment in the workplace has been linked to deleterious drinking outcomes, researchers have yet to examine the long-term effects of chronic workplace harassment. During a 10-year longitudinal mail survey, university employees (N = 2,265) were administered measures of sexual harassment, generalized workplace harassment, and problematic drinking. Using growth mixture modeling, two latent classes of workplace harassment emerged: infrequent and chronic. Demographic characteristics (gender, age, and race) predicted the shape of the trajectories and likelihood of class membership. As hypothesized, membership in the chronic harassment classes was linked to future problematic drinking, even after controlling for previous drinking.

Little attention has been paid to the relationship between caregiver burden and alcohol use. It is important to examine the particular aspects of caregiver burden that most influence alcohol use. A mail survey was conducted using a representative sample of 998 employed Chicago residents who provided informal care for at least one person. Ordinary least squares regression models were computed to examine the relationship between caregiver burden and drinking outcomes. Findings suggest that caregivers who experience social and emotional burdens related to caregiving are at risk for problematic alcohol use and warrant attention from health care and mental health service professionals.

Racial and ethnic disparities in alcohol use and alcohol-related problems have been well-documented. Less information is available about possible disparities in outcomes related to mental health services utilization. The differential effect of mental health services use by race on drinking outcomes was examined. Wave 2 of a national population sample of employed adults who reported having at least one alcoholic drink in the past year (N = 1,058) encompassed measures of the prevalence of mental health services use in response to stress, and alcohol-related outcomes. Non-white participants who reported using any mental health services, four or more mental health visits in the past year, and eight or more mental health visits in the past year reported lower rates of problematic drinking behaviors, including frequency of drinking to intoxication, heavy episodic drinking, and modified Brief MAST scores, than whites who reported similar use of mental health services.

Sociologists who embrace the stress or alienation paradigms generally focus on explaining problem drinking in low status occupations. By contrast, this paper argues that a broadened conceptualization of stress and alienation which incorporates abusive work relationships has utility for explaining male and female drinking outcomes in both high and low status occupations. We provide empirical data on the relationship between perceived abusive experiences and drinking outcomes in a cohort of male and female physicians in their internship year of training. The data show that perceived sexual harassment, discriminatory treatment and psychological humiliation relate to various drinking outcomes in men and women, controlling for drinking prior to the internship year. While females were more likely to report experiencing abuse, these perceived experiences had deleterious effects on drinking outcomes for both genders. Personal vulnerability (narcissism) brought into the training environment somewhat influenced the later reporting of abusive experiences by males but not by females. Regression analyses showed that, for both males and females, work-place abusive experiences in interaction with personality vulnerability best explained drinking outcomes. The implications of these results for the design of future alcohol-related work-place studies are discussed.

Psychiatric epidemiological research has focused disproportionate attention on traditionally female disorders such as depression. This paper shifts epidemiological gears to elaborate and test an etiological model of a traditionally male disorder, that of alcohol abuse. We argue that social-relational deficits (narcissistic orientations) lead to abuse of alcohol for stress reduction purposes, given interpersonally oriented stressors and the incapacity to form social supports. The model was tested in the context of training for a traditionally male occupation encompassing both social-relational demands and limited social supports. A cohort of medical students was surveyed from medical school entrance through a portion of clinical training. Time 1 social-relational deficits were predictive of time 3 alcohol abuse, partially as a function of social support deficits and, to a lesser extent, patient care-related stressors. Moreover, there was an initial gender difference in social-relational deficits and a trend-level gender difference in alcohol abuse that disappeared when social-relational deficits were held constant. By time 3, women did not differ from men in social-relational deficits or alcohol abuse.

This paper elaborates the conceptual frameworks and major results to date from an ongoing longitudinal study of alcohol problems in male and female future physicians. A medical student cohort was surveyed at medical school entrance and in the 2nd and 3rd years of training. Relative to life span developmental orientations, a sizable proportion of premedical school problem drinkers "matured out" of their earlier patterns after entrance into occupational training roles. Relative to occupational selection versus stress perspectives, medical school problem drinkers were equally divided between those manifesting onset prior to the initiation of training versus those manifesting onset during medical training. Overall, both male and female problem drinking declined during the preclinical years (in contrast to premedical school levels) but manifested a trend in the direction of a reversal of the previous decline after the initiation of clinical training. The major psychosocial predictor of alcohol abuse during clinical training involved social-relational deficits or narcissistic personality styles. Moreover, this relationship was mediated by social support deficits and patient care-related stressors. This cohort is currently being re-surveyed in the last year of medical school and will be followed again during residency training.

Etiologic research on alcohol-related impairment in physicians has elucidated various risk factors including family history of alcoholism, symptomatic distress, personality deficits, and high academic achievement. This study of medical students points to the additional salience of future practice orientations involving technological/status versus interpersonal concerns. A cohort of students was surveyed at medical school entrance and again in the second training year. Alcohol abusers (particularly medical school onset cases) manifested significantly higher technological/status and lower interpersonal concerns compared to non-abusers. Differences across future specialty choices were also found. However, additional longitudinal research is necessary to clarify the causal directionality of these relationships.