Perceived workplace harassment experiences and problem drinking among physicians: broadening the stress/alienation paradigm.

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.