Kivimäki M, Vahtera J, Koskenvuo M, Uutela A, Pentti J
University of Turku, Department of Public Health, Finland.
Psychol Med. 1998 Jul;28(4):903-13. doi: 10.1017/s003329179800659x.
According to the psychosocial vulnerability model, the health of hostile individuals is at greater risk than that of non-hostile individuals, due partly to lesser ability of the former to cope with psychosocial stress situations. We examined whether hostile individuals were more vulnerable than others to health problems when faced with stressful changes in their working lives.
Hostility, sickness absence and psychosocial stressors in 866 local government employees over a 5-year period, which included severe economic decline, were investigated. Hostility was measured by a questionnaire. Data on medically certified sickness absence were obtained from the records of the local authority. Information about exposure to psychosocial stressors after assessment of hostility was also derived from these records, and from the subjects.
Exposure to stressors during the period of economic decline was related to increased rates of sickness absence. In men, hostility increased risk of sickness absence after exposure to stressors only in cases of absence because of trauma. In women, hostility increased risk of absence through sickness overall and absence because of musculoskeletal disorders in individuals facing stressors such as severe organizational downsizing, high or increased levels of job demands or negative change in work. Findings were adjusted for sickness absence at the beginning of the decline, socio-economic background and behavioural risk factors.
The psychosocial vulnerability model was partly supported. However, heightened vulnerability through hostility may differ between the sexes, since it was more evident in the women studied than in the men.
根据心理社会脆弱性模型，怀有敌意的个体比非敌意个体的健康面临更大风险，部分原因是前者应对心理社会压力情境的能力较弱。我们研究了在工作生活中面临压力变化时，怀有敌意的个体是否比其他人更容易出现健康问题。
对866名地方政府雇员在包括严重经济衰退在内的5年期间的敌意、病假情况和心理社会压力源进行了调查。敌意通过问卷调查进行测量。经医学证明的病假数据从地方当局的记录中获取。在评估敌意后，关于接触心理社会压力源的信息也来自这些记录以及受试者。
经济衰退期间接触压力源与病假率上升有关。在男性中，只有在因创伤而缺勤的情况下，敌意才会增加接触压力源后病假的风险。在女性中，敌意总体上增加了因病缺勤的风险，以及在面临诸如严重机构精简、工作要求高或增加或工作出现负面变化等压力源的个体中因肌肉骨骼疾病而缺勤的风险。研究结果针对衰退开始时的病假情况、社会经济背景和行为风险因素进行了调整。
心理社会脆弱性模型得到了部分支持。然而，由于敌意导致的更高脆弱性在不同性别之间可能存在差异，因为在我们研究的女性中比男性中更明显。
