PSYCHOLOGY WIZARD
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CLINICAL KEY QUESTION

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WHAT ARE THE ISSUES SURROUNDING MENTAL HEALTH IN THE WORKPLACE?”

Remember it’s a Key QUESTION. If the Examiner asks you what it is, don’t write “Stress”. “Stress” isn’t a question. Questions have question marks at the end and start with a word like “what”.

The exam may ask you to “summarise” your Key Question. This means giving some of the information below.

FEATURES OF STRESS IN THE WORKPLACE

“Features” means facts about your Key Issue – what forms does it takes, what types are there? (You’re not talking any Psychology here. It’s general knowledge really.) Later you can explain the biological psychology behind the idea of the stress response
According to the HSE (Health and Safety Executive), in 2015/16 over 480,000 people in the UK reported that work-related stress was making them ill - over 11 million days are lost at work every year due to stress. This amounts to nearly 40% of all work-related illness.
Stress is defined as the 'adverse reaction people have to excessive pressures or other types of demand placed on them' - Health & Safety Executive (HSE)
Workers benefit from pressure in their work - it's motivating and produces ambition - but when there is too much pressure, workers become overloaded. Stress can lead to anxiety and depression and increase the risk of heart disease, back pain, gastrointestinal illnesses or skin conditions.
The HSE (Health and Safety Executive) has identified the six causes of work-related stress:
  • Demands of the job (too much work or work that is too burdensome or unpleasant)
  • Control over work (when workers have no say over how and when they do their work)
  • Support (sickness absence rises if workers cannot talk to managers about their troubles)
  • Relationships at work (this includes workplace bullying)
  • Role within the organisation (workers need to know what is expected of them)
  • Change (stress is increased by uncertainty)

SICK BUILDING SYNDROME

Sick Building Syndrome (SBS) is a set of symptoms linked to working in an unhealthy environment. The NHS lists these symptoms:
  • headaches
  • blocked or runny nose
  • dry, itchy skin
  • dry, sore eyes
  • rashes
  • tiredness and difficulty concentrating
SBS was first noticed in the 1970s and classified as a problem by the World Health Organisation (WHO) in 1986. A series of studies in Sweden linked SBS to allergies and suggested that modern buildings with air conditioning systems exposed workers to chemicals that had harmful long-term effects. Women seem to suffer from SBS more than men, but it's not clear if women are just more likely to report the symptoms.

However, Marmot et al. (2005) suggest that the cause is more likely to be psycho-social than environmental.  
Azuma et al. (2014) link specific work-related stressors with specific SBS symptoms:
  • excessive workload is associated with headache, fatigue and nausea
  • crowded workspaces and low work satisfaction are associated with breathing problems, coughs and sore throats
[We] don’t really know whether it’s the building or it’s the people - Alan Hedge
Is it the buildings or the people?
Long article from The Independent which interviews sufferers and considers whether SBS is a valid diagnosis or not

COMPUTER SCREENS MAKE YOU SICK

Spending just five hours a day in front of a computer increases the risk of depression and insomnia, according to Nakazawa et al. (2002). This study involved 25,000 people over a 3-year period and concluded that too much screen time is damaging the mental health of employees.

Staff at a large Japanese IT company complained of feeling depressed, anxious and reluctant to get up for work in the mornings. Many reported problems getting along with fellow workers and experienced broken sleep and daytime fatigue.
... the prevention of mental disorders and sleep disorders requires the restriction of computer use to less than five hours a day - Dr Tetsuya Nakazawa
​Previous research focused on how computers affect physical health (e.g. sitting at terminals has been linked with repetitive strain injury, eyestrain and back pain).
Researchers suggest the effects of computers at work might be due to:
  • Less time interacting socially with other workers
  • Lack of breaks from work
  • Overload of tasks (with new tasks being assigned as soon as old tasks are completed)

WORKPLACE BULLYING

Bullying makes someone feel intimidated or offended. Examples of bullying behaviour include:
  • spreading malicious rumours
  • unfair treatment
  • picking on someone or regularly undermining them
  • denying opportunities for training or promotion

Bullying itself isn’t against the law, but harassment is unlawful under the Equality Act 2010.  Harassment is when the bullying behaviour is related to age, sex, disability, gender, marriage and civil partnership, pregnancy and maternity, race, religion and sexual orientation.
According to a YouGov Poll, 29% of people have been the victims of workplace bullying - that's nearly 3 in every 10 workers or 9.1 million of the UK workforce. In November 2015, the Advisory, Conciliation and Arbitrary Service (Acas) reported that their helpline receives 20,000 phone calls every year in relation to bullying.  Acas claims that bullying at work costs the UK economy £18 billion a year (a combination of sickness-related absences, staff turnover and lowered productivity).
Cyber-bullying is any form of abuse that uses technology to harass a person, such as social media, email and SMS texts. According to UNISON, 80% of workers had experienced some form of cyber-bullying with nearly one in five people facing cyber-abuse at least once a week. Because mobile technology is always 'on' this means that victims often get no break from the abuse - even outside of work hours. 

WELLBEING AT WORK

Companies are becoming more aware of stress and poor mental health at work. They are countering this by promoting "Wellbeing"
Wellbeing can be understood as how people feel and how they function, both on a personal and a social level, and how they evaluate their lives as a whole - New Economics Foundation
Wellbeing can be measured using the Warwick-Edinburgh Mental Well-Being Scale (WEMWBS). This is a questionnaire of 14 positively worded items,  such as ‘I’ve been feeling optimistic about the future’ and ‘I’ve been interested in new things’. Respondents choose the answer that best describes their experience over the last two weeks, using a five point scale: this leads to a score between 14 and 70, with a higher score indicating better wellbeing.
In 2017, nearly half (48 per cent) of UK businesses offered something to promote wellbeing in the workplace. Examples include:
  • stress management seminars
  • free yoga and mindfulness classes
  • desks that can be used standing up
  • provision of showers to encourage physical exercise such as cycling to work
  • employee book clubs or running clubs
  • office garden for breaks
  • subsidised gym membership
  • treadmill desks
  • extended leave programmes for longer-serving employees
  • opportunity to work for up to a month in another country where the company has offices
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APPLYING PSYCHOLOGY TO THE KEY QUESTION
AO2

Any question on your Key Question will be assessing you on AO2 (Application of Concepts and Ideas) so as well as telling the Examiner about aggression and whether it can be helped, you need to explain the psychology behind these ideas.
  • You might get a question in two parts: one part asking you to summarise your Key Question and then another part asking you to use your psychological knowledge (the “apply” command from AO2).
  • Or you might get one question which asks you to explain and apply psychology to your Key Question: in this case, it’s a good idea to write the answer in two “halves”, getting all the explanation out of the way then dealing with the AO2 application.

THE FEATURES OF STRESS IN THE WORKPLACE

The main piece of research into stress is by Hans Selye (1954) who proposed the General Adaptation Syndrome (GAS). This is something that all life forms experience when they are faced with any sort of threat. The organism goes into the alarm stage (reacting to the threat) followed by the resistance stage (keeping the stress response going) and finally the exhaustion stage (when there are no more stress hormones left and the organism suffers disease and disorders).
Psychological Explanation

​The GAS is based on the biological approach, particularly evolutionary theory. The idea is that the GAS is a survival trait for most organisms: it's healthy to be able to go into the alarm stage when you have to hunt or fight or escape (the "fight-or-flight" response) and it's helpful to be able to maintain this body state for a long period. However, human beings did not evolve to work in stressful environments for long periods of time: daily commuting, bullying bosses, deadlines, late shifts, lack of breaks, these are all quite unnatural stressors that can go on for years, wearing down the body's resistance.

However, another explanation comes from the cognitive approach, particularly the negative cognitive triad. This is the idea that we interpret situations as threats where we could be interpreting them as opportunities instead.
Issues for Society

​If modern working environments cause humans stress that they haven't evolved to cope with, it's necessary to change the environment. More breaks and holidays would allow the GAS to 're-set' itself so that workers don't continue in the resistance stage for too long.

If there is a cognitive component to workplace stress, then cognitive behavioural therapy (CBT) might help workers interpret things in their jobs differently, viewing threatening experiences as challenges and viewing their own abilities as enough to meet those challenges.

However, giving workers more breaks and holidays can make businesses less productive and CBT would take up time and cost money to introduce - although it could be argued that so much time is currently lost to stress-related absences that productivity would actually go up​.

SICK BUILDING SYNDROME

SBS is a controversial idea. Originally it was proposed that SBS was caused by some sort of chemical in their air - perhaps something used in modern building techniques, modern air conditioning systems or even mold triggering an allergic reaction. However, researchers are starting to link SBS to more psychological features of the workplace such as isolation, workload, lack of privacy and lack of exercise.
Psychological Explanation

SBS can be linked to the stress response and the General Adaptation Syndrome (above). A chemical or allergen that you are only exposed to for a short period will let your body recover but, if you are exposed to it for long periods, you will enter the exhaustion stage and start getting diseases and disorders.

A study that resembles SBS is the Stanford Prison Experiment (SPE) by Haney, Banks & Zimbardo (1973). In this study, college students played the roles of prisoners and guards in a simulated prison (the converted basement of the Psychology Department). After only 6 days of oppressive treatment, several of the prisoners had become ill and symptoms included physical reactions like rashes. This shows that the prison had become a 'sick building' but it was the psycho-social environment rather than chemicals that had caused this.
Issues for Society

If buildings make people sick, then we need to re-design our buildings. Architects today give a lot more thought to the psychological impact of office design and are less likely to create the cubicles that office workers used to work in: open-plan offices with light, fresh air and opportunities to walk and mingle are being designed today.
Google is a company that takes the idea of a psychologically-healthy workplace very seriously. Check out the psychology-inspired Zurich office at 06:30

COMPUTERS CAUSE DEPRESSION

The research into computers links to the concept of sick buildings. There are biologically-unhealthy aspects of computer work (screen glare, poor posture from sitting at keyboards, repetitive strain from using the mouse, heat from the computer itself) and psychologically-unhealthy aspects of working with computers all day lack of human contact, lack of breaks, lack of variation in the work).
Psychological Explanation

As with sick buildings, computer work is a stressor that humans have not evolved to cope with. Working with machines instead of other humans seems to create anxiety. Harlow's monkey experiments demonstrated that monkeys will prefer the cloth mother that gives comfort over the wire mother that gives food. Zimbardo's Stanford Prison Experiment increased the stress for prisoners by replacing their names with numbers, de-humanising them. Rosenhan (1972) found something similar in mental hospitals where staff did not respond to patients or even make eye contact, leading to deindividuation.
Issues for Society

​​The science of designing things to improve how they work is called ERGONOMICS. There have been many ergonomically re-designed computers and computer desks. For example, it's common to have glare-vizors on office computers to protect workers' eyes from screen glare. However, this will not remove all the frustrations that come from using computers.
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WORKPLACE BULLYING

This is a purely psycho-social phenomenon that can be made worse by office layout (enabling bullying bosses to spy on workers) and computer-use (enabling bullies to harass workers at work and outside working hours).
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Psychological Explanation

Lots of psychology of aggression and prejudice explains workplace bullying. Adorno's theory of the Authoritarian Personality explains the workplace bully who likes to obey the boss and harass juniors. Social Identity Theory explains why a group (such as longstanding employees) might harass someone they see as being from an out-group (such as a new employee). Realistic Conflict Theory explains bullying when people are worried that their job or promotion is at risk.

Most workplace bullying is social (or relational) aggression, which is studied by Brendgen's Twin Study. If bosses see the bully as a 'good manager' who 'pushes his staff' then this behaviour may be rewarded (positive reinforcement) and the bully may be a role-model who is imitated by others (social learning theory).
Issues for Society

The trick for managers is to distinguish between behaviour which is genuinely motivational (such as setting high standards, pushing workers to achieve the best and disciplining workers who break the rules) as opposed to bullying and harassment (which sets impossible standards, pushes workers too far and unfairly selects certain individuals for discipline).

Understanding of workplace bullying has improved in recent years and many business put managers through skills training to recognise bullying behaviours in themselves or others and employ Human Resources (HR) officers to make sure that managers get the best out of staff without causing them emotional or psychological harm.

WELLBEING AT WORK

"Wellbeing" is a bit of a buzz word in modern workplaces, which focus on creating environments that produce happy, healthy, motivated workers rather than allowing staff to become stressed and sick and only dealing with the problem then. Wellbeing Programmes can be expensive to set up and run (either because they involve spending money on new resources or because they involve paying staff to do something other than work), however there is a huge saving to be made by reducing absences due to stress-related illness.
Psychological Explanation

Salvatore Maddi (1981) studied why some workers succumb to stress but others don't. Maddi studied a big company that was laying off workers and noticed that some workers coped with the stress but others became anxious and ill. He used psychometric tests on the workers to come up with the concept of HARDINESS, which is a sort of built-in stress resistance. 

​Hardiness is composed of the 'three Cs':
  • Challenge:  hardy individuals see problems as challenges rather than threats (which there is a tendency to try and avoid); if a problem is a challenge, you look for solutions and pursue the possibilities of a successful outcome.
  • Control: hardy individuals do not become overwhelmed or helpless, but try to gain control of what they can; they develop a positive, optimistic, hopeful outlook and try to feel in charge of circumstances.
  • Commitment: this refers to persevering or sticking it out through a hard time; hardy individuals overcome occasional losses of motivation and remain steadfast in their efforts.
Issues for Society

​Hardiness is about having positive cognitions, so this relates to the cognitive triad and using CBT to help workers cope with stress. However, there is a debate about whether employers should try to build hardiness into their workers or whether they should just try to select for hardiness at the recruitment stage (perhaps getting applicants to fill out questionnaires and just hiring the ones who score high for hardiness).

Hardiness seems to be something people acquire quite early in life and it's harder to change powerful LEARNED COGNITIONS later on. This means that instilling hardiness in children is really a job for parents and teachers.
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This school's policy for promoting hardiness has divided the Internet. Read about it in the Daily Mail.
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EXEMPLAR ESSAY
How to write a 8-mark answer

Discuss the key question you have studied from the Clinical Application, using your knowledge of psychology. (8 marks)
  • A 8-mark “apply” question awards 4 marks for summarising and 4 marks for AO2 (Apply). Don't forget to add a conclusion so that you can get into the top band (7-8 marks).

The Key Question
My Key Question was “What are the issues surrounding mental health in the workplace?”

According to the Health & Safety Executive, in 2016 there were over 480,000 people in the UK reporting that work-related stress was making them ill. This is nearly 40% of all work-related illness. Work stress can come from the demands of the job, lack of support, confusion over role or fear of change.

The psychology behind this would be Hans Selye's General Adaptation System (GAS) which explains how we adapt to short term stress by going into the alarm stage or long term stress by going into the resistance stage. Eventually, we go into the exhaustion stage and start becoming ill. This happens because humans have not evolved to cope with long term stressors like commuting, crowding, noise or pressure for months or years. Side-effects can include depression or rashes, as was noticed by Zimardo in his prison study.

One way to deal with workplace stress is to promote 'Wellbeing'. In 2017, nearly half of UK businesses offered something to promote wellbeing in the workplace, such as yoga and mindfulness classes, subsidised gym membership and opportunities to work for up to a month in another country where the company has offices. Companies like Google have introduced 'sleep pods', table tennis tables and free massages for staff.

The psychology behind this is that breaks let people return from the resistance stage to a normal level of functioning. A different explanation is Maddi's concept of 'hardiness' that makes people resistant to stress. This includes viewing problems as challenges to be overcome, being committed to doing your best and feeling that you are in control of what happens to you - otherwise known as the three Cs. Employers can build up hardiness in staff by focusing on the 3 Cs and using Cognitive Behavioural Therapy (CBT) to get staff to think about and change how they view the pressures of their job.

Conclusion
Since employers in the UK lose 11 million days of work every year due to stress and anxiety, they stand to gain a lot if they can improve mental health in the workplace. This means that offering more breaks and promoting wellbeing makes good economic sense even though there is an up-front cost. Healthy workers don't just take less time off, they also work more productively.

  • Notice that for a 8-mark answer you don’t have to include everything about mental health in the workplace. I haven’t mentioned sick building syndrome or the problem with computers; I haven’t described workplace bullying. But I have tried to make the two halves – Summary and Application – evenly balanced.
  • In 2017, the Key Question came up as a 16 mark question for Unit 2B (Child/Crime/Health) so it could come up as a 20-mark question for Unit 2A (Clinical). For a 20 mark response you'd want to include most of the topics on this page, not just two.
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PSYCHOLOGYWIZARD.NET
  • Home
  • Unit 1 FOUNDATIONS
    • Biological >
      • Adoption & Twin Studies AO1 AO2 AO3 >
        • Gottesman & Shields AO1 AO3
        • Kety AO1 AO3
      • Aggression AO1 AO2 AO3 >
        • Evolutionary Psychology AO1 AO2 AO3
      • The Brain AO1 AO2 >
        • Drugs & the Brain AO1 AO2 AO3
      • Brendgen AO1 AO3
      • Development (Maturation) AO1 AO2 AO3
      • Freud's Psychodynamic Theory AO1 AO3 >
        • Aggression & Freud AO1 AO2 AO3
        • Development & Freud AO1 AO2 AO3
        • Individual Differences & Freud AO1 AO2 AO3
      • Raine AO1 AO3
      • Biological Key Question AO1 AO2
    • Cognitive >
      • Baddeley AO1 AO3
      • Multi Store Model AO1 AO2 AO3
      • Reconstructive Memory AO1 AO2 AO3
      • Schmolck AO1 AO3
      • Tulving's Long Term Memory AO1 AO2 AO3
      • Working Memory AO1 AO2 AO3
      • Cognitive Key Question AO1 AO2
    • Learning >
      • Bandura AO1 >
        • Bandura AO3
      • Becker AO1 AO3
      • Classical Conditioning AO1 AO2 AO3
      • Operant Conditioning AO1 AO2 AO3
      • Pavlov AO1 AO3
      • Social Learning AO1 AO2 AO3
      • Therapies for Phobias >
        • Flooding
        • Systematic Desensitisation
      • Watson & Rayner AO1 AO3
      • Learning Key Question AO1 AO2
    • Social >
      • Agency Theory AO1 AO2 AO3
      • Burger AO1 AO3
      • Situational Factors AO1 AO2 AO3
      • Milgram AO1 >
        • Milgram AO3
      • Realistic Conflict Theory AO1 AO2 AO3
      • Sherif AO1 >
        • Sherif AO3
      • Social Impact Theory AO1 AO2 AO3
      • Social Identity Theory AO1 AO2 AO3
      • Social Key Question AO1 AO2
  • Unit 2 APPLICATIONS
    • Clinical >
      • Depression AO1 AO2 >
        • Biological Explanation AO1 AO2
        • Non-Biological Explanation AO1 AO2
        • Biological Treatment AO1 AO2
        • Psychological Treatment AO1 AO2
      • Diagnosing Abnormality AO1 AO2 AO3
      • Diagnostic Manuals AO1 AO2 AO3
      • Carlsson AO1 AO3
      • Kroenke AO1 AO3
      • HCPC Guidelines AO1 AO2 AO3
      • Rosenhan AO1 AO3
      • Schizophrenia AO1 AO2 >
        • Biological Explanation AO1 AO2
        • Non-biological Explanation AO1 AO2
        • Biological Treatments AO1 AO2
        • Psychological Treatment AO1 AO2
      • Clinical Key Question AO1 AO2
      • Issues & Debates >
        • Social Control AO2 AO3
  • Evaluation
    • Ethics AO1 AO2 AO3
    • Individual Differences AO1 AO2 AO3 >
      • Brain Differences AO1 AO2 AO3 >
        • Personality AO1 AO2 AO3
      • Mental Health Differences AO1 AO2 AO3
      • Differences in Obedience & Prejudice AO1 AO2 AO3
      • Memory Differences AO1 AO2 AO3 >
        • Loftus study AO1 AO2 AO3
    • Nature vs Nurture AO1 AO2 AO3
    • Scientific Status AO1 AO2
  • Methods
    • Animal Studies AO1 AO2 AO3
    • Case Studies AO1 AO2 AO3 >
      • Bradshaw AO1 AO3
      • Scoville & Milner AO1 AO3
    • Content Analyses AO1 AO2 AO3
    • Experimental Method AO1 AO2 AO3
    • Experimental Variables AO1 AO2
    • Hypotheses AO1 AO2
    • Inferential Statistics AO1 AO2 >
      • Chi-Squared Test AO1 AO2
      • Mann-Whitney U Test AO1 AO2
      • Spearman's Rho AO1 AO2
      • Wilcoxon Test AO1 AO2
    • Longitudinal Design AO1 AO2 AO3
    • Quantitative Data & Analysis AO1 AO2 AO3
    • Research Design AO1 AO2 AO3
    • Sampling AO1 AO2 AO3
    • Self Report Method AO1 AO2 AO3 >
      • Brown et al. AO1 AO3
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