Psychological Violence in the Workplace and the Emergence of Reactive Disorders

Abstract

Research on psychological violence in the workplace generally focuses on the emergence of specific disorders, and less often on a broader nosographic framework. This study, which investigates experiences of psychological violence at work, examines reactive disorders associated with such violence, the psychosocial risk factors involved, and the underlying psychological processes. Using a qualitative multiple-case study design with embedded clinical diagnostic assessment, data were collected through the french versions of the Leymann Inventory of Psychological Terror (LIPT), the Mini International Neuropsychiatric Interview (MINI), and a semi-structured interview guide. The findings suggest an association between workplace psychological violence and reactive anxiety disorders, mood disorders, and peritraumatic stress symptoms. These disorders were linked to experiences of separation, inter-individual professional conflicts, work-related stress issues, and verbal threats. The psychological processes involved include vulnerabilities related to negative perceptions of the work environment, anxiety-laden autobiographical memories, and intrusive re-experiencing of workplace violence. This study contributes to the literature by situating workplace psychological violence within a broader nosographic framework of reactive disorders rather than focusing on isolated diagnoses. However, the small sample size and case-study design limit the generalizability of the findings. The results underscore the need to establish independent and confidential listening and psychological support units to assist workers.

Abstrak: Penelitian mengenai kekerasan psikologis di tempat kerja umumnya berfokus pada munculnya gangguan-gangguan tertentu, dan lebih jarang menempatkannya dalam kerangka nosografis yang lebih luas. Studi ini, yang menelaah pengalaman kekerasan psikologis di tempat kerja, mengkaji gangguan reaktif yang terkait dengan kekerasan tersebut, faktor-faktor risiko psikososial yang terlibat, serta proses psikologis yang mendasarinya. Dengan menggunakan desain penelitian kualitatif studi multi-kasus yang dilengkapi dengan asesmen diagnostik klinis, data dikumpulkan melalui versi bahasa Prancis dari Leymann Inventory of Psychological Terror (LIPT), Mini International Neuropsychiatric Interview (MINI), serta panduan wawancara semi-terstruktur. Hasil penelitian menunjukkan adanya hubungan antara kekerasan psikologis di tempat kerja dengan gangguan kecemasan reaktif, gangguan suasana hati, dan gejala stres peritraumatik. Gangguan-gangguan ini berkaitan dengan pengalaman perpisahan, konflik profesional antarindividu, masalah stres terkait pekerjaan, serta ancaman verbal. Proses psikologis yang terlibat meliputi kerentanan yang berkaitan dengan persepsi negatif terhadap lingkungan kerja, ingatan autobiografis yang sarat kecemasan, serta pengalaman ulang intrusif terhadap kekerasan di tempat kerja. Studi ini memberikan kontribusi terhadap literatur dengan menempatkan kekerasan psikologis di tempat kerja dalam kerangka nosografis gangguan reaktif yang lebih luas, alih-alih berfokus pada diagnosis yang terisolasi. Namun, ukuran sampel yang kecil dan desain studi kasus membatasi generalisasi temuan. Hasil penelitian ini menegaskan perlunya pembentukan unit pendengaran dan dukungan psikologis yang independen dan bersifat rahasia untuk membantu para pekerja

INTRODUCTION

Psychological violence in the workplace is increasingly recognized as a major occupational health issue worldwide. In this study, the terms psychological violence, workplace harassment, bullying, and moral harassment are used interchangeably, following Leymann’s conceptualization, to refer to repeated hostile behaviors that undermine an employee’s dignity and psychological integrity (Leymann, 1996).

Beyond prevalence, research consistently highlights the psychological and clinical consequences of workplace violence. Victims frequently report anxiety, depressive symptoms, reduced self-esteem, sleep disturbances, and stress-related disorders (Arnetz, 1998; Einarsen et al., 2015). According to the ILO (2020), repeated exposure to violence and harassment may result in enduring psychological trauma. Although some studies have suggested causal relationships between workplace bullying and severe outcomes such as suicidal ideation (Leach et al., 2017), such causal interpretations must be approached with caution, particularly in non-experimental designs.

Educational institutions present a distinctive context for workplace psychological violence. Employees may face aggression not only from colleagues and supervisors but also from students and parents, creating complex power dynamics and multiple sources of exposure. These specific organizational features increase vulnerability to psychological violence while complicating reporting and protection mechanisms.

Despite the richness of existing research, most studies focus on specific psychiatric diagnoses in isolation (e.g., depression, anxiety, PTSD). Less attention has been paid to a broader nosographic perspective that conceptualizes these manifestations as reactive disorders, understood as maladaptive psychological responses to identifiable stressors. In this study, reactive disorders are approached within internationally recognized nosographic frameworks (DSM-5 and ICD-11), emphasizing the relationship between symptomatology and contextual stressors rather than fixed psychopathological entities (APA, 2013).

The present study therefore aims to (1) describe clinical profiles associated with exposure to psychological violence at work, (2) identify psychosocial risk factors, and (3) explore the psychological processes involved in these reactive manifestations. By adopting a clinical multiple-case study approach, this research seeks to contribute to a more integrated understanding of workplace psychological violence within a nosographic framework.

METHOD

Study design

This study adopts a qualitative multiple-case study design with embedded clinical diagnostic assessment, combining standardized diagnostic instruments and in-depth semi-structured interviews.

Participants and case selection

All participants worked in a private secondary school in Cameroon. Ten individuals were approached; four agreed to participate. Cases were selected based on a maximum variation strategy, considering gender, professional role, duration of exposure, and clinical presentation, in order to capture diverse experiences of workplace psychological violence.

Refusals may be explained by fear of retaliation, concerns about confidentiality, or the perception of work-related difficulties as private matters. Self-selection bias is therefore acknowledged.

Instruments and procedures

The French version of the Leymann Inventory of Psychological Terror (LIPT) was administered to assess exposure to psychological violence. The instrument includes 45 items describing hostile behaviors, with exposure defined as at least one behavior occurring weekly for a minimum of six months (Niedhammer et al., 2006). Administration time was approximately 10–15 minutes.

The Mini International Neuropsychiatric Interview (MINI), French version 5.0, was used to assess DSM-IV/DSM-5 compatible diagnoses. Interviews lasted 20–30 minutes, and diagnoses were established according to standardized scoring algorithms (Lecrubier et al., 2020).

Semi-structured interviews explored personal history, professional experiences, perceived stressors, and psychological coping strategies. All interviews were audio-recorded with consent and transcribed verbatim.

Qualitative analysis and trustworthiness

Interview data were analyzed using thematic content analysis (Bardin, 2013). Coding was conducted by the primary researcher and reviewed through peer debriefing to enhance credibility. An audit trail was maintained to document analytical decisions.

Ethical considerations

Ethical clearance was obtained from the Regional Ethics Committee of West Cameroon. Given the workplace setting, specific measures were implemented to reduce risks of identification or retaliation, including anonymization, interviews conducted outside working hours, and secure data storage. Participants were informed of their right to withdraw at any time. In case of emotional distress, referral information for psychological support services was provided.

RESULTS OF STUDY

Results are presented through an integrative approach linking exposure to psychosocial risks, clinical profiles, and subjective experience.

Participant Profiles

Two men and two women took part in this study. For confidentiality purposes, they were assigned the pseudonyms Arthur, Achille, Athena, and Cleopatra.

Arthur

Arthur is a support staff member (sector supervisor), aged 31, who has held this position for one year. He is a Catholic Christian, lives with a partner, and belongs to the large Bamiléké cultural group. As an adolescent, he was deeply affected by the death of his mother. Following this loss, he went to live with his aunt and her husband, whom he invested as substitute parental figures. At the professional level, Arthur reported being subjected to verbal threats and threats of physical attacks by student’s experiences that triggered intrusive recollections. He also perceives his position as the lowest in the hierarchical structure despite the workload it entails. Arthur feels that his colleagues fail to recognize his efforts and investment in his role.

Cleopatra

Cleopatra has been working as a secretary at the data collection site for one year. She is 27 years old, a member of the Bamiléké ethnic group, lives with a partner, and is the mother of two children. Like Arthur, she struggled with the loss of her mother at age 8. She was subsequently adopted by her maternal aunt. However, she describes persistent conflictual relationships with her cousins, who repeatedly harassed her. Additionally, she shared that separation from her father figure caused significant emotional distress. In the professional sphere, Cleopatra reported frequent threats of dismissal and demeaning comments about her academic background. These experiences have contributed to profound psychological distress.

Athena

Athena has worked as a cleaning technician for 12 years. She is a 38-year-old single woman, mother of four, and belongs to the Bamiléké cultural group. Although she describes a generally stable and secure childhood, she was significantly affected by the sudden death of her father during adolescence. At work, Athena reports conflictual relationships with colleagues, particularly men. She feels belittled and treated “like a child.” She also described being threatened with dismissal by one of her employers, toward whom she now displays avoidance behaviors. She considers her salary inadequate in relation to her workload and feels that her efforts are poorly acknowledged.

Achille

Achille is a 51-year-old general supervisor who has been employed in his school for 20 years. He is married under a polygamous system and father of eight children. He also belongs to the Bamiléké ethnic group. Achille was strongly affected by the separation from his former wife, which also distanced him from the children they had together. Professionally, he reports having been subjected to verbal threats and physical attacks by students. He also describes perceived stress resulting from pressure by the school administration regarding misconduct committed by some of his superior’s acts he feels unable to denounce. He reports a high workload with little autonomy and considers his salary insufficient given his responsibilities.

Findings from Diagnostic Instruments

The following section presents results from the LIPT and the MINI.

LIPT Results

Table 1. LIPT Scores of the Participants

Diagnostic Criteria(N)	Arthur	Cleopatra	Athena	Achilles
Number of checked items among the 45 situations described by Leymann	04	06	05	05
Frequency of the situation(s)	At least once per week	Almost every day	At least once per week	Almost every day
Duration of the situation(s)	7 months	24 months	72 months	60 months
Self-report	Yes	Yes	Yes	Yes

These findings indicate that all participants meet criteria for exposure to psychological violence at work according to the LIPT, based on frequency, duration, and subjective recognition.

Table 2. MINI Diagnostic Findings

Participants	Arthur	Cleopatra	Athena	Achilles
Disorders / Diagnostics
Major Depressive Episode (MDE)	Yes (past)N: 03Onset: 6 years agoDuration: 3 months	Yes (past)N: 05Onset: 19 years agoDuration: 1 year	Yes (past)N: 02Onset: 22 years agoDuration: 2 years	Yes (past)N: 03Onset: 20 years agoDuration: 2 years
MDE with Melancholic Features	No	No	No	No
Dysthymia (Persistent Depressive Disorder)	No	No	No	No
Suicidal Risk	No	No	No	No
(Hypo)manic Episode	Yes (past)N: 02Onset: 6 years agoDuration: 5 months	No	No	Yes (past)N: 01Onset: 1 year ago
Panic Disorder	No	No	Yes (lifetime)	No
Agoraphobia	No	No	No	No
Social Anxiety Disorder	No	Yes (current)	No	No
Posttraumatic Stress Disorder (PTSD)	Yes (past)Age at onset: 31 yearsDuration: 6 months	Yes (past)Age at onset: 26 yearsDuration: 1 year	No	No
Generalized Anxiety Disorder (GAD)	Yes (current)	Yes (current)	Yes (current)	Yes (current)

Note: ^[1] N = number of diagnostic criteria met; onset refers to age at first episode; duration refers to length of the episode; “past” and “current” follow MINI classification rules

MINI Results

All participants met criteria for current generalized anxiety disorder, and all reported at least one past major depressive episode. These findings describe clinical profiles without implying direct causality.

Results from the Interview Analyses

A cross-analysis of the interview data was conducted based on the themes of experiences of loss and separation, interpersonal conflicts in the professional sphere, psychological defense mechanisms, and fantasy life.

Experiences of Loss and Separation

Experiences of loss and separation refer to situations of death and separation from love objects in whom the participants had invested significant emotional attachment.

Arthur was confronted with multiple deaths, including that of his mother, which had a significant emotional impact. He states, “My mother’s death really shook me.” This event may have profoundly affected his psychic structure due to his close bond with the maternal figure and may have triggered feelings of emptiness and loneliness. Following this death, this young adult joined a new household where he developed attachment to substitute parental figures toward whom he feels a moral debt.

Cléopâtre also experienced her mother’s death painfully. She explains: “It really impacted the rest of my life because I had to go live with my aunt in another city.” This bereavement, which

generated significant emotional distress, gave rise to a sense of loss. Her distress was exacerbated by the rupture of family bonds (with siblings and her father) following her adoption, during which she reports having been bullied by her cousins. This resulted in later difficulties establishing healthy interpersonal relationships.

Athena reports having experienced good emotional security with her parents. However, she suffered greatly following the sudden death of her father during adolescence. This generated considerable distress. She explains: “It was really hard to get back on track.” This loss generated feelings of strangeness and helplessness.

For Achille, the separation from his ex-wife altered his relationship with their children. The separation distanced him from them, as they were raised by their mother in a single-parent context. He accuses his ex-wife of having poorly raised the children. He says: “She raised the children badly after I left.” This situation reflects role confusion within the couple and generates feelings of helplessness and frustration for Achille.

Narratives indicate that early experiences of loss may constitute vulnerability factors, potentially influencing later responses to workplace stressors.

Interpersonal Conflicts in the Professional Sphere

Professional conflicts affect all participants in this study.

Arthur reports instances of humiliation from students caught cheating during exams. He notes: “When they’re caught, some react violently, especially when they know they have connections higher up.” Here emerges a sense of helplessness combined with irritability toward both the students and the hierarchy that tolerates such behaviors. This sector supervisor feels devalued by colleagues. He states: “Colleagues belittle us and undermine our work, which is essential for the proper functioning of the school.” This devaluation, a source of suffering and frustration, may generate feelings of inferiority and initially raise questions about the value of his work and his contribution to the professional environment. Later, it fuels a need for recognition and validation.

In Cléopâtre’s case, family conflicts may explain the emergence of professional conflicts just as they accounted for difficulties in her interpersonal and social life. Moreover, her negative self-perception exacerbates situations of control and domination at work. She notes: “The most difficult relationships?... They were mostly at work. I had a supervisor who never missed an opportunity to put me down.” These negative experiences with her supervisor may also be understood as manifestations of unresolved internal conflicts, with the supervisor representing an authority figure embodying judgment, criticism, and rejection.

Athena describes recurrent disrespect from coworkers. The tension she experiences reflects difficulties with self-confidence and self-esteem. She states: “With all these situations, I often feel inferior to my colleagues.” This sense of inferiority is fueled by tense interactions (particularly with male colleagues) and a lack of support or recognition from her work team. Emerging here are feelings of devaluation possibly related to beliefs about gender roles and cultural or organizational stereotypes.

For Achille, interpersonal conflicts at work are tied to role conflicts with supervisors, leading to feelings of not being acknowledged or respected by both superiors and students. This conflict exposes him to humiliating experiences in his work. In his interactions with colleagues and students, Achille seeks to maintain his authority by following rules and seeking supervisors’ approval. Yet he frequently faces humiliation or rejection, reinforcing his sense of powerlessness and frustration. “I have often been humiliated,” he says, expressing anger toward colleagues who, according to him, fail to support him.

Participants described repeated conflicts, humiliation, and threats. These accounts document exposure to psychosocial risks rather than diagnostic conclusions.

Psychological Defense Mechanisms

The most prevalent defense mechanisms among participants when facing work-related stress include rationalization, avoidance, and withdrawal.

Arthur frequently uses rationalization or minimization in his relationships with colleagues. He says: “With them, my relationships are fairly cordial, but arguments are common.” He also uses it in his romantic relationship: “My current relationship is going very well, despite the small disputes and raised voices.” This mechanism allows him to make his suffering acceptable and to present himself as adaptable within his relationships (romantic, social, and professional).

Athena, when feeling insecure about her job and fearing dismissal, resorts to avoidance. She says: “I do everything to avoid confrontation by staying quiet.” Similarly, Achille uses avoidance in conflictual situations involving role conflicts at work. He says: “When there are breaches of the rules, I turn to my superiors to know what to do.” This indicates a sense of insecurity and a fear of taking risks, preventing him from exercising initiative.

Rationalization and avoidance were frequently reported coping strategies, particularly in contexts of perceived powerlessness.

Fantasy Life among Employees

Fantasy life refers to negative representations of work, fears of aggression or dismissal, anxiety about being attacked, work-related stress, and concerns about the rising cost of living.

Negative Representations of Work

Arthur experiences negative representations of his job. He finds it difficult, with long hours and little rest. He says: “My job is quite demanding because you have to be there very early, and it’s not always easy. During exam periods, it gets worse.” This indicates frustration and a sense of strain, heightened by the stress and pressure associated with exam periods.

Athena also expresses negative representations of her job, citing difficult working conditions. She notes: “I do a difficult job. Working conditions are not good because the salary is below minimum wage.” She also describes long hours combined with a lack of recognition: “What bothers me is that they often ask me to work outside my usual schedule […] but they never acknowledge the work you do.” Here we see stress and pressure related to workload, combined with a perceived lack of validation, leading to a desire for recognition.

For Achille, negative representations of work emerge from difficult conditions and inadequate compensation. He says: “Working conditions are not always favorable […]. Over time, the work increases but the salary does not.” He expresses additional pressure and a sense of organizational injustice.

Threats of Aggression

Arthur reports threats and harassment at work. He explains: “I was harassed by some students who were close to my supervisors; they thought they could do anything and even shouted threats. I felt really upset by this.” This illustrates moral harassment and generates feelings of vulnerability, injustice, devaluation, and humiliation. These threats also trigger psychic re-experiencing.

Similarly, Achille fears being physically assaulted by students, having already been threatened verbally (as were all participants) and physically. He states: “Verbal threats happen often. I was even physically attacked by a student once.” These experiences complicate his interactions with students and undermine his legitimacy within the hierarchy.

Threats of Dismissal

Cléopâtre experienced verbal threats from a supervisor. She states: “I had a supervisor who never missed an opportunity to put me down. She even interfered in my private life […]. She threatened to fire me many times.” These situations induce feelings of helplessness and place her under constant pressure and fear of job loss. The supervisor may represent a transfer figure embodying authority.

Athena also reports threats of dismissal, during which she felt irritated, belittled, and intimidated.

Work-Related Stress Issues

Work-related stress issues include low decision-making latitude, lack of recognition, high workload, and reduced interest in work.

Arthur faces low decision-making latitude, which hinders task performance. He says: “I always have to refer to my supervisors to make a decision, which complicates things a lot.” This subordinate position is a source of tension and frustration. Additionally, he experiences a lack of recognition from colleagues and students: “I am at the bottom of the academic hierarchy. I think this job should be valued because students and colleagues belittle us.”

Cléopâtre experiences high workload pressure with tight deadlines. She notes: “With the deadlines, I’m often so stressed that I sleep and dream about work […] I don’t even take breaks.” Her work-related dreams indicate significant anxiety. She also notes low decision-making autonomy: “Making decisions independently simply doesn’t exist in my position.” This lack of autonomy fuels doubts about her place and role in the work environment. This contributes to her loss of interest: “Sometimes I tell myself it's not worth it.”

Like Arthur and Cléopâtre, Athena faces low decision-making latitude, generating frustration and irritability. She says: “I wish they wouldn’t treat me like their go-to person […] as if I were a child.” This evokes feelings of exclusion related to gender-based or value-based discrepancies.

Achille, as previously mentioned, faces role conflicts that produce significant stress and pressure. He states: “They accuse me of not doing my job well […] I can’t say that the supervisors always do things right. It might backfire on me.” His fear of consequences, particularly job loss, is evident: “I could even lose my job. So I swallow things and stay quiet.” This highlights anxiety, loyalty to his job, and willingness to tolerate adversity to avoid unemployment.

He also expresses a lack of recognition similar to other participants: “I think what I do here is really important […] Others tend not to see it.” This perceived lack of recognition reinforces his need for validation from colleagues and supervisors.

Negative representations of work, fears of aggression or dismissal, and work-related stress illustrate the subjective impact of chronic exposure to workplace violence.

DISCUSSION

Employees resort to rationalization as a way to protect themselves from potential stress arising in intersubjective workplace conflicts. This particular defense mechanism consists of substituting a plausible explanation for an act or impulse when a more difficult-to-acknowledge motivation is evident to the observer (Perry et al., 2009). In the case of the aforementioned participants, the use of this defense mechanism serves to mitigate the stressful situation that initially triggered it.

The findings of this study reveal that all participants are victims of psychological violence in the workplace. This is reflected in verbal threats of aggression and dismissal. Such situations of workplace violence generate anxiety and stress among employees. This manifests as job insecurity in the cases of Athena and Cleopatra; feelings of insecurity and helplessness in the cases of Achilles, Arthur, and Cleopatra; lowered self-esteem for Athena; and intrusive recollections for Arthur. In this respect, Arnetz (1998) reports that some psychological consequences of workplace violence and harassment include higher rates of depression, anxiety, and stress, reduced self-confidence and self-esteem, increased insecurity, decreased job satisfaction, as well as similarities between symptoms caused by workplace violence and those of post-traumatic stress. The interview with Cleopatra showed that she had previously experienced moral harassment earlier in her life. In line with this, the work of Andersen et al. (2015) on continuous victimization indicates that having been previously harassed significantly increases the likelihood of being harassed again in the workplace.

Work-related stress factors such as low decision-making latitude, difficult working conditions (high workload, long hours, limited breaks, low remuneration) kept participants in a constant state of anxiety and stress. This resulted in a growing disengagement from work. Nielsen and Einarsen (2012) demonstrate that psychological harassment in the workplace significantly contributes to high turnover intentions, low job satisfaction, and reduced organizational commitment. Work-related stress issues also produced feelings of lack of recognition for the work accomplished, generating frustration and irritability, along with a desire for recognition and a sense of devaluation. Furthermore, following these experiences of violence, Cleopatra expressed a desire to change jobs, reflecting marked job dissatisfaction. The study by Hango and Moyser (2018), previously mentioned in this paper, indicates that workplace harassment can take various forms and have considerable effects on job duration, professional stability, and job satisfaction.

The findings suggest that chronic exposure to psychological violence may contribute to the emergence or exacerbation of reactive disorders through sustained stress, threats to self-esteem, and reactivation of prior vulnerabilities. These mechanisms are consistent with stress-diathesis models and previous research (Arnetz, 1998; Nielsen & Einarsen, 2012). Pre-existing psychological vulnerabilities and past traumatic experiences may also contribute to symptom expression, independent of workplace violence. The present findings should not be interpreted as evidence of causality, given the case-study design and self-selection of participants.

Clinically, these findings highlight the importance of context-sensitive assessment of work-related stress and reactive symptomatology. Organizationally, educational institutions should implement independent psychological support units, with confidential reporting pathways, trained clinicians, and referral mechanisms external to the hierarchy. This study is limited by its small sample size, single-institution context, and reliance on self-reported data. Generalization beyond the cases studied is not warranted.

CONCLUSIONS AND RECOMMENDATION

This study explored how employees experience psychological violence in the workplace by examining clinical profiles, psychosocial risk factors, and underlying psychological processes. The findings suggest that exposure to workplace psychological violence is associated with reactive disorders, particularly anxiety and mood-related manifestations, within a context of cumulative vulnerabilities.

To address these issues, we recommend the establishment of independent psychological support units within educational institutions, ensuring confidentiality, protection from retaliation, and structured clinical referral pathways. Such initiatives could inform broader workplace mental health policies at institutional and ministerial levels.

DECLARATIONS

Ethics Approval And Consent To Participate

Not applicable.

Consent For Publication

Not applicable.

Availability Of Data And Materials

Not applicable.

Conflicts Of Interest Statement

The authors declare that they have no conflicts of interest.

Funding

Not applicable.

Artificial Intelligence-Assisted Technology.

Not applicable.

ABOUT THE AUTHORS

Hassan Njifon Nsangou currently works at Université de Dschang in Cameroun. His researche in Clinical Psychology focused on the expérience of childreen growing up with siblings affected by a dishability in african cultural context.

Chounna Margarette studied clinical psychology and psychopathology at the University of Dschang. She currently resides in Canada where she is pursuing a professional career. Her research interests include workplace violence and disability.

Nguegno Fouadjo Martial is currently a PhD candidate in the psychology department at the University of Douala. A clinical psychologist, he is interested in the processing of psychological suffering among internally displaced persons in the context of armed conflict.

Messanga Gustave Adolphe, Ph. D, is a Full Professor of Social Psychology at the University of Dschang. He is interested in issues related to the social psychology of intergroup relations particularly in non-WEIRD repressive contexts. He is author of papers published in reputed journals as well as reviewer in several indexed journals.