Background. 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.
Methods. 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 reports
from the subjects.
Results. 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.
Conclusions. 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.