Hostile Attributions, Victimization and PTSD Among Social Workers in Israel

Background and purpose: Client aggression against social workers has been documented as a major problem worldwide. The current study represents a survey of 305 social workers, documenting the relations between the tendency for hostile attribution, different forms of client's aggression, and stress symptoms. It was hypothesized that (1)the tendency for hostile attribution among workers, would mediate between victimization and higher levels of PTSD, (2)physical aggression by clients towards social workers would account more for PTSD symptoms than other forms of aggression, such as verbal aggression or property damage.

Methods: the study was designed as a cross sectional survey. It encompassed 305 social workers in 16 general municipal welfare agencies throughout Israel. The survey was designed purposefully to represent the different municipal layout of general municipal welfare agencies throughout the country, and included cities, small towns, rural agencies and encompassed both Jewish and Arab municipalities as well as mixed ones. The majority of respondents were women (87.4%), with average age 42 (sd=8.9). The instruments of the survey included a measure of hostile attribution, a measure of client aggression towards social workers (3 subscales: a. verbal & threats, b. property directed aggression, c. physical and use of media), a measure of PTSD (PDS, Foa et al. 1997), and a measure of somatic ailments (a confirmatory factor analysis proved that both scales represent the same construct of posttraumatic stress symptoms). All scales had a satisfactory level of internal reliability (Chronbach's Alpha >0.75). Final analysis was carried out using descriptive statistics, and correlations in SPSS-17, and structural equation modeling (SEM) in AMOS-7 software.

Results: The hypotheses were partially supported. PTSD symptoms were positively correlated with all three forms of aggressive victimization, with the highest correlation with the physical violence and use of media for intimidation and harassment (r=.45). Incorporating all predictors into a SEM meditative model, indicated that whereas the tendency to attribute hostility was positively associated with higher levels of PTSD symptoms (ß=0.20), the relation was direct and not mediated through victimization. Moreover, hostile attribution had no significant correlation with neither of the aggressive victimization scales. Of the three aggressive victimization subscales, verbal aggression and physical aggression were indicated as as significant in predicting PTSD symptoms (ß=0.17 & ß=0.47, respectively).

Conclusions and implications: The issue of aggression against social workers has been sporadically studied over the years throughout the world. Yet, there is a dearth of knowledge regarding this issue, its causes, and outcomes. The current paper indicated the need to explore the outcomes of aggressive attacks on social workers, the need to separate the effects of different forms of client aggression, and especially indicates the importance of examining the impacts of new forms of intimidation and harassment that arise with the development of new technology. Such forms of harassment and intimidation were found to be associated with physical violence against social workers, and higher levels of PTSD and related somatic ailments. The implications for practice and further research will be discussed.