Discrimination is defined as the differential treatment of individuals due to their actual or perceived membership in particular groups (Williams et al., 1994). The extent to which individuals experience this differential treatment is usually referred to as perceived discrimination. Meta-analytic findings on perceived discrimination indicate that it is linked to lower levels of psychological well-being (Schmit et al., 2014) as well as deteriorated physical and mental health (Pascoe & Richman, 2009).

Discrimination is frequently encountered in the workplace (Workplace Discrimination, WD) (Hammond et al., 2010), where it can appear in various forms (e.g., gender discrimination, racial discrimination, age discrimination) and at various stages and procedures (e.g., hiring, performance evaluations, promotions, wage gaps, workload). WD has also been linked to poorer psychological well-being when comparing employees who have been exposed to employees who have not been exposed to WD (Hammond et al., 2010; Kim et al., 2020). Thus, the empirical evidence on the negative associations between perceived discrimination and mental health has been extended to WD.

To provide better support for the hypothesis that WD can significantly increase the probabilities of developing a Depressive Disorder (DD), Clausen et al. (2022) conducted a prospective study in the Danish workforce.

Methods

The authors conducted a prospective study in 2015 collecting data at two time points with an interval of six months. At baseline, 4,340 individuals responded (48.5% response rate) and 2,540 responded at the six-month follow-up (58.5%). The final sample of employees, after screening for missing data, was 2,157 (47% women). Participants were asked questions about:

• Perceived work discrimination, with one question from the Danish Psychosocial Work Environment Questionnaire (DPQ) by Clausen et al. (2019), which was: “Have you within the last 12 months experienced discrimination or been treated poorly in your workplace due to e. g. your sex, age, ethnicity, religion, health or sexual orientation?”
• Depressive symptoms, using the Major Depression Inventory (Bech et al., 2001)
• Other factors of the psychosocial work environment (e.g., high workload, relations with colleagues) (Clausen et al., 2019)
• Demographic variables

Logistic regression models were used to analyse the relationship between WD and DD.

Results

Regarding the occurrence of Workplace Discrimination (WD):

• Out of the 2,157 participants, 4.8% reported that they had experienced WD during the past six months
• WD was more frequent among women (6%) compared to men (4.8%)
• Participants who experienced WD also reported high workload, low sense of job control and poor relationships with their colleagues.

Regarding the onset of a Depressive Disorder (DD):

• 8% reported elevated depressive symptoms indicating onset of a DD
• DD onset was more frequent among participants who reported experiencing (15.5%) compared to those who reported not experiencing WD (4.3%).

Overall, the results of the logistic regressions showed that participants who reported experiencing WD were 2.7 times more likely to report high depressive symptoms that indicated the onset of a DD compared to participants who did not report experiencing WD (95% CI 1.38 to 5.40). The probability of a DD increased to 4.5 times (95%CI 1.91 to 10.76) when the authors excluded participants whose scores were very close to the DD cut-off point.

Conclusions

The authors concluded that perceived workplace discrimination can significantly increase the risk of employees developing severe depressive symptomatology and lead to the onset of a depressive disorder. Additionally, the authors highlighted that this relationship can be affected and differentiated by other work-related variables, such as workload and relationships with colleagues.

Strengths and limitations

The authors reported that this was the first study to prospectively examine the relationship between workplace discrimination (WD) and onset of a depressive disorder (DD) collecting data from a large sample of Dutch workers at two time points. The prospective design increased the validity of the findings. The large sample size stratified in 14 job groups adds to the representativeness of the population and lays a foundation for the generalisability of these findings – though the response rate at baseline was slightly below 50% and the attrition rate was substantial as well. It should be noted that the authors controlled for a considerable number of demographic characteristics and included some factors related to the work environment.

As far as the limitations are concerned, the authors reported that the precise nature of discrimination was not recorded, thus it was not possible to (a) identify which forms of discrimination might be more relevant to depression and (b) propose targeted interventions focused on specific forms of discrimination in the workplace. This would have also helped to better understand if perceived discrimination was more common among women due to a higher prevalence of gender discrimination.

Also, the use of self-report measures increases the chances for common-method bias that can affect the relationship between WD and DD. This means that, when the same type of measurement is used to collect data on the dependent and the independent variable, this might affect their relationship by either intensifying or masking it (Podsakoff et al., 2003). In this case, both work discrimination and depressive symptoms were measured with a self-report scale and the extent to which the relationship between WD and DD was affected by common method bias is unknown. Recall bias could also be affecting self-rated measures, while a clinical diagnostic interview would have been a more valid approach to identifying DD onset. Given the data was originally collected in 2015, the events of the latest years – and specifically the changes in the work industry caused by the COVID-19 pandemic – cannot be accounted for.

Additionally, the six-month interval between baseline and follow-up might have been insufficient to observe onset of a DD; collecting another wave of data at a third time-point would have significantly contributed to a better understanding of the longitudinal relationship between WD and DD onset.

This study was conducted in a developed country (Denmark) and thus, we cannot be sure to what extent these findings could be generalised to developing countries and different cultural contexts. A limited number of factors related to the work environment were included, and work-related variables that share strong links with depression – such as burnout (Koutsimani et al., 2019) – were not included.

Implications for practice

While the authors did not suggest direct implications, their findings can potentially help inform future research and practice:

• The Cognitive-Behavioral model for depression could serve as a framework for the relationship between workplace discrimination (WD) and depressive disorder (DD) onset: discrimination is experienced as an offense to the self, which has negative effects for the individual’s views of self-worth (Clausen et al., 2022). This makes the work environment an unpleasant and potentially threatening place and thus exposure to WD could potentially trigger negative thoughts about the self, the world, and future. This provides further support for the role of the Cognitive Triad in the relationship between WD and DD (Berghuis et al., 2020).
• The study highlighted the need for further exploration of the effects of specific forms of discrimination as well as the potential accumulative impact of experiencing more than one form of WD simultaneously or over time.

Statement of interests

I have no competing interests to declare.

Links

Primary paper

Clausen, T., Rugulies, R., & Li, J. (2022). Workplace discrimination and onset of depressive disorders in the Danish workforce: A prospective study. Journal of Affective Disorders, 319, 79-82.

Other references

Bech, P., Rasmussen, N. A., Olsen, L. R., Noerholm, V., & Abildgaard, W. (2001). The sensitivity and specificity of the Major Depression Inventory, using the Present State Examination as the index of diagnostic validity. Journal of affective disorders, 66(2-3), 159-164.

Berghuis, K. J., Pössel, P., & Pittard, C. M. (2020). Perceived discrimination and depressive symptoms: is the cognitive triad a moderator or mediator?. In Child & Youth Care Forum (Vol. 49, No. 4, pp. 647-660). Springer US.

Clausen, T., Madsen, I. E., Christensen, K. B., Bjorner, J. B., Poulsen, O. M., Maltesen, T., … & Rugulies, R. (2019). The Danish Psychosocial Work Environment Questionnaire (DPQ). Scandinavian Journal of Work, Environment & Health, 45(4), 356-369.

Hammond, W. P., Gillen, M., & Yen, I. H. (2010). Workplace discrimination and depressive symptoms: A study of multi-ethnic hospital employees. Race and social problems, 2(1), 19-30.

Kim, G., Kim, J., Lee, S. K., Sim, J., Kim, Y., Yun, B. Y., & Yoon, J. H. (2020). Multidimensional gender discrimination in workplace and depressive symptoms. Plos one, 15(7), e0234415.

Koutsimani, P., Montgomery, A., & Georganta, K. (2019). The relationship between burnout, depression, and anxiety: A systematic review and meta-analysis. Frontiers in psychology, 284.

Pascoe, E. A., & Smart Richman, L. (2009). Perceived discrimination and health: a meta-analytic review. Psychological bulletin, 135(4), 531.

Podsakoff, P. M., MacKenzie, S. B., Lee, J. Y., & Podsakoff, N. P. (2003). Common method biases in behavioral research: a critical review of the literature and recommended remedies. Journal of applied psychology, 88(5), 879.

Schmitt, M. T., Branscombe, N. R., Postmes, T., & Garcia, A. (2014). The consequences of perceived discrimination for psychological well-being: a meta-analytic review. Psychological bulletin, 140(4), 921.

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