Posttraumatic stress in organizations: Types, antecedents, and consequences

Date01 March 2020
AuthorJonathan Williams,Scott David Williams
Published date01 March 2020
Bus Soc Rev. 2020;125:23–40.
Received: 28 January 2020
Accepted: 29 January 2020
DOI: 10.1111/basr.12192
Posttraumatic stress in organizations: Types,
antecedents, and consequences
Scott DavidWilliams
© 2020 W. Michael Hoffman Center for Business Ethics at Bentley University. Published by Wiley Periodicals, Inc., 350 Main Street, Malden,
MA 02148, USA, and 9600 Garsington Road, Oxford OX4 2DQ, UK.
Raj Soin College of Business, Wright State
University, Dayton, OH, USA
Scott David Williams, Raj Soin College of
Business, Wright State University, 3640
Colonel Glenn Hwy, Dayton, OH 45435-
0001, USA
Research indicates that the well-being and productivity of
over 100 million people in the global workforce may be
compromised by posttraumatic stress (PTS). Given that
work-related experiences are often the source of the trauma
that leads to PTS, and that PTS due to any cause can interfere
with employees’ job performance, organizations would do
well to consider the antecedents and consequences of PTS.
This review of research—primarily within fields adjacent
to business—on the types, antecedents, consequences, and
organizational implications of PTS is presented to advance
inquiry within the field of business. The definition of PTS
requires attention to the new classification of complex post-
traumatic stress disorder that can result from threats that are
not life-threatening such as bullying and sexual harassment.
PTS antecedents include organizational and extraorganiza-
tional traumas, and risk and resilience factors. Absenteeism,
impaired cognitive functioning, strained relationships, and
growth are among the consequences of PTS. Organizations
can assist through disaster planning, empathetic leaders,
mental health literacy initiatives, and employee assistance
programs. Many research questions arise that, when an-
swered, will allow organizations to better understand how
they can improve employee productivity and well-being by
attending to PTS.
An estimated three to four percent of employees in the global workforce suffer from posttraumatic
stress disorder (PTSD) and related conditions that can compromise their productivity and well-being.
Rates of traumatic stress are even higher among women, people exposed to combat or terrorism, and
organizations and communities hit by disasters. PTSD is a chronic ailment that can last for years. In
addition to employers’ concerns for their employees’ well-being, there are important business reasons
for organizations to closely examine traumatic stress conditions. PTSD affects work attendance, cog-
nitive performance, and interpersonal relationships. In addition, occupational hazards and dysfunc-
tional employment situations can be the sources of trauma, and in many instances, traumatic stress is
a compensable disability.
In addition to our focus here on PTSD, we include complex PTSD complex posttraumatic stress
disorder (CPTSD), which is a relatively new diagnosis in psychology and psychiatry. Our focus rep-
resents a departure from the prevailing emphasis in business research on common employee stress that
is more routine and episodic. As we will explain, PTSD and CPTSD (hereafter referred to jointly as
PTS) are more enduring and life-affecting conditions than what is normally addressed in research on
“stress in organizations” (cf. Kahn & Byosiere, 1992). Posttraumatic stress (PTS) is not simply high
levels of stress. In the fields of psychology and psychiatry, PTS is a clinical disorder. In legal terms,
PTS is a mental injury. In most cases, PTSD symptoms persist in excess of 5years, and PTSD fails
to remit in over a third of cases, even with treatment (Kessler, Sonnega, Bromet, Hughes, & Nelson,
We contend that PTS is a matter sufficiently distinct from common employee stress to be worthy of
its own research focus, and toward that end, we present a review of extant research on its antecedents,
its consequences, and the organizational implications for prevention and treatment. We begin with a
review of the types of PTS and estimates of its prevalence. Then we present a review of several of its
important antecedents noting that, while some of the precipitating traumas are organizational, many
PTS antecedents are extraorganizational. Important work-related consequences will then be discussed,
including the effects on absenteeism, cognitive functioning, interpersonal relationships, and the po-
tential for posttraumatic growth. The potential for organizations to help prevent the occurrence and
assist with the treatment of PTS through approaches such as disaster planning, empathetic leadership,
mental health literacy initiatives, and employee assistance programs (EAPs) are presented as well.
We conclude by suggesting questions for future research on PTS in organizations that should produce
insights into the potential for reducing the ill-effects of PTS on employees.
PTSD is a consequence of exposure to a traumatic event or series of traumatic events and is a chronic
mental illness. Symptoms of PTSD may be present immediately after the traumatic event, but in some
cases may not present themselves until months or years after the traumatic event. For this article,
we will examine PTSD as a construct, which can be diagnosed using different diagnostic criteria.
Important diagnostic resources are the Diagnostic and Statistical Manual of Mental Disorders, 5th
mental health, post-traumatic stress disorder, resilience, social support,

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