Title:
Work organization and mental health problems in PhD students
工作组织与博士生心理健康问题

Keywords:
Mental health 心理健康
GHQ-12 一般健康问卷.
Work organization 工作组织
Psychosocial working conditions 心理社会工作条件
PhD students 博士生

Abstract:
Research policy observers are increasingly concerned about the potential impact of current academic working conditions on mental health, particularly in PhD students. The aim of the current study is three-fold. First, we assess the prevalence of mental health problems in a representative sample of PhD students in Flanders, Belgium (N = 3659). Second, we compare PhD students to three other samples: (1) highly educated in the general population (N = 769); (2) highly educated employees (N = 592); and (3) higher education students (N = 333). Third, we assess those organizational factors relating to the role of PhD students that predict mental health status. Results based on 12 mental health symptoms (GHQ-12) showed that 32% of PhD students are at risk of having or developing a common psychiatric disorder, especially depression. This estimate was significantly higher than those obtained in the comparison groups. Organizational policies were significantly associated with the prevalence of mental health problems. Especially work-family interface, job demands and job control, the supervisor’s leadership style, team decision-making culture, and perception of a career outside academia are linked to mental health problems.
研究政策的观察者越来越关注当前学术工作条件对心理健康的潜在影响，特别是在博士生中。本研究的目的有三个。首先，我们评估了比利时佛兰德斯（N=3659）一个有代表性的博士生样本中心理健康问题的患病率。其次，我们将博士生与其他三个样本进行比较：（1）普通人群中受过高等教育的（N=769）；（2）受过高等教育的雇员（N=592）；（3）受过高等教育的学生（N=333）。第三，我们评估了与博士生角色相关的组织因素，这些因素可以预测心理健康状况。结果基于12种心理健康症状（GHQ-12）的调查显示，32%的博士生有患或发展普通精神疾病的危险，尤其是抑郁症。这一估计值明显高于对照组的估计值。组织政策与心理健康问题的发生率显著相关。尤其是工作-家庭界面、工作要求和工作控制、主管的领导风格、团队决策文化和对学术界以外职业的看法与心理健康问题有关。

1. Introduction
1.1. Mental health concerns at universities

An unfavorable shift in the labor-supply demand balance, a growing popularity of short-term contracts, budget cuts and increased competition for research resources may paint a bleak picture of academic careers for prospective PhD students (e.g. Biron et al., 2008; Petersen et al., 2012; Walsh and Lee, 2015).
劳动力供求平衡的不利变化，短期合同的日益普及，预算削减以及对研究资源的竞争加剧，可能给潜在的博士生描绘出黯淡的学术生涯。

Some studies suggest that stress is more prevalent in younger academics (see e.g. Kinman, 2001), a group that typically faces high levels of job insecurity.
一些研究表明，压力在年轻学者中更为普遍，这一群体通常面临高度的工作不安全感。

As a result, the media increasingly reports testimonies of depression and anxiety, burnout and emotional exhaustion. However, the prevalence of mental health problems as shown in official registries remains low. National figures in 2012 for higher education in the UK, for example, show that approximately one in 500 individuals disclosed a mental health problem to their university(Shaw, 2015). Reluctance to seek help is often caused by fear of stigma, retaliation or the expected negative impact on one’s future career(OECD,
2015).
因此，媒体越来越多地报道有关抑郁和焦虑、精疲力尽和情绪衰竭的证词。然而，如官方登记所示，精神健康问题的流行率仍然很低。例如，2012年英国高等教育的全国数据显示，大约每500人中就有一人向自己的大学透露过心理健康问题。不愿寻求帮助通常是由于担心耻辱、报复或对未来职业的预期负面影响。

1.2. Why is the mental health of PhD students important for research policy?

2. Background and literature review
2.1. PhD students in Flanders, Belgium
2.2. Prior research on mental health in the university sector

First, previous studies have been largely restricted to one specific discipline (especially health and social care) (e.g. El-Ghoroury et al., 2012), campus, department or university (see also Gillespie et al., 2001), and are therefore prone to reflecting discipline or institution related pecificity. Second, the number of published studies focusing on mental health of PhD students is limited (El-Ghoroury et al., 2012), as most studies have focused on the undergraduate level (Peluso et al., 2011). Epidemiological studies provide a plethora of data demonstrating the steadily increasing rates of college students aged between 18 and 24 with diagnosable mental health problems, and there is evidence that students already begin their university careers with mood, anxiety and eating disorders (Blanco et al., 2008). The limited research that is available on graduate students suggests they may be vulnerable to developing depression (Peluso et al., 2011). Other studies, especially European and Australian ones, have tended to utilize samples of university employees in general and mostly reported aggregate findings (Kinman, 2008), making it difficult to draw fine-grained conclusions on the mental health of PhD students as a separate category.
首先，以前的研究主要局限于一个特定学科（特别是卫生和社会保健）、校园、系或大学，因此倾向于重新评价学科或机构相关的特异性。其次，针对博士生心理健康的已发表研究数量有限，因为大多数研究都集中在本科生层面。其次，针对博士生心理健康的已发表研究数量有限，因为大多数研究都集中在本科生层面。其次，针对博士生心理健康的已发表研究数量有限，因为大多数研究都集中在本科生层面。流行病学研究提供了大量数据，证明18岁至24岁的大学生患有可诊断的心理健康问题的比率稳步上升，有证据表明，学生在大学生涯开始时就已经患有情绪、焦虑和饮食障碍。对研究生的有限研究表明，他们可能容易患抑郁症。其他的研究，特别是欧洲和澳大利亚的研究，倾向于使用大学雇员的样本，并且大多报告了总体结果，这使得很难将博士生的心理健康作为一个单独的类别得出精细的结论。

Reported prevalence rates vary considerably, depending on the sample, the specific health problem considered and the measurement instrument being used. Most studies have focused on psychological well-being, psychological distress, or on depression as a specific manifestation of distress. As the issue of mental health is complex and multidimensional, comparison of prevalence rates assessed with different measurement tools should be carried out with caution, as convergent validity between mental health measures is not always high (e.g. Shankman and Klein, 2002).
报告的患病率差异很大，这取决于样本、考虑的具体健康问题和使用的测量工具。大多数研究都集中在心理健康、心理困扰或抑郁症作为困扰的具体表现上。由于心理健康问题是复杂和多层面的，应谨慎地比较使用不同测量工具评估的患病率，因为心理健康测量之间的趋同有效性并不总是很高。

2.3. Work organization and mental health problems in universities

For PhD students, the primary context for their roles as students and researchers is the university. The few studies on PhD students suggest that stress may stem from various problems in the PhD process, such as problems concerning one’s own learning, different aspects of insecurity (financial insecurity, insecurity concerning unwritten rules), frequent evaluation, competitive atmosphere, supervision, relationships to faculty and peers, workload and work-life interface (Appel and Dahlgren, 2003; Kurtz-Costes et al., 2006; Stubb et al., 2011, 2012).
对于博士生来说，他们作为学生和研究人员的主要背景是大学。针对博士生的少数研究表明，压力可能源于博士过程中的各种问题，例如与自己的学习有关的问题、不同方面的职业不安全感（经济不安全、与不成文规则有关的不安全感）、频繁的评估、竞争氛围、监督、与教师和同事的关系、工作量和工作生活界面。

For PhD students in the humanities and social sciences, establishing one’s own research idea (and thus often working in isolation) may constitute more of a challenge in terms of perseverance, given also the lack of consensus over the quality criteria in these fields (Long and Fox, 1995).
对于人文和社会科学领域的博士生来说，建立自己的研究理念（因此常常是孤立地工作）可能是一个更大的挑战，因为在这些领域的质量标准上也缺乏共识。

In Flanders, most PhD students have no prior work experience, implying that the initial PhD phase is associated with taking on new roles, new tasks and responsibilities and entering into new relationships. New work environments might stressful, and this can trigger, among other things, fear of failure (Elliset al., 2015). Fear of failure might also be more prevalent at the end of a PhD track, when funding is running out and the submission deadline is rapidly approaching. This stress is often accompanied by the stress associated with making future career decisions.
在法兰德斯，大多数博士生没有以前的工作经验，这意味着最初的博士阶段与承担新角色，新任务和职责以及建立新的关系有关。 新的工作环境可能会带来压力，除其他外，这可能会引发对失败的恐惧（Elliset等人，2015）。在博士课程结束时，当资金用尽且提交截止日期临近时，对失败的恐惧也可能更加普遍。这种压力通常伴随着做出未来职业决策的压力。对失败的恐惧在博士课程结束时可能更为普遍，因为资金即将耗尽，提交截止日期也在迅速临近。这种压力往往伴随着与未来职业决策相关的压力。

3. Data and methodology
3.1. Sample 1: PhD students
3.2. Sample 2: comparison groups
3.3. Variables
3.3.1. Mental health problems
3.3.2. Work context
3.3.4. Sociodemographics
3.4. Analytical strategy

4. Results

In Table 4 we assessed the prevalence of mental health problems. Results showed that 51% of PhD students experienced at least two symptoms (GHQ2+), 40% reported at least three symptoms (GHQ3+), while 32% reported at least four symptoms (GHQ4+).
在表4中，我们评估了精神健康问题的患病率。结果显示，51%的博士生出现至少两种症状（GHQ2），40%的博士生出现至少三种症状（GHQ3），32%的博士生出现至少四种症状（GHQ4）。

The percentages in columns 2–4 in Table 4 clearly demonstrate that, in terms of mental health problems, PhD students were consistently more affected (as indicated by the higher number of symptoms) than the highly educated general population, highly educated employees and higher education students.
表4第2列和第4列中的百分比清楚地表明，就心理健康问题而言，博士生始终比受过高等教育的普通人群、受过高等教育的雇员和受过高等教育的学生受到更大的影响（表现为更多的症状）。

For psychological distress (GHQ2+), the prevalence was about twice as high in PhD students compared to the highly educated general population (RR=1.90) and highly educated employees (RR=2.02).
对于心理困扰（GHQ2），博士生的患病率是普通高学历人群（RR 1.90）和高学历员工（RR 2.02）的两倍。

The odds of experiencing at least two psychological symptoms were 34% higher for female PhD students than for males (OR = 1.336); the odds of having at least four symptoms was 27% higher (OR = 1.273). Age was not significantly associated with mental health. The OR for having partner was 0.779 for GHQ2+, indicating that having a partner was associated with lower levels of psychological distress. As for having children in the household, Table 5 shows that there was no association with GHQ2+. However, there was a significant OR of 0.653 for the GHQ4+, indicating that those persons having one or more children in the household showed significantly lower odds of having or developing a common psychiatric disorder.
女性博士生出现至少两种心理症状的几率比男性高34%（或1.336）；出现至少四种心理症状的几率高27%（或1.273）。年龄与心理健康无显著相关。GHQ2中有伴侣的OR为0.779，表明有伴侣与较低水平的心理困扰有关。至于在家里有孩子，表5显示与GHQ2没有关联。然而，GHQ4的OR值为0.653，表明那些在家中有一个或多个孩子的人患或发展普通精神疾病的几率显著降低。

5. Discussion and conclusion
5.1. Contributions

Official registration of both staff and student mental health problems (e.g. depression, anxiety, burnout or emotional exhaustion) by universities is relatively low, which seems to be in stark contrast with the picture painted in media reports.
大学对教职工和学生心理健康问题（如抑郁、焦虑、倦怠或情绪衰竭）的正式登记率相对较低，这似乎与媒体报道中描绘的情况形成鲜明对比。

Previous research on well-being and mental health in academia has usually been restricted to one specific discipline or university.
以往学术界对幸福感和心理健康的研究通常局限于某一特定学科或大学。

5.2. Summary of main findings

Our study shows that 51% of the PhD students in Flanders report at least two symptoms on the GHQ-12 (GHQ2+), 40% report at least three symptoms (GHQ3+), while 32% experience at least four symptoms (GHQ4+). These prevalence rates suggest that a sizeable group of PhD students experience psychological distress or is at risk of having or developing a common psychiatric disorder. Most prevalent are feelings of being under constant strain, unhappiness and depression, sleeping problems due to worries, inability to overcome difficulties and not being able to enjoy day-to-day activities. The prevalence of having or developing a common psychiatric disorder was 2.43 times higher in PhD students compared to the highly educated in the general population. It was 2.84 times higher compared to highly educated employees and 1.85 times higher compared to higher education students.
我们的研究表明，51%的佛兰德斯博士生在GHQ-12（GHQ2）上报告至少两种症状，40%报告至少三种症状（GHQ3），而32%经历至少四种症状（GHQ4）。这些患病率表明，相当一部分博士生经历过心理困扰，或者有患或发展普通精神疾病的风险。最普遍的是经常感到紧张、不快乐和抑郁、担心导致睡眠问题、无法克服困难和无法享受日常活动。在普通人群中，博士生患或发展普通精神疾病的患病率是受过高等教育者的2.43倍。与受过高等教育的员工相比高出2.84倍，与受过高等教育的学生相比高出1.85倍。

Multivariate analyses show that work-family conflict is the most important predictor of both psychological distress and a risk of a common psychiatric disorder in PhD students. Another strong predictor is job demands, followed by family-work conflict, job control and inspirational leadership style. A closed decision making culture was found to have a significant impact on risk of psychiatric disorder only.
多变量分析表明，工作家庭冲突是博士生心理困扰和常见精神病风险的最重要预测因子。另一个强有力的预测因素是工作需求，其次是家庭工作冲突、工作控制和鼓舞人心的领导风格。研究发现，封闭的决策文化仅对精神障碍的风险有显著影响。

5.3. Limitations and alternative explanations
5.4. Policy implications

Acknowledgments