Predictors of work ability among victims of severe interpersonal violence: a file-based study in Germany

Background: Work ability has been rarely studied among victims of violence.Objective: The study aimed at identifying predictors of work ability among victims of severe violence.Method: In a retrospective file-based study, characteristics of 189 adult victims of violence from Germany were obtained using a standardized category system. We used decision tree analysis to examine predictors of the occupational status after victimization.Results: The average age of victims (64.6% female) at the time of the crime was 30 years. Mostly physical (41.8%) and sexual violence (39.2%) was reported. 85.2% of the victims had at least one mental disorder, most commonly posttraumatic stress disorder (PTSD; 55.5%) and depressive disorders (23.3%). 50.3% of victims were unemployed, and work-related participation was the most impaired participation domain. Decision tree analysis revealed the sex of the victim as the first predictor of occupational status, with women more likely to be unemployed than men. Among women, diagnosis of a depressive disorder differentiated best between unemployment and employment, while in men, multiple victimizations emerged as the strongest predictor of unemployment; however, very few multiply victimized men in our sample (n = 10) warrant cautious interpretation.Conclusions: Victims of severe violence are substantially impaired in their work ability. Given the adverse individual and socioeconomic consequences of unemployment, an early focus on work-related participation seems highly relevant. Our study suggests that female victims and those with depressive disorders might be in particular need for these measures, but prospective studies are required to back this implication. Low-threshold access to trauma clinics represents an important step and could be complemented by work-focused interventions.