Introduction

Aggression is behavior that is forceful, hostile or attacking. It is an intention to cause harm or an act intended to increase relative social dominance. Workplace aggression is any act of aggression, physical assault, threatening or coercive behavior that causes physical or emotional harm in a work setting (Rai, 2002). Aggression at workplace can also be to show or as a result of dissatisfaction and disapproval to other’s action.

Violence is defined by the World Health Organization as the intentional use of physical force or power, threatened or actual, against a person, or against a group or community that either results in or has a high likelihood of resulting in injury, death, psychological harm, mal-development or deprivation. Workplace violence is an action or incident that physically or psychologically harms another person. It includes situations where employees and other people are threatened, attacked or physically assaulted at work (Department of Health, 2004). It ranges from threats and verbal abuse to physical assaults and even homicide. It can affect and involve employees, clients, customers and visitors. Violence is aggression; however aggression does not necessarily imply violence. When people talk about workplace violence they may be referring to a range of hostile acts – from threats and intimidation to homicide.. Workplace aggression includes violent acts as well as nonviolent acts such as harassment, intimidation, and threats that create a hostile work environment.
Aggression can occur at the organizational level and a person might act aggressively based on factors of changes in the work environment, job changes, or injustice. If a person feels that they are not being treated fairly in comparison to others, then they could display aggressive behaviors to their co-workers or even supervisors. Changes in the workplace, such as increased stress, fatigue or anxiety can lead to aggression.
Violence and aggression are workplace hazards. They may cause physical and psychological injury or harm and may result in permanent disability or death. There can also be considerable direct and indirect costs for the organization, including lost productivity while people are not working, repairing property damage, medical and legal expenses.
Unethical as it is, in most of countries aggression and violence at workplace are marked as unlawful activities.

Types of Workplace aggression and violence

Workplace aggression and violence can be separated into three areas: 1) External: perpetrated by someone from outside the organization, such as during armed hold-ups; 2) Client-initiated: inflicted on workers by their customers or clients; and 3) Internal: occurs between workers within the same organization.
Buss identified eight types of aggression (Buss, 1961): 1) Verbal-passive-indirect (failure to deny false rumors about target, failure to provide information needed by target) 2) Verbal-passive-direct ("silent treatment", failure to return communication, i.e. phone calls, e-mails) 3) Verbal-active-indirect (spreading false rumors, belittling ideas or work) 4) Verbal-active-direct (insulting, acting condescendingly, yelling) 5) Physical-passive-indirect (causing others to create a delay for the target) 6) Physical-passive-direct (reducing target's ability to contribute, i.e. scheduling them to present at the end of the day where fewer people will be attending) 7) Physical-active-indirect (theft, destruction of property, unnecessary consumption of resources needed by the target) 8) Physical-active-direct (physical attack, nonverbal, vulgar gestures directed at the target)
So aggression can be physical or verbal, active or passive, direct or indirect.

Forms of workplace aggression and violence

Workplace aggression and violence can take various forms. All forms carry the same quality which causes the receiver to get backed out of the comfort zone. * Threats: A threat is an act of coercion wherein an act is proposed to elicit a negative response. Threat is more common for workers reporting low work group harmony and supervisor sup- port, handling money at work, and being a supervisor (Cole, Grubb, Sauter, Naomi, & Lawless, 1997) * Bullying: Bullying at work means harassing, offending, socially excluding someone or negatively affecting someone’s work tasks, it has to occur repeatedly and regularly (e.g. weekly) and over a period of time (e.g. about six months). Bullying is an escalating process in the course of which the person confronted ends up in an inferior position and becomes the target of systematic negative social acts. A conflict cannot be called bullying if the incident is an isolated event or if two parties of approximately equal ‘strength’ are in conflict. * Physical assault: Physical assault takes place when an individual or a group provokes and attacks a person physically, with or without the use of a weapon, or threatens to hurt that person. Work-related aggression happens through the use of force or threats to a non-consenting victim on the work premises or in the context of the victim’s work. * Verbal abuse: Verbal abuse is described as a negative defining statement told to the person or about the person or by withholding any response thus defining the target as non-existent. If the abuser doesn't immediately apologize and indulge in a defining statement, the relationship may be a verbally abusive one. * Harassment: It is commonly understood as behavior intended to disturb or upset, and it is characteristically repetitive. Harassment is more prevalent when workers reported low levels of work group harmony and co-worker support and increased layoffs in the organization. Women and younger workers were more likely to report being harassed (Cole, Grubb, Sauter, Naomi, & Lawless, 1997). * Intimidation: Intimidation is intentional behavior that "would cause a person of ordinary sensibilities" fear of injury or harm.
An Extreme Form: Workplace Homicide
Aggression and violence at workplace can sometimes take its extreme form: homicide. Workplace homicide rate is increasing in many countries. The figures in each country are alarming. Research by Fox and Levin showed that homicides committed against supervisors and coworkers by disgruntled employees have grown at a disturbing rate in the American workplace (Fox & Levin, 1994). Other researches also show same result in different countries.

Workplace prone to aggression and violence

Studies have shown that some types of work are more prone to acts of aggression in the workplace than others (Douglas & Matinko, 2001). For example, if someone is in an aggressive environment such as handling guns, then they might be more prone to act in an aggressive way. Individuals are more likely to act aggressively with violence when they are in a profession which isolates them from society and where they have a strong sense of lower-class mentality (Douglas & Matinko, 2001).
Research by Trevor Jones et. al. in showed that violence at work is not (usually) a case of ‘bad apples’ or ‘one-offs’, but is better explained as structurally induced because people in these jobs—regardless of their individual socio-demographic characteristics—are at higher risk of violence (Jones, Robinson, Fevre, & Lewis, 2011).
Some workplaces which have regular workplace aggression and violence are: * Health facilities: Staffs in health facilities are most likely to face situations in which other people are most likely in stress. Patients, old peoples, stressed caretakers, visitors, and even colleagues are likely to have stressful situations around them.
Privitera et. al. conducted a survey at Department of psychiatry with multidisciplinary committee. Their survey showed that threat and assault experienced by staff is within a large, multidisciplinary university psychiatric work setting. While experience protects staff, violence still occurs among experienced clinicians. (Privitera, Weisman, Cerulli, Tu, & Groman, 2005).
Pediatric residents are often exposed to verbal threats during the course of their work. They are also at risk of physical assaults by angry patients and/or families. Pediatric residents require more training on how to prevent and respond to workplace violence, and this important topic should be incorporated into the pediatric residency curriculum (Judy & Veselik, 2009)

* Social organizations: Social workers often come in contact with strangers. They come across several people with different types of emotions, moods, attitudes and intentions. Research by Heugten with seventeen social workers showed that they had been bullied in the workplace. Whilst participants had experienced significant distress and reported at least a temporary decline in work-related confidence, most considered themselves wiser as a result of their experiences and did not perceive a lasting diminishment of their professional opportunities (Heugten, 2010).

* Call Center: Call center employees usually have the opportunity to interact with a diverse, geographically large population, and to provide services and support to large numbers of individuals each day. Although satisfying customers can provide substantial intrinsic rewards, the work often takes the form of an assembly line of telephone calls, frequently with customers who are calling to resolve a problem. Difficult or angry customers are encountered often, and absenteeism and burnout are common (Grandey, Dickter, & Sin, 2004).

Effects of Aggression and violence in workplace

There are direct and indirect costs of workplace aggression and violence. The direct costs are easy to identify and include increased employee turnover, additional costs in recruitment and training, increased legal fees, settlement costs, and hiring temporary staff to fill in for those who call in sick or eventually quit, taking valuable company knowledge with them. Indirect costs, while difficult to quantify, can be seen in lowered productivity, high absenteeism, low morale, and a stressful environment. The effects can be generalized as following: * Job dissatisfaction: It is obvious that anyone would be dissatisfied if workplace environment threatens you out of your comfort zone. Aggressive and violent behavior causes other employee to suffer shame, humiliation, and depression, which can affect their non-work life as well as their job performance. Merecz et al. in their research on psychological consequences found out that satisfaction level derived from different aspects of work is inversely correlated with frequency of workplace aggression experiences (Merecz, Drabek, & Moscicka, 2009). This shows that higher number of aggression and violence experiences will decline the satisfaction one will get from the job.

* Burnout: Burnout effect due to aggression and violence in workplace can be divided into three-component syndrome of emotional exhaustion, depersonalization and diminished personal accomplishment experienced due to work performed. In their study, Merecz et al. found out (Merecz, Drabek, & Moscicka, 2009).
There is a strong association between depersonalization and aggression experienced from patients/clients.
Sense of emotional exhaustion is strongly affected by being the target both of clients’ and coworkers’ aggressive behaviors in service sector.

* Somatic Complains: Experience of aggressive behavior results in increased prevalence and higher intensity of somatic complains. (Merecz, Drabek, & Moscicka, 2009).
On her study of bullying on social workers, Kate van Heugten found bullying led to negative personal health effects on bullied employees. Personal health effects included muscle tension, skin rashes, intestinal problems and general debilitation and lack of resistance to infections. Health was affected by over- or under-eating for five of the participants, and problems with sleep for eight [ (Heugten, 2010) ].

* Psychological effects: Workplace aggression and violence is a major source of psychological disorder among employees. In Heugten’s study, amongst psychological effects, stress, distress, anger, shame, fear loss of concentration, loss of confidence and grief were prominent effects [ (Heugten, 2010) ]. Few employees were diagnosed with depression.
Employees having these psychological effects undergo different psychiatric sessions to correct the psychological disorder. Many times the employees have to adopt psychotropic drug.
Workplace bullying is strongly associated with psychotropic drug use. Past exposure to bullying increased the risk for this use. The more frequent and the longer the exposure to bullying, the stronger the association with psychotropic drug uses. Observing bullying on someone else at the workplace was associated with psychotropic drug use. Adjustment for covariates did not modify the results. Additional adjustment for self-reported health and depressive symptoms reduced the magnitude of the associations, especially for men [ (Niedhammer, David, Degioanni, Drummond, & Philip, 2011) ].

Predicting Workplace aggression and violence

Predictors for workplace aggression and violence can be widely categorized as; individual and situational factors. * Individual Factors: Individual factors refer to stable personality traits. Research has shown that individuals do have stable predispositions to engage in certain behaviors and that the manner in which an individual interprets a situation can vary as a function of these stable individual differences, suggesting an important role for individual differences in predicting workplace aggression. [ (Hershcovis, et al., 2001) ]. * Situational Factors: Situational factors refer to aspects of the social context that are perceived by people and are largely influenced by other members of the organization (e.g., organizational injustice). Researchers have suggested that perceived provocations, triggers, or cues are instrumental in predicting aggression [ (Anderson & Bushman, 2002) ]. Provocation may include factors that frustrate a person’s attempt at achieving a goal or a rude or unfair behavior (Anderson & Bushman, 2002). Employees may also engage in workplace aggression as a form of retaliation and that workplace aggression can represent an attempt to restore justice to an unfair situation. In contrast to the individual difference approach, this suggests that aggression is a reaction to a situation. Although most researchers acknowledge that both individual and situational predictors relate to workplace aggression, the debate surrounding which type of predictor explains more variance continues [ (Hershcovis, et al., 2001) ].

Preventing Workplace aggression and Violence

Prevention of workplace aggression and violence focuses on reducing instances of workplace aggression. Programs that incorporate personnel selection, organizational sanctions, and training are recommended. * Personnel selection: Based on a workplace prevention program developed by the United States Postal Service (USPS), Neuman and Baron encourage organizations to use personnel screening and testing to identify potential employees who are likely to behave aggressively before they are even hired. This proactive strategy prevents individuals who are predisposed to aggress from even entering the workplace [ (Neuman & Baron, 1998) ]. * Organizational sanctions: Explicit policies regarding workplace aggression may help organizations to reduce aggression. Employees who perceived that their organization would punish workplace aggressors reported less workplace aggression even when their perceptions of interpersonal justice were high. Neuman and Baron also suggest using organizational policies to curb workplace aggression and to shape strong anti-aggressive organizational norms [ (Neuman & Baron, 1998) ]. * Training: Training is also an important part of a prevention program. Neuman and Baron suggest that training for both supervisors and subordinates should focus on teaching employees methods for dealing with aggression [ (Neuman & Baron, 1998) ]. Similarly, Rai advises that appropriate training should "inform employees that management will take threats seriously, encourage employees to report incidents, and demonstrate management's commitment to deal with reported incidents [ (Rai, 2002) ].

Conclusion and Discussions

Different forms of workplace aggression and violence exist in workplaces. Researches in different countries by different research show consistent result about workplace aggression and violence existence and its increasing trends.
Various areas are more prone to these aggressions and violence. Different researches are conducted to find out those most probable areas. Health sector and social enterprises are shown to be more prone to these aggression and violence. Identifying these areas precisely and predicting aggressive behaviors and violence in these areas should be done.
Effects of aggression and violence in workplace are hazards to the organizations. The organization should be aware that employee’s mental and physical health, psychological intactness and occupational health are keys to high employee productivity.
This leads the organization and its managers to be aware of these hazards. It should consider predicting and preventing any aggressive behavior and violence among its employees.
In context of Nepal, data and researches on workplace aggression and violence are limited. More researches should be done and should be publicly available; also in digital form.

Works Cited
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