literature review of conflict management

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Conflict management.

Patricia Elgoibar , Patricia Elgoibar University of Barcelona
Martin Euwema Martin Euwema Katholieke Universiteit Leuven
and Lourdes Munduate Lourdes Munduate University of Seville
https://doi.org/10.1093/acrefore/9780190236557.013.5
Published online: 28 June 2017

Conflicts are part of nature and certainly part of human relations, between individuals, as well as within and between groups. Conflicts occur in every domain of life: family, work, and society, local and global. Conflict management, therefore, is an essential competency for each person. People differ largely in their emotional and behavioral responses to conflict and need to learn how to behave effectively in different conflict situations. This requires a contingency approach, first assessing the conflict situation, and then choosing a strategy, matching the goals of the party. In most situations, fostering cooperative relations will be most beneficial; however, this is also most challenging. Therefore, constructive conflict management strategies, including trust building and methods of constructive controversy, are emphasized. Conflict management, however, is broader than the interaction of the conflicting parties. Third-party interventions are an essential element of constructive conflict management, particularly the assessment of which parties are intervening in what ways at what escalation stage.

cooperation
competition
conflict behavior
conglomerate conflict behavior
constructive conflict management
conflict resolution strategies

Definition of Conflict

Conflicts are part of nature, and certainly part of human relations. People experience conflict with other persons, in teams or in groups, as well as between larger entities, departments, organizations, communities, and countries. Conflicts appear at home, at work, and in our spare-time activities with friends, with people we love and with people we hate, as well as with our superiors and with our subordinates and coworkers. Parties need to accept conflicts as part of life dynamics and learn to deal with them effectively and efficiently. Conflict management refers to the way we manage incompatible actions with others, where others can be a person or a group.

Conflict is a component of interpersonal interactions; it is neither inevitable nor intrinsically bad, but it is commonplace (Coleman, Deutsch, & Marcus, 2014 ; Schellenberg, 1996 ). In the 20th century , Lewin ( 1935 ) concluded that an intrinsic state of tension motivates group members to move toward the accomplishment of their desired common goals. Later on, Parker Follett ( 1941 ) explored the constructive side of conflict and defined conflict as the appearance of difference, difference of opinions or difference of interests. Deutsch ( 1949 ) developed this line of thought and analyzed the relation between the way group members believe their goals are related and their interactions and relationships.

A common definition of conflict argues that there is a conflict between two (or more) parties (individuals or groups) if at least one of them is offended, or feels bothered by the other (Van de Vliert, 1997 ; Wall & Callister, 1995 ). Traditionally, conflict has been defined as opposing interests involving scarce resources and goal divergence and frustration (Pondy, 1967 ). However, Deutsch ( 1973 ) defined conflict as incompatible activities: one person's actions interfere, obstruct, or in some way get in the way of another's action. Tjosvold, Wan, and Tang ( 2016 ) proposed that defining conflict as incompatible actions is a much stronger foundation than defining conflict as opposing interests, because conflicts also can occur when people have common goals (i.e., they may disagree about the best means to achieve their common goals). The key contribution of Deutsch’s ( 1973 ) proposal is that incompatible activities occur in both compatible and incompatible goal contexts. Whether the protagonists believe their goals are cooperative or competitive very much affects their expectations, interaction, and outcomes as they approach conflict (Tjosvold et al., 2016 ).

Characteristics of Conflict

Euwema and Giebels ( 2017 ) highlighted some key elements of conflict.

Conflict implies dependence and interdependence. Parties rely to some extent on the other parties to realize their goals (Kaufman, Elgoibar, & Borbely, 2016 ). This interdependence can be positive (a cooperative context), negative (a competitive context), or mixed. Positive interdependence is strongly related to cooperative conflict behaviors, while negative interdependence triggers competitive behaviors (Johnson & Johnson, 2005 ). Interdependence also reflects the power difference between parties. A short-term contractor on a low-paid job usually is much more dependent on the employer than vice versa. Many conflicts, however, can be seen as “mixed motive” situations.

Conflicts are mostly mixed motive situations because parties have simultaneous motives to cooperate and motives to compete. Parties are, on the one hand, dependent on each other to realize their goal, and, on the other hand, they are at the same time competitors. For example, two colleagues on a team are cooperating for the same team result; however, there is competition for the role as project leader. In a soccer team, the players have a team goal of working together to win, but they can be competing to be the top scorer. The mixed motive structure is very important to understand conflict dynamics. When conflicts arise, the competitive aspects become more salient, and the cooperative structure often is perceived less by parties. Interventions to solve conflict, therefore, are often related to these perceptions and the underlying structures.

Conflict is a psychological experience. Conflict is by definition a personal and subjective experience, as each individual can perceive and manage the same conflict in a different manner. Conflict doesn’t necessarily have an objective basis (Van de Vliert, 1997 ). It depends on the perception of the specific situation, and the perception is by definition subjective and personal.

Conflict concerns cognitive and affective tension. When someone perceives blocked goals and disagreements, he or she can also, although not necessarily, feel fear or anger. Many authors consider that conflict is emotionally charged (Nair, 2007 ; Pondy, 1967 ; Sinaceur, Adam, Van Kleef, & Galinky, 2013 ), although the emotion doesn’t need to be labeled necessarily as a negative emotion. Some people actually enjoy conflict. Emotional experiences in conflict are also scripted by cultural, historical, and personal influences (Lindner, 2014 ).

Conflict can be unidirectional. One party can feel frustrated or thwarted by the other while the second party is hardly aware of, and doesn’t perceive the same reality of, the conflict.

Conflict is a process. Conflict is a dynamic process that does not appear suddenly, but takes some time to develop and passes through several stages (Spaho, 2013 ). Conflict is the process resulting from the tension in interpersonal interactions or between team members because of real or perceived differences (De Dreu & Weingart, 2003 ; Thomas, 1992 ; Wall & Callister, 1995 ).

Type of Conflict: Task, Process, and Relationship Conflict

Early conflict and organizational research concluded that conflict interferes with team performance and reduces satisfaction due to an increase in tension and distraction from the objective (Brown, 1983 ; Hackman & Morris, 1975 ; Pondy, 1967 ; Wall & Callister, 1995 ). Jehn ( 1995 ) differentiated between task and relational conflict, and later also included process conflict (De Wit, Greer, & Jehn, 2012 ). Task conflict refers to different opinions on content (Jehn & Mannix, 2001 ). Examples of task conflict are conflict about distribution of resources, about procedures and policies, and judgment and interpretation of facts (De Dreu & Weingart, 2003 ). Process conflict refers to how tasks should be accomplished (Jehn, Greer, Levine, & Szulanski, 2008 ). Examples are disagreements about logistic and delegation issues (Jehn et al., 2008 ). Finally, relationship conflict refers to “interpersonal incompatibility” (Jehn, 1995 , p. 257). Examples of relationship conflict are conflict about personal taste, political preferences, values, and interpersonal style (De Dreu & Weingart, 2003 ). All three types of conflict—task, process, and personal (relational) conflicts—are usually disruptive, especially personal conflict, which is highly disruptive (De Dreu & Weingart, 2003 ; Jehn, 1995 , 1997 ). A review and meta-analysis by De Wit et al. ( 2012 ) showed that, under specific conditions, task conflict can be productive for teams. Moreover, conflict can wreck a team’s efforts to share information and reach a consensus (Amason & Schweiger, 1994 ). Therefore, research supporting the benefit of task and relationship conflict is not conclusive and each situation varies. What seems to be clear is that managing conflict efficiently to avoid escalation is a priority for teams.

Conflict Behavior, Conflict Management, and Conflict Resolution

Conflict behavior, conflict management, and conflict resolution are different layers of a conflict process and therefore should be distinguished. Conflict behavior is any behavioral response to the experience of frustration, while conflict management is the deliberate action to deal with conflictive situations, both to prevent or to escalate them. Also, conflict management is differentiated from conflict resolution, which is specific action aimed to end a conflict.

Conflict Behavior

Conflict behavior is the behavioral response to the experience of conflict (Van de Vliert et al., 1995 ). Conflict behavior is defined as one party’s reaction to the perception that one’s own and the other party’s current aspiration cannot be achieved simultaneously (Deutsch, 1973 ; Pruitt, 1981 ; Rubin, Pruitt, & Kim, 1994 ). It is both what people experiencing conflict intend to do, as well as what they actually do (De Dreu, Evers, Beersma, Kluwer, & Nauta, 2001 ; Van de Vliert, 1997 ). In conflict situations people often respond primarily, following their emotions, more or less conscientiously.

Many factors affect how people respond to the experience of conflict. Social psychology shows the processes are largely unconscious (Wilson, 2004 ). For example, how people respond to intimidating behavior by their supervisor might be primarily influenced by the context and individual perception, as well as previous relations with persons in authority, including parents and teachers (Gelfand & Brett, 2004 ; Van Kleef & Cote, 2007 ). These natural behavioral responses are also referred to as “conflict styles.” They are rooted in our personality and can differ in context. Some people will naturally respond by being friendly and accommodating, where others will start arguing or fighting (Barbuto, Phipps, & Xu, 2010 ; Kilmann & Thomas, 1977 ; Van Kleef & Cote, 2007 ).

Conflict behavior becomes more effective once we are more aware of our natural tendencies and are also able not to act upon them, and instead to show flexibility in behavioral approaches. This is where conflict behavior becomes conflict management. Therefore, one can be a naturally highly accommodating person who will spontaneously give in to others who make demands, but one will be more effective after learning to assess the situation at hand and to carefully decide on a response, which might be quite different from the natural or spontaneous reaction.

Dual-Concern Model

The dual-concern model holds that the way in which parties handle conflicts can de described and is determined by two concerns: concern for self (own interests) and concern for others (relational interests) (Blake & Mouton, 1964 ; Pruitt & Rubin, 1986 ; Rahim, 1983 ; Thomas, 1992 ; Van de Vliert, 1999 ) (see Figure 1 ). Usually, the two concerns define five different conflict behaviors: forcing, avoiding, accommodating, compromising, and problem solving or integrating. These behaviors are studied at the level of general personal conflict styles, closely connected to personality, as well as at the level of strategies and tactics (Euwema & Giebels, 2017 ).

The different conflict styles have been studied intensively, with three approaches. A normative approach, wherein integrating (also known as problem solving) is seen as the preferred behavior for conflict resolution; a contingency approach, exploring conditions under which each of the behaviors is most appropriate; and a conglomerate approach, focusing on a combination of the behaviors (see “ Conglomerate Conflict Behavior ”).

Figure 1. Dual-concern model.

In forcing, one party aims to achieve his or her goal by imposing a solution onto the other party. Concern for one’s own interests and own vision is what matters. There is little attention and care for the interests and needs of the other party, or the relationship with the other (Euwema & Giebels, 2017 ). This style is appropriate when the outcome is important for one party but trivial to the opponent, or when fast decision making is necessary. It becomes inappropriate when issues are complex, when both parties are equally powerful, when the outcome is not worth the effort for one party, or when there is enough time to make a collective decision. Moreover, forcing decisions can seriously damage a relationship and contribute to bullying in the workplace (Baillien, Bollen, Euwema, & De Witte, 2014 ); however, normative forcing, which is referring to rules and imposing them, can be effective (De Dreu, 2005 ). Note that some alternative terms that have been used for forcing in the literature are competitive , contending , or adversarial behavior .

With avoiding, one party aims to stay out of any confrontation with the other. This behavior prevents efforts to yield, to negotiate constructively, or to compete for one’s own gains. The conflict issue receives little attention, usually because the avoiding party thinks he or she won’t gain from entering into the conflict (Euwema & Giebels, 2017 ; Van de Vliert, 1997 ). Avoiding may be used when the benefits of resolving the conflict are not worth confronting the other party, especially when the problem is trivial or minor; when no good solutions are available for now; or when time is needed (Van Erp et al., 2011 ). An important motive for avoiding also is to prevent loss of face and to maintain the relationship. This is particularly true in collectivistic cultures, particularly in Asian societies (Oetzel et al., 2001 ). Avoiding is inappropriate when the issues are important to a party, when the parties cannot wait, or when immediate action is required (Rahim, 2002 ). Rubin, Pruitt, and Kim ( 1994 ) distinguished between long-term avoidance, which is a permanent move to leave the conflict, and short-term avoidance, defined as temporary inaction.

Accommodating

Accommodating is giving in or going along with the ideas, wishes, and needs of the other party. Accommodating usually is the result of a low concern for one’s own conflictive interests combined with a high concern for the interests and needs of the other party. Giving in often is related to a strong need for harmony and a sensitivity to the needs of the other. Accommodation is useful when a party is not familiar with the issues involved in the conflict, when the opponent is right, when the issue is much more important to the other party, and in order to build or maintain a long-term relationship, in exchange for future consideration when needed. Giving in also can be an educational strategy, giving space to the other to find out what the effect will be. Accommodating is less appropriate when the issue is of great concern, when accommodation creates frustration, or when accommodation reinforces dynamics of exploitation (Spaho, 2013 ). Note that an alternative term for this concept that can be found in the literature is yielding .

Compromising

Compromising involves searching for a middle ground, with an eye on both one’s own interest and the interest of the other. The premise is that both parties must find a middle ground where everyone receives equal consideration, meaning that each party makes some concession (Van de Vliert, 1997 ). Compromising is appropriate when a balance of forces exists and the goals of parties are mutually exclusive (Buddhodev, 2011 ). Compromise leads to a democratic solution; however, it may prevent arriving at a creative solution to the problem and a limited effort to increase resources before distributing them (Spaho, 2013 ).

Problem Solving or Integrating

Problem solving is a win–win strategy aimed at “optimizing rather than satisfying the parties” (Van de Vliert, 1997 , p. 36). Great value is attached to one’s own interests and vision, but also a lot of attention is given to the needs, ideas, and interests of the other. One looks for open and creative solutions that meet both interests. Problem solving or integrating is useful in dealing with complex issues, and it allows both parties to share skills, information, and other resources to redefine the problem and formulate alternative solutions. It is, however, inappropriate when the task is simple or trivial, and when there is no time. Also, it is more difficult to develop when the other party does not have experience in problem solving or when the parties are unconcerned about the outcomes (Pruitt & Rubin, 1986 ). Note that some alternative terms that can be found in the literature for this concept are cooperation and collaboration .

The dual-concern model is used as a contingency model, describing which conflict behaviors are used best under what conditions (Van de Vliert et al., 1997 ), and also as a normative model, promoting integrating behaviors as the most effective style, particularly when it comes to joined outcomes and long-term effectiveness. Forcing, in contrast, is often described as a noncooperative behavior, with risk of escalated and unilateral outcomes (Blake & Mouton, 1964 ; Burke, 1970 ; Deutsch, 1973 ; Fisher & Ury, 1981 ; Pruitt & Rubin, 1986 ; Rahim, 2010 ; Thomas, 1992 ). As a result, authors define forcing and integrating as two opposed behavioral approaches (Tjosvold, Morishima, & Belsheim, 1999 ). Following this model, many scholars during the 1970s and 1980s proposed that individuals use a single behavior in conflict, or that the behaviors should be seen as independent. Therefore, the antecedents and effects of different conflict behaviors are often analyzed separately (Tjosvold, 1997 ; Volkema & Bergmann, 2001 ). However, parties usually try to achieve personal outcomes, and try to reach mutual agreements by combining several behaviors in a conflict episode (Van de Vliert, 1997 ). This is the basic assumption of the conglomerate conflict behavior (CCB) theory (Van de Vliert, Euwema, & Huismans, 1995 ), which established that conflict behaviors are used in a compatible manner, sequentially or simultaneously.

Conglomerate Conflict Behavior (CCB)

In the dual-concern model, a contrast is made between forcing (contending with an adversary in a direct way) and integrating (reconciling the parties’ basic interests) as two opposed behavioral approaches (Tjosvold et al., 1999 ). However, the CCB framework assumes that individual reactions to conflict typically are complex and consist of multiple components of behavior (Van de Vliert, 1997 , Van de Vliert et al., 1995 ). The CCB theory covers the idea that behavioral components may occur simultaneously or sequentially and that the combination drives toward effectiveness (Euwema & Van Emmerik, 2007 ; Medina & Benitez, 2011 ). The theory has been supported in studies analyzing conflict management effectiveness in different contexts, such as in managerial behavior (Munduate, Ganaza, Peiro, & Euwema, 1999 ), in military peacekeeping (Euwema & Van Emmerik, 2007 ) and by worker representatives in organizations (Elgoibar, 2013 ).

The main reason that people combine different behaviors is because conflicts are often mixed-motive situations (Euwema, Van de Vliert, & Bakker, 2003 ; Euwema & Van Emmerik, 2007 ; Walton & McKersie, 1965 ). Mixed-motive situations are described as situations that pose a conflict between securing immediate benefits through competition, and pursuing benefits for oneself and others through cooperation with other people (Komorita & Parks, 1995 ; Sheldon & Fishbach, 2011 ). Therefore, a person's behavior in a conflict episode is viewed as a combination of some of the five forms of conflict behaviors. An example of sequential complex behavior is to first put the demands clearly (forcing), followed by integrating (searching for mutual gains, and expanding the pie), and finally compromising, where distributive issues are dealt with in a fair way. An example of serial complexity can be found in multi-issue conflict, when for some issues conflict can be avoided, while for high priorities, demands are put on the table in a forcing way. Another CCB pattern is the conglomeration of accommodating and forcing. This pattern is sometimes referred to as “logrolling” (Van de Vliert, 1997 , p. 35), and it is a classic part of integrative strategies, to maximize the outcomes for both parties. Logrolling behavior consists of accommodating the high-concern issues of the other party and forcing one’s own high-concern issues. This approach is usually helpful in multi-issue trade negotiations; however, it requires openness of both parties to acknowledging key interests.

How to Explore Your Tendency in Conflict

The most famous and popular conflict behavior questionnaires are:

MODE (Management of Differences Exercise). MODE, developed in 1974 by Thomas and Killman, presents 30 choices between two options representing different conflict styles.

ROCI (Rahim's Organizational Conflict Inventory). The ROCI is a list of 28 items that measures the five styles of conflict behavior described.

Dutch Test of Conflict Handling. This list of 20 items measures the degree of preference for the five styles (Van de Vliert & Euwema, 1994 ; De Dreu et al., 2001 , 2005 ). It has been validated internationally.

Conflict management is deliberate action to deal with conflictive situations, either to prevent or to escalate them. Unlike conflict behavior, conflict management encompasses cognitive responses to conflict situations, which can vary from highly competitive to highly cooperative. Conflict management does not necessarily involve avoidance, reduction, or termination of conflict. It involves designing effective strategies to minimize the dysfunctions of conflict and to enhance the constructive functions of conflict in order to improve team and organizational effectiveness (Rahim, 2002 ).

Conflicts are not necessarily destructive (De Dreu & Gelfand, 2008 ; Euwema, Munduate, Elgoibar, Pender, & Garcia, 2015 ), and research has shown that constructive conflict management is possible (Coleman, Deutsch, & Marcus, 2014 ). The benefits of conflict are much more likely to arise when conflicts are discussed openly, and when discussion skillfully promotes new ideas and generates creative insights and agreements (Coleman et al., 2014 ; De Dreu & Gelfand, 2008 ; Euwema et al., 2015 ; Tjosvold, Won, & Chen, 2014 ). To make a constructive experience from conflict, conflict needs to be managed effectively.

Deutsch’s classic theory of competition and cooperation describes the antecedents and consequences of parties’ cooperative or competitive orientations and allows insights into what can give rise to constructive or destructive conflict processes (Deutsch, 1973 , 2002 ). The core of the theory is the perceived interdependence of the parties, so that the extent that protagonists believe that their goals are cooperative (positively related) or competitive (negatively related) affects their interaction and thus the outcomes. Positive interdependence promotes openness, cooperative relations, and integrative problem solving. Perceived negative interdependence on the other hand, induces more distance and less openness, and promotes competitive behavior, resulting in distributive bargaining or win–lose outcomes (Tjosvold et al., 2014 ).

Whether the protagonists believe their goals are cooperative or competitive very much affects their expectations, interactions, and outcomes. If parties perceive that they can reach their goals only if the other party also reaches their goals, the goal interdependence is positively perceived and therefore parties will have higher concern for the other’s goals and manage the conflict cooperatively (De Dreu et al., 2001 ; Tjosvold et al., 2014 ). On the contrary, if one party perceives that they can reach their goals only if the other party fails to obtain their goals, the interdependence becomes negatively perceived and the approach to conflict becomes competitive (Tjosvold et al., 2014 ). Goals can also be independent; in that case, conflict can be avoided (the parties don’t need to obstruct each other’s goals to be successful). Therefore, how parties perceive their goals’ interdependence affects how they negotiate conflict and whether the conflict is constructively or destructively managed (Alper et al., 2000 ; Deutsch, 1973 ; Johnson & Johnson, 1989 ; Tjosvold, 2008 ).

Successfully managing conflict cooperatively requires intellectual, emotional, and relational capabilities in order to share information, to contribute to value creation, and to discuss differences constructively (Fisher & Ury, 1981 ; Tjosvold et al., 2014 ). In contrast, a competitive-destructive process leads to material losses and dissatisfaction, worsening relations between parties, and negative psychological effects on at least one party—the loser of a win–lose context (Deutsch, 2014 ).

Deutsch’s theory proposes that emphasizing cooperative goals in conflict by demonstrating a commitment to pursue mutually beneficial solutions creates high-quality resolutions and relationships, while focusing on competitive interests by pursuing one’s own goals at the expense of the other’s escalates conflict, resulting in imposed solutions and suspicious relationships (Tjosvold et al., 2014 ).

In summary, Deutsch’s theory states that the context in which the conflict process is expressed drives parties toward either a cooperative or a competitive orientation in conflicts (Alper et al., 2000 ; Deutsch, 2006 ; Johnson & Johnson, 1989 ). In other words, a cooperative context is related to a cooperative conflict pattern, and a competitive context is related to a competitive conflict pattern. When parties have a cooperative orientation toward conflict, parties discuss their differences with the objective of clarifying them and attempting to find a solution that is satisfactory to both parties—both parties win (Carnevale & Pruitt, 1992 ). On the contrary, in competition, there is usually a winner and a loser (Carnevale & Pruitt, 1992 ) (see Table 1 ). In the CCB model, the patterns can include cooperative (i.e., integrating) and competitive (i.e. forcing) behavior; however, the cooperative pattern will be dominated by integrating while the competitive pattern will be dominated by forcing (Elgoibar, 2013 ).

Table 1. Characteristics of Cooperative and Competitive Climates

Source : Coleman, Deutsch, and Marcus ( 2014 ).

How to Manage Conflicts Constructively

The need for trust.

Trust is commonly defined as a belief or expectation about others’ benevolent motives during a social interaction (Holmes & Rempel, 1989 ; Rousseau et al., 1998 ). Mutual trust is one important antecedent as well as a consequence of cooperation in conflicts (Deutsch, 1983 ; Ferrin, Bligh, & Kohles, 2008 ). As Nahapiet and Ghoshal pointed out, “Trust lubricates cooperation, and cooperation itself breeds trust” ( 1998 , p.255). There is ample evidence that constructive conflict and trust are tightly and positively related (Hempel, Zhang, & Tjosvold, 2009 ; Bijlsma & Koopman, 2003 ; Lewicki, Tonlinson, & Gillespie, 2006 ).

Successful constructive conflict management requires maximal gathering and exchange of information in order to identify problems and areas of mutual concern, to search for alternatives, to assess their implications, and to achieve openness about preferences in selecting optimal solutions (Bacon & Blyton, 2007 ; Johnson & Johnson, 1989 ; Tjosvold, 1999 ). Trust gives parties the confidence to be open with each other, knowing that the shared information won’t be used against them (Zaheer & Zaheer, 2006 ). Various studies revealed that trust leads to constructive conglomerate behaviors and to more integrative outcomes in interpersonal and intergroup conflicts (Lewicki, Elgoibar, & Euwema, 2016 ; Lewicki, McAllister, & Bies, 1998 ; Ross & LaCroix, 1996 ).

How can trust be promoted? Developing trust is challenging (Gunia, Brett, & Nandkeolyar, 2014 ; Hempel et al., 2009 ). Numerous scholars have noted that trust is easier to destroy than to create (Hempel et al., 2009 ; Meyerson et al., 1996 ). There are two main reasons for this assertion. First, trust-breaking events are often more visible and noticeable than positive trust-building actions (Kramer, 1999 ). Second, trust-breaking events are judged to have a higher impact on trust judgments than positive events (Slovic, 1993 ). Furthermore, Slovic ( 1993 ) concluded that trust-breaking events are more credible than sources of good news. Thus, the general belief is that trust is easier to destroy than it is to build, and trust rebuilding may take even longer than it took to create the original level of trust (Lewicki et al., 2016 ).

However, there is room for optimism, and different strategies have been shown to promote trust. As held in social exchange theory (Blau, 1964 ), risk taking by one party in supporting the other party has been found to signal trust to the other party (Serva et al., 2005 ). Yet, fears of exploitation make trust in conflict management and negotiation scarce. Therefore, the use of trust-promoting strategies depends on the specific situation, and parties need practical guidance on how and when to manage conflict constructively by means of promoting mutual trust.

How does the possibility of trust development between parties depend on the conflict context? Based on this practical question, some strategies for trust development have been proposed (Fisher & Ury, 1981 ; Fulmer & Gelfand, 2012 ; Gunia, Brett, & Nandkeolyar, 2012 ; Lewicki et al., 2016 ). In relationships where trust is likely, the following strategies can help: assume trustworthiness, prioritize your interests and give away a little information about them, engage in reciprocity (concessions), highlight similarities and spend time together, get to know your counterpart personally and try to be likable, behave consistently and predictably, and paraphrase your counterpart’s positions. In relationships where trust seems possible: emphasize common goals; focus on the subject, not on the people; look to the future and find a shared vision; mix questions and answers about interests and priorities—the fundamental elements of information sharing—with making and justifying offers; take a break; suggest another approach; call in a mediator; and forgive the other party’s mistakes. In relationships where trust is not possible, more cautious strategies can help: make multi-issue offers; think holistically about your counterpart’s interests; engage in reciprocity (concessions); express sympathy, apologize, or compliment your counterpart; and look for preference patterns in your counterpart’s offers and responses.

Constructive Controversy

C onstructive controversy is defined as the open-minded discussion of conflicting perspectives for mutual benefit, which occurs when protagonists express their opposing ideas that obstruct resolving the issues, at least temporarily (Tjosvold et al., 2014 ). Indicators of constructive controversy include listening carefully to each other’s opinion, trying to understand each other’s concerns, and using opposing views to understand the problem better. These skills are considered vitally important for developing and implementing cooperative problem-solving processes successfully and effectively.

Deutsch ( 2014 ) stated that there haven’t been many systematic discussions of the skills involved in constructive solutions to conflict, and he proposed three main types of skills for constructive conflict management:

Rapport-building skills are involved in establishing effective relationships between parties (such as breaking the ice; reducing fears, tensions, and suspicion; overcoming resistance to negotiation; and fostering realistic hope and optimism).

Cooperative conflict-resolution skills are concerned with developing and maintaining a cooperative conflict resolution process among the parties involved (such as identifying the type of conflict in which the parties are involved; reframing the issues so that conflict is perceived as a mutual problem to be resolved cooperatively; active listening and responsive communication; distinguishing between effective relationships between parties and positions; encouraging, supporting, and enhancing the parties; being alert to cultural differences and the possibilities of misunderstanding arising from them; and controlling anger).

Group process and decision-making skills are involved in developing a creative and productive process (such as monitoring progress toward group goals; eliciting, clarifying, coordinating, summarizing, and integrating the contributions of the various participants; and maintaining group cohesion).

Tjosvold et al. ( 2014 ) and Johnson et al. ( 2014 ) also elaborate on the skills needed for facilitating open-minded discussions and constructive controversy. They developed four mutually reinforcing strategies for managing conflict constructively:

Developing and expressing one’s own view. Parties need to know what each of the others wants and believes, and expressing one’s own needs, feelings, and ideas is essential to gaining that knowledge. By strengthening expression of their own positions, both parties can learn to investigate their position, present the best case they can for it, defend it vigorously, and try at the same time to refute opposing views. However, expressing one’s own position needs to be supplemented with an open-minded approach to the other’s position.

Questioning and understanding others’ views. Listening and understanding opposing views, as well as defending one’s own views, makes discussing conflicts more challenging but also more rewarding; therefore, the parties can point out weaknesses in each other’s arguments to encourage better development and expression of positions by finding more evidence and strengthening their reasoning.

Integrating and creating solutions. The creation of new alternatives lays the foundation for genuine agreements about a solution that both parties can accept and implement. However, protagonists may have to engage in repeated discussion to reach an agreement, or indeed they may be unable to create a solution that is mutually acceptable, and then they can both learn to become less adamant, to exchange views directly, and to show that they are trying to understand and integrate each other’s ideas so that all may benefit.

Agreeing to and implementing solutions. Parties can learn to seek the best reasoned judgment, instead of focusing on “winning”; to criticize ideas, not people; to listen and understand everyone’s position, even if they do not agree with it; to differentiate positions before trying to integrate them; and to change their minds when logically persuaded to do so.

Conflict Resolution

Conflict resolution processes are aimed at ending a conflict. So, while conflict management can also include escalation, conflict resolution searches for a way of ending the conflict. The difference between resolution and management of conflict is more than semantic (Robbins, 1978 ). Conflict resolution means reduction, elimination, or termination of conflict.

To find a resolution, parties have to bring an extra piece of information, relate the information they have differently, or transform the issue, change the rules, change the actors or the structure, or bring in a third party (Vayrynen, 1991 ). The most popular conflict resolution processes are: negotiation, mediation, conflict coaching, and arbitration (Rahim, 2002 ). Conflict resolution can also be accomplished by ruling by authorities. Integration of the different techniques sequentially or simultaneously has been shown to support optimal conflict resolution (Jones, 2016 ).

Negotiation

Negotiation is a process in which the parties attempt to jointly create an agreement that resolves a conflict between them (Lewicki & Tomlinson, 2014 ). Walton and McKersie ( 1965 ) were the first to identify the two polar yet interdependent strategies known as distributive and integrative negotiation. Distributive negotiation means that activities are instrumental to the attainment of one party’s goals when they are in basic conflict with those of the other party. Integrative negotiation means that parties’ activities are oriented to find common or complementary interests and to solve problems confronting both parties. Other scholars also focused on the opposite tactical requirements of the two strategies, using a variety of terms, such as contending versus cooperating (Pruitt, 1981 ), claiming value versus creating value (Lax & Sebenius, 1987 ), and the difference between positions and interests (Fisher & Ury, 1981 ).

If a distributive strategy is pursued too vigorously, a negotiator may gain a greater share of gains, but of a smaller set of joint gains, or, worse, may generate an outcome in which both parties lose. However, if a negotiator pursues an integrative negotiation in a single-minded manner—being totally cooperative and giving freely accurate and credible information about his/her interests—he or she can be taken advantage of by the other party (Walton & McKersie, 1965 ). The different proposals that have been formulated to cope with these central dilemmas in negotiation are mainly based on a back-and-forth communication process between the parties, which is linked to the negotiators’ interpersonal skills (Brett, Shapiro, & Lytle, 1998 ; Fisher & Ury, 1981 ; Rubin et al., 1994 ).

Mediation is process by which a third party facilitates constructive communication among disputants, including decision making, problem solving and negotiation, in order to reach a mutually acceptable agreement (Bollen, Munduate, & Euwema, 2016 ; Goldman, Cropanzano, Stein, & Benson, 2008 ; Moore, 2014 ). Using mediation in conflict resolution has been proven to prevent the negative consequences of conflict in the workplace (Bollen & Euwema, 2010 ; Bollen et al., 2016 ), in collective bargaining (Martinez-Pecino et al., 2008 ), in inter- and intragroup relations (Jones, 2016 ), and in interpersonal relations (Herrman, 2006 ). However, mediation is not a magic bullet and works better in conflicts that are moderate rather than extreme, when parties are motivated to resolve the conflict, and when parties have equal power, among other characteristics (Kressel, 2014 ).

Conflict Coaching

Conflict coaching is a new and rapidly growing process in the public as well as private sector (Brinkert, 2016 ). In this process, a conflict coach works with a party to accomplish three goals (Jones & Brinkert, 2008 ): (a) analysis and coherent understanding of the conflict, (b) identification of a future preferred direction, and (c) skills development to implement the preferred strategy. Therefore, a conflict coach is defined as a conflict expert who respects the other party’s self-determination and aims to promote the well-being of the parties involved. Giebels and Janssen ( 2005 ) found that, when outside help was called in, parties in conflict experienced fewer negative consequences in terms of individual well-being than people who did not ask for third-party help.

Sometimes, the leader of a team can act as conflict coach. A study by Romer and colleagues ( 2012 ) showed that a workplace leader’s problem-solving approach to conflicts increased employees’ perception of justice and their sense that they had a voice in their workplace, as well as reduced employees’ stress (De Reuver & Van Woerkom, 2010 ; Romer et al., 2012 ). In contrast, the direct expression of power in the form of forcing behavior can harm employees’ well-being (Peterson & Harvey, 2009 ). A forcing leader may become an additional party to the conflict (i.e., employees may turn against their leader; Romer et al, 2012 ).

Conflict coaching and mediation are different processes. First, in conflict coaching, only one party is involved in the process, while in mediation, the mediator helps all the parties in conflict to engage in constructive interaction. Second, conflict coaching focuses on direct skills instructions to the party (i.e., negotiation skills). In that, conflict coaching is also a leadership development tool (Romer et al., 2012 ). There is a growing tendency to integrate conflict coaching and workplace mediation, particularly in preparation for conflict resolution, because the coach can help the coached party to investigate options and weigh the advantages of the different options (Jones, 2016 ).

Arbitration

Arbitration is an institutionalized procedure in which a third party provides a final and binding or voluntary decision (Lewicki, Saunders, & Barry, 2014 ; Mohr & Spekman, 1994 ). Arbitration allows the parties to have control over the process, but not over the outcomes. Therefore, arbitration differs from negotiation, mediation, and conflict coaching, in which the parties decide the agreement themselves (Posthuma & Dworkin, 2000 ; Lewicki et al., 2014 ). In arbitration, the third party listens to the parties and decides the outcome. This procedure is used mainly in conflicts between organizations, in commercial disputes, and in collective labor conflicts (Beechey, 2000 ; Elkouri & Elkouri, 1995 ).

Decision Making by Authorities

The strategies of negotiation, mediation, conflict coaching, and arbitration have in common that the parties together decide about the conflict process, even when they agree to accept an arbitration. This is different from how authorities resolve conflict. Decision making by authorities varies from parents’ intervening in children’s fights to rulings by teachers, police officers, managers, complaint officers, ombudsmen, and judges. Here, often one party complains and the authority acts to intervene and end the conflict. This strategy is good for ending physical violence and misuse of power. However, the authorities’ decisive power is limited, and therefore in most situations authorities are strongly urged to first explore the potential for conflict resolution and reconciliation among the parties involved. The authority can act as an escalator for the process, or as a facilitator, and only in cases of immediate threat can intervene or rule as a last resort. Authorities who employ this strategy can improve the learning skills of the parties and can impose upon the parties an acceptance of responsibility, both for the conflict and for the ways to end it.

It is important to emphasize the natural and positive aspects of conflict management. Conflict occurs in all areas of organizations and private lives and its management is vital for their effectiveness. Through conflict, conventional thinking is challenged, threats and opportunities are identified, and new solutions are forged (Tjosvold et al., 2014 ). Therefore, when conflict occurs, it shouldn’t be avoided but should be managed constructively.

Conflict in virtual teams: a bibliometric analysis, systematic review, and research agenda

International Journal of Conflict Management

ISSN : 1044-4068

Article publication date: 6 June 2022

Issue publication date: 6 January 2023

The purpose of this study is to map the intellectual structure of the research concerning conflict and conflict management in virtual teams (VT), to contribute to the further integration of knowledge among different streams of research and to develop an interpretative framework to stimulate future research.

Design/methodology/approach

A data set of 107 relevant papers on the topic was retrieved using the Web of Science Core Collection database covering a period ranging from 2001 to 2019. A comparative bibliometric analysis consisting of the integration of results from the citation, co-citation and bibliographic coupling was performed to identify the most influential papers. The systematic literature review complemented the bibliometric results by clustering the most influential papers.

The results revealed different intellectual structures across several types of analyses. Despite such differences, 41 papers resulted as the most impactful and provided evidence of the emergence of five thematic clusters: trust, performance, cultural diversity, knowledge management and team management.

Research limitations/implications

Based on the bibliometric analyses an interpretative research agenda has been developed that unveils the main future research avenues. The paper also offers important theoretical contributions by systematizing knowledge on conflict in identifying VTs. Managerial contributions in the form of the identification of best practices are also developed to guide conflict management in VTs.

Originality/value

The uniqueness of this paper is related to its effort in studying, mapping and systematizing the knowledge concerning the topic of handling conflicts in VTs. Considering the current contingencies, this research is particularly timely.

Virtual teams
Conflict management
Bibliometric analysis
Remote working

Caputo, A. , Kargina, M. and Pellegrini, M.M. (2023), "Conflict in virtual teams: a bibliometric analysis, systematic review, and research agenda", International Journal of Conflict Management , Vol. 34 No. 1, pp. 1-31. https://doi.org/10.1108/IJCMA-07-2021-0117

Emerald Publishing Limited

Published by Emerald Publishing Limited. This is published under the Creative Commons Attribution (CC BY 4.0) licence. Anyone may reproduce, distribute, translate and create derivative works of this article (for both commercial and non-commercial purposes), subject to full attribution to the original publication and authors. The full terms of this licence may be seen at http://creativecommons.org/licences/by/4.0/legalcode

1. Introduction

Handling conflicts properly in teams is crucial for possible success ( Caputo et al. , 2019 ). Due to the specific contingencies experienced by virtual teams (VTs), this aspect becomes even more prominent ( Gilson et al. , 2015 ). The Covid-19 pandemic forced many organizations to implement remote working, often in an abrupt and fast way, indicating a particularly favorable historic momentum to systematize previous knowledge on the topic and to offer ways forward. With such a purpose in mind, this paper aims to provide an overview of the evolution of the literature regarding conflict and conflict management in the context of VTs over the past two decades. For this study, we broadly define conflict as the situation where parties within a VT perceive that their goals or interests are incompatible or in opposition ( Ayoko and Konrad, 2012 ); whereas we consider conflict management to refer to the understanding of conflict as a whole, its antecedents, the process, the styles and strategies of handling conflicts and associated behaviors in the context of VT ( Caputo et al. , 2018a ). Even in the context and dynamics of the virtuality of VTs, we concur with Caputo et al. (2018a , 2018b , p. 11) that:

The main objective of conflict management is not to eliminate conflict, but to find different ways to manage it properly by controlling the dysfunctional elements of the conflict while facilitating its productive aspects.

The Covid-19 pandemic has accelerated the already rapid development of technologies in information and communication, further reducing the distances and increasing remote work interactions ( Garro-Abarca et al. , 2021 ). The hyper-globalization processes of the past decades have led, already before the pandemic, to the growing importance of VTs in today’s organizations ( Gibson et al. , 2014 ). VTs can be considered as groups of geographically dispersed co-workers who work interdependently, share common objectives, practices and procedures using technology to communicate and collaborate across time and space ( DeSanctis and Monge, 1999 ). These teams may come from different cultures, yet they operate in the same organizational cultural framework, can bring together a variety of knowledge and experience and deal with a high degree of technologically mediated interactions ( Batarseh et al. , 2017 ). These factors contribute to making today’s organizations more diverse and possibly more conflictual.

Previous reviews and conceptual work have touched on the issues related to conflict and conflict management in the context of VTs. In particular, Schiller and Mandviwalla (2007) highlighted the issues related to conflict management in VT in an early theoretical piece that looked at the use of theories in VT research. More recently, Gilson et al. (2015) presented a seminal overview of the research in VTs that unveiled 10 themes and 10 opportunities for future research. According to the authors, conflict management was mostly studied as a mediator in a unidimensional relation, resulting in the suggestion that conflict is more likely to happen in VTs and it negatively affects team dynamics, processes and outcomes. A similar suggestion is made by Jimenez et al. (2017) , in reviewing the works about global VTs, and Raghuram et al. (2019) , reviewing studies about virtual work, who highlighted how conflicts emerge mostly from cultural and language differences affecting team dynamics. The fragmentation of empirical literature about conflict in VTs and the limited conceptual attention given to the topic calls for an investigation and systematization of the literature about conflict and conflict management in VTs as timely and necessary to support both research and practice to navigate the uncertainties of today’s world.

Shedding light on the evolution of the study of conflicts and their associated management in VTs, a bibliometric analysis of 107 relevant articles published in peer-reviewed scientific journals has been performed to first identify the most influential studies and second, to systematize the academic knowledge by unveiling the existence of five thematic clusters: trust, performance, cultural diversity, knowledge management and team management. In particular, an innovative approach has been adopted by comparing results from alternative, complementary bibliometric tools, i.e. citations, normalized citations and bibliographic coupling, to identify the most influential articles in the field ( Caputo et al. , 2021 ).

This study provides several contributions theoretically, methodologically and practically. First, it contributes to strengthening the integration and systematization of the two bodies of literature in conflict management and VTs. Second, it provides a rigorous and systematic identification of the most influential papers in these fields and identifies thematic areas to bring forward the research. Third, it contributes to bibliometric and reviews studies by advancing the use of comparative bibliometric approaches. Finally, the paper interprets in an integrative framework the current knowledge on the field comprising nonlinear and recursive loops between its elements and, thanks to that, elaborates future research avenues.

The paper is organized into five sections, including this introduction, as follows. Section 2 describes the protocol adopted for selecting the paper and the analyses performed. Section 3 presents the results of the analyses and determines the most impactful papers. Section 4 uses the most impactful papers to propose a framework aimed at suggesting an agenda for future research. Section 5 summarizes the contributions of the paper and its limitations.

This paper aims to provide a comprehensive yet succinct and timely knowledge map of the studies investigating conflict management in VTs. Such a knowledge map is purposed to provide both scholars and practitioners with an overview of what we know i.e. best practices and main findings, and what we still do not know i.e. future research directions about managing conflict in virtual workplaces. The Covid-19 pandemic that resulted in large part of the office workforce working remotely is disrupting social relationships in the workplace. A review of conflict management in VTs is therefore necessary and needs to be carried out in a timely fashion to serve its purpose.

To achieve these objectives, we have built upon best practices in systematic literature review and bibliometric studies and complemented the two methodologies to fulfill simultaneously the breadth and depth of the analysis. The simultaneous use of these two complementary methods, albeit recent, is not entirely new as it has been validated in several studies ( Caputo et al. , 2021 ; Caputo et al. , 2018b ; Dabić et al. , 2020 ). It allows researchers to investigate a topic in depth through the systematic review while maintaining a wider picture of the evolution of knowledge through bibliometric analysis. In this study, we have also included a methodological innovation in the complementary use of alternative bibliometric analyses to identify the most influential papers in the field.

2.1 Sampling protocol

Consistent with the systematic review method ( Thorpe et al. , 2005 ; Tranfield et al. , 2003 ), a panel of experts was formed to define the field of research, choose the keywords, the database and the set of inclusion and exclusion criteria. The panel of experts consisted of two professors, one an expert in strategy, negotiation and conflict management and the other in organizational studies and team working, together with a PhD student specifically focused on the organizational dynamics of dispersed teams. A step-by-step process was followed as outlined in this section.

Step 1 . The database Web of Science (WoS) Core Collection® (research areas “Business Economics” and “Psychology”) was chosen after several alternative searches in Scopus and EBSCO because it retrieved a sample of high-quality articles representative of the best conflict in VTs research published to date. The choice of WoS Core Collection® is also supported and validated as appropriate for the field of inquiry by recent bibliometric studies in conflict management ( Caputo et al. , 2019 ).

Step 2 . A wide search string based on multiple levels of keywords was used ( Caputo, 2013 ) to ensure the capture of the most relevant papers on the topic. The first level included the keyword “Conflict”. The second level included the keywords about the remote/virtual nature of the investigated relationships: “smart OR virtual OR distributed OR distant OR remote”. The third level included keywords related to the organizational aspect of the teams, including “team OR group OR workplace OR workspace”. The search was run with Boolean operators (AND and OR) via the TS command, which searches among Title, Abstract, Author Keywords and Keywords Plus®. Consistent with best practices in bibliometric research and to ensure the comparability among the indicators, the year 2020 was excluded ( Caputo et al. , 2019 ). The search was carried out among peer-reviewed articles written in the English language and resulted in the first sample of 397 papers.

Step 3 . Due to the wideness of the search string, we proceeded to the manual “cleaning” of the data set by reading all the titles and abstracts of the selected papers to eliminate those that were not relevant to our search. When it was not possible to assess the relevance of the abstract, we obtained a digital copy of the full text of the paper. Excluded papers fall into two main categories: a large number of papers do not investigate conflict at all ( Ebrahim, 2015 ; Presbitero and Toledano, 2018 ), although the word “conflict” is presented in the search items. This situation mainly occurs because many papers had a declaration of conflict of interest that was caught by the search; others were eliminated because they simply mentioned “conflicting results” in the abstract or where conflict was just mentioned incidentally; a smaller portion of papers investigated conflict but not in a virtual environment ( Sheehan et al. , 2016 ). Following these criteria, two-hundred-ninety-three papers were eliminated because they were not relevant.

2.2 Analyses

The final data set of 107 papers was used as a basis for both the bibliometric analysis and a qualitative systematic literature review to develop a comprehensive map of the knowledge of the field.

Bibliometrics is a subset of scientometrics and applies statistical methods to the study of scientific activity in a scientific community ( Zupic and Čater, 2015 ). For our research, we followed the perspective known as positive bibliometrics ( Todeschini and Baccini, 2016 ). This is because we aim to describe and explain phenomena in science via the analysis of its scientific communication. In this view, bibliometric indicators represent phenomena or proxies of phenomena. For example, the citations received by an article that expresses a concept are a proxy of the diffusion and impact of said concept in the scientific community. Examples of positive bibliometrics are citation analysis, co-citation analysis, citation networks and productivity analysis.

Complementary bibliometric analyses were instrumental to identify the sample of the most influential papers to review. Prior studies argue for the use of more than one indicator ( Caputo et al. , 2019 ; Dabić et al. , 2020 ) as an effective way to limit the intrinsic bias that every indicator has.

First, we undertook a performance analysis based on indicators of activity. These indicators provide data about the volume and impact of research during a given timeframe via word frequency analysis, citation analysis and counting publications by the unit of analysis (e.g. authorship, country, affiliation, etc.).

Second, we built a science map based on indicators that provide spatial representations of how different scientific elements are related to one another to picture the structural and dynamic organization of knowledge about conflict management in VTs. We combined results from co-citation analysis and bibliographic coupling to identify the most influential papers, authors and journals and the co-occurrence of keywords analysis to identify the thematic structure of the field. Co-citation analysis “constructs measures of similarity between articles, authors or journals by using the frequency with which two units are cited together, i.e. co-citation counts” ( Caputo et al. , 2019 ). Therefore, co-citation analysis is powerful in showing a picture from the past, and it is biased by the time-dependency i.e. an older paper has the probability of obtaining more citations than a newer one. Bibliographic coupling is often used to aggregate papers by similarity, and it “measures the similarity between papers through their common cited references” ( Todeschini and Baccini, 2016 ). The advantage of a bibliographic coupling is to compare recent papers even if not been cited yet. The analysis of the co-occurrence of keywords uses the article’s keywords to investigate the conceptual structure of a field. According to Caputo et al. ( Caputo et al. , 2019 ):

This is the only bibliometric method that uses the content of the articles to directly measure similarity in which others use indirect measures such as citations and authorships, co-word analysis is particularly powerful and appropriate to develop a semantic map that helps in understanding the conceptual structure of a field.

By comparing and contrasting the results from activity indicators, co-citation analysis, bibliographic coupling and co-occurrence of keywords, it is possible to provide a systematic overview of the field ( Caputo et al. , 2021 ). The activity indicators will show the evolution of the field and its impact. Co-citation and bibliographic coupling will show an unbiased view of the most influential articles, authors and journals, whereas the co-occurrence of keywords will show the thematic map of the topics investigated.

The software VOSViewer ( van Eck and Waltman, 2010 ) was used to calculate the bibliometric indicators and provide the graphic representation of the networks. For a detailed explanation of the scripts and mathematical algorithms adopted in VOSViewer, please see van Eck and Waltman (2007 , 2010 ).

Combining the results of co-citation analysis and bibliographic coupling allowed us to identify a list of the most influential papers that were then considered for the qualitative systematic literature review. We have combined the top 20 papers resulting from three indicators: absolute citations, normalized citations and bibliographic coupling strength. Absolute citations are represented by the total number of citations received by a paper. Normalized citations are represented by the number of citations of the paper divided by the average number of citations of all papers published in the same year and included in our data set ( van Eck and Waltman, 2016 ). The bibliographic coupling strength is measured by the bibliographic coupling total link strength algorithm in VOSViewer, indicating the level of similarity and interconnectedness of a paper in the field regardless of the received citations ( van Eck and Waltman, 2016 ). Integrating these three measures allows us to reduce the age bias of papers and include in the evaluation the influence of a paper, not only the number of citations received but also how the content of the paper relates to other papers in the same scientific community.

The resulting data set of unique papers in the top 20 list from each indicator is composed of 41 papers, which constituted the data set for the literature review.

Having selected the most influential articles to review, we proceeded to the literature review based on the content analysis of selected papers ( Duriau et al. , 2007 ). Following best practices, each article was read in full and analyzed qualitatively ( Barclay et al. , 2011 ; Pittaway and Cope, 2007 ). Articles were coded, tagged and later grouped into clusters based on their content; the articles were allowed to be part of more than one cluster ( Caputo et al. , 2016b ). The process was dynamic, allowing new tags to be included during the process of reading articles to allow flexibility in categorizing information and reducing biases that may arise from a rigidly pre-set system ( Caputo et al. , 2016b ; Dabić et al. , 2020 ). Short and Palmer (2008 , p. 279) categorize content analysis into three methods: “human-scored systems, individual word-count systems, and computerized systems that use artificial intelligence”. We combined computer-aided techniques with human-scored techniques, integrating rigor and insights from the bibliometric analyses with the interpretation of researchers.

3. Results of the bibliometric analyses

3.1 activity bibliometric indicators.

Our bibliometric analysis confirms a constant growth of attention to the handling problems in VTs over time with an increasing number of journal outlets.

Figure 1 shows how the field started in 2001 and is in a growing directory, although the number of papers published is still limited, making the study of conflict in VTs a niche.

In terms of journals, 58 unique outlets have published 107 papers in the data set. Table 1 shows the 20 most cited journals and indicates also the number of published papers and average citations received by them. In terms of total citations, Organ Sci., Acad. Manage. J., J. Manage. Inform. Syst., J. Int. Bus. Stud. and Inf. Manage., are the most influential outlets. However, if we consider the number of papers published, which is a proxy of the interest of a journal on the topic, Small Group Res., J. Manage. Inform. Syst., Organ Sci., Inf. Manage. and J. Manag. are the five most interested journals. Instead, looking at the impact of the individual articles, the situation changes again with J. Int. Bus. Stud., Acad. Manage. J., Organ Sci., Int. J. Confl. Manage. and Inf. Manage. It can be noted how Organization Science and Information Management are the journals appearing in the top five in all three measures.

Looking at the authors, 290 scholars have authored the 107 papers in the data set. Out of these, only three, Ahuja, Staples and Zornoza, have authored at least three papers and can, therefore, be considered the most prolific in the field. Table 2 lists the most prolific authors who have authored at least two papers. Interestingly, if we look at the most cited authors, only three of them (Hinds, Majchrzak and Staples) appear in the top 10 of most cited ( Table 3 ).

The studies in the data set were authored by affiliates of 186 research institutions from 28 different countries. The research in the field of conflict in VTs appears to be predominantly made in the USA (65 papers) and other western countries.

3.2 Co-citation analysis: the foundations of the field

The co-citation analysis is a powerful tool to investigate the foundations of the research about conflict in VTs through the analysis of the references cited by the papers in our data set. The analysis reveals those that are the most cited references, authors and journals. Table 4 shows the statistics and criteria used for the co-citation analysis.

By performing a co-citation analysis, we were able to identify the 10 most cited papers, authors and journals that constitute the theoretical pillars of the research on the conflict in VTs. The results show how such research is grounded in the literature about VTs and remote working ( Cramton, 2001a ; Jarvenpaa and Leidner, 1999 ) pillar studies in conflict management ( Jehn, 1995 ) and the early studies integrating the two ( Hinds and Bailey, 2003 ; Mortensen and Hinds, 2001 ).

A combined reading of the most influential cited references and the network of similarities ( Figure 2 ) show that the research about conflict in VTs relies on a coherent and homogeneous network grounded in the scientific community of the fields of management and organization studies ( Table 5 ).

3.3 Bibliographic coupling: the structure of the field

Bibliographic coupling analysis is used to evaluate the current structure of a field based on a clustering technique that allows us to compare recent papers even if not yet cited; therefore, not being biased by time. However, the method has severe limitations in cases like ours that analyze smaller research fields ( Jarneving, 2007 ); hence, the technique was adopted to complement citation and co-citation analysis and was not used to create clusters but rather to identify the network relevance of papers, authors and journals. All papers (107), authors (290) and journals (58) from the data set were included in the analysis ( Figure 3 ) ( Table 6 ).

By performing a bibliographic coupling analysis, we were able to identify the 10 most connected papers, authors and journals that constitute the current structure of the research in the conflict in VTs. Via the visualization of networks technique, is it also possible to show how the field is well interconnected across the three levels of analysis, confirming the finding that the research about conflict in VTs relies on a coherent and homogeneous scientific community.

3.4 Co-occurrence of keywords

The analysis based on the co-occurrence of keywords allows us to show the intellectual structure of the field by identifying and grouping the main topics that have been subject to investigation. This method is particularly useful to complement the previous analysis as it offers a direct measure of similarity of topics by analyzing the actual content of the papers via the keywords.

The keyword analysis was performed by adopting the Keyword Plus tool from WoS. Even though the Keyword Plus is usually chosen to ensure consistency across the classification of articles’ keywords, it was necessary to perform a manual harmonization of the spelling of those keywords.

Previous studies have considered Keyword Plus to be effective as the keywords provided by the authors in terms of bibliometric analysis, investigating the knowledge structure of scientific fields ( Zhang et al. , 2016 ). The adoption of Keyword Plus allows the researcher to limit biases and risks associated with the manual tagging of content. Only keywords that occurred at least five times were kept; this resulted in having only 39 keywords to constitute the largest usable set of connected terms ( Table 7 ).

The network diagram and overlay visualization of the keywords ( Figure 4 ) show that the intellectual structure of the topics is quite homogeneous and has evolved. In particular, the research on conflict in VTs started with the investigation of technological topics and issues related to cultural diversity, personality and leadership.

3.5 Synthesis of results

Having shown the individual results of activity indicators, co-citation, bibliographic coupling and co-occurrence of keywords, we moved our attention to a synthesis that allowed us to identify the most influential papers to be included in the systematic literature review.

Table 8 shows the top 20 articles according to three complementary metrics: the normalized citations, the total citations and the link strength. The total citations are computed by counting all citations received by a paper in the WoS Core Collection at the time of the study. The normalized number of citations in a paper equals the number of citations in the paper divided by the average number of citations of all papers published in the same year and included in the data set ( van Eck and Waltman, 2016 ). The total link strength indicates the total strength of the links of an article with the other articles in the data set calculated via the bibliographic coupling analysis ( van Eck and Waltman, 2016 ). By comparing these three measures, we can countereffect the biases of each of them in terms of age of the article, relative impact and connectedness in the field. As a result, 41 unique articles were discovered to be included in at least one of the metrics and formed the basis for our systematic literature review.

4. Systematic literature review

This section presents the results of the systematic literature review that has been based on the most influential articles belonging to each cluster and the classification obtained by analyzing the content of each article. We have identified five thematic clusters: trust, performance, cultural diversity, knowledge management and team management.

4.1 Trust cluster

The issue of trust is among the key topics in conflict and conflict management studies ( Caputo et al. , 2019 ). Trust is an extremely important variable for successful collaboration ( Donovan, 1993 ) and increased relational capital ( Connelly and Turel, 2016 ). Nevertheless, trust is also regularly perceived as a challenging issue for team effectiveness ( Breuer et al. , 2016 ), particularly under virtuality, due to the lack of clarity on interaction mechanisms ( Bierly et al. , 2009 ; DeRosa et al. , 2004 ). Being a crucial construct for any variation of teams, trust is proved as more difficult and important to achieve in the circumstances of physical dispersion of team members ( Brahm and Kunze, 2012 ; Breuer et al. , 2016 ; Connelly and Turel, 2016 ; Staples and Webster, 2008 ; Yakovleva et al. , 2010 ). Peñarroja et al. (2013) concluded that the level of virtuality negatively influences team trust, whereas trust is also vital for reducing both interpersonal and task conflicts ( Connelly and Turel, 2016 ; Curseu and Schruijer, 2010 ) as well as for successful conflict management processes ( Bierly et al. , 2009 ). Virtuality is mainly considered to be a moderating variable in the relationship between trust and conflict ( Bierly et al. , 2009 ), where trust may be both an output and an input of the group processes, such as conflict ( Marks et al. , 2001 ). A further explanation is provided by studies that determined that the greater the degree of virtuality, the greater the negative impact on trust by relationship conflict ( Bierly et al. , 2009 ; Peñarroja et al. , 2013 ). In this vein, Breuer et al. (2016) showed that a high degree of virtuality increases internal team risks that in turn increase the necessity for trust, thus forming a loop relationship between a group functioning, conflict and trust ( De Dreu and Weingart, 2003 ). In general, the relationship between team functioning, conflict and trust could be described as a negative association between conflicts and trust exacerbated by the degree of virtuality ( Bierly et al. , 2009 ; Polzer et al. , 2006b ).

4.2 Performance cluster

The next cluster is based on team performance which is considered to be highly influenced by internal team communication in VTs ( Massey et al. , 2014 ; Montoya-Weiss et al. , 2001 ; Sarker et al. , 2011 ). VTs have different characteristics than traditional teams ( Brahm and Kunze, 2012 ), and it was found that people are capable of adapting to the conditions of VTs, such as restricted communication channels, probable instability of internet connection and lacking opportunities for informal communication ( van der Kleij et al. , 2009 ). Moreover, video communication and similar technologies reduce the main differences between teams that are co-located and geographically dispersed teams ( Bradley et al. , 2013 ). A great number of studies have shown that geographical distance between team members may complicate conflict management ( Cramton, 2001b ; Hill and Bartol, 2016 ). However, the extensive usage of mediated communication technologies may exaggerate the negative impacts of conflict in teams ( Kankanhalli et al. , 2006 ) due to complexities such as the unavailability for frequent discussions, information exchange and clarifications regarding personal and task issues, which may result in misunderstandings and further communication closure ( Mortensen and Hinds, 2001 ). In other words, virtuality increases the complexity of the triggers and the dynamics of conflicts as well as their management and resolution ( Friedman and Currall, 2003 ). In turn, such communication complexities among team participants (conflicts) negatively influence team performance ( Connelly and Turel, 2016 ; Turel and Zhang, 2010 ). However, the understanding of the underlying mechanisms of how conflicts work and their influence on team performance in VTs still demands additional research ( Connelly and Turel, 2016 ). There are several debates about the impact of conflict on VT performance. For instance, Hinds and Mortensen (2005) state that the virtuality of teams increases the vulnerability to conflicts due to the lack of casual, unplanned communication between team members, which, in turn, negatively influences the overall team performance. However, in a review of the literature, Ortiz de Guinea et al. (2012) emphasize contrasting findings where virtuality and performance correlate both in positive and negative directions. The recent body of research regarding conflicts and team performance in VTs admits that virtuality should be perceived as a continuous rather than binary variable to avoid clashing results ( Griffith et al. , 2003 ; Malhotra and Majchrzak, 2014 ; Ortiz De Guinea et al. , 2012 ). It was discovered that a level of virtuality should include distance indicators of separation, the configuration of a proportion working virtually and face-to-face and time parameters of virtual collaboration ( Ortiz De Guinea et al. , 2012 ). For studies looking at team performances, it is crucial to consider contextual conditions, degrees of virtuality and mediating technologies as they may significantly alter the relationship ( Malhotra and Majchrzak, 2014 ). For example, research where virtuality is treated as a continuous variable shows less presence of conflicts in more VTs and no impact on the performance ( Ortiz De Guinea et al. , 2012 ). Kankanhalli et al. (2006) propose a theoretical framework where both task conflict and relationship conflict do not have a direct influence on VT performance, contingent upon the conflict resolution approach (for both), task complexity (for task conflict) and task interdependence (relationship conflict). Looking at conflict management, research has indicated that the conflict management style ( Paul et al. , 2004b ) and conflict management behavior ( de Dreu and van de Vliert, 1994 ; Montoya-Weiss et al. , 2001 ) are critical conditions for successful team performance in the dimension of virtual collaboration. Additionally, collaborative conflict management style was indicated as a positive influencing factor on team performance, whereas group heterogeneity was found to be a barrier to successful conflict management and effective group performance ( Paul et al. , 2004b ).

4.3 Cultural diversity cluster

Cultural diversity is one of the most ambiguous concepts regarding communication, teams and organizational studies. A series of meta-analyses validate this point stressing the nature of the complex notion to be both a benefit and a challenge ( Smith et al. , 1994 ; Stahl et al. , 2010 ). In the context of teams and team working, cultural diversity refers to the different cultural backgrounds of the team members ( Harush et al. , 2018 ), including diversity in nationality ( Gibbs et al. , 2017 ) and broader cultural aspects ( Kankanhalli et al. , 2006 ), such as linguistic diversity ( McDonough et al. , 1999 ) and cultural dimensions ( Hofstede, 1991 ). As a concept, cultural diversity is perceived as a key to a greater and innovative performance ( Polley and McGrath, 1984 ) or the contrary, as a reason for ingroup miscommunications ( Brett et al. , 2006 ; Staples and Zhao, 2006 ). Globalization dynamics and technological advancements ( Paul et al. , 2004b ) are increasing virtuality and multiculturality in teams ( Gibson et al. , 2014 ), resulting in the prevalence of geographically dispersed international teams over face-to-face ones ( Stahl et al. , 2010 ). The combination of physical dispersion and cultural diversity ( Shachaf, 2008 ) increases the complexity of VTs due to the more radical differences between team members’ attitudes and perceptions ( Zimmermann, 2011 ). As a result, communication and the gaining of possible benefits associated with diversity may become more problematic ( Gibson and Gibbs, 2006 ). Implementing cultural diversity may result in misunderstandings and conflicts between team members ( Maznevski et al. , 2006 ; Paul et al. , 2004b ; Stahl et al. , 2010 ) due to reasons such as the communication ( Shachaf, 2008 ) and social categorization ( Harush et al. , 2018 ). Hence, conflict management is of significant importance as often team dynamics are complicated not only in the virtual settings but also by the cultural heterogeneity ( Paul et al. , 2004a ; Paul, Seetharaman, et al. , 2004b ). The debate whether cultural diversity increases or decreases conflicts in VTs is continuing ( Kankanhalli et al. , 2006 ; Mortensen and Hinds, 2001 ). Kankanhalli et al. (2006) discovered from their in-depth study that cultural diversity in VT leads to relationship and task conflicts, which they explain by the similarity attraction theory ( Wells and Aicher, 2013 ) and social identity theory ( Ashforth and Mael, 1989 ). Usage of the latter theory is also supported by Mortensen and Hinds (2001) and Harush (2018) , who emphasized the vital role of forming a global identity as a self-categorization process to a shared team ingroup identity to reduce the level of relational conflicts in GVT’s environment, especially in the circumstances of low task interdependence. Paul, Seetharaman, et al. (2004b) support the negative impact of team members’ cultural diversity on conflict resolution processes and group interactions due to the variations in values. Furthermore, Staples and Zhao (2006) concluded that culturally diverse teams indicated lower levels of satisfaction and cohesion and higher levels of conflicts. However, it was also pointed out that culturally diverse VTs showed higher performance rates and fewer conflicts than face-to-face ones. This finding emphasizes the importance of taking under consideration not just every separate characteristic of a team but the combinations of the teams’ settings. Whilst to some, cultural heterogeneity of teams can negatively impact interactions and communication processes, increasing conflicts ( Pelled, 1996 ), to others, diversity can be very beneficial for teams’ dynamics and conflict reduction ( Staples and Zhao, 2006 ). These opposing viewpoints could be explained by several factors. For instance, Paul et al. (2004a) , in contrast to a widespread belief about the negative impact of cultural diversity on group dynamics, found that higher levels of agreement within international groups could be achieved by conflict management ( Paul et al. , 2004a ) and relevant media choices ( Klitmøller and Lauring, 2013 ). Additionally, according to Stahl et al. (2010) , the physical dispersion of team members tends to moderate the impact of cultural diversity on conflicts as the virtual international teams showed lower levels of conflicts and higher social integration compared with multicultural collocated teams. These findings were similarly indicated by Mortensen and Hinds (2001) in their earlier research with the reason that the notion of reduced conflicts could be a result of either stronger ingroup integration or an adverse environment for conflicts to arise.

4.4 Knowledge management cluster

Efficient knowledge management is vital for the success of a company, project or team ( Chiravuri et al. , 2011 ). The process of knowledge transferring, sharing and exchanging provides additional challenges for collocated teams ( Ortiz De Guinea et al. , 2012 ). Due to the globalization dynamics, knowledge sharing between geographically distributed team members and experts has become an integral part of international companies and VTs ( Raab et al. , 2014 ). Consequently, knowledge management in VTs and presumed conflicts came to the scholars’ attention due to the complex settings of geographically distributed teams. The implied challenges are explained as difficulties in sharing comprehensive knowledge with no face-to-face communication potentially creating sub-groups ( Boh et al. , 2007 ) and reducing the attention of team members under virtual circumstances ( Ortiz De Guinea et al. , 2012 ). This, in turn, may lead to misunderstandings ( Hinds and Bailey, 2003 ), failure of information sharing ( Hinds and Mortensen, 2005 ) and other interpersonal difficulties ( Boh et al. , 2007 ). Ortiz De Guinea et al. (2012) argue that the predominantly multicultural composition of geographically dispersed teams issues such as language diversity may jeopardize the knowledge sharing process and boost the frequency of conflicts. Chiravuri et al. (2011) indicated that a combination of a lack of face-to-face cues ( Klitmøller and Lauring, 2013 ) and probable culturally contrasting behavioral models can cause different patterns of information exchange, which in turn leads to misunderstandings ( Cramton, 2001b ; Kayworth and Leidner, 2002 ) and conflicts during the knowledge capture process. At the end of the study, the authors emphasized a repertory grid cognition-based technique (“cognitive mapping technique that attempts to describe how people think about the phenomena in their world” [ Tan and Hunter, 2002 , p. 40]) as a reliable measure for decreasing conflicts in VTs in the knowledge capture process ( Chiravuri et al. , 2011 ). Furthermore, Klitmøller and Lauring (2013) put a value on the multicultural element of VTs and its important role in the process of selecting particular types of media for knowledge exchange (e.g. using a rich media for more ambiguous matters and a lean media in case of canonical knowledge exchange). Raab et al. (2014) researched the mechanisms of knowledge sharing in a globally dispersed context identifying a link between the imbalance of the geographical distribution of group members and the low efficiency of knowledge sharing due to the strong social categorization processes ( Polzer et al. , 2006a ) and potential conflicts between subgroups ( Fiol and O’Connor, 2005 ; Hinds and Mortensen, 2005 ). Indeed, a proper mix of technological and organizational elements is believed to be crucial for proper knowledge exchange, open knowledge sharing and all other issues connected to knowledge management in the conditions of virtual collaboration ( Zammuto et al. , 2007 ). Tools of virtual communication may reduce cultural differences ( Stahl et al. , 2010 ) and positively impact knowledge-sharing processes ( Klitmøller and Lauring, 2013 ).

4.5 Team management cluster

“E-communicational”, i.e. a manager positions himself as a part of a VT and takes under consideration teleworking specificities maintaining informal communication, interpersonal trust, increasing perceived proximity and also exposing a strong shared identity that tends to prevent conflicts ( Mortensen and Hinds, 2001 ); and

“Control mode”, i.e. managers are not co-teleworkers as they manage VTs prevailingly, focusing on work objectives with high levels of institutionalization and formalization.

On the one hand, managerial interference may impede establishing social connections between group representatives ( Gulati, 1995 ). On the other hand, managers should intervene in the virtual setting of a team, stimulating frequent and effective communication. In this way: team members could build better social relationships ( Malhotra et al. , 2007 ; Raab et al. , 2014 ; Saunders and Ahuja, 2006 ) and not experience conflicts due to obstacles in the technological adaptation ( Thomas and Bostrom, 2010 ). The latter claim is also supported by Chiravuri et al. (2011) , who consider that a manager has to be involved in the in-group processes to discern the nature of conflicts. In the case of a cognitive conflict, this should be closely monitored as it is capable of causing either stagnation of the process or improved solutions ( Chiravuri et al. , 2011 ). In the study by Raab et al. (2014) , managerial involvement was found to be a mitigator of cultural boundaries but had no moderating effect on the relationship between trust and satisfaction with knowledge sharing in globally dispersed groups. Thus, managers may be concerned with tracking the essence and type of a conflict in VT’s dynamics and implementing appropriate conflict management techniques to increase the productivity of a project.

5. Setting-up a research agenda

The purpose of this paper is the systematization of the accumulated knowledge of the field and, because of that, paving interesting and promising research avenues ( Caputo et al. , 2018b ; Tranfield et al. , 2003 ), especially about the results of the systematic literature review, the clear focus characterizing research of emerging conflicts and conflict management in VT, and these are interpreted in a framework stressing possible interconnections and relationships among them.

The logic of the framework is consistent with the traditional input-process-output (IPO) approach to studies on VT and has been used in previous systematic literature reviews ( Garro-Abarca et al. , 2021 ; Gilson et al. , 2015 ). Differently from that, however, the linearity of a pure IPO logic did not emerge from the results of that literature. For this reason, our interpretative framework cannot postulate a single or cause-effect directionality between its theoretical blocks, hypothesizing fuzzy and yet to be untangled relationships. The “fuzziness” refers to a nonlinearity, i.e. a block seems to have several impacts on others e.g. direct, indirect, moderated or mediated effects; recursive relationships, i.e. most of the blocks have bi-directional relationships with the others; thus, self-reinforcing loops based on previous interaction either positive and negative may occur; configurational approach, i.e. a single block when considered in isolation seems to hold a limited explanatory power, and better results would be achieved analyzing several factors together. Thus, it would be reasonable to say that it is not so much the presence or the intensity of a single element/block to determines the outcomes but the co-presence or, conversely, the co-absence of a set of elements that is the key interpretation. In Figure 5 , we only adopted the categorization of the IPO framework, specifically the antecedents, dynamics and outcomes, and we also depicted rippled lines among these categories to represent the fuzziness of these relationships. However, any category of the theoretical blocks potentially influences and is influenced by the others; thus, the arrows are present at both ends of the lines.

The first category of antecedents is fixed elements that come from the structural contingencies in which a VT operates its composition. These structural elements refer to the demographic, cultural and individual characteristics of team members, and they can be grouped under the umbrella concept of the heterogeneity existing in a team. This heterogeneity is the root of several latent or actual conflicts and conflict-related dynamics that may affect individual team members or the whole group ( Schaubroeck and Yu, 2017 ). For example, different personalities or intensity of traits, e.g. consciousness and extraversion, may increase or lessen dyadic conflicts among members ( Turel and Zhang, 2010 ). However, these elements do not affect only conflicts but also shape different strategies to manage them, opening the debate to a contingent and contextual approach to conflict management in VTs. As evidenced from the thematic clusters, heterogeneity may pertain to different cultural backgrounds that may hinder the process of cohesion due to the homophily phenomenon, thus preferring individuals with similar characteristics or common shared culture. This stimulates the formation of sub-groups ( Gibson and Gibbs, 2006 ), highlighting the necessity of specific strategies to reduce conflicts and the fault-lines within a team. Heterogeneity, however, is a broader concept than merely culture ( Boh et al. , 2007 ). As the geographical dispersion of team members increases, the higher is the likelihood of having team members with diverse institutional, economic and other contingencies that may stimulate an increment of conflicts, stricter management of them and other problems in the functioning of a team ( Jimenez et al. , 2017 ). This heterogeneity may directly influence a team or individual performance, but its indirect effect via conflicts, conflict management strategies and functioning processes of a team are still yet to be explored (dynamics). Future research avenues could inquire what type of heterogeneity factors can have a different impact in VT from those traditionally stressed for co-located teams. Even more interesting could be a study of whether heterogeneity plays a different role in the strategy to manage those conflicts or affect the team functioning of a VT in different ways. For instance, are these potential tensions more marked in VTs related to the fact that interactions are less frequent and with less embedded exchanges ( Hinds and Bailey, 2003 )? Conversely, as individual differences seem to play a minor role in VTs, can these tensions be lessened when in co-located teams ( Wakefield et al. , 2008 )? Paying attention to the heterogeneity of a VT also holds strong implications for practice; managers and leaders should first carefully design the composition of a VT not only for reasons of technical competencies but also of cultural and soft skill aspects related to the team members. This may reduce potential conflicts at several levels. Second, even if a proper design is not implementable, the heterogeneity of a VT should be fully acknowledged to counterbalance the tendency to disengage.

The second category of this interpretative framework is represented by what has been termed as dynamics, as all these elements pertain to interactions among members and the several processes through which VT functions and performs ( Breuer et al. , 2016 ). In our framework based on identified clusters, we consider these categories: the conflicts, in terms of their nature and level of impact, the conflict management process and other relevant dynamic interactions occurring in a team, called team functioning that specifically includes the process of building trust and that of managing knowledge flows. As premised, the fuzziness of these relationships also reveals that blocks of the same category have internal relationships e.g. conflict management impacts, and is impacted by, the characteristic of conflicts in VTs and by the team functioning elements of VTs. Similarly, we expect conflicts to impact team functioning directly and via the various degrees of conflict management and vice versa.

In terms of conflicts in VTs, discrimination should be made of the nature of the conflict. Virtuality, on the one hand, may stimulate relational conflicts, as misunderstandings in communication and lack of trust occur more readily ( Hinds and Bailey, 2003 ). Caputo et al. (2019) , in a bibliometric overview of conflict management studies, highlighted the important role of culture in the relationship between trust and conflict. It is expected that building trust and managing trust-based conflicts are more complex in virtual settings due to their enhanced multicultural composition and the difficulty for individuals to decodify clues in a virtual environment. However, in task-based conflict, such a clear negative influence does not seem so prominent ( Gibbs et al. , 2017 ). To summarize, can conflicts of different nature be affected by virtuality, and in which ways? Are there interactional effects? Similarly, the specific level at which conflicts are embedded is also relevant. Conflicts may spur at an individual level, for example, a team member that has to juggle between work and personal life ( Clark, 2000 ). The Covid-19 pandemic poses serious questions about the ambivalence of flexible work arrangements and also in VTs, especially concerning team members with care duties ( Hilbrecht et al. , 2008 ). Conflicts can be related to a dyadic sphere from a faction of the team members to the whole group ( Park et al. , 2020 ). These different levels are not well addressed in team literature, and the virtuality adds complexity to the debate. How do individual, dyadic and group-level conflicts influence each other? How does virtuality impact the propagation of a specific level of conflict onto others? Is it stronger or more insulated?

Conflict and conflict management strategies should also be clear prerogatives of the leaders of VT. Leaders should determine the specific nature and level of impact of this conflict to design proper conflict management strategies. Escalating or de-escalating strategies should be in place to keep a high level of engagement and other team dynamics.

There are several dynamic processes, such as communication ( Jarvenpaa and Leidner, 1999 ), leadership ( Hill and Bartol, 2016 ) and temporality ( Saunders and Ahuja, 2006 ), all of which may cause or redeem conflicts in VTs. In turn, when properly (or poorly) executed, these dynamics create sediment (or detriment) for social identification and trust, fueling (or hindering) any further in-group interactions, exchanges and conflicts ( Brahm and Kunze, 2012 ; Harush et al. , 2018 ). Future studies are required to untangle the nexus between such dynamics, especially as moderators and mediators ( Gilson et al. , 2015 ). This is also true about the structural elements: are there joint processes influencing each other to cause conflicts? In addition, as Garro-Abarca et al. (2021) highlighted, the Covid-19 pandemic has quickly changed organizational routines moving traditional co-located teams into the virtual space. Did the changes induced by the pandemic create alternative processes and their related conflict? Does a “new normal” exist in which processes will be managed differently from the past, blending elements of virtuality into traditional teams? All these considerations are research avenues to be considered.

Virtuality, in general, seems to reduce the ability of a VT to manage knowledge ( Raab et al. , 2014 ), but some positive effects have also been depicted ( Klitmøller and Lauring, 2013 ). These contrasting results are probably because knowledge management is a broad concept traditionally articulated in sub-processes: knowledge acquisition, creation, sharing or transferring, accumulation or retrieving and application or usage ( Inkinen, 2016 ). Each of these processes may be influenced differently from virtuality, the heterogeneity of the team and the other team functioning dynamics. For example, knowledge sharing is reinforced by participative leadership styles ( Pellegrini et al. , 2020 ), but participation and engagement may be reduced in VT due to latent conflicts. Conversely, knowledge accumulation in a virtual environment may be enhanced as to properly function; most VTs need a large stock of codified knowledge. Thus, future studies should address the relationships between every single process of knowledge management and their interactional effects with the antecedents of conflicts, the type and level and strategies to manage them, not forgetting to consider the indirect and interactional effects of other team functioning processes. To summarize, how do the different processes of knowledge management relate to conflicts, conflict management strategies and team functioning in a VT context? Future studies may consider the fast-changing technological environment of the past decade, for example, considering the advent of the 4.0 revolution. If more inclusive and far-reaching information and communications technology tools alleviate the differences between co-located and VTs ( Bradley et al. , 2013 ), the sophisticated approaches of the 4.0 such as the Internet of Things ( Caputo et al. , 2016a ), big data ( Rialti et al. , 2020 ) and artificial intelligence algorithms may offer interesting modifications about the impact on knowledge management and team performance in general ( Manesh et al. , 2020 ). How will the 4.0 revolution affect conflicts in VTs?

Considering the practical implications related to several teams’ functioning processes, leaders may consider constructing a managerial grid to keep control of either the individual performance or the overall group-level results. These ongoing evaluations can help to detect conflicts earlier and thus structure a proper conflict management strategy.

Considering the final category of outcomes, conflicts have been generally studied concerning their negative impacts on the performance of VTs. Virtuality tends to exacerbate conflicts and may reduce the consequentially a VT’s performance ( Hinds and Mortensen, 2005 ). However, as already presented in this framework, a relationship of linearity must be excluded. Too many other co-factors may intervene due to the heterogeneity of the composition of the team, the way conflicts are handled, and their impacts on other crucial dynamics. Conflicts cannot be reduced in this univocal direction ( Ortiz De Guinea et al. , 2012 ). Future studies are, thus, invited to clearly define their performance variables and hopefully consider virtuality as a continuum ( Malhotra and Majchrzak, 2014 ) to avoid partial conclusions. Adopting this framework, interesting avenues may be explored about the interactional effects of its several theoretical building blocks. For example, does the different nature of conflicts impact differently on performance? Are these impacts also affected by the specific sources of conflicts (processes of latent elements)?

Further future research avenues may also come from the adoption of newer methodologies in the field of conflict management, such as fuzzy-set qualitative comparative analysis (fsQCA), a methodology we could not find in the analyzed data set but that is receiving growing attention in management research ( Kraus et al. , 2018 ; Pappas et al. , 2021 ). FsQCA is a set-theoretic approach that is used to investigate complex causality, and therefore, allows for the identification of specific combinations of conditions called configurations that are nonexclusive and lead to the same outcome ( De Crescenzo et al. , 2020 ; Ragin, 2008 ). Future studies could use fsQCA to test empirically our proposed framework allowing the complexity of conflict and conflict management in VTs to be investigated.

6. Conclusion

This paper presents the results of an investigation into the existing literature published over the past two decades about conflict management and VTs. To provide a thorough and systematic analysis in support of the growing needs of managing virtual workforces and projects, innovative bibliometric methods have been deployed, displaying an overall view of the field of research and a systematic review has provided us with the details of the five identified thematic clusters enabling a holistic framework to be developed. Results have shown the importance of the interlinkages between the five clusters such as trust, performance, cultural diversity, knowledge management and team management are well-defined topics that rely on each other’s findings for advancing knowledge and practice.

Although this study adopted a rigorous and systematic methodology of review, some limitations remain. Specifically, a limitation may lie in focusing on management studies that contribute to focusing and positioning the paper in a clear discipline of research and homogeneity of data, but it may result in overlooking contributions from other fields. Moreover, to fulfill the need for homogeneity of bibliographic data, the study focused only on published journal articles omitting books, book chapters, conference papers and nonpeer-reviewed papers. This limitation is balanced by the higher quality and rigor of studies that have been peer-reviewed and future studies, perhaps using a meta-analytic approach, may also consider these outputs. As in previous systematic review studies, our study has been privileged to offer a wider overview and research agenda rather than deepening into fine-grained details. However, as this tradeoff is a natural consequence of review studies, our review and agenda offer a solid ground for future studies to build upon and further advance our knowledge of conflict management in VTs, satisfying the latest needs of organizations and societies linked to the increase in remote working conditions.

literature review of conflict management

Number of papers published per year

Network diagram of co-citation analysis

Network diagram of bibliographic coupling analysis

Network diagram and overlay visualization of keywords

A framework for conflict management in virtual teams

Most cited journals

Most prolific authors

Most cited authors

Criteria of the co-citation analysis

Co-citation analysis

Bibliographic coupling analysis

Main topics from the co-occurrence of keywords analysis

Most influential articles

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Corresponding author

About the authors.

Andrea Caputo is an Associate Professor in Management at the University of Trento, Italy, and at the University of Lincoln, UK, where he is part of the UNESCO Chair in Responsible Foresight for Sustainable Development. His main research interests include entrepreneurial decision-making, negotiation, digitalization and sustainability, internationalization and strategic management of SMEs. He is the editor of the book series “Entrepreneurial Behaviour” (Emerald), and Associate Editor of the Journal of Management and Organization. His research was published in over 100 contributions, including articles in highly ranked journals, e.g. HRM Journal , Journal of Business Research, Small Business Economics , International Journal of Conflict Management , Journal of Knowledge Management , Business Strategy and the Environment and IEEE TEM among the others.

Mariya Kargina is a PhD Candidate in Organizational Behavior at the University of Rome “Tor Vergata”. She holds a Master of Science from the University of Lincoln, UK. Her research interests are cross-cultural management, cultural intelligence and global virtual teams. Her research was published in the Journal of Marketing Analytics and presented at several international conferences.

Massimiliano Matteo Pellegrini is an Associate Professor of Organizational studies and Entrepreneurial behaviors at the University of Rome “Tor Vergata”. Previously, he worked at Roehampton University Business School and University of West-London. He is the editor of the book series “Entrepreneurial Behaviour” (EmeraldPublishing), Associate Editor at International Journal of Transition and Innovation System, and past Chair of the Strategic Interest Group of Entrepreneurship (E-ship SIG) at the European Academy of Management (EURAM). He published in highly ranked journals as e.g. Journal of Business Research , Small Business Economics , Journal of Business Ethics , IEEE Transaction on Engineering Management and Journal of Small Business .

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The Effect of Leadership on Conflict Management

First Online: 01 January 2015

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Evren Erzen 2 &
Yasir Armağan 3

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The effect of leadership on conflict management was examined in this meta-analytic study. A total of 485 research studies were identified as a result of a literature review, out of which 32 were included in the meta-analysis. The 32 research studies were compiled to obtain a sample size of 6,838 subjects. The analytic results of a random effects model showed that leadership has a small-magnitude, significant effect on conflict management . In the study, none of a set of variables, including the sample group , leadership style , publication type or year of publication , was found to be a moderator.

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Erzen, E., Armağan, Y. (2015). The Effect of Leadership on Conflict Management . In: Karadağ, E. (eds) Leadership and Organizational Outcomes. Springer, Cham. https://doi.org/10.1007/978-3-319-14908-0_14

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Leadership & Conflict Management: A Review of the Literature

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PMID: 38650067
PMCID: PMC11060090
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Keywords: Problem Management Plus (PM+); common mental disorders; mental health services; psychosocial interventions; scoping review.

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Case report article, old woman with sheehan's syndrome suffered severe hyponatremia following percutaneous coronary intervention: a case report and review of literature.

1 School of Clinical Medicine, Shandong Second Medical University, Weifang, Shandong, China
2 Cardiology Department and Experimental Animal Center, Liaocheng People’s Hospital of Shandong University and Liaocheng Hospital Affiliated to Shandong First Medical University, Liaocheng, Shandong, China
3 Department of Central Laboratory, Liaocheng People’s Hospital, Liaocheng, Shandong, China
4 Department of Cardiology, Shandong Corps Hospital of Chinese People’s Armed Police Forces, Jinan, China

Glucocorticoid deficiency can lead to hypoglycemia, hypotension, and electrolyte disorders. Acute glucocorticoid deficiency under stress is very dangerous. Here, we present a case study of an elderly patient diagnosed with Sheehan's syndrome, manifesting secondary adrenal insufficiency and secondary hypothyroidism, managed with daily prednisone and levothyroxine therapy. She was admitted to our hospital due to acute non-ST segment elevation myocardial infarction. The patient developed nausea and limb twitching post-percutaneous coronary intervention, with subsequent diagnosis of hyponatremia. Despite initial intravenous sodium supplementation failed to rectify the condition, and consciousness disturbances ensued. However, administration of 50 mg hydrocortisone alongside 6.25 mg sodium chloride rapidly ameliorated symptoms and elevated blood sodium levels. Glucocorticoid deficiency emerged as the primary etiology of hyponatremia in this context, exacerbated by procedural stress during percutaneous coronary intervention. Contrast agent contributed to blood sodium dilution. Consequently, glucocorticoid supplementation emerges as imperative, emphasizing the necessity of stress-dose administration of glucocorticoid before the procedure. Consideration of shorter intervention durations and reduced contrast agent dosages may mitigate severe hyponatremia risks. Moreover, it is crucial for this patient to receive interdisciplinary endocrinologist management. In addition, Sheehan's syndrome may pose a risk for coronary atherosclerotic disease.

Introduction

In developed countries, studies have revealed varying prevalence rates of Sheehan's syndrome (SHS) among women, ranging from 0.0051% ( 1 ) to 3.1% ( 2 ). There were also studies showing that the prevalence of SHS ranged from 1% to 2% among women who experienced hypotension due to blood loss of 1–2 L ( 3 , 4 ). Contrastingly, in undeveloped nations, the prevalence varies from 3.1% to 27.6% ( 5 – 7 ). The diagnostic journey for SHS patients spans a considerable duration of 7–19 years from symptom onset to definitive diagnosis ( 8 ). Sheehan's syndrome arises from ischemic necrosis of the anterior pituitary gland triggered by postpartum hemorrhage ( 8 ), leading to pituitary hormone dysfunction, including insufficient secretion of growth hormone, thyroid stimulating hormone, gonadotropin, prolactin, and adrenocorticotropin (ACTH) ( 7 , 9 ). Predominant symptoms are associated with dysfunction of the gonads, thyroid, and adrenal cortex due to insufficient secretion of gonadotropins, thyroid stimulating hormones, and ACTH, respectively. The latter is the most prominent and sometimes life-threatening. Supplementing various deficient hormones is the primary treatment for SHS.

Glucocorticoids, pivotal adrenal cortex hormones, play crucial roles in regulating glucose metabolism, blood pressure, and electrolyte balance. Deficiency in glucocorticoids can lead to hypoglycemia, hypotension, and electrolyte disturbances. Lifetime glucocorticoid replacement therapy stands as a cornerstone in managing SHS patients. Fluctuations in neuroendocrine system activity necessitate adjustments in glucocorticoid supplementation, while metabolic disruptions from other etiologies also dictate dosage alterations. Inadequate comprehension of these dynamics among healthcare professionals may impact the prognosis of SHS patients and predispose them to risks. Surgical treatments, including interventional procedures, represent significant stressors in medical care. Failure to administer preoperative stress doses of glucocorticoids to SHS patients can engender serious consequences. To our knowledge, this article represents the first documented case of severe hyponatremia in an SHS patient following percutaneous coronary intervention (PCI).

Case presentation

A 70-year-old female patient presented with paroxysmal exertional chest tightness persisting for one month, alleviated by a few minutes of rest. Forty years ago, the patient suffered from postpartum hemorrhage, without blood transfusion, subsequently developing lactation failure and amenorrhea. Five years later, she was diagnosed with SHS at the Affiliated Hospital of Shandong University. Management included 5 mg of prednisone acetate in the morning for secondary adrenal insufficiency, and 50 ug of levothyroxine for secondary hypothyroidism. Apart from medication adherence, the patient lacked awareness regarding adrenal insufficiency. The patient had a decade-long history of hypertension, controlled with 5 mg of telmisartan and 5 mg of amlodipine daily. This patient had a weight of 46 kl, a height of 1.57 m, and a BMI of 18.66 kg/m 2 . Upon hospital admission, her vital signs were stable with a blood pressure of 122/58 mmHg, and a heart rate of 65 beats per minute. Physical examination revealed no pulmonary rales, cardiac murmurs, lower limb edema. Laboratory finding indicated elevated blood troponin I (0.5487 ng/ml, 0–0.0175 ng/ml), normal blood sodium (141.5 mmol/L, 137 mmol/L–147 mmol/L), and elevated fasting total cholesterol (6.28 mmol/L, 3 mmol/L–5.7 mmol/L). Thyroid function tests revealed low level of free thyroxine (FT4) (6.77 pmol/L, 7.98 pmol/L–16.02 pmol/L), with normal levels of free triiodothyronine (FT3) and thyroid stimulating hormone. Electrocardiogram indicated sinus bradycardia. We diagnosed the patient with acute non-ST segment elevation myocardial infarction (NSTEMI) and performed percutaneous coronary angiography (CAG) and intravascular ultrasound (IVUS) examination. We found that the stenosis degree was 40%, 80%, and 60%, 98%, and almost completely occluded, respectively, in the left main trunk (LM), the proximal and middle segments of the left anterior descending branch (LAD), the proximal segments of the left circumflex branch (LCX), and the middle segment of the right coronary artery (RCA) ( Figures 1A–C ). The minimum lumen area at the distal stenosis of the LM was 4.51 mm 2 ( Figure 1E ), the plaque load at the most severe stenosis of the proximal LAD was 80%, with a minimum lumen area of 2.88 mm 2 ( Figure 1F ). Due to the patient's refusal to undergo coronary artery bypass grafting, two stents were inserted in the middle segment of the RCA ( Figure 1D ). The intervention lasted for 2 h, including coronary angiography, bilateral intravascular ultrasound examination, patient involvement in treatment decision-making based on examination results, and subsequent coronary intervention treatment, utilizing 130 ml of iodixanol. The patient did not experience any chest discomfort, but was nervous and had a blood pressure rise to 190/100 mmHg, managed with sublingual nifedipine tablets and intravenous isosorbide nitrate. Following percutaneous intervention (PCI), the patient experienced a sequence of symptoms from the 12th to the 50th h, including nausea and loss of appetite, profuse sweating, mild limb twitching, and drowsiness in sequence ( Table 1 ). Limb twitching persisited for 18 h from the 38th to the 56th h post-PCI. On the 24th h post-PCI, the patient was diagnosed with hyponatremia ( Table 1 ), and 2%−3% sodium chloride was intermittently administered intravenously. Despite increased sodium chloride supplementation, symptoms persisted until administration of hydrocortisone, leading to symptom resolution and rapid improvement in blood sodium levels ( Table 1 ). By the 62nd h post-PCI, symptoms of hyponatremia completely resolved, with blood sodium level increasing from 114.2 mmol/L to 132 mmol/L ( Table 1 ). At the 86th h post-PCI, blood sodium level returned to normal. After 40 h, blood tests revealed low levels of cortisol (2.76 ug/dl, 6.7ug/dl–22.6 ug/dl), ACTH (4.26 pg/ml, 10.1 pg/ml–57.6 pg/ml), FT3 (3.41 pmol/L, 3.53 pmol/L−7.37 pmol/L), and FT4 (7.12 pmol/L, 7.98 pmol/L–16.02 pmol/L). Following discharge, the patient continued oral medication with 2.5 mg prednisone acetate and 50 ug levothyroxine sodium daily, as well as dual antiplatelet drugs, statins, and antihypertensive agents. During the next nine-month follow-up period, the patient did not experience ischemic symptoms or hyponatremia.

Figure 1 . Coronary angiography ( A – D ) and intravascular ultrasound examination ( E and F ) in an elderly patient with Sheehan's syndrome. ( A ) The stenosis degree is 40%, 80%, and 60%, respectively, at the end of the left main trunk, the proximal and middle segments of the left anterior descending branch. ( B ) The stenosis degree is 98% at the proximal segments of the left circumflex branch. ( C ) The stenosis degree is almost completely occluded at the middle segment of the right coronary artery. ( D ) Two stents are inserted in the middle segment of the RCA. ( E ) The minimum lumen area at the distal stenosis of the left main trunk is 4.51 mm 2 . ( F ) The plaque load at the most severe stenosis of the proximal left anterior descending branch is 80%, and the minimum lumen area is 2.88 mm 2 .

Table 1 . Timeline of changes in symptoms, blood sodium titers, and hyponatremia treatment in this patient at 12, 24, 38, 50, 56, 62 and 86 h after percutaneous intervention. normal titer blood sodium reference value: 137 mmol/L to 147 mmol/L.

SHS and hyponatremia

Sheehan's syndrome is characterized by insufficient secretion of ACTH due to pituitary necrosis, resulting in decreased synthesis and secretion of adrenocortical hormones, particularly glucocorticoids. Glucocorticoids play a vital role in regulating sodium and water excretion and maintaining electrolyte balance in the body. Insufficient glucocorticoid levels lead to diminished renal free water clearance, causing water retention and dilutional hyponatremia, resulting in reduced plasma osmolality. Furthermore, despite low osmolality, there is inappropriate secretion of antidiuretic hormone (vasopressin) due to the absence of cortisol's tonic inhibition ( 10 ).

Clinical presentation and management

In this case, the patient had a medical history of a SHS diagnosis, presenting with secondary adrenal insufficiency and secondary thyrotrophin deficiency necessitating hormone replacement therapy. Secondary adrenal insufficiency arises from pituitary impairment, causing decreased production of ACTH and subsequent reduction in adrenal stimulation, leading to decreased cortisol production. Glucocorticoid deficiency emerged as the primary mechanism of hyponatremia in this patient. During the 2-h of coronary diagnosis and treatment, the patient was anxious, had high blood pressure, and was in a severe stress state, which required additional cortisol to cope with. The specific amount could be evaluated by a specialist doctor. However, due to secondary adrenal insufficiency, the patient could not suddenly increase the secretion of glucocorticoids to copy with the stress. Additionally, glucocorticoids were not pre increased before the procedure. Therefore, the patient was at risk of acute and severe adrenal cortical hormone deficiency, leading to excessive sodium loss, water retention, and subsequent hyponatremia.

Treatment response

Despite intravenous supplementation of 24.05 g sodium chloride within 26 h, hyponatremia persisted, accompanied limb twitching and drowsiness, indicating an exacerbation of hyponatremia and the formation of hypotonic brain edema. Administration of 50 mg hydrocortisone effectively relieved excessive sodium excretion and water retention. Even with 6.25 g sodium chloride treatment, the patient's symptoms almost disappeared after 6 h, and blood sodium increased from 114.2 mmol/L to 132 mmol/L after 12 h. The subsequent increase in blood sodium levels highlights the importance of glucocorticoid replacement therapy in managing hyponatremia secondary to SHS.

Management considerations

The case underscores the importance of preoperative stress dose glucocorticoid therapy in SHS patients undergoing procedures such as PCI. However, we were unaware the importance. Additionally, awareness of the potential for contrast agents to induce dilutional hyponatremia and stress response caused by PCI is crucial. Lack of endocrinologist consultation before the procedure and inadequate patient education regarding adrenal insufficiency contributed to the suboptimal management of this patient. Inappropriately administered sublingual nifedipine treatment, intended to manage transient hypertension, not only increased the risk of acute cardiovascular and cerebrovascular disease, but also increased the risks of further activating the sympathetic nervous ( 11 ) and exacerbating stress. Therefore, the interdisciplinary management involving endocrinologists is crucial for optimizing the treatment for patients with complex endocrine disorders like SHS, facilitating appropriate examinations, treatment and health education to prevent adrenal crisis and improve long-term outcomes ( 12 , 13 ).

Prolonged limb twitching and sodium correction

Unlike the transient symptoms of epilepsy, the patient experienced persistent limb twitching for up to 18 h, possibly due to prolonged lower blood sodium levels. This prolonged imbalance could have led to sustained electrical instability in brain cells, resulting in repetitive abnormal electro-discharge and impaired brain function, posing significant risks to the patient. However, our approach to correcting hyponatremia may not have followed optimal guidelines. Our method of correcting hyponatremia may not have followed the best guidelines. The target value for increasing serum sodium was not set to not exceed 8–10 mmol/L/24 h ( 14 ). Our treatment rapidly increased the patient's blood sodium from 114 mmol/L to 132 mmol/L in 12 h, and then continued to supplement with hypertonic sodium chloride. Within 26 h after identifying hyponatremia, 24.05 g of sodium chloride was administered intravenously. These treatments are unreasonable, and the overly rapid correction of hyponatremia may be a risk factor for osmotic demyelination syndrome. Proper management should aim to increase blood sodium concentration gradually, with close monitoring to prevent such complications.

Other proposed mechanisms of hyponatremia

Contrast agents have been implicated in inducing hyponatremia, particularly in women ( 15 – 18 ). Following administration, the contrast agents elevate the osmotic pressure of extracellular fluid, leading to passive water transfer of intracellular to extracellular compartments and resultant diluted hyponatremia ( 15 , 16 ). Sweating caused by sympathetic nerve stimulation and sweating caused by adverse reactions to iodixanol injection may also contribute to sodium loss.

Role of hypothyroidism

The patient's thyroid hormone levels were low before and after the procedure, indicating the presence of secondary hypothyroidism. Hypothyroidism may have contributed to hyponatremia mainly through the reduced ability to excretal free water, caused by higher levels of ADH. The elevation in ADH levels is largely due to the decrease in cardiac output that stimulates the carotid sinus baroreceptors, prompting the release of ADH. In addition, hypothyroidism can promote hyaluronic acid deposition in extravascular tissues, leading to increased water retention and reduced blood volume. This not only reduces glomerular filtration, but also increases the secretion of antidiuretic hormone, thereby increasing the risk of diluted hyponatremia ( 19 – 22 ). Therefore, optimizing levothyroxine therapy to restore normal thyroid hormone levels may help mitigate the risk of hyponatremia in such cases.

SHS and coronary artery disease

Previous studies have indicated a higher mortality rate in patients with pituitary dysfunction, primarily attributed to cardiovascular diseases ( 23 – 25 ). Due to chronic inflammation, dyslipidemia, and abdominal obesity, patients with SHS tend to develop coronary artery disease (CAD) ( 26 ). This NSTEMI patient suffered from severe coronary atherosclerosis, with traditional risk factors including hypertension and hypercholesterolemia. Long-term oral administration of glucocorticoids may be associated with hypertension and hyperlipidemia in such patients ( 27 , 28 ). In addition, hypothyroidism, which is common in SHS, can also contribute to hyperlipidemia ( 29 ).

Although severe hyponatremia following PCI in SHS patients is not extensively reported, there are cases of female patients exhibiting life-threatening adrenal dysfunction post-PCI ( 30 , 31 ). The lowest blood sodium level in these cases is 122 mmol/L, and there is no hypoglycemia. Glucocorticoids have good therapeutic effects. The difference is that these patients exhibit significant hypotension, shock, and even Takotsubo syndrome ( 30 , 31 ).

Conclusions

The deficiency of glucocorticoids caused by secondary adrenal insufficiency is the primary mechanism for severe hyponatremia in this patient with SHS. The stress induced by PCI exacerbates glucocorticoid deficiency. The contrast agent further contributes to dilutional hyponatremia. The preoperative stress dose of glucocorticoid is crucial to avoid this complication. Glucocorticoids were crucial in correcting severe hyponatremia in this SHS patient with secondary adrenal insufficiency. Shortening the duration of PCI and minimizing the dosage of contrast agents may be beneficial for preventing severe hyponatremia. Meanwhile, it is also crucial for this SHS patient to receive interdisciplinary management involving endocrinologists before and after the procedure. Additionally, SHS may serve as a potential risk factor for CAD.

Data availability statement

The original contributions presented in the study are included in the article/Supplementary Material, further inquiries can be directed to the corresponding author.

Ethics statement

The studies involving humans were approved by Ethics Committee of Liaocheng People's Hospital. The studies were conducted in accordance with the local legislation and institutional requirements. Written informed consent for participation in this study was provided by the participants’ legal guardians/next of kin. Written informed consent was obtained from the individual(s) for the publication of any potentially identifiable images or data included in this article.

Author contributions

JG: Data curation, Writing – review & editing. YW: Data curation, Formal Analysis, Investigation, Writing – original draft, Writing – review & editing, Software, Methodology, Project administration, Supervision. AZ: Writing – review & editing. HP: Writing – review & editing, Data curation. FW: Writing – review & editing.

The author(s) declare that financial support was received for the research, authorship, and/or publication of this article.

The work was supported by Shandong Province Traditional Chinese Medicine Science and Technology Development Plan Project (No. 20190906).

Conflict of interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Publisher's note

All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.

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Keywords: Sheehan’s syndrome, percutaneous coronary intervention, severe hyponatremia, glucocorticoid deficiency, stress, contrast agent, coronary atherosclerotic disease

Citation: Gao J, Wang Y, Zhang A, Pang H and Wang F (2024) Old woman with Sheehan's syndrome suffered severe hyponatremia following percutaneous coronary intervention: a case report and review of literature. Front. Cardiovasc. Med. 11:1353392. doi: 10.3389/fcvm.2024.1353392

Received: 15 December 2023; Accepted: 17 April 2024; Published: 29 April 2024.

Reviewed by:

© 2024 Gao, Wang, Zhang, Pang and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

*Correspondence: Yuehai Wang [email protected]

† These authors have contributed equally to this work

This article is part of the Research Topic

Case Reports in General Cardiovascular Medicine: 2023

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Laser and Light-Based Therapies for Hirsutism Management in Women With Polycystic Ovarian Syndrome : A Systematic Review

1 Monash Health, Department of Dermatology, Melbourne, Australia
2 Monash Centre for Health Research and Implementation (MCHRI), Faculty of Medicine Nursing and Health Sciences, Monash University, Australia
3 Department of Obstetrics and Gynecology, Research Unit of Clinical Medicine, University of Oulu and Oulu University Hospital, Oulu, Finland
4 Eastern Health Clinical School, Monash University, Melbourne, 3128, Australia
5 Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, Rome, Italy

Question Are laser and light-based hair reduction therapies, either as stand-alone treatments or in combination with other systemic therapies, effective in addressing hirsutism in adults and adolescents with polycystic ovary syndrome (PCOS)?

Findings In this systematic review of 6 studies reporting data on 423 patients, laser and light-based therapies were found to be effective in reducing hirsutism severity, improving psychological well-being, and enhancing quality of life in women with PCOS, with generally tolerable adverse effects. Simultaneous use of metformin or the combined oral contraceptive pill may offer additional benefits.

Meaning These findings alongside broader efficacy data and patient preference informed the 2023 International Evidence-based PCOS Guideline, which has now introduced new recommendations on the use of laser and light-based hair reduction therapies for women with PCOS and hirsutism.

Importance Hirsutism represents a significant concern for women with polycystic ovary syndrome (PCOS), with deleterious psychological effects warranting acknowledgment and a clear imperative to provide effective management. To our knowledge, this is the first review to exclusively examine the effectiveness of laser and light-based therapies in addressing hirsutism in women with PCOS.

Objective To synthesize the existing literature regarding the effectiveness of laser and light hair reduction therapies, either as stand-alone treatments or in combination with systemic agents, in treating hirsutism for women with PCOS.

Evidence Review A systematic literature review was performed using MEDLINE, Embase, EMCARE, and CINAHL according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses ( PRISMA ) reporting guidelines. Articles written in English, reporting on patients who met pre-established inclusion criteria were selected. Objective and subjectively measured outcomes relating to the effect of laser or light-based hair reduction therapies on hirsutism were abstracted. Heterogeneity among included studies precluded a meta-analysis, necessitating a narrative synthesis.

Findings Six studies reporting data on 423 individual patients with PCOS who underwent laser or light-based hair reduction therapies were included: 4 randomized clinical trials and 2 cohort studies. Alexandrite laser demonstrated significant improvements in hirsutism severity and psychological outcomes, particularly at high-fluence application. Alexandrite laser was also found to be more effective than intense pulsed light (IPL). The combination of diode laser with either metformin or combined oral contraceptive pill was superior to the application of diode laser alone, just as the addition of metformin to IPL demonstrated superior results to IPL treatment alone. Overall, most interventions were well tolerated. The overall certainty of evidence across all outcomes and comparisons was limited in part due to the observational nature of some studies.

Conclusions and Relevance This systematic review highlights the potential of laser and light hair reduction therapies, both as stand-alone treatments and in combination with other pharmacological agents in PCOS. However, this review was limited by low certainty of the evidence, few studies evaluating effectiveness and safety in those with skin of color, and heterogeneity in outcome assessment. Future studies are needed to provide more robust evidence among diverse individuals with PCOS and hirsutism.

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Article Contents

Introduction, case report, author contributions, conflict of interest statement, intrarenal neurofibroma: unveiling a diagnostic challenge—a case report and literature review.

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Mahmoud Mustafa, Abdelkarim Barqawi, Amir Aghbar, Ibraheem Alami, Honood Abu Ras, Intrarenal neurofibroma: unveiling a diagnostic challenge—a case report and literature review, Journal of Surgical Case Reports , Volume 2024, Issue 5, May 2024, rjae285, https://doi.org/10.1093/jscr/rjae285

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A 53-year-old male patient presented with an incidental finding of a left kidney mass after being evaluated for elevated serum creatinine without having any symptoms. The left kidney mass was confirmed by ultrasound, computed tomography ‘CT’ scan and magnetic resonance imaging ‘MRI’. A left radical nephrectomy was done, and histopathology confirmed the presence of intrarenal neurofibroma with no evidence of malignancy.

Neurofibroma is an uncommon benign tumor arising in peripheral nerves, and rarely occurs in the kidneys and parapelvic areas [ 1 , 2 ]. Only eight cases were reported, the first of which was in 1967 [ 1–5 ]. A diagnostic dilemma has been faced in the preoperative diagnosis of kidney neurofibroma as it mimics renal cell carcinoma (RCC) or transitional cell carcinoma (TCC). Solitary neurofibroma occurs without a genetic, mutational or syndromic manifestations [ 1 , 4 ]. In this report, we are presenting a case of a 53-year-old male patient with an incidental finding of a left kidney mass, who underwent radical nephrectomy, and the histopathological result was consistent with neurofibroma.

A 53-year-old male patient with a past medical history of hypertension for 10 years, diabetes mellitus (DM) for 20 years and ischemic heart disease with previous percutaneous coronary intervention was incidentally found to have elevated serum creatinine (1.6 mg/dl) as part of routine follow-up evaluation for DM. The patient reported previous normal serum creatinine with no history of hematuria, abdominal pain, weight loss, anorexia or decreased oral intake. Moreover, there was no history of prior surgical or endourological interventions and no family history of kidney tumors.

As part of his evaluation for his elevated serum creatinine, abdominal ultrasound showed the presence of a large, well-defined hypoechoic medullary lesion with internal heterogeneity and minimal vascularity measuring about 6.7 × 7.4 cm 2 and abutting the inner aspect of the left renal cortex. Renal computed tomography (CT) scan without contrast demonstrated a well-defined rounded soft tissue density mass lesion measuring about 6.7 × 6.4 × 7.9 cm 3 in the lower aspect of the left renal medulla ( Fig. 1A and B ).

(A) CT scan axial section and (B) CT scan coronal section. Showing left kidney well-defined rounded soft tissue density mass lesions measuring about 6.7 cm in the lower aspect of the renal medulla. (C) MRI axial section, and (D) MRI coronal section. Showing left kidney large well defined rounded hypointense on T1W and heterogenous hyperintense on T2W images focus seen in the lower aspect of the medulla of the left kidney measuring about 6.8 cm approximately, resulting in mild calyceal dilatation.

As the serum creatinine was elevated, preventing the use of contrast material with the CT scan, abdomen magnetic resonance imaging ‘MRI’ with gadolinium IV contrast showed a large, well-defined rounded lesion, hypointense on T1W and heterogeneous hyperintense on T2W image, with a focus seen in the lower aspect of the medulla of the left kidney measuring about 6.8 × 7.5 cm 2 approximately, resulting in mild calyceal dilatation. After IV contrast administration, it showed mild heterogeneous enhancement, more marked in the delayed images. Two para-aortic small solid lymph nodes, the biggest measuring 1.2 cm, were detected. Chest imaging showed no evidence of distant metastasis ( Fig. 1C and D ).

The left kidney mass was suspicious for malignancy, for which the patient underwent left radical nephrectomy with the removal of the suspicious para-aortic lymph nodes ( Fig. 2 ). The histopathology report showed a final diagnosis of neurofibroma with no malignancy. Para-aortic lymph nodes were also free of malignancy. Histopathological description of the sample showed a 6 × 6 × 5 cm 3 tumor that was located in the lower pole of the removed kidney, encapsulated with yellowish cut surfaces, and was limited to the kidney and did not invade the Gertoa’s fascia. Tumor cells were focally positive for S100 and negative for smooth muscle actin ‘SMA’ and desmin. The pathological findings in the remaining part of the kidney included glomerulosclerosis, interstitial fibrosis and tubular atrophy ( Fig. 3 ). Neurofibroma in our case was truly intrarenal, and this can be demonstrated in Figs 2 and 3 , where tumorous tissues appear adjacent to normal kidney tissues.

(A) Gross images of the harvested left kidney with the tumor located in the lower pole. (B) Cross-section of the harvested specimen showing a well-demarcated circumscribed mass located inside renal parenchyma at the lower aspect of the left renal medulla.

Multiple histopathology sections showing intrarenal neurofibroma with normal kidney tissues. (A) and (B) show the tumor located inside renal parenchyma, juxta to the renal cortical parenchyma. (C) The image show spindle cell tumor with serpentine wavy nuclei arranged in a fascicular pattern.

Neurofibroma is a benign tumor rarely affecting the kidney, and few cases have been reported worldwide [ 1 ]. They tend to be solitary, localized and circumscribed [ 2 ]. Different clinical presentations have been described for the few reported cases of neurofibroma, ranging from no symptoms to flank pain or hematuria (depending on the lesion's extent within the kidney). All of the reported cases of renal or parapelvic neurofibroma had a preoperative diagnostic challenge in confirming the nature of the kidney mass, given its imaging resemblance to RCC or TCC, and thus all of the cases were treated radically [ 1 ]. Involvement of renal sinuses, calyces or upper ureters has also been reported, making preoperative diagnosis more challenging.

In our case, there was a suspicion of RCC based on preoperative imaging, including a CT scan and MRI, which favored our decision to proceed with radical nephrectomy. To our knowledge, most of the reported cases in the literature have also been managed similarly, given the diagnostic dilemma of preoperative diagnosis. Therefore, histopathological examination remains the only way to establish the diagnosis of kidney neurofibroma [ 4 ].

After reviewing all of the eight reported cases [ 1–5 ], there was no radiological suspicion related or specific to neurofibroma during the standard preoperative imaging techniques. Except for two patients who presented with hematuria, the remaining patients presented with pain. In our case, the patient’s diagnosis was incidental. The average age of presentation in all the reported cases ranged from 33 to 59 years, with no predominance in certain genders (four males, three females, and one unknown gender). The volume of the lesions in the reported cases did not exceed 10 cm, which did not raise any special suspicion during the workup, for which there was no deviation from the standard preoperative evaluation for renal RCC. Regarding the location of the tumor, in six out of the eight reported cases, the tumor was located in the renal sinus; the remaining two were located in the retroperitoneum and lower pole. In our case, the lesion was located in the lower aspect of the left renal medulla. Thus, a high index of suspicion is required for any patient with a mass in the renal sinus; ureteroscopy with or without biopsy should be done to distinguish the upper TCC from other renal masses, thus avoiding unnecessary ureterectomy and bladder cuff excision if TCC is ruled out.

Histologically, the examined tumor in the removed kidney in our patient showed an encapsulated lesion with yellowish cut surfaces and was limited to the kidney and did not invade the Gertoa’s fascia. Tumor cells were focally positive for S100 and negative for SMA and desmin, making other mesenchymal tumors, such as solitary fibrous tumor, unlikely. Thus, immunohistochemistry is vital in formulating a final diagnosis [ 2 ].

Neurofibroma of the kidneys is a rare benign tumor with a limited propensity to affect the kidney and parapelvic spaces. No imaging pathognomic findings have been described to help differentiate it from RCC or TCC, making diagnosis challenging and based mainly on histopathological examination. However, a preoperative ureteroscopy with biopsy may determine the nature of the tumor, thus avoiding unnecessary nephrectomy.

All authors made substantial contributions to conception and design. They have all agreed to submit to the current journal; gave final approval of the version to be published; and agreed to be accountable for all aspects of the work.

None declared.

This research did not receive any kind of funds.

A written signed consent was obtained from the patient for the purpose of this article publication and its attached images.

Singh BP , Krishnaswamy SA , Singhai A , Sankhwar S . Parapelvic solitary neurofibroma of the kidney . Case Rep 2015 ; 2015 : bcr2014208357 .

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Mondal SK , Mallick MG , Bandyopadhyay R , Mondal PK . Neurofibroma of kidney: an uncommon neoplasm and diagnostic dilemma with solitary fibrous tumor . J Cancer Res Ther 2010 ; 6 : 388 – 90 .

Corbellini C , Vingiani A , Maffini F , et al. Retroperitoneal pararenal isolated neurofibroma: report of a case and review of literature . Ecancermedicalscience 2012 ; 6 : 253 .

Eljack S , Rosenkrantz A , Das K . CT and MRI appearance of solitary parapelvic neurofibroma of the kidney . Br J Radiol 2010 ; 83 : e108 – e10 .

Kostakopoulos A , Chorti M , Protogerou V , Kokkinou S . Solitary neurofibroma of kidney: clinical, histological and chromosomal appearance . Int Urol Nephrol 2003 ; 35 : 11 – 3 .

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Article contents

Definition of Conflict

Characteristics of Conflict

Type of Conflict: Task, Process, and Relationship Conflict

Conflict Behavior, Conflict Management, and Conflict Resolution

Conflict Behavior

Dual-Concern Model

Accommodating

Compromising

Problem Solving or Integrating

Conglomerate Conflict Behavior (CCB)

How to Explore Your Tendency in Conflict

Table 1. Characteristics of Cooperative and Competitive Climates

How to Manage Conflicts Constructively

Constructive Controversy

Conflict Resolution

Negotiation

Conflict Coaching

Arbitration

Decision Making by Authorities

Further Reading

Related Articles

Conflict in virtual teams: a bibliometric analysis, systematic review, and research agenda

Design/methodology/approach

Research limitations/implications

Originality/value

1. Introduction

2.1 Sampling protocol

2.2 Analyses

3. Results of the bibliometric analyses

3.2 Co-citation analysis: the foundations of the field

3.3 Bibliographic coupling: the structure of the field

3.4 Co-occurrence of keywords

3.5 Synthesis of results

4. Systematic literature review

4.1 Trust cluster

4.2 Performance cluster

4.3 Cultural diversity cluster

4.4 Knowledge management cluster

4.5 Team management cluster

5. Setting-up a research agenda

6. Conclusion

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Leadership & Conflict Management: A Review of the Literature

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