Two models of job stress and depressive symptoms. Results from a population-based study

The Relationship Between Work-Related Stress and Depression: A Scoping Review

Objectives

Work-related stress is highly prevalent. Recent systematic reviews concluded on a significant association between common work-related stress measures and depression. Our scoping review aims to explore whether work-related psychosocial stress is generally associated with depression or depressiveness, the extent and methodology of the primary research undertaken on this topic and to elucidate inconsistencies or gaps in knowledge.

Methods

We searched for literature in Pubmed, PsycInfo and Web of Science including full reports in seven languages published between 1999 and 2022 and applied the PRISMA statement for scoping reviews criteria.

Results

Of 463 primarily identified articles, 125 were retained after abstract and full-text screening. The majority report significant associations between work-related stress and depression. Cross-sectional studies are most prevalent. Sufficient evidence exists only for job strain and effort-reward imbalance. Most studies are from Asia, North America and Europe. The health sector is the most studied. Several research gaps such as the lack of interventional studies were identified.

Conclusion

The consistency of most studies on the significant association between work-related stress and depression is remarkable. More studies are needed to improve evidence and to close research gaps.

Social support, distress and well-being in individuals experiencing Long-COVID: a cross-sectional survey study

OBJECTIVES

Increasingly attention of the COVID-19 pandemic is directed towards its long-term effects, also known as Long-COVID. So far, Long-COVID was examined mainly from a medical perspective, leaving psychosocial effects of Long-COVID understudied. The present study advances the current literature by examining social support in the context of Long-COVID. The study not only examines received support reported by individuals with Long-COVID, but also provided support reported by relatives of individuals with Long-COVID.

DESIGN

Cross-sectional study.

SETTING

The study was conducted from June to October 2021 in Austria, Germany and the German-speaking part of Switzerland.

PARTICIPANTS

We examined 256 individuals with Long-COVID (M_Age=45.05 years, 90.2% women) and 50 relatives of individuals with Long-COVID (M_Age=48.34 years, 66.1% female) in two separate online surveys, assessing social support, well-being and distress.

PRIMARY OUTCOME MEASURES

Primary outcomes were positive and negative affect, anxiety and depressive symptoms and perceived stress.

RESULTS

For individuals with Long-COVID, receiving emotional support was related to higher well-being (positive affect: b=0.29, p<0.01; negative affect: b=-0.31, p<0.05) and less distress (anxiety: b=-1.45, p<0.01; depressive symptoms: b=-1.04, p<0.05; perceived stress: b=-0.21, p<0.05) but no effects emerged for receiving practical support. For relatives of individuals with Long-COVID, providing emotional support was only related to lower depressive symptoms (b=-2.57, p<0.05). Again, provided practical support was unrelated to the outcomes considered.

CONCLUSIONS

Emotional support is likely to play an important role in well-being and distress of patients and relatives, whereas practical support does not seem to make a difference. Future research should clarify under what conditions different kinds of support unfold their positive effects on well-being and distress in the context of Long-COVID.

Gender and Workplace Stress Affect the Association Between Concussion History and Depression Symptoms in Professional Jockeys

Objective

Professional jockeys experience high rates of concussion, workplace stress, and poor mental health. The present cross-sectional study, for the first time, concurrently assessed the potential interplay between concussion history and workplace stress with current depression symptoms.

Method

Seventy-two professional flat-track jockeys (male = 49, female = 23) were grouped based on self-reported concussion history (CG; n = 56) and those who did not report a concussion history (NCG; total n = 16). Analyses featured both between (CG vs NCG) and within group (CG only) assessment on self-reported measures of workplace stress and depression symptoms (affect, daily functioning).

Results

Jockeys in the CG had more symptoms of negative affect than the NCG. This association, however, was nonsignificant after covarying for age, gender, and workplace stress. Higher workplace stress (p = .005) and gender (p = .001) were associated with poorer daily functioning after controlling for concussion history (CG vs. NCG) and age. Gender moderated the association between concussion group and poorer daily functioning (β = −18.739, t (71) = −2.924, p = .005), with the difference between CG and NCG significant for females, but not males (β = 33.648, t (71) = 3.420, p = .001).

Conclusions

The findings provide preliminary evidence that previously concussed females may be more likely to report poorer daily functioning than males with a history of concussion, and that workplace stress may reduce the association between a history of concussion and depression symptoms. Prospective studies are required to validate and extend these findings.

Objective Job Demands of Oneself and One's Partner, and Depressive Symptoms. Evidence from a Nationally Representative Longitudinal Study

Background: Job characteristics are an important predictor of depressive symptoms. Recent research detected unemployment’s spillover effects on spouses’ depressive symptoms, but there is still a lack of studies that examine the association between objective job demands of oneself and one’s partner and depressive symptoms. Methods: Data were derived from the German Ageing Survey (DEAS), which is a representative sample that includes individuals aged 40 years and older. Psycho-social, physical, and overall job characteristics were assessed objectively, using a validated index developed by Kroll. Depressive symptoms were quantified by the Center for Epidemiologic Studies Depression Scale (CES-D). Results: Regarding fixed-effects regression, we found no significant association between the own or the partner’s job demands and depression among the total sample and among men. However, among women, both increasing psychosocial demands of one’s own occupation and physical job demands of one’s partner’s occupation were related to higher levels of depression, as well as the partner’s overall job demands. Conclusions: The findings of the present longitudinal study highlight the association between job demands and depressive symptoms in women, but not in men, especially regarding the partner’s employment characteristics. Efforts to reduce the burden of high job demands may be helpful. This could help alleviate depressive symptoms. In turn, geriatric giants caused by increased depressive symptoms, such as frailty, could be postponed.

Depression symptoms mediate the association between workplace stress and interleukin 6 in women, but not men: The Whitehall II study

Workplace stress and depression are positively related with inflammation, and each other. Low-grade inflammation and concurrent high levels of workplace stress or depression has been related with future morbidity. The potential pathway between constructs however, remains elusive. For the first time, this study explored the concurrent relationship between workplace stress, depressive symptomology and low-grade inflammation, and considered the role of gender in these relationships. Data from the Whitehall II cohort study (N ​= ​2528, M_age ​= ​57.01, 23.7% females) provided measures of workplace stress (job demand-control; JDC), depressive symptomology (Centre for Epidemiological Studies Depression scale; CES-D) and circulating inflammatory markers, interleukin-6 (IL-6) and C-reactive protein (CRP) collected on the same day from a single time point. Females had higher workplace stress, depressive symptoms and lower serum IL-6 concentrations. For males, higher workplace stress was associated with higher depressive symptoms. For females, higher depressive symptoms were related with elevated IL-6 levels, and both higher workplace stress and IL-6 levels were associated with higher depressive symptoms. Higher depressive symptoms were related with higher CRP levels in men only. Higher depressive symptoms statistically mediated the relationship between higher workplace stress and IL-6 levels in females only, b ​= ​0.016, CI [0.002, 0.039]. Females in this large cohort had higher levels of job strain, depression and lower IL-6 concentrations than males. In females, higher depressive symptoms were associated with higher serum IL-6 levels and workplace stress was not. Considered together, these findings suggest that low job control may be more apparent in females than males, but it is primarily negative affect that drives the positive relationship between work stress and serum IL-6 concentrations in females. Replicating the current design with a suitably proximal follow-up is required to determine if the associations identified are causal.

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Females had higher workplace stress, depressive symptoms and lower IL-6.

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Association between stress, depression and inflammation was stronger in women.

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Among females, depressive symptoms and not stress associated with serum IL-6. .

The relationship between job stress and job burnout moderated by BDNF rs6265 polymorphism

RATIONALE

Job stress can lead to job burnout, and BDNF polymorphism has been found to be involved in its psychopathological mechanism. Research needs a better understanding of the important role of gene × environment (i.e., BDNF polymorphism × job stress) interaction on job burnout.

OBJECTIVE

This study aimed to explore how BDNF rs6265 polymorphism may moderate the relationship between job stress and job burnout.

METHODS

Three hundred forty-one healthy participants (187 males and 154 females) from a Chinese university were included. The present study used a standardized questionnaire including demographic characteristics, job stress assessed by the House and Rizzo's Work Stress Scale, and job burnout assessed by the Maslach Burnout Inventory-General Survey. The BDNF rs6265 polymorphism was genotyped.

RESULTS

Job stress showed a positive correlation with emotional exhaustion (p < 0.001), cynicism (p < 0.001), and reduced personal accomplishment (p < 0.01). The main effects of BDNF rs6265 polymorphism on emotional exhaustion and cynicism were significant [F_(1,333) = 5.136, p = 0.024; F_(1,333) = 4.175, p = 0.042, respectively]. The interaction between job stress and BDNF rs6265 on cynicism was significant (△ R² = 0.013, p = 0.014) after controlling for age, sex, education, and position, indicating that individuals with BDNF rs6265 TT genotype showed higher level of cynicism when in high job stress.

CONCLUSIONS

The results provided evidence for the association of BDNF gene rs6265 polymorphism, job stress, and their interaction with job burnout. Individuals with TT genotype in BDNF rs6265 might be susceptible to stressful situations, which would lead to cynicism.

Impact of shift work on the risk of depression

We studied the association between shift work and depressive symptoms in the prospective Heinz Nixdorf Recall Study, considering various demographic, lifestyle and work-related factors. Depressive symptoms were assessed using the Center for Epidemiologic Studies-Depression (CES-D)-Scale (≥17 points defined as high symptoms) and the Patient Health Questionnaire (PHQ) with a cutoff ≥9, or prescription of an anti-depressant. The definition of shift work included work hours outside 7:00 to 18:00, whereas night work was defined as a shift including work between 0:00 and 5:00. Poisson regression with robust error variances was calculated to estimate relative risks (RR) and 95% confidence intervals (CI), adjusted for age at follow-up, diurnal preference, monthly household income and education. Analyses were stratified by sex. We performed various sensitivity and stratified analyses to test the robustness of our results. At baseline, 1,500 gainfully employed subjects, 45-73 years of age and without a history of depression, were included. Until the 5-year follow-up, 896 participants were observed, and 486 participants survived through the 10-year follow-up. Although most analyses did not reach the level of formal statistical significance, women working night shifts tended to show increased relative risks for depressive symptoms according to the PHQ (RR = 1.78; 95% CI 0.71-4.45), in particular when working night shifts for ≥20 years (RR = 2.70; 95% CI 0.48-15.4). Stratification by age group revealed no increased risks among women above 60 years of age. Stratified analyses indicated that over-commitment was associated with higher risks for depressive symptoms among women (RR = 4.59; 95% CI 0.95-22.2 in the CES-D and RR = 12.7; 95% CI 2.89-56.1 in the PHQ). Exclusion of subgroups for the purpose of sensitivity analyses generally strengthened associations in women, whereas little evidence for an increased risk of depression remained among male shift workers. In summary, negative effects on depression were suggested among female shift workers, although results were based on small numbers. Among men, we did not identify consistently increased risks for depressive symptoms in relation to shift work.

Changes in Perceived Stress Following a 10-Week Digital Mindfulness-Based Stress Reduction Program: Retrospective Study

Background

As the need for effective scalable interventions for mental health conditions such as depression, anxiety, and stress has grown, the digital delivery of mindfulness-based stress reduction (MBSR) has gained interest as a promising intervention in this domain.

Objective

This study aims to evaluate the changes in perceived stress following a 10-week digital MBSR program that combined an app-based digital program with weekly one-on-one remote sessions with a health coach.

Methods

This study used a retrospective, observational design. A total of 229 participants with moderate-to-high perceived stress scores as assessed by the Perceived Stress Scale (PSS)-10 enrolled in the 10-week Vida Health MBSR program. The program included weekly remote sessions with a certified health coach and digital content based on concepts fundamental to mindfulness practice. The PSS-10 was used to evaluate perceived stress. Of the 229 participants, 131 (57.2%) were considered program completers and provided at least one follow-up PSS-10. A secondary analysis examined the changes in stress scores at 6 months. This analysis was restricted to participants who had been enrolled in the program for at least 6 months (n=121). To account for random and fixed effects, linear mixed effects modeling was used to assess changes in stress scores over time. An intention-to-treat approach was used to evaluate the changes in perceived stress across the entire study cohort, including those who were lost to follow-up. In addition, a reliable change index was computed to evaluate the changes in scores from the baseline.

Results

The findings revealed a significant positive association between program time and stress reduction (B=−0.365; P<.001) at 12 weeks. We observed an average reduction in stress scores of 3.17 points (95% CI −3.93 to −2.44) by program week 6 and 4.86 points (95% CI −5.86 to −3.85) by program week 12. Overall, 83.2% (109/131) of participants showed a reduction in stress scores by week 12, with 40.5% (53/131) of participants showing reliable improvement at 12 weeks and 47.8% (56/131) of participants showing a shift to a lower stress level category (ie, moderate-to-low stress). The intention-to-treat analysis revealed a significant, although attenuated, reduction in stress scores at 12 weeks (B=−0.23; P<.001). Participants who completed more lessons had an increased likelihood of moving down at least one stress level category (odds ratio 1.512, 95% CI 1.056 to 2.166; P=.02). In assessing medium-term outcomes, among participants who had completed at least 6 months in the program, 48.8% (59/121) of members provided a 6-month assessment. We observed a significant reduction in stress scores at 6 months (t58=10.24; P<.001), with 61% (36/59) of participants showing reliable improvement.

Conclusions

The findings of this retrospective, observational study suggest that a blended, digital mindfulness-based intervention may support program uptake and meaningful, sustained reduction in stress outcomes.

Assessing the Psychosocial Work Environment in Relation to Mental Health: A Comprehensive Approach

OBJECTIVES

Prevailing job stress models encourage a multidimensional view of the psychosocial work environment and highlight the role that multiple co-occurring stressors play in the aetiology of mental health problems. In this study, we develop a latent typology of psychosocial work environment profiles to describe how a comprehensive array of job stressors are clustered in the Canadian labour market. We also examine the association between these latent psychosocial work environment profiles and several indicators of mental health.

METHODS

Data were collected from 6408 workers who completed the Canadian National Psychosocial Work Environment Survey. Psychosocial work exposures were measured using standard items from the Copenhagen Psychosocial Questionnaire. We employed latent profile analyses to identify groups of individuals with similar psychosocial work environment profiles. We used log-linear regression models to examine the association between latent psychosocial work environment profiles and burnout, stress, and cognitive strain.

RESULTS

Four distinct groups with highly divergent psychosocial work environment profiles were identified. Adjusting for a range of demographic and socioeconomic factors, latent psychosocial work environment profiles were strongly related to mental health. Individuals who reported exposure to a comprehensive array of psychosocial job stressors (11% prevalence) reported the highest probability of burnout (PR: 7.51, 95% confidence interval [CI]: 5.56-10.15), stress (PR: 8.98, 95% CI: 6.20-13.0), and cognitive strain (PR: 7.29, 95% CI: 5.02-10.60).

CONCLUSIONS

Findings suggest that psychosocial work stressors are tightly clustered in the Canadian labour market, and that the clustering of work stressors is strongly associated with adverse mental health outcomes. Future scholarship may benefit from adopting a more comprehensive approach to the assessment of psychosocial job quality as a determinant of health and well-being.

Development and Validation of a Questionnaire to Measure Psychosocial Work Stressors in Modern Working Environments

OBJECTIVE

The rapid development of technology is changing working conditions of many employees. With this, appropriate measurement instruments to capture work-related psychosocial risks to create healthy working conditions are becoming more and more important. Therefore, we developed and validated a questionnaire to assess stressors in work settings which are characterized by a high degree of digitization.

METHOD

The validation was based on two independent studies with data collected in four subsamples. All participants were asked about their working conditions and health-related topics using online questionnaires.

RESULTS

The resulting 16-item questionnaire consists of five scales: work load, boundary permeability, participation, leader support, and usability.

CONCLUSIONS

The results show that the five identified stressors showed acceptable to good values with regard to reliability (internal consistencies, test-retest reliabilities, and interrater agreement) as well as (convergent and concurrent) validity.

Prevalence and associated factors of depression and anxiety among nurses during the outbreak of COVID-19 in China: A cross-sectional study

BACKGROUND

Coronavirus disease 2019 (COVID-19) is a public health emergency of international concern and has caused traumatic experience for nurses worldwide. However, the prevalence of depression and anxiety symptoms in nurses, and how psychosocial factors influence nurses in this public crisis are unknown.

OBJECTIVES

To determine the effect of COVID-19 on the mental health of nurses and the prevalence of anxiety and depression symptoms among nurses in China during the outbreak.

DESIGN

A cross-sectional study.

SETTINGS AND PARTICIPANTS

A total of 3,228 nurses in Sichuan Province and Wuhan City were selected by convenience sampling. All participants were invited to complete the questionnaire through WeChat from January 27 to February 3, 2020.

METHODS

A self-reported questionnaire combining depression and anxiety scale was used to collect data anonymously. Binary and multivariate logistic regression was applied to measure the odds of psychosocial factors of anxiety and depression and perceived health, respectively.

RESULTS

The total incidence of depression (34.3%) and anxiety (18.1%) during the COVID-19 outbreak was lower than that during the SARS outbreak; however, the rate of depression in our study (47.1%) was high and similar in a recent study (50.4%) about the health care workers exposed to COVID-19 in China. The results indicated that COVID-19-related stress, relationship quality with family, and demographic characteristics were associated with depression, anxiety, and perceived health status. Furthermore, the prevalence of depression was similar between nurses working in low-risk COVID-19 wards was as high as working in high-risk COVID-19 wards (OR, 1.078; 95% CI, 0.784-1.481).

CONCLUSIONS

Our study revealed the high prevalence of depression and anxiety among nurses during the outbreak of COVID-19. COVID-19 factors and psychosocial factors were associated with mental health of nurses. The results suggest that hospitals should implement effective mental health promotion programs focused on occupational safety and family support to improve the well-being of nurses.

The Association Between Financial Hardship and Mental Health Difficulties Among Adult Wage Earners During the COVID-19 Pandemic in Bangladesh: Findings From a Cross-Sectional Analysis

Background: The ongoing COVID-19 pandemic has created several challenges including financial burdens that may result in mental health conditions. This study was undertaken to gauge mental health difficulties during the COVID-19 pandemic and gain an insight into wage earners' mental health. Method: This cross-sectional study was conducted through an online survey. A t total of 707 individual Bangladeshi wage earners were enrolled between 20 and 30 May 2020. The questionnaire had sections on sociodemographic information, COVID-19 related questions, PHQ-9 and GAD-7 scales. STATA version 14.1 program was used to carry out all the analyses. Results: The study revealed that 58.6 and 55.9% of the respondents had moderate to severe anxiety and depressive symptoms, respectively. The total monthly income was <30,000 BDT (353.73USD) and displayed increased odds of suffering from depressive symptoms (OR = 4.12; 95% CI: 2.68-6.34) and anxiety (OR = 3.31; 95% CI: 2.17-5.03). Participants who did not receive salary income, had no income source during the pandemic, had financial problems, and inadequate food supply and were more likely to suffer from anxiety and depressive symptoms (p ≤ 0.01). Perceiving the upcoming financial crisis as a stressor was a potential risk factor for anxiety (OR = 1.91; 95% CI:1.32-2.77) and depressive symptoms (OR = 1.50; 95% CI:1.04-2.16). Limitations: The online survey method used in this study limits the generalizability of the findings and self-reported answers might include selection and social desirability bias as a community-based survey was not possible during the pandemic. Conclusion: Wage earners in a low resource setting like Bangladesh require mental health attention and financial consideration to deal with mental health difficulties.

Effects of job stress on symptoms of bipolar spectrum disorder in an electronic parts manufacturing company

Background

Mental illness is known to be caused by genetic, biological, and environmental risk factors. Although previous studies have established the link between mental illness and job stress, most of them are limited to major depression disorder. Therefore, this study examined the relationship between job stress and bipolar spectrum disorder (BSD).

Methods

This is a cross-sectional study based on a survey conducted in April 2017 at an electronic parts manufacturing company in Busan. In a total of 441 workers, the degree of BSD was identified using the Korean version of the Mood Disorder Questionnaire, and the degree of job stress was identified using the Korean Occupational Stress Scale Short Form. This study also identified general characteristics of workers and job-related factors. The χ² test and Fisher's exact test was conducted to determine the differences among the variables, based on BSD. Multiple logistic regression analysis was conducted to determine the influence of independent variables on BSD.

Results

Cross-analysis showed significant differences between the BSD high-risk and low-risk groups regarding age, sex, occupation, smoking, problem drinking, job stress total score, occupational climate, and major depression disorder symptom. In addition, the significant differences between the BSD high-risk and low-risk groups about job stress were observed in terms of job demand, job insecurity, and occupational climate. A multiple logistic regression analysis revealed that the high-risk group in the job stress group had a higher effect on BSD than the low-risk group (odds ratio [OR]: 2.32, 95% confidence interval [CI]: 1.10–4.88). Among the categories of job stress, high-risk groups in 3 areas—job demand (OR: 2.56, 95% CI: 1.27–5.17), job insecurity (OR: 4.42, 95% CI: 1.19–16.42), and occupational climate (OR: 2.55, 95% CI: 1.29–5.05)—were more likely to have an impact on BSD than the low-risk groups.

Conclusions

This study demonstrated that the high-risk groups of job stress total score, job demand, job insecurity, and occupational climate had a more significant effect on BSD than the low-risk groups. As workers with BSD may have difficulties in their work and personal lives, there is a need to manage job stress to prevention of BSD.

Oxytocin receptor gene polymorphisms moderate the relationship between job stress and general trust in Chinese Han university teachers

BACKGROUND

Chronic exposure to stressful work environments can influence general trust. High job stress is associated with low trust in others. Both environmental and genetic factors contribute to general trust; however, few empirical studies have explored the important role of gene-environment interactions on general trust. In this study, the moderating roles of the polymorphisms OXTR rs53576 and OXTR rs2268490 in the relationship between job stress and general trust were evaluated.

METHODS

362 healthy Chinese Han university teachers (196 males, 165 females, and 1 undisclosed) were included (M_age = 39.80, SD = 9.16). Standardized questionnaires about demographic characteristics, job stress, and general trust scale were collected. Blood samples were collected for OXTR rs53576 and rs2268490 genotyping.

RESULTS

Job stress scores showed a significant negative main effect on general trust (p < 0.001), while OXTR rs53576 and rs2268490 did not (p > 0.05). The effect of the interaction between job stress and OXTR rs53576 or rs2268490 on general trust was significant, even after controlling for gender and age. High job stress was associated with low general trust in OXTR rs53576 homozygous individuals (GG/AA) or OXTR rs2268490 CT individuals, demonstrating that the GA genotype in OXTR rs53576 and CC/TT genotype in OXTR rs2268490 are protective genotype of general trust.

LIMITATIONS

This study used a cross-sectional design, only considered Chinese Han university teachers, and only examined two polymorphisms in OXTR.

CONCLUSIONS

Our findings provide evidence that gene-environment interactions influence general trust and identify a new locus (rs2268490) underlying this phenotype.

Combined exposure of emotional labor and job insecurity on depressive symptoms among female call-center workers: A cross-sectional study

Call-center workers work under unfavorable psychosocial working conditions, including, emotional labor and job insecurity, which might be linked to depressive symptoms.The purpose of this study was to explore the link between emotional labor and depressive symptoms and to investigate the influence of combined exposure to emotional labor and job insecurity on depressive symptoms.A health survey was conducted among female call-center workers in Geumcheon-gu (a district in Seoul), South Korea, in November 2012. The short form of the Korean occupational stress scale was used to measure occupational stressors. A questionnaire with 8 items was employed to assess emotional labor. Depressive symptoms were estimated using the Korean Version of the Centre for Epidemiologic Studies Depression Scale (CES-D). The association of emotional labor and occupational stressors with depressive symptoms was assessed using multilevel mixed-effects logistic regression.Overall, 699 female call-center workers were enrolled into this study. The odds ratios of experiencing depressive symptoms in workers exposed to emotional labor and job insecurity were 5.45 (95% confidence interval [CI]: 3.38-8.80) and 2.37 (95% CI: 0.86-6.50), respectively. When workers were simultaneously exposed to excessive emotional labor and high job insecurity levels, the odds ratio of experiencing depressive symptoms was 10.13 (95% CI: 3.51-29.23). The Relative Excess Risk due to the Interaction (RERI) of job insecurity and emotional labor was 3.30 (95% CI: -5.50 to 12.11); however, this was not statistically significant (P = .46).Although a causal relationship could not be established due to the cross-sectional study design, the combined effect of emotional labor and job insecurity might have a serious influence on behavioral health among call-center female workers.

Psychological strains, depressive symptoms, and suicidal ideation among medical and non-medical staff in urban china

BACKGROUND

The Strain Theory of Suicide has been tested and well supported regarding rural people who show risk of suicide. Studies on the impact of psychological strains on psychopathologies and suicidality in urban environments in China have been lacking.

AIMS

This study was designed to further examine the associations between psychological strains, depressive symptoms, and suicidal ideation in two separate urban samples of adults in China.

METHODS

One sample consisted of randomly selected medical employees of a large hospital (n = 1012), and a second sample included heterogeneous office employees (n = 1052). A self-administered questionnaire was used to collect demographics, psychological strains, social support, depressive symptoms, and suicidal ideation.

RESULTS

Depressive symptoms were associated with longer work hours, less social support, value strain, aspiration strain and coping strain among medical staff, and were linked to longer work hours, less social support, aspiration strain and coping strain among non-medical staff. Suicide ideation was associated with longer work hours, coping strain, and depression among medical staff, and was linked to longer work hours, gender, religion, value strain and depression among non-medical staff.

CONCLUSIONS

Both depressive symptoms and suicidal ideation were associated with psychological strains among Chinese urban professionals. Reduction of psychological strain is necessary to help maintain proper mental health and to ensure optimal performance at work.

The role of optimism in the relationship between job stress and depressive symptoms. Longitudinal findings from the German Ageing Survey

BACKGROUND

The aim of the present study was to investigate the effect of job stress on depressive symptoms and whether optimism moderates this relationship longitudinally. Data were used from 2002 until 2014 (wave 2 to 5) of the German Ageing Survey. The sample consists of community-dwelling individuals living in Germany aged from 40 to 95 years (7086 observations in fixed effects regression analysis).

METHODS

A self-report questionnaire was used to measure depressive symptoms (Center for Epidemiologic Studies Depression Scale), job stress (scale 1 to 5) and optimism (Optimism Scale of Brandtstaedter & Wentura).

RESULTS

Adjusting for potential confounders, fixed effects regression analysis revealed that an increase in job stress was associated with an increase in depressive symptoms, whereas an increase in optimism was associated with a decrease in depressive symptoms. Optimism significantly moderated the relation between job stress and depressive symptoms.

LIMITATIONS

The possibility of a small sample selection bias cannot be dismissed.

CONCLUSIONS

The present study highlights the moderating role of optimism in the relation between job stress and depressive symptoms longitudinally. Thus, efforts to increase optimism in individuals might be beneficial in reducing depressive symptoms among individuals with high job stress.

Do workplace-based mindfulness meditation programs improve physiological indices of stress? A systematic review and meta-analysis

OBJECTIVE

Mindfulness-based interventions (MBI) have been related with improved job satisfaction, wellbeing, health, and reduced workplace stress with employees. However, until now, synthesis of the evidence of the effect of MBIs on physiological indices associated with stress and ill-health has been lacking. Therefore the current systematic review aimed to synthesise the literature from employee samples to provide guidance for future investigations in terms of which physiological indicators and biological systems may be most impacted by MBIs.

METHODS

Electronic databases were searched. Studies that conducted a mindfulness-based program with an employee sample, which targeted workplace stress or work engagement, and measured a physiological outcome were selected for inclusion. Studies using either a between-group or within-group design were included. Nine papers were found to meet the inclusion criteria for our systematic review and meta-analysis of the literature.

RESULTS

MBIs were found to be effective in reducing cortisol production, as indicated by lowered high and low diurnal cortisol slopes. However, no changes were found for cortisol awakening response or concentrations for single a.m. and p.m. time-points. MBIs also improved autonomic balance, assessed by heart rate variability coherence measures, but not blood pressure. Sympathetic nervous system reactivity as measured by salivary alpha amylase was also reduced following MBI. While aspects of immune function were also improved following MBIs, specifically, increased antibody response to a viral vaccine and reduced C-reactive protein concentrations, each of these outcomes were only assessed in a single study.

CONCLUSION

Taken together, the findings suggest that MBIs are a promising avenue for intervention for improving physiological indices of stress. Our findings suggest that changes in daytime cortisol secretion and HRV coherence may be particularly influenced by MBIs. Future studies should aim to assess multiple physiological indices to confirm the current findings and further improve current understanding of which biological systems (and indices within these systems) show responses indicative of reduced stress due to MBI.

Job characteristics and mental health for older workers

Background

Adverse job characteristics have been linked with increased incidence of depression and anxiety in working populations. However, the association between job characteristics and mental health, in an older working population while controlling for personality traits, is less well known.

Aims

To examine the association between job characteristics (job demands and job control) and mental health (depression and anxiety) for older workers while controlling for personality traits.

Methods

A sample of workers aged 50-69 years were recruited from a primary health care clinic in Southern Ireland. Job characteristics were measured using the Copenhagen Psychosocial Questionnaire; demands (quantitative and cognitive) and control (influence at work and possibilities for development). Personality traits were measured using the Ten-Item Personality Inventory, depression was measured using the Center for Epidemiological Studies-Depression Scale and anxiety was measured using the Hospital Anxiety and Depression Scale. Descriptive analysis, simple and multiple linear regression analyses were conducted.

Results

The final sample size was 1025 with an initial 67% response rate. Multiple linear regression analysis showed job characteristics (in particular, job demands) to be significant positive predictors of symptoms of depression and anxiety. The inverse was true for job control variables and symptoms of depression. Neither possibilities for development nor influence at work were associated with symptoms of anxiety.

Conclusions

Our findings indicate that despite potential confounders, higher demands at work can impact the worker's mental health negatively. Reducing job demands and encouraging role development may benefit the mental health of older workers.

The Influence of Recognition and Social Support on European Health Professionals' Occupational Stress: A Demands-Control-Social Support-Recognition Bayesian Network Model

Healthcare professionals undergo high levels of occupational stress as a result of their working conditions. Thus, the aim of this study is to develop a model that focuses on healthcare professionals so as to analyze the influence that job demands, control, social support, and recognition have on the likelihood that a worker will experience stress. The data collected correspond to 2,211 healthcare workers from 35 countries, as reported in the sixth European Working Condition Survey (EWCS). The results obtained from this study allow us to infer stress under several working condition scenarios and to identify the more relevant variables in order to reduce this stress in healthcare professionals, which is of paramount importance to managing the stress of workers in this sector. The Bayesian network proposed indicates that emotional demands have a greater influence on raising the likelihood of stress due to workload than do family demands. The results show that the support of colleagues, in general, has less effect on reducing stress than social support from superiors. Furthermore, the sensitivity analysis shows that, in high-demand and low-control situations, recognition clearly impacts stress, drastically reducing it.

Chronic exposure to adverse psychosocial work factors and high psychological distress among white-collar workers: A 5-year prospective study

OBJECTIVES

Prospective studies which evaluated whether the effects of chronic exposure to psychosocial work factors on mental health persisted over time are scarce. For the first time, this study evaluated: 1) the effect of chronic exposure to effort-reward imbalance over 5years on the prevalence of high psychological distress among men and women, and 2) the persistence of this effect over time.

METHODS

Overall, 1747 white-collar workers from three public organizations participated in a prospective study. Psychological distress and effort-reward imbalance were measured using validated questionnaires at baseline, and at 3- and 5-year follow-ups. Prevalence ratios (PRs) of high psychological distress were estimated using log-binomial regression according to baseline and repeated exposure.

RESULTS

Compared to unexposed workers, those with repeated exposure to effort-reward imbalance had a higher prevalence of high psychological distress. Workers exposed only at some time-points also had a higher prevalence. The deleterious effect of repeated exposure observed at the 3-year follow-up persisted at the 5-year follow-up among women (PR=2.48 95% confidence interval (CI) 1.97-3.11) and men (PR=1.91 95% CI 1.20-3.04). These effects were greater than those found using a single baseline measurement.

CONCLUSION

The current study supported a deleterious effect of repeated exposure to effort-reward imbalance on psychological distress, and a lack of adaptation to these effects over time among men and women. Since psychological distress may later lead to severe mental problems, current results highlight the need to consider exposure to these adverse work factors in primary and secondary preventions aimed at reducing mental health problems at work.

Depressive symptoms and psychosocial aspects of work in bank employees

BACKGROUND

The financial sector has seen an increase in the number of cases of violence and stress, which can result in adverse health outcomes, including depressive symptoms, but studies related to stress at work and depression for these workers are scarce.

AIMS

To investigate the association between exposure to psychosocial work stressors and depressive symptoms in bank employees.

METHODS

A self-administered questionnaire was completed by a sample of bank employees in Pará and Amapá, Brazil. The survey assessed sociodemographic characteristics, mental health (Patient Health Questionnaire-9), Demand-Control-Support and Effort-Reward Imbalance (ERI). Outcomes included two levels of depressive symptoms: major depressive symptoms (MDS) and other forms of depressive symptoms (ODS). Logistic regression models were used to estimate associations between depressive symptoms, the two job stress models and relevant covariates.

RESULTS

Of 2806 eligible subjects, there were 1445 respondents (52% response rate) and the final analyses included 1046 participants. The overall prevalence of depressive symptoms was 32% (MDS = 18%; ODS = 14%), with no statistically significant difference between men and women. High demands, low levels of control and low social support were associated with MDS and/or ODS, adjusted for gender, age and other work-related conditions. High effort/low reward, over-commitment and ERI were also associated with MDS and ODS.

CONCLUSIONS

Psychosocial conditions in banking activity involving high strain, low social support at work, high effort with low reward and over-commitment may represent possible risk factors for depressive symptoms in bank employees.

Communication, support and psychosocial work environment affecting psychological distress among working women aged 20 to 39 years in Japan

When compared with their older counterparts, younger women are more likely to have depressive symptoms because they more often experience interrupted work history and a heavy childrearing burden. The purposes of the present study were 1) to investigate the possible association of psychosocial work environment with psychological distress and 2) to examine the way by which communication and support in the workplace affect to psychological distress among young women. We studied 198 women aged 20 to 39 yr in a cross-sectional study. The Kessler Scale-10 (K10 Scale) was used to examine psychological distress. In employees who experienced interpersonal conflict, those who had little or no conversations with their supervisor and/or co-workers had a significantly increased risk of psychological distress (OR, 4.2), and those who received little or no support from their supervisor and/or co-workers had a significantly increased risk of psychological distress (OR, 3.8) compared to those who had more frequent communication and received more support. Harmonious communication in the workplace can help prevent psychological distress among employees, which in turn may enable them to be satisfied with their work.

Competition in human groups-Impact on group cohesion, perceived stress and outcome satisfaction

This study on competition in human groups was performed within the context of the competitive outcome interdependence concept: the degree to which personal outcomes among group members are affected by the consequences of task performance of others, e.g. when one group member gains a high reward for a task, this lowers the available reward for other group members. Our computer-based multi-participant game empirically assessed how competitive versus neutral conditions influenced the reward-maximising behaviour of 200 undergraduate students functioning in ten-person groups - each playing two games (1 neutral and 1 competitive), their perceived pay satisfaction as well as perceived stress levels and sense of calmness within the games' task to search for coins. Participants were represented by black dots moving on a virtual playground. Results showed that competition led to reward-maximising but fellow group member disadvantaging behaviour, and all participants experienced lower pay satisfaction, higher stress levels and less calmness. We conclude that short-term behavioural consequences of positive individual competitive behaviour were gained at the above-mentioned potential long-term negative costs for all group members. This implies group paradigms aimed at sustainability should avoid introducing competitive factors that at best result in short-lived gains and at worst cause widespread dissatisfaction, stress and a pervasive lack of calmness.

Impaired mental well-being and psychosocial risk: a cross-sectional study in female nursing home direct staff

OBJECTIVES

The present study sought to quantify the impaired mental well-being and psychosocial stress experienced by nursing home staff and to determine the relationship between impaired mental well-being assessed on the 12-item General Health Questionnaire (GHQ-12) and exposure to psychosocial stress assessed on Siegrist's effort/reward and overcommitment model.

METHODS

A transverse study was conducted in France on 2471 female employees in 105 nursing homes for the elderly. Personal and occupational data were collected by questionnaire for 668 housekeepers, 1454 nursing assistants and 349 nurses.

RESULTS

36.8% of participants (n=896) showed impaired mental well-being, 42.7% (n=1039) overcommitment and 9% (n=224) effort/reward imbalance. Overcommitment (prevalence ratio (PR)=1.27; 95% CI (1.21 to 1.34)) and effort-reward imbalance (PR=1.19; 95% CI (1.12 to 1.27)) were significantly associated with presence of impaired mental well-being after adjustment for personal factors (age and private life events). Taking effort and reward levels into account, the frequency of impaired mental well-being was highest in case of exposure to great extrinsic effort and low rewards of any type: esteem, PR=3.53, 95% CI (3.06 to 4.08); earnings, PR=3.48, 95% CI (2.99 to 4.06); or job security, PR=3.30, 95% CI (2.88 to 3.78). Participants in situations of overcommitment and of effort/reward imbalance were at the highest risk of impaired mental well-being: PR=3.86, 95% CI (3.42 to 4.35).

CONCLUSIONS

Several changes in nursing home organisation can be suggested to reduce staff exposure to factors of psychosocial stress. Qualitative studies of the relation between impaired mental well-being and psychosocial stress in nursing home staff could guide prevention of impaired mental well-being at work.

[The relationship of work-related psychosocial risk factors with depressive symptoms among Hungarian workers: preliminary results of the Hungarian Work Stress Survey]

INTRODUCTION

Research has shown that psychosocial stress acts as a risk factor for mental disorders.

AIM

The present study aims at processing the preliminary results of the Hungarian Survey of Work Stress, concerning the relationship between depressive symptoms and work stress.

METHODS

Cross-sectional survey among Hungarian workers was carried out (n = 1058, 27.5% man, 72.5% woman, age 37.2 years, SD = 11 years). Psychosocial factors were measured using the COPSOQ II questionnaire, while BDI-9 was used for the assessment of depressive symptoms. Statistical analysis was carried out applying Spearman's correlation and logistic regression.

RESULTS

A quarter of the workers reported moderate or severe symptoms of depression (BDI≥19). The study confirmed the association between depressive symptoms and work-family conflict (OR = 2.21, CI: 1.82-2.68), possibilities for development (OR = 0.76, CI: 0.59-0.97) meaning of work (OR = 0.69, CI: 0.59-0.89) and commitment (OR = 0.60, CI: 0.47-0.78).

CONCLUSION

The results point toward the need of such organizational measures that allow for the reduction of psychosocial stress.

Do time-invariant confounders explain away the association between job stress and workers' mental health? Evidence from Japanese occupational panel data

It is well known that job stress is negatively related to workers' mental health, but most recent studies have not controlled for unobserved time-invariant confounders. In the current study, we attempted to validate previous observations on the association between job stress and workers' mental health, by removing the effects of unobserved time-invariant confounders. We used data from three to four waves of an occupational Japanese cohort survey, focusing on 31,382 observations of 9741 individuals who participated in at least two consecutive waves. We estimated mean-centered fixed effects models to explain psychological distress in terms of the Kessler 6 (K6) scores (range: 0-24) by eight job stress indicators related to the job demands-control, effort-reward imbalance, and organizational injustice models. Mean-centered fixed effects models reduced the magnitude of the association between jobs stress and K6 scores to 44.8-54.2% of those observed from pooled ordinary least squares. However, the association remained highly significant even after controlling for unobserved time-invariant confounders for all job stress indicators. In addition, alternatively specified models showed the robustness of the results. In all, we concluded that the validity of major job stress models, which link job stress and workers' mental health, was robust, although unobserved time-invariant confounders led to an overestimation of the association.

The association between occupational stress and depressive symptoms and the mediating role of psychological capital among Chinese university teachers: a cross-sectional study

BACKGROUND

Depression is a major public health problem that affects both individuals and society. Previous studies report that university teachers are particularly susceptible to high levels of occupational stress and depressive symptoms. The aims of this study were to explore the association between occupational stress and depressive symptoms in a group of university teachers, and assess the mediating role of psychological capital between these variables.

METHODS

A cross-sectional study was performed between November 2013 and January 2014. Teachers from six universities were randomly sampled in Shenyang. The Center for Epidemiologic Studies Depression Scale, effort-reward imbalance scale, and psychological capital questionnaire (PCQ-24), as well as questions about demographic and working factors, were administered in questionnaires distributed to 1,500 university teachers. Completed questionnaires were received from 1,210 participants. Hierarchical linear regression analysis was used to examine the mediating role of psychological capital.

RESULTS

In the present study, 58.9% (95% CI (Confidence Intervals): 56.1% to 61.7%) of university teachers had a CES-D score equal to or above the cut-off of 16. Both effort-reward ratio (ERR) and scores of over-commitment were positively associated with depressive symptoms, whereas psychological capital was negatively associated with depressive symptoms among university teachers. Psychological capital partially mediated the relationship between occupational stress and depressive symptoms.

CONCLUSIONS

Among Chinese university teachers, occupational stress may be a risk factor for depressive symptoms, whereas psychological capital might be protective against depressive symptoms. Our results suggest that college administrators could support the development of psychological capital in their staff to alleviate depressive symptoms.

Mental health status and work environment among workers in small- and medium-sized enterprises in Guangdong, China-a cross-sectional survey

BACKGROUND

Small- and medium-sized enterprises (SMEs) generate nearly 80% of the jobs in China, but the dangerous work environment often found in these enterprises poses a major concern for public health. Psychosocial pressure and mental health problems among the workers are also common in SMEs. However, mental health of workers in SMEs is largely neglected in occupational health research and practice in China. The purpose of this study is to assess mental health of the workers and to explore the associations between physical and psychosocial work environment and workers' mental health in SMEs in South China.

METHODS

Data were collected in 2012 through a cross-sectional survey among 1200 workers working in small- and medium-sized enterprises (SMEs) in Guangdong, China. Mental health was measured by psychological well-being in the current study. Job Demand-Control-Support (JDCS) model was used as a theoretical framework to examine the psychosocial factors associated with workers' psychological well-being. Data were analyzed using SPSS 20.0 and analysis was performed using bivariate analyses and multivariate logistic regression.

RESULTS

About three in ten workers (35.3%) in the sample had poor psychological well-being. Those who were men, younger in age, or migrant workers had worse psychological outcome in bivariate analyses. After controlling for individual variables (gender, age, marital status, and household registration), we found that longer weekly work hours (OR = 1.30, 95% CI: 1.13 ~ 1.50), more exposure to hazardous work environment (OR = 1.26, 95% CI: 1.10 ~ 1.44), higher job demands (OR = 1.29, 95% CI: 1.12 ~ 1.49), and lower job autonomy (OR = 0.70, 95% CI: 0.60 ~ 0.81) were significant associated with worse psychological well-being. The results were consistent with predictions of the JDCS model.

CONCLUSIONS

The results indicate that the JDCS model is a useful framework in predicting psychological well-being among Chinese workers in SMEs. Future mental health promotion should focus on young migrant male workers as they appear to be most vulnerable in their psychological well-being. Both physical and psychosocial aspects of the work environment should be taken into account in policy making to prevent mental disorder and promote psychological well-being among workers in SMEs.

Are effort-reward imbalance and social isolation mediating the association between education and depressiveness? Baseline findings from the lidA(§)-study

OBJECTIVES

To investigate multiple mediations of the association between education and depressive symptoms (BDI-V) by work-related stress (ERI) and social isolation, the regional variation of the first mediation and a potential moderating effect of regional unemployment rate.

METHODS

6339 employees born in 1959 and 1965 were randomly recruited from 222 sample points in a German cohort study on work, age, health and work participation. A multilevel model of moderated lower-level mediation was used to investigate the confirmatory research question. Multiple mediations were tested corresponding to Baron and Kenny. These analyses were stratified for age and adjusted for sex, negative affectivity and overcommitment.

RESULTS

In the association between education and depressive symptoms, indirect effects of work-related stress and social isolation were significant in both age cohorts whereas a direct association was observable in the younger cohort, only. The significant regional variation in the association between work-related stress and depressive symptoms was not statistically explained by regional unemployment rate.

CONCLUSIONS

Our findings point out that work-related stress and social isolation play an intermediary role between education and depressive symptoms in middle-aged employees.

Psychological distress in the workforce: a multilevel and longitudinal analysis of the case of regulated occupations in Canada

Background

This study uses a multidimensional theoretical model to evaluate the role of regulated occupations and working conditions in explaining psychological distress.

Methods

Various multilevel regression analyses were conducted on longitudinal data for which measures repeated over time (n₁ = 36,166) were nested in individuals (n₂ = 7007).

Results

Results showed that when we controlled for working conditions, family situation, the social network outside the workplace, and personal characteristics, the level of psychological distress was significantly lower among professional workers in regulated occupations than among professionals not in regulated occupations. Among the working conditions studied, skill utilisation, psychological demands, and job insecurity were positively associated with psychological distress levels, whereas social support in the workplace was inversely related to distress. Finally, our results suggest that self-esteem reduced the effect of social support in the workplace on psychological distress levels in the workforce.

Conclusions

These results support our hypothesis that working in regulated occupations exerts a direct effect on mental health. These results also make clear the importance of developing new tools for measuring psychological distress among upper-level professional workers. Such tools will be much better suited to the realities characterising today's knowledge-based economies.

The mediating and moderating effects of workplace social capital on the associations between adverse work characteristics and psychological distress among Japanese workers

Our current study investigated how workplace social capital (WSC) mediates and moderates the associations between adverse work characteristics and psychological distress among Japanese workers. We collected cross-sectional data (N=9,350) from a baseline survey of an occupational Japanese cohort study. We focused on individual WSC and considered job demands/control, effort/reward, and two types (i.e., procedural and interactional) of organizational justice as work-characteristic variables. We defined psychological distress as a score of ≥5 on the Kessler Psychological Distress Scale (K6 scale). Multivariate logistic regression analyses predicted a binary variable of psychological distress by individual WSC and adverse work characteristics, adjusting for individual-level covariates. Individual WSC mediated the associations between adverse work characteristics and psychological distress in almost all model specifications. Additionally, individual WSC moderated the associations of psychological distress with high job demands, high effort, and low interactional justice when we used a high WSC cutoff point. In contrast, individual WSC did not moderate such interactions with low job control, reward, or procedural justice. We concluded that individual WSC mediated the associations between adverse work characteristics and psychological distress among Japanese workers while selectively moderating their associations at high levels of WSC.

The organizational work factors' effect on mental health among hospital workers is mediated by perceived effort-reward imbalance: result of a longitudinal study

OBJECTIVES

This longitudinal study aimed to test the hypothesis that organizational work factors (OWFs) may be related to depressive symptoms through an increased effort-reward imbalance (ERI) ratio among registered nurses (RNs) and nursing assistants working in hospitals.

METHODS

We studied 2117 female RNs and nursing assistants who stayed in the same work unit and position during the follow-up from the ORSOSA (ORganisation des SOins-SAnté) longitudinal study. The work characteristics and workers' health were assessed in 2006 and 2008.

RESULTS

We confirmed our hypothesis of both direct and mediated effects of OWFs on workers' health. We showed that issues about patient-related information exchanges increased RNs' depressive disorders by increasing first a perceived ERI.

CONCLUSIONS

Our results advocate integrating both the work organizational level and the individual level into preventive actions to improve workers' mental health.

Cohort profile: the lidA Cohort Study-a German Cohort Study on Work, Age, Health and Work Participation

The lidA Cohort Study (German Cohort Study on Work, Age, Health and Work Participation) was set up to investigate and follow the effects of work and work context on the physical and psychological health of the ageing workforce in Germany and subsequently on work participation. Cohort participants are initially employed people subject to social security contributions and born in either 1959 (n = 2909) or 1965 (n = 3676). They were personally interviewed in their homes in 2011 and will be visited every 3 years. Data collection comprises socio-demographic data, work and private exposures, work ability, work and work participation attitudes, health, health-related behaviour, personality and attitudinal indicators. Employment biographies are assessed using register data. Subjective health reports and physical strength measures are complemented by health insurance claims data, where permission was given. A conceptual framework has been developed for the lidA Cohort Study within which three confirmatory sub-models assess the interdependencies of work and health considering age, gender and socioeconomic status. The first set of the data will be available to the scientific community by 2015. Access will be given by the Research Data Centre of the German Federal Employment Agency at the Institute for Employment Research (http://fdz.iab.de/en.aspx).

Job stress and work-related musculoskeletal symptoms among intensive care unit nurses: a comparison between job demand-control and effort-reward imbalance models

BACKGROUND

The aims of this study were to compare job demand-control (JDC) and effort-reward imbalance (ERI) models in examining the association of job stress with work-related musculoskeletal symptoms and to evaluate the utility of a combined model.

METHODS

This study analyzed cross-sectional survey data obtained from a nationwide random sample of 304 intensive-care unit (ICU) nurses. Demographic and job factors were controlled in the analyses using logistic regression.

RESULTS

Both JDC and ERI variables had strong and statistically significant associations with work-related musculoskeletal symptoms. Effort-reward imbalance had stronger associations than job strain or iso-strain with musculoskeletal symptoms. Effort-reward imbalance alone showed similar or stronger associations with musculoskeletal symptoms compared to combined variables of the JDC and ERI models.

CONCLUSIONS

The ERI model appears to capture the magnitude of the musculoskeletal health risk among nurses associated with job stress at least as well and possibly better than the JDC model. Our findings suggest that combining the two models provides little gain compared to using effort-reward imbalance only.

Reassessment of the psychometric characteristics and factor structure of the 'Perceived Stress Questionnaire' (PSQ): analysis in a sample of dental students

Background

The training to become a dentist can create psychological distress. The present study evaluates the structure of the ‘Perceived Stress Questionnaire’ (PSQ), its internal consistency model and interrelatedness with burnout, anxiety, depression and resilience among dental students.

Methods

The study employed a cross-sectional design. A sample of Spanish dental students (n = 314) completed the PSQ, the ‘Goldberg Anxiety and Depression Scale’ (GADS), ‘Connor-Davidson Resilience Scale’ (10-item CD-RISC) and ‘Maslach Burnout Inventory-Student Survey’ (MBI-SS). The structure was estimated using Parallel Analysis from polychoric correlations. Unweighted Least Squares was the method for factor extraction, using the Item Response Theory to evaluate the discriminative power of items. Internal consistency was assessed by squaring the correlation between the latent true variable and the observed variable. The relationships between the PSQ and the other constructs were analysed using Spearman’s coefficient.

Results

The results showed a PSQ structure through two sub-factors (‘frustration’ and ‘tenseness’) with regard to one general factor (‘perceived stress’). Items that did not satisfy discriminative capacity were rejected. The model fit were acceptable (GFI = 0.98; RSMR = 0.06; AGFI = 0.98; NFI = 0.98; RFI = 0.98). All the factors showed adequate internal consistency as measured by the congeneric model (≥0.91). High and significant associations were observed between perceived stress and burnout, anxiety, depression and resilience.

Conclusions

The PSQ showed a hierarchical bi-factor structure among Spanish dental students. Using the questionnaire as a uni-dimensional scale may be useful in perceived stress level discrimination, while the sub-factors could help us to refine perceived stress analysis and improve therapeutic processes.

Work-related Stress, Caregiver Role, and Depressive Symptoms among Japanese Workers

Background

In Japan, more than 60% of employees are reported to suffer from anxiety and stress. Consequently, Japanese society has begun to address such important issues as psychogenic disability and job-related suicide. Furthermore, given the aging of society and the surge in the number of elderly people requiring care, it is necessary to adequately and proactively support employees who care for their elderly relatives. The purpose of the present study was to investigate caregiver burden in caring for elderly relatives and work-related stress factors associated with mental health among employees.

Methods

We studied 722 men and women aged 18–83 years in a cross-sectional study. The K10 questionnaire was used to examine mental health status.

Results

The proportion of participants with a high K10 score was 15% (n = 106). Having little conversation with their supervisor and/or coworkers significantly increased the risk of depression [odds ratio (OR) 1.8], as did high job overload (OR 2.7) and job dissatisfaction (OR 3.8), compared with employees who frequently conversed with their supervisor and/or coworkers. Caring for elderly relatives as a prominent characteristic of an employee was a significant risk factor for depression (OR 2.1).

Conclusion

The present study demonstrated that employees who were caring for elderly relatives were significantly associated with an increased risk of depression. To prevent depressive disorders, it may be important to focus on reducing the work-caregiving role conflict, as well as enhancing employees' job control and better rewarding their efforts in the workplace.

The importance of both workplace and private life factors in psychological distress: a large cross-sectional survey of French railway company employees

PURPOSE

The psychological well-being of employees is a priority in occupational health. This study aimed to estimate the prevalence of psychological distress among employees of a large French company, to calculate the associations between distress and stressors in the workplace and private life domains, and to explore confounding across stressor domains.

METHODS

8,058 employees of the French national railways company completed a nation-wide survey in 2006 (94.3 % participation). Psychological distress was measured by the 12-item General Health Questionnaire and 21 potential stressors and socio-demographic factors by a self-administered questionnaire. Stressors were summarized in scores for work pressure, workplace conflict, and personal life domains. Risk ratios (RRs) between psychological distress and stressors were calculated using robust-variance Poisson regression.

RESULTS

The prevalence of psychological distress was 32.8 % (95 % CI 31.8-33.9 %), higher among women (48.9 %, 95 % CI 46.5-51.7 %) than men (30.1 %, 95 % CI 29.0-31.2 %). Each stressor domain was associated with distress in the final model containing likely confounders and all three domains (RR highest vs. lowest level-work pressure: men 1.55, 95 % CI 1.42-1.70, women 1.42, 95 % CI 1.23-1.63; work conflict: men 2.63, 95 % CI 2.38-2.91, women 1.98, 95 % CI 1.70-2.30; life concerns: men 2.04, 95 % CI 1.86-2.23, women 1.53, 95 % CI 1.32-1.78). The mutually adjusted RRs for the stressor domains were smaller than the unadjusted RRs.

CONCLUSIONS

Almost one-third of all employees and one-half of female employees experienced psychological distress. All three stressor domains were associated with psychological distress and adjustment reduced the association size, suggesting possible over-estimation if one or more domains are omitted from the survey.

Emotional exhaustion and overcommitment to work are differentially associated with hypothalamus-pituitary-adrenal (HPA) axis responses to a low-dose ACTH1-24 (Synacthen) and dexamethasone-CRH test in healthy school teachers

Evidence for a detrimental impact of chronic work stress on health has accumulated in epidemiological research. Recent studies indicate altered hypothalamus-pituitary-adrenal (HPA) axis regulation as a possible biological pathway underlying the link between stress and disease. However, the direction of dysregulation remains unclear, with reported HPA hyper- or hyporeactivity. To disentangle potential effects on different functional levels in the HPA axis, we examined responses using two pharmacological stimulation tests in 53 healthy teachers (31 females, 22 males; mean age: 49.3 years; age range: 30-64 years): a low-dose adrenocorticotrophic hormone (ACTH(1-24), Synacthen) test was used to assess adrenal cortex sensitivity and the combined dexamethasone-corticotropin releasing hormone (DEX-CRH) test to examine pituitary and adrenal cortex reactivity. Blood and saliva samples were collected at - 1,+15,+30,+45,+60,+90,+120 min. Emotional exhaustion (EE), the core dimension of burnout, was measured with the Maslach Burnout Inventory. Overcommitment (OC) was assessed according to Siegrist's effort-reward-imbalance model. We found a significant association between EE and higher plasma cortisol profiles after Synacthen (p = 0.045). By contrast, OC was significantly associated with attenuated ACTH (p = 0.045), plasma cortisol (p = 0.005), and salivary cortisol (p = 0.023) concentrations following DEX-CRH. Results support the notion of altered HPA axis regulation in chronically work-stressed teachers, with differential patterns of hyper- and hyporeactivity depending on individual stress condition and the tested functional level of the HPA axis.

Effort-reward-imbalance in healthy teachers is associated with higher LPS-stimulated production and lower glucocorticoid sensitivity of interleukin-6 in vitro

BACKGROUND

According to the effort-reward-imbalance (ERI) model, a lack of reciprocity between costs and gains at work increases the risk for adverse health outcomes. Inflammation has been shown to play a crucial role in a variety of stress-related diseases and alterations in immune system glucocorticoid sensitivity may help to explain the increased risk for cardiovascular disease (CVD) and depression related to chronic work stress.

METHODS

Changes in lipopolysaccharide (LPS)-induced interleukin (IL)-6 production and inhibition of IL-6 production by dexamethasone in reaction to the Trier Social Stress Test (TSST) were assessed in forty-six healthy school teachers to test whether chronic work stress is accompanied by alterations in inflammatory activity and glucocorticoid sensitivity of the innate immune system.

RESULTS

High ERI was associated with an increase in pro-inflammatory potential, reflected in elevated IL-6 production before and after stress and with a lower capacity of dexamethasone to suppress IL-6 production in vitro over all measurement time points. ERI was not associated with stress-related changes in GC sensitivity.

CONCLUSION

The present findings suggest a less effective anti-inflammatory regulation by glucocorticoids in teachers suffering from chronic work stress.

[The Heinz Nixdorf Recall study]

The Heinz Nixdorf Recall Study is a population-based study that aims to improve the prediction of cardiovascular events by integrating new imaging and non-imaging modalities in risk assessment. One focus of the study is the evaluation of the quantification of subclinical coronary artery calcifications (coronary artery calcification, CAC) as a prognostic factor in predicting cardiac events. Primary endpoints are myocardial infarction and sudden cardiac death. The study was initiated in the late 1990s and enrolled a total of 4,814 participants aged 45-75 years between December 2000 and August 2003. A 5-year follow-up examination took place between 2006 and 2008. Currently, the 10-year follow-up is under way and is estimated to be finished in July 2013. Extending the original aims of the study, serial CAC measurements will allow the characterization of the natural history of CAC dynamics, the identification of its determinants and an understanding of the impact of CAC progression on the primary endpoints. The Heinz Nixdorf Recall Study will significantly extend our knowledge about new modalities in the prediction of cardiac events.

Moderating effects of leisure-time physical activity on the association between job strain and depressive symptoms: the Cardiovascular Risk in Young Finns Study

OBJECTIVE

We examined whether long-term leisure-time physical activity (LTPA) has a moderating effect on the association between job strain and depressive symptoms using prospective data.

METHODS

Full-time employees (455 men and 480 women) aged 30 to 45 years were followed from 2001 to 2007. Data were collected using questionnaires.

RESULTS

Sustained participation in LTPA was inversely associated with depressive symptoms in employed men and women. The direct relationship of job strain to depressive symptoms was significantly moderated by LTPA only in women when the potential confounders were controlled for.

CONCLUSIONS

Depressive symptoms are inversely associated with regular LTPA and directly associated with chronic job strain in both sexes. In women, persistent participation in LTPA may modify the relation between chronic job stress and subthreshold depressive symptoms by reducing depressive symptoms associated with job strain.

Trucking organization and mental health disorders of truck drivers

There are over 3 million truck drivers employed in the commercial transportation and material moving occupations, one of the largest occupational groups in the United States. Workers in this large and growing occupational segment are at risk for a range of occupational health-induced conditions, including mental health and psychiatric disorders due to high occupational stress, low access and use of health care, and limited social support. The purpose of this study was to explore male truck drivers' mental health risks and associated comorbidities, using a cross-sectional and quantitative design. Data were collected from a random sample of 316 male truckers between the ages of 23 and 76 at a large truck stop located within a 100-mile radius of Greensboro, North Carolina, USA, using a self-administered 82-item questionnaire. Surveyed truckers were found to have significant issues affecting their mental health, such as loneliness (27.9%), depression (26.9%), chronic sleep disturbances (20.6%), anxiety (14.5%), and other emotional problems (13%). Findings have potential to help researchers develop interventions to improve the emotional and occupational health of truck drivers, a highly underserved population. Mental health promotion, assessment, and treatment must become a priority to improve the overall trucking environment for truckers, the transportation industry, and safety on US highways.

Depressão em trabalhadores de linhas elétricas de alta tensão

OBJETIVO: Investigar a associação entre desequilíbrio esforços-recompensas no trabalho e sintomas depressivos em trabalhadores de linhas elétricas de alta tensão. MÉTODOS: Estudo de corte transversal realizado em 158 trabalhadores de uma empresa de energia elétrica no Nordeste do Brasil. As dimensões do modelo esforço-recompensa (ERI) constituíram as variáveis independentes principais e a variável resposta foi depressão, medida pela escala Center for Epidemiologic Studies Depression (CES-D). Os dados foram analisados com técnicas de regressão logística múltipla. RESULTADOS: Trabalhadores no grupo de baixa recompensa apresentaram prevalência de depressão 6,2 vezes maior em relação àqueles no grupo de alta recompensa. A prevalência de depressão foi 3,3 vezes maior entre os trabalhadores em condição de desequilíbrio esforço-recompensa do que entre aqueles em situação de equilíbrio. CONCLUSÕES: A prevalência de depressão estava fortemente associada às dimensões de esforços e recompensas presentes no trabalho dos eletricitários.