Relationship between concealment of emotions at work and musculoskeletal symptoms: results from the third Korean working conditions survey

The Potential Relationship Between a Cognitive Dissonance State and Musculoskeletal Injury: A Systematic Review

OBJECTIVE

The objective of this systematic review was to investigate the potential link between cognitive dissonance or its related constructs (emotional dissonance, emotional labor) and musculoskeletal disorders.

BACKGROUND

The etiology of musculoskeletal disorders is complex, as pain arises from complex interactions among physical, social, and psychological stressors. It is possible that the psychological factor of cognitive dissonance may contribute to the etiology and/or maintenance of musculoskeletal disorders.

METHOD

MEDLINE, APA PsycInfo, and CINAHL Plus databases were searched for studies investigating cognitive dissonance or its related constructs as exposure(s) of interest and outcomes related to physical health (including, but not limited to, musculoskeletal pain). Risk of bias was assessed using the Appraisal tool for Cross-Sectional Studies (AXIS) tool.

RESULTS

The literature search yielded 7 studies eligible for inclusion. None of the included studies investigated cognitive dissonance directly but instead investigated dissonance-related constructs of emotional dissonance and emotional labor, in which a mismatch between required and felt emotions might elicit a psychological response consistent with the cognitive dissonance state. Moderate effect sizes between dissonance-related constructs and musculoskeletal disorders were noted (OR 1.25-2.22).

CONCLUSION

There is likely a relationship between the two factors studied. However, as the included studies were cross-sectional in nature, a causal relationship between cognitive dissonance-related constructs and musculoskeletal disorders cannot be inferred. Therefore, future study proposing and validating a causal pathway between these variables is warranted.

APPLICATION

Cognitive dissonance and its related constructs may serve as risk factors for musculoskeletal disorders that have not been considered previously.

Emotional Demand and Mental Health in Korean Employees

Background: Emotional demand (ED) at work is related to mental health in the general workforce, not just emotional workers. We investigated the relationships between ED and mental health outcomes, including distress, depressive symptoms (DS), experience of depression (DE), and suicidal ideation (SI) on the entire general workforce using nationally representative data. Methods: 5787 full-time employees were analyzed using cross-sectional design with the fourth Korean National Health and Nutrition Examination Survey (K-NHANES IV). Work-related psychosocial factors and mental health status were measured through face-to-face interviews. Multi-stage and stratified survey designs were considered in the analysis, and the mental health effects of ED were analyzed using multivariable logistic analysis. The Cochran–Armitage trend test was conducted to investigate increases in the relationship between the severity of ED and mental health outcomes. Results: The subjects comprised 3089 men and 2698 women. ED was reported by 36.7% of men and 39.3% of women. The estimated prevalence of distress was 27.5% in men and 34.6% in women. Adjusted odds ratios (ORs) of ED for distress were 2.62 (95% confidence interval (CI) = 2.10–3.28) for men and 2.57 (95% CI = 1.92–3.45) for women. DS was significantly related to ED (men: OR = 1.72, 95% CI = 1.18–2.50; women: OR = 1.91, 95% CI = 1.33–2.74). ED was also significant psychosocial risk factor for DE (men: OR = 1.88, 95% CI = 1.07–3.29; women: OR = 1.77, 95% CI = 1.15–2.75) and SI (men: OR = 1.64, 95% CI = 1.11–2.41; women: OR = 2.31, 95% CI = 1.63–3.28). Conclusions: ED was a risk factor for distress, DS, DE, and SI in the general workforce. Legal and social safety networks should be constructed for workers whose emotions may be hidden at work, as well as workers in emotion-related fields.

Factors that Affect Depression and Anxiety in Service and Sales Workers Who Interact With Angry Clients

Introduction

We evaluated depression and anxiety in service and sales workers from Korea who interacted with angry clients to identify factors that mediated and moderated depression and anxiety in these workers.

Methods

This was a secondary analysis of data from the fifth Korean Working Conditions Survey conducted in 2017. A structural equation model was used for mediation and moderation analysis.

Results

Service and sales workers who had more interactions with angry clients had increased risk for depression and anxiety. Experiencing clients' adverse behaviors (acute episodes) mediated the relationship between interacting with angry clients (a chronic situation) on depression and anxiety. Job satisfaction and managers' support moderated the relationship between interacting with angry clients and mental health problems.

Conclusion

We suggest that employers of service and sales workers should recruit staff based on their aptitude for such work, thus ensuring job satisfaction, and train them to deal with angry clients in such a way that they experience less emotional burden. Employers should also make bylaws requiring managers to directly take care of adverse social behavior by clients. Furthermore, a sociocultural campaign to prevent adverse social behavior by clients is also needed.