Workaholism Prevention in Occupational Medicine: A Systematic Review

Manifestations of Paranoid Personality in Workaholic Middle Managers

ABSTRACT

The problem of paranoid disorders is widespread and difficult to diagnose due to the many mental symptoms that a person often perceives as character traits. Passion for work, the so-called pathological workaholism, harms not only the suffering person but also all the people around them, affecting their quality of life and disrupting social and family ties. The purpose of study was to determine the level of pathological workaholism and its main symptoms. The objectives of the study included interviewing respondents and identifying the correlation between the level of workaholism and mental manifestations, and finding differences in the manifestations of workaholism in men and women. For this purpose, 78 people were examined, including 38 women and 40 men. All participants worked as middle managers in multinational companies. The aim was to identify people with pathological workaholism among the participants using the "Work Addiction Risk Test" questionnaire. Among managers, a high degree of predisposition to workaholism was diagnosed. We found that women have a strong tendency to be fixated on work, and as a result, they have increased rumination anxiety. Regardless of gender, managers who took part in the study showed a pronounced manifestation of paranoid and obsessive-phobic disorders, depression, and asthenic manifestations. Regarding the relationship between neurotic symptoms and a tendency to workaholism, a high correlation was observed ( p < 0.05). The results of this study may be useful for specialists to develop means of preventing and effectively treating paranoid workaholism, as a disease that is increasingly having a negative impact on society.

Association Between Workaholism and Headaches Causing Presenteeism: A Cross-sectional Study in Japan

OBJECTIVES

This study investigates the association between workaholism and headaches causing presenteeism among Japanese employees.

METHODS

Used data from self-reporting questionnaire and annual health checkups. Workaholism was assessed using the Dutch Workaholic Scale and headaches causing presenteeism were identified as the symptom hindering work. We performed a logistic regression analysis adjusted for covariates.

RESULTS

Among 5802 respondents, 3.7% cited headaches as the symptom hindering work. We found an association between workaholism and such headaches (odds ratios [OR]: 1.05, 95% confidence intervals [CI]: 1.03-1.08). Both working excessively (OR: 1.08, 95% CI: 1.04-1.12) and working compulsively (OR: 1.10, 95% CI: 1.05-1.15) subscales were also related.

CONCLUSIONS

Workaholism may lead to productivity loss due to headaches, and addressing workaholism can prevent this loss. Combining health examination data with work hours data may enable the early detection of workaholism.

Burnout Mediates the Association Between Workaholism and Substance Use: Findings from a French National Company

To examine the mediation effect of burnout on the association between workaholism and tobacco and alcohol use. A total of 2199 workers from the French national electricity company fulfilled an online questionnaire. Smoking status, alcohol use disorder based on the Alcohol Use Disorders Identification Test-Consumption and workaholism based on the Work Addiction Risk Test were used as binary variables. Burnout was assessed as a continuous variable with the Copenhagen Burn-Out Inventory. Mediation analyses tested the direct effect of the associations between workaholism and each substance use, as well as the indirect effect passing through burnout, while adjusting for sociodemographic factors (gender, age, occupational grade and marital life), work stress using the effort-reward imbalance and overcommitment. When testing the mediation effect of burnout on the relation between workaholism and smoking, there was a significant direct effect of workaholism on smoking (Estimated effect of 0.27 [95% CI 0.01; 0.54]) and a significant indirect effect passing through burnout (Estimated effect of 0.09 [95% CI 0.02; 0.15]). When testing the mediation effect of burnout on the relation between workaholism and alcohol use, the direct effect of workaholism on alcohol use was not significant (Estimated effect of 0.21 [95% CI - 0.01; 0.44]) while the indirect effect passing through burnout was significant (Estimated effect of 0.10 [95% CI 0.04; 0.17]). Information and prevention regarding substance use should be reinforced among workers exposed to workaholism, especially if their workaholism led to a high level of burnout. Preventing the emergence of burnout among workaholics might have some benefits on their tobacco and alcohol use.

The consumption of psychoactive substances among French physicians: how do they perceive the creation of a dedicated healthcare system?

Introduction

Substance use among physicians can have negative impacts on their health, quality of life, and patient care. While Physician Health Programs (PHPs) have proven effective, many physicians with substance use disorders (SUDs) still face obstacles in seeking help. Our study explores the expectations, attitudes, and experiences of French physicians regarding the implementation of a specialized healthcare system (SHS) for addiction, and their opinions on the factors that could improve the effectiveness of such a service, with a focus on substance use disorders (SUDs).

Methods

We conducted a web-based survey from April 15 to July 15, 2021, which included questions about sociodemographic characteristics, substance use, and attitudes toward a specialized healthcare system (SHS) for physicians with SUDs.

Results

Of the 1,093 respondents (62.5% female), 921 consumed alcohol (84.2%), and 336 (36.4%) were categorized as hazardous drinkers (AUDIT-C ≥ 4 for women and ≥ 5 for men). The mean AUDIT-C score was 3.5 (±1.7 SD), with a range from 1 to 12. Factors associated with hazardous alcohol consumption included coffee consumption [OR 1.53 (1.11-2.12)], psychotropic drug use [OR 1.61 (1.14-2.26)], cannabis use [OR 2.96 (1.58-5.55)], and other drug use [OR 5.25 (1.92-14.35)]. On the other hand, having children was associated with non-hazardous alcohol consumption [OR 0.62 (0.46-0.83)]. Only 27 physicians (2.9%) had consulted a specialist in addiction medicine, while 520 (56.4%) expressed interest in such a consultation. The main barriers to accessing a dedicated consultation were denial (16.3%), physician self-medication (14.3%), fear of judgment (12.8%), and confidentiality concerns (10.2%).

Conclusion

A specialized consultation with trained professionals in a neutral location can improve access to care for healthcare workers and maintain patient confidentiality and anonymity. Prevention and awareness can reduce addiction stigma and help peers in need. The improvement of healthcare workers' addiction culture and detection of addictive behavior in peers depends on academic addiction medicine.

Work addiction in Chinese white-collar workers: the psychometric properties of its measure and its comorbidity with general anxiety in network analysis

BACKGROUND

Work addiction (WA) threatens occupation-related health in many countries including China. This research aims to evaluate the psychometric properties of the Chinese version of Bergen Work Addiction Scale (BWAS), the most common measure of WA, to facilitate relevant studies in Chinese workers. A network analysis was further conducted to identify central and bridge symptoms within the WA-anxiety network to improve intervention practices.

METHODS

A total of 694 Chinese white-collar workers completed an online questionnaire survey in March of 2022, and the responses to BWAS from a subsample of 50 participants one month after this survey were also collected.

RESULTS

The unidimensionality of BWAS was supported by results of exploratory factor analysis, exploratory graph analysis, and confirmatory factor analysis and we found satisfactory internal consistency and acceptable test-retest reliability. Multiple-group factor analyses confirmed the measurement invariance of BWAS across genders, districts (i.e., central China, eastern China, western China, and northeastern China), and age groups (i.e., young and middle-aged adults) while the convergent validity of BWAS was demonstrated by its significant correlations with Dutch Work Addiction Scale (r = 0.62, p < 0.001) and its criterion validity was indicated by its significant correlations with general anxiety, weekly work hours, and health status (r = -0.16 to 0.31, p < 0.001-0.01). Network analysis further revealed two central symptoms (WA-tolerance and WA-problems) and three bridge symptoms (WA-problems, WA-mood modification, and mouth dryness of general anxiety) maintaining the WA-anxiety comorbidity.

CONCLUSIONS

Our findings suggest that BWAS is a valid measure of WA in Chinese workers and interventions should put special attention to the identified central and bridge symptoms underlying the WA-anxiety network.

The Workaholism-Technostress Interplay: Initial Evidence on Their Mutual Relationship

During the pandemic, the occurrence of extreme working conditions (e.g., the sudden shift to remote work, isolation, and the slowdown of the work processes) exacerbated several phenomena, such as increased workaholism and stress due to technological devices; that is, technostress. Literature on the onset of these phenomena during the pandemic highlighted a possible interplay among them; however, there is still a dearth of knowledge about the direction of the relationship between workaholism and technostress. The present study assessed the relationship between workaholism and technostress through a two-wave cross-lagged study using path analysis in SEM (Structural Equation Modeling). The study was conducted in Italy during the pandemic, and a total of 113 Italian employees completed the online survey at each wave. Results showed that workaholism at Time 1 was a significant predictor of technostress at Time 2 (β = 0.25, p = 0.049), while the reversed causation was not supported (β = 0.08, p = 0.22). These findings may help employees and organizations to better understand the phenomena of technostress and workaholism and develop strategies to prevent the consequences of excessive and compulsive work and to improve the balanced use of technology for their daily activities.

The Role of an Individual and a Situation in Explaining Work Addiction: Disclosing Complex Relations

The current study aimed to test the relationships between perfectionism, type A personality, and work addiction via mediator of extrinsic work motivation and moderators of both parent work addiction and demanding organization profiles. A cross-sectional study was carried out using an online self-report questionnaire. A sample consisted of 621 employees working in different Lithuanian organizations that were selected on the basis of the convenience principle. Prior to testing the hypotheses, latent profile analysis (LPA) was conducted in order to identify the subgroups of participants based on situational variables. Two profiles (i.e., 'less addicted parents' and 'more addicted parents') for parent work addiction and tree profiles (i.e., 'slightly demanding organization', 'moderately demanding organization', 'highly demanding organization') for a demanding organization emerged from LPA. The hypotheses were tested using structural equation modeling. Main results revealed that direct relationships between perfectionism, type A personality, and work addiction were positive and stronger for those working in highly demanding organizations. Indirect relationships between perfectionism, type A personality, and work addiction (via extrinsic motivation) were positive and stronger for employees who have parents with higher levels of work addiction. Future researchers and those who implement preventive practices should be aware that personal factors can be the first impetus for work addiction, and the second one (comprised of situational factors in a family and organization) can enhance the expression of these personal factors and stimulate the development of work addiction.

Learned industriousness as a translational mechanism in anorexia nervosa

It remains unexplained why some behaviours persist despite being non-hedonic and ostensibly aversive. This phenomenon is especially baffling when such behaviours are taken to excess in the form of psychopathology. Anorexia nervosa is one psychiatric disorder in which effortful behaviours that most people find unpleasant (suchas restrictive eating) are persistently performed. We propose thatthe social psychology theory of learned industriousness providesa novel mechanistic account for such phenomena. This theoryposits that high-effort behaviour can be conditioned to acquire secondary reinforcing properties through repeated pairing with reward. Accordingly, effort sensations become less aversive andmore appetitive, increasing willingness to engage in effortful behaviour. In this Perspective, we review pre-clinical behaviouraland biological data that support learned industriousness, contrast learned industriousness with other models of non-hedonic persistence (such as habit learning), highlight evidence that supports learned industriousness in individuals with anorexia nervosa and consider implications of the model, including translation to other psychiatric presentations.

Validity and reliability of a Chinese version of the Bergen Work Addiction Scale

Background

Work addiction (WA), which can impair personal relationships, engagement in recreational activities, and/or health, is a behavioral addiction. A tool for the early detection of WA in China is needed.

Objective

The aim of this study was to develop and determine the validity and reliability of a Chinese version of the Bergen Work Addiction Scale (C-BWAS).

Methods

Two hundred social workers who provided post-discharge services for adolescents with non-suicidal self-injury (NSSI) were enrolled in this study. The construct validity of the C-BWAS was assessed by confirmatory factor analysis (CFA). Criterion validity was assessed by conducting Pearson correlation analyses of C-CWAS scores with Hamilton Depression Scale (HAM-D) and Hamilton Anxiety Scale (HAM-A) scores. Cronbach's α and the intra-class correlation coefficient (ICC) were used to evaluate the reliability of the C-BWAS.

Results

CFA confirmed a one-dimensional structure of the C-BWAS with good construct validity indices [comparative fit index (CFI) = 0.964, Tucker-Lewis index (TLI) = 0.951, root-mean-square error of approximation (RMSEA) = 0.079, and minimum discrepancy Ĉ/degrees of freedom (Cmin/DF) = 0.362]. The standardized regression weights ranged from 0.523 to 0.753. All C-BWAS items loaded on one major factor (loading weights, 0.646-0.943). Coefficients of correlation between C-BWAS scores and HAM-D and HAM-A scores were 0.889 and 0.933, respectively. The Cronbach's α coefficient and ICC for the instrument was 0.837 and 0.905, respectively.

Conclusion

The presently developed C-BWAS showed very good reliability and acceptably validity. It can be employed as a useful tool for assessing WA severity in social workers who provide post-discharge services for adolescents with NSSI.