STRESS AT WORK

Stress at Work

Stress at Work

Introduction

Work and family are the two domains from which most adults derive satisfaction in life; equally they are the common sources of stressful experiences. The working environment continues to change with globalisation of the world economy and economic rationalisation driving job restructuring, greater part-time and contract work, and greater workload demands that commonly occur in a context of higher job insecurity. There is thus not an unreasonable perception in the community that work is increasingly the source of much of our stress and distress.

Research Background

The implications of work -related stress include the effects on worker satisfaction and productivity, their mental and physical health, absenteeism and its economic cost, the wider impact on family function and finally, the potential for employer liability. While depression is the most likely adverse psychological outcome, the range of other possible “psychological” problems include “burnout,” alcohol abuse, unexplained physical symptoms, “absenteeism,” chronic fatigue and accidents, sick building syndrome and repetitive strain injury. This review focuses largely on prospective or “predictive” studies both of “depression” and “burnout,” and it is based on literature searches using Medline, Psych INFO and EMBASE from 1990 to 2006 (keywords: occupational stress, work, occupations, workload, occupational health, depression, anxiety).

Aim and Objective

The review assesses the stressor findings by different occupational groups because they may embrace different qualities of stress which furthermore may be a major factor contributing to psychological morbidity in these groups.

Chapter 2: Literature Review

Morbidity in different occupational groups

In the studies reviewed it is usual for depression to be diagnosed by a range of questionnaires including the Beck Depression Inventory, Zung scale, the General Health Questionnaire (GHQ), the Centre for Epidemiological Studies Depression Scale (CESD) or similar clinically validated questionnaires. Burnout is also a construct often used and embraces three clusters of symptoms; “emotional exhaustion,” “depersonalisation” (negative, insensitive attributes to clients) and a sense of reduced “personal accomplishment”. While burnout by definition is only assessed in an occupational setting, it may nonetheless be a precursor or correlate of depression.

Three broad but distinct occupational groups are readily identifiable in the literature. They are blue-collar/manual workers, white-collar/civil servants and the “helping” professions (teachers and healthcare workers). The Karasek “demand-control” model of work -related stress is commonly employed, especially in the first two groups. In this model, the composite construct of “job strain” is defined as a combination of the constructs of (high) job demands and (low) decision making latitude (or control over workload), both of which are “objectively” derived from descriptions of the nature of work. All three of the above constructs have been assessed in various studies (Romanov 2001).

Blue-collar workers

In factory and blue-collar workers studied over 3 years, in Japan (N=468), “lack of control over work, ” “unsuitable jobs” and “poor work place relations” predicted depression (Zung scale). Furthermore, the latter two work variables also predicted depressive disorder diagnosed clinically by a psychiatrist in a nested cohort of this sample; these relationships were significant even after controlling covariates and initial depressive ...