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Rhythm of the job stress blues: Psychosocial working conditions and depression in working life and across retirement
Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för folkhälsovetenskap. (Epidemiologi)ORCID-id: 0000-0002-3642-6391
2019 (Engelska)Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
Abstract [en]

A work environment characterized by poor psychosocial working conditions may lead to stress and mental health problems such as depression, a common and burdensome public health problem with significant consequences for individuals and for society at large. A number of psychosocial working characteristics have been found to be associated with increased depressive symptoms or clinical depression. This thesis aims to further examine how certain psychosocial working conditions predict depressive symptoms over time, in working life and across retirement. This was done by using several repeated measures from the Swedish Longitudinal Occupational Survey of Health (SLOSH) in 2006–2018.

In study I, we investigated how long-term patterns of exposure to job demands and job control were associated with major depressive symptoms. Those with high strain (high demands, low control) and active (high demands, high control) jobs were more likely to have subsequent major depressive symptoms compared to those with low strain jobs (low demands, high control). However, after adjusting for baseline depressive symptoms and various demographic factors, the associations did not remain statistically significant.

In study II, we assessed how job demands, job control and workplace social support were related to long-term development of depressive symptoms. A perception of high job demands and low social support predicted higher or increasing depressive symptom trajectories. In addition, negative changes in job demands, job control and social support were associated with increased symptoms, indicating that the onset of poor working conditions could negatively impact depressive symptoms.

In study III, we investigated simultaneous and lagged bidirectional associations between job demands, job control, balance between demands and control, social support, procedural justice, effort, reward, balance between efforts and rewards, and depressive symptoms, while controlling for individual time-stable characteristics. There were associations between all work stressors and depressive symptoms when measured simultaneously, except for job control. However, only efforts, were prospectively associated with depressive symptoms measured later.

In study IV, we examined how the same psychosocial working characteristics as in study III were associated with the development of depressive symptoms across retirement. Generally, depressive symptoms appeared to decrease across retirement. Job demands, job strain, social support, rewards, effort-reward imbalance and procedural justice, but to a lesser extent job control and efforts, were associated with a more negative and positive course of depressive symptoms across retirement. Especially, depressive symptoms decreased in relation to retirement for a small group with previously high exposure to work stress.

In conclusion, this thesis indicates that particularly perceptions of high job demands, low workplace social support and high work effort predict subsequent higher levels of depressive symptoms, and/or influence the course of symptoms both in working life and past retirement. In addition, changes in these types of conditions seemed to influence the course of depressive symptoms. Especially, the relief from previous exposure to work stress at retirement seemed to have a clear positive impact on depressive symptoms. These results contribute to strengthen the evidence of causality between these types of work stressors and depressive symptoms.

Ort, förlag, år, upplaga, sidor
Stockholm: Department of Public Health Sciences, Stockholm University , 2019. , s. 85
Serie
Stockholm Studies in Public Health Sciences, ISSN 2003-0061 ; 2
Nyckelord [en]
job stress, psychosocial working conditions, job demand-control-support model, effort-reward imbalance model, organizational justice, depressive symptoms, longitudinal studies, trajectory analysis, latent class analysis, fixed-effects regression
Nationell ämneskategori
Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi Arbetsmedicin och miljömedicin
Forskningsämne
folkhälsovetenskap
Identifikatorer
URN: urn:nbn:se:su:diva-168220ISBN: 978-91-7797-652-3 (tryckt)ISBN: 978-91-7797-653-0 (digital)OAI: oai:DiVA.org:su-168220DiVA, id: diva2:1307797
Disputation
2019-06-14, rum 207, Stressforskningsinstitutet, Frescati Hagväg 16 A, Stockholm, 13:00 (Engelska)
Opponent
Handledare
Anmärkning

At the time of the doctoral defense, the following paper was unpublished and had a status as follows: Paper 4: Manuscript.

Tillgänglig från: 2019-05-22 Skapad: 2019-04-29 Senast uppdaterad: 2019-05-09Bibliografiskt granskad
Delarbeten
1. Trajectories of job demands and control: risk for subsequent symptoms of major depression in the nationally representative Swedish Longitudinal Occupational Survey of Health (SLOSH)
Öppna denna publikation i ny flik eller fönster >>Trajectories of job demands and control: risk for subsequent symptoms of major depression in the nationally representative Swedish Longitudinal Occupational Survey of Health (SLOSH)
2018 (Engelska)Ingår i: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 91, nr 3, s. 263-272Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Purpose

Depression is a global health concern. High job demands, low job control, and the combination (high strain) are associated with depression. However, few longitudinal studies have investigated changed or repeated exposure to demands and control related to depression. We investigated how trajectories of exposure to job demands and control jointly influence subsequent depression.

Methods

We included 7949 subjects from the Swedish Longitudinal Occupational Survey of Health, who completed questionnaires of perceived job demands and control, and depressive symptoms from 2006 to 2014. None of them were depressed between 2006 and 2012. Univariate and joint group-based trajectory models identified groups with similar development of demands and control across 2006–2012. Logistic regression estimated the risk for symptoms of major depression in 2014 according to joint trajectory groups.

Results

The joint trajectory model included seven groups, all with fairly stable levels of demands and control over time. Subjects in the high strain and active (high demands and high control) trajectories were significantly more likely to have subsequent major depressive symptoms compared to those having low strain, controlling for demographic covariates (OR 2.15; 95% Cl 1.24–3.74 and OR 2.04; 95% CI 1.23–3.40, respectively). The associations did not remain statistically significant after adjusting for previous depressive symptoms in addition to demographic covariates.

Conclusions

The results indicate that the levels of job demands and control were relatively unchanged across 6 years and suggest that long-term exposure to a high strain or active job may be associated with increased risk for subsequent depression.

Nyckelord
Depressive symptoms, Demand-control model, Job strain, Work stress, Longitudinal studies, Latent class growth analysis
Nationell ämneskategori
Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi
Forskningsämne
folkhälsovetenskap
Identifikatorer
urn:nbn:se:su:diva-151280 (URN)10.1007/s00420-017-1277-0 (DOI)000427151700002 ()29128892 (PubMedID)
Tillgänglig från: 2018-01-10 Skapad: 2018-01-10 Senast uppdaterad: 2019-12-09Bibliografiskt granskad
2. Job demands, control and social support as predictors of trajectories of depressive symptoms
Öppna denna publikation i ny flik eller fönster >>Job demands, control and social support as predictors of trajectories of depressive symptoms
Visa övriga...
2018 (Engelska)Ingår i: Journal of Affective Disorders, ISSN 0165-0327, E-ISSN 1573-2517, Vol. 235, s. 535-543Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Background: Job demands, job control and social support have been associated with depressive symptoms. However, it is unknown how these work characteristics are associated with different trajectories of depressive symptoms, which this study aimed to examine. Methods: We included 6679 subjects in the Swedish Longitudinal Occupational Survey of Health (SLOSH), who completed biennial questionnaires in 2006-2016. Group-based trajectory models identified groups with similar development of depressive symptoms. Multinomial logistic regression estimated associations between baseline demands, control, social support and trajectories of depressive symptoms. Results: We identified six depression trajectories with varying severity and stability across four measurements. High job demands and low social support, but not low control, were associated with higher probability of belonging to subsequent trajectories with higher symptom level compared to very low symptom level. Adjusted risk ratios ranged from 1.26, 95% CI = 1.06-1.51 (low symptom trajectory) to 2.51, 95% CI = 1.43-4.41 (persistent severe symptom trajectory). Results also indicated that onset of high demands, low control and low social support increases depressive symptoms over time. Limitations: The results were based on self-reported data and all individuals did not have complete data in all waves. Conclusions: The results indicated that especially perceptions of high job demands and low social support are associated with higher or increasing levels of depressive symptoms over time. This support the supposition that high job demands, and low social support may have long-term consequences for depressive symptoms and that interventions targeting job demands and social support may contribute to a more favourable course of depression.

Nationell ämneskategori
Psykiatri Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi
Forskningsämne
folkhälsovetenskap
Identifikatorer
urn:nbn:se:su:diva-157628 (URN)10.1016/j.jad.2018.04.067 (DOI)000432686900077 ()29689506 (PubMedID)
Tillgänglig från: 2018-06-28 Skapad: 2018-06-28 Senast uppdaterad: 2019-12-09Bibliografiskt granskad
3. Are there bidirectional relationships between psychosocial work characteristics and depressive symptoms? A fixed effects analysis of Swedish national panel survey data
Öppna denna publikation i ny flik eller fönster >>Are there bidirectional relationships between psychosocial work characteristics and depressive symptoms? A fixed effects analysis of Swedish national panel survey data
2019 (Engelska)Ingår i: Occupational and Environmental Medicine, ISSN 1351-0711, E-ISSN 1470-7926, Vol. 76, nr 7, s. 455-461Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Objectives Psychosocial work characteristics have been prospectively associated with depressive symptoms. However, methodological limitations have raised questions regarding causality. It is also unclear to what extent depressive symptoms affect the experience of the psychosocial work environment. We examined contemporaneous (measured simultaneously) and lagged bidirectional relationships between psychosocial work characteristics and depressive symptoms, simultaneously controlling for time-stable individual characteristics.

Methods We included 3947 subjects in the Swedish Longitudinal Occupational Survey of Health (SLOSH), with self-reported job demands, control, social support, work efforts, rewards, procedural justice and depressive symptoms in four waves 2010–2016. We applied dynamic panel models with fixed effects, using structural equation modelling, adjusting for all time-stable individual characteristics such as personality and pre-employment factors.

Results Higher levels of job demands, job demands in relation to control, work efforts and efforts in relation to rewards were contemporaneously associated with more depressive symptoms (standardised β: 0.18–0.25, p<0.001), while higher levels of workplace social support, rewards at work and procedural justice were associated with less depressive symptoms (β: −0.18, p<0.001, β: –0.16, p<0.001 and β: −0.09, p<0.01, respectively). In contrast, only work efforts predicted higher levels of depressive symptoms 2 years later (β:0.05, p<0.05). No other lagged associations were foundin any direction.

Conclusions After controlling for all time-invariant confounding, our results suggest that psychosocial work characteristics predominantly affect depressive symptoms immediately or with only a short time lag. Furthermore, we found no evidence of reverse causation. This indicates short-term causal associations, although the temporal precedence of psychosocial work characteristics remains uncertain.

Nyckelord
depression, effort-reward imbalance model, organizational justice, longitudinal studies, job-demand-control-support model
Nationell ämneskategori
Arbetsmedicin och miljömedicin Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi
Forskningsämne
folkhälsovetenskap
Identifikatorer
urn:nbn:se:su:diva-168217 (URN)10.1136/oemed-2018-105450 (DOI)000471896300004 ()
Forskningsfinansiär
AFA Försäkring, 140323Forte, Forskningsrådet för hälsa, arbetsliv och välfärd, 2009-1758
Tillgänglig från: 2019-04-25 Skapad: 2019-04-25 Senast uppdaterad: 2019-12-09Bibliografiskt granskad
4. Psychosocial working characteristics before retirement and depressive symptoms across the retirement transition: a longitudinal latent class analysis
Öppna denna publikation i ny flik eller fönster >>Psychosocial working characteristics before retirement and depressive symptoms across the retirement transition: a longitudinal latent class analysis
(Engelska)Manuskript (preprint) (Övrigt vetenskapligt)
Abstract [en]

Background:

Retirement is a major life transition. However, previous evidence on how it influences mental health is inconclusive. Whether retirement is desirable or not may depend on work characteristics. We aimed to investigate trajectories of depressive symptoms across retirement, and how a number of psychosocial working characteristics influence these trajectories.

Methods:

We included 1735 subjects in the Swedish Longitudinal Occupational Survey of Health (SLOSH), retiring in 2008-2016 (mean age 66 years). They had completed biennial questionnaires and reported job demands, job control, workplace social support, effort, reward, procedural justice as well as depressive symptoms. We applied group-based trajectory modeling to model trajectories of depressive symptoms across retirement. Multinomial logistic regression analyses estimated the associations between the psychosocial working characteristics and the depressive symptom trajectories.

Results:

We identified five depression trajectories, of which in four groups, depressive symptoms decreased slightly around retirement. For a small group, the symptom level was initially high, but then decreased markedly in relation to retirement. Perceptions of job demands, job strain, workplace social support, rewards, effort-reward imbalance and procedural justice were associated with the trajectories, while perceptions of job control and work effort were only related to some of the trajectories.

Conclusion:

We observed positive effects of retirement on depressive symptoms in a sample of Swedish retirees, with a small group showing a clear improvement. A relief from poor psychosocial working conditions seemed to be associated with a more significant improvement. However, poor working conditions were also associated with persistent symptoms suggesting a long-term effect.

Nationell ämneskategori
Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi
Forskningsämne
folkhälsovetenskap
Identifikatorer
urn:nbn:se:su:diva-168219 (URN)
Tillgänglig från: 2019-04-25 Skapad: 2019-04-25 Senast uppdaterad: 2019-12-09Bibliografiskt granskad

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