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  • 1.
    Albrecht, Sophie C.
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Radboud University, The Netherlands.
    Rajaleid, Kristiina
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Leineweber, Constanze
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    The longitudinal relationship between control over working hours and depressive symptoms: Results from SLOSH, a population-based cohort study2017In: Journal of Affective Disorders, ISSN 0165-0327, E-ISSN 1573-2517, Vol. 215, p. 143-151Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Psychosocial work factors can affect depressive moods, but research is inconclusive if flexibility to self-determine working hours (work-time control, WTC) is associated with depressive symptoms over time. We investigated if either sub-dimension of WTC, control over daily hours and control over time off, was related to depressive symptoms over time and examined causal, reversed-causal, and reciprocal pathways.

    METHODS: The study was based on four waves of the Swedish Longitudinal Occupational Survey of Health which is a follow-up of representative samples of the Swedish working population. WTC was measured using a 5-item index. Depressive symptoms were assessed with a brief subscale of the Symptom Checklist. Latent growth curve models and cross-lagged panel models were tested.

    RESULTS: Best fit was found for a model with correlated intercepts (control over daily hours) and both correlated intercepts and slopes (control over time off) between WTC and depressive symptoms, with stronger associations for control over time off. Causal models estimating impacts from WTC to subsequent depressive symptoms were best fitting, with a standardised coefficient between -0.023 and -0.048.

    LIMITATIONS: Results were mainly based on self-report data and mean age in the study sample was relatively high.

    CONCLUSION: Higher WTC was related to fewer depressive symptoms over time albeit small effects. Giving workers control over working hours - especially over taking breaks and vacation - may improve working conditions and buffer against developing depression, potentially by enabling workers to recover more easily and promoting work-life balance.

  • 2.
    Albrecht, Sophie
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Radboud University, The Netherlands.
    Tucker, Philip
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Swansea University, UK.
    Leineweber, Constanze
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Investigating the factorial structure and availability of work time control in a representative sample of the Swedish working population2016In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 44, no 3, p. 320-328Article in journal (Refereed)
    Abstract [en]

    Aims: Past research has often neglected the sub-dimensions of work time control (WTC). Moreover, differences in levels of WTC with respect to work and demographic characteristics have not yet been examined in a representative sample. We investigated these matters in a recent sample of the Swedish working population. Methods: The study was based on the 2014 data collection of the Swedish Longitudinal Occupational Survey of Health. We assessed the structure of the WTC measure using exploratory and confirmatory factor analysis. Differences in WTC by work and demographic characteristics were examined with independent sample t-tests, one-way ANOVAs and gender-stratified logistic regressions. Results: Best model fit was found for a two-factor structure that distinguished between control over daily hours and control over time off (root mean square error of approximation = 0.06; 95% CI 0.04 to 0.09; Comparative Fit Index (CFI) = 0.99). Women, shift and public-sector workers reported lower control in relation to both factors. Age showed small associations with WTC, while a stronger link was suggested for civil status and family situation. Night, roster and rotating shift work seemed to be the most influential factors on reporting low control over daily hours and time off. Conclusions: Our data confirm the two-dimensional structure underlying WTC, namely the components 'control over daily hours' and 'control over time off'. Women, public-sector and shift workers reported lower levels of control. Future research should examine the public health implications of WTC, in particular whether increased control over daily hours and time off can reduce health problems associated with difficult working-time arrangements.

  • 3.
    Bernard-Oettel, Claudia
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Leineweber, Constanze
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Westerlund, Hugo
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Temporary, self-employed and permanent workers: A Swedish study on work characteristics and individual well-being over time2013In: , 2013Conference paper (Refereed)
  • 4. Bernhard-Oettel, C.
    et al.
    Leineweber, Constanze
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Westerlund, Hugo
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    The temporaries, theself-employed and the permanent staff: A Swedish study comparing work characteristics and individual well-being over time2013Conference paper (Refereed)
  • 5.
    Bernhard-Oettel, Claudia
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Work and organizational psychology.
    Eib, Constanze
    Griep, Yannick
    Leineweber, Constanze
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    How do Job Insecurity and Organisational Injustice relate to Mental Health Problems? A Multilevel Study on Synchronous and Delayed Effects2018In: Book of Proceedings 13th Conference of the European Academy of Occupational Health Psychology: Adapting to rapid changes in today’s workplace / [ed] K. Teoh, N. Saade, V. Dediu, J. Hassard, L. Torres, Nottingham: European Academy of Occupational Health Psychology , 2018, p. 216-217, article id O15Conference paper (Refereed)
    Abstract [en]

    Background: With the continuous changing world of work towards more automatisation, and global competition that requires organisations to cut costs wherever possible, job insecurity is a concern of workers across many different occupations. Job insecurity is a stressful experience and its negative impact on wellbeing and health is well-documented. However, the exact mechanisms for the link between job insecurity and health need further study.

    We argue that job insecurity is a breach of the psychological contract for permanent workers, leading to perceptions that the employer acts unfairly, which is related to immediate (synchronous) and long-term (two years delayed) negative health effects. Thus, we firstly hypothesise indirect effects between job insecurity on depressive symptoms and sleep difficulties via organisational injustice at the within person level. Furthermore, because employees who often experience job insecurity may no longer have security expectations in their psychological contract, we suggest that the strength of the job insecurity-injustice relationship differs between individuals, such that the relationship is weaker for individuals with higher average levels of job insecurity over time. Finally, we hypothesised that the relationship between organisational injustice and depressive symptoms and sleep difficulties is stronger for individuals who experience more over time-variation in organisational injustice. We expect this pattern because recent research shows that injustice has stronger effects for individuals whose justice experiences vary as opposed to relatively stable injustice perceptions.

    Method: The study population consisted of participants in the Swedish Longitudinal Occupational Survey of Health (SLOSH) study, a nationally representative longitudinal cohort survey. We selected only permanent workers over four consecutive data waves (2010, 2012, 2014, 2016) and analyzed the data with multilevel analysis.

    Results: At the within-person level, we found significant direct effects of job insecurity on organisational injustice. Job insecurity and organisational injustice displayed direct synchronous effects on both health outcomes, but few delayed effects were found. The indirect effects were significant for synchronous but not for delayed health outcomes. Significant cross-level interactions were found for between-individual differences in job insecurity, but not for between- individual differences in organisational justice. In particular, as hypothesised, the link between job insecurity and organisational injustice at each wave was weaker for individuals with higher average levels of job insecurity perceptions but stronger for those who rarely experienced job insecurity during the time of the study.

    Discussion: This study is one of the few studies investigating within- and between-person mechanisms that link feelings of job insecurity to the experience of organisational injustice and health outcomes over time. It also adds to the debate whether job insecurity and organisational injustice associate with health via mediation or moderation mechanisms by showing that both mechanisms may operate simultaneously yet on different levels. Furthermore, this study highlights that permanent workers view their organisation as less fair when they experience job insecurity, the more so if their psychological contract is largely intact and builds on security expectations. Both job insecurity and injustice have rather direct effects for health.

  • 6. Brenner, M. Harvey
    et al.
    Andreeva, Elena
    Theorell, Töres
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Goldberg, Marcel
    Westerlund, Hugo
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Leineweber, Constanze
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Magnusson Hanson, Linda L.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Imbernon, Ellen
    Bonnaud, Sophie
    Organizational downsizing and depressive symptoms in the European recession: the experience of workers in France, Hungary, Sweden and the United kingdom2014In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 9, no 5, article id e97063Article in journal (Refereed)
    Abstract [en]

    Background: Organizational downsizing has become highly common during the global recession of the late 2000s with severe repercussions on employment. We examine whether the severity of the downsizing process is associated with a greater likelihood of depressive symptoms among displaced workers, internally redeployed workers and lay-off survivors. Methods: A cross-sectional survey involving telephone interviews was carried out in France, Hungary, Sweden and the United Kingdom. The study analyzes data from 758 workers affected by medium-and large-scale downsizing, using multiple logistic regression. Main Results: Both unemployment and surviving layoffs were significantly associated with depressive symptoms, as compared to reemployment, but the perceived procedural justice of a socially responsible downsizing process considerably mitigated the odds of symptoms. Perception of high versus low justice was assessed along several downsizing dimensions. In the overall sample, chances to have depressive symptoms were significantly reduced if respondents perceived the process as transparent and understandable, fair and unbiased, well planned and democratic; if they trusted the employer's veracity and agreed with the necessity for downsizing. The burden of symptoms was significantly greater if the process was perceived to be chaotic. We further tested whether perceived justice differently affects the likelihood of depressive symptoms among distinct groups of workers. Findings were that the odds of symptoms largely followed the same patterns of effects across all groups of workers. Redeploying and supporting surplus employees through the career change process-rather than forcing them to become unemployed-makes a substantial difference as to whether they will suffer from depressive symptoms. Conclusions: While depressive symptoms affect both unemployed and survivors, a just and socially responsible downsizing process is important for the emotional health of workers.

  • 7. Canivet, Catarina
    et al.
    Aronsson, Gunnar
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Work and organizational psychology.
    Bernhard-Oettel, Claudia
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Work and organizational psychology.
    Leineweber, Constanze
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Moghaddassi, Mahnaz
    Stengård, Johanna
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Work and organizational psychology.
    Westerlund, Hugo
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Östergren, Per-Olof
    The negative effects on mental health of being in a non-desired occupation in an increasingly precarious labour market2017In: SSM - Population Health, ISSN 2352-8273, Vol. 3, p. 516-524Article in journal (Refereed)
    Abstract [en]

    Precarious employment has been associated with poor mental health. Moreover, increasing labour market precariousness may cause individuals to feel ‘locked-in’, in non-desired workplaces or occupations, out of fear of not finding a new employment. This could be experienced as a ‘loss of control’, with similar negative health consequences. It is plausible that the extent to which being in a non-desired occupation (NDO) or being in precarious employment (PE) has a negative impact on mental health differs according to age group. We tested this hypothesis using data from 2331 persons, 18–34, 35–44, and 45–54 years old, who answered questionnaires in 1999/2000, 2005, and 2010. Incidence rate ratios (IRR) were calculated for poor mental health (GHQ-12) in 2010, after exposure to NDO and PE in 1999/2000 or 2005. NDO and PE were more common in the youngest age group, and they were both associated with poor mental health. In the middle age group the impact of NDO was null, while in contrast the IRR for PE was 1.7 (95% CI: 1.3–2.3) after full adjustment. The pattern was completely the opposite in the oldest age group (adjusted IRR for NDO 1.6 (1.1–2.4) and for PE 0.9 (0.6–1.4)). The population attributable fraction of poor mental health was 14.2% and 11.6%, respectively, for NDO in the youngest and oldest age group, and 17.2% for PE in the middle age group. While the consequences of PE have been widely discussed, those of NDO have not received attention. Interventions aimed at adapting work situations for older individuals and facilitating conditions of job change in such a way as to avoid risking unemployment or precarious employment situations may lead to improved mental health in this age group.

  • 8. Eib, Constanze
    et al.
    Bernhard-Oettel, Claudia
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Work and organizational psychology.
    Magnusson Hanson, Linda L.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Leineweber, Constanze
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Organizational justice and health: Studying mental preoccupation with work and social support as mediators for lagged and reversed relationships2018In: Journal of Occupational Health Psychology, ISSN 1076-8998, E-ISSN 1939-1307, Vol. 23, no 4, p. 553-567Article in journal (Refereed)
    Abstract [en]

    Organizational justice perceptions are considered a predictor of health and well-being. To date, empirical evidence about whether organizational justice perceptions predict health or health predicts organizational justice perceptions is mixed. Furthermore, the processes underlying these relationships are largely unknown. In this article, we study whether bidirectional relationships can be explained by 2 different mediation mechanisms. First, based on the allostatic load model, we suggest that the relationships between organizational justice perceptions and different health indicators are mediated through mental preoccupation with work. Second, based on the affective perception and affective reaction assumption, we investigate if the relationships between different health indicators and organizational justice perceptions are mediated by social support at work. Using a large-scale Swedish panel study (N = 3,236), we test the bidirectional mediating relationships between procedural justice perceptions and self-rated health, depressive symptoms, and sickness absence with a cross-lagged design with 3 waves of data. Significant lagged effects from procedural justice to health were found for models predicting depressive symptoms and sickness absence. Mental preoccupation with work was not found to mediate the longitudinal relationship between procedural justice perceptions and indicators of health. Significant lagged effects from health indicators to procedural justice were found for models involving self-rated health, depressive symptoms, and sickness absence. Social support mediated the longitudinal relationships between all 3 health indicators and procedural justice. Results are discussed in light of previous studies and implications for theory and practice are outlined.

  • 9.
    Fransson, Eleonor I.
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden; Jönköping University, Sweden.
    Heikkilä, Katriina
    Nyberg, Solja T.
    Zins, Marie
    Westerlund, Hugo
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. University College London, United Kingdom.
    Westerholm, Peter
    Väänänen, Ari
    Virtanen, Marianna
    Vahtera, Jussi
    Theorell, Töres
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Suominen, Sakari
    Singh-Manoux, Archana
    Siegrist, Johannes
    Sabia, Séverine
    Rugulies, Reiner
    Pentti, Jaana
    Oksanen, Tuula
    Nordin, Maria
    Nielsen, Martin L
    Marmot, Michael G
    Magnusson Hanson, Linda L.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Madsen, Ida E. H.
    Lunau, Thorsten
    Leineweber, Constanze
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Kumari, Meena
    Kouvonen, Anne
    Koskinen, Aki
    Koskenvuo, Markku
    Knutsson, Anders
    Kittel, France
    Jöckel, Karl-Heinz
    Joensuu, Matti
    Houtman, Irene L.
    Hooftman, Wendela E.
    Goldberg, Marcel
    Geuskens, Goedele A.
    Ferrie, Jane E.
    Erbel, Raimund
    Dragano, Nico
    De Bacquer, Dirk
    Clays, Els
    Casini, Annalisa
    Burr, Hermann
    Borritz, Marianne
    Bonenfant, Sébastien
    Bjorner, Jakob B.
    Alfredsson, Lars
    Hamer, Mark
    Batty, G. David
    Kivimäki, Mika
    Job Strain as a Risk Factor for Leisure-Time Physical Inactivity: An Individual-Participant Meta-Analysis of Up to 170,000 Men and Women The IPD-Work Consortium2012In: American Journal of Epidemiology, ISSN 0002-9262, E-ISSN 1476-6256, Vol. 176, no 12, p. 1078-1089Article in journal (Refereed)
    Abstract [en]

    Unfavorable work characteristics, such as low job control and too high or too low job demands, have been suggested to increase the likelihood of physical inactivity during leisure time, but this has not been verified in large-scale studies. The authors combined individual-level data from 14 European cohort studies (baseline years from 1985-1988 to 2006-2008) to examine the association between unfavorable work characteristics and leisure-time physical inactivity in a total of 170,162 employees (50% women; mean age, 43.5 years). Of these employees, 56,735 were reexamined after 2-9 years. In cross-sectional analyses, the odds for physical inactivity were 26% higher (odds ratio = 1.26, 95% confidence interval: 1.15, 1.38) for employees with high-strain jobs (low control/high demands) and 21% higher (odds ratio = 1.21, 95% confidence interval: 1.11, 1.31) for those with passive jobs (low control/low demands) compared with employees in low-strain jobs (high control/low demands). In prospective analyses restricted to physically active participants, the odds of becoming physically inactive during follow-up were 21% and 20% higher for those with high-strain (odds ratio = 1.21, 95% confidence interval: 1.11, 1.32) and passive (odds ratio = 1.20, 95% confidence interval: 1.11, 1.30) jobs at baseline. These data suggest that unfavorable work characteristics may have a spillover effect on leisure-time physical activity.

  • 10.
    Fransson, Eleonor I.
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden; Jönköping University, Sweden.
    Nyberg, Solja T.
    Heikkilä, Katriina
    Alfredsson, Lars
    Bjorner, Jakob B.
    Borritz, Marianne
    Burr, Hermann
    Dragano, Nico
    Geuskens, Goedele A.
    Goldberg, Marcel
    Hamer, Mark
    Hooftman, Wendela E.
    Houtman, Irene L
    Joensuu, Matti
    Jokela, Markus
    Knutsson, Anders
    Koskenvuo, Markku
    Koskinen, Aki
    Kumari, Meena
    Leineweber, Constanze
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Lunau, Thorsten
    Madsen, Ida E. H.
    Magnusson Hanson, Linda
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Nielsen, Martin L.
    Nordin, Maria
    Oksanen, Tuula
    Pentti, Jaana
    Pejtersen, Jan H.
    Rugulies, Reiner
    Salo, Paula
    Shipley, Martin J.
    Steptoe, Andrew
    Suominen, Sakari B.
    Theorell, Töres
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Toppinen-Tanner, Salla
    Vahtera, Jussi
    Virtanen, Marianna
    Väänänen, Ari
    Westerholm, Peter J. M.
    Westerlund, Hugo
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Zins, Marie
    Britton, Annie
    Brunner, Eric J.
    Singh-Manoux, Archana
    Batty, G. David
    Kivimäki, Mika
    Job strain and the risk of stroke: an individual-participant data meta-analysis2015In: Stroke, ISSN 0039-2499, E-ISSN 1524-4628, Vol. 46, no 2, p. 557-559Article in journal (Refereed)
    Abstract [en]

    BACKGROUND AND PURPOSE: Psychosocial stress at work has been proposed to be a risk factor for cardiovascular disease. However, its role as a risk factor for stroke is uncertain.

    METHODS: We conducted an individual-participant-data meta-analysis of 196 380 males and females from 14 European cohort studies to investigate the association between job strain, a measure of work-related stress, and incident stroke.

    RESULTS: In 1.8 million person-years at risk (mean follow-up 9.2 years), 2023 first-time stroke events were recorded. The age- and sex-adjusted hazard ratio for job strain relative to no job strain was 1.24 (95% confidence interval, 1.05;1.47) for ischemic stroke, 1.01 (95% confidence interval, 0.75;1.36) for hemorrhagic stroke, and 1.09 (95% confidence interval, 0.94;1.26) for overall stroke. The association with ischemic stroke was robust to further adjustment for socioeconomic status.

    CONCLUSION: Job strain may be associated with an increased risk of ischemic stroke, but further research is needed to determine whether interventions targeting job strain would reduce stroke risk beyond existing preventive strategies.

  • 11. Fransson, Eleonor I.
    et al.
    Nyberg, Solja T.
    Heikkilä, Katriina
    Alfredsson, Lars
    De Bacquer, Dirk
    Batty, G. David
    Bonenfant, Sebastien
    Casini, Annalisa
    Clays, Els
    Goldberg, Marcel
    Kittel, France
    Koskenvuo, Markku
    Knutsson, Anders
    Leineweber, Constanze
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Magnusson Hanson, Linda L.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Nordin, Maria
    Singh-Manoux, Archana
    Suominen, Sakari
    Vahtera, Jussi
    Westerholm, Peter
    Westerlund, Hugo
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. University College London, UK.
    Zins, Marie
    Theorell, Töres
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Kivimäki, Mika
    Comparison of alternative versions of the job demand-control scales in 17 European cohort studies: the IPD-Work consortium2012In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 12, article id 62Article in journal (Refereed)
    Abstract [en]

    Background: Job strain (i.e., high job demands combined with low job control) is a frequently used indicator of harmful work stress, but studies have often used partial versions of the complete multi-item job demands and control scales. Understanding whether the different instruments assess the same underlying concepts has crucial implications for the interpretation of findings across studies, harmonisation of multi-cohort data for pooled analyses, and design of future studies. As part of the 'IPD-Work' (Individual-participant-data meta-analysis in working populations) consortium, we compared different versions of the demands and control scales available in 17 European cohort studies. Methods: Six of the 17 studies had information on the complete scales and 11 on partial scales. Here, we analyse individual level data from 70 751 participants of the studies which had complete scales (5 demand items, 6 job control items). Results: We found high Pearson correlation coefficients between complete scales of job demands and control relative to scales with at least three items (r > 0.90) and for partial scales with two items only (r = 0.76-0.88). In comparison with scores from the complete scales, the agreement between job strain definitions was very good when only one item was missing in either the demands or the control scale (kappa > 0.80); good for job strain assessed with three demand items and all six control items (kappa > 0.68) and moderate to good when items were missing from both scales (kappa = 0.54-0.76). The sensitivity was > 0.80 when only one item was missing from either scale, decreasing when several items were missing in one or both job strain subscales. Conclusions: Partial job demand and job control scales with at least half of the items of the complete scales, and job strain indices based on one complete and one partial scale, seemed to assess the same underlying concepts as the complete survey instruments.

  • 12. Hall, A. L.
    et al.
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Leineweber, Constanze
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Tucker, Philip
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Swansea University, UK.
    Work schedule and prospective antidepressant prescriptions in the swedish workforce: a 2-year study using national drug registry data2018In: Occupational and Environmental Medicine, ISSN 1351-0711, Vol. 75, p. A482-A483Article in journal (Other academic)
    Abstract [en]

    Introduction Mood disorders affect millions of individuals worldwide and contribute to substantial morbidity and disability. A better understanding of modifiable work-related risk factors for depression could inform and advance prevention efforts in this area. This study used a large Swedish longitudinal occupational survey to prospectively examine the effect of self-reported work schedule on registry-based antidepressant prescriptions over a two-year period.

    Methods The analytic sample (n=8643) was obtained from the Swedish Longitudinal Occupational Survey of Health. Sex-stratified and unstratified analyses were conducted using logistic regression. For exposure, 8 categories were used to describe work schedule in 2008: ‘regular days’ (3 categories: night work history=none,≤3 years, or 4+years) ‘night work (regular, rostered, or rotating)’, ‘regular shift work (no nights)’, ‘rostered work (no nights)’, ‘flexible/non-regulated hours’, and ‘other’. For the outcome, all prescriptions coded N06A according to the Anatomical Therapeutic Chemical System were obtained from the Swedish National Prescribed Drug Register and dichotomized into ‘any’ or ‘no’ prescriptions between 2008 and 2010. Estimates were adjusted for potential sociodemographic, health, and work confounders, and for prior depressive symptoms.

    Results In unadjusted analyses, an increased odds ratio for depression was observed for ‘Other’ work hours in unstratified (OR=1.75, 95% CI: 1.21 to 2.51) and female (OR=1.62, 95% CI: 1.05 to 2.51) models; in adjusted models effects persisted but confidence intervals widened to non-significance at the p=0.05 level. In models adjusted for previous depressive symptoms, females in ‘flexible/non-regulated’ schedules showed an increased odds ratio for depression (OR=2.01, 95% CI: 1.08 to 3.76), while a decreased odds ratio was observed for the unstratified model ‘regular shift work (no nights)’ category (OR=0.61; 95% CI: 0.38 to 0.97).

    Discussion This study’s findings support prospective relationships between work schedule and antidepressant prescriptions in the Swedish workforce. Future research should continue to assess sex-stratified relationships, using detailed shift work exposure categories and objective registry data where possible.

  • 13.
    Halonen, Jaana I.
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. University of Copenhagen, Denmark.
    Virtanen, Marianna
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Finnish Institute of Occupational Health, Finland.
    Leineweber, Constanze
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Rod, Naja H.
    Westerlund, Hugo
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Magnusson Hanson, Linda L.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Associations between onset of effort-reward imbalance at work and onset of musculoskeletal pain: analyzing observational longitudinal data as pseudo-trials2018In: Pain, ISSN 0304-3959, E-ISSN 1872-6623, Vol. 159, no 8, p. 1477-1483Article in journal (Refereed)
    Abstract [en]

    Existing evidence of an association between effort-reward imbalance (ERI) at work and musculoskeletal pain is limited, preventing reliable conclusions about the magnitude and direction of the relation. In a large longitudinal study, we examined whether the onset of ERI is associated with subsequent onset of musculoskeletal pain among those free of pain at baseline, and vice versa, whether onset of pain leads to onset of ERI. Data were from the Swedish Longitudinal Occupational Survey of Health (SLOSH) study. We used responses from 3 consecutive study phases to examine whether exposure onset between the first and second phases predicts onset of the outcome in the third phase (N = 4079). Effort-reward imbalance was assessed with a short form of the ERI model. Having neck-shoulder and low back pain affecting life to some degree in the past 3 months was also assessed in all study phases. As covariates, we included age, sex, marital status, occupational status, and physically strenuous work. In the adjusted models, onset of ERI was associated with onset of neck-shoulder pain (relative risk [RR] 1.51, 95% confidence interval [CI] 1.21-1.89) and low back pain (RR 1.21, 95% CI 0.97-1.50). The opposite was also observed, as onset of neck-shoulder pain increased the risk of subsequent onset of ERI (RR 1.36, 95% CI 1.05-1.74). Our findings suggest that when accounting for the temporal order, the associations between ERI and musculoskeletal pain that affects life are bidirectional, implying that interventions to both ERI and pain may be worthwhile to prevent a vicious cycle.

  • 14.
    Hasson, Dan
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Theorell, Töres
    Benka Wallén, Martin
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Leineweber, Constanze
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Canlon, Barbara
    Stress and prevalence of hearing problems in the Swedish working population2011In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 11, p. 130-Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Current human and experimental studies are indicating an association between stress and hearing problems; however potential risk factors have not been established. Hearing problems are projected to become among the top ten disabilities according to the WHO in the near future. Therefore a better understanding of the relationships between stress and hearing is warranted. Here we describe the prevalence of two common hearing problems, i.e. hearing complaints and tinnitus, in relation to different work-and health-related stressors. METHODS: A total of 18,734 individuals were invited to participate in the study, out of which 9,756 (52 %) enrolled. RESULTS: The results demonstrate a clear and mostly linear relationship between higher prevalence of hearing problems (tinnitus or hearing loss or both) and different stressors, e.g. occupational, poorer self-rated health, long-term illness, poorer sleep quality, and higher burnout scores. CONCLUSIONS: The present study unambiguously demonstrates associations between hearing problems and various stressors that have not been previously described for the auditory system. These findings will open new avenues for future investigations.

  • 15. Heikkilä, Katriina
    et al.
    Nyberg, Solja T.
    Fransson, Eleonor I.
    Alfredsson, Lars
    De Bacquer, Dirk
    Bjorner, Jakob B.
    Bonenfant, Sebastien
    Borritz, Marianne
    Burr, Hermann
    Clays, Els
    Casini, Annalisa
    Dragano, Nico
    Erbel, Raimund
    Geuskens, Goedele A.
    Goldberg, Marcel
    Hooftman, Wendela E.
    Houtman, Irene L.
    Joensuu, Matti
    Joeckel, Karl-Heinz
    Kittel, France
    Knutsson, Anders
    Koskenvuo, Markku
    Koskinen, Aki
    Kouvonen, Anne
    Leineweber, Constanze
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Lunau, Thorsten
    Madsen, Ida E. H.
    Magnusson Hanson, Linda L.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Marmot, Michael G.
    Nielsen, Martin L.
    Nordin, Maria
    Pentti, Jaana
    Salo, Paula
    Rugulies, Reiner
    Steptoe, Andrew
    Siegrist, Johannes
    Suominen, Sakari
    Vahtera, Jussi
    Virtanen, Marianna
    Vaananen, Ari
    Westerholm, Peter
    Westerlund, Hugo
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. University College London, United Kingdom.
    Zins, Marie
    Theorell, Töres
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Hamer, Mark
    Ferrie, Jane E.
    Singh-Manoux, Archana
    Batty, G. David
    Kivimäki, Mika
    Job Strain and Alcohol Intake: A Collaborative Meta-Analysis of Individual-Participant Data from 140 000 Men and Women2012In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 7, no 7, p. e40101-Article in journal (Refereed)
    Abstract [en]

    Background: The relationship between work-related stress and alcohol intake is uncertain. In order to add to the thus far inconsistent evidence from relatively small studies, we conducted individual-participant meta-analyses of the association between work-related stress (operationalised as self-reported job strain) and alcohol intake. Methodology and Principal Findings: We analysed cross-sectional data from 12 European studies (n = 142 140) and longitudinal data from four studies (n = 48 646). Job strain and alcohol intake were self-reported. Job strain was analysed as a binary variable (strain vs. no strain). Alcohol intake was harmonised into the following categories: none, moderate (women: 1-14, men: 1-21 drinks/week), intermediate (women: 15-20, men: 22-27 drinks/week) and heavy (women: > 20, men: > 27 drinks/week). Cross-sectional associations were modelled using logistic regression and the results pooled in random effects meta-analyses. Longitudinal associations were examined using mixed effects logistic and modified Poisson regression. Compared to moderate drinkers, non-drinkers and (random effects odds ratio (OR): 1.10, 95% CI: 1.05, 1.14) and heavy drinkers (OR: 1.12, 95% CI: 1.00, 1.26) had higher odds of job strain. Intermediate drinkers, on the other hand, had lower odds of job strain (OR: 0.92, 95% CI: 0.86, 0.99). We found no clear evidence for longitudinal associations between job strain and alcohol intake. Conclusions: Our findings suggest that compared to moderate drinkers, non-drinkers and heavy drinkers are more likely and intermediate drinkers less likely to report work-related stress.

  • 16. Heikkilä, Katriina
    et al.
    Nyberg, Solja T.
    Fransson, Eleonor I.
    Alfredsson, Lars
    De Bacquer, Dirk
    Bjorner, Jakob B.
    Bonenfant, Sebastien
    Borritz, Marianne
    Burr, Hermann
    Clays, Els
    Casini, Annalisa
    Dragano, Nico
    Erbel, Raimund
    Geuskens, Goedele A.
    Goldberg, Marcel
    Hooftman, Wendela E.
    Houtman, Irene L.
    Joensuu, Matti
    Jöckel, Karl-Heinz
    Kittel, France
    Knutsson, Anders
    Koskenvuo, Markku
    Koskinen, Aki
    Kouvonen, Anne
    Leineweber, Constanze
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Lunau, Thorsten
    Madsen, Ida E. H.
    Magnusson Hanson, Linda L.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Marmot, Michael G.
    Nielsen, Martin L.
    Nordin, Maria
    Pentti, Jaana
    Salo, Paula
    Rugulies, Reiner
    Steptoe, Andrew
    Siegrist, Johannes
    Suominen, Sakari
    Vahtera, Jussi
    Virtanen, Marianna
    Vaananen, Ari
    Westerholm, Peter
    Westerlund, Hugo
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. University College London, UK.
    Zins, Marie
    Theorell, Töres
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Hamer, Mark
    Ferrie, Jane E.
    Singh-Manoux, Archana
    Batty, G. David
    Kivimäki, Mika
    Job Strain and Tobacco Smoking: An Individual-Participant Data Meta-Analysis of 166 130 Adults in 15 European Studies2012In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 7, no 7, article id e35463Article in journal (Refereed)
    Abstract [en]

    Background: Tobacco smoking is a major contributor to the public health burden and healthcare costs worldwide, but the determinants of smoking behaviours are poorly understood. We conducted a large individual-participant meta-analysis to examine the extent to which work-related stress, operationalised as job strain, is associated with tobacco smoking in working adults. Methodology and Principal Findings: We analysed cross-sectional data from 15 European studies comprising 166 130 participants. Longitudinal data from six studies were used. Job strain and smoking were self-reported. Smoking was harmonised into three categories never, ex- and current. We modelled the cross-sectional associations using logistic regression and the results pooled in random effects meta-analyses. Mixed effects logistic regression was used to examine longitudinal associations. Of the 166 130 participants, 17% reported job strain, 42% were never smokers, 33% ex-smokers and 25% current smokers. In the analyses of the cross-sectional data, current smokers had higher odds of job strain than never-smokers (age, sex and socioeconomic position-adjusted odds ratio: 1.11, 95% confidence interval: 1.03, 1.18). Current smokers with job strain smoked, on average, three cigarettes per week more than current smokers without job strain. In the analyses of longitudinal data (1 to 9 years of follow-up), there was no clear evidence for longitudinal associations between job strain and taking up or quitting smoking. Conclusions: Our findings show that smokers are slightly more likely than non-smokers to report work-related stress. In addition, smokers who reported work stress smoked, on average, slightly more cigarettes than stress-free smokers.

  • 17.
    Hyde, Martin
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Magnusson Hanson, Linda
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Chungkham, Holendro Singh
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Leineweber, Constanze
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Westerlund, Hugo
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    The impact of involuntary exit from employment in later life on the risk of major depression and being prescribed anti-depressant medication2015In: Aging & Mental Health, ISSN 1360-7863, E-ISSN 1364-6915, Vol. 19, no 5, p. 381-389Article in journal (Refereed)
    Abstract [en]

    Objectives: Involuntary employment exit in later life has been shown to be a risk factor for poor physical and mental health. This study aims to examine the relationship between involuntary employment exit in later life and subsequent risk of reporting major depression or being prescribed anti-depressant medication (ADM). Method: Data were drawn from four waves of the Swedish Longitudinal Occupational Survey of Health (SLOSH). This is a nationally representative longitudinal cohort survey of persons employed in Sweden in 2003 and 2005. The sample was restricted to respondents who had exited the labour market aged 50+ years between 2006 and 2012 (N = 1433). Major depression was measured using the Symptom Checklist Core Depression Scale (SCL-CD6). Prescription ADM redeemed from a pharmacy was based on the National Prescribed Drug Register. Results: After controlling for socio-demographic variables, health, health behaviours, and baseline depression, involuntary employment exit was associated with an increased risk of reporting major depression (OR 3.16; CI 1.32-7.61) and becoming newly prescribed ADM (HR 2.08; CI 1.03-4.21) compared to voluntary employment exit. Conclusion: Involuntary employment exit represents a risk for subsequent depression in later life. Mental health and social services ought to consider identifying these individuals for possible intervention programs to reduce the burden of depression in later life.

  • 18.
    Leineweber, Constanze
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Baltzer, Maria
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Magnusson Hanson, Linda L.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Westerlund, Hugo
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Work-family conflict and health in Swedish working women and men: a 2-year prospective analysis (the SLOSH study)2013In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 23, no 4, p. 710-716Article in journal (Refereed)
    Abstract [en]

    Background: Research has suggested that gender is related to perceptions of work-family conflict (WFC) and an underlying assumption is that interference of paid work with family life will burden women more than men. There is, however, mixed evidence as to whether men and women report different levels of WFC. Even less studies investigate gender differences in health outcomes of WFC. Also the number of longitudinal studies in this field is low. METHODS: Based on the Swedish Longitudinal Occupational Survey of Health, we prospectively examined the effects of WFC on three different health measures representing a wide spectrum off ill health (i.e. self-rated health, emotional exhaustion and problem drinking). Logistic regression analyses were used to analyse multivariate associations between WFC in 2008 and health 2 years later. RESULTS: The results show that WFC was associated with an increased risk of emotional exhaustion among both men and women. Gender differences are suggested as WFC was related to an increased risk for poor self-rated health among women and problem drinking among men. Interaction analyses revealed that the risk of poor self-rated health was substantially more influenced by WFC among women than among men. CONCLUSIONS: We conclude that, despite the fact that women experience conflict between work and family life slightly more often than men, both men's and women's health is negatively affected by this phenomenon.

  • 19.
    Leineweber, Constanze
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Bernhard-Oettel, Claudia
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Work and organizational psychology.
    Peristera, Paraskevi
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Eib, Constanze
    Nyberg, Anna
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Westerlund, Hugo
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Interactional justice at work is related to sickness absence: a study using repeated measures in the Swedish working population2017In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 17, article id 912Article in journal (Refereed)
    Abstract [en]

    Background: Research has shown that perceived unfairness contributes to higher rates of sickness absence. While shorter, but more frequent periods of sickness absence might be a possibility for the individual to get relief from high strain, long-term sickness absence might be a sign of more serious health problems. The Uncertainty Management Model suggests that justice is particularly important in times of uncertainty, e.g. perceived job insecurity. The present study investigated the association between interpersonal and informational justice at work with long and frequent sickness absence respectively, under conditions of job insecurity.

    Methods: Data were derived from the 2010, 2012, and 2014 biennial waves of the Swedish Longitudinal Occupational Survey of Health (SLOSH). The final analytic sample consisted of 19,493 individuals. We applied repeated measures regression analyses through generalized estimating equations (GEE), a method for longitudinal data that simultaneously analyses variables at different time points. We calculated risk of long and frequent sickness absence, respectively in relation to interpersonal and informational justice taking perceptions of job insecurity into account.

    Results: We found informational and interpersonal justice to be associated with risk of long and frequent sickness absence independently of job insecurity and demographic variables. Results from autoregressive GEE provided some support for a causal relationship between justice perceptions and sickness absence. Contrary to expectations, we found no interaction between justice and job insecurity.

    Conclusions: Our results underline the need for fair and just treatment of employees irrespective of perceived job insecurity in order to keep the workforce healthy and to minimize lost work days due to sickness absence.

  • 20.
    Leineweber, Constanze
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden.
    Chungkham, Holendro Singh
    Indian Statistical Institute, North-East Centre, India.
    Lindqvist, Rikard
    Westerlund, Hugo
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Runnesdotter, Sara
    Smeds Alenius, Lisa
    Tishelman, Carol
    Nurses’ practice environment and satisfaction with schedule flexibility is related to intention to leave due to dissatisfaction: A multi-country, multilevel study2016In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 58, p. 47-58Article in journal (Refereed)
    Abstract [en]

    Background

    Nursing turnover is a major issue for health care managers, notably during the global nursing workforce shortage. Despite the often hierarchical structure of the data used in nursing studies, few studies have investigated the impact of the work environment on intention to leave using multilevel techniques. Also, differences between intentions to leave the current workplace or to leave the profession entirely have rarely been studied.

    Objective

    The aim of the current study was to investigate how aspects of the nurse practice environment and satisfaction with work schedule flexibility measured at different organisational levels influenced the intention to leave the profession or the workplace due to dissatisfaction.

    Design

    Multilevel models were fitted using survey data from the RN4CAST project, which has a multi-country, multilevel, cross-sectional design. The data analysed here are based on a sample of 23,076 registered nurses from 2020 units in 384 hospitals in 10 European countries (overall response rate: 59.4%). Four levels were available for analyses: country, hospital, unit, and individual registered nurse. Practice environment and satisfaction with schedule flexibility were aggregated and studied at the unit level. Gender, experience as registered nurse, full vs. part-time work, as well as individual deviance from unit mean in practice environment and satisfaction with work schedule flexibility, were included at the individual level. Both intention to leave the profession and the hospital due to dissatisfaction were studied.

    Results

    Regarding intention to leave current workplace, there is variability at both country (6.9%) and unit (6.9%) level. However, for intention to leave the profession we found less variability at the country (4.6%) and unit level (3.9%). Intention to leave the workplace was strongly related to unit level variables. Additionally, individual characteristics and deviance from unit mean regarding practice environment and satisfaction with schedule flexibility were related to both outcomes. Major limitations of the study are its cross-sectional design and the fact that only turnover intention due to dissatisfaction was studied.

    Conclusions

    We conclude that measures aiming to improve the practice environment and schedule flexibility would be a promising approach towards increased retention of registered nurses in both their current workplaces and the nursing profession as a whole and thus a way to counteract the nursing shortage across European countries.

  • 21.
    Leineweber, Constanze
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institute, Sweden.
    Chungkham, Holendro Singh
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Westerlund, Hugo
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Tishelman, C.
    Lindqvist, R.
    Hospital organizational factors influence work-family conflict in registered nurses: multilevel modeling of a nation-wide cross-sectional survey in Sweden2014In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 51, no 5, p. 744-751Article in journal (Refereed)
    Abstract [en]

    Background: The present shortage of registered nurses (RNs) in many European countries is expected to continue and worsen, which poses a substantial threat to the maintenance of healthcare in this region. Work-family conflict is a known risk factor for turnover and sickness absence. Objective: This paper empirically examines whether the nurse practice environment is associated with experienced work-family conflict. Design: A multilevel model was fit with the individual RN at the 1st, and the hospital department at the 2nd level using cross-sectional RN survey data from the Swedish part of RN4CAST, an EU 7th framework project. The data analyzed here is based on a national sample of 8356 female and 592 male RNs from 369 hospital departments. Results: We found that 6% of the variability in work-family conflict experienced by RNs was at the department level. Organizational level factors significantly accounted for most of the variability at this level with two of the work practice environment factors examined, staffing adequacy and nurse involvement in hospital affairs, significantly related to work-family conflict. Due to the design of the study, factors on ward and work group levels could not be analyzed, but are likely to account for additional variance which in the present analysis appears to be on the individual level, with private life factors likely explaining another major part. Conclusion: These results suggest that higher level organizational factors in health care have a significant impact on the risk of work-family conflict among RNs through their impact on the nurse practice environment. Lower level organizational factors should be investigated in future studies using hierarchical multilevel sampling.

  • 22.
    Leineweber, Constanze
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Eib, Constanze
    Bernhard-Oettel, Claudia
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Work and organizational psychology.
    Nyberg, Anna
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Trajectories in Effort-Reward Imbalance Over Time and their Associations with Health Complaints2018In: Book of Proceedings 13th Conference of the European Academy of Occupational Health Psychology: Adapting to rapid changes in today’s workplace / [ed] K. Teoh, N. Saade, V. Dediu, J. Hassard, L. Torres, Nottingham: European Academy of Occupational Health Psychology , 2018, p. 223-223, article id O23Conference paper (Refereed)
    Abstract [en]

    Objectives: The effort-reward imbalance (ERI) model is one of the predominant models in contemporary stress research. It defines stress as a combination of high efforts at work and low work-related rewards. While ERI has been found to be related to a range of health outcomes, little is known about developments in ERI over time. The aim of this study is to (i) identify long- term patterns (trajectories) of effort-reward imbalance in the Swedish working population, to (ii) describe these trajectories with respect to background and work-related factors, and to (iii) evaluate health complaints associated with these trajectories.

    Methods: The study was based on panel data with four measurement points (2010, 2012, 2014, 2016) collected within the Swedish Longitudinal Occupational Survey of Health. Latent class growth modelling was conducted and differences in background and work factors as well as differences in health outcomes, covering self-rated health, sickness absence, depression, musculoskeletal disorder, migraine, cardiovascular heart disease, and blood pressure between trajectories, were analysed.

    Results: Four trajectories were found. A low imbalance trajectory characterised by moderate values of effort and reward comprised the majority of the study population (90%). The next largest trajectory, comprising 4% of all participants, showed the highest baseline value of effort and the lowest baseline value of reward. This trajectory was characterised by a decrease in ERI score followed by an increase and labelled as U-shaped imbalance. The third trajectory, which we called inverted U-shaped, represented 3% of all participants. It was characterised by moderate values of effort matched with moderate values of reward. Its development showed an increase in ERI followed by a decrease. The last trajectory also represented 3% of all participants and was characterised by a rather high mean value in effort in combination with a moderate mean value of reward. This trajectory showed an accelerating increase in ERI over time. We labelled it the increasing imbalance trajectory. The most favourable trajectory was dominated by men working in the private sector, while women were overrepresented in the less favourable ERI trajectories. Also, being in a less favourable trajectory was found to be associated with health complaints and diseases. For the increasing imbalance trajectory, this association remained stable also after controlling for baseline health.

    Conclusion: Our results indicate that about 10% of all employees experience an imbalance between efforts and received rewards at work. To a large extent, these workers are women working in the public sector. As effort-reward imbalance is a contributing factor to these workers’ill-health, measures should be taken to increase balance between efforts and rewards, particularly in the most vulnerable groups identified in this study.

  • 23.
    Leineweber, Constanze
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Eib, Constanze
    University of East Anglia, UK.
    Peristera, Paraskevi
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Bernhard-Oettel, Claudia
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Work and organizational psychology.
    The influence of and change in procedural justice on self-rated health trajectories: Swedish Longitudinal Occupational Survey of Health results2016In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 42, no 4, p. 320-328Article in journal (Refereed)
    Abstract [en]

    Objectives: Procedural justice perceptions are shown to be associated with minor psychiatric disorders, long sickness absence spells, and poor self-rated health, but previous studies have rarely considered how changes in procedural justice influence changes in health. Methods: Data from four consecutive biennial waves of the Swedish Longitudinal Survey of Health (SLOSH) (N=5854) were used to examine trajectories of self-rated health. Adjusting for age, sex, socioeconomic position, and marital status, we studied the predictive power of change in procedural justice perceptions using individual growth curve models within a multilevel framework. Results: The results show that self-rated health trajectories slowly decline over time. The rate of change was influenced by age and sex, with older people and women showing a slower rate. After adjusting for age, sex, socioeconomic position, and marital status, procedural justice was significantly associated with self-rated health. Also, improvements in procedural justice were associated with improvements in self-rated health. Additionally, a reverse relationship with and change in self-rated health predicting procedural justice was found. Conclusions: Our findings support the idea that procedural justice at work is a crucial aspect of the psychosocial work environment and that changes towards more procedural justice could influence self-rated health positively. The reciprocal association of procedural justice and self-rated health warrants further research.

  • 24.
    Leineweber, Constanze
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Falkenberg, Helena
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Work and organizational psychology.
    A Review of Work-Family Research in the Nordic Region2018In: The Cambridge Handbook of the Global Work–Family Interface / [ed] Kristen M. Shockley, Winny Shen, Ryan C. Johnson, Cambridge: Cambridge University Press, 2018, p. 288-302Chapter in book (Refereed)
    Abstract [en]

    A fundamental issue concerning work and family is the extent that women and men work and take care of children. The Nordic countries (i.e., Sweden, Denmark, Norway, Finland, and Iceland for the purposes of this review) are characterized by a “dual-worker model” in which a majority of both women and men participate in paid work, but are also, to some extent, characterized by a “dual-carer model” in which both women and men actively take part in the upbringing of their children (Edlund & Öun, 2016). The Nordic countries have a history of family policies being directed toward both mothers and fathers, and state provisions for dual-earner family support and childcare were developed in a political context with women’s equality in mind (Ellingsaeter & Leira, 2006). Still, the challenge of combining work and family domains is under continual debate and development in the Nordic countries. In the next sections, we will briefly describe the general trends of women’s participation in the labor market in relation to the development of the welfare system. This historical development is crucial for the understanding of how women and men combine work and family in the Nordic countries today.

  • 25.
    Leineweber, Constanze
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Falkenberg, Helena
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Work and organizational psychology.
    Albrecht, Sophie C.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Parent's Relative Perceived Work Flexibility Compared to Their Partner Is Associated With Emotional Exhaustion2018In: Frontiers in Psychology, ISSN 1664-1078, E-ISSN 1664-1078, Vol. 9, article id 640Article in journal (Refereed)
    Abstract [en]

    A number of studies have found that control over work conditions and hours is positively related to mental health. Still, potential positive and negative effects of work flexibility remain to be fully explored. On the one hand, higher work flexibility might provide better opportunities for recovery. On the other hand, especially mothers may use flexibility to meet household and family demands. Here, we investigated the association between parent's work flexibility, rated relative to their partner, and emotional exhaustion in interaction with gender. Additionally, gender differences in time use were investigated. Cross-sectional analyses based on responses of employed parents to the 2012 wave of the Swedish Longitudinal Occupational Survey of Health (SLOSH) were conducted (N = 2,911). Generalized linear models with gamma distribution and a log-link function were used to investigate associations between relative work-flexibility (lower, equal, or higher as compared to partner), gender, and emotional exhaustion. After control for potential confounders, we found that having lower work flexibility than the partner was associated with higher levels of emotional exhaustion as compared to those with higher relative work flexibility. Also, being a mother was associated with higher levels of emotional exhaustion, independent of possible confounders. An interaction effect between low relative work flexibility and gender was found in relation to emotional exhaustion. Regarding time use, clear differences between mothers' and fathers' were found. However, few indications were found that relative work flexibility influenced time use. Mothers spent more time on household chores as compared to fathers, while fathers reported longer working hours. Fathers spent more time on relaxation compared with mothers. To conclude, our results indicate that lower relative work flexibility is detrimental for mental health both for mothers and fathers. However, while gender seems to have a pronounced effect on time use, relative work flexibility seems to have less influence on how time is used. Generally, mothers tend to spend more time on unpaid work while fathers spend longer hours on paid work and report more time for relaxation.

  • 26.
    Leineweber, Constanze
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Radboud University, The Netherlands.
    Lindfors, Petra
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Work and organizational psychology.
    Magnusson Hanson, Linda L.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Change in Work-Time Control and Work-Home Interference Among Swedish Working Men and Women: Findings from the SLOSH Cohort Study2016In: International Journal of Behavioral Medicine, ISSN 1070-5503, E-ISSN 1532-7558, Vol. 23, no 6, p. 670-678Article in journal (Refereed)
    Abstract [en]

    PURPOSE: The aim is to study the influence of change in work-time control (WTC) on work-home interference (WHI) while adjusting for other work-related factors, demographics, changes at work and WHI at baseline among women and men. An additional aim was to explore sex differences in the relation between change in WTC and WHI.

    METHODS: The study included working participants of the Swedish Longitudinal Occupational Survey of Health (SLOSH) study of the third (2010) and fourth (2012) waves (n = 5440). Based on a seven-item index, four groups of WTC were formed: stable high (40 %), stable low (42 %), increasing (9 %), or decreasing (9 %) WTC over the 2 years. WHI was measured by four items and individuals were categorised in whether suffering or not suffering of WHI. Sex-stratified logistic regression analyses with 95 % confidence intervals (CI) were used to estimate the odds of experiencing WHI by change in WTC.

    RESULTS: Controlling for demographics and work-related factors, women with stable low (OR = 1.46; 95 % CI 1.14-1.88) and women and men with decreasing WTC (women OR = 1.99; 95 % CI 1.38-2.85; men OR = 1.80; 95 % CI 1.18-2.73) had higher odds of WHI than those with a stable high WTC. Additionally, adjusting for changes at work and WHI at baseline did not alter the results substantially. Interaction analysis did not reveal any significant sex difference in the relation between WTC and WHI.

    CONCLUSIONS: For both women and men decreased and for women only, low control over working hours resulted in WHI also after adjusting for work-related factors and demographics.

  • 27.
    Leineweber, Constanze
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Theorell, Töres
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska institutet, Sverige.
    Åkerstedt, Torbjörn
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Alexanderson, Kristina
    Westerlund, Hugo
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Inflytande över arbetstiden och sjuknärvaro/sjukfrånvaro2013In: Arbetsmarknad & Arbetsliv, ISSN 1400-9692, Vol. 19, no 4, p. 87-99Article in journal (Other academic)
    Abstract [sv]

    Flexibla arbetstider blir allt vanligare. De förväntas underlätta verksamhetens förmåga att hantera arbetstoppar, tillgodose anställdas behov av livsbalans samt möjliggöra bättre hälsa och arbetsprestation. Flexibilitet skapas ofta genom att de anställda ges inflytande över arbetstiderna. Vetenskaplig kunskap om sambandet mellan arbetstidskontroll och sjukfrånvaro/sjuknärvaro saknas nästan helt. I föreliggande studie undersöks sambandet mellan arbetstidskontroll samt dess underdimensioner och självrapporterad sjukfrånvaro/sjuknärvaro i ett representativt urval av den arbetande befolkningen i Sverige.

  • 28.
    Leineweber, Constanze
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Westerlund, Hugo
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Low control over worktime increases the risk for sickness absence and sickness presenteeism2013Conference paper (Refereed)
  • 29.
    Leineweber, Constanze
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Magnusson Hanson, Linda
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Change in work-time control and work-home interference among Swedish working men and women2014In: Looking at the past – planning for the future: capitalizing on Occupational Health Psychology / [ed] Nicholas John Artin Andreou et al, Nottingham: EAOHP , 2014Conference paper (Refereed)
  • 30.
    Leineweber, Constanze
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Wege, Natalia
    Westerlund, Hugo
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Theorell, Töres
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Wahrendorf, Morten
    Siegrist, Johannes
    How valid is a short measure of effort-reward imbalance at work?:  A replication study from Sweden2010In: Occupational and Environmental Medicine, ISSN 1351-0711, E-ISSN 1470-7926, Vol. 67, no 8, p. 526-31Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: There is an urgent need for validated measures of health-adverse psychosocial work environments. We tested the validity of a newly developed short version of the original questionnaire measuring effort-reward imbalance at work (ERI). METHODS: The study sample comprised working men and women (n=4771) participating in the Swedish Longitudinal Occupational Survey of Health (SLOSH), a nationally representative longitudinal cohort study, in 2006 and 2008. Structural equation modelling was applied to test factorial validity, using the ERI scales. Furthermore, criterion validity was explored with two prospectively assessed health indicators, poor self-reported health and depressive symptoms. Results are based on logistic and linear regression analyses, with appropriate confounder control. RESULTS: The short version of the ERI questionnaire (16 items) provides satisfactory psychometric properties (internal consistency of scales, confirmatory factor analysis with a good model fit of the data with the theoretical structure). All scales, and the effort-reward ratio, were prospectively associated with an increased risk of poor general self-rated health and depressive symptoms, indicating satisfactory criterion validity. CONCLUSION: This short version of the ERI questionnaire provides a psychometrically useful tool for epidemiological studies focused on the health-adverse effects of work and employment in the context of a globalised economy.

  • 31.
    Leineweber, Constanze
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden.
    Westerlund, Hugo
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Chungkham, Holendro Singh
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Lindqvist, Rikard
    Runesdotter, Sara
    Tishelman, Carol
    Nurses' Practice Environment and Work-Family Conflict in Relation to Burn Out: A Multilevel Modelling Approach2014In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 9, no 5, p. e96991-Article in journal (Refereed)
    Abstract [en]

    Objectives: To investigate associations between nurse work practice environment measured at department level and individual level work-family conflict on burnout, measured as emotional exhaustion, depersonalization and personal accomplishment among Swedish RNs. Methods: A multilevel model was fit with the individual RN at the 1st, and the hospital department at the 2nd level using cross-sectional RN survey data from the Swedish part of RN4CAST, an EU 7th framework project. The data analysed here is based on a national sample of 8,620 RNs from 369 departments in 53 hospitals. Results: Generally, RNs reported high values of personal accomplishment and lower values of emotional exhaustion and depersonalization. High work-family conflict increased the risk for emotional exhaustion, but for neither depersonalization nor personal accomplishment. On department level adequate staffing and good leadership and support for nurses reduced the risk for emotional exhaustion and depersonalization. Personal accomplishment was statistically significantly related to staff adequacy. Conclusions: The findings suggest that adequate staffing, good leadership, and support for nurses are crucial for RNs' mental health. Our findings also highlight the importance of hospital managers developing policies and practices to facilitate the successful combination of work with private life for employees.

  • 32.
    Leineweber, Constanze
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Westerlund, Hugo
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden.
    Hagberg, Jan
    Svedberg, Pia
    Alexanderson, Kristina
    Sickness presenteeism is more than an alternative to sickness absence: results from the population-based SLOSH study2012In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 85, no 8, p. 905-914Article in journal (Refereed)
    Abstract [en]

    PURPOSE: Sickness presenteeism, defined as 'going to work despite judging that one should have reported in sick', is usually considered to be a complementary alternative to sickness absence. Nonetheless, several studies have reported a positive association between sickness absence and sickness presenteeism. The aim of the present study was to investigate whether the contemporaneous positive association between sickness absence and sickness presenteeism can be explained by illness, work incapacity, and/or work environment.

    METHODS: A cross-sectional study based on answers to a comprehensive questionnaire from 8,304 working women and men, those in the second wave of the nationally representative Swedish Longitudinal Occupational Survey of Health. Logistic regression was used to investigate the association between sickness presenteeism and sickness absence.

    RESULTS: Sickness absence was strongly associated with sickness presenteeism. Sickness absence of 1-7 days during a 12-month period more than doubled the odds of also having sickness presenteeism of more than 8 days during the same 12-month period (OR = 2.11; 95% CI: 1.79-2.49). Adjusting for age and sex did not attenuate the association; further adjustment for work environment, self-rated health, chronic diseases, and work capacity reduced the odds somewhat, but they remained highly significant (OR = 1.88; 95% CI: 1.56-2.25).

    CONCLUSIONS: The results suggest that sickness presenteeism is not, as earlier hypothesised, just an alternative to sickness absence, given a certain level of health or work incapacity. Other, so far unknown explanations for both sickness absence and sickness presenteeism must be sought.

  • 33.
    Leineweber, Constanze
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Westerlund, Hugo
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Hagberg, Jan
    Svedberg, Pia
    Luokkala, Marita
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Alexanderson, Kristina
    Sickness presenteeism among Swedish police officers2011In: Journal of occupational rehabilitation, ISSN 1053-0487, E-ISSN 1573-3688, Vol. 21, no 1, p. 17-22Article in journal (Refereed)
    Abstract [en]

    Introduction The aim was to describe the prevalence of sickness presenteeism (SP) and to explore possible associations with work characteristics among Swedish police officers. Methods Questionnaire data from 11,793 police officers were analysed. Relative risks (RR) and 95% confidence intervals (CI) for SP were calculated with modified Poisson regression. SP was defined as having gone to work on two or more occasions during the past 12 months despite judging that one's health would have motivated sickness absence. Results Of the police officers, 47% reported SP. All studied work environment factors were significantly associated with SP. The strongest association was found for stress (RR = 1.46; 95% CI: 1.41-1.52). Low support from colleagues and low control had higher impact on the risk estimates for SP among older subjects. Adjustment for self-rated health lowered the RRs, however, estimates remained statistically significant. The results indicated that SP was most affected by work environment among subjects with good self-rated health. Conclusions SP was high among police officers. Work environment factors seem to be associated with SP, particularly among subjects with good general health.

  • 34.
    Leineweber, Constanze
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Westerlund, Hugo
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Theorell, Töres
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Kivimäki, M.
    Westerholm, P.
    Alfredsson, L.
    Covert coping with unfair treatment at work and risk of incident myocardial infarction and cardiac death among men: prospective cohort study2011In: Journal of Epidemiology and Community Health, ISSN 0143-005X, E-ISSN 1470-2738, Vol. 65, no 5, p. 420-425Article in journal (Refereed)
    Abstract [en]

    Background: Covert coping with unfair treatment at work-occurring when an employee does not show the "aggressor" that he/she feels unfairly treated-has been found to be associated with cardiovascular risk factors. This study examined whether covert coping also predicts incident coronary heart disease.

    Methods: A prospective cohort study (the WOLF Stockholm study) of workplaces in the Stockholm area, Sweden. The participants were 2755 men with no history of myocardial infarction at baseline screening in 1992-1995. The main outcome measure was hospitalisation due to myocardial infarction or death from ischaemic heart disease until 2003 obtained from national registers (mean follow-up 9.8±0.9 years).

    Results: Forty-seven participants had myocardial infarction or died from ischaemic heart disease during follow-up. After adjustment for age, socioeconomic factors, risk behaviours, job strain and biological risk factors at baseline, there was a dose-response relationship between covert coping and risk of incident myocardial infarction or cardiac death (p for trend=0.10). Men who frequently used covert coping had a 2.29 (95% CI 1.00 to 5.29) times higher risk than those who did not use coping. Restricting the analysis to direct coping behaviours only strengthened this association (p for trend=0.02).

    Conclusions: In this study, covert coping is strongly related to increased risk of hard-endpoint cardiovascular disease.

  • 35.
    Leineweber, Constanze
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Marklund, Staffan
    Aronsson, Gunnar
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Work and organizational psychology.
    Gustafsson, Klas
    Work-related psychosocial risk factors and risk of disability pension among employees in health and personal care: A prospective cohort study2019In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 93, p. 12-20Article in journal (Refereed)
    Abstract [en]

    Background: Researchers have suggested that psychological factors at work contribute to early retirement due to disability pension in the general working population. Disability pension is a problem that shortens working careers among nursing professionals and personal care or related workers, but few researchers have focused on these occupational groups. Also, a need for studies based on measurements of specific work exposure instead of combined measures has been identified.

    Objectives: The aim was to study the potential influence of work-related psychosocial risk factors on the future risk of disability pension among nursing professionals and care assistants in Sweden. Those occupational groups are compared to all other occupations in Sweden. A specific aim was to describe differences in associations to cause-specific disability, and how the results were modified by occupation categories.

    Participants: A representative sample of 79,004 women and men in Sweden comprising 2,576 nursing professionals, 10,175 care assistants and 66,253 workers in other occupations.

    Methods: Factors of the psychosocial work environment were obtained from questionnaire data of the Swedish Work Environment Surveys (SWES) 1993–2013. Information on cause-specific disability pension during follow-up was added from the Social Insurance Agency’s database (1994–2014). We calculated Cox’s proportional hazards with 95% confidence intervals.

    Results: During a mean follow-up time of 11.1 years, 6.6% of nursing professionals and 9.4% of care assistants, as compared to 6.1% among all other occupations, received disability pension. Among nursing professionals and care assistants, high quantitative job demands and low social support, but not job control, were associated with future disability pension also after controlling for age, year of interview, socio demographic conditions, and physical work factors. An increase in risk was also noticeable among nursing professionals and care assistants who reported an active job in combination with low social support. An increased risk for disability pension due to mental diagnosis was found among care assistants who reported high job demands. In all other occupations, low social support was associated with an increased risk for disability pension under any condition of job strain (high strain, low strain, active, and passive jobs).

    Conclusion: Based on the results we conclude that high quantitative job demands and poor social support are predictors of future disability pension.

  • 36. Madsen, I. E. H.
    et al.
    Nyberg, S. T.
    Magnusson Hanson, Linda L.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Ferrie, J. E.
    Ahola, K.
    Alfredsson, L.
    Batty, G. D.
    Bjorner, J. B.
    Borritz, M.
    Burr, H.
    Chastang, J. -F.
    de Graaf, R.
    Dragano, N.
    Hamer, M.
    Jokela, M.
    Knutsson, A.
    Koskenvuo, M.
    Koskinen, A.
    Leineweber, Constanze
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Niedhammer, I.
    Nielsen, M. L.
    Nordin, Maria
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Umeå University, Sweden.
    Oksanen, T.
    Pejtersen, J. H.
    Pentti, J.
    Plaisier, I.
    Salo, P.
    Singh-Manoux, A.
    Suominen, S.
    ten Have, M.
    Theorell, Töres
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Toppinen-Tanner, S.
    Vahtera, J.
    Vaananen, A.
    Westerholm, P. J. M.
    Westerlund, Hugo
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Fransson, Eleonor I.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden; Jönköping University, Sweden.
    Heikkilä, K.
    Virtanen, M.
    Rugulies, R.
    Kivimäki, M.
    Job strain as a risk factor for clinical depression: systematic review and meta-analysis with additional individual participant data2017In: Psychological Medicine, ISSN 0033-2917, E-ISSN 1469-8978, Vol. 47, no 8, p. 1342-1356Article, review/survey (Refereed)
    Abstract [en]

    Background. Adverse psychosocial working environments characterized by job strain (the combination of high demands and low control at work) are associated with an increased risk of depressive symptoms among employees, but evidence on clinically diagnosed depression is scarce. We examined job strain as a risk factor for clinical depression. Method. We identified published cohort studies from a systematic literature search in PubMed and PsycNET and obtained 14 cohort studies with unpublished individual-level data from the Individual-Participant-Data Meta-analysis in Working Populations (IPD-Work) Consortium. Summary estimates of the association were obtained using random-effects models. Individual-level data analyses were based on a pre-published study protocol. Results. We included six published studies with a total of 27 461 individuals and 914 incident cases of clinical depression. From unpublished datasets we included 120 221 individuals and 982 first episodes of hospital-treated clinical depression. Job strain was associated with an increased risk of clinical depression in both published [relative risk (RR) = 1.77, 95% confidence interval (CI) 1.47-2.13] and unpublished datasets (RR = 1.27, 95% CI 1.04-1.55). Further individual participant analyses showed a similar association across sociodemographic subgroups and after excluding individuals with baseline somatic disease. The association was unchanged when excluding individuals with baseline depressive symptoms (RR = 1.25, 95% CI 0.94-1.65), but attenuated on adjustment for a continuous depressive symptoms score (RR = 1.03, 95% CI 0.81-1.32). Conclusions. Job strain may precipitate clinical depression among employees. Future intervention studies should test whether job strain is a modifiable risk factor for depression.

  • 37. Madsen, Ida E. H.
    et al.
    Hannerz, Harald
    Nyberg, Solja T.
    Magnusson Hanson, Linda L.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Ahola, Kirsi
    Alfredsson, Lars
    Batty, G. David
    Bjorner, Jakob B.
    Borritz, Marianne
    Burr, Hermann
    Dragano, Nico
    Ferrie, Jane E.
    Hamer, Mark
    Jokela, Markus
    Knutsson, Anders
    Koskenvuo, Markku
    Koskinen, Aki
    Leineweber, Constanze
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Nielsen, Martin L.
    Nordin, Maria
    Oksanen, Tuula
    Pejtersen, Jan H.
    Pentti, Jaana
    Salo, Paula
    Singh-Manoux, Archana
    Suominen, Sakari
    Theorell, Töres
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Toppinen-Tanner, Salla
    Vahtera, Jussi
    Väänänen, Ari
    Westerholm, Peter J. M.
    Westerlund, Hugo
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Fransson, Eleonor
    Heikkilä, Katriina
    Virtanen, Marianna
    Rugulies, Reiner
    Kivimäki, Mika
    Study protocol for examining job strain as a risk factor for severe unipolar depression in an individual participant meta-analysis of 14 European cohorts2013In: F1000 Research, E-ISSN 2046-1402, Vol. 2, article id 233Article in journal (Refereed)
    Abstract [en]

    Background: Previous studies have shown that gainfully employed individuals with high work demands and low control at work (denoted "job strain") are at increased risk of common mental disorders, including depression. Most existing studies have, however, measured depression using self-rated symptom scales that do not necessarily correspond to clinically diagnosed depression. In addition, a meta-analysis from 2008 indicated publication bias in the field.   Methods: This study protocol describes the planned design and analyses of an individual participant data meta-analysis, to examine whether job strain is associated with an increased risk of clinically diagnosed unipolar depression based on hospital treatment registers.  The study will be based on data from approximately 120,000 individuals who participated in 14 studies on work environment and health in 4 European countries. The self-reported working conditions data will be merged with national registers on psychiatric hospital treatment, primarily hospital admissions. Study-specific risk estimates for the association between job strain and depression will be calculated using Cox regressions. The study-specific risk estimates will be pooled using random effects meta-analysis.   Discussion: The planned analyses will help clarify whether job strain is associated with an increased risk of clinically diagnosed unipolar depression. As the analysis is based on pre-planned study protocols and an individual participant data meta-analysis, the pooled risk estimates will not be influenced by selective reporting and publication bias. However, the results of the planned study may only pertain to severe cases of unipolar depression, because of the outcome measure applied.

  • 38.
    Magnusson Hanson, Linda L.
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Leineweber, Constance
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Chungkham, Holendro Singh
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Westerlund, Hugo
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institute, Sweden.
    Work-home interference and its prospective relation to major depression and treatment with antidepressants2014In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 40, no 1, p. 66-73Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: Few longitudinal studies have investigated if "work-home interference" (WHI), conflicts between work and home demands, predicts depressive disorders. We examined if WHI was prospectively associated with indicators of major depression in a nationally representative sample.

    METHODS: We used multiple logistic and Cox regression models to examine if self-reported WHI was related to probable major depression [scoring high on a brief self-report scale based on the (Hopkins) Symptom Checklist] and/or any new antidepressant treatment using the prescribed drug register during a 2-year follow-up. The analytic sample comprised 1576 men and 1678 women, working respondents to the Swedish Longitudinal Occupational Survey of Health (SLOSH), free of major depression and prior purchases of antidepressants at baseline.

    RESULTS: Altogether, 7% experienced high (very often/the whole time) and 32% moderate (sometimes) WHI. Overall, the analyses indicated prospective associations between especially high WHI and major depression and/or antidepressant treatment also when adjusting for work characteristics (demands, control, support, overtime). However, the estimates for major depression differed by sex. Separate analyses indicated that only women with high WHI were significantly more likely to have subsequent major depression. Analyses further indicated an elevated rate of antidepressant treatment for men in particular, partly explained by work characteristics and that major depression was related to subsequent high WHI.

    CONCLUSIONS: Based on a two-year follow-up, this study indicated that high WHI prospectively predicted major depression and/or antidepressant treatment, though effects appeared to differ to some extent by sex.

  • 39.
    Magnusson Hanson, Linda. L.
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Leineweber, Constanze
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Chungkham, Holendro
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Westerlund, Hugo
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Prospective effects of work-to-home interference and its prospective relation to major depression and treatment with antidepressants using the Swedish Longitudinal Occupational Survey of Health2013Conference paper (Refereed)
  • 40.
    Magnusson Hanson, Linda L.
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Westerlund, Hugo
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Leineweber, Constanze
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Rugulies, Reiner
    Osika, Walter
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Theorell, Töres
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Bech, Per
    The Symptom Checklist-core depression (SCL-CD6) scale: Psychometric properties of a brief six item scale for the assessment of depression2014In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 42, no 1, p. 82-88Article in journal (Refereed)
    Abstract [en]

    Aims: Major depressive disorders are common, with substantial impact on individuals/society. Brief scales for depression severity, based on a small number of characteristics all of which are necessary for diagnosis, have been recommended in self-reported versions for clinical work or research when aiming to quickly and accurately measure depression. We have examined psychometric properties of a brief 6-item version of the Symptom Checklist (SCL), the Symptom Checklist core depression scale (SCL-CD6) and aimed to identify a cut-point for epidemiological research. Methods: The psychometric evaluation of the SCL-CD6 was mainly performed by a Mokken analysis of unidimensionality in a random sample of 1476 residents in the Stockholm County, aged 18-64 years. The standardization of SCL-CD6 was based on ROC analysis, using the Major Depression Inventory as index of validity. Predictive validity was subsequently assessed using register data on hospital admissions and purchases of prescribed medications linked to a sample of 5985 participants in the Swedish Longitudinal Occupational Survey of Health (SLOSH). Results: The SCL-CD6 obtained a coefficient of homogeneity of 0.70 by Mokken analysis, which indicates high unidimensionality and a meaningful dimensional measure of depression severity. By ROC we identified a score of 17 or higher (total range 0-24) as the best cut-point for major depression (sensitivity 0.68, specificity 0.98) which predicted subsequent purchases of antidepressants as well as hospitalisations with a depressive episode. Conclusions: The SCL-CD6 was found a valid depression scale with higher unidimensionality than longer epidemiological instruments and thus particularly suitable for assessment in larger population surveys.

  • 41.
    Magnusson Hanson, Linda L.
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Åkerstedt, Torbjörn
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Näswall, Katharina
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Leineweber, Constanze
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Theorell, Töres
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Westerlund, Hugo
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Cross-lagged relationships between workplace demands, control, support, and sleep problems2011In: Sleep, ISSN 0161-8105, E-ISSN 1550-9109, Vol. 34, no 10, p. 1403-1410Article in journal (Refereed)
    Abstract [en]

    STUDY OBJECTIVES: Sleep problems are experienced by a large part of the population. Work characteristics are potential determinants, but limited longitudinal evidence is available to date, and reverse causation is a plausible alternative. This study examines longitudinal, bidirectional relationships between work characteristics and sleep problems.

    DESIGN: Prospective cohort/two-wave panel.

    SETTING: Sweden.

    PARTICIPANTS: 3065 working men and women approximately representative of the Swedish workforce who responded to the 2006 and 2008 waves of the Swedish Longitudinal Occupational Survey of Health (SLOSH).

    INTERVENTIONS: N/A.

    MEASUREMENTS AND RESULTS: Bidirectional relationships between, on the one hand, workplace demands, decision authority, and support, and, on the other hand, sleep disturbances (reflecting lack of sleep continuity) and awakening problems (reflecting feelings of being insufficiently restored), were investigated by structural equation modeling. All factors were modeled as latent variables and adjusted for gender, age, marital status, education, alcohol consumption, and job change. Concerning sleep disturbances, the best fitting models were the "forward" causal model for demands and the "reverse" causal model for support. Regarding awakening problems, reciprocal models fitted the data best.

    CONCLUSIONS: Cross-lagged analyses indicates a weak relationship between demands at Time 1 and sleep disturbances at Time 2, a "reverse" relationship from support T1 to sleep disturbances T2, and bidirectional associations between work characteristics and awakening problems. In contrast to an earlier study on demands, control, sleep quality, and fatigue, this study suggests reverse and reciprocal in addition to the commonly hypothesized causal relationships between work characteristics and sleep problems based on a 2-year time lag. CITATION: Magnusson Hanson LL; Åkerstedt T; Näswall K; Leineweber C; Theorell T; Westerlund H. Cross-lagged relationships between workplace demands, control, support, and sleep problems.

  • 42. Mortensen, J.
    et al.
    Clark, A. J.
    Lange, T.
    Andersen, G. S.
    Goldberg, M.
    Ramlau-Hansen, C. H.
    Head, J.
    Kivimäki, M.
    Madsen, I. E. H.
    Leineweber, Constanze
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Lund, R.
    Rugulies, R.
    Zins, M.
    Westerlund, Hugo
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Rod, N. H.
    Informal caregiving as a risk factor for type 2 diabetes in individuals with favourable and unfavourable psychosocial work environments: A longitudinal multi-cohort study2018In: Diabetes & Metabolism, ISSN 1262-3636, E-ISSN 1878-1780, Vol. 44, no 1, p. 38-44Article in journal (Refereed)
    Abstract [en]

    AIM: To examine whether informal caregiving is associated with increased risk of type 2 diabetes (T2D), and whether job strain and social support at work modify the association.

    METHODS: Individual participant's data were pooled from three cohort studies-the French GAZEL study, the Swedish Longitudinal Occupational Survey of Health (SLOSH) and the British Whitehall II study-a total of 21,243 study subjects. Informal caregiving was defined as unpaid care for a closely related person. Job strain was assessed using the demand-control model, and questions on co-worker and supervisor support were combined in a measure of social support at work. Incident T2D was ascertained using registry-based, clinically assessed and self-reported data.

    RESULTS: A total of 1058 participants developed T2D during the up to 10 years of follow-up. Neither informal caregiving (OR: 1.09, 95% CI: 0.92-1.30) nor high job strain (OR: 1.04, 95% CI: 0.86-1.26) were associated with T2D risk, whereas low social support at work was a risk factor for T2D (OR: 1.18, 95% CI: 1.02-1.37). Also, informal caregivers who were also exposed to low social support at work were at higher risk of T2D (OR: 1.40, 95% CI: 1.08-1.82) compared with those who were not informal caregivers and had high social support at work (multiplicative test for interaction, P=0.04; additive test for interaction, synergy index=10).

    CONCLUSION: Informal caregiving was not independently associated with T2D risk. However, low social support at work was a risk factor, and informal caregivers with low social support at work had even higher risks of T2D.

  • 43. Mortensen, Jesper
    et al.
    Dich, Nadya
    Lange, Theis
    Høst Ramlau-Hansen, Cecilia
    Head, Jenny
    Kivimäki, Mika
    Leineweber, Constanze
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Rod, Naja Hulvej
    Weekly hours of informal caregiving and paid work, and the risk of cardiovascular disease2018In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 28, no 4, p. 743-747Article in journal (Refereed)
    Abstract [en]

    Background: Little is known on the association between weekly hours of informal caregiving and risk of cardiovascular disease (CVD). The objective was to investigate the individual and joint effects of weekly hours of informal caregiving and paid work on the risk of CVD. Methods: Pooled analysis with 1396 informal caregivers in gainful employment, from the Swedish Longitudinal Occupational Survey of Health and the Whitehall II study. Informal caregiving was defined as care for an aged or disabled relative. The outcome was CVD during 10years follow-up. Analyzes were adjusted for age, sex, children, marital status and occupational grade. Results: There were 59 cases of CVD. Providing care >20 h weekly were associated with a higher risk of CVD compared to those providing care 1-8 h weekly (hazard ratio = 2.63, 95%CI: 1.20; 5.76), irrespectively of weekly work hours. In sensitivity analyzes, we found this risk to be markedly higher among long-term caregivers (6.17, 95%CI: 1.73; 22.1) compared to short-term caregivers (0.89, 95%CI: 0.10; 8.08). Caregivers working >= 55 h weekly were at higher risk of CVD (2.23, 95%CI: 1.14; 4.35) compared to those working 35-40 h weekly. Those providing care >8 h and working <= 40 h weekly had a higher risk of CVD compared to those providing care 1-8 h and working <= 40 h (3.23, 95%CI: 1.25; 8.37). Conclusion: A high number of weekly hours of informal caregiving as opposed to few weekly hours is associated with a higher risk of CVD, irrespectively of weekly work hours. The excess risk seemed to be driven by those providing care over long periods of time.

  • 44. Müller, Karolina
    et al.
    Edvall, Niklas K.
    Idrizbegovic, Esma
    Huhn, Robert
    Cima, Rilana
    Persson, Viktor
    Leineweber, Constanze
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Westerlund, Hugo
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Langguth, Berthold
    Schlee, Winfried
    Canlon, Barbara
    Cederroth, Christopher R.
    Validation of Online Versions of Tinnitus Questionnaires Translated into Swedish2016In: Frontiers in Aging Neuroscience, ISSN 1663-4365, E-ISSN 1663-4365, Vol. 8, article id 272Article in journal (Refereed)
    Abstract [en]

    Background: Due to the lack of objective measures for assessing tinnitus, its clinical evaluation largely relies on the use of questionnaires and psychoacoustic tests. A global assessment of tinnitus burden would largely benefit from holistic approaches that not only incorporate measures of tinnitus but also take into account associated fears, emotional aspects (stress, anxiety, and depression), and quality of life. In Sweden, only a few instruments are available for assessing tinnitus, and the existing tools lack validation. Therefore, we translated a set of questionnaires into Swedish and evaluated their reliability and validity in a group of tinnitus subjects. Methods: We translated the English versions of the Tinnitus Functional Index (TFI), the Fear of Tinnitus Questionnaire (FTQ), the Tinnitus Catastrophizing Scale (TCS), the Perceived Stress Questionnaire (PSQ-30), and the Tinnitus Sample Case History Questionnaire (TSCHQ) into Swedish. These translations were delivered via the internet with the already existing Swedish versions of the Tinnitus Handicap Inventory (THI), the Hospital Anxiety and Depression Scale (HADS), the Hyperacusis Questionnaire (HQ), and the World Health Organization Quality of Life questionnaire (WHOQoL-BREF). Psychometric properties were evaluated by means of internal consistency [Cronbach's alpha (α)] and test-retest reliability across a 9-week interval [Intraclass Correlation Coefficient (ICC), Cohen's kappa] in order to establish construct as well as clinical validity using a sample of 260 subjects from a population-based cohort. Results: Internal consistency was acceptable for all questionnaires (α > 0.7) with the exception of the "social relationships" subscale of the WHOQoL-BREF. Test-retest reliability was generally acceptable (ICC > 0.70, Cohens kappa > 0.60) for the tinnitus-related questionnaires, except for the TFI "sense of control" subscale and 15 items of the TSCHQ. Spearmen rank correlations showed that almost all questionnaires on tinnitus are significantly related, indicating that these questionnaires measure different aspects of the same construct. The data supported good clinical validity of the tinnitus-related questionnaires. Conclusion: Our results suggest that most Swedish adaptations of the questionnaires are suitable for clinical and research settings and should facilitate the assessment of treatment outcomes using a more holistic approach by including measures of tinnitus fears, emotional burden, and quality of life.

  • 45.
    Nyberg, Anna
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Leineweber, Constanze
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Hanson Magnusson, Linda
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Gender differences in psychosocial work factors, work-personal life interface, and well-being among Swedish managers and non-managers2015In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 88, no 8, p. 1149-1164Article in journal (Refereed)
    Abstract [en]

    PURPOSE: To explore differences in psychosocial work factors, work-personal life interface, and well-being between managers and non-managers, female and male managers, and managers in the public and private sectors.

    METHODS: Data were drawn from the Swedish Longitudinal Occupational Survey of Health (SLOSH) 2010, including 602 female managers, 4174 female non-managers, 906 male managers, and 2832 male non-managers. Psychosocial work factors, work-personal life interface, satisfaction, and well-being were investigated among non-managers and managers and male and female managers, using logistic regression analyses adjusted for age, educational level, staff category, and labour market sector.

    RESULTS: Both female and male managers reported high job demands and interference between work and personal life, but also high influence, high satisfaction with work and life, and low amount of sickness absence more often than non-managers of the same sex. However, female managers reported high quantitative and emotional demands, low influence, and work-personal life interference more frequently than male managers. More psychosocial work stressors were also reported in the public sector, where many women work. Male managers more often reported conflicts with superiors, lack of support, and personal life-work interference. Female managers reported poor well-being to a greater extent than male managers, but were more satisfied with their lives.

    CONCLUSION: Lack of motivation due to limited increase in satisfaction and organisational benefits is not likely to hinder women from taking on managerial roles. Managerial women's higher overall demands, lower influence at work, and poorer well-being relative to men's could hinder female managers from reaching higher organisational levels.

  • 46.
    Nyberg, Anna
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Magnusson Hanson, Linda L.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Leineweber, Constanze
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Hammarström, Anne
    Theorell, Töres
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Occupational gender composition and mild to severe depression in a Swedish cohort: The impact of psychosocial work factors2018In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 46, no 3, p. 425-432Article in journal (Refereed)
    Abstract [en]

    Aims: The aim of the present study was to investigate associations between occupational gender composition, psychosocial work factors and mild to severe depression in Swedish women and men with various educational backgrounds.

    Methods: The study included 5560 participants from two waves of the Swedish Longitudinal Occupational Survey of Health, an approximately representative sample of the Swedish working population. Odds ratios (OR) and 95% confidence intervals of mild to severe depression in 2014 were estimated for five strata of occupational gender composition with >20-40%, >40-60%, >60-80% and >80-100% women, using 0-20% women as the reference. Analyses were stratified by gender and education. Job strain, organisational injustice, poor social support and effort-reward imbalance in 2012 were added in separate models, and changes in OR of mild to severe depression for strata of occupational gender composition were evaluated.

    Results: Among women, the odds of mild to severe depression did not vary by occupational gender composition. Among men with low to intermediate education, the odds were higher in the stratum with >80-100% women, and among men with high education, the odds were higher in strata with >20-40% and >60-80% women. Psychosocial work factors affected the odds ratios of mild to severe depression, but most of the variation remained unexplained.

    Conclusions: Odds of mild to severe depression appeared to vary by occupational gender composition among Swedish men but not women. This variation seemed only to a small extent to be explained by psychosocial work factors.

  • 47.
    Nyberg, Anna
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Magnusson Hanson, Linda L.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Leineweber, Constanze
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Johansson, Gunn
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Do Predictors of Career Success Differ between Swedish Women and Men? Data from the Swedish Longitudinal Occupational Survey of Health (SLOSH)2015In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 10, no 10, article id e0140516Article in journal (Refereed)
    Abstract [en]

    The aim of this prospective study was to explore predictors of objective career success among Swedish women and men, focussing on gender differences. Data were drawn from the 2008 and 2010 waves of the Swedish Longitudinal Occupational Survey of Health (SLOSH) with a total of 3670 female and 2773 male participants. Odds ratios and 95% confidence intervals for job promotion and an above-average salary increase between 2008 and 2010 were obtained through binary logistic regression analyses. Individual and organisational factors measured in 2008 were used as predictors in analyses stratified by sex. Mutual adjustment was performed for these variables, as well as for labour market sector and staff category at baseline. In both sexes, younger age predicted both job promotion and an above-average salary increase. Job promotion was also in both sexes predicted by being part of decision-making processes, having conflicts with superiors, and being eager to advance. Furthermore, promotion was predicted by, among men, being educated to post-graduate level and having an open coping strategy and, among women, working >60 hours/week. An above-average salary increase was predicted in both sexes by having a university education. Postgraduate education, having children living at home, and being very motivated to advance predicted an above-average salary increase among women, as did working 51-60 hours/week and being part of decision-making processes in men. Gender differences were seen in several predictors. In conclusion, the results support previous findings of gender differences in predictors of career success. A high level of education, motivation to advance, and procedural justice appear to be more important predictors of career success among women, while open coping was a more important predictor among men.

  • 48.
    Nyberg, Anna
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Peristera, Paraskevi
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Bernhard-Oettel, Claudia
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Work and organizational psychology.
    Leineweber, Constanze
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Does Work-Personal Life Interference Predict Turnover Among Male and Female Managers, and do Depressive Symptoms Mediate the Association?2018In: Book of Proceedings 13th Conference of the European Academy of Occupational Health Psychology: Adapting to rapid changes in today’s workplace / [ed] K. Teoh, N. Saade, V. Dediu, J. Hassard, L. Torres, Nottingham: European Academy of Occupational Health Psychology , 2018, p. 308-309, article id O135Conference paper (Refereed)
    Abstract [en]

    Background: To increase possibilities for women and men to remain in leadership positions a better understanding of turnover processes among female and male managers appears important. Although the interface between work and personal life has been recognised as a key issue for managers, it has seldom been empirically investigated in relation to turnover. In the present study we used a longitudinal multi-group design to examine associations between work- personal life interference, managerial turnover and depressive symptoms, and their differences with respect to gender. We hypothesised that 1) work-personal life interference predict managerial turnover, 2) depressive symptoms mediate the association, which 3) differ by gender. 

    Methods: Data were drawn from four waves (2010, 2012, 2014 and 2016) of the Swedish Longitudinal Occupational Survey of Health (SLOSH), a cohort of the Swedish working population. Participants who in any wave reported to have a managerial or other leading position were included (n=717 men and 741 women). Mediation models within a multilevel SEM framework, in which repeated measures were nested within individuals, were fitted. First, bivariate autoregressive and cross-lagged paths between the variables (t and t-1) were fitted in gender stratified models. Secondly, a full longitudinal gender stratified mediation model was built to estimate if the association between work-personal life interference (t-2) and turnover (t) was mediated through depressive symptoms (t-1). Gender differences in cross-lagged paths were estimated with multiple-group analysis. All analyses were adjusted for age, education, labour market sector, civil status and children living at home, and conducted in MPLUS 7.

    Results: In accordance with our first hypothesis, significant prospective paths between work- personal life interference and turnover were found among both male and female managers. In line with our second hypothesis, there were furthermore significant prospective associations between work-personal life interference and depressive symptoms as well as between depressive symptoms and turnover in both genders. However, no significant intermediate effect of depressive symptoms in the longitudinal association between work-personal life interference and turnover was found in any gender, and therefore our second hypothesis was not supported. We found gender differences in several of the estimated associations, lending partial support for our third hypothesis.

    Conclusions: Establishing organisational prerequisites for good work-personal life balance among managers may be a means to retain male and female managerial talent.

  • 49.
    Nyberg, Anna
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Peristera, Paraskevi
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Bernhard-Oettel, Claudia
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Work and organizational psychology.
    Leineweber, Constanze
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Does work-personal life interference predict turnover among male and female managers, and do depressive symptoms mediate the association? A longitudinal study based on a Swedish cohort2018In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 18, article id 828Article in journal (Refereed)
    Abstract [en]

    Background: In the present study we used a longitudinal design to examine if work-personal life interference predicted managerial turnover, if depressive symptoms mediated the association, and if the relationships differed by gender.

    Methods: Data were drawn from four waves (2010, 2012, 2014 and 2016) of the Swedish Longitudinal Occupational Survey of Health (SLOSH), a cohort of the Swedish working population. Participants who in any wave reported to have a managerial or other leading position were included (n = 717 men and 741 women). Autoregressive longitudinal mediation models within a multilevel structural equation modelling (MSEM) framework, in which repeated measures (level 1) were nested within individuals (level 2), were fitted to data. First, bivariate autoregressive and cross-lagged paths between the variables were fitted in gender stratified models. Secondly, a full gender stratified mediation model was built to estimate if the association between work-personal life interference and turnover was mediated through depressive symptoms. Gender differences in cross-lagged paths were estimated with multiple-group analysis. All analyses were adjusted for age, education, labour market sector, civil status and children living at home, and conducted in MPLUS 7.

    Results: In both genders there were significant paths between work-personal life interference and turnover. Depressive symptoms were, however, not found to mediate in the relationship between work-personal life interference and turnover. The models differed significantly between genders.

    Conclusions: Establishing organisational prerequisites for good work-personal life balance among managers may be a means to retain both male and female managerial talent.

  • 50. Nyberg, S. T.
    et al.
    Heikkilä, K.
    Fransson, E. I.
    Alfredsson, L.
    De Bacquer, D.
    Bjorner, J. B.
    Bonenfant, S.
    Borritz, M.
    Burr, H.
    Casini, A.
    Clays, E.
    Dragano, N.
    Erbel, R.
    Geuskens, G. A.
    Goldberg, M.
    Hooftman, W. E.
    Houtman, I. L.
    Jöckel, K-H
    Kittel, F.
    Knutsson, A.
    Koskenvuo, M.
    Leineweber, Constanze
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Lunau, T.
    Madsen, I. E. H.
    Magnusson Hanson, Linda. L.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Marmot, M. G.
    Nielsen, M. L.
    Nordin, M.
    Oksanen, T.
    Pentti, J.
    Rugulies, R.
    Siegrist, J.
    Suominen, S.
    Vahtera, J.
    Virtanen, M.
    Westerholm, P.
    Westerlund, Hugo
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden; University College London, UK.
    Zins, M.
    Ferrie, J. E.
    Theorell, Töres
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Steptoe, A.
    Hamer, M.
    Singh-Manoux, A.
    Batty, G. D.
    Kivimäki, M.
    Job strain in relation to body mass index: pooled analysis of 160 000 adults from 13 cohort studies2012In: Journal of Internal Medicine, ISSN 0954-6820, E-ISSN 1365-2796, Vol. 272, no 1, p. 65-73Article in journal (Refereed)
    Abstract [en]

    Job strain in relation to body mass index: pooled analysis of 160 000 adults from 13 cohort studies. J Intern Med 2012; 272: 6573. Background. Evidence of an association between job strain and obesity is inconsistent, mostly limited to small-scale studies, and does not distinguish between categories of underweight or obesity subclasses. Objectives. To examine the association between job strain and body mass index (BMI) in a large adult population. Methods. We performed a pooled cross-sectional analysis based on individual-level data from 13 European studies resulting in a total of 161 746 participants (49% men, mean age, 43.7 years). Longitudinal analysis with a median follow-up of 4 years was possible for four cohort studies (n = 42 222). Results. A total of 86 429 participants were of normal weight (BMI 18.524.9 kg m-2), 2149 were underweight (BMI < 18.5 kg m-2), 56 572 overweight (BMI 25.029.9 kg m-2) and 13 523 class I (BMI 3034.9 kg m-2) and 3073 classes II/III (BMI = 35 kg m-2) obese. In addition, 27 010 (17%) participants reported job strain. In cross-sectional analyses, we found increased odds of job strain amongst underweight [odds ratio 1.12, 95% confidence interval (CI) 1.001.25], obese class I (odds ratio 1.07, 95% CI 1.021.12) and obese classes II/III participants (odds ratio 1.14, 95% CI 1.011.28) as compared with participants of normal weight. In longitudinal analysis, both weight gain and weight loss were related to the onset of job strain during follow-up. Conclusions. In an analysis of European data, we found both weight gain and weight loss to be associated with the onset of job strain, consistent with a U-shaped cross-sectional association between job strain and BMI. These associations were relatively modest; therefore, it is unlikely that intervention to reduce job strain would be effective in combating obesity at a population level.

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