Herr Raphael M, Li Jian, Loerbroks Adrian, Angerer Peter, Siegrist Johannes, Fischer Joachim E
Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim, Heidelberg University, Germany; Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, Heinrich-Heine-University of Düsseldorf, Germany.
Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, Heinrich-Heine-University of Düsseldorf, Germany.
J Psychosom Res. 2017 Jul;98:27-33. doi: 10.1016/j.jpsychores.2017.05.003. Epub 2017 May 4.
Ample evidence documented the adverse health effects of work stressors, and recent research has increasingly focused on somatic symptoms which are very common and costly. Prospective evidence is however sparse and yielded mixed findings. Furthermore, there is reason to assume that depression and anxiety might mediate the effects of adverse psychosocial work conditions on somatic symptoms. This study aimed to investigate longitudinal effects of work stressors on somatic symptoms and the potential mediation by anxiety and/or depression.
Six year follow-up data from 352 individuals - free of potentially stress-related chronic disease - were utilized. Somatic symptoms were assessed by 19 items of an established list of complaints at baseline and follow-up. The effort-reward-imbalance (ERI) model measured adverse psychosocial work conditions and over-commitment (OC). Linear regressions adjusted for socio-demographics, social status, lifestyle, and baseline symptoms estimated the effects of the ERI ratio, effort, reward, OC, and the ERI ratio×OC interaction on somatic symptoms six years later. Furthermore, single and multiple mediation by anxiety and/or depression was investigated.
There was a strong longitudinal effect of the ERI ratio, as well as of its subcomponents, and OC on somatic symptoms (all Bs≥|0.49|; p-values ≤0.004). Moreover, the ERI ratio×OC interaction was significant (p-value=0.047). Multiple mediation analyses revealed especially anxiety to mediate the effect of work stressors on somatic symptoms (Sobel test=0.007).
Adverse psychosocial work conditions seem to longitudinally affect somatic symptoms, potentially moderated by OC, and mediated by anxiety.
大量证据证明了工作压力源对健康的不利影响，近期研究越来越关注非常常见且代价高昂的躯体症状。然而，前瞻性证据稀少且结果不一。此外，有理由认为抑郁和焦虑可能介导不良心理社会工作条件对躯体症状的影响。本研究旨在调查工作压力源对躯体症状的纵向影响以及焦虑和/或抑郁的潜在中介作用。
利用了352名无潜在压力相关慢性病个体的六年随访数据。在基线和随访时，通过一份既定的19项投诉清单评估躯体症状。努力-回报失衡（ERI）模型测量不良心理社会工作条件和过度投入（OC）。对社会人口统计学、社会地位、生活方式和基线症状进行调整的线性回归估计了ERI比率、努力、回报、OC以及ERI比率×OC交互作用对六年后躯体症状的影响。此外，还研究了焦虑和/或抑郁的单一和多重中介作用。
ERI比率及其子成分以及OC对躯体症状有很强的纵向影响（所有B值≥|0.49|；p值≤0.004）。此外，ERI比率×OC交互作用显著（p值=0.047）。多重中介分析显示，尤其是焦虑介导了工作压力源对躯体症状的影响（Sobel检验=0.007）。
不良心理社会工作条件似乎对躯体症状有纵向影响，可能受OC调节，并由焦虑介导。
