From the School of Psychology and Public Health, La Trobe University, Bundoora, Victoria, Australia.
Psychosom Med. 2018 Jan;80(1):103-113. doi: 10.1097/PSY.0000000000000505.
The association between effort-reward imbalance (ERI) and various health outcomes has been well documented over the past 20 years, but the mechanisms responsible for this association remain unclear. The present meta-analysis assessed the associations of ERI and overcommitment (OC) in the workplace with hypothalamic-pituitary-adrenal (HPA) axis measures.
Electronic databases were searched with the phrase "effortrewardimbalance," which yielded 319 studies leading to 56 full-text studies being screened. Thirty-two studies within 14 articles met inclusion criteria and were meta-analyzed using mixed and random effects models.
Greater ERI was associated with increased HPA axis activity (r = .09, p < .001, k = 14, N = 2541). The cortisol awakening response (r = .14, p < .001, k = 9, N = 584) and cortisol waking concentrations (r = .12, p = .01, k = 6, N = 493) were the only HPA measures associated with ERI. OC was also associated with greater HPA axis activity (r = .06, p < .01, k = 10, N = 1918). Cortisol (PM) (r = .13, p = .02, k = 3, N = 295) was the only HPA measure associated with OC.
ERI and OC were similarly related with HPA responsivity. However, because OC moderated the relationship between ERI and HPA axis markers, the importance of OC should not be overlooked. Because OC is likely more malleable than ERI to intervention, this may be a promising avenue for future research.
过去 20 年来，努力-回报失衡（ERI）与各种健康结果之间的关联已得到充分证明，但导致这种关联的机制仍不清楚。本荟萃分析评估了工作场所的 ERI 和过度投入（OC）与下丘脑-垂体-肾上腺（HPA）轴测量值的相关性。
使用短语“effortrewardimbalance”搜索电子数据库，共产生 319 项研究，导致对 56 篇全文研究进行筛选。符合纳入标准的 14 篇文章中的 32 项研究进行了荟萃分析，使用混合和随机效应模型。
ERI 越大，HPA 轴活性越高（r =.09，p <.001，k = 14，N = 2541）。皮质醇觉醒反应（r =.14，p <.001，k = 9，N = 584）和皮质醇唤醒浓度（r =.12，p =.01，k = 6，N = 493）是与 ERI 相关的唯一 HPA 测量值。OC 也与更大的 HPA 轴活性相关（r =.06，p <.01，k = 10，N = 1918）。皮质醇（PM）（r =.13，p =.02，k = 3，N = 295）是与 OC 相关的唯一 HPA 测量值。
ERI 和 OC 与 HPA 反应性具有相似的相关性。然而，由于 OC 调节了 ERI 和 HPA 轴标志物之间的关系，因此不应忽视 OC 的重要性。由于 OC 比 ERI 更易于干预，因此这可能是未来研究的一个有前途的途径。
