Lecture 7: Stress II Flashcards
(42 cards)
1
Q
What are the key developments over the last 20 years for stress theories?
A
- Adoption of Karasek’s Demand–Control (DC) theory at policy levels.
- Rise of Siegrist’s Effort–Reward Imbalance (ERI) theory, often compared with DC theory.
- Translation of theories into practical psychosocial risk management methods.
- Recognition of inadequate conceptual and methodological frameworks requiring further development, especially in intervention evaluation
2
Q
Why are theories important?
A
Theories are essential to occupational health psychology because they help make sense of complex phenomena, provide testable frameworks, predict outcomes, and guide interventions. Good theories combine empiricism (evidence-based) and pragmatism (applied usefulness)
3
Q
How can stress be defined?
A
Stress is not a singular concept; multiple definitions exist depending on the theoretical framework. However, contemporary theories commonly conceptualize stress as a process involving interactions between environmental factors and individual psychological, physiological, and behavioral responses, situated within broader social and organizational contexts
4
Q
Stimulus-based theories
A
- Stress conceptualized as a characteristic of the external environment (independent variable).
- Stressors are aversive or noxious events causing reversible physiological or behavioral reactions unless a threshold is crossed.
- Originates from engineering perspectives, focusing on environmental causes of stress.
- Stress is “that which happens to the person,” focusing on external causes rather than internal reactions
5
Q
Stimulus-based theories
A
- Stress conceptualized as a characteristic of the external environment (independent variable).
- Stressors are aversive or noxious events causing reversible physiological or behavioral reactions unless a threshold is crossed.
- Originates from engineering perspectives, focusing on environmental causes of stress.
- Stress is “that which happens to the person,” focusing on external causes rather than internal reactions
6
Q
What are response-based theories?
A
Stress is the physiological response (dependent variable) to external stressors. - Stress responses mediated by neuro-endocrine systems (e.g., adrenal glands), with implications for physical health (e.g., cardiovascular disease, cancer).
- Cannon’s fight-or-flight response (1929) corresponds to GAS’s alarm stage.
- Limitations: Neglects individual differences in perception and response, assumes uniform physiological reactions
7
Q
Selye’s General Adaptation Syndrome model
A
- Alarm Stage: Initial emergency reaction to stressor.
- Resistance Stage: Adaptation and energy storage.
- Exhaustion Stage: Burnout; symptoms include loss of energy, emotional flatness, and reduced responsiveness.
8
Q
What is the role of contemporary stress theories?
A
- Emphasize interaction between individual and environment.
- Acknowledge the active role of psychological processes such as perception, cognition, emotion, and coping.
- Recognize individual differences in appraisal and coping affecting stress outcomes [[6–7]].
-
Categories:
- Interactional (Structural) Theories: Focus on situational architecture and environmental factors.
- Transactional (Process) Theories: Emphasize cognitive appraisal, coping processes, and dynamic person-environment transactions
9
Q
Person-Environment fit theory
A
- Stress arises from a lack of fit between the individual and environment.
- Two types of fit:
- Objective Fit: Actual match/mismatch between environment and person.
- Subjective Fit: Individual’s perception of this fit.
- Forms of lack of fit:
- Demands exceed abilities.
- Needs are unmet by the environment.
- Combination of above.
- Outcomes: Psychological symptoms (anxiety, restlessness) and physical symptoms (raised blood pressure, lowered immunity).
- Criticisms: Broad definitions of “demand,” ill-defined measurement of fit, and the assumption that lack of fit is always negative.
10
Q
Job Demand-Control theory
A
- Two key dimensions:
- Job Demands: Workload, time pressure, role conflict.
- Job Control (Decision Latitude): Autonomy and skill discretion.
- Four job types (2x2 matrix):
- High Strain: High demands + low control → highest health risk.
- Active: High demands + high control → learning and growth.
- Low Strain: Low demands + high control → low stress.
- Passive: Low demands + low control → demotivating, moderate stress.
- Two testable hypotheses:
- High demands + low control produce strain.
- High demands + high control promote growth/well-being.
11
Q
How has DC theory been evaluated?
A
- Empirical support mixed; interaction effects modest and sometimes difficult to replicate.
- Incorporation of coping resources improves predictive power.
- Criticisms: Operationalization variability, narrow focus on only two job characteristics, limited applicability across health outcomes
12
Q
Iso-Strain Model (Demand–Control–Support Model)
A
- Extension of DC model by Johnson and Hall (1988).
- Adds Social Support as a third factor.
- High risk condition: High demands + low control + low social support.
- Social support can moderate or mediate stress effects; the “matching hypothesis” suggests specific types of support buffer particular demands.
- Evidence mixed regarding relative effectiveness of organizational vs. external social support
13
Q
Effort-Reward Imbalance Model
A
- Based on equity theory and social reciprocity norms.
- Focuses on the balance (or imbalance) between:
- Effort: Demands and obligations of work.
- Reward: Money, esteem, career opportunities, job security.
- Stress arises when high effort is not met with adequate reward, leading to emotional distress and possible health risks.
- Stress related to ERI can be exacerbated by:
- Poorly defined work contracts or limited job alternatives.
- Strategic acceptance of imbalance for future gain.
- Overcommitment to work demands.
14
Q
How has ERI been evaluated?
A
- Supported by numerous epidemiological studies showing links to health outcomes (e.g., myocardial infarction, lifestyle risk factors).
- Compared to DC model, ERI slightly better predicts health risks; combining both offers best prediction
15
Q
What are other interactional models?
A
- Demand-Induced Strain Compensation (DISC) model: Integrates DC and ERI models.
- Job Demands–Resources (JDR) model: Expands focus to include personal resources.
- Demand–Skill–Support model: Further development considering personal agency and personality
16
Q
What are transactional process theories?
A
- Emphasize cognitive appraisal and coping as central processes in stress experience (Lazarus & Folkman, 1984).
- Stress is neither solely environmental nor purely individual but a transaction between person and environment.
- Five components of the transactional model (Cox et al., 1995):
- Antecedent Factors: Exposure to hazards and psychosocial risks.
- Cognitive Processes: Individual’s perception of demands, coping ability, needs, and support.
- Correlates of Stress: Psychological, behavioral, physiological reactions including coping attempts.
- Secondary Effects: Ill-health, social and organizational behavior changes affecting broader systems.
- Feedback: Ongoing cycle influenced by coping success or failure.
- Highlights complexity: feedback loops, feedforward mechanisms, multi-level interactions, and time dependency.
17
Q
What are the further developments by Cox and colleagues?
A
- Emphasis on individual perception over objective measures.
- Recognition that individual ability to cope varies (due to fatigue, illness, age).
- Stress can arise from both over-demand and under-demand situations (e.g., monotonous work).
- Importance of individual needs and the meaningfulness of demands.
- Foundation for psychosocial risk management frameworks and assessment tools (e.g., European Agency taxonomy, UK Management Standards).
18
Q
What is Dewe’s work?
A
emphasizes contextualized individual appraisal and coping, balancing global generalizability with local specificity
19
Q
What are the limitations and challenges in stress theory?
A
-
Measurement Difficulty:
The transactional model, while comprehensive, is difficult to operationalize fully for research and practice. Many studies default to more static, interactional models despite claiming transactional frameworks -
Case Definition Complexity:
A comprehensive case definition includes multiple elements such as declared stress experience, exposure evidence, psychological ill-health, behavioral changes, and exclusion of negative affectivity. This complexity reflects the transactional nature but poses challenges for large-scale assessment
20
Q
What are the similarities across all contemporary theories?
A
- Emphasize interaction between individual and environment.
- Recognize importance of individual perception and appraisal.
- Incorporate core concepts of demand, control, and support, along with related notions like ability, needs, effort, coping, and reward.
- Treat individuals as active agents with coping attempts moderating health outcomes.
- Conceptualize stress as a complex system with feedback and probabilistic outcomes.
- Define stress as an unpleasant emotional state triggered by perceiving demands as exceeding coping ability or efforts as unrewarded.
21
Q
What is the European Commission’s definition of stress?
A
A pattern of emotional, cognitive, behavioural and physiological reactions to adverse and noxious aspects of work content, work organisation and work environment… Stress is caused by poor match between us and our work, conflicts between our roles, and insufficient control over work and life.
22
Q
What are the future directions in theory development?
A
- The chapter suggests that theory advancement will be driven by:
- Extending current research agendas.
- Responding to societal needs and practical applications.
- Emphasis on improving conceptual and methodological frameworks, especially for practical intervention evaluation
23
Q
Why is workplace stress important?
A
Workplace stress is a growing concern worldwide, contributing to absenteeism, injuries, and turnover. Americans have increased working hours, and stress-related sickness absence has tripled. Stress affects workers globally, including in the UK, Europe, and Australia. Organizations contribute substantially to stress due to job demands and social interactions. While stress cannot be eliminated, it can be managed through organizational programs designed to reduce stressors or help individuals cope
24
Q
How is job stress defined?
A
Job stress is defined as work-related factors interacting with employees to alter their psychological or physiological state, leading to impaired functioning
25
Stress management interventions
Stress management interventions (SMIs) target points in the stress cycle: reducing stressor intensity, altering appraisal of stress, or improving coping skills. SMIs are classified as primary (altering stressors), secondary (reducing symptoms), or tertiary (treating health conditions). Most SMIs are secondary and individual-focused, including cognitive–behavioral training, meditation, relaxation, exercise, journaling, and time management
26
Which interventions are most effective?
The effectiveness of SMIs varies by intervention type and outcome measure (psychological, physiological, or organizational). Early narrative reviews found generally positive but methodologically weak evidence. A meta-analysis found a small overall effect, with cognitive–behavioral interventions showing the largest effect. The current study updates that meta-analysis by including more recent, methodologically rigorous studies using randomized controlled designs and incorporating unpublished research to reduce publication bias
27
What is the criteria for inclusion?
Included only experimental studies with randomized assignment, working adult participants (excluding students and clinical populations), and sufficient statistical data to calculate effect sizes. Studies had to be published after 1976 and be primary or secondary SMIs (employee assistance programs excluded).
28
What were the reported types of interventions?
Most interventions were secondary prevention aimed at individuals. Only 8 studies included primary interventions targeting organizational factors. Intervention delivery was mostly group training, with some individual or self-taught methods. Relaxation/meditation techniques were used in 69% of studies; cognitive–behavioral training in 56%
29
What outcome variables were measured?
Over 60 outcome measures were used, averaging 3–4 per study, mainly psychological (stress, anxiety, mental health, job satisfaction). Physiological measures (blood pressure, epinephrine) used in ~25% of studies; organizational measures (absenteeism, productivity) were rare
30
What were the intervention-level moderators?
- Cognitive–behavioral interventions had the largest effect (d = 1.164), but with substantial heterogeneity.
- Relaxation interventions showed medium effects (d = 0.497).
- Organizational interventions had minimal effects (d = 0.144).
- Multimodal interventions showed small effects (d = 0.239), lower than previous meta-analysis.
- Alternative interventions (exercise, journaling) showed large but heterogeneous effects (d = 0.909).Adding more components to interventions generally reduced effectiveness; single-component cognitive–behavioral interventions were most effective
31
What did results find about treatment length?
Shorter interventions tended to have larger effects overall, but the pattern varied by intervention type. Relaxation interventions produced consistent medium effects regardless of length; multimodal interventions lost effect with longer duration
32
What was found about the outcome-level moderators?
- Cognitive–behavioral and alternative interventions mainly used psychological outcomes.
- Organizational interventions used organizational outcomes.
- Physiological outcomes were less common and mostly used in alternative and relaxation interventions. Psychological and physiological outcomes had comparable effect sizes overall, but organizational outcomes tended to show smaller effects
33
What was found about sample-level moderators?
Effect sizes varied by industry sector:
- Cognitive–behavioral interventions were most effective in education settings.
- Relaxation interventions were common in health care.
- Multimodal interventions were more frequent in office settings.These patterns are tentative due to small subgroup sizes
34
What were the implications of these findings?
- SMIs have a medium to large beneficial effect on occupational stress. CBI are most effective, due to their active approach targeting dysfunctional thoughts and behaviours, rather than passive relaxation techniques
- adding multiple components to CBI may reduce effectiveness, relaxation techniques are less affected by this
- outcome measures align with the intervention type
35
What are the two key stress models mentioned by Peter et al?
1. Job Strain Model (Karasek’s model)
- Focuses on *extrinsic/situational* characteristics of the work environment.
- Defines job strain as the combination of **high psychological demands** and **low decision latitude (control)**.
- Established association with coronary heart disease in many prospective studies [[1–6]].
2. **Effort-Reward Imbalance (ERI) Model (Siegrist’s model)**
- Includes both *extrinsic* and *intrinsic* components.
- **Extrinsic component**: Lack of reciprocity between efforts spent and rewards received (money, esteem, job security, career opportunities).
- **Intrinsic component**: Personal coping style described as **“overcommitment”**—a pattern of excessive striving combined with a strong desire for approval and esteem.
- This model links stressful work experiences to broader labor market conditions, beyond immediate job demands, linked to coronary risk
36
How do they differ?
- **Nature of focus**: Job strain is purely situational; ERI includes person-related intrinsic factors.
- **Scope of psychosocial factors**: ERI explicitly integrates broader labor market conditions (e.g., salary and job security).
- Combining these models could potentially capture a wider range of stress experiences at work, thereby improving risk estimation for myocardial infarction.
37
What are the gender specific effects?
- Recent research suggests that the impact of psychosocial work stress on cardiovascular health may differ by gender, possibly due to differing gender roles and exposures (e.g., women’s double exposure to work and family stress, less career continuity)
- Prior studies showed stronger effects of the **intrinsic ERI component (overcommitment)** in women and stronger **extrinsic ERI component** effects in men
- The intrinsic and extrinsic components of ERI may differentially impact men’s and women’s cardiovascular risk due to gender-related value preferences and roles.
38
What were the hypotheses of Peter et al?
1. **Gender-Specific Associations Hypothesis**:
- The two components of the ERI model (extrinsic effort-reward ratio and intrinsic overcommitment) have **differential impacts on myocardial infarction risk in men and women**.
- Specifically, the extrinsic component will be more predictive in men, and the intrinsic component more predictive in women.
2. **Combined Model Hypothesis**:
- Combining information from the two complementary job stress models (job strain and ERI) will **improve the risk estimation for first non-fatal acute myocardial infarction** compared to using each model separately.
39
What was the design of Peter et al?
Data was collected using the stockholm heart epidemiology program, included survivors of non-fatal acute myocardial infarction. Had clinical examinations of blood pressure, cholesterol, diabetes 3 months after the infarction. Involved standardized questionnaires assessing medical history, behavioral risk factors (smoking, physical activity), and psychosocial work stress. Measured job strain, extrinsic and intrinsic components of ERI. Adjusted for traditional CVD risk factors
40
Job strain
defined as high demands combined with low decision latitude; operationalized as the ratio of demands to decision latitude, with upper quartile indicating exposure.
41
What were the results of Peters et al?
Men:
-extrinsic ERI was significantly associated with heart attack risk, while intrinsic ERI was not significantly associated
- job strain was associated with increased risk (men had a stronger association)
- when exposed to ERI and job strain, men had a significantly increased risk
Women:
- overcommitment was significantly associated with MI risk, extrinsic ERI had no significant association
- women did not show significant risk increased for combined ERI and job strain
- women exposed to high overcommitment and job strain had significantly increased risk
42
What are the implications?
- The **job strain model** captures situational demands and control but misses personal coping styles and broader labor market dynamics.
- The **ERI model** complements this by including intrinsic personal factors (overcommitment) and wider socioeconomic factors (rewards).
- Combining models captures a broader psychosocial work stress spectrum, offering better risk prediction.
- Gender differences suggest that interventions may need to be tailored considering both work environment and individual coping styles, with attention to gender roles.
