All references are from the article: Schnall PL, Landsbergis PA. Job Strain and Cardiovascular Disease. Ann. Rev. Public Health1994, 15:381-411.
Another broader model of work stress is Johannes Siegrist’s “effort-reward” model. The model defines threatening job conditions as a “mismatch between high workload (high demand) and low control over long-term rewards” (103, p. 1128). Siegrist emphasizes personal control over long-term reward since “distressing experiences often result from basic threats to the continuity of a crucial social role”, among adults, often the occupational role. This is clearly the case “with job termination or job instability. However, related conditions of low reward and low security may also be identified, such as forced occupational change, downward mobility, lack of promotion prospects, jobs held with inconsistent educational background (status inconsistency)” (103, p. 1128). Components of workload in Siegrist’s research includes piecework, shiftwork, noise, work pressure, and increase in workload.
In addition, a psychological component (the coping pattern or “need for control”) is added to the model. Two relevant coping variables were identified from factor analysis — “vigor”, a state of active efforts with a high probability of positive feedback, and “immersion” a state of exhaustive coping reflecting frustrated, but continued efforts and associated negative feelings. “Immersion” is considered to increase an individual’s vulnerability to experiences of high demand and low status control.
In a prospective study of German factory workers, status inconsistency (OR=4.4), job insecurity (OR=3.4), work pressure (OR=3.4), and immersion (OR=4.5) independently predict CHD incidence after adjusting for other behavioral and somatic risk factors (103). A combined “low reward/high effort” variable is also a significant predictor (OR=3.4) in a separate analysis.
While the “need for control” components (“vigor” and “immersion”) are considered to be “rather stable person characteristics” in this model, it remains to be determined to what extent they are influenced by levels of work control. Several other studies provide some evidence for this process of adult socialization. For example, in a U.S. study, the substantive complexity of work (analogous to decision latitude) predicted increased intellectual flexibility, non-authoritarianism, and intellectually demanding leisure time 10 years later (66). In Sweden, workers whose jobs became more “passive” (low demand-low latitude) over six years reported less participation in political and leisure activities. In contrast, workers in jobs which became more “active”, participated more in these activities (58, p. 53).
An advantage of Siegrist’s model is that it expands the concept of control typically used in research on Karasek’s job demands-control model to include job security and upward mobility (promotion prospects). However, a limitation of Siegrist’s model is that it only predicts effects of job conditions on CHD. It does not explicitly hypothesize effects of job conditions on psychological functioning, motivation, activity, learning and coping patterns.
Appendix II a – short version ERI
The following items refer to your present occupation. For each of the following statements, please indicate to what degree it reflects your situation. Thank you for answering all statements.
I have constant time pressure due to a heavy work load.
1. Disagree
2. Agree, but I am not at all distressed
3. Agree, and I am somewhat distressed
4. Agree, and I am distressed
5. Agree, and I am very distressed
I have many interruptions and disturbances while performing my job.
1. Disagree
2. Agree, but I am not at all distressed
3. Agree, and I am somewhat distressed
4. Agree, and I am distressed
5. Agree, and I am very distressed
Over the past few years, my job has become more and more demanding.
1. Disagree
2. Agree, but I am not at all distressed
3. Agree, and I am somewhat distressed
4. Agree, and I am distressed
5. Agree, and I am very distressed
I receive the respect I deserve from my superiors.
Not applicable (no superiors) continue with S-ERI5
1. Disagree
2. Agree, but I am not at all distressed
3. Agree, and I am somewhat distressed
4. Agree, and I am distressed
5. Agree, and I am very distressed
My job promotion prospects are poor. (S-ER15)
1. Disagree
2. Agree, but I am not at all distressed
3. Agree, and I am somewhat distressed
4. Agree, and I am distressed
5. Agree, and I am very distressed
I have experienced or I expect to experience an undesirable change in my work situation.
1. Disagree
2. Agree, but I am not at all distressed
3. Agree, and I am somewhat distressed
4. Agree, and I am distressed
5. Agree, and I am very distressed
My employment security is poor.
1. Disagree
2. Agree, but I am not at all distressed
3. Agree, and I am somewhat distressed
4. Agree, and I am distressed
5. Agree, and I am very distressed
Considering all my efforts and achievements, I receive the respect and prestige I deserve at work.
1. Disagree
2. Agree, but I am not at all distressed
3. Agree, and I am somewhat distressed
4. Agree, and I am distressed
5. Agree, and I am very distressed
Considering all my efforts and achievements, my job promotion prospects are adequate.
1. Disagree
2. Agree, but I am not at all distressed
3. Agree, and I am somewhat distressed
4. Agree, and I am distressed
5. Agree, and I am very distressed
Considering all my efforts and achievements, my salary / income is adequate.
1. Disagree
2. Agree, but I am not at all distressed
3. Agree, and I am somewhat distressed
4. Agree, and I am distressed
5. Agree, and I am very distressed