The aim of this study was to investigate the relation between occupational variables and three forms of depression (major depressive episode, depressive syndrome and dysphoria). Researchers predicted that individuals involved in occupations with high psychological strain (having little control while facing high job demand) would more often express depression relative to those working in occupations with the other three possible conditions (hazardous work, control, and physical demand). The central model which the study was based on, is Hellmuth Karasek’s demand-control model, which consists of two basic dimensions; decision latitude and psychological demand.
Decision latitude is described as how much control (in terms of authority) the participant has over his/her tasks. Psychological demand is described as the participant’s capacity to complete any given task in a specific timeframe. In addition to the two previous factors, hazardous work environment is usually associated with injuries, but it presents psychological risks also. And physical demand was also added to modify the original model.
This specific analysis had two distinct aims, the first aim is to examine by factor analysis if the dimensions of the demand-control model are further supported by research. The second aim is to estimate the relation between the dimensions from the demand-control model and depression in logistic regression models with possible confounding etiologic factors affecting the analyses, such as socioeconomic and demographic variables.
The analyzed data consisted of interviews of 905 participants who were full-time employees between 1993-1996 in Baltimore, Maryland. The National Institute of Mental Health Diagnostic Interview Schedule was used to assess psychosocial work environment, sociodemographic variables and psychopathology in a household interview.
Findings showed that high job strain was associated with major prevalence of all three kinds of depression. These kinds of depressions were strongest related to decision authority. Psychological demand showed a trend for major depressive episode and depressive syndrome, and physical demand showed a trend for all three kinds of depression but was later shown to be insignificant.
Hazardous working conditions was also tested as the only independent variable in the logistic regression models with the three forms of depression and was found to have no association with depression.
Decision authority was the most significant factor in the models and protective against depression. High decision authority was more important as a protective factor for major depressive episode than for depressive syndrome and more important for depressive syndrome than for dysphoria.
High psychological job strain was highly related with an increased prevalence of all three forms of depression and increased risks for the more severe forms of depression.
Only 22% of those who had major depressive disorder were men and women were seven times more likely than men to experience high psychological job strain in this condition. A classification by sex showed that high psychological job strain was important for women only when it came to depression.
For women, the association for major depressive episode was stronger than the association for depressive syndrome and dysphoria. for men, the association was stronger with dysphoria than with depressive syndrome.
The findings also suggest a stronger correlation for women than men. However, men showed the strongest correlation when unmarried
Discussion & Conclusion
Finally, the researchers concluded that the psychosocial dimensions of the demand-control model are highly related to all three forms of depression. Findings from the new analyses showed that skill discretion was not related to depression and that decision authority was an important protective factor in regard to all three forms of depression
When the psychological job strain variable was tested alone in the logistic regression model, it showed a stronger relationship with depression compared with decision authority in the earlier models. This supports research conducted by Karasek and his team, who highlighted that most psychological job strain is induced by the fusion of high demands and low control (decision latitude) rather than by individual conditions alone.
The analyses revealed that job strain in terms of psychological demand and decision authority, affected depression more than job strain in terms of physical demand and decision authority. I.e. the psychological factor plays a grander role in affecting depression.
Limitations of the study include a directionality problem, where the cause and effect can’t be determined i.e. no causality between the work environment and depression is established.
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