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• Psychosocial work characteristics and depression: The importance of objective exposure measures
  Henrik A Kolstad
  Published on: 27 April 2016
• Reply to Kolstad & Bondes regarding “objective” exposure measurements of psychosocial working condit
  K Waldenström
  Published on: 27 April 2016

• Published on: 27 April 2016

  Psychosocial work characteristics and depression: The importance of objective exposure measures

  • Henrik A Kolstad, MD
  • Other Contributors:
    • Jens Peter Bonde

  Numerous studies have documented that perception of adverse psychosocial factors at work is related to major depression, but we still do not know if this reflects causal characteristics of the working environment, personal characteristics of the individual worker, trivial associations, common method variance or other types of reporting bias because most studies have relied on self-reported exposure information (1)....

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  Numerous studies have documented that perception of adverse psychosocial factors at work is related to major depression, but we still do not know if this reflects causal characteristics of the working environment, personal characteristics of the individual worker, trivial associations, common method variance or other types of reporting bias because most studies have relied on self-reported exposure information (1).

  Waldenström et al recently published a paper indicating a strong association between hindrances and time pressure at work and depression (2). This finding is important because assessment of psychosocial work factors relied on external work content analysis, and therefore is expected to be more objective and with a higher potential to guide preventive measures by change of the environment rather than the individuals’ psychological processing. We are concerned, however, whether the new findings can be interpreted this way because Waldenström et al previously reported that measures of psychological work characteristics obtained by external work content analysis did not differ systematically from measures based on self-reports in either distressed or non-distressed individuals (3). This seems to indicate that the exposure information in the Waldenström et al study was not independent of the individual worker’s perception and appraisal of his or her working conditions and that the risk estimates of depression may have been biased toward too high values. External assessment relying on worker interviews may perhaps not be the way forward to obtain unbiased psychosocial exposure data, even if study participants are asked to be concrete and provide examples as they did in the present study, as long as the information essentially is self-reported and analyzed on an individual level. Aggregated, average exposure measures obtained among colleagues with common working conditions, as suggested by Frese and Zapf, have recently been introduced in risk factor studies of depression and may be an alternative way forward (4;5).

  REFERENCES

  1. Bonde JP. Psychosocial factors at work and risk of depression: a systematic review of the epidemiological evidence. Occup Environ Med 2008.

  2. Waldenstrom K, Ahlberg G, Bergman P, Forsell Y, Stoetzer U, Waldenstrom M et al. Externally assessed psychosocial work characteristics and diagnoses of anxiety and depression. Occup Environ Med 2008; 65(2):90- 96.

  3. Waldenstrom K, Lundberg I, Waldenstrom M, Harenstam A. Does psychological distress influence reporting of demands and control at work? Occup Environ Med 2003; 60(11):887-891.

  4. Frese M, Zapf D. Methodological issues in the study of work stress: Objective vs. subjective measurement of work stress and the question of longitudinal studies. In: Cooper CL, Payne R, editors. Causes, coping and consequences of stress at work. John Wiley & Sons Ltd.; 1988. 375-411.

  5. Kouvonen A, Oksanen T, Vahtera J, Stafford M, Wilkinson R, Schneider J et al. Low workplace social capital as a predictor of depression: the Finnish Public Sector Study. Am J Epidemiol 2008; 167(10):1143-1151.

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  Conflict of Interest:
  None declared.

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• Published on: 27 April 2016

  Reply to Kolstad & Bondes regarding “objective” exposure measurements of psychosocial working condit

  • K Waldenström
  • Other Contributors:
    • G Ahlberg and I Lundberg

  Reply to Kolstad and Bondes regarding “objective” exposure measurements of psychosocial working conditions

  We agree with Kolstad and Bonde that it is important to identify measures of “psychosocial” working conditions that are less dependent of the individual appraisal than pure self-report. This was the intention of our two studies published in OEM (1-2). The studies were based on an exposure protocol to asses...

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  Reply to Kolstad and Bondes regarding “objective” exposure measurements of psychosocial working conditions

  We agree with Kolstad and Bonde that it is important to identify measures of “psychosocial” working conditions that are less dependent of the individual appraisal than pure self-report. This was the intention of our two studies published in OEM (1-2). The studies were based on an exposure protocol to assess different psychosocial working conditions through a description of the actual work content according to predetermined criteria (1,2). We asked the interviewee to provide concrete examples of such exposure.

  Kolstad and Bonde are concerned to what extent these measures are independent of the individual. They refer to our first study (1) where we found no systematic difference in the relationship between self-reported and externally-assessed demands and control among psychologically distressed and non-distressed subjects. Our best interpretation of these findings was that self-reported and externally-assessed work demands and control were equally valid for distressed and for non-distressed subjects. This also implies that it is reasonable to expect accordance between individual perception and external assessments. However, the levels of distress were probably low.

  In the second study (2), the outcome was diagnosis of depression and exposure assessment was performed singularly with the interview protocol from the first study (1). Kolstad and Bonde suspect that the depressed participants described their working conditions as worse than would have been obtained by an assessment truly independent of the affective state of the interviewee. As we stated in the paper, this is possible, but we believe that “overreporting of inappropriate work characteristics among those with psychiatric disorders is likely to be notably smaller than in self-report questionnaires.

  As a remedy for these potential biases Kolstad and Bonde suggest aggregated, average exposure measures obtained among colleagues with common working conditions. However, we see problems also with this approach. First, conditions in contemporary working life are individualised and the same job title may include quite varied tasks and conditions. Second, systematic under- or over reporting may be due to adaptation of expectations over time.

  However, we believe that both our, and Kolstad and Bonde’s, approaches to improve exposure assessment in occupational studies of determinants of mental disorder are of interest and may prove fruitful. More studies on psychiatric outcomes not based on pure self-report of exposure are certainly needed.

  G Ahlberg, I Lundberg and K Waldenström

  References:

  1. Waldenstrom K, Lundberg I, Waldenstrom M, Harenstam A. Does psychological distress influence reporting of demands and control at work? Occup Environ Med 2003;60:887-891.

  2. Waldenstrom K, Ahlberg G, Bergman P, Forsell Y, Stoetzer U, Waldenstrom M, Lundberg I. Externally assessed psychosocial work characteristics and diagnoses of anxiety and depression. Occup Environ Med 2008;65:90-96.

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  Conflict of Interest:
  None declared.

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