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Original research
Cumulative impact of high job demands, low job control and high job insecurity on midlife depression and anxiety: a prospective cohort study of Australian employees


Objective There is a lack of evidence concerning the prospective effect of cumulative exposure to psychosocial job stressors over time on mental ill-health. This study aimed to assess whether cumulative exposure to poor quality jobs places employees at risk of future common mental disorder.

Methods Data were from the Personality and Total Health Through Life project (n=1279, age 40–46 at baseline). Data reported on the cumulative exposure to multiple indicators of poor psychosocial job quality over time (ie, a combination of low control, high demands and high insecurity) and future common mental disorder (ie, depressive and/or anxiety symptom scores above a validated threshold) 12 years later. Data were analysed using logistic regression models and controlled for potential confounders across the lifespan.

Results Cumulative exposure to poor-quality work (particularly more secure work) on multiple occasions elevated the risk of subsequent common mental disorder, independent of social, health, verbal intelligence and personality trait confounders (OR=1.30, 95% CI 1.06 to 1.59).

Conclusions Our findings show that cumulative exposure to poor psychosocial job quality over time independently predicts future common mental disorder—supporting the need for workplace interventions to prevent repeated exposure of poor quality work.

  • mental health
  • occupational health practice

Data availability statement

Data may be obtained from a third party and are not publicly available. The availability of data is subject to relevant ethics and PATH committee approvals.

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