• Document: Effort-reward imbalance at work - theory, measurement and evidence
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Effort-reward imbalance at work - theory, measurement and evidence Johannes Siegrist∗ November 5, 2012 Contents 1 Theoretical background 2 1.1 Key publications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 2 Measurement 3 2.1 Key publications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 2.2 Other Publications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 3 Selected publications on research evidence 6 3.1 Reviews . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 3.2 Cardiovascular risk and diseases (including Type-II-diabetes) . . . . . . . 7 3.3 Psychiatric disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 3.4 Symptoms and subjective health . . . . . . . . . . . . . . . . . . . . . . . 10 3.5 Sickness absence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 3.6 Stress-related mechanisms . . . . . . . . . . . . . . . . . . . . . . . . . . 12 3.7 Other outcomes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 4 Intervention 17 4.1 Key publications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18 4.2 Other publications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18 ∗ johannes.siegrist@med.uni-duesseldorf.de 1 1 THEORETICAL BACKGROUND 1 Theoretical background Research on effort-reward imbalance and health is part of a larger scientific program that aims at understanding the contribution of social and psychological factors to human health and disease. More specifically, protective and damaging effects on health produced by peoples’ behaviours, cognitions and emotions through core social roles in adult life (work role, civic roles, family roles etc.) are analysed using a specific theoretical and methodological approach. This theoretical approach is focused on the notion of social reciprocity, a fundamental principle of interpersonal behavior and an ’evolutionary old’ grammar of social exchange. Social reciprocity is characterized by mutual cooperative investments based on the norm of return expectancy where efforts are equalized by respective rewards. Failed reciprocity resulting from a violation of this norm elicits strong negative emotions and sustained stress responses because it threatens this fundamental principle. The model of effort-reward imbalance (ERI) claims that failed reciprocity in terms of high efforts spent and low rewards received in turn is likely to elicit recurrent negative emotions and sustained stress responses in exposed people. Conversely, positive emotions evoked by appropriate social rewards promote well-being, health and survival. A major specification of this theoretical perspective concerns the work role, and in particular its contractual basis. So far, a majority of research evidence concerns ERI at work. More recently, this perspective has been applied to additional social roles in adult life (for further information please click here). According to the model, effort at work is spent as part of a social contract that reciprocates effort by adequate reward. Rewards are distributed by three transmitter systems: money, esteem, and career opportunities including job security. Each one of these components of work-related rewards was shown to matter for health. The model of ERI at work claims that an imbalance between (high) effort and (low) reward is maintained under the following conditions: 1. Work contracts are poorly defined or employees have little choice of alternative workplaces (e.g. due to low level of skill, lack of mobility, precarious labor market); 2. employees may accept this imbalance for strategic reasons (this strategy is mainly chosen to improve future work prospects by anticipatory investments); 3. the experience of ’high cost / low gain’ at work is frequent in people who exhibit a specific cognitive and motivational pattern of coping with demands characterized by excessive work-related commitment (’overcommitment’). Overcommitted men and women suffer from inappropriate perceptions of demands and of their own coping resources more often than their less involved colleagues, because perceptual distortion prevents them from accurately assessing cost-gain relations. A graphic representation of the model is given in figure 1. The following three hypot

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