I (Wendy Nilsen) presented preliminary data on the planned paper "Prospective predictors of sickness absence in Norwegian mothers and fathers followed for six years" based on the TOPP-data in the session "Work, Family & Well-being: Multiple Perspectives". I will put the presentation slides here in a couple of days
Gatchel and Kishino start of their chapter by explaining why there has
been an increase in clinical research in the field ofoccupational health
Some of the reasons (which are connected to each other) are:
- The rapid worldwide economic growth
- Increases in environmental, occupational and psychological stress,
These factors have increased clinical
research with different conceptual theories/models and perspectives to
examine aspects within occupational health and well-being. For instance the stress-illness relationship and individual differences in resilience and
productivity. In this handbook chapter, Gatchel and Kishino offer a brief
overview of: a) the history that leads to the development within occupational
health; b) some concepts within mediocolegal issues (i.e., medicine and legal)
and occupational injuries; c) issues within occupational stress theories; and
d) the nature of stress. I will here give a short overview of the chapter - mostly for myself to read later when I have forgotten everything.
History of occupational health
First, the authors go swiftly through the history of occupational health. For
someone new to this field, such as me, it is a good start and a pleasantly brief
summary (consisting of just a few paragraphs) to this field. They present political
occupational compensation issues throughout history, and how there were a shift
from workers being seen as replaceable parts to individuals with rights around the
early and middle 19th century, and how there already were differences between the
systems in Europe, who started building up a federal disability system, versus
the U.S, using private insurance companies as “middle men”, as a response to
the demands of focusing on employee’s rights.
Also, in the 19th century, chemicals and
neurotoxins (e.g., lead, mercury and asbestos) started being common in the work
place, which raised concern about the unhealthy work environments this created
when people started becoming sick. Later when for instance the sale of leaded
gasoline was eliminated - lead levels in the blood of Americans were shown to
decrease with 80%. But this was not before 1986. Gatchel and Kishino further
underscores that the quantity of lead still grows today both in the U.S
and worldwide. Moreover, and very unfortunate, as new science and technology is aimed to improve productivity, there might be new unhealthy
hazards that we not yet know about until symptoms and diseases appear. And even
more unfortunate, the authors states, the
proof has to be shown in scientifically acceptable manner with cause-effect
relations, which might take several years or decades, before federal actions
are implemented. All quite gloomy.....
Medicolegal issues and occupational injuries
Second, the authors briefly explain aspects/concepts
within mediocolegal issues and occupational injuries such as:
·Primary losses - e.g., the loss of employment. ·Secondary losses - e.g., financial losses, social
relationship losses, respect from family loss, and guilt of disability. ·Primary gains - e.g., alleviation of guilt in
physical symptoms. ·Secondary gains - e.g., gain of disability-related
financial rewards, social support from others. ·Malingering,
which refers to the intentional projection of psychosomatic or physical symptoms
for gaining external rewards (e.g., such as financial compensation or avoidance
of activities). Malingering is a described in the DSM-IV, but the current criteria
have been criticized. ·Compensation
Neurosis and Litigation Neurosis,
which refers to gain-related conscious or unconscious amplification of physical
and psychosocial symptoms.
The issue of malingering is treated further both with
regards to prevalence, compensation and assessment. For instance, the authors mention
different studies where the numbers of workers that are probably malingerers range
from 1.25 – 32 % - using with different samples and conditions/symptoms.
However, the rate of true malingering (i.e., those with no health problems faking
to be ill), is found to be low. Still, from employers’, practitioners’ or
insurance providers’ perspectives, there might often be biased assumptions of the
employees actual degree of disability or injury. Also, they state that
malingering might be very difficult to assess in a valid manner. Also, they
state that if malingering goes undetected, some individuals takes advantage of
the medical, insurance and legal systems, but if malingering is wrongly
diagnosed/assumed, then some individuals wrongly lose their benefits.
Third, the authors introduce
occupational stress issues. Much of this research started in the 1990s when
researchers tried to determine the most stressful occupations, or the most vulnerable work
characteristics for later coronary heart disease risks (in Karasek &
Theorell, 1990). Most of this research have become recognized relatively recent. Today, there is an acceptance for the
relationship between occupational stress and health problems. As you can see in the table, a search of publications
including the terms “work stress” or “occupational stress” did indeed show a
sharply increase in publications that includes these terms around the 1990s and
until today (The search was conducted by me today 9.7.2013, in PubMed. It must therefore
be interpreted with caution as the search was conducted fairly rapidly, and only
PubMed was searched.)
The authors mention that today it is mandated
by federal law to conduct research on working conditions that increase mental
or physical health problems. For instance, we have The National Institute for Occupational Safety
and Health (NIOSH) in the U.S., The Institute for Psychological
Factors and Health, part of the Karolinska Institute in Sweden; the Finnish
Institute of Occupational Health; and the Institute of Work, Health and
Organizations (I-WHO) at the University of Nottingham in the UK. In Norway, we
have the National Institute of
Occupational Health (Stami).
The authors further mention several risk factors for
coronary heart disease such as psychological demands (e.g., workload and
responsibilities), autonomy (e.g., control of speed, nature and conditions) and
satisfaction at work, and they give a brief description of the Karasek “job
demand/control”-model (In another chapter in this handbook there is a review of research examining this model in different populations (by Theorell)). The other theories of work and stress should also have been given some words in this chapter.
Further, Gatchel and Kishino mention a study
by Baum and colleagues from 1997 where working women are compared to housewives
and working men. This study illustrates the importance of demands in the home,
as well as at work for stress. Moreover, this study also finds that control
over these demands appear to buffer stress. While working women were found to
not be at higher risk of disease compared to housewives, working women with
children who had high demands, and women with low supervisor/manager support
were at higher risk of disease. Gatchel and Kishino also mentions that for
working women, the risk of coronary heart disease increases linearly with
number of children. However, be aware, as 1) this is at least 15 year old research; hopefully the circumstances for working women today have changed; and
2) this is only a summary of what I interpret that Gatchel and Kishino have
interpreted of Baum et als’ findings (For the original article see the
For newer literature on the field of work and home relations in
women, Gatchel and Kishino mentions a review by Terrill et al. from last year
(2012) and from the current handbook (2012) on coronary heart disease and
working women. Gatchel and Kishino briefly sum up factors suggested by Terrill
and colleagues to why coronary heart disease is one of the leading causes of
death in working women:
· 1. Conflicting demands (e.g., employment, financial
worries, childcare responsibilities, housework ) due to multiple roles that results in higher levels of stress.
· 2. Sympathetic
nervous system reactivity, allostatic load (i.e., effects of chronic stress)
and other biological pathways.
The nature of stress
Fourth, the authors give a brief overview of stress and its
impact on the individual. A review by Gatchel and Baum from 2009 is recommended
by the authors, that more thoroughly goes through the nature of stress. I will not provide a summary of these stress
processes in the body.
My opinion of the chapter:
It is a good introduction which is easy to read and well-written about occupational health and wellness. Several recommended reviews are
mentioned, and it is a good chapter to start off with when starting to work with occupational health.
So come to Adelaide in September and attend our presentations:
One oral presentation:
"What predicts burnout? A systematic review" (Nilsen et al., 2014)
Background: Burnout has gained increased interest the last decade. Burnout has been linked to ill health behaviour, ill somatic and mental health, and long-term sickness absence. In addition, burnout has been associated with poor subjective and objective job performance (e.g., turnover, low effectiveness and decreased job satisfaction), and might also have a spill-over effect from the work to home arena. By identifying longitudinal predictors and causal mechanisms behind the development of burnout, one might be able to further develop intervention and prevention efforts to be able to prevent or reduce burnout and hopefully the associated negative consequences for both the individual and the society at large. Aim: The current systematic review overall aim is thus to examine the longitudinal predictors of burnout with these two aims: 1) Systematically map studies examining longitudinal predictors of burnout with regards to mental health, work and family related factors, and 2) Systematically review and conduct a meta-analysis the findings.
Method: A systematic literature search was conducted in September 2013, with the electronic databases Medline, PsycINFO, and Embase using medical subject heading terms and key words. The search was not limited to years or language. Grey literature was identified in PsychInfo as well as in a separate search in Google. Two review authors will independently screen the abstracts by titles and abstracts. Full text articles will be retrieved for inclusion/exclusion. Papers were included when: 1) The aim of the article was to measure predictors of burnout; 2) Burnout was measured by already established standardized validated scales; 3) The study design was quantitative prospective studies. All populations were included. Quality assessment of the included studies will be conducted. If possible, a meta-analysis will be conducted.
and two poster presentations:
1. "What predicts burnout? A longitudinal study of mothers and fathers over a six year period." (Nilsen & Skipstein, 2014)
Background: Burnout has been linked to ill somatic and mental health, and long-term sickness absence. Also, burnout has been associated with poor subjective and objective job performance (e.g., turnover, low effectiveness and decreased job satisfaction). By identifying longitudinal predictors and causal mechanisms behind the development of burnout, one might be able to further develop intervention and prevention efforts to be able to prevent or reduce burnout and hopefully the associated negative consequences for both the individual and the society at large Aim: The current paper thus examines the role of psychological distress and strains as longitudinal predictors of burnout (disengagement and exhaustion) in mothers and fathers with a gender-specific perspective.
Method: Data from the longitudinal Tracking Opportunities and Problems in Childhood and Adolescence Study (TOPP) comprising of 913 families will be used. Measures of mothers' and fathers' psychological distress (measured by Hopkins Symptom Checklist) and strains (home, partner, child work, economy) at three time points across a four time period (Q1-Q2) is used to predict self-reported frequency of burnout (measured by the Oldenburg Burnout Inventory) at the last time point (Q3). Structural equation modeling will be used to examine 1) Longitudinal relations between the distress and strains and burnout, and 2) group differences and similarities between mothers and fathers concerning these longitudinal relations.
2. "Longitudinal predictors of sick leave
among mothers and fathers – A systematic review" (Skipstein & Nilsen, 2014)
Background: Sickness absence
rates are higher for women than for men. This gender difference has often been
linked to the high rate of women in the labour-force who have children. A
possible reason is that the combination of work participation and taking care
of children may lead to role conflict or role overload. This may in turn lead
to psychological distress and subsequent sickness absence. Another explanation might
be related to psychological distress since women typically report more symptoms
than men. However, knowledge about different predictors for sickness absence among parents is scarce, and there is
a lack of systematic reviews covering this field.
Aim: To systematically review the knowledge regarding longitudinal predictors of
sickness absence among mothers and fathers.
Methods:A systematic literature search was conducted in February 2014, with the
electronic databases Medline, PsycINFO, and Embase using medical subject
heading terms and key words. The search was not limited to years or language.
The two review authors will independently screen the abstracts by titles and
abstracts. Full text articles will be retrieved for inclusion/exclusion, and
quality assessment of the included studies will be conducted. If possible, a meta-analysis will also be conducted.
Results: After removing the
duplicates, the literature search revealed 2292 titles, before the screening. Final findings will be
presented at the conference.
The University of South Australia is hosting the 2014 Congress of the International Commission on Occupational Health – Work Organisation and Psychosocial Factors WE ARE ESPECIALLY LOOKING FORWARD TO: 1. The workshop about longitudinal design (with Mplus) on the 16th of September (pre-conference workshop), and 2. The eating of kengurus!
DATES: 17 September - 19 September 2014 PLACE: Adelaide, Australia WEBPAGE:
for more information.
The twentieth anniversary of the United Nation’s International Year of the Family has led the Institute for Advanced Family Studies in the Universitat Internacional de Catalunya to organise the II International Conference on Family and Society: Family and Sustainable Development.
During the Conference two international research projects will be presented. These are the World Family Map Project as well as the Santander ISFamily Chair (Intergenerational Solidarity in the Family), which was set up by the Institute for Advanced Family Studies. DATES - Wednesday the 24th of September 2014 (Afternoon) - Thursday the 25th of September 2014 (All day) PLACE Barcelona, Spain
See: http://www.fsconference.org/ for more information.