The reduction of stress reactivity resulting from stress management interventions prevents disorders and improves mental health, however, its long-term sustainability has been little examined. The objective of this study was, therefore, to determine the effectiveness of a stress management intervention, designed to improve stress reactivity, for mental health and sleep problems seven years later, using longitudinal data from 101 male industrial workers. Linear regressions estimated the adjusted effects of the changes in stress reactivity in general as well as in its six subdimensions (work overload, social conflict, social stress, failure at work, and anticipatory and prolonged reactivity) on depression, anxiety, and sleep problems seven years later. The improvement of the prolonged reactivity had positive effects on depression, anxiety, and sleep problems (unstandardized regression coefficients [Bs] ≥ 0.35, all p-values ≤ 0.01). Depression and sleep problems were further improved by a reduction of the reactivity to social conflicts (Bs ≥ 0.29, p-values < 0.05), and an improvement in the overall reactivity score positively influenced sleep problems (B = 0.07, p = 0.017). In conclusion, the improvement of stress reactivity resulting from a work stress intervention was effective and generally long-lasting in preventing mental health and sleep problems. The reduction of the prolonged reactivity seems of particular importance and efficient in inhibiting negative stress manifestations.

Objective Short- and medium-term effectiveness (up to 3 years) of individual level stress management interventions (SMI) at work were demonstrated, yet long-term effectiveness remains unexplored. We therefore aimed to address this research gap. Methods 94 male middle managers participated in a randomized wait-list controlled trial between 2006 and 2008 and in a post-trial-follow-up survey in 2015. During the first two years, all received an 18-hour psychotherapeutic SMI intervention which was based on the Effort-Reward Imbalance (ERI) model: tackling stressor on mismatch between effort and reward and promoting recovery on overcommitment. Work stress (i.e., ERI indicators) was the primary outcome, and the secondary outcome was depressive symptoms. The long-term effectiveness of the SMI was examined by mixed modeling, using an external control group (n = 94). Results Effort and reward were substantially improved with significant intervention ⁎ time interaction effects (p < 0.001) compared to the external control group; effects on overcommitment and depressive symptoms were also significant (p < 0.05 and p < 0.01, resp.), though their trajectories in the intervention group were less sustainable. Conclusions The effectiveness of this psychotherapeutic SMI at work based on the ERI model was observed over a 9-year period, particularly on the effort-reward ratio.

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In previous studies, it was found that patients treated at a psychosomatic outpatient clinic (PSOC) for common mental disorders showed more severe symptoms than those who used a psychotherapeutic consultation service at the workplace (PSIW). This study examines whether the higher symptom severity of the PSOC patients in comparison to their PSIW counterparts is also related to higher levels of occupational stress as measured by the demand-control-support model (DCS). N = 253 participants (PSIW n = 100; PSOC n = 153) provided self-reported data on demands, decision latitude, social support, and health before consultation. The association between mental health care setting, symptom level and demands, decision latitude, and social support was assessed by means of a path model. Results of the path model indicated that the higher level of depression in PSOC patients was related to higher levels of demands and lower levels of social support. Demands and social support were found to be indirectly associated with treatment setting. No interaction effect between demands, decision latitude, social support, and depression was found. Results of this study reveal that the working conditions influenced the pathway to care process via symptom severity.

This is the first study to provide some evidence for the effectiveness of an intervention that aimed at reducing job insecurity during organizational change. Health-related effects were observed in supervisors but not in team members. Further intervention studies are needed to add to the current knowledge base.

Prolonged work stress, as indicated by the effort-reward imbalance (ERI) model, jeopardizes health. Cortisol represents a candidate mechanism connecting stress to ill health. However, previous findings appear inconclusive, and recommendations were made to assess work stress at multiple time points and also to investigate ERI (sub-)components. This study therefore examines the effects of two single time points, as well as the mean and change scores between time points of ERI and its components on hair cortisol concentration (HCC), a long-term cortisol measurement. Participants were 66 male factory workers (age: 40.68 ± 6.74 years; HCC: 9.00 ± 7.11 pg/mg), who were followed up after a stress management intervention (2006-2008). In 2008 (T1) and 2015 (T2), participants completed a 23-item ERI questionnaire, assessing effort, the three reward components (esteem, job security, job promotion) and over-commitment. In 2015, participants also provided a 3-cm hair segment close to the scalp for HCC analysis, as well as information on relevant confounders (i.e. medication intake, age, work characteristics, socioeconomic and lifestyle factors, number of stressful life events). Linear regressions revealed hardly any cross-sectional or longitudinal effect of ERI and its components on HCC. Only the change scores between T1 and T2 of job security were negatively associated with lower HCC in unadjusted (β = -.320; p = .009) and adjusted (β = -.288; p = .044) models. In this study, only a decrease of perceived job security over time was significantly associated with higher HCC, and other predictors were not related to this outcome. Especially after correction for multiple testing, this study revealed just a weak association of different psychosocial work measurements with HCC. Lay summary This study showed that an increase in perceived job insecurity is correlated with higher levels of the stress hormone cortisol. The higher levels of cortisol might represent a biological explanation for the negative health effects of job insecurity. The association was, however, relatively low, and more and more voices are questioning whether cortisol in hair is a reliable marker for perceived work stress.

BackgroundJob insecurity has been associated with impaired self-rated health (SRH) in cross-sectional studies, but prospective findings with short, medium and long-term follow-up yielded mixed findings. Therefore, the aim of the present study was to assess the long-term association between perceived job insecurity and SRH, after controlling for baseline levels of health status and life-style choices. Furthermore, three different follow-up periods (14, 19 and 24 years) were considered.MethodsData were derived from the prospective population-based MONICA/KORA cohort study (southern Germany). N = 4356 participants (2622 men and 1734 women), aged between 25 and 64 years at baseline, were included in the sample, mean follow-up was after 19.1 years. Job insecurity, SRH and risk factors were assessed at baseline during three independent surveys (1984–1995). SRH was additionally assessed in 2009. The association of job insecurity and impaired SRH at follow-up was estimated using logistic regression analyses.ResultsOverall, perceiving job insecurity at baseline was significantly associated with a 20% higher risk of developing impaired SRH at follow-up in the pooled analysis (OR = 1.20, 95% CI = 1.01–1.43, p = .034), even after controlling for baseline SRH, socio-demographic characteristics, lifestyle, clinical and work-related factors. The association was strongest and significant after 14 years (OR = 1.58, 95% CI 1.17–2.13, p = .003) and weaker and not significant to 19 (OR = 1.20, 95% CI 0.89–1.62, p = .24) and 24 years (OR = 0.98, 95% CI 0.73–1.32, p = .89) of follow-up in the fully adjusted models.ConclusionsWe found that perceived job insecurity during working life was independently and significantly associated with impaired SRH both cross-sectionally as well as after 14 years, but not after 19 and 24 years.Electronic supplementary materialThe online version of this article (10.1186/s12889-018-5621-4) contains supplementary material, which is available to authorized users.