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Objectives: Vital exhaustion has been shown to predict the progression and manifestation of cardiovascular disease. Little is known about the relationship between vital exhaustion and overcommitment, the inability to withdraw from obligations at work. The aim of this study was to explore the relationship between vital exhaustion and overcommitment at work, as measured by the intrinsic-effort scale of the effort-reward model after consideration of other potentially salutogenetic and pathogenetic working conditions. Methods: This cross-sectional study is based on a stratified random sample of 634 employees (mean age 39.9 years, standard deviation 10.7 years) from a manufacturing and assembly plant for aeroplane parts. Participants completed a questionnaire, which included the nine-item shortened Maastricht exhaustion questionnaire to score the dependent variable exhaustion, and the six-item short form of the intrinsic-effort scale (''immersion'') of the effort-reward-imbalance model as the primary independent variable. Perceived work stress was assessed by Siegrist's effort-reward-imbalance questionnaire and the 52-item, 13 subscale salutogenetic subjective work assessment (SALSA) questionnaire, which focuses on indicators of perceived work stress in terms of pathogenetic and salutogenetic descriptors of decision latitude, psychological job demands, and social support. Additional candidate covariates included depression, anxiety and type-D personality. Results: In regression analysis, overcommitment (r=0.516; P<0.0001) was independently associated with vital exhaustion. Multivariable linear regression analysis showed that overcommitment explained 27% of the variance of vital exhaustion. Conclusions: Overcommitment, indicating an exhaustive work-related coping style, is independently associated with vital exhaustion. It appears to be an important personality trait that may contribute to feelings of exhaustion at times of increased job strain.

In recent years, the effort‐reward‐imbalance (ERI) model has become widely used as a framework for examining job characteristics and employee's health. The present study tested the predictive validity of the ERI model's components ‐ ERI, over‐commitment (OC) and their interaction ‐ on the basis of self‐reported health outcomes. In a cross‐sectional study, data were obtained from 1,587 employees working in the aircraft manufacturing industry in southern Germany. Results suggested that all components of the ERI model (effort‐reward‐ratio, effort, reward and over‐commitment) are associated with health‐related quality of life, vital exhaustion, depression and quality of sleep. The separate variables effort and reward explained more of the observed variance than the effort‐reward ratio. No interaction between ERI and OC in predicting measurements of self‐reported health could be found. The findings suggest (1) that the ERI ratio does not provide more information than the separate use of the variables effort and reward, and (2) that there are main effects of ERI and OC but no interaction effect on employees' health. Implications for theory and applied research are discussed.

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Within the last two decades, hemostasis factors have emerged as ‘new’ risk factors for coronary artery disease. Historical studies on the physiology of the sympathetic nervous system (SNS) attributed accelerated blood clotting to the components of the fight-flight response. Although this has not been demonstrated, exaggerated clotting related to SNS hyperactivity might confer an increased arterial thrombotic risk. This review outlines the effects of sympathetic activation as mimicked by adrenergic infusions and as elicited by mental stress and physical exercise, and the molecular mechanisms involved. A selective review of the pertinent literature was undertaken. Sympathetic activation provokes a simultaneous increase in molecules of both the coagulation and fibrinolysis pathways within minutes, resulting in net hypercoagulability as a part of normal human physiology. Catecholamines and adrenergic receptors interact to mediate hemostatic changes. Exaggerated procoagulant changes in individuals with a preexistent atherosclerotic disease, in those experiencing ongoing stressful life circumstances and in the physically untrained might confer a thrombotic threat with sympathetic activation. Initial evidence suggests that nonselective β-adrenergic blockade may attenuate clotting acceleration upon SNS activation. Prospective studies are needed to demonstrate whether exaggerated clotting as elicited by the SNS is associated with an increased risk of cardiovascular morbidity and mortality. If confirmed, intervention studies targeted at reducing this risk, for example with drugs, psychotherapy (including stress management) and regular physical exercise, would be warranted.