Job Strain and the Risk of Depression: Is Reporting Biased?

Abstract

It is unknown whether the relation between job strain and depression reflects causal characteristics of the working environment or reporting bias. The authors investigated reporting bias by analyzing individual versus work-unit measures of job strain and the risk of depressive symptoms (n = 287) and a diagnosis of depression (n = 97) among 4,291 employees within 378 work units in Aarhus, Denmark, 2007. All participants reported psychological demands and decision latitude, and the authors estimated mean values for each work unit. The odds ratios predicting depressive symptoms or a diagnosis of depression for the highest versus the lowest levels of individual, self-reported high psychological demands and low decision latitude were significantly increased above 2.5. When participants were classified by the work-unit mean levels, these associations were substantially smaller. For depressive symptoms, the odds ratios were 1.49 (95% confidence interval (CI): 0.88, 2.53) and 1.08 (95% CI: 0.84, 1.39), respectively, for psychological demands and decision latitude. For a diagnosis of depression, the odds ratios were 1.33 (95% CI: 0.57, 3.09) and 1.02 (95% CI: 0.68, 1.56), respectively, for psychological demands and decision latitude. These findings indicate that reporting bias inflates associations between job strain and the occurrence of depression, if studies rely on individual self-reports.

Studying the effect of the psychosocial work environment on risk of ill-health: towards a more comprehensive assessment of working conditions

“…The purpose of aggregating individual responses to group levels in the workplace (eg, departments or work groups) is that the influence of individual factors can be reduced and the shared work environment can be carved out. The method has been used in some studies (18)(19)(20), but has also been discussed controversially (21). Particular challenging is the identification of the organizational level at which individuals have a sufficient amount of shared work environment.…”

A two-year follow-up study of risk of depression according to work-unit measures of psychological demands and decision latitude

“…This is relevant even in follow-up studies, because depression often has a long insidious preclinical Psychological demands, decision latitude, and depression stage (4,7,8). Personality, temperament, and attitude to work may also be important causes of reporting bias.…”

“…Measures such as registry information on hospital overcrowding, reorganization, and workload (12)(13)(14), expert assessment (10,15), employer assessment (16), job title (17), and averaging across work units (8,18,19) or workplaces (20) are different approaches to this problem.…”

“…This may be obtained by aggregated measures among workers with similar psychosocial working conditions (8).…”

Health‐related quality of life and working conditions on public transport workers in the Metropolitan Region of Belo Horizonte, Brazil, 2012

“…Thus, it cannot be ruled out that there may have been overrepresentation of healthy individuals in the sample. However, it is also feasible that this effect may have been compensated for by the attraction of responding affirmatively to questions referring to an association between work, illness and quality of life, which is common in occupational surveys 37) .…”