Cost, Gain and Health: Theoretical Clarification and Psychometric Validation of a Work Stress Model with Data from Two National Studies.

OBJECTIVE To test non-symmetric effects of cost/gain imbalance at work on depression, based on the effort-reward imbalance (ERI) model. METHODS Study participants were derived from two large national studies from Germany and Sweden. Associations between the ERI scales, including the effort-reward (E-R) ratio, in 2016 and depression (in 2016 for German sample, and in 2018 for Swedish sample) were examined by multivariable logistic regression. RESULTS In both samples, high cost/low gain, but not low cost/high gain is associated with depression, with a 3-to 5-fold elevated risk in the highest decile of the E-R ratio. CONCLUSIONS The short version of the ERI questionnaire is a psychometrically useful tool for epidemiological research. The finding demonstrating non-symmetric effects of cost/gain imbalance contributes to a theoretical clarification of this stress-theoretical model.

• Publication year

  2019

• Venue

  Journal of Occupational and Environmental Medicine

• Publication date

  2019-11-01

• Fields of study

  Medicine, Psychology

• Identifiers
  DOI 10.1097/JOM.0000000000001696PMID 31490898
• External record

  Open on Semantic Scholar

• Source metadata

  Semantic Scholar, PubMed

• No claims are published for this paper.

• No concepts are published for this paper.

• Long working hours and depressive symptoms: systematic review and meta-analysis of published studies and unpublished individual participant data.

  2018cited by this paper
• Clustering of job strain, effort-reward imbalance, and organizational injustice and the risk of work disability: a cohort study.

  2018cited by this paper
• Cohort Profile Cohort Profile : The Swedish Longitudinal Occupational Survey of Health ( SLOSH )

  2018cited by this paper
• Effects of education and income on cardiovascular outcomes: A systematic review and meta-analysis

  2017cited by this paper
• Effort-reward imbalance at work and risk of depressive disorders. A systematic review and meta-analysis of prospective cohort studies.

  2017cited by this paper
• The Routledge International Handbook of Psychosocial Epidemiology

  2017cited by this paper
• Unfair Pay and Health

  2017cited by this paper
• Validating the short measure of the Effort-Reward Imbalance Questionnaire in older workers in the context of New Zealand

  2017cited by this paper
• Work Stress and Health in a Globalized Economy. The Model of Effort-Reward Imbalance

  2017cited by this paper
• Effort–Reward Imbalance at Work and Incident Coronary Heart Disease

  2017cited by this paper
• Karoshi: An international work-related hazard?

  2016cited by this paper
• Associations of Extrinsic and Intrinsic Components of Work Stress with Health: A Systematic Review of Evidence on the Effort-Reward Imbalance Model

  2016cited by this paper
• Financial hardship, mastery and social support: Explaining poor mental health amongst the inadequately employed using data from the HILDA survey

  2016cited by this paper
• Long working hours and risk of coronary heart disease and stroke: a systematic review and meta-analysis of published and unpublished data for 603,838 individuals.

  2015cited by this paper
• Effort-reward imbalance as a risk factor for disability pension: the Finnish Public Sector Study.

  2014cited by this paper
• The Symptom Checklist-core depression (SCL-CD6) scale: Psychometric properties of a brief six item scale for the assessment of depression

  2014cited by this paper
• Effort increases sensitivity to reward and loss magnitude in the human brain.

  2014cited by this paper
• Work stress and depressive symptoms in older employees: impact of national labour and social policies

  2013cited by this paper
• Social Position, Work Stress, and Retirement Intentions: A Study with Older Employees from 11 European Countries

  2013cited by this paper
• A review of lifestyle factors that contribute to important pathways associated with major depression: diet, sleep and exercise.

  2013cited by this paper
• Validation of a Short Measure of Effort‐Reward Imbalance in the Workplace: Evidence from China

  2012cited by this paper
• Testing Negative Error Variances

  2012cited by this paper
• [The Socioeconomic Panel (SOEP)].

  2012cited by this paper
• Negative emotionality, activity, and sociability temperaments predicting long-term job strain and effort-reward imbalance: a 15-year prospective follow-up study.

  2011cited by this paper
• Effort, reward and self-reported mental health: a simulation study on negative affectivity bias

  2011cited by this paper
• How valid is a short measure of effort–reward imbalance at work? A replication study from Sweden

  2010cited by this paper
• Welfare regimes, labour policies and unhealthy psychosocial working conditions: a comparative study with 9917 older employees from 12 European countries

  2010cited by this paper
• Financial hardship, socio-economic position and depression: results from the PATH Through Life Survey.

  2009cited by this paper
• A short generic measure of work stress in the era of globalization: effort–reward imbalance

  2009cited by this paper
• The relation between work-related psychosocial factors and the development of depression.

  2008cited by this paper
• Work stress and health risk behavior.

  2006cited by this paper
• Detecting and monitoring depression with a two-item questionnaire (PHQ-2).

  2005cited by this paper
• The measurement of effort-reward imbalance at work: European comparisons.

  2004cited by this paper
• The Patient Health Questionnaire-2: Validity of a Two-Item Depression Screener

  2003cited by this paper
• Measuring job stressors and studying the health impact of the work environment: an epidemiologic commentary.

  1998cited by this paper
• Workplace conditions, socioeconomic status, and the risk of mortality and acute myocardial infarction: the Kuopio Ischemic Heart Disease Risk Factor Study.

  1997cited by this paper
• Adverse health effects of high-effort/low-reward conditions.

  1996cited by this paper
• Resource conservation as a strategy for community psychology

  1993cited by this paper
• STRUCTURAL EQUATION MODELING IN PRACTICE: A REVIEW AND RECOMMENDED TWO-STEP APPROACH

  1988cited by this paper
• Job stress and coronary heart disease.

  1982cited by this paper
• Labor Contracts as Partial Gift Exchange

  1982cited by this paper
• Prospect theory: An analysis of decision under risk Econometrica 47

  1979cited by this paper
• Occupation, education, and coronary heart disease. Risk is influenced more by education and background than by occupational experiences, in the Bell System.

  1968cited by this paper
• American Journal of Epidemiology Original Contribution a Population-based Longitudinal Study on Work Environmental Factors and the Risk of Major Depressive Disorder

  year unknowncited by this paper

• Effort-reward imbalance and problem drinking among workers: Differences in gender and the gender composition of industries and main job activities in a prospective cohort study from Sweden.

  2025cites this paper
• Failed reciprocity in core social roles and cardiovascular disease mortality: prospective results from the U.S. health and retirement study

  2025cites this paper
• Patterns of Organisational Justice Among Swedish Employees: Results From a Latent Profile Analysis

  2025cites this paper
• Seeing Depression Through A Cultural Lens

  2025cites this paper
• EVALUATING THE ASSOCIATION BETWEEN EFFORT-REWARD IMBALANCE AND SUBOPTIMAL HEALTH STATUS AMONG HOSPITAL NURSES: A CROSS-SECTIONAL STUDY

  2024cites this paper
• Job satisfaction and work stress among physicians in Norway and Germany—A cross-sectional study

  2024cites this paper
• Psychosocial Workloads and Resilience of Heads of Municipal Public Health Authorities in Germany During the COVID-19 Pandemic: Perceptions of Operational Organization, Communication, and Measures

  2024influential citation
• Are Trajectories of Preferred Retirement Ages Associated with Health, Work Ability and Effort–Reward Imbalance at Work? Findings from a 6-Year Swedish Longitudinal Study

  2023cites this paper
• Effort-reward imbalance and its association with sociocultural diversity factors at work: findings from a cross-sectional survey among physicians and nurses in Germany

  2023cites this paper
• Prolonging working life among blue-collar workers: The buffering effect of psychosocial job resources on the association between physically demanding and hazardous work and retirement timing

  2023cites this paper
• Social inequalities, stressful work and non-fatal cardiovascular disease: follow-up findings from the CONSTANCES Study

  2023cites this paper
• Protecting well-being and performance after sickness presenteeism under demanding conditions: the dual effects of proactive personality and work reward as resources

  2023cites this paper
• The short form effort-reward imbalance: Measure of occupational stress for firefighters.

  2022cites this paper
• Unrewarding work and major depressive episode: Cross-sectional and prospective evidence from the U.S. MIDUS study.

  2022cites this paper
• Working Conditions and Wellbeing among Prison Nurses during the COVID-19 Pandemic in Comparison to Community Nurses

  2022cites this paper
• Do good psychosocial working conditions prolong working lives? Findings from a prospective study in Sweden

  2021cites this paper
• The mediating effect of exhaustion in the relationship between effort‐reward imbalance and turnover intentions: A 4‐year longitudinal study from Sweden

  2021cites this paper
• Trajectories of effort-reward imbalance in Swedish workers: Differences in demographic and work-related factors and associations with health

  2020cites this paper
• Der Beitrag von Gratifikationen zur Mitarbeitergesundheit

  2020cites this paper