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

Abstract

The aim of this study was to test nonsymmetric effects of cost/gain imbalance at work on depression, based on the effort-reward imbalance (ERI) model. 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. 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. The short version of the ERI questionnaire is a psychometrically useful tool for epidemiological research. The finding demonstrating nonsymmetric effects of cost/gain imbalance contributes to a theoretical clarification of this stress-theoretical model.