With anxiety disorders on the rise, and negatively impacting organizational and employee performance, a study in the Journal of Occupational & Environmental Medicine examined the influence that job stressors had on panic attacks (PA) and panic disorders (PD). The study's findings indicated a significant relationship between job stressors and anxiety, and most notably employees with a high effort-reward imbalance were found to be significantly more at risk of PAs and PDs than those with a low effort-reward imbalance.
Key Topics: Effort-reward imbalance; Job stress; Panic attacks; Panic disorders
Title of Reviewed Article: Association of Job Stressors With Panic Attack and Panic Disorder in a Working Population in Japan: A Cross-Sectional Study
Researchers: Yumi Asai, Kotaro Imamura, and Norito Kawakami (The University of Tokyo).
Publication: Journal of Occupational & Environmental Medicine, 2017, Vol. 59 No. 6, pp. 516–521.
Setting the Scene
Anxiety disorders are prevalent in many countries, with studies suggesting that they are on the rise. Panic disorder (PD) is one of the more common anxiety disorders and is characterized by having frequent panic attacks (PAs), which often leads to avoidance of situations and high impairment of social and work life.
The lifetime prevalence of PD in the US and Europe has been found to range from 1.6% to 2.1% (Bandelow & Michaelis, 2015), and slightly lower in eastern countries, such as Japan, at 0.8% of the population (Kawakami, et al., 2005). The lifetime prevalence of PAs is reported as significantly higher, at 11.2% in the US and 2.4% in Japan, for example (Aoki, Fujihara, & Kitamura, 1994; Kessler, et al., 2006).
Given the prevalence of PD and PA in general society, this can have a significant impact on organizations. Studies have shown PD and PA to have negative effects on worker motivation, productivity and absence (Lee Park, et al., 2014; de Graaf, et al., 2012).
Research has shown various workplace job stressors to lead to mental and physical health problems (Nieuwenhuijsen, Bruinvels, & Frings-Dresen, 2010), suggesting such stressors may increase the risk of PD and PA. For example, lack of workplace social support and job strain, where workers have high psychological demands but low decision-making latitude, can lead to cardiovascular issues (Kivima¨ki et al., 2002) and depression (Netterstrøm, et al., 2008). Similarly, effort-reward imbalance, where workers experience high-effort/low-reward conditions, has been linked to numerous negative physical and mental health outcomes (Netterstrøm, et al., 2008; Wang, et al., 2012).
The present study sought to investigate the relationship these job stressors have with PA and PD in a Japanese context.
How The Research Was Conducted
This study used an online questionnaire survey to access 2,060 workers in Japan. Job strain, effort-reward imbalance, and workplace social support were assessed. PA and PD were also measured using a similar process to the mini international neuropsychiatric interview (MINI). The researchers also considered demographic, lifestyle, and health related factors.
Key Findings and Practical Implications
The results indicated that the probability of experiencing PA or PD was significantly higher for workers with a high effort-reward imbalance than with low effort-reward imbalance. Job strain was not found to be associated with PA or PD, while those with only a moderate level of workplace social support were found to be at risk of PA or PD.
The results relating to effort-reward imbalance are consistent with prior research that linked such imbalance to major depression (Netterstrøm, et al., 2008; Wang, et al., 2012), non-clinical depression and anxiety symptoms (Godin, et al., 2005). The findings suggest that effort-reward imbalance may erode a worker’s capacity to cope with stress, leading to an increased risk of PA/PD.
Effort-reward imbalance has been linked with various negative worker outcomes and this study adds further weight to the negative implications of such imbalance. Organizations often focus predominantly on eliciting high effort and performance from workers through rewards, but pay less attention to creating perceived balance between effort and reward. This study should serve as a reminder that workers’ seeing the value and equity in reward programs is central to their success, and organizations should actively engage workers in designing rewards that are valued by organizations and workers alike.
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Source Article: Asai, Y., Imamura, K., & Kawakami, N. (2017). Association of Job Stressors With Panic Attack and Panic Disorder in a Working Population in Japan: A Cross-Sectional Study. Journal of Occupational & Environmental Medicine, 59(6), 516–521.
Published by: American College of Occupational and Environmental Medicine
For further details and access to the full journal article Click Here (subscription or payment may be required).
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de Graaf, R., Tuithof, M., van Dorsselaer, S., & ten Have, M. (2012) Comparing the effects on work performance of mental and physical disorders. Soc Psychiatry Psychiatr Epidemiol., 47, 1873–1883.
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