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Is There a Two-Way Relationship Between Cynicism and Job Strain? Evidence From a Prospective Population-Based Study Maria T¨ornroos, MA, Marko Elovainio, PhD, Liisa Keltikangas-J¨arvinen, PhD, Taina Hintsa, PhD, Laura Pulkki-R˚aback, PhD, Christian Hakulinen, PhD, P¨aivi Merjonen, PhD, T¨ores Theorell, PhD, Mika Kivim¨aki, PhD, Olli T. Raitakari, PhD, and Mirka Hintsanen, PhD Objective: To examine the bidirectional relationship between job strain and cynicism. Methods: The study sample was obtained from the Young Finns study and comprised 757 participants (399 women, 53%). The bidirectional association between cynicism and job strain over a 6-year-follow-up was examined with a cross-lagged structural equation model, controlling for a number of demographic variables. Results: High job strain (β = 0.08; P = 0.007) was associated with higher baseline-adjusted cynicism 6 years later. Nevertheless, cynicism was not associated with baseline-adjusted job strain. The additional analysis showed that cynicism mediated 21.5% of the relationship between job strain and depression. Conclusions: Perceptions of having a highly strenuous job may elicit mistrustful and cynical attitudes in employees, which in turn may lead to mental health problems.
O
utcomes of stressful work characteristics are a burden not only for the individual but also for the society as a whole. The European Commission reported that in 2002 the yearly cost of From IBS (Ms T¨ornroos, Dr Elovainio, Dr Keltikangas-J¨arvinen, Dr Hintsa, Dr Pulkki-R˚aback, Dr Hakulinen, Dr Merjonen, Dr Kivim¨aki, and Dr Hintsanen), Unit of Personality, Work and Health Psychology, University of Helsinki; National Institute for Health and Welfare (Dr Elovainio); Finnish Institute of Occupational Health (Dr Pulkki-R˚aback), Work and Mental Health Unit, Helsinki, Finland; Department of Biological Psychology (Dr Merjonen), VU University, Amsterdam, the Netherlands; Karolinska Institutet (Dr Theorell); Stress Research Institute (Dr Theorell), University of Stockholm, Sweden; Department of Epidemiology and Public Health (Dr Kivim¨aki), University College London, United Kingdom; Research Centre of Applied and Preventive Cardiovascular Medicine (Dr Raitakari), University of Turku; Department of Clinical Physiology and Nuclear Medicine (Dr Raitakari), Turku University Hospital; and Helsinki Collegium for Advanced Studies (Dr Hintsanen), University of Helsinki, Finland. This study has been supported by the National Doctoral Programme of Psychology (Academy of Finland) (MT), the Academy of Finland projects 128002 (ME) and 258578 (MH), the Finnish Work Environment Fund (ME), the Juho Vainio Foundation (LP-R), the Alfred Kordelin Foundation (PM), the Finnish Cultural Foundation (PM), the Economic and Social Research Council (MK), the Emil Aaltonen Foundation (MH), and the Signe & Ane Gyllenberg Foundation (MH). The Young Finns Study has been supported by the Academy of Finland: grants 134309 (Eye), 126925, 121584, 124282, 129378 (Salve), 117797 (Gendi), and 41071 (Skidi), the Social Insurance Institution of Finland, Kuopio, Tampere and Turku University Hospital Medical Funds, the Juho Vainio Foundation, the Paavo Nurmi Foundation, the Finnish Foundation of Cardiovascular Research and the Finnish Cultural Foundation, the Tampere Tuberculosis Foundation, and the Emil Aaltonen Foundation. The funding sources had no involvement in the study design, analysis, interpretation of the data, writing of the report, or decision to submit the article for publication. Authors T¨ornroos, Elovainio, Keltikangas-J¨arvinen, Hintsa, Pulkki-R˚aback, Hakulinen, Merjonen, Theorell, Kivim¨aki, Raitakari, and Hintsanen have no relationships/conditions/circumstances that present potential conflict of interest. The JOEM editorial board and planners have no financial interest related to this research. Address correspondence to: Liisa Keltikangas-J¨arvinen, PhD, IBS, Unit of Personality, Work and Health Psychology, University of Helsinki, P.O. Box 9, FIN-00014, University of Helsinki, Finland ([email protected]). C 2015 by American College of Occupational and Environmental Copyright Medicine DOI: 10.1097/JOM.0000000000000430
JOEM r Volume 57, Number 5, May 2015
Learning Objectives
r Define the trait of cynicism and discuss the pathways by which it might be related to job strain.
r Summarize the new findings on the association between cynr
icism and job strain, including the direction of the relationship(s). Identify the nature of the reported relationship between cynicism and depression.
work-related stress was €20,000 million in the 15 European Union countries.1 The European Union defines work-related stress as an employee’s experience of not being able to cope with (or control) the demands from the work environment.1 Across Europe, the most common causes of work-related stress are job insecurity and workload.2 Job strain, a measure of work-related stress, has been found to predict mental and physical health problems (eg, cardiovascular disease and depression),3–7 and thus have a great public health interest. Job strain is most commonly conceptualized by the demand– control model. The model defines work stress as two-dimensional: a high level of psychological demands combined with a low level of decision latitude constitutes the highest risk for job strain and stress-related diseases.3,7,8 The demand component refers to workload, whereas control (decision latitude) refers to the control over pace, use of skills, and decision authority an employee has.9 Job control is thought to be a stress-moderating factor, and thus intensifies or buffers the potential negative outcomes caused by excess job demands.10 Because stress is not measured directly (but through demand and control), the use of the word “job strain,” instead of “work-related stress,” is encouraged.11 The demand–control model maintains that structural aspects at the workplace are the cause of well-being and health outcomes, but job strain has also been found to be susceptible to individual dispositions, such as personality traits, in the perception of the work environment. For example, personality and temperament traits, such as neuroticism, negative emotionality, harm avoidance, and behavioral dispositions, such as type A behavior, have been shown to be associated with perceptions of higher job strain.12–15 An individual’s personality may contribute to every stage of the stress process (ie, exposure to the stressor, appraisal of the stressor, coping, vulnerability to illness, and disease, as well as response to stress).16,17 Some people seem to perceive their work environment to be more strenuous than others irrespective of objective environmental characteristics. An individual disposition that, by definition, may make someone to perceive the environment more demanding is cynicism. Cynicism—the cognitive component of hostility—is defined as cynical and mistrustful attitudes and the tendency to interpret the other’s actions as offensive.18,19 Cynicism is thought to be closely related to broader traits, such as neuroticism and agreeableness,20,21 but 479
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T¨ornroos et al
is considered to be a more narrow trait than the five-factor model traits. We are not aware of previous studies on associations between cynicism and job strain, but some studies suggest that cynicism is associated with other work-related factors, such as unemployment, unstable labor market prospects, and poor career achievement.22–24 Indeed, the antagonistic behavior by cynical individuals can produce interpersonal conflict and lead to reduced social support.19 Cynical individuals perceive their social environment more negatively than others,19 and thus it is reasonable to assume that they make more negative and extreme interpretations about their work environment. The reverse relationship is also possible. Previous studies have found that, in women, high workload predicts anger and cynicism, defined as an employee’s hostile attitudes toward work situations.25,26 In addition, prolonged exposure to stressful work characteristics can cause burnout, which is often characterized as cynicism, emotional exhaustion, and reduced professional efficacy.27,28 Furthermore, according to the social context model, adverse conditions, such as psychosocial stress, are antecedents of cynicism.29 Thus, the research literature on the association between stressful work characteristics and cynicism suggests that the relationship might be bidirectional, but there are no prior studies that would have investigated this. To explore the direction of the relationship between cynicism and job strain, we performed cross-lagged analyses using prospective data with two measurements of both constructs over time. On the basis of the evidence reviewed previously, we hypothesize that higher level of cynicism is associated with higher baseline-adjusted job strain and that the association also runs from perceptions of high job strain to higher baseline-adjusted cynicism. In addition, both job strain and cynicism have in several previous studies been shown to predict depressive symptoms later in life.30–33 To examine this effect, we performed additional mediation analyses, with depression as an outcome.
METHODS Participants The participants in this study were from the ongoing prospective population-based Young Finns study, which started in 1980 with 3596 participants from six age cohorts in the population register of the Social Insurance Institution in Finland.34,35 Measurements for this study were carried out in 2001 (N = 2105, 58.5% response rate) and 2007 (N = 2058, 57.2% response rate) when participants responded to a questionnaire on psychological variables, which was sent via post. In 2001, the participants were 24 to 39 years old (Mage = 31.5). The prerequisite for being included in the analyses was full-time employment, complete data in the study variables, and in the covariates from both time points. Thus, we included 757 participants (399 women, 53%) in the structural equation models on the relationship between cynicism and job strain.
Measurement of Cynicism
In 2001 and 2007, cynicism (2001: α = 0.79; 2007: α = 0.83) was assessed with seven items from the cynicism scale derived from the Minnesota Multiphasic Personality Inventory (eg, “It is safer to trust nobody”).36,37 The answers were given on a scale from 1 (totally disagree) to 5 (totally agree). It has been shown that the cynicism scale is invariant over the time points of this study.38
Measurement of Job Strain Job strain was assessed in 2001 and in 2007. Job demand was measured using a three-item scale (2001: α = 0.61; 2007: α = 0.63) from the Occupational Stress Questionnaire, developed by the Finnish Institute of Occupational Health (eg, “Does your work require you to work fast?”).39 These three items correspond to Karasek’s Job Content Questionnaire.40 The responses were given on a scale from 1 (never) to 5 (all the time). Job control was mea480
sured using nine items (2001: α = 0.86; 2007: α = 0.87) from the Job Content Questionnaire (eg, “In my work, I am allowed to make a lot of decisions”).40 The response scale was from 1 (disagree) to 5 (agree). Partial demand and control scales have been shown to assess the same underlying concepts as the full scales.41 Demand and control were formed by calculating a mean of the items in each scale only for those with no missing values. Job strain was calculated using linear terms (job demands—job control). The use of continuous variables has been recommended42 and when using a linear term of job strain, the contributions of job demands and job control are equally weighed43 and the effect of demand and control on job strain are additive (ie, job strain decreases by increasing control or decreasing demands). Several formulations of job strain have been suggested,43 but if the main effects are found for demand and control, the implications for job redesign are essentially the same for the different formulations.44
Covariates In addition to age and sex, we used educational level and occupational status, which indicate socioeconomic position, as covariates in this study. Educational level was classified as (1) low (comprehensive school), (2) intermediate (secondary education), or (3) high (academic—graduated from a polytechnic or a university). Occupational status was based on the Central Statistical Office of Finland: (1) manual, (2) lower nonmanual, and (3) upper nonmanual. The occupational status of entrepreneurs was determined on the basis of their educational level (low, intermediate, and high education corresponding to manual, lower nonmanual, and upper nonmanual, respectively). To take into account major life events during the follow-up, we also included marital status, which was coded (0) single, divorced, or widowed and (1) married or cohabiting; number of children (range, 0 to 10); moving to a new address during the followup, which was coded (0) no change in address and (1) change in address during the follow-up. The participants’ address information was derived from the Population Registry. For the additional mediation analysis, we included depressive symptoms in 2007. Depressive symptoms were measured using the Beck Depression Inventory II (α = 0.92).45 The participants answered the 21 statements on a scale from 1 (totally disagree) to 5 (totally agree).
Statistical Analyses A cross-lagged structural equation model on the reciprocal associations between the latent variable cynicism and the observed variable job strain (Fig. 1) from both study phases (2001 and 2007) was fitted to the data. The model was adjusted for age, educational level, change in occupational status, change in marital status, having children during the follow-up, and moving to another address during the follow-up. The structural equation model allowed for correlation between measurement errors over time. Three items in the cynicism scale had high correlations (r > 0.50) in addition to being conceptually similar to each other, and their errors were therefore allowed to correlate within time points. Goodness-of-fit of the models was judged by comparative fit index (CFI) and root mean square error of approximation (RMSEA) index. Root mean square error of approximation is not affected by model complexity, and CFI is independent of sample size.46 CFI values above 0.95 and RMSEA values below 0.08 indicate good fit. The estimation method was maximum likelihood. Additional mediation analysis for the association between job strain and depression with cynicism as a mediator (N = 750) was conducted using the sgmediation package in Stata, which utilizes the Sobel-Goodman test of mediation. To account for the effect of the covariates, we first regressed all the covariates of the study on the job strain variable and the depression variable. The mediation analysis was then performed using the residuals of job strain and depression. IBM SPSS
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Statistics (version 21, IBM Inc, Chicago, IL) and STATA (version 13, StataCorp, College Station, TX) software was used for the analyses.
RESULTS Sample Attrition The attrition analyses were run on the sample consisting of the 757 full-time employed participants who had complete data on job strain and cynicism from both 2001 and 2007 and no missing data in the covariates. These participants were compared with those 1744 participants who had participated in at least one of the follow-ups used in this study (ie, those conducted in 2001 and 2007). The results showed that there were proportionally more men in the included sample than in the excluded sample (47.3% vs 41.7%; P = 0.009) and that the included participants were somewhat older (32.65 vs 31.02; P < 0.001) than the excluded. Compared with the excluded, the included participants had higher educational level (2.24 vs 2.16; P = 0.001) and occupational status (1.99 vs 1.87; P < 0.001) in 2001. In addition, the included reported having fewer children in 2007 than the excluded (1.47 vs 1.65; P = 0.005) and proportionally fewer of the included had moved during the follow-up compared with the excluded (58.5% vs. 65.4%; P = 0.001).
Cynicism and Job Strain
TABLE 1. Description of the Study Variables Variable Demographics Age—01 Educational level—01 Occupational status—01 (1) Manual (2) Lower nonmanual (3) Upper nonmanual Occupational status—07 (1) Manual (2) Lower nonmanual (3) Upper nonmanual Cynicism—01 Cynicism—07 Job strain—01 Job strain—07
FIGURE 1. Cross-lagged structural equation model of cynicism and job strain with standardized coefficients. Measurement errors (not shown) are allowed to correlate over time. Adjusted for age, sex, educational level, change in occupational status, change in marital status, having children, and change in address. *P < 0.05; **P < 0.01; ***P < 0.001.
Count (%)
32.65 ± 4.86 2.24 ± 0.53 1.99 ± 0.76 217 (29) 326 (43) 214 (28) 2.15 ± 0.89 254 (34) 137 (18) 366 (48) 2.69 ± 0.68 2.50 ± 0.72 − 0.94 ± .90 − 0.83 ± 0.85
SD, standard deviation.
Bidirectional Relationships Between Cynicism and Job Strain Table 1 shows the descriptive statistics for the study sample. Correlations between the study variables are shown in Table 2. Correlations between cynicism and job strain ranged from r = 0.13 (cynicism in 2001 and job strain in 2007) to r = 0.25 (job strain in 2001 and cynicism in 2007). Model fit showed that the structural equation model on the association of cynicism with job strain fit the data well [χ 2 (df) = 463.18 (231); CFI = 0.949; RMSEA = 0.036]. All factor loadings for the items in the cynicism scale were significant at the 0.001 level and ranged between 0.31 and 0.76. Figure 1 depicts the standardized coefficients on the association of cynicism with job strain. The results revealed that high job strain (β = 0.08; P = 0.006) was associated with higher cynicism 6 years later. The association was independent of age, sex, educational level, change in occupational status, change in marital status, having children, and moving during the follow-up. The results for the additional Sobel-Goodman meditation analysis showed that cynicism mediated the relationship between
Mean ± SD
job strain in 2001 and depression in 2007 (P < 0.001). The total effect mediated by cynicism was 21.5%.
DISCUSSION We found that high job strain at baseline was associated with higher baseline-adjusted cynicism 6 years later. This effect was further examined in the additional mediation analysis, which revealed that cynicism mediated the relationship between job strain and depression. Our results bring new information on the relationship between the psychosocial working environment and personality. In this study, we found that high job strain related to an increase in cynicism. This result is in line with previous studies on burnout—a concept characterized by cynicism—showing associations of high workload and high demands with burnout.25,27,28 The result can also be explained by the social context model, which hypothesizes that cynicism is, in part, a result of an adverse environment and psychosocial stress.29 Indeed, the development of cynicism may be determined by both genetic and environmental factors,47–49 including early childhood experiences, low family socioeconomic status, parental type A behavior, and type A behavior in childhood.50 Although cynicism is considered to be a relatively stable trait in adulthood, mean level change over time is possible.38 Experiencing having little control over a highly demanding job not only induces perceiving work characteristics as stressful but might also elicit antagonistic and mistrustful thoughts and feelings in employees about their jobs. Cynicism is a personality construct that is closely related to many concepts of trait psychology, such as neuroticism and agreeableness.20,21 Previous research has shown that job strain is associated with temperament and personality traits conceptually similar to cynicism.12–15 The direction of the association has been from personality to job strain, not the other way round.51 In this study, cynicism was not associated with change in job strain over 6 years. Although the five-factor model traits are thought of as major broad traits, cynicism is described as a narrower facet or aspect of broader traits. According to the bandwidth-fidelity literature,52 narrow traits tend to relate more strongly to narrow outcomes. The narrow nature of cynicism might make it harder to detect prospective associations with broad constructs like job strain. Job strain has in several previous studies been shown to predict depression later in life,30,31 and cynicism has also been linked
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TABLE 2. Correlations Between the Study Variables Variable 1. Age 2. Sex 3. Educational level—01 4. Occupational status—01 5. Marital status—01 6. Number of children—01 7. Change in address 8. Cynicism—01 9. Cynicism—07 10. Job strain—01 11. Job strain—07
1
2
3
4
5
6
7
8
9
10
11
1 − 0.07 − 0.15* 0.02 0.23* 0.55* − 0.34* − 0.10† − 0.07 − 0.03 − 0.07‡
1 − 0.02 − 0.05 − 0.02 − 0.11† − 0.02 0.10† 0.17* − 0.09† − 0.09‡
1 0.58* − 0.01 − 0.18* 0.13* − 0.13* − 0.16* − 0.13* − 0.08‡
1 0.04 − 0.05 0.09‡ − 0.21* − 0.17* − 0.19* − 0.11†
1 0.46* − 0.19* − 0.04 − 0.04 − 0.01 − 0.05
1 − 0.29* − 0.08‡ − 0.06 − 0.02 − 0.07
1 − 0.01 − 0.01 0.01 0.05
1 0.70* 0.24* 0.13*
1 0.25* 0.21*
1 0.54*
1
*Correlation is significant at the 0.001 level (two-tailed). †Correlation is significant at the 0.01 level (two-tailed). ‡Correlation is significant at the 0.05 level (two-tailed).
to depressive symptoms.32,33 We thus explored whether our findings on the association between job strain and cynicism could be explained by cynicism, mediating the association between job strain and depression. We found that cynicism mediated a considerable amount (21.5%) of the effect of job strain on depression. High job strain might increase cynical attitudes and mistrustful feelings toward others, which in turn might increase depressive mood. Our results might also be explained by previous research on the reporting bias that affects the relationship between job strain and depression, when measured with self-reports.53 The present results might indicate that cynicism inflates the perceived relationship between job strain and depression and should therefore be taken into account when measuring this association. This study has some limitations that should be taken into account when interpreting the results. First, both cynicism and job strain were measured using self-reports, which may inflate the results because of response bias. Nevertheless, recent studies have argued that common method variance is not automatically a source of bias, especially in longitudinal designs where there is a time lag between predictor and outcome.54–56 Furthermore, controlling for the baseline level of cynicism/job strain controls for the common method variance. Second, the Cronbach α values for the job demands scale were 0.61 and 0.63, which can be considered at the lower range of acceptable reliability estimates. Nevertheless, despite the low α value, the mean interitem correlation showed satisfying internal consistency for the scale. In addition, the low α values may reflect the small number of items in the demand scale. In addition, this study only included subjective measures of work characteristics and possible job changes, apart from the change in occupational status, during the follow-up were not inquired. Measuring the change in work characteristics systematically in several time points would make the interpretations of the results more reliable, and taking into account possible job changes would help rule out the effect of these changes on the results. In future studies, it would also be beneficial to both subjective and objective measures, as proposed by the literature.8 Third, the included participants had higher educational level, higher occupational status, less children, and had moved less often than the excluded. One might therefore conclude that having children is one reason for not having a full-time job and therefore being excluded from this study. In addition, moving to a new address might increase the probability for dropping out from the study, because of difficulties obtaining the participants’ current addresses during the follow-ups. Nevertheless, the participants did not differ from the excluded on the cynicism or job strain score. Therefore, it 482
is unlikely that the selectivity in the sample is a major bias in this study, although our results may reflect groups with higher socioeconomic status somewhat better than groups with lower socioeconomic status. This study also has several important strengths. First, we used a well-established model to depict the working environment. The demand–control model is one of the most widely used models of stressful work characteristics and has been found to predict several adverse health outcomes, ranging from cardiovascular disease risk to depression.6,7 Second, using cross-lagged structural equation modeling allowed us to examine the bidirectional baseline-adjusted associations between cynicism and job strain over time. Third, our relatively large, population-based sample allows us to generalize our results to the greater public. Fourth, because cynicism has been linked to such detrimental health consequences as myocardial infarction, coronary heart disease, and all-cause mortality,57–59 studying the underlying factors of cynicism is important. The results of this study shed some light on the complex nature of the interaction between an individual and his or her psychosocial working environment. Individual dispositions, such as cynicism, can interact with the environment in several ways. Cynicism can steer individuals into certain jobs, make them more or less vulnerable to psychosocial risks, and also elicit responses from others that affect the individual’s response to and recovery from stress. It is also possible that stressful and unfair work environment make people more suspicious and increase mistrust toward environment. The result of the interaction between an individual and the objective working environment is the work characteristics that can be measured with the demand–control model. In future studies, it would be important to include several models that measure stressful work characteristics to achieve an even more comprehensive view of the working environment. In addition, future studies would benefit from including information on the type of occupation the employees have. Occupation could then be used as a moderator to examine how cynicism is associated with work characteristics in different occupations. Our results showed that high job strain was associated with higher baseline-adjusted cynicism 6 years later and that cynicism mediated the relationship between job strain and depression. Employers should be aware that a stress at work is associated with the change in personality, which in turn can influence the well-being of an individual. In the light of our results, it would be beneficial to take both structural aspects of work and personality into account when targeting stress interventions and considering well-being issues at work.
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REFERENCES 1. EU-OSHA. OSH in Figures: Stress at Work—Facts and Figures. European Agency for Safety and Health at Work; 2009. 2. EU-OSHA. European Opinion Poll on Occupational Safety and Health. European Agency for Safety and Health at Work; 2001. 3. Belkic KL, Landsbergis PA, Schnall PL, Baker D. Is job strain a major source of cardiovascular disease risk? Scand J Work Environ Health. 2004;30:85– 128. 4. Schnall PL, Landsbergis PA. Job strain and cardiovascular disease. Annu Rev Public Health. 1994;15:381–411. 5. Kivim¨aki M, Virtanen M, Elovainio M, Kouvonen A, V¨aa¨ n¨anen A, Vahtera J. Work stress in the etiology of coronary heart disease—a meta-analysis. Scand J Work Environ Health. 2006;32:431–442. 6. Stansfeld SA, Shipley MJ, Head J, Fuhrer R. Repeated job strain and the risk of depression: longitudinal analyses from the Whitehall II study. Am J Public Health. 2012;102:2360–2366. 7. Kivim¨aki M, Nyberg ST, Batty GD, et al. Job strain as a risk factor for coronary heart disease: a collaborative meta-analysis of individual participant data. Lancet. 2012;380:1491–1497. 8. Haeusser JA, Mojzisch A, Niesel M, Schulz-Hardt S. Ten years on: a review of recent research on the job demand-control (-support) model and psychological well-being. Work Stress. 2010;24:1–35. 9. Karasek RA, Theorell T. Healthy Work: Stress, Productivity and the Reconstruction of Working Life. New York, Basic Books; 1990. 10. Karasek R, Baker D, Marxer F, Ahlbom A, Theorell T. Job decision latitude, job demands, and cardiovascular-disease—a prospective-study of Swedish men. Am J Public Health. 1981;71:694–705. 11. Karasek RA. Job demands, job decision latitude, and mental strain— implications for job redesign. Adm Sci Q. 1979;24:285–308. 12. Hintsa T, Hintsanen M, Jokela M, Pulkki-R˚aback L, Keltikangas-J¨arvinen L. Divergent influence of different type a dimensions on job strain and effortreward imbalance. J Occup Environ Med. 2010;52:1–7. 13. Hintsa T, Hintsanen M, Jokela M, Elovainio M, Raitakari O, KeltikangasJ¨arvinen L. The influence of temperament on long-term job strain and its components: The cardiovascular risk in Young Finns Study. Pers Individ Dif. 2010;49:700–705. 14. Hintsanen M, Hintsa T, Widell A, Kivim¨aki M, Raitakari OT, KeltikangasJ¨arvinen L. Negative emotionality, activity, and sociability temperaments predicting long-term job strain and effort-reward imbalance: a 15-year prospective follow-up study. J Psychosom Res. 2011;71:90–96. 15. T¨ornroos M, Hintsanen M, Hintsa T, et al. Associations between Five-Factor model traits and perceived job strain: a population-based study. J Occup Health Psychol. 2013;18:492–500. 16. Code S, Langan-Fox J. Motivation, cognitions and traits: predicting occupational health, well-being and performance. Stress Health. 2001;17:159–174. 17. Bolger N, Zuckerman A. A framework for studying personality in the stress process. J Pers Soc Psychol. 1995;69:890–902. 18. Greenglass E, Julkunen J. Construct-validity and sex-differences in CookMedley hostility. Pers Individ Differ. 1989;10:209–218. 19. Smith TW. Concepts and methods in the study of anger, hostility, and health. In: Siegman AW, Smith TW, eds. Anger, Hostility and the Heart. Hillsdale, NJ: Lawrence Erlbaum; 1994: 23–42. 20. Costa PT, Busch CM, Zonderman AB, Mccrae RR. Correlations of MMPI factor scales with measures of the 5-factor model of personality. J Pers Assess. 1986;50:640–650. 21. Watson D, Clark LA. On traits and temperament—general and specific factors of emotional experience and their relation to the 5-factor model. J Pers. 1992;60:441–476. 22. Caspi A, Wright BRE, Moffitt TE, Silva PA. Early failure in the labor market: childhood and adolescent predictors of unemployment in the transition to adulthood. Am Sociol Rev. 1998;63. 23. Virtanen M, Kivim¨aki M, Elovainio M, Vahtera J, Kokko K, Pulkkinen L. Mental health and hostility as predictors of temporary employment: evidence from two prospective studies. Soc Sci Med. 2005;61:2084–2095. 24. Hakulinen C, Jokela M, Hintsanen M, et al. Hostility and unemployment: a two-way relationship? J Vocat Behav. 2013;83:153–160. 25. Greenglass E, Burke R, Fiksenbaum L. Workload and burnout in nurses. J Community Appl Soc Psychol. 2001;11:211–215. 26. Greenglass ER, Burke RJ, Moore KA. Reactions to increased workload: effects on professional efficacy of nurses. Appl Psychol. 2003;52:580– 597. 27. Schaufeli W, Leiter MP, Maslach C, Jackson SE. MBI—General Survey. Palo Alto, CA: Consulting Psychologists Press; 1996.
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28. Lindblom K, Linton S, Fedeli C, Bryngelsson I. Burnout in the working population: relations to psychosocial work factors. Int J Behav Med. 2006;13:51– 59. 29. Taylor S, Repetti R, Seeman T. Health psychology: what is an unhealthy environment and how does it get under the skin? Annu Rev Psychol. 1997;48:411– 447. 30. Bonde JPE. Psychosocial factors at work and risk of depression: a systematic review of the epidemiological evidence. Occup Environ Med. 2008;65:438– 445. 31. Virtanen M, Ferrie JE, Batty GD, et al. Socioeconomic and psychosocial adversity in midlife and depressive symptoms post retirement: a 21-year follow-up of the Whitehall II study. Am J Geriat Psychiat. 2015;23:99– 109.e1. 32. Heponiemi T, Elovainio M, Kivim¨aki M, Pulkki L, Puttonen S, KeltikangasJ¨arvinen L. The longitudinal effects of social support and hostility on depressive tendencies. Soc Sci Med. 2006;63:1374–1382. 33. Nabi H, Singh-Manoux A, Ferrie JE, Marmot MG, Melchior M, Kivim¨aki M. Hostility and depressive mood: results from the Whitehall II prospective cohort study. Psychol Med. 2010;40:405–413. ˚ 34. Akerblom HK, Uhari M, Pesonen E, et al. Cardiovascular risk in young Finns. Ann Med. 1991;23:35–39. 35. Raitakari OT, Juonala M, R¨onnemaa T, et al. Cohort profile: the cardiovascular risk in young Finns study. Int J Epidemiol. 2008;37:1220–1226. 36. Comrey AL. A factor-analysis of items on the MMPI paranoia scale. Educ Psychol Meas. 1958;18:99–107. 37. Comrey AL. A factor-analysis of items on the MMPI depression scale. Educ Psychol Meas. 1957;17:578–585. 38. Hakulinen C, Jokela M, Keltikangas-J¨arvinen L, Merjonen P, Raitakari OT, Hintsanen M. Longitudinal measurement invariance, stability and change of anger and cynicism. J Behav Med. 2014;37:434–444. 39. Elo A, Lepp¨anen A, Lindstr¨om K, Ropponen T. Occupational Stress Questionnaire: User’s Instruction (Reviews 19). Helsinki, Finnish Institute of Occupational Health; 1992. 40. Karasek RA. Job Content Questionnaire and User’s Guide. Revision 1.1. Los Angeles, Department of Industrial and Systems Engineering, University of Southern Los Angeles; 1985. 41. Fransson EI, Nyberg ST, Heikkil¨a K, et al. Comparison of alternative versions of the job demand-control scales in 17 European cohort studies: the IPD-work consortium. BMC Public Health. 2012;12:62. 42. MacCallum RC, Zhang SB, Preacher KJ, Rucker DD. On the practice of dichotomization of quantitative variables. Psychol Methods. 2002;7:19–40. 43. Landsbergis PA, Schnall PL, Warren K, Pickering TG, Schwartz JE. Association between ambulatory blood-pressure and alternative formulations of job strain. Scand J Work Environ Health. 1994;20:349–363. 44. Karasek RA. Control in the workplace and its health-related aspects. In: Sauter SL, Hurrell JJ, Cooper CL, eds. Job Control and Work Health. NY, Wiley; 1989:129–159. 45. Beck AT, Steer RA, Brown GK. Manual for the Beck Depression Inventory-II. San Antonio, TX: Psychological Corporation; 1996. 46. Cheung GW, Rensvold RB. Evaluating goodness-of-fit indexes for testing measurement invariance. Struct Equ Modeling. 2002;9:233–255. 47. Rebollo I, Boomsma D. Genetic analysis of anger: genetic dominance or competitive sibling interaction. Behav Genet. 2006;36:216–228. 48. Merjonen P, Keltikangas-J¨arvinen L, Jokela M, et al. Hostility in adolescents and adults: a genome-wide association study of the Young Finns. Transl Psychiatr. 2011;1:e11. 49. Hakulinen C, Jokela M, Hintsanen M, et al. Serotonin receptor 1B genotype and hostility, anger and aggressive behavior through the lifespan: the Young Finns study. J Behav Med. 2012;36:1–8. 50. Keltikangas-J¨arvinen L, Heinonen K. Childhood roots of adulthood hostility: Family factors as predictors of cognitive and affective hostility. Child Dev. 2003;74:1751–1768. 51. Sutin AR, Costa PT Jr, Reciprocal influences of personality and job characteristics across middle adulthood. J Pers. 2010;78:257–288. 52. Ashton MC. Personality and job performance: the importance of narrow traits. J Organ Behav. 1998;19:289–303. 53. Kolstad HA, Hansen AM, Kaergaard A, et al. Job strain and the risk of depression: is reporting biased? Am J Epidemiol. 2011;173:94–102. 54. Spector PE. Method variance in organizational research—truth or urban legend? Organ Res Methods. 2006;9:221–232. 55. Kivim¨aki M, Vahtera J, Kawachi I, et al. Psychosocial work environment as a risk factor for absence with a psychiatric diagnosis: an instrumental-variables analysis. Am J Epidemiol. 2010;172:167–172.
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56. Podsakoff PM, MacKenzie SB, Lee JY, Podsakoff NP. Common method biases in behavioral research: a critical review of the literature and recommended remedies. J Appl Psychol. 2003;88:879–903. 57. Smith T, Glazer K, Ruiz J, Gallo L. Hostility, anger, aggressiveness, and coronary heart disease: an interpersonal perspective on personality, emotion, and health. J Pers. 2004;72:1217–1270.
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58. Chida Y, Steptoe A. The association of anger and hostility with future coronary heart disease a meta-analytic review of prospective evidence. J Am Coll Cardiol. 2009;53:936–946. 59. Klabbers G, Bosma H, van den Akker M, Kempen GIJM, van Eijk JTM. Cognitive hostility predicts all-cause mortality irrespective of behavioural risk at late middle and older age. Eur J Public Health. 2013;23:701–705.
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Is There a Two-Way Relationship Between Cynicism and Job Strain? Evidence From a Prospective Population-Based Study Maria T¨ornroos, MA, Marko Elovainio, PhD, Liisa Keltikangas-J¨arvinen, PhD, Taina Hintsa, PhD, Laura Pulkki-R˚aback, PhD, Christian Hakulinen, PhD, P¨aivi Merjonen, PhD, T¨ores Theorell, PhD, Mika Kivim¨aki, PhD, Olli T. Raitakari, PhD, and Mirka Hintsanen, PhD Objective: To examine the bidirectional relationship between job strain and cynicism. Methods: The study sample was obtained from the Young Finns study and comprised 757 participants (399 women, 53%). The bidirectional association between cynicism and job strain over a 6-year-follow-up was examined with a cross-lagged structural equation model, controlling for a number of demographic variables. Results: High job strain (β = 0.08; P = 0.007) was associated with higher baseline-adjusted cynicism 6 years later. Nevertheless, cynicism was not associated with baseline-adjusted job strain. The additional analysis showed that cynicism mediated 21.5% of the relationship between job strain and depression. Conclusions: Perceptions of having a highly strenuous job may elicit mistrustful and cynical attitudes in employees, which in turn may lead to mental health problems.
O
utcomes of stressful work characteristics are a burden not only for the individual but also for the society as a whole. The European Commission reported that in 2002 the yearly cost of From IBS (Ms T¨ornroos, Dr Elovainio, Dr Keltikangas-J¨arvinen, Dr Hintsa, Dr Pulkki-R˚aback, Dr Hakulinen, Dr Merjonen, Dr Kivim¨aki, and Dr Hintsanen), Unit of Personality, Work and Health Psychology, University of Helsinki; National Institute for Health and Welfare (Dr Elovainio); Finnish Institute of Occupational Health (Dr Pulkki-R˚aback), Work and Mental Health Unit, Helsinki, Finland; Department of Biological Psychology (Dr Merjonen), VU University, Amsterdam, the Netherlands; Karolinska Institutet (Dr Theorell); Stress Research Institute (Dr Theorell), University of Stockholm, Sweden; Department of Epidemiology and Public Health (Dr Kivim¨aki), University College London, United Kingdom; Research Centre of Applied and Preventive Cardiovascular Medicine (Dr Raitakari), University of Turku; Department of Clinical Physiology and Nuclear Medicine (Dr Raitakari), Turku University Hospital; and Helsinki Collegium for Advanced Studies (Dr Hintsanen), University of Helsinki, Finland. This study has been supported by the National Doctoral Programme of Psychology (Academy of Finland) (MT), the Academy of Finland projects 128002 (ME) and 258578 (MH), the Finnish Work Environment Fund (ME), the Juho Vainio Foundation (LP-R), the Alfred Kordelin Foundation (PM), the Finnish Cultural Foundation (PM), the Economic and Social Research Council (MK), the Emil Aaltonen Foundation (MH), and the Signe & Ane Gyllenberg Foundation (MH). The Young Finns Study has been supported by the Academy of Finland: grants 134309 (Eye), 126925, 121584, 124282, 129378 (Salve), 117797 (Gendi), and 41071 (Skidi), the Social Insurance Institution of Finland, Kuopio, Tampere and Turku University Hospital Medical Funds, the Juho Vainio Foundation, the Paavo Nurmi Foundation, the Finnish Foundation of Cardiovascular Research and the Finnish Cultural Foundation, the Tampere Tuberculosis Foundation, and the Emil Aaltonen Foundation. The funding sources had no involvement in the study design, analysis, interpretation of the data, writing of the report, or decision to submit the article for publication. Authors T¨ornroos, Elovainio, Keltikangas-J¨arvinen, Hintsa, Pulkki-R˚aback, Hakulinen, Merjonen, Theorell, Kivim¨aki, Raitakari, and Hintsanen have no relationships/conditions/circumstances that present potential conflict of interest. The JOEM editorial board and planners have no financial interest related to this research. Address correspondence to: Liisa Keltikangas-J¨arvinen, PhD, IBS, Unit of Personality, Work and Health Psychology, University of Helsinki, P.O. Box 9, FIN-00014, University of Helsinki, Finland ([email protected]). C 2015 by American College of Occupational and Environmental Copyright Medicine DOI: 10.1097/JOM.0000000000000430
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Learning Objectives
r Define the trait of cynicism and discuss the pathways by which it might be related to job strain.
r Summarize the new findings on the association between cynr
icism and job strain, including the direction of the relationship(s). Identify the nature of the reported relationship between cynicism and depression.
work-related stress was €20,000 million in the 15 European Union countries.1 The European Union defines work-related stress as an employee’s experience of not being able to cope with (or control) the demands from the work environment.1 Across Europe, the most common causes of work-related stress are job insecurity and workload.2 Job strain, a measure of work-related stress, has been found to predict mental and physical health problems (eg, cardiovascular disease and depression),3–7 and thus have a great public health interest. Job strain is most commonly conceptualized by the demand– control model. The model defines work stress as two-dimensional: a high level of psychological demands combined with a low level of decision latitude constitutes the highest risk for job strain and stress-related diseases.3,7,8 The demand component refers to workload, whereas control (decision latitude) refers to the control over pace, use of skills, and decision authority an employee has.9 Job control is thought to be a stress-moderating factor, and thus intensifies or buffers the potential negative outcomes caused by excess job demands.10 Because stress is not measured directly (but through demand and control), the use of the word “job strain,” instead of “work-related stress,” is encouraged.11 The demand–control model maintains that structural aspects at the workplace are the cause of well-being and health outcomes, but job strain has also been found to be susceptible to individual dispositions, such as personality traits, in the perception of the work environment. For example, personality and temperament traits, such as neuroticism, negative emotionality, harm avoidance, and behavioral dispositions, such as type A behavior, have been shown to be associated with perceptions of higher job strain.12–15 An individual’s personality may contribute to every stage of the stress process (ie, exposure to the stressor, appraisal of the stressor, coping, vulnerability to illness, and disease, as well as response to stress).16,17 Some people seem to perceive their work environment to be more strenuous than others irrespective of objective environmental characteristics. An individual disposition that, by definition, may make someone to perceive the environment more demanding is cynicism. Cynicism—the cognitive component of hostility—is defined as cynical and mistrustful attitudes and the tendency to interpret the other’s actions as offensive.18,19 Cynicism is thought to be closely related to broader traits, such as neuroticism and agreeableness,20,21 but 479
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T¨ornroos et al
is considered to be a more narrow trait than the five-factor model traits. We are not aware of previous studies on associations between cynicism and job strain, but some studies suggest that cynicism is associated with other work-related factors, such as unemployment, unstable labor market prospects, and poor career achievement.22–24 Indeed, the antagonistic behavior by cynical individuals can produce interpersonal conflict and lead to reduced social support.19 Cynical individuals perceive their social environment more negatively than others,19 and thus it is reasonable to assume that they make more negative and extreme interpretations about their work environment. The reverse relationship is also possible. Previous studies have found that, in women, high workload predicts anger and cynicism, defined as an employee’s hostile attitudes toward work situations.25,26 In addition, prolonged exposure to stressful work characteristics can cause burnout, which is often characterized as cynicism, emotional exhaustion, and reduced professional efficacy.27,28 Furthermore, according to the social context model, adverse conditions, such as psychosocial stress, are antecedents of cynicism.29 Thus, the research literature on the association between stressful work characteristics and cynicism suggests that the relationship might be bidirectional, but there are no prior studies that would have investigated this. To explore the direction of the relationship between cynicism and job strain, we performed cross-lagged analyses using prospective data with two measurements of both constructs over time. On the basis of the evidence reviewed previously, we hypothesize that higher level of cynicism is associated with higher baseline-adjusted job strain and that the association also runs from perceptions of high job strain to higher baseline-adjusted cynicism. In addition, both job strain and cynicism have in several previous studies been shown to predict depressive symptoms later in life.30–33 To examine this effect, we performed additional mediation analyses, with depression as an outcome.
METHODS Participants The participants in this study were from the ongoing prospective population-based Young Finns study, which started in 1980 with 3596 participants from six age cohorts in the population register of the Social Insurance Institution in Finland.34,35 Measurements for this study were carried out in 2001 (N = 2105, 58.5% response rate) and 2007 (N = 2058, 57.2% response rate) when participants responded to a questionnaire on psychological variables, which was sent via post. In 2001, the participants were 24 to 39 years old (Mage = 31.5). The prerequisite for being included in the analyses was full-time employment, complete data in the study variables, and in the covariates from both time points. Thus, we included 757 participants (399 women, 53%) in the structural equation models on the relationship between cynicism and job strain.
Measurement of Cynicism
In 2001 and 2007, cynicism (2001: α = 0.79; 2007: α = 0.83) was assessed with seven items from the cynicism scale derived from the Minnesota Multiphasic Personality Inventory (eg, “It is safer to trust nobody”).36,37 The answers were given on a scale from 1 (totally disagree) to 5 (totally agree). It has been shown that the cynicism scale is invariant over the time points of this study.38
Measurement of Job Strain Job strain was assessed in 2001 and in 2007. Job demand was measured using a three-item scale (2001: α = 0.61; 2007: α = 0.63) from the Occupational Stress Questionnaire, developed by the Finnish Institute of Occupational Health (eg, “Does your work require you to work fast?”).39 These three items correspond to Karasek’s Job Content Questionnaire.40 The responses were given on a scale from 1 (never) to 5 (all the time). Job control was mea480
sured using nine items (2001: α = 0.86; 2007: α = 0.87) from the Job Content Questionnaire (eg, “In my work, I am allowed to make a lot of decisions”).40 The response scale was from 1 (disagree) to 5 (agree). Partial demand and control scales have been shown to assess the same underlying concepts as the full scales.41 Demand and control were formed by calculating a mean of the items in each scale only for those with no missing values. Job strain was calculated using linear terms (job demands—job control). The use of continuous variables has been recommended42 and when using a linear term of job strain, the contributions of job demands and job control are equally weighed43 and the effect of demand and control on job strain are additive (ie, job strain decreases by increasing control or decreasing demands). Several formulations of job strain have been suggested,43 but if the main effects are found for demand and control, the implications for job redesign are essentially the same for the different formulations.44
Covariates In addition to age and sex, we used educational level and occupational status, which indicate socioeconomic position, as covariates in this study. Educational level was classified as (1) low (comprehensive school), (2) intermediate (secondary education), or (3) high (academic—graduated from a polytechnic or a university). Occupational status was based on the Central Statistical Office of Finland: (1) manual, (2) lower nonmanual, and (3) upper nonmanual. The occupational status of entrepreneurs was determined on the basis of their educational level (low, intermediate, and high education corresponding to manual, lower nonmanual, and upper nonmanual, respectively). To take into account major life events during the follow-up, we also included marital status, which was coded (0) single, divorced, or widowed and (1) married or cohabiting; number of children (range, 0 to 10); moving to a new address during the followup, which was coded (0) no change in address and (1) change in address during the follow-up. The participants’ address information was derived from the Population Registry. For the additional mediation analysis, we included depressive symptoms in 2007. Depressive symptoms were measured using the Beck Depression Inventory II (α = 0.92).45 The participants answered the 21 statements on a scale from 1 (totally disagree) to 5 (totally agree).
Statistical Analyses A cross-lagged structural equation model on the reciprocal associations between the latent variable cynicism and the observed variable job strain (Fig. 1) from both study phases (2001 and 2007) was fitted to the data. The model was adjusted for age, educational level, change in occupational status, change in marital status, having children during the follow-up, and moving to another address during the follow-up. The structural equation model allowed for correlation between measurement errors over time. Three items in the cynicism scale had high correlations (r > 0.50) in addition to being conceptually similar to each other, and their errors were therefore allowed to correlate within time points. Goodness-of-fit of the models was judged by comparative fit index (CFI) and root mean square error of approximation (RMSEA) index. Root mean square error of approximation is not affected by model complexity, and CFI is independent of sample size.46 CFI values above 0.95 and RMSEA values below 0.08 indicate good fit. The estimation method was maximum likelihood. Additional mediation analysis for the association between job strain and depression with cynicism as a mediator (N = 750) was conducted using the sgmediation package in Stata, which utilizes the Sobel-Goodman test of mediation. To account for the effect of the covariates, we first regressed all the covariates of the study on the job strain variable and the depression variable. The mediation analysis was then performed using the residuals of job strain and depression. IBM SPSS
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Statistics (version 21, IBM Inc, Chicago, IL) and STATA (version 13, StataCorp, College Station, TX) software was used for the analyses.
RESULTS Sample Attrition The attrition analyses were run on the sample consisting of the 757 full-time employed participants who had complete data on job strain and cynicism from both 2001 and 2007 and no missing data in the covariates. These participants were compared with those 1744 participants who had participated in at least one of the follow-ups used in this study (ie, those conducted in 2001 and 2007). The results showed that there were proportionally more men in the included sample than in the excluded sample (47.3% vs 41.7%; P = 0.009) and that the included participants were somewhat older (32.65 vs 31.02; P < 0.001) than the excluded. Compared with the excluded, the included participants had higher educational level (2.24 vs 2.16; P = 0.001) and occupational status (1.99 vs 1.87; P < 0.001) in 2001. In addition, the included reported having fewer children in 2007 than the excluded (1.47 vs 1.65; P = 0.005) and proportionally fewer of the included had moved during the follow-up compared with the excluded (58.5% vs. 65.4%; P = 0.001).
Cynicism and Job Strain
TABLE 1. Description of the Study Variables Variable Demographics Age—01 Educational level—01 Occupational status—01 (1) Manual (2) Lower nonmanual (3) Upper nonmanual Occupational status—07 (1) Manual (2) Lower nonmanual (3) Upper nonmanual Cynicism—01 Cynicism—07 Job strain—01 Job strain—07
FIGURE 1. Cross-lagged structural equation model of cynicism and job strain with standardized coefficients. Measurement errors (not shown) are allowed to correlate over time. Adjusted for age, sex, educational level, change in occupational status, change in marital status, having children, and change in address. *P < 0.05; **P < 0.01; ***P < 0.001.
Count (%)
32.65 ± 4.86 2.24 ± 0.53 1.99 ± 0.76 217 (29) 326 (43) 214 (28) 2.15 ± 0.89 254 (34) 137 (18) 366 (48) 2.69 ± 0.68 2.50 ± 0.72 − 0.94 ± .90 − 0.83 ± 0.85
SD, standard deviation.
Bidirectional Relationships Between Cynicism and Job Strain Table 1 shows the descriptive statistics for the study sample. Correlations between the study variables are shown in Table 2. Correlations between cynicism and job strain ranged from r = 0.13 (cynicism in 2001 and job strain in 2007) to r = 0.25 (job strain in 2001 and cynicism in 2007). Model fit showed that the structural equation model on the association of cynicism with job strain fit the data well [χ 2 (df) = 463.18 (231); CFI = 0.949; RMSEA = 0.036]. All factor loadings for the items in the cynicism scale were significant at the 0.001 level and ranged between 0.31 and 0.76. Figure 1 depicts the standardized coefficients on the association of cynicism with job strain. The results revealed that high job strain (β = 0.08; P = 0.006) was associated with higher cynicism 6 years later. The association was independent of age, sex, educational level, change in occupational status, change in marital status, having children, and moving during the follow-up. The results for the additional Sobel-Goodman meditation analysis showed that cynicism mediated the relationship between
Mean ± SD
job strain in 2001 and depression in 2007 (P < 0.001). The total effect mediated by cynicism was 21.5%.
DISCUSSION We found that high job strain at baseline was associated with higher baseline-adjusted cynicism 6 years later. This effect was further examined in the additional mediation analysis, which revealed that cynicism mediated the relationship between job strain and depression. Our results bring new information on the relationship between the psychosocial working environment and personality. In this study, we found that high job strain related to an increase in cynicism. This result is in line with previous studies on burnout—a concept characterized by cynicism—showing associations of high workload and high demands with burnout.25,27,28 The result can also be explained by the social context model, which hypothesizes that cynicism is, in part, a result of an adverse environment and psychosocial stress.29 Indeed, the development of cynicism may be determined by both genetic and environmental factors,47–49 including early childhood experiences, low family socioeconomic status, parental type A behavior, and type A behavior in childhood.50 Although cynicism is considered to be a relatively stable trait in adulthood, mean level change over time is possible.38 Experiencing having little control over a highly demanding job not only induces perceiving work characteristics as stressful but might also elicit antagonistic and mistrustful thoughts and feelings in employees about their jobs. Cynicism is a personality construct that is closely related to many concepts of trait psychology, such as neuroticism and agreeableness.20,21 Previous research has shown that job strain is associated with temperament and personality traits conceptually similar to cynicism.12–15 The direction of the association has been from personality to job strain, not the other way round.51 In this study, cynicism was not associated with change in job strain over 6 years. Although the five-factor model traits are thought of as major broad traits, cynicism is described as a narrower facet or aspect of broader traits. According to the bandwidth-fidelity literature,52 narrow traits tend to relate more strongly to narrow outcomes. The narrow nature of cynicism might make it harder to detect prospective associations with broad constructs like job strain. Job strain has in several previous studies been shown to predict depression later in life,30,31 and cynicism has also been linked
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TABLE 2. Correlations Between the Study Variables Variable 1. Age 2. Sex 3. Educational level—01 4. Occupational status—01 5. Marital status—01 6. Number of children—01 7. Change in address 8. Cynicism—01 9. Cynicism—07 10. Job strain—01 11. Job strain—07
1
2
3
4
5
6
7
8
9
10
11
1 − 0.07 − 0.15* 0.02 0.23* 0.55* − 0.34* − 0.10† − 0.07 − 0.03 − 0.07‡
1 − 0.02 − 0.05 − 0.02 − 0.11† − 0.02 0.10† 0.17* − 0.09† − 0.09‡
1 0.58* − 0.01 − 0.18* 0.13* − 0.13* − 0.16* − 0.13* − 0.08‡
1 0.04 − 0.05 0.09‡ − 0.21* − 0.17* − 0.19* − 0.11†
1 0.46* − 0.19* − 0.04 − 0.04 − 0.01 − 0.05
1 − 0.29* − 0.08‡ − 0.06 − 0.02 − 0.07
1 − 0.01 − 0.01 0.01 0.05
1 0.70* 0.24* 0.13*
1 0.25* 0.21*
1 0.54*
1
*Correlation is significant at the 0.001 level (two-tailed). †Correlation is significant at the 0.01 level (two-tailed). ‡Correlation is significant at the 0.05 level (two-tailed).
to depressive symptoms.32,33 We thus explored whether our findings on the association between job strain and cynicism could be explained by cynicism, mediating the association between job strain and depression. We found that cynicism mediated a considerable amount (21.5%) of the effect of job strain on depression. High job strain might increase cynical attitudes and mistrustful feelings toward others, which in turn might increase depressive mood. Our results might also be explained by previous research on the reporting bias that affects the relationship between job strain and depression, when measured with self-reports.53 The present results might indicate that cynicism inflates the perceived relationship between job strain and depression and should therefore be taken into account when measuring this association. This study has some limitations that should be taken into account when interpreting the results. First, both cynicism and job strain were measured using self-reports, which may inflate the results because of response bias. Nevertheless, recent studies have argued that common method variance is not automatically a source of bias, especially in longitudinal designs where there is a time lag between predictor and outcome.54–56 Furthermore, controlling for the baseline level of cynicism/job strain controls for the common method variance. Second, the Cronbach α values for the job demands scale were 0.61 and 0.63, which can be considered at the lower range of acceptable reliability estimates. Nevertheless, despite the low α value, the mean interitem correlation showed satisfying internal consistency for the scale. In addition, the low α values may reflect the small number of items in the demand scale. In addition, this study only included subjective measures of work characteristics and possible job changes, apart from the change in occupational status, during the follow-up were not inquired. Measuring the change in work characteristics systematically in several time points would make the interpretations of the results more reliable, and taking into account possible job changes would help rule out the effect of these changes on the results. In future studies, it would also be beneficial to both subjective and objective measures, as proposed by the literature.8 Third, the included participants had higher educational level, higher occupational status, less children, and had moved less often than the excluded. One might therefore conclude that having children is one reason for not having a full-time job and therefore being excluded from this study. In addition, moving to a new address might increase the probability for dropping out from the study, because of difficulties obtaining the participants’ current addresses during the follow-ups. Nevertheless, the participants did not differ from the excluded on the cynicism or job strain score. Therefore, it 482
is unlikely that the selectivity in the sample is a major bias in this study, although our results may reflect groups with higher socioeconomic status somewhat better than groups with lower socioeconomic status. This study also has several important strengths. First, we used a well-established model to depict the working environment. The demand–control model is one of the most widely used models of stressful work characteristics and has been found to predict several adverse health outcomes, ranging from cardiovascular disease risk to depression.6,7 Second, using cross-lagged structural equation modeling allowed us to examine the bidirectional baseline-adjusted associations between cynicism and job strain over time. Third, our relatively large, population-based sample allows us to generalize our results to the greater public. Fourth, because cynicism has been linked to such detrimental health consequences as myocardial infarction, coronary heart disease, and all-cause mortality,57–59 studying the underlying factors of cynicism is important. The results of this study shed some light on the complex nature of the interaction between an individual and his or her psychosocial working environment. Individual dispositions, such as cynicism, can interact with the environment in several ways. Cynicism can steer individuals into certain jobs, make them more or less vulnerable to psychosocial risks, and also elicit responses from others that affect the individual’s response to and recovery from stress. It is also possible that stressful and unfair work environment make people more suspicious and increase mistrust toward environment. The result of the interaction between an individual and the objective working environment is the work characteristics that can be measured with the demand–control model. In future studies, it would be important to include several models that measure stressful work characteristics to achieve an even more comprehensive view of the working environment. In addition, future studies would benefit from including information on the type of occupation the employees have. Occupation could then be used as a moderator to examine how cynicism is associated with work characteristics in different occupations. Our results showed that high job strain was associated with higher baseline-adjusted cynicism 6 years later and that cynicism mediated the relationship between job strain and depression. Employers should be aware that a stress at work is associated with the change in personality, which in turn can influence the well-being of an individual. In the light of our results, it would be beneficial to take both structural aspects of work and personality into account when targeting stress interventions and considering well-being issues at work.
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