O20-1 Health effects of extrinsic and intrinsic components of the effort-reward imbalance model: a systematic review

Abstract

Mainstream psychological stress theory claims that it is important to include information on people’s ways of coping with work stress when assessing the impact of stressful psychosocial work environments on health. Yet, some widely used respective theoretical models focus exclusively on extrinsic factors. The model of effort-reward imbalance (ERI) differs from them as it explicitly combines information on extrinsic and intrinsic factors in studying workers’ health. As a growing number of studies used the ERI model in recent past, we conducted a systematic review of available evidence. Two databases of PubMed and PsycINFO were searched for papers published during January 1996 to December 2015 (20 years), with a special focus on the distinct contribution of the ERI model’s intrinsic component, the coping pattern ‘over-commitment’, towards explaining health. Moreover, we explore whether the interaction of intrinsic and extrinsic components exceeds the size of effects on health attributable to single components. 51 papers were included in our review. Our findings suggest an independent explanatory role of ‘over-commitment’ in explaining workers’ health in a majority of studies. However, support in favour of the interaction hypothesis is limited. In conclusion, the findings of this review suggest that work stress models should include aspects of personal coping to improve their explanatory power. This extension may enrich the design of tailored worksite stress prevention programs.