Overcommitment at work and mental health: the mediation role of Allostatic load

Abstract

Despite decades of efforts to test interventions to manage stress at work, the prevalence of mental health disorders has increased significantly among workers. The allostatic load (AL) model offers a potential mechanism through which work-related stress impacts workers' mental health. However, the relationship between stress, AL, and mental health disorders does not disentangle critical components that drive stress at work. This study examined the mediation effect of AL in the relationship between work-related stress and mental health among workers. Two hundred two nursing workers (n = 222; 90.1% female, mean age: 39.5 ±9.6) were randomly recruited from a University Hospital in Sao Paulo(Brazil), and applied the Effort-Reward Imbalance scale (ERI) that assesses work effort, reward, and overcommitment. Perceived Stress Scale (PSS), Beck Depression Inventory (BDI), and the Self-Report Questionnaire for psychiatric symptoms (SRQ-20) were the mental health indicators. Ten neuroendocrine, metabolic, immunologic, and cardiovascular biomarkers were analyzed, and values were transformed into an AL index using clinical reference cutoffs. ERI scores were not associated with either the scores on mental health indicators or the AL index (p>0.1). However, overcommitment were associated with higher SRQ-20 scores (r=-.417, p<0.001) and that relationship was mediated by higher AL index (total effect:B=-.482, 95% CI [-0.7195,-0.2463]; p=0.0001). Overcommitment at work, but not effort-reward imbalance, was associated with psychiatric symptoms, and high AL mediates that relationship. Those findings highlight the need to include personal characteristics assessment when designing tailored interventions to manage stress at work.