Occupational Health Psychology Research Articles

Essentials of Occupational Health Psychology

Essentials of Occupational Health Psychology

Crafting an ultrashort workplace incivility scale and determining cutoffs for varied risk levels through item response theory

Workplace incivility (WI), characterized by disrespectful or rude behavior in the workplace, is linked to poor mental health and overall well-being. The Workplace Incivility Scale (WIS) is a popular 7-item measure for assessing WI. There is a current need for an ultrashort conceptually clear version of the WIS. In addition, the cutoffs for varied at-risks of WI, requiring intervention, remains unknown. Using data from 426 employees across diverse organizations, we employed item response theory (IRT) to create an ultrashort WIS and establish cutoffs for high, moderate, low, and at-not risk of WI. Confirmatory factor analyses were utilized to validate WIS construct validity. In supporting convergent validity, WIS was correlated with workplace bullying and poor health-related quality of life. All items demonstrated adequate severity threshold parameters with very high discrimination and good reliability parameters except for item WIS7. We successfully developed an ultrashort and valid 3-item WIS, specifically comprising items WIS2–4, and identified cutoffs for varying levels of WI risk. This streamlined measure aims to reduce response burden and foster a healthier organizational culture. In essence, cutoff points streamline the classification process, allowing for quicker and more standardized identification of at-risk employees. This concise, valid, and reliable ultrashort WIS holds potential for use in intervention studies conducted by organizational and occupational health psychologists, ultimately promoting employee well-being and cultivating a positive workplace environment. The current study further advances the existing theoretical framework rooted in the social interactionist perspective by delineating WI as a distinct and independent construct.

Balancing work and family life during the COVID-19 pandemic: exploring within and between group differences across time, gender, and worksites

ABSTRACT This multi-wave survey was conducted at a Norwegian insurance company before (Time 0: N = 568) and during (Time 1: N = 558/Time 2: N = 601) the COVID-19 pandemic. Nearly twice as many employees agreed or highly agreed that it was harder to balance home life and work during the pandemic than before. No gender differences were found in work-home balance, meaning this applied to both men and women. However, a two-factor structure of the interaction showed higher levels of work-to-home conflict, but not work-to-home enrichment, among women during the pandemic. A repeated measure MANOVA suggested no interaction effects between gender and worksite. A non-significant effect of time suggested that work-to-home conflict and work-to-home enrichment were stable during the pandemic. Although the generalizability of these findings is limited to a WEIRD sample in one Norwegian company, gender differences found in work-to-home conflict and stability found in the work-home interaction might have implications for theory and practices beyond the present study. By exploring stability and change in the work-home interaction during a societal crisis, this study adds to the knowledge of occupational health psychology, with future relevance as work and home boundaries become increasingly blurred.

Opportunities and challenges in designing and evaluating complex multilevel, multi-stakeholder occupational health interventions in practice

ABSTRACT Extant research suggests the effectiveness of Occupational Health Psychology (OHP) interventions depends on their design in the broader organisational context. While the field recognises that pre- and posttest evaluation do not sufficiently capture the complex dynamics around OHP interventions, complex multi-level OHP interventions are still scarce in the literature. As established intervention implementation frameworks suggest, it remains difficult to address this complexity in practice. The present position paper re-evaluates lessons learned from two complex European OHP intervention projects, by applying the Integrated Process Evaluation Framework (IPEF) and related theories to bridge the gap between the theoretically recognised complexity and practical challenges. The re-evaluations emphasise that programme-multilevel theories rooted in OHP-perspectives contribute to adequately hypothesising around systemic factors and mechanisms relevant to OHP interventions. Concretely, middle range theories that outline how an intervention’s mechanisms work within a specific context to produce certain outcomes are crucial. Additionally, strategically and actively involving key stakeholders at all levels of the system and across the different intervention phases improves the embedding of OHP interventions in organisations. We elaborate on these insights with seven concrete recommendations for complex OHP intervention research.

Bayesian network prediction study on the impact of occupational health psychological factors on insomnia among thermal power generation workers

Objective: To explore the risk factors of insomnia among employees in the thermal power generation industry and the network relationships between their interactions, and to provide scientific basis for personalized interventions for high-risk groups with insomnia. Methods: In November 2022, 860 employees of a typical thermal power generation enterprise were selected as the research subjects by cluster sampling. On-site occupational health field surveys and questionnaire surveys were used to collect basic information, occupational characteristics, anxiety, depression, stress, occupational stress, and insomnia. The interaction between insomnia and occupational health psychological factors was evaluated by using structural equation model analysis and Bayesian network construction. Results: The detection rates of anxiety, depression and stress were 34.0% (292/860), 32.1% (276/860) and 18.0% (155/860), respectively. The total score of occupational stress was (445.3±49.9) points, and 160 workers (18.6%) were suspected of insomnia, and 578 workers (67.2%) had insomnia. Structural equation model analysis showed that occupational stress had a significant effect on the occurrence of insomnia in thermal power generation workers (standardized load coefficient was 0.644), and occupational health psychology had a low effect on insomnia (standardized load coefficient was 0.065). However, the Bayesian network model further analysis found that anxiety and stress were the two parent nodes of insomnia, with direct causal relationships, the arc strength was-8.607 and -15.665, respectively. The model prediction results showed that the probability of insomnia occurring was predicted to be 0 in the cases of no stress and anxiety, low stress without anxiety, and no stress with low anxiety. When high stress with low anxiety and low stress with high anxiety occurred, the predicted probability of insomnia occurring were 0.38 and 0.47, respectively. When both high stress and high anxiety occurred simultaneously, the predicted probability of insomnia occurring was 0.51. Conclusion: Bayesian network risk assessment can intuitively reveal and predict the insomnia risk of thermal power generation workers and the network interaction relationship between the risks. Anxiety and stress are the direct causal risks of insomnia, and stress is the main risk of individual insomnia of thermal power generation workers. The occurrence of insomnia can be reduced based on scientific intervention of stress conditions.

The chains of the past: A life course perspective on childhood adversity and organizational attitudes and behaviors.

Childhood adversity stains the past of millions of working adults worldwide. The impact on health and well-being is substantial-a now-acknowledged public health crisis. Yet, research in the organizational sciences has failed to recognize the burden that individuals with this difficult history carry with them into the workforce. By synthesizing an interdisciplinary body of scholarship into a cohesive theoretical framework, we provide a foundation for emerging work in occupational health psychology. Empirically, across two single-level multiwave studies, we demonstrate the importance of adversity in one's childhood and its impact on the workplace specifically showing that child adversity, directly and indirectly, impacts worker attitudes and discretionary behaviors. Further, providing one of the few examinations of stress proliferation theory in the workplace, we demonstrate adulthood adversity as an essential mediating mechanism that leads to these work outcomes. From an applied perspective, our results highlight a need to focus on the healing and recovery of adult survivors as they work toward breaking the chains of the past in their lives and at work. In presenting this life course perspective on organizational attitudes and behaviors, our work offers a unique and vital contribution to occupational health theory, practice, and research. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Characteristics of Multiprofessional and Client-Oriented Approach in Occupational Health Services: A Cross-Sectional Survey Among Occupational Health Professionals.

Multiprofessional and client-oriented approaches are considered key factors for successful occupational health services, and for impressive occupational health cooperation between a client organisation and occupational health service provider. The purpose of this study was to find out the views of occupational health physicians, occupational health nurses, occupational physiotherapists, and occupational health psychologists about multiprofessional and client-oriented working methods. These working methods describe the guidelines for good occupational health practice in Finland, also serving the framework of the present study. The survey was conducted in May and June 2022. The data consisted of answers to open-ended questions of a larger questionnaire. The data was analysed with the method of theory-related thematic analysis. Seven occupational health service providers committed to the study. Altogether 121 professionals responded to the question surveying the multiprofessional approach, and 119 professionals responded to the question of client-oriented approach. The results showed that both the multiprofessional and client-oriented approaches are closely related to each other, and the views of these approaches are in line with the good occupational health practice. Multiprofessional approach was most commonly described with the theme of sharing expertise. Respectively, the theme of smooth cooperation most commonly described the client-oriented approach. At its best, the answers showed that a multiprofessional working strategy takes into account the expertise of different professionals so that the client can be offered high-quality, accurate content and timely occupational health services. The results provide up-to-date information on working strategies of occupational health services in Finland. The results can be used in further development of multiprofessional and client-oriented work in occupational health services.

Examining the implications of work–nonwork demand congruence

AbstractExamining the implications of excessive work demands on employee well‐being is an important research area of occupational health psychology. Recovery during nonwork time has been emphasized as an important process for mitigating the negative implications of excessive work demands. However, this notion ignores the potential for nonwork activities to be comparably demanding to work activities. There has been a lack of attention paid to the potentially complex interrelationships between work and nonwork demands. Using the effort–recovery and challenge–hindrance stressor models, we developed a set of hypotheses for both the positive and negative implications of the interplay between employee work and nonwork cognitive demands. We collected information on cognitive workweek job demands (Friday) and nonwork cognitive weekend demands (Sunday) from a sample of workers (N = 146), and we used polynomial regression with response surface analysis to examine how different aspects of work–nonwork cognitive demand (in)congruence related to Monday work engagement. In general, higher cognitive workweek job demands promoted work engagement, even when nonwork cognitive demands were equally high. Cognitive demand incongruence that favoured higher cognitive work demands was also beneficial for employee work engagement. Theoretical and practical implications are discussed, along with directions for future research in this area.

Conirmatory Factor Analysis of Depression, Anxiety and Stress 21 (DASS 21) scale in a study on Occupational Health Psychology in Health Care Professionals from Anand, Gujarat

Introduction: Confirmatory factor analysis (CFA) is a statistical technique to verify the factor structure of a set of observed variables. Objective: The study was conducted with an objective to study the psychometric properties of DASS 21 scale by Confirmatory factor analysis Method: This study used a Multi Method Design (Multiple approach Design), one was a cross sectional study of 228 participants and the other was a Solomon 4 group Design with total 64 participants. Four groups of health care professionals viz Allopathic doctors, Physiotherapists, Nursing professionals and Community Health Officers (CHOs) were chosen for the study. Convenience sampling was done at two stages. Results: Confirmatory factor analysis was used to evaluate the construct validity of DASS 21 scale. The model was overidentified as the estimated parameters were less than the number of observed variances and covariances. CMIN/DF(Chi square (minimum discrepancy function) /Degree of freedom) value was 2.021 which was < 5. Goodness of Fit Index (GFI) value (0.892) was near to .9. Root Mean square Residuals (RMR) and Root Mean Square Error of Approximation (RMSEA) value were 0.031 and 0.063 respectively which were less than 0.08. Average variance extracted (AVE) for the three constructs were less than the squared interconstruct correlation. Conclusion: DASS-21 scale demonstrated a good convergent validity, but in this study, discriminant validity was found to be poor as determined by average variance extracted in comparison to squared Interconstruct correlation.

HOW TO START AN UNBIASED CONVERSATION ABOUT EXHAUSTION

AbstractThe author, a self‐employed occupational health psychologist, presents her research on various nuanced aspects of exhaustion, stress, and burnout, as they related to leadership and organizations. She also notes her TEDx talk “Let’s talk about the bright side of exhaustion,” and writes that “using study results based on data of more than 26,000 participants and illustrative anecdotes, I will explain why exhaustion is more complicated than most realize, that there is not only a dark but also a bright side, and how leaders can make sure that people in their environment experience the bright side of exhaustion by improving person‐job matches.” She describes her own personal background within these issues, and Figure 1 depicts a Conversation Starter for Exhaustion Model. The Venn diagram has “Joyfully Exhausted” in the middle, surrounded by the keywords Meaning, Support, Autonomy, and Appreciation. In the article text, regarding meaning, she writes “As a leader you need to know what kind of work is meaningful for each person around you and ideally create work environments where people can mainly focus on performing these tasks. This makes it easier for individuals in your work environment to better perform and make the effort feel worthwhile.”

Workers' emotional exhaustion and mental well-being over the COVID-19 pandemic: a Dynamic Structural Equation Modeling (DSEM) approach.

The COVID-19 pandemic has presented significant challenges to the workforce, particularly concerning emotional and mental well-being. Given the prolonged periods of work-related stress, unexpected organizational changes, and uncertainties about work faced during the pandemic, it becomes imperative to study occupational health constructs under a dynamic methodological perspective, to understand their stable and unstable characteristics better. In this study, drawing on the Dynamic Structural Equation Modeling (DSEM) framework, we used a combination of multilevel AR(1) models, Residual-DSEM (RDSEM), multilevel bivariate VAR(1) models, and multilevel location-scale models to investigate the autoregression, trend, and (residual) cross-lagged relationships between emotional exhaustion (EmEx) and mental well-being (MWB) over the COVID-19 pandemic. Data were collected weekly on 533 workers from Germany (91.18%) and Italy (8.82%) who completed a self-reported battery (total number of observations = 3,946). Consistent with our hypotheses, results were as follows: (a) regarding autoregression, the autoregressive component for both EmEx and MWB was positive and significant, as well as it was their associated between-level variability; (b) regarding trend, over time EmEx significantly increased, while MWB significantly declined, furthermore both changes had a significant between-level variability; (c) regarding the longitudinal bivariate (cross-lagged) relationships, EmEx and MWB negatively and significantly affected each other from week to week, furthermore both cross-lagged relationships showed to have significant between-level variance. Overall, our study pointed attention to the vicious cycle between EmEx and MWB, even after controlling for their autoregressive component and trend, and supported the utility of DSEM in occupational health psychology studies.

Vicenarian of workplace incivility: a bibliometric analysis and systematic review

PurposeThe purpose of this paper is twofold: first is to map and analyse prominent contributions, current dynamics, patterns, gaps and research prospects in the field of workplace incivility (WI); second is to provide a coherent theoretical research framework for future research.Design/methodology/approachThis study adopts a two-step analysis approach by combining bibliometric analysis and systematic literature review to explore the research topic of WI, besides, using multiple methodologies including bibliometric, network and content analyses.FindingsThis study found that L. M. Cortina and M. S. Hershcovis are the top two most influential authors among all authors in the sample publications. Journal of Occupational Health Psychology is one of the top-ranking journal that often publishes this topic of articles. USA and The Bowling Green State University are the most influential country and institutions, respectively. Besides, burnout and retention are also common keywords were identified based on keywords co-occurrence map, showing that WI has a major impact on burnout and employee retention. Based on the above analysis, this paper constructed a theoretical research framework of WI.Research limitations/implicationsThis paper only draw data from one database—Scopus—which cannot provide broad coverage of the research topic. WI research trends and trajectories may be assessed to enable academics and practitioners better understand the current and future trends and research directions. Future studies in this field might use the findings as a starting point to highlight the nature of the topic.Originality/valueThis study is the first to use an systematic literature review (SLR) to evaluate the association between WI and other organizational behaviour. The study contributions are fourfold, extending the work and overcoming the methodologies of prior research that only focussed on characteristics of incivility in nursing. In addition, this paper presents an in-depth analysis of this topic and provides a comprehensive theoretical research framework for future study.

IMPACT OF NURSE PRACTICE ENVIRONMENT, ORGANIZATIONAL COMMITMENT ON JOB SATISFACTION AND INTENT TO LEAVE IN HOSPITALS OF PAKISTAN

Aim: To measure impact of nurses’ practice environment, organizational commitment on job satisfaction and intent to leave in hospitals of Pakistan. Study Design: Cross sectional survey; Convenience sampling. Methods: Sample of 240 nurses were drawn from private and public sector hospitals. Nurses’ practice environment (Aiken, Clarke, & Sloane, Hospital Staffing, Organisation and Quality Care: Crossnational Findings, 2002), organizational commitment (Mowday, Steers, & Porter, 1979) , job satisfaction (Carbonell & Escudero, 2013) and intent to leave (Zopaitis, Constanti, & Theocharous, 2014) were used as instruments of measurement. Results: Nurse Practice environment with estimate of 0.176 has no significant effect on job satisfaction as the p value was 0.43 which was statistically insignificant ant 0.05. Hospital nurses’ organizational commitment with estimate of 0.043 has no significant effect on job satisfaction as was 0.526 which was statistically insignificant at 0.05. Job satisfaction with estimate of 0.254 has a significant effect on intent to leave as the p value was 0.007 which was statistically significant at 0.05. Hence, it is claimed that job satisfaction has significant impact on intent to leave. Conclusion: The study is integral to have in the field of occupational health psychology and to make sure that nurses are satisfied in their work whether employed in private or public hospitals. Keywords: nurse practice environment, organizational commitment, job satisfaction, intent to leave, nursing, Pakistan

IMPACT OF NURSE PRACTICE ENVIRONMENT, ORGANIZATIONAL COMMITMENT ON JOB SATISFACTION AND INTENT TO LEAVE IN HOSPITALS OF PAKISTAN

Aim: To measure impact of nurses’ practice environment, organizational commitment on job satisfaction and intent to leave in hospitals of Pakistan. Study Design: Cross sectional survey; Convenience sampling. Methods: Sample of 240 nurses were drawn from private and public sector hospitals. Nurses’ practice environment (Aiken, Clarke, & Sloane, Hospital Staffing, Organisation and Quality Care: Crossnational Findings, 2002), organizational commitment (Mowday, Steers, & Porter, 1979) , job satisfaction (Carbonell & Escudero, 2013) and intent to leave (Zopaitis, Constanti, & Theocharous, 2014) were used as instruments of measurement. Results: Nurse Practice environment with estimate of 0.176 has no significant effect on job satisfaction as the p value was 0.43 which was statistically insignificant ant 0.05. Hospital nurses’ organizational commitment with estimate of 0.043 has no significant effect on job satisfaction as was 0.526 which was statistically insignificant at 0.05. Job satisfaction with estimate of 0.254 has a significant effect on intent to leave as the p value was 0.007 which was statistically significant at 0.05. Hence, it is claimed that job satisfaction has significant impact on intent to leave. Conclusion: The study is integral to have in the field of occupational health psychology and to make sure that nurses are satisfied in their work whether employed in private or public hospitals. Keywords: nurse practice environment, organizational commitment, job satisfaction, intent to leave, nursing, Pakistan

"When the medium massages perceptions: Personal (vs. public) displays of information reduce crowding perceptions and outsider mistreatment of frontline staff": Correction.

Reports an error in "When the medium massages perceptions: Personal (vs. public) displays of information reduce crowding perceptions and outsider mistreatment of frontline staff" by Jean-Nicolas Reyt, Dorit Efrat-Treister, Daniel Altman, Chen Shapira, Arie Eisenman and Anat Rafaeli (Journal of Occupational Health Psychology, 2022[Feb], Vol 27[1], 164-178). In the original article, changes were needed to the labels under the images in the Appendix. Personal media were mistakenly labeled as public and vice versa. The four legends, from left to right, top to bottom, should be "Low crowding, public medium," "Low crowding, personal medium," "High crowding, public medium," and "High crowding, personal medium." The results and conclusions are unchanged. The online version of this article has been corrected. (The following abstract of the original article appeared in record 2022-30403-003). Crowded waiting areas are volatile environments, where seemingly ordinary people often get frustrated and mistreat frontline staff. Given that crowding is an exogenous factor in many industries (e.g., retail, healthcare), we suggest an intervention that can "massage" outsiders' perceptions of crowding and reduce the mistreatment of frontline staff. We theorize that providing information for outsiders to read while they wait on a personal medium (e.g., a leaflet, a smartphone) reduces their crowding perceptions and mistreatment of frontline staff, compared to providing the same information on a public medium (e.g., poster, wall sign). We report two studies that confirm our theory: A field experiment in Emergency Departments (n = 939) and an online experiment simulating a coffee shop (n = 246). Theoretical and managerial implications are discussed. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Correction to Diestel (2022).

Reports an error in "How strategies of selective optimization with compensation and role clarity prevent future increases in affective strain when demands on self-control increase: Results from two longitudinal studies" by Stefan Diestel (Journal of Occupational Health Psychology, 2022[Aug], Vol 27[4], 426-440). In the original article, Table 3 needed updates to align the columns properly and to add the asterisk and double asterisk symbols (indicating * p < .05 and ** p < .01) in several entries in the last 3 'Estimate' columns. In the same Table, the third decimal place of the standard error value for 'Affective strain at T1' needed to be corrected in the Step 2 section under the 'Changes in affective strain from T1 to T2 in Sample 2' header. Additionally, Figure 2 included an error in one of the t-values; for "High SOC-strategies and high role clarity at T1," t = 0.184 should have been t = 0.156. The online version of this article has been corrected. (The following abstract of the original article appeared in record 2022-55823-001). In modern working environments effective strategies for regulating goal-directed behavior and allocating and investing limited resources (e.g., selection, optimization, and compensation [SOC] strategies) should enable employees to cope up with job demands that require volitional self-regulation, thereby preventing strain over time. However, theoretical insights suggest that the beneficial impact of SOC strategies on psychological health depends on the degree to which employees experience clarity in their job role. To understand how employees stabilize their psychological health when demands increase over time, I examine interaction effects of changes in self-control demands (SCDs), SOC strategies and role clarity at an earlier point in Time on changes in affective strain in two longitudinal samples from different occupational and organizational settings (international private bank: N = 389; heterogenous sample: N = 313, 2 year lag). In line with recent conceptualizations of chronic forms of distress, affective strain involved emotional exhaustion, depressive symptoms, and negative affect. In support of my predictions, structural equation modeling revealed significant three-way interactions of changes in SCDs, SOC strategies and role clarity on changes in affective strain in both samples. In particular, the positive relationships between changes of SCDs and changes in affective strain were jointly buffered by SOC strategies and role clarity. The present findings offer implications for stabilizing well-being when demands increase over long time periods. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Correction to Choi et al. (2022).

Reports an error in "Flaws and all: How mindfulness reduces error hiding by enhancing authentic functioning" by Ellen Choi, Hannes Leroy, Anya Johnson and Helena Nguyen (Journal of Occupational Health Psychology, 2022[Oct], Vol 27[5], 451-469). In the original article, in the first sentence of the paragraph under "Participants" in the "Part I: Method" section, changes were needed to correct four numbers from percentages to whole numbers. The sentence "Of the 230 participants, most were women (93.5%), which is representative of the health-care context, and 29.6% of participants were between the ages of 25% and 34%, 39.6% between 35% and 44%, and 20.0% between 45 and 54" should have said "Of the 230 participants, most were women (93.5%), which is representative of the health-care context, and 29.6% of participants were between the ages of 25 and 34, 39.6% between 35 and 44, and 20.0% between 45 and 54." The online version of this article has been corrected. (The following abstract of the original article appeared in record 2022-60042-001). Hiding errors can undermine safety by amplifying the risks of undetected errors. This article extends research on occupational safety by investigating error hiding in hospitals and applies self-determination theory to examine how mindfulness decreases error hiding through authentic functioning. We examined this research model in a randomized control trial (mindfulness training vs. active control group vs. waitlist control group) within a hospital setting. First, we used latent growth modeling to confirm that our variables were related as hypothesized, both statically or cross-sectionally as well as dynamically as they evolved over time. Next, we analyzed whether changes in these variables were a function of the intervention and confirmed the effects of the mindfulness intervention on authentic functioning and indirectly on error hiding. To elaborate on the role of authentic functioning, in a third step, we qualitatively explored the phenomenological experience of change experienced by participants in mindfulness and Pilates training. Our findings reveal that error hiding is attenuated because mindfulness encourages a receptive view of one's whole self, and authentic functioning enables an open and nondefensive way of relating to positive and negative information about oneself. These results add to research on mindfulness in organizations, error hiding, and occupational safety. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Presenteeism Is Reloaded and Ready for Further Research – A Commentary on Priebe, J. and Hägerbäumer, M. (2023)

Presenteeism Is Reloaded and Ready for Further Research – A Commentary on Priebe, J. and Hägerbäumer, M. (2023)

Second Wind: Understanding How Academics from the Philippines Adjust to Retirement

Second Wind: Understanding How Academics from the Philippines Adjust to Retirement

Review of the psychometric properties of the Patient Health Questionnaire-9 (PHQ-9) Spanish version in a sample of Puerto Rican workers.

This study aimed to examine the internal structure and assess the psychometric properties of the Patient Health Questionnaire (PHQ-9) in a Puerto Rican sample of workers. This instrument is a nine-item questionnaire, which was conceptualized as a unidimensional structure; however, there are mixed results regarding this internal structure. This measure is used in the occupational health psychology context in organizations in Puerto Rico; nevertheless, there is little evidence of its psychometric properties with samples of workers. A total of 955 samples from two different study samples were used in this cross-sectional study design in which the PHQ-9 was used. We conducted confirmatory factor analysis, bifactor analysis, and random intercept item factor analysis to examine the internal structure of the PHQ-9. Moreover, a two-factor model was examined by randomly assigning items to the two factors. Measurement invariance across sex and the relationship with other constructs were examined. The best-fitted model was the bifactor model followed by the random intercept item factor. The five sets of two-factor models with items randomly assigned obtained acceptable and similar fit indices regardless of the items. The results suggest that the PHQ-9 appears to be a reliable and valid instrument to measure depression. The more parsimonious interpretation of its scores, for now, is a unidimensional structure. Comparison across sex appears to be useful in occupational health psychology research settings since the results suggest that the PHQ-9 is invariant regarding this variable.