Summaries per article with Stress, Health and Disease at Leiden University 22/23

Stress in organizations has both practical and economic consequences. Stress can lead to illness. A lot of absenteeism is not good for a company. Earlier research on stress in organizations has been criticized for the research method. Newer research has improved through better operationalization of concepts and therefore better models, more objective measures of stress, increased longitudinal studies, increased testing of nonlinear effects, use of within-person and other multilevel designs and growth curve models.

What are stressful stimuli, stress response, transaction and stressors?

Stressful stimuli are a subset of stimuli that cause tension or stress for most people. The stress response is people's physiological reaction to these stressful stimuli that cause the tension. Transaction tries to explain that stress is a response that arises as a result of an interaction between an individual and their environment.

Stressors are conditions and events that generate tension or stress. Stressors can be temporary, such as life events like someone dying. They can also be chronic, in the form of daily problems. Work-related stressors can be divided into different groups.

• Physical stressors: physical working conditions, such as noise and toxic substances.
• Task-related work stressors: high time pressure, too much work, high complexity, monotonous work and other things that can hinder performance.
• Role stressors: role conflicts, ambiguities, and expectations.
• Social stressors: interactions with supervisors and colleagues. Work schedules can also be stressors and fall in the social stressor category as well.
• Career-related stressors: job insecurity and poor career opportunities.
• Traumatic stressors: accidents and extremely dangerous activities are examples of this.
• Changes within the organization can also be seen as a stressor.

Support for role stressors has been found in role theory research. Next, action theory classifies stressors based on how they disrupt the regulation of goal-directed action. There are regulation obstacles, uncertainties and overload. There are also different approaches to stressors. Stressors can be approached as a threat or as a challenge. Challenges include, for example, time pressure and threats of social conflict. Challenges and threats have the same effect on health. However, challenges have a positive effect on performance. Within the research, the subjective approach focuses on the perceptions of those with a particular job. The objective approach focuses on things that are not related to the person's perceptions.

Do people respond differently to stress?

There are two types of stress response. The first one is the acute stress response. This is the direct response a person has to a stressful situation. However, after this, a long or chronic stress response might take place. This means the stress stays after the direct or acute situation passes. This means that at first, stress can motivate a person for a task, but in the long run, illness or long term consequences may occur. 

• It may affect the cardiovascular system and give people with stressful jobs high blood pressure.
• Hormones like adrenaline and cortisol may also be affected.
• People with more stress show more negative affect states like depression and burnout.
• At a behavioral level, long term stress may cause attention, working memory and involvement problems.
• The immune system might deteriorate.
• Work stress can also have consequences outside of work. Adrenaline levels remain elevated even after work after a stressful day. This can have an effect on private life, relationships and the raising of children.

What are the different theories related to work stress?

• The transactional stress model: according to Lazarus and Folkman, cognitive approaches play a major role in the stress process. There are primary and secondary approaches to stress. In the primary approach, people determine whether an experience is irrelevant, benign or stressful. Then, in the secondary approach, a person evaluates what can be done with the stressful experience or what the coping options are. According to this theory, more intra-individual research should be done for greater understanding.
• The cybernetic model: assumes that stress is caused by a difference between a person's perception and a person's desires. Perception can be influenced by the physical and social environment, personal characteristics and cognitive information. Stress influences the outcome for the person's well-being and coping effort. The influence of the stress is determined by the duration of the stress and how important the situation it is for the person. Coping influences the individual, the situation and duration.
• The person-environment fit theory: this theory assumes that stress is caused by a mismatch between the individual and the environment. In this theory, stress comes from both the environment and the person. The first type of mismatch is that between the demands of the environment and the competencies of the person. The second type involves the mismatch between the need of the person and the supply of the environment. The matches can be objective, but also subjective. Subjective refers to the person's perceptions of the aforementioned issues. Evidence has been found that the mismatch between individual and environment can lead to stress symptoms.
• The job demand-control model: this takes into account the demand from the work and the degree of decision-making ability or control. The combination of high work demand and low control gives the highest tension or stress. According to Demerouti and colleagues, sources such as feedback, reward, participation and support from supervisors can have a buffering effect on the stress induced. According to Jonge and Dormann, there is a triple-match principle. This means that buffers are more effective when they buffer an effect of a stressor in the same domain. For example, a cognitive buffer for cognitive stressors.
• The vitamin model: this model assumes that some positive characteristics of work can lead to better well-being. However, this effect can no longer increase at a certain point, just like the effect of vitamin C on the body. At a certain point, the work characteristics can even make the wellbeing decrease.
• The effort-reward imbalance model: looks at the effect of a difference between how hard someone tries at work and the rewards they are given for it. If there is a lot of effort but very little reward, this causes stress.

What does empirical research say about the effects of stress?

What is the effect of stress on health?

Stress at work appears to be related to bad health and decreased wellbeing. However, a strong connection between stressors at work and health has not been established. This might be because the effects of stressors differ per person, but might also be because moderators are present.

What are moderators?

A moderator is a variable that can influence the relationship between the stressor and the person. A moderator thus acts as a resource or buffer. There are resources that have to do with the work and resources that have to do with the individual.

One of the work-related resources is job control. This includes the employee's opportunity to influence activities related to a higher-order goal. Control means that the person can do something about the stressor.

Social support and characteristics of a team can also be resources. Social support is important for protecting health and well-being. Social support includes emotional, informational and instrumental support. Social support is especially helpful if it matches the needs and the support is also reciprocal. Working in a group can also have a buffering effect. This can be achieved through:

• Group cohesion.
• Group autonomy.
• Good team climate.
• Psychological safety.
• Collective effectiveness.
• Emotional contagion. This means that a state of mind can be transferred from certain members of the group to other members. This can be both positive and negative.

Coping styles can also be seen as a resource. Coping is the way one handles a situation, both cognitively and behaviorally. Problem-focused coping focuses on changing the stressor, the environment, or one's own behavior. Emotionally focused coping focuses on controlling cognitions and emotions. Problem-focused coping is related to a positive health outcome and emotionally-focused coping to a negative outcome. Research has shown that the positive effect of problem-focused does not apply when control over the situation is low.

Core self-evaluations could also be a moderator. Internal locus of control, high self-confidence, high self-efficacy and emotional stability are negatively related to stress symptoms. However, there is not much evidence for this yet.

The recovery process after a stressful experience is also important. It has a positive effect when people can relax well in their free time after the stress experience.

Possible other moderators could be personalities with competitiveness, hostility and impatience, rudeness and a sense of coherence. It is difficult to investigate their effects for all the above moderators. In general, resources have a positive effect on health and well-being.

What are the effects of stress on performance?

In addition to the well-being of employees, stress in organizations can also affect performance. Performance involves the actions of an individual that are relevant to the goals of the organization. Task performance is about technically performing the work properly. Contextual performance is not directly about technical execution, but about the support of the social, psychological and organizational environment. It can be assumed that stressors negatively affect performance. The stressor can directly hinder performance, but also indirectly because of its consequences, such as reduced attention and working memory. The latter can have negative consequences for speed and accuracy and the decision-making process. Stressors do not always negatively affect performance. When the stressor is perceived as a challenge rather than a threat, a few studies have found that performance improves.

Work stress can also influence organizational citizenship behavior. Role conflict has a greater negative effect on this than on performance. The opposite is true for role ambiguity. Low job satisfaction is a mediator between work stress and low levels of organizational citizenship behavior.

Does stress affect other organizational factors?

Work stress can also lead to counterproductive work behavior. This includes destructive behaviors such as aggression and sabotage. In addition, work stress can also lead to reduced involvement in the organization. However, there is not much evidence for causality. Research has shown that absenteeism is related to stress and poor physical and psychological conditions. However, it is not clear whether work stressors have a direct effect on absenteeism. Involvement could also play a role in this. When the effort-reward imbalance model is taken into account, unfavorable situations do lead to absenteeism. Finally, work stressors can also lead to dismissal and job search tendencies. Threatening stressors in particular can lead to actual job changes. The way in which stressors are perceived also plays a role here. The above factors are unfavorable for an organization.

Which interventions are available?

• Stress reduction: stress reduction for individual stressors is provided by stress management programs. Through these, people gain insight into the fact that they have control over certain matters at work. The reduction of organizational stressors can be done in many different ways. For example, a more pleasant working environment can be provided, or working hours can be reduced. However, stress reduction can also lead to a reduction in challenge, so it is important that resources are also increased.
• Increasing resources: stress management programs can also work to increase both individual and organizational resources. Coping skills, beliefs about one's own abilities (efficacy beliefs) and individual competencies are resources that can be increased on an individual level. At the organizational level, efforts can be made to increase work control and employee participation in the decision-making process. Social support is also a resource for reducing stress. For example, a good supervisor is important.
• Decreasing tension: tension decreasing programs aimed at the individual are widely used and appear to have positive effects. These programs focus on interpreting a situation as a challenge rather than something stressful, improving coping strategies and reducing stress through relaxation techniques. Cognitive behavioral techniques and relaxation techniques are widely used. Examples of therapies that help to use rational self-instruction are rational-emotive therapy and stress inoculation training. At the organizational level, rest periods can be used. Rest periods can include relaxation, meditation, moment to rest or sleep.
• Lifestyle changes: on an individual level, lifestyle can be adjusted by promoting a healthy diet, living more healthily, and getting enough physical exercise. Employee assistance programs often address alcoholism and other addictions, but stress management and exercise can also be included. Eating breakfast almost every day, hardly eating between meals, being at a healthy weight, not smoking, drinking very little and regular exercise are habits that have a very positive effect on health. From an organizational point of view, the use of stairs and bicycles can be encouraged.