CHAPTER ONE

INTRODUCTION

Stress, in general, has received widespread attention in the professional literature and popular press. This attention is due to the fact that excess stress has been known to have detrimental effects on an individual’s psyche. Moreover, stress has been a common factor affecting all aspects of life including interpersonal relationships, work, school, and family (Greenglass, 2002). It also represents a major health concern implicated in most of the top 10 causes of death in the United States, with the first being heart disease (World Health Organization, 1999). Coping, on the other hand, has been extensively researched as well. More importantly, coping strategies play a vital role in an individual’s physical and psychological well-being when confronted with challenges since these help alleviate the harmful stress effects individuals can face. Also, coping can be viewed as a goal managing approach that utilizes social resources such as co-worker and family support (Greenglass, 2002).

One form of stress that is commonly examined and is prevalent in today’s fast-paced society is occupational stress, also referred to as job or work stress. Such stress results in a variety of negative health outcomes, impacting the individual, the family and the organization at which the individual is employed. It stands to reason that a solid understanding of the causes and results of occupational stress can lead to improved health among workers, both young and old. According to Shultz and Adams (2006), the literature on aging in the workplace has been receiving more attention as the number of retirees reaching the age of Social Security and Medicare is on the rise. With more Americans finding their retirement incomes insufficient to keep up their standard of well being or simply wanting to supplement what they receive, the demographic shift of older workers continuing in the workplace has instigated a whole new area of research on aging and stress in the workplace and the coping mechanisms of the elderly. To retain an older workforce is to understand potential differences in how they, versus the young workforce, deal with occupational stress (Barnes-Farrell, 2005). Hence, this literature review contributes to the understanding of occupational stress and coping mechanisms by first reviewing the concept of stress, its causes and consequences, and established models within the literature that attempt to explain the relationships among individuals, environmental characteristics, their coping strategies, and stress. Furthermore, this paper will review the literature concerning coping and the impact of age and gender upon both coping mechanisms and the experience of occupational stress. It is imperative to understand how older workers deal with this type of stress compared to their younger counterparts since the past literature has failed to address the importance of how older workers uniquely cope with occupational stress and the existence of an interaction effect between age and gender in coping related to occupational stress.

General Stress

Background

The concept of stress incorporates two distinct ideas, stressors, which refer to environmental characteristics that cause adverse reactions in an individual, and strain, the actual adverse reaction to the stressors. While stress itself is most often associated only with the situation and the subsequent response, this conceptualization does not give consideration to mediating factors or individual susceptibility to the phenomenon. Therefore, stress is more aptly explained as a result or product of the interaction between individuals and their environment. As such, most stressful situations are not, in and of themselves stressful, but rather are defined that way by the unique individual involved in the situation. That is, “what one person may deem stressful, another individual may view as comfortable” (Bamber, 2006, p.5).

Universally, stress may also be viewed in a more positive manner. For example, McGowan, Gardner, and Fletcher (2006) characterized stress as an interaction between demands made upon an individual and the ability to respond to those demands. The outcome of this interaction need not be negative since there exists a term for positive stress known as eustress in which the stressor elicits a positive response depending on the positive psychological state of the individual. For example, eustress may be characterized by positive affect, meaningfulness, and hope in response to a particular stressor. Moreover, this type of stress helps an individual cope with stress in a healthy manner.

Larzarus and Folkman (1980) developed the Cognitive Theory of Stress and Coping. This theory of stress suggests that there exists a relationship that is transactional between individuals and their environment which can be strenuous, could exceed their resources and become threatening to their well-being. Judkins (2001) suggested that the emphasis of stress is on the individual’s perception or cognitive appraisal of its importance that takes into account the situational demands and individuals’ ability and resources for coping with that situation. Thompson (1992) used Lazarus and Folkman’s theoretical framework to further emphasize that stress is not an object in the world but it is a reaction of the organism to the events in the world. Thus, individuals experience stress based on how they react to life events such as stress at work.

Occupational Stress

As occupational stress has become a common fixture of the lives of millions of Americans, consequences of this type of stress for both employees and organizations has received growing interest. Occupational stress is related to a range of factors both external and intrinsic to the workplace. Intrinsic factors include work overload or under-load (i.e., boredom), shift work, long hours, travel requirements, larger work environments, and poor physical work settings. Other factors associated with it include role ambiguity, role conflict, mistrust or envy of coworkers, job insecurity, downsizing, poor communication among employees, low recognition by superiors, and low decision authority (Biron, Ivers, Brun,& Cooper, 2006; Danna & Griffin, 1999; Sexton, Teassley, Cox, & Carroll, 2007). External factors may be thought of as factors beyond the control of the individual. For example, a company’s decision to merge with another company for profit and does not take into account suggestions or concerns of their own employees. Occupational stress occurs when an individual experiences an overload of stressors stemming largely from the occupational environment. Bridger, Kilminster, and Slaven (2006) described a workplace stressor as an aspect related to the work environment which poses demands that the individual is not ready to comprehend, and as a result causing strain. So, a strain is caused by a stressor. For example, in attempting to meet an important deadline the employee is unsure about meeting and hence the employee may feel over-worked and skill-deficient. Past literature has specifically focused on researching domains that include the physical characteristics of the occupational climate such as heat, crowding, and noise and even the personal characteristics of workers within the occupational environments that include their coping styles, strong beliefs about avoiding stress, and cognitive capacities (Byrne & Espnes, 2008).

Sparks and Cooper (1997) argue that occupational stress can result from a combination of work stressors. Work relationships and interactions between supervisors and co-workers can be one source of both strain and support. For example, if employees considered their supervisors to be hostile towards them, they experienced more pressure at work than those employees who had supportive bosses. Moreover, if employees had brief interactions with their supervisors without having a sufficient supervisor-employee time, employees might think that their supervisors are taking them for granted and unsupportive of their work. Cartwright and Cooper (1997) argued that another potential stressor can be a lack of job security. If an employee working in a company is uncertain of his or her job position, it may affect the overall work productivity and satisfaction of the employee. The reason is that this employee might constantly be under the stress of fear of job loss. Additionally, negative performance appraisals and persistent role ambiguity can be detrimental to employee well-being. Moreover, over-promotion such as frustration of having reached a career ceiling can make stress unbearable. In other words, an employee who has taken a leadership role or has been laden with many responsibilities by the company might feel over-worked and worn out.

Cooper and Lewis (1994) suggested the fact that the work-family interface can also be a likely stressor for employees coping with occupational stress. Experiencing work overload, lack of role clarity, and a hostile environment at work may affect the home environment since the employee brings these problems home with him and thus can strain relationships with family members. Danna and Griffin (1999) also agreed with Cooper and Lewis that factors related directly to the work environment are not the only potential causes of stress but the link between home and work could also present problems. Difficulties in managing the dual environments, particularly among two-income couples or individuals experiencing a personal crisis, could contribute to occupational stress.

Other research suggests that individuals with certain personality traits are more prone to occupational stress. For example, the “Type D” personality is linked to introversion and neuroticism. Oginska-Bulik (2006) reported that individuals with this personality type were more likely to perceive their work environments as stressful, due to lack of rewards, control, and responsibility, and would experience greater frequency of burnout in the form of emotional exhaustion, and demonstrate mental health disorders, including anxiety, insomnia, and depressive symptoms. Other researchers have stated that individuals with high positive affect and low negative affect demonstrate lower levels of blood pressure in response to stress than do individuals with both a high positive and negative affect (Norlander, Bood, & Archer, 2002).

The consequences of occupational stress can range in severity from mild to severe and impact both professional and personal lives. In one study of university staff members, participants identified professional aspects negatively impacted by stress such as job performance, interpersonal work relations, commitment to the organization, and extra-role performance, the latter which refers to participation in extra tasks in the workplace or willingness to work extra hours. As previously mentioned, occupational stress can also spillover into one’s personal life. Negative consequences within this domain include physical health problems, such as weight loss, fatigue, back pain; psychological health problems such as burnout, anger, irritability, frustration, and feeling overwhelmed; as well as strained family and personal relations (Gillespie, Walsh, Winefield, Dua, & Stough, 2001). Several models on occupational stress have been proposed and have influenced contemporary organizational stress research and they are discussed in the following sections.

Theoretical Models of Occupational Stress

The Demand-Control Model of Occupational Stress

Developed by Karasek (1979), the Job Demand Control model explains the relationships among job demand, job control, and psychological strain in the workplace. Job demands are described as the amount of workload experienced by a worker, while job controls refer to a worker’s sense of autonomy in the workplace and the ability to control the response to job duties and how to complete them (Karasek & Theorell, 1990). An additional component, support, was added to this model in the early 1990s by other researchers and this component consisted of the instrumental and emotional assistance provided generally by immediate supervisors to the work. It is also a theoretical model that suggests psychological strain as being a result of a combination of factors. Strain from a job environment is influenced by job demands and by the amount of autonomy workers perceived they have in facing these work demands (Tansey, Mizelle, Ferrin, Tachopp, & Frain, 2004). These facets related to the work situation initiate conflicts and demands that place workers in a position dominated by stress. In other words, the interaction of high work demand and low job control can trigger the onset of occupational stress. The main theme of the Job Demand Control model is that job control is able to protect against the detrimental effects of high work demands on psychological strain.

The Job Demand Control model consists of four dimensions, each incorporating various levels of job demand and control. The first of the three dimensions, termed “High Strain Jobs”, suggests that the adverse effects of psychological strain, including anxiety, depression, fatigue, and physical illness occur when job control is low and job demand is high. “In situations with high levels of stress or strain, the resulting arousal becomes damaging when the worker has little to or no control over his environment and the constraints that restrict how he can respond to the strain” (Karasek & Theorell, 1990, p. 31).The second dimension of the model, known as “Active Jobs”, is characterized by high levels of both psychological demand and control. In this particular situation, workers have the liberty to use their talents and skills to mitigate negative psychological stressors. “The energy from these stressors is then translated into action through active problem solving, which results in little psychological disturbance and average amounts of psychological strain” (p. 35). For example, jobs of heart surgeons where psychological pressures such as operating on the heart and pressure to perform the operation on time is common practice, however, they have some decision latitude to make decisions in saving the life of the patient.

Karasek and Theorell (1990) described “Low Strain Jobs” as the third type of situation that is defined by a small number of psychological demands and high levels of control. “Such jobs are associated with relaxation and leisure and low levels of psychological strain and physical illness. There are a few challenges in the workplace, and the worker possesses the ability to respond to any challenges that may appear” (p.36). An example of low strain jobs may be monitor technicians who monitor patient heartbeats and only report to the nurses if they see a spike in the patient’s rhythm. Other than that, the job itself is comfortable because all you do is sit in front of the monitor until an abnormal heart rhythm is discovered.

The final component of the Job Demand Control model is “Passive Jobs”, distinguished by both low levels of demand and control. In this type of situation, the authors contended that the “worker’s skills and abilities eventually wither, resulting in negative learning, loss of skills, and low levels of leisure and political activity outside of the work environment” (p. 37). Motivation and productivity are threatened when one is incapable to fully satisfy one’s desire to implement one’s own ideas for improving the work environment or when a job is less challenging. “Jobs with low levels of both demand and control are also associated with average levels of psychological strain and illness” (p. 38). An example of a passive job might be janitorial duties. In this type of job, an individual is not challenged enough to do something about the work because the work requires minimal special knowledge or skills with little discretion of how to complete the work.

Mixed support for the Job Demand Control model exists in the literature surrounding occupational stress. Dollard, Winefield, and De Jong (2000) utilized the model to investigate differences in self-reported levels of job strain and productivity among different occupational groups, contending that occupational stress was primarily due to environmental factors rather than personal characteristics. The authors collected data on negative affectivity, work environment, emotional strain, and productivity. Findings indicated that a negative work environment significantly correlated with job strain. The level of job demand correlated positively with emotional exhaustion, depersonalization, and personal accomplishment, and negatively with job satisfaction. Job control, however, positively correlated with the latter two factors, while social support correlated negatively with emotional exhaustion and depersonalization.

Rusli, Edimansya, and Naing (2008) also utilized the Job Demand Control model to investigate the relationship between job demand, job control, social support, stress, anxiety, depression, and quality of life. They mentioned that the quality of life was predicted by increased social support and less social support led to increased health risks. Other results demonstrated a relationship between social support and job control and demand. Results indicated that job demand was reciprocally related to environmental work conditions and job control was positively correlated with social relationships in the workplace. The researchers concluded that stress, anxiety, and depression mediated the relationship between job demand and quality of life. An additional result from this study, which adds an interesting perspective to the Job Demand Control model, was that job control, stress, anxiety and depression increased with increasing age of the worker.

Another study conducted by Tarris and Feij (2004) addressed occupational stress by presenting findings that did not necessarily support Karasek and Theorell’s model. In this study, the researchers investigated how job demands, control, and strain impact working aspirations of young workers with respect to the motivation to learn from more experienced colleagues and supervisors. The data was collected from younger workers over a period of two years. Cross-sectional results supported each of the four tenets of the Job Demand Control model, assuming that reduced job strain translated into increases in motivation to learn; however, some of these results did not hold true over time. For example, the authors demonstrated that increased job demand and control led to increased learning in the short term, but no increases in learning over the long term. Within these conditions over time, the level of strain decreased, likely due to the opportunity to utilize new strategies in dealing with strain. These results as with the study conducted by Rusli et al. (2008), suggest that changes may occur over time which cannot be explained in full by the Job Demand Control model.

While the previous two studies involved younger workers with a mean age of 26 who were followed for a length of time, Totterdell, Wood, and Wall (2006) followed a group of workers for six months whose mean age was 48 years old. The purpose of their study was to investigate how the Job Demand Control model applied to changes within the individual with respect to work characteristics and strain over time. The researchers collected data concerning optimism, emotional stability, problem-solving demands, time and method control, emotional support, and job-related stress. Results suggested that while demands, control, and support all affected job strain, they did so in an independent manner rather than interactively, which is contrary to the model. However, when considering levels of personal optimism, interaction between demands and control was observed. For example, pessimists experienced greater levels of strain during periods of high demand and low control than did optimists. This study suggests that the components of the Job Demand Control model were affected by extraneous factors, such as individual emotional characteristics, although it provided no clue as to whether or not younger workers would yield similar results. In addition, studies done on job demand control model have looked more at psychological work demands of employees in general without paying close attention to the types of work demands that are stressful to workers from various groups (e.g., older versus younger workers). Yet, a recent study by Shultz, Wang, Crimmins, and Fisher (2009) did find some support of interactive effects of demand and controls for older workers, but not for younger workers. Specifically, they found that for the problem solving demand, only one job control mechanism such as having plenty of time to complete a work goal buffered a stressful response for younger workers while all job control mechanisms demonstrated buffering effects against job stress related to different job demand types for older workers.

The Effort/Reward Imbalance Model of Occupational Stress

A second model of occupational stress is the Effort/Reward Imbalance model or ERI, which adds a more subjective dimension to the Job Demand Control model. This model asserts that occupational status and successful role performance provide the means to increase self-esteem. However, both the individual’s efforts and the rewards obtained in response to those efforts, such as money or career opportunities are dependent on the psychological benefits associated with work. An individual who puts forth great efforts, whether due to extrinsic motivation such as job obligation and demands; intrinsic motivation like employee over-commitment to strive to do the best work possible on the job or a combination of both, but receives a few rewards experiences emotional stress and negative health consequences (Calnan, Wainwright, & Almond, 2000). Over-commitment, a third dimension of the model, may be a risk factor that impacts the balance between efforts and rewards (Niedhammer, Chastang, David, Barouhiel, & Barrandon, 2006).

Although this model can serve alone as a useful framework for understanding the impact of psychosocial factors on mental and physical health outcomes, it is further strengthened when considered in conjunction with the Job Demand Control model. For example, Niedhammer et al. (2006) investigated the health outcomes of workers in a company that distributed publications. In light of the Job Demand Control model, results indicated that, among male workers, job strain served as a risk factor for depressive symptoms, likely due to low levels of control and decision-making authority among such workers. In addition, women who experienced low levels of social support, an additional component of the Job Demand Control model, were at a greater risk for depressive symptoms. When viewed in light of ERI model, the data indicated that, among male workers, this imbalance was associated with depressive symptoms and psychiatric disorders, possibly due to low rewards and job instability. Taken together, the two models provided a more well-rounded picture of the association between work-related factors, including strain, social support, and an imbalance between effort and reward, upon the occurrence of depressive symptoms which is a negative health outcome. Moreover, Siegrist, Dagmar Starke, Chandola, Godin, Marmot, Niedhammer, and Peter (2004) agree with Niedhammer et al about ERI by suggesting that the consequences of occupational stress are related to the balance between the amount of effort an employee puts in the job and the level of rewards they receive such as money, self-esteem, and job security that can be gained from the effort put forth. The model further argues that those who are excessively motivated to be committed to their jobs may expose themselves to high work demands or they might exaggerate their efforts beyond what is required for a particular job. For example, employees might flatter their supervisors to make them feel worthy of them in order to receive a type of monetary reward.

Depressive symptoms are but one of many negative health outcomes that could occur when perceived effort does not correspond with perceived rewards (Martin-Fernandez, Gomez-Gascon, Beamud-Lagos, Cortes-Rubio, & Alberquilla-Menendez-Asenjo, 2007). Preckel, Meinel, Kudielka, Huag, and Fischer (2007) reported on the effects of ERI upon the health outcomes of skilled workers within an aircraft manufacturing plant. Results indicated that over-commitment, a third dimension to this model, increased the risk of poor health outcomes, including self-reported health-related quality of life factors such as physical functioning; freedom from pain; vitality; vital exhaustion, characterized by loss of energy, trouble sleeping, irritability, and apathy; depressed mood; and negative affectivity. Another research study suggested that in a nursing profession, burnout and the desire to leave that profession, positively correlated with imbalances between efforts and rewards (Hasselhorn, Tackenberg, & Peter, 2004). However, the notion of “rewards” is subjective in nature, with some individuals placing higher value on certain rewards that may be deemed unimportant to others.

Voltmer, Kieschke, Schwappach, Wirsching, and Spahn (2008) attempted to further clarify the relationship between efforts/rewards and health outcomes by categorizing individuals according to correlated psychosocial factors and outcomes. In their study of medical students and physicians, the authors gathered data concerning professional commitment, resistance to stress, and emotional well-being. Based upon the specific health risks that correlated with each of these work-related behaviors, researchers identified four categories of individuals. Type “G” or the Healthy Ambitious Type individuals are ambitious at work but remain capable of maintaining a healthy emotional distance from the environment. Such behaviors correlated with resistance to stress and positive emotions. The second type of individual, Type “S” or the Unambitious Type, demonstrated lower commitment to work and a higher sense of detachment from the work environment. However, individuals in this group also scored well on measures of inner balance, satisfaction with life, and social support, indicating an overall sense of commitment with their personal lives. Like Type G individuals, members of this group did not experience any significant negative health outcomes; however, the lack of motivation was identified as one negative outcome.

The remaining two groups of individuals demonstrated negative health outcomes related to behaviors at work. “Type A” individuals, described as excessively ambitious, were characterized by excessive commitment to their work and difficulty maintaining an emotional distance from that environment. Health outcomes for these individuals included higher risk for coronary artery disease and myocardial infarction. “Type B” individuals, defined as “resigned” demonstrated low scores for professional commitment, emotional distancing, and coping skills. Outcomes for these individuals included greater risk for mental instability, dissatisfaction with work and life, and limited social support, all of which are related to job burnout. This study clearly illustrates the main premise of the Effect/Reward Imbalance model in that psychosocial factors related to the work environment serve as risk factors for physical and mental health outcomes.

Person-Environment Fit

The Person-Environment Fit Model or P-E Fit explains that positive outcomes occur when individuals are closely matched to their work environment with respect to career-relevant personality type (Carless, 2005). Since individuals are often unique in regards to personal qualities, abilities, coping skills, and needs, different individuals may perceive the same job in different ways. What one person views as being demanding and stressful, another employee may regard the same situation as challenging and exciting. Thus, based upon this theory, it is important to closely match an employee’s unique characteristics with specific qualities of jobs. Occupational stress is lessened when an appropriate match exists between the work environment and the individual; however, when a poor match exists, occupational stress may be quite high (Bamber, 2006).

According to the literature, several different types of fit occur within the realm of P-E Fit: these include Person-Organization Fit, Person-Job Fit, and Person-Innovation Fit. Carless (2005) described Person-Job fit as match between an individual’s knowledge, skills, and abilities and job or personal demands and what the job provides. When these two dimensions closely match, positive outcomes occur, such as low attrition rate, high work performance, low turnover, and high job satisfaction. Person-Organization fit refers to the similarity that exists between the individual’s and the organization’s wants, needs, and characteristics. Individuals who perceive that an organization closely mirrors their own values, personality, attitudes, and goals are more likely to seek out and accept employment there.

Person-Innovation fit, a more recent development based upon the Person-Environment fit model, explains how people respond to innovations and predicts the outcomes of innovation implementation on an individual level. Values and abilities are two distinct attributes associated with the concept of innovation. The values attribute refers to the perceived values and goals underlying the innovation, while the abilities attribute refers to skills, knowledge, and expertise needed for successful implementation of innovation. Past research has shown that different types of person-innovation fit predict different types of individual outcomes. To be specific, job satisfaction, well-being and low stress is closely correlated with value-fit. While the value-fit correlates with affective outcomes, abilities-fit correlates with behavioral outcomes such as the use of technology or innovation and innovation implementation efforts (Choi & Price, 2005).

In addition to the characteristics associated with these three types of fit, including knowledge, skills, abilities, wants, needs, and values, another variation on the Person-Environment fit focuses upon an individual’s interests. The Interest-Vocation fit suggests that a person’s interests play a role in job satisfaction equal to the role played by skills and abilities. Furthermore, these factors are closely related, as research indicates that among some individuals, Interest-Vocation fit positively correlates with cognitive ability. More specifically, among individuals whose interests lie mostly in the artistic domains, high cognitive ability positively correlates with successful Interest-Vocation fit. Individuals with high cognitive ability whose interests are characterized as conventional or realists were less likely to participate in vocations that matched their interests than their lower-cognitive ability counterparts (Reeve & Heggestad, 2004). In spite of the support found in the literature for the applicability of Person-Environment fit model in predicting factors such as work stress, criticism does exist. Bright and Pryor (2005), for example, discussed a number of these criticisms found in the literature. According to these authors, one problem with the model is that the interaction between the person and the environment is characterized in terms of traits. These traits, along with the concepts of “persons” and “environment” represent static ideas that do not reflect the changing nature of today’s work environment. Other problems with this model include inadequate conceptualization and measurement within the literature with regards to the terms “person” and “environment” and the failure to incorporate the complexities and uncertainties associated with a changing job environment into the model.

Coping

Coping with stress has become a crucial area for research in reducing workers’ perceived level of stress. The focus on coping and ways in which it can reduce the levels of stress and promote a quality of life that is healthy has received abundant attention. According to Folkman and Laza