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Effort-Reward Imbalance and Post-Traumatic Stress After a Workplace Terror Attack

Published online by Cambridge University Press:  08 January 2016

Camilla Hem ,
Morten Birkeland Nielsen ,
Marianne Bang Hansen  and
Trond Heir
Camilla Hem*
Affiliation:
Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
Morten Birkeland Nielsen
Affiliation:
National Institute of Occupational Health and Department of Psychosocial Science, University of Bergen, Bergen, Norway
Marianne Bang Hansen
Affiliation:
Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
Trond Heir
Affiliation:
Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
*
Correspondence and reprint requests to Camilla Hem, Norwegian Centre for Violence and Traumatic Stress Studies, 181 Nydalen, 0409 Oslo, Norway (e-mail: camillahem.medisin@gmail.com).
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Abstract

Objective

Following adverse work conditions, health consequences can be explained by an imbalance between the effort made and the reward received. We investigated the association between extra effort, perceived reward, and post-traumatic stress disorder (PTSD). The Effort-Reward Imbalance Model was used to examine whether extra effort at work in the aftermath of a workplace-related terrorist attack affected the risk of PTSD and the effects of reward for extra effort from a leader or colleagues.

Methods

Cross-sectional data were collected 10 months after a terrorist attack in Norway in 2011. Out of 3520 Ministry employees invited, 1927 agreed to participate. Employees reported any extra effort performed as a result of the bomb explosion and any reward received from a leader or colleagues. PTSD was assessed with the PTSD Checklist.

Results

Employees who reported extra effort displayed increased risk for PTSD (odds ratio [OR]=1.71, 95% confidence interval [CI]: 1.15-2.55, P=0.008). Perceived reward for extra effort from a leader was associated with lower risk for PTSD (OR=0.39, 95% CI: 0.23-0.64, P<0.001) but not perceived reward from colleagues.

Conclusions

Extra effort may increase the risk of PTSD, but reward from a leader may mitigate this effect. The Effort-Reward Imbalance Model appears to be an appropriate approach that may contribute to understanding of the etiology of work-related PTSD. (Disaster Med Public Health Preparedness. 2016;10:219–224)

Keywords

stress disorderspost-traumaticEffort-Reward Imbalance (ERI) Modeljob-stresssocial supportleadership
Type
Original Research
Information
Disaster Medicine and Public Health Preparedness , Volume 10 , Issue 2 , April 2016 , pp. 219 - 224
Copyright
Copyright © Society for Disaster Medicine and Public Health, Inc. 2016 

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