Association between work stress and depression differs across cultures

A study of data on the association between work stress and depression from 100 world countries revealed that this association depends on certain characteristics of the national culture. While this link was stronger in cultures with pronounced power distance and individualism, it was weaker in cultures with pronounced masculinity, uncertainty avoidance, and long-term orientation. The study was published in Cross-Cultural Research.

Work stress is a globally widespread cause of social and economic adversities. It can lead to depression, which can in turn lead to suicide. In the USA alone, work stress is estimated to inflict several hundred billion dollars annually through accidents, absence from work, reduced productivity, medical expenses and employees leaving jobs.

However, previous studies have indicated that the link between work stress and depression depends on psychological appraisal of work events as work stress and on the person’s appraisal of his/her own potential to cope with such events. Both of these appraisals are known to be affected by cultural factors. Research has also demonstrated that national culture can predict other factors linked to depression such as anxiety.

To systematize differences between cultures, the researchers relied on the theory of cultural differences of Geert Hofstede that proposes a number of dimensions of cultural differences. Power distance determines what levels of inequality in power are acceptable to people at the bottom of the social hierarchy. Individualism-collectivism differentiates cultures in which a person is expected to prioritize his/her own wishes and desires over those of the wider social group from those where a person is expected to put group priorities before his/her own.

On the other hand, collectivist cultures have strong group connections that can buffer stress, depression and suicide, which are absent in highly individualistic cultures. Masculinity-femininity refers to how much activities are divided by gender, while uncertainty avoidance reflects the level to which cultures are tolerant or feel threatened by behaviors of others that do not conform to usual norms.

Finally, long- vs short-term orientation differentiates cultures that value perseverance and thrift, organization of social relations in accordance with the social status of a person and the feeling of shame, from cultures that value social relations that are based on reciprocal commitments, respect for tradition, protection of personal credibility and stability. Study authors hypothesize that all of these dimensions affect the association between work stress and depression, each in its own way.

To test these hypotheses, study authors analyzed data from 5918 clinical trials on mental health issues conducted between 1999 and 2020 in 100 countries. These trials included data on whether a person had depression or not and whether a person was experiencing work stress or not. Both variables were Yes-No coded. Researchers added values of cultural dimensions to these data based on the country where the trial was conducted.

Results showed that it was 11 times more likely for work stress to lead to depression than for work stress not to lead to depression. The cultural dimension of power distance increased these odds from 11 to 38, while individualism increased them from 11 to 148. Masculinity did not significantly change the odds of work stress being associated with depression.

Long-term orientation decreased it from 11 to 4.7. Uncertainty avoidance completely cancelled the link between work stress and depression. The researchers explain this by noting that uncertainty avoidance decreases life satisfaction, general life-happiness and subjective well-being. Thus, by directly negatively affecting mental health, it may also blanket the link between work stress and depression.

It should be noted that these values do not indicate the prevalence of depression in these countries, but only how strong the association between work stress and depression is i.e., how sure we can be that work stress people experiencing work stress will also experience depression.

The study offers important insight into the way cultural factors affect the relationship between depression and work stress. However, it should be noted that 40% of the sample of clinical trials used comes from the U.S. and also that it consisted of people who were in one way or another involved in clinical trials related to mental health.

Results on samples more representative of the general populations of world countries might not yield equal results. Additionally, the study design does not allow for any cause-and-effect conclusions.

The study, “National Cultural Moderates the Link Between Work Stress and Depression: An Analysis of Clinical Trial Projects Across Countries”, was authored by Tariq H. Malik and Chunhui Huo.

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