research paper stress strain

• A-Z Publications

Annual Review of Psychology

Volume 72, 2021, review article, stress and health: a review of psychobiological processes.

• Daryl B. O'Connor 1 , Julian F. Thayer 2 , and Kavita Vedhara 3
• View Affiliations Hide Affiliations Affiliations: 1 School of Psychology, University of Leeds, Leeds LS2 9JT, United Kingdom; email: [email protected] 2 Department of Psychological Science, School of Social Ecology, University of California, Irvine, California 92697, USA; email: [email protected] 3 Division of Primary Care, School of Medicine, University of Nottingham, Nottingham NG7 2UH, United Kingdom; email: [email protected]
• Vol. 72:663-688 (Volume publication date January 2021) https://doi.org/10.1146/annurev-psych-062520-122331
• First published as a Review in Advance on September 04, 2020
• Copyright © 2021 by Annual Reviews. All rights reserved

The cumulative science linking stress to negative health outcomes is vast. Stress can affect health directly, through autonomic and neuroendocrine responses, but also indirectly, through changes in health behaviors. In this review, we present a brief overview of ( a ) why we should be interested in stress in the context of health; ( b ) the stress response and allostatic load; ( c ) some of the key biological mechanisms through which stress impacts health, such as by influencing hypothalamic-pituitary-adrenal axis regulation and cortisol dynamics, the autonomic nervous system, and gene expression; and ( d ) evidence of the clinical relevance of stress, exemplified through the risk of infectious diseases. The studies reviewed in this article confirm that stress has an impact on multiple biological systems. Future work ought to consider further the importance of early-life adversity and continue to explore how different biological systems interact in the context of stress and health processes.

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Introduction, three paradigms of stress research, complex pathways, acknowledgements.

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Stress and adolescent well-being: the need for an interdisciplinary framework

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Inga Dora Sigfusdottir, Alfgeir Logi Kristjansson, Thorolfur Thorlindsson, John P Allegrante, Stress and adolescent well-being: the need for an interdisciplinary framework, Health Promotion International , Volume 32, Issue 6, December 2017, Pages 1081–1090, https://doi.org/10.1093/heapro/daw038

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Stress and strain among adolescents have been investigated and discussed largely within three separate disciplines: mental health, where the focus has been on the negative effects of stress on emotional health; criminology, where the emphasis has been on the effects of strain on delinquency; and biology, where the focus has been to understand the effects of stress on physiology. Recently, scholars have called for increased multilevel developmental analyses of the bio-psychosocial nature of risk and protection for behaviors of individuals. This paper draws on several different but converging theoretical perspectives in an attempt to provide an overview of research relevant to stress in adolescence and puts forth a new framework that aims to provide both a common language and consilience by which future research can analyze the effects of multiple biological, social and environmental factors experienced during specific developmental periods, and cumulatively over time, on harmful behavior during adolescence. We present a framework to examine the effects of stress on diverse behavioral outcomes among adolescents, including substance use, suicidal behavior, self-inflicted harm, and delinquency.

Adolescent substance use, self-harm, suicides and delinquency are large-scale problems in most economically advanced societies and of growing concern in developing countries. According to the most recent United Nations drug report, almost one-quarter of a billion people used illicit drugs in 2013 ( United Nations Office on Drugs and Crime, 2015 ). Around 1 in 10 of these users will become addicted, but drug abuse kills around 200 000 people worldwide each year ( United Nations Office on Drugs and Crime, 2015 ). In this context, it is important to note that most drug abusers initiate their use during adolescence ( Sigfusdottir et al. , 2009 ). According to Selfharm UK, it is thought that as many as 13% of young people between the ages of 11 and 16 may intentionally try to hurt themselves at some point ( Selfharm UK, 2015 ). New figures published in 2014 suggested a 70% increase in 10–14 year olds attending accident and emergency hospital departments for self-harm-related reasons over the preceding 2 years ( Selfharm UK, 2015 ). In addition, both substance abuse and self-inflicted harm are positively related to delinquent behaviors such as engaging in stealing, vandalism and violence ( Hirschi, 1969 ; Agnew, 2006 ). All these behavioral problems are also positively related to a host of additional issues in adolescents such as depressed mood ( Mann et al. , 2014 ) and increased risk of school drop-out ( Kristjansson et al. , 2008 ). Without attempting to mitigate the above-mentioned harmful behaviors, of an even graver concern are suicides, which have increased by 60% worldwide during the last four decades and are now among the three leading causes of death in this age group ( Wasserman et al ., 2005 ; www.Suicide.org ).

Often, these problems arise when young people experience major stress in their lives and/or are the result of being born into adverse circumstances. Although quite a lot is known about the effects of stress, there are still major gaps in our knowledge, especially in relation to how stress affects physiological and emotional reactions, and harmful behavior. An important reason for this lack of understanding is the fact that studies of the social environment and human biology have developed largely as independent scientific disciplines. Currently, there is an emerging consensus that integrating factors at multiple biological and social levels is necessary in order to further our knowledge of human health and behavior ( D'Onorfio and Lahey, 2010 ). It is, however, not an easy task to overcome the current disciplinary-based paradigms that are deeply rooted in the organizations of universities, funding agencies, and science policies. Often, studies that concern closely related topics, have developed along the lines of independent scientific disciplines in separate or even parallel ways, using different terminology for similar issues. An example of this can be found in public health and the lack of explicit theoretical and methodological linkages that exist between the disciplines of epidemiology and criminology in their work with marginalized populations ( Akers and Lanier, 2009 ). The concepts with which the two disciplines work essentially have the same meaning but are addressed differently within the disciplines; more theoretically within criminology, and more practically within public health. Research on the important topic of stress is another good example of this. Various disciplines have identified stress as a key variable in relation to health and social problems. We do, however, lack research that brings together knowledge from the various scientific disciplines in a coherent study on stress. One reason for this is the divide between social sciences that focus predominantly on the social environment and behaviors and the natural sciences that concern the human body and biology. We simply do not have the kind of studies that include both refined measurement of social contexts and sophisticated measurement of biological processes that are relevant to understanding specific health problems. Only recently, in part because of the emergence of new technologies, have behavioral scientists begun to think simultaneously about the relevant social and biological mechanisms in the context of an integrated, multilevel developmental analytic framework in order to understand the processes and pathways through which the environment, social circumstances and biology interact to influence healthy adolescent development. As Cullen ( Cullen, 2011) points out, social scientists can no longer pretend that biology is not a part of human behavior and thus an important part of harmful behavior. At the same time, we no longer need to fear that combining biology and social data will lead to ‘blaming the victim’, social engineering or biological reductionism. Ever since the human genome was sequenced in 2001, we have become more aware of the fact that the link between biology and environment is much more complex than we had thought. Studies have, for example, shown that increased maternal care given to rat pups permanently enhances the expression of a certain gene in areas of the brain that eventually affect the ways the animals react to stress ( Francis, 1999 ; Weaver et al. , 2004 ). These studies have provided us with evidence that we have moved beyond the nature–nurture conundrum. We now know that just as our environment is potentially modifiable, our biology is flexible, and may be largely dependent on social processes, and that the two work in tandem to shape the individual and the life course ( Rafter, 2008 ). In line with that, Francis and Kaufer ( Francis and Kaufer, 2011) recently argued that we should finally abandon the nature versus nurture debate and focus on understanding the mechanisms through which our biology and environments are intertwined and affect each other throughout people's lives.

In this paper, we propose a multilevel developmental framework that we believe can be used to examine the influence of stress factors on diverse behavioral outcomes among adolescents, including substance use, suicidal behavior, self-inflicted harm and delinquency. Drawing on biological, social and health theories, as well as plethora of research on the effects of stress on physiology, emotions and behavior, we put forth a framework that brings together three different paradigms. We describe the effects of multiple environmental factors experienced during specific developmental periods, and cumulatively over time, on behavior during adolescence, and we elaborate on the bio-social link between stress, physiology, emotions and behavior. Our aim is not to put forth a holistic integrated theory on the effects of stress on adolescent behavior, but rather to call the attention of the scholarly communities to the overlap in knowledge, the increasingly critical importance of consilience and the potential benefit of making scholars in the various communities familiar with the works of each other.

Three main paradigms have been developed and used over several decades to examine and understand the effects of stress on health and behavior. The first one is rooted in biology and focuses on the concept of allostatic load (AL) to capture the cumulative biological burden exacted on the body from repeated attempts to adapt to life's demands ( Seeman et al. , 2001 ). The second paradigm stems from the mental health literature and focuses on the negative effects of stress on emotional and mental health ( Dohrenwend and Dohrenwend, 1969 ; Aneshensel et al. , 1991 ). The third paradigm is rooted in criminology/sociology of deviance and studies the effects of what is labeled ‘strain’ on delinquent behavior ( Merton, 1938 ; Cohen, 1955 ; Cloward and Ohlin, 1960 ).

We argue that the main difference between these three paradigms on the effects of stress on health and behavior is that they study stress on different levels; physiological, psychological, behavioral and group or community levels using different theoretical perspectives, different terminology and often focusing on different variables. For example, the various disciplines have discussed the effects of stress and strain on separate outcomes. The health sciences have focused on the effects on physiological reactions, psychology on analyzing the effects on emotional reactions and mental health and some criminologists and sociologists on the effects of stress and strain on behavior, whereas other sociologists and criminologists have focused on the rates of sickness or crime within groups and the collective efficacy of communities or even populations to counteract health risks and problem behavior ( Sampson et al. , 1999 ). The focus within different fields has also been on diverse levels at which stress/strain is created. Some sociologists and criminologists, for example, have focused on the larger structure of society and the links between social structure and the health-related problems of communities and populations, while research on stress and health within biology and mental health disciplines have placed greater emphasis on different stress exposures experienced by individuals, for example, in the form of negative life events or clinically diagnosed conditions such as depression or anxiety disorders. Hence, there are numerous social factors and conditions that may influence or increase the likelihood of stress and strain; originating within the broader organization of society, in negative life events that include both chronic stressors, such as persistent family conflicts, and acute events, such as a sudden death of a parent. We believe that considerably more knowledge on the processes of how stress leads to physiological, emotional and behavioral outcomes is a necessary prerequisite for understanding stress-related health problems. Below we discuss the different aspects of the three paradigms.

Stress and physiology

The first paradigm is rooted in biology and focuses on the effects of stress on physiological reactions. While humans have evolved to cope well with the occasional instances of acute stress caused by life-threatening events, recurrent activation of the body's stress response, particularly if the individual lacks coping resources, may have harmful effects on the body's physiology in the long run. The hypothalamus–pituitary–adrenal axis (HPA) and the sympathetic adrenal medullary system (SAM) are considered primary mediators through which all stressors activate a common set of physiological pathways. These systems stimulate adaptation or ‘allostasis’ as defined by Sterling and Eyer ( Sterling and Eyer, 1988) . In the short term, allostasis allows us to adapt to a wide range of stressors, but when frequent or excessive demands push allostatic processes beyond their normal operating ranges, wear and tear at the cellular level follows. AL is the result, representing the cumulative impact of stressors on the body's regulatory systems, with AL contributing to outcomes such as poor mental and physical health outcomes ( Danese and McEwen, 2012 ).

Prior research has empirically supported some of the pathways by which stress influences physiology. For example, low socioeconomic status and poor interpersonal relationship histories have been associated with increased AL in a number of community-based cohorts ( Johnson et al. , 1992 ; Karlamangla et al. , 2002 ; Seplaki et al. , 2006 ) and prospective research has associated AL at baseline with increased risk for all-cause mortality, cardiovascular disease and declines in cognitive and physical functioning. Family environments, social conditions and psychological processes have in this way been shown to affect biological processes and biological functioning and predispositions influence the ways in which an individual selects and is shaped by the environment ( Rutter, 2002 ; Repetti et al. , 2011 ). All-in-all, research to date suggests that there are multiple interconnected biological systems that respond to psychosocial stress and influence each other. Hence, minor alterations in one system due to psychosocial stress may influence the functioning of the other(s).

Stress and emotions

Based on findings showing that stressful life events contribute to the onset and course of mental symptoms and disorders, the social stress model has guided efforts to examine social experiences and circumstances that are associated with variations in risk for mental health problems ( Dohrenwend and Dohrenwend, 1969 ; Turner et al. , 1995 ; Pearlin, 1999 ). The underlying assumption of the model is that variations in stress exposure are closely related to individual life conditions and social circumstances. In line with this reasoning, Aneshensel ( Aneshensel, 1992) called for a reorientation away from viewing stress as an isolated risk factor and toward its consideration as a link in a causal chain beginning with social conditions and ending with differences in risk for psychological distress. Numerous studies have supported the social stress model. Hence, both negative life events and chronic strain in the form of poverty, family conflict or abuse have been found to predict emotional problems ( Dohrenwend, 1990 ; Aneshensel et al. , 1991 ; Aneshensel, 1992 ; Turner and Lloyd, 1999 ; Ross, 2000 ).

The process through which stress affects emotions is obviously complicated. Understanding the underlying biological systems is a vital piece in this puzzle. A body of research has implicated disturbances in the HPA axis stress response system in the development of depression ( Murray et al. , 2010 ). Researchers have also suggested that perturbations of cortisol may represent a risk factor for the development of depression. Thus, Goodyer et al . ( Goodyer et al. , 2000) studied a sample of high-risk adolescents and found that the occurrence of one or more very high morning cortisol values over several days of salivary collection predicted the onset of depressive disorder in the subsequent 12 months. Adam et al . ( Adam et al. , 2010) reported similar findings, showing that a larger increase in cortisol in the 30 min after waking (i.e. the cortisol awakening response) predicted onsets of depression over the subsequent year among adolescents at risk for depression due to high levels of neuroticism. High levels of negative mood and life events at baseline also independently predicted onsets of depression in the same study.

Stress, social environment and social structure

It is now widely recognized that the social environment and social relationships can have powerful effects on health and behavioral outcomes. However, several studies underscore the complexity of capturing the social influences at various levels ( Brooks-Gunn et al. , 1993 ; Duncan and Raudenbush, 1999 ; Sampson, et al. , 1999 , 2002 ; Bernburg et al. , 2009a , b , c ). Colvin et al . ( Colvin et al. , 2002) emphasize that it is important to note that coercion can happen both at the micro level of interpersonal relations and at the macro level, where it includes economic and social pressure, created by social circumstances such as structural poverty, unemployment and conflict among groups. Thus, strain and conflict at the social and the neighborhood levels may influence the level of stress among groups or individuals. Merton's influential strain theory is good example of this complexity of levels. His ( Merton, 1938 ) classic theory of anomie describes how shared ideology of equal opportunity conflicts with cultural and social constraints that reduce or even hinder certain groups to achieve desirable social goals and may cause strain that is experienced as stress at both the group and individual level. Thus, Merton's theory of anomie and strain has inspired several sociological and criminological theories of the influence of social conditions on individuals ( Merton, 1938 ; Cohen, 1955 ; Cloward and Ohlin, 1960 ). Merton's ( Merton, 1938) theory of anomie also suggests that these cultural and social constraints may cause conflict and strain by hindering certain groups of adolescents to achieve desirable social goals. Researchers that have focused on these group effects of Merton's theory have described how community characteristics influence the life of children and adolescents over and beyond their individual-level experiences ( Brooks-Gunn et al. , 1991 , 1993 ; Kawachi et al. , 1997 ; Sampson et al. , 1999 ; Leventhal and Brooks-Gunn, 2000 ; Bernburg et al. , 2009a ).

Below, we discuss the individual and the community aspects of the social paradigm separately. But before we do that, we would like to make two points regarding this issue. First, while the physiological and psychological paradigms focus on the individual as a unit of analysis, the sociological paradigm operates on two different levels ( Duncan and Raudenbush, 1999 ; Sampson et al. , 1999 ; Billari, 2015 ). Recent advances in multilevel modeling have made it possible to analyze both the group and the individual level. In other words, we now can analyze the group level controlling for individual-level effects. Secondly, the same social mechanisms can operate on two different levels, for example, family conflict may exist between individual spouses, but they may also be influenced by community processes ( Bernburg et al. , 2009c ).

Individual-level effects

Several individual-level theories of stress research, which build on Merton's anomie theory, focus on the effects of strain on delinquent behavior. In 1992, Agnew put forth a revised version of strain theory, which he calls general strain theory (GST). GST combines aspects from different previously developed theories, including those on stress, equity/justice and aggression, to explain the effects of strain on harmful behavior among adolescents. Unlike prior strain theories, GST argues that adolescents are not only concerned with future goals of monetary success and middle class status but are also concerned about more immediate goals, such as doing well at school and being popular among peers. The theory proposes that social conditions may cause strain or blockage that frustrates adolescents and may lead to harmful behaviors.

While Agnew recognizes that there are many opportunities for individuals to experience strain, GST subsumes strain under three broad categories. First, strain may arise because individuals fail to achieve goals that they value. Secondly, GST maintains that strain arises if individuals experience threat or actual removal of valued stimuli, i.e. when individuals lose something that they value, for example, a boy- or girlfriend or when they need to leave their school and attend a new one. Thirdly, strain may emanate from the presentation of negative situations or events. This type of strain reflects the problems that arise for individuals when they experience adverse situations that they cannot legally escape from, such as family conflict, victimization or child abuse. GST proposes that adolescents are sometimes pressed into delinquency by negative emotional reactions that result from strain. In response to strain and its consequent negative emotional states, therefore, adolescents can respond with acts of theft, violence, vandalism and drug and/or alcohol use. Hence, GST can potentially explain a diverse range of delinquent behaviors, and provides an appropriate framework in the discussion on the effects of stress on multiple different outcomes, such as substance use, self-harm, suicides and delinquency.

A number of studies have provided support for GST, showing that strain leads to harmful behavior through negative emotional reactions. For the first 10 years, tests of the theory mainly focused on anger as the critical emotional reaction ( Mazerolle and Piquero, 1998 ; Aseltine et al. , 2000 ; Mazerolle et al. , 2000 ; Capowich et al. , 2001 ).

This was because anger results when individuals blame their adversity on others. It increases the individual's level of perceived injury, creates a desire for retaliation, energizes the individual for action and lowers inhibitions. However, results on the effects of strain on delinquent behavior mediated through anger were somewhat mixed. While extensive evidence has shown that higher levels of anger in adolescence are associated with a host of adverse psychosocial outcomes during that time period and in later life (e.g. Evans and English, 2002 ; Wittmann et al. , 2008 ; Midei and Matthews, 2009 ; Sigfusdottir and Silver, 2009 ; Sigfusdottir et al. , 2010 ), other studies have not revealed anger to be a key mediator ( Unnever et al. , 2004 ).

In line with these findings, scholars have pointed out that anger is not the only emotion likely to arise under stress and highlighted the importance of furthering our understanding of different emotions as mediating factors in this relationship ( Sigfusdottir et al. , 2004 ). In recent years, studies have shown that although anger and depressed mood are highly correlated emotions, comorbidity does not mean that these emotions are similar in their relations to behavioral outcomes ( Sigfusdottir et al. , 2004 , 2008 ; Asgeirsdottir et al. , 2011 ). Whereas anger energizes the individual for action, lowers inhibitions and hence increases externalizing behavior, depressed mood is not related to this type of behavior. Similarly, depressed mood is highly associated with certain kinds of (internalizing) behavior, such as suicidal ideation and self-harm, while anger is a much weaker predictor of those behaviors. These findings have added to our understanding of the implications of the interrelatedness between these phenomena, showing that whereas depressed mood and anger are overlapping phenomena, they are separate in their relations to behavioral outcomes. At the same time, they have revealed how complicated this process is, and the fact that the way adverse circumstances translate into behavior is still little understood. For example, a recent paper on family conflict/violence and sexual abuse, and suicidal ideation and attempt showed that even though depressed mood and anger were highly comorbid, co-occurring to a high degree, they differed in their behavioral outcomes; depressed mood was more strongly associated with suicidal ideation, whereas anger was more strongly related to suicidal attempts ( Sigfusdottir et al. , 2013 ). Furthermore, the complexity of the associations between stress, emotional reactions and harmful behavior become apparent when considering the findings that; when controlling for anger, depressed mood is strongly related to suicidal ideation and remains also quite strongly related to suicidal attempt, but when controlling for depressed mood, anger is only related to suicidal attempt.

Community-level effects

Merton's ( Merton, 1938) theory of Anomie suggests that some societal or neighborhood factors are contextual in the sense that they cannot be reduced to individual-level experience. They describe how community characteristics influence the life of children and adolescents over and beyond their individual-level experiences. It is therefore important to incorporate higher-level measures on the local community level and policy environment (e.g. counties, districts) that may now be studied in conjunction with individual-level outcomes using multilevel analysis techniques (e.g. hierarchical linear models, growth curve models, multilevel structural equation models). Such approaches provide an important way to study how community characteristics influence the life of children and adolescents in combination with individual characteristics. Studies on community-level stress have focused on important structural factors, such as community poverty, neighborhood instability, inequality and relative deprivation ( Brooks-Gunn et al. , 1991 , 1993 ; Kawachi et al. , 1997 ; Sampson et al. , 1999 ; Leventhal and Brooks-Gunn, 2000 ; Bernburg et al. , 2009a ). For example, community levels of family conflict influence not only the likelihood of harmful behavior among adolescents that experience disruption personally, but also that higher aggregated community levels of disrupted family processes increase the likelihood of harmful behavior among all adolescents in such communities ( Bernburg et al. , 2009c ). This point is important, especially given the central role that families play in many theories of child and adolescent harmful behavior ( Hirschi, 1969 ; Agnew, 1992 ; Sampson and Laub, 1993 ). The recent multilevel findings indicate that research on the effect of stress, including family conflict on adolescent behavior, should not be limited to individual-level analysis. Time and age also appear to matter in this respect; Odgers et al . have recently shown that neighborhood effects on child outcomes may be detected as early as from the age of 5, and that this association tends to increase over time ( Odgers et al. , 2012 ). In order to fully understand the processes through which neighborhoods affect individuals, we need to focus not only on the link between neighborhood characteristics and behavioral outcomes, but also on the mediating mechanisms in the form of emotional and biological responses. Recently, Wallace ( Wallace, 2012) made an important point by suggesting that disorder needs to invoke feelings of fear in order to affect peoples' health. Hence, it is necessary to study not only the main effects of neighborhood characteristics on outcomes, but to include possible mediating mechanisms, in the form of emotional reactions and biological responses. The framework we are putting forth proposes that stress, including neighborhood stress, affects behavior through both physiological and emotional reactions. Hence, the framework argues for the need to capture neighborhood characteristics all at once, is fit for neighborhood modeling and includes a variety of individual-level survey and biomarker measures. Recent findings indicate that research on the effect of stress, including family conflict on adolescent behavior, should not be limited to individual-level analysis, therefore adding a new dimension to previous research paradigms. In short, prior findings from multilevel analysis show that limiting research to the individual-level approach provides an incomplete account of the effects that the social environment has on children and adolescents.

Each of the three paradigms above have guided studies showing that stress affects our physiology, emotions and behavior. However, the relationships between stress, physiology, emotions, behavior, and social structure are complex. Exactly how stress translates into outcomes such as harmful behavior is little understood. Hence, it is highly likely that whether or not an environmental stress becomes relevant to an individual does not only depend on how often a stressor occurs and how severe it is, but how strongly the individual physiologically, and emotionally, reacts to stress. To corroborate the view of how complicated this process is, recent studies on disruption of the HPA axis and cortisol production paint an inconsistent picture on its relations with emotional reactions ( Tyrka et al. , 2010 ) and harmful behavior ( Sondeijker et al. , 2007 ; Ruttle et al. , 2011 ). In order to come closer than previous work has in estimating how environmental stress and strain may affect biological responses among adolescents, the framework presented in Figure  1  proposes that stress and strain at the community and individual levels affect physiological and emotional reactions along the early life to childhood continuum that can result in harmful behavior during adolescence.

Community-level stress and strain and the proposed pathways to harmful behavior, with associated measures.

This proposed multilevel developmental framework argues for the importance of examining the impact of stress on biological systems and specific emotions, as well as the interplay between these factors in order to elucidate the relevant pathways to different behavioral outcomes. The framework suggests that future studies examine in detail the influence of cumulative as well as specific stressors on emotional reactions, while identifying essential moderators and the potential mediating role of the biological systems in this relationship and the development of these pathways across important developmental transitions. The arrows connecting these factors to harmful behavioral outcomes in adolescence represent the pathways of primary interest. Thus, stress experienced early in life may have implications for harmful behavior in adolescence, through physiological and emotional reactions.

During the last 20 years, research with children and adolescents has linked stress to poor health and harmful behavior. Research has demonstrated that social conflict at various levels, ranging from societal levels to specific social groups, such as the family or peer groups, can increase stress that has harmful consequences for health and the well-being of children and adolescents. First, research at the societal level has shown how social environments can influence the consequences of stress. Secondly, research at the psychological level has demonstrated how stressful situations and life events interact with personal characteristics to produce harmful stress-related outcomes. Thirdly, research on stress at the biological level casts light on the biological and physiological mechanisms involved in the harmful influences of stress on human health. The diversity of concepts applied in the study of stress and strain mirrors the fact that the domain has been largely investigated and discussed within separate academic disciplines, each focusing on a certain level of analysis; with the biological sciences focusing on the effects of stress on physiological reactions, psychological sciences examining the effects of stress on emotional reactions and social sciences focusing on the effects of stress/strain on behavior. Within different fields, the focus has also been on diverse levels at which stress/strain is created, with sociologists and criminologists, for example, focusing on the larger structure of society and the links between social structure and population strain; they have mostly worked with the term strain and its effects on delinquency. Research on stress within health disciplines, however, has placed greater emphasis on different stress exposures experienced by individuals and their effects on individual mental and physical health.

There is no doubt that research at these different levels has furthered our understanding of the harmful effects of stress on the welfare of children and adolescents. But despite several decades of robust findings on the effects of adverse experiences on health and harmful behavior, major gaps still remain in our knowledge about the mechanisms through which adverse experiences work to increase the likelihood of poor health and harmful behavior during adolescence ( Cullen, 1994 ; Colvin et al. , 2002 ). We know, for instance, that exposure to, and experience of, stress increases the odds for later negative development, including emotional problems, deficits in physical health and even harmful behaviors. What we do not know is whether these odds are cumulative, can be quantified or can be reversed with external supportive interventions during early developmental stages and later adolescence.

We believe that bringing together knowledge from the various scientific disciplines in a coherent study on stress is critical for advancing our understanding of threats to adolescent well-being. Such an approach would have important implications for policies within education, criminal justice and physical and mental health. We propose that in order to come closer than previous work has in estimating how environmental stress may affect biological responses that in turn lead to different emotions and behavior among adolescents, a comprehensive research approach must form the basis for future empirical studies. Moreover, it is important to design longitudinal studies where data on participants are collected at several times over the lifespan, including data drawn on key variables from the pre-birth period, such as maternal and intrauterine factors. Developing a research design that allows us to combine developmental approaches and various contexts in a comprehensive and effective way is one of the major challenges for future research (see Duncan and Raudenbush, 1999 ). Also, to provide a basis for developing a novel and comprehensive understanding of adolescent health and harmful behavior, it is important to examine both mediating and moderating effects of social–environmental predictors on physiological, emotional and behavioral outcomes. By taking such a theoretical approach, we would overcome the methodological weaknesses that many studies focusing on the early determinants of children's environment on later outcomes have faced. Moreover, as pointed out in a recent review, clinical samples do not provide a comprehensive understanding of confounding and comorbid factors, as the thresholds of discrete conditions are already defined, while cross-sectional studies cannot enhance our understanding of developmental processes ( Thompson et al. , 2010 ). Thus, in addition to issues pertaining to research design, we argue that it is important to combine different theoretical paradigms of research on the effects of stress on behavioral outcomes.

It is important to capture variables from biological, individual and community levels in one comprehensive analysis. Such a holistic conceptual approach would allow us to disentangle how multiple environmental factors intertwine to produce greater odds for unhealthy development. To accomplish this task, we need to move beyond a narrow discipline-based approach by adding together viewpoints and methodological approaches from different fields. To facilitate such work, we need a universal language and uniform concepts and measures to describe similar processes that heretofore have been discussed using different terms within diverse disciplines. A prerequisite for such common language is a multilevel developmental framework, accompanied by empirical tests, telling us whether similar processes may be at work in different fields. The framework we have proposed provides such a prerequisite for investigating the effects of multiple-level factors, within the larger structure of society as well as in closer social circumstances of the individual, experienced during specific developmental periods, and cumulatively over time, on physiology, emotions and behavior in adolescence. Such a model would provide a unique opportunity to begin to understand the questions about whether the effects of stress may be conditioned by outside factors and what intervention approaches prove most beneficial in hindering harmful emotional and behavioral reactions to stress during adolescence.

This work was supported by a Project Grant (206580-21-22-23) from RANNIS, the Icelandic Centre for Research and a Research Consolidator Grant (ERC-CoG-2014—No. 647860) from the European Research Council.

We thank George Bonanno, Department of Clinical and Counseling Psychology, Teachers College, Columbia University, for offering insightful comments on an early draft of the manuscript. We also thank Ingibjorg Eva Thorisdottir, research assistant at Reykjavik University, and Lindsay Huffhines, Department of Community, Family, and Addiction Services, Texas Tech University (a Fulbright Student Program Scholar at Reykjavik University at the time), for their assistance in the preparation of the manuscript.

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Article contents

Work, stress, coping, and stress management.

• Sharon Glazer Sharon Glazer University of Baltimore
•  and  Cong Liu Cong Liu Hofstra University
• https://doi.org/10.1093/acrefore/9780190236557.013.30
• Published online: 26 April 2017

Work stress refers to the process of job stressors, or stimuli in the workplace, leading to strains, or negative responses or reactions. Organizational development refers to a process in which problems or opportunities in the work environment are identified, plans are made to remediate or capitalize on the stimuli, action is taken, and subsequently the results of the plans and actions are evaluated. When organizational development strategies are used to assess work stress in the workplace, the actions employed are various stress management interventions. Two key factors tying work stress and organizational development are the role of the person and the role of the environment. In order to cope with work-related stressors and manage strains, organizations must be able to identify and differentiate between factors in the environment that are potential sources of stressors and how individuals perceive those factors. Primary stress management interventions focus on preventing stressors from even presenting, such as by clearly articulating workers’ roles and providing necessary resources for employees to perform their job. Secondary stress management interventions focus on a person’s appraisal of job stressors as a threat or challenge, and the person’s ability to cope with the stressors (presuming sufficient internal resources, such as a sense of meaningfulness in life, or external resources, such as social support from a supervisor). When coping is not successful, strains may develop. Tertiary stress management interventions attempt to remediate strains, by addressing the consequence itself (e.g., diabetes management) and/or the source of the strain (e.g., reducing workload). The person and/or the organization may be the targets of the intervention. The ultimate goal of stress management interventions is to minimize problems in the work environment, intensify aspects of the work environment that create a sense of a quality work context, enable people to cope with stressors that might arise, and provide tools for employees and organizations to manage strains that might develop despite all best efforts to create a healthy workplace.

• stress management
• organization development
• organizational interventions
• stress theories and frameworks

Introduction

Work stress is a generic term that refers to work-related stimuli (aka job stressors) that may lead to physical, behavioral, or psychological consequences (i.e., strains) that affect both the health and well-being of the employee and the organization. Not all stressors lead to strains, but all strains are a result of stressors, actual or perceived. Common terms often used interchangeably with work stress are occupational stress, job stress, and work-related stress. Terms used interchangeably with job stressors include work stressors, and as the specificity of the type of stressor might include psychosocial stressor (referring to the psychological experience of work demands that have a social component, e.g., conflict between two people; Hauke, Flintrop, Brun, & Rugulies, 2011 ), hindrance stressor (i.e., a stressor that prevents goal attainment; Cavanaugh, Boswell, Roehling, & Boudreau, 2000 ), and challenge stressor (i.e., a stressor that is difficult, but attainable and possibly rewarding to attain; Cavanaugh et al., 2000 ).

Stress in the workplace continues to be a highly pervasive problem, having both direct negative effects on individuals experiencing it and companies paying for it, and indirect costs vis à vis lost productivity (Dopkeen & DuBois, 2014 ). For example, U.K. public civil servants’ work-related stress rose from 10.8% in 2006 to 22.4% in 2013 and about one-third of the workforce has taken more than 20 days of leave due to stress-related ill-health, while well over 50% are present at work when ill (French, 2015 ). These findings are consistent with a report by the International Labor Organization (ILO, 2012 ), whereby 50% to 60% of all workdays are lost due to absence attributed to factors associated with work stress.

The prevalence of work-related stress is not diminishing despite improvements in technology and employment rates. The sources of stress, such as workload, seem to exacerbate with improvements in technology (Coovert & Thompson, 2003 ). Moreover, accessibility through mobile technology and virtual computer terminals is linking people to their work more than ever before (ILO, 2012 ; Tarafdar, Tu, Ragu-Nathan, & Ragu-Nathan, 2007 ). Evidence of this kind of mobility and flexibility is further reinforced in a June 2007 survey of 4,025 email users (over 13 years of age); AOL reported that four in ten survey respondents reported planning their vacations around email accessibility and 83% checked their emails at least once a day while away (McMahon, 2007 ). Ironically, despite these mounting work-related stressors and clear financial and performance outcomes, some individuals are reporting they are less “stressed,” but only because “stress has become the new normal” (Jayson, 2012 , para. 4).

This new normal is likely the source of psychological and physiological illness. Siegrist ( 2010 ) contends that conditions in the workplace, particularly psychosocial stressors that are perceived as unfavorable relationships with others and self, and an increasingly sedentary lifestyle (reinforced with desk jobs) are increasingly contributing to cardiovascular disease. These factors together justify a need to continue on the path of helping individuals recognize and cope with deleterious stressors in the work environment and, equally important, to find ways to help organizations prevent harmful stressors over which they have control, as well as implement policies or mechanisms to help employees deal with these stressors and subsequent strains. Along with a greater focus on mitigating environmental constraints are interventions that can be used to prevent anxiety, poor attitudes toward the workplace conditions and arrangements, and subsequent cardiovascular illness, absenteeism, and poor job performance (Siegrist, 2010 ).

Even the ILO has presented guidance on how the workplace can help prevent harmful job stressors (aka hindrance stressors) or at least help workers cope with them. Consistent with the view that well-being is not the absence of stressors or strains and with the view that positive psychology offers a lens for proactively preventing stressors, the ILO promotes increasing preventative risk assessments, interventions to prevent and control stressors, transparent organizational communication, worker involvement in decision-making, networks and mechanisms for workplace social support, awareness of how working and living conditions interact, safety, health, and well-being in the organization (ILO, n.d. ). The field of industrial and organizational (IO) psychology supports the ILO’s recommendations.

IO psychology views work stress as the process of a person’s interaction with multiple aspects of the work environment, job design, and work conditions in the organization. Interventions to manage work stress, therefore, focus on the psychosocial factors of the person and his or her relationships with others and the socio-technical factors related to the work environment and work processes. Viewing work stress from the lens of the person and the environment stems from Kurt Lewin’s ( 1936 ) work that stipulates a person’s state of mental health and behaviors are a function of the person within a specific environment or situation. Aspects of the work environment that affect individuals’ mental states and behaviors include organizational hierarchy, organizational climate (including processes, policies, practices, and reward structures), resources to support a person’s ability to fulfill job duties, and management structure (including leadership). Job design refers to each contributor’s tasks and responsibilities for fulfilling goals associated with the work role. Finally, working conditions refers not only to the physical environment, but also the interpersonal relationships with other contributors.

Each of the conditions that are identified in the work environment may be perceived as potentially harmful or a threat to the person or as an opportunity. When a stressor is perceived as a threat to attaining desired goals or outcomes, the stressor may be labeled as a hindrance stressor (e.g., LePine, Podsakoff, & Lepine, 2005 ). When the stressor is perceived as an opportunity to attain a desired goal or end state, it may be labeled as a challenge stressor. According to LePine and colleagues’ ( 2005 ), both challenge (e.g., time urgency, workload) and hindrance (e.g., hassles, role ambiguity, role conflict) stressors could lead to strains (as measured by “anxiety, depersonalization, depression, emotional exhaustion, frustration, health complaints, hostility, illness, physical symptoms, and tension” [p. 767]). However, challenge stressors positively relate with motivation and performance, whereas hindrance stressors negatively relate with motivation and performance. Moreover, motivation and strains partially mediate the relationship between hindrance and challenge stressors with performance.

Figure 1. Organizational development frameworks to guide identification of work stress and interventions.

In order to (1) minimize any potential negative effects from stressors, (2) increase coping skills to deal with stressors, or (3) manage strains, organizational practitioners or consultants will devise organizational interventions geared toward prevention, coping, and/or stress management. Ultimately, toxic factors in the work environment can have deleterious effects on a person’s physical and psychological well-being, as well as on an organization’s total health. It behooves management to take stock of the organization’s health, which includes the health and well-being of its employees, if the organization wishes to thrive and be profitable. According to Page and Vella-Brodrick’s ( 2009 ) model of employee well-being, employee well-being results from subjective well-being (i.e., life satisfaction and general positive or negative affect), workplace well-being (composed of job satisfaction and work-specific positive or negative affect), and psychological well-being (e.g., self-acceptance, positive social relations, mastery, purpose in life). Job stressors that become unbearable are likely to negatively affect workplace well-being and thus overall employee well-being. Because work stress is a major organizational pain point and organizations often employ organizational consultants to help identify and remediate pain points, the focus here is on organizational development (OD) frameworks; several work stress frameworks are presented that together signal areas where organizations might focus efforts for change in employee behaviors, attitudes, and performance, as well as the organization’s performance and climate. Work stress, interventions, and several OD and stress frameworks are depicted in Figure 1 .

The goals are: (1) to conceptually define and clarify terms associated with stress and stress management, particularly focusing on organizational factors that contribute to stress and stress management, and (2) to present research that informs current knowledge and practices on workplace stress management strategies. Stressors and strains will be defined, leading OD and work stress frameworks that are used to organize and help organizations make sense of the work environment and the organization’s responsibility in stress management will be explored, and stress management will be explained as an overarching thematic label; an area of study and practice that focuses on prevention (primary) interventions, coping (secondary) interventions, and managing strains (tertiary) interventions; as well as the label typically used to denote tertiary interventions. Suggestions for future research and implications toward becoming a healthy organization are presented.

Defining Stressors and Strains

Work-related stressors or job stressors can lead to different kinds of strains individuals and organizations might experience. Various types of stress management interventions, guided by OD and work stress frameworks, may be employed to prevent or cope with job stressors and manage strains that develop(ed).

A job stressor is a stimulus external to an employee and a result of an employee’s work conditions. Example job stressors include organizational constraints, workplace mistreatments (such as abusive supervision, workplace ostracism, incivility, bullying), role stressors, workload, work-family conflicts, errors or mistakes, examinations and evaluations, and lack of structure (Jex & Beehr, 1991 ; Liu, Spector, & Shi, 2007 ; Narayanan, Menon, & Spector, 1999 ). Although stressors may be categorized as hindrances and challenges, there is not yet sufficient information to be able to propose which stress management interventions would better serve to reduce those hindrance stressors or to reduce strain-producing challenge stressors while reinforcing engagement-producing challenge stressors.

Organizational Constraints

Organizational constraints may be hindrance stressors as they prevent employees from translating their motivation and ability into high-level job performance (Peters & O’Connor, 1980 ). Peters and O’Connor ( 1988 ) defined 11 categories of organizational constraints: (1) job-related information, (2) budgetary support, (3) required support, (4) materials and supplies, (5) required services and help from others, (6) task preparation, (7) time availability, (8) the work environment, (9) scheduling of activities, (10) transportation, and (11) job-relevant authority. The inhibiting effect of organizational constraints may be due to the lack of, inadequacy of, or poor quality of these categories.

Workplace Mistreatment

Workplace mistreatment presents a cluster of interpersonal variables, such as interpersonal conflict, bullying, incivility, and workplace ostracism (Hershcovis, 2011 ; Tepper & Henle, 2011 ). Typical workplace mistreatment behaviors include gossiping, rude comments, showing favoritism, yelling, lying, and ignoring other people at work (Tepper & Henle, 2011 ). These variables relate to employees’ psychological well-being, physical well-being, work attitudes (e.g., job satisfaction and organizational commitment), and turnover intention (e.g., Hershcovis, 2011 ; Spector & Jex, 1998 ). Some researchers differentiated the source of mistreatment, such as mistreatment from one’s supervisor versus mistreatment from one’s coworker (e.g., Bruk-Lee & Spector, 2006 ; Frone, 2000 ; Liu, Liu, Spector, & Shi, 2011 ).

Role Stressors

Role stressors are demands, constraints, or opportunities a person perceives to be associated, and thus expected, with his or her work role(s) across various situations. Three commonly studied role stressors are role ambiguity, role conflict, and role overload (Glazer & Beehr, 2005 ; Kahn, Wolfe, Quinn, Snoek, & Rosenthal, 1964 ). Role ambiguity in the workplace occurs when an employee lacks clarity regarding what performance-related behaviors are expected of him or her. Role conflict refers to situations wherein an employee receives incompatible role requests from the same or different supervisors or the employee is asked to engage in work that impedes his or her performance in other work or nonwork roles or clashes with his or her values. Role overload refers to excessive demands and insufficient time (quantitative) or knowledge (qualitative) to complete the work. The construct is often used interchangeably with workload, though role overload focuses more on perceived expectations from others about one’s workload. These role stressors significantly relate to low job satisfaction, low organizational commitment, low job performance, high tension or anxiety, and high turnover intention (Abramis, 1994 ; Glazer & Beehr, 2005 ; Jackson & Schuler, 1985 ).

Excessive workload is one of the most salient stressors at work (e.g., Liu et al., 2007 ). There are two types of workload: quantitative and qualitative workload (LaRocco, Tetrick, & Meder, 1989 ; Parasuraman & Purohit, 2000 ). Quantitative workload refers to the excessive amount of work one has. In a summary of a Chartered Institute of Personnel & Development Report from 2006 , Dewe and Kompier ( 2008 ) noted that quantitative workload was one of the top three stressors workers experienced at work. Qualitative workload refers to the difficulty of work. Workload also differs by the type of the load. There are mental workload and physical workload (Dwyer & Ganster, 1991 ). Excessive physical workload may result in physical discomfort or illness. Excessive mental workload will cause psychological distress such as anxiety or frustration (Bowling & Kirkendall, 2012 ). Another factor affecting quantitative workload is interruptions (during the workday). Lin, Kain, and Fritz ( 2013 ) found that interruptions delay completion of job tasks, thus adding to the perception of workload.

Work-Family Conflict

Work-family conflict is a form of inter-role conflict in which demands from one’s work domain and one’s family domain are incompatible to some extent (Greenhaus & Beutell, 1985 ). Work can interfere with family (WIF) and/or family can interfere with work (FIW) due to time-related commitments to participating in one domain or another, incompatible behavioral expectations, or when strains in one domain carry over to the other (Greenhaus & Beutell, 1985 ). Work-family conflict significantly relates to work-related outcomes (e.g., job satisfaction, organizational commitment, turnover intention, burnout, absenteeism, job performance, job strains, career satisfaction, and organizational citizenship behaviors), family-related outcomes (e.g., marital satisfaction, family satisfaction, family-related performance, family-related strains), and domain-unspecific outcomes (e.g., life satisfaction, psychological strain, somatic or physical symptoms, depression, substance use or abuse, and anxiety; Amstad, Meier, Fasel, Elfering, & Semmer, 2011 ).

Individuals and organizations can experience work-related strains. Sometimes organizations will experience strains through the employee’s negative attitudes or strains, such as that a worker’s absence might yield lower production rates, which would roll up into an organizational metric of organizational performance. In the industrial and organizational (IO) psychology literature, organizational strains are mostly observed as macro-level indicators, such as health insurance costs, accident-free days, and pervasive problems with company morale. In contrast, individual strains, usually referred to as job strains, are internal to an employee. They are responses to work conditions and relate to health and well-being of employees. In other words, “job strains are adverse reactions employees have to job stressors” (Spector, Chen, & O’Connell, 2000 , p. 211). Job strains tend to fall into three categories: behavioral, physical, and psychological (Jex & Beehr, 1991 ).

Behavioral strains consist of actions that employees take in response to job stressors. Examples of behavioral strains include employees drinking alcohol in the workplace or intentionally calling in sick when they are not ill (Spector et al., 2000 ). Physical strains consist of health symptoms that are physiological in nature that employees contract in response to job stressors. Headaches and ulcers are examples of physical strains. Lastly, psychological strains are emotional reactions and attitudes that employees have in response to job stressors. Examples of psychological strains are job dissatisfaction, anxiety, and frustration (Spector et al., 2000 ). Interestingly, research studies that utilize self-report measures find that most job strains experienced by employees tend to be psychological strains (Spector et al., 2000 ).

Leading Frameworks

Organizations that are keen on identifying organizational pain points and remedying them through organizational campaigns or initiatives often discover the pain points are rooted in work-related stressors and strains and the initiatives have to focus on reducing workers’ stress and increasing a company’s profitability. Through organizational climate surveys, for example, companies discover that aspects of the organization’s environment, including its policies, practices, reward structures, procedures, and processes, as well as employees at all levels of the company, are contributing to the individual and organizational stress. Recent studies have even begun to examine team climates for eustress and distress assessed in terms of team members’ homogenous psychological experience of vigor, efficacy, dedication, and cynicism (e.g., Kożusznik, Rodriguez, & Peiro, 2015 ).

Each of the frameworks presented advances different aspects that need to be identified in order to understand the source and potential remedy for stressors and strains. In some models, the focus is on resources, in others on the interaction of the person and environment, and in still others on the role of the person in the workplace. Few frameworks directly examine the role of the organization, but the organization could use these frameworks to plan interventions that would minimize stressors, cope with existing stressors, and prevent and/or manage strains. One of the leading frameworks in work stress research that is used to guide organizational interventions is the person and environment (P-E) fit (French & Caplan, 1972 ). Its precursor is the University of Michigan Institute for Social Research’s (ISR) role stress model (Kahn, Wolfe, Quinn, Snoek, & Rosenthal, 1964 ) and Lewin’s Field Theory. Several other theories have since evolved from the P-E fit framework, including Karasek and Theorell’s ( 1990 ), Karasek ( 1979 ) Job Demands-Control Model (JD-C), the transactional framework (Lazarus & Folkman, 1984 ), Conservation of Resources (COR) theory (Hobfoll, 1989 ), and Siegrist’s ( 1996 ) Effort-Reward Imbalance (ERI) Model.

Field Theory

The premise of Kahn et al.’s ( 1964 ) role stress theory is Lewin’s ( 1997 ) Field Theory. Lewin purported that behavior and mental events are a dynamic function of the whole person, including a person’s beliefs, values, abilities, needs, thoughts, and feelings, within a given situation (field or environment), as well as the way a person represents his or her understanding of the field and behaves in that space. Lewin explains that work-related strains are a result of individuals’ subjective perceptions of objective factors, such as work roles, relationships with others in the workplace, as well as personality indicators, and can be used to predict people’s reactions, including illness. Thus, to make changes to an organizational system, it is necessary to understand a field and try to move that field from the current state to the desired state. Making this move necessitates identifying mechanisms influencing individuals.

Role Stress Theory

Role stress theory mostly isolates the perspective a person has about his or her work-related responsibilities and expectations to determine how those perceptions relate with a person’s work-related strains. However, those relationships have been met with somewhat varied results, which Glazer and Beehr ( 2005 ) concluded might be a function of differences in culture, an environmental factor often neglected in research. Kahn et al.’s ( 1964 ) role stress theory, coupled with Lewin’s ( 1936 ) Field Theory, serves as the foundation for the P-E fit theory. Lewin ( 1936 ) wrote, “Every psychological event depends upon the state of the person and at the same time on the environment” (p. 12). Researchers of IO psychology have narrowed the environment to the organization or work team. This narrowed view of the organizational environment is evident in French and Caplan’s ( 1972 ) P-E fit framework.

Person-Environment Fit Theory

The P-E fit framework focuses on the extent to which there is congruence between the person and a given environment, such as the organization (Caplan, 1987 ; Edwards, 2008 ). For example, does the person have the necessary skills and abilities to fulfill an organization’s demands, or does the environment support a person’s desire for autonomy (i.e., do the values align?) or fulfill a person’s needs (i.e., a person’s needs are rewarded). Theoretically and empirically, the greater the person-organization fit, the greater a person’s job satisfaction and organizational commitment, the less a person’s turnover intention and work-related stress (see meta-analyses by Assouline & Meir, 1987 ; Kristof-Brown, Zimmerman, & Johnson, 2005 ; Verquer, Beehr, & Wagner, 2003 ).

Job Demands-Control/Support (JD-C/S) and Job Demands-Resources (JD-R) Model

Focusing more closely on concrete aspects of work demands and the extent to which a person perceives he or she has control or decision latitude over those demands, Karasek ( 1979 ) developed the JD-C model. Karasek and Theorell ( 1990 ) posited that high job demands under conditions of little decision latitude or control yield high strains, which have varied implications on the health of an organization (e.g., in terms of high turnover, employee ill-health, poor organizational performance). This theory was modified slightly to address not only control, but also other resources that could protect a person from unruly job demands, including support (aka JD-C/S, Johnson & Hall, 1988 ; and JD-R, Bakker, van Veldhoven, & Xanthopoulou, 2010 ). Whether focusing on control or resources, both they and job demands are said to reflect workplace characteristics, while control and resources also represent coping strategies or tools (Siegrist, 2010 ).

Despite the glut of research testing the JD-C and JD-R, results are somewhat mixed. Testing the interaction between job demands and control, Beehr, Glaser, Canali, and Wallwey ( 2001 ) did not find empirical support for the JD-C theory. However, Dawson, O’Brien, and Beehr ( 2016 ) found that high control and high support buffered against the independent deleterious effects of interpersonal conflict, role conflict, and organizational politics (demands that were categorized as hindrance stressors) on anxiety, as well as the effects of interpersonal conflict and organizational politics on physiological symptoms, but control and support did not moderate the effects between challenge stressors and strains. Coupled with Bakker, Demerouti, and Sanz-Vergel’s ( 2014 ) note that excessive job demands are a source of strain, but increased job resources are a source of engagement, Dawson et al.’s results suggest that when an organization identifies that demands are hindrances, it can create strategies for primary (preventative) stress management interventions and attempt to remove or reduce such work demands. If the demands are challenging, though manageable, but latitude to control the challenging stressors and support are insufficient, the organization could modify practices and train employees on adopting better strategies for meeting or coping (secondary stress management intervention) with the demands. Finally, if the organization can neither afford to modify the demands or the level of control and support, it will be necessary for the organization to develop stress management (tertiary) interventions to deal with the inevitable strains.

Conservation of Resources Theory

The idea that job resources reinforce engagement in work has been propagated in Hobfoll’s ( 1989 ) Conservation of Resources (COR) theory. COR theory also draws on the foundational premise that people’s mental health is a function of the person and the environment, forwarding that how people interpret their environment (including the societal context) affects their stress levels. Hobfoll focuses on resources such as objects, personal characteristics, conditions, or energies as particularly instrumental to minimizing strains. He asserts that people do whatever they can to protect their valued resources. Thus, strains develop when resources are threatened to be taken away, actually taken away, or when additional resources are not attainable after investing in the possibility of gaining more resources (Hobfoll, 2001 ). By extension, organizations can invest in activities that would minimize resource loss and create opportunities for resource gains and thus have direct implications for devising primary and secondary stress management interventions.

Transactional Framework

Lazarus and Folkman ( 1984 ) developed the widely studied transactional framework of stress. This framework holds as a key component the cognitive appraisal process. When individuals perceive factors in the work environment as a threat (i.e., primary appraisal), they will scan the available resources (external or internal to himself or herself) to cope with the stressors (i.e., secondary appraisal). If the coping resources provide minimal relief, strains develop. Until recently, little attention has been given to the cognitive appraisal associated with different work stressors (Dewe & Kompier, 2008 ; Liu & Li, 2017 ). In a study of Polish and Spanish social care service providers, stressors appraised as a threat related positively to burnout and less engagement, but stressors perceived as challenges yielded greater engagement and less burnout (Kożusznik, Rodriguez, & Peiro, 2012 ). Similarly, Dawson et al. ( 2016 ) found that even with support and control resources, hindrance demands were more strain-producing than challenge demands, suggesting that appraisal of the stressor is important. In fact, “many people respond well to challenging work” (Beehr et al., 2001 , p. 126). Kożusznik et al. ( 2012 ) recommend training employees to change the way they view work demands in order to increase engagement, considering that part of the problem may be about how the person appraises his or her environment and, thus, copes with the stressors.

Effort-Reward Imbalance

Siegrist’s ( 1996 ) Model of Effort-Reward Imbalance (ERI) focuses on the notion of social reciprocity, such that a person fulfills required work tasks in exchange for desired rewards (Siegrist, 2010 ). ERI sheds light on how an imbalance in a person’s expectations of an organization’s rewards (e.g., pay, bonus, sense of advancement and development, job security) in exchange for a person’s efforts, that is a break in one’s work contract, leads to negative responses, including long-term ill-health (Siegrist, 2010 ; Siegrist et al., 2014 ). In fact, prolonged perception of a work contract imbalance leads to adverse health, including immunological problems and inflammation, which contribute to cardiovascular disease (Siegrist, 2010 ). The model resembles the relational and interactional psychological contract theory in that it describes an employee’s perception of the terms of the relationship between the person and the workplace, including expectations of performance, job security, training and development opportunities, career progression, salary, and bonuses (Thomas, Au, & Ravlin, 2003 ). The psychological contract, like the ERI model, focuses on social exchange. Furthermore, the psychological contract, like stress theories, are influenced by cultural factors that shape how people interpret their environments (Glazer, 2008 ; Thomas et al., 2003 ). Violations of the psychological contract will negatively affect a person’s attitudes toward the workplace and subsequent health and well-being (Siegrist, 2010 ). To remediate strain, Siegrist ( 2010 ) focuses on both the person and the environment, recognizing that the organization is particularly responsible for changing unfavorable work conditions and the person is responsible for modifying his or her reactions to such conditions.

Stress Management Interventions: Primary, Secondary, and Tertiary

Remediation of work stress and organizational development interventions are about realigning the employee’s experiences in the workplace with factors in the environment, as well as closing the gap between the current environment and the desired environment. Work stress develops when an employee perceives the work demands to exceed the person’s resources to cope and thus threatens employee well-being (Dewe & Kompier, 2008 ). Likewise, an organization’s need to change arises when forces in the environment are creating a need to change in order to survive (see Figure 1 ). Lewin’s ( 1951 ) Force Field Analysis, the foundations of which are in Field Theory, is one of the first organizational development intervention tools presented in the social science literature. The concept behind Force Field Analysis is that in order to survive, organizations must adapt to environmental forces driving a need for organizational change and remove restraining forces that create obstacles to organizational change. In order to do this, management needs to delineate the current field in which the organization is functioning, understand the driving forces for change, identify and dampen or eliminate the restraining forces against change. Several models for analyses may be applied, but most approaches are variations of organizational climate surveys.

Through organizational surveys, workers provide management with a snapshot view of how they perceive aspects of their work environment. Thus, the view of the health of an organization is a function of several factors, chief among them employees’ views (i.e., the climate) about the workplace (Lewin, 1951 ). Indeed, French and Kahn ( 1962 ) posited that well-being depends on the extent to which properties of the person and properties of the environment align in terms of what a person requires and the resources available in a given environment. Therefore, only when properties of the person and properties of the environment are sufficiently understood can plans for change be developed and implemented targeting the environment (e.g., change reporting structures to relieve, and thus prevent future, communication stressors) and/or the person (e.g., providing more autonomy, vacation days, training on new technology). In short, climate survey findings can guide consultants about the emphasis for organizational interventions: before a problem arises aka stress prevention, e.g., carefully crafting job roles), when a problem is present, but steps are taken to mitigate their consequences (aka coping, e.g., providing social support groups), and/or once strains develop (aka. stress management, e.g., healthcare management policies).

For each of the primary (prevention), secondary (coping), and tertiary (stress management) techniques the target for intervention can be the entire workforce, a subset of the workforce, or a specific person. Interventions that target the entire workforce may be considered organizational interventions, as they have direct implications on the health of all individuals and consequently the health of the organization. Several interventions categorized as primary and secondary interventions may also be implemented after strains have developed and after it has been discerned that a person or the organization did not do enough to mitigate stressors or strains (see Figure 1 ). The designation of many of the interventions as belonging to one category or another may be viewed as merely a suggestion.

Primary Interventions (Preventative Stress Management)

Before individuals begin to perceive work-related stressors, organizations engage in stress prevention strategies, such as providing people with resources (e.g., computers, printers, desk space, information about the job role, organizational reporting structures) to do their jobs. However, sometimes the institutional structures and resources are insufficient or ambiguous. Scholars and practitioners have identified several preventative stress management strategies that may be implemented.

Planning and Time Management

When employees feel quantitatively overloaded, sometimes the remedy is improving the employees’ abilities to plan and manage their time (Quick, Quick, Nelson, & Hurrell, 2003 ). Planning is a future-oriented activity that focuses on conceptual and comprehensive work goals. Time management is a behavior that focuses on organizing, prioritizing, and scheduling work activities to achieve short-term goals. Given the purpose of time management, it is considered a primary intervention, as engaging in time management helps to prevent work tasks from mounting and becoming unmanageable, which would subsequently lead to adverse outcomes. Time management comprises three fundamental components: (1) establishing goals, (2) identifying and prioritizing tasks to fulfill the goals, and (3) scheduling and monitoring progress toward goal achievement (Peeters & Rutte, 2005 ). Workers who employ time management have less role ambiguity (Macan, Shahani, Dipboye, & Philips, 1990 ), psychological stress or strain (Adams & Jex, 1999 ; Jex & Elaqua, 1999 ; Macan et al., 1990 ), and greater job satisfaction (Macan, 1994 ). However, Macan ( 1994 ) did not find a relationship between time management and performance. Still, Claessens, van Eerde, Rutte, and Roe ( 2004 ) found that perceived control of time partially mediated the relationships between planning behavior (an indicator of time management), job autonomy, and workload on one hand, and job strains, job satisfaction, and job performance on the other hand. Moreover, Peeters and Rutte ( 2005 ) observed that teachers with high work demands and low autonomy experienced more burnout when they had poor time management skills.

Person-Organization Fit

Just as it is important for organizations to find the right person for the job and organization, so is it the responsibility of a person to choose to work at the right organization—an organization that fulfills the person’s needs and upholds the values important to the individual, as much as the person fulfills the organization’s needs and adapts to its values. When people fit their employing organizations they are setting themselves up for experiencing less strain-producing stressors (Kristof-Brown et al., 2005 ). In a meta-analysis of 62 person-job fit studies and 110 person-organization fit studies, Kristof-Brown et al. ( 2005 ) found that person-job fit had a negative correlation with indicators of job strain. In fact, a primary intervention of career counseling can help to reduce stress levels (Firth-Cozens, 2003 ).

Job Redesign

The Job Demands-Control/Support (JD-C/S), Job Demands-Resources (JD-R), and transactional models all suggest that factors in the work context require modifications in order to reduce potential ill-health and poor organizational performance. Drawing on Hackman and Oldham’s ( 1980 ) Job Characteristics Model, it is possible to assess with the Job Diagnostics Survey (JDS) the current state of work characteristics related to skill variety, task identity, task significance, autonomy, and feedback. Modifying those aspects would help create a sense of meaningfulness, sense of responsibility, and feeling of knowing how one is performing, which subsequently affects a person’s well-being as identified in assessments of motivation, satisfaction, improved performance, and reduced withdrawal intentions and behaviors. Extending this argument to the stress models, it can be deduced that reducing uncertainty or perceived unfairness that may be associated with a person’s perception of these work characteristics, as well as making changes to physical characteristics of the environment (e.g., lighting, seating, desk, air quality), nature of work (e.g., job responsibilities, roles, decision-making latitude), and organizational arrangements (e.g., reporting structure and feedback mechanisms), can help mitigate against numerous ill-health consequences and reduced organizational performance. In fact, Fried et al. ( 2013 ) showed that healthy patients of a medical clinic whose jobs were excessively low (i.e., monotonous) or excessively high (i.e., overstimulating) on job enrichment (as measured by the JDS) had greater abdominal obesity than those whose jobs were optimally enriched. By taking stock of employees’ perceptions of the current work situation, managers might think about ways to enhance employees’ coping toolkit, such as training on how to deal with difficult clients or creating stimulating opportunities when jobs have low levels of enrichment.

Participatory Action Research Interventions

Participatory action research (PAR) is an intervention wherein, through group discussions, employees help to identify and define problems in organizational structure, processes, policies, practices, and reward structures, as well as help to design, implement, and evaluate success of solutions. PAR is in itself an intervention, but its goal is to design interventions to eliminate or reduce work-related factors that are impeding performance and causing people to be unwell. An example of a successful primary intervention, utilizing principles of PAR and driven by the JD-C and JD-C/S stress frameworks is Health Circles (HCs; Aust & Ducki, 2004 ).

HCs, developed in Germany in the 1980s, were popular practices in industries, such as metal, steel, and chemical, and service. Similar to other problem-solving practices, such as quality circles, HCs were based on the assumptions that employees are the experts of their jobs. For this reason, to promote employee well-being, management and administrators solicited suggestions and ideas from the employees to improve occupational health, thereby increasing employees’ job control. HCs also promoted communication between managers and employees, which had a potential to increase social support. With more control and support, employees would experience less strains and better occupational well-being.

Employing the three-steps of (1) problem analysis (i.e., diagnosis or discovery through data generated from organizational records of absenteeism length, frequency, rate, and reason and employee survey), (2) HC meetings (6 to 10 meetings held over several months to brainstorm ideas to improve occupational safety and health concerns identified in the discovery phase), and (3) HC evaluation (to determine if desired changes were accomplished and if employees’ reports of stressors and strains changed after the course of 15 months), improvements were to be expected (Aust & Ducki, 2004 ). Aust and Ducki ( 2004 ) reviewed 11 studies presenting 81 health circles in 30 different organizations. Overall study participants had high satisfaction with the HCs practices. Most companies acted upon employees’ suggestions (e.g., improving driver’s seat and cab, reducing ticket sale during drive, team restructuring and job rotation to facilitate communication, hiring more employees during summer time, and supervisor training program to improve leadership and communication skills) to improve work conditions. Thus, HCs represent a successful theory-grounded intervention to routinely improve employees’ occupational health.

Physical Setting

The physical environment or physical workspace has an enormous impact on individuals’ well-being, attitudes, and interactions with others, as well as on the implications on innovation and well-being (Oksanen & Ståhle, 2013 ; Vischer, 2007 ). In a study of 74 new product development teams (total of 437 study respondents) in Western Europe, Chong, van Eerde, Rutte, and Chai ( 2012 ) found that when teams were faced with challenge time pressures, meaning the teams had a strong interest and desire in tackling complex, but engaging tasks, when they were working proximally close with one another, team communication improved. Chong et al. assert that their finding aligns with prior studies that have shown that physical proximity promotes increased awareness of other team members, greater tendency to initiate conversations, and greater team identification. However, they also found that when faced with hindrance time pressures, physical proximity related to low levels of team communication, but when hindrance time pressure was low, team proximity had an increasingly greater positive relationship with team communication.

In addition to considering the type of work demand teams must address, other physical workspace considerations include whether people need to work collaboratively and synchronously or independently and remotely (or a combination thereof). Consideration needs to be given to how company contributors would satisfy client needs through various modes of communication, such as email vs. telephone, and whether individuals who work by a window might need shading to block bright sunlight from glaring on their computer screens. Finally, people who have to use the telephone for extensive periods of time would benefit from earphones to prevent neck strains. Most physical stressors are rather simple to rectify. However, companies are often not aware of a problem until after a problem arises, such as when a person’s back is strained from trying to move heavy equipment. Companies then implement strategies to remediate the environmental stressor. With the help of human factors, and organizational and office design consultants, many of the physical barriers to optimal performance can be prevented (Rousseau & Aubé, 2010 ). In a study of 215 French-speaking Canadian healthcare employees, Rousseau and Aubé ( 2010 ) found that although supervisor instrumental support positively related with affective commitment to the organization, the relationship was even stronger for those who reported satisfaction with the ambient environment (i.e., temperature, lighting, sound, ventilation, and cleanliness).

Secondary Interventions (Coping)

Secondary interventions, also referred to as coping, focus on resources people can use to mitigate the risk of work-related illness or workplace injury. Resources may include properties related to social resources, behaviors, and cognitive structures. Each of these resource domains may be employed to cope with stressors. Monat and Lazarus ( 1991 ) summarize the definition of coping as “an individual’s efforts to master demands (or conditions of harm, threat, or challenge) that are appraised (or perceived) as exceeding or taxing his or her resources” (p. 5). To master demands requires use of the aforementioned resources. Secondary interventions help employees become aware of the psychological, physical, and behavioral responses that may occur from the stressors presented in their working environment. Secondary interventions help a person detect and attend to stressors and identify resources for and ways of mitigating job strains. Often, coping strategies are learned skills that have a cognitive foundation and serve important functions in improving people’s management of stressors (Lazarus & Folkman, 1991 ). Coping is effortful, but with practice it becomes easier to employ. This idea is the foundation for understanding the role of resilience in coping with stressors. However, “not all adaptive processes are coping. Coping is a subset of adaptational activities that involves effort and does not include everything that we do in relating to the environment” (Lazarus & Folkman, 1991 , p. 198). Furthermore, sometimes to cope with a stressor, a person may call upon social support sources to help with tangible materials or emotional comfort. People call upon support resources because they help to restructure how a person approaches or thinks about the stressor.

Most secondary interventions are aimed at helping the individual, though companies, as a policy, might require all employees to partake in training aimed at increasing employees’ awareness of and skills aimed at handling difficult situations vis à vis company channels (e.g., reporting on sexual harassment or discrimination). Furthermore, organizations might institute mentoring programs or work groups to address various work-related matters. These programs employ awareness-raising activities, stress-education, or skills training (cf., Bhagat, Segovis, & Nelson, 2012 ), which include development of skills in problem-solving, understanding emotion-focused coping, identifying and using social support, and enhancing capacity for resilience. The aim of these programs, therefore, is to help employees proactively review their perceptions of psychological, physical, and behavioral job-related strains, thereby extending their resilience, enabling them to form a personal plan to control stressors and practice coping skills (Cooper, Dewe, & O’Driscoll, 2011 ).

Often these stress management programs are instituted after an organization has observed excessive absenteeism and work-related performance problems and, therefore, are sometimes categorized as a tertiary stress management intervention or even a primary (prevention) intervention. However, the skills developed for coping with stressors also place the programs in secondary stress management interventions. Example programs that are categorized as tertiary or primary stress management interventions may also be secondary stress management interventions (see Figure 1 ), and these include lifestyle advice and planning, stress inoculation training, simple relaxation techniques, meditation, basic trainings in time management, anger management, problem-solving skills, and cognitive-behavioral therapy. Corporate wellness programs also fall under this category. In other words, some programs could be categorized as primary, secondary, or tertiary interventions depending upon when the employee (or organization) identifies the need to implement the program. For example, time management practices could be implemented as a means of preventing some stressors, as a way to cope with mounting stressors, or as a strategy to mitigate symptoms of excessive of stressors. Furthermore, these programs can be administered at the individual level or group level. As related to secondary interventions, these programs provide participants with opportunities to develop and practice skills to cognitively reappraise the stressor(s); to modify their perspectives about stressors; to take time out to breathe, stretch, meditate, relax, and/or exercise in an attempt to support better decision-making; to articulate concerns and call upon support resources; and to know how to say “no” to onslaughts of requests to complete tasks. Participants also learn how to proactively identify coping resources and solve problems.

According to Cooper, Dewe, and O’Driscoll ( 2001 ), secondary interventions are successful in helping employees modify or strengthen their ability to cope with the experience of stressors with the goal of mitigating the potential harm the job stressors may create. Secondary interventions focus on individuals’ transactions with the work environment and emphasize the fit between a person and his or her environment. However, researchers have pointed out that the underlying assumption of secondary interventions is that the responsibility for coping with the stressors of the environment lies within individuals (Quillian-Wolever & Wolever, 2003 ). If companies cannot prevent the stressors in the first place, then they are, in part, responsible for helping individuals develop coping strategies and informing employees about programs that would help them better cope with job stressors so that they are able to fulfill work assignments.

Stress management interventions that help people learn to cope with stressors focus mainly on the goals of enabling problem-resolution or expressing one’s emotions in a healthy manner. These goals are referred to as problem-focused coping and emotion-focused coping (Folkman & Lazarus, 1980 ; Pearlin & Schooler, 1978 ), and the person experiencing the stressors as potential threat is the agent for change and the recipient of the benefits of successful coping (Hobfoll, 1998 ). In addition to problem-focused and emotion-focused coping approaches, social support and resilience may be coping resources. There are many other sources for coping than there is room to present here (see e.g., Cartwright & Cooper, 2005 ); however, the current literature has primarily focused on these resources.

Problem-Focused Coping

Problem-focused or direct coping helps employees remove or reduce stressors in order to reduce their strain experiences (Bhagat et al., 2012 ). In problem-focused coping employees are responsible for working out a strategic plan in order to remove job stressors, such as setting up a set of goals and engaging in behaviors to meet these goals. Problem-focused coping is viewed as an adaptive response, though it can also be maladaptive if it creates more problems down the road, such as procrastinating getting work done or feigning illness to take time off from work. Adaptive problem-focused coping negatively relates to long-term job strains (Higgins & Endler, 1995 ). Discussion on problem-solving coping is framed from an adaptive perspective.

Problem-focused coping is featured as an extension of control, because engaging in problem-focused coping strategies requires a series of acts to keep job stressors under control (Bhagat et al., 2012 ). In the stress literature, there are generally two ways to categorize control: internal versus external locus of control, and primary versus secondary control. Locus of control refers to the extent to which people believe they have control over their own life (Rotter, 1966 ). People high in internal locus of control believe that they can control their own fate whereas people high in external locus of control believe that outside factors determine their life experience (Rotter, 1966 ). Generally, those with an external locus of control are less inclined to engage in problem-focused coping (Strentz & Auerbach, 1988 ). Primary control is the belief that people can directly influence their environment (Alloy & Abramson, 1979 ), and thus they are more likely to engage in problem-focused coping. However, when it is not feasible to exercise primary control, people search for secondary control, with which people try to adapt themselves into the objective environment (Rothbaum, Weisz, & Snyder, 1982 ).

Emotion-Focused Coping

Emotion-focused coping, sometimes referred to as palliative coping, helps employees reduce strains without the removal of job stressors. It involves cognitive or emotional efforts, such as talking about the stressor or distracting oneself from the stressor, in order to lessen emotional distress resulting from job stressors (Bhagat et al., 2012 ). Emotion-focused coping aims to reappraise and modify the perceptions of a situation or seek emotional support from friends or family. These methods do not include efforts to change the work situation or to remove the job stressors (Lazarus & Folkman, 1991 ). People tend to adopt emotion-focused coping strategies when they believe that little or nothing can be done to remove the threatening, harmful, and challenging stressors (Bhagat et al., 2012 ), such as when they are the only individuals to have the skills to get a project done or they are given increased responsibilities because of the unexpected departure of a colleague. Emotion-focused coping strategies include (1) reappraisal of the stressful situation, (2) talking to friends and receiving reassurance from them, (3) focusing on one’s strength rather than weakness, (4) optimistic comparison—comparing one’s situation to others’ or one’s past situation, (5) selective ignoring—paying less attention to the unpleasant aspects of one’s job and being more focused on the positive aspects of the job, (6) restrictive expectations—restricting one’s expectations on job satisfaction but paying more attention to monetary rewards, (7) avoidance coping—not thinking about the problem, leaving the situation, distracting oneself, or using alcohol or drugs (e.g., Billings & Moos, 1981 ).

Some emotion-focused coping strategies are maladaptive. For example, avoidance coping may lead to increased level of job strains in the long run (e.g., Parasuraman & Cleek, 1984 ). Furthermore, a person’s ability to cope with the imbalance of performing work to meet organizational expectations can take a toll on the person’s health, leading to physiological consequences such as cardiovascular disease, sleep disorders, gastrointestinal disorders, and diabetes (Fried et al., 2013 ; Siegrist, 2010 ; Toker, Shirom, Melamed, & Armon, 2012 ; Willert, Thulstrup, Hertz, & Bonde, 2010 ).

Comparing Coping Strategies across Cultures

Most coping research is conducted in individualistic, Western cultures wherein emotional control is emphasized and both problem-solving focused coping and primary control are preferred (Bhagat et al., 2010 ). However, in collectivistic cultures, emotion-focused coping and use of secondary control may be preferred and may not necessarily carry a negative evaluation (Bhagat et al., 2010 ). For example, African Americans are more likely to use emotion-focused coping than non–African Americans (Knight, Silverstein, McCallum, & Fox, 2000 ), and among women who experienced sexual harassment, Anglo American women were less likely to employ emotion focused coping (i.e., avoidance coping) than Turkish women and Hispanic American women, while Hispanic women used more denial than the other two groups (Wasti & Cortina, 2002 ).

Thus, whereas problem-focused coping is venerated in Western societies, emotion-focused coping may be more effective in reducing strains in collectivistic cultures, such as China, Japan, and India (Bhagat et al., 2010 ; Narayanan, Menon, & Spector, 1999 ; Selmer, 2002 ). Indeed, Swedish participants reported more problem-focused coping than did Chinese participants (Xiao, Ottosson, & Carlsson, 2013 ), American college students engaged in more problem-focused coping behaviors than did their Japanese counterparts (Ogawa, 2009 ), and Indian (vs. Canadian) students reported more emotion-focused coping, such as seeking social support and positive reappraisal (Sinha, Willson, & Watson, 2000 ). Moreover, Glazer, Stetz, and Izso ( 2004 ) found that internal locus of control was more predominant in individualistic cultures (United Kingdom and United States), whereas external locus of control was more predominant in communal cultures (Italy and Hungary). Also, internal locus of control was associated with less job stress, but more so for nurses in the United Kingdom and United States than Italy and Hungary. Taken together, adoption of coping strategies and their effectiveness differ significantly across cultures. The extent to which a coping strategy is perceived favorably and thus selected or not selected is not only a function of culture, but also a person’s sociocultural beliefs toward the coping strategy (Morimoto, Shimada, & Ozaki, 2013 ).

Social Support

Social support refers to the aid an entity gives to a person. The source of the support can be a single person, such as a supervisor, coworker, subordinate, family member, friend, or stranger, or an organization as represented by upper-level management representing organizational practices. The type of support can be instrumental or emotional. Instrumental support, including informational support, refers to that which is tangible, such as data to help someone make a decision or colleagues’ sick days so one does not lose vital pay while recovering from illness. Emotional support, including esteem support, refers to the psychological boost given to a person who needs to express emotions and feel empathy from others or to have his or her perspective validated. Beehr and Glazer ( 2001 ) present an overview of the role of social support on the stressor-strain relationship and arguments regarding the role of culture in shaping the utility of different sources and types of support.

Meaningfulness and Resilience

Meaningfulness reflects the extent to which people believe their lives are significant, purposeful, goal-directed, and fulfilling (Glazer, Kożusznik, Meyers, & Ganai, 2014 ). When faced with stressors, people who have a strong sense of meaning in life will also try to make sense of the stressors. Maintaining a positive outlook on life stressors helps to manage emotions, which is helpful in reducing strains, particularly when some stressors cannot be problem-solved (Lazarus & Folkman, 1991 ). Lazarus and Folkman ( 1991 ) emphasize that being able to reframe threatening situations can be just as important in an adaptation as efforts to control the stressors. Having a sense of meaningfulness motivates people to behave in ways that help them overcome stressors. Thus, meaningfulness is often used in the same breath as resilience, because people who are resilient are often protecting that which is meaningful.

Resilience is a personality state that can be fortified and enhanced through varied experiences. People who perceive their lives are meaningful are more likely to find ways to face adversity and are therefore more prone to intensifying their resiliency. When people demonstrate resilience to cope with noxious stressors, their ability to be resilient against other stressors strengthens because through the experience, they develop more competencies (Glazer et al., 2014 ). Thus, fitting with Hobfoll’s ( 1989 , 2001 ) COR theory, meaningfulness and resilience are psychological resources people attempt to conserve and protect, and employ when necessary for making sense of or coping with stressors.

Tertiary Interventions (Stress Management)

Stress management refers to interventions employed to treat and repair harmful repercussions of stressors that were not coped with sufficiently. As Lazarus and Folkman ( 1991 ) noted, not all stressors “are amenable to mastery” (p. 205). Stressors that are unmanageable and lead to strains require interventions to reverse or slow down those effects. Workplace interventions might focus on the person, the organization, or both. Unfortunately, instead of looking at the whole system to include the person and the workplace, most companies focus on the person. Such a focus should not be a surprise given the results of van der Klink, Blonk, Schene, and van Dijk’s ( 2001 ) meta-analysis of 48 experimental studies conducted between 1977 and 1996 . They found that of four types of tertiary interventions, the effect size for cognitive-behavioral interventions and multimodal programs (e.g., the combination of assertive training and time management) was moderate and the effect size for relaxation techniques was small in reducing psychological complaints, but not turnover intention related to work stress. However, the effects of (the five studies that used) organization-focused interventions were not significant. Similarly, Richardson and Rothstein’s ( 2008 ) meta-analytic study, including 36 experimental studies with 55 interventions, showed a larger effect size for cognitive-behavioral interventions than relaxation, organizational, multimodal, or alternative. However, like with van der Klink et al. ( 2001 ), Richardson and Rothstein ( 2008 ) cautioned that there were few organizational intervention studies included and the impact of interventions were determined on the basis of psychological outcomes and not physiological or organizational outcomes. Van der Klink et al. ( 2001 ) further expressed concern that organizational interventions target the workplace and that changes in the individual may take longer to observe than individual interventions aimed directly at the individual.

The long-term benefits of individual focused interventions are not yet clear either. Per Giga, Cooper, and Faragher ( 2003 ), the benefits of person-directed stress management programs will be short-lived if organizational factors to reduce stressors are not addressed too. Indeed, LaMontagne, Keegel, Louie, Ostry, and Landsbergis ( 2007 ), in their meta-analysis of 90 studies on stress management interventions published between 1990 and 2005 , revealed that in relation to interventions targeting organizations only, and interventions targeting individuals only, interventions targeting both organizations and individuals (i.e. the systems approach) had the most favorable positive effects on both the organizations and the individuals. Furthermore, the organization-level interventions were effective at both the individual and organization levels, but the individual-level interventions were effective only at the individual level.

Individual-Focused Stress Management

Individual-focused interventions concentrate on improving conditions for the individual, though counseling programs emphasize that the worker is in charge of reducing “stress,” whereas role-focused interventions emphasize activities that organizations can guide to actually reduce unnecessary noxious environmental factors.

Individual-Focused Stress Management: Employee Assistance Programs

When stress become sufficiently problematic (which is individually gauged or attended to by supportive others) in a worker’s life, employees may utilize the short-term counseling services or referral services Employee Assistance Programs (EAPs) provide. People who utilize the counseling services may engage in cognitive behavioral therapy aimed at changing the way people think about the stressors (e.g., as challenge opportunity over threat) and manage strains. Example topics that may be covered in these therapy sessions include time management and goal setting (prioritization), career planning and development, cognitive restructuring and mindfulness, relaxation, and anger management. In a study of healthcare workers and teachers who participated in a 2-day to 2.5-day comprehensive stress management training program (including 26 topics on identifying, coping with, and managing stressors and strains), Siu, Cooper, and Phillips ( 2013 ) found psychological and physical improvements were self-reported among the healthcare workers (for which there was no control group). However, comparing an intervention group of teachers to a control group of teachers, the extent of change was not as visible, though teachers in the intervention group engaged in more mastery recovery experiences (i.e., they purposefully chose to engage in challenging activities after work).

Individual-Focused Stress Management: Mindfulness

A popular therapy today is to train people to be more mindful, which involves helping people live in the present, reduce negative judgement of current and past experiences, and practicing patience (Birnie, Speca, & Carlson, 2010 ). Mindfulness programs usually include training on relaxation exercises, gentle yoga, and awareness of the body’s senses. In one study offered through the continuing education program at a Canadian university, 104 study participants took part in an 8-week, 90 minute per group (15–20 participants per) session mindfulness program (Birnie et al., 2010 ). In addition to body scanning, they also listened to lectures on incorporating mindfulness into one’s daily life and received a take-home booklet and compact discs that guided participants through the exercises studied in person. Two weeks after completing the program, participants’ mindfulness attendance and general positive moods increased, while physical, psychological, and behavioral strains decreased. In another study on a sample of U.K. government employees, study participants receiving three sessions of 2.5 to 3 hours each training on mindfulness, with the first two sessions occurring in consecutive weeks and the third occurring about three months later, Flaxman and Bond ( 2010 ) found that compared to the control group, the intervention group showed a decrease in distress levels from Time 1 (baseline) to Time 2 (three months after first two training sessions) and Time 1 to Time 3 (after final training session). Moreover, of the mindfulness intervention study participants who were clinically distressed, 69% experienced clinical improvement in their psychological health.

Individual-Focused Stress Management: Biofeedback/Imagery/Meditation/Deep Breathing

Biofeedback uses electronic equipment to inform users about how their body is responding to tension. With guidance from a therapist, individuals then learn to change their physiological responses so that their pulse normalizes and muscles relax (Norris, Fahrion, & Oikawa, 2007 ). The therapist’s guidance might include reminders for imagery, meditation, body scan relaxation, and deep breathing. Saunders, Driskell, Johnston, and Salas’s ( 1996 ) meta-analysis of 37 studies found that imagery helped reduce state and performance anxiety. Once people have been trained to relax, reminder triggers may be sent through smartphone push notifications (Villani et al., 2013 ).

Smartphone technology can also be used to support weight loss programs, smoking cessation programs, and medication or disease (e.g., diabetes) management compliance (Heron & Smyth, 2010 ; Kannampallil, Waicekauskas, Morrow, Kopren, & Fu, 2013 ). For example, smartphones could remind a person to take medications or test blood sugar levels or send messages about healthy behaviors and positive affirmations.

Individual-Focused Stress Management: Sleep/Rest/Respite

Workers today sleep less per night than adults did nearly 30 years ago (Luckhaupt, Tak, & Calvert, 2010 ; National Sleep Foundation, 2005 , 2013 ). In order to combat problems, such as increased anxiety and cardiovascular artery disease, associated with sleep deprivation and insufficient rest, it is imperative that people disconnect from their work at least one day per week or preferably for several weeks so that they are able to restore psychological health (Etzion, Eden, & Lapidot, 1998 ; Ragsdale, Beehr, Grebner, & Han, 2011 ). When college students engaged in relaxation-type activities, such as reading or watching television, over the weekend, they experienced less emotional exhaustion and greater general well-being than students who engaged in resources-consuming activities, such as house cleaning (Ragsdale et al., 2011 ). Additional research and future directions for research are reviewed and identified in the work of Sonnentag ( 2012 ). For example, she asks whether lack of ability to detach from work is problematic for people who find their work meaningful. In other words, are negative health consequences only among those who do not take pleasure in their work? Sonnetag also asks how teleworkers detach from their work when engaging in work from the home. Ironically, one of the ways that companies are trying to help with the challenges of high workload or increased need to be available to colleagues, clients, or vendors around the globe is by offering flexible work arrangements, whereby employees who can work from home are given the opportunity to do so. Companies that require global interactions 24-hours per day often employ this strategy, but is the solution also a source of strain (Glazer, Kożusznik, & Shargo, 2012 )?

Individual-Focused Stress Management: Role Analysis

Role analysis or role clarification aims to redefine, expressly identify, and align employees’ roles and responsibilities with their work goals. Through role negotiation, involved parties begin to develop a new formal or informal contract about expectations and define resources needed to fulfill those expectations. Glazer has used this approach in organizational consulting and, with one memorable client engagement, found that not only were the individuals whose roles required deeper re-evaluation happier at work (six months later), but so were their subordinates. Subordinates who once characterized the two partners as hostile and akin to a couple going through a bad divorce, later referred to them as a blissful pair. Schaubroeck, Ganster, Sime, and Ditman ( 1993 ) also found in a three-wave study over a two-year period that university employees’ reports of role clarity and greater satisfaction with their supervisor increased after a role clarification exercise of top managers’ roles and subordinates’ roles. However, the intervention did not have any impact on reported physical symptoms, absenteeism, or psychological well-being. Role analysis is categorized under individual-focused stress management intervention because it is usually implemented after individuals or teams begin to demonstrate poor performance and because the intervention typically focuses on a few individuals rather than an entire organization or group. In other words, the intervention treats the person’s symptoms by redefining the role so as to eliminate the stimulant causing the problem.

Organization-Focused Stress Management

At the organizational level, companies that face major declines in productivity and profitability or increased costs related to healthcare and disability might be motivated to reassess organizational factors that might be impinging on employees’ health and well-being. After all, without healthy workers, it is not possible to have a healthy organization. Companies may choose to implement practices and policies that are expected to help not only the employees, but also the organization with reduced costs associated with employee ill-health, such as medical insurance, disability payments, and unused office space. Example practices and policies that may be implemented include flexible work arrangements to ensure that employees are not on the streets in the middle of the night for work that can be done from anywhere (such as the home), diversity programs to reduce stress-induced animosity and prejudice toward others, providing only healthy food choices in cafeterias, mandating that all employees have physicals in order to receive reduced prices for insurance, company-wide closures or mandatory paid time off, and changes in organizational visioning.

Organization-Focused Stress Management: Organizational-Level Occupational Health Interventions

As with job design interventions that are implemented to remediate work characteristics that were a source of unnecessary or excessive stressors, so are organizational-level occupational health (OLOH) interventions. As with many of the interventions, its placement as a primary or tertiary stress management intervention may seem arbitrary, but when considering the goal and target of change, it is clear that the intervention is implemented in response to some ailing organizational issues that need to be reversed or stopped, and because it brings in the entire organization’s workforce to address the problems, it has been placed in this category. There are several more case studies than empirical studies on the topic of whole system organizational change efforts (see example case studies presented by the United Kingdom’s Health and Safety Executive). It is possible that lack of published empirical work is not so much due to lack of attempting to gather and evaluate the data for publication, but rather because the OLOH interventions themselves never made it to the intervention stage, the interventions failed (Biron, Gatrell, & Cooper, 2010 ), or the level of evaluation was not rigorous enough to get into empirical peer-review journals. Fortunately, case studies provide some indication of the opportunities and problems associated with OLOH interventions.

One case study regarding Cardiff and Value University Health Board revealed that through focus group meetings with members of a steering group (including high-level managers and supported by top management) and facilitated by a neutral, non-judgemental organizational health consultant, ideas for change were posted on newsprint, discussed, and areas in the organization needing change were identified. The intervention for giving voice to people who initially had little already had a positive effect on the organization, as absence decreased by 2.09% and 6.9% merely 12 and 18 months, respectively, after the intervention. Translated in financial terms, the 6.9% change was equivalent to a quarterly savings of £80,000 (Health & Safety Executive, n.d. ). Thus, focusing on the context of change and how people will be involved in the change process probably helped the organization realize improvements (Biron et al., 2010 ). In a recent and rare empirical study, employing both qualitative and quantitative data collection methods, Sørensen and Holman ( 2014 ) utilized PAR in order to plan and implement an OLOH intervention over the course of 14 months. Their study aimed to examine the effectiveness of the PAR process in reducing workers’ work-related and social or interpersonal-related stressors that derive from the workplace and improving psychological, behavioral, and physiological well-being across six Danish organizations. Based on group dialogue, 30 proposals for change were proposed, all of which could be categorized as either interventions to focus on relational factors (e.g., management feedback improvement, engagement) or work processes (e.g., reduced interruptions, workload, reinforcing creativity). Of the interventions that were implemented, results showed improvements on manager relationship quality and reduced burnout, but no changes with respect to work processes (i.e., workload and work pace) perhaps because the employees already had sufficient task control and variety. These findings support Dewe and Kompier’s ( 2008 ) position that occupational health can be reinforced through organizational policies that reinforce quality jobs and work experiences.

Organization-Focused Stress Management: Flexible Work Arrangements

Dewe and Kompier ( 2008 ), citing the work of Isles ( 2005 ), noted that concern over losing one’s job is a reason for why 40% of survey respondents indicated they work more hours than formally required. In an attempt to create balance and perceived fairness in one’s compensation for putting in extra work hours, employees will sometimes be legitimately or illegitimately absent. As companies become increasingly global, many people with desk jobs are finding themselves communicating with colleagues who are halfway around the globe and at all hours of the day or night (Glazer et al., 2012 ). To help minimize the strains associated with these stressors, companies might devise flexible work arrangements (FWA), though the type of FWA needs to be tailored to the cultural environment (Masuda et al., 2012 ). FWAs give employees some leverage to decide what would be the optimal work arrangement for them (e.g., part-time, flexible work hours, compressed work week, telecommuting). In other words, FWA provides employees with the choice of when to work, where to work (on-site or off-site), and how many hours to work in a day, week, or pay period (Kossek, Thompson, & Lautsch, 2015 ). However, not all employees of an organization have equal access to or equitable use of FWAs; workers in low-wage, hourly jobs are often beholden to being physically present during specific hours (Swanberg McKechnie, Ojha, & James, 2011 ). In a study of over 1,300 full-time hourly retail employees in the United States, Swanberg et al. ( 2011 ) showed that employees who have control over their work schedules and over their work hours were satisfied with their work schedules, perceived support from the supervisor, and work engagement.

Unfortunately, not all FWAs yield successful results for the individual or the organization. Being able to work from home or part-time can have problems too, as a person finds himself or herself working more hours from home than required. Sometimes telecommuting creates work-family conflict too as a person struggles to balance work and family obligations while working from home. Other drawbacks include reduced face-to-face contact between work colleagues and stakeholders, challenges shaping one’s career growth due to limited contact, perceived inequity if some have more flexibility than others, and ambiguity about work role processes for interacting with employees utilizing the FWA (Kossek et al., 2015 ). Organizations that institute FWAs must carefully weigh the benefits and drawbacks the flexibility may have on the employees using it or the employees affected by others using it, as well as the implications on the organization, including the vendors who are serving and clients served by the organization.

Organization-Focused Stress Management: Diversity Programs

Employees in the workplace might experience strain due to feelings of discrimination or prejudice. Organizational climates that do not promote diversity (in terms of age, religion, physical abilities, ethnicity, nationality, sex, and other characteristics) are breeding grounds for undesirable attitudes toward the workplace, lower performance, and greater turnover intention (Bergman, Palmieri, Drasgow, & Ormerod, 2012 ; Velez, Moradi, & Brewster, 2013 ). Management is thus advised to implement programs that reinforce the value and importance of diversity, as well as manage diversity to reduce conflict and feelings of prejudice. In fact, managers who attended a leadership training program reported higher multicultural competence in dealing with stressful situations (Chrobot-Mason & Leslie, 2012 ), and managers who persevered through challenges were more dedicated to coping with difficult diversity issues (Cilliers, 2011 ). Thus, diversity programs can help to reduce strains by directly reducing stressors associated with conflict linked to diversity in the workplace and by building managers’ resilience.

Organization-Focused Stress Management: Healthcare Management Policies

Over the past few years, organizations have adopted insurance plans that implement wellness programs for the sake of managing the increasing cost of healthcare that is believed to be a result of individuals’ not managing their own health, with regular check-ups and treatment. The wellness programs require all insured employees to visit a primary care provider, complete a health risk assessment, and engage in disease management activities as specified by a physician (e.g., see frequently asked questions regarding the State of Maryland’s Wellness Program). Companies believe that requiring compliance will reduce health problems, although there is no proof that such programs save money or that people would comply. One study that does, however, boast success, was a 12-week workplace health promotion program aimed at reducing Houston airport workers’ weight (Ebunlomo, Hare-Everline, Weber, & Rich, 2015 ). The program, which included 235 volunteer participants, was deemed a success, as there was a total weight loss of 345 pounds (or 1.5 lbs per person). Given such results in Houston, it is clear why some people are also skeptical over the likely success of wellness programs, particularly as there is no clear method for evaluating their efficacy (Sinnott & Vatz, 2015 ).

Moreover, for some, such a program is too paternalistic and intrusive, as well as punishes anyone who chooses not to actively participate in disease management programs (Sinnott & Vatz, 2015 ). The programs put the onus of change on the person, though it is a response to the high costs of ill-health. The programs neglect to consider the role of the organization in reducing the barriers to healthy lifestyle, such as cloaking exempt employment as simply needing to get the work done, when it usually means working significantly more hours than a standard workweek. In fact, workplace health promotion programs did not reduce presenteeism (i.e., people going to work while unwell thereby reducing their job performance) among those who suffered from physical pain (Cancelliere, Cassidy, Ammendolia, & Côte, 2011 ). However, supervisor education, worksite exercise, lifestyle intervention through email, midday respite from repetitive work, a global stress management program, changes in lighting, and telephone interventions helped to reduce presenteeism. Thus, emphasis needs to be placed on psychosocial aspects of the organization’s structure, including managers and overall organizational climate for on-site presence, that reinforces such behavior (Cancelliere et al., 2011 ). Moreover, wellness programs are only as good as the interventions to reduce work-related stressors and improve organizational resources to enable workers to improve their overall psychological and physical health.

Concluding Remarks

Future research.

One of the areas requiring more theoretical and practical attention is that of the utility of stress frameworks to guide organizational development change interventions. Although it has been proposed that the foundation for work stress management interventions is in organizational development, and even though scholars and practitioners of organization development were also founders of research programs that focused on employee health and well-being or work stress, there are few studies or other theoretical works that link the two bodies of literature.

A second area that requires additional attention is the efficacy of stress management interventions across cultures. In examining secondary stress management interventions (i.e., coping), some cross-cultural differences in findings were described; however, there is still a dearth of literature from different countries on the utility of different prevention, coping, and stress management strategies.

A third area that has been blossoming since the start of the 21st century is the topic of hindrance and challenge stressors and the implications of both on workers’ well-being and performance. More research is needed on this topic in several areas. First, there is little consistency by which researchers label a stressor as a hindrance or a challenge. Researchers sometimes take liberties with labels, but it is not the researchers who should label a stressor but the study participants themselves who should indicate if a stressor is a source of strain. Rodríguez, Kozusznik, and Peiró ( 2013 ) developed a measure in which respondents indicate whether a stressor is a challenge or a hindrance. Just as some people may perceive demands to be challenges that they savor and that result in a psychological state of eustress (Nelson & Simmons, 2003 ), others find them to be constraints that impede goal fulfillment and thus might experience distress. Likewise, some people might perceive ambiguity as a challenge that can be overcome and others as a constraint over which he or she has little control and few or no resources with which to cope. More research on validating the measurement of challenge vs. hindrance stressors, as well as eustress vs. distress, and savoring vs. coping, is warranted. Second, at what point are challenge stressors harmful? Just because people experiencing challenge stressors continue to perform well, it does not necessarily mean that they are healthy people. A great deal of stressors are intellectually stimulating, but excessive stimulation can also take a toll on one’s physiological well-being, as evident by the droves of professionals experiencing different kinds of diseases not experienced as much a few decades ago, such as obesity (Fried et al., 2013 ). Third, which stress management interventions would better serve to reduce hindrance stressors or to reduce strain that may result from challenge stressors while reinforcing engagement-producing challenge stressors?

A fourth area that requires additional attention is that of the flexible work arrangements (FWAs). One of the reasons companies have been willing to permit employees to work from home is not so much out of concern for the employee, but out of the company’s need for the focal person to be able to communicate with a colleague working from a geographic region when it is night or early morning for the focal person. Glazer, Kożusznik, and Shargo ( 2012 ) presented several areas for future research on this topic, noting that by participating on global virtual teams, workers face additional stressors, even while given flexibility of workplace and work time. As noted earlier, more research needs to be done on the extent to which people who take advantage of FWAs are advantaged in terms of detachment from work. Can people working from home detach? Are those who find their work invigorating also likely to experience ill-health by not detaching from work?

A fifth area worthy of further research attention is workplace wellness programing. According to Page and Vella-Brodrick ( 2009 ), “subjective and psychological well-being [are] key criteria for employee mental health” (p. 442), whereby mental health focuses on wellness, rather than the absence of illness. They assert that by fostering employee mental health, organizations are supporting performance and retention. Employee well-being can be supported by ensuring that jobs are interesting and meaningful, goals are achievable, employees have control over their work, and skills are used to support organizational and individual goals (Dewe & Kompier, 2008 ). However, just as mental health is not the absence of illness, work stress is not indicative of an absence of psychological well-being. Given the perspective that employee well-being is a state of mind (Page & Vella-Brodrick, 2009 ), we suggest that employee well-being can be negatively affected by noxious job stressors that cannot be remediated, but when job stressors are preventable, employee well-being can serve to protect an employee who faces job stressors. Thus, wellness programs ought to focus on providing positive experiences by enhancing and promoting health, as well as building individual resources. These programs are termed “green cape” interventions (Pawelski, 2016 ). For example, with the growing interests in positive psychology, researchers and practitioners have suggested employing several positive psychology interventions, such as expressing gratitude, savoring experiences, and identifying one’s strengths (Tetrick & Winslow, 2015 ). Another stream of positive psychology is psychological capital, which includes four malleable functions of self-efficacy, optimism, hope, and resilience (Luthans, Youssef, & Avolio, 2007 ). Workplace interventions should include both “red cape” interventions (i.e., interventions to reduce negative experiences) and “green cape” interventions (i.e., workplace wellness programs; Polly, 2014 ).

A Healthy Organization’s Pledge

A healthy workplace requires healthy workers. Period. Among all organizations’ missions should be the focus on a healthy workforce. To maintain a healthy workforce, the company must routinely examine its own contributions in terms of how it structures itself; reinforces communications among employees, vendors, and clients; how it rewards and cares for its people (e.g., ensuring they get sufficient rest and can detach from work); and the extent to which people at the upper levels are truly connected with the people at the lower levels. As a matter of practice, management must recognize when employees are overworked, unwell, and poorly engaged. Management must also take stock of when it is doing well and right by its contributors’ and maintain and reinforce the good practices, norms, and procedures. People in the workplace make the rules; people in the workplace can change the rules. How management sees its employees and values their contribution will have a huge role in how a company takes stock of its own pain points. Providing employees with tools to manage their own reactions to work-related stressors and consequent strains is fine, but wouldn’t it be grand if organizations took better notice about what they could do to mitigate the strain-producing stressors in the first place and take ownership over how employees are treated?

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• DOI: 10.3183/npprj-2012-27-02-p318-328
• Corpus ID: 56427649

Stress-strain curve of paper revisited

• S. Borodulina , A. Kulachenko , +1 author S. Galland
• Published 1 May 2012
• Materials Science, Engineering
• Nordic Pulp & Paper Research Journal

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Constitutive modelling of a paper fibre in cyclic loading applications, relating nonuniform deformations to fracture in uniaxially loaded non-woven fiber networks, compression failure in dense non-woven fiber networks, toughness of network materials: structural parameters controlling damage accumulation., effect of fiber and bond strength variations on the tensile stiffness and strength of fiber networks, micromechanical numeric investigation of fiber bonds in 3d network structures., strength of stochastic fibrous materials under multiaxial loading., understanding extensibility of paper(cid:29) role of fiber elongation and fiber bonding, evaluation of the out-of-plane response of fiber networks with a representative volume element model, experimental and theoretical analysis of in-plane cohesive testing of paperboard.

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• Published: 15 July 2024

Enhancing psychological well-being in college students: the mediating role of perceived social support and resilience in coping styles

• Shihong Dong 1 ,
• Huaiju Ge 1 ,
• Wenyu Su 1 ,
• Weimin Guan 1 ,
• Xinquan Li 1 ,
• Yan Liu 2 ,
• Qing Yu 1 ,
• Yuantao Qi 2 ,
• Huiqing Zhang 3 &
• Guifeng Ma 1  

BMC Psychology volume  12 , Article number:  393 ( 2024 ) Cite this article

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The prevalence of depression among college students is higher than that of the general population. Although a growing body of research suggests that depression in college students and their potential risk factors, few studies have focused on the correlation between depression and risk factors. This study aims to explore the mediating role of perceived social support and resilience in the relationship between trait coping styles and depression among college students.

A total of 1262 college students completed questionnaires including the Trait Coping Styles Questionnaire (TCSQ), the Patient Health Questionnaire-9 (PHQ-9), the Perceived Social Support Scale (PSSS), and the Resilience Scale-14 (RS-14). Common method bias tests and spearman were conducted, then regressions and bootstrap tests were used to examine the mediating effects.

In college students, there was a negative correlation between perceived control PC and depression, with a significant direct predictive effect on depression ( β = -0.067, P  < 0.01); in contrast, negative control NC showed the opposite relationship ( β  = 0.057, P  < 0.01). PC significantly positively predicted perceived social support ( β  = 0.575, P  < 0.01) and psychological resilience ( β  = 1.363, P  < 0.01); conversely, NC exerted a significant negative impact. Perceived social support could positively predict psychological resilience ( β  = 0.303, P  < 0.01), and both factors had a significant negative predictive effect on depression. Additionally, Perceived social support and resilience played a significant mediating role in the relationship between trait coping styles and depression among college students, with three mediating paths: PC/NC → perceived social support → depression among college students (-0.049/0.033), PC/NC→ resilience → depression among college students (-0.122/-0.021), and PC/NC → perceived social support → resilience → depression among college students (-0.016/0.026).

The results indicate that trait coping styles among college students not only directly predict lower depression but also indirectly influence them through perceived social support and resilience. This suggests that guiding students to confront and solve problems can alleviate their depression.

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Introduction

Depression is a complex mental disorder, characterized by cognitive, affective and psychosocial symptoms [ 1 , 2 ]. It is projected that by 2030, depression will rank first globally in terms of years lived with disability [ 3 , 4 ]. Depression is also one of the most common mental health issues among contemporary college students [ 5 , 6 ]. Studies have shown that the detection rate of depression among Chinese college students ranges from 23–34% [ 7 , 8 ]. Compared to non-student populations, college students have a higher prevalence of depression, and this rate seems to be increasing [ 9 ]. This vulnerable group of college students is in a unique developmental stage, facing pressures not only from life but also from the demands of academic coursework and complex interpersonal relationships, making the factors influencing depression among college students, particularly complex [ 9 , 10 ].

Exploring the mechanisms by which influencing factors affect the occurrence of depression in college students is of significant importance for early prevention [ 11 ]. Research has demonstrated that trait coping style is one of the risk factors for depression among college students. Trait coping refers to the strategies individuals employ in challenging situations, categorized into positive coping and negative coping [ 12 , 13 ]. Positive coping focuses on taking effective action and changing stressful situations, typically associated with problem-solving behaviors and regulation of positive emotions, which can help reduce the incidence of depression [ 14 ]. Conversely, negative coping is a passive approach centered around negative evaluations and emotional expression, often involving avoiding problems and social isolation, which is more likely to lead to the development of depression [ 14 ]. Research indicates that positive coping strategies are inversely correlated with depression, serving as protective factors against depression. Conversely, negative coping strategies are positively associated with depression, acting as risk factors for its onset [ 15 ].

Perceived social support refers to an individual’s subjective emotional state of feeling supported and understood by family, friends, and other sources [ 16 , 17 ]. Prior studies have shown that perceived social support can directly impact an individual’s level of depression and also have indirect effects [ 18 ]. The data indicate that social support can significantly influence coping mechanisms, with groups having higher levels of social support tended to respond more actively and positively to stress from various sources [ 19 ]. Social support is considered an important mediating factor in determining the relationship between psychological stress and health, representing an emotional experience where individuals feel supported, respected, and understood [ 16 ]. The relationship between individuals’ coping strategies and depression may be influenced by the mediating role of perceived social support [ 20 , 21 ]. In addition to this, resilience plays a role in all three.Resilience refers to the ability to adapt to stress and adversity, enhancing an individual’s psychological well-being [ 22 ]. Both coping styles and perceived social support significantly predict resilience positively [ 23 ]. For individuals with strong resilience, possessing a high level of adaptive capacity can mitigate the negative effects of stress on individuals, thereby enhancing their mental health.

In recent years, there has been a growing body of research on the prevalence of depression among college students. However, the rates of depression vary in different environments, and there is limited research on the mechanisms through which trait coping styles, perceived social support, and resilience impact depression. Therefore, this study aims to investigate the mechanisms through which positive coping styles(PC), negative coping styles(NC), perceived social support, and resilience influence depression among college students. Additionally, it seeks to analyze the mediating roles of perceived social support and resilience in this context. The goal is to provide insights into the reasons behind depression among college students under different coping strategies, aiding in timely psychological adjustment to promote the comprehensive development of the mental and physical well-being of college students.

The following assumptions were made:

Hypothesis 1

PC has a significant negative predictive effect on depression among college students. NC has a significant positive predictive effect on depression among college students.

Hypothesis 2

Perceived social support serves as a mediator between PC/NC and depression among college students.

Hypothesis 3

Resilience mediates the relationship between PC/NC and depression among college students.

Hypothesis 4

Perceived social support and psychological resilience mediate the relationship between PC/NC and depression among college students in a serial manner.

Data and methods

This is a cross-sectional study that was conducted from January through February 2024. Using the Questionnaire Star network platform, we presented the questionnaire online, which was openly accessible to college students at a university in Shandong. The average time to complete the survey was 15 min. Participation was voluntary and students were informed about the purpose of the study. Confidentiality was assured and questionnaires were submitted anonymously. A total of 1267 enrolled college students participated in the questionnaire survey. After excluding invalid questionnaires, 1262 valid questionnaires were included, resulting in an effective rate of 99.57%.

Trait coping style questionnaire

The Trait Coping Style Questionnaire (TCSQ) [ 24 ], developed by Qianjin Jiang, was utilized to assess the trait coping styles of college students. This questionnaire reflects the participants’ approaches to coping with situations, comprising a total of 20 items. It consists of two dimensions: negative coping style and positive coping style, each with 10 items. Using a 5-point Likert scale ranging from “definitely not” to “definitely yes,” scores were assigned from 1.00 to 5.00. The Cronbach’s α coefficient for negative coping style was 0.906 and for positive coping style was 0.786 in this study.

Depression scale

The Patient Health Questionnaire-9 (PHQ-9) [ 25 ] was used to assess depressive symptoms in the past two weeks. This scale consists of 9 items rated on a 4-point Likert scale ranging from “not at all” to “nearly every day,” with scores from 0 to 3. The total score ranges from 0 to 27, with higher scores indicating more severe depressive symptoms. The Cronbach’s α coefficient for this scale in the current study was 0.884.

Perceived Social Support Scale

The Perception Social Support Scale (PSSS) was compiled by James A.Blumenthal in 1987 and later translated and modified by Qianjin Jiang to form the Chinese version of the Zimetm Perception Social Support Scale (PSSS) [ 26 , 27 ]. PSSS comprises 12 self-assessment items rated on a 7-point Likert scale. The scale includes three dimensions: family support (items 3, 4, 8, 11), friend support (items 6, 7, 9, 12), and other support (items 1, 2, 5, 10), with a total score ranging from 12 to 84. Scores of 12–36 indicate low support, 37–60 indicate moderate support, and 61–84 indicate high support. The Cronbach’s α for this scale in the current survey was 0.968.

Resilience scale

The Resilience Scale (RS-14) [ 28 ] Chinese version consists of 14 items, each rated on a 7-point Likert scale from “not at all” to “completely,” with scores ranging from 1 to 7. The total score ranges from 14 to 98, with higher scores indicating better resilience. The Cronbach’s α for this scale in the current study was 0.925.

Statistical analysis

Data were organized and analyzed using SPSS 26.0 software. Confirmatory factor analysis was first conducted on the questionnaires. Descriptive analysis was then performed on the scores of each scale. Spearman was used to examine the relationships between trait coping styles, perceived social support, resilience, and depression. Mediation analysis was carried out using the SPSS PROCESS macro 3.4.1 software model 6 developed by Hayes, specifically designed for testing complex models. Model 6 was applied for two mediating variables, followed by the bias-corrected percentile Bootstrap method with 5000 resamples to estimate the 95% confidence interval of the mediation effect. A significant mediation effect was indicated if the 95% confidence interval (CI) did not include zero. A significance level of P  < 0.05 was considered statistically significant.

Examination of common method bias

Systematic errors in indicator data results caused by the same data collection method or measurement environment can typically be assessed through the Harman single-factor test on 55 items in the dataset to examine common method bias. The results indicated that there were 7 factors with eigenvalues greater than 1, and the variance explained by the first factor was 34.84%, which was below the critical threshold of 40%. Therefore, this study may not have a significant common method bias.

Descriptive statistics and correlation analysis

The mean scores, standard deviations, and correlations of each variable are presented in Table  1 . PC ( r = -0.326, P  < 0.01), resilience ( r =-0.445, P  < 0.01), and perceived social support ( r =-0.405, P  < 0.01) were negatively correlated with depression. PC ( r  = 0.336, P  < 0.01) and resilience ( r  = 0.469, P  < 0.01) were significantly positively correlated with perceived social support. PC was significantly positively correlated with resilience( r  = 0.635, P  < 0.01). NC was significantly positively correlated with depression( r  = 0.322, P  < 0.01) and PC( r  = 0.146, P  < 0.01). NC was significantly negatively correlated with perceived social support ( r =-0.325, P  < 0.01).

Analysis of chain mediation effects

The chain mediation model was validated using SPSS PROCESS Model 6. Trait coping styles were considered as the independent variable, while depression among college students was treated as the dependent variable. Perceived social support and resilience were included as the mediating variables, culminating in the path model depicted in Figs.  1 and 2 .

The results of the regression analysis, as shown in Table  2 , indicated that PC could significantly predict perceived social support in a positive direction ( β  = 0.575, P  < 0.01). Both PC ( β  = 1.363, P  < 0.01) and perceived social support ( β  = 0.303, P  < 0.01) had significant positive predictive effects on psychological resilience. When simultaneously predicting depression using PC, perceived social support, and psychological resilience, all three exhibited significant negative predictive effects ( β = -0.067, β = -0.085, β = -0.090, P  < 0.01). NC could significantly predict perceived social support in a negative direction ( β = -0.457, P  < 0.01). When NC ( β  = 0.191, P  < 0.01) and perceived social support ( β  = 0.508, P  < 0.01) jointly predict psychological resilience, they both had significant positive predictive effects. When simultaneously predicting depression using NC, perceived social support, and psychological resilience, NC ( β  = 0.057, P  < 0.01) showed a significant positive predictive effect, while perceived social support ( β = -0.072, P  < 0.01) and psychological resilience ( β = -0.112, P  < 0.01) demonstrated significant negative predictive effects.

Further employing the Bootstrap sampling method, with 5000 repetitions, the significance of the mediating effects and chain mediation effects between trait coping styles and depression among college students was examined. The results indicated that the direct effects of PC/NC on depression were significant, with direct impact values of -0.067/0.057 (26.38%/60.00%). Perceived social support and psychological resilience mediated the relationship between PC/NC and depression, with this mediation encompassing three pathways: the separate mediating effect of perceived social support, with effect values of -0.049 and 0.033 respectively; the separate mediating effect of resilience, with effect values of -0.122 and − 0.021 respectively; and the serial mediating effect from perceived social support to resilience, with effect values of -0.016, -0.021, and 0.026. The 95% confidence intervals for all pathways did not include 0, indicating significant indirect effects. Therefore, the total indirect effects were − 0.187 (73.62%) and 0.038 (40.00%), showing that PC had a weaker direct effect on depression compared to NC, but a stronger indirect effect. This was illustrated in Table  3 .

Chain mediation model of perceived social support and resilience between PC and depression. ** p  < 0.01

Chain mediation model of perceived social support and resilience between NC and depression. ** p  < 0.01

Previous research on the associations and specific pathways among depressive symptoms, trait coping styles, perceived social support, and resilience in college students has been limited. Therefore, this study utilized a chain mediation model to examine how trait coping styles, perceived social support, and resilience influence depressive symptoms in college students. The results indicate that perceived social support and resilience not only act as separate mediators between PC/NC and depression but also exhibit a chain mediation effect.

Mechanisms of the impact of PC/NC on depression in college students

This study found that trait coping styles can significantly and negatively predict depressive symptoms in college students directly, consistent with previous research [ 29 ]. In recent years, amidst the backdrop of the pandemic, numerous studies have emerged domestically and internationally focusing on college students’ mental health from the perspective of crisis event coping [ 30 ]. These studies have predominantly concentrated on trait coping styles as a mediating variable in predicting the occurrence of depressive symptoms, with fewer studies examining the direct impact of trait coping styles on depressive symptoms. College students, being in a unique developmental stage, face challenges from various aspects and bear the pressures of academic coursework, interpersonal relationships, and future employment. Research indicates that trait coping styles are a key factor influencing mental health [ 31 ]. Implementing healthy coping techniques and interventions can help individuals overcome negative emotions caused by stress, which is an adaptive coping mechanism that assists college students in facing stress and enhancing problem-solving abilities, thus preventing or reducing the occurrence of depression. Conversely, adopting passive or avoidant coping strategies, leading to inadequate resolution of stress events, can increase psychological stress [ 14 ], thereby exerting a negative impact on the mental health of college students [ 32 ]. Therefore, trait coping styles play a negative predictive role in depressive symptoms among college students. PC was a positive predictor of depression and NC was a negative predictor of depression. This is consistent with previous studies [ 24 , 29 ].

Separate mediating effects of perceived social support and resilience

After introducing perceived social support and resilience as two mediating variables, the predictive effect of PC/NC on depressive symptoms in college students remained significant. The results show that PC can positively predict perceived social support, and NC is the opposite, consistent with previous research [ 33 ]. Trait coping styles are an important predictive factor in altering college students’ perceptions of social support and the occurrence of depression. Individuals who adopt negative coping styles tend to perceive relatively less external support. Some argue that social support plays a reverse predictive role in trait coping styles; the more social support college students receive and feel, the more likely they are to actively adopt positive coping strategies to alleviate stress, potentially due to variations in study subjects and time [ 34 ]. In this pathway, perceived social support can significantly and negatively predict depressive symptoms, aligning with previous research findings [ 35 ]. Perceived social support is considered a crucial mediating factor influencing mental health, referring to an individual’s ability to perceive support and understanding from family, friends, and others. College students with lower levels of perceived social support often feel neglected and undervalued, leading to negative evaluations and self-doubt, making them more susceptible to depression. PC/NC and perceived social support can interact and influence the occurrence of depressive symptoms in college students [ 16 ].

Research indicates that PC can significantly and positively predict resilience, with an indirect effect value of 48.03%.In this pathway, the mediating effect of resilience is more pronounced, consistent with previous studies [ 36 ]. There is a close connection between resilience and coping styles; college students who adopt positive coping strategies often exhibit stronger psychological resilience, being more willing to confront issues and seek help from others to solve problems. When facing pressures such as academic challenges, they approach them with a positive mindset, overcoming adversity [ 37 ]. It is believed that adopting positive coping strategies to address problems can enhance college students’ levels of psychological resilience [ 10 , 38 ]. Resilience can significantly and negatively predict depressive symptoms. depressive symptoms, College students with higher levels of resilience tend to define the severity of events less severely when stress events occur, resulting in lower psychological burdens and reduced likelihood of experiencing depressive symptoms [ 10 ]. Additionally, when facing setbacks or stress, individuals who adopt positive coping strategies actively utilize internal and external protective factors to combat current difficulties and pressures, and employ effective emotional control to mitigate the impact, thereby enhancing their levels of psychological resilience and reducing the occurrence of depression.

Chain mediation effect of perceived social support and psychological resilience

This study elucidates that PC/NC perceived social support, and psychological resilience are independent factors influencing depressive symptoms in college students, with perceived social support and psychological resilience playing a mediating role between coping styles and depressive symptoms. The share of total indirect effect values is 73.62% and 40.00%, respectively, with the third chain path accounting for 6.30% and 27.37% of the total effect ratio, respectively. This confirms the existence of this chain mediation effect, although the chain mediation effect is not as pronounced as the individual mediation effects. Positive coping styles not only directly negatively predict depressive symptoms in college students but also exert an indirect influence on depressive symptoms through perceived social support and psychological resilience. Likewise, negative coping styles not only directly positively predict depressive symptoms in college students but also have an indirect impact on depressive symptoms through perceived social support and psychological resilience, thus demonstrating the value and significance of these two mediating variables in reducing the occurrence of depressive symptoms in college students.

Initially, adopting positive coping styles and being able to perceive social support are crucial factors influencing psychological resilience in college students. There exists a relatively stable systemic relationship between students’ social support and psychological resilience, confirming that social support can enhance individuals’ levels of psychological resilience [ 16 ]. Furthermore, coping styles can affect the occurrence of depressive symptoms from both internal and external perspectives. This is because the social support perceived by college students includes not only tangible social support resources but also their subjective perception of social support, with these two factors constituting external and internal protective factors of psychological resilience [ 39 ]. Positive coping and effective adaptation can enhance college students’ perception of social support, enabling them to mobilize personal, familial, and societal protective factors better when facing various life challenges, thereby mitigating or eliminating difficulties and suppressing the onset of depressive symptoms, whereas negative coping styles yield the opposite effect. The chain mediation proposed in this study integrates the research on perceived social support, psychological resilience, and depressive symptoms in college students, facilitating a more comprehensive understanding of the internal mechanisms through which coping styles influence depressive symptoms in college students. This holds significance in advocating for a proactive attitude in college students to confront and resolve difficulties and in increasing attention to the mental health of college students.

Limitations, strengths and future research

The findings of this study hold theoretical value and practical implications, offering a reference basis for improving the mental health of college students. However, there are certain limitations to consider. Firstly, the survey in this study was conducted through self-reporting, which may introduce certain biases. Future research could explore data collection through various methods. Secondly, this study employed a cross-sectional design to investigate the impact of trait coping styles, on depression among college students and its potential mechanisms. However, this research approach does not allow for causal inferences between variables, and further validation of the study’s conclusions could be achieved through longitudinal or experimental research.

In summary, this study aims to improve the mental health of college students by examining how their coping styles, along with their perceived social support and psychological resilience, affect depressive symptoms. The research analyzes the connections between these factors and suggests that positive coping styles may help prevent depression. However, the study has its limitations and future research should use long-term experiments to better understand these relationships. Since depression in college students can be influenced by many factors, future studies should also consider additional variables and use a mix of experimental and longitudinal approaches to more clearly understand how to reduce depression in this group.

Data availability

The datasets used and analysed during the current study are available from the corresponding author upon reasonable request.

Abbreviations

Patient Health Questionnaire-9

Trait Coping Style Questionnaire

Positive coping styles

Negative coping styles

Resilience Scale

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Acknowledgements

We would like to provide our extreme thanks and appreciation to all students who participated in our study.

This work was financially supported by the National Food Safety Risk Center Joint Research Program [grant number (LH2022GG06)] and the Weifang Medical College Teaching Reform Program (2023YBC008).

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SD and GM conceived and designed the study. HG, WS, WG, and YL undertook the data collection and analysis. SD, QY, YQ, XLand HZ drafted the manuscript. SD and GM reviewed the manuscript. The authors read and approved the final manuscript.

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Dong, S., Ge, H., Su, W. et al. Enhancing psychological well-being in college students: the mediating role of perceived social support and resilience in coping styles. BMC Psychol 12 , 393 (2024). https://doi.org/10.1186/s40359-024-01902-7

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DOI : https://doi.org/10.1186/s40359-024-01902-7

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Danielle r. adams.

a Department of Psychology, Roosevelt University, 430 S. Michigan Avenue, Chicago, Illinois 60605

b Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, 3535 Market Street, 3015, Philadelphia, PA 19104, USA, 312-550-3878

Steven A. Meyers

Rinad s. beidas.

Financial strain may directly or indirectly (i.e., through perceived stress) impact students’ psychological symptoms and academic and social integration, yet few studies have tested these relationships. We explored the mediating effect of perceived stress on the relationship between financial strain and two important outcomes: psychological symptomology and academic and social integration.

Participants

Participants were 157 undergraduate students. Data were collected from December 2013 to March 2014.

Cross-sectional data collection conducted using online survey software.

We found that perceived stress mediated the relationship between financial strain and (a) psychological symptomology and (b) academic and social integration. Both models included first-generation status as a covariate.

Conclusions

Results suggest that perceived stress is an important intervention target for reducing psychological symptoms and improving academic and social integration for undergraduate students. Implications for university health centers and mental health professionals include incorporating a public health model to minimize stress risk.

Introduction

A college education is critical to economic success and upward social mobility in America. This is especially important for low-income (i.e., young adults whose families fall below the federal poverty line) and/or first-generation (i.e., young adults whose parents have not earned a four year college or university degree) students. 1 , 2 These individuals have the most to gain from attaining a college degree, as returns on investment for them are at least as high (if not higher) compared to students with average socioeconomic status. 3 Children born into the bottom income quartile who attain a college degree quadruple their chances of making it into the top quartile, and increase their chances of making it out of the bottom quartile by 50%. 4 Unfortunately, college completion rates for low-income and/or first-generation students are very low. Just one in ten low-income and/or first-generation students will have a college degree by age 25, vs. one in two for their non-low-income and/or non-first-generation peers. 2 This is not due to a lack of enrollment in post-secondary education. In fact, low-income and/or first-generation students make up 24% of the undergraduate student population, a percentage that is increasing steadily. 2 This enrollment-to-graduation gap may be due to greater financial and non-financial strain faced by low-income and/or first-generation students in postsecondary education, resulting in poorer graduation rates. 2 While first-generation students do not always come from low-income families, and low-income students are not always first-generation students, often the two groups converge, creating two dimensions of disadvantage that have negative associations with degree attainment. 5 – 7 Given the benefits associated with degree completion, it is essential to understand the primary mechanism causing the large enrollment-to-graduation gap and poor academic outcomes of low-income and/or first-generation students.

Financial Strain

One of the most robust stressors for low-income and/or first-generation students is financial strain, defined as perceived economic stress and lack of economic support. Past research has identified a strong relationship between financial strain and probability of graduation. 8 , 9 Specifically, students reported that four out of the five top stressors in their lives involved personal finances, and that these stressors affected their academic progress and performance. 10 Further, unmet financial needs may require low-income and/or first-generation students to work full time jobs and live off campus, which may hinder their academic and social interaction on campus as well as increase the probability for attrition. 11

Perceived Stress

Perceived stress is defined as the extent to which an individual perceives that their demands exceed their ability to cope, and is a major factor in academic disruption and poor academic performance. 12 , 13

Academic and Social Integration

Low-income and/or first-generation students are more likely to experience difficulty with academic and social integration, defined as student’s involvement and adaptation to their university (e.g., the ability to make social connections with peers and/or faculty on campus, meeting academic demands, participating in on-campus clubs or activities, and having clear career direction). 14 Difficulties with academic and social integration can be expressed in a variety of ways in low-income and/or first-generation students. For example, first-generation students are less likely to socialize with faculty or students outside of the classroom, less likely to develop close friendships with other students, and less likely to participate in extracurricular activities (academic or social clubs) on campus. 2 , 14 Difficulties with academic and social integration among low-income and/or first-generation students is scantly studied.

Psychological Symptomology

Mental health problems have been identified as a critical public health issue on college campuses by the American Psychological Association. 15 – 17 Mental health issues are prevalent on college campuses, can be detrimental to overall academic performance and success, and frequently lead to student attrition. 15 In addition, mental health issues are linked to suicidal ideation, a growing public health concern, specifically on college campuses. 18 Mental health issues may be exacerbated for low-income and/or first-generation students due to the negative impact that financial strain has on perceived stress. 19

Theoretical Framework

We theorize that the constructs of interest (i.e., financial strain, perceived stress, psychological symptoms, and academic and social integration) are related to one another (see Figure 1 ). Perceived stress and financial strain have a negative impact on students’ well-being, specifically their mental health. 20 – 22 For example, research suggests that financial strain and its sequelae (e.g., insufficient food, shelter, heat, inability to pay bills) are critical factors in negative psychosocial outcomes such as stress and depression in students. 23 , 24 Finally, financial strain and perceived stress have been related to difficulty with academic and social integration as students who experience financial strain may be less likely to engage in campus activities potentially due to financial barriers. 2 Increased perceived stress may also exacerbate already present difficulties with academic and social integration that low-income and/or first-generation students face.

Model Illustrating how Financial Strain is Hypothesized to be Related to Perceived Stress, Psychological Symptomology, and Academic and Social Integration in Undergraduate Students.

Given that past studies have indicated the importance of perceived stress on low-income and/or first-generation students’ outcomes, we were interested in testing the theory that perceived stress may be the primary mediating mechanism between financial strain, psychological symptomology, and academic and social integration. 20 – 22 Possible direct and indirect effects (e.g., increased perceived stress levels) of financial strain on students’ academic and social integration levels have been seldom studied, and have not been studied using a mediational model to date. While past studies have established a strong correlational relationship between financial strain and psychological symptoms in undergraduate students, a solid understanding of the potential mediating mechanisms for this relationship has not yet been established. 20 Therefore, the mechanism through which financial strain impacts poor outcomes is especially important to understand, as early identification may be the best way to prevent negative sequelae, potentially boosting the capacity for first-generation and low-income students to improve their academic performance and enhance their mental health and well-being.

The current study utilized a cross-sectional survey methodology with a sample of university undergraduates to examine the relationships among financial strain, perceived stress, psychological symptoms, and academic and social integration at college. We tested two primary hypotheses: (1) Perceived stress was expected to mediate the relationship between financial strain and psychological symptoms, and (2) Perceived stress was expected to mediate the relationship between financial strain and academic and social integration. Both models included first-generation status as a covariate given our interest in this particular sub-group of undergraduate students.

After approval by the university Institutional Review Board, participants were recruited primarily through undergraduate psychology courses. Participants were also recruited through Student Support Services, a university office at that works with identified low-income, first-generation, and disabled students, and the university’s honors program. Inclusion criteria included being an undergraduate student at the university; there were no exclusion criteria. The survey was administered using Qualtrics, an online survey software system, and required an average of ten minutes to complete. Consent was obtained prior to participation via an online description of the study and the option to participate or leave the study.

Instruments

Demographics.

Basic demographics were collected using an investigator-created measure. These demographics included job status, hours worked per week, family income level, the number of individuals who lived off this income, and enrollment status in university, i.e., part-time (less than twelve credits) or full-time (twelve or more credits) in university.

The Financial Strain and Economic Support Measure (FSESM); 25 only the chronic financial strain subscale was used to measure this construct. Financial strain was assessed with three indicators that asked whether study participants have enough money to live on each month, whether they have sufficient spending money, and how their financial situation compares to that of other people their own age. These items include, “Does your family have enough for daily living expenses each month?” “Compared to other people your own age, how do you feel about your financial situation?” and “Do you have enough pocket money to spend?” Participants were asked to rate items on a four point scale, ranging from 1 ( Plenty) to 4 ( Extremely tight ), a three point scale ranging from 1 ( Better ) to 3 ( Worse ), or a 2-point scale ranging from 2 ( No ) to 1 ( Yes ), depending on the question asked. Previously reported reliability is strong for the financial subscale (Cronbach’s alpha = .73). 25 Cronbach’s alpha in the present investigation was .74.

The Perceived Stress Scale (PSS), 13 a brief ten item measure, was used to assess the degree to which situations in one’s life are appraised as stressful. Sample items include, “In the last month, how often have you found that you could not cope with all the things that you had to do?” and “In the last month, how often have you been able to control irritations in your life?” Participants rated items on a five-point scale, ranging from 0 ( Never ) to 4 ( Very often ). Previously reported reliability is good for this measure (Cronbach’s alpha = .85). 13 Cronbach’s alpha in the present investigation was .83. PSS scores have displayed convergent validity with other well-known measures, i.e., the State-Trait Anxiety Inventory (STAI-A factor) 26 and the State-Trait Depression Inventory (STAI-D factor). 27 , 28

The Inventory of College Challenges for Ethnic Minority Students (ICCEMS), 29 a 52 item measure, was used to assess challenges faced by college students across a range of academic and social domains. The following subscales were used in this study: counseling needs (e.g., “Difficulty finding a counselor”), financial worry (e.g., “Worried about family obligations”), academic demands (e.g., “Felt conflict between studying and making friends”), unclear career direction (e.g., “Worried about post-graduation plans”), social isolation, (e.g., “Felt isolated from the college community”), difficulty with academic expression, (e.g., “Felt you could not express yourself adequately in class discussions”), unfamiliarity with campus (e.g., “Had trouble accessing various campus resources”), and inability to study (e.g., “Been unable to study when you wanted to for as long as you wanted to”). These subscales were used for their relevance to the extant literature on academic and social integration in low-income and/or first-generation students. 14 Participants were asked to rate items on a five point scale, ranging from 0 ( Not at all ) to 4 ( All the time). Previously reported reliability is very good for this measure (Cronbach’s alpha = .89). 29 Cronbach’s alpha in the present investigation was .91. ICCEMS scale scores have displayed convergent validity with other well known-measures, i.e., the Center for Epidemiologic Studies Depression Scale (CES-D) 30 and the Rosenberg Self-Esteem Scale (RSE). 31

The Brief Symptom Inventory (BSI), 32 a 53 item self-report inventory of psychopathology and psychological distress, is used with both clinical and non-clinical populations. The following subscales were used in this study: somatization (SOM; e.g., “Faintness or dizziness”), obsessive-compulsive (OC; e.g., “Having to check and double-check what you do”), interpersonal sensitivity (IS; e.g., “Feeling inferior to others”), depression (DEP; e.g., “Feeling no interest in things”), anxiety (ANX; e.g., “Feeling tense or keyed up”), and phobic anxiety (PHB; e.g., “Feeling uneasy in crowds, such as shopping or at a movie”). Participants were asked to rate each of the items on a five point Likert scale of distress, ranging from 0 ( Not at all ) to 4 ( Extremely ). Cronbach’s alpha in the present investigation was .94. BSI scale scores have displayed convergent validity with other well known-measures, i.e., Minnesota Multiphasic Personality Inventory (MMPI) 33 and the Symptom Checklist-90-Revised (SCL-90-R). 34

Data Analytic Plan

We used descriptive analyses to report demographic characteristics of our sample. To test the two hypotheses in this study, we conducted two separate mediation analyses. Specifically, we tested whether perceived stress, as measured by the PSS, 13 mediated the relationship between financial strain (i.e., FSESM) and (a) psychological symptoms (i.e., BSI) and (b) academic and social integration (i.e., ICCEMS), using first-generation status as a covariate in both models. To test these two mediation analyses, we used the SPSS macro, “PROCESS,” based upon the Preacher and Hayes 35 method to produce bootstrap bias corrected and accelerated confidence intervals to evaluate the indirect effect and model coefficients. 35 , 36

Mediational modeling attempts to identify the mechanism (M) that underpins a relationship between an independent variable (X) and a dependent variable (Y). Traditional mediational modeling follows the Baron and Kenney approach, 37 which puts forth the following four steps: (1) Does X affect Y? (2) Does X affect M? (3) Does M affect Y while holding X constant? (4) Is the direct effect of X closer to zero than the total effect? This approach is no longer the preferred approach to mediational modeling as it is greatly underpowered. 36 Therefore, the recommended approach to mediation includes the estimation of paths within the model using the bootstrap confidence interval. Bootstrapping allows for empirical estimation of the sampling distribution of the indirect effect (not measured in the Baron and Kenney approach), 37 and produces a confidence interval to be used as part of hypothesis testing. Briefly, this method allows the researcher to treat the sample as a “pseudo population;” randomly sample n from that sample with replacement; and estimate the indirect effect in the resample k times. Then, the distribution of the indirect effect over multiple resamples is estimated. Bias corrected and accelerated confidence intervals are the preferred method for bootstrapping because they adjust for bias and skewness in the bootstrap distribution. 36 We used biased corrected and accelerated bootstrapping as it adjusts for bias and skewness in the bootstrap distribution. 36 This method is currently the suggested manner to conduct mediational analyses. 38

Descriptive Statistics and Bivariate Correlations

Table 1 reports descriptive statistics (i.e., means and standard deviations) and bivariate correlations among study variables.

Descriptive Statistics and Correlations for Study Variables.

Participants included 157 undergraduate students from a large Midwestern university, the majority of whom were female ( n = 112). Ten participants were excluded from the mediational analyses but were included in descriptive analyses as they completed less than half of the survey. The average age of participants was 22 years ( SD = 6.23). The sample was ethnically diverse, with 63 Caucasians (41.1%), 35 African Americans (22.3%), 35 Hispanic/Latino/Latinas (22.3%), 6 Asians (3.8%), and 18 individuals who were multi-racial or “other” race (11.5%).

Participants reported an average GPA of 3.23 ( SD = .76). The sample included 54 Freshman (34.4%), 41 Sophomores (26.1%), 27 Juniors (17.2%), and 35 Seniors (22.3%). Approximately 51% ( n = 80) of the participants met criteria for being a first-generation student (i.e., both parents had not completed a four-year college or university degree, or higher). Approximately 38% ( n = 59) of the participants met criteria for being “low-income,” as defined by self-reported family income (measured by asking the participant which total family income bracket they fell into, and how many people lived off this income; low-income status was then determined by the number of those falling below the federal poverty guidelines). 39 Approximately 30% ( n = 47) of the participants met criteria for being both a low-income and a first-generation student. Approximately 43% ( n = 68) of the participants reported having a job, working an average of 20 hours per week ( SD = 3.5). Students also provided demographic information regarding their maternal and paternal level of education (see Table 2 ). Participants were primarily (94%) enrolled full-time in university ( n = 147).

Participants’ Maternal and Paternal Level of Education

Mediational Model 1

We predicted that perceived stress would mediate the relationship between financial strain (independent variable) and average psychological symptoms (dependent variable; see Figure 2 ). First-generation status was included as a covariate.

Model Illustrating how Perceived Stress Mediates the Relationship Between Financial Strain and Psychological Symptomology with First-Generation Status as a Covariate.

Note. All coefficients are standardized and were significant at the p < .01 level. Number in parenthesis indicates coefficient standard error. The c′ path is the direct effect of the predictor on the dependent variable. The total effect includes the mediator.

The direct effect of financial strain on psychological symptoms was not significant ( c’ = −.0094, p = .93; 95% CI = −.21 to .19). Using a 95% confidence level, boot-strapping with 10,000 iterations produced a bias corrected and accelerated confidence interval of −.24 to .19. Zero was not included in this confidence interval, suggesting that the indirect effect (i.e., mediation) was significantly different from zero ( ab’ = −.12; 95% CI = −.25 to −.01). The Sobel test corroborated this finding ( Z = −2.07, p = .04), suggesting that Hypothesis 1 was supported.

Mediational Model 2

We also predicted that perceived stress would mediate the relationship between financial strain (independent variable) and academic and social integration (dependent variable; see Figure 3 ). First-generation status was included as a covariate.

Model Illustrating how Perceived Stress Mediates the Relationship Between Financial Strain and Academic and Social Integration with First-Generation Status as a Covariate.

The direct effect of financial strain on academic and social integration was not significant ( c’ = −.0057, p = .58; 95% CI = −.26 to .14). Using a 95% confidence level, boot-strapping with 10,000 iterations produced a bias corrected and accelerated confidence interval of −.25 to .01. Zero was not included in this confidence interval, suggesting that the indirect effect (i.e., mediation) was significantly different from zero ( ab’ = −.12; 95% CI = −.25 to −.01). The Sobel test corroborated this finding ( Z = −2.07, p = .04), suggesting that Hypothesis 2 was supported.

The findings from the current study provide insight on the relationships between financial strain, psychological symptoms, and academic and social integration in undergraduate students enrolled in post-secondary education. Taken together, these two mediational models suggest that perceived stress is an important mechanism to separately explain the relationship between both financial strain and psychological symptoms, and financial strain and academic and social integration. In these models, the influence of perceived stress serves to increase the negative effects of financial strain on psychological symptomology and on academic and social integration. This is new information which can inform interventions to improve psychological and academic outcomes in college students through programming that directly addresses both financial strain and perceived stress.

Programming that addresses financial strain has already been deployed in post-secondary education settings (e.g., Student Support Services; McNair Scholars program, TRiO programming, Upward Bound), as well as efforts to make financial aid more accessible. 40 Student Support Services and the McNair Scholars program seek to improve graduation rates for these populations and prepare low-income and/or first-generation students for advanced graduate study. 2 These programs provide low-income and/or first-generation students with the opportunity to participate in four to six week long summer programming that prepares students for their transition into college. Other programs offered include: academic, career, and financial aid counseling, direct financial assistance in the form of scholarships, peer assistance, cultural events, workshops, and instructional courses. 41 Students who participated in Student Support Services have higher grades, earn more credits, and have higher retention and graduation rates than low-income and/or first-generation college students who do not participate in these programs. 42

Research has found that increases in financial aid are directly correlated with retention of first-generation students, while increases in loan debt are directly correlated with the likelihood of attrition. 2 , 43 , 44 One study found that combining scholarships with peer advising, organized study groups, and mentoring increases retention, persistence, and degree completion significantly. 45 Another study found that one-on-one student coaching increased retention by 14% after two years of the intervention, and increased graduation rates from 31% to 34% in the subset of students who participated in the study. 46 Colleges and universities must remove financial barriers that prevent low-income and/or first-generation students from fully participating and engaging in experiences that are associated with success in college (e.g., living on campus, participating in extracurricular activities), while also promoting activities that support social and academic success.

While programming around financial strain has been implemented across many colleges, less attention has been paid to perceived stress in undergraduate students. Given the findings of this study that indicate that perceived stress plays an important role in the relationship between financial strain and two negative outcomes (i.e., psychological symptomology and academic and social integration), we suggest that university stakeholders turn their attention to this important issue from a prevention lens (i.e., this is an opportunity to intervene before mental health difficulties or attrition occurs).

Colleges and universities should consider incorporating a three-tiered public health model to minimize universal risk for increased perceived stress by (1) universal capacity building in existing settings for all students; (2) prioritizing high-risk (i.e., low-income and/or first-generation) groups for screening and services to reduce onset and severity of symptoms; and (3) implementing intervention programs for individuals with the highest risk (i.e., low-income and/or first-generation students with identified high levels of perceived stress) to prevent and/or mitigate negative outcomes. 47 One way to address the first tier of universal capacity building in colleges and universities would be to implement free or low-cost campus wide yoga, support groups, or meditation groups that all students are invited to attend. Another option is to enroll first year low-income and/or first-generation students into groups that would support integration, financial counseling, and teaching students coping mechanisms and meditating techniques to prevent perceived stress issues in this population before they begin.

A potential avenue to addressing the second tier, screening high-risk (i.e., low-income and/or first-generation) students, might be through greater coordination between Student Support Services, college and university health centers, and college and university counseling centers. Student Support Services personnel can take steps to learn about enrolled students’ perceived stress levels (e.g., by administering the PSS 13 on a routine basis) to screen for students who have high levels of stress. Another existing setting that could offer screenings is college and university health centers, as they are utilized by students of all backgrounds and are therefore an ideal location for a screening. Similar to above, this could begin by having students complete the PSS 13 as they are waiting for their yearly physical and/or shots/immunizations. The provider on staff could use the PSS 13 as a screener to identify students with high levels of perceived stress, and then either refer them to the university counseling center and/or provide the student with resources for how to cope with their elevated perceived stress levels to prevent or reduce psychological symptoms and/or difficulties with academic and social integration.

Given that undergraduate students may face additional barriers to accessing mental health care inside of their university (potentially due to stigmatization around mental health issues and counseling center waitlists) 48 and outside of their university (potentially due to financial constraints, especially for low-income students, and availability of counseling services), 49 it is essential that college and university health centers take it upon themselves to provide interventions students with identified high perceived stress levels in order to reduce these levels. After identifying students with highest levels of perceived stress colleges and universities should invest in low-cost, easy to implement interventions such as the “Maximize Your Potential” intervention, a six-week course that utilizes cognitive behavioral techniques and has been shown to decrease perceived stress scores in students in a randomized controlled trial. 50 Another randomized control trial of a meditation group that teaches various skills (e.g., sitting meditation, mindful or focused attention, patience and slowing down) has been proven to reduce stress among undergraduate students, and could be implemented as an intervention for students in the highest risk group. 51 By doing so, they address the third tier of the public health model, that is, providing interventions for the highest risk students, potentially mitigating the influence of perceived stress on identified negative outcomes (i.e., psychological symptomology and academic and social integration).

Limitations and Future Directions

Because of the cross-sectional nature of this study, causal relationships between financial strain and psychological symptomology/academic and social integration cannot be determined from this investigation. Instead, results document the associations among the variables rather than patterns of cause and effect. Longitudinal and prospective studies are needed to identify causal relationships. A convenience sample was used for this study. The sample was primarily female, and results were gathered only at one Midwestern University, which may reduce the generalizability of this study. We did not verify financial demographics (i.e., the actual amount the student’s family earns in a year and how many people are supported). The question was posed to participants, however, college students may not have a thorough understanding of their family’s financial situation. Future studies should utilize Free Application for Federal Student Aid (FASFA) information to gain a more accurate account of students’ family’s financial situation.

Student attrition and student mental health are increasing concerns at many colleges and universities. Low-income and/or first-generation students are at a higher risk for dropping out, suggesting the importance of understanding factors predicting dropping out as potential targets for intervention. Past research has found both financial strain and mental health issues to be sources of attrition. Prior to this study, the mechanism between financial strain and psychological symptoms/academic and social integration was unknown. This study found that perceived stress mediated the relationship between financial strain and (a) psychological symptoms and (b) academic and social integration. Perceived stress is therefore an important intervention target. University stakeholders, such as college administrators, advisors, support staff, university health center staff, and mental health professionals, should take note of these results in order to improve academic, social, and mental health outcomes for low-income and/or first-generation students. Given the increasing number of low-income and/or first-generation students enrolling, colleges and universities act as promising venue for prevention and intervention of mental health disorders, which can help set young adults on a path to academic, social, and mental well-being.

Acknowledgments

We are especially grateful to Active Minds for providing author DRA with an Emerging Scholars Fellowship to complete this work. Funding for RSB was provided by K23 MH099179. We would like to thank the following experts who provided their time and input into this study: Dr. Daniel Eisenberg and Sarah Ketchen Lipson of the Health Minds Network at The University of Michigan, Ann Arbor. We would also like to thank Dr. Andrew Hayes of the Department of Psychology at the Ohio State University who provided feedback on the statistical analyses conducted.

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Estimation of stress-strain state of a gas pipeline section with different types of defects

• Fugarov, D. D.
• Purchina, O. A.
• Purchina, A. D.

This work is aimed at assessing the stress-strain state of a gas pipeline section with different types of defects. The purpose of the calculations is to determine the reliability of the pressurized structure and to assess its serviceability in future operation. The paper presents an assessment of the "dent" type defects and a non-through surface fracture, which were obtained as a result of impact loading. The calculations were performed in the ANSYS mathematical modelling software package, which is a multipurpose package for solving complex physics and mechanics problems based on the finite element method. A model of the gas pipeline section was created in the vicinity of which the defect is located. Preliminary equivalent stresses at normal operation of the object were calculated in this section, as a result of which the place was found, which has the highest load at normal operation. In this zone, defects are applied programmatically. In the process of research, it is revealed that at given geometric parameters, the considered defects do not pose a threat to further operation of the object. The considered assessment method is well suited for objects of different complexity and size, so the scope of application is vast - from machine parts to huge structures.

Numerical analysis of fissure development and self-healing mechanism on surface due to longwall mining

• Original Paper
• Published: 24 July 2024
• Volume 83 , article number  329 , ( 2024 )

Cite this article

• Na Zhang 1 , 2 ,
• Yuxin Ren 1 , 2 ,
• Yingming Yang 3 , 4 &
• Pingye Guo 1 , 2  

The causes of ground fissure formation are closely related to the change in the stress state in a loose layer, but many researchers often ignore the dynamic processes of mining when studying mining-induced damage mechanisms. The study of stress evolution in a loose layer during mining can help to reveal the causes of surface damage and its self-healing mechanism. This paper establishes a numerical model to study a loose layer’s stress evolution and its causes during mining. The discriminative conditions of the potential dynamic fissure formation cycles and self-healing are given. The vertical and horizontal stresses in the loose layer at the mining boundary increase and then decrease under the mining disturbance, and the vertical stresses in the loose layer above the comprehensive mining surface undergo two increasing and decreasing stages, while the horizontal stresses increase and decrease and then increase again. The permanent fissures at the mining boundary form because of the decompression- and compression-related damage caused by horizontal unloading, while the dynamic fissures in the loose layer at the mining surface form due to the first horizontal unloading effect; the shear damage is caused by the second increase in vertical stress. Additionally, the soil Mohr‒Coulomb strength criterion and the linear elastic stress‒strain relationship are used to discriminate the single- and double-cycle development patterns of the dynamic fissures on the ground surface.

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Data availability

The data used and analyzed during the current study are available from the corresponding author on reasonable request.

Code availability

The code used and analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

This work was supported by the National Natural Science Foundation of China (41941018) and supported by the Beijing Natural Science Foundation (8212033) and supported by the Fundamental Research Funds for the Central Universities (2021JCCXLJ05).

National Natural Science Foundation of China,41941018,Pingye Guo,Beijing Natural Science Foundation,8212033,Pingye Guo,Fundamental Research Funds for the Central Universities,2021JCCXLJ05,Pingye Guo

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State Key Laboratory for Tunnel Engineering, China University of Mining and Technology, Beijing, 100083, China

Na Zhang, Yuxin Ren & Pingye Guo

School of Mechanics and Civil Engineering, China University of Mining and Technology, Beijing, 100083, China

State Key Laboratory of Water Resource Protection and Utilization in Coal Mining, Beijing, 102209, China

Yingming Yang

National Energy Investment Group Co., Beijing, 100011, China

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Na Zhang: Conceptualization, Methodology, Software, Formal analysis, Writing – review & editing. Yuxin Ren: Methodology Software, Formal analysis, Writing – review & editing. Yingming Yang: Resources, Data curation, Writing – review & editing. Pingye Guo: Conceptualization, Methodology, Project administration, Funding acquisition, Writing – review & editing.

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Zhang, N., Ren, Y., Yang, Y. et al. Numerical analysis of fissure development and self-healing mechanism on surface due to longwall mining. Bull Eng Geol Environ 83 , 329 (2024). https://doi.org/10.1007/s10064-024-03829-0

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Received : 18 March 2023

Accepted : 16 July 2024

Published : 24 July 2024

DOI : https://doi.org/10.1007/s10064-024-03829-0

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