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Am J Ind Med. 2020 Feb;63(2):170-179. doi: 10.1002/ajim.23070. Epub 2019 Nov 12.

Psychosocial work stressors, high family responsibilities, and psychological distress among women: A 5-year prospective study.

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Axe Santé des Populations et Pratiques Optimales en Santé, CHU de Québec Research Center, Québec City, Quebec, Canada.
Department of Organization and Human Resources, Université du Québec à Montréal (UQAM), Quebec, Canada.
Department of Social and Preventive Medicine, Laval University, Québec City, Québec, Canada.
Institut National de Santé Publique du Québec, Québec City, Quebec, Canada.



Psychological distress is a strong and independent predictor of major depression. Assuming multiple roles (such as being both a mother and an employee) under stressful conditions may lead to psychological distress. This study evaluated, for the first time, the longitudinal effect of the simultaneous exposure to psychosocial work stressors and high family responsibilities on women's psychological distress.


Women were assessed at baseline (N = 1307) and at 3- and 5-year follow-ups. Psychosocial work stressors of the demand-control and effort-reward imbalance models were measured with validated questionnaires. Family responsibilities were also self-reported and referred to the number of children and their age(s) as well as housework and childcare. Psychological distress was measured with the validated Psychiatric Symptoms Index questionnaire. Prevalence ratios (PR) of psychological distress were modeled with log-binomial regressions.


Having high family responsibilities did not increase women's prevalence of psychological distress. However, being exposed to either job strain or effort-reward imbalance led to a higher prevalence of psychological distress at the 3- and 5-year follow-ups (PR of 1.25-1.62). Being simultaneous exposed to these psychosocial work stressors and high family responsibilities also increased the prevalence of psychological distress (PR of 1.44-1.87), but no interactions were observed between stressors and responsibilities.


In this 5-year prospective study, simultaneous exposure to psychosocial work stressors and high family responsibilities increased the prevalence of psychological distress among women. Work stressors were, however, driving most of the effect, which reinforces their importance as modifiable risk factors of women's mental health problems.


effort-reward imbalance; family responsibilities; job strain; mental health; psychological distress


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