Stress: A look at the relationship between stress, job types, and decision fatigue

Overview of Determinants

Social determinants are often used to examine the causes of mental or physical health problems.  Determinants can be considered as factors or influences, medical or non-medical, upon the health of an individual or group. By examining local or downstream determinants that have a more direct impact and association with the individual or group, links and causes can be traced to more general or cultural factors, called upstream determinants, with wider-ranging effects and implications.  The relationships between such factors, local and general, can be complex (Braveman et al, 2011).  This paper attempts to explore the complicated inter-relationships of stress and its determinants and poses further questions considering implications of upstream determinants.

The Stress Problem

The American Psychological Association releases studies yearly monitoring the levels of stress in Americans.  Each year, Americans report what they consider to be unhealthy levels of stress (APA 2011).   “Year after year, many Americans report extreme stress (22 percent in 2011; 24 percent in 2010 and 2009; 30 percent in 2008; and 32 percent in 2007) — an 8, 9 or 10 on a 10-point scale where 1 is little or no stress and 10 is a great deal of stress” (APA 2011).  In the same study, the APA warns that these trends in stress can have serious health consequences.  
Often, stress itself is considered a social determinant of health conditions.  However, according to a press release distributed by the APA, health conditions are strongly considered to be a determinant of stress: in fact, personal health and family health are listed by 53% each (this represents an increase since 2009) by respondents to APA’s Stress in America™ survey (APA 2011).  As shown in this APA study, there are nearly unlimited sources or perceived sources of stress; there are an equal number of downstream effects of stress on health.  It is, thusly, difficult to write about the determinants of stress, as stress is often considered an important determinant for many other health and social conditions.  
Several studies, as this paper attempts to summarize, have demonstrated a relationship between the nature of employment and the concept of stress.  In addition, this paper will explore the complicated relationship between the concept of “decision fatigue” and stress.  Finally, by linking the both nature of employment and the concept of “decision fatigue,” this paper investigates the unequal effect that employment can have upon the limited psychological resources used for willpower and self-control.

Employment as a Determinant

Independent of job satisfaction, stress from work still accounts for a significant source of stress by more than half of employed study respondents (APA 2009).  The sources of stress are often just as important as to the degree of personal exposure or emotional involvement: an individual’s judgment of the severity of stress varies between sources of stress, (i.e. personal relationships, work, school, etc.) (Brotheridge & Gandey, 2002).  When considering the impact employment has on stress, import is therefore given to the types of work that a person does, and more importantly, the level of personal control over that work, or, according to the Coreil text, “…the ability of an employee to make decisions about when, where, and how to do their jobs” (2009, p. 406).  An individual’s perceived self-importance and the importance of their work are directly related to their level of control in the workplace (Brunner 1997).  
Perception of employment qualities, more so than objective considerations of employment qualities, can determine stress levels, particularly when associated with employment (McIntyre, Korn & Matsuo, 2008). The perceived importance of a person’s work can produce more stress when related to work, even when consequences of failure and economic significance were low (McIntyre, Korn & Matsuo, 2008).  In fact, much in the same way stress becomes linked to health, perceived lack of control has been directly linked to low levels of health and other factors related to poor health (Brunner 1997).
This stress-perception link can operate, it seems, as a negative feedback loop, work strain creates lower levels of perceived control, which, in turn, produce higher levels of stress.  The importance of stress as a physical as well as an emotional response must be considered: high levels of stress at work have been shown not only to present higher risk to adverse health conditions, but to produce lower morale and job satisfaction, which color the perception of the work environment (Peterson & Wilson, 2002).  
To further the argument that the type of employment is an important consideration of stress, consider human services.  The human services have been studied with particular regard to their unique qualities and sources of stressors.  While human services employees have the same type of stress as other fields, the emotional attachment or dis-attachment necessary for those in this field presents a particular strain on those employees (Dollard, Dorman, Boyd, Winefield & Winefield, 2003).  This suggests that there may be a link beyond physical or social demands at work and the stress levels of workers in that field.  Indeed, according to a recent article by Hobfoll, the negative consequences of illness or stress on workers has perhaps a broader cause than their perceptions of stress on the job (2001). 

Willpower as a Determinant

The active and intertwined relationship between stress and “ego-depletion” or “willpower fatigue” it a complicated subject, and remains an area of continued interest and research by both public health and behavioral health efforts.  The far-reaching problems that are caused by depletion of willpower and failure to self-regulate have been demonstrated thoroughly (Baumeister 2002).  According to Baumeister, “These include addiction, alcohol abuse, drug abuse, eating disorders and binges, unwanted pregnancy, AIDS and other sexually transmitted diseases, debt and bankruptcy, lack of savings, violent and criminal behavior, underachievement in school and work, procrastination, lack of exercise, and cigarette smoking, all of which could be reduced or eliminated if people controlled their behavior better” (Baumeister, pg 130).   Through his continued development of “ego-depletion” and “decision fatigue,” Baumeister has shown considerable additional evidence that a reserve, although not completely understood, exists and limits the amount of energy availability for self regulation, among other psychological efforts (Baumeister 2002).  Directly stated, “Acts of self-control, responsible decision making, and active choice seem to interfere with other such acts that follow soon after,” (Baumeister, Bratslavsky, Muraven & Tice, 1998).  In their 1998 study, Baumeister, et al, obtained results that demonstrated a strong argument for a limited psychological resource that can be and is depleted by a range of activities requiring concentration, self-control, willpower, or decision-making (Baumeister, Bratslavsky, Muraven & Tice, 1998).
This depletion, under the Conservation of Resources (COR) theory, could be seen to be among the most important causes of stress (Hobfoll, 2001).  COR theory lends focus to objective terms of stress and the nature of the environment, less on the individual’s perception of stressors (Hobfoll 2011).  It is clearly human nature to adapt to environments and that our stress response is a part of this adaptation.  Even early studies show that despite this ability to adapt, the act of  continued adaptation depletes the ability to handle additional stress (Glass, Singer & Friedman 1969).  Expenditures of energy exercised for self-control were not only associated with increases in stress but also manifested as forms of mental health distress (Schmidt & Neubach, 2007).   Loss of willpower indeed has been shown to create an obstacle for personal life changes that could help alleviate stress; in fact, the ability to manage stress ranks among the most important in perceived well-being (61 percent of respondents report “managing stress” is an important part of well-being, second only to “good family relationships”) (APA 2011).  

Further Questions

Is poverty itself an upstream social determinant of poverty?  Certainly, many studies have shown aspects of poverty that suggest this may be the case.  This paper has demonstrated an idea that stress can produce its own downstream determinants, which can, in turn, produce increased levels of stress.  Does poverty work in the same way, in such that the types of service work that regularly employ those in lower social strata deplete necessary willpower reserves required for upward mobility?  
Hobfoll contends, “It has been the history of management to blame workers, rather than the conditions of the workplace for workers' maladies,” (2001).  This concept very well could remain true, but perhaps not in the same historical context.  Conditions of the workplace could have a lesser impact on the maladies of workers than the effects of stress and stress perception on workers.   In the broader sense, however, the perceived condition of workers and the continuing depletion of willpower reserves may more accurately share the majority of blame for the specific malady of stress.   “Ego-depletion” although not necessarily developed in an attempt to explain poverty, remains applicable when discussing aspects of poverty: the willpower needed to restrict spending will disproportionately be required of a person of lesser means. (Spears, 2011, p. 35).
The effect that regular shopping, meaning ordinary purchases according to income levels, had on those of limited means was shown to have created a degree of “ego depletion” not seen those with means (Spears, 2011, p. 32).  The demands of self control, which draw from the same reserves as willpower (Baumeister 2002), are often under-represented in importance when considering sources of stress at work (Schmidt & Neubach, 2007).   The implication is clear that depletion of willpower of those with such employment and limited economic means may deplete the same resources needed to escape poverty: resources used to gain better employment, to seek higher levels of education, and to exercise self-control towards alcohol, drugs, commercialism, and other temptations.

References

The American Psychological Association (2011). The Impact of Stress. Retrieved from http://www.apa.org/news/press/releases/stress/2011/impact.aspx

The American Psychological Association (2009). Stress in America 2009. Retrieved from http://www.apa.org/news/press/releases/stress-exec-summary.pdf

Baumeister, R. F. (2002). Ego depletion and self-control failure: An energy model of the self’s executive function. Self and Identity, 1(2), 129-136.

Baumeister, R. F., Bratslavsky, E., Muraven, M., & Tice, D. M. (1998). Ego depletion: is the active self a limited resource?. Journal of personality and social psychology, 74(5), 1252.

Baumeister, R. F., Heatherton, T. F., & Tice, D. M. (1994). Losing control: How and why people fail at self-regulation. Academic Press.

Braveman, P., Egerter, S., & Williams, D. R. (2011). The social determinants of health: coming of age. Annual review of public health, 32.

Brotheridge, C. M., & Grandey, A. A. (2002). Emotional labor and burnout: Comparing two perspectives of “people work”. Journal of vocational behavior,60(1), 17-39.

Brunner, E. (1997). Socioeconomic determinants of health: stress and the biology of inequality. BMj, 314(7092), 1472.

Coreil, J. (2009). Social and behavioral foundations of public health. Sage Publications, Incorporated.

Dollard, M. F., Dormann, C., Boyd, C. M., Winefield, H. R., & Winefield, A. H. (2003). Unique aspects of stress in human service work. Australian Psychologist, 38(2), 84-91.

Glass, D. C., Singer, J. E., & Friedman, L. N. (1969). Psychic cost of adaptation to an environmental stressor. Journal of Personality and Social Psychology, 12(3), 200.

Hobfoll, S. E. (2001). The influence of culture, community, and the nested‐self in the stress process: advancing conservation of resources theory. Applied Psychology, 50(3), 337-421.

McIntyre, K. P., Korn, J. H., & Matsuo, H. (2008). Sweating the small stuff: How different types of hassles result in the experience of stress. Stress and Health, 24(5), 383-392.

Peterson, M., & Wilson, J. F. (2002). The culture-work-health model and work stress. American Journal of Health Behavior, 26(1), 16-24.

Schmidt, K. H., & Neubach, B. (2007). Self-control demands: A source of stress at work. International Journal of Stress Management, 14(4), 398.

Spears, Dean. (2011). Economic Decision-Making in Poverty Depletes Behavioral Control. The B.E. Journal of Economic Analysis & Policy: Vol. 11: Iss. 1 (Contributions), Article 72.