Skip to main content
SpringerLink
Log in

The Demand Control Support Work Stress Model

  • Living reference work entry
  • Latest version View entry history
  • First Online:
Handbook of Socioeconomic Determinants of Occupational Health

Part of the book series: Handbook Series in Occupational Health Sciences ((HDBSOHS))

Abstract

The chapter first gives a historical background starting with the introduction of the demand control by Karasek in 1976 and the extension of the model with social support by Johnson and Hall in 1988. Societal debates and previous theoretical job stress models available at the time are described. In the next segment, assessments of the three components of the model in epidemiological studies are described and discussed, ranging from worker self-ratings of the work environment to job exposure matrices and expert ratings. This is followed by a summary of findings based upon epidemiological studies, with a discussion of relative risks and attributable fractions. Ischemic heart disease, depression, and atrial fibrillation are some of the disease outcomes discussed. The final discussion is about physiological links between the model and disease outcomes.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution

Institutional subscriptions

References

  • Bullough B (1970) Alienation theory – development and synthesis. Proc Nurs Theory Conf 3:36–42

    PubMed  Google Scholar 

  • Choi B, Ko S, Ostergren PO (2015) Validity test of the IPD-Work consortium approach for creating comparable job strain groups between Job Content Questionnaire and Demand-Control Questionnaire. Int J Occup Med Environ Health 28(2):321–333. https://doi.org/10.13075/ijomeh.1896.00355

    Article  PubMed  Google Scholar 

  • Chungkham HS, Ingre M, Karasek R, Westerlund H, Theorell T (2013) Factor structure and longitudinal measurement invariance of the demand control support model: an evidence from the Swedish Longitudinal Occupational Survey of Health (SLOSH). PLoS One 8(8):e70541. https://doi.org/10.1371/journal.pone.0070541. eCollection 2013

    Article  PubMed  PubMed Central  Google Scholar 

  • Collins SM, Karasek RA, Costas K (2005) Job strain and autonomic indices of cardiovascular disease risk. Am J Ind Med 48:182–193

    Article  PubMed  Google Scholar 

  • Frankenhaeuser M, Gardell B (1976) Underload and overload in working life: outline of a multidisciplinary approach. J Hum Stress 2(3):35–46

    Article  Google Scholar 

  • Frankenhaeuser M, Dunne E, Lundberg U (1976) Sex differences in sympathetic-adrenal medullary reactions induced by different stressors. Psychopharmacology 47(1):1–5

    Article  PubMed  Google Scholar 

  • Fransson EI, Nyberg ST, Heikkilä K, Alfredsson L, Bacquer de D, Batty GD, Bonenfant S, Casini A, Clays E, Goldberg M, Kittel F, Koskenvuo M, Knutsson A, Leineweber C, Magnusson Hanson LL, Nordin M, Singh-Manoux A, Suominen S, Vahtera J, Westerholm P, Westerlund H, Zins M, Theorell T, Kivimäki M (2012) Comparison of alternative versions of the job demand-control scales in 17 European cohort studies: the IPD-Work consortium. BMC Public Health 12:62. https://doi.org/10.1186/1471-2458-12-62

    Article  PubMed  PubMed Central  Google Scholar 

  • Hacker W (1978) Allgemeine Arbeits- and Ingenieurpsychologie. Huber, Bern

    Google Scholar 

  • Hallqvist J, Diderichsen F, Theorell T, Reuterwall C, Ahlbom A (1998) Is the effect of job strain on myocardial infarction risk due to interaction between high psychological demands and low decision latitude? Results from Stockholm Heart Epidemiology Program (SHEEP). Soc Sci Med 46(11):1405–1415

    Article  PubMed  Google Scholar 

  • Hasselhorn H-M, Theorell T, Hammar N, Alfredsson L, Westerholm P, WOLF-studiegruppen (2002) Olika sätt att mäta psykologiska krav och kontroll pÃ¥ arbetsplatsen. In: Psykosocial belastning och riskfaktorer för hjärt-kärlsjukdom. Red. Westerholm, P. Minisymposium i WOLF-projektet 8 februari, 2001. ALI, Arbete och hälsa, vetenskaplig skriftserie. Nr. 2002:7. ISBN 91–7045.641-0, sid 15–19

    Google Scholar 

  • Hasselhorn H-M, Theorell T, Hammar N, Alfredsson L, Westerholm P, the WOLF Study Group (2004) Occupational health care team ratings and self reports of demands and decision latitude. Stress research report # 314

    Google Scholar 

  • Ingre M (2015) Excuse me but did the IPD-consortium just falsify the job-strain model? Scand J Work Environ Health 41(5):504–505. https://doi.org/10.5271/sjweh.3512

    Article  PubMed  Google Scholar 

  • Johnson JV, Hall EM (1988) Job strain, work place social support, and cardiovascular disease: a cross-sectional study of a random sample of the Swedish working population. Am J Public Health 78(10):1336–1342

    Article  PubMed  PubMed Central  Google Scholar 

  • Johnson JV, Hall EM, Theorell T (1989) Combined effects of job strain and social isolation on cardiovascular disease morbidity and mortality in a random sample of the Swedish male working population. Scand J Work Environ Health 15(4):271–279

    Article  PubMed  Google Scholar 

  • Johnson J, Stewart W, Hall E, Fredlund P, Theorell T (1996) Long-term psychosocial work environment and cardiovascular mortality among Swedish men. Am J Public Health 86:324–331

    Article  PubMed  PubMed Central  Google Scholar 

  • Kahn RL (1974) On the meaning of work. J Occup Med 16(11):716–719

    Article  PubMed  Google Scholar 

  • Karasek RA (1976) The impact of the work environment on life outside the job. PhD dissertation, Thesis order no. PB 263-073, Massachusetts Institute of Technology. Distributed by National Technical Information Service, US Department of Commerce, Springfield

    Google Scholar 

  • Karasek RA, Theorell T (1990) Healthy Work. Basic Books, New York NY

    Google Scholar 

  • Karasek R, Baker D, Marxer F, Ahlbom A, Theorell T (1981) Job decision latitude, job demands, and cardiovascular disease: a prospective study of Swedish men. Am J Public Health 71(7):694–705

    Article  PubMed  PubMed Central  Google Scholar 

  • Karasek RA, Schwartz J, Theorell T (1982) Job characteristics, occupation and coronary heart disease. Final report to the National Institute of Occupational Safety and Health. Columbia University, New York

    Google Scholar 

  • Karasek RA, Theorell T, Schwartz JE, Schnall PL, Pieper CF, Michela JL (1988) Job characteristics in relation to the prevalence of myocardial infarction in the US Health Examination Survey (HES) and the Health and Nutrition Examination Survey (HANES). Am J Public Health 78(8):910–918

    Article  PubMed  PubMed Central  Google Scholar 

  • Karasek RA, Brisson C, Kawakami N, Houtman I, Bongers P, Amick B (1998) The Job Content Questionnaire (JCQ): an instrument for internationally comparative assessments of psychosocial job characteristics. J Occup Health Psychol 3:322–355

    Article  PubMed  Google Scholar 

  • Karasek RA, BongKyoo C, Östergren PO, Ferrario M (2007) Testing two methods to create comparable scale scores between the job content questionnaire (JCQ) and JCQ-like questionnaires in the European JACE study. Int J Behav Med 14:189–201

    Article  PubMed  Google Scholar 

  • Karlson B, Lindfors P, Riva R, Mellner C, Theorell T, Lundberg U (2012) Psychosocial work stressors and salivary cortisol. In: Kristenson M, Garvin P, Lundberg U (eds) The role of salivary cortisol measurement in health and disease. Bentham Books, Sharjah, pp 43–66

    Google Scholar 

  • Kivimäki M, Steptoe A (2018) Effects of stress on the development and progression of cardiovascular disease. Nat Rev Cardiol 15(4):215–229. https://doi.org/10.1038/nrcardio.2017.189. Epub 2017 Dec 7

    Article  PubMed  Google Scholar 

  • Kivimäki M, Nyberg ST, Batty GD, Fransson EI, Heikkilä K, Alfredsson L, Bjorner JB, Borritz M, Burr H, Casini A, Clays E, De Bacquer D, Dragano N, Ferrie JE, Geuskens GA, Goldberg M, Hamer M, Hooftman WE, Houtman IL, Joensuu M, Jokela M, Kittel F, Knutsson A, Koskenvuo M, Koskinen A, Kouvonen A, Kumari M, Madsen IE, Marmot MG, Nielsen ML, Nordin M, Oksanen T, Pentti J, Rugulies R, Salo P, Siegrist J, Singh-Manoux A, Suominen SB, Väänänen A, Vahtera J, Virtanen M, Westerholm PJ, Westerlund H, Zins M, Steptoe A, Theorell T, IPD-Work Consortium (2012) Job strain as a risk factor for coronary heart disease: a collaborative meta-analysis of individual participant data. Lancet 380(9852):1491–1497. https://doi.org/10.1016/S0140-6736(12)60994-5. Epub 2012 Sep 14

    Article  PubMed  PubMed Central  Google Scholar 

  • Kivimäki M, Nyberg ST, Fransson EI, Heikkilä K, Alfredsson L, Casini A, Clays E, De Bacquer D, Dragano N, Ferrie JE, Goldberg M, Hamer M, Jokela M, Karasek R, Kittel F, Knutsson A, Koskenvuo M, Nordin M, Oksanen T, Pentti J, Rugulies R, Salo P, Siegrist J, Suominen SB, Theorell T, Vahtera J, Virtanen M, Westerholm PJ, Westerlund H, Zins M, Steptoe A, Singh-Manoux A, Batty GD, IPD-Work Consortium (2013) Associations of job strain and lifestyle risk factors with risk of coronary artery disease: a meta-analysis of individual participant data. CMAJ 185(9):763–769. https://doi.org/10.1503/cmaj.121735. Epub 2013 May 13

    Article  PubMed  PubMed Central  Google Scholar 

  • Kivimäki M, Pentti J, Ferrie JE, Batty GD, Nyberg ST, Jokela M, Virtanen M, Alfredsson L, Dragano N, Fransson EI, Goldberg M, Knutsson A, Koskenvuo M, Koskinen A, Kouvonen A, Luukkonen R, Oksanen T, Rugulies R, Siegrist J, Singh-Manoux A, Suominen S, Theorell T, Väänänen A, Vahtera J, PJM W, Westerlund H, Zins M, Strandberg T, Steptoe A, Deanfield J, IPD-Work Consortium (2018) Work stress and risk of death in men and women with and without cardiometabolic disease: a multicohort study. Lancet Diabetes Endocrinol 6(9):705–713. https://doi.org/10.1016/S2213-8587(18)30140-2. Epub 2018 Jun 5

    Article  PubMed  PubMed Central  Google Scholar 

  • Landsbergis P, Schnall P, Warren K, Pickering TG, Schwartz J (1994) Association between ambulatory blood pressure and alternative formulations of job strain. Scand J Work Environ Health 20(5):349–363

    Article  PubMed  Google Scholar 

  • Levi L (1972) Stress and distress in response to psychosocial stimuli. Laboratory and real life studies on sympathoadrenomedullary and related reactions. Acta Med Scand Suppl 528:1–166

    PubMed  Google Scholar 

  • Lundberg U, Frankenhaeuser M (1980) Pituitary-adrenal and sympathetic-adrenal correlates of distress and effort. J Psychosom Res 24(3–4):125–130

    Article  PubMed  Google Scholar 

  • Madsen IEH, Nyberg ST, Magnusson Hanson LL, Ferrie JE, Ahola K, Alfredsson L, Batty GD, Bjorner JB, Borritz M, Burr H, Chastang JF, de Graaf R, Dragano N, Hamer M, Jokela M, Knutsson A, Koskenvuo M, Koskinen A, Leineweber C, Niedhammer I, Nielsen ML, Nordin M, Oksanen T, Pejtersen JH, Pentti J, Plaisier I, Salo P, Singh-Manoux A, Suominen S, Ten Have M, Theorell T, Toppinen-Tanner S, Vahtera J, Väänänen A, Westerholm PJM, Westerlund H, Fransson EI, Heikkilä K, Virtanen M, Rugulies R, Kivimäki M, IPD-Work Consortium (2017) Job strain as a risk factor for clinical depression: systematic review and meta-analysis with additional individual participant data. Psychol Med 47(8):1342–1356. https://doi.org/10.1017/S003329171600355X. Epub 2017 Jan 26

    Article  PubMed  PubMed Central  Google Scholar 

  • Magnusson Hanson LL, Westerlund H, Chungkham HS, Vahtera J, Rod NH, Alexanderson K, Goldberg M, Kivimäki M, Stenholm S, Platts LG, Zins M, Head J (2018) Job strain and loss of healthy life years between ages 50 and 75 by sex and occupational position: analyses of 64 934 individuals from four prospective cohort studies. Occup Environ Med 75:486–493. https://doi.org/10.1136/oemed-2017-104644. Epub 2018 May 7

    Article  PubMed  PubMed Central  Google Scholar 

  • Mutambudzi M, Theorell T, Li J (2018) Job strain and long-term sickness absence from work – a ten-year prospective study in German working population. J Occup Environ Med. https://doi.org/10.1097/JOM.0000000000001525

  • Pan KY, Xu W, Mangialasche F, Dekhtyar S, Fratiglioni L, Wang HX (2018) Working life psychosocial conditions in relation to late-life cognitive decline: a population-based cohort study. J Alzheimers Dis. https://doi.org/10.3233/JAD-180870. [Epub ahead of print]

  • Sales SM, House J (1971) Job dissatisfaction as a possible risk factor in coronary heart disease. J Chronic Dis 23(12):861–873. No abstract available

    Article  PubMed  Google Scholar 

  • Schnall PL, Schwartz JE, Landsbergis PA, Warren K, Pickering TG (1998) A longitudinal study of job strain and ambulatory blood pressure: results from a three-year follow-up. Psychosom Med 60(6):697–706

    Article  PubMed  Google Scholar 

  • Schwartz JE, Pieper CF, Karasek RA (1988) A procedure for linking psychosocial job characteristics data to health surveys. Am J Public Health 78(8):904–909

    Article  PubMed  PubMed Central  Google Scholar 

  • Taylor LJ (1968) Alienation, anomie and delinquency. Br J Soc Clin Psychol 7(2):93–105

    Article  PubMed  Google Scholar 

  • Theorell T (2014) Commentary triggered by the Individual Participant Data Meta-Analysis Consortium study of job strain and myocardial infarction risk. Scand J Work Environ Health 40(1):89–95

    Article  PubMed  Google Scholar 

  • Theorell T, Perski A, Akerstedt T, Sigala F, Ahlberg-Hultén G, Svensson J, Eneroth P (1988) Changes in job strain in relation to changes in physiological state. A longitudinal study. Scand J Work Environ Health 14(3):189–196

    Article  PubMed  Google Scholar 

  • Theorell T, Karasek RA, Eneroth P (1990) Job strain variations in relation to plasma testosterone fluctuations in working men – a longitudinal study. J Intern Med 227(1):31–36

    Article  PubMed  Google Scholar 

  • Theorell T, Tsutsumi A, Hallquist J, Reuterwall C, Hogstedt C, Fredlund P, Emlund N, Johnson JV (1998) Decision latitude, job strain, and myocardial infarction: a study of working men in Stockholm. The SHEEP Study Group. Stockholm Heart epidemiology Program. Am J Public Health 88(3):382–388

    Article  PubMed  PubMed Central  Google Scholar 

  • Theorell T, Hammarström A, Aronsson G, Träskman Bendz L, Grape T, Hogstedt C, Marteinsdottir I, Skoog I, Hall C (2015) A systematic review including meta-analysis of work environment and depressive symptoms. BMC Public Health 15:738. https://doi.org/10.1186/s12889-015-1954-4

    Article  PubMed  PubMed Central  Google Scholar 

  • Theorell T, Jood K, Järvholm LS, VingÃ¥rd E, Perk J, Östergren PO, Hall C (2016a) A systematic review of studies in the contributions of the work environment to ischaemic heart disease development. Eur J Pub Health 26(3):470–477. https://doi.org/10.1093/eurpub/ckw025. Epub 2016 Mar 31

    Article  Google Scholar 

  • Theorell T, De Manzano Ö, Lennartsson AK, Pedersen NL, Ullén F (2016b) Self-reported psychological demands, skill discretion and decision authority at work: A twin study. Scand J Public Health 44(4):354–360. https://doi.org/10.1177/1403494815626610. Epub 2016 Jan 29

    Article  PubMed  Google Scholar 

  • Trudel X, Brisson C, Gilbert-Ouimet M, Milot A (2018) Psychosocial stressors at work and ambulatory blood pressure. Curr Cardiol Rep 20(12):127. https://doi.org/10.1007/s11886-018-1070-z. Review

    Article  PubMed  Google Scholar 

  • Volpert W (1974) Handlungsstrukturanalyse. Pahl-Rugenstein, Köln

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Stress Research Institute, University of Stockholm, Stockholm, Sweden

    Töres Theorell

  2. Department of Public Health, Karolinska Institutet, Stockholm, Sweden

    Töres Theorell

Authors
  1. Töres Theorell
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Töres Theorell .

Editor information

Editors and Affiliations

  1. Stress Research Institute, Stockholm University, Stockholm, Stockholms Län, Sweden

    Töres Theorell

Section Editor information

  1. Institute of Medical Sociology, Centre of Health and Society (CHS), University of Düsseldorf, Düsseldorf, Germany

    Morten Wahrendorf

  2. Fielding School of Public Health, School of Nursing, University of California Los Angeles, Los Angeles, USA

    Jian Li

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Switzerland AG

About this entry

Check for updates. Verify currency and authenticity via CrossMark

Cite this entry

Theorell, T. (2020). The Demand Control Support Work Stress Model. In: Theorell, T. (eds) Handbook of Socioeconomic Determinants of Occupational Health. Handbook Series in Occupational Health Sciences. Springer, Cham. https://doi.org/10.1007/978-3-030-05031-3_13-2

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-05031-3_13-2

  • Received:

  • Accepted:

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-05031-3

  • Online ISBN: 978-3-030-05031-3

  • eBook Packages: Springer Reference Behavioral Science and PsychologyReference Module Humanities and Social SciencesReference Module Business, Economics and Social Sciences

Publish with us

Policies and ethics

Chapter history

  1. Latest

    The Demand Control Support Work Stress Model
    Published:
    21 April 2020

    DOI: https://doi.org/10.1007/978-3-030-05031-3_13-2

  2. Original

    The Demand Control Support Towards Work Stress
    Published:
    20 February 2020

    DOI: https://doi.org/10.1007/978-3-030-05031-3_13-1

Search

Navigation