Can a single-item measure of job stressfulness identify common mental disorder?

Abstract

There is a need for brief and non-intrusive measures to identify common mental disorder (CMD) in worker populations. The primary aim of this study was to determine whether workers reporting CMD symptoms indicative of minor psychiatric morbidity could be reliably identified by a single-item job stressfulness measure (SIJSM). A secondary aim was to determine the number of response categories required to maximize the sensitivity and specificity of the SIJSM. Data from seven occupational groups were analysed (N = 20,658). We measured CMD using the 12-item General Health Questionnaire (GHQ-12) and job stressfulness with a single item involving five response options. We applied tests of discriminatory power to assess whether a report of high job stressfulness (SIJSM score ≥4, very stressful or extremely stressful) correctly classified CMD cases (GHQ-12 score ≥4) and non-cases. Both sensitivity and specificity of the SIJSM were acceptable (≥70%) in samples where at least 50% of respondents reported high job stressfulness (prison officers, public protection unit police officers dealing with domestic violence and child abuse). Discriminatory power was optimal and almost identical at the ≥4 cut-off on a 5-point scale and ≥6 on a 9-point scale. In occupations with elevated prevalence of high job stressfulness the SIJSM appears to demonstrate acceptable sensitivity and specificity, providing for efficient and non-intrusive identification of likely minor psychiatric morbidity. The measure could be used with such groups to identify workers that would benefit from in-depth psychosocial risk assessment and targeted intervention.