Work Stress and Alcohol Use

Mediation and Moderation Model
by National Institute of Health

(Page 3 of 5)

Mediation Model

The mediation model explicitly incorporates the variables thought to link work stressors to alcohol use, such as sadness or anger (negative affect), inability to relax, and the drinker's reason for drinking (drinking motives), such as to "let off steam." By including these mediating (intervening) variables, the mediation model goes beyond the simple cause-effect model by trying to explain why or by what mechanism work stressors are related to alcohol use.

Although two studies failed to support the mediating role of negative affect, a number of studies support mediated models of work stress. For example, Vasse and colleagues reported that high work demands and poor interpersonal relations with supervisors and coworkers were positively related to anxiety, which was positively related to average weekly alcohol consumption. Martin and colleagues found that job demands and low job control were related to higher levels of drinking to cope with negative affect, which was positively related to both average monthly alcohol consumption and problem drinking. In addition, one study examined the mediating role of both job dissatisfaction and drinking to cope. Greenberg and Grunberg reported that workers who felt their skills were underused, had low job control, and had little participation in decisionmaking were more likely to be dissatisfied with their jobs. This dissatisfaction was, in turn, positively related to drinking to cope, which was positively related to both heavy drinking and problem drinking.

Moderation Model

The moderation model explicitly includes variables that moderate the relation between work stressors and alcohol use. This model is an interactional one, in which work stressors interact with certain variables that either place a worker at increased risk for or protect the worker from developing problems with alcohol. The basic premise is that the strength of the relation between work stressors and alcohol use differs as a function of the level of the risk and protective variables. The moderation model, therefore, goes beyond the simple cause-effect model by trying to explain when or under what conditions work stressors are related to alcohol use. In other words, work stressors are not assumed to be related to alcohol use among all employees.

Several studies have tested this model. For example, building from identity theory, Frone and colleagues showed that both job demands and the lack of a clearly defined role at the workplace (role ambiguity) were positively related to heavy drinking only among employees who reported that their work role was psychologically important for self-definition. Among participants who reported low psychological importance of work, the work stressors were unrelated to heavy drinking. Grunberg and colleagues reported that work pressure predicted higher average daily alcohol consumption and problem drinking among people who reported that they typically drank to relax and forget about problems than among people who did not drink for those reasons. Among people in the latter group, work pressure was unrelated to the alcohol outcomes. Finally, Parker and Harford examined the moderating influence of gender-role attitudes on the relation of job competition to alcohol use. Traditional gender-role attitudes represent the belief that men should be breadwinners and women should take care of home and family. Egalitarian gender-role attitudes represent the belief that men and women should share breadwinning and domestic responsibilities. For women, job competition was more strongly related to drinks per drinking occasion, whereas loss of control over drinking was more strongly related among those with more traditional gender-role attitudes. In contrast, for men, job competition was more strongly related to drinks per drinking occasion and loss of control over drinking among those individuals with more egalitarian gender-role attitudes.

Moderated Mediation Model

This model combines the features of the mediation and the moderation models. By explicitly including both mediating and moderating variables, the moderated mediation model goes beyond each of the other three models by simultaneously trying to explain how as well as when work stressors are related to alcohol use. Several variations of this model can be devised, depending on the moderator variables. For example, one could have a model in which a given vulnerability or protective factor only moderates one of the paths connecting work stressors to alcohol use. One also might hypothesize moderating effects on both paths, but with different vulnerability or protective factors moderating each path.

Only two studies have proposed and tested a moderated mediation model of work stress and alcohol use. Building from several different theoretical frameworks, Cooper and colleagues and Grunberg and colleagues hypothesized that 1. work stressors are positively related to job dissatisfaction and 2. job dissatisfaction is positively related to alcohol use among vulnerable people. Supporting the first hypothesis, Cooper and colleagues found that work demands and lack of job control were positively related to job dissatisfaction. Likewise, Grunberg and colleagues reported that high levels of job demands, interpersonal criticism from supervisors and coworkers, and feeling stuck in one's job were positively related to job dissatisfaction. With regard to the second hypothesis, Cooper and colleagues found some support that positive alcohol expectancies, the general belief that one is competent, and coping with difficult situations by avoiding them (avoidance coping) had a moderating influence. For example, job dissatisfaction was more strongly related to problem drinking among people who reported high levels of avoidance coping. Likewise,

Grunberg and colleagues reported that job dissatisfaction was related to problem drinking among those who reported that they drank to reduce negative emotions. Among people who did not drink for this reason, job dissatisfaction was unrelated to problem drinking.

About the Author

NIH is the nation's medical research agency - making important medical discoveries that improve health and save lives. The National Institutes of Health (NIH), a part of the U.S. Department of Health and Human Services, is the primary Federal agency for conducting and supporting medical research.