Measures of mental health and addictions conditions show a U-shaped relationship with self-rated worker performance

Soc Psychiatry Psychiatr Epidemiol. 2021 Oct;56(10):1823-1833. doi: 10.1007/s00127-020-01894-w. Epub 2020 Jun 15.

Abstract

Background: Reports of a meaningful relationship between mental health-related conditions and work productivity measures are relatively common. These, however, are frequently examined for their linearity while ignoring untapped, and potentially rich, non-linear associations.

Methods: Following a serendipitous finding of a curvilinear relationship between workplace presenteeism (lowered productivity while at work) and depression, an investigation was undertaken of the association between worklife prevalence measures of presenteeism (measured by the W.H.O. Health & Work Performance Questionnaire) and lifetime prevalence of twelve psychosocial vulnerabilities, encompassing mental health, mental health-related, and addictive conditions. Linear and quadratic (U-shaped) functions were calculated across the "relative" presenteeism measure (self vs. other workers) for each of the 12 conditions.

Results: A visual analysis revealed a U-shaped graphic function in all conditions, and excepting anxiety all were statistically significant. In general, increases beyond the lowest ("poorest") level of self-reported comparative productivity were associated with increases in psychosocial stability, but only as far as deemed equality. Beyond that, increases in self-confidence resulted in a reversal, thus returning to a higher level of vulnerability for the condition in question. A cursory scan of five relevant journals indicated that non-linear analyses were often possible, but rarely carried out.

Conclusions: This has informative value for our conceptualization of overconfidence, and it begs the question of whether an over-reliance on linear measures has caused us to overlook important curvilinear human relationships. The inclusion of analyses of non-linear functions is suggested as a matter of course for future studies.

Keywords: Addiction; Mental health; Non-linear; Overconfidence; Presenteeism.

MeSH terms

  • Absenteeism
  • Anxiety
  • Cross-Sectional Studies
  • Efficiency
  • Humans
  • Mental Health*
  • Presenteeism*
  • Surveys and Questionnaires
  • Workplace