ArticleInternational archives of occupational and environmental health2018
Effort-reward imbalance among students at German universities: associations with self-rated health and mental health.
Article in International archives of occupational and environmental health, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 2 of them syntheses that pooled it.
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Who cites it
19 citing papers in PubMed, 2 syntheses or guidelines pooled it, 57 citations in OpenAlex.
- Assessing psychological distress among medical students: a systematic review and meta-analysis of tools available.BMC medical education · 2026Pooled it
- Depressive Symptoms Among Higher Education Students in Germany-A Systematic Review and Meta-Analysis.Public health reviews · 2024Pooled it
- The UFair Questionnaire: Measuring Perceived University Unfairness and Its Association with Students' Mental Health.Behavioral sciences (Basel, Switzerland) · 2025Article
- What is the impact of social support on self-rated health and depressive symptoms in university students: a survey study in two German universities.BMC public health · 2025Article
- Study-Related Predictors for Depression, Suicidal Ideation and Suicide Risk in German Veterinary Medical Students.Healthcare (Basel, Switzerland) · 2025Article
- The Role of Optimism and Self-Efficacy in the Relationship between Academic Stress and Depressive Symptoms in Medical Students Including the Use and Knowledge of Structural Health Promotion Offers.Medical science educator · 2025Article
- Well-being among university students in the post-COVID-19 era: a cross-country survey.Scientific reports · 2024Article
- Sleep and mental health among Chinese adolescents: the chain-mediating role of physical health perception and school adjustment.BMC psychology · 2024Article
- Self-care strategies for medical students: an uncontrolled mixed-methods evaluation of a mind-body-medicine group course.BMC medical education · 2023Article
- The association between study conditions and hair cortisol in medical students in Germany - a cross-sectional study.Journal of occupational medicine and toxicology (London, England) · 2023Article
- Associations between Poorer Mental Health with Work-Related Effort, Reward, and Overcommitment among a Sample of Formal US Solid Waste Workers during the COVID-19 Pandemic.Safety and health at work · 2023Article
- Self-rated health of university students in Germany-The importance of material, psychosocial, and behavioral factors and the parental socio-economic status.Frontiers in public health · 2023Article
- University Fairness Questionnaire (UFair): Development and Validation of a German Questionnaire to Assess University Justice-A Study Protocol of a Mixed Methods Study.International journal of environmental research and public health · 2022Article
- Mental Health and Physical Activity of Female Higher Education Students during the COVID-19 Pandemic: A Comparative Cross-Sectional Study from Lithuania.International journal of environmental research and public health · 2022Article
- A Web-Based Stress Management Intervention for University Students in Indonesia (Rileks): Feasibility Study Using a Pretest-Posttest Design.JMIR formative research · 2022Article
- Understanding Reciprocity Among University Students in Low-Resource Settings: Validation and Measurement Using a Mixed-Methods Approach.Frontiers in public health · 2022Article
- Classification of psychiatric symptoms using deep interaction networks: the CASPIAN-IV study.Scientific reports · 2021Article
- The association between depressive symptoms and self-rated health among university students: a cross-sectional study in France and Japan.BMC psychiatry · 2020Article
- Stress among university students: factorial structure and measurement invariance of the Italian version of the Effort-Reward Imbalance student questionnaire.BMC psychology · 2019Article
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
Abstract
purposeAlthough psychosocial stress has been associated with adverse health parameters, little is known about this topic among the variety of university students. We thus examined associations of psychosocial stress due to academic education with self-rated health, and symptoms of depression and anxiety among students from various study disciplines.
methodsWe used data from the Nutrition and Physical Activity (NuPhA) Study, a cross-sectional online survey among students enrolled across German universities (n = 698). Academic stress was assessed by a newly developed and validated student version of the Effort-Reward Imbalance (ERI-Student) Questionnaire. Depressive and anxiety symptoms were measured by applying the Patient Health Questionnaire-4 (PHQ-4) and using validated cut-offs.
resultsSeparate multivariate logistic regression analyses run for the different ERI components, the ERI-ratio revealed that high effort, low reward, high over-commitment, and a high ERI-ratio were associated with poor self-rated health, and depressive and anxiety symptoms (odds ratios ≥ 2.43). Separate analyses for medical students and non-medical students largely confirmed these findings for both groups. Associations between all ERI components, the ERI ratio, and both mental health measures were, however, more pronounced among medical students.
conclusionsWe were able to show consistent associations between the ERI-Student Questionnaire and self-rated health and mental health across students from different study disciplines. Further research on associations between academic stress and health parameters is necessary to develop effective strategies that prevent students from adverse health outcomes during their academic education.
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