Available online on 15.04.2023 at http://jddtonline.info

Journal of Drug Delivery and Therapeutics

Open Access to Pharmaceutical and Medical Research

Copyright  © 2023 The  Author(s): This is an open-access article distributed under the terms of the CC BY-NC 4.0 which permits unrestricted use, distribution, and reproduction in any medium for non-commercial use provided the original author and source are credited

Open Access   Full Text Article                                                                                                                                                               Research Article 

Career Development and Psychopathological Symptoms on Female Workers

Lie Tanu Merijanti ¹* , Pusparini² , Meiyanti³ , Alvina² , Monica Dwi Hartanti⁴ , Muljadi Tjahjadi⁵ 

¹ Department of Occupational Medicine, Faculty of Medicine, Universitas Trisakti, Jakarta, Indonesia,

² Department of Clinical Pathology, Faculty of Medicine, Universitas Trisakti, Jakarta, Indonesia 

³ Department of Pharmacy and Pharmacology, Faculty of Medicine, Universitas Trisakti, Jakarta, Indonesia

⁴ Department of Biology, Faculty of Medicine, Universitas Trisakti, Jakarta, Indonesia

⁵ Bureau of Industrial Human Resource Development, Ministry of Industry, Republic of Indonesia

INTRODUCTION

Female workers are potential human resources for strategic roles and positions in both family and society. Within this time, women start to give a contribution to the family economy, and many women even occupy important positions in various business fields. Based on data from the Central Bureau of Statistics in Indonesia in 2021, there are 36,20% of the total 140.15 million workers in Indonesia are women.¹ The improvement of human resources can be maximized by balancing the factors of workers, workloads, organizational system, and work environment. If these factors are not harmonized or even considered, they can cause various problems such as discomfort at work, burnout syndrome, physical problems, and also mental health problems, which will affect work performance and productivity.²

The tendency for psychopathological symptoms to arise in workers can be caused by stressors existing in their workplace, which are one of the potential hazards and need to be anticipated.² Work stressors can be classified into work content and work context. Stressors that are included in work content are the characteristics and type of work, workload, length of a working hour, control of personal work, and participation in teamwork. Meanwhile, work context contains career development, employee status including income and benefits, interpersonal relations at work, workplace organizational culture, as well as work-life balance.²

According to a survey by American Psychological Association, it was found that women experience higher and more frequent stress exposures than men. Women also have higher tendencies to feel various mental symptoms caused by this stress.^{3 .} Based on Hayes's macro process model, there is a relationship between work stressors and mental health that is indirectly mediated by the social support that workers receive.⁴ The higher social support workers have, the easier it is for them to protect themselves from work stress tension, and the following physical and mental problems.⁵ Social support has a greater impact on reducing the level of job stress among female workers than male workers. Quantitative workload stressors have a significant relationship with higher work stress in men, whereas in female workers qualitative stressors have a higher significant relationship with work stress.⁶ 

Research on mental health researchers found that there is a strong relationship between mental health in them and psychosocial stressors in work organizations such as work influences, opportunities for career development, and also in work and life balance such as commitment to work, job uncertainty, work quality, job satisfaction, and both conflict inside and outside the work with others.⁷ The career development process can be useful to find and set goals for the employee to improve worker welfare.⁸ It was found that workers who experience stressors tend to remain silent and do not seek proper help from experts due to the stigma associated with work stress. If this is allowed to continue, it might get worse over time and affect larger populations.⁹ High workload effect, especially on mental load, is found more common in female workers at the managerial level compared to non-manager workers, but female managers tend to have lower psychological stress than non-managers.¹⁰ Research on university instructors in India also shows results that male workers tend to be more capable of managing their career in work and also the work stress than female workers.¹¹ Another research also found that there is no significant relationship between work activities and psychopathological problems caused by work.¹² Therefore, it is needed to find out whether there is any relationship between stressors in the workplace and the emergence of psychopathological disorders in female workers to find out the possible solutions for the problems.

MATERIAL AND METHODS

Cross-sectional analytic observational research was used in this study. The study sample was selected by consecutive non-random sampling from the person who works in the West Jakarta area medium-scale company,  who met the inclusion criteria:  female, good mobility, still actively working, able to communicate, and willing to participate in research. The exclusion criteria were: history of mental illness. The Research Ethics Committee, Medical Faculty, Trisakti University No. 60/KER/FK approved this study protocol. The study included 134 female correspondences in total. All participants gave written informed consent. 

The respondents filled out a questionnaire relating to demographic data including age, education,  marriage status, and years of work. Work stress was measured using a stress diagnostic survey questionnaire consisting of 30 questions, for each question there was a choice of answers valued by a scale of one to seven. Respondents chose one answer that was considered most appropriate to them. The assessment will include six job stressors named role ambiguity, role conflict, quantitative overwork, qualitative overwork, career development, and personal responsibility that are tested with related questions. Therefore, the assessment scores will be carried out to find out the degree of stress the female workers had. The degree of stress is low if the total score is less than 10, moderate if the score is between 10-24, and high if the score is more than 24.¹³

The tendency for mental disorders was obtained using the Symptom Checklist 90.¹⁴  This questionnaire consists of 90 questions, each question consisting of a choice of answers with a scale of 0 to 4. Respondents chose a value scale that was considered most representative according to the symptoms they have experienced in the past month. If the total score shown by this test is less than 60, it is considered normal, whereas if it is more than or equal to 61 it is considered a mental health disorder or psychopathology. 

Categorical variables were summarized using frequencies and percentages. Chi-square and Fisher's tests were used to analyze the correlation between the categories of work stressors and tendencies of psychopathological problems. The tests were continued by doing logistic regression analysis to find the dominant work stress factor that might be the most threatening factor of mental health problems. Statistical significance was set at p < 0,05.

RESULTS

There were 134 female workers in the company who met the inclusion and exclusion criteria. The following table shows the data related to the age distribution, education level, and marital status of the 134 female workers (Table 1.)

Table 1: Characteristics of Female Worker Respondents in Company X  (n=134)

                                                                                               In Table 1, it can be seen that most of the respondents were aged between 31-50 years, with the highest level of education being diploma 3 or bachelor’s degree graduates. From marital status, it can be seen that 86 respondents were married. Most of the respondents (63,4%) have worked for this company for more than 5 years.

To analyze the impact of different work stressors, we can see the degree of each stressor in Table 2.

Table 2:  Types of Stressors in Work and Degree of Work Stress. (n= 134)

Table 3 shows the association between the types of job stressors (role ambiguity, role conflict, quantitative overwork, qualitative overwork, career development, and personal responsibility) with the presence of psychopathological symptoms.

Table 3: Types of stressors in work and psychopathological tendencies.

^#Chi square Test  ^*Fisher Test              p < 0,05

From the analysis conducted on the six types of stressors found in work, it was found that three types of job stressors have significant relationships with the tendency of psychopathological symptoms, which are quantitative overwork (p= 0,003, OR 7,188; 95 % CI 1,620 – 31,898), qualitative overwork (p=0,012, OR 1,405; 95% CI   1,252 – 1,576) and career development (p = 0,000, OR 13,630; 95 % CI 3,097 – 59,976). From these three types of job stressors that have significant relationships with the tendencies of psychopathological symptoms, logistic regression analysis was carried out to determine the stressors that play the most role in causing psychopathological symptoms. The results can be seen in Table 4.

Table 4: Results of Logistic Regression Analysis using Model of Job Stressors

In Table 4. above, it is known that the stressor of career development mainly causes psychopathological symptoms with p 0,003; OR adjusted 10,069; 95% confidence interval 2,238 – 45,296. Female workers who have stressors related to career development are ten times more likely to experience psychopathological symptoms when compared to female workers who do not have stressors related to career development.

DISCUSSION

In this study, it was found that out of the six job stressors, career development plays a major role in psychopathological problems in workers from this workplace. Respondents involved in this study are female workers in medium-scale companies located in the West Jakarta area, working from 8 AM to 5 PM every day, getting off on Sundays and national holidays with a range of salaries following the regional minimum wage in Jakarta. A total of 85 people have worked for more than five years, but with a constant job role from the beginning until now. Career development is a process to increase individual achievements in the desired career. Every employee must be allowed to develop their abilities and provide the best results for the company where they work. Career development is influenced by the training system, motivation, and performance review at work.¹⁵ Poor job promotion opportunities, excessive workload, and feelings of insecurity at work are strongly associated with work stress in small and medium-sized companies.¹⁶

According to Fiori, et al., the ability of workers to manage development and career challenges will affect the increase in job satisfaction to reduce work stress, which is mediated by the individual’s affective state. Workers with higher career adaptability will experience higher job satisfaction and lower job stress level when compared to those with lower adaptability. Career adaptability is a source of self-regulation in which individuals evaluate their potential to cope with the demands of the work environment while at the same time forming their affective state in evaluating the work done.¹⁷ Research conducted by Pratiwi and Lo states that the opportunity to develop a career in the workplace has a positive relationship with job satisfaction and reduces the intention to quit or change jobs.¹⁸ Idris and Lusiyani's study, on the other hand, found no connection between workplace stress and the emergence of psychopathological symptoms in Indonesian Air Force military pilots. Possibly even though they were working in an environment with high work stressors, most of the workers found ways to adapt on focusing ways to solve problems, then to be able to suppress emotion when dealing with problems.¹⁹ 

The results of this study indicated that 34 workers (25,4%) experienced a tendency toward psychopathological symptoms. Of the 134 workers, 86 are married female workers who face conflicting roles as career women and housewives. In the realm of Indonesian culture, women have highly demanded their role as good and righteous housewives, so career women might feel guilty when they choose to work. Feelings of guilt that were coupled with demands from both household and work tasks might let working married women to experience more stress.²⁰

The integrated biological circuit of the central nervous system, neuroendocrine systems, and immunological systems, which control and regulate genes and gene expression by many receptors, regulates homeostatic stress adaptation mechanisms.²¹ After activation of the Hypothalamic Pituitary Adrenal axis and the sympathetic system, corticotropin-releasing hormone (CRH) and adrenaline are the primary factors that modulate the stress response. Specifically, CRH-R1 and CRH-R2 are the two receptors that control the CRH response. While CRH-R2 receptors control emotional, affective, and cognitive behavior, CRH-R1 receptors are involved in sensory information processing and motor control. ^22,23 Workload stressors are associated with greater physical and psychological tension. If they are not properly managed, they will not be able to strike a balance between their personal and professional obligations, leading them to feel guilty and emotionally exhausted.²⁴ Research by Hill et al., conducted on groups of researchers found that 27 workers (13,4%) with severe distress, even to the point where there were suicidal ideations. ⁷ Studies investigating the mediating role of self-criticism and self-confidence as a link between stress, depression, and anxiety found that feelings of self-uselessness contribute to the development of depression.^25,26,27 The impact of injustice and low self-control on stressors at work is stronger in causing distress to workers with low cognitive levels than those with high cognitive levels.²⁸

In addition, interpersonal relationships are very important in the workplace. Support from fellow workers, managers or subordinates, family, and also non-workplace friends is believed to prevent and reduce stress from occurring. Thus, the management team should show empathy and care for the workers so a harmonious and healthy working environment is always created. Employees usually have various expectations in their career life, which are aimed to fulfill their self-actualization needs. If the company cannot support the hope of the employees, for example, the promotion system is not clear, there are no opportunities to increase income, employees will feel hopeless, and feelings of uncertainty will grow which can lead to stressful behavior. Some steps that can be taken to reduce work stress for workers are increasing income, providing opportunities and training for career advancement, creating a support system from senior staff, and balancing work and personal problems.²⁹ 

This research study hasn’t used the comparison and evaluation of other possible risk factors, such as personality type, individual coping mechanisms to stress, and important life events. The SCL 90 instrument also works only as a screening tool and not a diagnostic tool, and on the positive results obtained, no further examination is carried out in the form of a physical or mental examination with a psychiatrist. In addition, we can implement this study as a reference to study the female worker problems within other risk factors included.

CONCLUSION

                  As a conclusion of this study, we found that the prevalence of mental and emotional problem symptoms exists in female workers with high career development stressors (25,4% of all stressors) and these were significantly related to the occurrence of the psychopathological symptoms.

ACKNOWLEDGEMENT

The research can be done on behalf of the Medical Faculty, Trisakti University for funding this study. The author also gives credit to the respondents who have given their time and energy to participate in this study.

Conflict of interest

Lie Tanu Merijanti, Pusparini, Meiyanti, Alvina, Monica Dwi Hartati and Muljadi Tjahjadi declare no conflicts of interest in this study.

Author Contribution

Lie Tanu Merijanti prepared research designs, collected data analyzed data, and wrote the manuscript. Pusparini, Meiyanti, Alvina, Monica, and Muljadi Tjahjadi were involved in collecting and analyzing data.

REFERENCES

1.    Biro Pusat Statistik. Persentase tenaga kerja formal menurut jenis kelamin ( persen), 2019-2021. Available from https://www.bps.go.id/indicator/6/1170/1/persentase-tenaga-kerja-formal-menurut-jenis-kelamin.html

2.    WHO. Occupational health: Stress at the workplace. WHO;2020. Available from https://www.who.int/news-room/questions-and-answers/item/ccupational-health-stress-at-the-workplace

3.    American Psychological Association. Stress in America. Paying with our Health.APA; 2015: 11.

4.    Mensah A. Job stress and mental well-being among working men and women in Europe: The Mediating role of social support. Int.J.Environ.Res.Public Health 2021,18,2494 https://doi.org/10.3390/ijerph18052494 

5.    Pow J, King DB, Stephenson E, DeLongis A. Does social support buffer the effects of occupational stress on sleep quality among paramedics? A daily diary study. J Occup Health Psychol. 2017; 22(1):71–85.

6.    Rivera-Torres P, Araque-Padilla RA, Montero-Simó MJ. Job stress across gender: the importance of emotional and intellectual demands and social support in women. Int J Environ Res Public Health. 2013 Jan 14; 10(1):375-89. https://doi: 10.3390/ijerph10010375. PMID: 23343989; PMCID: PMC3564148.

7.    Hill NTM, Bailey E, Benson R, Cully G, Kirtley OJ, Purcell R, Rice S, et al. Researching the researchers: psychological distress and psychosocial stressors according to career stage in mental health researchers. BMC Psychology 2022; 10(19):1-14. https://doi.org/10.1186/s40359-022-00728-5

8.    Redekopp DE, Huston M. The broader aims of career development: mental health, well-being, and work. British Journal of Guidance &Counselling. 2019;47(2):246-257 https://doi.org/10.1080/03069885.2018.1513451

9.    Maulik PK. Workplace stress: A neglected aspect of mental health wellbeing. Indian J Med Res. 2017; 146(4):441-444. https://doi:10.4103/ijmr.IJMR_1298_17

10.  Shiraki N, Doki S, Ikeda Y, Ikeda T, Takahashi T, Andrea CS, Hori D, et al. Differences in psychological distress between managers and non-managers in female workers: a cross-sectional study in Tsukuba Science City, Japan. Nagoya J. Med. Sci. 2021; 83. 63-74. https://doi:10.18999/nagjms.83.1.63

11.   Solanki S, Mandaviya M. Does gender matter? Job stress, work-life balance, health and job satisfaction among University Teachers in India. Journal of International Women’s studies. 2021; 22(7):121-134.  https://vc.bridegew.edu/jiws/vol22/iss7/10 12

12.   Nolfe G, Mancini P, Mancusi R, Zontini G, Nolfe G. Work-related psychopathology: rates in different work activities and the relationship between subjective perception of work distress and psychiatric disturbances. Work. 2014; 47(4):501-8. https://doi: 10.3233/WOR-131619. PMID: 23531581.

13.   Survey diagnosis stress. Available at https://idoc.pub/documents/survey-diagnosis-stress-9n0kj8e2z24v

14.   Symptom Checklist- 90 (SCL 90). Available at https://arc.psych.wisc.edu/self-report/symptom-checklist-90-scl90/

15.   Niati DR, Siregar ZME, Prayoga Y. The effect of training on work performance and career development: The role of motivation as intervening variable. Budapest International research and critics institute-Journal humanities and social sciences. 2021; 2385-2393. https://doi.org/10.33258/birci.v4i2.1940

16.   Lai Y, Saridakis G, Blackburn R. Job stress in the United Kingdom: Are small and medium-sized enterprises and large enterprises different? Stress & Health. 2013; 31(3);222 – 235.  Available at https://doi.org/10.1002/smi.2549

17.   Fiori M, Bollmann G, Rossier J. Exploring the path through which career adaptability increases job satisfaction and lower job stress: The role of affect. Journal of Vocational Behavior. 2015; 91:113-121. https://doi.org/10.1016/j.jvb.2015.08.010

18.   Pratiwi F, Lo JS. Job satisfaction as a mediator of effect job stress and career development on employee turnover intention PT PKSS. Dinasti International Journal of digital business management. 2020; 1(4): 580 -592. https://DOI:10.31933

19.   Idris M, Lusiyani NL. Hubungan tingkat stress dengan gejala psikopatologi pada penerbang militer TNI AU di Lakespra Saryanto. Jurnal Afiat Kesehatan dan anak. 2021; 6(1):35-47.     

20.   Haythornthwaite J. Stress on the job: 4 tips for working women. John Hopkins medicine. Available at https://www.hopkinsmedicine.org/health/wellness-and-prevention/stress-on-the-job-4-tips-for-working-women

21.  Ketchesin KD, Stinnett GS, Seasholtz AF. Corticotropin-releasing hormone binding protein and stress: From invertebrates to humans. Stress. 2017; 20:449-464. https://doi:10.1080/10253890.2017.1322575.

22.  Klenerova V, Kvetnansky R, Hynie S. The effect of acute and repeated stress on CRH-R1 and CRH-R2 mRNA expression in pituitaries of wild type and CRH knock out mice. Cell Mol. Neurobiol. 2018; 38:163-169. https://Doi:10.1007/s10571-017-0556-3.

23.  Cannizzaro E, Ramaci T, Cirrincione L, Plescia F. Work-related stress, physio-pathological mechanisms, and the influence of environmental genetic factors. Int J Environ Res Public Health. 2019; 16(20):4031. https://Doi:10.3390/ijerph16204031

24.  Didymus FF, Norman L, Hurst M, Clarke NJ. Job stressors, strain, and psychological well-being among women sports coaches. International journal of sports science & coaching. 2021; 16(3): 456-464. https://doi.org/10.1177/1747954120974345

25.   Kotera Y, Dosedlova J, Andrzejewski D, Kaluzeviciute G, Sakai M. From stress to psychopathology: Relationship with self-reassurance and self-criticism in Czech University students. International Journal of Mental Health and Addiction. 2022; 20:2321-2332. https://doi.org/10.1007/s11469-021-00516-z

26.  Too LS, Butterworth P. Psychosocial job stressors and mental health: the potential moderating role of emotion regulation. J. Occup Environ Med. 2018; 60(10):518-524. https://DOI:10.1097/JOM.0000000000001416.

27.  Istriana E. Prevention of self-harm and suicide in adolescents. Univ Med [Internet]. 2020; 39(1); 1-2. DOI; https://doi.org/10.18051/UnivMed.2020.v39.1-2

28.  Allan BA, Dexter C, Kinsey R, Parker S. Meaningful work and mental health: job satisfaction as a moderator. Journal of mental health. 2018; 27:38-44. https://doi.org/10.1080/09638237.2016.1244718

29.  Lu Y, Hu XM, Huang XL, Zhuang XD, Guo P, Li FF, Hu W, et al. The relationship between job satisfaction, work stress, work-family conflict, and turnover intention among physicians in Guangdong, China: a cross-sectional study. BMJ open 2017; 7e014894. http://dx.doi.org/10.1136/bmjopen-2016-014894