title: Overcommitment but not effort-reward imbalance relates to stress-induced coagulation changes in teachers.
abstract: BACKGROUND
  Stress-related hypercoagulability might link job stress with atherosclerosis.
  
  
  OBJECTIVE
  This paper aims to study whether overcommitment, effort-reward imbalance, and the overcommitment by effort-reward imbalance interaction relate to an exaggerated procoagulant stress response.
  
  
  METHODS
  We assessed job stress in 52 healthy teachers (49 +/- 8 years, 63% women) at study entry and, after a mean follow-up of 21 +/- 4 months, when they underwent an acute psychosocial stressor and had coagulation measures determined in plasma. In order to increase the reliability of job stress measures, entry and follow-up scores of overcommitment and of effort-reward imbalance were added up to total scores.
  
  
  RESULTS
  During recovery from stress, elevated overcommitment correlated with D-dimer increase and with smaller fibrinogen decrease. In contrast, overcommitment was not associated with coagulation changes from pre-stress to immediately post-stress. Effort-reward imbalance and the interaction between overcommitment and effort-reward imbalance did not correlate with stress-induced changes in coagulation measures.
  
  
  CONCLUSIONS
  Overcommitment predicted acute stress-induced hypercoagulability, particularly during the recovery period.
authors.affiliation: Division of Psychosomatic Medicine, Bern University Hospital (Inselspital) and University of Bern, Bern, Switzerland.
authors.forename: Roland
authors.initials: R
authors.lastname: von Känel
authors.forename: Silja
authors.initials: S
authors.lastname: Bellingrath
authors.forename: Brigitte M
authors.initials: BM
authors.lastname: Kudielka
mesh_terms: D001779:Blood Coagulation Factors / Q000378:metabolism*; D001794:Blood Pressure; D005178:Faculty; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000378:metabolism; D005340:Fibrinogen / Q000378:metabolism; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D009638:Norepinephrine / Q000097:blood; D012201:Reward; D012463:Saliva / Q000378:metabolism; D013315:Stress, Psychological; D014937:Work / Q000523:psychology*
chemical_list: D001779:Blood Coagulation Factors; D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D; D005340:Fibrinogen; D006854:Hydrocortisone; D009638:Norepinephrine