title: Managerial leadership is associated with employee stress, health, and sickness absence independently of the demand-control-support model.
abstract: OBJECTIVE
  Research on health effects of managerial leadership has only taken established work environment factors into account to a limited extent. We therefore investigated the associations between a measure of Attentive Managerial Leadership (AML), and perceived stress, age-relative self-rated health, and sickness absence due to overstrain/fatigue, adjusting for the dimensions of the Demand-Control-Support model.
  
  
  METHODS
  Blue- and white-collar workers from Finland, Germany and Sweden employed in a multi-national forest industry company (N=12,622).
  
  
  METHODS
  Cross-sectional data on leadership and health from a company-wide survey analysed with logistic regression in different subgroups.
  
  
  RESULTS
  AML was associated with perceived stress, age-relative self-rated health, and sickness absence due to overstrain/fatigue after controlling for the Demand-Control-Support model. Lack of AML was significantly associated with a high stress level in all subgroups (OR=1.68-2.67). Associations with age-relative self-rated health and sickness absence due to overstrain/fatigue were weaker, but still significant, and in the expected direction for several of the subgroups studied, suggesting an association between lack of AML and negative health consequences.
  
  
  CONCLUSIONS
  The study indicates that managerial leadership is associated with employee stress, health, and sickness absence independently of the Demand-Control-Support model and should be considered in future studies of health consequences for employees, and in work environment interventions.
authors.affiliation: Stress Research Institute, Stockholm University, Stockholm, Sweden. hugo.westerlund@stressforskning.su.se
authors.forename: Hugo
authors.initials: H
authors.lastname: Westerlund
authors.forename: Anna
authors.initials: A
authors.lastname: Nyberg
authors.forename: Peggy
authors.initials: P
authors.lastname: Bernin
authors.forename: Martin
authors.initials: M
authors.lastname: Hyde
authors.forename: Gabriel
authors.initials: G
authors.lastname: Oxenstierna
authors.forename: Paavo
authors.initials: P
authors.lastname: Jäppinen
authors.forename: Ari
authors.initials: A
authors.lastname: Väänänen
authors.forename: Töres
authors.initials: T
authors.lastname: Theorell
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D004647:Employee Discipline / Q000379:methods / Q000706:statistics & numerical data*; D005260:Female; D005387:Finland; D005858:Germany; D006801:Humans; D038622:Internationality; D007857:Leadership; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016272:Occupational Health; D009790:Occupations; D016017:Odds Ratio; D012016:Reference Values; D018570:Risk Assessment; D012737:Sex Factors; D018434:Sickness Impact Profile; D012944:Social Support; D013315:Stress, Psychological / Q000175:diagnosis / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D013548:Sweden; D017132:Workplace / Q000523:psychology