title: Are effort-reward imbalance and social isolation mediating the association between education and depressiveness? Baseline findings from the lidA(§)-study.
abstract: OBJECTIVE
  To investigate multiple mediations of the association between education and depressive symptoms (BDI-V) by work-related stress (ERI) and social isolation, the regional variation of the first mediation and a potential moderating effect of regional unemployment rate.
  
  
  METHODS
  6339 employees born in 1959 and 1965 were randomly recruited from 222 sample points in a German cohort study on work, age, health and work participation. A multilevel model of moderated lower-level mediation was used to investigate the confirmatory research question. Multiple mediations were tested corresponding to Baron and Kenny. These analyses were stratified for age and adjusted for sex, negative affectivity and overcommitment.
  
  
  RESULTS
  In the association between education and depressive symptoms, indirect effects of work-related stress and social isolation were significant in both age cohorts whereas a direct association was observable in the younger cohort, only. The significant regional variation in the association between work-related stress and depressive symptoms was not statistically explained by regional unemployment rate.
  
  
  CONCLUSIONS
  Our findings point out that work-related stress and social isolation play an intermediary role between education and depressive symptoms in middle-aged employees.
authors.affiliation: Institute of the History, Philosophy and Ethics in Medicine, Ulm University, Ulm, Germany, Jean-Baptist.du-Prel@uni-ulm.de.
authors.forename: Jean-Baptist
authors.initials: JB
authors.lastname: du Prel
authors.forename: Mario
authors.initials: M
authors.lastname: Iskenius
authors.forename: Richard
authors.initials: R
authors.lastname: Peter
mesh_terms: D000367:Age Factors; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology / Q000523:psychology*; D004522:Educational Status; D005260:Female; D005858:Germany; D006304:Health Status; D006801:Humans; D008297:Male; D016272:Occupational Health; D012201:Reward; D012737:Sex Factors; D012934:Social Isolation / Q000523:psychology*; D013315:Stress, Psychological / Q000453:epidemiology / Q000523:psychology*; D016526:Workload / Q000523:psychology; D017132:Workplace / Q000523:psychology*