Danger-early maladaptive schemas at work! The role of early maladaptive schemas in career choice and the development of occupational stress in health workers

The schema-focused model of occupational stress and work dysfunctions (Bamber & Price, 2006, Bamber, 2006) hypothesizes that individuals with EMS (unconsciously) gravitate toward occupations with similar dynamics and structures to the toxic early environments and relationships that created them. They subsequently re-enact these EMS and their associated maladaptive coping styles in the workplace. For most individuals, this results in 'schema healing', but for some individuals with more rigid and severe EMS, schema healing is not achieved and the structures and relationships of the workplace, together with the utilization of maladaptive coping styles, serve to perpetuate their EMS. The model hypothesizes that it is these individuals who are most vulnerable to developing occupational stress syndromes To date, this model has been subjected to very little empirical investigation, so the main aim of this study was to address this gap in the literature by testing out some of its main assumptions and to provide empirical data, which would either support or reject the model using a population of health workers. Specifically, it was hypothesized that 'occupation-specific' EMS would be found in health workers from a range of different healthcare professions. It was also hypothesized that the presence of higher levels of EMS would be predictive of raised levels of occupational stress, psychiatric caseness and increased sickness absence in those individuals. A cross-sectional study design was employed and a total of 249 staff working within a NHS Trust, belonging to one of five occupational groups (medical doctors, nurses, clinical psychologists, IT staff and managers), participated in the study. All participants completed the Young Schema Questionnaire-Short Form (Young, 1998); the Maslach Burnout Inventory-Human Services Form (Maslach & Jackson, 1981), and the General Health Questionnaire-28-item version (Goldberg, 1978). A demographic questionnaire and sickness absence data was also collected. The results of a between groups analysis of variance and further post hoc statistical analyses identified a number of occupation specific EMS. Also, the results of a series of multiple linear regression analyses indicated the presence of some EMS to be predictive of higher levels of burnout, psychiatric caseness and sickness absence in health workers. In conclusion, the findings of this study provide empirical support for the schema-focused model of occupational stress and work dysfunctions (Bamber & Price, 2006; Bamber, 2006), and it appears that the existence of underlying EMS may constitute a predisposing vulnerability factor to developing occupational stress. Copyright (c) 2008 John Wiley & Sons, Ltd.