Affektive Störungen bei Lehrerinnen und Lehrern. Untersuchungen zur Diagnostik von Depressivität, zu berufsbezogenen Risikofaktoren und zur Bewältigung beruflicher Belastungen

Mental disorders are the main reason for early retirement in German school teachers. Retirement as a consequence of bad health marks a major break in the biography of an individual. Associated costs for society and public health are considerable. This dissertation focuses on occupational health in school teachers. Firstly, the health status of teachers is described. Depressive symptoms and affective disorders represent the major problems. Accordingly, the aim of the first study is to investigate characteristics of two measurements of depressive symptomatology, the Center for Epidemiologic Studies-Depression Scale and the State-Trait Depression Scales. Based on Item-Response Theory, Rasch-analyses reveal that both questionnaires are appropriate measurements of depressive symptomatology covering the range from normal to clinically ill populations. The focus of the study is on the evaluation of critical cut-off-values. Therefore receiver-operating characteristics analyses are conducted. It is important to underline that evaluated cut-off-values are one option to ensure the validity of occupational health studies and provide assistance to assess the clinical relevance of results. Secondly, a review on general und occupational risk factors for affective disorders is given. Additionally, a systematic review on risk factors for school teachers is presented. Theoretical models and corresponding empirical evidence for teachers health are outlined in order to explain associations between work and health. The objectives of the following studies are deduced. The objective of the second study is to evaluate the validity of the Effort-Reward Imbalance Model in teachers. The associations between different rewards and affective disorders are in the center of interest. Logistic regression analyses reveal that a lack of external esteem at work is the main risk factor for depressive disorders. As a consequence, it is suggested to add a new component to the model: occupational self-appreciation. Preliminary results on the operationalization and validity of this construct are presented. Additional prospective analyses support the assumption of an adverse effect of Effort-Reward Imbalance on depressive symptomatology. The theoretical framework of the third study is the Transactional Stress Model. Flexibility is thought to be a central characteristic of successful coping. Following this approach, the repertoire of coping strategies and coping patterns are in the center of attention. The objective of the study is to identify patterns of habitual coping with occupational stress. Different cluster analyses are undertaken. The association between affective disorders and three different coping patterns are investigated. Additional analyses demonstrate the benefit of a multivariate perspective on coping. Characteristics of functional coping are described. Finally, implications for stress management trainings for teachers are suggested.