Longitudinal trajectories of psychosocial work stress and their associations with health-related quality of life among mothers and fathers within the prospective cohort study DREAM

The study aims to examine the development of psychosocial work stress, operationalized through the Effort-Reward Imbalance (ERI) model (Siegrist, 1996), among parents from pregnancy to 4.5 years after childbirth using data from the prospective cohort study DREAM (DResdner Studie zu Elternschaft, Arbeit und Mentaler Gesundheit). ERI conceptualizes work stress as a violation of reciprocity between high work-related efforts and insufficient rewards (Siegrist, 1996), which has been empirically linked to adverse mental and physical health outcomes (e.g., Kuper et al., 2002; Rugulies et al., 2017). While ERI has primarily been studied cross-sectionally, the limited longitudinal evidence suggests intra- and interindividual variability with distinct trajectories characterized by stable, increasing, or decreasing imbalance over time (Feldt et al., 2013; Leineweber et al., 2018; Meyer et al., 2016; Meyer et al., 2017). The transition to parenthood represents a critical life phase characterized by profound physical, psychological, and social transformations. Parents must adapt to new caregiving responsibilities, evolving family structures, and shifting social identities (Kuersten-Hogan & McHale, 2021; Olivieri et al., 2024). Empirical findings indicate that ERI may change during pregnancy and the early postpartum period among mothers (Karl et al., 2020; Meyer et al., 2016; Meyer et al., 2017), yet little is known about its longer-term development for both mothers and fathers as work and family demands continue to change. Therefore, we aim to identify distinct longitudinal trajectories of ERI. A further aim is to explore whether these trajectories differ between mothers and fathers. Mothers and fathers may differ in their exposure and adaptation to psychosocial work stress, given persistent gender inequalities in caregiving and paid work (Allen & Eby, 2016; European Institute for Gender Equality, 2020; Sheikh et al., 2025). Although evidence on sex differences in ERI is mixed, prior findings indicate that women may be overrepresented in less favorable ERI trajectories (Leineweber et al., 2018). By adopting a sex-sensitive and longitudinal perspective, this project seeks to contribute to and expand the limited research on the long-term relationship between psychosocial work stress and parental health outcomes (Karl et al., 2020; Koerber et al., 2023). Specifically, we aim to examine how trajectory membership predicts parental health-related quality of life (HrQoL; Ware et al., 2001) at 4.5 years after childbirth. HrQoL represents a multidimensional indicator of subjective physical and mental well-being and has been shown to be sensitive to psychosocial work stress exposure (Preckel et al., 2007). Persistently high or increasing ERI is therefore expected to be associated with poorer HrQoL outcomes, whereas stable low ERI trajectories are expected to be linked to more favorable HrQoL.