Metabolic Syndrome and Self-Reported Stress
Chandola and colleagues present data from the Whitehall II Study correlating the relationship between self-reported stress and the metabolic syndrome. The paper does not comment on the "elephant in the room" that is the relationship between self-reported stress and "objective" measures of psychosocial adversity. The notion of an objective measure of such adversity may be an oxymoron but surely this is a key consideration if this study, which is essentially ecological, is not to be misrepresented.
Chandola and colleagues state in their discussion that "greater exposure to job stress over 14 years was linked to greater risk of metabolic syndrome in a dose-response manner." What the study does perhaps demonstrate is the way in which self-reported work stress clusters with a range of non-adaptive coping responses such as excess alcohol consumption and failure to engage in self care behaviours such as exercise. Stress is a complex personal construct and not the unproblematic external variable which Chandola et. al. might suggest they have measured.
GP and Occupational Health Physician
Competing interests: No competing interests