Occupational Medicine 2004;54:122-127
Occupational Medicine, Vol. 54 No. 2 © Society of Occupational Medicine 2004; all rights reserved
Perfectionism and coping strategies as risk factors for the development of non-specific work-related upper limb disorders (WRULD)
1 Department of Physical Medicine and Rehabilitation, University Hospital Maastricht, Maastricht, The Netherlands
2 Department of Psychiatry, University Hospital Maastricht, Maastricht, The Netherlands
3 Department of Epidemiology, University of Maastricht, Maastricht, The Netherlands
Background The incidence of non-specific work-related upper limb disorders (WRULD) is rising throughout western society. Literature and our own WRULD file (>1200 patients) revealed that both physical and psychosocial work-related factors are major causes of non-specific WRULD. It also appeared that non-specific WRULD was more likely to develop in patients with neurotic-perfectionist personalities.
Aim To see if, alongside physical and psychosocial work-related factors, personality factors play an important role in developing non-specific WRULD.
Method This was a case-control study with two control groups, comparing 45 computer workers with non-specific WRULD with 45 computer workers free from upper limb disorder (first control group) and 42 chronic pain patients (second control group). Main questionnaires administered were: the Utrecht Coping List (UCL), measuring coping-styles; the Multidimensional Perfectionism Scale (MPS), measuring neurotic perfectionism; and the Symptom Check List (SCL-90), measuring general psychological complaints (psychoneuroticism). The SCL-90 was added because of its known high correlation with neurotic perfectionism.
Results Logistic regression analysis revealed significant differences in SCL-90 scores (
2 = 17.2, P < 0.0001), thereby potentially negating the significance of the higher neurotic perfectionism in the non-specific WRULD group. A second control group of chronic pain patients, with prospective high score on the SCL-90, was added. Logistic regression showed that, after controlling for psychoneuroticism, non-specific WRULD patients had more neurotic perfectionist traits (2 = 22.83, P < 0.0001). There were no significant differences in mean UCL scores (P > 0.05).
Conclusion Alongside physical and psychosocial work-related factors, psychoneuroticism and neurotic perfectionism appear to be important risk factors for developing non-specific WRULD.
Keywords Computer workers; coping strategies; neurotic perfectionism; non-specific work-related upper limb disorder (WRULD); personality structure
Received 11 September 2002
Revised 27 August 2003
Accepted 13 October 2003
Correspondence to: M.D.F. van Eijsden-Besseling, Physiatrist, University Hospital Maastricht, Department of Physical Medicine and Rehabilitation, Postbus 5800, NL-6202 AZ Maastricht, The Netherlands. Tel: +31 (0)43 3875919/3877151; fax: +31 (0)43 3875142; e-mail: mdf_van_eijsden{at}hotmail.com