National Cultural Moderates the Link Between Work Stress and Depression: An Analysis of Clinical Trial Projects Across Countries

Work stress (WS) and depression have become globally ubiquitous, leading to high socioeconomic costs, including high suicide rates. Unfortunately, depression and its association with WS are often ignored in substantive empirical studies. The current study addresses this gap by exploring the direct link between WS and depression and the moderating link between WS and national culture. Based on appraisal stress theory and vitamin stress theory, we used clinical trial data from 100 countries, with 5918 clinical trial projects (1999–2020). The baseline hypothesis finds that the chances of WS exacerbating into depression is about 11 times higher than that of WS not exacerbating into depression. In the moderation hypothesis, cultural moderators show an increase or decrease in directional effects. The power distance moderator increases the odds of the net effect of WS from 11 to 38, the individualism moderator increases the odds of net effects of WS from 11 to 148, the masculinity moderator decreases the odds from 11 to 9, the uncertainty avoidance moderator decreases it from 11 to 0, and long-term orientation decreases it from 11 to 4.7. An increase or decrease in the net effect suggests that moderators decrease or increase the correlation, respectively. Power distance and individualism decrease the link between WS and depression, while masculinity, uncertainty avoidance, and long-term orientation increase it. Thus, our study contributes to WS issues, theories of cultural contingencies/structures, and the practice of mental health management.