Job strain, rank, and mental health in the UK Armed Forces.

We assessed whether job demand and job control have independent effects on psychological symptoms or whether job control modifies effect of job demand; we also assessed whether rank modified associations between job strain and psychological symptoms. We used the Post Traumatic Stress Disorder (PTSD) Checklist (PCL-C), General Health Questionnaire-12 (GHQ-12), Chalder Fatigue Scale, a checklist of 53 physical symptoms, and the WHO's Alcohol Use Disorders Identification Test (AUDIT). Job control, job demand, and rank were independently associated with PTSD, common mental disorders, multiple physical symptoms, and fatigue, but not with severe alcohol problems. Job control and demand had additive effects on psychological symptoms. Commissioned officers had lower risk of caseness for psychological symptoms than other ranks. Adjustment for rank had negligible effect on level of association between job strain and psychological symptoms. Reported job strain and rank contributed independently to psychological symptoms.