job demands as aspects of the job that require physical and/or psychological effort. Workaholism Those who exhibit workaholism tend to demonstrate higher levels of presenteeism. As defined by Schaufeli, Bakker, van der Heijden, and Prins, workaholics tend to work excessively and compulsively, and they are internally motivated to work to an excessive extent. In addition to their high levels of presenteeism, Schaufeli et al. discovered that workaholics also displayed the highest burnout and lowest happiness levels relative to other groups who were not defined as workaholics. Performance-based self-esteem Performance-based self-esteem (PBSE) has also been considered another antecedent of presenteeism. This term describes the idea that individuals' self-esteem may depend on their performance. Employees who demonstrate high levels of this construct have to prove their worth while on the job. Love et al. found that PBSE positively predicted presenteeism; however, the authors also discovered that the relationship between PBSE and presenteeism was strengthened when workers experienced high physical and psychological work demands. This finding suggested that demanding work environments could interact with employees' overambitious work styles, which could result in over performance and increased levels of presenteeism. Health factors Certain health factors serve as risk factors for presenteeism as opposed to absenteeism. Boles, Pelletier, and Lynch examined a variety of emotional and physical health symptoms and noted that the odds of reporting presenteeism were largest for those with high stress compared to those without stress. Those with poor diet and less emotional fulfillment also reported higher levels of presenteeism than those without these conditions. The researchers noted that individuals with diabetes tended to report higher levels of absenteeism as opposed to those without the condition. Individuals who partook in no physical activity were more prone to report higher levels of both absenteeism and presenteeism compared to those who took part in some physical activity. Consequences Productivity loss One consequence of presenteeism is productivity loss, and scholars have attempted to estimate these productivity numbers. While examining productivity decrements, however, it is implied that losses are measured relative to not having a particular sickness or health issue. Furthermore, in comparison to being absent from a job, those exhibiting presenteeism may be far more productive. Nonetheless, a large study by Goetzel et al. estimated that on average in the United States, an employee's presenteeism costs or lost on-the-job productivity are approximately $255. Furthermore, the authors concluded that of all the health related costs faced