An integrative approach is suggested to track symbolically simulated work environment stressors, as an act to burden higher cortical function in the exposed groups. ERP would be made together with measurement of end organ stress responses as well as measurements of perceived conditions. Field studies would be the necessary complement. The following conclusions are culled from the reviewed literature: among the pilots, cardiovascular problems are the most important cause of loss of licence in Europe and North America. Interactions with coworkers for air traffic controllers have been associated with cardiovascular disability. Comparing various degrees of heart disease severity among professional drivers, the IHD drivers showed the smallest N2 amplitudes and the greatest diastolic blood pressure reactivity. P300 target amplitude showed an inverse correlation with number of work hours behind the wheel. The IHD drivers were envisioned in a phase of disturbance of the selective attentional process. An interrelation has been found between Event-Related Slow Potential ERSP and midinterval heart rate acceleration associated with displeasure and arousal. A positive correlation has been found between the amplitude of the ERSP and ventricular arrhythmia rate in cardiac patients. Lowering of arrhythmia rate in response to antiarrhythmic agents was associated with a significant attenuation of the ERSP. Either acceleration or deceleration is associated with the appearance of the late CNV to the aversive noise burst. There might be a "common generator behind both anticipatory heart rate responses and cortical events." CNV might be related to frontally mediated stress mechanisms.

Arousal↗

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Psychophysiological correlates of organizational change and threat of unemployment among police inspectors.

The study examined psychosocial work-conditions and physiological reactions among thirty-six police inspectors (median age 45 years, 81% males) who participated in a reorganization. At this time, subjects were threatened by unemployment and had to re-apply for their positions in a new police district. Data were collected during the reorganization and at three years follow-up, by means of questionnaires (Stress Profile) and blood samples. The blood samples were used to determine serum levels of gamma-glutamyltransferase (GGT), glucose, lipids, prolactin, testosterone and cortisol. The results show a positive association between worry about employment and symptoms of burnout during the reorganization. Mean scores for the Stress Profile sub-scales worry about employment (p<.01) and work-load (p<.05) decreased between measurements, but an impairment in relationships with management was noticed (p<.05). No significant changes were observed in terms of self-rated health complaints. Significant decreases in total cholesterol (p<.0001), LDL-cholesterol (p<.0001), LDL/HDL-ratio (p<.01), prolactin (p<.0001), as well as increases in testosterone (p<.01) and cortisol (p<.001) were observed for the whole sample. Glucose decreased with marginal significance (<.07). Controlling for age and gender, multivariate regression analyses showed that subjects who reported deteriorations in satisfaction with work manifested the most modest decreases in prolactin (p<.05). Also, the decrease in glucose was larger for subjects who experienced impairments in satisfaction with work (p<.05), information (p<.05), task-oriented leadership, (p<.05), and respect and dignity (p<.05). Subjects who perceived deteriorations in the ethical and moral standards of the organization increased their cortisol level to a lower degree than their counterparts (p<.05). Favorable changes in employment status and psychosocial work environment seem to be related to improved physiological functioning.

Adult↗

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Prolactin--a hormone that mirrors passiveness in crisis situations.

According to previous animal research and psychological laboratory experiments in humans, plasma prolactin varies in relation to psychosocial stress. However, the findings in published studies are difficult to interpret. In some studies increased levels and, in other studies, decreased levels were observed. The present report summarizes findings from four different real-life stress studies that have had a longitudinal design. Findings indicate that change situations associated with passive coping are accompanied by increased plasma prolactin levels whereas change situations associated with active coping are associated with unchanged or even lowered levels. The regulation of plasma prolactin is part of a dopaminergic system. It is speculated that prolactin may be needed for preservation of vital functions during withdrawal.

Animals↗

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Electrocortical responses to ecologically relevant visual stimuli among professional drivers with and without cardiovascular disease.

Electrocortical responses were assessed using two simulated aspects of visual signals encountered in traffic: the Glare Pressor Test (GPT) and Event-Related Potential Avoidance Task (ERPAT) among four groups of male professional drivers: 12 with ischemic heart disease (IHD), 12 hypertensives, 10 borderline hypertensives, 34 who were apparently healthy and 23 nonprofessional driver healthy control subjects. The blood pressure (BP) responses immediately after the ERPAT were also measured. There was a significant between groups effect for the amplitude of the target N2 component in the ERPAT (p = 0.02), with the lowest means among the drivers with IHD and the highest among those with hypertension. Drivers with IHD also showed the highest diastolic BP reactivity to the ERPAT. Significantly more than the expected number of drivers with IHD failed to recover alpha activity after the first glare impulse of the GPT. Professional drivers who failed to recover baseline levels of alpha activity after the GPT showed a significantly smaller N2 amplitude compared to those who recovered (p = 0.01). There was a positive correlation between abundance of alpha activity at rest with P300 amplitude (p = 0.02). An inverse relation was found between number of work hours behind the wheel and the amplitude of the target P300 (p = 0.04). Results are interpreted in light of recent advances concerning integrative mechanisms of defence versus vigilance response patterns. The findings in this study justify further applications of these psychophysiologic methods to assess the relationship between simulated signals of the work environment and mechanisms of cardiac risk in this occupational group.

Adult↗

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Biological correlates of social support and pressure at work in managers.

The aim was to explore the patterns of correlations between psychosocial stress indices and neuroendocrinological factors in managers. Fifty-eight male managers in three Swedish companies constituted the sample. They answered two questionnaires with 17 selected stress indices and also an organizational test. The indices have been analyzed by means of computations of age adjusted partial correlations with nine different variables analyzed in fasting blood samples. The serum concentrations of lipids were the variables most strongly correlated with psychosocial factors. Neither smoking nor physical activity changed the correlations significantly. Good social support at work and in private life was consistently associated with low adverse serum lipids and corresponding lipoproteins. On the other hand, some indices of social support were associated with indices of high arousal levels. This may indicate a possible psychophysiological "load effect" of some aspects of social support in managers. The analyses of corporate culture measured as "Rules of the Game" indicated that "bureaucracy" was significantly associated with high LDL-cholesterol and low HDL-cholesterol. Managers have special conditions and therefore the patterns of associations between psychosocial conditions and coping strategies on one hand and endocrine-biochemical state on the other hand may be different from those of other groups. To what extent such differences are due to individual characteristics or environmental factors needs to be further investigated. According to the results, however, good social support is in general health promoting also to managers, at least with regard to serum lipids. Bureaucracy, on the other hand, seems to be dangerous to the health of managers.

Adult↗

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Emotions and cardiac contractility as reflected in ballistocardiographic recordings.

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Adult↗

PubMedDate not supplied

Differences in the association between psychosocial work conditions and physical work load in female- and male-dominated occupations. MUSIC-Norrtälje Study Group.

This study investigated whether there is a relationship between high physical work load and adverse psychosocial work factors, and whether this relationship is different for women and men. Separate analyses for female registered nurses and assistant nurses were made because these are common occupations involving high physical and psychological demands. This study was part of the MUSIC-Norrtälje study, a population study with the overall aim of identifying risk factors for musculoskeletal disorders. The respondents, 1423 gainfully employed men and women, were randomly selected from the study population. The exposure assessments referred to a typical workday during the previous 12 months. Physical exposure was investigated by interview, psychosocial work factors by interview and questionnaire. For the women, but not the men, mainly routine work and a job strain situation, according to the model of Karasek and Theorell, increased the probability of having a high physical work load, assessed as a time-weighted average of energy expenditure in multiples of the resting metabolic rate. Results indicated that in female-dominated occupations, high physical work load might also imply adverse psychosocial conditions. A higher frequency of high physical work load and job strain was observed among assistant nurses compared with registered nurses. Covariance between physical and psychosocial demands makes it difficult to determine the relative influence of each in health problems. Results of the present study imply that this is a larger problem in studies of women than men.

Adult↗

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A longitudinal study of 21 subjects with coronary heart disease: life changes, catecholamine excretion and related biochemical reactions.

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Adult↗

PubMedDate not supplied

Immune function in unemployed women.

Immunologic effects of unemployment were prospectively studied in women over a period of 8 months. Subjects were classified into three groups depending on their employment history, and were studied concomitantly. Group A consisted of unemployed women who were recipients of traditional support from the Swedish welfare state. Group B was composed of unemployed women who were given the opportunity to participate in a psychosocial program, in addition to receiving the traditional unemployment benefits received by group A. Group C, the control, consisted of securely employed women. Phytohemagglutinin (PHA) reactivity of lymphocytes decreased significantly in both groups of unemployed women after 9 months of unemployment. The psychosocial program did not counteract this decrease. Reactivity to purified protein derivative (PPD) of tuberculin also decreased significantly in the unemployed subjects. No changes were observed in the securely employed women. There were no significant differences among the groups in T cell subpopulations, B cells, and serum cortisol. The data suggest that some aspects of the immune system may be altered at a specific time period following the loss of work. Further studies are needed to see if this effect is only temporary or more long lasting.

Adult↗

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Slow-reacting immunoglobulin in relation to social support and changes in job strain: a preliminary note.

Fifty working subjects in the ages 25 to 60 were asked to rate the amount of job strain (demands divided by decision latitude) that they experienced on four occasions at intervals of three to four months. Blood samples were taken for the analysis of immunoglobulin G before work started on these work days. After the end of the studied year each subject was asked to rate the total amount of social support that he/she had experienced. Both availability and adequacy of support were rated. The reported degree of job strain was unrelated to season and number of order of observation. Immunoglobulin G was observed to rise progressively with rising job strain. The reported adequacy of social support was negatively associated with immunoglobulin G--the more adequate the support was reported to be, the lower the immunoglobulin G level. This association was stronger at peak levels of job strain and became weak and nonsignificant at low levels of job strain. Thus, when job strain increased immunoglobulin G increased mainly among those with poor adequacy of social support.

Adult↗

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"Person under train" incidents: medical consequences for subway drivers.

UNLABELLED: From the subway driver's point of view, a "person under train" (PUT) incident is a serious life event. This study focuses on the 1-year consequences of such events. Follow-up was made 3 weeks, 3 months, and 1 year after the event. Forty consecutive PUT subway drivers were followed. For each PUT driver, a control driver matched with regard to gender, age, and country of birth was followed at identical intervals. MAIN RESULTS: The PUT group had significantly more sick days during the interval from the event to 3 weeks later. During the period 3 weeks to 3 months after the event no difference between the groups was observed. From 3 months to 1 year after the PUT significantly more days were again reported by the PUT group. Thirty-eight percent in the PUT group versus 14% in the control group had at least 1 month of sickness absence during this period. A mild acute psychophysiological reaction was observed 3 weeks after the event, with elevated prolactin and increased sleep disturbance in the PUT group. Such acute reactions were transitory and not correlated with long-term sick leave, which was predicted independently, however, by a high plasma cortisol level (analyzed in men) and a high depression score. Drivers in the group with seriously injured victims were absent from work for longer periods than drivers in the groups with mildly injured or dead victims.

Absenteeism↗

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Social support and the development of immune function in human immunodeficiency virus infection.

A psychosocial investigation offered to all human immunodeficiency virus (HIV)-infected men with moderately severe or severe hemophilia in Sweden was made in 1986. Most of these men had been infected in the years 1980 to 1984 and told about their infections in 1985. Forty-nine subjects had answered questions in regard to sources of emotional support in their life situation. Based on the responses to these questions a score of "availability of attachment" (AVAT) was calculated, and two groups of patients were identified: one with high AVAT and one with low AVAT scores. The subjects were followed with regard to the state of their immune system, as reflected by CD4 counts, until 1990. The results indicated that a low AVAT score in 1985 was associated with a significantly more rapid progressive deterioration in CD4 count during subsequent years. The mechanism behind this association is unknown. Several possible confounders were not studied. However, if the association between a poor AVAT score and rapid CD4 deterioration after HIV infection is replicated in other samples, it could be important to the future clinical care of HIV-infected subjects.

Adolescent↗

PubMedDate not supplied

Gastrin, cholecystokinin, and somatostatin in a laboratory experiment of patients with functional dyspepsia.

OBJECTIVE: To explore the pattern of gastrointestinal hormonal variations in plasma and to relate this to possible pathophysiological mechanisms in functional dyspepsia. METHOD: There were 25 patients, 12 men and 13 women, aged 24 to 50 years, with recurrent functional dyspepsia, compared with community control subjects pair-wise, matched for age and sex. The subjects participated in a laboratory stress experiment with timed provocations. At fixed intervals, 22 samples of blood were drawn from each subject and frozen for later peptide analyses. Levels of gastrin, cholecystokinin (CCK), and somatostatin were measured by radioimmunoassay. Peptide levels were studied during a friendly greeting, a stress interview, and a food stimulation. RESULTS: Mean hormone values did not differ between the groups. Smokers had lower mean CCK than nonsmokers. Patients with a high degree of dyspeptic symptoms during the week preceding the experiment had a higher mean somatostatin level than patients with a low degree of dyspeptic symptoms. Heartburn correlated positively with the mean somatostatin level. Mean gastrin correlated with body mass index. During the 15-minute stress interview, significant changes in peptide variations were noted: Gastrin increased in both patient and control group subjects. CCK levels increased in patients from 7.2 pmol/l (6.0-8.5) to 9.8 pmol/l (8.2-11.4), but not in control subjects (p < 0.04, two-way interaction). Somatostatin increased significantly earlier in patients than in the control subjects during the stress interview. CONCLUSIONS: A positive relationship was found between the mean level of somatostatin and the degree of dyspeptic symptoms. Gastrin, CCK, and somatostatin were all sensitive to an anxiety-provoking interview. CCK and somatostatin may possibly link psychological reactions to the pathophysiology of functional dyspepsia.

Adult↗

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Critical life events, infections, and symptoms during the year preceding chronic fatigue syndrome (CFS): an examination of CFS patients and subjects with a nonspecific life crisis.

OBJECTIVE: The purpose of this study was to describe the sequence of psychosocial events and infections preceding the onset of chronic fatigue syndrome (CFS). This information was related to the temporal development of crucial symptoms in relation to the onset of, namely, fatigue, sadness, irritability, pain, and feeling of fever. METHODS: A personal interview was conducted in 46 patients (mean age, 39.5 years; SD, 9 years) who fulfilled international CFS criteria. These patients were matched with regard to age and gender to 46 carefully matched control subjects. Twenty-three percent of the study subjects were men, and 77% were women. The patient at first identified the month that coincided with the onset of CFS. Similarly, each control subject was asked to identify a "very difficult period" within approximately the same period as the patient with whom the control subject was matched. A list of 14 different life events was perused. Participants were asked to identify for each month whether each of the listed events had occurred. Furthermore, they were asked to rate the importance of the events they had experienced. In addition, for each of the cardinal symptoms (fatigue, sadness, irritability, pain, and feeling of fever) and for each month, the subjects were asked to rate, on a visual analogue scale, the symptom intensity. Also, the number of infections was noted. RESULTS: A statistically significant group difference in fatigue intensity existed during the period 4 to 10 months before the onset of CFS. During the 3 months preceding the diagnosis for the CFS patients or the peak of the crisis for the control group, there was a dramatic rise in fatigue in both groups. The CFS group reached a much higher fatigue level, which leveled off somewhat during the first year of follow-up but still remained very high in comparison with the control group, which reached precrisis levels 4 months after the peak. Similar patterns were observed for fever and pain. With regard to sadness and irritability, no group difference was observed during the period preceding the crisis. In the patient group, the level stayed high throughout the whole first year of follow-up, whereas a slow return started in the control group; precrisis levels were reached after 1 year in this group. The prevalence ratio (CFS patients/control subjects) for negative events was around 1.0 for the periods 4 to 12 months preceding CFS but 1.9 during the quarter year preceding the onset. For infections, the prevalence ratio increased successively during the four quarters preceding CFS (from 1.4 to 2.3). CONCLUSIONS: According to the retrospective self-reports, there were differences between the groups in fatigue, pain, and feeling of fever during the months preceding the crisis. With regard to depressive and irritable feelings, no preillness differences were reported between the groups. There was a reported excess prevalence of both infections and negative life events during the quarter year preceding the onset of CFS or crisis. Potential sources of error are discussed. These findings must be replicated in longitudinal studies.

Adult↗