Stress and the Workplace
	Related article:  Stress Busting Techniques
	Corporations are spending increasing sums to combat the negative effects of stress on workplace morale, attendance, accidents (85 percent of industrial accidents are said to be stress-induced), and employee health and productivity. No work is without stressors, but some jobs seem to produce particular stress and to have clear risks to health. Air-traffic controllers and Marine Navigation Officers, for example, who must make split-second decisions that affect the lives of hundreds of people, have an extremely high turn-over rate and an incidence of gastric ulcers that is well above average. People who must adapt their sleep patterns to the changing hours of a rotating shift suffer stress as a result of the disruption of their circadian (daily) rhythms. Women who must balance the demands of a job with those of child care are twice as likely to suffer from coronary heart disease as housewives with the same number of children. What makes a job stressful! A research team questioned people working in a variety of fields about two aspects of their jobs: (1) the amount of psychological demand in their work - how hard or fast they had to work, the time pressure involved, how hectic they felt their jobs were; and (2) the amount of decision control they had - did they have any control over working conditions, did their jobs offer variety or an opportunity to use their skills and learn new things? Then the research team tallied the rates of cardiovascular disease in different occupations. Thus far, the research has revealed a consistent and significant finding: Jobs with high psychological demand and low decision control are associated with high rates of heart disease. While this research cannot be taken as definitive evidence that certain occupations result in a high risk of heart disease, it does indicate an apparent link between job-related stress and heart disease. The research defines a high-stress job as one that is repetitive and machine-paced. The work is monotonous and yet demands close attention. The workers have little or no control over their working situation. Some of the many jobs that fit this description are assembly-line work, freight-handling, and garment assembly. Low-stress jobs, according to research team findings, are those with low psychological demand or those with high levels of control. For chief executive officers and top professionals, high demand is offset by high levels of decision control. Popular wisdom to the contrary, such high-level jobs have relatively low levels of cardiovascular risk. In fact, a study of male employees at a major corporation found that the rate of coronary disease was lower with each step up the corporate ladder. Other important factors in determining the levels of job-related stress are the management style and personality of the supervisor. One study of personnel management showed that the single factor that correlated with evidence of stress in employees (specifically, high blood cholesterol levels) was a supervisor who gave more attention to trivial details than to larger goals of efficiency and productivity. The attitudes of co-workers is also a factor in job-related stress. Camaraderie and social support can do much to buffer the effects of a stressful work environment.
	Coping With Stress
	Coping mechanisms come into play as an individual seeks to adapt to a stressful event - to master, tolerate, minimize, or reduce stress. It is the way we respond to stress, not so much the stressors themselves, that determines whether the impact will be large or small - even whether the individual experiences eustress or distress. Poor coping may fail to address the stressor and may even worsen it, as with a student who dreads an examination and puts off studying to the last moment. Or a person may attempt to distract him- or herself from the immediate distress, perhaps with drug or alcohol (See also: 'Effects of Alcohol Abuse') use or by overeating, and the stressor simply may be ignored. Sometimes the methods used to cope with a stressful situation become symptoms of psychopathology themselves. For example, a man whose feelings of masculine inadequacy make social situations stressful might "cope" by avoiding such situations entirely. Good coping, on the other hand, enables an individual to meet the demands of a stressful situation effectively and at the same time promotes psychological and physical well-being.
	Personality Factors
	Some people simply are more effective than others in dealing with the vicissitudes of life. Research has shown that an individual's coping resources can buffer the effects of stress, as reflected in the development of illness. Some personality traits found to be associated with protection against illness under stress are an active (versus passive) coping orientation, a positive (versus negative) attitude, a sense of personal control over one's life, personal commitment, and adaptive flexibility - that is, the ability to try various approaches in seeking a satisfactory one.
	Coping Principles
	People who cope successfully with stress tend to adopt the following strategies. It is important to note that skilled professional help can help in implementing these strategies and maximizing their chances for success. Cope actively. Whenever possible, stressors should be dealt with by taking direct action. Individuals must also learn to recognize what is beyond their control, however. Manage time. Pacing oneself, refusing to take on too much, and learning to say "wait" or "no" are valuable ways of reducing stress. Regulate the stress. Stressful information can be handled better in manageable amounts and at manageable intervals. For example, a distant goal can be redefined as a number of short-term objectives. A stressful situation often can be broken down into units, to be dealt with separately. Or, if there are several concurrent stressful events, possibly they can be faced one at a time. Identify priorities. Long- and short-term priorities can be distinguished from one another and a realistic, flexible plan of action set up. From time to time, and as dispassionately as possible, the plan should be reevaluated. Make contact. In times of stress, human contacts are helpful in sorting out priorities and making choices. Refuse to admit defeat, and rely on others. Studies of people who have survived situations of extreme stress or danger show that two further coping strategies were of particular importance to them: a refusal to admit defeat and a reliance on the support of others. Both strategies have been found, for example, in those who survived the Nazi death camps. A notable feature of the support system in this group was the exchanging of gifts - insignificant except for the message of caring that they conveyed. Although little is known about the underlying processes by which social support affects health, that it plays an important role in protecting people from the effects of stress has been well demonstrated. It may act as a buffer against the destructive effect of adverse events, or it may have an intrinsic positive effect. Another possibility is that lack of support itself may be a stressor. Social support allows someone to know that he or she is cared for, is esteemed and valued, and is a member of a network of communication and mutual obligation. The sources of such support may be family members, friends and neighbors, a person's supervisor or co-workers, health professionals, or a self-help group. Accumulating evidence suggests that, when people are undergoing severe distress, those who have had similar experiences are in a unique position to provide effective support.
	TYPE A BEHAVIOUR AND STRESS
	The term "Type A behaviour" was coined by California heart specialists, to describe a behaviour pattern shared by many of their heart-attack patients. Type A behaviour, is an action-emotion complex that can be observed in any person who is aggressively involved in a chronic, incessant struggle to achieve more and more in less and less time, and if required to do so, against the opposing efforts of other things and other persons. Type A people are always in a hurry, often doing or thinking two or more things simultaneously, and creating deadlines where none exist. They tend to be aggressive and hostile, frequently challenging and competing with others. They are prone to speaking explosively, dominate conversations, and impatiently finish other people's sentences. Type Bs, in contrast, are more relaxed, less competitive, less driven by "hurry sickness" and the desire to achieve, and, very importantly, less susceptible to heart attacks. Type A behaviour is associated with high levels of the so-called stress hormones cortisol, epinephrine, and norepinephrine. Noted also that Type As tend to have an excessive amount of insulin in their bloodstream and take much longer to rid themselves of dietary cholesterol after a meal than do Type Bs. These Type A physiological changes could produce narrowed blood vessels and increase the deposits of plaque on the vessel walls, leading to heart attack. Recent research has attempted to identify the most damaging component or components in the Type A behaviour pattern. Rather than the stress-related time urgency characteristic of Type A behaviour, it appears that it is free-floating hostility - described as "a permanently indwelling anger that shows itself with ever greater frequency in response to increasingly trivial happenings" - that is the major contributing factor in heart disease. This finding notwithstanding, it is clear that Type A behaviour is closely associated with a stressful lifestyle. Changing Type A Behaviour The goal is not to change the personality of a Type A person but, rather, to eliminate the destructive components of the behaviour. Attempts to modify Type A behaviour are best tried in a group setting, with the guidance of a trained professional. However, such a group may not be available, or may be accessible only to those who have already suffered a heart attack. Under such circumstances, someone who recognizes a propensity to Type A behaviour in him- or her-self might usefully note these guidelines: Evaluate your strengths and weaknesses. Ask yourself whether your real interests are being satisfied and your abilities realized. Establish realistic long-term goals for your working and private lives and review these goals frequently. Regularly give time to pursuits unrelated to your vocation. Learn to recognize the value of rituals and tradition. Learn to enjoy time alone. Manage your time so that you are not competing against the clock. Revise your daily activities so that there is more than enough time for things that are important; eliminate activities that do not make a contribution to your well-being. Set priorities. Learn to delegate responsibility and to say "no". Avoid the people and situations that provoke your hostility. If avoiding them is not possible, call on your humor and good sense. Forget the "standards of excellence" that are in fact excuses for anger at those who will inevitably fail to live up to them. Learn to recognize and accept calmly those anger-provoking situations that you cannot control. Smile at other people and laugh at yourself.
	THE SOCIAL READJUSTMENT RATING SCALE
	Life Event..............................[Mean Value] 1. Death of a spouse......[100] 2. Divorce......[73] 3. Marital separation......[65] 4. Jail term......[63] 5. Death of close family member......[63] 6. Personal injury or illness......[53] 7. Marriage......[50] 8. Fired at work......[47] 9. Marital reconciliation......[45] 10. Retirement......[45] 11. Change in health of family member......[44] 12. Pregnancy......[40] 13. Sex difficulties......[39] 14. Gain of new family member......[39] 15. Business readjustment......[39] 16. Change in financial state......[38] 17. Death of close friend......[37] 18. Change to different line of work......[36] 19. Change in number of arguments with spouse......[35] 20. Mortgage or loan for a major purpose (home, etc.)......[31] 21. Foreclosure of mortgage or loan......[30] 22. Change in responsibilities at work......[29] 23. Son or daughter leaving home......[29] 24. Trouble with in-laws......[29] 25. Outstanding personal achievement......[28] 26. Spouse begins or stops work......[26] 27. Begin or end school......[26] 28. Change in living conditions......[25] 29. Revision of personal habits......[24] 30. Trouble with boss......[23] 31. Change in work hours or conditions......[20] 32. Change in residence......[20] 33. Change in schools......[20] 34. Change in recreation......[19] 35. Change in church activities......[19] 36. Change in social activities......[18] 37. Mortgage or loan for a lesser purpose (car, TV, etc.)......[17] 38. Change in sleeping habits......[17] 39. Change in number of family get-togethers......[16] 40. Change in eating habits......[15] 41. Vacation......[13] 42. Christmas......[12] 43. Minor violations of the law......[11]