Miranda Olff

Health complaints and job stress in Norwegian physicians: the use of an overlapping questionnaire design

An extensive research program has been undertaken in Norway on physician health, sickness, working conditions and quality of life. Data are collected from cross-sectional and longitudinal prospective and retrospective surveys, qualitative studies, and vital statistics. This paper presents findings on subjectively experienced health problems, emotional distress, experienced job stress and job satisfaction, based on an extensive cross-sectional postal questionnaire study in 1993. An overlapping questionnaire design was used to allow many relationships to be estimated without exhausting the recipients. 9266 active physicians were included, which comprises close to the total Norwegian physician work-force minus a representative sample of 2100, used for other studies. The primary questionnaire was returned by 6652 (71.8%), the great majority of which also returned three secondary questionnaires. The results indicate that health complaints were significantly more frequent in female physicians and decreased with age. Low job satisfaction, high job stress, and emotional distress were all found to be significant predictors of subjective health complaints, as measured by the Ursin Health Inventory.

Psychobiology of coping and defence strategies

The stress response should be regarded as an alarm system, occurring whenever there is something missing. Lack of information (uncertainty), and the absence or loss of control produce alarm, presence of information and control (coping), or cognitive defence mechanisms (distorted stimulus expectancies) reduce the alarm. Both immune and endocrine parameters of stress are dampened by defence and coping. Biologically, these two mechanisms have different time axes. While coping is related to the fast catecholamine response, defence is related to the slower pituitary-adrenal response. The role of cortisol seems to be to suppress and dampen the acute stress response in the later phase, once it has been elicited. The relation between stress and health depends on the stress-dampening mechanisms, on how the alarm is turned off, why it sometimes seems to be left on, and what the consequences really are of leaving the alarm on.

COPING STYLES AND HEALTH

Abstract The present study aims to clarify whether strategies that people use to handle stressful situations cluster into global coping styles and whether such coping styles would be related to subjective health parameters. In previous literature ‘coping styles’ have been treated under many labels (e.g. ways of coping, defence mechanisms, personality traits, appraisal strategies) and have been assessed by many instruments. There are, however, few studies on the relationships between these concepts and instruments. In this study 254 male high school teachers were tested with the Utrecht Coping List, the Defence Mechanism Inventory, the Life Style Index and the Internal, Powerful Others and Chance locus of control scales. In addition, the teachers filled out questionnaires on stressful events and on psychological and physical health complaints. Factor analysis showed four interpretable clusters of coping styles: two clusters with defensive strategies (‘cognitive defence’ and ‘defensive hostility’) and two clusters with coping styles (‘instrumental mastery-oriented coping’ and ‘emotion-focused coping’). The ‘instrumental mastery-oriented coping’ and ‘cognitive defence’ factor played a positive moderating role in the effect of stressful situations on subjective health parameters.

Handedness and anxiety in normal and clinical populations.

Previous research has yielded inconclusive evidence as to the relationship between handedness and anxiety. In order to further examine this relationship, two studies were carried out. In the first study, university students (N = 167) completed the Edinburgh Handedness Inventory, the Fear Questionnaire, and the Maudsley Obsessive Compulsive Inventory. No evidence was found to suggest that phobic fears are more prevalent or more severe among individuals with a tendency to left-handedness than among pure right-handers. Statistical tests reveled a marginally significant positive association between social phobia scores and right-handedness. In the second study, handedness was assessed in 77 anxiety disorder patients and compared with handedness patterns in normal controls. Again, no support was found for the claim that anxiety and left-handedness are related to each other. However, the normal pattern of women being more right-handed than men was reversed in the anxiety disorder group.

Relationships Between Cardiovascular and Immunological Changes in an Experimental Stress Model

To investigate the relationships between cardiovascular variables (SBP, DBP, and HR) and circulating natural killer (NK) cell numbers, 70 male volunteers were subjected to a rest condition (N = 30) or a stressful laboratory task (N = 40). At baseline, no significant relationships could be demonstrated between the number of NK cells and the cardiovascular variables. Analysis of covariance showed that the stressor induced increases in the number of NK cells, SBP, DBP, and HR. Changes in Nk cell numbers were highly correlated to changes in cardiovascular variables in both the task and the no-task group. These results indicate that there is no relationship between the number of circulating NK cells and cardiovascular levels per se, but that changes in these variables, either stress-induced or under rest conditions, are regulated by a common mechanism.

Quantification of human defence mechanisms

Preface.- I: The Problem Area.- Defence, defence and defence: How do we measure defence?.- The relationship between objective measures of defences.- II: Interview and Questionnaire Methods.- Interview techniques and assessment of defence mechanisms.- The Dutch and the Norwegian translations of the Plutchik questionnaire for psychological defence.- III: The Defence Mechanism Test: Method.- Notes on the development of the DMT.- An evaluative study of the Defence Mechanism Test.- Construct validity of the DMT.- G-analysis of the DMT.- Hard and soft models for the assessment of personality organization by DMT.- The DMT method in Europe: State of the art.- IV: Validation of DMT.- The use of the Defence Mechanism Test (DMT) in Norway for selection and stress research.- DMT defences in neurotic and somatically ill patients.- The relation between defence and overt aggression.- Application of the DMT for assessing serious drinking and driving offenders.- V: DMT and Biological Parameters.- Defence and activation theory: An example of reinterpretation and reductionism in explaining the process of psychological defence.- The relationship between psychological defence, cortisol, immunoglobulins, and complements.- Defensiveness and cardiovascular reactions.- Lateralization of defence mechanisms related to creative functioning.- VI: Relationships Between DMT and Other Methods.- Perceptual defence: The use of digitized pictures.- The Defence Mechanism Test and questionnaire methods for measurement of psychological defences.

Revisiting the factor structure of the ways of coping checklist: A three-dimensional view of the problem-focused coping scale. A study among norwegian physicians

Abstract The factor structure of the Ways of Coping Checklist (WCCL) developed by Folkman and Lazarus was re-examined and the emerging factors related to eight different measures of health and stress in a large representative sample of Norwegian physicians ( N = 1030). The 42-item Vitaliano revision of the WCCL was applied, and a six-factor solution of the principal component analysis was chosen as the most appropriate one. The traditional comprehensive Problem-focused coping factor was split into three new ones: a narrower, more instrumental Action-oriented factor, an Accommodation factor and a Positive thinking factor. Vitalianos Seek support and Self-blame scales were reproduced, while the Wishful thinking and Avoidance scales collapsed to one Defense factor. The health related validity of the new solution was examined in two parallel series of regression analyses. Our new WCCL-dimensions were included as hypothetical predictors of health and stress in one series, and the Vitaliano factors in another. Whereas the comprehensive Problem-focused coping dimension predicted the health and stress measures significantly in six of the equations, the new Action-oriented coping factor was not included in any of them. Accommodation and Positive thinking seem to account for most of the variance covered by the comprehensive Problem-focused coping scale. It is argued that Accommodation and Positive thinking are more productive ways of coping when the source of stress is not likely to be eliminated or substantially weakened by individual action.

Aggression, defense, and coping in humans

One way of identifying emotional behaviors across species, language, and cultures is to describe the “instrumental” effects of each particular behavior. Since aggression and defense may be instrumental they also represent coping behavior. The term coping is being used partly to indicate whether or not the behavior is successful and partly to describe how a situation is being handled (coping strategies). This review deals with how these behaviors are observed and quantified in humans and how they are linked to physiological changes. The internal state of the individual is decided by the expectancy of the outcome of a given situation, but each behavior strategy may have specific links to particular brain mechanisms and particular physiological effectors.