Shiftwork, job type, and the work environment as joint predictors of health-related outcomes.

This article examines the potential confounding of observed relations between shiftwork and health outcomes by differences in the jobs typically carried out by shiftworkers and dayworkers. Objective factors (daywork vs. day/night shiftwork and job type) and work perceptions (job demand, discretion, social support, and physical stressors) were analyzed as joint predictors of psychosomatic complaints (headaches and musculoskeletal, gastric, and sleep problems), affective distress, and work-related injuries in data from oil industry personnel (N = 1,462). Logistic regression showed that, after control for individual differences (including age and negative affectivity), shiftwork and job type each predicted specific health outcomes when evaluated simultaneously. Work perceptions also contributed significantly to each outcome, partially mediating relations between job type and health.

Psychosocial aspects of stress, health and safety on North Sea installations.

In recent years, the North Sea oil and gas industry has been exposed to widespread change, including organizational restructuring, "down-sizing", and increased safety regulation. This article reviews the literature on psychosocial stress, health, and safety among offshore personnel in the light of these developments. Few studies directly compare onshore and offshore populations; the available data suggest that, relative to their onshore counterparts, offshore personnel experience greater anxiety, more sleep problems, and higher work load. Within the offshore population, objective factors (eg, size, age, type of installation, work patterns, and occupational differences), subjective work perceptions, individual differences (age and personality), and health behavior, all play significant roles in relation to health and safety outcomes. However, much of the research in stress and health offshore has methodological limitations and does not allow causal interpretation. The need for prospective studies of the long-term mental and physical health of offshore personnel, and for research in several specific areas, is noted.

Epinephrine and cortisol responses to work: a test of the models of Frankenhaeuser and Karasek.

Both Frankenhaeuser and Karasek have put forward models describing how job demand and control influence epinephrine and cortisol levels. These models were tested in a sample of 53 women and 51 men in a variety of occupations. They were studied over one rest day and two working days. Subjects reported their perceived demand and control and their mood on each day, as well as providing urine for assessment of urinary excretion rates of epinephrine and cortisol. In men, but not women, epinephrine levels were higher on the working days than on the rest day, and demand was found to covary positively with epinephrine, supporting Frankenhaeuser's model with respect to epinephrine variation in men. However, cortisol levels were not elevated on working days compared to the rest day, and no relationship between job control and cortisol was seen which is in contradiction of Frankenhaeuser's model with respect to cortisol variation. There was some suggestion that demand was most strongly associated with elevated epinephrine in men when job control was low in accordance with Karasek's model, but there was no evidence for such an effect with respect to cortisol.

Sleep patterns, shiftwork, and individual differences: a comparison of onshore and offshore control-room operators.

The sleep patterns of offshore control-room operators were compared with those of personnel carrying out similar work onshore, taking into account individual differences in age, number of years of shiftwork, and neuroticism. The dependent variables were self-reported sleep quality and duration for day-shift (D-S) and night-shift (N-S) work, and during leave periods (L-P). Offshore workers reported longer N-S sleep duration, and lower D-S sleep quality than those onshore, but the two groups did not differ in L-P measures. The effects of environmental differences (onshore versus offshore) on sleep patterns were more marked than those of the two different shift systems (weekly rotation and fast rotation) in operation onshore. Age was negatively related to both duration and quality of sleep; over and above age, number of years of shiftwork was negatively related to sleep duration. Neuroticism was also negatively related to sleep duration and, more strongly, to sleep quality. These findings are discussed in relation to the literature on shiftwork and sleep in general, and the characteristics of the offshore environment in particular.

Mental health in the oil industry: a comparative study of onshore and offshore employees.

Few empirical studies have examined the mental health of workers on North Sea oil and gas installations, and it is unclear from the available literature whether offshore employees show impaired mental health relative to their onshore counterparts. The present study was intended to clarify this issue by direct comparison of the General Health Questionnaire (GHQ) scores of onshore and offshore personnel engaged in similar work. As compared with published data, only the onshore group showed low GHQ-12 scores, although both groups were low in neuroticism. Analysis of GHQ subscale scores demonstrated that anxiety was significantly higher among offshore workers than among those working onshore, but there were no significant differences in somatic symptoms or social dysfunction. Regression analyses showed that this result was not affected by control for age, job level, and neuroticism, although there was a significant interaction between job level and neuroticism in predicting anxiety. The nature of the offshore environment, and the factors which may play a causal role in elevated anxiety among offshore workers, are discussed.

Locus of control as moderator: an explanation for additive versus interactive findings in the demand-discretion model of work stress?

Research based on Karasek's (1979) model of work stress has produced conflicting results; although some evidence of the demand X discretion interactions predicted by the model has been reported, most studies have failed to demonstrate interactive effects in relation to mental health outcomes. The present article investigates locus of control (LOC) as a potential moderator of demand/discretion effects. In a sample of civil servants (N = 590), regression analyses demonstrated a three-way LOC X demand X discretion interaction (p less than .01) for affective distress, but not for absence frequency. In longitudinal data from student teachers (N = 147), a similar three-way interaction was observed (p less than .05). In this case, the result applied specifically to anxiety as an outcome, and not to social dysfunction. In each study, the form of the three-way interaction was such that demand and discretion combined interactively to predict outcome for externals (-1SD LOC), in a manner consistent with Karasek's predictions, whereas for internals (+1SD LOC) additive findings were obtained. The implications of these results are discussed with reference to the demand-discretion model, and to the issues of stressor-outcome specificity raised by Broadbent (1985).

Coping, negative affectivity, and the work environment: additive and interactive predictors of mental health.

The present study tested the hypothesis that direct coping would moderate relations between work stress and mental health outcome, whereas suppression (a form of emotion-focused coping) would show an overall effect on outcome. Data on coping, perceived work demand and support, and affective symptoms were obtained from trainee teachers (N = 157). The results supported the hypothesis. Gender differences also were observed; men reported more use of suppression than did women. In addition, negative affectivity (NA) was examined as a confounding variable and as an index of reactivity in stress-outcome relations. NA acted to inflate associations between work perceptions and affective symptoms, but it was also a significant moderator variable; high NA subjects showed greater reactivity to work demand than did low NA subjects.

Work preferences as moderators of the effects of paced and unpaced work on mood and cognitive performance: a laboratory simulation of mechanized letter sorting.

This article describes a laboratory study of work preferences (ideal job demand and discretion levels) as moderators of the effects of paced and unpaced work on cognitive and affective responses. Posttest measures of cognitive performance and self-reported stress and arousal were used as outcome measures with covariance control for the corresponding pretest values. The experimental design allowed within-subjects contrasts of fast versus slow pacing and of machine-paced versus self-paced conditions. Self-paced performance compared favorably with machine-paced performance; however, individual differences in ideal demand influenced the relative speed of work under the two conditions. Work preferences also moderated relationships between pacing and outcome measures; ideal discretion moderated machine-pacing versus self-pacing effects in relation to cognitive performance and stress, and ideal demand moderated fast versus slow pacing effects in relation to arousal. These findings are discussed in relation to existing literature on pacing and on person-environment fit.

Coping in stressful episodes: the role of individual differences, environmental factors, and situational characteristics.

Theoretical models emphasize the importance of person and environmental variables in stress and coping processes. This article examines individual differences (extraversion and neuroticism), environmental factors (social support and work demand), and situational characteristics (type of stressful episode and its perceived importance) as predictors of three self-report measures of coping (general coping, direct coping, and suppression) derived from the Ways of Coping Questionnaire. The data analyzed were collected from 135 first-year female student nurses. Individual differences were assessed prior to exposure to the ward environment, and information about stressful episodes was obtained during the initial period of nursing practice. Multiple regression analyses showed that individual differences and environmental and situational factors were significant predictors of the coping scores and that patterns of main and interactive effects were different for each type of coping. For direct coping and suppression, predicted interactions across person, environmental, and situational variables contributed significantly to the explained variance. Curvilinear interactions between work demand and neuroticism were significant for both direct coping and suppression; interactions of social support and extraversion with perceived importance predicted direct coping; and interactions between neuroticism and extraversion and between work demand and importance predicted suppression. These findings are discussed in relation to current substantive and methodological issues in the study of coping and adaptation.

Stressful episodes reported by first-year student nurses: a descriptive account.

This article examines stressful episodes reported by student nurses (N = 150) interviewed during the early stages of their training at two general hospitals. The approach is qualitative rather than empirical, and the paper focuses on how students perceive and interpret the day-to-day demands and frustrations they encounter in the course of their work in the wards. The episodes were classified into six major content areas. Three of these (the care of dying patients; interpersonal conflicts with other nurses; and insecurity about professional skills and competence) were found to account for two-thirds of the total episodes reported. The types of episodes are discussed in the context of literature findings relating to nursing stress. Underlying factors common to many episodes were the inadequate support and guidance given by senior nurses and clinical tutors, coupled with the students' lack of experience and the demanding nature of the ward environment. Ways in which adverse effects of stress among student nurses might be alleviated, including improving communication skills, enhancing social support, and the use of stress management techniques, are discussed in the light of this material.

Smoking and the Eysenck personality dimensions: an interactive model.

Evidence relating smoking and neuroticism is inconsistent; some studies report no significant relationship, while others report a positive association. The present study examined smoking in relation to neuroticism (N), extraversion (E) and psychoticism (P), in the light of predictions that interactions between N and E, and between N and P, could underly these inconsistent findings. The subjects were female student nurses (N = 270), of whom 34.1% were smokers. Discriminant analyses revealed that E differentiated most strongly between smokers and non-smokers. N and P did not add to the predictive power of the discriminant function, but the N x P and N x E interactions did make significant contributions. Among extraverts, and among subjects low in psychoticism, N was not related to smoking; but among introverts, and among subjects high in psychoticism, the relationship was significant and positive.

Locus of control, cognitive appraisal, and coping in stressful episodes.

Evidence suggests that internals and externals differ in the nature and effectiveness of their coping behavior. This study investigated locus of control and coping processes in relation to specific stressful episodes reported by 171 female student nurses. Scores on each of three measures (General Coping, Direct Coping, and Suppression) that were derived from the "Ways of Coping" Questionnaire were analyzed to examine the role of appraisal (in terms of the extent to which the situation was perceived as amenable to control) and the perceived importance of the episode as mediators of the relation between locus of control and coping. The results showed significant interactions between locus of control and appraisal for each of the measures. Further examination of the interactions showed that the patterns of coping reported by internals were potentially more adaptive in relation to types of appraisal than those of externals. The perceived importance of the episode was significantly related, negatively, to suppression, but the interaction with locus of control was not significant.

Field dependence and the factor structure of the General Health Questionnaire in normal subjects.

The factor structure of the General Health Questionnaire (GHQ) was investigated in a non-clinical sample in relation to the role of field dependence (assessed by the Hidden Figures Test) in influencing the extent to which different aspects of psychoneurotic disturbance are differentiated. Greater differentiation was achieved by the field independent (FI) group than by the field dependent (FD) group, as shown by: (i) the proportion of variance accounted for by the general factor in the principal components analysis of the 60-item GHQ data was lower (17 per cent) in the FI group than in the FD group (33 per cent); (ii) the factor loadings in the FI group, but not the FD group, corresponded closely with the four subscales of the 28-item scaled GHQ; (iii) the interscale correlations were significantly lower in the FI group than in the FD group. The implications of these findings are discussed, particularly their relevance to 'unitary' and 'distinct-syndrome' models of minor anxiety and depressive disorders, and the greater probability of occurrence of mixed states in field dependent subjects.

The Cognitive Failures Questionnaire (CFQ) and its correlates.

This paper describes a questionnaire measure of self-reported failures in perception, memory, and motor function. Responses to all questions tend to be positively correlated, and the whole questionnaire correlates with other recent measures of self-reported deficit in memory, absent-mindedness, or slips of action. The questionnaire is however only weakly correlated with indices of social desirability set or of neuroticism. It is significantly correlated with ratings of the respondent by his or her spouse, and accordingly does have some external significance rather than purely private opinion of the self. The score is reasonably stable over long periods, to about the same extent as traditional measures of trait rather than state. Furthermore, it has not thus far been found to change in persons exposed to life-stresses. However, it does frequently correlate with the number of current psychiatric symptoms reported by the same person on the MHQ; and in one study it has been found that CFQ predicts subsequent MHQ in persons who work at a stressful job in the interval. It does not do so in those who work in a less stressful environment. The most plausible view is that cognitive failure makes a person vulnerable to showing bad effects of stress, rather than itself resulting from stress.

Field dependence and the differentiation of affective states.

The extent to which anxiety, irritability and depression were differentiated as separate entities associated with characteristic patterns of somatic and cognitive symptoms by field dependent (FD) and field independent (FI) normal female subjects was studied with the Hidden Figures Test and Unpleasant Emotions Questionnaire. In the FI group the correlations between the three emotions were low and non-significant, reflecting a clear-cut differentiation in symptom configuration, as shown by psychiatrists. In the FD group the inter-correlations were significant and positive, corresponding to relatively poor symptom differentiation, comparable to that of a psychiatric patient group. This suggests that the cognitive style variable of field dependence may underly differences in symptom differentiation associated with psychiatrist/patient differences and, more generally, with social class and sex differences.

Social Desirability, defensiveness and self-report psychiatric inventory scores.

The effects of social desirability and defensiveness on scores on 2 self-report psychiatric inventories, the General Health Questionnaire (GHQ) and the Middlesex Hospital Questionnaire (MHQ) were investigated in a female subject group assessed for research purposes in an occupational setting. It was found that defensiveness did not affect the reporting of somatic symptoms, but it significantly affected the reporting of all psychological distress. The effect of social desirability was more specific, only the GHQ social dysfunction subscale showing a significant correlation, an effect attributable to the influence of the setting in which the data were obtained.