Stress at work linked to heart disease

overworked manPeople who have highly demanding jobs and little freedom to make decisions are 23 per cent more likely to experience a heart attack compared with their counterparts without such work stress, according to a study of nearly 200 000 people from seven European countries.

Professor Mika Kivimäki from UCL Epidemiology & Public Health led the research which is published today in The Lancet.

The pooling of published and unpublished studies allowed us to investigate the association between coronary heart disease (CHD) and exposure to job strain – defined by high work demands and low decision control – with greater precision than has been previously possible,” explains Professor Kivimäki.

Our findings indicate that job strain is associated with a small, but consistent, increased risk of experiencing a first CHD event such as a heart attack.

Previous studies examining the impact of job strain on CHD have been inconsistent in their findings, limited in scope, and plagued by methodological shortcomings including publication bias and reverse causation bias.

In this collaborative meta-analysis, Professor Kivimäki and colleagues analysed job strain in employees without CHD who participated in 13 European national cohorts conducted in Belgium, Denmark, Finland, France, Netherlands, Sweden, and the UK between 1985 and 2006. All participants completed questionnaires at the start of the studies to assess job demands, excessive workload, the level of time-pressure demands, and their freedom to make decisions.

People who have highly demanding jobs and little freedom to make decisions are 23 per cent more likely to experience a heart attack compared with their counterparts without such work stress, according to a study of nearly 200 000 people from seven European countries.

Professor Mika Kivimäki from UCL Epidemiology & Public Health led the research which is published today in The Lancet.

“The pooling of published and unpublished studies allowed us to investigate the association between coronary heart disease (CHD) and exposure to job strain – defined by high work demands and low decision control – with greater precision than has been previously possible,” explains Professor Kivimäki.

“Our findings indicate that job strain is associated with a small, but consistent, increased risk of experiencing a first CHD event such as a heart attack.”

Previous studies examining the impact of job strain on CHD have been inconsistent in their findings, limited in scope, and plagued by methodological shortcomings including publication bias and reverse causation bias.

In this collaborative meta-analysis, Professor Kivimäki and colleagues analysed job strain in employees without CHD who participated in 13 European national cohorts conducted in Belgium, Denmark, Finland, France, Netherlands, Sweden, and the UK between 1985 and 2006. All participants completed questionnaires at the start of the studies to assess job demands, excessive workload, the level of time-pressure demands, and their freedom to make decisions.
UCL

mature-woman-running

iStockphoto

Moderate exercise may help people cope with anxiety and stress for an extended period of time post-workout, according to a study by kinesiology researchers in the University of Maryland School of Public Health published in the journal Medicine and Science in Sports and Exercise.

“While it is well-known that exercise improves mood, among other benefits, not as much is known about whether these positive effects endure when we’re faced with everyday stressors once we leave the gym,” explains Dr. J. Carson Smith, the study author and an assistant professor in the Department of Kinesiology. “We found that exercise helps to buffer the effects of emotional exposure. If you exercise, you’ll not only reduce your anxiety, but you’ll be better able to maintain that reduced anxiety when confronted with emotional events.”

Smith, whose research explores how exercise and physical activity affect brain function, aging and mental health, compared how moderate intensity cycling versus a period of quiet rest (both for 30 minutes) affected anxiety levels in a group of healthy college students. He assessed their anxiety state before the period of activity (or rest), shortly afterward (15 minutes after) and finally after exposing them to a variety of highly arousing pleasant and unpleasant photographs (from the International Affective Picture System), as well as neutral images. Smith found that exercise and quiet rest were equally effective at reducing anxiety levels initially. However, once they were emotionally stimulated for ~ 20 minutes, the anxiety levels of those who had simply rested went back up to their initial levels, whereas those who had exercised maintained their reduced anxiety levels. The study findings suggest that exercise may play an important role in helping people to better endure life’s daily anxieties and stressors.

Learn more about Dr. J. Carson Smith’s research.

The article “Effects of Emotional Exposure on State Anxiety after Acute Exercise” was written by J. Carson Smith and published online ahead of print on August 14, 2012 in the journal Medicine and Science in Sports and Exercise. Download a PDF of the article at: http://www.exerciseforbrainhealth.com/publications

Pinball as a model for dealing with grief

grief

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The process of grieving can be compared to the workings of a pinball machine, where mourners’ movement between different stages of grief such as shock and depression may be unpredictable, according to authors writing in September’s issue of Mental Health Practice journal.

Margaret Baier of Baylor University, Waco, Texas and Ruth Buechsel of Brooke Army Medical Center, Fort Sam Houston, San Antonio, Texas, say they are not trying to suggest grief is a game or downplay the experience, but that the metaphor can help people understand that grieving is not a linear process.

As on a pinball machine, there are triggers which can prolong or even restart the process. For the mourner these could be the anniversary of a death or a special event they used to share with their loved one. This model can be used in therapy by healthcare professionals to help people understand that their
responses are normal. It may also be adaptable to help those coping with separation, divorce, loss of employment or financial loss, say the authors.

They identify numerous models and factors for understanding grief in the literature as helpful in predicting coping and adjustment in bereavement. However, they say, many of the models are misinterpreted as linear. Grieving patients often speak of feeling as though they are ‘bouncing’ from one stage to another, which elicited the image of a pinball.

They say their model contains elements of the seminal work by Kubler-Ross (1969) but illustrates the process in a way that helps bereaved people see and understand their emotional processes, which helps them normalise and move through the experience of grief. This normalisation may help people to relax and better process grief, make sense of a seemingly chaotic experience, and be prepared when grief is triggered by other events or prolonged, as in the process of complicated grief.

Reference

Kubler-Ross E (1969) On Death & Dying. Macmillan, New York NY.

Source: RCN Publishing Company Baier M, Buechsel (2012) A model to help bereaved individuals understand the grief process. Mental Health Practice. 16, 1, 28-32.

The Emotional Side of Autism

by Norma Desmond

Image: Norma Desmond

Stanford University
 
Two Stanford psychologists have found that the emotional difficulties faced by many individuals with autism come from a lack of effective emotion regulation strategies. In an ongoing collaboration with the Stanford Autism Center, the researchers are now planning to help people with autism learn to cope better.

The diagnostic manual of the American Psychiatric Association defines autism in what seems to be a fairly comprehensive way: social impairment, difficulties with communication, repetitive behavior and restricted interests – the so-called “core symptoms” of the autism spectrum disorders.

But autism is a complex condition, and even a description as official and thorough as this one may leave out something important.

“If you talk to parents of children with autism, they’ll say all these characteristics are important,” said Stanford psychology Professor James Gross. “But what’s not featured in the diagnostic manual is the extreme difficulty many kids with autism have with emotion.”

From a caretaker’s perspective, sudden emotional outbursts can be one of the single most disruptive aspects of the disease. Still, emotion regulation in autism has attracted relatively little research.

In a survey of adults with high-functioning autism or Asperger’s syndrome, Gross, psychology postdoctoral scholar Andrea Samson and University of Fribourg psychology Professor Oswald Huber found that individuals with the disorder consistently reported using less effective emotion regulation strategies than typically developing individuals.

Now, in an ongoing collaboration with Stanford School of Medicine psychiatry Associate Professor Antonio Hardan, Samson and Gross have begun to take a closer look at emotional development among children and youths with autism – and how this knowledge might lead to new treatments for the condition. [continue reading…]