Psychological distress may be causally related to multiple, unexplained somatic symptoms. We have... more Psychological distress may be causally related to multiple, unexplained somatic symptoms. We have investigated job stress, coping strategies and subjective health complaints in patients with subjective food hypersensitivity. Sixty-four patients were compared with 65 controls. All participants filled in questionnaires focusing on job stress, job demands and control, work environment, coping strategies and subjective health complaints. Compared with controls, patients scored significantly lower on job stress and job demands, and significantly higher on authority over job decisions. Coping strategies and satisfaction with work environment did not differ significantly between the two groups, but the patients reported significantly more subjective health complaints than the controls. Scores on job stress and job demands were generally low in patients with subjective food hypersensitivity. It is unlikely, therefore, that the patients’ high scores on subjective health complaints are causal...
Scandinavian Journal of Work, Environment and Health, Supplement
The cognitive activation theory of stress (CATS) offers a psychobiological explanation for the re... more The cognitive activation theory of stress (CATS) offers a psychobiological explanation for the relationship between life events, from hassles in worklife to dramatic events, and individual health. It differs from other prevalent stress theories by offering a formal system of systematic definitions, it relies on cognitive formulations within learning theory, it offers a consistent pathophysiological model for health and disease, and it is valid across species and cultures. The aim of this paper was to compare CATS with other prevalent theories with respect to the relationships between worklife and health. The main concern was the comparison with the demand–control theory of Karasek & Theorell. A brief review is presented of interventions based on CATS positions, in particular interventions aimed at modifying patients’ expectations, as well as at attempts to prevent illness and disease in the working population.
Background: Sick leave and return to work are common outcome variables in studies where the aim i... more Background: Sick leave and return to work are common outcome variables in studies where the aim is to measure the effect of targeted interventions for individuals that are on sick leave benefits or other allowances. Use of official register data is often restricted, and research on sick leave and return to work are often based on the participants self-reports. However, there is insufficient documentation that there is agreement between self-reports and register data on sick leave benefits and allowances.Aims: The aim of this study was to analyse the individuals' knowledge about states of sick leave benefits or allowances compared with register data from The Labour and Welfare Administration (NAV) in Norway.Method: 153 individuals, sick-listed or on allowances, participated in a 4-week inpatient occupational rehabilitation program. 132 (86%) answered a questionnaire on assessments of work, sick leave, and allowances three months after completed rehabilitation. Self-reported data ...
Aims: The aims of this project were to study the distribution of sickness leave in a population o... more Aims: The aims of this project were to study the distribution of sickness leave in a population of Norwegian power company workers, and to characterise those with most sickness leave. Method: A survey was done in 13 power companies during the autumn of 1999. 2435 employees participated, the response rate was 73%. The employees were asked to fill in questionnaires about sickness leave, physical work environment, stress, coping, psychological demands, control, and subjective health complaints. Results: A group of 10% of the employees reported 82% of the sickness leave. They were characterised by hea-vy physical work, lower education, and high levels of many health risk factors, such as smoking, low job satis-faction, sleeping badly, job stress, and low levels of physical exercise. They also had more health complaints. Conclusion: The person most at risk was the old-fashioned manual labourer with low education and heavy physical work. Interventions aiming to reduce sickness leave shoul...
Increasing social inequalities in health have been ascribed to unequal distribution of resources,... more Increasing social inequalities in health have been ascribed to unequal distribution of resources, and to exposure factors. We propose that these differences also may be explained by principles from cognitive stress theory. There seems to be consensus in the stress literature that the stress response is not predicted from the external situation. The acquired expectancies to stimuli and response outcome
International journal of behavioral medicine, Jan 29, 2015
Musculoskeletal pain is associated with comorbidity, extensive use of health services, long-term ... more Musculoskeletal pain is associated with comorbidity, extensive use of health services, long-term disability and reduced quality of life. The scientific literature on effects of treatment for musculoskeletal pain is inconclusive. The purpose of this study is to compare a multidisciplinary intervention (MI), including use of the novel Interdisciplinary Structured Interview with a Visual Educational Tool (ISIVET), with a brief intervention (BI), on effects on mental and physical symptoms, functioning ability, use of health services and coping in patients sick-listed due to musculoskeletal pain. Two hundred eighty-four adults aged 18-60, referred to a specialist clinic in physical rehabilitation, were randomized to MI or BI. Patients received a medical examination at baseline and completed a comprehensive questionnaire at baseline, 3 months and 12 months. Both groups reported improvements in mental and physical symptoms, including pain, and improved functioning ability at 3 and 12 month...
The diurnal rhythm of saliva cortisol and its association to adaptation, performance and health w... more The diurnal rhythm of saliva cortisol and its association to adaptation, performance and health were examined in personnel over-wintering at two British Antarctic stations. In total, 55 healthy individuals (49 males, 6 females) participated in the study. Cortisol in saliva was sampled on 3 consecutive days (at awakening, 15 and 45 min after waking, at 15.00 h, and 22.00 h) immediately after arrival at the station, midwinter, and the last week before departure. Subjective health complaints were also measured at arrival, midwinter, and the last week before departure, while depression (Burnam screen for depression) and positive and negative affect (PANAS) were measured at midwinter only. At the end of the winter appointment, base commanders evaluated the performance of all personnel. The variations in external light (darkness during winter, midnight sun during arrival and departure) did not influence the diurnal rhythms. The normal peak level in the morning, and the normal and gradual ...
The potential advantage of including a psychological test battery in the selection process for se... more The potential advantage of including a psychological test battery in the selection process for service in the Antarctic was examined in 348 applicants for employment in Antarctica with the British Antarctic Survey (BAS). Applicants were screened with the Selection of Antarctic Personnel battery (SOAP) consisting of nine well-known psychological instruments. The SOAP scores were not revealed to the BAS selection panel members, who based the selection on operational criteria, interview, and a general medical examination. The SOAP scores of those selected (n = 177) were further compared with station commanders' reports of winter adaptation (n = 140), and subjective health complaints (SHC) (n = 86). There were no significant agreements between SOAP scores (n = 348) and those actually selected by the BAS panel (121 accepted, 227 not accepted) (Cohen's Kappas for inter-rater agreement < 0.20). Participants characterized as exceptionally well adapted by the station commanders ha...
Modifying effects in multivariate analyses of a randomized controlled trial. To identify prognost... more Modifying effects in multivariate analyses of a randomized controlled trial. To identify prognostic factors for the effect of a brief intervention ("modifiers") at a spine clinic on return to work in patients with subacute low back pain. A previous study of a brief intervention showed significant reduction of sick leave, compared with usual primary healthcare treatment. Randomized controlled trials give data only on the group as an average. Identifying prognostic factors that interact with the treatment ("modifiers") may identify specific groups requiring this or other types of treatment. A total of 457 patients who had been sick-listed 8 to 12 weeks for low back pain were randomized into an intervention group (spine clinic with medical examination, information, reassurance, encouragement to engage in physical activity, n = 237), and a control group (primary health care, n = 220). All subjects filled out questionnaires. Logistic regression and tests for interacti...
This paper presents a cognitive activation theory of stress (CATS), with a formal system of syste... more This paper presents a cognitive activation theory of stress (CATS), with a formal system of systematic definitions. The term "stress" is used for four aspects of "stress", stress stimuli, stress experience, the non-specific, general stress response, and experience of the stress response. These four meanings may be measured separately. The stress response is a general alarm in a homeostatic system, producing general and unspecific neurophysiological activation from one level of arousal to more arousal. The stress response occurs whenever there is something missing, for instance a homeostatic imbalance, or a threat to homeostasis and life of the organism. Formally, the alarm occurs when there is a discrepancy between what should be and what is-between the value a variable should have (set value (SV)), and the real value (actual value (AV)) of the same variable. The stress response, therefore, is an essential and necessary physiological response. The unpleasantness ...
Occupational and social factors are thought to be important determinants of health inequality. Th... more Occupational and social factors are thought to be important determinants of health inequality. The aim of this study was to examine the relationships between occupation, lifestyle and subjective health complaints (SHC). SHC and self-reported sickness absence were recorded in a cross-sectional study of 662 individuals aged between 16 and 67 from five occupational groups: blue-collar, school/education, health service, white-collar and service. Differences in SHC and sickness absence were investigated. A model of sociodemographic, lifestyle and work-related factors was tested to examine associations with SHC. Few differences in SHC and sickness absence were found when educational level, age and gender were controlled for. Female health service workers did, however, show significantly higher prevalence of pseudoneurological complaints compared with white-collar workers. Male blue-collar workers had significantly higher frequency of sickness absence than white-collar workers; otherwise, ...
Psychological distress may be causally related to multiple, unexplained somatic symptoms. We have... more Psychological distress may be causally related to multiple, unexplained somatic symptoms. We have investigated job stress, coping strategies and subjective health complaints in patients with subjective food hypersensitivity. Sixty-four patients were compared with 65 controls. All participants filled in questionnaires focusing on job stress, job demands and control, work environment, coping strategies and subjective health complaints. Compared with controls, patients scored significantly lower on job stress and job demands, and significantly higher on authority over job decisions. Coping strategies and satisfaction with work environment did not differ significantly between the two groups, but the patients reported significantly more subjective health complaints than the controls. Scores on job stress and job demands were generally low in patients with subjective food hypersensitivity. It is unlikely, therefore, that the patients’ high scores on subjective health complaints are causal...
Scandinavian Journal of Work, Environment and Health, Supplement
The cognitive activation theory of stress (CATS) offers a psychobiological explanation for the re... more The cognitive activation theory of stress (CATS) offers a psychobiological explanation for the relationship between life events, from hassles in worklife to dramatic events, and individual health. It differs from other prevalent stress theories by offering a formal system of systematic definitions, it relies on cognitive formulations within learning theory, it offers a consistent pathophysiological model for health and disease, and it is valid across species and cultures. The aim of this paper was to compare CATS with other prevalent theories with respect to the relationships between worklife and health. The main concern was the comparison with the demand–control theory of Karasek & Theorell. A brief review is presented of interventions based on CATS positions, in particular interventions aimed at modifying patients’ expectations, as well as at attempts to prevent illness and disease in the working population.
Background: Sick leave and return to work are common outcome variables in studies where the aim i... more Background: Sick leave and return to work are common outcome variables in studies where the aim is to measure the effect of targeted interventions for individuals that are on sick leave benefits or other allowances. Use of official register data is often restricted, and research on sick leave and return to work are often based on the participants self-reports. However, there is insufficient documentation that there is agreement between self-reports and register data on sick leave benefits and allowances.Aims: The aim of this study was to analyse the individuals' knowledge about states of sick leave benefits or allowances compared with register data from The Labour and Welfare Administration (NAV) in Norway.Method: 153 individuals, sick-listed or on allowances, participated in a 4-week inpatient occupational rehabilitation program. 132 (86%) answered a questionnaire on assessments of work, sick leave, and allowances three months after completed rehabilitation. Self-reported data ...
Aims: The aims of this project were to study the distribution of sickness leave in a population o... more Aims: The aims of this project were to study the distribution of sickness leave in a population of Norwegian power company workers, and to characterise those with most sickness leave. Method: A survey was done in 13 power companies during the autumn of 1999. 2435 employees participated, the response rate was 73%. The employees were asked to fill in questionnaires about sickness leave, physical work environment, stress, coping, psychological demands, control, and subjective health complaints. Results: A group of 10% of the employees reported 82% of the sickness leave. They were characterised by hea-vy physical work, lower education, and high levels of many health risk factors, such as smoking, low job satis-faction, sleeping badly, job stress, and low levels of physical exercise. They also had more health complaints. Conclusion: The person most at risk was the old-fashioned manual labourer with low education and heavy physical work. Interventions aiming to reduce sickness leave shoul...
Increasing social inequalities in health have been ascribed to unequal distribution of resources,... more Increasing social inequalities in health have been ascribed to unequal distribution of resources, and to exposure factors. We propose that these differences also may be explained by principles from cognitive stress theory. There seems to be consensus in the stress literature that the stress response is not predicted from the external situation. The acquired expectancies to stimuli and response outcome
International journal of behavioral medicine, Jan 29, 2015
Musculoskeletal pain is associated with comorbidity, extensive use of health services, long-term ... more Musculoskeletal pain is associated with comorbidity, extensive use of health services, long-term disability and reduced quality of life. The scientific literature on effects of treatment for musculoskeletal pain is inconclusive. The purpose of this study is to compare a multidisciplinary intervention (MI), including use of the novel Interdisciplinary Structured Interview with a Visual Educational Tool (ISIVET), with a brief intervention (BI), on effects on mental and physical symptoms, functioning ability, use of health services and coping in patients sick-listed due to musculoskeletal pain. Two hundred eighty-four adults aged 18-60, referred to a specialist clinic in physical rehabilitation, were randomized to MI or BI. Patients received a medical examination at baseline and completed a comprehensive questionnaire at baseline, 3 months and 12 months. Both groups reported improvements in mental and physical symptoms, including pain, and improved functioning ability at 3 and 12 month...
The diurnal rhythm of saliva cortisol and its association to adaptation, performance and health w... more The diurnal rhythm of saliva cortisol and its association to adaptation, performance and health were examined in personnel over-wintering at two British Antarctic stations. In total, 55 healthy individuals (49 males, 6 females) participated in the study. Cortisol in saliva was sampled on 3 consecutive days (at awakening, 15 and 45 min after waking, at 15.00 h, and 22.00 h) immediately after arrival at the station, midwinter, and the last week before departure. Subjective health complaints were also measured at arrival, midwinter, and the last week before departure, while depression (Burnam screen for depression) and positive and negative affect (PANAS) were measured at midwinter only. At the end of the winter appointment, base commanders evaluated the performance of all personnel. The variations in external light (darkness during winter, midnight sun during arrival and departure) did not influence the diurnal rhythms. The normal peak level in the morning, and the normal and gradual ...
The potential advantage of including a psychological test battery in the selection process for se... more The potential advantage of including a psychological test battery in the selection process for service in the Antarctic was examined in 348 applicants for employment in Antarctica with the British Antarctic Survey (BAS). Applicants were screened with the Selection of Antarctic Personnel battery (SOAP) consisting of nine well-known psychological instruments. The SOAP scores were not revealed to the BAS selection panel members, who based the selection on operational criteria, interview, and a general medical examination. The SOAP scores of those selected (n = 177) were further compared with station commanders' reports of winter adaptation (n = 140), and subjective health complaints (SHC) (n = 86). There were no significant agreements between SOAP scores (n = 348) and those actually selected by the BAS panel (121 accepted, 227 not accepted) (Cohen's Kappas for inter-rater agreement < 0.20). Participants characterized as exceptionally well adapted by the station commanders ha...
Modifying effects in multivariate analyses of a randomized controlled trial. To identify prognost... more Modifying effects in multivariate analyses of a randomized controlled trial. To identify prognostic factors for the effect of a brief intervention ("modifiers") at a spine clinic on return to work in patients with subacute low back pain. A previous study of a brief intervention showed significant reduction of sick leave, compared with usual primary healthcare treatment. Randomized controlled trials give data only on the group as an average. Identifying prognostic factors that interact with the treatment ("modifiers") may identify specific groups requiring this or other types of treatment. A total of 457 patients who had been sick-listed 8 to 12 weeks for low back pain were randomized into an intervention group (spine clinic with medical examination, information, reassurance, encouragement to engage in physical activity, n = 237), and a control group (primary health care, n = 220). All subjects filled out questionnaires. Logistic regression and tests for interacti...
This paper presents a cognitive activation theory of stress (CATS), with a formal system of syste... more This paper presents a cognitive activation theory of stress (CATS), with a formal system of systematic definitions. The term "stress" is used for four aspects of "stress", stress stimuli, stress experience, the non-specific, general stress response, and experience of the stress response. These four meanings may be measured separately. The stress response is a general alarm in a homeostatic system, producing general and unspecific neurophysiological activation from one level of arousal to more arousal. The stress response occurs whenever there is something missing, for instance a homeostatic imbalance, or a threat to homeostasis and life of the organism. Formally, the alarm occurs when there is a discrepancy between what should be and what is-between the value a variable should have (set value (SV)), and the real value (actual value (AV)) of the same variable. The stress response, therefore, is an essential and necessary physiological response. The unpleasantness ...
Occupational and social factors are thought to be important determinants of health inequality. Th... more Occupational and social factors are thought to be important determinants of health inequality. The aim of this study was to examine the relationships between occupation, lifestyle and subjective health complaints (SHC). SHC and self-reported sickness absence were recorded in a cross-sectional study of 662 individuals aged between 16 and 67 from five occupational groups: blue-collar, school/education, health service, white-collar and service. Differences in SHC and sickness absence were investigated. A model of sociodemographic, lifestyle and work-related factors was tested to examine associations with SHC. Few differences in SHC and sickness absence were found when educational level, age and gender were controlled for. Female health service workers did, however, show significantly higher prevalence of pseudoneurological complaints compared with white-collar workers. Male blue-collar workers had significantly higher frequency of sickness absence than white-collar workers; otherwise, ...
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