Of the factors impacting on mental health, stress is particularly significant. Stress can be defined as a “negative emotional experience” accompanied by biochemical, physiological, cognitive and behavioural changes which serve to overcome the stress or accommodate its presence (Taylor, 2003). Lazarus and Folkman (1984) suggested that when an individual is faced with a potential stressor they engage in primary appraisal to determine whether the stressor is positive, negative or neutral in nature. Secondary appraisal occurs when a stimulus is deemed negative and the individual must decide if their resources and coping abilities are sufficient to deal with the challenge, threat or harm posed by the situation. It can therefore be said that the extent to which a situation or event is experienced as stressful depends on the individual’s appraisal of it, i.e. greater levels of stress are experienced when the individual perceives a discrepancy between the demands of the situation and the resources they have to cope with it. In addition to the psychological distress caused by stress, it also causes physiological changes in the body, which if sustained can have long-term consequences for our physical health.
One way in which researchers have examined the physiological outcomes of psychological stress is to examine one’s pattern of cardiovascular reactivity in response to stress. Cardiovascular reactivity refers to the change in one’s resting blood pressure and heart rate in response to an “aversive, challenging or engaging” stressor (Treiber et al., 2003). The findings from a number of studies have shown that a person’s pattern of cardiovascular reactivity to stress in the laboratory can predict their blood pressure levels when tested again at a later date in the future. These findings suggest a pathway between stress and cardiovascular disease such that stress contributes to increased cardiovascular reactivity which in turn is a risk factor for cardiovascular disease. These findings also suggest that we can identify those at greatest risk of future cardiovascular related disease by examining their cardiovascular reactivity in the laboratory. The significance of this finding is highlighted by the fact that only 50% of the variance in new cardiovascular disease cases can be attributed to risk factors such as family history, smoking, obesity, diabetes mellitus and hypercholesteremia (Treiber et al., 2003) and by figures obtained from the Central Statistics Office, which show that diseases of the circulatory system including hypertensive disease and ischaemic heart disease accounted for the greatest number of deaths each year in Ireland from 1998 to 2006 ahead of cancer, disease of the respiratory system, injury and poisoning (CSO, 2009). Research investigating the factors contributing to stress and the means by which these factors can be alleviated or moderated is thus one way by which we can aim to reduce the incidence of cardiovascular disease, improve the health of our population and contribute to the sustainability of communities.
STRESS IN THE WORKPLACE
Figures from the European commission in 2005 stated that 28% of employees in Europe report stress at work (European Commission, 2005). Stress in the workplace can be related to
a number of factors including work overload, poor organisation of working time, poor management and leadership styles, role ambiguity and little input in decision making. Although stress can at times be adaptive such as when it prompts us to work harder or faster to complete tasks and meet deadlines, the adverse impact of ongoing or intense stress extends beyond the individual and the quality of their work to increased business costs and lower profitability. High levels of stress in the workplace can lead to absenteeism, a decline in efficiency and productivity, staff turnover, interpersonal conflict between staff who may feel under appreciated or that their workload and responsibility is greater than that of others, poor job satisfaction and poor job commitment. Sparks, Faragher and Cooper (2001) in reviewing the factors that influence health and well-being in the workplace, pointed to employees perceptions’ of job security as a significant factor. Perceived job insecurity may affect an organization or business through reduced employee morale, motivation and commitment to the employer. Smithson and Lewis (2000 as cited in Sparks et al., 2001) proposed that the negative outcomes of perceived job insecurity be counteracted by providing affected employees with greater opportunities for training and self-development, by ensuring open communication during times of uncertainty and by encouraging employees to develop their repertoire of transferable skills. Other factors implicated by Sparks et al. (2001) in the experience of stress in the workplace include work hours, the level of control over one’s work and management style.
The economic costs of stress in the workplace are reflected in increased social welfare payments in the form of sick benefit and disability allowances to those who are unfit to engage in paid employment. Health care costs increase as individuals seek treatment for their illness and businesses are faced with lower profits and reduced levels of innovation. O Shea and Kennelly (2008) pointed to the results of the Quarterly National Household Survey (QNHS) published by the Central Statistics Office in 2002 as evidence of the disruption in job performance arising from mental illness. The findings of this report showed that those suffering from a “mental, nervous or emotional” disability worked on average 29.5 hours a week compared to the national average of 36.8 hours (O Shea & Kennelly, 2008). The implementation of stress management programs and efficient methods of delegating tasks are ways by which we can aim to reduce stress in the workplace.
ANXIETY
As is the case with the term ‘stress’, a concept familiar to the majority of individuals in today’s society whether or not they are directly affected by it, most individuals are familiar with the term ‘anxiety’ and will agree to experiencing this emotion to a greater or lesser extent on occasion. In clinical terms, anxiety can be described as an “aversive emotional and motivational state” which occurs in threatening circumstances (Eysenck et al., 2007). Anxiety is commonly experienced when one’s current goals or values are threatened. As referred to above, anxiety is one of the most commonly experienced mental illnesses. A distinction can be made between state anxiety, i.e. the level of anxiety being experienced at a particular moment in time, and trait anxiety, the level of anxiety an individual characteristically experiences across situations. State anxiety is the outcome of the interaction between an individual’s level of trait anxiety and situational factors which could include an imminent presentation or job interview. Depending on the level of anxiety being experienced, it can interfere greatly with an individual’s ability to focus on a given task and in severe cases can disrupt everyday life to the extent that the individual is unable to direct their thoughts away from the source of their anxiety. Research findings illustrate the existence of an attentional
biasin those experiencing anxiety such that their attention is directed to thoughts and stimuli that relate to their anxiety. Compared to those who are not experiencing anxiety, anxious individuals find it difficult to ignore threatening or negative information. The existence of this attentional bias has been shown using the emotional Stroop task. In the emotional Stroop task individuals are presented with a series of words, which are positive, negative or neutral in meaning and which appear in different colours on the computer screen. Individuals are instructed to ignore the emotional content of the word and to report instead the colour in which the word is presented. Results across a number of studies have been consistent with the finding that individuals with a greater vulnerability to anxiety take longer to report the colour of words which are negative in meaning, suggesting that they are distracted from the task of colour naming by the semantic meaning of the word (MacLeod et al., 2002).
This bias in attention towards threatening and negative material interferes with the individual’s ability to focus on day to day tasks. When such distraction occurs in the workplace it can ultimately lead to a decline in productivity and to the individual taking longer to complete tasks. Dual task performance and the ability to switch between tasks are impaired (Eysenck et al., 2007). A growing body of research on anxiety is now also examining the impact that one’s interpretation of objects and events has on anxiety levels and the findings of this research offers promising ways of reducing anxiety related thoughts. This research has shown that anxiety can occur when an individual interprets an ambiguous situation or object as something that poses a threat to them in some way. An interpretation bias can develop when the individual consistently interprets situations or events in the same manner. When this interpretation bias is negative or threatening in nature it can lead to the experience of repeated anxiety. Those exhibiting a negative/threatening interpretation bias have been shown to experience greater anxiety reactions when faced with a stressor (Wilson, MacLeod, Rutherford, & Mathews, 2006). Mathews and Mackintosh (2000) among others have demonstrated that individuals can be trained to interpret ambiguity in either a positive or negative manner. These findings have important implications for approaches aimed at reducing anxiety. MacLeod, Koster and Fox (2009) concluded that approaches that modify one’s interpretation bias have proven to be effective in “ameliorating emotional dysfunction, reducing the symptoms of clinical pathology and attenuating vulnerability factors associated with the development of psychological disorders” (Macleod et al., 2009, pg 96). These findings represent just one approach to reducing anxiety. Given that anxiety has a number of causal factors, such an approach will not be effective for all individuals. Furthermore, the extent to which such an approach is successful will depend on the severity of the anxiety. Of significance here is the fact that this research has a value in suggesting one way by which anxiety may be alleviated, allowing individuals to engage fully in their daily lives. The importance of communicating such findings to policy makers should not be underestimated. From an economical point of view, the increased capacity of the individual in the workplace will improve productivity and efficiency and reduce absenteeism, while from a humanitarian point of view, quality of life and well being is improved, thus contributing to the sustainability of communities.