.Journa1
Of
Psychosomatic
Research,
“01.
21,
pp.
313 - 321. Pergamon
Preys,
1977. Printed
I" Great
8ritain.
JOB DEMANDS, KEAU'H AND WEZLEEING Marianne Frankenhaeuser Department of Psychology, Universityof Stockholm, Box 6706, 113 85 Stockholm, Sweden. pality of Working Life During the last decade, harmful consequencesof modern technology,on the psychologicaland social levels, have received increased attention. So far, these new concerns seem to have had their greatest impact in the area of working life. I shall focus my paper on data from some ongoing research projects concerned with the stress involved in the psychosocialconditions characteristicof work in advanced industrialikedcountries. E!& let me start with some general reflections about the reason why quality of life has become a major political issue in the 1970's, just as growth was in the 60's. The realizationthat economic measures are no longer acceptable as the sole criterion of desirable social developmenthas inspired social scientists to devise measures which would reflect life conditions in a wider sense and permit non-economicfactors to be taken into account when evaluating the social consequencesof technologicalinnovations. With this aim, new statistical series have been developed - at both national and internationallevel monitoring change in such areas of social concern as health, employment, education,housing, etc. Wflilethese level-of-livingindices have improved the data-base for a variety of social programmes and preventive actions, they are obviously not the ultimate touch-stonesagainst which human wellbeing can be evaluated. In fact, recent studies in many countries show consistentlylow correlationsbetween objective level-of-livingindices and self-reportsof satisfactionand happiness (e.g., 1, 2). This discrepancybetween objective welfare and subjective wellbeing has upset the old notion that the quality of life would continue to improve with increasingmaterial assets. There is a growing understandingof the dynamics of human need structure and of the fact that people whose basic survival and safety are more or less guaranteed will develop new needs and expectations. On the political level, these changes in human need structure have to come to the fore as new and growing groups of people experience demands and expectations that used to be restricted to a privilegedminority. As a consequence of this developmentwe are witnessing a rapidly growing tendency to utilize knowledge built up by the behavioral sciences with the aim of improving work conditions. Moreover, there is a growing realizationthat ill-effectsof psychologically unrewarding work conditionstend to spread to life outside work and, hence, may colour the individual'stotal life situation. This seems true, in particular, of work characterizedby automation and mechanization. The view that the worker would be able to compensatefor a monotonous, boring job by stimulatingand enriching activities in his free time, is being replaced by an understandingof the strong links between a job that is circumscribedand repetitious,and a leisure which is passive and psychologicallyunrewarding(3k I shall illustrateexperimentalapproaches to these problems by examples from basic research in which I have been involved over a number of years and which has gradually become more oriented towards problems of working life. The research strategy rests on the ass'~.~t:.on that a better understandingof the 313
314
M. Frankenhaeuser
causes underlying ill health and dissatisfaction related to work can be gained by integrating within a common framework, concepts and methods from psychophysiology, social psychology, psychosomatic medicine, and ergonomics. Experimental
Approaches
to Job Stress
In essence, we are studying acute psychophysiological and neuroendocrine stress reactions in real-life and laboratory settings, and relating these to short-term and long-term adjustments as manifested in different indices of health and wellbeing. Among neuroendocrine reactions, catecholamine secretion plays a &ey role for several reasons (for reviews see ref. 4, 5). Firstly, the urinary excretion of adrenaline and noradrenaline is a sensitive indicator of psychological arousal, reflecting both the effort that a person invests in what he is doing and the intensity of his feelings. This applies in particular to adrenaline Secondly, an increase in peripheral catecholamines mobilizes excretion. resources which facilitate mental and physical adjustment to acute environmental demands. And, thirdly, it is assumed that long-lasting elevation of catecholamine levels may result in structural changes of pathogenic signlficance (e.g., 6). For these reasons, the detection of psychosocial factors which increase peripheral catecholamines, may aid in identifying high-risk workers and may The fact that serve as a basis for changing adverse work conditions. techniques are available for estimating free catecholamines in urine (71 is, of course, a great advantage in field experiments, since urine samples can be obtained without seriously interfering with the subjects' normal routines. We have focussed on conditions characterized by stimulus underload and overload, and I shall illustrate our results by some examples, starting with data from laboratory experiments. Fig. 1 shows adrenaline and moradrenaline excretion, estimated by a fiourimetric technique, under three environmental conditions (8). It is seen that understimulation (represented by a repetitive, monotonous vigilance task) and overstimulation (represented by a complex audiovisual choice-reaction task requiring selective attention and rapid response) both induced an increase of adrenaline and noradrenaline output as compared with a situation designed to match the input level of an "ordinary" environment of medium stimulation. On the psychological level, understimulation and in that both were experienced as distressing and is a point that I want to underscore: The impact by catecholamine excretion, is not determined by such, but by the individual's cognitive appraisal context in which the stimulus is embedded.
10
I-
overstimulation were similar This both required effort. of a stimulus, as assessed its physical properties as of its meaning and the
I
I
S,lrn
Fig.1. .
Sfll-fl
1
Job
Demands,Health
and
Wellbeing
We have been particularly interested in the issue of personal control, on the assumption that a person who is in a position to regulate stimulus input, may be able to maintain optimal arousal under a wide range of conditions. CUr results are consistent with the view that personal control, over the long run, facilitates adjustment and counteracts stress reactions. This is true, alth-ugh the effort required to exercise control may be accompanied by a temporary increase in arousal (cf. ref. 9). By experimental variations of the work load, or level of task demand, we can manipulate the effort that a person invests in what he is doing and, thereby, his catecholamine secretion (10). Fig. 2 gives an example of stress reactions induced by one and the same cognitive task performed at two levels of task In the demand, one denoted "single" conflict , the other "double" conflict. more demanding task, adrenaline excretion was significantly higher and remained so during a subsequent period in which arithmetic was performed. (The results are expressed as deviations from baseline level). 6
4
/ &ill “Doublr”con,/rc,
“srngir”
con,,rct 0,
2
0
f *rrmm
Inact
i
’
2
3
A striking result in this experiment was the ability of the subjects to In Hans maintain the same performance level when task difficulty increased. Selye's terminology, "raising the body's thermostat for defense", led to a compensatory increase in adrenaline secretion, and performance remained intact. This line of reasoning is supported by other experiments (11, 12) showing that performance deteriorates when subjects do not respond to increased task demands by increasing their effort and physiological arousal. 'This raises the question whether the psychological and physiological costs involved in adjusting to higher work loads increases the wear and tear, leaving the person less fit to cope with subsequent demands and more vulnerable to A case in point is the duration of the catecholamine harmful influences. Since the speed at which basesecretion elicited by a temporary stressor. line levels are regained may determine the relative potency of harmful versus beneficial consequences, it is interesting that individuals differ with regard to the temporal pattern of catecholamine release (13, 14). Fig. 3 shows data from two groups of subjects classified as rapid or slow "decreasers", depending upon the time taken for their adrenaline excretion to return to baseline after short-term exposure to a heavy mental load. The rapid "decreasers" differed from the slow "decreasers" in that their adrenaline output was higher during inactivity, they performed better in a sensorimotor task, and had lower neurotocism scores on Eysenck's Personality Inventory. A rapid drop in catecholamine secretion as demands decrease - or quick 'unwinding" - implies an "economic" mode of response, whereas a slow drop indicates poor adjustment in the sense that the organism "over-reacts" by mobilizing resources which are no longer needed. It is interesting, that in one of our investigations (in preparation) where l-hr periods of mental work and of inactivity alternated, subjects classified as Type A and as Type B, with the aid of a Swedish questionnaire (based on Jenkins‘ Activity Survey), showed different temporal patterns of.arousal. Type A's tended to maintain the same arousal level (as measured by catecholamine excretion and heart rate) under inactivity as under mental work, whereas Type B's adapted to the inactivity condition by lowering their In addition, our data suggest that Type A's tend to secrete more arousal.
315
M. Erankenhaeuser
316
Adrrnalrnr
;
25oc
:
x ; zooc ; :
5 1soc ‘0 6 = IOOC
0 Rapgd 5,aw
Adrenalfne
decrease
Fig.3 adrenaline when forced to remain unoccupied over an extended period of time than when required to engage in a challenging task. Sex Differences
in Stress Reactions
At this point, I want to call attention to the fact that the data which I have reported so far emanate'from male subjects and hold only in part for females. During rest and relaxation the two sexes do not differ in their catecholamine But psychosocial stress secretion (when body weight is taken into account). conditions produce a different picture, suggesting that females are less prone than males to respond to psychosocial stimuli by increased catecholamine This is true, regardless of whether the situation requires passive secretion. acceptance or active effort, as illustrated in Fig. 4.
Fig. 4
These data were obtained in an experiment (15) in which students of both sexes were exposed to two different stress situations, in one of which they were In the passive situation, given a passive role, in the other an active. stress was induced by repeated venipuncture, a procedure that is generally In the active considered somewhat stressful by members of both sexes. situation, the subjects performed a cognitive task. The results show that, in the female group, adrenaline excretion during both stress conditions was the same as when they relaxed in a controlled condition, whereas in the male group Sex differences in each of the stressors induced a significant increase. noradrenaline excretion were less marked. Similar results have been obtained in a series of experiments (16, 17, 18) in which the two sexes have been compared under stressful and non-stressful conditions. It is worth emphasizing that, in none of these studies, did males This suggests and females differ with regard to their level of performance. that, in women, the ability to master stressful situations may not be as closely linked to sympathetic-adrenal medullary activity as is the case for
Job
Demands,
Health
and
Wellbeing
males. In other words, the physiological cost involved in counteracting performance decrement under stress may be lower in females than in males. It is interesting to speculate about the mechanisms underlying this sex difference. One of our hypotheses is that the tendency to respond by increased catecholamine release to requirements of the psychosocial environment is associated with early so-ial and cultural influences. Insofar as this holds true, the current change in male and female work roles may tend to decrease the sex difference in catecholamine secretion. This, in turn, may lead to a decrease in the difference between sexes in their susceptibility to diseases associated with the action of peripheral catecholamines. However, insofar as the sex difference in catecholsmine secretion has a biological origin, it may be relatively insensitive to attitudinal and environmental factors. To explore different hypotheses we are at present investigating possible interactions between steroid hormones and catecholamines in the regulation of stress reactions Stress in the Sawmill The problem of sex differences forms part of a project concerned with job stress in real life. So far, however, data are available only for male workers in the highly mechanized sawmill industry. In a pilot study (19, 20), we examined a group classified as high-risk workers on the basis of the extremely constricted, machine-paced nature of their jobs on the assembly line. These workers were compared with a control group from the same mill, whose job wa,s not as restricted physically and mentally. Fig. 5 shows four measurements of catecholamine excretion, taken during an &hr work shift and expressed as percentages of baseline values obtained under work-free conditions at home. The average adrenaline excretion was signifiFurthermore, the cantly higher in the high-risk group than in the controls. time course was strikingly different for both amines, catecholamine release decreasing towards the end of the work day in the control group, but The differences between the last measureincreasing in the high-risk group. Such a build-up of ments of the day were significant for both amines. catecholamine arousal during a long work day should be regarded as a warning signal, indicating that the organism is forced to mobilize "reserve capacity", which in the long run is likely to add to its wear and tear. In other words, the cost of adaptation may be exceedingly high. And, in agreement with these assumptions, the frequency of psychosomatic symptoms as well as absenteeism were exceptionally high in this group.
Noradrrnblrne
. 0
H,gh-rrtk group Confrol group
u” 8.15
1030
12.rs
1500
Ttme of day
8.15
IO.30
12.45
TlnlF
Of day
15.0
Of
Psychosomatic
Research,
“01.
21,
pp.
313 - 321. Pergamon
Preys,
1977. Printed
I" Great
8ritain.
JOB DEMANDS, KEAU'H AND WEZLEEING Marianne Frankenhaeuser Department of Psychology, Universityof Stockholm, Box 6706, 113 85 Stockholm, Sweden. pality of Working Life During the last decade, harmful consequencesof modern technology,on the psychologicaland social levels, have received increased attention. So far, these new concerns seem to have had their greatest impact in the area of working life. I shall focus my paper on data from some ongoing research projects concerned with the stress involved in the psychosocialconditions characteristicof work in advanced industrialikedcountries. E!& let me start with some general reflections about the reason why quality of life has become a major political issue in the 1970's, just as growth was in the 60's. The realizationthat economic measures are no longer acceptable as the sole criterion of desirable social developmenthas inspired social scientists to devise measures which would reflect life conditions in a wider sense and permit non-economicfactors to be taken into account when evaluating the social consequencesof technologicalinnovations. With this aim, new statistical series have been developed - at both national and internationallevel monitoring change in such areas of social concern as health, employment, education,housing, etc. Wflilethese level-of-livingindices have improved the data-base for a variety of social programmes and preventive actions, they are obviously not the ultimate touch-stonesagainst which human wellbeing can be evaluated. In fact, recent studies in many countries show consistentlylow correlationsbetween objective level-of-livingindices and self-reportsof satisfactionand happiness (e.g., 1, 2). This discrepancybetween objective welfare and subjective wellbeing has upset the old notion that the quality of life would continue to improve with increasingmaterial assets. There is a growing understandingof the dynamics of human need structure and of the fact that people whose basic survival and safety are more or less guaranteed will develop new needs and expectations. On the political level, these changes in human need structure have to come to the fore as new and growing groups of people experience demands and expectations that used to be restricted to a privilegedminority. As a consequence of this developmentwe are witnessing a rapidly growing tendency to utilize knowledge built up by the behavioral sciences with the aim of improving work conditions. Moreover, there is a growing realizationthat ill-effectsof psychologically unrewarding work conditionstend to spread to life outside work and, hence, may colour the individual'stotal life situation. This seems true, in particular, of work characterizedby automation and mechanization. The view that the worker would be able to compensatefor a monotonous, boring job by stimulatingand enriching activities in his free time, is being replaced by an understandingof the strong links between a job that is circumscribedand repetitious,and a leisure which is passive and psychologicallyunrewarding(3k I shall illustrateexperimentalapproaches to these problems by examples from basic research in which I have been involved over a number of years and which has gradually become more oriented towards problems of working life. The research strategy rests on the ass'~.~t:.on that a better understandingof the 313
314
M. Frankenhaeuser
causes underlying ill health and dissatisfaction related to work can be gained by integrating within a common framework, concepts and methods from psychophysiology, social psychology, psychosomatic medicine, and ergonomics. Experimental
Approaches
to Job Stress
In essence, we are studying acute psychophysiological and neuroendocrine stress reactions in real-life and laboratory settings, and relating these to short-term and long-term adjustments as manifested in different indices of health and wellbeing. Among neuroendocrine reactions, catecholamine secretion plays a &ey role for several reasons (for reviews see ref. 4, 5). Firstly, the urinary excretion of adrenaline and noradrenaline is a sensitive indicator of psychological arousal, reflecting both the effort that a person invests in what he is doing and the intensity of his feelings. This applies in particular to adrenaline Secondly, an increase in peripheral catecholamines mobilizes excretion. resources which facilitate mental and physical adjustment to acute environmental demands. And, thirdly, it is assumed that long-lasting elevation of catecholamine levels may result in structural changes of pathogenic signlficance (e.g., 6). For these reasons, the detection of psychosocial factors which increase peripheral catecholamines, may aid in identifying high-risk workers and may The fact that serve as a basis for changing adverse work conditions. techniques are available for estimating free catecholamines in urine (71 is, of course, a great advantage in field experiments, since urine samples can be obtained without seriously interfering with the subjects' normal routines. We have focussed on conditions characterized by stimulus underload and overload, and I shall illustrate our results by some examples, starting with data from laboratory experiments. Fig. 1 shows adrenaline and moradrenaline excretion, estimated by a fiourimetric technique, under three environmental conditions (8). It is seen that understimulation (represented by a repetitive, monotonous vigilance task) and overstimulation (represented by a complex audiovisual choice-reaction task requiring selective attention and rapid response) both induced an increase of adrenaline and noradrenaline output as compared with a situation designed to match the input level of an "ordinary" environment of medium stimulation. On the psychological level, understimulation and in that both were experienced as distressing and is a point that I want to underscore: The impact by catecholamine excretion, is not determined by such, but by the individual's cognitive appraisal context in which the stimulus is embedded.
10
I-
overstimulation were similar This both required effort. of a stimulus, as assessed its physical properties as of its meaning and the
I
I
S,lrn
Fig.1. .
Sfll-fl
1
Job
Demands,Health
and
Wellbeing
We have been particularly interested in the issue of personal control, on the assumption that a person who is in a position to regulate stimulus input, may be able to maintain optimal arousal under a wide range of conditions. CUr results are consistent with the view that personal control, over the long run, facilitates adjustment and counteracts stress reactions. This is true, alth-ugh the effort required to exercise control may be accompanied by a temporary increase in arousal (cf. ref. 9). By experimental variations of the work load, or level of task demand, we can manipulate the effort that a person invests in what he is doing and, thereby, his catecholamine secretion (10). Fig. 2 gives an example of stress reactions induced by one and the same cognitive task performed at two levels of task In the demand, one denoted "single" conflict , the other "double" conflict. more demanding task, adrenaline excretion was significantly higher and remained so during a subsequent period in which arithmetic was performed. (The results are expressed as deviations from baseline level). 6
4
/ &ill “Doublr”con,/rc,
“srngir”
con,,rct 0,
2
0
f *rrmm
Inact
i
’
2
3
A striking result in this experiment was the ability of the subjects to In Hans maintain the same performance level when task difficulty increased. Selye's terminology, "raising the body's thermostat for defense", led to a compensatory increase in adrenaline secretion, and performance remained intact. This line of reasoning is supported by other experiments (11, 12) showing that performance deteriorates when subjects do not respond to increased task demands by increasing their effort and physiological arousal. 'This raises the question whether the psychological and physiological costs involved in adjusting to higher work loads increases the wear and tear, leaving the person less fit to cope with subsequent demands and more vulnerable to A case in point is the duration of the catecholamine harmful influences. Since the speed at which basesecretion elicited by a temporary stressor. line levels are regained may determine the relative potency of harmful versus beneficial consequences, it is interesting that individuals differ with regard to the temporal pattern of catecholamine release (13, 14). Fig. 3 shows data from two groups of subjects classified as rapid or slow "decreasers", depending upon the time taken for their adrenaline excretion to return to baseline after short-term exposure to a heavy mental load. The rapid "decreasers" differed from the slow "decreasers" in that their adrenaline output was higher during inactivity, they performed better in a sensorimotor task, and had lower neurotocism scores on Eysenck's Personality Inventory. A rapid drop in catecholamine secretion as demands decrease - or quick 'unwinding" - implies an "economic" mode of response, whereas a slow drop indicates poor adjustment in the sense that the organism "over-reacts" by mobilizing resources which are no longer needed. It is interesting, that in one of our investigations (in preparation) where l-hr periods of mental work and of inactivity alternated, subjects classified as Type A and as Type B, with the aid of a Swedish questionnaire (based on Jenkins‘ Activity Survey), showed different temporal patterns of.arousal. Type A's tended to maintain the same arousal level (as measured by catecholamine excretion and heart rate) under inactivity as under mental work, whereas Type B's adapted to the inactivity condition by lowering their In addition, our data suggest that Type A's tend to secrete more arousal.
315
M. Erankenhaeuser
316
Adrrnalrnr
;
25oc
:
x ; zooc ; :
5 1soc ‘0 6 = IOOC
0 Rapgd 5,aw
Adrenalfne
decrease
Fig.3 adrenaline when forced to remain unoccupied over an extended period of time than when required to engage in a challenging task. Sex Differences
in Stress Reactions
At this point, I want to call attention to the fact that the data which I have reported so far emanate'from male subjects and hold only in part for females. During rest and relaxation the two sexes do not differ in their catecholamine But psychosocial stress secretion (when body weight is taken into account). conditions produce a different picture, suggesting that females are less prone than males to respond to psychosocial stimuli by increased catecholamine This is true, regardless of whether the situation requires passive secretion. acceptance or active effort, as illustrated in Fig. 4.
Fig. 4
These data were obtained in an experiment (15) in which students of both sexes were exposed to two different stress situations, in one of which they were In the passive situation, given a passive role, in the other an active. stress was induced by repeated venipuncture, a procedure that is generally In the active considered somewhat stressful by members of both sexes. situation, the subjects performed a cognitive task. The results show that, in the female group, adrenaline excretion during both stress conditions was the same as when they relaxed in a controlled condition, whereas in the male group Sex differences in each of the stressors induced a significant increase. noradrenaline excretion were less marked. Similar results have been obtained in a series of experiments (16, 17, 18) in which the two sexes have been compared under stressful and non-stressful conditions. It is worth emphasizing that, in none of these studies, did males This suggests and females differ with regard to their level of performance. that, in women, the ability to master stressful situations may not be as closely linked to sympathetic-adrenal medullary activity as is the case for
Job
Demands,
Health
and
Wellbeing
males. In other words, the physiological cost involved in counteracting performance decrement under stress may be lower in females than in males. It is interesting to speculate about the mechanisms underlying this sex difference. One of our hypotheses is that the tendency to respond by increased catecholamine release to requirements of the psychosocial environment is associated with early so-ial and cultural influences. Insofar as this holds true, the current change in male and female work roles may tend to decrease the sex difference in catecholamine secretion. This, in turn, may lead to a decrease in the difference between sexes in their susceptibility to diseases associated with the action of peripheral catecholamines. However, insofar as the sex difference in catecholsmine secretion has a biological origin, it may be relatively insensitive to attitudinal and environmental factors. To explore different hypotheses we are at present investigating possible interactions between steroid hormones and catecholamines in the regulation of stress reactions Stress in the Sawmill The problem of sex differences forms part of a project concerned with job stress in real life. So far, however, data are available only for male workers in the highly mechanized sawmill industry. In a pilot study (19, 20), we examined a group classified as high-risk workers on the basis of the extremely constricted, machine-paced nature of their jobs on the assembly line. These workers were compared with a control group from the same mill, whose job wa,s not as restricted physically and mentally. Fig. 5 shows four measurements of catecholamine excretion, taken during an &hr work shift and expressed as percentages of baseline values obtained under work-free conditions at home. The average adrenaline excretion was signifiFurthermore, the cantly higher in the high-risk group than in the controls. time course was strikingly different for both amines, catecholamine release decreasing towards the end of the work day in the control group, but The differences between the last measureincreasing in the high-risk group. Such a build-up of ments of the day were significant for both amines. catecholamine arousal during a long work day should be regarded as a warning signal, indicating that the organism is forced to mobilize "reserve capacity", which in the long run is likely to add to its wear and tear. In other words, the cost of adaptation may be exceedingly high. And, in agreement with these assumptions, the frequency of psychosomatic symptoms as well as absenteeism were exceptionally high in this group.
Noradrrnblrne
. 0
H,gh-rrtk group Confrol group
u” 8.15
1030
12.rs
1500
Ttme of day
8.15
IO.30
12.45
TlnlF
Of day
15.0
