Riassunto
The widespread interest in "stressful" aspects of contemporary society which contribute to its burden of illness and diseases (e.g. gastro intestinal, cardiovascular) has led to a large number of state ments and reports which relate the manifestations to a maladaptation of the individual. Furthermore, recent research suggests that under some condi tions stress may have a more generalized effect of decreasing the body IS ability to combat destructive forces and expose it to a variety of diseases. Breakdown in adaptation occurs when an individual cannot cope with demands inherent in his environment. These may be due to an excessive mental or physical load, including factors of a social or psychological nature and task performance requirements ranging from those which are monotonous, simple and repetitive to complex, fast, decision-taking ones. Experience shows however that not all people placed under the same condi tions suffer similarly, and it follows that to the social and psychological environment should be added a genetic factor influencing, through the brain, the responses of individuals. It is clear that, besides human suffering, this "breakdown in adaptation" causes massive losses of revenue to industry and national health authorities. Thus a reduction in "stress", before "breakdown" occurs, or an improvement in coping with it would be very valuable.
Contenuti
1 — Psychological and Sociological Parameters for Studies of Breakdown in Human Adaptation.- I.General Overviews.- Towards a taxonomy of methods: a general overview of psychological approaches in the study of breakdown of human adaptation.- Psychological field study techniques: overview and needs.- Psychological field study techniques: a critical evaluation.- Sociological parameters in studies of breakdown: a selective overview.- Use of psychological indices in epidemiological studies: overview and needs.- Stressful life events and illness: a review with special reference to a criticism of the life-event method.- II. Conceptual Approaches.- A lifetime prospective study of human adaptation and health.- Psychosocial and psychophysiological factors in the design and the evaluation of working conditions within health care systems.- The relation of social to pathophysiological processes: evidence from epidemiological studies.- Unemployment and health: a review of methodology.- Ontogenetic development and breakdown in adaptation: a review on psychosocial factors contributing to the development of myocardial infarction, and a description of a research program.- Physiological issues in establishing links between psychosocial factors and cardiovascular illness.- White collar occupation and coronary prone behaviour.- III. Methods.- Psychological methods: an overview of clinical applications.- Psychological factors in the breakdown of human adaptation: some methodological issues.- Monitoring signs of decrease in human adaptation: use of quantitative measures available in official statistics.- Inventory of stressful life-events (ILE).- The Norwegian female climacteric project (VOS).- Questionnaire for organisational stress (VOS).- A scale for measuring the marital relationship among males.- 2 — Human Performance and Breakdown in Adaptation.- Human performance in transport operations: introductory remarks.- I. Air Transport.- Air crew workload.- Safety, individual performance and mental workload in air transport: Oedipus as Icarus.- Stress management in air transport operations: beyond alcohol and drugs.- Reasons for eliminating the “age 60” regulation for airline pilots.- Human factors education in European air transport operations.- II. Road Transport.- Behaviour research in road traffic.- Some theoretical considerations on accident research.- Accident of bus drivers — practical and methodological problems.- Effects of alcohol on driving performance: a critical look on the epidemiological, experimental and psychosocial approaches.- Investigations on the influence of continuous driving on the motion activity of vehicle drivers.- III. Sea Transport.- Human performance in seafaring.- Stress factors and countermeasures in navigation.- Ship of the future: human problems and performance.- Accidents on board merchant ships.- Sleep data sampled from the crew of a merchant marine ship.- IV; Special Reviews.- Transport operators as responsible persons in stressful situations.- Stress response as a function of age and sex.- Drugs and transport operations.- Mechanical vibration in transport operations.- V. Methods.- Continuous electrophysiological recording.- Dimensions of flight crew performance decrements: methodological implications for field research.- Methodology in workstress studies.- 3 — Psychoneuroimmunology and Breakdown in Adaptation: Interactions within the Central Nervous System, the Immune and Endocrine Systems.- Immunology for nonimmunologists: some guidelines for incipient psychoneuroimmunologists.- Neuroendocrine interactions with brain and behaviour: a model for psychoneuroimmunology ?.- Psychoneuroimmunology.- Emotions, immunity and disease: an historical and philosophical perspective.- Immunoglobulins as stress markers ?.- Problems of clinical interdisciplinary research — investigation into bronchial asthma as a paradigm.- Factors involved in the classical conditioning of antibody responses in mice.- The bone marrow, our autonomous morphostatic “brain”.- Immune regulation of the hypothalamic — hypophysial — adrenal axis: a role for thymosins and lymphokines.- Stress and immune response: parameters and markers.- 4 — Breakdown in Human Adaptation and Gastrointestinal Dysfunction: Clinical, Biochemical and Psychobiological Aspects.- The brain and the gut.- The role of psychiatric assessment in the management of functional bowel disease.- Application of psychological measures in epidemiological studies of gastrointestinal disease: a critical opinion.- Stress–related nicotine abuse and disorders of the gastrointestinal tract.- Use of quantitative methods for the study of psychological factors in ulcer patients.- Stress, the immune system and GI function.- Clinical recognition of stress related gastrointestinal disorders in adults.- Stress and inflammatory bowel disease (IBD).- Upper GI bleeding lesions related to- or associated with-stress.- 5 — Acute Effect of Psychological Stress on Cardiovascular System: Models and Clinical Assessment.- I. Systems Interplay in Stress Response.- Need for clinical models: physiopathological versus epidemiological study.- Psychosocial stress: endocrine and brain interactions and their relevance for cardiovascular processes.- Hormonal response to acute stress: focus on opioid peptides.- II. Myocardial Infarction.- Clinical studies.- Emotional stress and heart disease: clinical recognition and assessment.- Possibilities and limitations of longterm studies on the effect of psychological stress on cardiovascular function.- Interaction between short- and long-term stress in cardiovascular disease.- Clinical clues of neuro-humoral interpretation of the genesis of coronary spasm.- Provocative testing for coronary spasm.- Hemodynamic characterization of different mental stress tests.- Experimental studies.- Thoracic autonomic nerves regulating the canine heart.- Nervous coronary constriction via ?–adrenoreceptors: counter–acted by metabolic regulation, by coronary ?-adrenoreceptor stimulation or by flow dependent, endothelium–mediated dilation.- III. Cardiac Arrhythmias.- Clinical studies.- Clinical clues to psychological and neuro-humoral mechanisms of arrhythmogenesis.- Clinical clues and experimental evidence of the neuro–humoral interpretation of cardiac arrhythmias.- IV. Arterial Hypertension.- Clinical Studies.- Blood pressure control during mental stress.- Somatic responses to acute stress and the relevance for the study of their mechanisms.- Neurohumoral factors involved in the pathogenesis of hypertension.- Experimenta1 studies.- Results of experimental studies favouring the hypothesis of the influence of stress on the genesis of hypertension.- Animal models for the assesment of stress on arterial blood pressure.- V. Methods.- Validation and quantification of mental stress tests, and their application to acute cardiovascular patients.- Methods and limits for the detection of the response of coronary circulation to acute stress.
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