a review of biomarkers in leadership research

7/29/2019 A Review of Biomarkers in Leadership Research

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A Review of Biomarkers in Leadership Research

Can Heart Rate Variabili ty be a Suitable Method?

Frfattare: Ingegrd E. Malmros

Institutionen f r Lrande, Informatik,

Management och Etik (LIME)

Frontiers in leadership research 5 pong

Examensarbete

Vrterminen 2007


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A Review of Biomarkers in Leadership Research Can Heart Rate Variability be a Suitable Method?Ingegrd E. Malmros, [email protected], Karolinska Institutet, LIME

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Content

Content .......................................................................................................................................2Abstract ...................................................................................................................................... 3Introduction ................................................................................................................................ 4Purpose and questions to be answered.......................................................................................5Methods......................................................................................................................................5Results ........................................................................................................................................5

Leadership .............................................................................................................................. 6Leadership history .............................................................................................................. 6Gender aspects.................................................................................................................... 8Leadership and stress ......................................................................................................... 8

Biomarkers ............................................................................................................................. 9What is a biomarker?..........................................................................................................9HRV, stress and sleep.......................................................................................................10HRV, Organizational changes and stress ......................................................................... 12HRV and gender differences ............................................................................................ 12

Discussion ................................................................................................................................ 12Conclusion........................................................................................................................ 13

References ................................................................................................................................ 13


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AbstractLeadership research is a very young discipline from the 20th century, with its background inthe ancient history of Plato, Sun Tzu, Machiavelli and Pareto. The focus has changed fromwar strategies to individuals and organisations. The purpose of this report was to examinewhat has been written about leadership research and the use of biomarkers. The focus was laidon Heart Rate Variability (HRV) as HRV is an easy way to record the sympathetical

parasympathetical balance which reflects the autonomous nervous system that is stronglyinfluenced by psychological as well as physiological activities from the environment bothoutside and inside a person. HRV is considered to be the strongest predictor forcardiovascular diseases. No reports were found with the key words leadership and HeartRate Variability but some were found when extending the searching to professionals whohad to practise leadership in their professions. It is worth underlining the importance ofcorrelation between leadership and management with stress, sleep disturbances and a negativeimpact on HRV which means disturbances in the heart power. There are gender differences in

both interpretation of the female and male leadership among subordinates as between leadersthemselves. There also are gender differences in HRV mean values among healthy subjectswhich has to be noticed when analyzing material. In many of the reports there is a demand for

further investigations on HRV in different inventions and sleep. No studies on correlationbetween psychological and physiological datas are found expressing indications of unhealthystress-levels within leadership research for sorting out the most efficient and cost-effectiveways of predicting cardiovascular diseases and burnouts. The conclusion is that there is a needfor biomarkers in leadership research and HRV is proposed as a suitable method.

Keywords: Biomarkers, gender, Heart Rate Variability (HRV), leadership, sleep, stress.


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Introduction

Can biomarkers be of interest in leadership research and if so, why? Leadership is a rather

young research field and started to develop as a science during the 20 th century (Grint, 1977;Yukl, 1989). Leadership often was connected to war strategies and it was not until theindustrial revolution in the 19th century that the work environment with its differenthierarchies and roles came into focus (Grint, 1997; Tyrstrup, 2005). One of the forerunners ofmanagement research is Taylor1 who examined the production time of the subordinates forincreasing the productivity (Tyrstrup, 2005). The theory also made the role identification ofleaders and subordinates more distinctive. Henry Ford was very impressed by the Tayloristicapproach and wanted to produce cheap cars for the people using the assembly line principlewhere the subordinates were working like robots. It is said that he thought he got unnecessary

problems as the subordinates turned out to be not only hands but whole persons (Tyrstrup,

2005). Fords leadership was surely firm, prosperous and visionary but was it good for thehealth of the subordinates? There are also studies reporting leadership impact on subordinates(Lewis, 2000; Mc Coll-Kennedy & Andersson, 2002; Newcombe & Aschkanasy, 2002;Pescosolido, 2002; Pirola-Merlo, Hrtel, Mann & Hirst, 2002; Nyberg, Bernin & Theorell,2005; Sy, Cot & Saavedra, 2005). Many studies point out that psychosocial effort and workstrain are risk factors for diseases, and then especially stressrelated diseases as cardiovascularones (Theorell, 2001; Ekman & Arnetz, 2005; Jansson von Vulte, 2004, Vtijkotte, Doornen& de Geus, 2000; Lindholm, Savolainen, Ahlberg, Rantala, Savinen, Knnen & Nissinen,2001; Ta-Chen, Lian-Yu, Wen-Tsan, Yuan-The, Chen-Fong & Jung, cited 2007; Westerholm,2001). For predicting cardiovascular diseases the biological markers as electrocardiogram(ECG) and blood pressure often were used but today the strongest predictor is Heart Rate

Variability (HRV) (Task Force of the European Society of Cardiology and The NorthAmerican Society of Pacing and Electrophysiology, 1996). HRV is said to reflect theautonomous sympathetical parasympathetical balance indicating a persons stress-level(Organisation of the Nervous System, Kimballs Biology pages, 2007). Human beings havean inherited circadian rhythm with an impact on the hormonal balanced mood as well as

physiological changes where the cortson level is low just before it raises in the morningwhen it is time to wake up (Ekman & Arnetz, 2005; Sderstrm, 2007). Stress and sleep has aclose negative relationship ( Ekman & Arnetz, 2005). To compare biological markers duringdaytime and sleep gain new information on psychophysiological background data withoutinfluencing the subject with questionaires or interviews. The intervention with blood samplesmight be stressing for some subjects which will be avoided with the use of devices for Heart

Rate Variability. These devices are now available as small, wireless online sensors easy towear almost anywhere (during work and sleep,sporting activites etc) without any intervention.

Most studies in leadership research are performed by psychologists or professionals closelyrelated to that scientific field where interviews, questionnaires and behavioural research arein focus. The emotions, feelings and mood are examined with a qualitative methodologywhich is subjective and gives a lot of information that is very useful for understanding what isgoing on from a psychological point of view. But on which stress-level is the body working?Is there a balance between anabolic and katabolic prosesses? Long-lasting catabolic processesas during stress will usually cause illnesses. So what have been done and what doulc be done?

1 Theory of Scientific Management


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Purpose and questions to be answered

The purpose of this review is to search out information on what is done in leadership researchdealing with psychophysiological reactions among leaders, registered with biomakers thatmight give interesting objective datas about the physiological well-being within a person. Asmentioined above leadership and stress are closely connected and heart diseases are verymuch stress-related. Leadership therefore ought to be examined not only from a psychological

point of view but also from a medical one as the impact of health is of great concern both forthe individual (quality of life) as well as for the society (great economical costs).

Questions to be ansewered:Are there any reports on biomarkers in leadership research?Which biomarkers are then examined?Have Heart Rate Variability (HRV) been used for predicting heart diseases among stressedleaders and subordinates?

Have distincion been made between daytime and sleep?

Definitions:Heart Rate Variability (HRV): A method for recording electrical activity within the heartindicating shifts in the sympathical parasympathical balance and thus telling the stress-levelwithin a person. Very early signs of diminished power in the heart predicting heart disease isalso registered.Biomarkers: According to MedTerms in MedicineNet.com http://www.medterms.com a

biomarker is a biochemical feature of facet that can be used to measure the progress of diseaseor the effects of treatment.

MethodsThe methodology is mainly a literature review.Databases used: PubMed, MedLine, Wikipedia, Google, Mednet, MedicineNet.com, Liber.se,Biblioteket.se.Key words used: Biomarkers, gender, Heart Rate Variability (HRV), leadership, sleep, stress.Inclusion criteria: Literature edited 1982-2007.Leadership: No distinction is made between different kinds of theories on leadership, leaders,managers or chief executive officers. Reports are included dealing with work environmentsand jobb stress where professionals are acting as leaders in their practise.

ResultsLeadership research from a psychophysiological point of view is a multidisciplinary andchallenging field. For being able to understand basics of leadership philosophy andterminology it is necessary also for biomarker researchers to be acquainted with some of theleadership history which succesively lead into leadership research. For psychologists it might

be useful to know something more about the pontential usefulness of different kinds ofbiomarkers (biological markers). In this literature research hardly any reports dealing exactlywith leadership and biomarkers were found, but some reports that are closely related, as many

professional act as leaders even if the key words might be different, for example physicians,coachers among others.


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Leadership

Leadership history

How to define leadership? Leadership as a science is a rather young discipline but has itsroots in the ancient history more than 2000 years ago. A review of Leadership Classical,

Contemporary, and Critical Approaches (Grint, 1997) gives an interesting introduction ofleadership in a historical perspective. Leadership has always existed even if the terminologyand interest in it has changed over the decades. The Classical Leadership emanates fromPlato, Sun Tzu, Machiavelli and Pareto. Plato in Greece proclaims that only the leader has thenecessary economic and occupational knowledge to lead like a captain on the boat andleaves a very anti-democratic image of a leader. Women only act as service providers to theleaders and citizens of Ancient Athens but some women anyway could get a higher rank. It isinteresting though that Plato argued that the citizens were their own experts in moralknowledge. Almost in the same period between the fifth and the third centuries BC, Sun Tzuin China wrote The Art of War which became classic as the oldest known written militarytext. It is dealing about strategies to avoid the war or to end it as fast as possible. The way of

peace is always sought in preference to violence but if you have to fight you shall execute theviolence with the minimum of effort and maximum effect. The heritage of this philosophyyou still can find in the Kung Fu movies and also in martial art. The famous martial artistconnected to Sun Tzu called Li Chuan brought the art into the Shaolin Temple where it is still

practised today! This philosophy also have a connection between conflict and medicine whichcan be seen in Tai Chi. The underlying philosophy generates a hierarchy of strategies both incombat and in medicine. Avoidance is always the first strategy and face-to-face contact thelast one. Sun Tzu like Plato had the opinion that only one leader was in charge and politicalleaders had no right to interfere with the military strategists as the responsibility for a martialhost of a million lies in one man. He is the trigger of its spirit. The Warring States period

of ancient China was the background for Sun Tzus war strategy work. Sun Tzu stated that ifyou can not eliminate the enemy completely you should provide a golden bridge for givingthem a possibility to escape and lower their wish for revenge. Machiavelli and Sun Tzu bothhad experiences of war but totally different approaches to it. Bertrand Russel calledMachiavellis book The Prince written in 1513 a handbook for gangsters while Napoleoncalled it the only book worth reading. Machiavellis background was the civil war. For himthere was no reason to act morally in such an immoral world as such an action was consideredinefficient. At the same time he did not celebrate the tyranny but had no hope that the pacifistor goodness could save the world. The book is a polemic review of the world. ForMachiavelli the approach to leadership is not just concerning the leader himself but he the

politic body: leading the corporate body of the state not the body of the corporate leader. He

also argues for alliances for getting strength and the usage of technology. Machiavelliintroduced the dual strategies of the lion and the fox which means that the prince in the book(the leader) has to be like a centaur; a half-beast and a half-man. Pareto (1848-1923)incorporated Machiavellis distinction between the lion and the fox in his elite theory wherethe lites, not the people, were ruling the society which meant that necessarily allorganizations had to be non-democratic. According to Pareto lites always rule and the wayindividuals get to leaders are up to the people. As soon as the leader is chosen the opponentsstart to plan for their downfall.

Referring to Yukl (1989) scientific research did not begin until the twentieth century. First thefocus laid on determinants of leadership, later on traits, abilities and behaviours that will

determine the possibility for a leader to be able to influence his/hers followers and accomplishgroup activities. Leadership effectiveness was in focus. An on-going discussion also deals


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with leadership versus management and there is no sharp distinction between them. A personcan be a manager without leading people and some managers do not even have anysubordinates (especially in the financial business). Some has the opinion that managers areoriented towards stability and leaders are oriented towards innovation which means thatmanagers get people to work more effectively whereas leaders works for getting people to

agree about what should be done. Yukl is discussing leadership as a specialised role and asocial influence process. Major research approaches: Trait approach, behavioural approach,power-influence approach, situational approach and integrative approaches. The situationalapproach emphasizes the importance of contextual factors such as the nature of the work andthe external environment and the characteristics of followers. Managerial behaviour is heretreated as a dependent variable where the researchers try to discover how this behaviour isinfluenced by aspects of the situation such as the type of organisation or managerial position.The research investigates how managers cope with demands and constraints for subordinatesas well as from superiors. The primary research method is a comparative study of two or moresituations in which managerial activities or behaviours are measured with leader descriptionquestionnaires, job description, questionnaires or direct observation. Effectiveness depends on

how well a manager resolves role conflicts, copes with demands, recognizes opportunities andovercomes constraints. Cross-cultural leadership is a part of this. The other group of researchin this situational approach is focusing on identifying aspects of situations that moderate therelationship of leaders behaviours (or traits) to leadership effectiveness and much knowledgeabout that is found in the contingency theories. Also the Integrative approaches point outinteresting research ideas trying to explain why followers of some leaders are willing to exertexceptional effort and make personal sacrifices to accomplish the group objective or mission.The effectiveness of a leader is explained in terms of influence on the way followers viewthemselves and interpret events. Effective leaders influence followers to have more optimism,self-confidence and commitment to the objectives or missions of the organization. Mosttheories of charismatic and transformational leadership identify behaviours and traits thatfacilitate the leaders effectiveness. The same behaviour by one special leader may have adifferent effect on followers depending on the situation, the history of interaction between theleader and followers and the way the behaviour is interpreted by the followers (Grint, 19979.

Contemporary leadership styles are traditional, modern, mythical and alternative according toGrint (1997) but will not be summarized here. These styles are important as they are the

background for the modern leadership styles. Developmental leadership (Larsson &Kallenberg, 2003) and Improvising leadership (Tyrstrup, 2006) styles are modern examples ofleadership that are focused on the individual on a high ethical level grounded on trust betweenthe leader and the subordinate respective having the managerial power to improvise.

Bolman (1997) discussed the problem with the terminology of leadership and chief executiveofficer in his book Reframing Organization, Artistry, Choice and Leadership. He states thatleadership seems to be something that is highly evaluated and something people look for andstill there is no strict definition of what it really stands for. Bolman (1997) and Tyrstrup(2005) refers to authors like Gardner2 and Bennis & Nanus3 who claim that the attributes ofleadership is separated from the ones of a chief executive officer and propose a distinctionwhich means that chief executives are doing the right things and leaders are doing it in theright manner. Still Gardener at the same time argues against the idea of separating thesetalents totally from each other as one person may have both.

2 in 1989 in his book On Leadership3 1985, in their book Leaders: Strategies for Taking Charge.


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Gender aspects

Gender aspects will not be focused in this report but is of importance in all studies. There aredifferent gender theories. In the biological theory there are both psychological and biologicaldifferences according to biological and physiological reasons (Dahlstrm, 2007). For thosewho are belonging to the socialconstructionistic theory the assumption is that human beings

themselves are creating, building and constructing the male and female norms and what to callfeministic or masculine (Wahl, Holgersson, Hk & Linghag, 2000). Reports have started todrop in dealing with male and female leaders and in one of them When leaders displayemotion: how followers respond to negative emotional expression of male and femaleleaders (Lewis, 2000) a significant interaction between leader, gender and emotion wasfound. Female leaders received lower effective rating when expressing either sadness or angerwhile male leaders received lower ratings when expressing sadness compared to neutrality.Eagly and Carli (2003) was checking leadership styles and concluded that a female styleought to be more effective under contemporary conditions but prejudices, especially inorganizations with a masculine context made that style to an disadvantage.

Leadership and s tress

To act as a leader or a manager is many times an activity on a very high stress level. In Onthe Brink of Failure (Tyrstrup, 2006) the stressful situation is pointed out. while discussingthe improvising leadership as a working environment issue due to the uncertainties andconfusion around what actually happens. Tyrstrup was interested in the physical as well as the

psychological strain and stress in that context. He focused on adrenalin and cortisol whichtemporarily can increase a persons stress level, which is good, but the same agentsnevertheless can cause illness it they are on a sustained high level and cause cardiovasculardiseases and burnout syndroms. Tyrstrup made contact with researchers closely related to thehealth care for employees at Ericssons who hade performed a study on cortison in saliva

which is very easy to handle (Tyrstrup, 2006, LOOP, 2006). Their report on a simple salivatest for preventing bournouts (Loop, 2006) tells how a test with a follow-up talk withsuggestions on lifestyle changes can prevent unnecessary suffering and lower the high costsfor sick-listings. In a stressed person the cortisol level do not fall which is the normal situationduring the sleep and this also causes sleep disturbances as the cortisol speeds up themetabolism (Ekman & Arnetz, 2005; LOOP, 2006; Sderstrm, 2007). Several differentanalyzes of leaders and managers from a therapeutic point of view are made from different

perspectives according to which psychological approaches the therapists belong to. At theGrubb Institutes approach to Organizational Role Analysis (ORA) (Newton, Long & Sievers,2006) the analyze is focused on how leaders and managers shall be able to find, make andtake up their organizational roles more effectively within their organizational settings. To take

a role eliminates much of the stress related to a personal approach as role-taking is related toones professional role, not to ones person. For most leaders loss of prestige is a nightmare andcauses a very high stress-level which also was the cause of this ORA methodologydevelopment (Newton, Long & Sievers, 2006).

There are many reports on leadership impact of subordinates and groups related to their mood(Sy & Cot, 2005) and psychological well-being (Gilbreath & Benson, 2004). In Emergentleaders as managers of group emotion (Pescosolido, 2002) and The role of affect andaffective congruence in perceptions of leaders (Newcombe & Ashkanasy, 2002) theemotional leader member exchanges are focused. In Impact of leadership style andemotions on subordinate performance (McColl-Kennedy & Andersson, 2002) the positive

effect of transformational leadership style is discussed and pointed out as significant butindirect. Pirola-Merlo, Hrtel, Mann & Hirst (2002) highlights the emotional dimensions of


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teamwork and knowledge work with particular attention to the role of team leadership inHow leaders influence the impact of affective events on team climate and performance inR&D teams. There are reports on leadership and health, but most frequently on thesubjective evaluation from a psychological perspective as The impact of leadership on thehealth of subordinates (Nyberg, Bernin & Theorell, 2005) which is a literature research

including a wide range of different studies. Burnout stressors that are mentioned are jobstrain, lack of social support, low control, conflict at work and that the job is threatened. InLeadership Burnouts (2007) business coaching and chief executive officer leadership

burnout is discussed as employee engagement and long-term improvements in corporateperformance cant be accomplished with a burned out, low energy and low confidenceleadership team.

Biomarkers

What is a biomarker?

The definition of a biomarker according to MedTerm, the Medical Dictionary ofMedicineNet.com, states that a biomarker is a biochemical feature or facet that can be used tomeasure the progress of disease or the effects of treatment. Theorell ( 2001) stated in his

paper Introduction: Biological Markers of Long-Term Effects of Naturally Occuring Stressthat it has become evident that no distinction can be made between psyche and body. accordingly all life situations that arouse the body are reflected to some extent in biologicalchanges.

Biomarkers often used are blood pressure, electrocardiogram (ECG), pulse, saliva and urinetests (Theorell, 2001). Stress and cardiovascular diseases are related and for predicting

cardiovascular diseases Heart Rate Variability (HRV) is the most suitable biomarker, as thereis a signifikant relationship between the autonomic nervous system and cardiovascularmortality including sudden cardiac death (Task Force of the European Society of Cardiologyand The North American Society of Pacing and Electrophysiology, 1996). The autonomicnervous system consists of both the symphatethic and the parasympathetic system and this isan involuntatry system which has to be in balance for keeping up the health. Thesympathetical parasympathetical balance is like the accelerator and the brake pedal for adriver, where the sympathetical drive increases heart beats and blood pressure with theinstinct for fight or flight and the parasympathetical drive relaxes a person and activates therebuilding of the body (The Task Force, 1996). The sympathetical drive is causing a stresssituation within a person and if a person is staying on this level for a longer period deseases

can emerge not only in the cardiovascular system but also in many other organ systems, forexample the digestive system (Ekman & Arnetz, 2005).

Humans are continuously reacting on stimuli from the environments outside as well as insidea person for keeping the total psychophysiological balance for being able to survive. The

physiological biofeedback system which regulates the internal environment in an subject iscalled homeostasis (Organisation of the Nervous System, cited 2007). It is possible toregistrate the autonomous nervous system in many different ways and in this report the focusis laid on HRV. Health informatics combines health care, medicine and information sciences(digital devices, information- and communication systems) and gives new opportunities forresearch in reell and virtual environments. Today HRV can easily be registered in almost any

environement in a mobile online mode with a small device allowing ordinary work which


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offers new possibilities for leadership research and research of subordinates. Not only daytimeregistration is of interest, but also the sleep registration.

HRV, stress and sleep

In a journal ( The Independent, 2006) a report A Cure for Stress? is decribing amethodology with hi-tech relaxation technique for burnt-out executives that is now used bysportsmen on top levels as well as schoolchildren and ordinary people. It is a combination of asmall sensor on the fingertip for recording Heart Rate Variability with breathing deeplyslowly and rhythmically while trying to refresh ones memory of periods with happiness andlove with biofeedback instantly. The subject is reinforced in healthy breathing and thinkingwhile checking the curves of HRV indicated by smoother waves on the computer display aswell as the a higher variability of the heart power when the subject is turning from thesympathetical stress-drive into the healthier relaxing parasympathetical drive. The goal is verysimilar to ordinary relaxation and mediation. The executives noted a brighter mind duringstressful situation as did the pupils, which is explained by breaking and changing the harmful

signals between the heart and the brain. Deep and rhythmic breathing brings theparasymphathetic system back to its baselevel where relaxation and rebuilding takes place andwhere the mind is open and visions take place (A Cure for Stress, The Independent, 2006).

Jobb stress can kill your heart was on WebMD Medical News (2002) and the study wasperformed in Finland. In the same report Greenland who leads the department of preventivemedicine at Chicagos Northwestern University says that still the most risky lifestyle is tosmoke,have high blood pressure and high cholesterol, more important than to reduce thework-strain. Stress markers in Relation to Job Strain in Human Service Organizations(Ohlson, Sderfeldt, Sderfeldt, Jones & Theorell, 2001) is a report analyzing six different

parameters4 along with a questionnaire specially designed to measure emotional demands.The conclusion was that emotional strain during work may cause psychological stressindicated by slightly increased levels of cortisol. Also the sleep is often disturbed by astressful work situations which is written about in Smn and Stress (Ekman & Arnetz,2005; Sderstrm, 2007). Some reports indicate that work stress might disturb the sleep in aserious way and in the end contribute to burn out syndromes (Ekman & Arnetz, 2005;Biologisk frklaring till utmattningsdepression, Dagens Medicin, 2006; Sderstrm, 2007)).Lifestyle factors do also have a great impact of the health (Psykosocial belastning ochriskfaktorer fr hjrt-krlsjukdom, 2001).

Does Work Affect Sleep or Does Sleep Affect Work? was the question in 2005 on

www.ergoweb.com written by the reporter Jeanie Croasman who made a review of MedicalNews Today. The reason was that Senior Researcher Mikko Harma of the Finnish Instituteof Occupational Health, who had studied sleeping disorders for more than 30 years, had foundthat these problems were increasing. He saw a relation between sleeping problems,occupational stress and abnormal working hours. He therefore wanted to have some sort ofeducational programs about the importance of sleep and recovery compared with those forsmoking and alcohol. There is a report in 2006 (Hynynen, Uusitalo, Konttinen &Rusko) onHeart Rate Varaibility during Night Sleep and after Awakening in Overtrained Athleteswith the purpose to check the autonomic balance while also testing the nocturnal urine stresshormones. No differences were found in HRV or stress hormones during the sleep and theywere the same as for the control group but after awakening there was a slight difference in the

4 cortisol, prolactin, thyroid-stimulating hormone (TSH), testosterone, IgA and IgG.


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parasymphatetic cardiac modulation on a somewhat lower level which indicates stress signs.The researchers asks for further investigations concentrating on autonomic responses todifferent challenges, such as awakening. A study on call-on-duty physicians (Malmberg,Persson, Jnsson, Carlsson, Karlsson & rbank, 2005) for catabole processes compared withrecovery only showed slight changes in the Heart Rate Variability indicating stress, but only

skilled persons were studied and further studies are asked for. No changes were found insaliva cortisol. TSH (thyroid stimulating hormone) was dicreased after call-on-duty duringrecovery period but the reason was unclear and the study ought to be reproduced in a largergroup according to the researchers. It might be stress-induced.

Psychosocial strain and risk factors for cardiovascular diseases have been examined in the socalled WOLF-project in Sweden, presented in 2001 (Westerholm). Risk factors analyzed arehypertension, hypercholesterolemia, low HDL5 cholesterol and a high amount of plasmafibrinogen and physical activity. The beneficial effect of physical activity was confirmed.Jobstrain and low control had negative effects on many parameters. ECG and HRV were notrecorded. One Chapter in the WOLF-study is dealing with sleep disturbances as disturbed

sleep can affect the precision at work, and the jobstrain can affect the sleep. It is also notedthat there is amazingly few studies made on the relation between stress and other workenvironmental variables at the one hand and disturbances of the sleep, alertness and sleepinessat the other hand.

On the 4th ICOH Conference on Work Environment and Cardiovascular Diseases with TresTherorell as key note speaker in 2005, an interesting report was presented from the NationalTaiwan University about Elevated Blood Pressure, Decreased Heart Rate Variability andDelayed Recovery after Working on a 12-hour Night Shift (Ta-Chen, Lian-Yu, Wen-Tsan,Yuan-The, Chen-Fong & Jung-Der). They referred to the American Journal of Cardiology(1966;77:681), Circulation (1966;94:2850) and American Journal of Epidemiology(1997,145:696) where HRV was stated as a predictor of Cardiovascular Disease (CVD). Theyalso noted that decreased HRV have been associated with higher work stress and shift work asnoted in the journals Hypertension (200;35:880) and Hypertension Research (2001;24:25)6.The purpose of their own study was the observation that shift work has been associated withincreased risk for CVD, which they also could confirm.

Acute stress affects HRV during sleep says a research team at University of Pittsburg(2004). Their conclusion was that changes in HRV associated with acute stress may representone pathway to disturbed sleep. Stress and anxiety are risk factors for cardiovascular diseaseaccording to another report (Brosschot, Van Dijk, Thayer, 2007) and Daily worry is related

to low HRV during waking and the subsequent nocturnal sleep period. In 2004 Jansson vonVulte defended her doctoral thesis on management development programs targeting femalephysicians. The female physicians were compared with male physicians for checking genderand manager-reported differences on individual and organizational well-being. The female

physicians reported a clearer organizational structure, influence and professionalism but noimprovement in well-being, health or career development.

5 High Density Lipoproteins6 A decrease in HRV is a pathological sign..


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HRV, Organizational changes and stress

Organizational changes are stressful for the executives as well as for the subordinates(Bolman, 1998; Tyrstrup, 2006; Yukl, 1989). A study is made on Work stress and autonomicnervous system function in workers of different age groups during organisational changes byLindholm, Ahlberg, Rantal, Suvinen, Knnen & Nissinen (2001). The aim of the study was

to evaluate the autonomic control of the circulatory system in three different age groups in alarge company during organizational changes (1999-2001). The parameters of ECG, blood

pressure and HRV were recorded. The subjective feelings of stress were increasing duringthese years. The result shows that the autonomic nervous system (analyzed via HRV),contributes in the physiological adaptive process during this period. There is also a difference

between the age groups where increasing age attenuates the regulatory capacity. The aginggroup (50 years) had the most prominent changes in neurocardiological control parametersand this imbalance in the autonomic nervous system gives a loss of functional reserves thataugments the decrease in work ability. These factors predispose for intolerance to changes inthe work, delayed recovery after stress situations, increased risk for cardiovascular morbidityand problems with the health. Here the research team point out the new possibility foroccupational health professionals to use non-invasive techniques that may serve as

physiological indicators of stress adaptation, both in the evaluation of stress reactions inpersonnel and in improvement of stress management. In the report on Effects of Work Stresson Ambulatory Blood Pressure, Heart Rate, and Heart Rate Variability (Vrijkotte, Doornen,de Geus, 2000) the result showed that a stress-ful day also affects the sleeping period wherethe effects of work stress are mediated by increased heart rate reactivity, an increase insystolic blood pressure level and lower vagal tone.

HRV and gender dif ferences

Are there any gender differences in HRV? The answer is yes, and there are several reportsconfirming this statement and one will be mentioned here by Ramaekers, Ector, Aubert,Rubens and Van de Werf (1998). The report on Heart rate variabilility and heart rate inhealthy volunteers is a study of 276 subject (135 women, 141 men). The result is that HRVcardiac autonomic modulation as determined by HRV is significantly lower in healthy womencompared to healthy men. The researchers hypothesize that the results might be explained bylower sympathetic activity which may then provide protection agains heart diseases as thesediseases have been lower for women compared to men. Their subtitle of the report is thereforeIs the female autonomic nervous system cardioprotective?

DiscussionWhen looking for frontiers in leadership research, biomarkers seem to be of highest interest.As psychologists were the first researchers who realized the importance of leadership researchas a science it naturally has been a focus on the qualitative methodology. As the leadershipresearch is a very young discipline from the 20 th century it probably will still take some time

before the physicians and alike will hook on and make quantitative studies. No reports werefound on pure leadership and HRV as key search words but when professionals were includedwho probably had to act as leaders or managers, there were some reports of interest. Heartrate, blood pressure and cortisol in saliva seems to be the most used biomarkers until now butHRV seems to take over more and more because of its great predicting power for identifyingvery early signs of cardiovascular diseases. Until now HRV has not been used for pure

leadership research.


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Many reports confirm that leadership and stress are related as are stress and cardiovasculardiseases. There are also many studies showing that leaders have impact on their subordinatesand also that there is an interchange of emotions. As emotions give responses in theautonomous nervous system, which is an involuntary system, it means that the leader

probably has an impact also on the health of the subordinates. As the autonomous system has

an impact on the Heart Rate Variability reflecting the well-being of the heart it seems to be otinterest to try to make recordings in working environments for analyzing both leaders andtheir subordinates with HRV. At the same time sleeping recordings ought to be done as thework stress negatively influences the sleep where negative changes are visible in HRVrecordings according to some studies. Distinction between HRV-recording during daytimeand sleep has been asked for from some researchers.

The technology for recording and analyzing physiological activities within the body withoutintervention in a mobile and often even online manner, changes the possibilities for addingnew research methods to the older ones. As there is hardly any research made on HRV-

biomarker in leadership research it would be a challenge to use this tiny easy wearable online

HRV device in work environment and sleeping interventions. Probably it would be visibleHRV-changes reflecting the sympathetical parasympathetical balance. If a sustained highstress-level will show up it means that the heart power will be lowered, which is a bad signand can predict cardiovascular disease.

Reports on gender in this review tells that there are significant biological differences betweenmen and women in the HRV analyses. It is interesting that the gender discussion is veryinflamed and there are political correct opinions and not much depending on which countryyou are living in. It seems impossible to deny the biological importance but it is possible todiscuss when and why the changes between the sexes occur. In this review the changes occuralready in healthy women.

Conclusion

There is a need for adding biomarkers to the leadership research. HRV is proposed as amethod with its tiny mobile (online) tool with the potential to predict cardiovascular diseasesin a very early stage for stressed leaders and subordinates in their work environment andduring sleep. There is a demand for further investigations in many of the reports reviewed. Aquestion not discussed here is what correlation could be found between psychological and

physiological datas expressing indications of unhealthy stress-levels within leadershipresearch for sorting out the most efficient and cost-effective ways of predicting cardiovasculardiseases and burnouts.

ReferencesA Cure for Stress? (2006). The Independent, [Cited May 3]. Available at:http://news.independent.co.uk/uk/health_medical/article571540.eceAmelsvoort, L., Schouten, E., Maan, A., Swenne, E. & Kok, F. (2001). Changes in frequenceof premature complexes and heart rate variability related to shift work. Occup. Environn.Med,Vol.58, 678-681.Biologisk frklaring bakom utmattningsdepression. (2006). Tema kvinnohlsa. Dagens

Medicin 25 oct, 20.Bolman L.G; Terrence D.E.. (1997).Reframing Organization. Artistry, Choice and

Leadership. Second Edition. San Francisco: Jossey-Bass Publishers.


14/15


14

Brosschot, J., Van Dijk, E., Thayer, J. 2006). Daily worry is related to low heart ratevariability during waking and the subsequent nocturnal sleep period. Science Direct, vol. 63,39-47.Croasmun, J. ( 2005). Does Work Affect sleep or Does Sleep Affect Work? [Cited March 22]Available at: http://www.ergoweb.com/news/detail.cfm?id=1085

Dahlstrm, A. (2007). Knet sitter i hjrnan. Gteborg: Corpus Gullers.Eagly, A., Carli, L. (2003). The female leadership advantage: An evaluation of the evidence.The Leadership Quarterly, vol. 14, 807-834.Ekman, R., Arnetz, Q. (2005). Stress. Individen Organisatonen Samhllet Molekylerna.Stockholm: Liber.Gilbreath, B., Benson, g. (2004). The contribution of supervisor behaviour to employee

psychological well-being. Work & Stress, Vol. 18, Number 3, 255-266.Grint, K. (1997).Leadership: Classical, Contemporary and Critical Approaches, Oxford:Oxford Press.Hall, M., Vasko, R., Buysse, D., Ombag, H., Chen, Q., Cashmere, D., et al. (2004). AcuteStress Affects Heart Rate Variability During Sleep. Psychosomatic Medicine, Vol. 66, 52-62.

Hynynen, E., Uusitalo, Q., Konttinen, N., Rusko, H. (2006). Heart Rate Variability duringNight Sleep and awakening in overtrained Athletes.Medicine & Science in Sports & Exercise,Vol. 38 (2), 313-317.HRV STRESS Teach Leader. www.emwave.comJansson von Vulte, P. (2004). Physicians Work Environment and Health.[Diss.].Uppsala:Acta Universitatia Upsaliensis.Job Stress Can Kill Your Heart. WebMD Medical News(2002). [Cited March 22]. Availableat: http://www.webmd.com/balance/news/20021017/job-stress-can-kill--your-heartLarsson, G. & Kallenberg, K. (2003).Direkt Ledarskap. Vrnamo: Flth & Hssler.

Med Term. Medical Dictionary of MedicineNet.com [Cited 2007 May 3] Available at:www.medterms.comLeadership Burnout. [Cited 2007 May 3] . Available at:http://coachingtip.blogs.com/coaching_tip/2005/08/leadership_burn.htmlLewis, K. (2000). When leaders display emotion. How followers respond to negativeemotional expression on male and female leaders.Journal of Organizational Behviour, Vol.21, 221-234.Lindholm, H., Savolainen, A., Ahlberg, J., Rantala, M., Savinen, T., Knnen, M., Nissinen,M. (2001). Work stress and autonomic nervous system function in workers of different agegroups during organisational changes. NES 2001 33rd Annual Congress Proceedings.LOOP. Tema. (2006). Vol. 1, 12-15.Organisation of the Nervous System. Kimballs Biology pages. [Cited 2007 May 3]. Avaible

at: http://users.ren.com/jkimball.ma.ultranet/BiologyPages/P/PNS.htmlMc Coll-kennedy., Andersson, R. (2002).Impact of leadership style end emotions onsubordinate performances. The Leadership Quarterly, vol. 13, 545-559.Malmberg, B., Persson, R., Jnsson, B., Carlsson, F., Karlsson, B., rback, P. (2005).

Jourtjnstgring: Pverkan p katabola processer och terhmtning en fltstudie av lkareinom anestesi, ron-nsa-hals- och barnsjukvrd. Yrkes-och miljmedicinklin.universitetssjukhuset Lund & Arbejdsmiljoinstitutet, Copenhagen.

Newton, J., Long, S. & Sievers, B. (2006). Coaching in Depth. The Organizational RoleAnalysis Approach. London: Karnac.Nyberg, A., Bernin, P., Theorell, T. (2005). The impact of leadership on the health ofsubordinates. SALTSA joint programme for working life research in Europe. Report 1:2005.

The National Institute for Working Life and the Swedish Trade Union in Co-operation.


15/15


15

Newcombe, M., Aschkanasy, N. (2002). The role of affect and affective congruence inperseptions of leaders: an experimental study. The Leadership Quaterly, vol. 13, 601-614.Ohlson, C-G., Sderfeldt, M., Sderfeld, B., Jones, I., Theorell, T. (2001). Stress Markers inRelation to Job Strain in Human Service organizations. Psychotherapy and Psychosomatics,Vol. 70, No. 5, 268-275.

Pescosolido, A. (2002). Emergent leaders as managers of group emotion. The LeadershipQuarterly, 13, 583-599.Pirola-Merlo, A.,Hrtel, C., Mann, L., Hirst, G. (2002). How leaders influence the impact ofaffective events on team climate and performance in R&D teams. The Leadership Quarterly,vol. 13, 561-181.Ramaekers, d., Ector, H., Aubert, E., Rybens, A., Van de Werf, F. (1998). Heart ratevariability and heart rate in healthy volunteers.European Heart Journal, 19, 1334-1341.Sy,T., Cot, S. & Saavedra,R. (2005). The Contagious Leader: Impact of the Leaderss Moodon the Mood of Group members, Group Tone and Group Processes.Journal of

AppliedPpsychology, 90, 295-305.Sderstrm, M. (2007). Smn. Falun: Skandia Book.

Task Force of The European society of Cardiology and The North American society of Pacingand Electrophysiology.(1996). Guidelines: Heart Rate Variability. Standards ofmeasurements, physiological interpretation and clinical use.European Heart Journal, vol. 17,354-381.Theorell, T. (2001).Everyday Biological Stress Mechanisms.Advances in Psychosomatic

Medicine. Ed. T.N. WISE, Vol. 22.Basel: Karger.Theorell, T. (ed). (2001). Introduction: Biological Markers of Long-Term Effects of naturallyoccurring Stress.Everyday Biological Stress Mechanisms. Adv. Psychosom Med. Basel.Karger, vol. 22, 1-6.Tyrstrup, M. (2005). Sovereigns of Time: A Scandinavian View of executive Work, Time and

Leadership. Lund: Studentlitteratur.Tyrstrup, M. (2006). On the Brink of Failure: te Art of Impromptu Action in Everyday

Leadership. Lund: Studentlitteratur.Ta-Chen Su, Lian-Yu L, Wen-Tsan H, Yuan-Teh L, Chen-Fong C, Jung-Der W. ElevatedBlood Pressure, Decreased Heart Rate Variability and Delayed Recovery after Working on a12-hour Night shift. [Cited 2007 May 3]. Available from:http://www.google.com/search?hl=en&q=ta-chen+lian-yu+elevated+blood+pressureThe Independent, on Sunday. Hunter Kane powered by HeartMath. 28 May, 2006.Wahl, A., Holgersson, C., Hk, P., Linghag, S. (2001).Det ordnar sig. Teorier omorganisation och kn. Lund: Studentlitteratur.Westerholm, P. (2001). Psykosocial belastning och riskfaktorer fr hjrt-krlsjukdom.

Minisymposium i WOLF-projektet 8 februari 2001.Arbete och hlsa. Vetenskaplig skriftserieNr. 2002:7. ISBN 91-7045-641-0. Swedish National Institute for Working Life.Vtijkotte, T., Doornen, L., de Geus E. (2000). Effects of Work Stress on ambulatory BloodPressure, Heart Rate and Heart Rate Variability.Hypertension,35, 880.Yukl, G. (1989). Managerial Leadership: A Review of Theory and Research.Journal ofmanagement, Vol. 15 Issue 2, 251.

a review of biomarkers in leadership research

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