EmotionEmotional Stressal Stress

and its and its

consequenceconsequencess

► Photographs Photographs of Hans Selye of Hans Selye at work in at work in 1951, at his 1951, at his International International Institute of Institute of Experimental Experimental Medicine and Medicine and Surgery at Surgery at the the University of University of MontrealMontreal

Three Views of StressThree Views of Stress► Focus on the environment: stress as a stimulus (stressors) (The Focus on the environment: stress as a stimulus (stressors) (The

SRRS)SRRS)► Reaction to stress: stress as a response (distress) (F/F)Reaction to stress: stress as a response (distress) (F/F)► Relationship between person and the environment: stress as an Relationship between person and the environment: stress as an

interaction (coping)interaction (coping)► Fight or Flight Response and its physiological consequences: Fight or Flight Response and its physiological consequences:

IncreaseIncrease in in Epinephrine & Cortisol, Heart rate & blood pressure, Epinephrine & Cortisol, Heart rate & blood pressure, Levels & mobilization of free fatty acids, cholesterol etcLevels & mobilization of free fatty acids, cholesterol etc

► Selye’s General Adaptation Syndrome (1956, 1976, 1985)Selye’s General Adaptation Syndrome (1956, 1976, 1985)

Alarm Reaction Fight or flight

Exhaustion Limited physical resources; resistance to disease collapses; Disease/death

Resistance Arousal high as body tries todefend and adapt.

Perceived Stressor

Cognitive Model of Stress Cognitive Model of Stress (Lazarus & Folkma)(Lazarus & Folkma)

► Potential stressor (external event) Potential stressor (external event) ► Primary appraisal – is this event positive, neutral Primary appraisal – is this event positive, neutral

or negative; and if negative, how bad? or negative; and if negative, how bad? ► Secondary appraisal – do I have resources or skills Secondary appraisal – do I have resources or skills

to handle event? If No, then to handle event? If No, then distressdistress..► Primary appraisalPrimary appraisal – Is there a potential threat? – Is there a potential threat? ► Outcome – Is it irrelevant, good, or stressful? Outcome – Is it irrelevant, good, or stressful?

If stressful, evaluate further: If stressful, evaluate further: Harm-loss – amount of damage already caused. Harm-loss – amount of damage already caused. Threat – expectation for future harm. Threat – expectation for future harm. Challenge – opportunity to achieve growth, etcChallenge – opportunity to achieve growth, etc

Stress CausesStress Causes

The following are risk The following are risk factors for factors for uncontrollable stress: uncontrollable stress:

► Social and financial Social and financial problemsproblems

►Medical illnessMedical illness► Lack of social supportLack of social support► Family historyFamily history

Affecting the inner emotionsAffecting the inner emotions

Stress usually first affects the inner Stress usually first affects the inner emotions. Initial symptoms may emotions. Initial symptoms may include the following feelings:include the following feelings:

►AnxiousnessAnxiousness►NervousnessNervousness►DistractionDistraction►Excessive worryExcessive worry► Internal pressureInternal pressure

Affecting a person's outward Affecting a person's outward appearanceappearance

These emotional These emotional states can then states can then begin to affect a begin to affect a person's outward person's outward appearance:appearance:

► Unusually anxious Unusually anxious or nervousor nervous

►DistractedDistracted► Self-absorbedSelf-absorbed► IrritableIrritable

Emotional or physical effectsEmotional or physical effects Excessive fatigueExcessive fatigue DepressionDepression Sometimes even think of hurting yourself or othersSometimes even think of hurting yourself or others HeadachesHeadaches NauseaNausea andand vomitingvomiting DiarrheaDiarrhea Chest pain or pressureChest pain or pressure Heart racingHeart racing Dizziness or flushingDizziness or flushing Tremulousness or restlessnessTremulousness or restlessness Hyperventilation or choking sensationHyperventilation or choking sensation

► In most cases, these symptoms are very minor and In most cases, these symptoms are very minor and don’t last very long. If they become more severe or don’t last very long. If they become more severe or increase in frequency and severity, seek medical increase in frequency and severity, seek medical help.help.

Relationship Between Stress and PerformanceRelationship Between Stress and Performance

Exams and TestsExams and Tests

► Many times, a careful interview can be the best Many times, a careful interview can be the best source of information about the cause of patient’s source of information about the cause of patient’s symptoms. It is extremely important to describe any symptoms. It is extremely important to describe any situations that you think might be causing patient’s situations that you think might be causing patient’s problems or making them worse.problems or making them worse.

► The doctor then performs a physical exam that is The doctor then performs a physical exam that is focused on the symptoms you have described.focused on the symptoms you have described.

► Lab tests or other diagnostic tests such as an Lab tests or other diagnostic tests such as an ECGECG (a (a heart tracing) may be needed to completely rule out heart tracing) may be needed to completely rule out an underlying physical cause for these symptoms.an underlying physical cause for these symptoms.

► If these tests and doctor’s exam findings are normal, If these tests and doctor’s exam findings are normal, the doctor may consult other specialists for further the doctor may consult other specialists for further evaluation and treatment of patient’s condition.evaluation and treatment of patient’s condition.

High Threat High Threat Low Resources Low Resources High DemandsHigh Demands High Stress High Stress

High Threat High Threat High Resources High Resources High/low High/low demands demands

Moderate Moderate StressStress

Low Threat Low Threat Low Resources Low Resources Low demands Low demands Some StressSome Stress

Low Threat Low Threat High Resources High Resources Low demands Low demands Low/No StressLow/No Stress

Secondary appraisalSecondary appraisal ► Situational Factors Affecting Stress AppraisalsSituational Factors Affecting Stress Appraisals► Strong demands Strong demands ► Life transition,Timing Life transition,Timing ► Ambiguity – role or harm ambiguity Ambiguity – role or harm ambiguity ►Desirability, Controllability, Cognitive control – Desirability, Controllability, Cognitive control –

using a mental strategyusing a mental strategy► Learned Helplessness – Seligman, Peterson, et Learned Helplessness – Seligman, Peterson, et

al.al.► Sources of Occupational Stress:Sources of Occupational Stress:

Role OverloadRole Overload Role AmbiguityRole Ambiguity Role ConflictRole Conflict Little Control over WorkLittle Control over Work Sexual, Gender or Ethnic HarassmentSexual, Gender or Ethnic Harassment Helping ProfessionsHelping Professions

Intensity of stressIntensity of stress

► Everyone is familiar with Everyone is familiar with stressstress. We . We experience it in varying forms and degrees experience it in varying forms and degrees every day. In small doses, stress can every day. In small doses, stress can actually be beneficial to us. It is only when actually be beneficial to us. It is only when the stress becomes too great, affecting our the stress becomes too great, affecting our physical or mental functioning, that it physical or mental functioning, that it becomes a problem. becomes a problem.

► In small doses, stressors can help give us In small doses, stressors can help give us increased energy and alertness, even increased energy and alertness, even helping to keep us focused on the problem helping to keep us focused on the problem at hand. This type of stress is good. People at hand. This type of stress is good. People may refer to the experience of this type of may refer to the experience of this type of stress as feeling "pumped" or "wired."stress as feeling "pumped" or "wired."

Individual reaction to stressIndividual reaction to stress► As the level of pressure gets too great, stress As the level of pressure gets too great, stress

eventually surpasses our ability to cope with it in a eventually surpasses our ability to cope with it in a positive way. Often, people describe themselves as positive way. Often, people describe themselves as being stressed out, burned out, or at wits end. At being stressed out, burned out, or at wits end. At this point, it is important to find positive and this point, it is important to find positive and productive ways to deal with the stress and, more productive ways to deal with the stress and, more importantly, to address the person or situation that importantly, to address the person or situation that is causing the stress.is causing the stress.

► Everyone reacts to stress differently. Each of us Everyone reacts to stress differently. Each of us has a different level of pressure and has a different level of pressure and anxietyanxiety that that we can handle without a bad outcome. Only you we can handle without a bad outcome. Only you can assess your level of tolerance to stressful can assess your level of tolerance to stressful situations. The best treatment for stress is to situations. The best treatment for stress is to prevent getting into situations that are likely to prevent getting into situations that are likely to overwhelm your ability to cope. This is not always overwhelm your ability to cope. This is not always possible because the stressors may often come possible because the stressors may often come from outside sources that are beyond your control.from outside sources that are beyond your control.

Biopsychosocial Aspect of StressBiopsychosocial Aspect of Stress How stress affects healthHow stress affects health► Via behaviour Via behaviour

Increased alcohol Increased alcohol Smoking Smoking Increased caffeine Increased caffeine Poor diet Poor diet Inattention leading to carelessnessInattention leading to carelessness Psychological Effects: Psychological Effects: Irritability, Insomnia, Changes in Irritability, Insomnia, Changes in

appetite or sleep, Anger, Depression, PTSD, Anxiety, appetite or sleep, Anger, Depression, PTSD, Anxiety, BurnoutBurnout

► Via physiology Via physiology Cardiovascular reactivity – e.g., increased blood Cardiovascular reactivity – e.g., increased blood

pressure, pressure, Endocrine reactivity – increased catecholamine and Endocrine reactivity – increased catecholamine and

corticosteroidscorticosteroids Digestive system – e.g., ulcers, irritable bowel syndromeDigestive system – e.g., ulcers, irritable bowel syndrome Respiratory system – e.g., asthma Respiratory system – e.g., asthma Immune reactivity – increased hormones impairs Immune reactivity – increased hormones impairs

immune functionimmune function

When to Seek Medical When to Seek Medical CareCare

Recommendations for patients:Recommendations for patients: If, in conjunction with your friends, family, or If, in conjunction with your friends, family, or

spiritual advisers, you cannot identify a source or spiritual advisers, you cannot identify a source or solution for your anxiety and stress. solution for your anxiety and stress.

A physical problem may be causing your A physical problem may be causing your symptoms. There may be a hidden cause symptoms. There may be a hidden cause that requires the assistance of a counselor to help that requires the assistance of a counselor to help uncover. uncover.

You should never be embarrassed about your You should never be embarrassed about your situation or the fact that you are seeking help. situation or the fact that you are seeking help.

Remember, the sooner you get help, the sooner Remember, the sooner you get help, the sooner you will feel better. you will feel better.

Urgent help requiredUrgent help required

Patient should call 911 or go to the nearest Patient should call 911 or go to the nearest hospital’s emergency department if your hospital’s emergency department if your stress is resulting in any of these symptoms: stress is resulting in any of these symptoms:

► Thoughts about harming yourself Thoughts about harming yourself ► Thoughts about harming others Thoughts about harming others ► Chest pain Chest pain ► Fluttering or rapid heartbeats Fluttering or rapid heartbeats ►Headaches unlike usual headaches Headaches unlike usual headaches ► Any condition that he feels might cause his Any condition that he feels might cause his

serious harm if not treated immediately serious harm if not treated immediately

MODERATOR and MODIFIER of STRESS:MODERATOR and MODIFIER of STRESS:

► 1) 1) COPINGCOPING: : Process of managing the Process of managing the discrepancy between the demands of the discrepancy between the demands of the situation and the available resources. situation and the available resources. Ongoing process of appraisal and Ongoing process of appraisal and reappraisal (not static) Can alter the stress reappraisal (not static) Can alter the stress problem OR regulate the emotional problem OR regulate the emotional response.response.

► 2) 2) PERSONALITYPERSONALITY: : Personality factors that Personality factors that influence how one responds to stress.influence how one responds to stress.

► 3) 3) Social SupportSocial Support

Personality factors that influence how Personality factors that influence how one responds to stressone responds to stress

► Coping Style Coping Style ► Negative affectivity Negative affectivity ► Pessimism – optimism Pessimism – optimism ► Hardiness Hardiness ► Negative affectivity is a pervasive negative mood marked Negative affectivity is a pervasive negative mood marked

by anxiety, depression a,d hostility. High negative by anxiety, depression a,d hostility. High negative affectivity is associated with greater distress, more affectivity is associated with greater distress, more drinking, more likely to be depressed, poorer health, drinking, more likely to be depressed, poorer health, greater reports of physical symptoms, and they are more greater reports of physical symptoms, and they are more likely to commit suicide.likely to commit suicide.

► Pessimism-optimism – Seligman’s ASQ – pessimists more Pessimism-optimism – Seligman’s ASQ – pessimists more likely to attribute negative events in their lives to internal likely to attribute negative events in their lives to internal (someone wrong with me), stable (never gong to change), (someone wrong with me), stable (never gong to change), and global (effects all aspects of my life) qualities. and global (effects all aspects of my life) qualities.

► Pessimists generally associated with poorer health and Pessimists generally associated with poorer health and premature mortality.premature mortality.

► Optimists on the other hand have better health, engage in Optimists on the other hand have better health, engage in more effective coping strategies, and are more likely to more effective coping strategies, and are more likely to engage in slef-management health care practices. Scheirer engage in slef-management health care practices. Scheirer and Carver’s work with optimism-pessimism.and Carver’s work with optimism-pessimism.

Personality factors that influence how Personality factors that influence how one responds to stressone responds to stress

► HardinessHardiness is another psychosocial modifier of is another psychosocial modifier of stress. Hardy individuals have a strong sense of stress. Hardy individuals have a strong sense of

► CControlontrol, , internal locus of control,internal locus of control,► CCommitmentommitment, , (tendency to get involved fully), (tendency to get involved fully), andand► CChallengehallenge; ; (willingness to undertake change and (willingness to undertake change and

to confront new activities that represent to confront new activities that represent opportunities for growth). opportunities for growth).

► They tend to remain healthier when under stress They tend to remain healthier when under stress than individuals who are less hardy.than individuals who are less hardy.

► The effects of hardiness, social support, and The effects of hardiness, social support, and exercise (or exercise (or Health-RelatedHealth-Related BehaviorBehavior) , appear to ) , appear to add to each other in protecting people from illness.add to each other in protecting people from illness.

► Other personal Factors Affecting Stress AppraisalOther personal Factors Affecting Stress Appraisal► Intellectual, Motivational, Beliefs systemIntellectual, Motivational, Beliefs system

Personality factors that influence how Personality factors that influence how one responds to stressone responds to stress

► The The Type AType A behavior pattern consists of three behavior pattern consists of three characteristics: characteristics: CompetitiveCompetitive achievement achievement orientationorientation, , Time UrgencyTime Urgency, and , and Anger or Anger or HostilityHostility. . associated with increased risk of heart associated with increased risk of heart disease which may have disease which may have more to do with more to do with hostilityhostility

► Type B Personality Relaxed, patient, Type B Personality Relaxed, patient, easygoing, friendlyeasygoing, friendly

► – – Type C Cooperative, unassertive, inexpressive of Type C Cooperative, unassertive, inexpressive of negative emotions (suppression), compliance:negative emotions (suppression), compliance:

► Risk for developing cancer ?Risk for developing cancer ?► Growth of tumoursGrowth of tumours

Social SupportSocial Support► Emotional support – expression of empathy, Emotional support – expression of empathy,

understanding, caring, etc. Esteem support – positive understanding, caring, etc. Esteem support – positive regard, encouragement, validating self-worth. Tangible or regard, encouragement, validating self-worth. Tangible or instrumental – lending a helpful hand. Information instrumental – lending a helpful hand. Information support – providing information, new insights, advice. support – providing information, new insights, advice. Network support – feeling of belongingNetwork support – feeling of belonging

► Note that not all social support is necessarily beneficial to Note that not all social support is necessarily beneficial to health. In one study it was found that while participating health. In one study it was found that while participating in pleasurable social activities was associated with a in pleasurable social activities was associated with a lower risk of premature mortality following an acute lower risk of premature mortality following an acute myocardial infarction, larger sized social networks was myocardial infarction, larger sized social networks was associated with a higher mortality risk (CAMIAT study).associated with a higher mortality risk (CAMIAT study).

► Note that social support can also be a source of stress Note that social support can also be a source of stress when supporters don’t provide the kind of support we when supporters don’t provide the kind of support we need (e.g., not empathic, keep offering unrealistic need (e.g., not empathic, keep offering unrealistic suggestions for what the person can achieve). Generally suggestions for what the person can achieve). Generally Social Support Associated with Good Effects. Increase Social Support Associated with Good Effects. Increase survival rates in women who have breast cancer. Lower survival rates in women who have breast cancer. Lower blood pressure. Decrease risk of mortality.blood pressure. Decrease risk of mortality.

PreventionPrevention

► Set realistic goals and limits for yourself. Set realistic goals and limits for yourself. ► Put things into perspective and try not to get upset Put things into perspective and try not to get upset

about insignificant or relatively unimportant about insignificant or relatively unimportant matters. matters.

► Take stress, time management, or anger Take stress, time management, or anger management classes. management classes.

► Find activities that you enjoy and set aside time to Find activities that you enjoy and set aside time to participate in them on a regular basis. participate in them on a regular basis.

► Participate in regular physical exercise. Participate in regular physical exercise. ► Maintain a positive outlook. Maintain a positive outlook. ► Set goals and break them into easily achievable Set goals and break them into easily achievable

tasks. tasks. ► Reward yourself for the good things that you do Reward yourself for the good things that you do

each day. each day.

Why is there more stress Why is there more stress today?today?

► Americans perceive they are under much more stress Americans perceive they are under much more stress than a decade or two ago. A 1996 than a decade or two ago. A 1996 PreventionPrevention magazine magazine survey found that almost 75% feel they have "great survey found that almost 75% feel they have "great stress" one day a week with one out of three indicating stress" one day a week with one out of three indicating they feel this way more than twice a week. In the same they feel this way more than twice a week. In the same 1983 survey only 55% said they felt under great stress 1983 survey only 55% said they felt under great stress on a weekly basis. It has been estimated that 75 - 90 on a weekly basis. It has been estimated that 75 - 90 percent of all visits to primary care physicians are for percent of all visits to primary care physicians are for stress related problems. stress related problems.

► Job StressJob Stress is far and away the leading source of stress is far and away the leading source of stress for adults but stress levels have also escalated in for adults but stress levels have also escalated in children, teenagers, college students and the elderly for children, teenagers, college students and the elderly for other reasons, including: increased crime, violence and other reasons, including: increased crime, violence and other threats to personal safety; pernicious peer other threats to personal safety; pernicious peer pressures that lead to substance abuse and other pressures that lead to substance abuse and other unhealthy life style habits; social isolation and unhealthy life style habits; social isolation and loneliness; the erosion of family and religious values loneliness; the erosion of family and religious values and ties; the loss of other strong sources of social and ties; the loss of other strong sources of social support that are powerful stress busters. support that are powerful stress busters.

To view "To view "WORKING WITH STRESSWORKING WITH STRESS" online " online (streaming video) or to download a Flash video (streaming video) or to download a Flash video

version version click here.click here. http://http://www.cdc.gov/niosh/docs/videowww.cdc.gov/niosh/docs/video//

Job StressJob Stress► Numerous surveys and studies confirm that occupational Numerous surveys and studies confirm that occupational

pressures and fears are far and away the leading source pressures and fears are far and away the leading source of stress for American adults and that these have steadily of stress for American adults and that these have steadily increased over the past few decades. While there are increased over the past few decades. While there are tons of statistics to support these allegations, how tons of statistics to support these allegations, how significant they are depends on such things as how the significant they are depends on such things as how the information was obtained (self-report vs. answers to information was obtained (self-report vs. answers to carefully worded questions), the size and demographics carefully worded questions), the size and demographics of the targeted group, how participants were selected of the targeted group, how participants were selected and who sponsored the study. and who sponsored the study.

► Some self-serving polls claiming that a particular Some self-serving polls claiming that a particular occupation is "the most stressful" are conducted by occupation is "the most stressful" are conducted by unions or organizations in a attempt to get higher wages unions or organizations in a attempt to get higher wages or better benefits for their members. Others may be or better benefits for their members. Others may be conducted to promote a product, such as the "Stress In conducted to promote a product, such as the "Stress In the Nineties" survey by the maker of a deodorant that the Nineties" survey by the maker of a deodorant that found housewives were under more stress than the CEO's found housewives were under more stress than the CEO's of major corporations. Such a conclusion might be of major corporations. Such a conclusion might be anticipated from telephone calls to residential phones anticipated from telephone calls to residential phones conducted in the afternoon. It is crucial to keep all these conducted in the afternoon. It is crucial to keep all these caveats in mind when evaluating job stress statistics. caveats in mind when evaluating job stress statistics.

The The NIOSHNIOSH report on the right is an report on the right is an excellent resource that cites the excellent resource that cites the

following:following: ► 40% of workers reported their job was very or 40% of workers reported their job was very or

extremely stressful;extremely stressful;► 25% view their jobs as the number one stressor 25% view their jobs as the number one stressor

in their lives;in their lives;► Three fourths of employees believe that Three fourths of employees believe that

workers have more on-the-job stress than a workers have more on-the-job stress than a generation ago;generation ago;

► 29% of workers felt quite a bit or extremely 29% of workers felt quite a bit or extremely stressed at work;stressed at work;

► 26 percent of workers said they were "often or 26 percent of workers said they were "often or very often burned out or stressed by their very often burned out or stressed by their work";work";

► Job stress is more strongly associated with Job stress is more strongly associated with health complaints than financial or family health complaints than financial or family problems.problems.

More recently, the 2000 annual "More recently, the 2000 annual "Attitudes In Attitudes In The American Workplace VIThe American Workplace VI" Gallup Poll " Gallup Poll sponsored by the Marlin Company found that:sponsored by the Marlin Company found that:

► 80% of workers feel stress on the job, nearly half 80% of workers feel stress on the job, nearly half say they need help in learning how to manage say they need help in learning how to manage stress and 42% say their coworkers need such stress and 42% say their coworkers need such help; help;

► 14% of respondents had felt like striking a 14% of respondents had felt like striking a coworker in the past year, but didn't; coworker in the past year, but didn't;

► 25% have felt like screaming or shouting because 25% have felt like screaming or shouting because of job stress, 10% are concerned about an of job stress, 10% are concerned about an individual at work they fear could become violent; individual at work they fear could become violent;

► 9% are aware of an assault or violent act in their 9% are aware of an assault or violent act in their workplace and 18% had experienced some sort of workplace and 18% had experienced some sort of threat or verbal intimidation in the past year. threat or verbal intimidation in the past year.

2000 Integra Survey2000 Integra Survey similarly reported that: similarly reported that:

► 65% of workers said that workplace stress had 65% of workers said that workplace stress had caused difficulties and more than 10 percent caused difficulties and more than 10 percent described these as having major effects; described these as having major effects;

► 10% said they work in an atmosphere where 10% said they work in an atmosphere where physical violence has occurred because of job physical violence has occurred because of job stress and in this group, 42% report that yelling stress and in this group, 42% report that yelling and other verbal abuse is common; and other verbal abuse is common;

► 29% had yelled at co-workers because of workplace 29% had yelled at co-workers because of workplace stress, 14% said they work where machinery or stress, 14% said they work where machinery or equipment has been damaged because of equipment has been damaged because of workplace rage and 2% admitted that they had workplace rage and 2% admitted that they had actually personally struck someone; actually personally struck someone;

► 19% or almost one in five respondents had quit a 19% or almost one in five respondents had quit a previous position because of job stress and nearly previous position because of job stress and nearly one in four have been driven to tears because of one in four have been driven to tears because of workplace stress; workplace stress;

► 62% routinely find that 62% routinely find that they end the day with they end the day with work-related neck pain, work-related neck pain, 44% reported stressed-44% reported stressed-out eyes, 38% complained out eyes, 38% complained of hurting hands and 34% of hurting hands and 34% reported difficulty in reported difficulty in sleeping because they sleeping because they were too stressed-out; were too stressed-out;

► 12% had called in sick 12% had called in sick because of job stress; because of job stress;

► Over half said they often Over half said they often spend 12-hour days on spend 12-hour days on work related duties and work related duties and an equal number an equal number frequently skip lunch frequently skip lunch because of the stress of because of the stress of job demands. job demands.

From a wood engraving From a wood engraving "The Light" by Fritz "The Light" by Fritz

EichenbergEichenberg

► To read the 2001 To read the 2001 ""Attitudes in the Attitudes in the American American Workplace VIIWorkplace VII" " report and take a report and take a quick "Workplace quick "Workplace Stress" quiz Stress" quiz created by the created by the Marlin Company Marlin Company and The American and The American Institute of Stress Institute of Stress Click HereClick Here

Violence has become an increasingly Violence has become an increasingly serious problemserious problem

► According to two studies the United States has the According to two studies the United States has the dubious distinction of having the highest violent crime dubious distinction of having the highest violent crime rate of any industrialized nation. An average of 20 rate of any industrialized nation. An average of 20 workers are murdered each week in the U. S. making workers are murdered each week in the U. S. making homicide the second highest cause of workplace homicide the second highest cause of workplace deaths and the leading one for females. 18,000 non-deaths and the leading one for females. 18,000 non-fatal violent crimes such as sexual and other assaults fatal violent crimes such as sexual and other assaults also occur each week while the victim is working, or also occur each week while the victim is working, or about a million a year. about a million a year.

► The figures are probably higher since many are not The figures are probably higher since many are not reported. Certain dangerous occupations like police reported. Certain dangerous occupations like police officers and cab drivers understandably have higher officers and cab drivers understandably have higher rates of homicide and non-fatal assaults. rates of homicide and non-fatal assaults. Nevertheless, postal workers who work in a safe Nevertheless, postal workers who work in a safe environment have experienced so many fatalities due environment have experienced so many fatalities due to job stress that "going postal" has crept into our to job stress that "going postal" has crept into our language. "Desk rage" and "phone rage" have also language. "Desk rage" and "phone rage" have also become increasingly common terms.become increasingly common terms.

Absenteeism due to job stress has Absenteeism due to job stress has escalatedescalated

► According to a survey of 800,000 workers in over 300 According to a survey of 800,000 workers in over 300 companies, the number of employees calling in sick companies, the number of employees calling in sick because of stress tripled from 1996 to 2000. An because of stress tripled from 1996 to 2000. An estimated 1 million workers are absent every day due estimated 1 million workers are absent every day due to stress. The European Agency for Safety and Health at to stress. The European Agency for Safety and Health at Work reported that over half of the 550 million working Work reported that over half of the 550 million working days lost annually in the U.S. from absenteeism are days lost annually in the U.S. from absenteeism are stress related and that one in five of all last minute no-stress related and that one in five of all last minute no-shows are due to job stress. If this occurs in key shows are due to job stress. If this occurs in key employees it can have a domino effect that spreads employees it can have a domino effect that spreads down the line to disrupt scheduled operations. down the line to disrupt scheduled operations.

► Unanticipated absenteeism is estimated to cost Unanticipated absenteeism is estimated to cost American companies $602.00/worker/year and the American companies $602.00/worker/year and the price tag for large employers could approach $3.5 price tag for large employers could approach $3.5 million annually. A 1997 three year study conducted by million annually. A 1997 three year study conducted by one large corporation found that 60% of employee one large corporation found that 60% of employee absences could be traced to psychological problems absences could be traced to psychological problems that were due to job stress.that were due to job stress.