Table Of ContentBREAKDOWN IN HUMAN ADAPTATION TO 'STRESS' VOLUME I
BREAKDOWN IN HUMAN ADAPTATION
TO 'STRESS'
Towards a multidisciplinary approach
VOLUME I
Part 1: Psychological and sociological parameters for studies of
breakdown in human adaptation
J. Cullen and J. Siegrist (editors)
Part 2: Human performance and breakdown in adaptation
H.M. Wegmann (editor)
VOLUME II
Part 3: Psychoneuroimmunology and breakdown in adaptation:
interactions within the central nervous system, the im
mune and endocrine systems
R.E. Ballieux (editor)
Part 4: Breakdown in human adaptation and gastrointestinal
dysfunction: clinical, biochemical and psychobiological
aspects
J.F. Fielding (editor)
Part 5: Acute effect of psychological stress on the cardiovas
cular system: Models and clinical assessment
A. L'Abbate (editor)
Compendium of papers presented in workshops sponsored by the Commis
sion of the European Communities as advised by the Committee on Medical
and Public Health Research. (Dublin, Ireland (Dec. 1982), Utrecht, the
Netherlands (Dec. 1982), Koln, FRG (Jan. 1983), Bad Homburg, FRG (Feb.
1983), Dublin, Ireland (March 1983) and Pisa, Italy (April, 1983))
BREAKDOWN IN HUMAN
ADAPTATION TO 'STRESS'
Towards a multidisciplinary approach
VOLUME I
Part 1: Psychological and sociological parameters for studies of
breakdown in human adaptation
J. Cullen and J. Siegrist (editors)
Health Care and Psychosomatic Unit, Dublin, Ireland
Dept. of Medical Sociology, University of Marburg, Marburg,
Federal Republic of Germany
Part 2: Human performance and breakdown in adaptation
H.M. Wegmann (editor)
Institute of Aerospace Medicine, Cologne, Federal Republic of
Germany
1984 MARTINUS NIJHOFF PUBLISHERS ....
1111
a member of the KLUWER ACADEMIC PUBLISHERS GROUP
BOSTON I THE HAGUE I DORDRECHT I LANCASTER .'1IIIIIIII
for
THE COMMISSION OF THE EUROPEAN COMMUNITIES
Distributors
for the United States and Canada: Kluwer Boston, Inc., 190 Old Derby Street,
Hingham, MA 02043, USA
for all other countries: Kluwer Academic Publishers Group, Distribution Center,
P.O.Box 322, 3300 AH Dordrecht, The Netherlands
Library of Congress Cataloging in Publication Data
Main entry under title:
Breakdown in human adaptation to "stress."
"Compendium of papers presented in workshops
sponsored by the Commission of the European Communi ties
as advised by the Cammi ttee on Medical and Public Health
Research. (Dublin, Ireland (Dec. 1982), Utrecht, the
Netherlands (Dec. 1982), Kaln, FRG (Jan. 1983), Bad
Hamberg, FRG (Feb. 1983), Dublin, Ireland (March 1983),
and Pisa, Italy (April 1983»"
Vol. 2. edi te:d by R. E. Ballieux, J. F. Fielding, and
A. L'Abbate.
Contents: v. 1. pt. 1. Psychological and sociological
parameters for studies of breakdown in human adaptation /
J. Cullen and J. Siegrist, editors. pt. 2. Human perform
ance and breakdown in adaptation / H.M. Wegmann, editor
-- v. 2. pt. 3. Psychonenroimmunology and breakdown in
adaptation / R.E. Ballieux, editor -- [etc.]
1. Medicine, Psychosomatic--Addresses, essays, lectures.
2. Adaptation (Physiology)--Addresses, essays, lectures.
3. Stress (PsYChology)--Addresses, essays, lectures.
I. Cullen, John H. II. Ballieux, R.E. III. Commission
of the European Communi ties. IV. Commission of the
European Communi ties. Committee on Medical and Public
Health Research. [DNLM: 1. Stress, Psychological-
Complications--Congresses. 2. Adaptation, Psychological
--Congresses. 3. Disease--Etiology--Congresses. WM 172
B828 1982-82]
Rc49.B727 1983 616.08 83-19333
ISBN-13: 978-94-010-7974-7 e-ISBN-13: 978-94-009-3283-8
DOl: 10.1007/978-94-009-3283-8
Book information
Publication arranged by: Commission of the European Communities, Direc
torate-General Information Market and Innovation, Luxembourg
Copyright/legal notice
© 1984 by ECSC, EEC, EAEC, Brussels-Luxembourg.
Softcover reprint of the hardcover 1st edition 1984
All rights reserved. No part of this publication may be reproduced, stored in a
retrieval system, or transmitted in any form or by any means, mechanical,
photocopying, recording, or otherwise, without prior written permission of the
publishers,
Martinus Nijhoff Publishers, 190 Old Derby Street, Hingham, MA 02043, USA.
Neither the Commission of the European Communities nor any person acting on
behalf of the Commission is responsible for the use which might be made of the
following information.
v
PREFACE
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's 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.
An area of the Commission of the European Communi ties mul tiannual
coordination programme in Medical and Public Health research considers
"breakdown in human adaptation" occurring when facing the industrial
life style in countries of the European Community or a too rapid change
of the urban/industrial environment. The problem is of great economic
importance from the points of view of industrial productivity, movement
of workers and health care of all the population.
VI
The principal aim of the programme is to determine a series of mea
surable parameters which could indicate, first a-posteriori but then
a-priori the tendency or initiation of breakdown in adaptation and the
form it may take if no counter measure was introduced. Such a programme,
it is hoped, could contribute to a wider integration of European know
how, promote a better understanding of biological parameters underlying
organic correlates of stress, and lead eventually to applied routine pro
cedures. Harmonized and standardized measurements would give values for
parameters from various laboratories in the European Community; these
will be compared, integrated in a wider context and, results fed back at
regular intervals to scientists taking part in the exercise for discus
sion and interpretation.
The broad outline of this programme calls for stUdies to:
1.- Investigate, simultaneously if possible, the sociological, psycholo
gical and endocrinological factors which may indicate "high risk
groups" among the population,
2.- Develop reliable but relatively simple indicators which will allow
the identification of persons likely to suffer a breakdown in adapta
tion,
3.- Establish the mechanisms by which certain factors lead to a higher
risk in adaptive breakdown and the mani festati ons of performance,
cardiovascular and gastro intestinal dysfunction,
4.- Use the information gathered to establish situations which will
avoid or minimize breakdown in adaptation.
It is evident that to be successful, the combined expertise of
researchers in biology, biochemistry, physiology, sociology, psychology,
epidemiology and clinical sciences would be required. Through coordinat
ed studies, these scientists could adapt and compare methods, follow
results and test hypotheses since standardized or at least harmonized
protocols would have been used by the various disciplines. This coordina
tion will, it is hoped, allow the identification of real gaps and make
specific recommendations as research develops to achieve the aims stated.
VII
In this context one should mention studies to determine whether or
not different categories or causes of adaptive breakdown are selectively
correlated with pathogenic tendencies at the level of specific organs.
The answer to this question would greatly facili tate the assessment of
the relevancy of specific versus non specific organic markers of poten
tial diseases.
Finally, because the programme would be directed towards one single
but crucial goal with a well coordinated multinational and interdiscipli
nary approach, it is hoped to establish firm, productive and long last
ing links between scientists, in Europe and elsewhere.
The publications in this series stem from a number of workshops
held in 1982-1983 under the auspice of the Commission of the European
Communities in the framework of the above mentioned programme, as
advised by the Committee for Medical and Public Health Research.
These are not proceedings, but a compendium of recent overviews, in
some cases examples of methods, and reports on specific topics, or
approaches used or envisaged in the various disciplines where there
could be fruitful collaboration in the overall study of breakdown in
human adaptation to some stressful conditions. The purpose is to help
identify important problems, indicate interdisciplinary research possibi
Ii ties offered and through the references quoted make available sources
of further information on methods and aspects outside the normal speci
fic field of the scientist concerned.
The separation into five parts each dealing more specifically with
one aspect is only done for the ease of the reader and the publication
should be considered as a whole.
The Commission of the European Communi ties and its Committee for
Medical and Public Health Research wish to thank all those who contribut
ed through their participation in the elaboration of this programme and
the organization of the meetings.
IX
TABLE OF CONTENTS
VOLUME I
PART 1 - PSYCHOLOGICAL AND SOCIOLOGICAL PARAMETERS FOR STUDIES
OF BREAKDOIVN IN HlWlAN ADAPTATION
I. GENERAL OVERVIEVlS
Towards a taxonomy of methods: a general overview of psycholo
gical approaches in the study of breakdown of human adaptation
J. Cullen 3
Psychological field study techniques: overview and needs
D. Broadbent 38
Psychological field study techniques: a critical evaluation
Katherine R. Parkes 53
Sociological parameters in studies of breakdown: a selective
overview
J. Siegrist, Karin Siegri st and 1. "I!;Teber 61
Use of psychological indices in epidemiological studies: over
view and needs
C.D. Jenkins 83
Stressful life events and illness: a review with special refe
rence to a criticism of the life-event method
J. Aagaard 98
II. CONCEPTUAL APPROACHES
A lifetime prospective study of human adaptation and health
M.E.J. vladsworth 122
Psychosocial and psychophysiological factors in the design and
the evaluation of working conditions within health care systems
T. Cox 135
The relation of social to pathophysiological processes:
evidence from epidemiological studies
M.G. Marmot 144
Unemployment and health: a review of methodology
S.C. Farrow 149
x
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
P. Falger, A. Appels and R. Lulofs 159
Physiological issues in establishing links between psychosocial
factors and cardiovascular illness
T. Theorell 188
'.vhi te collar occupation and coronary prone behaviour
J. Siegrist 198
III. HETHODS
Psychological methods: an overview of clinical applications
A. Steptoe 208
Psychological factors in the breakdown of human adaptation:
some methodological issues
C. Hackay 219
Monitoring signs of decrease in human adaptation: use of quan
titative measures available in official statistics
T. Theorell 241
Inventory of stressful life-events (ILE)
J. Siegrist and K.H. Dittmann 251
The Norwegian female climacteric project (VOS)
Aslaug Mikkelsen and A. Holte 257
Questionnaire for organisational stress (VOS)
N. van Dijkhuiz2n 262
A scale for measuring the marital relationship among males
M. 'I"lal tz 267
PART 2 - Htn1AN PERFORMANCE AND BREAKDOVJN IN ADAPTATION
Human performance in transport operations: introductory remarks
H.B. vlegmann 275
XI
I. AIR TRANSPORT
Air crew workload
S.R. Mohler and H.D. Nichamin 279
Safety, individual performance and mental workload in air
transport: Oedipus as Icarus
Patricia Shipley 285
Stress management in air transport operations: beyond alcohol
and drugs
F.H. Hawkins 305
Reasons for eliminating the "age 60" regulation for airline
pilots
S.R. Mohler 322
Human factors education in European air transport operations
F.H. Hawkins 329
II. ROAD TRANSPORT
Behaviour research in road traffic
J. Moraal and J.B.J. Riemersma 363
Some theoretical considerations on accident research
M.L.I. Pokorny and D.H.J. Blom 374
Accident of bus drivers - practical and methodological
probl~s
D.H.J. Blom and M.L.I. Pokorny 385
Effects of alcohol on driving performance: a critical look on
the epidemiological, experimental and psychosocial approaches
E.A. Sand 394
Investigations on the influence of continuous driving on the
motion activity of vehiCle drivers
M. Lemke 409
III. SEA TRANSPORT
Human performance in seafaring
A. Low and H. Goethe 422
Stress factors and countermeasures in navigation
G. Athanassenas 449
