Psychobiological Markers of Stress in Surgeons and Anaesthetists

Abstract

Recent theorizing about the relationship between environmental stress and psychophysiological strain has suggested that the simple direct relationship between the two may be moderated by two other variables. Karasek and various co-authors (Karasek 1979; Karasek et al. 1982) have demonstrated that the degree of control the person has over his environment affects the degree to which he may experience strain. The most stressful occupational environments are those that have high demands combined with low ability to control the situation. In a study of cases of coronary heart disease carefully matched with controls, Alfredsson et al. (1982) showed that CHD was higher among those who had been employed in jobs with these sorts of characteristics. Other investigators have demonstrated that the level of social support available to the person can buffer the person from experiencing the worst effects of environmental stressors (Pinneau 1975; La Rocco et al. 1980). Payne (1979) has proposed that the degree of environmental stress can only be estimated when the three variables od demands, supports and constraints (i. e. control) are measured simultaneously. It is possible to construe support as a means of increasing control: the more help one has, the more one can control both the situational demands and therefore one’s own reactions to them. The advantage of making this assumption for present purposes is that it reduces the model to two variables — demands and control — and permits us to utilize the theorizing of Karasek et al. (1982), who have most thoroughly related environmental stress situations to physiological responses.