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problems, financial difficulties, substance abuse and health problems
can all negatively affect work and increase stress.
Karasek (1979) found that two work-related elements contribute to
job stress: the demands of the job and how much freedom workers have
to meet those demands. If job demands are high and freedom to resolve
those demands in ways that fit an individual's coping style is low, workers
experience high job strain. Beehr (1995) found that ambiguous work
assignments and conflict with others are additional reasons for job stress.
Sutherland and Cooper (1988) report that job stress substantially increases
with the existence of job insecurity, under-promotions, over-promotions,
and hindered ambition.
Personal problems that are not connected to work can also add to
work stress. These include marital and relationship issues untreated
depression and anxiety, other more serious mental health conditions, sub-
stance abuse, undiagnosed medical problems, anger issues (which are dis-
cussed in greater detail in the chapter on workplace violence), deep
insecurities that affect performance and relationship with others on the
job, and a number of other issues that can impact job performance. In
the chapter on treatment, we will include treatment suggestions for all
three conditions: stress, job unhappiness, and burnout.
The University of Massachusetts, Lowell ( U. Mass. Lowell Center for
the Promotion of Health in the New England Workplace, 2012, p. 1 )
reports that studies indicate a strong relationship between workplace stress
and the development of cardiovascular problems such as hypertension and
myocardial infarction. The report notes that “ ... up to 23 percent of
heart disease related deaths per year could be prevented if the levels of job
strain in the most stressful occupations were reduced to average levels
seen in other occupations” (p. 1). The report explains that work stressors
can trigger cardiovascular disease (CVD) and other chronic health pro-
blems and points to three main areas of the body:
￿ Changes in physiological processes that increase the risk for CVD—high
cholesterol, high blood pressure, high blood sugar, weakened immune
response, high cortisol, and changes in appetite and digestive patterns;
￿ Changes in behavior that increase the risk for CVD—low physical activity
levels, excessive coffee consumption, smoking, poor dietary habits.
￿ Development of mental health conditions—anxiety and depression—
that independently increase the risk for a range of chronic health con-
ditions, including CVD, obesity, stroke, atherosclerosis, arrhythmias,
and myocardial infarction.
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