Psychobiological Markers of Stress in Surgeons and Anaesthetists

  • R. L. Payne
  • J. T. Rick
Conference paper


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.


Heart Rate Cortisol Level Standardize Mortality Ratio Average Heart Rate Senior Consultant 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Alfredsson L, Karasek R, Theorell T (1982) Myocardial infarction risk and psychosocial work environment: an analysis of the male Swedish working force. Soc Sci Med 16: 463–467PubMedCrossRefGoogle Scholar
  2. Baker GH, Byrom NA, Irani MS et al (1984) Stress, Cortisol and lymphocyte sub-populations. Lancet I: 574Google Scholar
  3. Bates E (1982) Doctors and their spouses speak: stress in medical practice. Soc Health Illness 4: 25–39CrossRefGoogle Scholar
  4. Becker WGE, Ellis H, Goldsmith R, et al (1983) Heart rates of surgeons in theatre. Ergonomics 26: 803–808PubMedCrossRefGoogle Scholar
  5. Branton P, Oborne DJ (1979) A behavioural study of anaesthetists at work. In: Oborne DJ, Gruneberg MM, Eiser JR (eds) Research in psychology and medicine, vol 1. Academic, LondonGoogle Scholar
  6. Caplan RD, Cobb S, French JRP Ur (1979) White collar work load and Cortisol: disruption of a circadian rhythm by job stress. J Psychosom Res 23: 181–192PubMedCrossRefGoogle Scholar
  7. Dimsdale JE, Moss J (1980) Short-term catecholamine response to psychological stress. Psychosom Med 42 (5): 493–497PubMedGoogle Scholar
  8. Doll R, Peto R (1979) Mortality among doctors in different occupations. Br Med J1: 1433–1436CrossRefGoogle Scholar
  9. Foster GE, Evans DF, Hardcastle J (1978) Heart rates of surgeons during operations and other clinical activities and their modification by oxprenolol. Lancet 1: 1323–1325PubMedCrossRefGoogle Scholar
  10. Frankenhaeuser M, Johansson G (1982) Stress at work: psychobiological and psychosocial aspects. 20th International Congress of Applied Psychology, Edinburgh 1982Google Scholar
  11. Friedman EH (1982) Stress and intensive care nursing: a ten year reappraisal. Heart Lung 11: 26–29PubMedGoogle Scholar
  12. Gentry DW, Parkes KR (1982) Psychological stress in intensive care unit and non–intensive care unit nursing. A review of the past decade. Heart Lung 11: 43–47Google Scholar
  13. Gough RM, Ellis G (1981) The radioimmunassay of Cortisol in urine: difficulties experienced in the development of an assay, and problems of specificity observed with commercial reagents as supplied as kits. Clin Biochem 14 (2): 74–81PubMedCrossRefGoogle Scholar
  14. Hennigan JK, Wortham AW (1975) Analysis of workday stresses on industrial managers using heart rate as a criterion. Ergonomics 18 (6): 675–681PubMedCrossRefGoogle Scholar
  15. Hunt TJ, Marcus P (1966) The investigation of habitual activity in bus crews using SAMI heart-rate integrator. J Physiol 189: 36–37Google Scholar
  16. Ira GH, Bogdonoff MD, Durham NC (1962) Application of radiotelemetry in man for continuous recording of heart rate. JAMA 180 (11): 976–977Google Scholar
  17. Karasek RA (1979) Job demands, job decision latitude and mental strain: implications for job redesign. Admin Sci Q 24: 285–308CrossRefGoogle Scholar
  18. Karasek RA, Russell RS, Theorell T (1982) Physiology of stress and regeneration in job related cardiovascular illness. J Human Stress 8: 29–42CrossRefGoogle Scholar
  19. Kaupinnen–Toropainen K, Kandolin I, Mutanen P (1983) Job dissatisfaction and work–related exhaustion in male and female work. J Occup Behav 4 (3): 193–207Google Scholar
  20. Krakowski AJ (1982 a) Stress and the practice of medicine. J Psychosom Res 26: 91–98PubMedCrossRefGoogle Scholar
  21. Krakowski AJ (1982 b) Stress and the practice of medicine II. Stressors, stresses and strains. Psychother Psychosom 38: 11–23Google Scholar
  22. La Rocco JM, House JS, French JRP Jr (1980) Social support, occupational stress and health. J Health Soc Behav 21: 202–218CrossRefGoogle Scholar
  23. Leonard RA (1983) A psychological study of stress in London school-teachers. PhD Thesis, University of London, LondonGoogle Scholar
  24. Nakamura J, Yakata M (1983) Clinical evaluation of the liquid-chromatographic determination of urinary free Cortisol. Clin Chem 29 /5: 847–851PubMedGoogle Scholar
  25. Norman JC (1980) Histrionics, vignettes and quartets: a syndrome of stress in heart surgeons. Cardiovasc Dis 7: 339–343PubMedGoogle Scholar
  26. Payne RL (1979) Demands, supports, constraints and psychological health. In: Mackay CJ, Cox T (eds) Response to stress: occupational aspects. International Publishing Corporation, LondonGoogle Scholar
  27. Pinneau SR Jr (1975) Effects of social support on psychological and physiological stress. PhD Thesis, University of Michigan, Ann ArborGoogle Scholar
  28. Pisano JI, Crout RJ, Abraham D (1962) Determination of 3-methoxy-4-hydroxymandelic acid in urine. Clin Chim Acta 7: 285–291PubMedCrossRefGoogle Scholar
  29. Rodahl K, Vokac Z (1977) Work stress in Norwegian trawler fishermen. Ergonomics 20 (6): 633–642PubMedCrossRefGoogle Scholar
  30. Schwertner HA, Troxler EG, Uhl GS, Jackson WG (1984) Relationship between Cortisol and cholesterol in men with coronary artery disease and Type A behaviour. Arteriosclerosis 4: 59–64PubMedCrossRefGoogle Scholar
  31. Selye H (1956) The stress of life. McGraw Hill, New YorkGoogle Scholar
  32. Taggart P, Gibbons D, Sommerville W (1969) Some effects of motor–car driving on the normal and abnormal heart. Br Med J 4: 130–134PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1986

Authors and Affiliations

  • R. L. Payne
    • 1
  • J. T. Rick
    • 2
  1. 1.MRC/ESRC Social and Applied Psychology UnitUniversity of SheffieldSheffieldUK
  2. 2.Department of PsychologyUniversity of SheffieldSheffieldUK

Personalised recommendations