Category: Stress

Executive Summary

Stress at the workplace is a common phenomenon in many professions. However, unlike other professionals, correctional officers experience unique work dynamics that introduce new stress factors to their work experiences. Particularly, correctional officers have to manage and supervise the activities of people held by the state against their will.

Furthermore, most inmates have a record of violence. This paper explores the unique perceptive stress factors for correctional officers by focusing on five main categories of stress factors – external organizational factors, internal organizational factors, work environment factors, attitudinal variables, and demographic factors.

After sampling the views of correctional officers from Washington D.C and Baltimore City, this paper shows that work environment factors have the highest impact on occupational stress. Particularly, this paper identifies the dangerous nature of work for correctional officers as the highest contributor of stress. Therefore, to reduce the level of stress among correctional officers, this paper proposes the creation of a favorable work environment for correctional officers.

Introduction

Background

Workplace stress affects different professionals around the world. Finn (2000) says that about 30% of the general workforce experiences some type of stress in the workplace. Stress manifests as a psychological strain that affects people’s mental state. Unattended stress may lead to employee burnout, decreased organizational commitment, and low employee productivity (Finney & Stergiopoulos, 2013).

Employees may show its symptoms through frustration, exhaustion, and detachment (among other factors). The past decade has witnessed several attempts at explaining the main factors that affect stress. For example, several research studies conducted in the 1960s investigated the main causes of stress across different work categories (Brough & Williams, 2007; Finney & Stergiopoulos, 2013; Millson, 2000).

However, most of these studies focused on investigating stress factors across the most established industrial categories. Focus on human service sectors only emerged in the 1970s when researchers tried to investigate the real causes and solutions for stress across several work categories (such as police and nurses) (Millson, 2000).

At the same time, there were parallel attempts aimed at investigating the real causes of stress for correctional officers. Such studies aimed to identify and provide remedies for stress-related factors in the largest cohort on the correctional department – correction officers (Brough & Williams, 2007).

Cullen & Link (1985) say the focus on stress-related factors for correctional officers brought a new agenda in social research where correctional officers became worthy and interesting subjects for social studies.

Indeed, correctional officers were of great interest to many researchers because they supervised and managed the activities of a large population (inmates) that the government held against their will. Their job description also outlines the need to foster public safety by exercising human control as they interact and engage with prisoners.

Based on the nature and organizational structures of correctional facilities, it is inevitable for correctional officers to experience strict and pervasive bureaucracies that could contribute to their overall perception of stress. It is therefore unsurprising that the levels of stress for correctional officers are higher than other work categories. In fact, Lambert & Hogan (2010) say correctional officers record a 37% stress level, while employees from other job groups record a stress level of about 30%.

Brough & Williams (2007) say the symptoms of this high-stress level (employee dissatisfaction and lack of work commitment) comprise the greatest risks for the safety of correctional facilities. Similarly, Taxman & Gordon (2009) say a possible counterproductive behavior may manifest when correctional officers help detainees to carry out criminal activities within the correctional facilities. However, to prevent these adverse outcomes, it is important to understand, first, the nature of stress for correctional officers.

The Problem

Sources of stress often vary across different professions. People do not have the same experiences and effects of stress. Most social studies have focused on explaining work-related issues that affect employee productivity and turnover (Finney & Stergiopoulos, 2013; Millson, 2000).

Few studies have however bothered to investigate the experiences of correctional officers in their work setting. Unlike other work environments where officers interact with other people, correctional officers unique work circumstances because they interact with people held by the state against their will.

Moreover, the nature of interaction between a correctional officer and an inmate is subject to daily meetings that often arise in negative interactions. These factors mostly make the nature or work for correctional officers to be risky and dangerous. Figure 1 shows incidences where correctional officers have been assaulted in the line of duty, received death threats against their lives and the lives of their family members.

Figure 2 shows that many officers have also missed work because of injuries inflicted by inmates (some officers have missed work up to three times in a year because of such incidences). The adverse nature of relationships between correctional officers and inmates therefore provides a new layer of possible stresses that distinguish them from other professionals who interact with people.

Arguably, the conditions that correctional officers face in their work environments are more severe than other professions. The unique dynamics that correctional officers experience in the workplace create a special focus for this paper because this study strives to fill the gap in literature regarding the unique experiences of correctional officers, viz-a-viz other professions. To do so, the present study strives to understand the predictors of occupational stress among correctional officers

Research Aim

To understand the predictors of occupational stress among correctional officers

Research Objectives

• To investigate the impact of demographic factors on the occupational stress of correctional officers
• To understand internal organizational factors that affect occupational stress for correctional officers
• To comprehend the effect of external organizational factors that affect occupational stress for correctional officers
• To evaluate the impact of work environment dynamics on the occupational stress of correctional officers
• To assess the magnitude attitudinal factors of correctional officers have on their stress levels

Purpose of Study

By understanding the predictors of stress for correctional officers, it would be easier to prevent any adverse outcomes that may arise from increased stress levels among the state officers. Particularly, it would be easier to reduce levels of crime in correctional facilities because many researchers affirm a link between stressed officers and increased crime in such facilities (Brough & Williams, 2007; Finney & Stergiopoulos, 2013; Millson, 2000).

Furthermore, since suicide among stressed officers is a common phenomenon, an understanding of the predictors of stress for correctional officers would help to reduce this phenomenon. Broadly, the findings of this study may help to inform the process of formulating successful interventions that would help stressed officers to overcome their plight. Stated differently, it would be easier to provide focused interventions that would have a high efficacy if people use the findings of this study to detect and treat stressed officers.

Literature Review

Historical Review

To understand stress-related issues for correctional officers, many researchers have applied different models and theories to explain the experiences of correctional officers in the work setting. Several attempts at studying the impact of occupational stress on correctional officers have led to a growing body of knowledge in this area of study.

This section of the paper provides a framework for understanding disparate stresses by analyzing five core sources of occupational stress – external, internal, attitudinal, work, and demographic sources of stress. Lastly, this study analyzes the theories surrounding occupational stress factors.

External Organizational Factors

Studies that focus on the effect of external organizational factors on correctional officers are scanty. Instead, many researchers have focused on studying intra-organizational factors, such as poor communication, organizational hierarchy, poor management support (among other factors), in understanding how occupational stress influences correctional officers.

Although some of these indices appear in later sections of this paper, it is important to mention that most studies that have focused on external factors affecting occupational stress on correctional officers have concentrated on evaluating people’s perceptions of correctional officers and the pay that the officers get (Millson, 2000).

Publicly, the media portray correctional officers (mostly in films and movies) as stern disciplinarians and brutal officers who would not hesitate to punish offenders. Such perceptions have created a sense of misinformation about correctional officers. In fact, Millson (2000) argues that such misconceptions have made some officers to be embarrassed about their profession, thereby treating it with a lot of secrecy.

Recent studies have focused on understanding the community’s view of correctional officers by attempting to understand if there is a changing perception about the profession (in the public’s eye). For example, Abdollahi (2002) conducted a study to evaluate this issue by interviewing about 266 correctional officers in several correctional facilities in the US.

The respondents received self-administered questionnaires to report about the community’s respect for their profession and the respect they receive in the same regard (the study used these measures because they were the best predictors for evaluating employee burnout and job satisfaction) (Abdollahi, 2002). Related studies have focused on addressing the impact of low pay for correctional officers by citing it as a common factor that leads to increased stress levels among correctional officers.

In one study, Hogan & Lambert (2006) reported a high level of stress for correctional officers that pursued a second job to make ends meet. Similar studies show that most officers are willing to work overtime to supplement their incomes (Stergiopoulos & Cimo, 2011). Although many researchers affirm the impact of external sources of stress on correctional officers, the majority of them believe these external stresses are products of internal failures.

Internal Organizational Factors

Most studies focus on internal causes of occupational stress among correctional officers. Such studies have shown that organizational factors and managerial expectations are the greatest contributors of occupational stress. Relative to this observation, Millson (2000) says some common issues that also emerge in such studies include, “understaffing, overtime, management support, career progression, communication and decision-making, and role conflict and ambiguity” (p. 16).

Stergiopoulos & Cimo (2011) say all these indices have an effect on occupational stress. However, their effects (degree of correlation) vary. For example, Millson (2000) says management support and career progression have the highest level of correlation with occupational stress. A study that evaluated the views of 1,750 correctional officers in the US (cited in Millson, 2000) established that career progression had a very strong correlation with occupational stress.

Except for feelings of personal security, a study by Abdollahi (2002) shows that career progression accounted for a significant variance in occupational stress (personal feelings of security accounted for 19% of variance, while career progression accounted for about 7% of the variance). Abdollahi (2002) also says understaffing and the involvement of officers in decision-making have the least effect on occupational stress.

Attitudes Towards Correctional Work

Researchers who have investigated the impact of work attitudes on occupational stress have mainly concentrated on understanding correctional orientation and job satisfaction (Millson, 2000). Intuitively, many researchers say correctional officers who have high levels of job satisfaction report low-stress levels (Millson, 2000).

Furthermore, Neveu (2007) and Kienan & Malach-Pines (2007) say job satisfaction has a negative correlation with occupational stress. Studies that are more specific about the different roles of correctional officers show that front-line employees of correctional facilities report the highest levels of occupational stress (Kienan & Malach-Pines, 2007).

Correctional orientation is also another important dynamic of attitudinal behaviors that affect occupational stress among correctional officers. This orientation stems from a shift of roles where correctional officers do not only play the role of providing security at correctional facilities but also play a new role of helping inmates rehabilitate.

A growing body of literature affirms this shift (from advocating for punitive measures to advocating for rehabilitative measures) (Millson, 2000). This attitudinal diversity has created a lot of curiosity among sociologists ass they strive to understand how the correctional re-orientation of correctional officers affects occupational stress (Millson, 2000).

Lambert & Hogan (2007) argue that an orientation towards custody is synonymous with stress. In other words, correctional officers who experience high levels of stress prefer to adopt a custodial approach to reduce their level of stress. Lambert & Hogan (2007) also say that most correctional officers are generally inclined to adopt a custodial approach that may manifest as resentment towards inmates or the advocacy of punitive actions for offenders.

Interestingly some studies show no correlation between correctional orientation and occupational stress. Millson (2000) argues that correctional orientation is highly related to job dissatisfaction, but not occupational stress.

Therefore, such studies show that most officers who are inclined to adopt a punitive attitude in their responsibilities are more likely to report high levels of job dissatisfaction. Studies by Lambert & Hogan (2007) (using the Klofas-toch measure) also reported similar findings when they found out that, “counseling roles, concern with corruption of authority, social distance, and punitive orientation” did not affect occupational stress” (p. 45).

Demographic Factors

Studies that have focused on understanding the effect of demographic characteristics of occupational stress have mainly focused on using gender, education, and age as the main indices of this analysis (Millson, 2000).

Studies that have focused on age as an indicator of stress have shown highly inconsistent findings. For example, Armstrong & Griffin (2004) found out that age had a direct correlation with occupational stress, but Millson (2000) postulates that age does not have a direct correlation with stress (as measured by total exhaustion scores).

Studies that show a direct correlation between age and stress also show that younger officers report lower levels of stress than older officers do (Millson, 2000). Interestingly, similar studies report that older officers report lower levels of stress in the workplace because they adapt better to their work environments, as opposed to younger officers (Armstrong & Griffin, 2004).

Studies that have focused on gender show that gender also shares a direct correlation with occupational stress because female correctional officers report higher levels of stress than their male counterparts do (Griffin, 2007).

Using a stratified sample of about 1000 correctional officers drawn from 39 correctional facilities, Millson (2000) disputed the above findings by saying men and women experience the same level of stress. Millson (2000) further said that such results should not be surprising because most work environments today are progressive and therefore offer the same working conditions for both genders.

Besides gender, studies that have used education as a predictor of stress have always advocated for a cautious understanding of their findings (Robinson & Porporino, 1997). However, most of them say educated officers are likely to report higher levels of stress than officers who are less educated.

The reasons advanced for such findings stem from high expectations about the work environments and unrealistic career expectations that may be unmet in their work environments. Such analyses highlight the cautiousness that most analysts need to accord such findings because, as Robinson & Porporino (1997) purport, these educational cohorts may be responsible for moderating stress levels, and not the mere understanding of education as a predictor of stress.

Comparatively, some studies show that there is no significant difference between occupational stress levels for educated and uneducated people. For example, Millson (2000) suggests that education is a not a strong predictor of educational stress. Similarly, Millson (2000) says there is not much difference in the occupational stress levels for officers who have completed their education and those who have low educational qualifications.

Lastly, previous research also focused on job experience as a predictor of stress. Most of such researchers have combined age and years on the job as the best predictors of occupational stress (Millson, 2000).

Lavigne & Bourbonnais (2010) say the analysis of work experience is critical because it is a strong predictor of employees’ job conditions and work environments. Unlike other studies that have shown conflicting results regarding demographic factors and occupational stress, most of the researchers who have investigated work experience and stress levels show that the two variables have a strong correlation (Millson, 2000).

For example, Lavigne & Bourbonnais (2010) say correctional officers who have experienced continual employment report high levels of stress. Regression analyses conducted to understand the same relationship also show a high level of the predictive equation between both variables (Lavigne & Bourbonnais, 2010). Interestingly, most of such results show a high correlation between occupational stress and work experience and not on job dissatisfaction and a general sense of stress, as other studies do.

Work Environment

Studies that have investigated the impact of internal organizational factors of occupational stress have focused on investigating the nature of work, inmate interactions, and boredom as significant predictors of occupational stress. Concerning boredom, several researchers report that this index is a moderate predictor of stress among correctional officers (Millson, 2000). Analysts regard the independent and solitary nature of officer activities as the primary cause of employee boredom in the workplace (Lavigne & Bourbonnais, 2010).

Moreover, since the duties of correctional officers follow a strict routine, many of the officers may easily get bored. Interactions with inmates have often merged with the dangerousness of officer duties to explain occupational stress because many correctional officers believe their interactions with inmates expose them to unknown danger. Most of them cite this issue a stress-causing facto (Lavigne & Bourbonnais, 2010).

A survey by Millson (2000) to explore the views of more than 900 correctional officers highlighted the danger of their work as a key predictor of stress. Here, Millson (2000) explains that stress means, “The general milieu of working in correctional settings” (p. 26).

Bourbonnais & Jauvin (2007) say this correlation should not be surprising because many correctional officers interact with people who have a history of violence. Furthermore, correctional officers are supposed to ensure inmates perform duties that are often against their wishes (such actions may aggravate their violent nature). The dangerous nature of job roles therefore stands out as a significant predictor of stress.

Theories

Historically, researchers say the potential of a theory to measure and predict a scientific phenomenon greatly depends on the accuracy of data collected to formulate the theory (Millson, 2000). Although many researchers have advanced different theories that explain occupational stress, this section of the paper focuses on the most significant types of occupational theories. They outline below

Identity Theory

The identity theory suggests that most adults create their identities based on their daily activities. Since most of these activities occur within the normative expectations of social behavior, people’s performances, viz a viz these expectations, have a very profound impact on how they evaluate themselves. Carlson (2008) says that stress plays a vital role in evaluating a person’s performance because it affects their abilities to fulfill a specific social role.

Paoline & Lambert (2006) also say that job stress has a direct link with the identity theory because job involvement represents a direct cognitive involvement with a person’s psychological identification with a job. Therefore, from this analysis, job involvement represents a person’s involvement between job-related stress and personal identity. This is because job-related stress normally occurs to people who consider their work as a tenet of their identities.

Although the identity theory has shown merit in understanding how occupational stress relates to work, some researchers believe it is ineffective in explaining the depth of this relationship because of the difficulties in measuring job involvement and relating the same measurement to job stress (Paoline & Lambert, 2006).

It is however important to show that intra-personal and interpersonal relationships may still affect the interaction between people’s occupations and stress (some researchers question the ability of the theory to explain the underlying causes of work-related stress).

Person-Environment Fit Model

The person-environment (PE) fit model is among the most commonly cited models for understanding the relationship between occupational stress and employees’ psychological state of mind. The PE fit model postulates that the failure of the work environment to fit in an individual’s psychological cohort may lead to unmet needs and unmet job demands (Millson, 2000). These undesirable outcomes cause stress.

The misfit between individual needs and work environments therefore means that occupational stress may reduce by minimizing this misfit (Castle & Martin, 2006). If we extrapolate this finding to the work environment, we see that occupational stress occurs from the unproductive interaction between people and their work environments.

Stated differently, Millson (2000) says, “Occupational stress occurs when job demands that pose a threat to the worker contribute to an incompatible person-environment fit, thereby producing stress” (p. 10). Lambert & Paoline (2010) say when most workers face these occupational stress factors, they often rely on internal and external stress factors to manage this stress by striving to strike a balance between their individual needs and the needs of the workplace environment.

While the PE fit model has contributed immensely to the knowledge surrounding work environments and individual stress, some researchers criticize it for failing to provide a specific analysis of this phenomenon (Lambert & Paoline, 2010). Moreover, Castle (2008) posits that serious methodological limitations undercut the validity of the theory in understanding occupational stress.

Some of these methodological limitations include, “Inadequate distinctions between different versions of fit, confusion of different functional forms of fit, poor measurement of fitness components, and inappropriate analysis of the effects of fit” (Millson, 2000, p. 10). Nonetheless, despite the existence of these criticisms, it is crucial to show that the criticisms surround the application of the theory and not the theory itself.

Recent findings address some of the limitations for the shortcomings of this model and prove that the model can sufficiently predict the level of fit between employees and their work environments (Millson, 2000). Certainly, so long as researchers continue to address the methodological problems of this theory, future research may continue to rely on this theory to comprehend occupational stress and its impact on employees.

Demand-Control Model

Finn (2000) says the demand control model helps to understand the relationship between the joint effects of demand and job control (plus its effect on predicting stressful outcomes in the workplace). Recent analyses of this model show that occupational stress only intensifies when the relationship between job control and job demands increases. Stated differently, the model posits that the highest stress levels exist in highly stressful work environments.

Such high levels of stress especially manifest when workers lack adequate control over their duties. Comparatively, low-stress levels occur in work environments that have low employee demands and the employees have a high control of their duties (Finn, 2000). Millson (2000) also says passive jobs create intermediary stress levels for employees. Such passive jobs may include low stress and low control, or high stress and high control.

Although assessing an employee’s level of stress is a key tenet of the demand-control model, Millson (2000) says three hypotheses are pivotal to the understanding of the same model – iso-stress hypothesis, active learning hypothesis, and the dynamic demand-control hypothesis. The iso-stress hypothesis postulates that most employees who work in socially isolating environments and face highly stressful environments (with low control) are most likely to report the highest levels of occupational stress (Millson, 2000).

The active learning hypothesis is different from the iso-stress hypothesis because it predicts that the highest motivation levels exist in work environments where employee skills/control matches their job requirements. The dynamic demand environment differs from the above hypotheses because it considers the effect of the work environment of the employees, over a long period.

For example, Finn (2000) says this hypothesis posits that an overexposure to the work environment may lead to the development of feelings of mastery among employees. Such feelings of mastery may affect the level of stress by minimizing it. The hypothesis also posits that an overexposure to daily residual stress, over a long time, may lead to the creation of anxiety and depression among employees. This outcome may increase their stress levels, encourage them to avoid job challenges and force them to abandon their jobs.

Evidence gathered from the demand-control model shows that the model is useful in understanding the relationship with the work environment and an employee’s level of stress (Finn, 2000). Despite the fact that some criticisms exist within the context of implementing the control construct, recent advancements of the model have addressed this issue.

For example, Summerlin & Oehme (2010) addressed issues of autonomy and control by saying that these factors are important in analyzing employee perceptions of stress. Moreover, the same factors are instrumental in helping employees to overcome their stress. Lastly, the model is also useful in addressing different types of jobs (job demands) and understanding issues in the work environment that may lead to an enhancement of employee stress (job factors).

Research Hypothesis

Work Environment Factors contribute the greatest indices of occupational stress

Methodology

Subjects

This study sampled a group of ten correctional officers from Washington D.C and Baltimore City. The paper chose a minimum sample because of the need to optimize confidence during the data collection process. In detail, the present study chose this sample size to provide a minimum confidence interval of about five percentage points (95% confidence level).

An equal number of respondents came from both regions because five respondents came from Washington D.C and the other half came from Baltimore City. The intention of striking a numerical and gender balance in the selection of the respondents was to gather a representative sample of the predictors of occupational stress among correctional officers.

Instruments

This study used a set of self-administered questionnaires to collect data from the ten respondents sampled in the study. After the respondents completed the questionnaire, they sealed it in a folder titled, “confidential.”

The participants also had the option of mailing the questionnaire to the researcher, but none of them chose this option. The dependent and independent variables emanated from the findings of the literature review section. The research analyzed the respondents’ views based on the five major categories of stress that affect correctional officers.

The main categories were external factors and international factors that affect correctional institutions and correctional officers. Work environments and demographic factors also outlined another category for understanding the views of the respondents, while work attitudes outlined the last category of analysis. This study used a seven-point Likert scale to gather the respondents’ views. The scale varied from “strongly agree” to “strongly disagree.”

The dependent variable was job stress. Other studies that have used this type of measure for assessing occupational stress among correctional officers have shown a high level of internal consistency (Brough & Williams, 2007; Finney & Stergiopoulos, 2013; Millson, 2000).

This consistency has especially been reliable when measuring job stress, relative to empathy and punishments. Indeed, two studies reported by Lambert & Hogan (2008) and Millson (2000) show a high level of internal consistency based on the reports on alphas studies.

Since researchers have reported this high level of internal consistency across different parts of the world, it is true to say, the job stress scale is reliable across different settings. This fact provides sufficient grounds to believe the job stress scale was highly reliable for this study.

Procedure

The main research design was quantitative. This is because the study gathered responses through a predetermined framework of analysis. Because of the need to provide a gender balance among the respondents sampled, the research used purposeful sampling. Before providing the questionnaires to the respondents, I ensured the participants understood that the survey would be confidential and anonymous.

The respondents also understood that the researcher would be the only person required to see their responses. Here, the hope was to make the respondents feel comfortable to participate in the study. On the day of the research, the respondents received the questionnaires after their managers allowed them to do so (by borrowing some of their working time). The respondents completed the questionnaires in about 30 minutes. The study used the stepwise regression analysis to analyze the data collected.

Statistics

Initially, the intention of this study was to interview five men and five women. However, only four women participated in the study (one female respondent was unable to do so for personal reasons). In sum, six male officers and four female officers participated in the study. Their mean age was 35 years.

Results

All the respondents agreed to participate in the study by completing a self-administered questionnaire. The response rate was therefore 100%. Although this study used a small sample of respondents, other regional and national surveys on correctional officers have reported low response rates (Brough & Williams, 2007; Finney & Stergiopoulos, 2013; Millson, 2000).

For example, a federal study to evaluate the attitudes of correctional officers across 47 correctional institutions reported a response rate of 41% (Millson, 2000). In another study, researchers reported a response rate of 46.9% after sampling the views of correctional officers from seven adult and juvenile correctional facilities (Finney & Stergiopoulos, 2013).

Nonetheless, after evaluating the responses given by the informants of this paper, it is correct to say most of the respondents reported a neutral range of answers to questions that evaluated the effect of various types of stress factors at work. Stated differently, an almost equal number of respondents rated the items as “agree” and “disagree.”This finding is important for the formulation of the overall findings of this paper because it shows an equal variety of results.

An evaluation of the external factors affecting occupational stress showed the poor public image and low pay as having a stronger correlation with occupational stress than the lack of public accountability.

Most of the respondents said they agreed that poor public image and low pay contributed to their stress levels, but only two respondents polled the same about the lack of accountability. The two respondents therefore believed that the management of the correctional facilities should be more accountable to the public about their activities.

Nonetheless, an evaluation of work environment dynamics showed the most profound results from most of the respondents (except one) said they “strongly agreed” that personal security and staff empowerment affected their stress levels. Poor training and the failure to understand work procedures showed a dismal correlation with occupational stress.

More so, most of the respondents were undecided about the effect of the failure to understand work procedures on occupational stress. However, half of the respondents believed poor training was a contributor of stress.

An analysis of the demographic factors affecting stress showed no correlation of age and gender with stress. In fact, most of the female respondents (except one) strongly disagreed with the fact that gender affected their stress levels. However, seven respondents partially agreed that the lack of education contributed to occupational stress.

An analysis of the internal factors affecting occupational stress shows a significant correlation between strenuous work shifts and occupational stress. The lack of growth opportunities and job security also showed a significant correlation with occupational stress. However, most of the responses showed that the officers either agreed or partially agreed with this relationship.

An analysis of the attitudinal variables showed that job satisfaction had a negative correlation with occupational stress. Interestingly, very few respondents agreed that there was a link between correctional orientation and occupational stress. Regarding the criterion validity for the dependent variable, the paper used a correlation analysis to examine the likelihood of job stress, by evaluating job satisfaction, and lifestyle indicators.

The analyses showed that the correctional officers with the highest stress levels reported the lowest levels of job satisfaction. This finding supports the view of other researchers who have reported a high level of job dissatisfaction for employees with high-stress levels. Lifestyle and health factors also emerged as important indices in past analyses because past research showed a high correlation between them and occupational stress (Stergiopoulos & Cimo, 2011).

Lastly, although the results showed that many factors affected the levels of occupational stress among the respondents sampled, not all of them were significant enough. For example, the study identified the correlation between gender and age to be insignificant in affecting the level of stress.

However, education, years employed, and security levels emerged to have a moderate significance with occupational stress. A negative correlation existed between job stress and job security because most of the respondents polled that the lack of job security brought stress. In sum, the graph below rates the five categories of perceptive indices according to their levels of influence of occupational stress.

Discussion

Throughout the analysis of this paper, perceptions of the dangerousness of the job that correctional officers do emerge as the strongest predictor of stress. However, not all the independent variables showed the same influence on the level of stress. For example, a few demographic factors (age and gender) emerged as having an insignificant correlation with stress levels.

Such findings help to clarify inconsistencies in previous researchers that have tried to use demographic indices to predict the levels of stress among correctional officers. For the few demographic indices used in this paper, the number of years employed (only) emerged to have a moderate correlation with stress. The others had either an insignificant correlation (age and gender) or no correlation at all. This finding affirms the minimal use of demographic variables to predict occupational stress among correction officers.

Nonetheless, the moderate correlation between job tenure and occupational stress emerged as an interesting finding because conventional belief portrays job tenure as a significant correlate of occupational stress. Indeed, several researchers have elevated the importance of job tenure in predicting occupational stress.

For example, Millson (2000) said, “Time on the on the job would reduce stress because increased job experience would be expected to enhance competence and self-confidence” (p. 88). Nonetheless, from the same background, the present study shows that work experience draws a moderate correlation with occupational stress. This finding is consistent with other studies that have shown a correlation between the two variables (Brough & Williams, 2007; Finney & Stergiopoulos, 2013).

An analysis of external factors in the organization shows that only two factors have a strong correlation with occupational stress. One notable finding was the strong belief that correctional institutions should have a greater accountability to the public.

However, the study found the correlation between the public image of correctional facilities and correctional officers had an insignificant correlation with occupational stress. Although people should treat these findings cautiously, the findings still help to demystify anecdotal information surrounding the effects of external organizational factors on organizational stress.

Internal factors emerged as having the most impact on occupational stress. In fact, all the internal indices of occupational stress reported significant correlations. This finding means that all the internal organizational factors contributed to occupational stress. Although this paper diversified the internal organizational factors, their effect on occupational stress only focus on three key areas of analysis – employee advancement, staff management, and organizational duty management.

It is therefore unsurprising to see that most issues affecting employee career development had a significant impact on occupational stress for the correctional officers. In my view, this issue emerged profoundly in the present study because, today, career growth opportunities are important in shaping employee perceptions about their jobs.

Mainly this is because pay increments depend on career growth opportunities. The strong correlation between career advancement issues and occupational stress is consistent with other studies, which have affirmed the same relationship. Indeed, as Stergiopoulos & Cimo (2011) found out, limitations on career development were leading causes of health problems among employees.

The internal organizational factors that affect employee treatment in the organization also showed the same level of correlation because the treatment of employees in the correctional facilities had a profound impact on how officers perceived their jobs.

It is therefore unsurprising that most of the respondents said the quality of supervision, staff recognition, and the general treatment of employees played a huge role in influencing how they perceived their job. These findings support the views of past researchers who have emphasized the importance of considering management support when formulating strategies for reducing occupational stress among employees.

Management of work is also another area of internal organizational control that emerged to have a correlation with occupational stress. This analysis highlighted the importance of understanding different facets of work management, such as communication within the organization, policy orientation, and the empowerment of staff (attributes that affect the management of work schedules). Past studies have also shown that some deficits in these managerial facets have a profound impact on how employees perceive their work.

For example, Hogan & Lambert (2006) had affirmed the influence of employee empowerment and policy orientation on occupational stress. The same studies showed the influence of role conflict and ambiguities in influencing how employees perceive their work (job satisfaction). This analysis is especially relevant for correctional officers because people expect them to observe high levels of discipline and role command (professional discretion) in the execution of their duties.

Most researchers have investigated the influence of role conflicts on the execution of duties by understanding how the same factors affect employee empowerment levels. The same studies have presented the influence of role conflicts and job ambiguities by understanding the relevance of policies and procedures (Millson, 2000). For example, in one study, a respondent claimed the failure to observe rules and procedures could lead to negative outcomes for employees.

Variables concerning the work environment suggested a negative correlation with occupational stress. This was true for most indices including perceptions of personal security and the knowledge of the work. Similarly, the same results were true for the impact of shift work and the danger associated with the jobs of correctional officers.

As explained in this paper, the danger associated with the job reported the highest negative correlation with occupational stress. Given the focus of past studies on the nature of work and occupational stress, I expected that the dangerous nature of the work that correctional officers do would have a negative correlation with occupational stress.

Employees’ understanding of their work and their level of training also showed the same negative correlation, although to a lesser extent. This finding shows that most correctional officers who have not received proper training to undertake their duties have a higher likelihood of experiencing stress. The same outcome is true for correctional officers who do not have a proper knowledge of the jobs. A notable outcome of this analysis is the impact of work shifts because most of the respondents polled that strenuous routines stressed them.

Past studies have compared this fact to the commitment of correctional officers to organizational goals and objectives (Finney & Stergiopoulos, 2013). Their findings support the findings of the present study because they argued that most correctional officers who report low commitment levels of organizational goals experience more stress in the workplace.

An analysis of the influence of attitudinal variables on organizational control showed that correctional officers who were less empathetic in their interactions with inmates were more likely to experience occupational stress. The positive correlation between the punitive attitudes of correctional officers and occupational stress affirms this fact. Although there is a small body of research that has focused on understanding the impact of attitudinal factors on occupational stress, the findings of this paper are congruent with previous findings.

Considering the level of correlation for many of the independent variables highlighted in this paper, conducting the stepwise regression analysis was important for this paper to ascertain the main predictors of occupational stress. The hypothesis of this paper is therefore true because one aspect of personal security emerged as the most reliable predictor of occupational stress.

Indeed, the dangerous nature of the job emerged to have a very strong correlation with occupational stress. Staff empowerment (which came second in this analysis) does not match to this correlation. Although most of the independent variables identified in this paper showed a correlation with occupational stress, the impact of these independent variables on the safety of correctional officers at work is insignificant.

Contributions from the staff empowerment scale to occupational stress levels among the correctional officers show that some feelings of lack of empowerment contribute immensely to work stress among the same group of employees. This analysis is true beyond the perceptions of the dangers associated with the job. The contributions of other variables in this analysis also show that the routine nature of workplace responsibilities and strict work schedules may contribute to high levels of stress among the employees.

Conclusion

After weighing the findings of this study, the importance of work environment variables emerges as the most important influence of occupational stress. Demographic factors have the least effect on occupational stress. This analysis shows that the feelings of personal safety top the list of issues that stress correctional officers.

Stated differently, this analysis shows that personal factors are the most significant factors that cause stress among employees. Comparatively, organizational issues outline secondary concerns of personal stress. Psychologists, policymakers, and other stakeholders should therefore consider the importance of improving the work environment of correctional officers if they want to optimize the output of these professionals.

Stress-reduction strategies should also appeal to these issues because this is the best way they can achieve maximum impact on employees. Stakeholders should therefore regard the personal well-being of correctional officers as an important tenet of our justice system because their role in rehabilitating inmates is as important as the need for the justice system to prosecute offenders.

From this background, the findings of this paper support the research hypothesis – work environment factors contribute the greatest indices of occupational stress. Future research should however explore how well stress management philosophies may integrate environmental solutions to relieve correctional officers of stress. A perfect synchrony of work environment dynamics and psychosocial interventions should suffice.

References

Abdollahi, M. (2002). Understanding police stress research. J Forensic Psychology, 2(2), 1–24.

Armstrong, G., & Griffin, M. (2004). Does the job matter? Comparing correlates of stress among treatment and correctional staff in prisons. J Crim Justice, 32(1), 577–592.

Bourbonnais, R., & Jauvin, N. (2007). Psychosocial work environment, interpersonal violence at work and mental health among correctional officers. Int J Law Psychiatry, 30(1), 355–368.

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Carlson, J. (2008). Thomas G: Burnout among prison caseworkers and corrections officers. Journal of Offender Rehabilitation, 43(3), 19–34.

Castle, T. (2008). Satisfied in jail? Exploring the predictors of job satisfaction among jail officers. Crim Justice Rev, 33(1), 48–63.

Castle, T., & Martin, J. (2006). Occupational hazard: predictors of stress among jail correctional officers. Am J Crim Justice, 31(1), 65–80.

Cullen, F., & Link, B. (1985). The social dimensions of correctional officer stress. Justice Quarterly, 2(4), 505–533.

Finn, P. (2000). Addressing Correctional Officer’s Stress: Programs and Strategies. Washington, D.C: U.S. Department of Justice.

Finney, C., & Stergiopoulos, E. (2013). Organizational stressors associated with job stress and burnout in correctional officers: a systematic review. BMC Public Health, 13(82), 1-13.

Griffin, M. (2007). Gender and stress: a comparative assessment of sources of stress among correctional officers. J Contemporary Crim Justice, 22(1), 4–25.

Hogan, N., & Lambert, E. (2006). The impact of occupational stressors on correctional staff organizational commitment: a preliminary study. J Contemporary Crim Justice, 22(1), 44–62.

Kienan, G., & Malach-Pines, A. (2007). Stress and burnout among prison personnel. Crim Justice Behav, 34(3), 380–398.

Lambert, E., & Hogan, N. (2007). The impact of distributive and procedural justice on correctional staff job stress, job satisfaction, and organizational commitment. Journal of Criminal Justice, 35(6), 644–656.

Lambert, E., & Hogan, N. (2008). I want to know and I want to be a part of it: the impact of instrumental communication and integration on private prison staff. Journal of Applied Security Research, 3(2), 205–229.

Lambert, E., & Hogan, N. (2010). An exploratory examination of the consequences of burnout in terms of life satisfaction, turnover intent, and absenteeism among private correctional staff. The Prison J, 90(1), 94–114.

Lambert, E., & Paoline, E. (2010). Take this job and shove it: an exploratory study of turnover intent among jail staff. J Crim Justice, 38(1), 139–148.

Lavigne, E., & Bourbonnais, R. (2010). Psychosocial work environment, interpersonal violence at work and psychotropic drug use among correctional officers. Int J Law Psychiatry, 33(1), 122–129.

Millson, W. (2000). Predictors of Work Stress among Correctional Officers. Ottawa, Ontario: Carleton University.

Neveu, J. (2007). Jailed resources: conservation of resources theory as applied to burnout among prison guards. J Organ Behav, 28(1), 21–42.

Paoline, E., & Lambert, E. (2006). A calm and happy keeper of the keys: The impact of ACA views, relations with co-workers, and policy views on the job stress and job satisfaction of correctional staff. The Prison Journal, 86(2), 182–205.

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Summerlin, Z., & Oehme, K. (2010). Disparate levels of stress in police and correctional officers: preliminary evidence from a pilot study on domestic violence. J Hum Behav Soc Environ, 20(1), 762–777.

Taxman, F., & Gordon, J. (2009). Do fairness and equity matter? An examination of organizational justice among correctional officers in adult prisons. Crim Justice Behav, 36(7), 695–711.

Personal Story

Carlos Huerta is an American Soldier. In 2004, he was diagnosed with PTSD by Army doctors. In a year, the man was told to speak with others about his problem, but he refused. Five years later, Huerta’s condition worsened greatly, and he had a panic attack when got home one evening. He is not sure what triggered it but mentions that he was informing the families that their relatives will never return and saw several people die. Being a soldier, the man did not want to talk about his problem with professionals, as was afraid to be treated as genetically dysfunctional and broken (Huerta, 2012).

Experience with PTSD

Huerta started to experience critical problems only in five years after he came home. The man could not breathe and was afraid to be closed off. From the very beginning, he tried to ignore these feelings, but an opportunity that it might have been a heart attack made Huerta visit a doctor. After numerous tests, he was sent to see someone in CHMS. The first conversation was not official, but soon he realized that it is not enough and came for some psychotropic medication. Huerta had nightmares and felt guilty for telling people that their husbands, fathers, and sons were dead and for making those families suffer as well as his own one. He experienced panic attacks being at home.

Connections with Course Materials

With the help of the course materials, I was able to understand that Huerta had a panic attack just from its description. I also recognized it as one of the symptoms of PTSD as well as those nightmares about the scenes at the battlefield and conversations with the families. I also pointed out that the man’s physical condition was examined before offering him mental health services. I recognized psychotropic medication as a way to deal with anxiety. Even though the very trigger of the first panic attack was not clear, all experiences described by the man relate to possible causes. Moreover, alcohol abuse is frequent among Veterans with PTSD, and Huerta was not an exception.

Recommendations

The only treatment that is described in the case is the prescription of psychotropic medication. Still, I believe that it is just a part of it. I would recommend paying attention to the day-to-day activities. Even exercising, established routine and healthy food can reduce the level of stress. It will be beneficial if Huerta asks for help from family and friends, as they are also worried and willing to improve relations. It would be great if he joins some support group to communicate with people who have the same problem and know how to cope with it. It is critical to be honest with oneself and to accept the problem. Huerta should spend more time with his children to receive more positive feelings. Still, he should also express negative ones (Post-traumatic stress disorder, n.d.)

Conclusion

From this case, I found out that soldiers may start to suffer from PTSD even in several years after the war ends because they still have traumatic experiences. I understood that they fail so see the sense of living after coming home and are afraid of getting closer to their families and being broken. I realized that the main issue they face is admitting the existence the problem and necessity of professional treatment. If I had an opportunity to interview Huerta, I would ask if he experienced flashbacks when being outdoors, if he felt depressed, if he fails to remember some events and if he tends to be engaged in dangerous behaviors now.

References

Huerta, C. (2012). Leaving the battlefield: Soldier shares story of PTSD. Web.

Post-traumatic stress disorder (PTSD) and war-related stress. (n.d). Web.

Introduction

Stress forms an integral part of our daily life despite negative notions people have developed against it. According to Wein (2000), stress ensures that the body functions optimally particularly when responding to adverse situations. He further explains that the flight or fight response guarantees individual’s safety since the body is able to react swiftly to the changes in environmental conditions. However, chronic exposure to stress may pose adverse effects to one’s physical health.

To begin with, stress has been known to suppress immune system thereby increasing the body’s susceptibility to infections (Wein, 2000). Moreover, stress triggers the onset of heart diseases as well as high blood pressure thus subjecting an individual to health risks. Finally, stress is associated with a variety of health problems including backaches, stomachaches, pain, headaches, diarrhea, loss of sleep as well as weight gain (Wein, 2000).

Chronic exposure to stress lowers the body’s immune system thereby reducing its ability to respond to invaders such as viruses or bacteria. It is therefore important for individuals to know their stress limits in an attempt to effectively manage stress.

Health effects of stress

Psychological stress triggers the physical symptoms as well as onset of various illnesses in the body. According to Centers for Disease Control and Prevention, about ninety percent of all diseases and illnesses are stress-related (Wein, 2000). Chronic stress interferes with the normal functioning of the body systems. At the outset, chronic stress suppresses the immune system, elevates blood pressure, and increases cardiac risk as well as stroke.

Effects of stress on the immune system

When the body is subjected to stressful conditions, stress hormones such as cortisol hormones are released by the pituitary and adrenal glands so as to initiate the stress response in the body. Such response is vital since both the brain and immune system can communicate to ensure effective stress management.

However, such communication may be disrupted when one is exposed to chronic stress thereby suppressing the immune system. This would pave way for stress-related illnesses to attack the body. In such situations, stress hormones are persistently pumped into the blood thereby lowering the fighting ability of immune cells. According to Niess et al (2002), prolonged psychological stress suppresses immune system by reducing the macrophages, CD8+ lymphocytes as well as NK cells. This exposes the body to various infections.

Effects of stress on the heart

The heart functions best at certain levels of stress. However, chronic stress may lead to adverse effects on the heart performance thus posing cardiac risks. Stressors trigger cardiac events including pathophysiological changes such as myocardial infarction and ischemia, abnormalities associated with the wall motion, sudden death as well as changes in heart regulation (Soufer, 2004).

Deepa, Pradeep, & Mohan (2001) argue that when an individual is exposed to psychological stress, there is a speedy increase in blood pressure as well as heart rate following an increase in sympathetic response and plasma epinephrine. Such heightened sympathetic nerve response poses high cardiac risks as oxygen demands increases.

Heightened psychosocial stress may also aggravate myocardial ischemia (Soufer, 2004). According to Niess et al (2002), psychological stress triggers myocardial ischemia in individuals with recognized cardiovascular disease. They further assert that individuals with abnormalities in wall motion as well as negative personality traits have increased cardiac risks and even death.

Deepa, Pradeep, & Mohan (2001) argue that the development of cardiovascular diseases such as myocardial infarction is preceded by chronic levels of psychological factors an individual is exposed to. Besides, mental stress also induces cardiovascular illnesses through vasoconstriction of the coronary vessels. Psychological stress may trigger recurrence of medical events in individuals with cardiovascular diseases.

Finally, psychological stress is also associated with induction of atherosclerosis by thickening the coronary artery (Deepa, Pradeep, & Mohan, 2001). Macleod et al (2002) argue that heightened stress affects health through neuroendocrine mechanism as well as unhealthy behavior among individuals in the population. They however, cite bias reporting as some of the reasons why such associations may not be accurate (Macleod et al, 2002).

Effects of stress on the intestinal epithelia as well as neuroendocrine system

The stress-induced interactions between the immune and the neuroendocrine systems may lead to changes in the physiologic functions of intestinal epithelium thereby stirring up relapses in the Inflammatory Bowel Disease (IBD) (Niess et al, 2002). According to the scientists such occurrence is possible because stress induces the production of neuropepetides such as tachykinins well as cytokines.

The interaction between the neuronal and immune system is facilitated by the corticotrophin releasing factor (CRF) that is found in the nuclei of the brain cells.

Recent studies have shown that activation of CRF receptors in the brain nuclei mediates the stress-induced intonation of gastrointestinal functions. The normal epithelial functions are hindered when the body is subjected to either acute or chronic stress. Such interruptions in the epithelial functions may lead to mucosal inflammation thereby resulting into the clinical manifestation of IBD.

Conclusion

It is noteworthy that stress is an important factor in our day-to-day life. Stress prepares an individual by initiating responses aimed at protecting the body against perceived threats. Such body response involving either fighting or fleeing from the danger zone guarantees the safety of an individual. However, chronic exposure to stress may be harmful to the body.

Prolonged exposure to stress suppresses immune system thereby making the body prone to infections. Such chronic stress has been associated with the development of cardiovascular illnesses including blood pressure as well as heart disease. Research shows that almost ninety percent of all diseases are stress-induced. Stress management strategies as well as stress reduction methods including relaxation, exercise and meditation are vital procedures in curbing stress-related diseases.

Reference List

Deepa R., Pradeep R., Mohan V. (2001). Role of Psychological Stress in Cardiovascular Disease. Int J Diab Dev Ctries; 21:121-4. Web.

Macleod, J., Davey-Smith, G., Heslop, P., Metcalfe, C., Carroll, D., & Hart, C., (2002). Psychological stress and cardiovascular disease: Empirical demonstration of bias in a prospective observational study of Scottish men. British Medical Journal, 324(7348), 1247-1252. Web.

Niess, J., Monnikes, H., Dignass, A., Klapp, B., & Arck, P., (2002). Review of the influence of stress on immune mediators, neuropeptides and hormones with relevance for inflammatory bowel disease. Digestion: International Journal of Gastroenterology, 65(3), 131-140. Web.

Soufer, R. (2004). Neurocardiac interaction during stress-induced myocardial ischemia: How does the brain cope? Circulation, 110(13), 1710-1713. Web.

Wein, H. (2000). Stress and Disease: New Perspectives. Web.

Niess, J. H., Monnikes, H, Dignass, A. U., Klapp, B. F., & Arck, P. C. (2002). Review of the influence of stress on immune mediators, neuropeptides and hormones with relevance for inflammatory bowel disease. Digestion: International Journal of Gastroenterology, 65(3), 131-140.

Macleod, J., Davey-Smith, G., Heslop, P., Metcalfe, C., Carroll, D., & Hart, C. (2002). Psychological stress and cardiovascular disease: Empirical demonstration of bias in a prospective observational study of Scottish men. British Medical Journal, 324(7348), 1247-1252.

Stress

Stress is the harmful and natural response that occurs when something unexpected happens that is against to the victim’s nature (Stress in the workplace, 2007).

Workplace Stress

Workplace is the physical and injurious reaction that happens as soon as there is a poor and destructive match between the job demands and your expertise, reserves, strain and desires of the work done.

Problems during work are mostly connected to the adverse physical condition; moreover arise because of financial troubles or sometimes because of some inheriting issues. Most of the studies prove that job stress increases the risk for development of back and upper-extremity. The elevated stage of stress occurs in significant rise in health examination exploitation. Employees with workplace stress moreover prove disproportionate health care exploitation.

When one goes to job, stress is waiting for him in various shapes. Manager, workers, team members are under-pressurized by workload and hence stress arises automatically in their mind. Therefore, they must relax their mind and generate useful thinking in order to solve the problems to overcome stress. Due to stress, one feels helpless and cannot solve any of the issues in real, infect easy situations become puzzled stuff. It has also being found that shift jobs also increase the level of stress in employees (Workplace stress, 2008).

Reactions of Workplace Stress

The following are the some core reactions of stress at work:

• Blood regulation system is totally disturbed and blood regulation to brain affects. This problem causes severe headache or nervous down problems.
• The veins of brain don’t work as per their natural activeness due to stress which results in facial expression having unreleased vision. However stress sharpens hearing and vision.
• Vitamins in our body steam up due to stress.
• Blood pressure also rises due to stress. Severe heart problems like heart attack are observed in employees due to excessive stress.

Causes of Workplace Stress

It has been found out that people at work have been facing supreme and dominant problems (Babcock, 2009). Job stress rises due to the condition of work. The diverse perspectives propose unusual causes of workplace stress. Following are some major causes of workplace stress;

• When job conditions do not fulfill the demands of workers ans when the workers are not physically as well as mentally fit.
• When workers have been facing some severe family issues and they feel unable to solve them.
• When workers face financial issues.
• When salaries of the workers don’t fulfill their total expenses.
• Future-oriented workers have much more stress because they always think to move up and up in very short span of time.
• Greedy workers are always under stress because they cannot be satisfied with their present statuses and they always want to achieve higher positions. Ultimately, this causes them severe work stress.
• Workers who have very little control on individuals, who are organization’s decision makers, are also in stress.
• Female worker usually bear a nature of competition with other female workers in different aspects. This could be in terms of dressing, fashion or in terms of looking different. Such competition causes stress in women at workplace.

British Association for Counseling and Psychotherapy

People under this association conducted a survey of about 1440 workers and found that majority of them admire the counseling service. About 84% of the employees believe that the workers need proper counseling so that the recession is reduced (Kadu, 2002).

Rick Hughes, the workplace leading advisor at the British Association for counseling and psychotherapy said that beside the organizational work, employees also needs some counseling, social and moral support so that they are efficient in their work.

Symptoms of Excessive Job and Workplace Stress

• Loss of decision making power that causes a big loss especially when you are at workplace.
• Feeling anxious, irritable and tired or depressed.
• Social withdrawal or lack of social gathering.
• Using alcohol or drugs to attain mental relaxation.
• Apart of it, loss of interest in work.
• Sleeping after hearing the problems.
• Fatigue. Loss of capability to take any powerful decision by themselves.

Workplace stress is identical in genders

Gender disparity pressurizes workplace stress. The Kenexa Research Institute conducted a survey in which it was found out that stress of women workers is 10% greater than the stress in male workers. Numerous studies prove that workplace stress in women is greater than of the workplace stress in men. This can be the result of sensitive nature. In general, female employees are not as regular as male employee.

Ladies are more in to household activities that may result in absenteeism or irregularity. Psychologically, they realize the consequences of their work behavior. Secondly, female employees are more sensitive than male employees. It has been notices that probability of weeping at workplace is excessively found in female workers as compare to male workers. However, women are more conscious and sincere with their work as compared to man.

Workplace stress in the occupation of nursing:

Researchers from different research centers and institutions proved that the profession of nursing is more stressful occupation as compare to the other occupations. Nurses at work do not have time to take rest or to take some break in order to relax. In general, there are three shifts of nurses like morning, evening and night.

Nurses who work in the evening and night shifts are in much stress than the nurses in the morning shifts. In night shifts, nurses can’t take proper sleep. This is the most important reason of stress. Proper sleep is the important source to regain strength not only for job, but also for other routine activities. There is a requirement for the nursing staff to be taught with proper methods of coping with stress as well as providing a positive work environment.

How to reduce workplace stress?

Following are some major suggestions to prevent workplace stress;

Create a balanced schedule

Worker must analyze the schedule, daily task and orders. He should take care of his responsibilities. It is very important to analyze and classify social tasks / activities and private quests.

Don’t over commit yourself

Stay away from setting up things back-to-back or hard to meet appointments within short span of time. Drop the tasks that aren’t necessary in the list of today’s work.

Plan regular breaks

Breaks play a very creative role in coping with the workplace stress. Due to break, employees relax their mind and regain their lost energy and power. Therefore, worker must take a break during work.

Breaking projects into small steps

If an employee is assigned with some crucial projects, then he must schedule and break his tasks in chunks to avoid stress.

Clean up your act

If you are always running late then you must pay proper attention to your schedule out some time for you in order to maintain your personality, cleaning up your act also relaxes your mind.

Flip your negative thinking:

If you have negative thinking or have negative approach for others, then it is quite common to feel stress, because negative thinking brings a person in complex and puts negative effect on work.

Try to leave early in the morning:

The basic reason of stress is going late to office. Try to keep yourself punctual and regular to your workplace as this leave positive impact on your mind. Employees who are not punctual not only leave negative impact on office by violating office environment, but also bring themselves in stress.

This is because they do realize the consequences of their behavior. There could be several reasons for getting later. Late comers can either be habitual or are late for some genuine reason. However, consequences do not really change for both the types. One must tend to schedule his routine in order to be punctual so that to avoid such stress.

Develop a responsive, easy and social environment:

Present chances for communal and group communication among workers. Friendly relations reduce stress because sharing problems with each other helps feeling light and relaxed.

Must take a break:

Workers should take break during work because human mind needs break to relax.

Keep yourself ready to face any kind of problem:

Ambitious and work-oriented workers always prepare themselves for facing any kind of problem and they energize themselves with the ability to solve their problem peacefully.

Reducing working hours

The main reason of stress is to do work in the time limit. Continuing work in tiredness causes excessive stress. If a mind is relaxed, one can do more and more work in short period of time than a person in stress at workplace who wastes time and energy to do the same work. To increase efficiency and effectiveness, one must work without stress.

Conclusion

Workplace stress is nothing, but it is made by us only. If we take care of a few small, but noticeable points, then we surely can get rid of this psychological illness. (Stress, 2008). Sometimes it happens due to some severe health issues, but most of the times, it is generated by us uselessly. If someone is unable to manage work with other issues, then he should break his work in short terms instead of taking stress.

Some organizations and institutions provide proper lectures and take classes of workplace stress and discuss all points and weaknesses that cause hyper stress during work. One must know his prior task and the time limit.

Workers must work hard to get rid of stress. They must tend to be goal-oriented, target-oriented and well-wisher for other employees working in the same field and departments. Workers must create a friendly and peaceful environment which also removes stress to the great extent.

People who take extra hypo-tension can neither perform big tasks nor can they be able to complete simple and small tasks. Workers must keep their mind relax so that they do their work efficiently and effectively. Workers must have a proper checkup if they are not fit physically. It is important to take care of health. Stress affects less on a healthy and fit employee than a sick individual. So if we take proper care of our health, we can cope up with stress and can easily face the workplace stress.

References

Babcock, P. (2009). Workplace Stress? Deal with It! HRMagazine. Alexandria , 54 (5), 67, 4.

Kadu, D. (2002). Human Buildong Report. Background Papers and Student Essays , 11.

Stress in the workplace. (2007). Health Minutes . Workplace stress a hidden injury. (2008). AAP General News Wire .

Introduction

Stress is a feeling created when we respond to some events. It is the body’s natural way of preparing to face a difficult situation with alertness, stamina, power, and focus. The stress provokers are called stressors, which cover a variety of situations.

In addition, stress is caused by negative thoughts that have an effect on a person’s mental and physical well being. Stress is also caused by accumulation of continued stressful situations, especially those situations that a person is unable to control, relentless stress that causes a severe acute response to some traumatic events, and acute stress that causes serious illness.

These traumatic events lead to psychological disturbance and anxiety resulting to stress. The following paragraphs discuss the biological factors involved in stress.

Biological Factors Involved in Stress

Stress is subjective because what may be good to one person may be stressful to the other. For example, when flying, many people have anxieties while others love to fly.

Human beings bodies responds the same way to stressful situations, but those who suffer from stress related diseases like depression are unable to turn their body’s’ responses off.

The body’s’ reaction to stress is meant to enhance flow of both adrenaline and cortisol in the blood. Psychological stress may be caused by events leading to emotional disturbances.

Some of these events include losing a loved one or ending a relationship. As the person thinks about the event, his psyche may cause anxiety that leads to stress. He/she might feel unattractive or lose confidence (Aldwin, 2007).

According to scientists, there is no cause of anxiety, but they also argue that the possible causes of anxiety may be due to heredity, brain chemistry and life experiences (Keil, 2004).

Nevertheless, researchers are still learning more about the causes of anxiety. With advancement in technology, scientists will be able to learn more about the biological and psychological effects that causes anxiety and stress. As they continue to analyze the causes, they will be able to offer efficient cure. According to studies, anxiety disorders can also run in families.

Children whose parents have suffered from anxiety disorder have greater chances of having stress. Neuroscientists from Harvard school have found out that prolonged exposure to stress hormones such as corticotrophin and cortisol in mites have resulted to anxiety that leads to depression (Aldwin, 2007).

How the Body Reacts to Stressors

According to Ron de Kloet, Joels, and Holsboer (2005), the body reacts to stressors by stimulating the nervous system and some of the hormones. The hypothalamus sends a signal to the adrenal glands to discharge more adrenaline and cortisol to the blood.

When such hormones are released, they increase the blood pressure: the blood vessels expand to accommodate the blood, thus preparing the muscle for sudden changes.

Other body organs such as the liver respond to the body’s reaction since it releases the stored glucose in order to give the body more energy. In addition, more sweat is released to cool the body.

All these body changes are meant to make a person to react and be able to deal with the situation. The natural result from the body is what we refer to as stress response. Nevertheless, either the body’s response enables a person to cope with stress or it can also cause problems when a person overreacts.

The Role of Brain in Stress

In addition, the brain is the main organ that plays a major role in the body’s view and reaction to stress. In case there is danger, it sends signals to the spinal cord up to the adrenal glands hence alerting them to release adrenaline.

It increases glucose in the blood, heart rate and blood pressure. The hypothalamus is a small part of the brain that helps connect the body’s endocrine and the nervous system because it contains many bidirectional neural inputs and outputs, which come from or to other parts of the brain.

These links enables the regulation of the hypothalamus and gives it ability to produce more hormones into the blood. During stress reaction, the hypothalamus produces a variety of hormones such as corticotrophin releasing hormone that helps in stimulating the body’s pituitary gland to reduce stress (Keil, 2004).

Likewise, amygdala is a section of the brain’s limbic system located in areas such as hypothalamus and locus coerus. Although its main role is to process emotions, it has also been associated with adjusting stress reaction mechanisms, especially when the body experiences fear and anxiety.

The hippocampus is at the medial temporal lobes in the brain; its role is considered memory formation. There are many links from the hypothalamus from cerebral cortex, which includes hypothalamus and amygdale. It influences enhancement, suppression and generating of stress responses (Davis et al., 2007).

Hippocampus can be greatly damaged in case a person has chronic stress. The locus coeruleus is found at the Pons of the brainstem, which is the main area of synthesis of neurotransmitter norepinephrine that has a big role in the sympathetic nervous system reaction to stress. Locus coeruleus receives input from other parts of the brain and protrudes to other parts of the brain to the spinal cord.

The raphe nucleus is at the brain stem. It regulates the body’s moods, especially when stress is brought about by anxiety and depression. The spinal cord’s main role is to transfer stress reaction neural impulses from the brain to the other parts of the body.

The Hypothalamic Pituitary Adrenal (HPA)

HPA is a pathway that transmits information from one part of the body to the other through the chemical messengers. Each pathway receives response in the pathway to hold back the earlier steps.

A biochemical pathway regulates itself through a feedback mechanism. For instance, stress response flow occurs when the hypothalamus gets signals from the limbic system about some of the conditions like energy deficiency that diverge from homeostatic state.

The hypothalamus gets its stimulation from its inputs and then produces corticotrophin hormones. This hormone is then is taken to the pituitary gland, which also secretes its own messenger in form of a hormone to the blood.

When adrocorticotropic hormone gets its target, the adrenal gland, it releases the last messenger – cortisol, which has many effects in the body.

During some situations like a threat, the hypothalamus is notified, and cortisol instructs the body to regain homeostasis by releasing sugar to the heart and brain, but far from the digestive and reproductive system in order to prevent the threat.

When enough cortisol is released to restore homeostasis and the threat is no longer present, the levels of cortisol in the blood flows to the pituitary gland and hypothalamus where it binds and inhibits, thus putting to an end the HPA-axis stress response flow through response inhibition.

Stress and the Immune System

Glavas and Weinberg (2006) affirm that stress affects the immune system particularly when the body’s reaction to stimuli bothers its balance. It also affects cortisol, which is released by adrenal glands.

Cortisol is good in small quantities, but when a person has excessive stress, the level of cortisol rises and slows the production of the prostaglandins that is required. Prostaglandin enhances immune capability and improves the flow of blood.

Many signs of stress correlate with unequal levels of some neuro transmitters. The amount of stress during pregnancy determines the amount of glutocorticoids structure and physiology.

High levels of glutocorticoids as well as some other hormones brought about by anxiety can destroy the limbic system and other parts of the brain that regulate homeostasis.

This affects a person’s mind thus making stress more painful. According to researchers, since stress affect many parts of the body such as the cardiovascular immune and endocrine, then we ought to believe that such stress can cause defects to the unborn baby especially during the early weeks of pregnancy when the fetus body is developing (Davis et al., 2007).

Conclusion

In conclusion, this paper has focused more on biological factors of stress and as discussed, stress is caused by negative thoughts and can have bad effects on an individual’s mental and well being.

It may be psychological or mental. We have also discussed how the body reacts to the stressors, the neuro anatomy and the role of each organ or hormone in the brain, the Hypothalamic Pituitary Adrenal system, the effects of stress on immune system, and effects of stress passed from a pregnant mother to the unborn. Therefore, stress is caused by hormonal responses, internal chemical reactions, and environment changes.

Reference List

Aldwin, C 2007, Stress, coping, and development, 2^nd edition, The Guilford Press, New York.

Davis et al. 2007, ‘Prenatal exposure to maternal depression and cortisol influences infant temperament’, Journal of the American Academy of Child & Adolescent Psychiatry, vol. 46, no. 6, p. 737.

Glavas, MM & Weinberg, J 2006, ‘Stress, alcohol consumption, and the hypothalamic-pituitary-adrenal axis’, In Yehuda, S & Mostofsky, DI, Nutrients, stress, and medical disorders, Humana Press, Totowa, NJ, pp. 165–183.

Keil, RMK 2004, ‘Coping and stress: A conceptual analysis, Journal of Advanced Nursing, vol. 45, no. 6, pp. 659–665.

Ron de Kloet, E, Joels, M, & Holsboer, F 2005, ‘Stress and the brain: From adaptation to disease’, Nature Reviews Neuroscience, vol. 6, no. 6, pp. 463–475.

Introduction

Refreshing sleep is critical for good health and well-being. Sleep presents the human body a period of time to restore energy, grow, repair cellular damage, detoxify vital organs, including allowing the brain a much needed opportunity to dream, generate neurotransmitters that are essential for stable mental health, and assimilate newly learned information (Vukovic, 2010).

More importantly, recent studies have identified a positive correlation between adequate sleep and enhanced capacity to cope with stress, while sleep deprivation have been positively associated with increased mood disturbances and impaired mental, emotional, and physical performance (Levy et al, 2006).

The need to understand about normal sleep and sleep disorders, therefore, has never been so urgent. It is the purpose of this paper to argue and demonstrate evidence that sleep disorders have a negative impact on our ability to handle stress and whether caused by stress or simply adding to our stress, they have a profound impact on our work life and our home life.

There exists compelling evidence to demonstrate that sleep research had been neglected for decades as this important facet of our own being was viewed to be of no germane consequence to the wellbeing of humans, and therefore was dropped back into a void (Sleep Mechanics, 2010).

Yet, new studies underscore a huge transformation in the way psychologists, scientists, and sleep researchers have taken a keen interest on sleep and sleep disorders (Carey, 2007). Human beings sleep for one third of their life (Levy et al, 2006), and the devastating effects caused by sleep disorders are too painful to imagine, necessitating a keen interest on this broad topic.

There has been a convergence of interest for many researchers on the topic of sleep disorder and stress. Indeed, among a multiplicity of factors affecting healthy sleep, a wealth of literature has reported the unfavorable influence of psychological stress and psychiatric disorders (Brand et al, 2010).

Some researchers are of the opinion that sleep disorders occasions psychological stress, while others support a more liberal view that sleep disorders and stress are geometrically related and affect each other proportionately depending on the variables at play (Overeem & Reading, 2010).

The situation is further compounded by the fact that it is exceedingly difficult to define stress as it encompass all types of stimuli of varying intensities and duration , not mentioning the fact that divergent types of stressors brings with them diverse impacts on sleep (Eui-Joong & Dimsdale, 2007). What is known at this stage is that sleep disorder and stress are inexorably linked, and both are associated with undesirable outcomes.

Normal Sleep and its Positive Effects

For decades now, it has proven difficult for researchers to offer an objective and unified definition of what normal sleep entails (Lichstein et al, 2004). Sleep researchers, aware of the complexities involved in offering a holistic definition, have developed benchmarks that could be used to offer a justifiable description of normal sleep.

In simple terms, however, normal sleep can be defined as “…normally distributed range of sleep” (Lichstein et al, 2004, p. 73). Normal sleep should be viewed and evaluated within the realms of both good and poor sleepers since it is not necessarily true that poor sleepers have a sleep disorder. Still, normal sleep can be defined as the lack of or absence of sleep disorder, known as a state of normality (Vukovic, 2010).

NINDS (2010a)¹ posits that “…for most adults, a normal night’s sleep lasts about 8 hours and is composed of four to six separate sleep cycles…A sleep cycle is defined by a segment of non-rapid eye movement (NREM) sleep followed by a period of rapid eye movement (REM) sleep” (para. 4).

It is imperative to note that sleep, which is defined as a natural sporadic state of rest, comes in phases and different individuals forms their own conceptions of what is enough sleep for them. However, the inability to accomplish the sleep cycle in a single night must never be viewed as a sleep disorder (Brand et al, 2010).

The intrigues of definition notwithstanding, the positive effects of normal sleep have been confirmed and well-documented by researchers (Cai & Richard, 2009). On the physical front, numerous studies have demonstrated that normal sleep is positively correlated to improved vigilance, alertness, improved reaction time, vibrant energy, improved accuracy, and decreased fatigue, among others (Overeem & Reading, 2010).

Biologically, enjoying normal sleeping patterns is not only critical to the proper functioning of the brain, but also enhances its performance, including concentration, learning capacities and memory formation. As such, normal sleep is indispensable for our mental health, vitality, and intellectual development.

In equal measure, normal sleep is ingeniously needed to give our bodies an opportunity to repair worn out body cells, a process that makes us wake up feeling refreshed and ready to face the challenges of the day. This is indeed important as it necessitates us to fulfill our work and family responsibilities without feeling fatigued or stressed out to unhealthy limits (Levy et al, 2006).

The debate about normal sleep is multifaceted in nature and scope owing to the very fact that it not only benefits people at an individualized level, but it also benefits the organizations that these people work for. Seminal studies by Shaw and Bernard² on 500 employees working for different organizations demonstrated that employees who received adequate sleep were more likely to be productive and creative at work than those who slept less than 3 hours a night or those who worked in nightshifts.

Productive employees are an asset to the organization. According to Patlak (2005), “…as many as 70 million Americans may be affected by chronic sleep loss or sleep disorders, at an annual cost of $16 billion in health care expenses and $50 billion in lost productivity” (p. 2). This serves as a wake up call for organizations to allow their employees adequate time for sleep since it becomes counterintuitive to the management’s performance objectives if they deny their employees adequate time for sleep and rest.

Sleep Disorders and their Negative Effects

Sleep disorders are a category of syndromes or medical disorders characterized by disturbances in a person’s sleep patterns, quality of sleep, or in psychological or physiological conditions that must come into play for one to fall asleep (Overeem & Reading, 2010). Epidemiological studies on sleep have identified about 70 diverse sleep disorders affecting populations worldwide, bringing with them different ramifications ranging from mild complications to life-threatening episodes (Levy et al, 2006).

According to Patlak (2005), an estimated 40 million Americans are affected by sleeping disorders. It is also estimated that more than 50 percent of U.S. citizens aged 65 and older suffers from a sleeping disorder (Levy et al, 2006).

It should be noted at this early juncture that lack of sleep for a few days cannot be equated to a sleep disorder. On the contrary, a sleep disorder is a far more serious and persistent condition that causes the sufferer substantial emotional distress and impede his or her social or work-related functioning (Sleep Mechanics, 2010).

Sleep researchers and psychologists have particularly focused attention to the correlation between sleep disorders and stress. It is a well known fact that psychological stress affects the amount and quality of sleep, making it extremely difficult to sleep normally or attain REM sleep (Patlak, 2005).

Stoppler & Marks (2010) are of the opinion that “stress is simply a fact of nature — forces from the outside world affecting the individual…The individual responds to stress in ways that affect the individual as well as their environment” (para. 1). Such forces may arise from the death of a loved one, medical condition, job-related experiences, family relationships, financial difficulties, and alcohol and substance dependence, among others.

Internal determinants determine our bodies’ capacity to react to, and deal with, the forces that induce stress. Of fundamental importance to this research paper is the realization that the amount of sleep that an individual gets is one of the internal factors that influence his or her own capacity to handle stress (Stoppler & Marks, 2010). As such, it can be logically concluded that sleeping disorders are positively correlated to enhanced stress levels.

Sleep disorders brings with them a myriad of negative effects, especially on an individual’s social, physical, emotional, and mental wellbeing.

According to the National Institute of Neurological Disorders and Stroke, the severity of sleep disorders is further compounded by well-entrenched rules of modern living, which is fast-paced and aggressive, thereby keeping sleep in extreme disregard (Levy et al, 2006). The reality is that sleep disorders can lead to a range of negative outcomes, causing mild to potentially life-threatening ramifications, from weight gain to cardiovascular seizures. Below, some of the most common sleep disorders are discussed.

Sleep Apnea

Sleep researchers and medical professionals have for years tried to understand the dynamics and causative agents of these condition that is far more widespread than holistically understood. By description, sleep apnea is a breathing disorder typified by short interruptions of breathing occasioned by muscle relaxation during sleep (Levy et al, 2006).

At a general level, the condition usually arises in association with lack of fitness, fat accumulation, and loss of muscle tone that comes with aging (Overeem & Reading, 2010). This potentially life-threatening condition is a serious concern for vital body organs such as the brain and cardiovascular system.

The condition, which was first identified in 1965, is much feared for its episodes of pausing of breathing. During an episode, a person’s attempt to inhale air during sleep produces suction that occasions the windpipe to collapse. According to Levy et al (2006), the collapsed windpipe obstructs the air flow for duration of time ranging from ten seconds to a minute, while the person, already in sleep mode, tries to grasp for breathe.

As the episode progresses, the blood oxygen level drops forcing the brain to react by waking up the person in a response that is aimed at contracting the upper airway muscles and open the collapsed windpipe (Overeem & Reading, 2010). The person may grunt or gasp for a while as he or she attempts to respond before resuming normal breathing. This most excruciating cycle can be repeated numerous times in a single night, compounding the condition even further.

The frequent awakenings brought about by sleep apnea are counterintuitive to the health and wellbeing of an individual. A study conducted on subjects with known condition of sleep apnea identified a strong relationship between the condition and personality problems such as irritability, stress, depression, and perceived instability of mental health.

The deprivation of oxygen during the seizures may have grave consequences, including brain damage, decline in mental functioning and performance, enhanced risk of suffering from stroke, heart failure, coronary heart disease, injury from accidents, and high blood pressure, among others (Lichstein et al, 2004). In the U.S., sleep apnea and its complications accounts for an estimated $42 million in treatment and hospital bills.

Hypersomnia

Hypersomnia is a sleep disorder characterized by recurring and excessive amounts of daytime sleepiness or extended nighttime sleep (Grohol, 2010). Available literature demonstrates that hypersomnia is a rare disorder, occurring in less than 5 percent of the adult population worldwide (Levy et al, 2006).

The condition usually affects people between ages 15-30, and progresses gradually over a period of years. Unlike feelings of tiredness or fatigue felt by people largely as a result of lack of adequate sleep at night, people suffering from this condition are compelled to sleep frequently during daytime, often at unsuitable times such as working hours thereby lessening their productivity.

Of particular interest is the fact that these daytime naps hardly offer any relief from symptoms of fatigue and disorientation experienced by people with this condition (Overeem & Reading, 2010).

Hypersomnia is evaluated along a continuum of duration and level of severity. According to Overeem & Reading (2010), an individual must exhibit symptoms related to the condition for at least three weeks to be diagnosed with hypersomnia, not mentioning the fact that the symptoms must have a substantial effect on the person’s life for the person to be categorized as suffering from hypersomnia. Studies conducted over time has identified some unique symptoms or behaviors exhibited by people suffering from the condition.

In one particular study, Levy et al (2006) identified excessive daytime sleep (EDS), diminished levels of alertness and energy, anxiety, depression, disorientation, prolonged sleep at night, diminished mental functioning, memory difficulty, and enhanced irritation. Other symptoms include restlessness, slow or retarded speech, antisocial behavior, appetite loss, and hallucinations (Brand et al, 2010). In severe cases, a person suffering from this condition loses his ability to undertake his or her family, social, or occupational responsibilities.

Hypersomnia is occasioned by the presence of another sleeping disorder, medications, drug or alcohol dependence, injury or impairment of the central nervous system, and head tumors, among others (Brand et al, 2010). The condition, according to Levy et al (2006), can also be caused by other medical complications such as multiple sclerosis, epileptic seizures, post traumatic stress disorder, and obesity.

Of importance to the broad objective of this report is that this condition can be caused by medications used to alleviate stress. As such, a correlation between sleep disorders and the negative outcomes brought about by stress can be drawn.

Narcolepsy

There is no known cause for this chronic disorder, which is described as excessive and overwhelming sleep attacks especially during daytime even after having adequate sleep at night (Levy et al, 2006). Some sleep researchers defines narcolepsy as a chronic neurological disorder which weaken the capacity of the central nervous system to regulate normal sleep patterns (Overeem & Reading, 2010).

As such, a person suffering from this condition is more likely to become sleepy and fatigued at inappropriate times and situations. According to the NINDS (2010a), “…people may involuntarily fall asleep while at work or at school, when having a conversation, playing a game, eating a meal, or, most dangerously, when driving an automobile or operating other types of potentially hazardous machinery” (para. 2).

If the urge to sleep becomes irresistible, people with this condition fall asleep for periods ranging from a few seconds to one hour or even for longer periods of time.

Other symptoms that characterize narcolepsy include abrupt loss of voluntary muscle tone, hallucinations, and brief periods of total paralysis especially at the beginning or end of every episode (NINDS, 2010a). It is inarguably difficult to diagnose narcolepsy. For a person to be fully diagnosed as suffering from the condition, he or she must have suffered repeated episodes of sleep attacks for a period not less than three months (Sleep Mechanics, 2010).

The situation is further compounded by the fact that the condition is not ultimately diagnosed in most victims until 10 to 15 years after the onset of the first symptoms (NINDS, 2010a). Scientists have now formed the opinion that narcolepsy is occasioned by disease processes which affects the brain’s capacity to regulate REM sleep. Of particular relevance to this report is the fact that narcoleptic sleep seizures can occur anywhere at any given time, profoundly disabling the victim’s productive capabilities.

Restless Legs Syndrome

Restless legs syndrome (RLS) is a neurological sleep disorder characterized by uncomfortable, stinging sensations in the legs followed by spontaneous urge to move the legs when at rest or sleeping in an attempt to relieve these unpleasant and often painful feelings (NINDS, 2010b). According to Buchfuhrer & Kushida (2007), “…the medical term for these sensations is dysesthesia, which is defined as disagreeable or abnormal sensation” (p. 3).

These sensations normally occur in the calf sections of the legs but may also be felt elsewhere. The most unique or extraordinary characteristic of RLS is that relaxing or lying down for prolonged periods of time automatically activates the symptoms. The sensations vary in severity from slight uncomfortable feelings to painful episodes. Some individuals have reported experiencing the sensations in the arms too.

Accounts of people with RLS reveals a trend whereby the sensations are more pronounced at night than during the day (NINDS, 2010b). In most occasions, the uncomfortable sensations disappear by early morning, allowing the person some time to sleep. Despite extensive research, the causative agents of RLS remain unknown.

Although many people don’t take the condition seriously, especially in mild cases, severe cases of RLS can disrupt daytime functions due to the onerous interruption of sleep during the night. More importantly, the syndrome is known to cause exhaustion, stress, and daytime fatigue if left untreated (NINDS, 2010b).

Such a scenario bears obvious ramifications on the victims’ work-related responsibilities, personal and family relations, and other activities of daily living. In addition, people with RLS are unable to concentrate, and therefore are unable to accomplish their daily roles (NINDS, 2010b; Buchfuhrer & Kushida, 2007).

Exploding Head Syndrome

According to American Sleep Association (2007), “…exploding head syndrome is a rare and relatively undocumented parasomnia event in which the subject experiences a loud bang similar to a bomb exploding, a gun going off, a clash of cymbals or any other form of loud, indecipherable noise that seems to originate from the head” (para. 1). This condition is not associated with pain or any other physical characteristic.

Many people have only reported shortness of breath after experiencing the syndrome. This noise occurs just before a person enters into deep sleep, and occasionally upon waking up. Attacks can, on their own volition, increase or decrease with time or even disappear altogether.

People with this condition often experience fear and distress after an episode, followed by elevated heart rate. Though the condition is not life-threatening, it is highly associated with stress and overbearing fatigue in most people. At this stage, the cause of this syndrome is not yet known (ASA, 2007).

Population Affected by Sleeping Disorders

Sleep disorders are known to affect people based on their age, lifestyle behaviors, immediate environment, and their mental and health status, among other factors (Levy et al, 2006). It is difficult to draw a fine line between who is at risk of being affected by the sleep disorders because situations keep shifting and our experiences at an individual level keep on changing inline with the trends of modern living.

One thing that has reverberated all along the discussion, though, is the fact that sleep disorders and stress are inexorably linked, and that one variable triggers a spontaneous response from the other. This notwithstanding, extensive research carried out on these disorders has explicitly identified the percentage of Americans who may be at risk and, in some occasions, stated the age categories that are most affected.

A cohort study conducted in 1993 revealed that one in every 15 people in the U.S were affected by at least one form of sleep apnea, a figure that is equivalent to 18 million Americans (CureResearch.com, 2010). It is also estimated that 2-4 percent of Americans lives with the condition but are yet to be diagnosed.

People in middle-age are thought to be more at risk of being affected by the condition, with figures demonstrating that as many as 9 percent of American women and a massive 24 percent of American men in middle-age are affected by the condition yet they remain undiagnosed and untreated (Levy et al, 2006).

Available data on hypersomnia demonstrate that the condition affects an estimated 5 percent of the population as they progress through the lifespan (AllPsychOnline, 2004). However, hypersomnia is more widespread in males than in females. The symptoms appear before an individual celebrates his or her 30^th birthday, and continue to advance as one ages unless treated.

Narcolepsy is a common sleep disorder in populations around the world, but it often goes unrecognized or misdiagnosed. It is therefore hard to account for the total percentage of the population suffering from the condition. But going by NINDS (2010a) estimates, one in every 2,000 people living in the U.S. is affected by the condition.

Narcolepsy is neither gender specific nor racial or ethnic specific; it affects people from all walks of life globally. It is feared that a larger segment of the population might be suffering from the condition in silence. According to NINDS (2010a), the disorder “…prevalence rates vary among populations…Compared to the U.S. population, for example, the prevalence rate is substantially lower in Israel (about one per 500,000) and considerably higher in Japan (about one per 600)” (para. 6).

Researchers put the figure of Americans suffering from restless legs syndrome (RLS) at 12 million (NINDS, 2010b). However, this is a provisional figure because RLS, as is the case with narcolepsy, is thought to be grossly misdiagnosed and, in some instances, under-diagnosed. Still, some people with the condition fail to go for medical checkup on the belief that theirs is not a serious condition that warrants medical attention. As such, the prevalence levels could be higher than currently estimated.

There exist no objective statistics on people affected by exploding head syndrome due to the fact that the disorder is relatively new. What is known at this stage is that individuals over the age of 50 stands more chance of being affected by the syndrome. It is also known that women are at higher risk of being affected by the disorder than men (ASA, 2007).

How Sleep Disorders Affect Family Life

Evidence adduced in this report has demonstrated that the amount of sleep that an individual gets is one of the internal factors that influence his or her own capacity to cope with stress (Stoppler & Marks, 2010). This therefore implies that sleep and the capacity to handle stress are proportionately linked, with the amount of sleep serving as a variable over the capacity to handle stress.

More importantly, it has been revealed that sleep disorders affect family life in numerous ways. A good starting point in this discussion would be to reinforce the proven concept that normal sleep is indispensable for our mental health, vitality, and intellectual development (Sleep Mechanics, 2010). In the absence of normal sleep, individuals will be deprived of these critical aspects that enhance their ability to cope with stress.

Fatigue and stress occasioned by sleep disorders makes a person to be unproductive at the family level. As a matter of fact, these undesirable characteristics are not only counterproductive to the family as a unit, but they also impact substantial harm on the victim and his or her own personal and social relationships (Brand et al, 2010).

The frequent awakenings occasioned by sleep apnea, according to available literature, are counterintuitive to the health and wellbeing of an individual.

According to Lichstein et al (2004), these individuals may be unable to maintain a long term relationship with their partners, not mentioning that the disorders takes a toll on their quality of life, denying them the confidence and vigor that is copiously needed for modern living. Subjectively, some of the sufferers of serious sleep disorders such as sleep apnea think of themselves as abnormal human beings.

There exists a strong relationship between sleep disorders such as sleep apnea and personality problems, including irritability, stress, depression, and perceived instability of mental health. Hypersomnia is known to decrease the level of alertness and energy while enhancing depression, disorientation, antisocial behavior, and enhanced irritation, among others (Levy et al, 2006).

These undesirable outcomes not only reduces our capacity to effectively cope with the stressors experienced in modern living, but also entraps the sufferers in a vicious cycle of unresponsiveness and low quality life on the family front. Studies have positively correlated these characteristics to increased suicide rates (Vokovic, 2010).

It is, therefore, not difficult to see that people suffering from sleep disorders stands a high risk of losing their ability to holistically undertake their family responsibilities. Family breakups and divorces may be witnessed in cases where the sufferer is the sole breadwinner of the family since the disorder will force him or her to forego family responsibilities.

Sleep disorders comes with profound financial obligations in medical costs that are bound to weigh heavily on the family. Statistics demonstrates that an estimated $16 billion is used annually in the U.S. to treat people with sleep disorders (Patlak, 2007). Such costs may have an overbearing effect on the family, affecting its ability to function normally and, in some cases, draining all the resources earmarked for other activities.

This only serves to increase stress levels. More importantly, some of the medical complications associated with sleep disorders such as stroke, brain damage, coronary heart disease, and high blood pressure have the capacity to bring permanent ramifications on family life (Eui-Joong & Dimsdale, 2007).

How Sleep Disorders Affect Work Life

It is indeed true that work environments are stressful environments. Our ability to handle and cope with stress therefore becomes of critical value if we are to perform to expectations and remain productive at work. However, this is better said than done when it comes to sleep disorders and work life as many of the negative outcomes associated with sleep disorders only serves to diminish our own abilities to handle stress.

Some symptoms such as fatigue, depression, loss of memory, disorientation, and daytime sleepiness (Eui-Joong & Dimsdale, 2007) curtails people’s productive and creative nature at work. Chances are that, such symptoms increases cases of absenteeism from work and enhances turnover.

According to Lichneistein et al (2004), productive employees are an asset to the organization. Sleep disorders, however, works against the grain to make people with such complications become less productive in their work and therefore a liability to the organization.

Patlak (2007) opines that the U.S. alone loses in excess of $50 billion annually in lost productivity due to complications associated with sleep disorders. This is an astronomical figure whose effect on the economy cannot be wished away. People with sleep disorders such as hypersomnia or narcolepsy are unable to optimize their work life owing to the fact that they are compelled to sleep frequently during daytime, often at unsuitable times such as work hours (O vereem & Reading, 2010).

In particular, people with narcolepsy cannot operate hazardous machinery or drive for long hours as they are bound to involuntarily fall asleep on the job and if they do, other expenses may have to be incurred in terms of covering for accidents and hospital bills. Other stress disorders such as RLS and exploding head syndrome are known to cause exhaustion, stress, lack of concentration, and daytime fatigue, profoundly disabling the person’s productive capabilities at work (NINDS, 2010b; Buchfuhrer & Kushida, 2007).

Conclusion

Clearly, the facts have been laid bare that not only does sleep disorders affects our ability to handle stress, but they also have a profound effect on our work and home life. Specifically, the paper has focused attention to the interrelations between sleep disorders and stress, and how the resulting multiplicity of negative outcomes affects our family and work life.

The paper has gone a step further to discuss some of the most common sleep disorders and the populations that are most at risk of being affected. The astronomical costs in terms of lost productivity, medical complications, family breakups, stress and stress-related complications, lack of creativity, among others calls for action among all stakeholders directed at offering practical yet manageable solutions to the millions of people suffering from these devastating yet treatable complications.

Reference List

AllPsychOnline. (2004). Psychiatric disorders: Primary hypersomnia. Web.

Brand, S., Gerber, M., Puhse, U., & Holsboer-Tracchsler, E. (2010). Depression, hypomania, and dysfunctional sleep related cognitions as mediators between stress and insomnia: The best advice is not always found in the pillow. International Journal of Stress Management, Vol. 17, Issue 2, p. 114-134. Web.

Buchfuhrer, N. J., & Kushida, C.A. (2007). Restless legs syndrome: coping with your sleepless nights. Montreal Avenue, Saint Paul, MN: AAN Enterprises

Carey, B. (2007). New studies suggest sleep is vital to learning and memory. The New York Times. Web.

CureResearch.com. (2010). Statistics about sleep apnea. Web.

Eui-Joong, K., & Dimsdale, J. E. (2007). The effects of psychosocial stress on sleep: A review of Polysomnographic evidence. Behavioral Sleep Medicine, Vol. 5, Issue 4, p. 256-278. Academic Source Premier Database.

Grohol, J. M. (2010). Hypersomnia, Primary Symptoms. Web.

Levy, P., Viot-Blanc, V., & Pepin, J. L. (2006). Sleep disorders and their classifications – An overview. In: W. J. Randerath, B. M. Sanner, & V. K. Somers (Eds) Sleep Apnea: Current diagnosis and treatment. Karger Publishers.

Lichstein, K. L., Durrence, H. H., Riedel, B. W., & Taylor, D. J. (2004). Epidemiology of sleep: Age, gender, and ethnicity. Mahwah, New Jersey: Taylor & Francis.

National Institute of Neurological Disorders and Stroke. (2010). Narcolepsy fact sheet. Web.

Overeem, S., & Reading, P. (2010). Sleep disorders in neurology. Oxford: Blackwell Publishing

Patlak, M. (2005). Your guide to healthy sleep. U.S. Department of Health and Human Services. Web.

Sleep Mechanics: A guide to guide to getting a good night’s rest. (2010). MasterFILE Premier Database.

Stoppler, M. C., & Marks, J. W. (2010). Stress. MedicineNet.com. Web.

Vukovic, L. (2010). The power of sleep. Better Nutrition, Vol. 72, Issue 4. MasterFILE Premier Database.

Footnotes

1. National Institute of Neurological Disorders and Stroke.
2. See: Lichstein et al (2004).

There is a variety of mental disorders that are a result of various causes. However, a significant example is the Post traumatic stress disorder (PTSD). It is a convoluted typology of a mental disorder that affects the patient’s nervous system, reminiscence, emotional responses and coherent abilities.

The condition destabilizes the patient’s nervous system through the uncontrollable recurrence of memories of past traumatic experiences (Beth, 2002). There are various causes of the condition that determine its intensity. They include:

The Physiological factor affects the human nervous system; it is characterized by irregular secretion of stress hormones in the brain. Initial research on the patients suffering from post-traumatic stress disorder indicate that at some point in life, when an individual witnesses harrowing events, he/she may later in life develop symptoms of PTSD, depending on the intensity of the experience and the length of time exposed (Beth, 2002).

The disorder results in the fact that the person is undergoing chemical changes in the amygdale and the hippocampus. These are the parts of the mind which form the boundary between fear and memory.

This variation alters with the normal functioning of the mind, trials carried out by researchers with ketamine; the medicine that inhibits some of the neurotransmitter compounds in the human mind implies that, trauma effect works in a similar manner to dent coordination processes, in the human central nervous system. The resultant effects are observed as inhibitions to speech and language abilities of the patient (Beth, 2002).

Secondly, we look at the social cultural causes of PTSD. According to research activities carried out on PTSD patients like long serving soldiers, survivors of rape, genocide survivors and horror victims.

The research showed that, in communities where harrowing incidents are prevalent like Iraq and the war dominated countries like Somalia in Africa, cases of patients with PTSD are very common. This is evidence by a direct link between the disorder, the terrorism, harrowing events and activities (Beth, 2002).

Work related causes also come up as some of the major causes of the condition. Doctors and individuals, whose work involves consistent harrowing scenes, may end up developing symptoms of the condition. This form of the disorder is called secondary PTSD, as it results from the continuous exposure of the person, to observable consequences of traumatic events.

Examples of such professions are the rescues personnel, emergency doctors, psychiatric therapist and catastrophe investigators. However, the risk to contracting the condition is always determined by the resilience of the personnel to these exposures, past unsettled concerns in their life history, and the quantity as well as intensity of depiction to the suffering of trauma victims.

Individual variations also determine the probability of the person to develop the condition. The traumatic events play a major role as the cause of PTSD; however, people vary in their cognitive resilience and expressive response to shocking exposures. Some people have more emotional stability than others.

For example, in burial some people even faint due to the weight of the loss while others don’t even cry. Furthermore, some of the cases may be due to natural abilities of the person’s intellect, while others are caused by chronic diseases, upbringing challenges during child hood and life challenges experienced by the patient (Dalenberg, 2000).

Diagnosis criteria

The most widely used diagnostic criteria employed in the diagnosis of PTSD, is the standard Diagnostic and statistical manual of mental disorders (DSM-IV-TR). It is the specific criteria recommended, and used by medical personnel while making a diagnosis on a patient with the condition. It involves establishing the existence of the key symptoms of the disorder in the patient which include:

1. Observable constant nervous tension by the patient. This is where the patient suffers from frequent flashbacks that cause revulsion feelings of intense fear. The fear may be as a result of a past exposure to a harrowing event, in which the patient experienced fast hand threats to his life which stuck to his mint. In most cases, threats caused by humans have extreme consequences than events due to natural causes like tsunamis and earthquakes. As a result, it keeps recurring in the memory of the patient; causing feelings of helplessness and dissolution in life (Dalenberg, 2000).
2. Regular invasive symptoms; if the patient experiences constant uncontrollable flashbacks they cause him to undergo harrowing daydreams or nightmares. The flashbacks happen in such a way that the patient feels as if the incidents are presently happening all over again. This is due to an unusual memory formation processes caused by the intensity of the event to the patient. This is seen when the flashback is triggered by an enticement, which reminds the patient of the harrowing experience, or a speechless eminence with images solely seen by the patient (Schiraldi, 2000).
3. Constant Avoidant symptoms where, the patient tries everything possible to avoiding things, occasions and places that might remind him/her of the harrowing experience. The patient does this aiming at reducing the frequency of the flashbacks to him/her. It is characterized by the patient’s constant need to isolate himself from other people, constrained feelings and avoidance of things related to the ordeal. Those suffering from the condition, if not properly handled, have a high probability of abusing drug in an attempt to control the feelings (Dalenberg, 2000)..
4. The symptoms must have been consistently observable on the patient, for more than one month to be considered as a symptom.
5. The intensity of the condition, may sometimes determine the ability of the patient to maintain a regular relationships in his life. He/she may have difficulty working properly due to PTSD, and may be seen to withdraw from people such as, family and friends. In extreme cases, the patient dissociates from the society completely and other sources of meaning in life.
6. Hyper-arousal is the states of mind were the individual is constantly, unusually attentive and watchful for any signs of danger, even where there is none. It is characterized by an extremely startled response, inability to concentrate on detailed tasks and a short temper. According to most doctors, this is believed to be the major symptom of PTSD (Dalenberg, 2000)..

Factors Affecting Diagnosis of PTSD

In other cases, it becomes a challenge for the doctor to make the correct diagnosis of the condition due to the following challenges;

The fact that the condition is based on psychological measures is a challenge. Unlike other conditions that involve running tests on the patient before a clear diagnosis is done. PTSD involves listening to the history of the patient, and relying on the given information to make conclusions. Some of the instruments used to make inferences on the patient may include: the Hamilton Anxiety Scale, the Impact of event scale and the Beck Depression on Inventory (Foa, 2000).

There is also the problem of dual diagnoses. This occurs when the patient is diagnosed of having two disorders at the same time. It affects the progress of the treatment and as a result complicates the whole process.

Some of the conditions of double diagnosis include: A patient with PTSD diagnosed with substance abuse, someone with PTSD diagnosed with personality disorder and someone with PTSD diagnosed with anxiety dissociative disorder. The task of treating two disorders with different effects on the patient is both challenging to the doctor and complicating (Foa, 2000).

Naturally, people are different and they tend to respond differently to medication as well as to effects of PTSD. The variation in reaction to causes of stress, may also affect the response of the patient to treatment. Depending on the resilience of the patient to the disorder, it may take longer or shorter for the patient to completely recover from the condition.

To ease the whole process, the benchmarks used in the diagnosis of PTSD incorporated the use of adjustment disorder; in categorization and setting a limit between anomalous responses to normal life strains and devastation from horrors (Foa, 2000).

Conceptualization based on your theoretical perspective

PTSD is a condition that has been in existence since time immemorial. Henry IV, a close relative to Shakespeare, had all the characteristics that define the present day PTSD due to his past experiences. Although at that time the condition was not taken seriously because of its complicated nature.

The symptoms were prevalent to war veterans, and other victims of harrowing experiences. Initially, the condition was referred to with several names such as post rape syndrome, battle fatigue, shell shock and accident neurosis (French, 1998).

However, it took a very long time for the condition to be recognized officially as a disorder. This was after a relentless research activity by researchers like Gersons and Carlier. In 1980, the condition was recognized by the American Psychiatric Association, after the recognition of its standard diagnostic criteria in the DSM III.

At first, the condition was full of controversy due to its nature. Over time it has proved to be of greater significance in the psychiatric theory and concept. This is because of the external causative agents of the disorder, and not the patient’s personal weakness as it was initially thought (French, 1998).

Overtime, the criterion for the diagnosis has been improving for the people’s well fare. Initially, there were no clear distinctions between the stressors, which resulted from normal life activities such as divorce, job loss and rejection. And catastrophic events such as battle field stressors, terrorism explosions and rape ordeals.

This lack of a clear distinction may lead to, poor diagnosis of the condition and complication during treatment. Since that time, there has been considerable interest by researchers on the condition; with diagnoses mainly being made in soldiers and individuals, from countries that have been experiencing war activities for some time (French, 1998).

The interests by scientists lead to the development of longitudinal research in PTSD. According to these research activities, if PTSD is not treated early, it may affect the patient for a longer time than imagined. Those suffering from chronic PTSD may undergo longitudinal itinerary, characterized by diminutions and degeneration.

Sometimes, it may take a longer time to diagnose the condition due to the presence of inadequate symptoms, until after a long time ranging from a few months to several years when the symptoms resurface. Initially, the patient may experience conditions similar to the horrifying circumstances (French, 1998).

Special concerns from the legal/ ethical issues

Some times, the intense effects of PTSD may make the person to undergo traumatizing memories, which result in irritable moods. In extreme cases, the patient may be perceived to be insane. The psychological association supports the law in defending such patients, in the event that a crime was committed when the patient was suffering from the condition. This is done on the grounds of insanity, because the patient may not be in a mental position to control his actions, or comprehend happenings in his immediate environment (French, 1998).

In some cases, due to the sensitivity of the case involved, forensic applications are employed to improve on the reliability of the evidence in court. A Professional psychiatrist, who may be a witness for a case that is in progress in a court of law, should be able to maintain both honesty and professional integrity.

He/she should consider the use of both standard psychological criteria and medical evaluations. Furthermore, he must be able to specify the criteria for diagnosis, and give a well detailed report, of whether the patient measures up as a beneficiary of this scope of the law or not. Where compensation is being sort, the professionals must be very cautious, as the patient may exaggerate his condition due to personal interest, unlike in other cases (Hart, 2001).

On the other hand, the law enforcers have also grown to become victims of the condition due to the nature of their job. However, the expectation of the society to the police of always expecting them to be perfect has also put a challenge to the police themselves. This is why, it is very hard for police personnel to take initiative, and seek professional help in their own case.

Police are always trying to measure up to this expectation, and provide their service to the society. In the process they put up to being at work, even immediately after horrifying experiences. This may lead to piled up pressure, causing symptoms of PTSD. It should be therefore noted that, police officers are also human and prone to the disorder (Hart, 2001).

In the ethical perspective, PTSD has increased cases of ethical dilemmas. In the USA alone, approximately a quarter a million war veterans are in prison, mostly due to murder. Majority of the soldiers come back home as changed people, due to their experiences in the battle field.

Most of them do not seek professional help, leading to chronic PTSD. As a result, some commit serious crimes believed to be due to the effects of PTSD, and end up being imprisoned. Surprisingly according to records, majority of these veterans lacked criminal records before they went to war (Hart, 2001).

Later on, after the government discovered that rates of suicide among veterans of resent wars were increasing. It initiated national studies in 2005, and they established that, veterans had twice the probability to commit suicide as compared to those who had never served in the army.

It is increasingly becoming evident that most of the crimes committed by the ex- soldiers are the consequences of PTSD symptoms on the patients. The condition has compromised the ethics of even those soldiers that, before the war, were law abiding citizen and cautious to morals (Schiraldi, 2000).

It becomes even worse, for those individuals who were involved in the battlefield either as rescuers or doctors. When they come back home from the war, they experience PTSD and if not treated early, some of them end up as drug addicts.

A good example is Anthony Ortega, who ended up as a drug addict, before recuperation and now serves at Union Mission. In some cases, the ex-soldiers ends up living in the streets of Los Angeles were they make up to 25% of the homeless. To make it worse, they are prone to more crimes (Matsakis, 1994).

Cross-cultural perspectives related to assessment and treatment

Cultural perspective if expressed in terms of meaning and various insights vary from culture to culture. However, as a major source of the framework within which facts and major aspect are formulated to form rationality and relations. Culture, either directly or indirectly affects how the various parties involved treat and relate to PTSD as the major effect of horror.

Due to the diversity presented by culture, it may be better if the perception of trauma is dealt with in a dynamic way. This is a form that incorporates the use of universal diagnostic criteria. Treatment such as therapy should be formulated depending on the culture of the people to be treated.

A research carried in Mozambique proves that, what is perceived to be a traumatic event in one culture may not be so in another culture. To be able to understand the distinctions, one must be able to establish the relationship between death and the living people.

We must also be able to understand, the person believes in relation to, government and their patriotism. There are various methodologies used in the cross culture analysis of PTSD, depending on the aim of the research activity. The appropriate criterion is always the one that can accommodate as many views and perceptions as possible.

The criterion to be used in cross cultural perspective must incorporate the socialized view of psychological health. In the non western world, individuals take the effects of the war as a community, but not as an individual as it is observed in the western world. This is a form of automatic precaution in the non western world and as a result, the effect of the trauma to individuals is much less than to the western personnel.

Currently, research activities by the VA scientists in their examination of the prescription practices in the treatment of PTSD indicate a continuously high medication of anti depressants; and a decrease in the antipsychotics and benzodiazepines in the last 10 years (Volkman, 2005).

It was also established that most doctors preferred the use of first line PTSD treatment. However, for those patients that may not respond to the first line treatment, other psychotropic medication may be used although they may involve some significant risk.

In another research carried out it was established that, regardless of the presence of pain, the patients are more likely to be prescribed with opioids. Unfortunately, this increases the possibility of a poor feedback. The study identified an increased use of off-label antipsychotics and opioid therapies in patients; the current levels are too high and should be managed at lower levels.

Current research related to diagnosis and assessment of the disorder

Current research like research carried out in May 2011 established that, a soldier who experienced mental illnesses before going to war had increased chance of developing symptoms of PTSD after returning from the battle field. Such soldiers were more than twice likely to contract PTSD, than other soldiers who never suffered from any mental diseases.

The army has also taken initiative to put in place activities that may prevent PTSD, like giving counseling sessions for those that may show signs of weakness just before combat. Studies also showed that, if soldiers were married, they were allowed to communicate through emails and letters to their spouses. During the period of combat they exhibited reduced chances of developing PTSD.

Transcendedental medication is one of the new forms of treatment for PTSD, studies on the medication proved that it helped to reduce symptoms of PTSD on the patients thus improving their life (Volkman, 2005).

Future trend

According to research activities, it is clear that the effects of PTSD are overwhelming to the patients especially ex-soldiers. It is, therefore, necessary for the community and the government to take extra measures to reduce the effects. Some of the efforts may include giving the patients more support. The government may collaborate with professional psychiatrists, and invest more in counseling personnel, and research on better treatment methods.

References

Beth, W.M. (2002). The PTSD Workbook: Simple, Effective Techniques for Overcoming Traumatic Stress Symptoms. New York: Penguin publishers.

Dalenberg, C. J. (2000). Countertransference and the Treatment of Trauma. San Francisco: Brooks Cole publishers.

Foa, E. B. (2000). Effective Treatments for PTSD: Practice Guidelines from the International Society for Traumatic Stress Studies. OXFORD: Oxford University press.

French, G. D. (1998). Traumatic Incident Reduction (TIR). New York: CRC PRESS LLC.

Hart, A. (2001). An Operators Manual for Combat PTSD: Essays for Coping. London: Universal publishers.

Matsakis, A. (1994). Post-Traumatic Stress Disorder: A Complete Treatment Guide. California: New Harbinger Publications.

Schiraldi, G. (2000). Post- Traumatic Stress Disorder Source Book. ILLINOISE: Lowell House publishers.

Volkman, V.R. (2005). Beyond Trauma: Conversations on Traumatic Incident Reduction, Second Edition (Explorations in Metapsychology). Chicago: Williamson & Sons publishers.

Introduction

Post-traumatic stress disorder (PTSD) is a condition that develops when one feels when their safety is threatened and when they feel helpless. The common notion in today’s environment is that the condition is attributed to soldiers who are scared of battle. Whereas military combat is listed as the most common cause of PTSD in men, it can occur due to a number of different reasons in both women and men.

An event in one’s life that is overwhelming and one that is both uncontrollable and unpredictable in a person’s life can be the trigger of PTSD.

The condition does not only affect those who went through a traumatizing ordeal but also those who witnessed it, law enforcement agents and emergency aid workers who pick up the pieces after the occurrence or even to the family and friends of the people who were the victims of the actual trauma.

Every person is created different. As such, it follows that the symptoms of PTSD can manifest themselves in a person maybe hours after, days, weeks, months or even years.

There are many events that can lead to the manifestation of PTSD in people. War has been detailed as the most common. Others include car clashes, sudden death occurring to a close person; be it friend or relative, plane clashes, kidnapping, rape, neglect during childhood, deadly assault, attack by terrorists, sexual abuse mostly from a close person, physical abuse, natural disasters among many others.

The thesis developed for this paper is the understanding of the causes, symptoms, stigma, treatments and prevention of post-traumatic stress disorder. The facts that are going to be discussed in this research paper will aid in the proving of this thesis.

Discussion

PTSD can manifest itself in many ways. The symptoms may arise gradually, suddenly or may be on and off. The symptoms can either be triggered by a cue in the environment like a noise which makes the person remember the trauma or can appear out of nowhere. Symptoms can be classified into those arising from re-experience of the traumatic event, avoidance of the events and those arising from emotional arousal and increased anxiety.

Specifically, a person who re-experiences the trauma will have upsetting and intrusive memories of that event, nightmares of the event itself or other things that are frightening, intense physical reactions including nausea, pounding of the heart, sweating, rapid breathing, and tension of the muscles, flashbacks to the particular event so that it seems like it is occurring again and intense distress that arises from being reminded of the trauma.

One who is trying to numb and avoid remembrance of the event is likely to avoid thoughts, activities, places and even feelings that may associate with the trauma, have a feeling of detachment from others and be emotionally numb, lose interest in the daily activities and even in life itself, have an abnormal sense of a normal life and tend to expect nothing resembling it; like a career, family or even a normal life span and lack the ability to remember the exact aspects of the trauma.

Those who experience increased emotional arousal and anxiety are likely to have difficulty in falling asleep, feeling uneasy such that they are easily startled and feel jumpy, be on constant alert, have decreased concentration and be easily irritated and occasionally burst out in anger (Kimerling & Calhoun, 1994).

Other symptoms that are common with the disorder include hopelessness, pains, anger, suicidal thoughts, depression, guilt and shame, drug abuse, self, loneliness even in the presence of others and self-blame. Individuals who are affected by PTSD do not portray normal behavior. They tend to avoid being in certain situations that normal behavior expects them to be.

These individuals will occasionally seem lost since they are incapable of paying attention and can neither therefore sustain a conversation nor can they keep at an activity for long. The behavior that people with PTSD portray is not considered normal. Recurring distressing recollections, nightmares, distress, lack of interest in normal life and sleeplessness are some of the abnormal behavior that people with PTSD show.

These behaviors are considered abnormal since they were usually associated with people with mental illnesses and not in otherwise normal people. This perception that has been engraved in the minds of people and resulting from cultural beliefs are what makes the behaviors of PTSD to be classified as abnormal.

Often, these people will withdraw themselves from society and will always stay alone (Meltzer et al, 2000). Since they do not sleep much, they may be drowsy. Other abnormal behavior is the ease of irritability, aggression, agitation and experience of panic attacks. PTSD is classified as being in axis 1.

This is because the disorder is often characterized by major psychiatric illness, major depression, substance abuse and in most cases is recurrent without any psychotic features.

There are negative qualities that society has attached with having mental illnesses. People who have mental disorders are stigmatized which results to feeling of weakness, hopelessness and shame (Britt, 2000). 61% of the soldiers who return from combat admit that a disclosure of their psychological condition would mean a negative effect on their careers.

Such people who are mostly victims of PTSD do not therefore seek treatments and instead attempt to deal with the situation on their own which worsens it. Once a soldier has been diagnosed with a psychological problem associated with PTSD, they are less likely to go for referral treatment compared to referral for physical illnesses.

The society that we live in has not changed much even with the attempt to sensitize people on the condition. 43% of soldiers returning from battle believe that a disclosure of their psychological conditions will make other people not want to be around them (Hoge et al, 2004). This shows that they believe that the society negatively treats those who have any king of psychological problem however minute or whether treatable or not.

Studies that have been done on soldiers indicate that most of them do not seek treatment for PTSD for fear that the members of their respective units will see them as being weak. The major barrier to the treatment of PTSD is the perception of the society on those who do seek the treatment.

PTSD is treated by psychotherapy also known as talk therapy, medication or a combination of both.. Psychotherapy involves talking to a professional and can occur one-on-one or as a group therapy. The treatment usually takes a minimum of 6 weeks and can extend up to 12 weeks.

During this period, friends and family are encouraged to assist as research has shown that the support of these people actually improves the chances of success of the therapy.

The focus of treatment can either be on the alleviation of the symptoms of the disorder or can be on the social aspects of the patient’s life including family and the job. The therapists in conjunction with doctors try out a number of different therapies to determine which combination works best for a particular patient.

Cognitive Behavioral Therapy (CBT) is the most common type of therapy and includes; exposure therapy, cognitive restructuring and stress inoculation training. Medications include sertraline (Zoloft) and paroxetine (Paxil), both antidepressants, which have been approved by the U.S.

Food and Drug Administration (FDA). A combination of both psychotherapy and medicines has been proposed as the most effective way of treatment which is known as psychopharmacology. There are some ethical issues that arise from the use of psychopharmacology.

The most common is that the drugs that are used for treatment have been found to have negative side effects which include thoughts of suicide in victims (Bridge et al, 2007). This begs the question among critics of whether such side effects are desirable considering the outcome that needs to be arrived at.

In order to prevent the adverse effects that are associated with PTSD, there are a number of precautions that can be taken. The first is that the victim should be immediately taken or take himself to a safe place to prevent further exposure to the trauma.

Secondly, one should consult a doctor if they have suffered any physical injury. Thirdly, the person should be availed with or should look for food and water. Fourth, the person should contact a loved one either friend or family and inform them of the occurrence and lastly, one should immediately seek help.

Conclusion

PTSD is a condition that affects people who have undergone a major trauma or event that leaves them feeling powerless. Such events are usually unpredictable and uncontrollable. The condition is characterized by a wide range of symptoms that can occur immediately after the ordeal or after some time.

Society should be sensitized on the condition in order to reduce the stigma that is associated with it which prevents people with the symptoms from seeking treatment. The condition can be treated by psychotherapy, medication or psychopharmacology which is a combination of both. However, a person who has been caught up in a traumatic occurrence should take precautions to ensure that PTSD does not develop in him.

References

Bridge, J.A. et al. (2007). Clinical response and risk for reported suicidal ideation and suicide attempts in pediatric antidepressant treatment, a meta-analysis of randomized controlled trials. Journal of the American Medical Association, 297(15): 1683-1696.

Britt, T.W. (2000). The stigma of psychological problems in a work environment: Evidence from the screening of service members returning from Bosnia. Journal of Applied Social Psychology, 30, 1599-1618.

Hoge, C.W. et al. (2004). Combat duty in Iraq and Afghanistan, mental health problems, and barriers to care. The New England Journal of Medicine, 351, 13-22.

Kimerling, R., & Calhoun, K.S. (1994). Somatic symptoms, social support, and treatment seeking among sexual assault victims. Journal of Consulting and Clinical Psychology, 62, 333-340.

Meltzer, H. et al (2000). The reluctance to seek treatment for neurotic disorders. Journal of Mental Health, 9, 319-327.

Post traumatic stress disorder as the name suggests is a syndrome of processes which are dynamically related in psychobiological manner (Erica, 2011).The affected areas of the body include the nervous system, the brain and hormonal system. Changes thus occur in the manner in which one behaves afterwards and in the manner in which one perceives things (Wilson, Keane, 2004).

When one experiences terrific incidents which could be heard, seen or felt, the aftermath may not be that pleasant. It could be stress. The stressors could include horrifying incidents of mass death, witnessing a rape case or natural disasters like landslides. The person’s response to the horrifying incidents may be emotion and fear, ego defenses and cognitive alterations, and even helplessness (Wilson, et al, 2004).

There are a number of basic principles of assessing the disorder. Studies have indicated that there is not much of a difference between the PTSD and the non-PDST (Kawata, & Itman, 2006). The difference only comes where the PDST patients having a relatively higher portion of widows were well reared in the urban areas. Looking at the diagnoses given at the outpatient clinics, fewer patients suffering from PDST’s diagnosis referred to Axis (Corales, 2005).

A number of issues are to be taken into consideration as for the treatment of the PDST. These factors include the type of trauma, chronicity of PDST, gender and age (Foa, 2009). Research on the need for treatment began in the early 1980s with improvements to the point of introduction of DSM-111. Ever since numerous case reports have been published.

These studies are diverse and hence the conclusions which can be drawn from the studies vary with the varying disorders (Foa, 2009). A good number of people exposed to traumatic stress do not develop it forever. They have adequate resilience to protect them from developing the disorder. Research on risk factor categorizes the PTDS into three groups namely, the pre-traumatic actors, the peri-traumatic actors and the post traumatic factors (Friedman, Keane and Resik, 2010).

The symptoms associated with the PTSD disorder may vary depending on the type patient. If one’s dramatization was interpersonal, prolonged and occurred early, then the symptoms may be complex. The most common symptoms include changes in the regulation of emotion and impulses or instance, a patient of PTSD finds difficulty in managing and controlling anger or even sexual involvement (Timothy, 2007).

As for the changes of one’s consciousness. The patient experiences amnesia when one develops chronic pains, digestive system problems along with evident symptoms of cardiopulmonary; Panic is also obvious in the current case. Alterations in one’s perception of other things may be accompanied by self blame, shame as well as guilt.

The patient develops poor interpersonal relationships with others which is unhealthy along with the feeling of guilt as well as loneness. There is helplessness and lack o meaning in life (Williams, 2009). The treatment applied in case of PTSD disorder is Cognitive Behavioral Therapy (CBT), which in turn is subdivided into two kinds of treatment; they are Cognitive Processing Therapy and Prolonged Exposure Therapy (Wilson & Keane, 2004).

In accordance with the first way of treatment, a patient tries to learn the way trauma has changed their way of thinking and feelings. The second treatment consists in the fact that a person utters one’s problem a number of times until memories no longer hurt. The person is on purpose go to places that have been associated with this or that particular trauma (Wilson & Keane, 2004)

References

Corales, T. (2005). Focus on post traumatic stress disorder. New York: Nova science.

David, E. (2011). PTSD: a spouse’s perspective: how to survive in a world of PTSD (p. 1). Bloomington: Bow press.

Foa,. B. (2009). Effective treatments for PTSD: practice guidelines from the International Society for Traumatic Stress Studies. New York: Guilford Press.

Friedman, M. J., Keane, T. M., & Resick, P. (2010). Handbook of PTSD: science and practice. New York: Guilford Press.

Kawata, M., & itman, R. (2006).PTSD: brain mechanisms and clinical implications. new york, tokyo: springer.

Timothy, K. (2007). PTSD: Pathways through the Secret Door. New York: Gardeners Books.

Williams, B., & Poijula, S. (2009). The PTSD workbook : simple, effective techniques for overcoming traumatic stress symptoms. Portland: Read HowYouWant.

Wilson, J. & Keane, P. (2004). PTSD and complex PTSD symptoms, syndromes and diagnoses: Assessing psychological trauma and PTSD. New York: Guilford Press.

Societal issues have been long known to influence the state of health of lesbian, gay, bisexual and transgender (LGBT) community. These people are affected by various negative attitudes which lead to complicated health issues. Discrimination and societal stigma cause problems with physical, as well as mental health in LGBT people. They often have psychiatric disorders, there is a high tendency towards suicides among them, and they suffer from substance abuse more frequently than people with traditional sexual orientation. Due to the peculiarities of the LGBT people’s personal life, they might experience limited support and restricted access to medical services. These factors negatively impact the LGBT community’s health.

Stigma is considered to have the most powerful effect on LGBT people. They are victimized at different levels of social life communication (school, workplace, or home), LGBT.¹ Victimization causes significant adverse outcomes. LGBT people acquire high levels of psychological anxiety which negatively impacts their health. The research has shown that suicide attempts are much higher among gay, lesbian, and bisexual people than among heterosexual citizens.¹ Stigma varies from minor forms like anti-gay humor to major forms like physical offense. Any of these forms may present harsh societal pressure.

Another societal factor which is close to stigma but still different from it is discrimination. Although these two factors have similar outcomes, the effects of discrimination may be more dangerous. LGBT people feel it when they are receiving medical treatment.¹ They remark that if a medical worker is homophobic, it may influence the treatment methods and results. Such fear often is a reason why LGBT people are reluctant to apply to hospitals for care, which may lead to dramatic health damage.¹

Apart from victimizing factors impacting the LGBT people’s health, there is also danger presented by the legislation system. The stress levels can be caused by the barriers to government recognition. Advocates of LGBT rights have difficulty framing their endeavors.² The most common problems concerned with legislation are caused by the LGBT people’s inability to get married in most countries of the world. Additionally, they are often forbidden to adopt children. These restrictions negatively impact people’s lives, again causing constant stress risks.² To prevent this societal issue’s damage presented to LGBT community, governments should implement changes which would allow these people to feel equal with the heterosexuals. This way, their life satisfaction will be higher, and health risks will be reduced.

Finally, there is a crucial factor of unequal access to health services for LGBT people. World Health Organization (WHO) fails to meet all the needs of these people regarding access to health facilities.³ While special normative acts have been created to improve the situation, WHO remains impartial in any cases. The need for LGBT people’s access to proper medical care is explained by the high disposition to some risks (psychological disorders, HIV/AIDS, suicides).³ Thus, equal access to medical care is another crucial factor in treating LGBT community.

While societal factors impacting the LGBT people’s health are various, they all have the similar outcome: the lives of these people are put under a lot of pressure. Physical and mental health disorders, tendency to suicides, constant depression, and high stress levels are caused by the society’s reaction to LGBT community. The society should reduce the negative factors deteriorating the lives of LGBT people. Everyone deserves to be treated equally, and it is of particular importance to sustain the health of the community.

Reference List

Kelleher C. Minority stress and health: implications for lesbian, gay, bisexual, transgender, and questioning (LGBTQ) young people. Counselling Psychol Quart. 2009;22(4):373-379.

Mertus J. The rejection of human rights framings: the case of LGBT advocacy in the US. Human Research Quart. 2007;29(4):1036-1064.

Duvivier RJ, Wiley E. WHO and the health of LGBT individuals. The Lancet. 2009;385:1070-1071.