The Occupational Stress Index: An Approach Derived from Cognitive Ergonomics and Brain Research for Clinical Practice

Paraphrasing the late Professor Bertil Gardell, a pioneer in the effort to develop multi-facetted strategies to humanize the work environment: work is one of the most important potential sources of social and psychological well-being, which can provide much of the meaning and structure in adult life (Gardell 1987). Unfortunately, however, for many working people, this potential is far from reality. Instead, the contemporary work environment has all too frequently become the locus in which employed adults spend the majority of their waking hours performing activities that are characterized as demanding, constraining, and otherwise stressful. Reflecting pressures of global competition, trends in working life are towards increasing job demands, working hours and job instability. Growing dependence on computer technology, which could improve working life, has de facto lead to greater workload and pressure.
The toll taken by unhealthy work is enormous. Mental health problems and other stress-related disorders are recognized to be the largest overall cause of premature death in Europe (Levi 2002). Cardiovascular disease, the major cause of morbidity and mortality in the industrialized world, and for which the stressful work environment is increasingly recognized as an important risk factor (Belkic 2000a, Karasek 1990, Kristensen 1998, Schnall 2000), is projected within the next twenty years, to become the leading cause of death worldwide (Braunwald 1997). In purely economic terms, a recent estimate is that job-related cardiovascular disease costs for the...