Personality styles of patients asserting environmental illness
Article Abstract:
The field of clinical ecology, which claims that multiple foods and chemicals in the environment of the patient provoke problems in bodily systems, is new and controversial. Passionate debate arises among its adherents and detractors, not to mention patients believing themselves to be suffering from such environmental illnesses. The debate is affected by several factors. Most clinical ecologists are classically trained physicians who challenge much of traditional medicine. Often, patients have a wide range of symptoms without objective medical or laboratory abnormalities, and the patient's syndrome may be experienced as a challenge to a physician's competence. Popularization through the media has also given the field a degree of respectability. Patients with environmental illnesses have been suggested to have a psychiatric illness. In previous eras, syndromes referred to as hysteria or somatization disorder were common; patients had dramatic and exaggerated but vague complaints of physical problems. These patients benefited from nurturing relationships with the medical practitioner. In contrast, many patients with environmental illness can provide comprehensive histories of their illness, often relating these to potential environmental triggers. Such patients tend to be knowledgeable about biology and medicine. This article suggests that these patients do not resemble those with somatization, but rather may have a paranoid or obsessive component to their personalities. A case history is described in which a patient with possibly environmentally-triggered respiratory illness underwent psychological evaluation; the results of a Rorschach Inkblot Test are presented. The authors suggest that in contrast to the somatizing patient's quest for nurturing, the patient with environmental illness is searching for an explanation consistent with his or her assumption. It is suggested that psychological consultation is most helpful when presented as a focus on the effects of the physical symptoms on psychological functioning. Most patients will probably not accept an assertion of their need for an external explanation for the physical symptoms. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Journal of Occupational Medicine
Subject: Health care industry
ISSN: 0096-1736
Year: 1990
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Indoor air quality: a psychosocial perspective
Article Abstract:
There has been a large increase in the number of reports of illnesses related to office environments over the past 10 years. A definitive cause is found in only about one third of these cases. Psychosocial and organizational dynamics are often related to these outbreaks. Mass psychogenic illness (MPI) is characterized by one or more workers becoming sick and attributing their illness to something in the work place; anxiety spreads and other workers become sick with various complaints. Odors are the most common trigger for MPI. Indoor air quality (IAQ) problems may be a variant of MPI with the following differences: the workers are frequently highly skilled, the symptoms are less severe, and the problem usually occurs in an office setting. There are similarities between MPI and IAQ and anxiety disorders. Several psychosocial factors have been suggested that predispose the workplace to IAQ problems including, rigid organizations, poor communication between management and employees, a patronizing attitude of management, and workers feeling demeaned. Contributing factors may include lack of job security, a sense of isolation, boredom, production pressures, and the inability to control environmental conditions. The recent increase in IAQ problems may be due to increased awareness of conditions in the workplace that may be harmful to health. There are factors that increase the perception of risk, such as authority figures giving conflicting information. The following guidelines are presented for dealing with IAQ problems: limit the number of consultants involved; avoid insensitive managers; use clinic rather than hospital settings; move affected workers to one area; do not suggest that the workplace be closed; involve workers in the investigation of the problem; effectively communicate with the media; and avoid jumping to conclusions and issuing statements prematurely. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Journal of Occupational Medicine
Subject: Health care industry
ISSN: 0096-1736
Year: 1990
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Health and illness behavior of type A persons
Article Abstract:
According to its definition, the type A personality is characterized by chronic impatience, hostility, excessive job involvement, and responsiveness to constant pressures of time and the challenges of responsibility. These attributes frequently enhance a person's job performance, but at the same time may have adverse health effects. The predictive relationship of type A behavior with heart attack has long been a controversial association. The relationship of this personality type with other health and illness consequences has not been considered widely. This study examines the illness behavior of the type A person, with regard to the seeking, finding, and following medical advice and care. One scheme divides the process into five stages: experience of symptoms, assumption of sick role, medical care contact, the dependent patient role, and the recovery or rehabilitation stage. A target population of 385 managerial banking personnel were enrolled in the study. Questionnaires comprising 10 sections addressing demographics, health status, current medical services use, health-promotion behavior, type A behavior characteristics, job stress and preoccupation, rejection of the sick role, recovery aspects, and delay in seeking medical care, were submitted by 210 participants. Analyses of the responses indicated that A type persons are more likely to reject the sick role, delay seeking medical advice, be impatient for recovery, and frequently return to work before recovery is complete. These patterns suggest that such individuals may be at risk for more serious illness because of the delayed response, as early care is important. This person is less likely to miss work time for minor illnesses. Contrary to previously expressed hypotheses, type A persons do practice health-promoting behavior and some good health habits. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Journal of Occupational Medicine
Subject: Health care industry
ISSN: 0096-1736
Year: 1991
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