دامنه خاص بیان خشم و فشار خون در محیط شغلی

Objective The purpose of the present study was to extend a previous work in a sample of American undergraduates demonstrating the effects of situational factors on reported anger expression behavior and blood pressure. Method General and domain-specific anger expression behavior and subjective work stress were assessed in 218 nurses from the Frankfurt am Main metropolitan area using the original and three altered versions of the State Trait Anger Expression Inventory (STAXI) and the Job Stress Survey (JSS). The altered versions of the STAXI asked for individuals' anger expression at home, during free time, and at work. Blood pressure and heart rate (HR) were measured in the field during working breaks. Results Women had higher scores on anger-out and lower on anger-control in the original and in the home version of the STAXI, but no sex difference was found in the work version. Participants scoring high on anger-out at work displayed elevated blood pressures and HR compared with those scoring low on this scale. High job stress was associated with greater reports of anger-in and anger-out behavior. Conclusion The results suggest that the way people express stress at their work place might be an important factor in determining the impact of experienced stress on cardiovascular health.

Maladaptive anger-coping behavior has been thought to be associated with elevated cardiovascular activation and heightened risk for cardiovascular diseases [1], [2], [3], [4] and [5]. However, reported results related to this hypothesis are rather heterogeneous. Some authors found an anger suppressive coping style to be related to heightened cardiovascular activation and, consequently, greater risk for cardiovascular diseases [6], [7], [8], [9] and [10], while others reported greater cardiovascular activation and disease risk for persons with an open anger expressive coping style [11], [12], [13] and [14]. Finally, in a prospective study, extreme tendencies of both anger-in and anger-out were associated with heightened blood pressure and hypertension status [5]. The current status of evidence suggests the possibility that moderating variables influence the association between anger expression style and blood pressure. We recently introduced a procedure that assesses anger expression style in three domains: at home, at work, and during free time. We have found that individuals adapt their anger expression style according to situational requirements with decreasing open anger expression from the home setting over free time to the work setting [15]. Results for anger suppression and anger control pointed into the opposite direction, with increasing scores for both styles from the home domain, over free time to the work domain. Furthermore, we found that only an open anger expression style at work was reliably associated with heightened blood pressures. Individuals scoring high on anger-out at work displayed higher SBP and diastolic blood pressure (SBP and DBP, respectively) levels during rest and during acute stress than those scoring low on anger-out at work. The study indicates that situational circumstances are important in determining the direction of anger expression (i.e., outward or inward; [15]). This study, however, was conducted with relatively young, healthy American students, and it was conducted in a laboratory setting. Hence, it was not clear whether results can be generalized to occupational settings. Furthermore, it was not clear what psychological mechanisms might mediate the influence of situational factors on anger expression and the association between open anger expression style at work and heightened blood pressure. One of the proposed mechanisms is that greater work strain might be common to both an open anger expression style at work and a heightened blood pressure. An interdependent relationship between emotional factors, environment setting, and job strain is hypothesized in many studies. Theorell et al. [16] assessed blood pressure, emotion, and job strain in female nurses at work and during leisure time. They reported significant correlations between job strain and DBP, but only during work hours, and no relationship between mood and job strain. Similarly, van Egeren [17] found greater SBP at home and at work for workers reporting high job strain compared with those with low job strain. Differences between low- and high-job-strain employees in DBP, however, were evident only at work, and the effect of job strain on blood pressure was the same for both Types A and B men and women. Matthews et al. [18], however, reported that men and women with high work strain experienced more negative emotion compared with those with low-work-strain positions, but they did not find differences in ambulatory blood pressure. These findings indicate a complex association between job strain, mood, and blood pressure. The purpose of the present study was to investigate the extent to which the previously reported association between an open anger expression style at work and elevated blood pressure can be replicated in an occupational field setting. We also examined the extent to which work stress influences anger expression and blood pressure. We predicted that high job stress would be associated with greater anger expression and greater blood pressure. Moreover, in the previous study, we found that women reported more anger-out at home than men do, while men reported more anger-out at work than women do. An additional aim for this study, therefore, was to examine whether these differences generalize to an occupational setting.