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Coping with critical life events and lack of control--the exertion of control.

Theorell T, Westerlund H, Alfredsson L, Oxenstierna G

National Institute for Psychosocial Factors and Health, Karolinska Institute, P.O. Box 230, 171 77 Stockholm, Sweden. tores.theorell@ipm.ki.se

Coping strategies in relation to unfair treatment or conflicts at work are discussed. 'Covert coping' has been assessed by means of a short questionnaire. Its relationship with cardiovascular risk and sick leave has been examined in an epidemiological study (WOLF) of working men and women in Stockholm. The findings indicate that in men 'covert coping' is associated with elevated cardiovascular risk and prospective long-term sick leave. In women such a coping strategy is related to current sick leave, but not to cardiovascular risk or long-term sick leave. Openness of coping strategies is also discussed in relation to bouts of anger preceding myocardial infarction. Another epidemiological study (SHEEP, ONSET) has shown that severe bouts of anger are reported significantly more often than expected during the hour preceding myocardial infarction. This was not the case in subjects who reported 'open coping patterns', however. Openness of coping strategies is partly determined by the working climate--the higher the decision latitude, the less 'covert' the coping strategies. The results support the idea that dialogue in the work place may be health promoting.

Published 22 July 2005 in Psychoneuroendocrinology, 30(10): 1027-32.
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