Dedication |
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v | |
Preface |
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xvii | |
Acknowledgements |
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xix | |
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xxi | |
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xxiii | |
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Chapter 1 Work as a Potential Source of Meaning versus of Stress: Implications for Mental Health |
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1 | (6) |
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1.1 The need for an integrative clinical approach |
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2 | (1) |
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1.1.1 Preventing and overcoming demoralization: a critical task |
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3 | (1) |
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1.2 Insights from cognitive neuroscience |
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3 | (1) |
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1.2.1 Work stressors vs. the stress response: a key distinction |
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4 | (1) |
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1.3 The aims and organization of this book |
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4 | (3) |
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Part I Background: Evidence, Mechanisms, Current Standard of Care and Methodology |
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7 | (156) |
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Chapter 2 The Work Environment's Impact on Mental Health: Epidemiologic Evidence |
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9 | (38) |
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2.1 Sociological models to assess the association between the psychosocial work environment and health outcomes |
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9 | (4) |
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10 | (2) |
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2.1.2 Effort reward imbalance |
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12 | (1) |
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2.2 The work environment and mental health outcomes |
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13 | (14) |
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2.2.1 Depression, burnout and related mental health disorders |
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14 | (4) |
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18 | (1) |
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19 | (2) |
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2.2.4 Occupations at risk for adverse mental health outcomes |
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21 | (6) |
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2.3 Neurological disorders, cognitive function, cerebrovascular disease and work-related exposures |
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27 | (3) |
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27 | (1) |
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27 | (2) |
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2.3.3 Cognitive function and work hours |
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29 | (1) |
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2.3.4 Neuropsychiatric consequences of physical/chemical exposures |
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29 | (1) |
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2.3.5 Occupational groups at risk for cerebrovascular disease |
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30 | (1) |
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2.4 Unhealthy behaviors associated with work stressors |
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30 | (5) |
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30 | (2) |
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32 | (1) |
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33 | (1) |
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2.4.4 Combined lifestyle related risk profile |
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33 | (1) |
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2.4.5 Absenteeism and presenteeism |
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34 | (1) |
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2.5 Other health outcomes related to the work environment |
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35 | (7) |
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2.5.1 Coronary heart disease, hypertension, other cardiovascular disease |
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35 | (4) |
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2.5.2 Peptic ulcer disease and diabetes mellitus |
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39 | (1) |
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2.5.3 Vulnerability to malignancy |
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39 | (2) |
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2.5.4 Musculoskeletal disorders |
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41 | (1) |
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2.6 Mental health consequences of job insecurity, precarious employment, unemployment and retirement |
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42 | (5) |
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Chapter 3 Work Stress Mechanisms and Mental Health: A Focused Overview |
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47 | (54) |
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3.1 Gender, work stressors and health: a richer conceptualization |
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47 | (2) |
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3.2 Econeurologic mechanisms: mental burden of work processes |
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49 | (24) |
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3.2.1 A deeper understanding of psychological demands |
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50 | (16) |
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3.2.2 Emotional dimensions of work |
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66 | (7) |
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3.3 Burden upon mental resources and the recovery process |
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73 | (3) |
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3.3.1 The role of cognitive appraisal |
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74 | (2) |
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3.4 Event-related potentials, quantitative EEG and neuropsychiatry |
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76 | (13) |
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77 | (3) |
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3.4.2 Post-traumatic stress disorder |
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80 | (1) |
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3.4.3 Depression, burnout and related disturbances |
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81 | (2) |
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83 | (1) |
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84 | (1) |
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85 | (1) |
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86 | (3) |
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3.5 The environment--brain--cardiovascular system: econeurocardiology |
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89 | (12) |
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3.5.1 The glare pressor test |
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90 | (8) |
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98 | (3) |
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Chapter 4 Work Fitness and Occupational Rehabilitation: The Current Standard of Care |
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101 | (30) |
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4.1 Mental health disorders, work fitness and rehabilitation |
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101 | (9) |
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4.1.1 General observations |
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101 | (3) |
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4.1.2 Explicitly stress--related mental health disorders |
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104 | (3) |
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107 | (1) |
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108 | (1) |
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109 | (1) |
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4.1.6 Psychotic disorders |
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110 | (1) |
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4.1.7 Alcohol and drug misuse |
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110 | (1) |
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4.2 Neurological disorders |
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110 | (5) |
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111 | (1) |
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111 | (2) |
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4.2.3 Disorders of sleep and awareness |
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113 | (1) |
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4.2.4 Disorders related to neurotoxicity exposure |
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114 | (1) |
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4.2.5 Cerebrovascular disorders |
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114 | (1) |
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114 | (1) |
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4.3 Experience regarding work fitness and rehabilitation from other areas of medicine |
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115 | (11) |
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115 | (2) |
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4.3.2 Ischemic heart disease and hypertension |
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117 | (3) |
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4.3.3 Rheumatologic/musculoskeletal disorders |
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120 | (2) |
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4.3.4 Diabetes, peptic ulcer disease and other gastrointestinal disorders |
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122 | (2) |
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4.3.5 Respiratory disorders |
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124 | (2) |
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4.4 Special issues for work fitness and occupational rehabilitation |
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126 | (5) |
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4.4.1 Further considerations about public safety |
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126 | (3) |
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4.4.2 Women, work fitness and return to work |
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129 | (2) |
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Chapter 5 The Occupational Stressor Index (OSI): A Comprehensive Model derived from Cognitive Ergonomics for Clinical Practice |
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131 | (32) |
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5.1 Basis and organization of the OSI |
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132 | (13) |
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5.1.1 The axes of the OSI: formation of a two-dimensional matrix |
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132 | (11) |
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5.1.2 The OSI model in its entirety |
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143 | (2) |
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5.2 The occupation-specific OSI instruments |
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145 | (5) |
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5.2.1 Generic versus occupation-specific instruments |
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145 | (1) |
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5.2.2 The process of developing occupation-specific OSI's |
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146 | (4) |
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5.2.3 Available occupation-specific OSI's and those in development |
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150 | (1) |
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5.3 Reliability of the OSI |
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150 | (2) |
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152 | (11) |
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5.4.1 Construct validity of the OSI: theoretical/biological coherence |
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152 | (1) |
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5.4.2 Face validity of the OSI |
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153 | (1) |
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5.4.3 Criterion validity of the OSI: empirical results |
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154 | (5) |
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5.4.4 Clinical validity of the OSI |
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159 | (4) |
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Part II The Clinical Case Studies |
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163 | (100) |
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Chapter 6 Introduction to Part II: The Clinical Case Studies |
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165 | (4) |
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6.1 A brief recapitulation |
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165 | (1) |
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6.2 Aims, scope and organization of part II |
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165 | (4) |
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6.2.1 The structure of the clinical case studies |
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166 | (3) |
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Chapter 7 An Exhausted Psychiatrist Thinking about Suicide: Our First Clinical Case Study |
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169 | (16) |
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7.1 The case: Dr. R is extremely fatigued and admits to thoughts of suicide |
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170 | (2) |
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171 | (1) |
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7.1.2 Initial assessment, management and clinical course |
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171 | (1) |
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7.1.3 Additional psychometric and neurophysiologic evaluation |
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172 | (1) |
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7.2 Dr. R's case re-visited: insights from the OSI |
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172 | (4) |
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7.3 How to proceed? Return to healthier work with bolstered coping strategies |
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176 | (7) |
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177 | (2) |
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7.3.2 Step II--cognitive/behavioral therapy focusing on psychosocial work stressors |
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179 | (2) |
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7.3.3 Step III--outreach: initial efforts towards improving work organization |
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181 | (2) |
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7.4 Comments and further thoughts |
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183 | (2) |
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Chapter 8 Middle-School Teacher with Panic Attacks and Migraine Headaches: Second Case Study |
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185 | (12) |
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8.1 The case: M.A.'s panic attacks and severe migraines |
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186 | (2) |
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186 | (2) |
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8.2 M.A.'s work situation: insights from the OSI |
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188 | (3) |
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8.3 M.A. meets with the occupational neuropsychiatrist |
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191 | (6) |
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191 | (1) |
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8.3.2 Therapeutic measures: cognitive-behavioral therapy, immediate work-related and lifestyle changes and pharmacotherapy |
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191 | (3) |
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8.3.3 Outreach: initial efforts towards improving work organization |
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194 | (3) |
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Chapter 9 Computer Programmer with Epilepsy and Agoraphobia: Third Case Study |
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197 | (10) |
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9.1 The case: S.P.'s epilepsy and agoraphobia |
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198 | (2) |
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199 | (1) |
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9.2 S.P.'s work situation: insights from the OSI |
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200 | (3) |
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9.3 S.P. meets with the occupational neuropsychiatrist |
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203 | (3) |
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203 | (1) |
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9.3.2 Integrative therapeutic approach: supportive/cognitive-behavioral therapy, disclosure and targeted workplace modifications |
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204 | (2) |
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206 | (1) |
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Chapter 10 Oncology Nurse with Breast Cancer and Disturbed Sleep: Fourth Case Study |
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207 | (12) |
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10.1 The case: C.G. has breast cancer and disturbed sleep |
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208 | (2) |
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10.1.1 Objective findings |
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209 | (1) |
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10.2 C.G.'s work situation: insights from the OSI |
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210 | (3) |
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10.3 C.G. meets with the occupational neuropsychiatrist |
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213 | (3) |
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214 | (1) |
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10.3.2 Integrative therapeutic approach: supportive/cognitive-behavioral therapy, disclosure and targeted worksite modifications |
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215 | (1) |
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216 | (3) |
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Chapter 11 Control Panel Worker with Paranoid Ideation: Fifth Clinical Case Study |
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219 | (8) |
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11.1 The case: T.S. mistrusts his entire work collective |
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220 | (2) |
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11.1.1 Objective findings |
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220 | (2) |
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11.2 T.S.'s work situation: insights from the OSI |
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222 | (4) |
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11.3 Intervention by the occupational neuropsychiatrist |
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226 | (1) |
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11.4 Further thoughts and comments |
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226 | (1) |
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Chapter 12 Tram Driver with Post-traumatic Stress Disorder: Sixth Case Study |
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227 | (14) |
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12.1 The case: B.F. has post-traumatic stress disorder |
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228 | (2) |
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12.1.1 Objective findings |
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229 | (1) |
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12.2 B.F.'s work situation: insights from the OSI |
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230 | (5) |
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12.3 Return to healthier work: the process for B.F. |
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235 | (6) |
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12.3.1 Immediately implementable modifications in work conditions |
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236 | (4) |
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12.3.2 Outreach: initial efforts towards improving work organization |
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240 | (1) |
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Chapter 13 Scientist with Bipolar Disorder: Seventh Clinical Case Study |
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241 | (12) |
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13.1 The case: Dr. A. has bipolar disorder |
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242 | (2) |
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13.1.1 Objective findings |
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243 | (1) |
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13.2 Dr. A.'s work situation: insights from the OSI |
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244 | (2) |
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13.3 What are the feasible options for Dr. A. vis-a-vis the work environment? |
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246 | (4) |
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13.4 Healthy work for scientists? |
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250 | (3) |
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Chapter 14 A Dysphoric Academic Physician near Formal Retirement Age: Concluding Case Study |
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253 | (10) |
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14.1 Dr. L. is nearing formal retirement age and is dysphoric |
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254 | (1) |
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14.2 Dr. L.'s work situation: insights from the OSI |
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255 | (4) |
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14.3 The transition process for Dr. L. |
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259 | (1) |
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14.4 Comments and further thoughts |
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260 | (3) |
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Part III A New Clinical Approach to Neuropsychiatry Focusing upon the Work Environment |
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263 | (12) |
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Chapter 15 The Need for a New Subspecialty: Occupational Neuropsychiatry |
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265 | (6) |
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15.1 An occupational neuropsychiatry paradigm: mental health disorders as potential "occupational sentinel health events" |
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267 | (1) |
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15.2 A larger framework for the occupational neuropsychiatrist |
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268 | (2) |
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15.3 Can workplace modifications suggested by the clinician for individual patients help inform workplace intervention trials? |
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270 | (1) |
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Chapter 16 Perspectives towards a Humane Work Environment: A Clinical View |
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271 | (4) |
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275 | |
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Appendix A Diagnostic Criteria for Selected Mental, Behavioral and Somatic Disorders |
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277 | |
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Section 1 Diagnostic criteria for selected mental and behavioral disorders based on the ICD-10 |
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278 | |