Contents -- Dedication -- Preface -- Acknowledgements -- List of Panels and Table -- List of Figures -- Chapter 1 Work as a Potential Source of Meaning versus of Stress: Implications for Mental Health -- 1.1 The need for an integrative clinical approach -- 1.1.1 Preventing and overcoming demoralization: a critical task -- 1.2 Insights from cognitive neuroscience -- 1.2.1 Work stressors vs. the stress response: a key distinction -- 1.3 The aims and organization of this book -- Part I - Background: Evidence, Mechanisms, Current Standard of Care and Methodology -- Chapter 2 The Work Environment's Impact on Mental Health: Epidemiologic Evidence -- 2.1 Sociological models to assess the association between the psychosocial work environment and health outcomes -- 2.1.1 Job strain -- 2.1.2 Effort reward imbalance -- 2.2 The work environment and mental health outcomes -- 2.2.1 Depression, burnout and related mental health disorders -- 2.2.2 Suicide risk -- 2.2.3 Anxiety disorders -- 2.2.4 Occupations at risk for adverse mental health outcomes -- 2.2.4.1 Health professionals -- 2.2.4.2 Teachers -- 2.2.4.3 Professional drivers -- 2.2.4.4 Certain creative professions -- 2.2.4.5 Other occupational groups in whom mental distress is reported -- 2.3 Neurological disorders, cognitive function, cerebrovascular disease and work-related exposures -- 2.3.1 Headache -- 2.3.2 Epilepsy -- 2.3.3 Cognitive function and work hours -- 2.3.4 Neuropsychiatric consequences of physical/chemical exposures -- 2.3.5 Occupational groups at risk for cerebrovascular disease -- 2.4 Unhealthy behaviors associated with work stressors -- 2.4.1 Smoking -- 2.4.2 Obesity -- 2.4.3 Alcohol and drugs -- 2.4.4 Combined lifestyle related risk profile -- 2.4.5 Absenteeism and presenteeism -- 2.5 Other health outcomes related to the work environment.

2.5.1 Coronary heart disease, hypertension, othe rcardiovascular disease -- 2.5.1.1 Work stressors and cardiovascular disease (CVD) -- 2.5.1.2 Occupational groups at high risk of CHD and/or hypertension -- 2.5.2 Peptic ulcer disease and diabetes mellitus -- 2.5.3 Vulnerability to malignancy -- 2.5.4 Musculoskeletal disorders -- 2.6 Mental health consequences of job insecurity, precarious employment, unemployment and retirement -- Chapter 3 Work Stress Mechanisms and Mental Health: A Focused Overview -- 3.1 Gender, work stressors and health: a richer conceptualization -- 3.2 Econeurologic mechanisms: mental burden of work processes -- 3.2.1 A deeper understanding of psychological demands -- 3.2.1.1 Mental chronometry: the time dimension of information processing -- 3.2.1.2 Allocation of mental resources and P300 amplitude -- 3.2.1.3 Work processes as reflected in electroencephalographic activity -- 3.2.1.4 Attentional demands of knowledge-based versus skill-based work -- 3.2.1.5 The concept of energy regulation and the job-strain model -- 3.2.2 Emotional dimensions of work -- 3.2.2.1 Emotional burden versus emotional reward of work -- 3.2.2.2. Sensitization: Repeated work exposure to fear-inducing stimuli -- 3.2.2.3 Threat-avoidant vigilant activity (TAV) -- 3.3 Burden upon mental resources and the recovery process -- 3.3.1 The role of cognitive appraisal -- 3.4 Event-related potentials, quantitative EEG and neuropsychiatry -- 3.4.1 Anxiety -- 3.4.1.1 Panic disorders -- 3.4.1.2 Specific phobias -- 3.4.2 Post-traumatic stress disorder -- 3.4.3 Depression, burnout and related disturbances -- 3.4.3.1 Anhedonia -- 3.4.3.2 Burnout -- 3.4.4 Bipolar disorder -- 3.4.5 Psychoses -- 3.4.6 Migraine headache -- 3.4.7 Epilepsy -- 3.5 The environment-brain-cardiovascular system: econeurocardiology -- 3.5.1 The glare pressor test.

3.5.1.1 Central arousal and cardiovascular responses to the GPT -- 3.5.1.2 The GPT among professional drivers with hypertension and/orischemic heart disease -- 3.5.2 Further directions -- Chapter 4 Work Fitness and Occupational Rehabilitation:The Current Standard of Care -- 4.1 Mental health disorders, work fitness and rehabilitation -- 4.1.1 General observations -- 4.1.1.1 Illness model versus disability model -- 4.1.1.2 Suggested strategies for vocational rehabilitation of persons with mental health disorders -- 4.1.2 Explicitly stress-related mental health disorders -- 4.1.2.1 Acute stress reactions -- 4.1.2.2 Post-traumatic stress disorder -- 4.1.2.3 Burnout and related disorders -- 4.1.3 Anxiety disorders -- 4.1.4 Depression -- 4.1.5 Bipolar disorders -- 4.1.6 Psychotic disorders -- 4.1.7 Alcohol and drug misuse -- 4.2 Neurological disorders -- 4.2.1 Migraine headaches -- 4.2.2 Epilepsy -- 4.2.3 Disorders of sleep and awareness -- 4.2.4 Disorders related to neurotoxicity exposure -- 4.2.5 Cerebrovascular disorders -- 4.2.6 Brain tumors -- 4.3 Experience regarding work fitness and rehabilitation from other areas of medicine -- 4.3.1 Oncology -- 4.3.2 Ischemic heart disease and hypertension -- 4.3.3 Rheumatologic/musculoskeletal disorders -- 4.3.4 Diabetes, peptic ulcer disease and other gastrointestinal disorders -- 4.3.5 Respiratory disorders -- 4.4 Special issues for work fitness and occupational rehabilitation -- 4.4.1 Further considerations about public safety -- 4.4.1.1 Suggestions for a safer return to work for professional drivers -- 4.4.2 Women, work fitness and return to work -- Chapter 5 The Occupational Stressor Index (OSI): A Comprehensive Model derived from Cognitive Ergonomics for Clinical Practice -- 5.1 Basis and organization of the OSI -- 5.1.1 The axes of the OSI: formation of a two dimensional matrix.

5.1.1.1 Levels of information transmission: the vertical axis -- 5.1.1.2 Stressor aspects: the horizontal axis -- 5.1.2 The OSI model in its entirety -- 5.1.2.1 General principles for scoring/coding the OSI -- 5.1.2.2 Calculation of the additive burden of occupational stressors -- 5.2 The occupation-specific OSI instruments -- 5.2.1 Generic versus occupation-specific instruments -- 5.2.2 The process of developing occupation-specific OSI's -- 5.2.2.1 Initial steps: qualitative analysis together with the generic OSI -- 5.2.2.2 The three major modifications by which the occupation-specific OSI's differ from the generic OSI instrument -- 5.2.2.3 Making use of objective information about the workplace -- 5.2.3 Available occupation-specific OSI's and those in development -- 5.3 Reliability of the OSI -- 5.4 Validity of the OSI -- 5.4.1 Construct validity of the OSI: theoretical/biological coherence -- 5.4.2 Face validity of the OSI -- 5.4.3 Criterion validity of the OSI: empirical results -- 5.4.3.1 Results among physicians -- 5.4.3.2 Results among professional drivers -- 5.4.3.3 Published studies among heterogeneous occupational groups -- 5.4.4 Clinical validity of the OSI -- Part II - The Clinical Case Studies -- Chapter 6 Introduction to Part II: The Clinical Case Studies -- 6.1 A brief recapitulation -- 6.2 Aims, scope and organization of part II -- 6.2.1 The structure of the clinical case studies -- Chapter 7 An Exhausted Psychiatrist Thinking about Suicide: Our First Clinical Case Study -- 7.1 The case: Dr. R is extremely fatigued and admits to thoughts of suicide -- 7.1.1 Objective findings -- 7.1.2 Initial assessment, management and clinical course -- 7.1.3 Additional psychometric and neurophysiologic evaluation -- 7.2 Dr. R's case re-visited: insights from the OSI -- 7.3 How to proceed? Return to healthier work withbolstered coping strategies.

7.3.1 Immediate steps -- 7.3.2 Step II-cognitive/behavioral therapy focusing on psychosocial work stressors -- 7.3.3 Step III-outreach: initial efforts towards improving work organization -- 7.4 Comments and further thoughts -- Further Reading -- Chapter 8 Middle-School Teacher with Panic Attacks and Migraine Headaches: Second Case Study -- 8.1 The case: M.A.'s panic attacks and severe migraines -- 8.1.1 Objective findings -- 8.2 M.A.'s work situation: insights from the OSI -- 8.3 M.A. meets with the occupational neuropsychiatrist -- 8.3.1 Assessment -- 8.3.2 Therapeutic measures: cognitive-behavioral therapy, immediate work-related and lifestyle changes and pharmacotherapy -- 8.3.3 Outreach: initial efforts towards improving work organization -- Further Reading -- Chapter 9 Computer Programmer with Epilepsy and Agoraphobia: Third Case Study -- 9.1 The case: S.P.'s epilepsy and agoraphobia -- 9.1.1 Objective findings -- 9.2 S.P.'s work situation: insights from the OSI -- 9.3 S.P. meets with the occupational neuropsychiatrist -- 9.3.1 Assessment -- 9.3.2 Integrative therapeutic approach: supportive/cognitive-behavioral therapy, disclosure and targeted workplace modifications -- 9.4 The outcome -- Further Reading -- Chapter 10 Oncology Nurse with Breast Cancer and Disturbed Sleep: Fourth Case Study -- 10.1 The case: C.G. has breast cancer and disturbed sleep -- 10.1.1 Objective findings -- 10.2 C.G.'s work situation: insights from the OSI -- 10.3 C.G. meets with the occupational neuropsychiatrist -- 10.3.1 Assessment -- 10.3.2 Integrative therapeutic approach:supportive/cognitive-behavioral therapy, disclosure and targeted worksite modifications -- 10.4 Comment -- Further Reading -- Chapter 11 Control Panel Worker with Paranoid Ideation: Fifth Clinical Case Study -- 11.1 The case: T.S. mistrusts his entire work collective -- 11.1.1 Objective findings.

11.2 T.S.'s work situation: insights from the OSI.