Attention, awareness and occupational stress

http://www.hse.gov.uk/research/rrpdf/rr644.pdf


Symptoms associated with occupational stress, such as muscular pain and fatigue, are common in the working population. These types of symptoms have been termed idiopathic; in other words, it is difficult to link these symptoms to a definite physical cause. To complicate matters further, idiopathic symptoms are often associated with psychological variables such as anxiety and depression. Despite these difficulties, idiopathic symptoms represent an important index of occupational health and play a significant role in the decision to seek medical consultation. However, the origins of these symptoms are not well understood particularly with respect to the influence of psychological factors.
This project is primarily concerned with the influence of attentional factors on the perception of
idiopathic symptoms associated with occupational stress. Attention is fundamentally goal-driven and selective. We attend to a certain category of stimuli to reinforce existing beliefs. If a person has negative beliefs about health, they are inclined to actively monitor bodily signs and symptoms for evidence of illness. A person who is experiencing an uncomfortable or troubling symptom also tends to direct attention internally to the body, at the expense of attending to events in the external world. By directing attention internally, the person experiences a higher level of body consciousness or awareness. Attention and awareness of the body influences the perception of symptoms. If a person has negative health beliefs that elevate body consciousness, they tend to report a higher frequency of symptoms compared to the general population. Symptoms of occupational stress, being idiopathic and ambiguous with respect to psychological/physical origins, may be particularly susceptible to this kind of
psychological inflation. Also, the bodily experience of occupational stress tends to increase autonomic activity at a physiological level. For example, heart rate and blood pressure may be elevated for a stressed person. The registration of bodily symptoms by the brain is achieved via a neurological process called interoception. It has been argued that stress tends to intensify the experience of bodily signs and symptoms via elevated autonomic activity. Therefore, the experience of occupational stress may amplify symptoms at the physiological as well the psychological level.
To summarise, the experience of occupational stress may inflate symptom perceptions in two ways; (a) the psychological route by creating a negative bias and amplifying symptoms by directing attention to the body, and
(b) the physiological route whereby awareness of symptoms is magnified and intensified by
elevated autonomic activity.
The role of attention and awareness during the perception of stress-related symptoms was studied via an experiment and a number of survey exercises. The first was a laboratory study to investigate the influence of stress on the physiological process of interoception. This process was studied using a standard protocol known as the heartbeat detection task wherein participants must correctly distinguish between live (accurate) and delayed (inaccurate) aural feedback of the heart rate. It was predicted that exposure to stress would increase participants’ accuracy on the heartbeat detection task. It was also assumed that participants who exhibited higher levels of interoceptive sensitivity on this task would report a higher frequency of symptoms (because they had a higher level of awareness of bodily activity). Both hypotheses were not supported by the study; exposure to stress actually diminished performance on the heartbeat detection task for females and we found no evidence for any association between performance on the heartbeat detection task and symptom reporting.