The aim of this study was to determ

The aim of this study was to determine if a group of individuals
who exhibited phobic avoidance of the workplace
could be identified in terms of their psycho-physiological
and psychological responses to stressful work events. All
participants demonstrated increased psycho-physiological
arousal and psychological response to stressful work events
in comparison with neutral events. The workplace phobic
group demonstrated a markedly elevated heart rate response
and subjective reports of fear that distinguished them from
the other groups. The development of the phobic avoidance
response was discussed by the authors in terms of learning
theory.
Another approach is now done by focusing on differential
diagnostic aspects and a description of workplace phobia as
a clinically and socio-medically relevant phenomenon (Linden,
2006) which occurs partly independent from conventional
mental disorders: Investigations in samples of psychosomatic
as well as cardiac rehabilitation inpatients have
shown that there were patients with workplace-related anxieties
and workplace phobia who at the same time had no
conventional anxiety disorder (Linden & Muschalla, 2007;
Muschalla, 2008). On the other hand, there were also patients
who fulfilled the criteria of one or more conventional
anxiety disorder, but did not report anxiety at the workplace.
It was also found that patients with workplace phobia had
higher job-anxiety self-rating scores and longer sick leave
duration than patients without workplace phobia, but did
not differ significantly concerning general psychosomatic
symptom load.
Workplace phobia must be distinguished from neighboured
concepts like mobbing or burnout. Mobbing is not an illness,
but a perception of specific interaction processes at work
characterized by intentional actions by work colleagues or
superior directed towards a specific person (often called
victim) in order to make damage to him/her. Burnout is a
rather unspecified syndrome of vital and psychological exhaustion
often related to overtaxation in employees working
in the helping social professions (Maslach & Jackson, 1981).
In contrast, workplace phobia is a phobic anxiety syndrome
with physiological arousal when confronted with the stimulus
workplace in vivo or in sensu and a clear (tendency for)
workplace avoidance.
In the following a theoretical framework for understanding
the clinical phenomenon of workplace phobia is developed,
covering the aspects of aetiology, diagnostic criteria and
Figure 1. Aetiology of workplace phobia. In this aetiology model, individual dispositions (mental disorder, personality
and individual constitution) as well as acute workplace-related or non-workplace-related releases and stressors are
expected to be in interaction. Unfavourable conditions and dispositions in multiplication may lead to or support the
development of workplace-related anxieties and eventually workplace phobia. Diagnostic interviews for the assessment of
workplace-related and conventional mental disorders are mentioned beside (Mini International Neuropsychiatric Interview
MINI (Sheehan et al., 1994), Mini-Work-Anxiety-Interview Mini-WAI (Linden & Muschalla, 2007).
Workplace Phobia
(Panic-like reaction when thinking of or approaching the workplace,
avoidance of the workplace, „sick leave“ and work-related activity
impairments)
Conventional
Mental Disorder
(e.g. Depressive Episode,
Generalized Anxiety Disorder,
Social Phobia,
Hypochondriasis, Obsessive
Compulsive Disorder)
explored in MINI
Workplace-related
Releases
(in the sense of a stressful
event, e.g. life-endangering
traumatic event, conflicts
with colleagues or superiors,
changes in work
structure or work content)
explored in Mini-WAI
Not-Workplacerelated
Events,
Psychosocial
Stressors
(in the sense of a stressful
event, e.g. stressing events
in family, loss or change of
partner, moving)
explored in MINI
Personality
and Individual
Mental and Physiologic
Disposition
(in the sense of personality
traits, including e.g.
coping strategies and
cognitive schemes)
Workplace-related Anxieties
(Posttraumatic Stress Disorder, Adjustment Disorder with Anxiety, Specific Social Phobia, Unspecific Social
Phobia, Situational Anxiety, Hypochondriac Anxiety, Anxiety of Insufficiency, Generalized Anxiety (worrying)
explored in Mini-WAI
48
differential diagnosis, specific consequences for work participation
and specific requirements for therapy:
Aetiology of workplace phobia
Different primary workplace-related anxiety qualities (Linden
& Muschalla, 2007) are expected to potentially appear together
with (or lead to) workplace phobia (Figure 1). Similar
to conventional anxiety disorders, these primary workplacerelated
anxieties can occur as different phenotypes, like
anxiety of insufficiency, generalized worrying, specific social
fears, panic in specific non-social working situations, posttraumatic
stress or adjustment reactions, health-related
anxieties.
Workplace phobia can be seen as a kind of global workplacerelated
anxiety, including the workplace as a whole and going
beyond specific anxiety provoking stimuli like certain demands
for achievements (Beutel et al., 2004), major changes
(Chevalier et al., 1996; Griffin et al., 2002), specific colleagues
or superiors (Bilgel et al., 2006), dangerous work
situations (Laposa et al., 2003; Price et al., 2005) or environmental
aspects (Nakazawa et al., 2005; Nicholson & Vincenti,
1994). To know the primary anxiety provoking stimuli
is necessary for the specification of the quality of workplacerelated
anxiety, which becomes relevant for treatment.
Workplace phobia has been found to occur in comorbidity
with on average two basic workplace-related anxieties, like
specific social anxiety towards a special superior or colleague,
or anxiety of insufficiency after changes at work (Muschalla,
2008).
From a specific anxiety that has originally manifested at the
workplace, a complex system of phobic avoidance behaviour
may develop, exceed the workplace and generalize to other
domains of life. This is due to the fact that anxiety often
tends to generalize (Kolassa et al., 2007; Lissek et al., 2008).
Thus workplace phobia may result in an agoraphobic symptomatic
with avoidance of public places, whereby the fear is
to be confronted with workplace-associated stimuli, mostly
colleagues or superiors, but also objects or places which
remind the person of the workplace.
However, also primary conventional anxiety or other mental
or somatic disorders (Haslam et al., 2005; Munir et al., 2007)
or an inadequate coping style (Schaarschmidt & Fischer,
2001) or personality accent (Cramer & Davidhizar, 2000;
Girardi et al., 2007; Sakai et al., 2005) can cause problems at
the workplace and trigger workplace-related anxiety and
avoidance behaviour.
Workplace phobia often appears as a secondary symptom or
complication of an underlying primary disorder or vulnerability.
Therefore, workplace phobia can be seen in analogy
to a cerebral insult which occurs in the context of a metabolic
syndrome or a thromboemboly or a tumor disease. In
this diction, it can be seen as an additional complication of a
primary disorder. A metabolic syndrome with a cerebral
insult would be diagnosed and treated in a different way than
a metabolic syndrome without a cerebral insult. Furthermore,
the prognosis is worse in a person with both metabolic
syndrome and cerebral insult than in a person with
metabolic syndrome only.

ผลลัพธ์ (ไทย) 1:

The aim of this study was to determine if a group of individualswho exhibited phobic avoidance of the workplacecould be identified in terms of their psycho-physiologicaland psychological responses to stressful work events. Allparticipants demonstrated increased psycho-physiologicalarousal and psychological response to stressful work eventsin comparison with neutral events. The workplace phobicgroup demonstrated a markedly elevated heart rate responseand subjective reports of fear that distinguished them fromthe other groups. The development of the phobic avoidanceresponse was discussed by the authors in terms of learningtheory.Another approach is now done by focusing on differentialdiagnostic aspects and a description of workplace phobia asa clinically and socio-medically relevant phenomenon (Linden,2006) which occurs partly independent from conventionalmental disorders: Investigations in samples of psychosomaticas well as cardiac rehabilitation inpatients haveshown that there were patients with workplace-related anxietiesand workplace phobia who at the same time had noconventional anxiety disorder (Linden & Muschalla, 2007;Muschalla, 2008). On the other hand, there were also patientswho fulfilled the criteria of one or more conventionalanxiety disorder, but did not report anxiety at the workplace.It was also found that patients with workplace phobia hadhigher job-anxiety self-rating scores and longer sick leaveduration than patients without workplace phobia, but didnot differ significantly concerning general psychosomaticsymptom load.Workplace phobia must be distinguished from neighbouredconcepts like mobbing or burnout. Mobbing is not an illness,but a perception of specific interaction processes at workcharacterized by intentional actions by work colleagues orsuperior directed towards a specific person (often calledvictim) in order to make damage to him/her. Burnout is arather unspecified syndrome of vital and psychological exhaustionoften related to overtaxation in employees workingin the helping social professions (Maslach & Jackson, 1981).In contrast, workplace phobia is a phobic anxiety syndromewith physiological arousal when confronted with the stimulusworkplace in vivo or in sensu and a clear (tendency for)workplace avoidance.In the following a theoretical framework for understandingthe clinical phenomenon of workplace phobia is developed,covering the aspects of aetiology, diagnostic criteria andFigure 1. Aetiology of workplace phobia. In this aetiology model, individual dispositions (mental disorder, personalityand individual constitution) as well as acute workplace-related or non-workplace-related releases and stressors areexpected to be in interaction. Unfavourable conditions and dispositions in multiplication may lead to or support thedevelopment of workplace-related anxieties and eventually workplace phobia. Diagnostic interviews for the assessment ofกล่าวถึงโรคจิตที่เกี่ยวข้อง กับการทำงาน และทั่วไปด้านข้าง (มินินานาชาติ Neuropsychiatric สัมภาษณ์มินิ (Sheehan et al., 1994), Mini-งานวิตกกังวลสัมภาษณ์มินิหวาย (ลินเดน & Muschalla, 2007)อาการกลัวที่ทำงาน(ตกใจเหมือนปฏิกิริยาเมื่อคิด หรือกำลังทำงานหลีกเลี่ยงของที่ทำงาน "ลาป่วย" และกิจกรรมที่เกี่ยวข้องกับการทำงานไหวสามารถ)ปกติโรคจิต(เช่น Depressive ตอนโรควิตกกังวลเมจแบบทั่วไปโรคกลัวสังคมHypochondriasis, Obsessiveโรค compulsive)อุดมในมินิทำงานที่เกี่ยวข้องประชาสัมพันธ์(ในความรู้สึกของความเครียดเหตุการณ์ เช่น ชีวิตอำเภอใจเหตุการณ์เจ็บปวด ความขัดแย้งเพื่อนร่วมงานหรือเรียร์เปลี่ยนแปลงในการทำงานโครงสร้างหรืองานเนื้อหา)อุดมในมินิหวายไม่ Workplacerelatedเหตุการณ์Psychosocialลด(ในความรู้สึกของความเครียดเหตุการณ์ ย้ำเหตุการณ์เช่นในครอบครัว สูญหาย หรือเปลี่ยนแปลงพันธมิตร ย้าย)อุดมในมินิบุคลิกภาพและแต่ละจิต และ Physiologicโอนการครอบครอง(ในแง่ของบุคลิกภาพลักษณะ การรวมเช่นฝรั่ง และแผนงานการรับรู้)วิตกกังวลในช่วงที่ทำงานเกี่ยวข้อง(Posttraumatic ความเครียดโรค โรคการปรับปรุง มีความวิตกกังวล โรคกลัวเฉพาะสังคม สังคม Unspecificโรคกลัว ความวิตกกังวลในสถานการณ์ Hypochondriac วิตก วิตกกังวลของไม่เพียงพอ ตั้งค่าทั่วไปวิตก (ความกังวล)อุดมในมินิหวาย48ส่วนการวินิจฉัย ลำดับเฉพาะสำหรับการเข้าร่วมงานและข้อกำหนดเฉพาะสำหรับการบำบัด:Aetiology of workplace phobiaDifferent primary workplace-related anxiety qualities (Linden& Muschalla, 2007) are expected to potentially appear togetherwith (or lead to) workplace phobia (Figure 1). Similarto conventional anxiety disorders, these primary workplacerelatedanxieties can occur as different phenotypes, likeanxiety of insufficiency, generalized worrying, specific socialfears, panic in specific non-social working situations, posttraumaticstress or adjustment reactions, health-relatedanxieties.Workplace phobia can be seen as a kind of global workplacerelatedanxiety, including the workplace as a whole and goingbeyond specific anxiety provoking stimuli like certain demandsfor achievements (Beutel et al., 2004), major changes(Chevalier et al., 1996; Griffin et al., 2002), specific colleaguesor superiors (Bilgel et al., 2006), dangerous worksituations (Laposa et al., 2003; Price et al., 2005) or environmentalaspects (Nakazawa et al., 2005; Nicholson & Vincenti,1994). To know the primary anxiety provoking stimuliis necessary for the specification of the quality of workplacerelatedanxiety, which becomes relevant for treatment.Workplace phobia has been found to occur in comorbiditywith on average two basic workplace-related anxieties, likespecific social anxiety towards a special superior or colleague,or anxiety of insufficiency after changes at work (Muschalla,2008).From a specific anxiety that has originally manifested at theworkplace, a complex system of phobic avoidance behaviourmay develop, exceed the workplace and generalize to otherdomains of life. This is due to the fact that anxiety oftentends to generalize (Kolassa et al., 2007; Lissek et al., 2008).Thus workplace phobia may result in an agoraphobic symptomaticwith avoidance of public places, whereby the fear isto be confronted with workplace-associated stimuli, mostlycolleagues or superiors, but also objects or places whichremind the person of the workplace.However, also primary conventional anxiety or other mentalor somatic disorders (Haslam et al., 2005; Munir et al., 2007)or an inadequate coping style (Schaarschmidt & Fischer,2001) or personality accent (Cramer & Davidhizar, 2000;Girardi et al., 2007; Sakai et al., 2005) can cause problems atthe workplace and trigger workplace-related anxiety andavoidance behaviour.Workplace phobia often appears as a secondary symptom orcomplication of an underlying primary disorder or vulnerability.Therefore, workplace phobia can be seen in analogyto a cerebral insult which occurs in the context of a metabolicsyndrome or a thromboemboly or a tumor disease. Inthis diction, it can be seen as an additional complication of aprimary disorder. A metabolic syndrome with a cerebralinsult would be diagnosed and treated in a different way thana metabolic syndrome without a cerebral insult. Furthermore,the prognosis is worse in a person with both metabolic
syndrome and cerebral insult than in a person with
metabolic syndrome only.

ผลลัพธ์ (ไทย) 3:

จุดมุ่งหมายของการศึกษานี้คือ เพื่อตรวจสอบว่า กลุ่มบุคคลที่มีการหลีกเลี่ยง phobic ของ

อาจจะระบุสถานที่ในแง่ของการตอบสนองทางสรีรวิทยาและจิตวิทยาไซโค
เหตุการณ์ทำงานเคร่งเครียด ผู้เข้าร่วมทุกคน

) เพิ่มขึ้นโรคจิตสรีรตื่นตัวตอบสนองต่อเหตุการณ์เครียด
เมื่อเปรียบเทียบกับเหตุการณ์ที่เป็นกลางและจิตวิทยาสถานที่ทำงานของกลุ่มแสดงให้เห็นอย่างเด่นชัดขึ้น

หัวใจอัตราการตอบสนองเชิงรายงานของความกลัวนั้นแตกต่างจาก
กลุ่มอื่น การพัฒนาของการตอบสนองของการหลีกเลี่ยง
กล่าวถึงโดยผู้เขียนในแง่ของทฤษฎีการเรียนรู้
.
อีกวิธีหนึ่งทำเสร็จแล้ว โดยเน้นการวินิจฉัยด้านและรายละเอียดค่า

ที่ทำงานในฐานะของความหวาดกลัว