We have so much more gadgetry. The fax needs to be checked. The beeper needs to be answered. In mid conversation, we are interrupted. Your cell phone rings in an elevator and the battery is low, ending that important discussion. It is life’s daily hassles instead of traumatic events that cause the buildup of stress. Relaxation is the key.

Rest breaks should be taken in a calm environment without interruptions. They should last at least 10 minutes. A lunch break is essential to well-being.

Some of the signs of stress overload are restlessness, chronic fatigue, sleeplessness and problems in concentrating. If you have any of these problems it is time to reengineer your work environment or take a vacation. You might also want to consult with a professional to learn positive stress reduction techniques. The usual course of treatment is 6 to 10 sessions in which the symptoms are treated and then stress prevention strategies are employed.

Other, more dramatic symptoms such as noncardiac chest pain, panic attacks, or high blood pressure require psychological interventions. They are sure signs that you are pushing yourself too hard, too far, and too fast. An objective professional can help you to set up reasonable and healthy priorities. He/she can also help you to learn how to ask for assistance from others.

I was practicing a new specialty called Clinical Health Psychology. The field was beginning to have some spectacular successes including increasing the longevity of cancer patients with psychotherapy, and reducing the negative consequences of cardiovascular surgery through consultation-liason visits.

In the last ten to twenty years a new sub-field of health psychology has emerged called Psychoneuroimmunology. It is concerned with the role of the mind on disease processes, particularly on the immune system. We now know through our study in this field that depression reduces the level of efficiency of the immune system. We are also now aware that people who have a higher level of hostility are more prone to heart disease. These are just two examples of the type of information I will be sharing with you.

In the course of our journey through the upcoming issues of this publication, I hope to provide you with the newest information from the fields of clinical psychology and clinical health psychology to improve your health and sense of well being. My colleagues and I are looking forward to communicating with you so that you can live a healthier and happier life.

If you are representing the family of a suicide victim, it is important to note that there is no psychological test that is predictive of suicide. As one might expect, the best predictor of future suicide is past attempts. Hopelssness is also one of the major indicators of a potential suicide. Nearly two thirds of suicide victims communicate their attempt to others prior to the attempt. This is why information from friends and relatives is so important in formulating a treatment plan and deciding whether hospitalization is required. Approximately thirty percent (30%) of suicides occur either in the psychiatric hospital or in the twelve months post discharge.

If your client expresses suicidal ideation, you must contact a professional immediately. All thoughts of suicide or attempts are to be taken seriously. You should do a follow-up with the professional to establish that your client has met his/her appointments.

Recently, the Journal of Consulting & Clinical Psychology published an article by the esteemed psychologist A. T. Beck and colleagues that examined risk factors for suicide. What makes this study so valuable is that it included over 600 outpatients and that it was prospective. That is, the authors used data to predict suicide as opposed to looking at suicide cases to ascertain what they had in common.

Those factors directly related to suicide included suicidal ideation (thoughts of suicide), major depressive disorder, bipolar disorder, previous psychiatric hospitalization, previous suicide attempts, increasing age, and unemployment. Other predictors included hopelessness, previous use of psychiatric medication, severity of depression, family history of suicide, and personality disorders (Axis II).

These findings suggest the importance of understanding suicide as a consequence of a multiplicity of risk factors. Seldom is self-inflicted injury or death due to a single ?cause?. As you can see from the variables above, there are certain factors that are pre-conditions. Also, there are situational factors such as unemployment, or access to weapons that may relate to suicide.

Contrary to the popular belief that employees are violent, the vast majority of cases of workplace violence occur as a result of armed robbery and related crimes perpetrated by persons from outside the workplace. Eighty-two percent of homicides in the workplace are crime related. Seven percent of U.S. employees report that they have been threatened in the workplace and three percent have actually experienced violence by co-workers. Overwhelmingly, the targets of violence, in and out of the workplace, are women. Of all women who die on the job forty-nine percent are victims of assault compared to only eighteen percent for men.

Corporations concerned about workplace violence will need to focus their efforts on establishing an environment that is safe and secure from both external and internal threats. This might entail hiring a security firm to redesign work areas and to equip them with monitoring devices. A much less likely threat is the occurrence of an employee going “postal”; that is, inflicting violence on co-workers. In almost all such cases the perpetrator has probably made threats or has chronically complained about working conditions. His/her productivity has usually decreased as well as the quality of his/her work just previous to a breakdown or severe outburst. This employee must be confronted before his/her threats become a reality. Companies should have a “threat team” or at least an employee assistance program professional who is assigned to work specifically on this kind of problem. In addition, the company should have in place a zero tolerance policy for violence with specific procedures for its implementation. If violence or threats are not addressed immediately they tend to reoccur and worsen.

The direct victims and even the witnesses of workplace violence often suffer from psychological disturbances that can negatively impact their ability to work and enjoy life for a considerable period of time following the episode of workplace violence.

Sixty-eight years later, it is wise to remember his words again, and his definition of fear: ?nameless, unreasoning, unjustified terror.? Fear has gripped our workplaces, our communities. Schools plan germ warfare drills. Gas masks fly off the shelves. People cancel home sales, flights, trips. People are paralyzed by uncertainty, which is exactly what terrorists want.

Clearly, it is time to get a grip. In an excellent article in the Sept. 30 New York Times Magazine, economist Paul Krugman attributed the 12-year Great Depression not to a single cause, such as a stock market crash, but to a deepening dread and fear that froze purchases, ruined demand, shuttered businesses and shattered lives.

It could happen again - or we could avoid it, if we keep our heads clear and examine how we are behaving. Many of us refuse to fly. Yet airplanes are safer than they have been in years. Indeed, even on the morning of Sept. 11, it would have been safer to step on a plane than to drive to work on a busy interstate. Some of us are obsessively turning to news channels and websites in the middle of a workday to keep abreast of the latest developments, although getting too distracted simply thwarts our own attempts at economic well-being. Others are struggling to focus at work, citing anxiety about the attacks and the economy. In such cases - more often than not - the anxiety and trauma were dormant before the Sept. 11 attacks.

There is no question these are difficult days. We have all been shaken. Many in New York and Washington are coping with symptoms similar to post-traumatic stress disorder. Many of us who have lost loved ones, friends and colleagues need to talk it through withy a professionals. Others can benefit from a confidential, friendly pep talk from a colleague or superior. It is important for all of us to reach out to troubled people, show concern, and make them feel part of a greater team. The prescription for well-being is companionship, exercise, rest, and a sense of purpose.

The best therapy is to focus on tasks. A good day’s work goes a long way toward creating a good night’s sleep.

Now we evidence that psychological tests can be as valid as physical tests. In a recent article in the American Psychologist (2001), Meyer, Finn, Eyde, Kay, Moreland, Dres, Eisner, Krubaszyn, and Reed present comparisons of physical and psychological assessment validity coefficients. They point out, for example, that the ability to detect dementia with psychological tests is as good as with an MRI.

Validity scores for such commonly employed tests as the MMPI, the MCMI, and the TAT are essentially the same as commonly used physical tests such as mammography, electrocardiograms, MRI, and Pap smears. In common English, predicting positive or negative outcomes from psychological tests are about the same as predictions from common medical tests.

Psychological assessment requires a battery of tests because results of one test may be contradictory to another, not unlike physical tests. That is why assessments require a comprehensive battery including a thorough case history. Repeated assessments are also required to establish changes over time. It is also particularly valuable if pre-condition evaluations or baselines can be used to compare current functions. This is usually difficult to obtain with most psychological tests. The major exception is intellectual functioning. Most clients have had this type of assessment during their school years.

Personality tests like the Rorschach Inkblot Test, the Thematic Apperception Test (TAT), and the Minnesota Multiphasic Personality Inventory (MMPI) are widely used. The Rorschach consists of 10 symmetrical inkblots. The respondent is asked to inform the tester about what he sees. The TAT consists of 30 pictures categorized for a boys, girls, men, women. The respondent is asked to tell a story about the pictures. The most commonly used objective personality test is the MMPI, which has recently been revised. It consists of 567 items to be answered true or false.

The most widely respected intelligence test for adults is the Wechsler Adult Intelligence Scale Revised (WAIS-R) which provides an intelligence quotient (IQ) . A similar test for children is the Wechsler Intelligence Scale for Children (WISC-III).

Besides assessing general intellectual capabilities, the intelligence test answers a number of other important questions for the psychologist including: (1) Is organic disease or injury present? (2) Is there a thought disorder? (3) Is there an emotional disorder that is impairing intellectual functioning? The patterning of scores on the intelligence test gives the psychologist clues to the presence, extent, and relative influence of organic and personality factors on the expression of intelligence. Intelligence tests are also used to ascertain if a child is gifted or has a learning disability.

Schizophrenia affects approximately 1% of the population, occurring first between the ages of 13 and 30. It tends to be a severely debilitating condition causing the sufferer to go in and out of reality.

The next most frequent psychological disability is major depressive disorder. This disorder occurs much more frequently in the population than schizophrenia, affecting approximately 15% of the population at one time or another in their lives, but is not usually as debilitating as in the case of schizophrenia. However, it is estimated that by the year 2020, major depressive disorder will be the second leading cause of disability behind heart conditions. Major depressive disorder is manifested by an inability to concentrate, eating disturbances, sleep disturbances, feelings of self loathing, and indecisiveness. In extreme conditions, suicidal ideation or actual suicidal gestures may emerge. Psychotherapy is essential in accelerating the improvement of this disorder and in decreasing the probability of reoccurrence.

A variety of disorders caused by either job stress or personal injury may produce psychological disability. These include phobias, posttraumatic stress disorder, major depression, and generalized anxiety disorder. A thorough psychological evaluation will determine the nature and extent of the psychological disability and how to appropriately treat it. The evaluation includes a diagnostic interview as well as a variety of psychological tests to assess intellectual impairment as well as psychological impairment.

Fortunately, burnout is temporary if you alter your living habits. First, you must understand why you feel the way you do before you can change how you feel. Burnout can be viewed as a form of emotional fatigue. People who drive themselves too hard too often are at risk. Each of us is healthiest when we establish a regular routine of work, leisure, and rest. There are times when events disrupt usual cycles such as tax time for an accountant or trial work for a lawyer. When you make a habit of stretching yourself too thin to meet difficult deadlines, you stress yourself in two ways. First overworking causes physical and psychological fatigue. Second, the disruption of normal sleep and rest patterns in and of itself is a stress producer.

Just as some of us are capable of playing with pain, some of us can produce through fatigue. Eventually, however, we all will become exhausted. This state will negatively affect our judgement, our personal relationships, and eventually our health.

I know that some of you are asked to put in long hours for weeks on end. This requires some creativity in managing your time to avoid burnout. Invest in your health and well-being. Join a health club near your office. Exercise regularly for at least 30 minutes a day, three of four days per week. Meditate or at least recline in a chair or on a couch for a 20 minute period each day. If you cannot leave the office for lunch or dinner at least eat at the same times each day. Plan to reward yourself with a vacation or a present upon completion of a particularly arduous project. Chronic fatigue can lead to depression. In this case, your will need to consult with a psychologist. He/she will assist you with stress reduction exercises and/or time management techniques.