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Individual differences in behavioral, cardiovascular, and endocrine responses to varying workload among 381 air traffic controllers were assessed using random regression modeling. Although most men showed significant increases in behavioral arousal associated with increasing planes, there were major individual differences in response in systolic and diastolic blood pressure, heart rate, and cortisol. Approximately 20% to 25% of those studied had large increases in each of these domains, along with a smaller group showing inverse responses in heart rate and cortisol. There was also evidence of a smaller number of enhanced responders within the highest groups, who tended to have more missing values at higher levels of workload. There was convergence in the definition of responders using three statistical strategies: random regression, correlational analyses, and ANOVA. Response in one physiological/behavioral domain was essentially independent of response in another, supporting the conclusion of specificity, rather than a global tendency to respond to increasing work load.

Plasma cortisol and growth hormone (HGH) responses to venous catheterization were studied in 29 volunteer subjects. Repeat characterizations were performed in 18 individuals. Mean plasma cortisol levels were significantly elevated during the first hour of the initial catheterization experience. Morning and afternoon levels of cortisol were not distinguishable during the first catheterization, but PM levels were significantly lower than AM levels during the second catheterization experience. Growth hormone responses were much more variable than cortisol and were distributed logarithmically. Growth hormone responses tended to parallel cortisol responses during the first catheterization experience. Individuals who listed more symptoms in response to venipuncture and catheterization after finishing their first catheterization had significantly higher cortisol and growth hormone levels during this experience. These data suggest a definite endocrine adaptation to catheterization by the second or third hour of the experience.

From a prospective study of health changes in air traffic controllers, it was determined that high scores on self-report measures of work-related life change distress, other life changes outside the work setting, the type A behavior pattern, and dissatisfaction with management were positively related to future rates of injuries and physician-diagnosed acute illness episodes. Depending on the risk factor involved, high scorers on these psychosocial risk predictors incurred from 80% to 252% more future accidental injuries and from 38% to 69% more future total morbidity over a 27-month follow-up period than the men in the low scoring groups. Moreover, coworker-rated amicability, probably an indication of the amount of social support available to an individual, was significantly protective against these outcome variables, with the rarely or never chosen group experiencing 60% more total morbidity and 174% more injuries than the often chosen group. A multiple-regression equation revealed that stress, amicability, type A, and satisfaction with management had an additive effect on the outcome variables. Work- and non-work-related life change distress subscales were similar in their ability to predict later morbidity. Prediction was stronger for 27-month follow-up than for only the first 9-month period. The findings, if replicated, raise the possibility of screening programs to identify employees at high risk of future illness and injury.

This final report in the series of three examines the relationships between physical health change, psychopathology and work responsiveness to cortisol and growth hormone secretion in air traffic controllers. In contrast to expectations, those who had the lowest rates of mild to moderate physical health change showed a modest tendency to have higher average cortisol. Those men who experienced more psychiatric symptomatology in terms of impulse control problems, alcohol abuse and subjective distress had slightly higher average cortisol values at work. Those men who responded to increased workload with increases in cortisol, possibly reflecting increased job involvement, also had higher average cortisol. Physical health change, levels of psychopathology and cortisol responses to increased workload were statistically independent predictors of average cortisol levels.

A comprehensive life events questionnaire was administered to 416 men. Total life change scores were computed from published normative weights and from individuals' own ratings of events that occurred. The results showed that the rank order of life events was highly correlated between our sample and the original normative groups. However, in the population of men we studied, there were significant differences between the total life event scores derived by summing the published normative weights and the total adjustment or distress reported by those men who experienced the events. Other results indicated that life event scores based on normative weights reflect more on the number of life events that are experienced, whereas life change scores based on individuals' ratings may better reflect on the potential impact of life change. Finally, the psychometric properties of several life change inventories are poor.

Twenty-one healthy women were studied during one menstrual cycle in order to determine whether cortisol and growth hormone responsivity to psychological stress was related to estrogen levels. Blood was drawn approximately three times per week for analysis of estradiol, progesterone, cortisol, and human growth hormone. During either the menstrual or intermenstrual phase, each subject participated in an interview that was designed to be mildly stressful. State and trait anxiety were assessed using the Spielberger State-Trait Anxiety Inventory. Anxiety state was measured prior to and immediately following exposure to the psychological stress; trait anxiety was assessed at the end of the study. Cortisol and growth hormone responses to the psychological stress were not related to menstrual cycle phase. Anxiety levels were also independent of menstrual cycle phase. Subjects who displayed significant cortisol and/or growth hormone responsivity to the interview had significantly higher anxiety levels post stress than did nonresponders, although anxiety level prior to the interview was not different for the two groups.

In association with conditioned avoidance sessions of 72 hours' duration, monkeys showed a response pattern characterized by increased levels of 17-hydroxy-corticosteroids and decreased levels of pepsinogen during the stress period, with a marked and prolonged elevation of pepsinogen levels occurring during the recovery period.