Dysfunctional fear

In the workplace, there are two kinds of fear functional fear and dysfunctional fear. In using a Dr. Jekyll and Mr. Flyde analogy to make an obvious good vs. bad comparison, functional fear is good (Dr. Jekyll) and dysfunctional fear is bad (Mr. Hyde). 

So what does all this talk about feat have to do with making chemical industry workers safer on the job Where does fear fit into the chemical-safety equation The chemical-safety equation is shown below keep in mind that the "fear part of the equation is functional fear. Dysfunctional fear has no plac e in chemical safety, in chemical-safety compliance efforts, or anywhere else, for that matter. 

Clonazepam is the most extensively studied BZ for treatment of generalized SAD. It improved fear and phobic avoidance, interpersonal sensitivity, fears of negative evaluation, and disability measures. Adverse effects include sexual dysfunction, unsteadiness, dizziness, and poor concentration. Clonazepam should be tapered at a rate not to exceed 0.25 mg every 2 weeks. 

Your entire life is affected when one whiff of perfume, fabric softener or fresh paint can result in a throbbing headache, brain dysfunction, an asthma attack, a convulsion or a myriad of other symptoms. Work performance, relationships and community ties collapse when your olfactory system is so heightened that you become ill from the smell of laundry products on the clothes of someone sitting all the way across the room. Fear overcomes you when suddenly carpeting, photocopies, car exhaust and other products produce the same effects, and the only way to protect yourself is through isolation. 

In this interview Katy shares her view that chemical exposures can lead to an inability to tolerate stress, to loss of mental functioning, to fear and to violence. Since I met with her, two studies have been published that validate her remarks. One, a University of Wis-consin-Madison study published in the journal Toxicology and Industrial Health, January-March 1999, found that the pesticide-fertilizer mixtures commonly found in groundwater can affect patterns of aggression and the ability to learn, and causes hormone disruptions that increase sensitivity to stimuli, irritability and immune dysfunction. A University of Arizona study published by Environmental Health Perspectives in June 1998 showed a decrease in mental ability and an increase in aggressive behavior among children exposed to pesticides. 

BZs should be reserved for patients at low risk of substance abuse, those who require rapid relief, or those who have not responded to other therapies. Clonazepam is the most extensively studied BZ for treatment of generalized SAD. It improved fear and phobic avoidance, interpersonal sensitivity, fears of negative evaluation, and disability measures. Adverse effects include sexual dysfunction, unsteadiness, dizziness, and poor concentration. Clonazepam should be tapered at a rate not to exceed 0.25 mg every 2 weeks. Gabapentin was effective for SAD, and onset of effect was 2 to 4 weeks. j8-Blockers blunt the peripheral autonomic symptoms of arousal (e.g., rapid heart rate, sweating, blushing, and tremor) and are often used to decrease anxiety in performance-related situations. For specific SAD, 10 to 80 mg of propranolol or 25 to 100 mg of atenolol can be taken 1 hour before the performance. A test dose should be taken at home on a day before the performance to be sure adverse effects wUl not be problematic. Incomplete response to a first-line agent may benefit from augmentation with buspirone or clonazepam. 

Overdose is common amongst users (up to 22% of heavy users report losing consciousness). The desired euphoria and excitement turns to acute fear, with psychotic symptoms, convulsions, hypertension, haemorrhagic storke, tachycardia, arrhythmias, hyperthermia coronary vasospasm (sufficient to present as the acute coronary syndrome with chest pain and myocardial infarction) may occur, and acute left ventricular dysfunction. Treatment is chosen according to the clinical picture (and the known mode of action), from amongst, e.g. haloperidol (rather than chlorpromazine) for mental disturbance diazepam for convulsions a vasodilator, e.g. a calcium channel blocker, for hypertension glyceryl trinitrate for myocardial ischaemia (but not a p-... 

Phobias such as the fear of snakes, closed-in spaces, heights, and so on, are generally considered to be associated either with age-appropriate fears (fears that subside with maturation) or conditioned responses. There is little evidence that these disorders are due to biological dysfunction, and medication treatment is generally not warranted. 

Needle-free injectors have been developed to resolve the issue of pain and fear and hence to improve compliance. There are two types of needle-free injectors fluid and powder. Needle-free powder injectors have been utilized for the delivery of vaccines for hepatitis B, aprostadil for erectile dysfunction, the anesthetic lidocaine, a granulocyte-macrophage colony-stimulating factors tumor vaccine for malignant melanoma, and DNA-coated particles. 

Despite the overwhelming benefit demonstrated in clinical trials, /3-blockers are still widely underused, perhaps because clinicians fear that patients will experience adverse reactions, including depression, fatigue, and sexual dysfunction. A recent systematic review of 15 trials that included more than 35,000 patients demonstrated that withholding /3-blocker therapy in such a group was not founded because /3-blockers do not significantly increase the risk of depression and only modestly increase the risk of fatigue and sexual dysfunction. ... 

Bosma H, van Boxtel MP, Ponds RW, et al Pesticide exposure and risk of mild cognitive dysfunction (letter). Lancet 356 912-913, 2000 Furst JB, Cooper A Failure of systematic desensitization in 2 cases of obsessive-compulsive neurosis marked by fears of insecticide. Behav Res Ther 8 203-206,1970 Gauthier E, Fortier I, Courchesne F, et al Environmental pesticide exposure as a risk factor for Alzheimer s disease a case-control study. Environ Res 86 37-45, 2001... 

The user must also define which failure modes are the feared events (EE). These events will be studied by the global analysis provided by the tool Safety Architect. A dysfunctional simulation of the system is then executed by propagating failures along the dataflow dependencies of components and until a feared event is reached. 

Exercise limitation and functional disability in COPD have a complex, multifactorial basis. Ventilatory limitation is caused by increased airways resistance, static and dynamic hyperinflation, increased elastic load to breathing, gas exchange disturbances, and mechanical disadvantage and/or weakness of the respiratory muscles (4-6). Car-diocirculatory disturbances (7,8), nutritional factors (9), and psychological factors, such as anxiety and fear, also contribute commonly to exercise intolerance. Skeletal muscle dysfunction is characterized by reductions in muscle mass (10,11), atrophy of type I (slow twitch, oxidative, endurance) (12,13) and type Ila (fast twitch) muscle fibers (14), altered myosin heavy chain expression (15), as well as reductions in fiber capillarization (16) and oxidative enzyme capacity (17,18). Such a dysfunction is another key factor that contributes... 

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