This review highlights theory and research that have attempted to relate physical fitness training to improvements on psychological variables among normals as well as selected clinical populations. Theoretical speculations in this area are critiqued, and research designs are evaluated as either experimental or quasiexperimental and therefore interpretable, or preexperimental and therefore largely uninterpretable. The research suggests that physical fitness training leads to improved mood, self-concept, and work behavior; the evidence is less clear as to its effects on cognitive functioning, although it does appear to bolster cognitive performance during and after physical stress. Except for self-concept, personality traits are not affected by improvements in physical fitness. Mentally retarded ' children demonstrate psychological improvement following physical fitness training, but no conclusion can be reached regarding the effects of physical fitness training with other clinical syndromes. Guidelines for upgrading future research designs are discussed.

An intervention designed to clarify individual roles was tested experimentally on the business service division of a major university. Following a pre‐test which identified role stress as a significant problem in the organization, top managers clarified their respective departmental roles in meeting organizational objectives. This was followed by a post‐test (Time 2) survey of workers’stressors and symptoms. Supervisors were then trained in the method of clarifying subordinate roles using a dyadic exchange process. Workers were randomly assigned to either participate in a thorough role clarification discussion with their supervisors or join a wait‐list control group. Based on a follow‐up (Time 3) questionnaire, the intervention appeared to reduce role ambiguity and supervisor dissatisfaction. There were no effects on other aspects of subjective strain, physical symptoms, or time lost due to illness. Role conflict decreased in both the experimental and control groups. We discuss the implications of these findings for systemic efforts to reduce employee stress.

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Stress, emotional exhaustion, and burnout are widespread in the medical profession in general and in orthopaedic surgery in particular. We attempted to identify variables associated with burnout as assessed by validated instruments. Surveys were sent to 282 leaders from orthopaedic surgery academic departments in the United States by e-mail and mail. Responses were received from 195 leaders for a response rate of 69%. The average surgeon worked 68.3 hours per week and more than ½ of this time was allocated to patient care. Highest stressors included excessive workload, increasing overhead, departmental budget deficits, tenure and promotion, disputes with the dean, and loss of key faculty. Personal-professional life imbalance was identified as an important risk factor for emotional exhaustion. Withdrawal, irritability, and family disagreements are early warning indicators of burnout and emotional exhaustion. Orthopaedic leaders can learn, and potentially model, ways to mitigate stress from other highstress professions. Building on the strength of marital and family bonds, improving stress management skills and selfregulation, and improving efficiency and productivity can combine to assist the orthopaedic surgery leader in preventing burnout and emotional exhaustion.

Although the deleterious effects of work-related stress on employee well-being and organizational effectiveness have received wide attention in the literature, few, if any, controlled experiments have been attempted to assess the effects of stress reduction interventions. In the present study, a stress management training program was evaluated in a field experiment with 79 public agency employees who were randomly assigned to treatment (« = 40) and control (n -39) groups.The training program consisted of 16 hours of group exposure distributed over 8 weeks. Using procedures based upon those developed by Meichenbaum (1975), treatment subjects were taught to recognize and alter their cognitive interpretations to stressful events at work. Subjects were also taught progressive relaxation techniques to supplement this process. Dependent variables were epinephrine and norepinephrme excretion at work, anxiety, depression, irritation, and somatic complaints, all measured at three times (pretest, posttest, and 4 months after treatment). Treatment subjects exhibited significantly lower epinephrine and depression levels than did controls at the posttest, and 4-month follow-up levels did not regress to pretest levels. However, treatment effects were not replicated in a subsequent intervention on the original control group. The general adoption of such stress management programs was not recommended.