Causes of Stress

Sources within the person

Illness itself can produce stress. The ability of the body to fight disease normally improves in childhood and declines in old age (Rogers et al, 1979). Children have a limited understanding of disease and death. When ill, children tend to focus on the current rather than future concerns (La Greca & Stone, 1985). Patients worry about being disabled or possibly dying from their illness.

Another source of stress is when conflict exists. The conflicts do not have to concern the choice between two negative outcomes. Making a choice between which of two houses to buy can produce stress.

Approach/approach conflict

This is the conflict produced when the choice is between two good strategies. For example needing to follow a diet and wanting to eat a fattening cake. These conflicts are easily resolved but the more important the decision seems to be, the more difficult it is for the person to solve the conflict.

Avoidance/Avoidance conflict

This is the conflict produced when the choice is between two bad strategies. For example, the choice between two equally harrowing treatments for an illness. Patients often delay making a choice and might easily change their minds repeatedly. Patients might even change their doctor in the hope that they will be given an easier choice. They might even get somebody else to make the decision for them. This conflict is difficult to resolve and very stressful.

Approach/Avoidance conflict

This is when a single goal has good points and bad points. For example giving up smoking might mean a gain in weight.

Sources in the family

Interpersonal conflict can arise from financial problems, from inconsiderate behaviour, and from opposing goals. Overcrowded conditions increases conflict over privacy and the use of family resources, such as the Bathroom. Major sources of stress in the family are the addition of a new family member, illness, infirmity, and death in the family.

An addition to the family

Obviously the mother will experience much stress during pregnancy and after the birth. But the father may also worry over money, or his wife's and baby's health, or fear that his relationship with his wife may deteriorate.

Parents may experience stress from their relationship with the baby. Each baby comes into the world with certain personality dispositions, which are called temperaments (Buss & Plomin, 1975). There are easy babies and difficult ones. Babies react differently to feeding, cuddling, bathing, and dressing.

Difficult babies tend to cry a great deal. They resist new foods, routines, and people, and their patterns of Sleep, hunger, and bowel movements are hard to predict. About 10% of babies are classified as difficult displaying most of these traits fairly consistently, many others show some of these traits occasionally. Longitudinal studies have shown that children's temperaments are stable across time. Many traits continue for many years, although many difficult children show changes toward the development of easy traits (Carey & McDevitt, 1978).

The arrival of a new baby can also be stressful to other children in the family (Honig, 1987). Much stress can be experienced in children aged two or three years old who do not want to share their parents with the new brother or sister. These children often show increased clinging to the mother and their sleeping and toileting problems also increase. Older children experience stress from the changes in the pattern of family interaction, such as when the parents introduce new rules.

Family illness, disability, and death

A working mother with a sick child will experience much stress. When children have a serious chronic illness, their families have to cope with stress over a long period. The amount of time needed to care for the child conflicts with other activities. The family also needs to make difficult decisions. They need to learn about the illness and how to care for their child. There is much expense and other children begin to feel left out.

Adult sickness can also produce much stress in the family. If a principal breadwinner is ill there will be a strain on the family's financial resources. The family's time and personal freedom are curtailed producing changes in interpersonal relationships.

If an elderly person who is ill or disabled must live with and be careful by relatives, the stress for those in the household can be severe, especially if the person requires constant care and shows mental deterioration (Robinson & Thurner, 1986).

If a parent dies children under about five years of age seem to grieve for the lost parent less strongly and for a shorter time than older children and adolescents do (Garmezy, 1983). Children's concept of death changes between four and eight years of age (Lonetto, 1980). Young children think death is reversible: the person will come back eventually.

An adult whose child or spouse dies suffers a tremendous loss. Bereaved mothers reported that they had lost important hopes and expectations for the future (Edelstein, 1984). A mother who loses her only child loses her identity and role as a mother too. The loss of a spouse is especially stressful in early adult (Ball, 1976-77).

Child abuse

The stress caused by long-lasting psychological effects of sexual abuse in childhood has been found to increase the likelihood of certain diseases in old age. Women who were assaulted in their teens appeared to run greater risk of developing arthritis and breast cancer in later life, while Male victims are more likely to develop diseases of the thyroid than men who were not abused as children. 1,300 elderly middle-class participants were studied 12% of the women and 5% of the men reported unwanted sexual contact for childhood. Breast cancer and arthritis were relatively common amongst participants who had suffered sexual abuse; the more sustained the abuse the higher the risk of developing the diseases. However those abused were less likely to suffer from hypertension, but this was probably due to survivor bias, in other words, people with hypertension tend to die younger, so do not feature in studies of elderly people. Stein and Barrett-Connor (2000).

Sources in the community and society

 

Children experience stress at school and in competitive events, such as in sports and band performances (Passer, 1982).

 The threat of chemical and biological weapons could have serious long-term social and psychological consequences for the populations of the US and Europe, leading to widespread anxiety and outbreaks of panic-induced illness, according to a leading psychiatrist.

Jobs and stress

The TUC identifies four main causes:

  1. Environmental (noise, overcrowding, open plan offices, for child care facilities, for instance):
  2. Contractual (low pay, shift work, excessive overtime, job insecurity);
  3. Job designed (boring work, too much/little work, lack of job control):
  4. Relationships (poor relations with colleagues, lack of communication, impersonal treatment).

Loss of self-esteem and a lack of control are two very common themes.

 Demands of the task 

Excessive workloads are associated with increased rates of accidents and health problems (Mackay & Cox, 1978). The workload for mothers is particularly heavy because not only do they work outside of the home but also do most of the chores at home (Frankenhaeuser, 1991). Repetitive jobs that under utilise the workers abilities can produce stress. The evaluation of an employee's job or performance is also particularly stressful for both the supervisor and the employee (Quick and Quick, 1984).

 

Responsibility for people's lives

 

People working in the health professions need to take many life and death decisions instantly and experience appalling things, this leads to feelings of emotional exhaustion (Maslach & Jackson, 1982). The same applies to the police and fire fighters.

 

Stress can result from other aspects of jobs:

  1. The physical environment of the job. Extreme levels of noise, temperature, humidity, or illumination cause stress (Mackay & Cox, 1978).
  2. Perceived insufficient control. People experience stress when they have little influence over work procedures or the pace of the work (Cottington &House, 1987).
  3. Poor interpersonal relationships. Stress increases when an employee's boss or colleague is socially abrasive, being insensitive to the needs of others or condescending and overly critical of the work other individuals do (Quick and Quick, 1984).
  4. Perceived inadequate recognition or advancement. Workers feel stress when they do not get the recognition or promotions they believe they deserve (Cottington et al, 1986).
  5. Job loss. The sense of job insecurity is stressful, particularly if the employee has little prospect of finding another job (Cottington et al, 1986). Unemployment is associated with stress, such as in people's loss of self-esteem and heightened blood pressure (Olafsson & Svensson, 1986).

 

Retirement can be stressful because retired people have lost opportunities for social interaction and an important part of their identity. They may miss the power and influence they once hand, the structure and routines of a job, and the feeling of being useful and competent (Bohm & Rodin, 1985). In addition retired people often live on low incomes, which again produces stress.

 A study carried out by Langer and Rodin (1976) attempted to discover the effects of giving people a greater sense of personal control. They compared two different wards in a nursing home for elderly people in Connecticut, USA. The residents in the two wards were of similar age, health and socioeco­nomic status, and they had been resident in the home for the same period of time on average (resi­dents who were too uncommunicative or bedridden to take part were excluded from the study).

Both groups of residents were given a talk, but the issue of personal responsibility was strongly stressed with one of them and not the other. Furthermore, residents in this first group were offered a plant each for their rooms and were asked where they wanted it placed. Additionally, they were allowed to choose which night to go and watch a film. Residents in the other group were simply given the plant and told which night to go and see the film.

Even this fairly minimal manipulation of personal control seemed to have a dramatic effect. Residents who were given a greater sense of personal control were happier, more active, more alert and, when the researchers returned after eighteen months, were in better health and fewer had died. This study implies that having a greater sense of personal control actu­ally helps to reduce stress.

 

Commentary

•   There are methodological and ethical criticisms that can be made of Langer and Rodin’s study. The sam­ple was very limited (elderly Americans living in a particular care home). On the other hand, Langer and Rodin took care to avoid demand characteristics by not informing the residents, nurses or research assis­tants (who collected the data) of the purpose of the study.  Controlled experiments on the damaging effects of stress in human beings can be very unethical. In this case, Langer and Rodin would argue that they did not harm anyone’s health, but actually improved it for those residents who were given a greater sense of control. On the other hand, when the experiment was over, we do not know whether the situation reverted to what it had been before, and it may be that being given a sense of control for three weeks, then having it removed again, did more harm than good in the long term.

•   There are clear implications of this study for the way people are treated in residential homes. There is also a lesson to be learnt when developing therapy to help people suffering from extreme stress. If it is true that a low sense of personal control (that is, having a very external locus of control) can lead to stress, then in cases where this applies it may be beneficial for ther­apy to focus on shifting people’s locus of control from external to internal.

Environmental stress

Crowded conditions can be stressful for three reasons:

  1. Lack of control over interpersonal interaction, as when other people can overhear your conversation.
  2. The restricted ability to move about freely or reduced access to resources, such as seats.
  3. Intrusion into personal space (Sarafino, 1987).

 

People exposed to hazardous substances in their environment worry for years about what will happen to them (Baum, 1988).

 

People who lived near the three mile Island power plant in Pennsylvania, where a nuclear accident had happened suffered more stress more than a year after the accident than other residents near a similar facility (Fleming et al., 1982).

 

Adapted from Health Psychology, Edward Sarafino, Wiley, 1994, pages 84-91.

Stressors - produce stress
Source of stressors can be Family (as when trying to cope with a newborn baby or when looking after a sick relative), Work or the Environment.

Stress response - response to stresssor

Stressors - external - e.g. heat, crowding, noise, difficulties with a loved one or contact with a hated one.

internal - e.g. pain, thoughts, feelings.

But not straightforward - heat can be relaxing and crowds can be exciting.
Individual differences.

Other factors

Event

-

Lundberg (1976)
Using urine samples
Commuters on crowded trains more stressed than in empty trains

but those that had been on the train since the start, showed less stress, even though they had been exposed to the crowded condition longer.

Being able to choose seat, control the situation, reduced the stress.

Post - traumatic stress disorder and 'The Herald of Free Enterprise'.

Hodgkinson and Stewart (1991)
PTSD -described in DSM-III (1980)

1) Re-experiencing phenomena.

Most of the children reported intrusive thoughts and some experienced full-blown flashbacks.

2) Avoidance or numbing reactions.

Detached from others
Avoided not only ferry travel, but also the sea.
Immediate aftermath - avoided shower or bath.
Cyclical - reappear and disappear.
Onset can be several months later.
Just as severe.
Therapy or counselling - not that useful.

These people who found the counselling as 'unhelpful', fared no worse than people who reported that it was 'helpful'.

Link between stress and arousal

The diagram below shows the relationship between stress and arousal as determined by a factor analytic technique (Mackay et al 1978)

Causes of Stress

Due to individual differences, pinpointing specific workplace activities that are likely to cause stress, does not go beyond the obvious. What may be seen as a challenge by one individual may be an impossible task or boring and repetitious to another.

Our background, motivation, experience, skills and knowledge on the one hand and the support and encouragement from managers, supervisors and colleagues on the other, all play an important role.

While it may be beyond the employer's responsibility, it is necessary to take into consideration the fact that not everyone comes to work with a cheerful disposition to start with. A death or sickness in the family, a temporary setback or other personal problems will influence the way in which we cope with the pressures of work. Good employers are aware of this and encourage their employees to address the problems that persist and work through them.

Levels of stress that become harmful are likely to occur when there is:

Those not in supervisory or management positions may have a heightened sense of these situations.

They can be started or made worse by:

Some occupations are, by their nature, stressful. They include those dealing with violent and aggressive behaviour or the threat of it occurring, or dealing with injury, disease and death, and having continuous contact with people and human suffering.

Workplace physical conditions can themselves create stress. Excessive noise with no control over sound levels can cause severe physical and behavioural problems. Severe vibration can have similar effects. Hot, humid conditions and the constant presence of hazardous substances or other hazards will also create stress.

Soccer shoot-out stress increases heart attack rate
By Oliver Wright, Health Correspondent Times 20-12-02 (abridged)

The study, published in today’s British Medical Journal, investigated England’s 4-3 defeat on penalties by Argentina in the 1998 World Cup. The researchers found that on the day of the match hospital admissions for heart attacks increased by 25 per cent compared with the average. The day after the match, admissions were up by 21 per cent; it was only three days later that there was a significant fall.

The shoot-out had no effect on road traffic injuries or statistics for deliberate self-harm, despite England’s demise, and no death in England has been attributed to the shoot-out.

The study, by Birmingham and Bristol Universities, backs up previous studies showing that moments of acute stress can bring on heart attacks. Research in Israel found that the number of heart attacks doubled during Iraq’s missile attack on Tel Aviv in 1991. A study during the week after the 1994 earthquake in southern California found a 35 per cent increase in hospital admissions for heart attacks compared with the week before.

The researchers examined data on patients aged between 15 and 64 attending English hospitals on June 30, 1998, who had had a heart attack. They then compared the figures with numbers admitted on the same date the previous year and in subsequent years. They accounted for common environmental factors such as temperature at the time and the day of the week on which the 30th fell and used a mathematical model to assess the risks.

The expected number of admissions for heart attacks should have been about 72, but on the day of the Argentina match there were 91. The day after the match, when there should have been 71 admissions, there were 88.

Shah Ebrahim, of Bristol University, one of the authors of the report, said that it appeared the stress of the situation was responsible for the increased risk. “We were only looking at people aged between 15 and 64 for whom to have a heart attack would be considered premature,” Professor Ebrahim said.

General Anxiety Disorder

Causes of stress link

excellent site covering Stress

Notes from Canberra University
Stress Theories

Acknowledgement

Harari. P. and Legge. K., 2001, Psychology and Health, Heinemann, 0-435-80659-9, Highly recommended text for the whole class.

Return to Gary Sturt's home page.