Stress

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.

The Effect of Stress on Health

In the British Medical Journal (1884) it was reported that bereaved persons are prone to infection.
There is a link between stress and cancer. Stress inhibits natural-killer (NK) cell activity, which helps to combat cancer cells.
Greer and Morris (1975) women who did not express their anger were more likely to prove positive in a biopsy test for cancer.
Greer et al (1979) - The greatest mortality amongst cancer sufferers is associated with groups who do not demonstrate a fighting spirit or do not use denial styles of coping.(See "Chronic" Document)

Early work on stress

Sympathetic division of the autonomic nervous system
release of adrenaline

Too little or too much arousal affects performance.
Yerkes-Dodson Law.

Fight or flight response

Upon arousal we experience an immediate physiological response.

we are ready to fight or flight.
Response takes a long time to subside.

If once burgled, then every little sound at night would disturb you. Lack of sleep increases the problem.

General Adaptation Syndrome (GAS)

Selye (1920's)
Basically - Alarm - typical fight or flight reaction.

Resistance - Body adapts to the stress. Appears to be not affected by the stress, but person will snap at new stressors.

Exhaustion - Body can deal with this resistance for only so long. If stressor continues, illness and even death.

Tennes and Kreye (1985) intelligent school children have higher stress when they are taking exams. GAS does not take into account psychosocial factors.

We should not forget that different people will react differently to the same level of stress because of purely physiological differences between them.

Psychological contributions

Look at Sarafino (1994) quote p21.

Models of Stress

Lazarus and Folkman (1984)

[Study figure 2.3 in Banyard]

Conflict and Stress

  1. Approach/Approach - Two desirable alternatives. This dilemma is easy to solve, but stress increases the more important the decision is felt to be.
  2. Approach/Avoidance - Good and Bad points within a single goal. Like giving up smoking - healthier but person puts on weight.
  3. Avoidance/Avoidance - This is most stressful. This can be seen when a patient has to choose between two equally undesirable treatments. Patient often delays making a decision, or may change their doctor in the hope of getting a better option.

Personal qualities affecting appraisal of stress.

Kobasa (1979)
People who can handle stress possess 'hardiness'.
There are three components

  1. Control - can you control events? (See Locus of control)
  2. Commitment - Sense of purpose, involvement.
  3. Challenge - problems seen as an opportunity for personal growth.

Kobasa (1979) - High stress executives
2 groups - high illness Vs low illness.
Using questionnaire, the low illness group had more hardiness.

Problems

  1. People vary with their personality. Unlikely to be one type of person all of the time.
  2. Only looked at white professional American men - may not be true of other groups.

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'.

Measuring stressors

  1. Effect of stressors - performance on simple behavioural tasks or self-report scales.
  2. Stressful life events
  3. Social environment

Moos and Moos (1981) looked at a number of social climates, including psychiatric wards, college dorms, prisons, work groups, families.

[See Box 2.2 p26]
+ve environments - reduce recovery time from illness.

Responsibility, work pressure and change increase the likelihood of illness or subjective distress.

Stressful life events

Holmes and Rahe (1967)
Test your stress using Holmes and Rahe(1967)

Scale developed from asking 400 adults to rate 43 different life events, for the amount of adjustments needed to deal with them. High correlation between men and women, Catholics and Protestants. Not so high for Black Vs White.

Holmes and Rahe felt there was a correlation between high ratings and illness, but Sarafino reports the correlation to be really quite weak (r = 0.3).

As an exercise why not criticise the items used in the scale.

Problems with the scale

  1. Major life events are rare therefore low scores
  2. Some items are ambiguous.
  3. Value of items vary depending on what group the respondent belongs to.
  4. Large individual differences in ability to cope
  5. large cultural differences in our experience of events.
  6. Value of events change over time. So text loses its validity.

Kanner et al (1981) - minor stressors and pleasures of everyday life might have a more significant effect on health than the big events. - Takes account of the cumulative nature of stress.

See Box 2.3 hassles and uplifts of middle-aged adults.

This was a better predictor of psychological problems than life event scores. men are not affected by uplifts though.

Other Event scales

  1. Life Experiences Survey (LES)- this contains 57 items more precisely stated. A 7 point scale is used, ranging from -3 to +3. (Sarason et al 1978)
  2. PERI Life events scale items are arranged under 11 topic areas, -work, finances, family and health. Events that have occurred within a stated period are indicated by the subject (Dohrenwend et al 1978)
  3. Unpleasant Events Schedule (UES) 320 items are divided into categories. Items are precise and are rated twice; for frequency and aversiveness. A three point scale is used. The two ratings are multiplied together and the total for all items is calculated. (Lewinsohn et al 1985)

Measuring the stress response

Biochemical measures - various processes in the body, adrenaline, noradrenaline, and the immune system.

behavioural observation - facial expressions, rate of speech, posture, nail biting. Self report on marital satisfaction and frequency of urination.

Cognitive measures - perceived control over one's life, perceived level of arousal, mood and attitudes.

Perceived Stress Scale (Cohen, Kamarck and Mermelstein, 1983) 14 items rated on a 5 point scale. (See pp 92 - 97, Sarafino)

Problem - simple responses, unable to capture the richness of human experience.

Better scale.

Life events and Difficulties Schedule (Brown and Harris, 1989) - looks at range of issues to do with health, employment, social role, etc. Requires trained interviewers and trained judges to operate it.

Other methods of measuring stress

Above methods only provide a snapshot.
Stress varies from day to day.

Gulian et al (1990) - study of British drivers. Completed psychometric tests (e.g. Rotter's Internal - External Locus of Control Scale).

Also filled in a diary of their feelings while driving over 5 days.

Results

More stress in the evening and midweek.

Stress varied with age and experience, health condition, sleep quality, driving conditions, driver's perception of driving as stressful.

Douglas et al (1988) used diary and physiological measures
100 fire fighters from 12 stations.

Heart rate recorded for minimum of 48 hours (used portable electrocardiogram)

Results yielded a 'Ventricular cardiac strain score'.

High scores were found to correspond with number of call-outs, level of seniority, and stressful events recorded in diaries.

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)


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Notes from Canberra University
Stress Theories

Fussing can double risk of heart attack
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