G543 Section Two Stress

Starter task P95 (try this) P95 (try this)

The first big question is what is stress anyway? The first big question is what is stress anyway? Give a definition (3 minutes) Give a definition (3 minutes) It is a term we read about in the papers almost daily. It is a term we read about in the papers almost daily. As a society we are supposedly suffering from this thing, it costs the country millions of pounds a year in days off work and stress related illness not to mention broken marriages, arguments and neglected children. As a society we are supposedly suffering from this thing, it costs the country millions of pounds a year in days off work and stress related illness not to mention broken marriages, arguments and neglected children.. Stress Introduction

Task Explain how could test for stress levels Explain how could test for stress levels Now design a study to measure stress (this can be based on jobs, school, etc) Now design a study to measure stress (this can be based on jobs, school, etc)

Stress Introduction We tend to think of stress as something `out there`. We tend to think of stress as something `out there`. Subjectively it feels as if there is just too much to do, or too much being expected of us. Subjectively it feels as if there is just too much to do, or too much being expected of us. We feel unable to cope and if it goes on for too long we may even become ill We feel unable to cope and if it goes on for too long we may even become ill

50 years ago the term was not really used. 50 years ago the term was not really used. People would get tired, they might have been unhappy, but they probably would not have said they were stressed. People would get tired, they might have been unhappy, but they probably would not have said they were stressed. So is stress what happens to us or is it more about the way in which we choose to think about what happens to us? Discuss So is stress what happens to us or is it more about the way in which we choose to think about what happens to us? Discuss Stress Introduction

If we make different choices in life can we reduce stress? If we make different choices in life can we reduce stress? Is stress just a modern term for unhappiness? Is stress just a modern term for unhappiness? We might also ask whether stress is always a bad thing? We might also ask whether stress is always a bad thing? Is a lack of stress stressful?! Is a lack of stress stressful?! Discuss Discuss Stress Introduction

Definition Lazarus and Folkman (1984) define stress as:- Lazarus and Folkman (1984) define stress as:- “A pattern of negative physiological states and psychological responses occurring in situations where people perceive threats to their well being which they may be unable to meet.” “A pattern of negative physiological states and psychological responses occurring in situations where people perceive threats to their well being which they may be unable to meet.”

Stress Questionnaire Task 1 and 2 in the booklet on stress questionnaire Task 1 and 2 in the booklet on stress questionnaire

What we will be looking at: In this section we will look at three causes of stress: - In this section we will look at three causes of stress: - Work (study 10, Johansson) Work (study 10, Johansson) Life events (study 11, Kanner) Life events (study 11, Kanner) Hassles and lack of control (study 12, Geer and Maisel). Hassles and lack of control (study 12, Geer and Maisel). We will also look at and evaluate different methods used by psychologists to measure stress. We will also look at and evaluate different methods used by psychologists to measure stress.

Task Complete work 1.1 task and discuss (5 minutes) P4 Complete work 1.1 task and discuss (5 minutes) P4 Why is work seen as stressful? Why is work seen as stressful? Are some jobs more stressful than others? Are some jobs more stressful than others? What makes certain jobs more stressful than others? What makes certain jobs more stressful than others?

Johansson (1978) – Swedish Sawmill (Key Study 10) Aim: To measure the psychological and physiological stress response in two categories of employees. Aim: To measure the psychological and physiological stress response in two categories of employees.

Method: This was a natural experiment (could also be classed as a case study) using an independent measures design. The participants were 24 workers at a Swedish Sawmill. 14 were classified as being in a high stress risk group, these were the finishers. Method: This was a natural experiment (could also be classed as a case study) using an independent measures design. The participants were 24 workers at a Swedish Sawmill. 14 were classified as being in a high stress risk group, these were the finishers. Johansson (1978) – Swedish Sawmill (Key Study 10)

The finishers had to work at a set pace, governed by the production line, their work was complex and required a great deal of knowledge. The finishers had to work at a set pace, governed by the production line, their work was complex and required a great deal of knowledge. They were also responsible for their own and their team’s wages and worked in social isolation. They were also responsible for their own and their team’s wages and worked in social isolation. So their jobs were repetitive, constrained, socially isolated, but also complex and very responsible. So their jobs were repetitive, constrained, socially isolated, but also complex and very responsible. The other group of 10 workers were classified as the control group (low risk of stress) they were cleaners or maintenance workers. The other group of 10 workers were classified as the control group (low risk of stress) they were cleaners or maintenance workers. Johansson (1978) – Swedish Sawmill (Key Study 10)

Each participant was asked to give a daily urine sample, body temperature was checked and they were asked to complete a self-report about mood, alertness and caffeine and nicotine consumption, when they first arrived at work and a further four times during the day. Each participant was asked to give a daily urine sample, body temperature was checked and they were asked to complete a self-report about mood, alertness and caffeine and nicotine consumption, when they first arrived at work and a further four times during the day. Baseline readings were taken at home before the study started. Baseline readings were taken at home before the study started. Johansson (1978) – Swedish Sawmill (Key Study 10)

Results: In the first urine sample of the day, the high risk group had adrenaline levels twice as high as their baseline and these continued to increase throughout the day. Results: In the first urine sample of the day, the high risk group had adrenaline levels twice as high as their baseline and these continued to increase throughout the day. The control group had a peak of 1.5 times their baseline in the morning and this declined during the rest of their shift. The control group had a peak of 1.5 times their baseline in the morning and this declined during the rest of their shift. In the self-report, the high risk group felt more rushed and irritated than the control group. In the self-report, the high risk group felt more rushed and irritated than the control group. They also rated their well-being as lower than the control group. They also rated their well-being as lower than the control group. Johansson (1978) – Swedish Sawmill (Key Study 10)

Conclusions: The repetitive, machine-paced work, which was demanding in attention to detail and highly mechanised, contributed to the higher stress levels in the high risk group. Conclusions: The repetitive, machine-paced work, which was demanding in attention to detail and highly mechanised, contributed to the higher stress levels in the high risk group. Johansson (1978) – Swedish Sawmill (Key Study 10)

Evaluation A major advantage of this study is that it measures stress in two ways: - A major advantage of this study is that it measures stress in two ways: - physiological (adrenaline levels and self-report), this increases the reliability of the study. physiological (adrenaline levels and self-report), this increases the reliability of the study. Johannson was an occupational psychologist and used his findings to suggest ways in which the working lives of the finishers could be made less stressful. Johannson was an occupational psychologist and used his findings to suggest ways in which the working lives of the finishers could be made less stressful.

Task P95 task P95 task How stressful is your job? Why and how could you overcome this? How stressful is your job? Why and how could you overcome this? What jobs are stressful and why? How could you overcome this stress? What jobs are stressful and why? How could you overcome this stress?

Suggestions What suggestions would you make to decrease the stress of the finishers? What suggestions would you make to decrease the stress of the finishers? Complete tasks on page 7 Complete tasks on page 7

Study Evaluation

Life events and hassles (1.2) Life changes are significant changes in a person’s life which disrupt their normal routines. Life changes are significant changes in a person’s life which disrupt their normal routines. They include both positive and negative events They include both positive and negative events Events which are seen as desirable and undesirable. Events which are seen as desirable and undesirable. A number of researchers argue that life events are a major source of stress. A number of researchers argue that life events are a major source of stress.

Holmes & Rahe – Social Readjustment Rating Scale (1967) (SRRS) Aim: - Aim: - The main aim for this study was to construct an instrument for measuring stress. The main aim for this study was to construct an instrument for measuring stress. Holmes and Rahe defined stress as the amount of change an individual has had to deal with during a particular period of time. Holmes and Rahe defined stress as the amount of change an individual has had to deal with during a particular period of time. They claimed that the degree of stress is related to both physical and psychological illness. They claimed that the degree of stress is related to both physical and psychological illness. People are more likely to show symptoms following periods of stress. People are more likely to show symptoms following periods of stress. The greater the stress the more serious the illness. The greater the stress the more serious the illness.

Holmes & Rahe – Social Readjustment Rating Scale (1967) (SRRS) Procedure Procedure Holmes and Rahe examined the medical records of 5,000 patients (all American service men). From these, they put together a list of 43 life events which seemed to precede (come before) illness. Holmes and Rahe examined the medical records of 5,000 patients (all American service men). From these, they put together a list of 43 life events which seemed to precede (come before) illness.

Holmes & Rahe – Social Readjustment Rating Scale (1967) (SRRS) They told 100 people (‘judges’) that ‘marriage’ had been given an arbitrary value of 500. They told 100 people (‘judges’) that ‘marriage’ had been given an arbitrary value of 500. The judges then had to give a number to each of the other life events, indicating how much readjustment they’d involve relative to marriage. The judges then had to give a number to each of the other life events, indicating how much readjustment they’d involve relative to marriage.

Holmes & Rahe – Social Readjustment Rating Scale (1967) (SRRS) So, death of a spouse was judged (on average) to require twice as much readjustment as marriage. So, death of a spouse was judged (on average) to require twice as much readjustment as marriage. The average (mean) of the numbers given to each event was then divided by 10. The average (mean) of the numbers given to each event was then divided by 10. The resulting values became the weighting (numerical value) of each life event. The resulting values became the weighting (numerical value) of each life event. For example, the weighting for death of a spouse was 100 (1000 divided by 10). For example, the weighting for death of a spouse was 100 (1000 divided by 10).

Holmes & Rahe – Social Readjustment Rating Scale (1967) (SRRS) The amount of life stress a person has experienced in a given period (e.g. 12 months) is measured by the total number of life change units (LCUs). The amount of life stress a person has experienced in a given period (e.g. 12 months) is measured by the total number of life change units (LCUs). These units are calculated by adding the mean values (in the right hand column of the table on the next page) associated with the events the person has experienced during that time. These units are calculated by adding the mean values (in the right hand column of the table on the next page) associated with the events the person has experienced during that time. The ranks (left hand column) simply denote the order in which the life events appear in the SRRS. The ranks (left hand column) simply denote the order in which the life events appear in the SRRS.

(NB- When participants are given the SRRS, they’re presented only with the list of life events without mean values and asked to tick the ones that apply to them.) (NB- When participants are given the SRRS, they’re presented only with the list of life events without mean values and asked to tick the ones that apply to them.)

Holmes & Rahe – Social Readjustment Rating Scale (1967) (SRRS) Most life events were judged to be less stressful than getting married. Most life events were judged to be less stressful than getting married. But 6, including death of a spouse, divorce and personal injury or illness were rated as more stressful. But 6, including death of a spouse, divorce and personal injury or illness were rated as more stressful. Holmes and Rahe found that people with high LCU scores for the preceding year were likely to experience some sort of physical illness the following year. Holmes and Rahe found that people with high LCU scores for the preceding year were likely to experience some sort of physical illness the following year. For example, someone scoring over 300 LCU s For example, someone scoring over 300 LCU s

Holmes & Rahe – Social Readjustment Rating Scale (1967) (SRRS) Conclusion Conclusion Holmes and Rahe concluded that stress could be measured objectively as an LCU score. Holmes and Rahe concluded that stress could be measured objectively as an LCU score. This, in turn, predicts the person’s chances of becoming ill (physically and / or mentally) following the period of stress. Stress and illness are not just correlated. This, in turn, predicts the person’s chances of becoming ill (physically and / or mentally) following the period of stress. Stress and illness are not just correlated. Stress actually makes us ill. Stress actually makes us ill.

Holmes & Rahe – Social Readjustment Rating Scale (1967) (SRRS) Evaluation Task Evaluation Task Look at the list of life events, see if any apply to you and work out your LCU Look at the list of life events, see if any apply to you and work out your LCU

Holmes & Rahe – Social Readjustment Rating Scale (1967) (SRRS) In groups, complete the evaluation of Holmes and Rahe. In groups, complete the evaluation of Holmes and Rahe. You need to consider:- You need to consider:- Is this SRRS useful? Is this SRRS useful? Are any of the events ambiguous? Are any of the events ambiguous? Are any missing? Are any missing? What about their sampling? What about their sampling? Does it matter if change is unpredictable or not? Did Holmes and Rahe take this into account? Does it matter if change is unpredictable or not? Did Holmes and Rahe take this into account? Are all life events viewed the same by people- think about divorce? Are all life events viewed the same by people- think about divorce? Could the relationship between life events and illness be the other way round? Could the relationship between life events and illness be the other way round? The data is retrospective- people are asked to recall the last 12 months- why is this a problem? The data is retrospective- people are asked to recall the last 12 months- why is this a problem?

Daily Hassles & Uplifts Some researchers have suggested that daily hassles lead to more stress and are a better predictor of health problems than life events. Some researchers have suggested that daily hassles lead to more stress and are a better predictor of health problems than life events. Daily hassles are ‘irritating, frustrating, distressing demands that to some degree characterise everyday transactions with the environment’ (Kanner 1981) – i.e. the straw that broke the camel’s back! Daily hassles are ‘irritating, frustrating, distressing demands that to some degree characterise everyday transactions with the environment’ (Kanner 1981) – i.e. the straw that broke the camel’s back!

Daily Hassles & Uplifts Complete Daily hassles Daily uplifts

Kanner et al (1981) (study 11) Aim To compare Hassles and Uplifts and Life Events as predictors of psychological symptoms of stress Aim To compare Hassles and Uplifts and Life Events as predictors of psychological symptoms of stress

Procedure 100 Californians (mostly white, protestant with at least 9th grade education) completed a hassles and uplift rating scale every month for nine months and a life events rating scale (SRRS) after 10 months. Procedure 100 Californians (mostly white, protestant with at least 9th grade education) completed a hassles and uplift rating scale every month for nine months and a life events rating scale (SRRS) after 10 months. Their psychological symptoms of stress were measured using the HSCH and Bradburn Morale Scale every month for 9 months. (NB all of these are self-report measures). Their psychological symptoms of stress were measured using the HSCH and Bradburn Morale Scale every month for 9 months. (NB all of these are self-report measures). Kanner et al (1981) (study 11)

Findings Hassles were consistent from month to month. Findings Hassles were consistent from month to month. For men life events correlated positively with hassles and negatively with uplifts. For men life events correlated positively with hassles and negatively with uplifts. For women, both hassles and uplifts were positively correlated with life events. For women, both hassles and uplifts were positively correlated with life events. Hassles correlated positively with psychological symptoms than life events. Hassles correlated positively with psychological symptoms than life events. Kanner et al (1981) (study 11)

Conclusions Hassles are a more powerful predictor of psychological symptoms of stress than life events. Conclusions Hassles are a more powerful predictor of psychological symptoms of stress than life events. Kanner et al (1981) (study 11)

Evaluation

Lack of Control (1.3) One of the most stressful things we can experience is that feeling of having absolutely no control over our situation. One of the most stressful things we can experience is that feeling of having absolutely no control over our situation. Why is this so stressful? Why is this so stressful?

Geer & Maisel (study 12)) Aim: To see if perceived control or actual control can reduce reactions to aversive stimuli. Aim: To see if perceived control or actual control can reduce reactions to aversive stimuli.

Geer & Maisel (study 12) Method: 60 psychology undergraduates were shown pictures of dead car crash victims and their stress levels were measured using galvanic skin response. Method: 60 psychology undergraduates were shown pictures of dead car crash victims and their stress levels were measured using galvanic skin response.

Geer & Maisel (study 12) Group 1 were given actual control over how long they were exposed to the picture, they could press a button to terminate and each picture was preceded by a tone (predictability & control). Group 1 were given actual control over how long they were exposed to the picture, they could press a button to terminate and each picture was preceded by a tone (predictability & control).

Geer & Maisel (study 12) Group 2 were warned that pictures were 60 seconds apart and were preceded by a tone. Group 2 were warned that pictures were 60 seconds apart and were preceded by a tone. However, length of exposure was controlled by group 1 (predictability, no control) However, length of exposure was controlled by group 1 (predictability, no control)

Geer & Maisel (study 12) Group 3 were just told they would see pictures from time to time, again length of exposure was controlled by group 1 (no predictability and no control) Group 3 were just told they would see pictures from time to time, again length of exposure was controlled by group 1 (no predictability and no control)

Geer & Maisel (study 12) Participants had a baseline GSR taken when they were relaxed, measurements were then took at the onset of the tone, during the second half of the tone and during exposure to the pictures. Participants had a baseline GSR taken when they were relaxed, measurements were then took at the onset of the tone, during the second half of the tone and during exposure to the pictures.

Geer & Maisel (study 12) Results Results Group 1 (predictability & control) experienced the lowest stress response as measured by the GSR, compared to groups 2 & 3. Group 1 (predictability & control) experienced the lowest stress response as measured by the GSR, compared to groups 2 & 3. Group 2 showed most stress in response to the tone. Group 2 showed most stress in response to the tone.

Geer & Maisel (study 12) Conclusion Participants showed less GSR reaction, indicating less stress, when they had control over the length of time they looked at the disturbing pictures. Conclusion Participants showed less GSR reaction, indicating less stress, when they had control over the length of time they looked at the disturbing pictures. It is likely that being able to terminate aversive stimuli reduces its stressful impact. It is likely that being able to terminate aversive stimuli reduces its stressful impact.

Evaluation Complete my notes Complete my notes

Stress Re-cap

Stress is… Stress is a biological response to an external stressor/s Stress is a biological response to an external stressor/s Biological response to the fight or flight mechanism: Biological response to the fight or flight mechanism: The bodies stress response causes an increase in blood pressure, reduction in blood flow to the peripheral blood vessels (hand and feet) and an increase in adrenaline and noradrenalin (fight or flight chemical) to be released into the blood stream. The bodies stress response causes an increase in blood pressure, reduction in blood flow to the peripheral blood vessels (hand and feet) and an increase in adrenaline and noradrenalin (fight or flight chemical) to be released into the blood stream. Over a long period of time this stress response causes the body’s immune systems to eventually break down. Over a long period of time this stress response causes the body’s immune systems to eventually break down.

Why is understanding stress useful: 1. Causes psychological problems like anxiety and depression. 1. Causes psychological problems like anxiety and depression. 2. Causes everyday physical illness like cough and colds by lowering the effectiveness of the immune system. 2. Causes everyday physical illness like cough and colds by lowering the effectiveness of the immune system. 3. Can cause heart disease and stroke by increasing build up of cholesterol. 3. Can cause heart disease and stroke by increasing build up of cholesterol. 4. May lead to illnesses like cancer 4. May lead to illnesses like cancer 5. Causes millions of lost sick days from work 5. Causes millions of lost sick days from work 6. Causes accidents and injuries at work due to loss of concentration 6. Causes accidents and injuries at work due to loss of concentration

Evidence to show different factors which cause stress: Work, Johansson Work, Johansson Lack of control, Geer and Maisel Lack of control, Geer and Maisel Life events and hassles, Holmes and Rahe and Kanner Life events and hassles, Holmes and Rahe and Kanner

Johansson Aim: to investigate whether work stressors such as repetitiveness, machine-regulated pace of work and high levels of responsibility increase stress-related physiological arousal and stress related illness Aim: to investigate whether work stressors such as repetitiveness, machine-regulated pace of work and high levels of responsibility increase stress-related physiological arousal and stress related illness

Findings Findings: The high-risk group of 14 finishers secreted more stress hormones (adrenaline and noradrenaline) on work days than on rest days, and higher levels than the control group. Findings: The high-risk group of 14 finishers secreted more stress hormones (adrenaline and noradrenaline) on work days than on rest days, and higher levels than the control group. The high-risk group of finishers also showed significantly higher levels of stress-related illness such as headaches and higher levels of absenteeism than the low-risk group of cleaners. The high-risk group of finishers also showed significantly higher levels of stress-related illness such as headaches and higher levels of absenteeism than the low-risk group of cleaners.

Conclusions A combination of work stressors- especially repetitiveness, machine-pacing of work and high levels of responsibility – lead to chronic (long- term) physiological arousal. A combination of work stressors- especially repetitiveness, machine-pacing of work and high levels of responsibility – lead to chronic (long- term) physiological arousal. This in turn leads to stress-related illness and absenteeism. This in turn leads to stress-related illness and absenteeism.

Conclusion If employers want to reduce illness and absenteeism in their workforce, they need to find ways of reducing these work stressors, If employers want to reduce illness and absenteeism in their workforce, they need to find ways of reducing these work stressors, for example by introducing variety into employees’ work and by allowing them to experience some sense of control over the pace of their work. for example by introducing variety into employees’ work and by allowing them to experience some sense of control over the pace of their work.

Evaluation Each participant had to give a urine sample four times a day so that their adrenal levels could be measured. Each participant had to give a urine sample four times a day so that their adrenal levels could be measured. Their body temperature was recorded at the same time as this can give an indication of how alert a person is. Their body temperature was recorded at the same time as this can give an indication of how alert a person is.

Evaluation These two physiological measures were combined with self report where each participant had to say how much caffeine and nicotine they had consumed since the last urine test. These two physiological measures were combined with self report where each participant had to say how much caffeine and nicotine they had consumed since the last urine test. They also had to report on a range of emotions and feelings as well as sleepiness, well-being, calmness, irritation and efficiency etc. They also had to report on a range of emotions and feelings as well as sleepiness, well-being, calmness, irritation and efficiency etc. They had to scale these feelings on a continuum from minimum to maximum using a scale with millimetres. They had to scale these feelings on a continuum from minimum to maximum using a scale with millimetres. The score was how many millimetres from the base point the participants had marked themselves to be feeling. The score was how many millimetres from the base point the participants had marked themselves to be feeling.

Evaluation This combined approach gave both qualitative and quantitative measurements enabling Johannson to compare the two groups of workers and understand the impact of higher stress levels on the participants. This combined approach gave both qualitative and quantitative measurements enabling Johannson to compare the two groups of workers and understand the impact of higher stress levels on the participants.

Stress on the job and its relation to control: Numerous studies show that job stress is far and away the major source of stress for American adults and that it has escalated progressively over the past few decades. Numerous studies show that job stress is far and away the major source of stress for American adults and that it has escalated progressively over the past few decades. Increased levels of job stress as assessed by the perception of having little control but lots of demands have been demonstrated to be associated with increased rates of heart attack, hypertension and other disorders. Increased levels of job stress as assessed by the perception of having little control but lots of demands have been demonstrated to be associated with increased rates of heart attack, hypertension and other disorders. In New York, Los Angeles, the relationship between job stress and heart attacks is so well acknowledged, that any police officer who suffers a coronary event on or off the job is assumed to have a work related injury and is compensated accordingly (including a heart attack sustained while fishing on vacation or gambling in Las Vegas). In New York, Los Angeles, the relationship between job stress and heart attacks is so well acknowledged, that any police officer who suffers a coronary event on or off the job is assumed to have a work related injury and is compensated accordingly (including a heart attack sustained while fishing on vacation or gambling in Las Vegas).

Geer and Maisel: Stress and control: Aim : To see if perceived control or actual control can reduce stress reactions to averse stimuli. Aim : To see if perceived control or actual control can reduce stress reactions to averse stimuli.

Geer and Maisel: Stress and control: Group 2 showed most stress. Group 1 showed least stress. Group 2 showed most stress. Group 1 showed least stress. Conclusions : that having control over your environment can reduce stress responses. Conclusions : that having control over your environment can reduce stress responses.

Hassles and Uplifts - Kanner

Hassles and uplift task: Finding your home a pleasant environment 10 Finding your home a pleasant environment 10 Physical appearance 10 Physical appearance 10 Spending time with the family 9 Spending time with the family 9 Crime 9 Crime 9 Visiting, phoning or writing to someone 8 Visiting, phoning or writing to someone 8 Property, investment or taxes 8 Property, investment or taxes 8 Meeting your responsibilities 7 Meeting your responsibilities 7 Outside home maintenance 7 Outside home maintenance 7 Eating out 6 Eating out 6 Misplacing or losing things 6 Misplacing or losing things 6

Hassles and uplift task: Getting enough sleep 5 Getting enough sleep 5 Too many things to do 5 Too many things to do 5 Feeling healthy 4 Feeling healthy 4 Home maintenance 4 Home maintenance 4 Completing a task 3 Completing a task 3 Rising price of common goods 3 Rising price of common goods 3 Relating well to friends 2 Relating well to friends 2 Health of a family member 2 Health of a family member 2 Relating well to spouse or partner 1 Relating well to spouse or partner 1 Concerns about weight 1 Concerns about weight 1

Life events or daily hassles? Which is the best indicator of health issues? Which is the best indicator of health issues? Discuss with a partner and form an argument Discuss with a partner and form an argument one group life events and one daily hassles one group life events and one daily hassles

Validity and measurements It is possible that a question could arise which is entirely about validity – the most common way in which this is usually addressed is when the area specifically looks at measurements – as validity obviously means are we measuring what we say we are measuring! It is possible that a question could arise which is entirely about validity – the most common way in which this is usually addressed is when the area specifically looks at measurements – as validity obviously means are we measuring what we say we are measuring! However reliability is a different issue However reliability is a different issue

Group task Name the different way of measuring stress explaining when best to use them, strengths, limitation and how to improve these limitations Name the different way of measuring stress explaining when best to use them, strengths, limitation and how to improve these limitations

Physiological Measures(2.1) We have already looked at some forms of physiological measurements, here is another: We have already looked at some forms of physiological measurements, here is another: According to the biological models of Cannon and Seyle, stress is characterised by distinctive physiological symptoms which can be measure using polygraphs (like lie detectors) According to the biological models of Cannon and Seyle, stress is characterised by distinctive physiological symptoms which can be measure using polygraphs (like lie detectors) A polygraph involves wiring the person up to a series of sensors. A polygraph involves wiring the person up to a series of sensors. These are used to measure external physiological symptoms such as respiration and heart rate, blood pressure and sweatiness. These are used to measure external physiological symptoms such as respiration and heart rate, blood pressure and sweatiness.

Physiological Measures(2.1) Evaluation Evaluation a) These are reliable and objective and produce quantitative results. a) These are reliable and objective and produce quantitative results. b) Demand characteristics. The act of being tested may create a stress response which can bias the results. This is why lie-detector results are not admissible evidence in British courts. b) Demand characteristics. The act of being tested may create a stress response which can bias the results. This is why lie-detector results are not admissible evidence in British courts. c) Generalisability: bodily arousal can come from many non-stress causes, weight, activity, drug consumption. Also it is possible to feel stress without having physiological arousal. c) Generalisability: bodily arousal can come from many non-stress causes, weight, activity, drug consumption. Also it is possible to feel stress without having physiological arousal.

Psychological Measures (psychometric tests) (2.2) Psychological measures are self-report measures using psychometric tests. Psychological measures are self-report measures using psychometric tests. Holmes and Rahe (1967) Social Readjustment Rating Scale (SRRS). Holmes and Rahe (1967) Social Readjustment Rating Scale (SRRS). H&R defined stress in terms of the change caused to a person’s life (change can be positive, negative or neutral but would still be stressful by their definition). H&R defined stress in terms of the change caused to a person’s life (change can be positive, negative or neutral but would still be stressful by their definition). H&R argued that whenever an individual had to make “a substantial adjustment to the environment, the likelihood of stress is high”. H&R argued that whenever an individual had to make “a substantial adjustment to the environment, the likelihood of stress is high”.

Holmes & Rahe (study 14) and second part to the study First examined the medical records of around 5000 people. First examined the medical records of around 5000 people. They found that, in many cases, significant life changes occurred in the months preceding the onset of illness. They found that, in many cases, significant life changes occurred in the months preceding the onset of illness. They selected 43 of these life events and asked a sample of 394 people to rate the degree of ‘social readjustment’ required for each event (death of spouse was given the arbitrary value of 100 and marriage the arbitrary value of 50). They selected 43 of these life events and asked a sample of 394 people to rate the degree of ‘social readjustment’ required for each event (death of spouse was given the arbitrary value of 100 and marriage the arbitrary value of 50). Based on these results, they constructed the final SRRS. Based on these results, they constructed the final SRRS.

Holmes & Rahe (study 14) Each life event was ranked and assigned a number of life change units (LCUs) from 100 to 11. Each life event was ranked and assigned a number of life change units (LCUs) from 100 to 11. A person’s stress score is the sum of all the life change units for events they have experienced within a period of 12 months. A person’s stress score is the sum of all the life change units for events they have experienced within a period of 12 months.

Evaluation a) Reliability and Validity: There was considerable consensus about which events were most and least stressful. However, it is not valid because it doesn’t find out about the real meaning of these events which could vary – bereavement after a long illness is felt differently to premature bereavement. b) Usefulness: Questionnaire, easy to fill in and to compile results. Therefore widely used in medicine. b) Usefulness: Questionnaire, easy to fill in and to compile results. Therefore widely used in medicine.

Evaluation c) Ethnocentricity: look at the items for evidence that the SSRS assumes American norms and values. c) Ethnocentricity: look at the items for evidence that the SSRS assumes American norms and values. d) Individual differences: some items may involve wide differences in stress levels. Whether change is positive or negative could well effect the stress level. Marriage and death for example depend on the circumstances. d) Individual differences: some items may involve wide differences in stress levels. Whether change is positive or negative could well effect the stress level. Marriage and death for example depend on the circumstances. e) Retrospective data: Information about life events is usually collected at least 6 months and often 18 months after the events happened. This means problems of validity – people may interpret past events in the light of present illness (or health). e) Retrospective data: Information about life events is usually collected at least 6 months and often 18 months after the events happened. This means problems of validity – people may interpret past events in the light of present illness (or health).

Individual task Complete the evaluation table Complete the evaluation table

Exam Question Evaluate the usefulness of measuring stress (15) Evaluate the usefulness of measuring stress (15) Personal study 5 Personal study 5

Wednesdays lesson

Managing stress What techniques can be used to manage stress? What techniques can be used to manage stress? Make a list and evaluate your thoughts with a partner. Make a list and evaluate your thoughts with a partner.

1) Cognitive Behavioural Therapy (CBT) CBT (pioneered by Aaron Beck) focuses on the secondary appraisal stage of the cognitive appraisal theory of stress in that it has the dual aim of encouraging participants to be realistic about the nature of the stressor and their ability to cope. CBT (pioneered by Aaron Beck) focuses on the secondary appraisal stage of the cognitive appraisal theory of stress in that it has the dual aim of encouraging participants to be realistic about the nature of the stressor and their ability to cope. Those suffering stress often exaggerate the stressor. For example: Those suffering stress often exaggerate the stressor. For example: over-generalisation – eg if one person doesn’t like me then everyone hates me over-generalisation – eg if one person doesn’t like me then everyone hates me catastrophisation - eg if I have a headache it means I am about to die of a brain tumour catastrophisation - eg if I have a headache it means I am about to die of a brain tumour

The cognitive techniques include (ie the ‘C’ in CBT) (i) Get patients to be realistic. This can be done by one- to-one discussions in which alternative explanations are considered. It might involve building up evidence of the stressor, like keeping a diary, so that the real level can be demonstrated. (i) Get patients to be realistic. This can be done by one- to-one discussions in which alternative explanations are considered. It might involve building up evidence of the stressor, like keeping a diary, so that the real level can be demonstrated. (ii) Design experiments to test interpretations, eg see how others react. (ii) Design experiments to test interpretations, eg see how others react. The behavioural techniques include (ie the ‘B’ in CBT) The behavioural techniques include (ie the ‘B’ in CBT) (i) Setting targets and gaining positive reinforcement when meeting them. (i) Setting targets and gaining positive reinforcement when meeting them.

Task Explain when it would be best to use CBT with a patient Explain when it would be best to use CBT with a patient

Cognitive techniques (SIT) Stress Inoculation Therapy: Stress Inoculation Therapy: Can be used to help people learn to identify when they will become stressed and use positive thoughts to try and reduce future stress responses during sessions of cognitive therapy. Can be used to help people learn to identify when they will become stressed and use positive thoughts to try and reduce future stress responses during sessions of cognitive therapy.

Meichenbaum (1975) Standard behavioural measures have tried to help people become desensitised to stress. Standard behavioural measures have tried to help people become desensitised to stress. Meichenbaum compared these standard behavioural methods with cognitive ones. Meichenbaum compared these standard behavioural methods with cognitive ones. Cognitive therapy sessions aimed at enabling people to identify their stressors and change their mental processes when under stress rather than just their behaviours. Cognitive therapy sessions aimed at enabling people to identify their stressors and change their mental processes when under stress rather than just their behaviours.

The study (16) Students ages 17 – 25 responded to an advert about treatment of test anxiety. Students ages 17 – 25 responded to an advert about treatment of test anxiety. It was a field experiment with participants put into three groups, It was a field experiment with participants put into three groups, SIT, SIT, standard desensitisation standard desensitisation and a control group. and a control group. Each participant was tested using a test anxiety questionnaire. Each participant was tested using a test anxiety questionnaire.

The study (16) The SIT group received 8 therapy sessions giving them insight into their thoughts before tests. The SIT group received 8 therapy sessions giving them insight into their thoughts before tests. They were then given some positive statements to say and relaxation techniques to use in test situations. They were then given some positive statements to say and relaxation techniques to use in test situations.

The study (16) The systematic desensitisation groups were also given 8 therapy sessions with only progressive relaxation training whilst imaging stressful situations. The systematic desensitisation groups were also given 8 therapy sessions with only progressive relaxation training whilst imaging stressful situations.

The study (16) The control group were told they were on a waiting list for treatment. The control group were told they were on a waiting list for treatment.

The study (16) Findings: performance in tests in the SIT group improved the most although both therapy groups showed improvement over the control groups. Findings: performance in tests in the SIT group improved the most although both therapy groups showed improvement over the control groups.

Conclusions That SIT is an effective way of reducing anxiety in students who are prone to anxiety in test situations and more effective than simply behavioural techniques when a cognitive component is added in. That SIT is an effective way of reducing anxiety in students who are prone to anxiety in test situations and more effective than simply behavioural techniques when a cognitive component is added in.

Task Describe the strengths and weaknesses of using SIT Describe the strengths and weaknesses of using SIT

Behavioural Techniques Biofeedback, like drugs, also deals with the physiological symptoms of stress. These physiological symptoms such as raised blood pressure and increased muscle tension are involuntary. Biofeedback, like drugs, also deals with the physiological symptoms of stress. These physiological symptoms such as raised blood pressure and increased muscle tension are involuntary. We are unable to control them consciously because they are governed by our autonomic nervous system (ANS). We are unable to control them consciously because they are governed by our autonomic nervous system (ANS). Biofeedback is a method by which an individual learns to exert voluntary control over involuntary (autonomic) behaviours by being made aware of what is happening in the ANS. Biofeedback is a method by which an individual learns to exert voluntary control over involuntary (autonomic) behaviours by being made aware of what is happening in the ANS.

Biofeedback involves four processes Feedback: the patient is attached to various machines which provide information (feedback) about various ANS activities. For example, heart rate can be monitored and displayed visually on a computer screen. Feedback: the patient is attached to various machines which provide information (feedback) about various ANS activities. For example, heart rate can be monitored and displayed visually on a computer screen. Relaxation: The patient is taught techniques of relaxation in order to reduce activity of the sympathetic nervous system. The result should be reduced heart rate, blood pressure etc. Relaxation: The patient is taught techniques of relaxation in order to reduce activity of the sympathetic nervous system. The result should be reduced heart rate, blood pressure etc. Successful behaviours are repeated because they are rewarding. Successful behaviours are repeated because they are rewarding. The patient then needs to transfer the skills learned to the real world. The patient then needs to transfer the skills learned to the real world.

Task Argue reasons for and against biofeedback Argue reasons for and against biofeedback

Budzynski et al brief (study 17) Conducted research into the effectiveness of biofeedback as a way of treating tension headaches. Conducted research into the effectiveness of biofeedback as a way of treating tension headaches. He assigned 18 participants into 3 groups of six. He assigned 18 participants into 3 groups of six. Group A had biofeedback sessions, Group A had biofeedback sessions, Group B were taught relaxation techniques Group B were taught relaxation techniques and Group C were a control who received no intervention. and Group C were a control who received no intervention. Group A reported a significant decrease in headaches, this shows biofeedback can be effective. Group A reported a significant decrease in headaches, this shows biofeedback can be effective.

Aim : To see if biofeedback techniques work and help reduce tension headaches or whether the effect is due to the placebo effect. To see if biofeedback techniques work and help reduce tension headaches or whether the effect is due to the placebo effect. The placebo effect is a positive psychological effect that can occur even when there is no actual treatment. The placebo effect is a positive psychological effect that can occur even when there is no actual treatment.

Method : Experimental method with patients trained in the laboratory. Experimental method with patients trained in the laboratory. Data was collected using muscle tension measurements (EMG) with an electromyography, a machine which gives feedback by a graph by applying electrodes to the muscles. Data was collected using muscle tension measurements (EMG) with an electromyography, a machine which gives feedback by a graph by applying electrodes to the muscles. Patients were also given a psychometric test for depression (MMPI) and asked to complete questionnaires on their headaches. Patients were also given a psychometric test for depression (MMPI) and asked to complete questionnaires on their headaches. It was an independent measures design with participants randomly assigned to one of three groups. It was an independent measures design with participants randomly assigned to one of three groups.

Participants : 18 replied to a newspaper advert in the USA. 18 replied to a newspaper advert in the USA. They were screened by telephone and then had psychiatric and medical examinations to ensure there were no other reasons for their headaches. They were screened by telephone and then had psychiatric and medical examinations to ensure there were no other reasons for their headaches. There were 2 males and 16 females aged with a mean age of 36. There were 2 males and 16 females aged with a mean age of 36.

Participants : Group A had real biofeedback training with relaxation using the EMG Group A had real biofeedback training with relaxation using the EMG Group B had biofeedback training but with false (pseudo) feedback Group B had biofeedback training but with false (pseudo) feedback Group C were used as a control group Group C were used as a control group

Procedure : All groups kept a diary of their headaches for two weeks, rating them from 0 mild to 5 severe. All groups kept a diary of their headaches for two weeks, rating them from 0 mild to 5 severe. Groups A and B were told to practice relaxation after the training for 15 – 20 mins each day. Groups A and B were told to practice relaxation after the training for 15 – 20 mins each day.

Results : After 3 months group A’s muscle tension was significantly lower than the other two groups. After 3 months group A’s muscle tension was significantly lower than the other two groups. Reporting of headaches in group A also fell significantly compared to their base line which it did not in the other two groups. Reporting of headaches in group A also fell significantly compared to their base line which it did not in the other two groups.

Conclusions : Biofeedback is an effective way to reduce stress levels by reducing tension. Biofeedback is an effective way to reduce stress levels by reducing tension.

Evaluation Effectiveness Effectiveness Biofeedback has been found to be successful in treating a wide assortment of behaviours. Bradley (1995) compared the effectiveness of using biofeedback versus relaxation to control muscle tension headaches. After treatment the biofeedback group had significantly fewer headaches than the relaxation group. Biofeedback has been found to be successful in treating a wide assortment of behaviours. Bradley (1995) compared the effectiveness of using biofeedback versus relaxation to control muscle tension headaches. After treatment the biofeedback group had significantly fewer headaches than the relaxation group.

Evaluation +No side effects. +No side effects. It does not alter the body in any permanent way as drugs do. The only effects (or side effects) are increased relaxation, which can only be desirable. It does not alter the body in any permanent way as drugs do. The only effects (or side effects) are increased relaxation, which can only be desirable. Expensive. The technique requires specialist equipment. If the success of biofeedback is mainly due to relaxation rather than feedback there is no need for these expensive and time consuming procedures. Expensive. The technique requires specialist equipment. If the success of biofeedback is mainly due to relaxation rather than feedback there is no need for these expensive and time consuming procedures.

Evaluation Treating the symptoms not the problem. Biofeedback has short-term gains. Treating the symptoms not the problem. Biofeedback has short-term gains. But, it does not treat the source of stress such as workplace tension. But, it does not treat the source of stress such as workplace tension. But, it might provide the patient with a potentially long lasting means of dealing with stress symptoms- relaxation techniques. But, it might provide the patient with a potentially long lasting means of dealing with stress symptoms- relaxation techniques. Biofeedback gives people a feeling of control. Biofeedback gives people a feeling of control. This sense of control, rather than biofeedback itself may produce beneficial effects. This sense of control, rather than biofeedback itself may produce beneficial effects.

Task Why is social support helpful in managing stress? Why is social support helpful in managing stress? Discuss Discuss

Social support and coping with stress (3.3) Some stress management programmes promote the importance of social support and encourage the stressed person to access this. Some stress management programmes promote the importance of social support and encourage the stressed person to access this. Research suggests that individuals with wide support networks experience less stress in response to a stressor and can cope with stressful situations more successfully than individuals without this network. Research suggests that individuals with wide support networks experience less stress in response to a stressor and can cope with stressful situations more successfully than individuals without this network.

Cohen and Willis (1985) claim there are four types of social support (1) Esteem support: (1) Esteem support: When people are suffering from stress they can suffer from low self-esteem When people are suffering from stress they can suffer from low self-esteem Attention, love and care and being held in high regard can raise self-esteem. Attention, love and care and being held in high regard can raise self-esteem. This can help the individual to overcome stress. This can help the individual to overcome stress.

Social Support (2) Informational support (2) Informational support When individuals are suffering from stress it often helps if they can get useful information form other people. When individuals are suffering from stress it often helps if they can get useful information form other people. Information from others can be used to help the individual suffering from stress to reassess the situation that is causing the problem, especially if the person giving the information has faced a similar situation. Information from others can be used to help the individual suffering from stress to reassess the situation that is causing the problem, especially if the person giving the information has faced a similar situation.

Social Support (3) Instrumental support (3) Instrumental support When individuals are suffering from stress, they often need practical support When individuals are suffering from stress, they often need practical support This support can alleviate some of the stress that the person is under and can help the individual to cope. This support can alleviate some of the stress that the person is under and can help the individual to cope.

Social Support (4) Social companionship (4) Social companionship Interpersonal interaction can help the individual who is suffering from stress in that they often feel less stressed after spending time with and talking to other people. Interpersonal interaction can help the individual who is suffering from stress in that they often feel less stressed after spending time with and talking to other people.

Evaluation Evidence suggests that when individuals experience high levels of social support: Evidence suggests that when individuals experience high levels of social support: They experience illness less than others. They experience illness less than others. They recover faster when they do become ill. They recover faster when they do become ill. There is less chance of dying as a result of illness. There is less chance of dying as a result of illness.

Waxler-Morrison et al (study 18) Aim Aim To look at how a woman’s social relationships influence her response to breast cancer and survival. To look at how a woman’s social relationships influence her response to breast cancer and survival.

Waxler-Morrison et al (study 18) Procedure Procedure Prospective study (starts with participants and follows them to find out which behaviours they show in the future, the opposite of a retrospective study, which asks participants to recall past behaviours) Prospective study (starts with participants and follows them to find out which behaviours they show in the future, the opposite of a retrospective study, which asks participants to recall past behaviours) involving 133 women under the age of 55, involving 133 women under the age of 55, from Vancover Canada, from Vancover Canada, with a diagnosis of breast cancer. with a diagnosis of breast cancer.

Waxler-Morrison et al (study 18) They completed a self-administered questionnaire on demographic details and existing social networks, They completed a self-administered questionnaire on demographic details and existing social networks, 18 were also interviewed. 18 were also interviewed.

Waxler-Morrison et al (study 18) Findings Findings The six aspects of social network significantly linked with survival were: - marital status, support from friends, contact with friends, total support, social network and employment. The six aspects of social network significantly linked with survival were: - marital status, support from friends, contact with friends, total support, social network and employment.

Waxler-Morrison et al (study 18) Conclusions Conclusions The more social networks and social support a woman has the higher her chance of survival. The more social networks and social support a woman has the higher her chance of survival. This assumes that social support reduces stress. This assumes that social support reduces stress. However, the main factor influencing survival is the state of the cancer at the time of diagnosis. However, the main factor influencing survival is the state of the cancer at the time of diagnosis. Early detection is key to survival. Early detection is key to survival.

Evaluate this study

Stress Remember stress is not necessarily a bad thing! Remember stress is not necessarily a bad thing! Stress is blamed for a whole range of physical illnesses and psychological disorders. Stress is blamed for a whole range of physical illnesses and psychological disorders. It is said to be costing industry vast sums of money in absence from work and poor performance at work. It is said to be costing industry vast sums of money in absence from work and poor performance at work. Stress is now pictured almost exclusively in negative terms. Stress is now pictured almost exclusively in negative terms.

Stress But, it is important to remember that the stress response is a valuable survival mechanism which motivates people. But, it is important to remember that the stress response is a valuable survival mechanism which motivates people. It warns of a threat in the environment and galvanises the individual to take action and deal with the situation. It warns of a threat in the environment and galvanises the individual to take action and deal with the situation. But, many of the techniques of stress management are designed to calm people down and subdue the stress response. But, many of the techniques of stress management are designed to calm people down and subdue the stress response.

Stress Stress is also motivational, without a bit of stress in our lives many of us would not perform at our best. E.g. Stage fright and performance anxiety often bring out the best in people. Stress is also motivational, without a bit of stress in our lives many of us would not perform at our best. E.g. Stage fright and performance anxiety often bring out the best in people. Stress management is big business; millions of pounds are spent every year by organisations and individuals dealing with stress. Stress management is big business; millions of pounds are spent every year by organisations and individuals dealing with stress.