The Psychology Of Stress

AQA PSYCHOLOGY: UNIT 2: PHYSIOLOGICAL PSYCHOLOGY: STRESS


1 a) SHORT TERM PHYSIOLOGICAL RESPONSE TO A STRESSOR

  • The General Adaptation Syndrome (Selye, 1950)
  • Alarm, Resistance & Exhaustion
  • Evaluation of the GAS

1 b) LONGER TERM PHSYIOLOGICAL RESPONSES TO A STRESSOR

  • Direct Mechanical Effects (Wear and Tear of the Cardiovascular system)
  • Atherosclerosis (Strokes or Haemorrhages)
  • Hypertension (High blood pressure)
  • Immuno-suppression (Immune system shuts down)

2. SOURCES AND MEASUREMENT OF STRESS

  • Social Readjustment Rating Scale (Holmes and Rahe, 1967)
  • Life Events Survey (Sarason, et al, 1978)
  • Hassles and Uplifts Scale (DeLongis et al, 1982)
  • Type A Personality (Friedman and Rosenman, 1974)
  • Gender Differences
  • Cultural Variations
  • Workplace Stress

3. STRESS MANAGEMENT

  • Physical Methods (Drugs and Biofeedback)
  • Psychological Methods (Stress Inoculation Training & Hardiness and Hardiness Training)
  • Aspects of Lifestyle approaches. (Control & Social Support)

1 a) SHORT TERM PHYSIOLOGICAL RESPONSE TO A STRESSOR

The General Adaptation Syndrome (Selye, 1950)

  • The study of stress as a series of physiological changes bringing about a state of stress began in the laboratory with the work of Hans Selye (1936,1950,1956).
  • Working in the laboratory with rats and later in hospital with humans, Selye formulated his three stage theory of the stress response which we have come to know as the General Adaptation Syndrome.
  • There are three phases to the GAS

Alarm, Resistance & Exhaustion

  • In the alarm stage, an individual is confronted with a stressor and signals are sent through the brain to the hypothalamus (higher brain centre)
  • Signals are sent along two axes

  • The First is known as the hypothalamic pituitary axis. This then releases CRH (Corticotrophic Releasing Hormone). This, in turn releases ACTH (Adrenocorticotrophic hormone) which acts upon the adrenal cortex to produce corticosteroids (fats sugars and acids) for energy mobilisation

  • The second Axis is known as the Hypothalamic ANS Axis. ANS is the autonomic nervous system and this sends signals to the adrenal medulla to produce adrenaline (increases the heart rate and blood pressure) and noradrenaline which constricts the arteries.

  • The individual is now in a state of stress (fight or flight)

  • In the resistance phase, all non necessary functioning, shuts down. Growth hormone ceases to be produced and the immune system shuts down temporarily, in order to divert all resources to the stress response

  • Exhaustion. Selye’s model assumes that if the organism is placed in a state of perpetual stress then pathology (disease) and even death of the organism may result.

Evaluation

Selye’s model was the first to accurately depict the physiological changes that occur in the short term response to a stressor. However there are at least 3 separate problems

Ethical objections: Selye subjected the rats to horrific forms of treatment including, exposure to extreme and rapidly altered temperatures, heavy exercise, surgical injury and sub lethal doses of drugs. Such treatment would be regarded as unethical today and a licence would be required under the Scientific Procedures Act (1986).

Absence of psychological factors: The GAS suggests that human responses to stressors are singular, uniform and passive. Mason (1975) has argued that when we are confronted with a stressor, individuals make an assessment or appraisal of the situation. This helps determine the bodily response to a stressor and has been lent some support from the work of Symington et al (1955).

Progression: The GAS assumes a neat progression from alarm, through resistance to exhaustion, thus implying a non adaptive response to the stressor as the most likely outcome. The GAS would be improved if it took into account the possibility of adaptive responses to stressors, leading through to parasympathetic activity and homeostasis.

1.b) LONGER TERM PHSYIOLOGICAL RESPONSES TO A STRESSOR

Direct Mechanical Effects (Wear and Tear of the Cardiovascular system)

  • The direct mechanical effects of repeated or prolonged exposure to stress without an adaptive response include wear and tear of the cardiovascular system, CVD and CHD. (Curtis, 2000)
  • One Key Study into the relationship between stress and CVD/CHD is that of Timio et al, 1979
  • Aims were to measure the effects of occupational stress on levels of adrenaline and noradrenaline
  • Urinary levels of free adrenaline and noradrenaline were measured in two groups of healthy male industrial workers exposed to alternate four- day periods of working conditions with and without time stress, to test the hypothesis that the sympathetic nervous system is overactivated by occupational stress.
  • Under time stress urinary free adrenaline was 450 per cent and noradrenaline 230 per cent of the levels for similar work, without time stress
  • occupational stress in industrial workers influences the adreno-sympathetic system and  indicates the effects of high levels of sympathetic activity on the aetiology (cause) of  heart disease.

Atherosclerosis (Strokes or Haemorrhages)

  • Sympathetic arousal results in the stimulation of the adrenal cortex which in turn secretes corticosteroids.
  • Collectively the fats, sugars and acids mobilise energy throughout the bloodstream which if not utilised may be reabsorbed.
  • The body’s ability to reabsorb is finite, such that a non adaptive response or repeated or prolonged exposure to a stressor means that the residual facts acids and sugars remain present in the blood stream.
  • This contributes to the furring up of the arteries, hypertension, atherosclerosis and haemorrhages.

Hypertension (High blood pressure)

  • Psychologists have identified a clear link between hypertension and stress.
  • Hypertension may be caused by a number of risk factors including diet, alcohol or caffeine consumption, smoking, lack of exercise, genetics and psycho-social factors such as personality type.
  • Despite these causal factors Cobb and Rose (1973) noted a clear relationship between occupational stress and hypertension in air-line pilots and air traffic controllers.

Immuno-suppression (Immune system shuts down)

Sympathetic arousal has been shown to dampen immune function.

  • When our immune systems shut down in a state of stress this is called immunosupression.
  • Prolonged or repeated exposure to stress results in inhibited leucocyte and lymphocite production. These are responsible for creating antibodies and antigens which attack viruses and infections.
  • Numerous investigations with both laboratory animals and human participants have revealed that stress suppresses the immune system.
  • Riley (1981) exposed mice with cancer cells and divided them into high stress conditions and low/no stress conditions. The mice in the high stress condition went on the develop tumours whereas the no stress group did not. There was a clear difference between the two groups in terms of lymphocite production.
  • There are also a range of T-cells which perform various functions in relation to viruses, bacteria and other infectious agents. Corticosteroids are known to suppress immune functioning leading to inhibited T-cell production.
  • Whilst short term immune suppression is relatively harmless, repeated or long term immunosuppression may be dangerous (Willis et al, 1987)
  • Kiecolt-Glaser et al. (1984) studied responses to stress by taking blood samples from 75 first year medical students (49 males and 26 females).
  • The samples were taken one month before their finals and again on the first day after their examinations commenced, when the students’ stress levels should be at their highest.
  • Kiecolt-Glaser et al. found that natural killer T – cell activity declined between the two samples, confirming other research findings that stress is associated with a reduced immune response.
  • The volunteers were also assessed using behavioural measures. On both occasions they were given questionnaires to assess psychiatric symptoms, loneliness, and life events. This is because there are theories which suggest that all three are associated with increased levels of stress.
  • Kiecolt-Glaser et al. found that immune responses were especially weak in those students who reported feeling most lonely, as well as those who were experiencing other stressful life events and psychiatric symptoms such as depression or anxiety.
  • There were two key findings from this study. One was that stress was associated with a lowered immune response in humans. The second was that there were a number of different sources of stress and factors that moderate or increase it.
  • In further research Kiecolt –Glaser et al. (1984, 1987) devised ways of measuring the activity of the immune system from blood samples. They then compared immune function in control groups with groups accepted to be under chronic stress, and found significant immunosuppression in these high-risk groups (Kiecolt-Glaser et al 1984, 1987):
  • unhappily married women, recently separated women, especially if they were unhappy about the separation, long-term carers for Alzheimer patients
  • Other researchers have reported similar findings for the recently bereaved (Antoni 1987), and recently, Kiecolt-Glaser’s group have found reductions in immune function in couples even after short episodes of marital conflict (Kiecolt-Glaser et al 1998).

Evaluation

First of all, it was a natural experiment which means that there can be fewer ethical objections.

Another advantage of this study, related to the choice of independent variable (exam stress), is that it was a long-term form of stress.

Stress and immune response are negatively correlated (as one increases the other decreases), but we cannot say that one caused the other.

Further, not all people exposed to high levels of stress developed disorders (hence the relatively low correlations between these in life-event studies)

Finally there may have been a number of confounding variables such as lifestyle which skewed the results

SOURCES AND MEASUREMENT OF STRESS

Social Readjustment Rating Scale (Holmes and Rahe, 1967)

  • Holmes and Rahe (1967) examined 5000 patient records and compiled a list of 43 CLEs. (Critical Life Events)
  • From this they developed their self administer measure, the Social Readjustment Rating Scale (SRRS). Each CLE has a value attached to it.
  • Those whose LCU (Life Changing Unit) scores over a period of one year or more exceeded 300 were deemed to be at risk of a wide range of physical and mental disorders such as diabetes, fatal and non-fatal heart attacks, high blood pressure, strokes, ulcers and even, strangely, accidents!
  • In addition the symptoms of depression and obsessive compulsive and anxiety disorders were likely to be in evidence.

Evaluation

Strengths

Importance lies in the SRRS being the 1st comprehensive attempt to quantify and measure sources of stress and their relationship with longer term health outcomes

The SRRS confirmed a relationship between CLEs and subsequent ill health did exist

Numerous subsequent studies have confirmed this link

The correlations found were small but statistically significant

The Social Readjustment Rating Scale takes into account the possibility that CLES which are positive may cause stress. E.G Childbirth

Weaknesses

Jenkins, Hurst and Rose (1979) identified memory problems as likely to affect individual ratings. Participants were asked to report CLEs over a fixed 6 month period on 2 occasions nine months apart and found that the scores were 40% lower on the second report. Similar problems have been reported by Raphael, 1991.

Martin, 1981 has argued that

“…at present the consensus is that the CLE measures should only include undesirable events”

A further difficulty with the SRRS is that it does not take into account individual differences in response to CLEs. Gender, personality, cross cultural and sub cultural variations,perception/appraisal, control and coping skills as well as past experience may all vary the impact of a specific CLE for different individuals.

The SRRS is not specific enough. It fails to link specific kinds of stressor with specific kinds of ill health.

The SRRS fails to take into account the presence or impact of intervening or confounding variables

Much of the supporting work has been conducted by Rahe himself (1970,1977) raising the possibility of researcher bias.

Life Events Survey (Sarason, et al, 1978)

  • As a result of problems evident in the SRRS Sarason et al (1978) attempted to refine the Holmes-Rahe scale in an attempt to remedy some of the main problems with it.
  • In the first instance they increased the number of items on the scale from 43 to 57, in order to include more stress inducing CLEs which may have an impact on subsequent health.
  • Secondly, they attempted to differentiate between CLEs which could be rated as positive and those which could be rated as negative.
  • Thirdly they differentiated between the degree of stress afforded by a particular CLE. Negative CLEs could be rated as mildly, moderately or extremely stressful, whilst positive CLEs could be rated mild, moderate or very positive. This allowed the researchers and participants to individually rate CLEs instead of imposing an artificial value. The scale ran from –3 to +3 with 0 indicating a neutral CLE.
  • Finally Sarason et al’s scale had sub sets for particular occupational and other sub groupings where more particular stressors could be identified and recorded. The LES produces a series of individual scores for both positive and then negative events and then produced a single total score. In the limited amount of research conducted using this scale, negative scores have correlated highly with poorer health outcomes.

Evaluation

Strengths

Increased number of life events (57 as opposed to 43) more likely to fit the pattern of people’s lives

It takes account of the individual’s perception of events and their impact

It distinguished between positive and negative CLEs

CLEs are graded by the individuals themselves and are not assigned an arbitrary value

the inclusion of a specialised subsection for a wide variety of populations improves the validity of CLE research

Weaknesses

There remains a lack of supporting research evidence, as to the utility of the scale

There may be a problem with the assumption that positive events cancel out the effects of negative events

10-30% of participants will score nothing for CLEs but this does not mean that they are stress free or free of  the possible health implications

Hassles and Uplifts Scale (DeLongis et al, 1982)

Aims:

  • To augment previous scales based research by investigating the role minor stressors (hassles) and uplifts may play alongside CLEs.
  • Investigators thought there might be a cumulative health outcome from exposure to minor stressors and used four scales of measurement

HASSLES SCALE: 117 events

UPLIFTS SCALE: 135 positive uplifts

LES: 24 major CLEs

HEALTH STATUS QUESTIONNAIRE

  • The purpose of the use of these four different scales was to triangulate as much relevant information about all kinds of stressors and then to relate these to health outcomes.

Participants

  • 100 , well educated high income males between the ages of 45-64 from the San Francisco area.

Procedures

  • Participants were asked to complete 4 questionnaires, once a month for a one year period

Findings

  • The frequency and intensity of hassles were significantly correlated with health outcomes
  • Uplifts were neutral in terms of impact
  • The relationship between life events and health outcomes is a deferred relationship
  • The recording of hassles improves the validity of Life events research but the use of uplifts does not provide any further useful information

Evaluation

Strengths

The use of a hassles scale allows a correlation between the frequency and intensity  of hassles and negative health outcomes to be drawn

The study was relatively large scale and took place over a relatively long period of time

The correlations were statistically significant

Weaknesses

There is a problem, with the generalisability of the study given the participants

Later modifications were made by the researchers themselves implying weaknesses in the original design (DeLongis, Folkman and Lazarus, 1988)

The survey did not take into account chronic stressors such as poor living or working conditions.

Type A Personality (Friedman and Rosenman, 1974)

  • A study to link the coronary heart disease (CHD) and Type A behaviour has shown that people with aggressive and hostile characteristics tend to have higher possibility to suffer CHD.
  • The Western Collaborative Group Study was set up in the 1960s to test Friedman and Rosenman’s hypothesis that Type A individuals were more likely to develop heart disease than Type B.
  • The individual’s tendencies towards impatience and hostility are assessed by the interviewer deliberately interrupting the person being interviewed from time to time.
  • The Type A behaviour pattern has also been assessed by various self-report questionnaires.
  • With four classed groups of A1, A2, X, and B, nearly 3200 healthy men aged between 39 and 59 living around San Francisco were assessed in 1960.
  • Eight and half years later 257 men from the original sample had developed CHD and from this figure 70 percent of them were classed as Type A, nearly twice as many as the Type Bs.
  • These findings, when combined with those of Matthews et al. (1977), suggest that high levels of hostility produce increased activity within the sympathetic nervous system, and this plays a role in the development of coronary heart disease.

Gender Differences

  • Psychologists have demonstrated some gender differences in response to stress.
  • Stone et al. (1990) found that women showed lower increases in blood pressure than men when performing stressful tasks.
  • In a similar study conducted by Stoney, David and Matthews (1987) it seems that men respond more strenuously than women to stressful situations.
  • Both research studies seem to indicate that physiological arousal is higher in men than women when confronted with a stressor.
  • Furthermore, Frankenhaeuser et al. (1976) measured levels of adrenaline in both boys and girls about to take an examination. Boys showed a much more rapid increase in adrenal levels and took longer to return to base level. An additional interesting factor noted by the researchers was that both genders reported similar perceived levels of stress.
  • A further explanation is that the hormone oestrogen moderates the levels of physiological arousal in stress response mode. Hostrup, Light, and Obrist (1980) tested women’s cardiovascular activity during their menstrual cycle when oestrogen levels would be highest and found that this too had a moderating effect on sympathetic activity.

Cultural Variations

  • Whilst the physiology of the stress response is obviously not subject to significant cross-cultural variation, both sources of stress and responses to stress through coping strategies vary greatly.
  • Kim and McKenry (1998) found that there was significant cross-cultural variation in the use of social support as a protective factor against stress. Their research was part of a much wider study which is ongoing in the United States called the National Survey of Families and Households.
  • The survey included 13,007 participants in 9,637 households of a range of different ethnic groupings in the United States.
  • One adult per household was designated as the primary respondent, was interviewed, and self-administered reports.
  • A considerable amount of life history information was collected including the participants’ childhood, partner-history, education, domestic living arrangements, employment history, frequency and quality of kin contacts, quality of domestic relationship, and the participants’ own estimation of their psychological well-being.
  • Kim and McKenry found that African-Americans, Asian-Americans, and Hispanics made more extensive use of the family ties and social support networks such as membership of religious organization than white Americans.
  • Although exposure to racism, prejudice, and discriminations might suggest that stress levels amongst these groups would be higher, cultural variations in social networks appear to be clearly implicated in successful stress management strategies.

Workplace Stress

RELATIONS WITH CO-WORKERS

  • This has been identified as a source of occupational stress. Conflicts often take place with co-workers and these are known to activate the stress response.
  • Relations may cause hassles or uplifts on a daily basis and these have been shown to have a statistically significant relationship with health outcomes.

PHYSICAL ENVIRONMENT

  • A number of factors such as noise, temperature and crowding have been identified by psychologists as significant causal factors in stress.
  • The relationship with occupational stress is less straightforward but we may assume that the physical working environment may subject the individual to stress if there is noise, extreme temperature or overcrowding / absence of proper work space.

CAREER PROGRESSION

  • Occupational stress may also arise from an anxiety that one wishes to be promoted and to develop one’s career.
  • Where goals are blocked or frustrated the frustration aggression hypothesis suggests that stress, aggression and conflict may occur.

WORKLOAD

  • One definition of stress is that it occurs when the demands being placed on the organism outweigh its ability or perceived ability to cope.
  • It is reasonable to assume that heavy demands and tight schedules, which are often ongoing, may place us in a continual state of stress.

HOME-WORK INTERFACE

  • Following on from this one of the coping strategies adopted in the face of heavy workloads is for us to work increasingly long hours.
  • Since control is a key component of moderating stress levels then a strategy of longer working hours makes sense – i.e. the longer we work, the more we will be able to meet our targets.
  • However there is often a price to pay in terms of performance and the quality of the work we produce.
  • There is also a price to pay in terms of our domestic life and relationships. Working longer hours may simply mean that the source of the stress is transferred from work to home.
  • There may also be some rebound whereby a struggle to meet domestic commitments begins to influence our ability to perform our work efficiently.

JOB INSECURITY

  • Job insecurity is a factor in occupational stress.

LACK OF CONTROL

  • A great deal of research has been conducted into the relationship between control, coping abilities and stress.
  • The greater the degree of control, the less likely one is to experience a stress related illness.
  • Marmot et al, 1997 in a study of civil service employees found that those on the lowest grades were more likely to suffer strokes, cancer and ulcers and four times more likely to die from a heart attack. This study concluded that there was an inverse relationship between stress related illnesses and the degree of control exercised at work.

ROLE AMBIGUITY

  • A major factor contributing to occupational stress is role ambiguity. Where there are no clear limits on what employees may be asked to do stress levels are much higher.

Key Study: Occupational Stress: Johansson et al (1978)

Aims:

  • Johansson et al  (1978) were asked by the owners of a Swedish sawmill to investigate the relationship between levels of occupational stress and productivity. The company was specifically interested in whether stress levels could be reduced and productivity increased.

Procedures

  • After preliminary observations, one group of skilled workers was seen to be particularly vulnerable to occupational stress. This group was responsible for transforming planed timber into a finished product The rate at which they worked determined the overall pay of everyone at the factory. The work was also repetitive, machine paced and the finishers worked in social isolation.
  • Johansson et al recorded the levels of adrenaline and noradrenaline at various intervals during work days and rest days and examined records of illness and absence. They then reported these findings back to the factory management.

Findings

  • According to the research team the finishers experienced high levels of occupational stress attributable to four factors:
  • Responsibility for setting the wage rates of the whole factory
  • Skilled but monotonous and repetitive work
  • Machine paced work/absence of control
  • Working in isolation

Conclusions

  • The researchers recommended that the factory should implement fixed weekly wages, rotate work, improve the degrees of social contact and give the skilled workers higher levels of control over the pace at which they worked. Occupational stress was reduced and workers recorded higher levels of job satisfaction.

STRESS MANAGEMENT

  • Physical Methods (Drugs and Biofeedback)

  • Psychological Methods (Stress Inoculation Training & Hardiness and Hardiness Training)

  • Aspects of Lifestyle approaches. (Control & Social Support)

Physical Methods (Drugs and Biofeedback)

Physical approaches to combating or reducing the effects of stress include the use of anti – anxiety drugs and biofeedback

Drugs

  • The most commonly used drugs to combat stress are Benzodiazepines (BZ) and beta-blockers
  • BZs, such as librium (chlordiazepoxide) and valium (diazepam), are the most prescribed drugs for psychological disorders and can be very effective against states of stress and anxiety.
  • They appear to act by reducing activity of the brain neurotransmitter serotonin. Beta-blockers, such as inderal, do not enter the brain, but directly reduce activity in pathways of the sympathetic nervous system around the body.
  • As sympathetic arousal is a key feature of stressful states, they can be very effective against symptoms such as raised heart rate and blood pressure.
  • Though they are very effective in the short term there are important problems with the use of drugs over the long term.

PROBLEMS ARISING FROM DRUG TREATMENTS FOR STRESS AND ANXIETY

  • Use of BZs especially can lead to psychological and physical dependency
  • They should only be prescribed for short periods of a week or so, to help cope with short-term stress
  • All drugs have side effects; BZs can cause drowsiness and affect memory
  • Drugs treat symptoms, not causes
  • Many stressors are essentially psychological, so drugs, while helping in the short term, may prevent the real cause of stress being addressed
  • They are best used to manage acute (short-lived) stressors, such as the initial shock of a bereavement, or examination

Biofeedback

Biofeedback, is a technique that works by

“transforming some aspect of physiological behaviour into electrical signals which are made accessible to awareness.” (Gatchel, 1997)

For example, when an individual is attached to a machine that produces feedback or information about their physiological activity, the machine would produce an auditory or visual signal to indicate whether an individuals’ heart rate is too high or about right.

Biofeedback training has three stages, and the first is developing an awareness of the particular physiological response by being attached to machines that produce visual and auditory representations of our current physiological state.

The second stage is learning ways of controlling that physiological response in quiet conditions. This can include providing rewards for successful control in addition to feedback.

The third is transferring that control into the conditions of everyday life.

Evaluation

Strengths

Miller and DiCara (1967) demonstrated that rats were able to learn how to control their cardiac muscles using operant conditioning techniques.

Dworkin and Dworkin (1988) also conducted a research with teenagers were suffering from curvature of the spin but learnt how to control the muscles of their spins using biofeedback techniques and as a result, they were able to alter their posture and overcome the disorder.

Budzynski et al. (1973) found that regular biofeedback sessions helped people suffering from chronic muscle-contraction headaches, and the result was a successful reduction of tension in their muscles and headaches after three months.

Some doctors even claim to use biofeedback techniques successfully with asthma and high blood pressure, although there is considerable controversy about the success rates (Wade & Tavris, 1993)

Weaknesses

Firstly, there are the serious ethical concerns about the laboratory treatment of non-human animals.

Secondly, no other study has managed to replicate the findings. (Dworkin and Miller, 1986)

Finally, extrapolating findings from non-human animals to humans is difficult. Human behaviour and physiology is greatly influenced by cognitive controls, something that is less true of non-human animals.

Gatchel (1997) commented that,

There have been claims for the therapeutic efficacy of biofeedback which have been grossly exaggerated and even wrong.”

Lastly, biofeedback is expensive in terms of equipment and time, so the efficiency of the successful treatment is varied for different individuals.

Psychological Methods (Stress Inoculation Training & Hardiness and Hardiness Training)

Stress Inoculation Training

  • Meichenbaum and Cameron (1977, 1983, 1985)
  • Meichenbaum’s programme is directed at both ends of the stress problem: sources of stress and coping strategies.
  • By reviewing the coping methods they have used in the past, clients can gain a clearer understanding of their strengths and weaknesses.
  • The acquisition of new skills and techniques reduces the gap between demands and coping resources, and gives clients more confidence in their ability to handle previously stressful situations.

There are three main phases in stress inoculation training:

  • Assessment: the therapist discusses the nature of the problem with the individual, and solicits the individual’s perception of how to eliminate it.
  • Stress reduction techniques: the individual learns various techniques for reducing stress, such as relaxation and self-instruction. The essence of self-instruction is that the individual practises coping self-statements such as “If I keep calm, I can handle this situation” or “stop worrying, because it’s pointless”
  • Application and follow-through: the individual imagines using the stress reduction techniques learned in the second phase in difficult situations, and/or engages in role play of such situations with the therapist. Finally, the techniques are used in real-life situations.

Evaluation

Strengths

Meichenbaum treated individuals suffering from both snake phobia and rat phobia. Each patient received treatment for only one phobia using one of two methods, desensitisation and SIT

Meichenbaum found that both forms of treatment were effective in reducing or eliminating the phobia that was treated.

However, stress inoculation also greatly reduced the non-treated phobia, whereas desensitisation did not. The implication is that self-instruction easily generalises to  new situations, which makes it more useful than very specific forms of treatment.

The combination of cognitive (thinking about situations in the past and using cognitive strategies as part of a general relaxation technique) and behavioural (training in new skills) therapies, in theory, makes stress-inoculation training a powerful method of stress management.

Weaknesses

However, few controlled studies of its effectiveness have been carried out, although Meichenbaum has reported encouraging results (Meichenbaum and Turk 1982).

It takes time and application – and money. Clients have to go through a rigorous programme over a long period, requiring high levels of motivation and commitment. It is not a quick and easy fix.

Stress inoculation has proved to be fairly effective in reducing the stress that people experience in moderately stressful situations. However, it is of less value when treating individuals who are highly stressed or exposed to very stressful situations.

There is evidence that the way we cope with life’s stressors can reflect basic aspects of our personality, possibly innate or acquired during early experience.

Any technique aimed at improving stress management may be acting against habits which are well established, even if they are not very effective. Changing cognitions and behaviour will always be difficult.

Hardiness and Hardiness Training

According to Kobasa & Maddi (1977) there are ranges of personality characteristics which make some people resistant to stress. These factors are cited as control, commitment, and challenge which when present counteract with effects of stress.

An absence of these factors may make individuals more vulnerable to stress. Control is the factor that equates with the ability to cope.

One of the definitions of stress is that demands or perceived demands outweigh the ability or perceived ability to cope.

A greater sense of control (whether perceived or real) increases our coping resources and helps us combat stress.

Psychologists such as Rotter (1966) have identified an internal and external focus of control.

Similarly psychologists have investigated the concept of attribution (explanation of cause) and have identified dispositional and situational attributions as important determinants of the degrees of control an individual possesses.

Commitment is defined as the degree to which individuals actively engage with the world around them.

It does not refer to solely to careers but includes all aspects of life such as hobbies, tasks, relationships and social situations. It refers to a strong sense of purpose in and engagement with one’s activities.

Challenge is the third factor, and critical life events life changing units as well as hassles are not viewed as threats to one’s integrity or resources but as challenges to be overcome. Change and personal growth are seen as very important.

The degree of hardiness inversely correlated with the degree of psychological and physical illness.

These who have high scores on hardiness are less likely to suffer from the ill effects of stress.

Evaluation

+            A positive approach to stressors, which one seen as challenges to be overcome, improves our prospects of dealing with stress and limiting potentially negative effects.

+            Comparative psychology has shown that submissive behaviour relation to stressors results in higher levels of autonomic arousal, prolonged states of stress and ultimately pathology.

Aspects of Lifestyle approaches. (Control & Social Support)

  • The concept of control is central to stress and stress management.
  • When there is a gap between perceived demands and perceived coping resources, we define it as ‘state of stress.’
  • Control or perceived ability to control the stressor is an effective antidote to stress. The Meichenbaum and Kobasa approaches to stress management both directly address ways of increasing the sense of being in control.
  • The concept of locus of control (Rotter 1966) refers to individual differences in how we see the world and out ability to control what happens to us. There are two extremes, which are internal and external locus of control.
  • Internal locus of control refers to people who attribute events that happen to them to sources within themselves; people with a strong internal locus tend to cope well with stressful situations, showing less physiological arousal.
  • External locus of control attributes events in their lives to outside agencies and factors. They have a sense that ‘things happen to them’ and are largely uncontrollable. Luck or fate is important factors.
  • People who sense they have little control over life events confront stressful situations with a more passive or fatalistic attitude, where a more active strategy is usually better for stress management. They suffer more stress-related illness and are less active in coping (Kamen and Seligman 1989).
  • Most people are not at the extremes, but can often be characterized as more internal or more external.
  • Locus of control questionnaires are common in stress research as locus of control relates to how we cope and how we react to stress, and one of the aims of stress management training is to internalize the sense of control.
  • The work of Seligman on learned helplessness (1975) is probably the best known, showing that animals and people can in some circumstances learn that coping is impossible in some situations, and that this learning can transfer to other circumstances.
  • Other work shows that even the illusion of active coping can reduce stress
  • Marmot et al, 1997 in a study of civil service employees found that those on the lowest grades were more likely to suffer strokes, cancer and ulcers and four times more likely to die from a heart attack. This study concluded that there was an inverse relationship between stress related illnesses and the degree of control exercised at work.

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