cause ill health in a number of ways:
Effect on the body
Possible effect on
Increased heart rate
Friedman & Rosenman
Cobb & Rose (1973)
Suppression of the
Colds, flu, cold
sores, other viral infections.
Possible links with
Visintainer et al
Disturbance of the
It is also
vital to mention that many of these effects could be attributable to
habits taken up by stressed people. Much of the evidence outlined below
is correlational so does not imply cause and effect!!! More on this
Stress and Stomach ulcers
Brady’s executive monkeys (1958).
Brady yoked two monkeys together and
administered electric shocks every 20 seconds for six-hour periods. One
of the monkeys, the ‘executive,’ was able to press a lever that delayed
the shocks for 20 seconds. However, it was unable to stop all shocks.
Many of the ‘executives’ died of
Brady concluded it was the stress of
being in control that had caused the ulcers. It couldn’t have been the
shocks per se since the other monkey got the same number of
shocks to its feet but didn’t get ulcers.
Where do you start?
Ethics: this is one of the cruellest
experiments carried out in Psychology and would not be possible today.
Relatively intelligent creatures were subjected to the pain and stress
of foot shocks and died slow, painful deaths.
Method: The experiment appears to
have been flawed. Weiss (1972) repeated the experiment on rats (these
lack the aaahhh value of monkeys). He found no difference between
‘executives’ and ‘controls.’ The researchers noticed that in the
original study Brady had used the most active and ‘extrovert’ monkeys as
executives. They concluded that it wasn’t being in control that had
killed the monkeys but their ‘personality’ or behaviour type.’
In another study Weiss preceded the
shock with a warning tone. These executives were far less likely to
develop ulcers which Weiss put down to the rats being able to ‘chill’
for some of the time. The effects of continual stress seemed far more
damaging. This could be compared to some jobs such as air traffic
controllers who need to maintain constant vigilance.
of Plymouth has an excellent section on this study and the follow ups.
Weiner et al
(1957) examined the gastric secretions of army recruits! (What would you
like to do when you grow up?). They found that after 4 months of
stressful training 14% of those who produce a lot of stomach acid
developed ulcers, whereas none of those who produce little acid developed
them. From this they concluded:
there may be a link
between stress and ulcers
stress could not be the
only cause since 86% of over-secretors did not develop ulcers.
Stress and the immune
We have already
seen that during times of stress the adrenal cortex produces steroids
(called corticosteroids since they’re produced by the adrenal cortex).
These stop the body producing lymphocytes (white blood cells) that attack
foreign bodies such as viruses, in the bloodstream.
More detail for those who are comfy
Viruses have antigens on their
surface. In order to neutralise the effects of a virus the body must
produce antibodies. Antibodies need to be specific to the antigens
present and are produced by white blood cells. There are different
types of white blood cell, e.g. T-cells, B-cells and natural killer
cells (not to be confused with a film by Quentin Tarantino!). B-cells
have antibodies on their surface. These lock onto antigens. When a
B-cell is mature it can produce thousands of antibodies an hour.
Importantly, the cells appear to ‘remember’ previous attackers so that a
future infection can be fought off quickly. Unfortunately, B-cells only
‘live’ for two days so need to be continually replaced. Increased
levels of steroids, caused by stress, slows down the production of
B-cells, leaving us more susceptible to infection
T-cells attack infections while
they’re in the body, rather than the blood. Cortico-steroids shrink the
thymus gland and slow down the production of T-cells.
There’s lots of
it. Choose the ones you prefer or think you’re most likely to remember.
Kiecolt-Glaser et al (1984) is a good one to use as key study. Note: it’s
Janice Kiecolt-Glaser so refer to her as ‘she.’
Kiecolt-Glaser et al (1984)
They took blood samples from 75
1. One month before examinations
2. On the first day of their exams
They also completed a questionnaire
to assess their psychiatric state, their level of loneliness and number
of life events.
In the stressed condition, on the
day of their finals, they had significantly fewer natural killer cells.
They also found that loneliness,
lots of life events and problems such as depression were all associated
with a weak immune response.
Good points (This is an excellent
piece of research!)
It is a natural experiment
since it took advantage of a naturally occurring event; examinations.
The independent variable (IV) was
exam stress, a long-term form of stress. Most studies have concentrated
on short-term stress. Note: natural experiments are high in ecological
Because this was a natural
experiment confounding variables are difficult to control. As a result
we cannot be certain that stress led to the immune suppression. Other
factors that were not controlled could be responsible.
(1981) placed mice on a turntable at 45 rpm; (they must be single mice.
I’ll try this ‘joke’ again and see if you get it this year!). This
induced stress and decreased their number of lymphocytes.
(1975) found that American astronauts who had just gone through the stress
of re-entry had a lower white blood cell count.
(1995) took biopsies from the arms of volunteers. It was found that
participants who were stressed by caring for elderly relatives took longer
to heal. Think of the practical implications of this for people
recovering from major surgery!
Cohen et al (1991)
carried out an impressive study on 394 participants. They each had their
stress index measured using a questionnaire that also took into account
their ability to cope and their feelings about their stress. They were
then given nasal drops that infected them with cold viruses. When tested
by doctors there was a direct correlation between their stress index and
the probability that they developed a cold.
Stress and cancer
The link is by
no means proven, but there is some evidence.
& Charles (1980) found that children who had developed cancer have often
been exposed to above average levels of stress in the previous year.
et al (1983) injected cancerous cells into animals. Those that were then
stressed were less able to fight the cancer.
et al (1979) found that cancer is more likely in single, separated or
divorced people. This was put down to lack of social support in reducing
the effects of stress.
(1993) believed that immune suppression might again be to blame. It is
thought that the immune system produces chemicals that fight cancer. As
with CHD it may be behaviours associated with stress, such as smoking,
that cause cancer, not the stress itself.
affects of stress on health.
essential that this be considered in any part c question on stress and
physical health as it will guarantee AO2 marks.
associated with all manner of bad habits, for example smoking, drinking
alcohol to excess, poor diet due to lack of time, lack of exercise for the
same reason, lack of sleep etc… All of these are likely to have an
adverse effect on a person’s health so could cause some of the ill-effects
attributed to stress per se.
Williamson (1991) found that people who are stressed tend to smoke more,
take less exercise, drink more alcohol and sleep less than others. All of
these habits can lead to ill health.
found that stressed teenagers were more likely to start smoking.
Similarly, Carey et al (1993) found that adults who had given up smoking
were more likely to take it up again when stressed.
found that life events were more likely to cause students to seek medical
advice if the students were low in physical fitness, as compared to
students high in physical fitness.
It may not be
stress itself that causes ill health but the behaviours that stressed
people tend to engage in.
b. Sources of Stress
can loosely be split into two sections:
stress” (or stressors as they are known), such as life events, hassles,
occupational stress etc.
differences in the stress response” looks at factors that may effect how
we cope with stress such as personality, culture and gender.
events (Social Readjustment Rating Scale: SRRS)
Rahe were two hospital doctors who noticed that many of the patients that
they visited on their rounds had suffered life events causing disruption
to their lives in the previous year. They decided to construct a
questionnaire to examine the possible link between life changing events
and physical ill-health.
examined the medical records of over 5000 patients
compiled a list of 43 life events
these in order of the time it would take to get your life back to some
semblance of normality following the event
‘marriage’ an arbitrary score of 500 and got others to rate the other
events in comparison to this. They averaged out the scores and divided
them by 10, so in the final scale ‘marriage’ has a score of 50.
starts at 100 LCUs (Life Change Units) for ‘death of a spouse and ends
with 11 LCUs for ‘minor violation of the law.’
The scale was
tested on different groups of people to determine its relevance. Patients
would add up the score for each life event and this would be their total
LCU. They believed that a score of over 300 meant an 80% chance of
developing a serious physical illness in the following year.
the life events in the list will have different meaning and cause
different amounts of disruption to different people. For example the
effects of divorce will depend on how long the couple have been married,
whether or not children are involved, whether the person is escaping a
violent partner etc…
the scale implies a correlation between stress and ill-health, however, as
I’m sure you must have realised by now correlations do not prove cause
and effect. All manner of other reasons could be used to explain the
link. Ill-health could be causing the stress, or the life events. For
example a heart attack could cause loss of job, major changes in standard
of living resulting in break up of marriage etc.
Martin (1989) found no correlation between positive life events such as
‘outstanding personal achievement’ and ill-health.
other problems as you would have found when you did the test, such as not
relevant to people your age and does not consider other forms of stress
such as hassles. However, it is unlikely that you would be expected to
mention more than two.
On a positive
the SRRS was the first of its type and inspired many others to follow and
devise more relevant and useful tests. The scale is rarely used in
serious psychological research today.
Use of the
Rahe et al
(1970) tested 2500 naval personnel on board 3 ships just before they set
sail. During their six months tour of duty the sailors kept health
records. A correlation of 0.118 was found between LCUs and ill-health.
This is relatively low; however, because of the size of the sample (2500)
it is statistically significant.
Hassles and Uplifts
everyday feeling of being stressed can probably be attributed more to
minor, irritating problems than to the rarer major life events. Some
research has found that hassles have a greater correlation with ill-health
than do the seemingly more serious life events.
hassles and uplifts (Kanner et al 1981)
price of goods
things to do
or losing things
time with the family
Longis et al (1982) Key Study
To see if
life events of hassles were better predictors of ill health
participants completed 4 questionnaires every month for one year:
scale (117 items)
scale (135 items)
events questionnaire (24 events)
hassles were correlated with ill health, but neither uplifts nor life
hassles are more likely to cause stress related illnesses than life
Many of the
earlier problems still exist:
still many examples of stressor not considered such as so called chronic
stressors such as poverty, poor housing, overcrowding in inner cities
differences are still not considered. We all perceive and react to
stress differently, some people seemingly being able to cope better than
others, and again these are not considered.
effect. Yet again the study is a correlation so does not prove that the
stress is causing the illnesses. For example just before a cold we may
feel more hassled, but this could be because the virus is already having
its effect, leaving us tired and less able to cope with everyday
events. That is the illness is actually causing the hassle!
This is a
favourite topic for examination questions as well as being an important
issue for workers around the World. Recently stress has overtaken the
common cold as the main reason for absence from work.
stress in the workplace:
Buell (1960) found that employees working more than 48 hours a week were
twice as likely to develop CHD than those working 40 hours a week.
However, it is
probably the perception of long hours that is more important than the
number of hours per se.
any aspect of the working environment that is likely to cause stress; most
obvious examples include noise, temperature, vibration, lighting and
people can cope reasonably well with noise it does appear to cause some
impairment in performance, particularly if the noise is unpredictable.
Glass et al got 60 participants to complete cognitive tasks such as word
searches under one of four conditions:
mistakes and were less persistent on the task.
Participants adapted to the noise and made fewer mistakes. Had lower
arousal levels (GSR).
task okay in both conditions.
researchers concluded that we can adapt to high noise levels but this is
more difficult if the noise is not constant or is unpredictable.
The stress of
overcrowding has been studied in other species particularly rats where it
has lead to bizarre behaviours such as parents eating their offspring.
Freedman et al (1975) found a correlation between high density living
conditions such as inner cities, and admissions to psychiatric hospitals.
Yet again this is a correlation so does not prove c_____ and e_____.
Perhaps you could think of some other reasons, other than overcrowding to
explain why inhabitants of inner cities are more likely to be diagnosed
with mental illness. Clues perhaps in the next topic!
To some extent
we all play roles, particularly in the work situation. You may have
noticed that some teachers behave very differently out of work when
playing a different role! Role ambiguity is likely to occur when a person
is unsure of their precise responsibilities within an organisation and has
been reported as a major source of stress by 35% of workers in the USA.
This is a
common form of stressor and arises when the job requires you to behave in
a way that is at odds with your own desires or beliefs. For example
working overtime may be at odds with your role as parent. Similarly
someone in middle management may find it difficult to balance the needs of
their superiors for higher output with the needs of their staff for a
shorter working week.
other forms of workplace stress including burnout, repetitive work,
isolation, lack of control etc.; some of these are addressed by the key
study of Johansson et al (1978)
1. Civil Servants
Marmot et al
hypothesis that control was negatively correlated with stress-related
illness; that is as control decreases the level of illness increases.
civil servants were investigated over a period of three years.
Researchers assessed the level of job control by self report
questionnaires and by assessments by personnel managers and this was then
compared to levels of stress related illness.
that workers with less control were four times more likely to die of heart
attack than their colleagues with more control. In addition they were
more likely to suffer from other stress related illnesses such as cancers,
ulcers, stomach disorders and strokes. Even when other possible
contributory factors such as diet, smoking, social support etc. had been
taken into account the additional risk remained!
was obvious, that lack of control seemed to be associated with illness and
they recommended that employers gave their staff more autonomy and
Criticisms of this study:
method is correlational it can only be said that there appears to be an
association between low control and stress-related illness. It cannot be
assumed that low control is causing illness! It could be that workers
with poor health are less likely to achieve the higher grades where
control is greater. This would explain the findings just as well.
in self-report questionnaires which are notoriously inaccurate and prone
to participant reactivity (see notes on research methods). Basically, if
the workers suss what the researchers are looking to find they may answer
questions accordingly. Similarly the personnel managers assessing
people’s jobs may do the same!
studied a small group of workers in a large sawmill. Their job was
‘finishers’, i.e. they were the final link on a conveyer belt system. The
rate at which they worked determined the output of the mill so their job
was very responsible.
stress included: responsibility for the mill’s output, responsibility for
the pay of other employees (since pay was linked to productivity), working
in isolation, so didn’t have others to share problems with, little control
(since they worked on a conveyor belt), highly skilled but repetitive
researchers’ measured their stress hormones (adrenaline and noradrenaline)
and patterns of illness.
They had much higher levels of stress than other workers in the mill and,
presumably as a result, had more stress related illnesses and days off
The researchers recommended that the finishers should move to a salary
structure (i.e. pay not based upon output) and should be allowed to rotate
jobs with other workers.
Individual Differences in the stress response
We will look
at individual differences in detail in the next topic, but you have had a
brief introduction to them in attachments (Ainsworth in case you’d
forgotten). Individual differences, as the title suggests looks at ways
in which we differ from one another, rather than the ways in which we are
similar. Generally we could differ because of personality, gender, social
class, ethnicity, age, genes, life experiences etc. In terms of our
response to stress we’ll concentrate on:
and behaviour (Type A or B and Hardiness)
(There appears to be a difference in our biological response to stress)
do some ethnic groups seem to be less stressed?)
Personality and behaviour
longitudinal study carried out by Friedman & Rosenman (1974). The
researchers had earlier identified two basic behaviour types:
desire to achieve goals
recognition and advancement
to rush to finish tasks
noticeable lack of:
Desire to compete
Being a bit of
a saddo, I think of these things in terms of Eastenders’ characters, for
example Phil Mitchell (type A) and Patrick, (Paul’s dad, (type B).
Perhaps you can think of your own to help you remember the characteristic
traits of each.
behaviour and CHD (See earlier notes for fuller details)
Friedman & Rosenman’s
longitudinal study (1974).
3200 participants (all men) were
given questionnaires. From their responses, and from their manner, each
participant was put into one of three groups
Type A behaviour: competitive,
ambitious, impatient, aggressive, fast talking.
Type B behaviour: relaxed,
Type C behaviour: ‘nice,’ hard
working but apathetic when faced with stress
Eight years later 257 of the
participants had developed CHD.
70% of these had originally been
classed as type A.
believed that people with a hardy personality were less likely to see
events as stressful. Managers of a large US company were tested using the
SRRS. Those who scored highly were then examined and split into two
groups; those who were frequently ill and those who were rarely ill. She
found a difference in personality between the two with those reporting few
illnesses being described as hardy.
Kobasa there are three characteristics of the hardy personality:
hardy individuals see themselves as being in charge of their environment
hardy individuals get involved and tackle problems head on
hardy individuals see change as a challenge rather than as a threat
Kobasa’s original study used only white middle class males so is both
androcentric and biased in terms of sub-culture.
because the study is correlational can we be sure that it was hardiness
that had the beneficial effects on the managers’ health? Perhaps as
(Alfred & Smith 1989) have suggested, hardy people are more likely to
look after their health.
appear to be a sex difference in both the ways in which stress is
experienced physically and the way it is experienced psychologically.
Certainly men are far more likely to die from CHD than women.
Post (1972): Men and women were moved from a non-stressful situation into
a more stressful one; they were given an intelligence test. Men showed a
much higher increase in adrenaline than did the women. Generally women do
appear to show a greater increase in their physiological response to
There could be
a number of reasons for this:
differences between the sexes for example testosterone and other
differences with men being more physically aggressive
roles of the sexes with women being more caring
Hastrup et al
(1980) provided evidence for the hormonal theory. Women appear to have
marked changes in their response to stress throughout their menstrual
cycle, showing the least response when their oestrogen levels were
As women take
on more traditionally male roles it could be that the situation will
change. There has been evidence of this in the past 30 years.
Frankenhauser et al (1983) found that adrenaline levels in female
engineering students and bus drivers were just as high as their male
At a cultural
level the best study is Weg’s (1983) study of a Georgian tribe who have a
particularly impressive life-expectancy; they are more than 100 times more
likely to reach a ton than people in the UK! Weg attributed this to their
relatively stress-free lifestyle, particularly the high level of social
support available to individuals within the communities. However, there
could be many other reasons for their longevity, such as lack of alcohol
and tobacco, diet of fresh meat and veg., social support and lots of
exercise. Genes could also be a major factor.
Cooper et al
(1999) looked at why black Americans suffer more from CHD than either
white Americans or the black Africans from whom they are descended. They
found that there had been inadvertent genetic selection on board the slave
ships bringing the first generation black Americans to the New World.
Many of the slaves had died form diarrhoea during the journey. Those able
to retain water would have been most likely to survive and create the
black American population of today.
any discussion of this area it is crucial not to overlook how the possible
social and psychological factors could also contribute to the stress
related illnesses of Black Americans. Rates of unemployment amongst Black
Americans are twice those of the white population and on average their
incomes significantly lower. Black children typically receive a poorer
education resulting in fewer job prospects later in life. As a result of
this blacks are more likely to suffer poverty-related stress and have more
repetitive, stressful jobs. In addition to this, discrimination per se is
a major stressor, (Anderson 1991). All of these factors could add to the
increased risk of stress related illnesses.
Greer et al
(1979) looked at the way in which women’s attitudes towards discovering
they had breast cancer influenced the outcome and prognosis.
interviewed regarding their attitude towards their recent diagnosis.
Four kinds of
attitude were recorded:
I’m being treated
for a lump but it isn’t serious.’
‘This is not going
to get me’
‘It’s God’s will!’
‘Well there’s no
hope with cancer is there?’
studies 5 years and 15 years later found that women with the first two
attitudes were significantly more likely to fight ff the cancer.
attitude and adapting to our situation is more beneficial than giving in.
The cognitive approach to stress management teaches people how to do this.
Critical issue: Stress Management
become a major issue in recent years and few topics have received so much
attention, either in serious scientific journals or in popular
publications such as magazines. Recently there has been TV series such as
‘Stressed Eric’ and the paperback ‘Little book of calm’ that sold over 2
million copies in 2000. In the workplace stress has become a major
concern of managers and Company bosses following successful litigation by
employees claiming harm done by unnecessary exposure to stress. Stress
management or stress reduction is now a multi-million pound business and
many methods of coping have been devised, some with more success than
At the outset
it is important to make a distinction between various approaches. Methods
of coping could, for example, be split between:
methods that seek to temporarily help people cope with the symptoms but do
little to tackle the root causes. These methods include alcohol, drugs,
methods deal with the root causes of stress and include time management.
also be split between:
methods that seek to reduce the bodily symptoms of stress such as arousal
and increased heart rate.
methods that help people cope with the subjective feelings of stress such
as anxiety and lack of control.
One way to
reduce stress is to eliminate the factors causing it. However, since so
many factors can cause stress this is not always realistic. Many ways of
managing and reducing stress have been devised. Dixon (1980) suggested
that humour can help because it stimulates the output of endorphins.
This section examines some more orthodox approaches to the management and
reduction of stress.
Physiological methods of stress reduction
several methods for reducing the physiological effects of stress. One
is the use of drugs which act directly on the ANS to reduce our
level of arousal.
Librium and Valium). These reduce the physiological effects of
lead to physical dependence in at least some people and also have
unpleasant side effects such as drowsiness.
activity in the sympathetic nervous system so reduce heart rate, blood
such as Prozac
and Tofranil can help people to cope more effectively with their symptoms
of stress but again do have side effects.
therapies are only providing symptomatic relief; they do nothing to tackle
the root causes of stress.
The body is
not designed to allow us to be consciously aware of subtle changes in our
bodies such as blood pressure. Biofeedback aims to provide this
information allowing us to take steps to reduce heart rate etc. by
relaxation. A biofeedback machine produces precise information (or
feedback) about bodily processes such as heart rate and/or blood
pressure. This may be presented in visual or auditory form (or
both). For example, a tone whose pitch varies and/or a line on a
television monitor that rises or falls when heart rate increases or
decreases may indicate heart rate changes.
The fact that
some people can apparently regulate some bodily processes has led to
biofeedback being used with many types of stress-related disorders. These
include migraine headaches, tension headaches and high blood pressure.
compared patients who were receiving biofeedback for muscle contraction
headaches with patients on a waiting list for such treatment. Biofeedback
was in the form of feedback about muscle tension (provided by EMG).
Significant reductions in the number of headaches was found in patients
undergoing the feedback treatment.
biofeedback appears to be effective in treating some stress-linked
disorders the way in which it works is in doubt. It may not be the
biofeedback per se but other related factors that cause the
techniques taught with the biofeedback.
feeling of being in control that the biofeedback encourages.
effect. Holroyd et al (1984) found that tension headaches improved in
patients who thought they’d received muscle relaxation even
when they hadn’t!
has several disadvantages associated with it.
requires physiological measuring devices. These are both expensive and
too bulky to be easily transported.
practice appears to be needed for the development and maintenance of any
beneficial effects (although this is also true of some other methods).
may eventually enable a person to learn to recognise the symptoms of, say,
high blood pressure without the need for the biofeedback machine, but it
is not known exactly how biofeedback works. Some sceptics argue that
biofeedback itself exerts no effects, and that the important thing is a
person's commitment to reducing stress and the active involvement of a
methods of stress reduction
responses to stress may also be reduced through relaxation.
Jacobson (1938) observed that people experiencing stress tended to add to
their discomfort by tensing their muscles. To overcome this, Jacobson
devised progressive relaxation. In this, the muscles in some area
of the body are first tightened and then relaxed. Typically the patient
starts with their feet and gradually works their way up the body, relaxing
each set of muscles in turn.
Once a person
becomes aware of muscle tension and can differentiate between feelings of
tension and relaxation, the technique can be used to control
stress-induced effects. Progressive relaxation lowers the arousal
associated with the alarm reaction and reduces a number of recurrent heart
attacks. However, progressive relaxation only has long-term benefits if
it is incorporated into a person's lifestyle as a regular procedure
techniques of this sort are not easy to carry out when stuck in a traffic
Is similar to
muscle relaxation but involves the repetition of a mantra or number, for
example saying ‘one’ when breathing in and ‘two’ on expiration. The
person is encouraged to concentrate on their breathing and take steps to
reduce it. Try it. ‘In… out’, slowly, ‘in… out’…. No need to shake it
all about!!! It isn’t easy to feel stressed when breathing very deeply
and slowly! The repetition also acts to remove all distracting thoughts
from the mind. Some of you will find this easier than others!
activity and exercise
conducted (pardon the pun) a study of London bus drivers and conductors,
(people that used to collect tickets on buses in the good old days. See
an episode of ‘On the Buses’ for further information). He found that the
conductors, who moved around the bus collecting fares, were far less
likely to suffer from cardiovascular disorders than the sedentary
drivers. An obvious criticism of the study is that many other factors may
result in drivers being more stressed than conductors. Although Morris'
study was correlational, subsequent research has confirmed that physical
activity and exercise are beneficial in stress reduction (Anshel,
almost certainly reduces some of the more dangerous effects of stress.
Remember that the 3Fs response is preparing the body for action. By
taking action in the form of exercise you are burning off some of the
energy the body is mobilising. High blood sugar levels are therefore
reduced, circulation is improved and the heart muscles strengthened.
Psychologically, exercise might also be therapeutic, since sustained
exercise can reduce depression and boost feelings of self-esteem (Sonstroem,
Cognitive techniques for stress
called ‘cognitive’ since they concentrate on people’s perceptions of
stress and the way they think about the stressful situation and their
ability to cope. Hardiness and stress inoculation both encourage the
patient to view their stressors differently and increase their perceived
ability to cope with the stress.
differ in their abilities to resist a stressor's effects. One
characteristic that apparently helps resist stress is hardiness (Kobasa,
1979). According to Kobasa, 'hardy' individuals differ in three main ways
(see your earlier notes on this).
Commitment: they have more direction to their lives.
Challenge: interpreting any stress as making life more interesting, and
Control, the amount of stress experienced can be regulated.
in hardiness tend to be healthier even though the levels of stress that
they’ve suffered have been similar to less hardy individuals. (Pine
1994). Maddi, a colleague of Kobasa, has devised a series of programmes
for increasing hardiness. These include ‘HardiTraining’ and
suggestions for increasing hardiness:
Patients are taught to recognise the symptoms of stress such as heightened
heart rate and muscle tension.
stressful encounters. Patients are asked to think about recent stressful
situations that they’ve overcome and to consider better ways of dealing
with similar situations in future.
Emphasises that challenges can be coped with. Suggests that circumstances
that we feel are beyond us should be avoided! (At last sensible
advice!). However she does propose that in this situation we take on a
different challenge that is within our capabilities so that we experience
the positive aspects of dealing with stress.
(1976, 1985) stress inoculation therapy assumes that people
sometimes find situations stressful because they think about them in
catastrophising ways. Stress inoculation therapy aims to train people
to cope more effectively with potentially stressful situations. It is
similar to hardiness and has three stages.
therapist and patient exploring the ways in which stressful situations are
thought about. Typically, people react to stress by offering negative
self-statements like 'I can't handle this'. This makes the situation
acquisition and rehearsal,
attempts to replace negative self-statements with incompatible positive
coping statements. These are then learned and practised. (See examples
that follow, practise a few if you so desire).
and follow through
involves the therapist guiding the person through progressively more
threatening situations that have been rehearsed in actual stress-producing
situations. Initially the person is placed in a situation that is moderate
to cope with. Once this has been mastered, a more difficult situation is
Meichenbaum et al (1982), the 'power of positive thinking' approach
advocated by stress inoculation therapy can be successful in bringing
about effective behaviour change, particularly in relation to anxiety and
and reinforcing self-statements used in stress inoculation therapy
for stressful situation
What is it
I have to do?
develop a plan to deal with it.
worry. Worry won’t help anything.
negative thoughts; just think rationally.
at a time, you can deal with it.
you’re in control, you can deal with it.
with the feeling of being over-whelmed.
It will be
the worst thing that can happen.
fear from 0 to 10 and watch it change.
the fear manageable.
et al 1995
Reinforcing self statements
you did it!
You can be
pleased with the progress you’re making.
as bad as you expected!
I was able
to do it because I was well prepared.
Some methods have
been successful in reducing the ill effects of stress, for example Carver
& Humphries (1982) showed that they reduced the incidence of CHD.
Their main advantage
over other interventions such as drugs is that they try to deal with the
problem of stress directly, teaching people how to identify stress and
develop effective techniques for dealing with it
methods also consider the needs of the individual and if used properly can
be tailored to a person’s specific situation.
stressful situations are completely out of the control of the individual
for example a repetitive job or having to travel to work or traffic jams
etc. In such cases stress reduction is the best that can be hoped for.
In some cases
companies have been criticised for setting up such stress management
courses as a cheap or easy option rather than trying to tackle the real
causes of the stress. In so doing they are laying the blame squarely on
their employees rather than facing up to their own responsibilities.
seems that having lots of friends that we can share our problems with does
help us to reduce and minimise the negative effects of stress. For
example work related stress tends to be lower in organisations where there
is lots of support from co-workers. However, this is not an easy one to
Karmack et al (1998) found a reduction in heart rate when difficult tasks
could be completed with a friend nearby.
Kulik & Mahler (1989) found that recovery from heart disease is faster
when social support is available.
Watson et al
(1998) carried out research on the cynomolgus monkey. Apparently
this species is famed for its ‘very social behaviour.’ Apparently David
Attenborough never misses their fancy dress parties and they regularly
occupy the pages of Hello magazine. I digress! Anyway the
researchers found that when kept in isolation they show obvious signs of
stress, such as increased heart rate. When returned to their colony these
symptoms disappear and the parties continue late into the night.
suggests (phrase to use when you either can’t remember the researchers’
names or, as in this case, none are provided) that men tend to have larger
networks of friends but that it’s women that use them more in times of
al (1981) think social support has two different meanings:
represents the number of people available to provide support
is the strength of social support they are able to provide.
Clearly it is
the second one that is most important. Having many friends is not
particularly useful if they are unable to offer support in times of
Brown & Harris
life events can trigger depression in women. (61% of depressed women
had experienced a major life event in the previous 12 months).
friends can alleviate the effects of stressful events. Only 10% with a
close friend in whom they could confide became depressed, compared to
37% who had no such intimate friend. (aargh!).
Tache et al
(1979) found that cancer is more common in the single, divorced or
separated. This was put down to the lack of social support these have
compared to married couples or those living together.
But as a
general evaluation point to most of these studies, they are all
correlations. As such it is impossible to infer cause and effect:
i.e. can we assume that being single causes a worsening of stress? Could
it be that being stressed makes us more difficult to live with, resulting
in us staying single? Perhaps being lonely means we drink or smoke more
and as a result are more likely to develop cancer etc.
This is a
general criticism to bear in mind whenever a study is correlational. Add
it to your repertoire of evaluation points such as ‘lacks ecological
validity’ or ‘ethical concerns.’ As with these you will need to back it
up by explaining what you mean!
of Social Support
can be useful in alleviating the effects of stress but the assistance
provided needs to be measured and appropriate.
need different kinds of support from different people:
Family and friends
needed for emotional support
Doctors and nurses
needed for informational support
This may seem
obvious but informational support from family and friends was seen by the
patients as unhelpful, as was overly positive comments from anyone.
Pets have long
been associated with lower stress levels (in their owners, not in them!).
Baun et al (1994) found that pet owners were more likely to survive long
term following a heart attack and that stroking a pet dog was more likely
to reduce your blood pressure than stroking a strange dog!