Psychology (9990) | Stress

Welcome to Health Psychology: The Stress Chapter!

Hello future psychologists! Stress is something we all experience, whether it's the pressure of exams or dealing with difficult life changes. In this chapter, we dive into Health Psychology to understand exactly what stress is, how it affects our bodies and minds, and, most importantly, how we can measure and manage it.

Don't worry if the biological parts seem tricky at first; we’ll break down the body's reaction into easy-to-understand stages. Let's begin!

3.4.1 Sources of Stress

The Physiology of Stress: The General Adaptation Syndrome (GAS)

The body's predictable response to any stressor (a stressful stimulus) was mapped out by Hans Selye. He called this the General Adaptation Syndrome (GAS). It describes a sequence of three stages that the body goes through when facing prolonged stress.

Analogy: Think of the GAS model like the battery life and eventual breakdown of a phone dealing with a major software update.

Stage 1: Alarm Reaction (The Fight-or-Flight Response)

• What happens: The body recognizes the stressor. The sympathetic nervous system (SNS) is activated, leading to the release of stress hormones (like adrenaline and cortisol).
• Physical effects: Heart rate increases, blood pressure rises, digestion slows down. The body is ready to fight or flee.

Stage 2: Resistance

• What happens: If the stressor continues, the body tries to cope and return to normal, but remains on high alert.
• Physical effects: The body adapts to the high stress levels. Hormone levels remain high, but the outward symptoms of the alarm stage may decrease. This drains the body’s resources over time.

Stage 3: Exhaustion

• What happens: The body's resources are completely depleted. The long-term effects of chronic stress begin to show, as the body can no longer sustain the resistance.
• Effects on Health: Increased risk of stress-related illness, such as immune system suppression, heart disease (CHD), and ulcers.

Key Takeaway: The GAS model shows that stress is a general response, regardless of the stressor, and that prolonged stress ultimately leads to exhaustion and potential health breakdown.

Causes of Stress

1. Stress Caused by Life Events (Holmes and Rahe)

Thomas Holmes and Richard Rahe developed the Social Readjustment Rating Scale (SRRS). This scale proposes that life changes—both positive (like marriage) and negative (like divorce)—require an individual to adjust, and this adjustment causes stress.

• Procedure: Participants were asked to rate 43 life events (called Life Change Units, LCUs) based on the amount of readjustment they required.
• LCU Scores: The higher the LCU score assigned to an event, the more stressful it is presumed to be (e.g., Death of a spouse = 100 LCUs).
• Findings: A high score on the SRRS within a short period (e.g., the last year) correlates with an increased likelihood of experiencing illness in the following months.

Quick Review Point: The SRRS measures stress subjectively via self-report and suggests that situational factors (the environment/events) cause stress, not just individual traits.

2. Work-Related Stress

Workplace demands are a major source of stress. This can include role conflict, lack of control, and high workload.

• Example (Work): Studies like Chandola et al. (2008) investigated the link between workplace factors (such as job control and effort-reward imbalance) and cardiovascular risk, finding that those with chronic job stress often had higher risks.

3. Personality Types (Friedman and Rosenman)

This theory suggests that certain personality traits predispose people to stress and associated health problems, particularly Coronary Heart Disease (CHD).

• Type A Personality:
  • Highly competitive and ambitious.
  • Experience time urgency (rushing, impatience).
  • Easily provoked into anger and hostility. (Note: Hostility is considered the most toxic component relating to CHD risk.)
• Type B Personality:
  • Relaxed, patient, and less competitive.
  • Less likely to experience stress-related illnesses.

Did you know? Friedman and Rosenman originally identified Type A behaviour during a routine inspection of their waiting room furniture, which they noted was being worn down only on the front edges of the seats—suggesting impatient, restless patients.

3.4.2 Measures of Stress

Psychologists use both objective (biological) and subjective (psychological) measures to assess stress levels.

A. Biological Measures (Objective Data)

These techniques measure the physiological responses associated with the stress hormones released during the GAS (cortisol, adrenaline).

1. Recording Devices (Heart Rate and Brain Function)

• Heart Rate/Blood Pressure: Stress increases heart rate and blood pressure. These can be measured using simple monitors or even through specialized recordings like ECGs.
• Brain Function (fMRI): Functional Magnetic Resonance Imaging (fMRI) can be used to observe brain activity associated with stress response. Wang et al. (2005) used fMRI to study areas of the brain associated with different types of emotional stress.

2. Sample Tests for Salivary Cortisol

• What it is: Cortisol is the primary stress hormone. It is secreted by the adrenal glands and increases glucose in the bloodstream to prepare for action.
• Measurement: Cortisol levels can be measured non-invasively using saliva samples. This provides an objective measure of physiological arousal.
• Example: Evans and Wener (2007) investigated stress in children (measured via cortisol samples) who were exposed to noise and crowding due to long bus commutes.

B. Psychological Measures (Subjective Data)

These involve self-report methods where the individual reports on their own experiences, thoughts, and feelings regarding stress.

1. Tests of Friedman and Rosenman's Type A Personality

These are questionnaires designed to assess the competitive, time-urgent, and hostile traits associated with the Type A personality.

2. Holmes and Rahe's Life Events Questionnaire (SRRS)

As discussed above, this is a self-report questionnaire where individuals check which life events they have experienced over a specific period (usually 6–12 months) and sum their LCU scores.

Key Takeaway: Biological measures provide objective, physiological data, while psychological measures provide rich, subjective data about the experience and cognitive interpretation of stress.

3.4.3 Managing Stress

Health Psychology offers several techniques for helping people cope with and prevent stress.

1. Psychological Therapy: Biofeedback

Biofeedback is a technique where individuals are trained to control involuntary physiological processes (like heart rate, muscle tension, or skin temperature) using immediate, continuous feedback from monitoring instruments.

Step-by-Step Biofeedback

1. Monitoring: Sensors (e.g., heart rate monitors or EMG devices for muscle tension) are attached to the patient to measure a physiological response.
2. Feedback: The patient receives real-time feedback, usually via an auditory signal (a beep) or a visual display (a graph).
3. Training: The patient learns to associate certain cognitive or relaxation techniques (e.g., deep breathing) with a change in the feedback signal (e.g., the beep slows down, or the graph line drops).
4. Transfer: Eventually, the patient learns to control the response without the equipment, transferring this self-regulation skill to real-life stressful situations.

Key Study Example: Budzynski et al. (1969) used EMG biofeedback to successfully reduce tension headaches, demonstrating that patients could learn to relax forehead muscles and sustain that relaxation.

2. Use of Imagery to Reduce Stress

Cognitive strategies involve using mental processes to reduce the stress response. Relaxation and imagery involve forming peaceful, non-stressful mental images while simultaneously engaging in relaxation techniques (like progressive muscle relaxation or deep breathing).

• How it works: By focusing the mind on calm, positive scenes, the sympathetic nervous system is inhibited, and the body’s natural relaxation response is activated.

Key Study: Bridge et al. (1988)

Bridge et al. investigated the effectiveness of relaxation and imagery training in reducing psychological distress and reducing the physical symptoms (e.g., nausea and vomiting) experienced by women undergoing chemotherapy for breast cancer.

• Procedure: Patients were taught relaxation and guided imagery techniques (e.g., imagining a soothing place).
• Finding: The intervention group reported significantly less distress and fewer side effects compared to the control group.
• Conclusion: Cognitive strategies like relaxation and imagery are effective tools for managing the physical and psychological stress associated with medical procedures and chronic illness.

3. Preventing Stress: Stress Inoculation Training (SIT)

Developed by Donald Meichenbaum, SIT is a cognitive-behavioural therapy (CBT) approach that teaches individuals how to prepare for and cope with future stressors, acting like a psychological "vaccine."

The Three Phases of SIT

Memory Aid: C-S-A (Conceptual, Skills, Application)

1. Conceptualisation Phase:
   • The client works with the therapist to understand their stress. They learn to view stress as a problem that can be managed, rather than something overwhelming.
   • They identify their current maladaptive (unhelpful) thoughts and behaviours.
2. Skills Acquisition and Rehearsal Phase:
   • The client learns and practices specific cognitive and behavioural coping skills.
   • Cognitive skills: Learning self-statements (e.g., "I can handle this," "Stay calm"), cognitive restructuring, and time management.
   • Behavioural skills: Learning relaxation techniques, communication skills, and potentially biofeedback.
3. Application and Follow-Through Phase:
   • The client practices the learned skills in increasingly stressful situations, starting with role-play in the safe environment of the therapy room (low-level stress exposure).
   • They apply the skills to real-life situations, preparing for potential relapses and generalizing the coping strategies to new stressors.

Key Takeaway: SIT is proactive—it prepares the person for stress before it happens, offering a toolkit of psychological resources.