Biological Psychology

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Biological Psychology

• Stress

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Getting Started on Stress
Thinking Time

• You have 3 minutes to think of a time/situation
  when you experienced STRESS.
• What was it that caused the stress?
• How did you react to the stress
• Your psychological feelings (e.g. anxious)
• Your bodily/physiological feelings (e.g. tired)
• Your behaviour? (e.g snapped my Mums head off)
• How did you try to deal with the stress?

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Paired Share

• Find a partner (not the person you are sitting
  next to)
• Whoever has a birthday nearest the beginning of
  the year begins.
• You have 1 minute to tell your partner-
• What it was that caused the stress
• How you reacted to the stress
• Your psychological feelings (e.g. anxious)
• Your bodily/physiological feelings (e.g. tired)
• Your behaviour? (e.g snapped my Mums head off)
• How you tried to deal with the stress

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• The thing that causes the stress is known as a
  STRESSOR.
• Look at the stressors identified by you and your
  partner
• Were the stressors predictable or unpredictable?
• Did the person have any control over the
  stressor?
• Categorise each stressor as one (or more) of the
  following
• Environmental
• Biological
• Life event
• Major traumatic event
• Psychological
• Social

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• The effects of stress on you and your partner-
• Identify the following effects on you and your
  partner
• Psychological,
• Physiological
• Behavioural.

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• Coping with stress
• A persons way of dealing with stress may take
  either of the following approaches
• They may be emotion focused try to deal with
  the effects of the stressor on the person
• They may be problem focused try to remove the
  stressor (avoidance technique) or to cope with
  (approach technique) it before it produces the
  stress reaction.

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• Try to identify whether you and your partners
  way of coping with the stress was a problem or
  emotion focussed strategy.
• E.g In response to your looming driving theory
  test you may have tried to deal with the stress
  involved by
• Getting drunk the night before (emotion focussed)
• Practising test questions for several days
  before.(problem focussed)

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So what is stress ?
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  Engineering model

• Sees stress as something that happens to a person
  - an external stimuli that exerts a destructive
  force on the individual.
• This model gives rise to the question What
  causes stress?
• It suggests that stress can be measured in terms
  of the number of stressful events a person is
  experiencing.

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• This model was popularised by Hans Selye in the
  30s 40s

Exposed rats to different types of unpleasant
stimuli (excessive exercise, injury, cold,
dangerous drugs) Measured their physiological
responses to the stimuli (heart rate, muscle
tone, temperature, working of internal organs etc)
All rats responded in a similar way regardless of
the type of stimuli He also found that- All rats
showed the same pattern of response over time
with prolonged exposure to the stressor, this led
to the development of the next model of stress.
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The physiological model

• Sees stress as an automatic biological reaction
  to a stressor. It is concerned with what happens
  inside the persons body.
• This model asks the question What are the
  effects of stress?
• It suggests that stress can be measured in terms
  of the physiological responses a person displays
  in response to a stressor

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The Transactional model (the current accepted
model)

• Sees stress as arising from an interaction
  between an individuals perception of the demands
  of the stressor and their ability to meet those
  demands this is known as cognitive appraisal.
  
•        Primary appraisal is when the individual
  decides whether or not the potential stressor is
  a threat.
•        Secondary appraisal is when the
  individual decides whether or not they have the
  resources to cope with the demands of the
  stressor.

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• This model gives rise to the question How do we
  cope with stress?
• It suggests that it is possible to measure stress
  in terms of how the person is behaving/coping and
  also by using subjective self-reporting of how
  they feel.
• It takes individual differences into account
  stress is the result of each individuals
  perceptions of the demands and their ability to
  cope with those demands.

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• Actual coping ability Actual demands
• Perceived coping ability Perceived demands
• Cognitive Appraisal
• Mismatch between demands and coping ability
• Feelings of stress Bodily stress response

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The Bodys response to stress

• We are going to look at the parts of the body
  that are involved in the stress response. First
  of all we will consider
• The Structure of the Nervous System-

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• In order to understand how the nervous system
  operates we need to look at the basic building
  block of the nervous system-
• The Neuron and the Synapse

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Direction of nerve impulse (action potential)
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The Synapse
Direction of impulse
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• How does the synapse work?
• The transmitter substance is made and stored in
  the vesicles
• The Action Potential arrives at the synapse.
• The Transmitter substance is released from the
  vesicles.
• The Transmitter substance flows across the
  synaptic cleft.

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• The Transmitter substance attaches to the
  appropriate receptor sites on the post synaptic
  membrane (lock key principle).
• The post synaptic neuron summates the excitatory
  and inhibitory input in order to decide whether
  or not to fire.
• The Transmitter substance is reabsorbed into the
  vesicles of the synaptic button.

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Examples of Transmitter substances

• Acetylcholine at neuron muscle synapses
• Dopamine found throughout the brain, important
  in movement and other behaviours
• Serotonin found throughout the brain, important
  in many behaviours including mood, sleep,
  alertness
• Noradrenaline produced in adrenal glands,
  important in response to stress.
• GABA found in pathways throughout the nervous
  system involved in mood states

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The Brain
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The structure of the BRAIN
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• Cortex
• Cerebral hemispheres Basal Ganglia Limbic
  system (hippocampus amygdala)
• Forebrain
• Thalamus
• Diencephalon
• Hypothalamus
• Midbrain
• Pons Brain Stem
• Hidbrain Meudulla
• Cerebellum

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The Autonomic Nervous system

• The organs (the "viscera") of our body, such as
  the heart, stomach and intestines, are regulated
  by a part of the nervous system called the
  autonomic nervous system (ANS).
• The ANS is part of the peripheral nervous system
  and it controls many organs and muscles within
  the body.
• In most situations, we are unaware of the
  workings of the ANS because it functions in an
  involuntary, reflexive manner. For example, we do
  not notice when blood vessels change size or when
  our heart beats faster. However, some people can
  be trained to control some functions of the ANS
  such as heart rate or blood pressure

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• The ANS regulates
•                     
• Muscles
• in the skin (around hair follicles smooth
  muscle)
• around blood vessels (smooth muscle)
• in the eye (the iris smooth muscle)
• in the stomach, intestines and bladder (smooth
  muscle)
• of the heart (cardiac muscle)
• Glands
• The ANS is divided into two parts
• The sympathetic nervous system
• The parasympathetic nervous system

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The Sympathetic Nervous System
It is a nice, sunny day...you are taking a nice
walk in the park. Suddenly, an angry bear
appears in your path. Do you stay and fight OR do
you turn and run away? These are "Fight or
Flight" responses. In these types of situations,
your sympathetic nervous system is called into
action - it uses energy - your blood pressure
increases, your heart beats faster, and digestion
slows down.
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The Parasympathetic Nervous System
It is a nice, sunny day...you are taking a nice
walk in the park. This time, however, you
decide to relax in comfortable chair that you
have brought along. This calls for "Rest and
Digest" responses. Now is the time for the
parasympathetic nervous to work to save energy -
your blood pressure decreases, your heart beats
slower, and digestion can start.
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The Endocrine System

• The endocrine system helps regulate and maintain
  various body functions by synthesizing (making)
  and releasing hormones, chemical messengers.
• The endocrine system is composed of glands that
  release their hormones directly into the
  bloodstream for chemical signaling of target
  cells.
• These glands include the pituitary gland, the
  pineal gland, the hypothalamus, the thyroid
  gland, the parathyroid glands, the thymus, the
  adrenal glands, the ovaries (in females) or
  testes (in males), and the pancreas.
• Hormones alter the metabolism of target organs by
  increasing or decreasing their activity. These
  changes in activity are strictly balanced to
  maintain homeostasis (a stable internal
  environment).

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How do these systems interact in the stress
response?

• HPA Hypothalamic-pituitary-adrenal axis
• SAM Sympathetic-adrenomedullary pathway

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COGNITIVE APPRAISAL OF THE STRESSOR
 
HYPOTHALAMUS does two things -
SAM
Fight or Flight response is stimulated via NEURAL
PATHWAYS OF Autonomic Nervous system (sympathetic
branch)
HPA
CRF stimulates the PITUITARY GLAND
As part of this response the ADRENAL
MEDULLA Releases ADRENALINE
ACTH is released from Pituitary
ADRENAL CORTEX Releases CORTICOSTEROIDS
AAdrenaline facilitates the action of the ANS
the Fight or Flight response. E.g.   Increased
HR BR, Increased blood coagulation, Reduces
activity in digestive system, Dilates pupils,
Quick release of glucose from liver into blood
stream to provide energy.
Causes the steady release of glucose and fats
into the blood stream for energy. Prevents an
excessive immune response suppresses immune
system
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The Relationship between Stress and Illness

• Hans Selyes General Adaptation Syndrome
• GAS a non-specific physiological response that
  occurs to a variety of stressful stimuli.
• GAS has three stages (phases).
• Stage 1 Alarm Reaction Stage.
• The hypothalamic-pituitary-adrenal system
  is in operation
  (flight or fight response).

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• Stage 2 Resistance Stage.
• If the stress persists the body
  seeks to maintain arousal at a
  constant if slightly lower level. The body is
  adapting to the demands of the environment.

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• Stage 3 Exhaustion Stage.
• Eventually continued arousal exhausts bodily
  resources producing negative physiological and
  psychological effects. The initial fight or
  flight response reappears.

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• Physiological effects of the 3rd stage
• Reduced resistance to infection (suppression of
  immune system) e.g. headaches, asthma, colds,
  cancer, stomach ulcers.
• Heart and circulatory disorders.

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• Psychological effects of the 3rd stage
• Anger Frustration, Depression
  Helplessness, Anxiety

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How did Selye discover the GAS?

• 1936
• Method-
• Experiment with rats
• Exposed rats to different types of unpleasant
  stimuli (excessive exercise, injury, cold,
  dangerous drugs)
• Measured their physiological responses to the
  stimuli (heart rate, muscle tone, temperature,
  working of internal organs etc. . )

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• Findings-
• All rats responded in a similar way regardless of
  the type of stimuli
• Therefore the response is non specific
• All rats showed the same pattern of response over
  time with prolonged exposure to the stressor.
• Stage 1 (6 48 hours of exposure)
• Stage 2 (2 days 1 to 3 months)
• Stage 3 (1 to 3 months and above)

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Evaluation of Selyes research

• Positive
• Selye found a similar pattern of response in
  hospital patients who were suffering from various
  injuries(1950)
• His research first alerted medical science to the
  relationship between stress and illness.
• He emphasised the roles of the SAM and HPA

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• Negative
• Ethics suffering of rats
• Use of non human animals to support a theory on
  humans response to stress- may be why
  physiological factors are over emphasised and
  psychological factors under emphasised.

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Types of Stress (Segerstrom and Miller)

• Selyes research looked at the effect of CHRONIC
  STRESSORS long lasting stressors
• Human examples of chronic stressors
• Long term Disability
• Long term Illness
• Caring for someone who needs constant care
• Long term unemployment
• High pressured employment

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• Other types of stressors include-
• ACUTE TIME LIMITED STRESSORS lasts between 5
  100 minutes e.g. giving a presentation, singing a
  solo

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• BRIEF NATURALISTIC STRESSORS
• everyday stressors of a limited duration e.g.
  exams, driving lessons
• .

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• Stress is a normal and expected part of life.
• It can be necessary for motivating us to achieve
  our goals.
• It is when the stress become CHRONIC that it
  causes health problems.

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The evolution of the stress response.
STRESS AND ILLNESS

• The sympathetic branch of the ANS responds as a
  unit causing the fight or flight response.
• This was probably important in our evolutionary
  past when our ancestors were faced with life
  threatening dangers.
• They often had a need to use the physical energy
  that was released as a result of the fight or
  flight response.

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E.g. when faced with a hungry looking bear,
running for shelter may well be a very
appropriate response.
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However the release of energy increase in blood
flow is mostly not appropriate in response to
many modern day stressors.
Running from the exam room would not be an
appropriate response !!! What may have been an
adaptive response for our ancestors may have
become a maladaptive response for us today.
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The damage caused to the Cardiovascular System

• 1) Direct mechanical damage-
• To the heart and blood vessels as a result of
  extra workload and raised blood pressure.

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•    2) The effect of the release of energy into
  the blood stream -
• Fatty acids and glucose which are not used up in
  physical activity thicken the blood and are also
  laid down in the blood vessels.
• This leads to blocking of
• blood vessels
• (ATHEROSCLEROSIS),
• which increases blood
• pressure and strain on the heart.

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• The damage caused to the Immune System
• In order to understand how stress damages the
  immune system you need to have an understanding
  of how the immune system works.

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• THE IMMUNE SYSTEM (the following subdivisions
  work together resulting in a coordinated response
  to pathogens)

• SPECIFIC IMMUNITY
• Specific type of white blood cells Lymphocytes
• Produce antibodies in response to specific
  pathogens they recognise.
• Specific immunity is divided into-
• 1) Cellular Immunity T cells grown in
  Thymus gland they secrete antibodies that
  attack intracellular pathogens (viruses)
• 2) Humoral immunity B cells grown in bone
  marrow they secrete antibodies that attack and
  destroy extracellular pathogens (bacteria
  parasites)
• Works more slowly - develops over several days as
  pathogens are recognised and cellular humoral
  immune systems are mobilised.

NATURAL IMMUNITY White blood cells are known as
Leucocytes (Natural Killer Cells) Attack invading
pathogens (viruses bacteria) Works fast
(minutes hours), first line of defence.
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• Immune System Problems
• Immunodeficiency Diseases (e.g. AIDS acquired
  immune deficiency syndrome)
• This is where the immune system is destroyed.
• Autoimmune Disease (e.g. some cancers, rheumatoid
  arthritis) a failure to recognise ones own body
  tissues and so attacks them.

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• So, how does stress affect the immune system?
• Two possibilities-
• Generally overall suppression of immune
  function.
• More specifically may affect natural immunity
  more than specific immunity or may alter balance
  between cellular and humoral immunity.
• What does the research suggest?

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• We will look at two very different major stress
  immune system studies and then at a meta-review
  of stress immune system studies.
• Meta review -
• All papers (studies) studying similar problems
  are statistically analysed together to provide a
  more reliable overview of findings.

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• Study 1
• Cohen et al (1993) looked at the effect of
  general life stress on vulnerability to the
  common
• cold virus.
• Method
• 394 Participants each gave 3 measures of stress
  that were combined to give a stress index
• A questionnaire - No. of stressful life events in
  previous year
• Self- rating degree of stress
• Self- rating - negative emotions
• They were then exposed to common cold virus
  (nasal drops).

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• Findings
• 82 became infected
• Those infected were followed up after 7 days to
  see if they had developed a cold.
• The chance of developing a cold was significantly
  correlated with the stress index scores.
• Conclusion
• Life stress and negative emotions reduce the
  effectiveness of the immune system.

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• Evaluation / discussion points
• Methodological
• Immune system not directly measured
• Supporting research from Evans Edington (1991)
• Measured illness outcome, so does show
  relationship between stress and illness
• Correlation research (no IV manipulated) rather
  than an experiment, so cause and effect cant be
  confirmed.
• Not clear which of the 3elements of the stress
  index is important.

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• Ethical -
• Would have been checked by a professional
  committee and subject to strict ethical
  considerations before being carried out.
• Participants would have to be in good health
  before taking part in the study.
• Full informed consent debriefing essential.
• Careful monitoring throughout the study for signs
  of a sever reaction to the virus.
• Balance between scientific value of research and
  distress to participants would have to be
  considered.

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• Study 2
• Kiecolt-Glaser et al (1984) looked at the effect
  of a naturalistic life stressor on immune
  functioning.
• Method
• Participants 75 first year medical
• students taking their final exams
• Natural experiment( an IV but not manipulated by
  researchers)
• Repeated measures design (1 month before exams-no
  stress sample during exams-stress sample)
• Blood samples taken
  measured natural killer cell activity
  (leucocytes)
• Questionnaire about life events, loneliness
  psychiatric symptoms.

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• Findings
• Blood samples decline in immune responses
  (killer cell activity) in stress sample
  compared to no stress sample.
• Immune system especially poor in students who
  were lonely
• Conclusion
• Examination stress (brief naturalistic stressor)
  reduces immune function making people more
  vulnerable to illness and infections. This was
  more apparent in lonely people.

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• Evaluation / discussion points
• Methodological
• Was a direct measure of immune system activity.
• Didnt measure actual illness/health outcomes.
• Other research by Keicolt-Glaser et al with long
  term carers of Alzheimer sufferers, looking at
  immune system functioning and wound healing time,
  supported the link between stress and
  health/illness outcomes.
• Biased sample (medical students) can the
  results be generalised?
• Other research by Keicolt-Glaser et al with other
  groups of participants also support these
  findings.
• Looked at natural killer cell activity which is
  only one component of the immune system, which is
  a highly complex and sophisticated system.

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• Evaluation / discussion points
• Methodological continued. .
• Natural experiment (IV not manipulated) so, cant
  confirm cause effect relationship.
• Natural experiment (IV not manipulated) so,
  finding have high ecological validity.
• Ethical
• Naturally occurring stressor so very little extra
  distress caused to participants.
• Informed consent and debrief necessary.
• In their studies looking at wound healing rates
  they would have needed full approval by the
  ethical committee and medical supervision.

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• Meta-Review of Stress Research
• Any one stress / illness study can only look at
  some of the factors that might influence the
  effect of stress on the immune system illness,
  therefore all studies will be slightly different
  from each other. However studies can be grouped
  together into groups of studies that look at the
  same general area, e.g. effect of long term
  stressors on the immune system.
• A mete-review of these studies by Segerstrom and
  Miller (2004) has shown some consistent findings
  across many studies.

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• Segerstrom and Miller (2004)
• reviewed 293 studies and found -

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• Segerstrom and Miller concluded-
• Acute time-limited stressors produce an increase
  in natural immunity, this can be seen as an
  adaptive response to stressors that trigger the
  fight or flight response.
• Chronic long lasting stressors result in global
  immunosuppression (general decrease in all immune
  functioning), leaving the person vulnerable to
  infections and illness.
• The effect on the immune system of stress is
  rarely simple and straight forward.
• No evidence to suggest gender differences in
  immune reactivity to stress, however
  Kiecolt-Glaser reported that women show greater
  reductions in immune system functioning in
  response to marital conflict.

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• Finally, how might chronic stress lead to global
  immunosuppression?
• The HPA system results in an increase of
  corticosteroids (e.g. cortisol) high levels of
  corticosteroids in the blood stream have been
  shown damage the thymus gland and therefore
  reduce the production of T lymphocytes.
• Long term activation of the HPA results in
  increased levels of corticosteroids and damage to
  the thymus gland.

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• This finding has been put to good use, steroid
  treatment is given to patients with autoimmune
  diseases such as some cancers and rheumatoid
  arthritis to suppress their immune system and
  help prevent destruction of their body tissue,
  but a side effect is vulnerability to infections.

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• Stress in Everyday Life
• Stress is seen as a part of everyday life short
  lasting, minor, longer lasting and more serious.
  Major events in life that involve some sort of
  readjustment known as life events.
• Many illnesses are often attributed to stress.
• However,
• Although most people are under some form of
  stress most of the time, not everyone develops a
  stress-related illness.
• Some stress is necessary for motivating us and
  can lead to satisfaction.
• Stress only exists when the perceived demands
  outstrip our perceived resources and ability to
  cope.

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Measuring Stress in everyday life

• SELF-REPORTS
• Usually involves the use of questionnaires (or
  interviews) filled in by the participants
  themselves.

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• Self-report questionnaires on frequency of life
  stress e.g. how many major life events or minor
  daily stressors
• Self-report questionnaires on perceived
  (subjective) stress e.g. how stressed do you
  feel?
• Semi-structured interviews in which the
  participant talks through their life stressors
  and a trained interviewer assesses the impact of
  these stressors.

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Advantages and disadvantages of self-reports-

• Disadvantages
• Interviews take longer the interviewer has to
  be highly trained.
• Self-reports are open to bias, in that some
  individuals may exaggerate and distort their
  symptoms of stress, while others may minimise how
  stressed they are (i.e. they lack objectivity).

• Advantages
• Questionnaires are usually relatively quick
  easy to use.
• A reasonable way of finding out how stressed a
  person is, is to ask them.

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• Self-report questionnaires on frequency of life
  stress-
• LIFE EVENTS
• e.g. The Social Readjustment Rating Scale (SRRS)
  was developed by Holmes Rahe (1967).
• Medical doctors working with
• heart disease patients.
• Noted that large number of
• life events in previous year were
• a common factor between patients.

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• Drew up a list of these common life events and
  asked 394 people to rate each one for how much
  readjustment they thought the event required
• Marriage was given an arbitrary
• score of 500 and they were asked
• to compare the other events and
• rate them higher or lower than marriage.
• The final score given to each event was divided
  by 100 to make it more manageable e.g. marriage
  50, death of spouse 100, pregnancy 40
• These scores were known as LIFE CHANGE UNITS

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• The events were put into an inventory
  (questionnaire) which became known as the Social
  readjustment Rating Scale
• To measure the level of stress a person is
  experiencing they simply tick all of the events
  they have experienced during the previous year
  and add up LCUs for those events. They then have
  their LIFE CHANGE SCORE.
• According to Holmes Rahe an LCU score of 150
  life crisis increases chance of stress-related
  illness by 30
• 300 major life crisis increases chance of
  stress-related illness by 50

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• Problems with the SRRS-
• Culturally specific developed in the USA
• Time specific developed in 1967
• No objective measure of the amount of
  readjustment involved in each event based on
  394 peoples opinions
• Relies on memory being accurate
• Relies on individual interpretation of some of
  the events (e.g. trouble with the in-laws) as to
  whether or not someone thinks it has happened to
  them.

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• Research studies that use the SRRS
• Retrospective studies - show a significant
  correlation between LCU scores and stress-related
  disease.
• Prospective studies an example is
• Rahe et al (1970)

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• Rahe et al (1970)
• Method-
• Correlation study
• 2500 male navy personnel
• Filled in SRRS questionnaire for the previous 6
  months before a tour of duty
• Followed for the 7 month tour of duty
• Stress related illnesses recorded and rated for
  severity to give an illness score
• Findings
• A low but significant positive correlation of
  0.118 between LCU and Illness score
• Conclusion
• There is a relationship between life events and
  the development of stress related illnesses.

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• Evaluation of the study
• Gender culturally specific findings (sample all
  male US navy) generalisation problem to other
  groups.
• However other studies using different
  participants have found similar low but
  significant correlations.
• Not clear which illnesses are specifically
  related to life event stress as all illnesses
  were recorded.
• The hypothesis for the study was too general

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• Correlation study cant confirm a causeeffect
  relationship, all we can say is that there is a
  relationship but it may have been caused by other
  factors (e.g. Ps with lots of life events may not
  eat healthily)
• However correlation is a useful research method
  when for ethical or practical reasons the
  researcher cant manipulate an IV
• May have been distressing for participant to have
  to recall traumatic events.
• However they would have given full informed
  consent and agreed to the procedure beforehand

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• If there is a strong link between LCU and
  illness, why are the correlations found low?
  more problems with the SRRS itself
• LCU scores do not take into account the emotional
  impact of the event (positive or negative) all
  Life events were seen as stressful because they
  needed a degree of readjustment.
• LCU scores do not take individual appraisal of
  life events into account.
• Retrospective self-reporting of events relies
  heavily on memory which may not always be
  reliable.
• Correlation does not imply causation divorce
  depression (which caused which or was there
  something else that caused booth to happen at the
  same time?)

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• Sarason et al (1978) developed the
• Life Event Scale (LES) this tried to address
  some of the problems of the SRRS, particularly
  individual differences
• LES a list of 57 life events
• - Ps rate each event for severity of impact and
  whether the impact was positive or negative.
• - Specialised sections can be added for
  different groups e.g teenagers
• - Three scores are produced from the LES
  (negative change, positive change, total change)
  and it is usually negative change that has been
  more highly correlated with illness outcomes.

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• DAILY HASSLES and UPLIFTS
• Lazarus suggested that daily hassles
• (stresses and strains) were a more
• important source of everyday stress than life
  events.
• Kanner et al (1981) Lazarus research group
  developed
• the HASSLES scale.
• HASSLES scale
• 117 items relating to everyday life modified as
  needed for different groups
• Think what items would you put on a hassle
  scale?
• They also developed an UPLIFTS scale (uplift
  everyday positive events) 135 positive items.
• Think what items would you put on an uplifts
  scale?

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• The Hassles and uplifts scales have been used in
  many correlation studies looking at stress
  related problems, generally they suggest that
  hassles have a stronger correlation with ill
  health than life events
• E.g. Anita DeLongis et al (1982) used the SRRS,
  the Hassles and the Uplifts scales with her
  participants and found that the Hassles score was
  the only one of the three to be correlated with
  illness.
• An important source of Daily Hassles for many
  people is their workplace.

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Workplace Stress

• Work-related stress accounts for a 1/3 of all new
  incidences of ill health.
• Each case of stress-related ill health leads to
  an average of 30.9 working days lost.
• A total of 12.8 million days were lost to stress,
  depression and anxiety in 2004/5

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• Possible causes of Workplace Stress
• The Physical Environment
• Workload too much to do or not enough to do
• Home-work interface (trying to balance the
  demands of home and work). The ideal is a good
  work-life balance.
• Control the degree of control a person has over
  their workload (decisional latitude) affects
  levels of stress.
• Other factors e.g. career progression, ambiguity
  over roles, relationships.

93

• These sources can interact to increase or
  decrease levels of stress.
• E.g. Karasek (1979) suggests the following-

• Research supports this suggestion but also shows
  that this relationship can be moderated by other
  factors like social support.
• Can you think of examples of each of these types
  of jobs?

94

• Example of research into control in the workplace
  and stress related illness (CHD)-
• Marmot et al (1997)
• Based on the data gathered in the Whitehall
  studies that have been running since 1960s
  looking at the relationship (correlation) between
  workplace stress and health. They also looked at
  participants other risk factors smoking, blood
  pressure, cholesterol, obesity, socioeconomic
  status.
• Participants London based
• civil servants

95

• What did Marmot do?
• Analysed data from over 7000 participants. The Ps
  were followed up over 5 years. All fit and
  healthy at the start.
• Found
• lowest grade paid workers had 1.5 times the rate
  of heart disease than highest grade paid workers.
  
• Risk factors such as smoking could account for
  some of this increase in the lower grades but the
  most significant factor was the degree of
  decisional latitude (control) they felt they
  had.

96

• Evaluation commentary on the study-
• Self report questionnaires used
• Some factor not measured in the study may have
  been a common factor in all lower paid workers
  that may have contributed to the development of
  CHD (this is a problem with correlational
  analysis).
• Sample bias London based civil servants
  generalisation problems. However, when using
  employees in a sawmill, Johannson et al (1978)
  showed that employees who were highly skilled but
  had no control over their work rate had increased
  levels of hormones and stress related illness.

97

• Van der Doef Maes (1998) have reviewed other
  research done in the area of low control /high
  demand and CHD . They concluded that the evidence
  suggests that there is a relationship between CHD
  and high demand/low control in the workplace as
  suggested by Marmot et al.
• Ethical issues in Marmots study? very few.
  The usual guidelines would have been followed.
  Anyone showing signs of CHD would have been given
  the necessary support.

98

• Dealing with workplace stress-
• There are many questionnaire packages
  specifically designed to measure workplace
  stress.
• E.g.The occupational stress indicator
  questionnaire (Cooper et al , 1998). This
  measures perceived sources of stress, social
  support, coping strategies and behaviour type of
  the individual.
• The outcome of the analysis of the questionnaire
  is a profile of the individual and their
  workplace in terns of sources and degree of
  stress.

99

• The results of the questionnaires can then be
  used as a basis for devising strategies for
  reducing the negative effects of stress-
• On the individual (health outcomes)
• Individually tailored stress management
  programmes (see later)
• On the organisation (absenteeism, lowered
  productivity)
• Changes to the structure and/or way the
  organisation is managed e.g. workload
  distribution and organisation changes, team
  building exercises.

100
Personality Differences in Vulnerability To
Stress Related problems In the 1950s and 60s
Friedman Rosenman studied patients who had CHD
(Coronary heart disease). They discovered that
they had certain personality characteristics and
attitudes in common. They suggested that these
characteristics and attitudes were associated
with vulnerability to CHD. They called these
characteristics and attitudes Type A Behaviour
Pattern
101

• Type A behaviour (TAB) characteristics
• 1)Time Pressured-
• Doing several things at once.
• Working against the clock
• Unhappy doing nothing
• 2)Competitive-
• Always plays to win
• Achievements measured as material productivity
• 3)Hostility-
• Anger
• Irritation and impatience with others
• Self-critical - Anger often directed inwards

102

• They also described Type B behaviour pattern.
• TBB is basically the opposite to TAB.
• i.e.
• Relaxed
• Not Competitive
• Not Hostile
• All together a more chilled person than a TAB
  person.

103

• Research into TAB and CHD
• Rosenman et al (1976) in (West coast)
• 3,454 middle-aged interviewed
• Behaviour answers to questions analysed and
  their Behaviour Type was categorised. They were
  followed up 8.5 years later.

104

• Findings
• During the 8.5 years there were 257
• 69 of these heart attacks were in the TAB group.
  Even after taking into account other risk
  factors, such as smoking, this is a
  significant effect.

105

• Conclusion
• A high TAB individual is vulnerable to Heart
  Disease
• Evaluation-
• Generalisation issues (Sample - Culture, gender
  specific, TAB description western concepts)
• Not all lifestyle variables could be controlled
  for in the study, other important variables
  contributing to CHD may have been missed.
• High Ecological Validity
• No serious ethical issues

106

• However, not all studies found such a clear
  association between TAB and CHD, suggesting that
  the apparent link between TAB and CHD is not
  reliable.
• Example of alternative findings-
• Shekelle et al (1985) 12,000 men, TAB
  (Self-report questionnaire interview
  assessment) 7 year follow up no difference in
  incidence of CHD between TAB and TBB

107

• Reviews of studies into TAB and CHD suggest
• ½ of the studies show a significant link between
  TAB and CHD (Matthews Haines, 1986)
• The Hostility characteristic of TAB has been
  found to be the characteristic that is most
  important in vulnerability to CHD
• Booth-Kewley Friedman (1987) Dembroski et al
  (1989) Miller at al (1996)

108

• However,
• Not all TAB people develop CHD
• In fact some TAB people cope very well with
  stress
• So is there some other aspect of TAB pattern that
  is actually beneficial when faced with stress?

109

• Hardiness
• Kobasa (1979 1982) described hardiness as
  being a protective variable against the effects
  of stress.
• She said that a hardy individual has the
  following characteristics (three Cs) -
• Commitment
• Control
• Challenge

110

• COMMITMENT a tendency to involve ones self in
  whatever one is doing, and to approach life with
  a sense of curiosity. They have direction in
  life. They find meaning in their work and
  relationships.

111

• CONTROL to feel in control of their situation
  and able to influence events in their lives.

112

• CHALLENGE a tendency to believe that change
  rather than stability is normal in life, and to
  anticipate change as an incentive to personal
  growth and development rather than a threat to
  security. They view stressors as a challenge
  rather than a problem.

113
Can you identify a hardy personality?

• You have 5 minutes to work in pairs-
• Look at the description of a hardy personality
  (thee Cs pg 167 in your textbooks).
• Without using the words Challenge, Commitment and
  Control, write a description of a fictional
  person such that
• he/she could be defined as having a hardy
  personality. Give him/her a name.
• he/she could be defined as not having a hardy
  personality. Give him/her a name.
• Read your descriptions out to the rest of the
  class see if they can identify them as either
  hardy or not.

114

• Kobasa et al developed a questionnaire to measure
  hardiness (you can have a go at one on the
  internet).
• She carried out two different studies, in both
  studies the Participants were executives and
  managers of large companies.
• Questionnaires were used to assess illnesses and
  stress experienced during the previous three
  years and hardiness of personality.
• A longitudinal study over 2 years. Assessed
  hardiness of personality and illness.

115

• Findings-
• She found a correlational relationship, in both
  studies those participants who scored high on
  hardiness had less stress related illness.
• Conclusion-
• High levels of control, commitment and challenge
  help to protect against the effects of stress.

Hardiness score
Illness rating
116

• Evaluation-
• -ve Participants were all white middle class
  males not representative of the general
  population, therefore generalisation is
  difficult.
• BUT there is supporting research from Beasley et
  al who studied students (high hardiness/low
  psychological distress).
• -ve Correlational data it has been assumed
  that hardiness is a causal factor in good
  health but correlational data can not demonstrate
  cause and effect. It may be that people who are
  ill find it difficult to be hardy (i.e. the
  other way round).

117

• What is the connection between TAB and
  Hardiness?
• Hardiness - Control, Commitment Challenge
• TAB - competitiveness achievement orientated,
  - this could be seen as having commitment and
  seeing life as a series of challenges to be
  overcome.

118

• What can we conclude about TAB and Hardiness in
  relation to vulnerability to stress related
  illness?
• TAB less vulnerable to stress than first thought
• Studies linking TAB CHD are inconsistent this
  may be because some TAB characteristics decrease
  vulnerability to stress (- the hardiness
  characteristics -Commitment, Challenge) whereas
  others increase vulnerability to stress
  (Hostility).

119

• Other Personality Types and Vulnerability to
  Stress related illness.
• Eysenck (1988) proposed
• A personality type vulnerable to cancer
  (difficulties in expressing emotion and in social
  relationships)
• A personality type vulnerable to CHD (similar to
  TAB high levels of anger hostility)
• However, research evidence is not consistent and
  does not support these claims

120

• Denollet (2000) Type D personality
  (Ddistressed)
• Characteristics of Type D personality-
• high levels of negative emotions
• social inhibition
• (avoid social interactions)
• Research suggests that high levels of negative
  emotions social inhibition are associated with
  increased risk of CHD.

121

• Coping With Stress
• Lazarus (1999) The more confident we are of our
  capacity to overcome obstacles and dangers, the
  more likely we are to be challenged rather than
  threatened and vice versa, a sense of inadequacy
  promotes threat
• Once an event is appraised as threatening, the
  physiological stress response is aroused.
• The high level of physiological arousal motivates
  the individual to try to reduce the stress and
  thus to return the physiological response back to
  normal.
• This process is called coping. It refers to the
  ways way individual people deal with everyday
  stressors - there are many different coping
  strategies and people differ in which strategies
  they use.

122

• The COPE scale (Carver et al , 1989)
• It is a questionnaire used to assess a persons
  range of coping strategies.
• It looks at 15 different strategies such as
  denial, humour, seeking emotional support (see
  page 169 in the text book).
• It consists of 60 statements and for each
  statement the person has to rate each one
  according to how much it applies to them.
• It is a good assessment tool but is very time
  consuming to use. There is an abbreviated version
  available see http//www.psy.miami.edu/faculty/c
  carver/sclBrCOPE.html if you would like to have
  ago

123

• It has been suggested that people may favour
  using a particular style of coping strategies.
• Styles include-
• Approach and Avoidance coping strategies (Roth
  Cohen, 1986)
• Problem-focussed and Emotion-focussed coping
  strategies (Lazarus Folkman,1984)

124

• Approach and Avoidance coping strategies (Roth
  Cohen, 1986)
• Approach coping-
• Tackling the stressor directly
• e.g. Go to see the new neighbour
• about the noise level of their
• sons drum kit after 8pm
• Useful when dealing with long term stressors
• e.g. when the new neighbours are here to stay

125

• Avoidance coping-
• Denial of the significance of the stressor and
  minimising the seriousness of it
• e.g. Telling yourself that the drumming is not
  really disturbing you that much
• May be useful for dealing with short term
  stressors
• e.g. When the son is only home from
• university for two weeks
• Approach Avoidance strategies are opposites.
• People tend to use one style more than the other
  as their adopted style of coping.

126

• Problem-focussed and Emotion-focussed coping
  strategies (Lazarus Folkman,1984)
• Problemfocused coping
• A form of coping with stress that attempts to
  understand the cause of the stress and tries to
  find possible practical courses of action to
  reduce the stressful situation.
• Problem focused coping can involve
• taking direct action in order to reduce the
  demands of the stressor,
• increasing your resources for
  coping with the stressor.

127

• Examples of problem focussed coping-
• taking direct action in order to reduce the
  demands of the stressor-
• Planning a revision schedule to deal with exam
  stress
• Arranging for someone to come and sit with your
  wife who has a long term illness to give you a
  break
• increasing your resources for coping with the
  stressor-
• Going to see your friend who is good at
  psychology to ask them for tips on how to revise
• Can you think of a stressor you faced recently
  suggest what problem focussed strategy you could
  have used to deal with it?

128

• Emotion-focused coping
• A form of coping with stress that attempts to
  reduce the negative emotions which often
  accompany stress. This form of coping deals with
  how you feel, rather than with the stressor
  itself.

129

• Emotion focussed coping can involve Behaviour
  strategies and Cognitive strategies
• Behaviour strategies (venting your anger, doing
  sport, seeking out support from friends, drinking
  alcohol etc.)
• Examples
• Go round to your friends house to watch a film
  together
• Go out for a run in the park or play a game of
  footie.
• Get drunk or at least have a couple of drinks

130

• Cognitive strategies involve changing ones
  thinking about the problem (e.g. decide that it
  can wait until later to be sorted out, or see it
  as a challenge).
• Examples
• Deliberately think about the easier assignment
  you have to do rather than the difficult one.
• Convince yourself that the mole on your skin
  isnt really growing

131

• Discussion points-
• Which strategy do you think you use most often?
• Which strategy do you think is the most effective
  and why?

132

• What does the research into Problem Emotion
  focussed coping styles suggest about which is the
  best strategy to use?
• There is no straightforward answer, rather
  several factors may affect the best coping to
  use-
• The stressor itself Vitaliano et al (1990)
• Work related stressors problem focussed coping
• Personal relationship stressors emotion
  focussed coping

133

• A controllable or non-controllable stressor
• Lazarus and Folkman (1987)
• Controllable stressor problem focussed
  Example- examinations, work related stress
• Non-controllable emotion focussed
• Example- life threatening illnesses,
• e.g Carver et al (1993) denial led to better
  adjustment in women with breast cancer.
• Social support helps when coping with cancer,
  DeBoer et al (1999)

134

• Gender (inconsistent findings)
• Females use more emotion focussed strategies and
  males use more problem focussed strategies (Stone
  and Neal, 1984)
• No difference between genders in their coping
  styles (Hamilton and Fagot, 1988)

135

• What does the research into Problem Emotion
  focussed coping styles suggest about whether
  people are consistent in which strategy they use?
• Tennen at al (2000)
• Longitudinal study on patients with chronic pain.
• Each day they completed a coping style
• questionnaire and assessed their
• pain level. This is a self-reporting
• method.
• Can you remember the problems of
• using self-reporting?

136

• The findings suggested that
• The two strategies (emotion and problem focussed)
  are used by individuals simultaneously, they are
  not independent rather they interact. (emotion
  focussed used 4.4 times more on days when problem
  focussed also used)
• Individuals are responsive to the success and
  failure of each coping style, they adjust their
  style accordingly. (e.g. an increase in pain
  level associated with problem focussed coping
  would be followed the next day by an increase in
  emotion focussed coping)

137

• So, are people are consistent in which strategy
  they use?
• People can use both strategies, they may have a
  preferred strategy which they will try first but
  they are able to alter the strategy they use on
  the basis of success or failure.

138
Stress Management

• formal approach to coping with stress (as opposed
  to Coping mechanisms (e.g. problem emotion
  coping natural informal ways of managing
  stress).
• Often given or carried out in a in professional
  or clinical setting.
• The aim is to reduce the harmful levels of stress

139

• WE will look at-
• Psychological Methods of Stress Management
• 1) MichenbaumsStress Inoculation Training
• 2) Hardiness Training
• Physiological Methods of Stress Management
• 1) Drugs
• a) Benzodiazepines
• b) Beta-blockers
• Alternative Methods of Stress Management
• 1) Biofeedback
• 2) Relaxation meditation
• 3) Physical Exercise
• 4) Social Support

140

• Psychological Methods of Stress Management
• Stress the result of mismatch between our
  perception of the demands of the situation and
  our resources to cope with the demands.
• Psychological Stress management approaches target
  a persons perception and evaluation of the
  stressful situation. These approaches come from a
  category of therapies known as
• Cognitive Behavioural therapies - CBT (aims to
  change behaviour through altering irrational
  thoughts )

141

• 1) Michenbaums Stress Inoculation Training
• The training involves three stages
• Conceptualisation
• work with therapist to identify and analyse
  sources of stress in their lives and challenge
  any exaggerated appraisals of the stressful
  situations
• Skills training Rehearsal
• - Specific skills relevant to stressful
  situations are taught by the therapist and
  practiced by the client in a controlled
  environment(e.g. social skills like making eye
  contact, relaxation techniques)
• Real World Application
• - Client tries out these new skills in the real
  world situations and returns to the therapist for
  regular checks on the success or failure of
  these.

142

• Evaluation of SIT-
• Good start to managing stress look at sources
  of stress how you dealt with it in the past
• Example of problem focussed coping trying to
  get realistic appraisal improve coping
  resources
• Example of emotion focussed coping relaxation
  techniques reduces the emotionally physiological
  arousal
• Takes time, effort, commitment money, so not
  available or suitable for everyone.
• Has been shown to be effective e. g.
  Examination stress in students (Berger, 2000)

143

• 2) Kobassas Hardiness Training
• The training involves three stages
• Focussing
• - Focus on the physiological symptoms of stress
  identify stressful situations, learn new skills
  for dealing with stressful situations
• Reconstructing stressful situations
• - A cognitive strategy aimed to develop realistic
  appraisal of life stress - look at recent
  stressful situations and think about how they
  might have turned out better or worse
• Self-Improvement
• - Client encouraged to take on real life
  manageable sources of stress and deal with them
  success will lead to an improvement in
  self-efficacy (sense of control and effectiveness)

144

• Evaluation of Hardiness Training-
• Aims to reduce gap between demands and resources
• Provides client with increased sense of
  self-efficacy make them ready to deal with
  future stressful situations
• Takes time, effort, commitment money, so not
  available or suitable for everyone.
• Has been shown to be effective e.g. improving
  health performance in both working adults and
  students (Maddi, 1987 2000)

145

• Physiological Methods of Stress Management
• These methods aim to reduce the feelings of
  anxiety brought about by the physiological
  response to stress e.g. increased heart rate
  and blood pressure.
• Drugs
• Benzodiazepines (BZs)
• Beta-blockers

146

• Benzodiazepines (BZs)
• (Librium, Valium, Mogadon)
• Work in the brain
• Increases the production of the neurotransmitter
  GABA
• GABA is an inhibitory neurotransmitter so its
  effect is to reduce the effect of other
  neurotransmitters such as noradrenalin and
  serotonin these are important in reducing the
  effects of stress and anxiety.

147

• Evaluation of benzodiazepines-
• Successful anti-anxiety drugs they work!
• Relatively safe in overdose
• Side effects e.g. tiredness, impairment of
  motor coordination memory
• Dependence withdrawal syndrome (so should only
  be used for short periods)
• Do not target the source of the stress
• Do not help to develop better coping strategies
• Best used in conjunction with psychological
  method of stress management
• Ethical issues - because of possible dependency
  side effects full informed consent needed but
  someone with severe stress related anxiety may
  not be fully competent to give consent.

148

• Beta-blockers
• (Propranolol, Alprenolol)
• Work on the body rather than the brain.
• Reduce the activity in the sympathetic nervous
  system so directly reducing activity in the
  cardiovascular system - heart rate and blood
  pressure.
• Hence reduce the effects of stress.

149

• Evaluation of beta-blockers-
• Work fast at reducing HR BP
• Fewer side effects because not operating in the
  brain
• Do not target the source of the stress
• Do not help to develop better coping strategies
• Best used in conjunction with psychological
  method of stress management and are inappropriate
  for long-term stress management

150

• Other Methods of Stress Management
• Some stress management method can not easily be
  classified as psychological or physiological
  because they may involve elements of both.

151

• Biofeedback
• What is it?
• Based on the principles of operant conditioning
  (Reinforcement)
• Aim is to find and practice a strategy (usually
  relaxation techniques breathing exercises)
  which can be used to reduce the physiological
  responses to stress.

152

• Conscious control of unconscious physiological
  responses by receiving feedback from the bodys
  physiological stress response as it occurs. Done
  by-
• Monitoring devices attached to the body heart
  rate, BP, BR, Muscle tone etc are measured.
• Person is inform