Stress

Question 1

What are the two main ways the body responds to stress?

Answer 1

The sympathomedullary pathway

The hypothalamic pituitary-adrenal system

Question 2

Outline the sympathomedullary pathway/ diagram

Answer 2

Hypothalamus activates sympathetic branch of ANS(preparing body for f/f)

Then it stimulates the medulla of the adrenal gland to release stress hormones -adren+noradren- into the blood stream.

:heart rate and blood pressure increase, blood is directed to muscles, blood sugar level increases, bone marrow produces more white blood corpuscles, increased perspiration, slowing down digestion, muscles tense, saliva and mucus dry up increasing size of air passages to the lungs, the body’s natural pain killers endorphins are secreted and surface blood vessels construct to reduce blood loss in case of injury.

If stressor is short term and goes away, the parasympathetic branch of the ANS is activated. - reducing arousal and reversing the changes brought about by the sympathetic system and stress hormones and the body returns to normal. (Necessary to conserve energy)

But if stressor persists and arousal remains high for while, we eventually become ill. Bc of prolonged high levels of cortisol may weaken the immune system and prolonged high levels of adrenaline increase levels of blood cholesterol - linked to heart disease.

Question 3

How would the body respond to an acute stressor

Answer 3

by activating the sympathomedullary pathway

Question 4

How would the body respond to a chronic stressor

Answer 4

By activating the hypothalamic pituitary-adrenal system

Question 5

What is stress?

Answer 5

A pattern of physiological and psychological responses to a stressor

When a person has to cope with something in the environment and feels unable to do so

Question 6

Outline the hypothalamic pituitary-adrenal system

Answer 6

Hypothalamus releases corticotrophin-releasing factor, which stimulates the anterior lobe of the pituitary gland to release the hormone Adreno-cortico-trophic hormone into the bloodstream.

Reaches cortex of adrenal gland causing it to release cortisol into the bloodstream, which stimulates the liver to release glucose into the bloodstream, to provide energy.

Question 7

Outline the role of cortisol

Answer 7

CORTISOL IS A GLUCOCORTICOID.
It affects glucose metabolism by mobilising and restoring energy supplies to power the stress response-meaning that individuals have a steady supply of bloody sugar, thus a constant supply of energy, allowing the body to deal with stressors.

Another positive effect is that it lowers our sensitivity to pain. - negative effect of suppressing the immune system and impairing cognitive function.

Cortisol is in a negative feedback loop. Levels of cortisol are measured by the pituitary and hypothalamus. High levels of cortisol trigger a reduction in both corticotrophin-releasing factor and adreno-cortico-trophic hormone-resulting in a corresponding reduction in cortisol.

Question 8

Outline the general adaption syndrome

Answer 8

PROPOSED BY SELYE
1. Alarm reaction-stressor is perceived and the physiological responses of the body are activated in preparation for fight or flight

2. Resistance-body tried to adapt itself to the stressful situation by resisting the stressor. The individual appears to be coping, but the bodies resources are being consumed at a potentially harmful rate. E.g high levels of stress hormones that could potentially cause damage to heart and blood vessels. The pns is activated to conserve energy for long term bc the stressor is becoming chronic
3. Exhaustion- Adaptation to a chronic stressor is now failing. Resources are drained, the immune system may be compromised. Stress-related illnesses such as high blood pressure, coronary heart disease and depression are now likely.

Question 9

Evaluate GENERAL ADAPTION SYNDROME

Answer 9

+ supporting research evidence - SELYE experimented on rats. He subjected them to stressors such as extreme cold+ surgical injuries and monitored their response. Identified a general response to stress which could not be attributed to other factors.

• not really that general- MASON replicated the study using 7 stressors(monkeys not rats) - levels of urinary cortisol differed depending on the stressor. Extreme cold increased cortisol, extreme heat reduced it.
• male bias in research- females don’t fight or flight, they tend and befriend. Studies using rats suggest that the release of oxytocin in females during the stress response inhibits fight/ flight whilst increasing relaxation and fearlessness.
• ignores psychological factors - much of research carried out on animals. LAZARUS argues we make cognitive appraisals of a stressor by actively working out if it is a threat/ if we can cope. SPEISMAN ET AL asked students to watch a primitive and gruesome medical procedure on film whilst heart rate was measured. Changed to heart rate depended on how individuals interpreted the film.
• lack of resource depletion in the exhaustion stage- recent research shows that sugars and hormones do not deplete under extreme stress, but increase during the exhaustion phase. The current thinking is that it is the increase in stress hormones such as cortisol during the exhaustion phase that leads to stress-related illnesses.

Question 10

What helps to prevent illness and how

Answer 10

The immune system is our defensive barrier against invading germs and other foreign bodies (antigens).

One line of defence is innate, such as white blood cells (leucocytes) and natural killer cells.

Second line of defence is acquired immunity which is specific to the invading antigen. This includes lymphocytes such as B cells that produce antibodies to destroy the invading antigens; and T cells which destroys cells infected with antigens.

Stress can suppress the immune system directly (immunosuppression) e.g cortisol inhibits production of lymphocytes

Stress can work indirectly by influencing lifestyle patterns that in turn have a detrimental effect on the immune system e.g smoking, drinking

Question 11

What are the titles of both studies by Kiecolt-Glaser et al into immunosuppression?

Answer 11

Effects of preparing for exams

Effects of looking after relatives that are ill

Question 12

Outline Kiecolt-Glaser et al’s first study into immunosuppression

Answer 12

Natural experiment using 75 medical students whose blood was sampled one month before their final exams and again on the first day of their final exams.
No. Of T cells was measured as indicators of immune functioning.+ students filled in questionnaires on both occasions which measured psychiatric symptoms, loneliness and life events.

T CELL ACTIVITY DECLINED BETWEEN THE LOWER STRESS AND HIGH STRESS CONDITIONS.
Findings confirm the assumption that stress is associated with reduced immune functioning.
Questionnaire: immune responses were particularly low in ps who reported psychiatric symptoms.

Question 13

Outline Kiecolt-Glaser et al’s second study into immunosuppression

Answer 13

Longitudinal study comparing health and immune functioning of two groups of people.

Carers looking after a relative with Alzheimer’s disease.
Matched group of non carers

Over 13 months, carers showed an increase in antibodies to EBV. Not the same with non-carers. Carers also had infectious illnesses on significantly more days and higher levels of depression.

Question 14

Outline Riley

Answer 14

Mice on a turntable for 5hours. White blood cell count decreased.

Question 15

Outline Wilbert-Lampen et al

Answer 15

ACUTE STRESS

looks into incidences of heart attacks during football matches played in Germany in the 1996 World Cup.

On days when Germany played, cardio emergencies increased by X2.66 compared with a control period. - appears that ACUTE emotional stress of watching your team play football can more than double your risk of suffering a cardiovascular effect.

Question 16

Evaluation of Wilbert-Lampen et al

Answer 16

+seems to show the effect of acute emotional arousal.

• natural experiment makes it difficult to draw causal relationships.
• gives no indication of the other factors that must be involved. One event is highly unlikely to be the only cause of cardial emergencies.

Question 17

Outline Yusuf et al

Answer 17

CHRONIC STRESS

Investigated 52 countries, seeking to identify risk factors for CVD’s that exist across different cultures. They compared 15000 people who had suffered a heart attack (myocardial infarction) with a similar number of people who had not.

They found that several chronic stressors had a strong link to MI, including workplace stress and life events. In fact, the contribution of stress was greater than obesity ( but not so much as smoking and high cholesterol). Stress contributes to the development of CVD’s but also makes existing disorders worse.

Question 18

Evaluation of Yusuf et al

Answer 18

+ international study with large sample size, making generalisation possible

-there is a problem with the retrospective nature of the study. Patients who have experienced a heart attack may be subject to distortion.

Question 19

Evaluation of research into the role of stress in illness

Answer 19

+ stress can benefit immunity
Rats exposed to mild stressors and found that it stimulated a substantial immune response. Due to lymphocytes flooding into the blood stream and into body tissues in preparation for physical damage. Acute stressors stimulate the immune system and give some protection against short term stress (compared to chronic stressors- the opposite)

~evidence that stress increases risk of heart attack in patients Who already have cardiovascular disorders. Evidence that stress directly causes a patient to develop cardiovascular disorders is more mixed, as many patients to experience a lot of stress never go on to develop cardiovascular disorders.

+ The measure of the immune function is objective and so cannot be biased or subjectively interpreted by the investigator increasing the validity. The experiment to utilise a real life experience of stress which increases its external validity.

-natural experiments therefore, lack of control over the independent variable. Proving that they might in fact be other factors which have affected the results. Study uses specific groups of participants and limits the extent to which the results can be generalised to other groups in society.

-Immunosuppression and cancer
Pereira et al studied women who were HIV+
Women who experienced many stressful life events were more likely to develop cervical cancer than those who experience few stressful life events

Real life application-Kiecolt Glaser and Glasert found that students who took a relaxation training program seriously had better immune functioning during an exam period than those who didn’t bother with it.

Question 20

Outline rahe et al

Answer 20

Used the social readjustment rating scale to measure correlation between life changes and onset of illness.

Investigated 2500 male US naval personnel over a six month period. Ps were asked to say how many of the life events they had experienced in the past six months. A health record was also kept of each participant during the six months tour of duty, after which they calculated the correlation between total life changes and incidence of illness.

Findings: they found a significant positive correlation of +0.118 between the total LCU Score and illness. The relationship is small but significant.

Question 21

Evaluation of rahe et al

Answer 21

The correlation they found is weak- significant because large sample size but there may be other factors affecting health as well as life changes.

Cause-and-effect- correlational study, third variable such as anxiety may play a role in stress. For example more anxious people are more likely to report life changes and would be more prone to illness.

Population validity-The sample only included male US Navy personnel; ethnocentric and androcentric. -reduces validity and more difficult to generalise

Individual differences- Study does not take into account individual differences in reaction to stress. Some people may react more to stress than others.

Supporting research-Stone et al

Reliability of recall- rahe used the test-retest message to show a low reliability for the SRRS but other studies have found acceptable levels of reliability

Question 22

Who devised the hassles scale?

Answer 22

DeLongis et al
Original form had 117 items although shorter versions have been constructed for specific groups.

Some research suggests that the negative effects of daily hassles can be offset by daily uplifts.
Uplifts scale has 135 items that cheer people up.

Question 23

Outline DeLongis et al

Answer 23

Gave 100 middle-aged adults 4 scales to complete once a month for year.
1) hassles scale
2) uplifts scale
3) Life events questionnaire
4) Health status questionnaire
Findings: there was a significant correlation between hassles scores and ill-health, but no significant correlation between uplifts scores and health. Comparing hassles scores with life events score, they found that although both showed significant correlations with health status, the correlation for hassles scores was greater.

Question 24

Evaluation of daily hassles

Answer 24

Correlational research

Self-report measures

Retrospective

Amplification hypothesis

Gender differences

Question 25

Outline workplace stress in reference to work load

Answer 25

JOHANSSON et al studied the effects of workload stress and lack of control in a Swedish sawmill.

2 groups of workers at a Swedish sawmill were identified. The first group was a group of 14 “finishers” whose job was at the end of the production line. They worked in a noisy environment, isolated from other people. Their work was very repetitive but highly skilled. The pace at which they worked was determined by the production line so they had little control over their speed of work. Also their job was highly responsible. Their productivity determined the pay of everybody’s pay was reduced.

They were compared with a control group of 10 cleaners whose work was more varied; they worked at their own pace and had more social contact.
Both groups’ stress levels were measured by testing the amount of adrenaline and noradrenaline in their urine. Also medical records were checked to look at illnesses suffered and their number of days off work through illness.

Findings- the finishers had higher stress levels than the cleaners. They had higher blood pressure, a higher rate of stomach and intestinal disorders and reported suffering from more headaches. They had more days off work due to illness. Urine samples showed that they had higher levels of adrenaline and noradrenaline than the cleaners and they had higher levels of adrenaline and noradrenaline in their urine on work days than on rest days.

When management changed the organisation of the factory so that pay was not determined by productivity, their stress levels dropped significantly!

Question 26

Evaluation of workload (workplace stress)

Answer 26

+highly realistic- findings related to real life

• individual differences were not controlled (certain people who are vulnerable to stress may be attracted to high risk demanding jobs, such as finishers
• cannot exclude other variables (repetitive jobs often low paid- poor housing-financial problems-stress)
• DEMAND CHARACTERISTICS feel better bc someone is paying attention to their needs

Question 27

Outline work place stress in reference to control

Answer 27

MARMOT ET AL investigated relationship between job control and stress related illness.

A sample of 10,308 civil servants aged 35-55 (6895 men- 67% and 3413 women- 33%) were investigated in a longitudinal study over three years using questionnaires and observation.

Job control was measured through both a self- report questionnaire and by independent assessments of the work environment by personnel managers. Job control was assessed on two occasions, three years apart. Records were also kept of stress-related illness.

Findings- participants with low job control were four times more likely to die of a heart attack than those with high job control. They were also more likely to suffer from other stress- related disorders such as cancers, strokes and gastrointestinal disorders.

Findings were consistent in both occasions that job control was measured and the association was still significant after other factors, such as employment grade, negative attitude to work, job demands, social support and risk factors for CHD had been accounted for.

Question 28

Evaluation of job control (workplace stress)

Answer 28

Demand characteristics - ps trying to help researchers by doing what they think the researcher wants.

• social desirability bias, giving the socially desirable answers and answering how they think they ought.
• lack insight- perceive themselves as high workload or lack of control, when others disagree

Cause and effect-correlations so there may be other variables involved

Self efficacy- people with low self efficacy are not capable of taking advantage of the opportunities that control over their jobs gives them.

Cultural differences- individualist cultures job control is important and lack of it is stressful but in collectivist cultures job control is less desirable.

Work underload- people are employed in jobs that are beneath their capabilities, they are just as likely to experience work place stress as those who are overworked.

Evolution of work place stressors- knowledge becomes out of date as new technology, virtual offices and the blurring of work/Home environment comes into place

Question 29

Outline the social readjustment rating scale

Answer 29

self- report measure of the stress associated with 43 life changes, developed by HOLMES AND RAHE.

43 items choose after medical records of thousands of patients had been studied. 700 ps were asked to rate each of the 43 items in terms of how much readjustment was needed after the event (on a scale of 1-1000 units, where marriage required 500 units)
H+R calculated means for each time and further divided by 10. This created a life change unit score which allowed the events to be put in rank order.

SRRS is used by asking participants to indicate which life changes they have experienced over 12 months. The LCU’s for these events are added up to give an overall score. This score may then be used to indicate the likelihood of stress- related illness for those participants.

Question 30

Outline the hassles and uplifts scale

Answer 30

KANNER developed it to measure the combined effects of daily hassles and uplifts. They thought this would be a more useful indicator of stress than the SRRS.

Consists of 117 items in the hassles scale selected by researchers from 7 categories (work, health, family, friends, environment, practical considerations and chance events.) the scale measures the severity of each hassle in a 3 point scale.

The severity measure reflects that the psychological meaning of each hassle to the individual is more important than how often it happens

135 items on the uplifts scale- same 7 categories
The participant identifies the uplifts that occurred that day and how often they have happened.

Question 31

Outline the skin conductance response

Answer 31

A physiological measure of the degree of sweating associated with arousal of the autonomic nervous system.

ANS arousal activates the fight or flight response when a stressor occurs. Small increases in sweating can be detected as greater electrical conductance across the skin.

Electrodes are attached to the index and middle fingers of one hand. A tiny current is applied to the electrodes to measure how much electricity is being conducted.

Human skin is a good conductor of electricity, so the more we sweat, the more conductance there is. (Can be measured in microSiemens)

Two types of skin conductance;
Tonic conductance-when we are not experiencing a stimulus and is used as a baseline measure.

Physical conductance -when you have been shown a picture or someone asks a stressful question. (Follows a typical pattern and lasts for approximately 4-5 secs)

It makes up a polygraph(lie detector test)

Question 32

Outline Friedman and Rosenman

Answer 32

Self-selected sample of 3200 Californian men aged between 39-59 years. (Longitudinal- assessed over a period of 8 and a half years.

Part one- structured interviews and observations which assessed personality type and current health status.

Type A personality- impatient, hostile, competitive, workaholics, irritated by small delays, time conscious and multi-taskers

Type B personality-patient, relaxed and easy going

Part two- follow up 8 years later when incidence of coronary heart disease was recorded.
A correlational analysis carried out to test the association between Type A/B behaviour pattern and CHD

Findings : 257 participants had developed CHD during the 8 and a half years, 70% had been classed as Type A. Other factors such as bloody pressure, obesity and smoking were taken into account. Type As had higher levels of cholesterol, adrenaline and noradrenaline than Type Bs.
Correlation between type A behaviour and CHD.
High levels of stress hormones suggest that they do experience more stress than Type bs.

The release of the hormone cortisol from the adrenal glad tends to raise the fat content of blood- helping narrow arteries etc and prolonged periods of high blood pressure can lead to damage to arteries as well as forcing the heart to work harder.

Question 33

Outline Morris et al

Answer 33

Type C personality- related to cancer because they tend to repress emotions to deal with stressful events.

Interviewed 50 women seeking treatment for a breast lump to determine their typical responses to stress. They found that the women whose lumps were malignant typically expressed less anger than those whose lumps were benign.

This supports the view that suppressing emotions may be linked to increased stress, which weakens the immune system and makes cancers develop.

Research into Type C personality has inconsistent findings and failures to replicate. If type C is associated with cancer proneness, the relationship is not straightforward and prob moderated by age, amongst other factors.

Question 34

Evaluation of Type A and B personality

Answer 34

+measures real life variables so is easier to generalise to real life.

+valuable way of studying a sensitive issue such as CHD, without having to induce more stress on participants.

+personality types were identified by structured questionnaires rather than the less reliable self reporting.

• contradictory evidence- type Bs are associated with a greater risk of CHD than Type as. type as are less likely to die for CHD than Type bs. Type As are more motivated to make life style changes after the first heart attack than Type Bs.
• Type A behaviour includes a number of characteristics and is too broad a definition to be useful.(lacks validity)
• correlational study and it is difficult to establish a cause and effect relationship.
• although some aspects of lifestyle were controlled for, there may have been other variables that could have affected vulnerability to heart disease
• classifying personality into two types is over simplistic. Later research described other personality types e.g Type C personality was described as nice, hard-working, sociable but tend to be repressed and react to stress or threat with a sense of helplessness.

Question 35

Evaluation of SRRS and Hassles scale

Answer 35

Validity - participants interpret the life events in different ways. Researchers pointed out that Ps experiencing the most stress are more likely to interpret the life events on the scale more negatively.

Contamination effect- the scales are intended to be used as predictors of stress-related illness, but many items on both scales overlap with physical or psychological disorders.

Global vs specific

Controllable vs uncontrollable

Question 36

Evaluation of skin conductance response

Answer 36

Individual differences -taken into account by the use of a baseline assessment. However, individual differences are more complicated than that. Some people are known as “stabiles” their SCR vary little and aren’t influenced by internal thoughts or external events. “Labiles”, produce a lot of SCR’s, even when they are at rest. Therefore SCR measurement is not a straightforward matter of comparing SCL to SCR. (Failure to take account of this threatens validity.

Appropriateness- avoids some of the problems associated with self -report measures e.g social desirability. Only way to measure stress in certain groups of participants.

Non-specific response- actually measures sympathetic arousal which occurs in response to any emotion, so it may not be caused by stress. It could be caused by fear, anger, surprise or sexual arousal. Changes in skin conductance also occur when someone feels they are being treated unfairly. Temperature, humidity and any meds can have an effect.

Method is used as a lie detector but psychopaths generally lack emotional responsiveness, which means they can lie without any associated physiological response.

Question 37

Outline kobassa and maddi

Answer 37

Link between stress and hardy personality.

Study carried out in a large US public utility company that had become concerned about the high levels of stress experienced by its personnel due to promotions and demotions - wide spread restructuring.

Longitudinal study with all 837 people in the company executives and participants.

Used a modified version of the SRRS to measure stress. The scale was improved by adding 15 stressors identified by a group of executives as common to their lives. The additional items were weighted for seriousness by the same group. To assess illness, an illness rating scale was used. This included 118 illnesses, rated for seriousness by doctors. To questionnaires were posted out to all 837 participants and would be answered for the previous three years.

About three months later the same participants were asked to complete a number of questionnaires designed to assess personality.

Findings: two groups are identified from the original sample. 100 executives who had high stress scores and high illness scores and 100 executives who had high stress scores but low illness scores. Using the personality tests she identified differences between the two samples.

Those executives who despite high levels of stress did not become ill, scored higher on three personality characteristics.

Control- A person with high perceived control has the feeling of being able to strongly influence events in their own life

Commitment-high commitment means high involvement in and appreciation of self,family, work and society

Challenge- A person high in challenge thinks of change as an exciting opportunity rather than as something to be feared

These characteristics became known as the hardy personality. Hardiness has consistently been found by later studies to act as a buffer between stress and illness.

Question 38

What are the characteristics of a hardy personality?

Answer 38

Control- A person with high perceived control has the feeling of being able to strongly influence events in their own life

Commitment-high commitment means high involvement in and appreciation of self,family, work and society

Challenge- A person high in challenge thinks of change as an exciting opportunity rather than as something to be feared

Question 39

Evaluation of kobassa and maddi hardiness

Answer 39

The study has made a valuable contribution to the understanding of workplace stress.

Much of the data is retrospective and based on self-report therefore may not be reliable.

Characteristics of hardiness have been criticised as some researchers feel that they aren’t separate but interlink -assessing someone on such characteristics maybe flawed. Research indicates that control is probably the most important factor.

Hardiness, stress and illness were assessed by using questionnaires which can be problematic as they are subjective-biased.

Real life app- research has shown that hardiness is linked to resilience in the face of combat stress. The elite military unit of the US military now routinely assess candidates for high levels of hardiness, with training programmes frequently used to increase them further

Question 40

What are the drugs therapies for stress

Answer 40

Benzodiazepines

Beta blockers

Question 41

Outline benzodiazepines

Answer 41

Most frequently prescribed.
Includes Librium and Valium.

The work by enhancing the activity of gamma-amino-butyric acid (GABA), a neurotransmitter substance in the brain. GABA has the effect of blocking nerve impulses, so drugs that increase its action reduce arousal and increase relaxation. They also reduce the action of serotonin, a neurotransmitter substance that leads to anxiety if there is too much of it. GABA quietens activity in the neurons by reacting with GABA receptors on the outside of postsynaptic neurons. When GABA locks into these receptors it opens a channel that increases the flow of chloride ions into the postsynaptic neuron. Chloride ions make t harder for the postsynaptic neuron to be stimulated by other neurotransmitters, thus slowing down its activity and making the person feel more relaxed and less stressed.

Question 42

Outline beta blockers

Answer 42

Beta-blockers are sometimes used when prolonged stress has led to hypertension (prolonged high blood pressure). They act on nerves that serve the heart so that the rate of the heartbeat is reduced and so is blood pressure.

Beta-blocker sites that are usually activated by the hormones adrenaline and noradrenaline. Adrenaline and Noradrenaline are released in the stress response and function to increase blood pressure and heart rate. Beta blockers bind to beta receptors in cells of the heart and prevent adrenaline and noradrenaline having such a strong affect.

Question 43

Strengths and weaknesses of using drugs

Answer 43

+ they can be very useful in reducing symptoms of stress and so making the person feel better, enabling them to deal more effectively with the stressors

+ they are quick and easy to use

+many studies have shown that BZs and BBs are effective in reducing symptoms of anxiety

-side-effects
Benzodiazepines~ drowsiness, impaired concentration and memory, and depression. Not safe to drive
Beta blockers~ do not experience any side-effects, although some studies have linked them to an increased risk of developmental diabetes

• if they are taken for a long period of time people can become physically and/or psychologically dependent and have difficulty in coming off them. For this reason, benzodiazepines are usually only prescribed for a limited period
• when medication stops, anxiety may return
• drugs do not address any underlying problems that they might be

Question 44

Outline biofeedback

Answer 44

A method of stress management that turns physiological processes such as heart rate into signals that a client then learns to control. Clients do this by applying the techniques they have learnt.

Stages:

1. Client uses a heart rate monitor to become aware of the physiological response and how it can be adjusted in the desired direction
2. Client learns how to use various techniques to control the response
3. Control of the response has to be transferred to every day life, so client practices in stressful situations rather than in the safety and comfort of a therapy room

Question 45

Evaluation of bio feedback

Answer 45

Research support-

Jane Lemaire et al used medical doctors as their participants and trained them to use a biofeedback device. They used it 3 times a day over a 28 day period and also completed a questionnaire measuring their perception of how stressed they were. The mean stress scores feel significantly. The control groups score also fell but by a smaller amount.

However, Lemaire et al found that there were no significant changes in heart rate, blood pressure and cortisol levels between the start and end of the study for the biofeedback users. Effectiveness depends on the outcome measure.

Bussone et al studied children suffering with tension headache. he found that biofeedback and relaxation techniques provided better health outcomes than just relaxation techniques over a period of three years.

Convenience-

Biofeedback monitoring has become more convenient with the advent of new technology on mobile phones and smart watches

Individual differences-

BioFeedback will only suit people who have the motivation to learn and apply the skills needed to change in their physiological arousal. Motivation can be improved by introducing a gaming element, but the techniques still requires a lot of motivation to practice the skills in the real world once they have mastered them in a controlled setting.

Non-invasive

Biofeedback is useful for treating children who were too young to be given powerful drugs or who wouldn’t cope with SIT. Unlike drugs, it tackles the symptoms and the underlying causes and provides a long lasting way of reducing stress

Question 46

What are the three phases of stress inoculation therapy

Answer 46

Conceptualisation

skills training practice

application and follow through

Question 47

Outline stress inoculation therapy

Answer 47

1)conceptualisation~ client and therapist begin to develop a relationship.

Meichenbaum considers this relationship to be very important as it helps them to work together.

Client is encouraged to re-live stressful situations and if there are many stressful situations to see what they have in common. Allowing the client to develop a more realistic understanding of what makes them stressed.

2)skills training and practice~ the client is taught skills and strategies for coping with their stressful situations e.g time management, relaxation training, study skills, social skills training. Skills are practiced in a therapeutic setting.

3)application and follow through~ in the final phase skill learned are carried out in real life situations, starting with low stress situations and gradually increasing to higher stress situations.
Client keeps in contact with therapist and follow up sessions and more training provided if necessary.

Question 48

Evaluation of stress inoculation therapy

Answer 48

+targeting symptoms~Meichenbaum’s approach looks at both sources of stress and coping strategies.

By reviewing the coping methods they have used in past, clients can gain a clearer understanding of their strengths and weaknesses. By acquiring new skills and techniques, they can improve their coping strategies and clients gain more confidence in their ability to handle previously stressful situations.

Skills are long lasting and should give clients confidence to deal with future stress.

+effectiveness~ combination of cognitive therapy and behavioural therapy makes SIT an effective method of stress management.

• hello/goodbye effect~ difficult to assess the effectiveness of SIT since we depend on subjective reports from clients.
• practicality~takes time, effort and money. Clients have to go through a rigorous programme over a long period. This requires high levels of motivation and commitment, so it is not a quick and easy fix.
• difficulties~ ways we cope with stressors can be part of our personality, and have been part of our behaviour for a long time. Changing well established habits will always be difficult.
• unnecessarily complex~ One suggestion is that the key ingredient in the success of SIT is just learning to talk more positively and relax more. Relaxation reduces activity in the sympathetic nervous system so that a person feels less stressed.
• not effective for everybody~ one study used SIT with asylum seekers who were suffering with post-traumatic stress disorder caused by torture. SIT was ineffective. This could be because the clients were in a state of continuous trauma in constant fear of being deported. Perhaps the transfer of skills to every day life does not work when the client feels they cannot gain control over their situation.

Question 49

Outline psychological explanations for gender differences in coping with stress

Answer 49

STONE AND NEALE found that men are more likely to use problem focused coping strategies, whilst women are more likely to use emotion focused coping strategies.

ROSARIO ET AL found that women consistently make better use of social support than men. These gender differences may exist because of differences in socialisation. Women are taught to express their emotions openly but to act in a more passive way than men. Men are taught to approach stressful situations in a more active problem focused way.

Problem focused coping-strategies that attempt to do something active to remove the stressful situation.

1. Taking control -researching the problem
2. Evaluating the pros and cons of different approaches
3. Suppressing competing activities -avoiding the temptation to surf the Internet instead of doing something productive to solve the stressful situation

Emotion focused coping-strategies that attempt to regulate the emotional distress associated with the stressful situation.

1. Denial -going about life as if nothing had happened
2. Focusing on and venting emotions -crying, worrying
3. Seeking social support -talking about their emotions the support network of friends

PETERSON ET AL
Procedure- just over 1000 men and women seeking fertility treatment at hospital recruited for a study on coping styles and asked to complete several questionnaires, including the ways of coping questionnaire designed by Lazarus and Folkman.

Findings- there were clear gender differences found. Women used confrontative coping. Men engaged in problem-solving. There was some emotion focused coping in men, which indicates that the gender difference is not clear cut.

Question 50

Evaluation of psychological explanations for gender differences in coping with stress

Answer 50

Role constraint- coping responses are actually a product of the roles that males and females tend to occupy. If males and females occupy the same social role they tend to use similar coping responses.

BRENNAN PETERSON ET AL studied infertility stress in men and women referred for IVF. They found some gender differences in coping strategies but they challenged the distinction between emotion and problem focused approaches.

Simplistic- Some of the problem of establishing gender difference in coping strategies might lie in the simplistic division of coping styles into emotion or problem focused.
Subsequent research by Endler and Parker using the ‘Multidimensional Coping Inventory’ has shown that there is a third coping strategy called ‘Avoidance-oriented’.

Both- some research has shown that the best strategy to coping with stress is to use emotion focused strategies first since this enables us to identify and expressed emotions about the stressful experience, and this leads to better choices about the right problem-solving strategy for us.
Going straight to a problem focused strategy can be counter-productive if the person has not taken the time to understand and express their emotions first.

Retrospective research-many studies are retrospective ~ Ps think back to stressful occasions and recall the methods they used to cope. Denise De Ridder found the woman reported using emotion focused coping more than men but only when recalling retrospectively. This difference disappeared when ps used Ecological Momentary Assessment, a method of reporting coping strategies at regular intervals during the day.

Methodological issues- research in this field uses self-report scales. Women may be more likely to reveal the emotional side of coping, whilst men play down their emotional difficulties. This means that there may be no differences in actual coping strategies just a difference in the way they are reported.

Question 51

Outline physiological explanations for gender differences in coping with stress

Answer 51

Fight or flight -men

Tend and befriend -women

Researchers argue that fight/ flight can be displayed by both sexes, but for females there would be a greater evolutionary advantage to produce a tend/ befriend response, so this has become more common.

The reason for this difference is differences in parental investment -females invest in each single reproduction more than males. Therefore female stress responses have a evolved to maximise the survival of self and offspring.

Both males and females produce adrenaline, noradrenaline and cortisol. Alongside the production of these stress hormones, oxytocin is produced. This is sometimes called ‘the love hormone’ because it promotes feelings of bonding and general socialness. In males, testosterone levels also rise and this has a dampening effect on male oxytocin. Therefore, males become more aggressive, whilst females seek closeness to others because of unrepressed oxytocin. This response would be at its strongest in women who are breastfeeding because more oxytocin is released at this time.

Question 52

Evaluation of physiological explanations for gender differences in coping with stress

Answer 52

Women would be aggressive towards an intruder who threatened to their offspring-instead of the more generalised ‘fight’ response in men, women only become aggressive in situations that require defence.

Same is true for the ‘flight’ response in females- in animal species where the offspring are fairly mobile after birth, the mother and offspring will flee rather than stay all huddled together. Thus, the female response is not simply ‘tend and befriend’ but it involves a whole range of strategies that are adopted to parental investment by females.

It is possible that the difference in physiological stress response in men and women could explain the fact that men are more likely than women to die of cardiovascular disorders.

Question 53

Outline the role of social support in coping with stress

Answer 53

Instrumental support- refers to offers of tangible (actual) assistance e.g providing money or driving you to the doctors. This is a problem solving kind of approach where the focus is on ‘doing’ something. This can be offered by anyone.

Emotional support- refers to emotional support (emotion-focused) offers assistance designed to help manage the emotions involved in the stressed person e.g listening or giving advise on how to deal with emotions. This is usually offered by close friends, but strangers could do it in an emergency situation.

Esteem support- someone else trying to make you feel better about yourself in order to reduce the sense of being stressed e.g reminding you of your strengths. This is likely to be unique to close friendships.

KAMARCK ET AL- used 39 female psychology student volunteers who recruited to perform a difficult mental task while their physiological reactions were measured. Each P were asked to either attend the lab alone or bring a close same-sex friend with them. During the task the friend was asked to simply touch the P on the wrist. To avoid friend evaluation-apprehension, the friend was given a task to do at the same time, so was not monitoring the P. All Ps filled in questionnaires relating to mood and personality.

In general the Ps with friends showed lower physiological reactions to the stress task. This supports the idea that social support can reduce the physiological effects of stress.

Question 54

Evaluation of the role of social support in coping with stress

Answer 54

Gender differences- studies have shown that women use social support more than men. However, this may be because studies have focused on emotional support where men are more likely to use instrumental support

Cultural differences-Studies have shown that Ps from a collectivist culture are more likely to use emotional support, whilst Ps from an individualist culture are more likely to use instrumental support

Distinguishing types of support-researchers have argued that esteem support is actually a form of emotional support and should not be a category in its own right. Different researchers use different distinctions between types of social support so categorisation may not be useful.

Pets-The term ‘social’ refers to one’s own species, however there is growing research do you suggest that the presence of pets can reduce stress as well. One study has shown that talking to pets was more effective in reducing stress than talking to people. Perhaps then, the benefit of social support is to do with ‘not feeling alone’ and this would be explain why pets help reduce stress too.

Negative effects-sometimes social support can be counter-productive e.g when a friend insists on coming to a medical appointment with you, making you more anxious than if you had gone alone. The positive effects of social support come when the relationship between you is healthy and happy, rather than strained. Perhaps social support is most beneficial when it is sought by the recipient rather than imposed by the supporter.

Question 55

What is social support?

Answer 55

The help you may receive from other people at times of stress. It seems to help to ‘buffer’ against stressful events. Research has shown that social support has physiological effects that increase relaxation.