Definition: Perceived mismatch between demands and the ability to cope with them.
Why is stress studied? Because of change in patterns of illness from short term illnesses (acute) and long term illnesses (chronic)
Example: Leading causes of death in 1900s: Pneumonia, tuberculosis, gastro-enteritis, Heart disease.
Leading causes of death in 1994: Heart disease, cancers, strokes, lung disease.
Psychogenic illnesses: When someone thinks they’re ill when they aren’t.
Psychosomatic illnesses: When someone makes themselves ill (stress or thinking they are already ill).
Epidemiology: The study of illnesses and where they come from. As knowledge changes, there are new directions in health psychology. (Human genome project).
Models in health psychology
Biomedical: stress caused by genetics, bacteria, physical health etc.
– Reductionist. Emphasis on health, not illness.
– Individual differences.
Psychodynamic (Freud): stress caused by lifestyle, attitudes and beliefs, fear etc.
+ Showed that cause of illness is psychological sometimes (Freud cured a blind lady).
– Can’t prove it, can’t test it, Freud is weird.
Biopsychosocial (Engel, 1970s-80s): Stress caused by social pressure, race, wealth, job, system’s theory (can predict our death).
+ involves both psychodynamic and biomedical.
Experiments: Ex Finding out how self-help groups help make you live longer.
Correlational research: not changing anything, comparing two variables.
Positive correlation: one increase makes the other increase (ex: more red meat makes more cancer)
Negative correlation: one increase makes the other decrease (ex: the more exercise you do the longer you live)
+ Quantitative data
– Cause and effect problems
– Extraneous variables.
Prospective research: Looking at how relationships change over time.
+ In-depth data, reliable.
– Cause and effect problems
– Longitudinal study: attrition rates.
– Extraneous variables
Retrospective research: Looking back in time. (ex: help understand where aids came from by looking at people’s diet, sexual orientation etc)
+ Helps solves problems
– Self report from a long time ago, not accurate.
[[Causes of stress]]
Internal: stressed because of genetics, stressed parents, personality, type A vs type B.
External: stressed because of job, marriage, unemployment etc
Rosenman and Friedman
Type B or not Type B
The hypothesis of this study was that people with type A patterns of behavior were more likely to have high levels of blood cholesterol and hence coronary life disease.
Traits from type A behavior: tendency to compete, desire for recognition and advancement, involvement in several activities at the same time, tendency to rush to finish activities.
Participants all came from business jobs (executive and non-executive positions) and who predominantly were told to show pattern A behavior. 83 men in total were studied for group A with around half being 40 to 50 years old.
Type B were matched with type A based on physical appearance. Group B were made up of accountants and union officials.
Each was interviewed on their family heart disease, past and present illnessed, hours of work and sleep, smoking habits, activity and dietary habits. All men had to keep a full diary of their food and alcohol take-in for seven days.
They measured: serum cholestoral level, blood coagulation time, electrocardiograph readings, arcus senilis (looking for opaque ting around cornea which is caused by fat breaking down in the body)
Group A worked longer, exercised more, smoked more, drank more alcohol but ate fewer fats
However, there was little difference in the blood clotting time.
Group A showed higher cholestoral levels, and higher incidence of arcus senilis.
A Quarter of the men in Group A showed signs of coronary heart disease.
– Those who survive in type A from coronary heart disease strive to stop smoking etc, type Bs however just don’t do anything about it.
– A long time ago.
Langer and Rodin (1976)
Locus of control.
Will the experience of being in control affect long-term health? (Originally, it was Rotter who came up with the idea of the locus of control)
External locus: don’t feel they can control events that happen to them
Internal locus: experience themselves as exerting personal control over events in their lives.
Why old people? They’re going to die soon, don’t have much control over their lives, incontinent etc.
Done in Connecticut, USA. Two of the four floors were studied. One continued normally (control group), the other gave choice. This was a field experiment.
The subjects in the experimental group were 8 males and 29 females. Control group had 8 males and 35 females.
The experimental group were told:
a) Responsibility of caring for yourselves
b) decide how you want your rooms arranged
c) Decide how you want to spend your time
d) it’s your life
e) responsibility to make complaints known.
They were also offered a plant and asked when they wanted to watch a movie.
Results (Gathered by a research assistant and nurses (unaware of hypothesis)
It was found that the experimental group were happier and more active than the CG. They saw themselves as having control, unlike CG who wanted control. They were more alert during interviews, visits patients and others more. They talked more to staff, but watched them much less than the other group.
Even upon returning to the home 18 months after, the experimental group still seemed to be doing better and fewer had died.
+ Good for knowing how to treat old people to make them live longer 😛
+ Can be useful for diabetics, kidney diseases etc which require long-term commitement to getting better
– unethical! The old people are treated very fairly and as soon as the experiment is over are just left back to normal
– Many other studied have shown that an internal locus of control does not always improve health in diabetes (see Strenstrom et al, 1988.
Can be done by measuring the stressors themselves or the effects of stress. In each case a range of ways can be used, including:
+ can’t lie
– reductionist, too simply explained.
– DC if they known, unethical if they don’t xD
(blood or urine samples to measure hormone level, using a polygraph to measure physiological arousal)
+ empirical evidence, can’t lie and can’t be DC
– Doesn’t prove stress
– the situation may cause different results (hot girl or stress of the actual event etc)
– more expensive.
+ Hands on, straight from the horse’s mouth
– Demand characteristics.
*Holmes and Rahe (1967) The social re-adjustment rating scale.
394 people complete a paper test on the most stressful life events.
The sample wasn’t representable, there were more females than males (215 vs 179), there were less lower class people than upper class people (71 vs 323).
The participents had to rate the events according to the amount of adjustment they think they require.
Marriage was given an arbitrary value of 500. The subjects had to decide weither each events needed more or less time to re-adjust.
1. Death of spouse (100)
2. Divorce (73)
3. Marital separation (65)
4. Prison (63)
5. Death of close family member (63)
This questionnaire was given to different groups of people with a high correlation in results, except in group of white subject compared to black subjects.
+ Straightforward way of measuring stress
– Many people, can generalize
– Self report, so may not be accurate
– Gender bias (having a child is more stressful for the woman)
– Ethnic bias (Some people don’t celebrate Christmas)
– Some haven’t lived experiences such as divorce, childbirth or death of spouse, so they can’t judge how stressful the event is.
*Kanner et al (1981) The daily hassles and uplifts scale
100 participants (51 women, 48 men, all white, all well-educated and comfortably well off) were selected from a population of 7000 in Alameda County, USA.
Each participant was assessed once a month for 10 months on the following:
– A daily hassles and uplifts scale developed by the researchers
– A life events scale similar to the SRRS
– The Hopkins symptoms checklist of psychological symptoms
Results: It was found that the hassles scale was a better predictor of psychological symptoms than the life events scores. The hassles scores and the symptoms were significantly correlated.
However, the uplifts score was positively related to symptoms for women but not for men.
+ Better predictor and more valid way of measuring stress: more questionnaires.
– Symptoms and scores only correlated with women, not men
– Only 100 people, not a representative scale.
Kanner was not the only one to have done a test on daily hassles, other stress scales have been developed like this one: The daily stress inventory by Brantley and Catz, the Stress Schedule by Hallberg et al, and the weekly stress inventory by Brantley and Jones.
[[Effects of stress]]
The effects of stress can be varied, but are usually an adrenaline rush, insomnia, increased heart-rate, sleep deprivation, and stomach ulcers.
The executive monkey experiment
Why? To look at how stress could affect people working in industries and business organizations, because they are the one that deal with the most stress.
The monkey were in pairs where one was an executive monkey, and the other was a “yoked control”.
Both monkey received electric shocks every 20 seconds, but only the executive monkey was responsible for pressing the lever to stop the shock.
Results: The executives developed severe ulcers and eventually died, but the yoked control showed no signs of stress or ill effect.
Evaluation: + Can suggest why people with high power are so stressed
– unethical: monkeys stressed
– test on monkeys, maybe not the same effect on humans
– Weiss (1972) did almost the same experiment on rats, but before they got the shock they were given a warning sign, and many managed to survive. This may mean that the monkeys were actually just stressed because they had to be constantly vigilant.
[[ Managing stress]]
Environmental change One way to prevent people from dealing with stress is to remove them from the stressor or stressful circumstance (for example breaking off a bad relationship, or moving away from the stresses of living in the city)
Systematic desensitization A technique used to help people with irrational fears. The patient is asked to relax and is shown an anxiety-provoking object at more and more intense levels every time they go to the therapy. (falls into the active behaviourist category).
Stress inoculation People are exposed to the stressful problem step-by-step. They are encouraged to express their thoughts and feelings through a series of self-statements, they develop coping-skills and are helped to perceive it as less threatening.
Cognitive-behavioural therapy Encouraging patients to be realistic about their ability to deal with the situation. Can take place in group therapy or alone therapy and even self-help manuals. How they got over the stress: 1) support their thoughts and feelings (“Why do you think…”)
2) alternative assumptions (“Perhaps he did that because….”)
3) writing down advantages and disadvantages of a particular course of action
4) designing experiments to rehearse new skills (to deal with stress in a new way)
5) questioning self-critical thoughts
This strategy is used when there is no way to get away from the stressor or when the levels of anxiety are so high that trying to tackle the actual problem would be pointless.
This strategy is done by giving recreational drugs, physical relaxation, and biofeedback.
Other examples of Self-Report stress scales
Parenting Stress Index by Richard R. Abidin
The PSI index is widely used in the early identification of dysfunctional parent-child systems. It is often used with parents of children who may have behavioral or emotional problems. The third edition incorporates the most recent research, more reference group profiles and case illustrations, and an updated bibliography. The short version (PSI-SF) measures the source of parenting distress, parent-child dysfunctional interaction, and the difficult temperamentally-based behavioral characteristics of the child. Both versions can be used with parents of children as young as one month. How to Use the Assessment:
The PSI provides scores for all the parent and child domains, along with a Total Stress score and optional Life Stress score. The short form (PSI-SF) is a direct derivative of the full PSI. It yields a Total Stress score from three scales: Parental Distress, Parent-Child Dysfunctional Interaction, and Difficult Child. It is ideal when time with the parent is limited, or as a progress monitoring tool