Stress Flashcards

Question

Describe findings of how Kiecolt-Glaser investigate the effects of stress on the immune system?

Answer 1

Study found that activity of natural killer and killer t-cells decreased between first and second samples given This is evidence of their immune response being suppressed by a common stressor and this decline was most apparent in students who had reported feeling most lonely and other sources of stress such as experiencing significant events in their lives

Answer 2

Any disorder of the heart, circulatory system, strokes

Answer 3

Stress activates SNS Leads to production of adrenaline and noradrenaline High levels of adrenaline will: Heart works faster so increased heart rate Constriction of blood vessels so increased blood pressure, putting tension on the blood vessels which can cause them to wear away over time Increased pressure can also dislodge plaques on the walls of blood vessels and this can lead to blocked arteries (atherosclerosis) which can lead to heart attack or stroke

Answer 4

Study to see if anger was linked to heart disease This is because anger is often linked to stress and the activation of the SNS

Answer 5

13000 ppts completed 10-question anger scale which included questions on whether they were 'hot-headed', whether they felt like hitting someone when angry, or whether they got annoyed when not recognised for not doing good work None of the ppts were identified as suffering from heart disease at the outset of the study

Answer 6

After six years, the health of the ppts were checked and it was found that 256 had experienced heart attacks Ppts that had scored highest on the anger scale were over 2.5 times more likely to have had a heart attack than those with the lowest ratings Ppts that scored moderately in the anger ratings were 35% more likely to experience a coronary event compared to those with lower ratings This suggests that SNS arousal is closely linked to CVDs

Answer 7

Much of the date is based on self-reports such as questionnaires which may be subjective in nature e.g. if an individual has a tendency to move towards negative perceptions and remembering unpleasant events over pleasant ones, this may lead to exaggerated scores on both measures The result would therefore be a significant correlation being more likely, which results in an unjustified link between higher perceived stress and CVD symptoms

Answer 8

Some research shows that stress can benefit immunity Study by Dharbhar (2008) demonstrated that stress can have an immune-enhancing effect Rats were subjected to mild stressors which was found to stimulate a substation immune response with lymphocytes flooding the blood stream and body tissues in prep for physical damage This demonstrated that while chronic stressors may be dangerous due to their immunosuppressive effect, acute stressors do not act on the immune system in the same way Instead, it appears that acute stressors stimulate the immune system to give it protection against short-term stress This demonstrates the relation between stress and the immune system is complex and not completely understood

Answer 9

Studies women who were HIV-positive and found that women that experienced significant stressful events in their lives were also more likely to develop pre-cancerous lesions of the cervix one year later, compared to those who experienced fewer stressful events This study demonstrated that the effects of stress on the immune system has wider and more direct consequences on health and illness beyond just CVDs

Answer 10

-People react differently to stress -Consistent findings of gender differences in the stress/immune system relationship e.g. women have more adverse hormonal and immunological changes in the way they react to marital conflict (Kiecolt-Glaser et al. 2005) -Age as stress can have a greater effect on those who are older (Segerstrom and Miller, 2004) -Sympathetic branch of ANS is more reactive in some individuals than others (Rozanski et al. 1999)

Answer 11

Stress can increase risk of heart attack in people who already have CVDs Kristina Orth-Gomer et al. (2000) Women with CVDs, marital conflict created stress that tripled risk of heart attack for them This offers an alternative explanation rather than attributing stress as the initial cause for CVDs Therefore, stress may increase a persons vulnerability to developing CVDs through indirect effects such as lifestyle and behavioural changes that may activate the immune system

Answer 12

Significant and relatively infrequent events in a person's life that can cause stress They are considered stressful as the individual often has to expend significant psychological energy coping with changed circumstances

Answer 13

Holmes and Rahe (1967) Social Readjustment Rating Scale (SRRS)

Answer 14

List of 43 stressful life events that are believed to contribute to illness and scores events in terms of life changing units (LCUs)

Answer 15

1. Death of spouse 100 2. Divorce 73 3. Marital separation 65

Answer 16

More adjustment the life change requires, making it more stressful

Answer 17

Retrospective Ppts ticked off all life changes they could recall from previous 12 months The LCUs were then added up to produce a total score, and this would then be correlated with a measure of the illnesses the ppts had experienced over the same period

Answer 18

Likely experience reasonable health the following year

Answer 19

50% would experience illness the next year

Answer 20

Up to 80% report illnesses within the next year

Answer 21

US navy personnel assigned to three aircraft carriers Ppts completed earlier version of SRRS known as the Schedule of Recent Experiences This measurement tool covered the six months before their deployment on a tour of duty with a total LCU score calculated for each participant and their retrospective 6-month period Once the personnel had boarded the ship, every illness had to be reported to medical unit Upon the ships return from their tour of duty, an independent researcher examined the medical records and calculated an illness score for each ppt Neither the ppts or medical staff knew the purpose of the study

Answer 22

A significant positive correlation was found (0.118) between the LCU scores for the six months before departure and the scores for illnesses on board the ship This meant that those who reported to have experienced the most stressful life events in the final six months before leaving the ship, also had the most (or most severe) illnesses in the following six months on the ship Rahe et al. concluded life changes were a reasonably robust predictor of later illnesses

Answer 23

Lietzen et al (2011) Used date from Health and Social Support Study (HeSSup) in Finland that followed over 160000 who did not have asthma in beginning of study Found that a high level of life changes was a strong predictor for the onset of asthma in ppts and this link was not explained by other known risk factors such as having pets or smoking Follow-up studies have also found robust and significant correlation between stress of life changes and illnesses which further supports life changes as a source for illness through stress

Answer 24

Stress doesn't affect everyone in the same way e.g. getting pregnant can be either positive or negative based on whether the pregnancy was planned or unexpected Research by Bryan and Whyte (1980) found that predicting heart attacks on the basis of life change scores only worked if the ppts subjective interpretations were taken into account The classic life changes approach does not consider the impact of such individual differences and perception which reduces its validity as an explanation of stress In addition to personality, there are other individual differences that are ignore which likely also factor in to CVD vulnerability such as gender and age

Answer 25

Based on assumption that all change is stressful and effectively models together several different types of life changes Psychologist now believe that positive and negative life changes have different effects Turner and Wheaton (1995) found that when ppts were asked to rate desirability of the life changes from the SRRS, and they found undesirable or negative life events caused most of the stress measured by the scale, and not necessarily life changes themselves This challenges the validity of the global life changes approach and promotes looking at the effects of specific life stressors instead

Answer 26

Therefore most evidence is based on correlational findings The issue with this is causality cannot be established and it is not possible to establish which factors are contributing the most in the development of CVDs

Answer 27

Everyday irritations and annoyances one experiences throughout a typical day

Answer 28

Queuing at the shop Stuck in traffic Disagreement with colleague

Answer 29

Positive experiences a person experiences that may counteract the effects of stress

Answer 30

Accumulation of minor daily stressors create persistent irritations, frustrations and hassles that lead to more significant stress related outcomes such as anxiety and depression (Lazarus 1999)

Answer 31

Suggests that chronic stress due to major life changes may make people more vulnerable to daily hassles Due to individual already being in a state of distress, other associated minor stressors may amplify the experience of stress May also be that a major life change may deplete the resources of the person mentally and physically which makes them less able to cope with minor stressors

Answer 32

Suggests the psychological appraisal of daily hassles is important and stress is dependent on whether we engage in primary appraisal or secondary appraisal When we experience a daily hassle, Lazarus suggests we engage in primary appraisal where we subjectively calculate how threatening, we then engage in secondary appraisal where we subjectively assess how well equipped we are to cope with the hassle Therefore, the theory of daily hassles factors in the importance of psychological appraisal or interpretation of the meaning of hassles to individuals

Answer 33

100 ppts 45-67 years Hassles and Uplifts Scale (HSUP) for events over previous month as well as every month following for up to 9 months Ppts also completed a life event scale for the six months preceding the start of the study as well as for the two yearly period prior to that They also completed the life event scale at the end of the study Two measures were used to assess their psychological well-being : the Hopkins Symptom Checklist, which assesses symptoms of anxiety and depression, and the Bradburn morale Scale, which assesses positive and negative emotions The psychological well-being assessments were completed every month

Answer 34

Significant negative correlation between the frequency of hassles and psychological well-being was identified What this meant was that ppts with the fewest daily hassles demonstrated higher levels of wellbeing Study also found that hassles and uplifts differed to those selected by another group of ppts who were students; e.g., the students identified more problems related to having to do too much work without being able to relax Kanner et al ultimately concluded that hassles were a better predictor of wellbeing than life events and uplifts

Answer 35

Supporting evidence from studies have reaffirmed the importance of daily hassles Ruffin (1993) found daily hassles were linked to greater psychological and physical dysfunction in comparison to major negative life events Flett et al investigated why this was and asked 320 students m and f to read a scenario describing a male or female who had experienced a major life event or daily hassles Ppts were then asked to rate amount of support they would receive or seek from others Flett found that those who suffered major life events were rated higher in seeking and receiving support from significant others This suggests that the reason daily hassles are a greater source of stress is because there is less social and emotional support received in comparison to life events

Answer 36

Based on the ppts ability to recall the hassles they have experienced accurately Therefore issues of reliability occur which can distort the significance of daily hassles while more relevant ones may be suppressed or ignored There are also issues of validity when using self-reports as people may not always report their experiences honestly Social desirability may be a factor as people may not wish to show all their hassles because it puts them in a 'bad light' For example, people may not wish to report they have problems with their children or may simply lack the ability to openly express themselves and their hassles Therefore some issues may be played down or ignored completely which can invalidate findings

Answer 37

Genders particularly Helms et al argued that men and women have different roles withing most families and therefore they would experience everyday hassles differently Some researchers have highlighted domestic chores performed rarely may be bearable or even enjoyable however it may become a hassle for someone to carry it out regularly The implication is it is difficult to identify reliable daily hassles and extract valid results

Answer 38

Although daily hassles research has shown consistent correlations between hassles and illness, we are not able to conclusively claim that hassles cause illnesses This is because other confounding variables may be the true cause that lays in-between these two variables, e.g., depression

Answer 39

Usefulness of findings and conclusion drawn that can helps towards the formulation of effective stress management strategies This can help develop ways to deal with the ever-rising number of stress related illnesses and deaths, both direct and indirect

Answer 40

Karasek 1979

Answer 41

1. Due to high workload - which creates greater demands from the job. This involves the number of tasks and obligations individuals ahem to perform or complete within specified timeframes. The greater the workload for the individual, the more stress they will experience. 2. Low control over the job itself due to deadlines, procedures and the degree of influence an individual has over their workload and job requirements. It is expected that the greater the control the individual has in their job, the lower their stress levels would be.

Answer 42

Marmot followed over 10000 UK civil servants that worked in Whitehall from 1985 Included professional staff with high levels of workload control (e.g. accountants) as well as lower grade staff that had less workload and control (administrative staff). Both sets of staff were thought to experience stress but for different reasons. At the start of the study, pps completed a range of questionnaires assessing their job workload, subjective sense of control and the social support they had. Ppts were then examined 11 years later for their risk of developing coronary heart disease based on the effects of stress.

Answer 43

Researchers found the highest-grade workers tended to have the highest workload and also highest sense of control in their job. High workload was not associated with coronary heart disease however, low job control was. The combination of low job control and high workload, as described in the job demands-control model, was strongest among younger workers and this was not reduced by high levels of social support. Such participants were found to be more likely to develop CHD 5 years later, even when other risk factors such as lifestyle, smoking and diet were accounted for.

Answer 44

Johannsson et al. studied 28 manual labourers in a sawmill. The high-risk group, that had high workload and low control, were 14 'wood finishers' who were compared to a low-risk group of stickers, repair men and maintenance workers, who were matched in terms of factors such as education and job experience. To assess stress, researchers measured levels of adrenaline daily as well as obtained self-reports of job satisfaction and illness.

Answer 45

The high-risk group were found to have higher rates of illness as well as adrenaline in their urine samples when compared to the low-risk group, as well as more reports of illnesses. The self-report data confirmed the high-risk group felt they had a greater workload and less control since their jobs were repetitive and constrained. These findings support the job demands-control model.

Answer 46

Over-simplistic as an explanation While lack of control and high workload may be stressors in some cultures, they are not the only ones The amount of stress a worker experiences is the outcome of a number of complex factors between the type of work someone does, how well they use coping mechanisms and other factors such as the objective amount of control, support or workload an employee has compared to their perception as such The job-demands model ignores such and therefore lacks validity due to its simplistic focus on just two-job related sources of stress

Answer 47

Lazarus argued that individual differences were also ignored by such explanation that there are wide differences in the way people react and cope with stressors Lazarus argued the degree to which a workplace stressor is perceived as stressful largely depends on the persons perceived ability to cope For example, Schaubroeck et al found that some workers were actually less stressed by having no control or responsibility This study assessed ppts immune system with saliva samples and found some had better immune responses in low-control situations An explanation for this may be that some people view negative work outcomes as their fault and therefore high control can exacerbate the unhealthy effects of stress

Answer 48

Most research uses questionnaires This raises criticisms of validity for data collected e.g. there are issues of social desirability bias, demand characteristics or people simply being dishonest in their responses Newton found that in a study of engineers, the use of interviews instead of questionnaires revealed stressors that were not usually identified Similarly, role conflict and ambiguity, which were normally included in questionnaires were rarely mentioned as significant stressors Interviews may therefore be better suited than questionnaires but this opens up other potential issues such as the interviewer projecting their own subjective interpretations to responses and how these are recorded

Answer 49

Social readjustment ratings scale (SRRS) Hassles and uplifts scale (HSUP)

Answer 50

Holmes and Rahe

Answer 51

To test their hypothesis about the relationship between life changes and physical illness

Answer 52

5000 patient records were examined to identify 43 common life events reported by patients. These 43 life events were then scored by 400 participants based on how much readjustment would be required by the average person using a numerical figure. A baseline score of 50 was given for marriage and events that would take greater adjustment than this, would be scored higher. The scores were then totalled and averaged to produce life change units (LCUs) for each event. The scale is then completed by selecting the life events which have occurred for an individual within a particular time period and the life change units scored are added up.

Answer 53

Kanner et al 1981

Answer 54

That hassles and uplifts were significant factors in illness

Answer 55

Asked research staff to generate a list of hassles and uplifts related to work, health, family, friends, the environment and practical considerations and chance occurrences. The total list consisted of 117 hassles and 135 uplifts which were rated on a 3-point scale and completed in reference to a specific time period over the last month or week.

Answer 56

Blood pressure Levels of adrenaline Signs of arousal from the sympathetic nervous system Also skin conductance responses aka lie detector test

Answer 57

Immediate stress relates to sympathetic arousal of the ANS and the rationale behind using the skin conductance response is based on fight or flight response When experiencing stress, autonomic nervous system becomes aroused and one of the consequences of this is we sweat more with One of the most sensitive and practical parts of the body where this can be measured is the hand Electrodes are attached to index and middle finger to detect sweating and a tiny current, that is too weak to be felt, is applied via the electrodes to measure how much electricity is being conducted Human skin tends to be a good conductor of electricity, so the more sweat, the more conductive their skin becomes

Answer 58

Individuals will have higher skin conductance response scores when stressed compared to not, therefore readings need to be taken across both states to draw comparisons The readings are measured through the use of a polygraph which measures blood pressure, pulse, respiration as well as their skin conductance response Individual will normally begin test by sitting quietly for 30 mins to establish baseline score so readings from the test can then be compared to assess when they are becoming stressed

Answer 59

Most of the items on self-report stress measures are general categories rather than individual events Means they are open to varying degrees of interpretations by different ppts Dohrenwend et al demonstrated this point by asking ppts what they thought each item meant Items such as serious illness and injury were interpreted in a variety such as having flu or sprained arm to life-threatening heart attack He highlights that people experiencing the greatest degree of stress when completing self-report scales place greater negative interpretations on the item (and vice versa) This problem of intra-category variability reduces the validity of self-report measures Make it difficult to assess the true relationship between stress, life events, daily hassles and illness

Answer 60

Determining when someone is lying This has led to their usage for criminal matters through polygraph tests however these are not completely reliable or conclusive Oshumi and Ohira found that psychopaths are much less affected by being treated fairly or unfairly and generally lack emotional responsiveness which means they can lie without any physiological response

Answer 61

Cardiologists Friedman and Rosenman

Answer 62

CHD was associated with certain behavioural characteristics which they classed as a Type A Personality

Answer 63

Competitiveness: Driven and achievement-motivated, ambitious and aware of their own and other people status. They view life in terms of challenges, goals and targets Time urgency: Fast-talking, impatient, determinedly proactive, see creative pursuits as time-wasting and have a preference for multi-tasking Hostility: May be aggressive, intolerant, inflexible and quick to anger

Answer 64

Hypertension: high blood pressure CVDs

Answer 65

More laid back and relaxed, tolerant and reflective as well as non-competitive in their manner compared to Type A personalities Same level of ambition as type a but are steady and more self-confident Capable of relaxing and doing nothing which is something type a individuals struggle to do

Answer 66

To study the link between Type A behaviour and coronary heart disease

Answer 67

Longitudinal 3000 men Aged 39 to 59 Living in California Examined for signs of CHD - those showing signs were excluded Personalities assessed by interview which consisted of 25 questions about how they responded to every day pressures, e.g., how they would cope with having to wait in a long queue The interview was conducted in a proactive manner to elicit Type A behaviour, e.g., interviewer may talk slowly and hesitantly so a Type A person would likely interrupt Based on this interview, ppts were classed as Type A or B

Answer 68

After 8.5 years 257 ppts had developed CHD 12% of individuals classed with Type A personality has a heart attack compared to only 6% of individuals classes with Type B personalities. Type A personality also had higher blood pressure and cholesterol with twice as many having died due to CV problems Those with Type A personality were also more likely to smoke and have history of CHD which contributed to their greater risk

Answer 69

Individuals are believed to strongly suppress their emotions, particularly negative ones and are seen as passive, unassertive, 'people pleasers' that may manifest pathological niceness They are seen to cope with stress in a way that ignores their own needs which includes physical needs that can result in negative consequences

Answer 70

Due to stressors activating the autonomic nervous system which is related to coronary heart disease As most chronic stressors affect healthy immune system functioning, this in turn increases the risk for cancer

Answer 71

Examined the link between Type C personality traits and cancer

Answer 72

Over two year period Women that were attending cancer clinic in London were asked to take part in the study 75 women participated and were interviewed to assess typical behaviour patterns which included questions on how often they expressed affection, unhappiness by crying or losing control when angry The interviewer was not aware of ppts initial diagnosis of cancer

Answer 73

Found that women who had cancerous breast lumps experienced and expressed far less anger than those women whose lumps were found to be non-cancerous This supports link between suppression of anger in line with Type C personality traits

Answer 74

Some researchers have failed to replicate Friedman and Rosenman's findings Also, not all aspects of lifestyle were controlled in Friedman and Rosenman's study so it may be other factors such as hardiness that affects vulnerability to CHD While Type A men are more at risk of developing CHD, the risk is relative as the vast majority of Type As do not, while some Type Bs do

Answer 75

Found 15% of Friedman and Rosenman's original had died of CHD with age, high blood pressure and smoking all proving to be significant factors in death, however little evidence of Type A personality being a risk factor This undermines the theory that Type A personality may contribute to CHD

Answer 76

Only men Riska claimed the preoccupation with Type A behaviour was a reflection of the importance of traditional masculinity in the 1950s and 1960s given behaviours such as competitiveness and assertiveness are very masculine Friedman et al conducted a follow-up study on 800 ppts that included men and women that had experienced CHD Ppts were then randomly allocated to either a treatment group that received cardiac and Type A counselling or a control group that received only cardiac counselling Findings were that treatment group less likely to have further CHD related problems Suggests men and women both experience type a behaviours and would benefit from treatments designed to reduce them

Answer 77

Found that they were typical of type c personality individuals However this was only in women under 50 Research into the link has produced inconsistent findings with low reliability in replicating any significant results This would suggest the relationship between type c personality is not straight forward and moderated by a number of factors that may include age

Answer 78

Set of personality traits that make people more resistant against the negative effects of stress Associated with lower physiological arousal when faced with stressors which reduces stress-related disorders

Answer 79

Control: feel a sense of personal control over what they are doing and do not see external factors as key determinants of their lives Commitment: Committed to what they are doing and have a sense of self and purpose Challenge: See problems as challenges. they see change as something to be expected and an opportunity for personal development

Answer 80

Benzodiazepines

Answer 81

Slow down the activity of the CNS and are commonly known as Librium and Diazepam

Answer 82

Reduce anxiety Enhance actions of neurotransmitter GABA Dampen excitatory effects of the neurotransmitter serotonin, which further slows down the activity of the nervous system and adds to the feeling of relaxation

Answer 83

The body's natural form of anxiety relief with approximately 40% of the neurons in the brain responding to GABA to induce a inhibiting effect

Answer 84

GABA reacts with GABA-A receptors on the outside of postsynaptic neurons Once GABA locks into these receptors, it opens a channel which increases the flow of chloride ions into the postsynaptic neuron Chloride ions make it harder for the postsynaptic neuron to be stimulated by other neurotransmitters which slows down its activity and results in a person feeling more relaxed and less anxious

Answer 85

Act on SNS by blocking area which are normally activated by the hormones adrenaline and noradrenaline which are released in response to stressors They block transmission of nerve impulses by sitting on beta-adrenergic receptors that would normally be activated by hormones The hormones bind to beta-adrenergic receptors located throughout CV system, principally receptors located in the heart and blood vessels which results in increased heart rate and blood pressure, symptoms normally linked to stress Beta blockers effectively block the beta-adrenergic receptors from being stimulated by adrenaline and noradrenaline which slows down the heart, reduces blood pressure and causes the heart to pump less intensely

Answer 86

Over 250 patients 8 weeks Found that BZs were significantly more effective compared to placebos for the treatment of anxiety and stress Lockwood also found beta blockers were effective when over 2000 musicians were studies 27% of the musicians reported to be taking beta blockers and reported to feel better about their performances due to taking the drug therapy Music critics consistently judged their performances as better too although Schweizer et al found that not all kinds of beta blocker reduced participants subjective sense of stress

Answer 87

Drug therapies require little effort from the user beyond remembering to take the pill itself which is much easier than applying other psychological therapies such as stress inoculation which requires significant more time, effort and motivation. Therefore patients are more likely to engage with drug therapies which are easy to use, fast acting and cost effective

Answer 88

Patients taking benzodiazepines have shown withdrawal symptoms when trying to stop and due to this, it is recommended that benzodiazepines are taken for a maximum of four weeks (Ashton, 1997). Due to the potential for such addiction, BZs are not appropriate for treating everyday stress and mostly limited to people experiencing psychological disorders that have an anxiety component.

Answer 89

The other issue with drug therapies such as benzodiazepines is the potential for side-effects such as paradoxical symptoms, which are the opposite of what one would expect from their usage. These side effects include increased agitation, aggressiveness and cognitive side effects such as impaired memory. Most people fortunately do not suffer from such side effects however some research has linked them with an increased risk of developmental diabetes.

Answer 90

A strength of beta blockers is unlike benzodiazepines, they are not associated with dependency or addiction although they can have serious side effects such as cold extremities, tiredness, nightmares and hallucinations.

Answer 91

Such drug therapies are only effective as long as individuals continue to take them and as soon as they stop, their effectiveness stops also. There is an argument that the causes of stress may be better tackled through psychological therapies which may stop the stress response that contributes to anxiety by altering peoples perception of the stressor

Answer 92

A form of cognitive behavioural therapy developed especially to cope with stress. Involves cognitive restructuring of the way people think about themselves, their lives and the way they think about stress itself

Answer 93

Meichenbaum

Answer 94

It is considered a cognitive approach because it targets the way a person thinks, in particular, negative thoughts that would lead to anxiety or depression and looks to replace them with more positive thoughts instead.

Answer 95

Conceptualisation Skills acquisition and rehearsal Application and follow-through

Answer 96

The client and therapist work together to identify and understand the stressors the client faces through a therapeutic relationship that is warm, collaborative and supportive. The client is considered the expert on their own stress experiences rather than the therapist as they work to identify negative self-statements. The client is also educated about the nature of stress and how this can be caused by their own cognitive appraisals (thoughts). The client is encouraged to understand that stressors can be positively reframed as challenges that can be overcome, as well as understand what aspects of a situation they can and can't change.

Answer 97

The therapist helps the client to develop and practise coping skills that will enable them to cope with stressors they have identified. This may include positive self-talk where they challenge their own negative thoughts that create feelings of anxiety or techniques such as relaxation exercises, social skills, communication or cognitive restructuring where the client thinks about the stressful situation in a more optimistic manner. This phase sees the client plan in advance how they would cope with stressors using such skills.

Answer 98

Clients will visualise using the stress-reduction techniques learned from the skills acquisition and rehearsal phase and then apply them in role-play scenarios before applying them to real-life situations. The client may initially begin practicing with a non-threatening example such as imaging themselves dealing with the stressor. They may then move on to practice the coping strategy in a role play before finally applying it to real-life. The therapist may also set homework tasks, also known as personal experiments, for the client to use the skills in everyday life by deliberately seeking out moderately stressful situations where they can apply their learnt skills. This is then fed back to the therapist for discussion. An important feature of this phase is relapse prevention where the therapist helps prepare the client on how to cope with setbacks.

Answer 99

The therapy can be used with individuals, couples, groups and even families in a variety of settings. The duration of the training itself can range from 20 minutes to 40 or more hours and over several months with techniques tailored to meet the specific needs of the individual. This may include elderly people, those with learning difficulties or even adapted for use online (Litz et al. 2004). Stress inoculation therapy can even be used in situations where people face racism or homophobia which is a distinct advantage of this therapy.

Answer 100

Clients also have to be highly motivated for it to be most effective and requires a high degree of self-reflection and openness to learning new skills. Not everyone is capable of this and applying the learned skills to real life situations can be quite demanding. Failure in this respect can be demotivating which means some people do not continue with the treatment. A benefit is stress inoculation therapy factors in potential setbacks and helps people prepare for these while exploring ways to overcome them.

Answer 101

The therapies success is based on subjective reports from clients. Clients may initially exaggerate their problems during the conceptualisation phase in order to gain support by a therapist. At the end of the treatment, patients may be grateful for any help they were given and may minimise the remaining problems they have. This might make the therapy seem more effective than it actually is and undermines its effectiveness.

Answer 102

Patients can continue to use the skills they have learnt in a number of other stressful situations and it can be generalised across different types of stressors. However, there are many threads to the therapy and it is difficult to work out which element is most important in addressing the negative effects of stress. For example, It may be that relaxation is the main skill that helps tackle stress and not necessarily cognitive appraisal or positive self talk.

Answer 103

A behaviourist method of stress management that trains people to lower their stress levels by using physical signals from their bodies involuntary processes. Biofeedback targets the physiological response to stress and arousal of the sympathetic nervous system that leads to increased heart rate and blood pressure with the aim of learning to better manage this.

Answer 104

By attaching patients to a machine that gives visual or auditory feedback about their physiological activity and teaches them to learn to control these involuntary responses. For example, a clients heart rate is monitored and a signal is amplified and fed back to the client via a display or the sound of a tone through earphones. Muscular tension can also be measured using an electromyogram (EMG), as well as brain activity via an electroencephalogram (EEG) and displayed on a screen.

Answer 105

Relaxation Feedback Operant conditioning Transfer

Answer 106

The patient is taught relaxation techniques that help reduce the activity of the sympathetic nervous system and instead activates the parasympathetic nervous system which stops adrenaline and noradrenaline from being produced. The result should then be reduced heart rate, blood pressure and the symptoms normally associated with stress.

Answer 107

The patient is attached to various machines that provide feedback about their autonomic nervous system activity. This might include their heartbeat played as a sound or visual representation, live changes in blood pressure or muscle tension or any other physiological response. The patient then practices relaxation techniques while seeing or listening to the feedback from these involuntary responses and respond by relaxing themselves which should cause their activity to decrease

Answer 108

As the patient learns to use relaxation techniques to lower their physiological response, for example heart rate, this is seen as rewarding because the person achieves their goal and this reinforces the behaviour which increases its likelihood of being repeated. Learning to lower or manage ones arousal is conditioned eventually without any conscious thought as over time, this behaviour is cemented in.

Answer 109

The patient then attempts to transfer the skills they have learned to real-world situations using the relaxations techniques in response to any stressors they encounter.

Answer 110

Henry Davis

Answer 111

Thirteen 45-minute sessions of biofeedback were held over a period of 8 weeks where breast cancer patients learnt deep-breathing and relaxation techniques.

Answer 112

After eight months, the cortisol level in urine, as well as self-reported anxiety levels had lowered significantly in patients compared to the start of the study. A control group of participants who received no biofeedback therapy had increased levels of cortisol. The researchers therefore concluded that this was evidence of significant stabilisation of the hypothalamic-pituitary-adrenal system due to biofeedback.

Answer 113

Jane Lemaire et al. (2011) used medical doctors as her participant and trained them to use biofeedback three times a day over a 28-day period. They also completed questionnaires that measured their perception of how stressed they were. The mean stress scores for biofeedback users fell significantly more over the course of the study when compared to a control group demonstrating it was effective.

Answer 114

The benefits of biofeedback training see it as a potential long-term strategy that can be employed when necessary and applied to a number of different stressful situations. Also, unlike drug therapies, the symptoms may not return because they stop taking the medication nor is there any risk of dependence or addiction. Research by Attanasio et al. (1985) also found biofeedback worked well with children, as they were more willing to engage and try hard in achieving success. This suggests the therapy is more suited to those who are motivated to engage and reduce their stress levels.

Answer 115

If the success of biofeedback is mainly due to relaxation rather than feedback and conditioning, there really is no need for the expensive equipment and time-consuming procedure. The use of specialistic equipment also makes it expensive and only usable with supervision. The treatment time can also be quite lengthy spanning a number of weeks which may make it inappropriate. Biofeedback also requires a level of effort and motivation from the client which may present a barrier to its usage due to individual differences and some people also not understanding the relationship between their physiological functioning and the visual/auditory feedback they receive.

Answer 116

For example, PTSD is just one of the many conditions which have been successfully treated with biofeedback. PTSD develops when a person experiences a traumatic event and therefore remains in a state of stress. Biofeedback had also been used in sports such as biathlon, where individuals are required to have control over bodily stress levels in order to be successful. The ability to manage ones arousal to keep themselves performing optimally has a number of advantages across a number of high-pressure sports too from tennis to football.

Answer 117

The main reason studies into stress have focused primarily on men is due to their hormone levels not altering due to an ovulation cycle. Research has shown there are significant gender differences in coping with stress by females compared to males, which appears to be biologically based.

Answer 118

'Flight-or-flight' response in men, however in women a 'tend-and-befriend' response occurred.

Answer 119

Women produce more oxytocin, a hormone that is released from the pituitary gland which promotes nurturing and cooperative behaviour. From an evolutionary perspective, fight-or-flight is disadvantageous for females as confronting or fleeing a predator would make it difficult to protect their children. Instead research has shown that women will engage in behaviour that looks to protect, calm or nurture offspring as well as blend into the environment. The tend-and-befriend response also involves seeking support from social networks as a coping mechanism for stress. Research has shown that befriending behaviour among women is more selective during times of stress and it tends to be with other women (Lewis and Linder (2000).

Answer 120

Men are more reluctant to perceive or admit that stress impacts them negatively which affects the ways in which they cope with it. Males are less likely to make necessary changes to their lifestyle or seek professional help from therapists which has a negative impact on their mental health.

Answer 121

Men have a tendency to use problem-focused methods of coping with stress, compared to women who use more emotion-focused strategies.

Answer 122

Lazarus and Susan Folkman (1984) were the first to make this distinction suggesting problem-focused methods reduced stress by tackling its root causes in a direct, practical and rational way that looks to take control and remove or escape stressors.

Answer 123

Lazarus and Susan Folkman (1984) Motion-focused methods reduce stress indirectly by tackling the anxiety associated with stressors. Strategies may include various forms of avoidance, distraction, or cognitive appraisal that sees the stressor differently.

Answer 124

Self report methods prone to bias and are therefore difficult to objectively validate. For example, women may be more willing to reveal the emotional side of coping, whereas men may play down their emotional difficulties. Additionally, dividing the way in which people cope with stress down to gender differences is overly simplistic and can create a self-fulfilling prophecy where people react in a way they think they are supposed to simply because of their gender. There are significant individual differences between people which means men and women will not cope with stress in gender-stereotypical ways.

Answer 125

For example, work based stressors lend themselves to problem-focused coping strategies whereas relationship-focused stressors require more emotion-focus strategies. Pilar Matud (2004) found men and women experienced the same number of stress life changes, however they were different types of stressors. Women tended to report more family-related stressors which they perceived as negative and less controllable. Their responses also tended to be more emotion focused. Men on the other hand, reported more work-related stressors. The demonstrates that gender differences in coping strategies may be due to men and women experiencing different kinds of stressors rather than reflecting something fundamentally down to being a man or woman.

Answer 126

For example, it would be adaptive for women to be aggressive also particularly to protect their offspring. Taylor et al. does not that while females are less aggressive than males, they are aggressive towards anyone that threatens their offspring. This suggests aggression in situations that require defence may be typical rather than the generalised 'fight' response seen by males. The same is true of the 'flight' response as animals that have offspring that are mobile will flee rather than stay huddled together. Therefore, the female response is not simply a tend-and-befriend but encompasses a range of strategies that are adapted to parental investment.

Answer 127

For example, the degree of social support a person receives may act as a confounding variable as women are more likely to receive social support in comparison to men. Social support reduces the amount of stress a person experiences and this may mean women may experience less, thereby selecting different coping styles.

Answer 128

The level of social support they receive from friends, family and those available around them. The more social support they receive, the better able they will be at coping with stressful situations as social support acts as a buffer against stressors.

Answer 129

The lack of social support not only prevents individuals from dealing with stress, it can also lead to a sense of isolation and mental illnesses such as depression.

Answer 130

Stroebe (2000)

Answer 131

Esteem support Emotional support Appraisal support Informational support Instrumental support

Answer 132

Occurs when an individual perceives that others value them and hold them in high regard. This increases and strengthens their feelings of self-value which is helpful in stressful situations as it helps them feel competent enough to cope with the stressors.

Answer 133

Occurs when an individual perceives that others care and have sympathy for them with an understanding of the stressful situation they are faced with. This type of support expresses warmth, concern, affection, empathy and love. This support doesn't offer practical help but rather makes the stressed person feel better, to lift their mood.

Answer 134

Occurs when others assist an individual to identify and understand the stressors and the impact they are having on their health, which allows a realistic view of the situation.

Answer 135

Involves others giving advice and guidance on how to deal with the stressor and might come from a therapist, or from others on how the individual is coping.

Answer 136

Occurs when people provide practical and tangible assistance by physically doing something to help, for example, giving someone a lift to the doctors or loaning them money. This type of support is seen as a problem-focused type of support to coping with stress as it involves doing something.

Answer 137

39 female psychology students volunteered to perform a mental task that was stressful while their physiological reactions were monitored. Each of the participants attended a lab session either alone or with a close same-sex friend. During the mental task, the friend was told to touch the participant on the wrist while they also completed a task. This was done so as to avoid the participant feeling like they were being evaluated by their friend but also to avoid the friend from monitoring what the participant was doing. All the participants also completed questionnaires related to their mood and personality.

Answer 138

Participants that were with a friend showed lower physiological arousal (e.g. lower heart rate) than those who were alone. For some of the tasks, only those with Type A personality showed reduced physiological responses which supports the hypothesis that social support acts as a buffer, although this may only be for those who already show a high response to stressors.

Answer 139

Men for example, have been found to have larger social networks than women, however the size of the network is not the crucial factor that influences the effectiveness of social support. During times of stress, on virtually every measure, women are more likely to seek out and use social support as well as provide it. This is supported by Luckow et al. (1998) who reviewed 26 studies into gender differences and social support. In 25 of the 26 studies, women were found to use social support as a means of coping with stress more than men. This difference was especially evidence in the case of emotional support.

Answer 140

What tends to matter is who provides the support and the type of social support they give. For example, emotional support is helpful when given by friends and family however instrumental support in the form of information and advice is more valued when coming from appropriate professionals. Also, there are times when emotional support from close friends or family is not helpful and may lead to people feeling more anxious. It is possible the benefits of social support are realised when the recipient seeks it rather than has it imposed on them.

Answer 141

Fawzy et al. (1993) randomly allocated patients with malignant melanoma to a support group for six weeks. The group provided emotional support by giving patients the opportunity to express their feelings, as well gain instrumental support through gaining information and advice about their illness. Patients were examined six years later and it was found that patients who received social support had better NK cell (white blood cell) functioning and were more likely to be alive as well as cancer free in comparison to a control group. This demonstrated that the benefits of social support can be substantial, long-lasting and effective.

Answer 142

Different types of social support have been investigated and it is difficult to isolate and test the different types, which makes it difficult to assess which are the most influential in helping individuals cope with stress. Additionally, it is not fully understood how social support helps combat stress. It may be that social support raises self-esteem, which enables individuals to be more persistent in dealing with stressors which would mean that it is not necessarily social support that is helping people cope with increased stress but increased self-esteem or confidence. This raises the point around correlational research and being unable to establish the true cause and effect. Most research findings are based on correlations between stress and social support and as this demonstrates, there may be confounding variables involved.

Stress Flashcards

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