Stress as a Bodily Response
THE PITUITARY ADRENAL SYSTEM
When the body experiences a stressor the hypothalamus releases CRF which stimulates the pituitary gland to release ATCH and this travels to the adrenal cortex. The adrenal cortex releases corticosteroids which suppress the immune system; in addition, fat and protein are converted into energy.
THE SYPATHOMEDULLARY PATHWAY
When experiencing a stressor the sympathetic response occurs.The hypothalamus sends a signal to the adrenal medulla which stimulates the release of adrenaline and nor adrenaline. These hormones triggera range of physical effects such as increased heart rate, raised blood pressure, quicker breathing, dilated pupils, and the release of glucose from the liver. These physical effects induce the fight or flight state. The parasympathetic response occurs when the stressor stops, this involves all physical effects to reverse.
The Immune System
The immune system protects the body agains infections and diseases caused by pathogens. An antigen is a substance that when recognised as being foreign triggers an immune response. There are two types of immunity, natural and specific. In natural immunity white blood cells called phagocytes are sent to destroy the antigen, this type of immunity requires no prior sensitisation to the antigen and is an immediate response to infection. Specific immunity involves the production of antibodies that are specific to antigens. Lymphocytes produce two types of antibody, T cells and B cells. Specific immunity is a longer process as cells need to recognise the antigen before being able to destroy it. Upon second exposure to an antigen there are memory cells already in the blood stream specific to it so specific immunity is likely to have a quicker response that natural immunity on this occasion.
Research into Immunity and Stress
AIM: To investigate the link between stress and the immune system
PROCEDURE: 75 medical students had blood samples taken from them at different times, once in a low stress period which was before their final exams and te other sample was taken in a high stress period duirng their final exams. Immune functioning was assessed by measuring T cell activity within the blood samples and participants completed quesitonnaires that measured psychological variables.
FINDINGS: during low stress conditions the students' T cell functioning was normal however in high stress conditions T cell activity was reduced.
CONCLUSION: The immune system can be affected by high levels of stress
Kiecolt-Glaser 1984: An Evaluation
- Participants were all medical students therefore the results are difficult to generalise. The demand placed on medical students do not accurately reflect those placed on others so the results cannot be generalised to wider populations.
- Research supports the biological overview regarding stress and the immune system as prolonged stress increases your risk of becoming ill.
- Students reported illness due to stressors such as life changes; other students did not report such illness, individual differences were an extraneous variable in this experiment.
Life Changes: The SRRS
Devised by Holmes and Rahe in 1967. It is based upon research that found some events required a life change and this caused stress, therefore the scale looks at stress caused by life events. To develop the scale Holmes and Rahe looked at 5000 patient records and made a list of 43 life events that seemed to precede illness.
Research into Life Changes
RAHE ET AL 1970
AIM: to test whether there is a correlation between stress and illness.
PROCEDURE: 2500 US naval personnel were investigated over six months. Participants had to indiciate how many life events they had experienced in the past six months when given the SRRS. A stress score was calculated for each participant and a health record was also kept for them.
FINDINGS: results show a positive correlation of +0.118 between total stress score and illness.
CONCLUSION: findings suggest that life events are associated with physical illness. Implications include the improtance of using stress management techniques when experiencing life events.
Life Changes and SRRS: An Evaluation
- How stressful a situation is found varies from person to person but the scale disregards this. The scale does not distinguish positive life events from negative ones but instead assumes that any life change is stressgful, and there is no evidence to support this.
- The scale is rather dated. There is a life change denoting mortgage over $10,000 but now the majority have a mortgage above this figure.
- The scale is androcentric, it is written from a male point of view i.e. one life change listed is 'wife begins or stops work' and there is no reference to a husband beginning or stopping work.
KANNER ET AL 1981 developed the Hassles and Uplifts Scale. This lists 117 events that range from minor annoyances to major difficulties. 100 middel aged adults had to indicate the hassles they had experienced in the past month and had to rate them on severity: 'somewhat', 'moderately' , 'extremely'. This was repeated over 9 months. Frequently reported hassles were:
- weight concerns
- health of a family member
- misplacing or losing things.
In the uplifts scale there were 135 items that cheer people up. The frequently reported uplifts wer:
- relating well to spouse/lover
- feeling healthy
- getting enough sleep.
Daily Hassles: An Evaluation
- DELONGIS ET AL 1982 tested middle aged adults using the Hassles and Uplifts Scale and a Life Events scale. Participants were also given a health questionnaire. Both hassles and life events scores were associated with health status but more so with hassles. Uplifts had almost no association with health status
- The scale ignores individual differences, what is a hassle to one person could be and uplift to another.
- The findings from the scale are based on correlations, such data does not infer causality between variables.
Workplace Stress: Effect of Job Control
MARMOT ET AL 1997 THE STUDY OF THE ASSOCIATION BETWEEN WORKPLACE STRESS AND STRESS-RELATED ILLNESS
AIM: To investigate the association between job control and stress related illness in male and female civil servants.
PROCEDURE: a sample of 10,308 civil servants aged 35-55 (67% male and 33% female) were investigated in a longitudinal study over three years. Job control was measured through a self report survey and by assessments of the the work environment by personell managers. Job control was assessed twice, 3 years apart. Records were also kept of stress related illnesses. A correlational analysis was carried out to test the association between job control and stress related illnesses.
FINDINGS: Participants with low job control were 4 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.
CONCLUSION: findings show that job control is assocated with high stress as indicated by the number of stress related illnesses.
Marmot et al 1997: An Evaluation
- This study had a very large sample which allows for the findings to be generalised to a wider population. It is possible to suggest that similar results would be found in other civil servants.
- The investigation is correlational therefore it is difficult to esablish what the findings suggest as correlation does not always infer causation.
Workplace Stress: Effect of Workload
JOHANSSON 1978 A STUDY OF WORKLOAD AND STRESS
AIM: To investigate the differences between two job conditions, high stress and low stress.
PROCEDURE: The high stress group were 14 Swedish sawmill finishes whose work was largely machine paced, repetitive and high skilled. Their job was to complete the timber at its final stage. The low stress group were 10 cleaners whose job was largely self-paced and allowed for social interaction. Levels of stress hormones were measured on work days and rest days.
FINDINGS: the study showed that finishers secreted more stress hormones overall than the cleaners and the finishers also had a higher level of ill health and absenteeism than the cleaners.
CONCLUSION: a demanding job environment with high stress and workload can significantly affect your health.
Johansson 1978: An Evaluation
The role of individual differences was not controlled in this study but this study is useful as it contributes to an extensive body of scientific knowledge which shows a connection between stress and ill health.
WHAT ARE TYPE A PEOPLE LIKE: People with a Type A personality are competitive and strive to achieve. They are always in a hurry, find it difficult to relax and get impatient and angry with people who do things too slowly or are perceived as being incompetent.
TYPE A CHARACTERISTICS: Always in a hurry, multi-tasking, wanting to achieve and win in all areas of life, easily irritated and easily angered.
THE LINK BETWEEN TYPE A AND STRESS: Type A people have a tendency to place themselves in more stressful situations that are very demanding. Type A people often have a need for control, so once in a stressful situation they must take control which also increases stress levels.
WHAT ARE TYPE B PEOPLE LIKE: They are the complete opposite to those with a Type A personality. They can relax and make time for leisure activities without feeling guilty. They do not feel the need to be constantly busy but they are just as hard working as type A.
Type A Personality: Research
FRIEDMAN AND ROSENMAN 1974 RESEARCH INTO TYPE A PERSONALITY
AIM: to investigate the link between personality type and ill health
PROCEDURE: structured interviews were conducted with 3200 Californian men aged between 39-59 years over a period of 8 years. The men were categorised as one of the three personality types, A, B, or X.
FINDINGS: Once the study completed only 257 men of the original sample remained. From the 275 men, 70% of them(180) were classed as type A and had twice the rate of heart disease comparing to type B men.
CONCLUSION: Type A men are more likely to develop heart disease therefore personality is an influential factor on health.
Friedman and Rosenman 1974: An Evaluation
This study is useful as it highlights the link between personality and health but as only 8% of the original sample remained (257 men from the original 3200) the validity of the findings are lowered so it is difficult to conclusively state that personality will influence health.
Personality Factors: Hardiness
PROCEDURE: 600 male managers were asked to report on illnesses and stressful events experienced in the previous 3 years. They also had to complete a questionnaire assessing personality characteristics of hardiness.
FINDINGS: those who experienced high stress but little illness were more likely to have a hardy personality compared to those who experienced high stress levels and high levels of illness.
CONCLUSION: those with hardy personality are better able to cope with stress and so are less likely to contract illness.
BENZODIASEPINES: they are one of the most prescribed drug for psychological disorders and are effective against stress and anxiety. They work in reducing central brain arousal by working with GABA as an inhibitory role on neuron activity. A consequence of this drug is reducing the excitatory neurotransmitters making the person feel calmer.
BETA BLOCKERS: they work in the blood stream and control the stress hormones by binding to beta adrenergic receptors of heart cells in order to reduce stimulation of them. Overall heart beat is reduced and the force of contractions is reduced.
EVALUATION: drugs work rapidly in reducing symptoms such as reducing blood pressure. However, patients can develop a tolerance to drugs for example regular use of benzodiazepines will have progressively less effect. A problem with drug treatment is that it only treats symptoms rather than the underlying causes. Nevertheless, drugs have high availability so they can be prescribed immediately and allows individuals to take control of their stressful situations.
Stress Inoculation Therapy
This therapy aims to encourage clients who are suffering with stress, to perceive and evaluate stressful situations accurately and to improve coping strategies by training and practice. The training involves preparing individuals for future stressors and to promote resilience. The therapy has three phases-
PHASE 1 CONCEPTUALISATION: The main cognitive element of the therapy. Clients should recall a stressful situation and analyse aspects of the situation e.g. what is caused that situation to be stressful? through this analysis clients will have a greater understanding of how their thinking patterns can influence their behavioural patterns.
PHASE 2 SKILLS TRAINING AND PRACTICE: In this part the client is taught relaxation techniques in order to remain in control during stressful situations.
PHASE 3 REAL LIFE APPLICATION: The client is encouraged to apply their newly learnt skills in real life settings. Appointments with the therapist is maintained and if necessary further training is provided.
Stress Inoculation Therapy: An Evaluation
The therapy addresses the sources of stress and how to cope with it, it combines cognitive and behavioural strategies making it a very useful technique of stress management. There are issues regarding this therapy though, the programs clients are put through are rigorous programs which requires a high level of commitment and motivation from the client.