Health and Clinical Psychology - Stress

- Causes of stress

  • Johansson - Work
  • Kanner - Hassles & life events
  • Geer & Maisel - Lack of control

-Measuring stress

  • Geer & Maisel - Physiological 
  • Holmes & Rahe - Self-report
  • Johansson - Combined

-Managing stress

  • Meichenbaum - Cognitive
  • Budzynski - Behavioural - Biofeed back
  • Waxler & Morrison - Social (support)
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  • Created by: SarahD95
  • Created on: 29-05-14 11:48

Jonhansson 1978 - Work

Aim: measure the psychological & physiological stress respones in 2 categories of employees

Method/Design: quasi exp, independent MD, workers were defined as being high risk or in a control group (cleaners), urine & self-report

Participants: 24 workers - swedis sawmill, 14 high risk & 10 cleaners (control g)

Procedure: daily urine sample on arrival at work & 4 other times, body temperature was checked & were asked to complete a self-report on mood and alertness (sleepiness, irritation, efficiency) & caffeine & nicotine consumption. Baseline reading were taken at home before the study started.

Results: high risk g adrenaline levels were twice as high as baseline & increase throughout the day. Control g had a peakod 1.5 time their baseline in morning & this declined during the day. Self-report - high risk felt more rushed & irritated, rated their wellbeing lower than control g

Conclusion: the repetitive, machine-paced work, which was demanding in attention to detail and highly mechanised, contributed to the higher stress levels in the high risk g

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Kanner 1981 - Daily hassles & uplifts

Aim: compare the hassles & uplift scale & the Berkman Life Event Scale as predictors of psychological symptoms of stress

Method/Design: repeated MD 

Participants: 100 p previously completed asurvey in '65 on helath, Cali, mostly white protestant, adequet income

Procedure: surveys sent out by post 1 month before
Hassles rating - 9 months
HSCL & the Bradburn morale scale - 9 months 
Life event rating scale - 1 month after the 9 months (after 10 months)

Results: hassles were consistent from month to month. Men life events pos correlated with hassles & neg with uplifts. Womenboth hassles & life events pos correlated with life events. Hassles correlated positively with psychological symptoms than life events

Conclusion: hassles are a more powerful predictor of psycholoical symptomsthan life events

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Geer & Maisel 1972 - Lack of control

Aim: to see if perceived control can reduce stress reactions to aversive stimuli

Method/Design: lab exp, independent MD, Ps randomly assigned to 1 of 3 conditions, seeing pics of dead car crash victims. Control group - G1

Participants: 60 undergrads, psych course at NY uni, 

Procedure: ps seated in a shielded room wired to GSR and heart rate, machine callibrated for 5 mins whilst ps relaxed & baseline measurement was taken, rules read.
G1 given actual control, could press a button to terminate pic, 10 sec tone would precede
G2 yoked to a p in G1 (timing) - pre-determined time, warned pics would be 60 sec apart, 10 sec tone would precede. Had no control, length of exposure controlled by a p in g1.
G3 yoked to p in G1, told they would see pics from time to time, no control, no predictability

Results: heart rate discarded. G1 experienced the lowest stress response maesured by GSR, compared to G2 which showed the most stress in response to the tone (they knew what was coming, but had no controlover pic)

Conclusion: ps showed less GSR reaction, indicating less stress, when they had control over the situation. Likely that being able to terminate aversive stimuli reduces its stressful impact. 

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Geer & Maisel 1972 - Physiological measures

Aim: to see if perceived control can reduce stress reactions to aversive stimuli

Method: lab exp, pics of dead car crash victims

Participants: 60 undergrad, psych course NY uni

Procedure: shielded room, wired to GSR & heart rate. G1 had control over of time & termination of pic, G2 yoked & had no control, G3 yoked & knew time to time they would see pics. 10sec tone.

Results: G2 showed most stress to tone, knew what would happen but had no control over pic. Control g - G1 showed less stress in reaction to photos than G2&3

Conclusion: ps showed less GSR reaction, indicating less stress when they had control over the situation. 

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Holmes & Rahe - Self-report: social readjustment s

Aim: to create a method that estimates the extent to which life events are stressors

Method: questionnaire designed to acertain how much each life event was considered a stressor

Participants: 394 ps, from range of educational abilities, ethic groups & religions, 179M & 215F

Procedure: ps asked to rate a series of 43 life events. Ratings could be based on personal experience & perceptions of other people. The amount of readjustment & the time it would take to readjust were both considered.

Results: Final SRRS was completed based on the mean scores allocated by Ps. Correlations between groups were tested & found to be high in all but one group. M & F agreed, as did Ps of diff ages, religions, ed level, but there was less correlation between white & black Ps

Conclusion: these events are mostly ordinary. Some social desirable events which reflect the western values of materialism, success & conformism. Degree of similarity bewteen diff gourps is impressive & shows agreement in general about what constitutes life events & how much they cause stress. 

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Jonhansson 1978 - Combined

Combined approch of Johansson, showed work as a cause of stress, used both self report & phys measures.

24 P - 14 high risk (incharge of everyone's wages) & 10 cleaners (control group)

Each p gave a urine sample 4 times a day, so adrenaline levels could be measured (phys measure), body temp was recorded at same time. These measures were also combined with a self report were each p had to say how much caffeine & nicotine they had consumed since last urine sample.

They also had a list of emotions & feelings - sleepiness, well-being, calm, irritation. These were on a continuum from min to mas & on a milimetre sclae. The score was how many milimetres from the min base point the P had marked themselves to be feeling. This combined methos of phys measures & self-reports gave some good qual & quant data that enable Johansson to compare the 2 groups, & have some understanding of the impact of higher stress levels on Ps. 

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Meichenbaum - Cognitive

Aim: compare SIT with behaviour systematic desentisisation & a control group on a waiting list

Method: field exp, students assessed before & after treatments using self-reprt

Participants: 21 students aged 17-25, responded to an ad for treament of test anxiety

Procedure: Ps took an IQ test & were assessed using anxiety adjective checklist. Baseline score from IQ test & allocated to groups. SIT g received 8 therapy sessions help id thoughts prior to test.SD g 8 therapy sessions with progressive relaxation training, encouraged to practise at home. Control g told they were on a waiting list & would receive therapy in future.

Results: performance in the tests improved in the SIT g compared to the other 2 g, signif diff was found betweeen the 2 therapy g & the control g

Conclusion: SIT more effective way of reducing anxiety in students who are anxiety prone in test sits

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Budzynski - Behavioural - biofeedback

Aim: to test the effectivenee of biofeedback tech in reducing tension headaches

Method/Design: independent MD, Ps randomly allocated to 1 of 3 g, 6 in each. GA - biofeedback sessions with relaxation training, GB - relaxation training, pseudo feedback, GC - control g, waiting list

Participants: 18p 16F &2M aged 22-44, replied to ad in local paper - Colorado, 

Procedure: ps kept record of headaches for 2 weeks rating them from 0-5 every hr to give a basleine reading, completed the MMPI which tested hysteria & hypochondria. GA&B given 16 sessions of training, GA taught relaxation, told clicks of biofeedback machinewould reflect their muscle tension, slower clicks=lower tension. GC given no training told they would begin in 2 months & p were to record headache activity. After 3m  GA&B given an EMG test & MMPI.

Results: GA's muscle tension & reported headaches was signif lower than GB&C. Follow up Q for GA&B showed GA had more reduction in symptoms than GB - heart rate & depression. Only control g showed less hypochondria, drug usage fell & effects persisted 18m later

Conclusion: biofeedback is an effective way of training p to relax 7 reduce their tenion headaches, so can be seen as an effective method of stress management. 

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Waxler & Morrison - social support

Aim: look at how  woman's social relationships influence her response to breast cancer & survival

Method/Design: quasi exp-women diagnosed wiht breast cancer, independent MD

Participants: 133 women under 55y, reffered to clinic in Vancouver, comfirmed diagnosis of BC

Procedure: ps were sent self admin Q gather info on demography & existing social networks. Included Q on ed level, responsible for children, contact with friends & fam. Details of their diagnosis was extracted from med records between June'80 & May'81 , survival & recurrence rates were checked in med records in Jan'85. 

Results: 6 aspects of social network signif linked with survival were: marital status, support from friends, contact with friends, total support, social network & employment. Qual data showed that practical help such as childcare, cooking & transport to hospital were concrete aspects of support.

Conclusion: the more social networks & support , the higher the survival rate of women with breast cancer. The assumption is that therefore the P's stress has been reduced

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