OCR psychology - Managing Stress

Methods for Managing Stress:

For this section...

• Stress Innoculation Therapy (SIT) - A cognitive (& behavioural) therapy that helps to reconstructure thoughts that contribute to stress.
• Biofeedback - A physiological & behavioural concept of reinforcement of stress reduction.
• Social Support - Shows how a person's social network can help to reduce stress.

Other methods...

• Relaxation techniques - Physiological
• Channeling negative thoughts - Cognitive
• Exercise - Physiological
• Drug therapy - Physiological
• Systematice Desensitisation - Cognitive & behavioural
• CBT - Cognitive

Aim: To compare SIT with standard behavioural systematic desensitisation and a control group on a waiting list.

Methodology: A field experiment using matched pairs design

Participants:

• 21 Students (Aged 17-25)
• THey had responded to a newspaper advert for treatment of test anxiety.
• Students were assessed before & after treatment using elf report and grade averages - this was done blind as the people assessing them didn't know which condition they'd been in.

Procedure:

• Pps were randomly assigned to SIT, waiting list, or systematic desensitisation group.
• Each pp was tested using a test-anxiety questionnaire.
• They were then told they had to do some IQ tests & would be assessed using an Anxiety Adjective Checklist.
• After the IQ tests pps were given a baseline score 7 allocated to their group

Procedure:  In the SIT group...

• Pps received 8 therapy sessions.
• They were given the 'insight' approach to help them identify their thoughts prior to the tests.
• They were then given some positive statements to say & relaxation techniques to use in the test situation.

In the systematice desensitisation group...

• Pps were given 8 therapy sessions with progressive relaxation training which they were encouraged to practice at home while imaging progressively more anxiety causing situations. 

(The control group were told that they were on the waiting list and would receive treatment in the future).

Findings: Performance on the tests improved more in the SIT group compared to the other groups, although the significant difference was between the 2 therapy groups and the control group. Both therapy groups showed improvements in anxiety levels compared to the control group.

Reliable - Standardised procedure (3 stages) so can be easily repeated.

Useful - Shown to be useful/effective at reducing stress/anxiety in anxiety prone people.

Considered Reductionist - if it's applied to people with high anxiety/stress because it doesn't take into account individual differences such as personality type. Also doesn't consider physiological factors.

Reliant on good communication/relationship/trust with therapist which some people may struggle with.

Biofeedback is simply feedback on one's biological functioning by giving visible or audible feedback on the state of the body, and rewarding the person for reducing the stress reaction (e.g. from flight or fight).

Biofeedback helps people to be aware of their stress responses (educational method) through operant conditioning.

Stages:

1. Connected to EMG (reads muscle tone activity & produces a high pitched tone) and thermistor (body temperature digital readout).

2. Focus thoughts of body tensions

3. Signals start to reduce --> patient can see this change & this acts to reinforce their behaviour & perceived control.

4. When conditioned response has occured, patient should be able to:

• recognise stress symptoms
• via progressive relaxation techniques, be able to reduce stress.

Aim: To investigate whether biofeedback is an effective method of reducing tension headaches.

They used an experimental method...

• Patients were treated in a lab.
• Data collected by measuring muscle tension using an EMG (electromyography) feedback machine with electrodes on the muscles, producing a graph of muscle tension.
• Patients also given a psychometric test of depression (MMPI).

Participants:

• 18 people who responded to a newspaper ad.
• From Colorado
• 16 females, 2 males.
• Aged 22-44 (mean age of 36)
• Initially screened by telophone & then underwent psychiatric and medical examination to ensure there was no other reason for their headaches.

It used an independant design as participants were randomly placed in 3 groups of 6 people.

The 3 groups...

Group A: Had biofeedback sessions with relaxation training and EMG feedback.

Group B: Relaxation training but only pseudofeedback --> this was a tape recording of real biofeedback from another person's session but was obviously not linked to the pps relaxation.

Group C: Control group --> they were told that they were on the waiting list but asked to come to lab appointments to keep them in the study & to control for the attention that the others might be getting.

Procedure:

• For 2 weeks, patients recorded their headaches, rating them from 0/mild to 5/severe every hour - this gave a baseline headache reading.
• They completed MMPI which tested for depression, hysteria and hypochondria.
• Groups A & B were given 16 sessions of training with 2 sessions each week for 8 weeks.
• Group A taught relaxation & told the 'clicks' of the biofeedback machine would reflect their muscle tension.

Procedure (continued...)

• Group B were told to concentrate on the varying clicks (the slower the clicks, the less muscle tension).
• Groups A & B were also told to practice relaxation at home for two 15-20 min sessions each day.
• After 3 months, groups A & B were given an EMG test and completed a questionnaire, plus the MMPI.

Findings:

• Group A's muscle tension was significantly lower than group B's by the end of training AND after 3 months.
• Group A's headaches dropped significantly from their basleine whereas the other did not.
• MMPI tests showed high levels of hysteria, depression & hypochondriasis for all groups before the study --> this reduced for all groups after training period. HOWEVER, only group A showed a significant reduction in hypochondriasis.

Conclusion: Biofeedback is an effective way of training patients to relax and reduce their tension headaces so can be seen as an effective method of stress management.

Reliable: Patients treated in a lab and physiological methods (EMG) follow a standardised procedure so easily replicated to look for consistancies/comparisions in results. --> However, very small sample size so difficult to generalise results.

Ethnocentric: All participants from Colorado --> low population validity.

Self rating scales: Are interpreted differently by participants so lowers validity.

Evaluation of biofeedback:

Objective: At measuring stress reduction to assess the effectiveness of biofeedback as a method fro managing stress (e.g. number of clicks).

Not biased or ethnocentric: Unlike SRRS etc...

Addresses cause or symptoms? - It doesn't deal with cognitions or emotions which may be the root cause of stress - Individual differences!?

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

Uses a Quasi-experiment and independant design. Information was gathered using questionnaires & 18 interviews, plus examination of medical records.

Participants:

• 133 women under 55 years.
• They had been referred to a clinic in Vancouver with a confirmed diagnosis of breast cancer.

Procedure:

• Patients were sent a self administered questionnaire to gather info on their demography and their existing social networks --> these included questions on their educational level, who they were reponsible for, perception of support etc...
• The details of their diagnosis were abstracted from their medical records between June 1980 & May 1981

Findings:

There were 6 aspects of social networks that significantly linked with survival...

• Marital status
• Support from friends
• Contact with friends
• Total supoort
• Employment
• Social Networks

Qualitative data from the interviews showed that...

• Practical help such as childcare, cooking & transport to hospital was the concrete aspect of support.
• Married women who survived reported supportive spouses
• Jobs were seen as important, even if not financially, as they were a source of support and information.