Psychology - Ms Smith

Stress has two meanings:

• It can be the environmental stimulus that triggers a response
• It can be the response to the stimulus

However it has been explained as:

• Stress is the response that occurs when we think the demands being placed on us are greater than our ability to cope. These are our own judgements - so we could over or underestimate the demands, or our ability to cope.
• The evaluation of whether something is a stressor occurs in the higher brain centres - the cerebal cortex.
• When there's a stressor in the environment, these higher areas send a signal to the hypothamalus.
• The hypothalamus controls the physisiological activities involved in stress. It produces the sympathomedullary pathway and the pituitary-adrenal system.

Sympathomedullary pathway

• In the initial shock response, the hypothalamus triggers activity in the sympathetic branch of the autonomic nervous system - which is a branch of the peripheral nervous system.
• The sympathetic branch becomes more active when the body is stressed and using energy.
• It stimulates the adrenal medulla within the adrenal glands, which releases adrenaline and noradrenaline into the bloodstream.
• These affect the body in several ways, such as increased blood pressure and heart rate, decreased digestion, tensed muscles, increased perspiration and increased breathing rate.
• The results of these changes is that the body is ready to use energy to deal with the stressful situation.

Pituitary-adrenal system

If the stress is long term, then the sympathomedullary response will start to use up the body's resources, so a second system produces a countershock response, which supplies the body with more fuel.

• The hypothalamus also triggers the release CRH (corticotopin-releasing hormone).
• CRH stimulates the anterior pituitary gland.
• This then releases a hormone called ACTH (adrenocoricotropic hormone)
• ACTH travels through the body and then stimulates the adrenal cortex, which is near the kidneys.
• The adrenal cortex then releases corticosteroids which give us energy by converting fat and protein.
• This energy is needed to replace that used up by the body's initial reaction to stress e.g. running away.

• During our evolution many threats to us would have been from predators or other physical dangers.
• So, to successfully resond to them, we would have required energy to fight or run away - the 'fight or flight' response.
• However, in modern society stressors are more likely to be psychological than physical and are more long-term
• Therefore the physical stress response is not really needed, and in the long term it may actually be harmful to our bodiies.
• Some stress can be positive and exhilarating, this is known as eustress,

Hans Selye was researching the effects of hormones when he noticed that rats would become ill even when they were given harmless injections. He concluded that the stress of the daily injections caused the illness and suggested that all animals and humans react to stressors through the three-stage physiological response. General Adaptation Syndrome (GAS):

• The Alarm Stage - when we perceive a stressor, our body's first reaction is to increase arousal levels so that we're ready to make any necessary physical response. These mean we're able to run away when in danger.
• The Resistance Stage - if the stressor remains for a long time, our bodies can adapt to the situation and we seem to be able to cope in a normal way.
• The Exhaustion Stage - after long-term exposure to a stressor, our bodies will eventually be unable to continue to cope with the situation. Alarm signs may return and we may develop illnesses. Selye called these 'diseases of adaptation'.

Krantz et al - stress and the heart

• In a lab experiment, 39 participants did one of three stress-inducing tasks (a maths test, a Stroop test and public speaking). Their blood pressure and the extent to which the vessels around their heart contracted (myocardial ischaemia) was measured. 
• Participants with the greatest myocardial ischaemia showed the highest increases in blood pressure.
• Stress may have a direct influence on aspects of body functioning, making cardiovascular disorders more likely.
• There is no cause and effect, as these things might happen when a person is relaxed.
• Not everyone showed the same reaction, sugggesting individual differences may have played a role.
• There isn't much ecological validity, as it was done under laboratory conditions.

Brady et al - stress and the development of ulcers

• Monkeys were put in pairs and given electric shocks every 20 seconds for 6 hour sessions. One monkey of each pair (the 'executive') could push a lever to postpone each shock. The other could not delay them
• The 'executive' monkeys were more likely to develop illness (ulcers) and later die.
• The illness and death was not due to the shocks but due to the stress that the executives felt in trying to avoid them. In the long term, this stress reduced the immune system's ability to fight illness.
• The experiment was unethical.
• We can't generalise results from monkeys to humans.

Kiecolt-Glaser et al - stress and wound healing

• In a study with an independent measures design, a punch biopsy was used to create a small wound on the arms of 13 women who cared for relatives with Alzheimer's disease (a very stressful responsibility). A control group of 13 people also took part.
• Wound healing took an average of 9 days longer for the carers than those in the control group.
• Long-term stress impairs the effectiveness of the immune sytem to heal wounds.
• The effects on the carers could be due to poor diet, lack sleep, etc.
• The study only contained a small number of participants - for more reliable results it should be repeated with a larger number.

Holmes and Rahe

• Holmes and Rahe assumed that both positive and negative life events involve change, and that change leads to experiencing stress.
• To test this assumption, they studied approx. 5000 hospital patients' records and noted any major life events that had occurred before the person became ill.
• It was found that patients were likely to have experienced life changes prior to becoming ill and that more serious life changes seemed to be more linked to stress and illness.
• Holmes and Rahe made a list of 43 common life events and asked people to give each one a score to say how stressful it waas. They called the numbers that made up each score the Life Change Units (LCU). The higher this number of LCUs, the more stressful it was.
• They then ranked the events from most stressful to least stressful and called it the Social Readjustment Rating Scale (SRRS).
• They found a positive correlation between the likelihood of illness and the score on the SRS - as one variable increases, so does the other. SO, the more stress a person experienced, the more likely they were to suffer illness.

Rahe et al - LCU score and illness

• In a correlational study, more than 2500 American Navy seamen were given a form of the SRRS to cmoplete just before they set sail on millitary duty.
• They had to indicate all o the events that they had experienced over the previous six months.
• Higher LCU scores were found to be linked to a higher incidence of illness over the next seven months.
• The stress involved in the changes that life events bring is linked to an increased risk of illness.
• The results are not representative of the population and can only be generalised to American Navy seamen.
• Results don't explain individual individual differences in response to stress. 
• You can't assume a causal relationship between the variables - the correlation might be caused by a third, unknown variable.

Problems with the SRRS

• It doesn't separate positive and negative life events.Stress and illness might be more linked to negative life changes. 
• Long-term, minor sources of stress, such as everyday hassles at work are not considered.
• The research is correlational, not experimental.
• Several of the life changes within the SRRS could be related to each other. For example, a big change in job conditions or getting fired are likely to affect a person's financial situation. This means that lfie changes could be both the cause and effect of stress.

Kanner et al - stress and daily hassles

• 100 adults completed a questionnaire each month which asked them to choose which hassles they had experienced that month from a list of 117. They then had to rate each hassle to show how severe it had been for them. This was repeated for 9 months.
• Certain hassles occurred more frequently than others e.g. worrying about weight.
• They found that those with high scores were more likely to have physical and psychological health problems.
• They found that scores on an uplifts scale were negatively related to ill health - these events may reduce stress or protect us from it.
• Daily hassles are linked to stress and health, with a stronger correlation than that found with the SRRS.
• It isn't possible to establish a cause and effect relationship between the variables.
• Questionnaires give quantitative data, which is useful for making comparisons, but don't allow participants to explain why certain experiences are stressful to them.
• They rely on honesty in order for results to be valid - participants may not be completely truthgul.
• They're relying on the participants' recall to be accurate.

Stress in the workplace:

• Relationships at work - our relationships with our bosses, colleagues and customers may be stressful. For example, we might feel undervalued and that we lack support.
• Work pressures - having a large workload, maybe with strict deadlines.
• The physical environment - Where we work may be very noisy, overcrowded, or too hot or cold. Also, our work may involve health risks or unsociable working hours.
• Stressed linked to our role - worrying about job security or our prospects for promotion. Also, the range of our responsibilities may be unclear, and we may experience conflict.
• Lack of control - we may not have much influence over the type and amount of work we do, or where and when we do it.

Marmot et al - lack of control and illness in the workplace

• Over 7000 civil service employees working in London were surveyed. 
• Information was obtained about their grade of employment, how much control they felt they had, how much support they felt they had etc.
• When the medical histories of these employees were follwed up 5 years later, those on lower employment grades who felt less control over their work were found to be more likely to have cardiovascular disorders.
• Participants on the lowest grade of employment were four times more likelt to die of a heart attack than those on the highest grade.
• Believing that you have little control over your work influences work stress and the development of illness.
• The study only looked at 'white coller' work, so the results may not apply to other jobs.
• Smoking was found to be common in those who developed illnesses, so maybe the smoking caused the heart problems rather than stress.
• Other factors such as diet and exercise may be linked to job grade and could be linked to job grade and could be causing illness rather than the perceived lack of control.
• The research is correlational, not causal.

Frankenhaeuser - stress levels in sawmill workers

• Studied two groups of workers at a sawmill. One group had the task of feeding logs into a machine all day. The job was very noisy and the workers were socially isolated They didn't have much control over their work as the machine dictated how quickly they should feed the logs in.
• The other group had a different task which gave them more control and more social contact.
• Stress levels were measured by testing urine samples and blood pressure.
• The workers who had minimal control and social contact had higher levels of stress hormones in their urine. They were more likely to sugger from high blood pressure and stomach ulcers.
• A lack of control and social contact at work can lead to stress.
• This was a field experiment, so it has high ecological validity. The findings are supported by Marmot's study. 
• It doesn't take individual differences into account.

• Type A - competitive and ambitious.
• Type B - non-competitive, relaxed and easy-going.
• Type C - mild-mannered, easy going people who suppress their emotions
• Type D - negative/pessimistic people who worry too much about things
• Type X - a balance of type A and type B

Friedman and Rosenman

• Approx. 3000 39-59 year old American males were assessed to class their personality characteristics into Type A, Type B or Type X using interviews and observation. At the start of the study none of them had CHD.
• 8 years later, 257 of them had developed CHD. 70% of these were classed as Type A personality. This includes being 'workaholic', extremely competitive, hostile and always in a rush. 
• Participants classed as Type B were less competitive and less impatient. They are found to have half the rate of heart disease of Type A. These results were found even when the extranrous variables of weight and smoking were taken into account.
• Three personality types is a bit simplistic. The study doesn't prove that personality characteristics can cause stress and illness. It could be the other way round. Sample was limited; can't generalise.

Kobasa

• Hardy personalities are very involved in what they do, and show a high level of commitment. This means that they work hard at relationships, jobs and other activities in life.
• They view change in a positive rather than a negative way, seeing it as an opportunity for challenge. Hardy personalities enjoy a challenge and see it as an opportunity to develop themselves.
• They have a strong feeling of control over their life and what happens to them. This is known as having an internal locus of control.
• Non-hardy personalities view any life experiences in a much more negative way and feel that they're unable to cope with situations. 
• They feel that external agencies have control over what happens to them and that it isn't worth trying to become more powerful.
• They give up easily and don't see any value in trying to change what's happening around them.

Stress in relation to gender

Biological explanation

• Through evolution, men in their role of 'hunter-gatherer' may have developed a stronger 'fight or flight' response than women, who had the role of caring for the kids. In this way, males and females may have developed different physiological responses to stress.
• Taylor et al suggest that women produce a calmer response to stress due to a hormone. Oxytocin is released in response to stress and has been shown to lead to maternal behaviour and social affiliation. Taylor called this the 'tend and befriend' response, and thought it might make females more likely to seek social support to help them cope with stress.

Social explanation

• A Western stereotypical social role is that men are less open about their feelings than women. This means they're less likely to discuss stressful experiences with others and may use harmful coping methods instead.
• Carroll found that women do generally make more use of social support to deal with stress. However, coronary heart disease has increased in women - but this could just be because a change in social roles means that it's now more acceptable for women to drink and smoke.

Cognitive explanation

• Vogele et al claim tat women are better able to control and therefore respond more calmly to stressful situations.
• Men may feel that anger is an acceptable way to respond, and feel stress if they cannot show it. These cognitive differences could be the result of biology or the roles we are taught to follow, or a bit of both.

Stress in relation to culture

• Culture is a really vague term that is used to group people by beliefs, behaviours, morals or customs they share.
• It influences how people live and how others react to them.
• Variables such as low socio-economic status can lead to poor living conditions and experience of prejudice - which could lead to negative thinking.
• Also, some people believe that biological factors could influence the link between culture, stress and illness.

Drug treatments

Drug treatments work in two ways:

• They slow down the activity of the central nervous system - Anti-anxiety drugs called benzodiazepines increase the body's reaction to its own natural anxiety-relieving chemical GABA, which slows down the activity of neurones and makes us feel relaxed.
• They reduce the activity of the sympathetic nervous system - The SNS increases heart rate, blood pressure and levels of the hormone cortisol. High levels of cortisol can make our immune system weak and also cause heart disease. The group of drugs called beta blockers reduce all these unpleasant symptoms.
• Drugs are quick and effective in reducing dangerous symptoms such as high blood pressure. Kahn et al found that benzodiazepines were superior to a placebo when they tracked around 250 patients over an 8-week period.
• Drugs only help with the symptoms and only so long as the drugs are taken.
• They can have minor side effects such as dizziness or tiredness. Withdrawal symptoms can also occur. Benzodiazepines can be addictive.
• Drugs are relatively easy to prescribe and use.

Biofeedback

• The person is attached to a machine that monitors and gives feedback on internal physical processes such as heart rate, blood pressure or muscle tension.
• They are then taught how to control these symptoms of stress through a variety of techniques. These can include muscle relaxation - muscle groups are tensed and relaxed in turn until the whole body is relaxed. This teaches people to notice when their body is becoming tense. Other techniques include actively clearing the mind using meditation, or breathing control exercises.
• This feeling of relaxation acts like a reward and encourages the person to repeat this as an involuntary activity.
• The person learns to use these techniques in real-life situations.
• Attansio et al found that biofeedback helped teenagers and children with stress-related disorders to gain control over the symptoms of migraine headaches. They also showed an increase in enthusiasm and a more positive attitude.
• Biofeedback aims to reduce symptoms, but can give a person a sense of control and have more long-lasting benefits.
• There are no side effects.
• It needs specialist equipment and expert supervision.

Excercise

• Exercise and being physically active reduces the likelihood of stress-related illness.
• Morris compared bus conductors and bus drivers and found that the conductors had lower rates of cardiovascular problems.
• This could be the result of having a more active job or the stress of driving.
• Or it could be caused by any number of other variables.
• However, it's difficult to get a clear idea of the relationship because active people may be less likely to engage in harmful behaviours like smoking and drinking. Active people are likely to sleep better, which will have both a biological and psychological influence on levels of stress.

Meichenbaum's Stress Inoculation Training (SIT)

This works like immunisation. You can protect yourself from the harmful effects of stress. Three steps are involved:

1. Conceptualisation: Identify fears and concerns with the help of a therapist.

2. Skill acquisition and rehearsal: Train to develop skills like positive thinking and relaxation in order to improve self-confidence.

3. Application and follow-through: Practise the newly acquired skill in real-life situations with support and back-up from the therapist

Meichenbaum found that SIT works both with short-term stressors such as preparing for public speaking, and longer-term stressors such as medical illness, divorce or work-related stress.

Hardiness Training

Kobasa suggests that a strong and hardy person shows 3 Cs: Control over their lives, commitment and challenge.

Maddi introduced a training programme to increase hardiness, arguing that the more hardy the person, the better they cope with stress. This training has 3 steps:

1. Focusing: Learning to recognise physical symptoms of stress e.g. increase in heart rate, muscle tension and sweating.

2. Reliving stressful encounters: Learn to analyse stressful situations to better understand possible coping strategies.

3. Self-improvement: Take on challenges that can be coped with and build confidence, thereby gaining a greater sense of control.

Maddi et al got 54 managers who went on a hardiness training programme to report back on their progress. They recorded an increase in hardiness and job satisfaction and a decrease in strain and illness.

Hardiness Training

Kobasa suggests that a strong and hardy person shows 3 Cs: Control over their lives, commitment and challenge.

Maddi introduced a training programme to increase hardiness, arguing that the more hardy the person, the better they cope with stress. This training has 3 steps:

1. Focusing: Learning to recognise physical symptoms of stress e.g. increase in heart rate, muscle tension and sweating.

2. Reliving stressful encounters: Learn to analyse stressful situations to better understand possible coping strategies.

3. Self-improvement: Take on challenges that can be coped with and build confidence, thereby gaining a greater sense of control.

Maddi et al got 54 managers who went on a hardiness training programme to report back on their progress. They recorded an increase in hardiness and job satisfaction and a decrease in strain and illness.

Weaknesses in psychological methods

• Psychological methods only suit a narrow band of individuals who are determined to stick to the technique.
• Reseach tends to be based on white, middle-class business folk and so can't necessarily be generalised to others.
• The procedures are very lengthy and require considerable commitment of time and effort.
• The concepts may be too complex. For example, a lack of hardiness might just be another label for negativity. It could be argued that it's just as effective to relax and think positively.

Cognitive Behavioural Therapy

• CBT techniques were developed to treat abnormality using concepts from the cognitive approach.
• The idea is that changing the way information is cognitively processed with result in a change in behaviour.
• These techniques can be used in stress management - by changing the way we think in stressful situations we can cope better and behave in ways that help to minimise or remove the stressor.

Rational-Emotive Therapy (RET)

Ellis suggest an ABC model:

• It begins with an activating event (A) which leads to a belief (B) about why this happened.
• This then leads to a consequence (C). If the beliefs are irrational, they will lead to maladaptive consequences - such as depression, anxiety, or symptoms of stress.
• For example, if somebody fails to get a promotion at work, they may believe that it happened because they're useless, and the emotional consequence may be feeling depressed.
• RET focuses on encouraging people to change irrtional beliefs into rational beliefs, for a more positive consequence.

Cognitive Reconstructuring Therapy

Beck identified a cognitive triad of types of negative thought which can be applied to stress management. These thoughts are about:

• Themselves - 'I'm useless at everything'
• The future - 'Nothing will change and I won't improve'
• The world - 'You need to be better than I am to succeed in life'

The therapist's goal is to disprove the negativity in a person's thinking. After a while they should be able to use different cognitive processes, leading to a more positive belief system. Beck initially developed the therapy for use with depression, but it's been adapted for use beyond this. 

The biological (or medical or somatic) model assumes that psychological disorders are physical causes. When the same symptoms frequently occur, they represent a reliable syndrome or disorder. The cause or 'aetiology' may be one or more of the following:

• Genetics - Faulty genes are known to cause some diseases that have psychological effects, e.g. Huntington's disease that leads to a deterioration of mental abilities.
• Neurotransmitters - Too much or too little of a particular neurotransmitter may produce psychological disorders, e.g. an increased level of dopamine is linked to schizophrenia - drugs like cocaine, which increase dopamine levels, can lead to schizoprenia-like symptoms.
• Infection - Disorders may be caused by infection. General paresis is a condition involving delusions and mood swings, leading to paralysis and death. It is caused by syphilis, and can now be treated.
• Brain injury - Accidental brain damage may produce psychological disorders. E.g. in 1848 an explosion sent an iron rod through Phineas Gage's head, destroying parts of his frontal lobes. He survived, but he became more impulsive and disorganised, couldn't plan for the future and had a strangely different personality.

Research into the genetic basis of schizophrenia

Twin Studies

• Gottesman carried out a meta-analysis of approximately 40 twin studies.
• It was found that having an identical twin with schizophrenia gave you a 48% chance of developing the condition. This reduced to 17% in non-identical twins.
• Schizophrenia has a strong genetic basis.
• The meta-analysis was carried out on field studies, giving the research high ecological validity. Because identical twins share 100% of their genes, it might be expected that both twins would always suffer from the same conditions. The fact that both twins had developed schizophrenia in only about half of the cases means that another factor must also be involved. Identical twins tend to be treated more similarly than non-identical twins, and so the family environment might play a large role.

Adoption Studies

• 47 adopted children whose biological mothers had schizophrenia were studied. The control group consisted of 50 adopted children whose biological mothers didn't suffer from schizophrenia. The children were followed up as adults and were interviewed and given intelligence and personality tests.
• Of the experimental group, 5 of the 47 became schizophrenic, compared to 0 in the control group. Another 4 of the experimental group were classified as borderline schizophrenic by the raters.
• The study supports the view that schizophrenia has a genetic basis.
• Interview data can be unreliable and affected by social desirability bias. However, interviews are a good way of getting data in a naturalistic way. The adopted children whose mothers didn't suffer from any conditions might have not shown any symptoms of schizophrenia yet - it can't be completely ruled out.

Treatments

• Drugs - Drugs can be used to change neurotransmitter levels in the brain. For example, phenothiazines reduce levels of dopamine and can therefore relieve symptoms of schizophrenia.
• Psychosurgery - Psychosurgery is brain surgery involving destruction or separation of parts of the brain. Moniz developed the 'frontal lobotomy' in the 1930s to separate parts of the frontal lobes from the rest of the brain. This reduced aggression and generally made people more placid. However, it's not a cure, but a change - the irreversible changes to personality may have just made parients easier to manage. Psychosurgery is now only a last resort treatmeny for some disorders.
• Electroconvulsive therapy (ECT) - uring ECT, an electric shock of around 225 volts is given to a person's brain. This can help to relieve depression, but can also produce memory loss. Although quite commonly used in the past, it's now only used as a last resort therapy.

Strengths and weaknesses

Strengths

• It has a scientific basis in biology and a lot of evidence shows that biological causes can produce psychological symptoms.
• It can be seen as ethical because people are not blamed for their disorders. They just have an illness.
• Biological therapies have helped relieve conditions that could not be treated very well previously.

Weaknesses

• Biological therapies raise ethical concerns. Drugs can produce addiction and may only suppress symptoms rather than cure the disorder. The effects of psychosurgery are irreversible.
• Psychological disorders may not be linked to any physical problem. Psychological therapies can be just as effective as biological treatments, without any interference to biological structures.