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  • Created on: 20-05-14 09:13

Kiecolt-Glaser: the effects of acute stressors...

Aim - To study the capability of the immune system in people facing exams.

Participants - 75 first year medical students.

Procedure - Blood samples were taken one month before the exams and the day of, after they had sat one paper. They were tested for natural killer cell activity. Questionnaire data was also collected on psychiatric symptoms, loneliness and life events.

Findings - A negative correlation between stress and the number of NK cells. Those with psychiatric symptoms, who were lonely and experiencing life events showed greater suppression of the immune system.

Conclusion - Exam stress affects the ability of the immune system to respond to viruses but other factors are involved.

Evaluation -

:)  High ecological validity.

:(  Did not assess illness, the changes in the immune system may be so small.

:(  Small sample size and only medical students so unrepresentative.

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Kiecolt-Glaser: the effect of chronic stressors...

Aim - To see if psychological stress (looking after a relative with Alzheimer's) can cause damage to the immune system (in the form of wound healing).

Participants - Two groups; 1) 13 female caregivers 2) 13 female control participants matched in age and income to the caregivers.

Procedure - They were assessed on a perceived stress scale. They were given a punch biopsy and the time taken for it to heal was observed. A small sample of blood was taken beforehand.

Findings - The caregivers scored much higher on the perceived stress scale. The healing time for the caregivers was significantly longer with an average of 48.7 days compared to the controls' time of 39.3 days. Analysis of blood samples revealed that the caregivers produced significantly less interleukin-1B.

Conclusion - High levels of psychological stress can damage the functioning of the immune system.

Evaluation -

:)  Matched pairs design was used so leads to a more accurate comparison.

:)  High ecological validity.

:(  Ethical issues as the participants were physically harmed.

:(  Only women used so unrepresentative.

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Segerstrom and Miller...

Procedure - Performed a meta-analysis of 293 studies looking at the different stressors on measures of immune system functioning.

Findings - Identified 3 types of stress:

1.Acute time-limited stressors – usually studied under lab conditions, last between 5-100 minutes
2.Brief naturalistic stressors – everyday stressors of limited duration e.g. exams 3.Chronic stressors – long lasting e.g. caring for dementia patients. •Acute time limited stressors lead to an up regulation of natural immunity. •Brief naturalistic stressors overall have no effects on immune system, despite significant findings of Kiecolt-Glaser, 1984. •Chronic stressors have the most consistent effects.  All measures showed a significant down regulation, consistent across gender and age.

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Rahe et al: Life Changes...

Aim - To test whether the stress of life evetns were correlated with illness.

Participants - 2500 male US naval personnel.

Procedure - Participants filled in a questionnaire based of the SRRS and indicated how many life events they had experienced in the last 6 months. A total LCU score was recorded and individual health records were kept for the next 6 months.

Findings - A positive correlation was found of +0.118 between LCU score and illness. (The correlation was weak but significant due to the sample size).

Conclusions - The stress of life events is correlated with illness.

Evaluation -

:)  Implications - the importance of stress management.

:(  Culture/Gender/Employment bias.

:(  Correlation - cause and effect can't be established.

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Delongis et al: Daily Hassles...

Aim - To compare correlations on both the hassles and life events scale to see which are better predictors of ill health.

Participants - 100 people aged between 45-64 who were well educated and had high incomes.

Procedure - Participants were asked to complete four questionnaires once a month for a year. The questionnaires were on; 1) Hassles 2) Uplifts 3) Life events 4) Health status.

Findings - Daily hassles were correlated with ill health but neith uplifts or life events were.

Conclusions - Daily hassles are more likely to cause illness.

Evaluation -

:)  Implications - the importance of stress management.

:(  Questionnaires rely on memory, a diary would have been easier.

:(  The definition of daily hassles is vague.

:(  Daily hassles and life events may have an effect on one another.

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Marmot: Workplace Stress...

Aim - To investigate the negative correlation between job control and stress related illness in civil servants.

Participants - 10,308 civil servants aged between 35-55 (67% men and 33% women).

Procedure - Job control was measured though both a self-report and independent assessments of work environment by managers. this was done twice, 3 years apart. Record were also kept of stress-related illness and correlation analysis to test the association between job control and stress-related illness.

Findings - Those with low job control were 4 times more likely to die of a heart attack.

Conclusions - Low job control is associated with high stress.

Evaluation -

:)  High ecological validity.

:(  Population validity.

:(  Socio-economic status may play a part.

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Johanssen et al: Workplace Stress...

Aim - To investigate whether repetitive jobs and high levels of responsibility increased stress.

Participants - 'High risk group' 14 wood finishers in a Swedish sawmill. Their work was repetitive, fast-paced and isoloated. 'Low risk group' 10 cleaners in the Swedish sawmill. Their work was varied and allowed for more socialising.

Procedure - Adrenaline and Noradrenaline was tested for in urine samples collected on work and rest days.

Findings - The 'high risk group' secreted more adrenaline and noradrenaline. They also had higher levels of illness and absenteeism.

Conclusions - Repetitiveneess and high levels of responsibility can cause stress.

Evaluation -

:)  High ecological validity

:(  Culture/Employment bias and small sample.

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Friedman and Rosenman: Personality Factors...

Aim - To test the hypothesis that Type A individuals are more likely to develop CHD than Type B's.

Participants - Self-selected sample of 3000 Californian men aged 39-59.

Procedure - A longitudinal study over 8 1/2 years where participants were healthy at the outset. Personality was assessed by a structured interview. Participants were assessed for impatience, competitiveness and hostility through the interview being conducted in a provactive manner.

Findings - 257 participants developed CHD, 70% of whom were Type A. Other factors were taken into account such as obesisty, blood pressure and smoking. The Type A's had higher levels of adrenaline, noradrenaline and cholesterol.

Conclusions - Type A behaviour increases stress and increases vulnerability to CHD. The stress response inhibits digestion leading to high levels of cholesterol.

Evaluation -

:)  Supported by Framingham Heart  Study.

:)  The use of interviews rather than questionnaires.

:(  Gender bias.

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Kobasa: Hardiness...

1)   Involved highly stressed male managers for a company. Participants were high hardiness scores and who exercised a lot had the least illness.

2)   Involved male executives in stressful jobs who were interviewed and followed up a year later. Hardiness, exercise and social support were found to be important factors in their health with hardiness playing the biggest role.

Evaluation -

:)  High ecological validity.

:) Use of interviews.

:(  Gender bias.

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Stress Management: Drugs...

  • Benzodiazepines enhance the action of GABA, a brain hormone, which quietens activity in the central nervous system making a person feel calmer. They also dampen excitatory effect of serotonin.

Research by Davison to support:  Performed an assessment of BZ usage. Participants were 75 patients with social-anxiety disorder. Randomly assigned to drug/placebo treatment for 10 weeks. Drugs had a sustained positive effect as 78% improved on drugs.

  • Beta-Blockers reduce the activity of adrenaline and noradrenaline by binding receptors on the heart and other body parts that are stimulated during arousal. This reduces heart rate.

Research by Lau et al to support:  Meta-analysis assessing BB's effectiveness. It found they reduced high blood pressure.They reduced the risk of death by 20% for patients with heart disease.

Evaluation of Drugs -

:)  Cost effective and easy to administer.

:(  Addictive.

:(  Can have side effects such as hallucinations.

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Stress Management: Stress Inoculation Therapy...

1) Conceptualisation - identifying the individual's irrational beliefs so the therapist can try to help/change their perception of how to deal with the situation.

2) Stress Reduction - the use of techniques that will reduce stress levels such as self-coping statements and direct action like relaxation techniques.

3) Application - patients visualise using stress reduction techniques and use them in role play exercises and then in real life.

Research by Sheehy and Horan to support:  Reported the case of law students who received 4 weekly sessions of SIT, each lasting 90 minutes. They found afterwards lower levels of anxiety and an improvement in grades.

Evaluation of Stress Inoculation Therapy -

:)  Inoculates against future, as well as current, situations.

:(  Requires motivated patients and committment.

:(  There are many separate components and it is unknown which works the best.

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