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  • Created on: 18-05-15 02:19

Sympathomedullary Pathway - Acute Stress

  • Sypathetic Nervous System (SNS) prepares the body for action in conditions of acute stress
  • SNS causes changes such as an increase in heart rate and blood pressure
  • SNS causes the adrenal medulla to release adrenaline into the bloodstream
  • Adrenaline boosts the supply of oxygen to the brain and suppresses non-emergency bodily processes
  • Parasympathetic Nervous System (PNS) restores body to resting state once the stressor has passed
    • PNS slows down heartbeat and reduces blood pressure 
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The Pituitary-Adrenal System - Chronic Stress

  • Activated under conditions of chronic stress
  • Hypothalamus activated when stressors are perceived by higher brain centres
  • Activation of hypothalamus leads to release of CRF into the bloodstream
  • CRF causes pituitary gland to release ACTH into the bloodstream which activates adrenal cortex
    • Prolonged release of ACTH causes the adrenal cortex to increase in size to cope with increased cortisol production
  • Activation of adrenal cortex leads to release of the hormone cortisol
  • Cortisol lowers sensitivity to pain, but also lowers the immune response
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Stress-related illnesses and the immune system

Kiecolt-Glaser et al

  • Natural experiment with 75 medical students
  • Researchers assessed immune system 1 month before an exam and then during exam period
    • By looking at NK cell activity
  • Students also took a questionnaire to measure other life stressors being experienced at the time
  • Found NK activity significantly reduced during exam period compared to one month before
  • Found students reporting the highest level of loneliness had lowest immune system functioning

Kiecolt-Glaser et al

  • Studied the effects of unhappy relationships on immune system functioning
  • Involved a volunteer sample of married couples aged between 22 and 77 years
  • Found that blister wounds healed more slowly on couples that showed high levels of hostile behaviour toward each other
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Stress-related illnesses - Evaluation

  • P - Research support from Segerstrom and Miller
  • E - Meta-analysis of 293 studies conducted over a 30 year period found that short term stresors could boost the immune system whereas long term stressors suppress it
  • E - Short term stressors promoted immune system to deal with potential challenges to body. Most chronic long-term stressors led to the most global suppression of immune system
  • L - Suggests the more long-lasting the stressors, the more damaging effect on immune system
  • P - Not a simple relationship as it is difficult to establish a causal relationship 
  • E - Health is affected by several factors - hard to only observe specific possible causes of stress
  • E - Health is slow to change, therefore it's difficult to demonstrate that exposure to particular stressors has caused a change in immune system functioning
  • L - As a result, demonstrating a link over the long term is difficult, which is why researchers focus mainly on short term stressors.
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Life Changes

Rahe et al 

  • 2,664 US Navy sailors
  • Completed SRE (military version of SRRS)
    • Measured life events experienced over the 2 years prior to 6-month tour of duty
  • Recorded any illnesses over 6-month period
  • Found a small but positive correlation between scores on the SRE and reported illnesses
  • Relationship between life events and illness was more evident in married than single sailors

Holmes and Rahe et al

  • SRRS was developed to test the idea that life changes are related to stress-related illnesses
  • Based on 43 life events taken from an analysis of over 5000 patient records
  • 400 participants rated each event in terms of the amount of readjustement would be required by an average person
  • Marriage was the comparison point and was given a Life Change Unit (LCU) of 50
  • Anything that require more readjustment than marriage was given a higher LCU and vice versa
  • Highest LCU was 100 for death of a spouse
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Life Changes - Evaluation

  • P - Individual differences in the impact of life events
  • E - Life change questionnaires ignore the fact that the impact of life changes such as divorce
  • E - Sherbourne et al found that the impact of bereavement was greater for younger people that older.
  • L - Although questionnaires may provide a quantative measure of life changes, they may not reflect the actual amount of stress resulting from specific life events for different individuals.
  • P - Life changes as a source of stress may be less important than daily hassles
  • E - Life-changing events are rare whereas daily hassles are commonplace e.g. missed bus
  • E - DeLongis et al found no relationship between life events and health in a sample of married couples but found a significant correlation between hassles and next-day health problems
  • L - Suggests that daily hassles may be more siginificant as a source of stress in their own right, or might amplify stress caused by major life events.
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Daily Hassles

Bouteyre et al

  • French psych. students making transition from school to uni
  • 207 females and 26 males
  • Students completed hassles questionniare & depression questionnaire
  • Found 41% of students suffered from depressive symptoms
  • Found a positive correlation between scores of the hassles scale and depressive symptoms


  • Asked nurses to keep diaries for a month recording all the daily hassles and uplifts experienced at work
  • Also asked to rate their performance at work and to note any physical strain
  • Found that daily hassles increased job strain and dereased job performance
  • Daily uplifts appeared to counteract the stressful impact of daily hassles
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Daily Hassles - Evaluation

  • P - Studies such as the Bouteyre et al study only produce correlational data.
  • E - Means we can't draw casual relationships between daily hassles and well-being.
  • E - The Bouteyre et al research does not demonstrate that depression was directly attributable to hassles, as a third variable may have been the cause e.g. financial problems.
  • L - But correlations do suggest that hassles have the potential to have adverse effects on people.
  • P - Real-world appplications of research into daily hassles.
  • E - Research has shown that an accumulation of daily hassles can mean that some people are more likely to experience road rage during their commute home.
  • E - Gulian et al found that participants who reported a difficult day at work tended to report a higher levels of stress on their drive home.
  • L - Shows that unresolved hassles during the day can be carried forward so that the behaviour of others are more likely to be interpreted negatively by the stressed driver.
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Workplace Stressors - Workload

Johansson et al

  • Sawmill 'finishers' performed repetitive tasks that required high levels of attention and responsibility (high workload) and rated themselves on well-being and efficiency
  • Cleaners used as a control group
  • Adrenaline was measured several times a day at work and home
  • Found finishers had higher illness rates and adrenaline levels
  • Found that finishers adrenaline was twice as much at work than at home

Naylor and Malcomson

  • 644 secondary English teachers in Canada
  • Survey on their levels of stress and workload
  • Asked to idnetify the most significant aspects of stress in their professional lives
  • Found female and younger teachers reported the worst impact and least coping ability
  • More than 85% reported that their work resulted in significant levels of fatigue 
  • More than 1/3 reported health problems that related to their work life
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Workload - Evaluation

  • P - Research support from Kivimaki et al
  • E - Meta-analysis of 14 studies found employess with high workload were 50% more likely to develop CHD.
  • E - Choi et al argued that Kivimaki examined impact of only one factor yet other stressors are assoicated with CHD.
  • L - Suggests tackling job strain alone without other factors may not dramatically reduce CHD levels.
  • P - Other research disagrees that workload is a significant source of stress
  • E - Marmot et al did a study on civil servants found workload was not a factor in stress-related ilness.
  • E - Marmot et al's study found that it was job control rather than workload was the main factor.
  • L - Suggests that although job strain is determinant of stress-related illness, control appears to be more influential than workload.
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Personality Factors

Friedman & Rosenman

  • Studied 3,000 men aged 39-59 in California
  • Men examined for sign of CHD - to exclude any that were already ill
  • Interviewed an obsevered to see how they responded to everyday pressures
  • Men were classfied Type A or Type B
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Type A & Type B Personality - Friedman & Rosenman

  • Type A is described as possessing 3 major characteristics
    • Competiveness & achievement striving
    • Impatient & time urgency
    • Hostility & aggressiveness
  • Type B is described as having 3 major characteristics
      • Relaxed
      • One thing at a time
      • Expresses feelings
    • It is also thought to decrease risk of stress-related illness
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The Hardy Personality - Kobassa

  • Claims that some people are more resistant
    • To the harmful effects of stress
    • Because they have a 'hardy personality'
  • Consists of:
    • Control 
      • Hardy people see themselves as being in control of their lives
        • Rather than being controlled by external factors
    • Commitment 
      • Hardy people are involved with the world around them
      • Have a strong sense of purpose
    • Challenge
      • Life challenges are seen as problems to overcome
        • Rather than stressors
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Hardy Personality Study

  • The stress scores of 800 American business executives
    • Determined using Holmes & Rahe's SRRS
    • And Hardiness was assessed using a hardiness test
  • Kobassa found that 150 of the participants
    • Classified as having high stress level
    • Individuals differed in their illness record over the same period
      • Low levels of illness
        • More likely to have scored high on all 3 points of the hardy personality
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Hardy Personality Study - Evaluation

  • Hardy people are simply low on 'negative affectivity' (NA)
    • They don't dwell on their failures or negative aspects of themselves
  • Much of the data collected has been obtained through self-report questionnaires
    • Tend to be long and awkward wording and negatively worded items
  • Concept of hardiness has been used to explain why some soldiers remain healthy
    • Even under extreme stress
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Stress Inoculation Training (SIT)

  • Meichenbaum believed that although we can't change the causes of stress
    • We can change the way we think about stressors and the way we react to them
  • People can be trained to 'innoculate' themselves against a stressor before it arrives.

The 3 main phases of SIT are:

  • Conceptualisation
    • Clients are taught to think differently about stressors e.g. as problems that can be solved
  • Skills Aquistition
    • Coping skills are taught and rehearsed
  • Application
    • Learned coping skills are applied in increasingly stressful situations
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Evaluation of SIT


  • Meichenbaum compared SIT with systematic desensitisation
    • To deal with snake phobias
      • Both were effective
        • But SIT helped to reduce fear
  • Psychologists found the sessions of SIT
    • Reduced anxiety & stress among students over time
      • As well as improving academic performance
  • SIT gives the client necessary skills
    • So they are less affected by stressors in the future


  • SIT is time consuming & requires high motivation
    • Meichenbaum showed effectiveness of relatively brief periods of training
  • SIT is unnecessarily complex
    • Possible that effectivness of SIT can still be achieved with just some of its elements
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Hardiness Training

  • Kobassa identified a personality type that was especially resistant to stress
    • The Hardy Personality
  • Kobassa believed that people could be trained in hardiness
    • To help them manage stress better.

Hardiness training involves:

  • Focusing
    • Client is taught to recognise the sources of stress
      • And the psychological signs of stress
  • Reliving stress encounters 
    • The client is given an insight into current coping strategies
      • By relieving previous encounters & their response to them
  • Self-Improvement 
    • These insights can be used to move forward & learn new techniques
    • E.g. seeing stressors as challenges
      • They can take control over rather than problems they must give in to
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Hardiness Training - Evaluation


  • Hardiness training has been shown to be effective in many different populations
  • Hardiness training has been used to increase commitment to training in Olympic swimmers
    • By helping to control aspects of their daily lives
    • Might interfere with their training schedules


  • Training must first address basic aspects of personality & learned habits of coping that are difficult to modify
    • Therefore hardiness training cannot be seen as a rapid solution to stress managment
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Drug therapies - BZs

  • Used to treat anxiety that is a consequence of stress
    • They do this by slowing down the activity of the central nervous system
  • GABA (Gamma-Amino-Butyric-Acid)
    • Neurotransmitter that is the body's natural form of anxiety relief
    • GABA makes it harder for neurons to be stimulated
      • Making the person feel more relaxed
    • BZs enhance the action of GABA
      • Making neurons in the brain even more resistant to excitation
      • And making the person feel a lot calmer.
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Drug therapies - BBs

  • Reduce activity of adrenaline & noradrenaline
      • Are part of the sympathomedullary pathway
    • Bind to receptors on the cells of the heart & other parts of the body
    • Are stimulated during arousal
  • By blocking these receptors
    • It is harder to stimulate these cells
      • So the heart beat slower with less force & blood pressure falls
      • The person then feels calmer & less anxious
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Evaluation of Drug Therapies


  • Research support - Kahn et al
    • Found that BZs were significantly superior at reducing anxiety compared to a placebo
  • Drugs have been shown to be effective in managing the effects of stress
    • Meta-analysis found that BZs were more effective than other drugs in reducing anxiety
  • Drug treatments require little effort from the patient


  • Patients exhibit withdrawal symptoms when they stop taking BZs
    • Indicating psychological dependence 
  • Side effects - BZs
    • Increased aggression and impairment of memory
    • Some studies have linked BBs to an increased risk of developing diabetes
  • Effectiveness of drug treatments
    • Only lasts as long as the person takes the drugs
      • Drugs treat the symptoms not the cause
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Workplace Stressors - Control

Marmot et al

  • Longitudinal study of 10,308 civil servants aged 35-55
  • Completed a questionnaire on job control, workload and level of social support
  • Researchers checked for any symptoms of CHD in participants
  • Found after 5 years those who reported low levels of job control were more likely to develop CHD
  • Workload and social support at work were not related to risk of CHD

McCarthy et al

  • 227 men who had experienced a first time coronary event
  • Each man was matched with a man of a similar age and background
  • Found a significant factor in the likelihood of a coronary event was low job control
  • Older workers (over 50) reported a signifcantly lower levels of job control than younger workers did and were also more susceptible to coronary events
  • Higher job control was seen as a potential protective factor of heart disease.
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Control - Evaluation

  • P - Individual differences in how wokers respond to lack of control
  • E - Research into the impact of workplaces stressors misses the point that there are wide individual differences in how people react to and cope with individual stressors such as lack of control
  • E - Schaubroeck et al found that some workers respond differently to lack of control - they are less stressed by having no control or responsibility in their work. They also had higher mmune responsibility in low rather than high control situations
  • L - Suggests that lack of control may only be experienced as stressful by some individuals.
  • P - Lack of control can be harmful as it can have adverse effects on mental health
  • E - High levels of stress at work combined with other stressors (e.g. daily hassles) can make illnesses like depression more likely
  • E - Melchior found that work stress, in particular low levels of job control, can precipiate depression and anxiety in previously healthy young workers
  • L - Suggests that helping workers cope with work stress or reducing work stress levels can prevent the occurance of mental health problems
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Personality Factors - Type A

Friedman and Rosenman

  • After 8 years twice as many Type A men had died of cardiovascular problems than Type B
  • Over 12% of the Type A men had experienced a heart attack compared to 6% Type B men
  • Type A men also had higher blood pressure and higher levels of cholesterol


  • Meta-analysis covering all prospective studies carried out up to 1998
  • Correlated the relationship Type A behaviour and development of CHD
  • Relationship between Type A behaviour and CHD was not significant
  • There was a significant relationship between hostility and CHD but it was so low that it was considered to have no practical meaning for the prevention and prediction of CHD
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Type A Evaluation

  • P - Criticism of Friedman and Rosenman from Bunker et al
  • E - They found no strong/consistent evidence for a casual relationship between Type A behaviour patterns and the development of CHD
  • E - Bunker et al carried out a review and found Type A behaviour was no more significant than other risk factors
  • L - Suggests although Type A behaviour is a risk factor, it has no causal relationship with CHD
  • P - Type D is more important than Type A in predicting adverse health outcomes
  • E - Type D individuals have increased levels of anxiety and depression. They overreact to stressful situations but conceal their feelings from others out of fear of rejection.
  • E - Denollet et al studied 300 heart patients in a cardiac rehabilitation programme nd found that 27% of those classified as Type D died within 8 years compared to 7% of non-Type Ds
  • L - Unlike Type As who end to vent their anger and impatience, Type Ds have no outlet for their stress, which ames it so harmful for them and CHD is more likey
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