Techniques for managing stress

Aim: To compare a group of students receiving cognitive modification with a group being streated by desensitisation and a control group waiting for therapy.

Background: Anxiou people are known to ruminate over their performance, feel inadequate and anticipate negative outcomes when exposed to a test. This worrying is thought to be more of a problem for patient than the emotional response. Stress Inoculation Therapy (SIT) directly tackles the negative thinking and replaces it with positive thinking and relaxation strategies. 

Sample: 21 volunteers who responded to an advert in a university newpaper for 'treatment of test anxiety' participated.

Method: Lab experiment using a matched pairs design and three groups.

Procedure: Participants were pretested for anxiety levels by a lab based anxiety adjective test, an IQ test and test anxiety questionnaire and then assigned to one of the groups so that each group had equally anxious students. They all received eight sessions of treatment except the control group. The SIT group had insight training and the systematic desensitisation group had progressive relaxation and imagery techniques. Grade averages, IQ and digital performance tests and self-reports post treatment were the measurements of the DV. The experimenters were blind to the conditions participants had been assigned to.

Results: The two therapy groups both improved but were not signficantly different from each other on the grade averages, digital symbols and the IQ test. On the self-report of test anxiety, the SIT group showed the most positive change. It wa concluded that cognitive therapy was most helpful in test anxious students.

Evaluation: Could a sample of Uni students be more responsive to a cognitive solution because they will be more able to express their worries and more likely to practice the skills needed because they are highly motivated to pass tests? Ethnocentrism - is this research a feature of westernised society? Cognitive therapy has been shown to be effective in many other anxiety disorders but does require the patient to be convinced it will work.

Aim: To test the effectivene of bio-feedback technique in reducing headaches.

Background: Tension headache are associated with sustained contraction of the scalp and neck muscles. In this case auditory tone are used to feedback to patient as they relax their tight muscles: the lower the tone, the greater the relaxation.

Sample: 18 patients volunteered to take part after responding to an advert. They were screened for having tension headaches only, with no other problems.

Method: A lab experiment was used with an independant meaures design. Group A had biofeedback sessions which included relaxtion training and EMG feedback (information on muscle tension). Group B had relaxtion training with pseudo-feedback ( tape recording from someone else's session with no link to them personally - a control for 'noise'). Group C were told they were on a waiting list but had to come to appointment to remain in the study (a control for attention).

Procedure: For two weeks, patients kept a diary of their headaches, rating them on a scale of 1(mild) - 5(severe) to provide baseline data. They also completed the MMPI which tested depression, hysteria and hypochondria. Group A had 16 sessions of training twice a week for 8 weeks. They were told that slower clicks of the machine indicated less muscle tension and had to practice at home twice a day for 15-20mins. Group B were just told to listen to clicks. All patients kept a record of their headaches while on the program.

Results: Group A's muscle tension was significantly lower than Group B's and their headaches were significantly less too. The MMPI showed lower levels of hysteria and depression at the end of the study for all the groups but only the experimental group showed less hypochondriasis. Drug usuage fell and the effects persisted even 18 months later.

Evaluation: Ethically sound because both control groups were offered treatment in the end. High control and use of psychmetric data with the muscle relaxation and diary entries providing good reliablity. Validity also improved as the technique is used at home. FRee will vs. determinism - how much is illness under our own free will? Do people choose to be ill or choose to be well? Is illness always determined by external factors? Biofeedback appears to be an effective technique and useful for teaching relaxation. It is relatively cheap and has no side effects so can be widely prescribed for stress- related conditions.

Aim: To look at predictors of survival from cancer including social support from friends and family.

Background: It appears that women who tend to survive longest from cancer are those who are hostile to the diagnois and uncooperaative with their doctors, while those who stoically accept the diagnosis tend to die earlier. This indicates that there is a big pschological component to the illness. 

Sample: 133 women who were referred with breat cancer under age of 55 to a clinic in Vancouver. They were similar in their pathology.

Method: A quasi-experiment where the women fell naturally into their categories. 

Procedure: The women completed a questionnaire to obtain demographic and psychsocial data such as how many dependants they had, how many friends etc. Clinical factors were taken from patients medical records by a clerk. Survival was calculated from time of diagnosis. Finally, 18 patients were interviewed in detail to fully understand the effects of the psychosocial factors.

Results: 6/11 aspects of social network were significantly associated with survival. They were: marital status, support from friends, contact with friends, total support, employment status and social network. From the interviews it appeared that practical help was the most useful, such as cooking, childcare and shopping. Complex relationships with young adult children were the least supportive with womens feeling that they to support them by remaining cheerful. Maritial status was very important, particularly with the husbands reaction to mastectomy. Earlier research about involvement in social activities, degree of extraversion and anger were not significant in this study against the six key findings.

Evaluation: The method is strong with a large sample and data was gathered directly from the patients. However, restricting the sample to those aged below 55 rules out most 'at risk' group of older women who may have very different social lives. Situational vs. dispositional explanations of behaviour - it seems one's disposition or personality is less important than external or situational factors in helping to survive cancer, despite earlier findings. Very useful research which shows how support group could be key to survival and also that the whole family is part of the healing process.