STRESS MANAGEMENT

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STRESS MANAGEMENT

• PHYSICAL METHODS
• These include 1. Biofeedback
• 2. Anti-anxiety drugs
• PSYCHOLOGICAL METHODS
• These include 1.Social support
• 2.Cognitive therapy
• (hardiness
  training and
• stress
  inoculation)
• 3. Adoption of
  strategies

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LAZARUS AND FOLKMAN

• Distinguished between
• PROBLEM focussed strategies, where a person
  tackles the problem itself (external)
• and
• EMOTION focussed strategies, where a person
  concentrates on reducing the stress response
  (internal)

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BIOFEEDBACK

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BIOFEEDBACK

• This transforms aspects of our physiology, e.g.
  heart beat, into signals.(see p.144/172)
• A person is attached to a machine which transmits
  an auditory or visual signal to indicated heart
  rate.

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BIOFEEDBACK

• The person has been trained in relaxation
  technique, e.g. breathing
• The key feature of biofeedback muscles under
  involuntary control of the ANS are brought under
  voluntary control

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THE 3 STAGES

• DEVELOP AWARENESS of a physiological body
  response, e.g. breathing, heart rate
• LEARN RELAXATION TECHNIQUE how to quieten the
  body Indian yogis are good at this, as are
  Buddhist monks
• TRANSFER THE CONTROL to everyday life situation

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EVIDENCE FOR BIOFEEDBACK

• MILLER AND DICARA demonstrated biofeedback on
  rats
• AIM to see if learning by reward can alter body
  responses
• PROCEDURE Paralysed rats were rewarded when
  their heart rate slowed. Another group were
  rewarded when it speeded up. Reward consisted of
  stimulating the pleasure centre of the brain.

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FINDINGS AND CONCLUSIONS

• FINDINGS slow group heart rate fell from 400
  to 316 beats per minute. In the fast group,
  heart rate speeded up
• CONCLUSION this demonstrates that involuntary
  muscles respond to operant conditioning

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SCOLIOSIS IN TEENAGERS

• Dworkin attached teenagers
• with curvature of the spine to
• a biofeedback machine.
• They learnt how to control
• their spinal muscles and
• improve their posture

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HEADACHES

• TENSION HEADACHES have been reduced by
  biofeedback, and has also been successful with
  asthma and high blood pressure.

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EVALUATION OF BIOFEEDBACK

• Successful trials have not always been replicated
• It may be the relaxation, rather than the
  biofeedback, which is restoring the homeostatic
  body mechanisms

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EVALUATION OF BIOFEEDBACK 2

• Biofeedback may work because it gives the person
  a sense of control, rather than the biofeedback
  itself working
• More successful with children
• than adults
• See case study p.174 new book

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ANTI-ANXIETY DRUGS

• When the body is under stress, it produces
  hormones which create anxiety. Drugs which
  control these mechanisms are
• BETA BLOCKERS (or barbiturates) which block the
  activity of the sympathetic nervous system
• BENZODIAZAPINES which control neurotransmitter
  levels (serotonin) which reduces anxiety
• BUSPIRONE, a more modern drug which regulates
  serotonin

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BETA BLOCKERS

• These decrease heart rate and lower blood
  pressure. They therefore reduce the risk of
  heart disease in stressed individuals
• TAYLOR found them
• effective for public
• speakers and musicians.
• They are not addictive,
• but their effect is only temporary

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BENZODIAZAPINES

• Valium and librium are examples. They increase
  the activity of a neurotransmitter
• GABA serotonin
  reduces
• activity
  arousal

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PROBLEMS WITH BENZODIAZAPINES

• They have unwanted side effects
• Make you drowsy
• Can cause cognitive and auditory impairment
• Can lead to depression
• Interact unpredictably with alcohol
• You can become dependent on them
• People become more accident prone

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BUSPIRONE

• This is a more recent drug with fewer side
  effects. It facilitates the action of serotonin
  and does not cause drowsiness

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BUSPIRONE

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EVALUATION OF ANTI-ANXIETY DRUGS

• Reduce intense feelings of stress ()
• They dont address the problem (-)
• Can have side effects (-)
• Benzodiazepines can only be used for up to 4
  weeks (-)
• It can take years to come off benzodiazepines(-)

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COGNITIVE THERAPIES

• These aim to replace negative, irrational
  thoughts with
• positive, rational ones
• Maladaptive cognitions
• are restructured into
• adaptive ones.
• This in itself can
• sometimes eliminate stress

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STRESS INOCULATION

• Meichenbaum argued
• that if you prepare a
• person to cope with
• stress, they will be
• ready when it arrives

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3 STAGES OF TRAINING

• ASSESSMENT therapist discusses the nature of
  the problem with the client
• STRESS REDUCTION TECHNIQUE client learns ways
  to cope with stress, e.g. relaxation, coping
  self-statements,
• APPLICATION AND FOLLOW-THROUGH client learns to
  use these techniques in difficult situations, and
  practices with the use of role play

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RESEARCH SUPPORT

• MEICHENBAUM compared stress inoculation with
  desensitisation. (Patients gradually lose their
  fear by working through a hierarchy of fearful
  situations with therapist)
• He treated patients who had 2 phobias rat and
  snake.
• 1 group received desensitisation, the other
  stress inoculation
• They both improved the phobia, but stress
  inoculation had also helped the non-treated
  phobia

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EVALUATION OF STRESS INOCULATION

• It is fairly effective for
• moderate levels of stress
• It is not as successful for
• high levels of stress
• Individuals respond
• differently
• to making coping self
• statements
• See p.150/177

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HARDINESS TRAINING

• Kobasa aimed to increase hardiness in stressed
  individuals. This involves
• FOCUSSING on the physical signs of stress and
  become aware when they are starting
• RECONSTRUCTING STRESS SITUATIONS think abuot
  recent stress situations and evaluate how it
  could have turned out better
• COMPENSATING THROUGH SELF IMPROVEMENT if a
  stressor cannot be changed, learn to accept and
  master it

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HARDINESS

• It works better in conjunction with social support

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EVALUATION OF HARDI-TRAINING

• SARAFINO reported that people who had undergone
  this training scored higher on hardiness tests
  and had lowered blood pressure
• FISCHMAN found it increased job satisfaction and
  reduced headaches in executives

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SENSE OF CONTROLOLD BOOK ONLY P.150

• We have seen that a sense of control reduces the
  extent to which a situation may be experienced as
  stressful
• Langer and Rodins study demonstrates how control
  can lead to improvement in health and happiness
• Breier demonstrated that the intervening factor
  was the immune system
• If Ps could control noise, their blood samples
  contained less adrenaline

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SOCIAL SUPPORT

• This provides protection against stress
• Keicolt-Glaser found that students who had more
  social support suffered less reduction in their
  immune system before exams

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SOCIAL SUPPORT

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2 MEANINGS OF SOCIAL SUPPORT

• SOCIAL NETWORK Number of people available to
  provide it. It is unrelated to wellbeing.
• PERCEIVED SUPPORT the strength of useful support
  given by individuals. This is positively related
  to wellbeing

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STUDIES OF SOCIAL NETWORKS

• BROWN AND HARRIS found that 61 of severely
  depressed women had experienced a very stressful
  life event in the previous 9 months, compared
  with 25 of non-depressed women.
• Women who had had a serious life event
• 37 without a friend depressed
• 10 with a friend depressed

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PREGNANT WOMEN

• These were found to
• have more medical
• complications if they
• had low
• psychosocial assets.
• E.g. social support

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MARRIAGE AND DIVORCE

• Selye et al found that divorced, widowed and
  separated adults had higher rates of cancer than
  married adults (but cause and effect cannot be
  established)

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INDIVIDUAL DIFFERENCES

• People have different coping strategies.
• TASK ORIENTED dealing with the situation
  itself, e.g. doing some revision, planning a
  revision timetable, extra lessons
• EMOTION ORIENTED getting some counselling,
  talking about it
• AVOIDANCE ORIENTED minimise the situation,
  decide exams are not important

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EFFECTIVENESS OF STRATEGY

• Highly anxious people are more likely to use
  emotion- and avoidance strategies
• Type As use task oriented strategies
• Task oriented strategies are effective when the
  person has the resources to change the situation
• Emotion oriented strategies are effective when
  the situation cannot be changed
• Individual differences are important, but so is
  the situation