Life Changes & Daily Life Changes & Daily HasslesHassles

Part (b) Stress in everyday lifePart (b) Stress in everyday life

Daily hassles Kanner Daily hassles Kanner et al 1981, Delongis et et al 1981, Delongis et al 1982 al 1982 Kanner et al 1981 designed the first form Kanner et al 1981 designed the first form

which included 117 daily hassles.which included 117 daily hassles. Adults were given the hassles Adults were given the hassles

questionnaire each month over a 9 month questionnaire each month over a 9 month period to see which were occurred most period to see which were occurred most often. often.

Findings showed that P’s who had hassles Findings showed that P’s who had hassles repeated experienced more physiological repeated experienced more physiological and psychological health problems. and psychological health problems.

Kanner found that daily hassles affected Kanner found that daily hassles affected more than life events, correlate with levels more than life events, correlate with levels of depression anxiety, etc., of depression anxiety, etc.,

Uplifts scale added Uplifts scale added laterlater Kanner et al introduced uplifts scale to Kanner et al introduced uplifts scale to

see if positive events in life could see if positive events in life could reduce the impact of daily hassles. reduce the impact of daily hassles.

135 Uplifts items that cheer people up, 135 Uplifts items that cheer people up, e.g.., exercise, music, enjoying a film.e.g.., exercise, music, enjoying a film.

Delongis et al compared hassles with Delongis et al compared hassles with life events and found hassles correlated life events and found hassles correlated higher with health status problems higher with health status problems more than life events. No statistical more than life events. No statistical relationship found with uplifts scale. relationship found with uplifts scale.

Type A personalityType A personality

Friedman and Rosenman 1959 investigated if Friedman and Rosenman 1959 investigated if there was a link between type A personality there was a link between type A personality and CHD. and CHD.

ProceduresProcedures:- A structured interview was given :- A structured interview was given to 3,000 men aged 39-59, they were examined to 3,000 men aged 39-59, they were examined for CHD (to exclude any P who had already for CHD (to exclude any P who had already CHD).CHD).

Examples of question “How would you cope Examples of question “How would you cope with having to wait in a long queue?” with having to wait in a long queue?”

The interview was conducted in a provocative The interview was conducted in a provocative manner to elicit type A behaviuor. There was a manner to elicit type A behaviuor. There was a follow up study 8 ½ years later. follow up study 8 ½ years later.

Type A personalityType A personality

Findings:- Findings:- 257257 of the men had developed of the men had developed CHD, 70% of which were type A – this was CHD, 70% of which were type A – this was twice the rate for type B. twice the rate for type B.

The difference in the incidence of CHD The difference in the incidence of CHD between both types dependant on lifestyle between both types dependant on lifestyle factors such as smoking and obesity, factors such as smoking and obesity, known to increase likelihood of CHD.known to increase likelihood of CHD.

AO2:- AO2:- Only American male P’s, only Only American male P’s, only between 39-59, not an experiment, cause between 39-59, not an experiment, cause and effect difficult to establish. There and effect difficult to establish. There could have been other variables eg, could have been other variables eg, hardiness. hardiness.

Hardy PersonalityHardy Personality

Kobasa and Maddi 1977, outlined Kobasa and Maddi 1977, outlined 3 main characteristics important 3 main characteristics important in the defence against the in the defence against the negative effects of stress. negative effects of stress.

ControlControl CommitmentCommitment ChallengeChallenge

Hardiness – Kobasa & Hardiness – Kobasa & Maddi 1977Maddi 1977 Control:- Hardy people see themselves Control:- Hardy people see themselves

as being in control of their lives, rather as being in control of their lives, rather than being controlled by external than being controlled by external factors beyond their control.factors beyond their control.

Commitment:-Hardy people are Commitment:-Hardy people are involved with the world around them, involved with the world around them, and have a strong sense of purpose.and have a strong sense of purpose.

Challenge:-Hardy people see life Challenge:-Hardy people see life challenges as problems to be overcome challenges as problems to be overcome rather than as threats or stressors. rather than as threats or stressors. Enjoy changes as opportunities for Enjoy changes as opportunities for development. development.

Kobasa & Maddi 1977Kobasa & Maddi 1977

Aim:- to see if personality had an impact on Aim:- to see if personality had an impact on stress-related illnessstress-related illness

Procedure:- clients trained to spot signs of Procedure:- clients trained to spot signs of stress such as muscle tension, increase in stress such as muscle tension, increase in heart rate and anxiety.heart rate and anxiety.

Use CBT methods to control stressorsUse CBT methods to control stressors Findings:- clients responded well to hardiness Findings:- clients responded well to hardiness

training were more able to cope training were more able to cope AO2:- only male white collar workers used in AO2:- only male white collar workers used in

study. Difficult to generalise to women or study. Difficult to generalise to women or different cultures or classes. different cultures or classes.

Life Changes Holmes & Life Changes Holmes & Rahe 1967Rahe 1967 Holmes & Rahe developed a scale Holmes & Rahe developed a scale

known as the SRRS (Social known as the SRRS (Social Readjustment Rating Scale, it contains Readjustment Rating Scale, it contains 43 life changes which affect health.43 life changes which affect health.

These events contain both positive and These events contain both positive and negative events that change lives eg., negative events that change lives eg., Death of a spouse = ranked highest, Death of a spouse = ranked highest, whereas Christmas is ranked 42. whereas Christmas is ranked 42.

Life Changes Holmes & Life Changes Holmes & Rahe 1967Rahe 1967 AimsAims: Rahe hypothesized that the more stress full life : Rahe hypothesized that the more stress full life

events experienced by p’s over 6 months the higher the events experienced by p’s over 6 months the higher the positive correlation with illness. Rahe studied a positive correlation with illness. Rahe studied a “normal” sample e.g.., Navy personnel. “normal” sample e.g.., Navy personnel.

ProceduresProcedures: 2700 Navy personnel filled in : 2700 Navy personnel filled in questionnaires (prior to a tour of duty) on the amount of questionnaires (prior to a tour of duty) on the amount of life events they had experienced in the previous 6 life events they had experienced in the previous 6 months. During their tour the number of illnesses were months. During their tour the number of illnesses were recorded to establish a correlation. recorded to establish a correlation.

Findings:Findings: A small positive correlation was found +.118 A small positive correlation was found +.118 Conclusion:Conclusion: There is a correlation between life events There is a correlation between life events

and illness. and illness. AO2:AO2: Both positive and negative events were used, but Both positive and negative events were used, but

some may have a beneficial effect, eg., marriage. SRRS some may have a beneficial effect, eg., marriage. SRRS ignores individual differences, only male used in study, ignores individual differences, only male used in study, specific to job. specific to job.

Work place stress Work place stress

Marmot et al 1997 proposed the “job-Marmot et al 1997 proposed the “job-strain model” causes stress and illness in strain model” causes stress and illness in 2 ways, (1) High work load (creates 2 ways, (1) High work load (creates greater work loads), (2) Low job control greater work loads), (2) Low job control (eg., over deadlines, procedures, etc., (eg., over deadlines, procedures, etc., Marmot studied civil servants with either Marmot studied civil servants with either high-grade or low-grade positions, high-grade or low-grade positions, believing that both aspects (1) & (2) believing that both aspects (1) & (2) would be experienced by each group, but would be experienced by each group, but for different reasons. for different reasons.

Work place stressWork place stress

Aims: To see if there is a correlation between Aims: To see if there is a correlation between workload and control in the workplace. workload and control in the workplace.

Procedures: 7372 civil servants were given Procedures: 7372 civil servants were given questionnaires on workload, job control and the questionnaires on workload, job control and the amount of social support they had in their lives. These amount of social support they had in their lives. These p’s were assessed for CVD, 5 yrs later assessed again.p’s were assessed for CVD, 5 yrs later assessed again.

Findings: No correlation was found between high work Findings: No correlation was found between high work load and stress related illness. Whereas the higher load and stress related illness. Whereas the higher level civil servants experienced less CVD problems = level civil servants experienced less CVD problems = the more job control the less the stress.the more job control the less the stress.

Conclusions: Control over job workload, and social Conclusions: Control over job workload, and social support helps lessen stress – supports Hardiness.support helps lessen stress – supports Hardiness.

AO2: Questionnaire used, results may be biased, large AO2: Questionnaire used, results may be biased, large sample, specific job difficult to generalise to wider sample, specific job difficult to generalise to wider population. population.

Approaches to coping Approaches to coping with stress – problem-with stress – problem-focused and emotion-focused and emotion-focusedfocused Problem-focused coping: The use of Problem-focused coping: The use of

strategies designed directly to alleviate the strategies designed directly to alleviate the stressful situation itself.stressful situation itself.

Emotion-focused coping: The use of Emotion-focused coping: The use of strategies that deal only with the emotional strategies that deal only with the emotional distress associated with stress events. distress associated with stress events.

The key difference between these two: one The key difference between these two: one deals with the stressor, the other deals with deals with the stressor, the other deals with the emotions generated by the stressor. the emotions generated by the stressor.

Problem-focused Problem-focused copingcoping TAKING CONTROL:- of the situation, TAKING CONTROL:- of the situation,

eg., finding out causes of problem, eg., finding out causes of problem, how to deal with debt or illness. how to deal with debt or illness.

EVALUATING THE PRO’S & CONS:- EVALUATING THE PRO’S & CONS:- looking at different options, eg., looking at different options, eg., whether to plan a new life or to take whether to plan a new life or to take other actions to avoid financial ruin.other actions to avoid financial ruin.

SUPPRESSING COMPETING ACTIVITES:- SUPPRESSING COMPETING ACTIVITES:- take action rather than putting off take action rather than putting off making a decision.making a decision.

Problem-Focused Problem-Focused coping coping Penley et al 2002 studied nursing Penley et al 2002 studied nursing

students – found that students who students – found that students who adopted a problem-focused adopted a problem-focused approach to work positively approach to work positively correlated on overall good health, correlated on overall good health, compared to students who adopted compared to students who adopted a negative emotion-focused a negative emotion-focused approach eg., (avoidance, wishful approach eg., (avoidance, wishful thinking), was associated with poor thinking), was associated with poor health. health.

Problem-Focused Problem-Focused copingcoping Gilbar 2005 examined the coping Gilbar 2005 examined the coping

strategies and psychological strategies and psychological distress in patients suffering from distress in patients suffering from breast cancer (major life event). breast cancer (major life event). The results showed that emotion-The results showed that emotion-focused coping caused more focused coping caused more psychological stress, whereas psychological stress, whereas problem-focused coping strategies problem-focused coping strategies were more beneficial in alleviating were more beneficial in alleviating stress. stress.

Emotion-focused Emotion-focused coping coping DENIAL:- Going on as if nothing is DENIAL:- Going on as if nothing is

wrong, avoiding taking action. wrong, avoiding taking action. Distancing:- just not thinking about Distancing:- just not thinking about

it. it. FOCUSING:- Focusing on expressing FOCUSING:- Focusing on expressing

emotions eg., crying, getting angry. emotions eg., crying, getting angry. WISHFUL THINKING:- dwelling on WISHFUL THINKING:- dwelling on

what might have been. what might have been.

Emotion-focused Emotion-focused copingcoping Folkman & Lazarus 1985 looked Folkman & Lazarus 1985 looked

at coping with exam stress, found at coping with exam stress, found that problem-focused coping most that problem-focused coping most useful during exam pressure, useful during exam pressure, whereas emotion-focused coping whereas emotion-focused coping was more evident after exams – was more evident after exams – waiting for results, eg., waiting for results, eg., distancing. distancing.

Emotion-focused Emotion-focused copingcoping Rukholm and Viverais 1993 looked Rukholm and Viverais 1993 looked

at the relationship between stress, at the relationship between stress, threat and coping. They discovered threat and coping. They discovered that when faced with threat when that when faced with threat when faced with stress they need to deal faced with stress they need to deal with the anxiety through emotion-with the anxiety through emotion-focused coping before being able to focused coping before being able to apply a problem-focused approach. apply a problem-focused approach.

Psychological methods Psychological methods of stress managementof stress management Stress Inoculation training (SIT), Stress Inoculation training (SIT),

Meichenbaum 1985, proposed that although Meichenbaum 1985, proposed that although it might be difficult to avoid stress we can it might be difficult to avoid stress we can alter the way we think about the stressors in alter the way we think about the stressors in our lives.our lives.

Meichenbaum believed that a person could Meichenbaum believed that a person could “inoculate” themselves against stress the “inoculate” themselves against stress the same way we might inoculate ourselves same way we might inoculate ourselves against diseases eg., MMR, Flu jabs, Tetanus against diseases eg., MMR, Flu jabs, Tetanus etc,. etc,.

Meichenbaum’s therapy uses CBT developed Meichenbaum’s therapy uses CBT developed specifically to deal with stress. specifically to deal with stress.

(SIT) Meichenbaum (SIT) Meichenbaum 19851985 Meichenbaum proposed the following 3 phases:-Meichenbaum proposed the following 3 phases:- Conceptualisation:- The client and therapist Conceptualisation:- The client and therapist

establish a relationship, the client will learn about establish a relationship, the client will learn about the impact of stress and shown how to identify the impact of stress and shown how to identify how to think differently about their stressors. how to think differently about their stressors.

Skills acquisition phase (& rehearsal):- Skills are Skills acquisition phase (& rehearsal):- Skills are taught to the client, eg., positive thinking, taught to the client, eg., positive thinking, relaxation, social skills. Skills are aimed at relaxation, social skills. Skills are aimed at allowing the client to view their problems in a allowing the client to view their problems in a different way.different way.

Application (& follow-through):- Clients are Application (& follow-through):- Clients are helped to find new ways to approach problems helped to find new ways to approach problems by role play, imagery, and modelling (watching by role play, imagery, and modelling (watching another cope in a similar situation). another cope in a similar situation).

SIT Meichenbaum 1985SIT Meichenbaum 1985evaluation pointsevaluation points Effectiveness – the combination of cognitive and Effectiveness – the combination of cognitive and

behavioural makes this approach very effective. behavioural makes this approach very effective. Practicality – SIT takes time, money and Practicality – SIT takes time, money and

commitment to learn the techniques required. commitment to learn the techniques required. Difficulties – mainly in changing life long thought Difficulties – mainly in changing life long thought

processes and habits, as the techniques may not processes and habits, as the techniques may not be easy to implement due to personality factors, be easy to implement due to personality factors, eg., type B personality.eg., type B personality.

Weaknesses of SIT – There is very little research Weaknesses of SIT – There is very little research support, only a few controlled studies have support, only a few controlled studies have shown encouraging results, (Meichenbaum & shown encouraging results, (Meichenbaum & Turk 1982) Turk 1982)

Hardiness training Hardiness training Kobasa & Maddi 1977Kobasa & Maddi 1977 Can hardiness be trained? Can hardiness be trained? Kobasa & Maddi began teaching hardiness Kobasa & Maddi began teaching hardiness

training following 3 phasestraining following 3 phases Focusing:-Focusing:- The client is taught how to recognise The client is taught how to recognise

the physical symptoms of stress e.g.., muscle the physical symptoms of stress e.g.., muscle tension, rapid heart rate etc., tension, rapid heart rate etc.,

Reliving stress encountersReliving stress encounters:- Client relives the :- Client relives the stressful event e.g.., interview situation, and stressful event e.g.., interview situation, and explains their feelings about the event, this may explains their feelings about the event, this may give the client an insight into how they could give the client an insight into how they could improve.improve.

Self-improvement:-Self-improvement:- The client uses these The client uses these insights to learn how to cope in future situations. insights to learn how to cope in future situations.

Evaluation of Evaluation of hardiness training - hardiness training - successsuccess Utah Valley State College showed that Utah Valley State College showed that

hardiness training helped “at risk” hardiness training helped “at risk” students. It was found to help them to students. It was found to help them to cope and succeed academically.cope and succeed academically.

Olympic swimmers used hardiness Olympic swimmers used hardiness training to build on their commitment, training to build on their commitment, and challenge to increase their and challenge to increase their performance and control the stresses performance and control the stresses that interfered with success, Fletcher that interfered with success, Fletcher 2005. 2005.

Evaluation of Evaluation of hardiness training - hardiness training - criticismscriticisms Theoretical issuesTheoretical issues – the concept of hardiness – the concept of hardiness

has been criticized as the role of the three has been criticized as the role of the three factors control, commitment, challenge is factors control, commitment, challenge is unclear. Personal control is seen as important in unclear. Personal control is seen as important in coping with stressors and overlaps with coping with stressors and overlaps with Kobasa’s view of control. Kobasa’s view of control.

Can it be generalized? – it is difficult generalize Can it be generalized? – it is difficult generalize the study as it was conducted on white, middle the study as it was conducted on white, middle class businessman, difficult to generalize to class businessman, difficult to generalize to women, different classes and cultures. women, different classes and cultures.

Effectiveness & Practicality – the training Effectiveness & Practicality – the training involves commitment, and motivation. It is not a involves commitment, and motivation. It is not a quick fix solution. Individual differences, quick fix solution. Individual differences, personality also need to be considered. personality also need to be considered.