Evaluation points for Stress

As requested, I've done some evaluation points for stress. They aren't the only ones, so if you think of any more, feel free to use those. 

Causes of Stress

• You could evaluate the extent to which each of these were nomothetic - does everybody have lack of control/work/daily hassles/life events? Does it cause each person stress?
• You could look at situational versus dispositional - all of these actually tend to favour situational explanations of stress, but the treatments tend to be dispositional, so this could be a good issue to look into. 
• You could maybe also look at how simple these causes would be to fix, and how the knowledge that they cause stress could be use. This leads you to evaluation issues such as usefulness and application. 

Measures of Stress

• Validity is a major issue here. You've got low construct validity in that it's hard to define stress and thus hard to know when you're measuring it, as well as face validity because the measures of stress can be affected by lying, memory, demand characteristics, illness, emotion, etc. Also, different people experience stress differently so using only one measure on participants may not be a valid approach.
• Reliability is also important. As different people experience stress differently, measures are unlikely to give consistent results if used again in similar situations. Too many things affect measures of stress and stress itself in order to give consistent results on physiological or self-report measures.
• Reductionism is a potential issue. Obviously, measures which are only self-report (e.g. SRRS) or only physiological (e.g. heart rate monitor) are reductionist and don't look at many features of stress response or the dynamic between them, whilst combined measures are holistic and thus may be more appropriate and useful.

Managing Stress

• Situational versus dispositional is also appropriate to evaluate here. Social support takes the situational approach whilst cognition is dispositional, as is behaviourism (biofeedback). Though, behaviourist ways of managing stress emphasise the role of positive reinforcement, so it has a situational element as well. You could obviously link this to reductionism and holism. 
• You could look at whether symptoms or causes of stress are targeted, and evaluate whether this is a good approach to managing stress. SIT attempts to prevent stress as well as help the individual overcome their current stress which Meichenbaum suggests is the actual cause of stress, thus it targets causes rather than symptoms. Biofeedback treats the symptoms of stress response rather than the causes as it teaches relaxation, though this may prevent stress too. Social support targets the symptoms and causes in that having strong social networks can provide support to prevent stress, and provide support once stress has onset. 
• You could also look at effectiveness by looking at whether research supports it, or by cost and time effectiveness. Biofeedback in the form of EMG machines are expensive and require a practitioner, it's somewhat difficult and expensive to get a therapist but once you've learned the skills it lasts a long time, and social support is free and lasts a long time, but is not instantaneous. 

Also, some of the studies are pretty unethical, such as Geer and Maisel, and those which put participants on waiting lists rather than giving them therapy. Though control groups help with internal validity checks, they aren't the most ethical. E.g. Meichenbaum's study had a control group of students who did worse on their exams than the experimental groups - if they were in the other group, they'd have benefited and thus they lost out. 

MANAGING STRESS: Social support networks [Waxler-Morrison et al.]

Many forms of dysfunctional behaviour are treated in group therapy and support sessions, such as alcoholism, drug addiction and anger management. Some stress management also emphasises the need for social support in coping with stressful situations.

Cohen and Willis argue that there are four types of social support (all of which we need):

1. Instrumental support; practical support such as help with taking care of loved ones or help with getting to where you need to be.

2. Informational support; advice on what to do and how to cope with different situations.

3. Esteem support; emotional support from friends, colleagues, loved ones and others which makes you feel valued, safe, loved and respected. 

4. Social companionship; general interaction with others for its own sake rather than functional relationships such as at work.

Study: Waxler-Morrison et al. 

Waxler-Morrison et al conducted a study on the impact someone's social support networks had on their ability to cope with the stress of and survive cancer. It used a sample of 133 Canadian women under the age of 55 who had been diagnosed with breast cancer. Data was taken from medical records as well as self-report methods (largely questionnaires but also some interviews). The findings suggested six aspects of social support were most closely associated with cancer survival:

1. Marital status (married women who survived tended to report supportive husbands)

2. Support from friends

3. Contact with friends

4. Employment (employed women found this important in coping with cancer as it was a source of information and social support).

5. Social network

6. Total support

A strong social support system was concluded to reduce the stress associated with life-threatening but not necessarily terminal illnesses such as breast cancer, and thus make survival more likely. Though, obviously the most important factor in survival is the diagnosis of the cancer (i.e. how developed the cancer is).

MANAGING STRESS: Behaviourist Approach and biofeedback [Budzynski et al]

The behaviourist approach to psychology assumes that we are all born as a blank slate, and we learn all of our behaviour. It's a very reductionist approach as it is purely on the nurture side of the nature-nurture debate, the situational side of the situational-dispositional debate, and deterministic on the freewill-determinism debate. 

It essentially works on the basis of three concepts: classical conditioning (learning via association), operant conditioning (learning via punishment and reinforcement) and social learning theory (learning via imitation and interaction with others).

In terms of stress management, the behaviourist approach takes the view that as behaviour is learned, you can be taught to manage stress through the same processes. Stress is often dealt with in behavioural therapies through the use of CBT (mentioned in this post on cognitive therapies) or through the use of positive reinforcements. This often involves direct positive reinforcement in terms of improved relaxation and reduced stress combined with feedback from a biodot (which shows you reducing your stress) or a monitor such as a heart rate monitor.

Study: Budzynski et al 

Budzynski et al conducted a study on the role of biofeedback in reducing stress management. It was a field experiment using 18 volunteers who had responded to an advert asking for people with tension headaches. They were split into 3 conditions. Group 1 were taught relaxation techniques during two weekly sessions for eight weeks, during which they had their muscle tension measured by an EMG machine. They were informed about the biofeedback in terms of clicks, (more clicks = more tension) and encouraged to relax. Group 2 had the same relaxation training but didn't know about the biofeedback and were given a false soundtrack of clicks, whilst Group 3 were not trained in the relaxation techniques nor taught about the biofeedback and so acted as a control group. The study showed that Group 1 had the lowest muscle tension, lowest levels of hysteria and depression and the fewest tension headaches by the end of the study, concluding that biofeedback combined with relaxation techniques help to significantly reduce stress-related illness. 

MANAGING STRESS: Cognitive Approach and SIT [Meichenbaum]

The cognitive approach works on the assumption that it is necessary to refer to internal mental processes such as thought, perception and language in order to understand and explain behaviour. 

It would thus view stress as the result of faulty thinking and poor perceptions, and as a form of dysfunctional and maladaptive behaviour which can be improved or cured via cognitive restructuring. This is the fundamental concept behind all forms of cognitive behavioural therapy (CBT).

One form of CBT specifically targeted at coping with stress is Stress Inoculation Therapy (or SIT). It was developed in the 1970s by Meichenbaum, and has three stages which aim to help clients to replace "self-defeating thoughts" which cause stress with more positive ones, which can help to reduce the effect of potential stressors, and thus reduce the overall stress response.

The three stages of SIT are:

1. Conceptualisation - the client and therapist work together to identify the nature of stress, and the therapist educates the client on the general effects of stress to help them understand what stress is and thus how it can be overcome

2. Skills acquisition - the therapist helps to train the client in relevant skills which will aid them to cope with and reduce their stress. This often includes monitoring their own internal dialogue and reassuring themselves that things are okay if not everything goes to plan.

3. Follow through/application - the patient has to apply their skills to real-life situations, and the therapist helps them with this. 

Study: Meichenbaum: comparing SIT to systematic desensitisation and a control group in reducing test anxiety (a major cause of stress)

The study consisted of 21 students aged 17 to 25, who had responded to an advert asking for participants in a study on test anxiety. It was a field experiment, where the IV was the type of therapy (if any) the participant received, and the DV was reduction in test anxiety, which was measured through the use of grade averages and self-reported measures. It was a matched pairs design with three conditions. Group 1 received eight therapy sessions where they were taught to identify stress, learn how to reduce thoughts which increased their stress, monitoring their internal dialogue, etc. Group 2 received the same number of sessions but were given the behavioural therapy of systematic desensitisation, whilst Group 3 were put on a waiting list. Both therapy groups had improved results, but Group 1 (SIT group) performed better in test conditions and had reduced anxiety levels than both other groups, and thus it was concluded that SIT helped to reduce the test-associated stress people felt and enabled them to perform better. 

Tackling part a) questions

You've got to answer 4 part a) questions for the G543 paper, and it's important to get them right because it's a lot easier to get top marks in this part than part b). 

If you're struggling on how to go about it, here's how I answer part a):

• Is it asking about a theory or research? Some sections don't really have "theories" as such, like the stress subsection, but you'll need a bit of an intro. If they're asking about a theory, it won't hurt to make the last paragraph a bit of a study to help illustrate your point. It's generally what they're looking for.
• Identify what the question is asking you, and actually answer it. Pre-learned part a)s won't be the most effective way of gaining marks; you need to apply your knowledge of studies and theories to the actual question.  
• Keep referring back to the question.

Generally, this is my structure:

1. Set the scene. If it's a question on the behavioural approach to managing stress, briefly define stress and outline the assumption of the behaviourist approach. You might also want to list that there are many approaches to managing stress, but it's not necessary. 

e.g. Stress is the body's response to either physical, emotional or mental demands that are perceived to stretch an individual in some way (often because they may feel they are unable to deal with it). Some stress is good, like stress that makes you want to revise, but some stress is unnecessary and has a strong aversive effect on overall health. There are many proposed ways to manage stress. The behavioural approach to psychology believes that all behaviour, including stress is learned, and thus assumes that you can learn to manage stress.

2. The theory. Start with the basic explanation, as simple as you can. Then you can expand on it and show what you know, giving the example of a specific or main theory. 

e.g. The behavioural approach to managing stress often includes teaching stressed clients to be aware of their central nervous system and their stress, and then learning how to reduce the stress. This is often also combined with positive reinforcements. One key behavioural technique of managing stress emphasises the role of biofeedback. It involves being taught relaxation techniques, whilst being made aware of the effect on the body that they have, and then receiving feedback on their progress, through the use of biodots, or heart rate monitors which show the physical reduction of stress. This use of double positive reinforcement in the form of relaxation and biofeedback is supposed to help the client feel in control of their stress.

3. The study. Even if the question doesn't ask for it, I would rarely recommend skipping this step. It helps to illustrate your understanding and get you those full marks.

e.g. One study which illustrates how the behaviourist approach uses biofeedback to manage stress was conducted by Budzynski et al. It was a field experiment involving 18 volunteers with tension headaches who were split into three conditions. Group 1 received relaxation training for 2 weekly sessions for 8 weeks, during which they had their muscle tension measured by an EMG. They were informed of the biofeedback in the form of clicks as their positive reinforcement; more clicks meant higher tension, and thus they were encouraged to relax. Group 2 had the same relaxation training but didn't have accurate biofeedback, and Group 3 was a control group with neither. Both experimental groups showed improvement in tension headaches and other stress-related illnesses such as hysteria and depression, but Group 1 showed the most improvement. This suggests that biofeedback is one technique in which stress can be managed. 

If there's a question you'd like me to go over, leave a comment and I'll take a look.