1. Managing Stress The Theories/Studies Cognitive: SIT (Michenbaum 1975) Behavioural: Biofeedback. (Budzynski 1973) Social: social support (Waxler-Morrison 2006)

2. Approaches The social, behavioural and cognitive approaches all view the physiological symptoms of stress as caused by different aspects: Cognitive – Behavioural – Social –

3. Meichenbaum Cognitive: Stress inoculation therapy What does inoculation mean? Managing stress

4. Background: Meichenbaum’s assumption is that stress is caused by the faulty processing of information. Therefore, stress inoculation therapy assumes that some people find situations stressful because they think about them in catastrophising ways and so the aim of the therapy is to train people to cope more effectively with stressful situations.

5. Background: Stress Inoculation Therapy, SIT, has 3 stages: Cognitive preparation; Therapist and client identify the sources of stress. Encouraged to keep a diary of stressful events so the therapist can challenge some of the client’s appraisals of stressful situations if they seem exaggerated. Skill acquisition and rehearsal; Training the individual to cope with their stress using different techniques for different stressors. I.e relaxation techniques. Application and follow through; Therapist guides the client through progressively more stressful situations.

6. Aim: To compare effectiveness of standard behavioural methods with cognitive techniques. Cognitive methods aimed to enable people to identify their stressors and change their mental processes when under stress. What would a behavioural therapy concentrate on?

7. Methodology: Field experiment Participants put into three groups; SIT, standard desensitisation, control. Tested using anxiety questionnaires and grade averages before and after treatment. Single Blind study- people assessing did not know which condition they had been in. Matched pairs design with gender controls and a random allocation to a group.

8. Procedure: 21 students aged 17-25 responded to an advert about treatment of test anxiety. The SIT group received 8 therapy sessions giving them insight into their thoughts. They were then given some positive statements to say and progressive relaxation training whilst imagining stressful situations. The systematic desensitisation group was also given 8 therapy sessions with only progressive relaxation training whilst imagining stressful situations. The control group were told that they were on a waiting list for treatment.

9. Results: Performance in tests from the SIT group improved the most in comparison to the other two groups. Both therapy groups improved more in comparison to the control group. Participants in the SIT groups showed more reported improvement in their anxiety levels, although both therapy groups showed an improvement over the control group.

10. Conclusions: SIT is an effective way of reducing anxiety in students who are prone to anxiety in test situations and more effective than simply behavioural techniques when a cognitive component is added.

11. Issues: Generalisability/External Validity Ecological validity Usefulness Ethics Replicability Validity

12. Debates: Psychology as science Determinism vs Free will Reductionism vs Holism

13. January 2011 Describe one cognitive technique for managing stress. (10)

14. Budzynski Behavioural: Biofeedback

15. Background: Biofeedback is a means for gaining control of our body processes to increase relaxation, relieve pain and develop healthier and more comfy life patterns. Biofeedback gives us information about ourselves by the means of external instruments, for example thermometers. Biofeedback familiarises ourselves with the body processes and so can help us to learn to control them to relieve stress.

16. Aim: To see if biofeedback was effective in reducing tension headaches or whether it is due to the placebo effect.

17. Methodology: Experimental method with participants trained in a lab. Data was collected using muscle tension measurements with an electromyography. Psychometric tests for depression. Questionnaires on headaches. Independent measures with participants randomly assigned to 3 groups.

18. Procedure: 18 participants replied to a newspaper advert, 2 males and 16 females. Screened by telephone and then had psychological and medical examinations to ensure there were no other reasons for their headaches. Group A: Real biofeedback training with relaxation Group B: Biofeedback training but false feedback Group C: Used as a control group All groups kept a diary of their headaches for 2 weeks.

19. Results: After 3 months, group A’s muscle tension was significantly lower than the other two groups. Reported headaches in group A fell significantly compared to their baseline measurements, this did not happen in the other two groups.

20. Conclusions: Biofeedback is an effective way to reduce stress levels by reducing tension. By giving visible or audible feedback on the state of the body it is assumed that we would be more likely to repeat the method of reducing stress. These headaches are thought to be caused by sustained contraction of the scalp and neck muscles. Which is associated with stress, therefore by relaxing the muscles (reducing the stress response), the headaches should be reduced. Biofeedback is not a treatment. Rather, biofeedback training is an educational process for learning specialized mind/body skills. Learning to recognize physiological responses and alter them is not unlike learning how to play the piano or tennis - it requires practice. Through practice, we become familiar with our own unique psychophysiological patterns and responses to stress, and learn to control them rather than having them control us.

21. Issues: Low ecological validity Ethics Objectivity Usefulness Validity Generalisability Reliability

22. Debates: Psychology as science Reductionism vs holism –Determinism vs Free-will –Usefulness

23. Waxler-Morrison Social: Relationships and cancer survival

24. Background: A strong, social support network can be critical in helping individuals through stressful situations. It has been shown that cancer growth is amplified by stress and therefore by reducing this stress, there are positive outcomes on the cancer.

25. Aim: To look at how women’s social relationships influence her response to breast cancer and survival.

26. Methodology: A quasi experiment where women were already diagnosed with breast cancer. Used questionnaires and 18 interviews plus an examination of medical records. The women naturally fell into categories based on social support networks.

27. Procedure: 133 women all under 55 years old who were referred to a clinic in Vancouver after being diagnosed with breast cancer. Mailed questionnaires to gather information about their demography and existing social networks. Questions included education level, who they were responsible for- children- contact with friends and family and perceived support from others. Details of their diagnosis were taken from their medical records as were their survival and recurrence rates.

28. Results: 6 aspects of social networks were significantly linked with survival; –Marital status –Support from friends –Contact with friends –Total support –Social networks –Employment Qualitative data showed that practical support, such as childcare, were the concrete sources of support.

29. Conclusions: Several characteristics of women's social networks are significantly linked with survival rates. So, the more social support networks, the higher the rate of survival in breast cancer patients.

30. Issues: Ecological validity Demand characteristics Subjective

31. Debates: Individual vs Situational Reductionism vs Holism Determinism vs Free-will Usefulness

32. January 2012 Outline the social approach to managing stress. (10)

33. Evaluation Exam Questions January 2011 Discuss whether stress should be managed by treating the individual or their situation. (15) January 2012 Compare the techniques for managing stress. (15)