Psychology
3.3 Managing stress
Psychology
Learning outcomes
Understand the following three studies on managing
stress:
• Cognitive (Meichenbaum, D. (1972) ‘Cognitive
modification of test anxious college students’, Journal
of Consulting and Clinical Psychology 39, 370–80);
• Behavioural (Budzynski et al. (1970) ‘Feedback
induced muscle relaxation applied to tension
headache’, Journal of Behaviour Therapy and
Experimental Psychology 1, 205–11);
• Social (Waxler-Morrison et al. (1993) ‘Effects of social
relationship on survival or women with breast cancer’,
Social Science and Medicine 33 (2), 177–83).
Psychology
Cognitive method
Key theory: Meichenbaum (1972), Stress
inoculation therapy (SIT)
Meichenbaum suggests that there are three
components of SIT:
• The patients with the stress have to become
aware of the thoughts they have in any
stressful situations.
Psychology
Key theory: Meichenbaum (1972), Stress
inoculation therapy (SIT) (cont.)
• The second component is the coping
strategies that patients are taught to enable
them to restructure their thoughts.
• Finally the person puts into practice what
they have learned in a real-life stressful
situation.
Psychology
Key study: Meichenbaum (1972)
Aim
• To compare SIT with standard behavioural
systematic desensitisation and a control group
on a waiting list.
Method
• A field experiment where students were
assessed before and after treatment using selfreport and grade averages.
Psychology
Participants
• 21 students aged from 17 to 25 who responded
to an advert for treatment of test anxiety.
Design
• Matched pairs design with random allocation to
either the SIT therapy group, the waiting list
control group or the standard systematic
desensitisation group.
• Matched groups on gender and anxiety levels.
Psychology
Procedure
• Each participant was tested using a test anxiety
questionnaire and allocated to their group.
• In the SIT group the participants received eight
therapy sessions. They were given the ‘insight’
approach to help them identify their thoughts
prior to the tests. They were then given some
positive statements to say and relaxation
techniques to use in test situations.
Psychology
Procedure (cont.)
• In the systematic desensitisation group the
participants were given eight therapy sessions
with progressive relaxation training, which they
were encouraged to practise at home.
• The control group were told they were on a
waiting list and that they would receive therapy
in the future.
Psychology
Findings
• Performance on the tests improved in the SIT
group compared with the other two groups.
• The significant difference was between the two
therapy groups and the control group.
• Participants in the SIT group showed more
reported improvement in their anxiety levels,
although both therapy groups showed overall
improvement compared to the control group.
Psychology
Conclusions
• SIT is a more effective way of reducing anxiety
in students who are anxiety prone in test
situations. It is more effective than behavioural
techniques such as systematic desensitisation as
it adds a cognitive component to the therapy.
Psychology
Behavioural method
Key study: Budzynski et al. (1970)
Aim
• To see whether biofeedback is an effective
method of reducing tension headaches.
Method
• Experimental method, with patients being
trained in a laboratory.
Psychology
Participants
• 18 participants who replied to an
advertisement in a local paper in Colorado.
Design
• Independent design. The participants were
randomly allocated to one of three groups.
Psychology
Procedure
• For two weeks patients kept a record of their
headaches.
• Groups A and B were given 16 sessions of
training, with 2 sessions each week for 8 weeks.
• Group A were taught relaxation and told the
‘clicks’ of the biofeedback machine would
reflect their muscle tension, with slower
clicks indicating less muscle tension.
Psychology
Procedure (cont.)
• Group B were told to concentrate on the
varying clicks. They were given pseudofeedback.
• Group C were given no training but were told
they would begin training in two months.
Psychology
Findings
• The muscle tension of Group A was significantly
different from Group B by the end of the
training, and after three months, Group A’s
tension was significantly lower than Group B’s.
• Group A’s reported headaches dropped
significantly from their baseline, whereas the
other didn’t, and was also significantly less
than Group B’s and Group C’s reported
headaches.
Psychology
Findings (cont.)
• Drug usage in Group A decreased, more than in
Group B.
• Group A reported less headache activity than
Group B.
• There was a follow up for Group A after 18
months, when four out of the six participants
were contacted. Three reported very low
headache activity, and the fourth reported
some reduction.
Psychology
Conclusions
• Biofeedback is an effective way at training
patients to relax and reduce their tension
headaches, so can be seen as an effective
method of stress management.
• Relaxation training is also more effective than
just being monitored, but is better when used
together with biofeedback.
Psychology
Social support
Key study: Waxler-Morrison et al. (1993)
Aim
• To see how social relationships influence
response to breast cancer and survival.
Method
• A quasi-experiment with women who were
diagnosed with breast cancer.
Psychology
Participants
• 133 women under 55 years (pre-menopausal).
Design
• Independent design as women had existing
social networks.
Psychology
Procedure
• Patients were mailed a self-administered
questionnaire to gather information on: their
demography and existing social networks, their
educational level, who they were responsible
for (e.g. children), contact with friends and
family, perception of support from others.
• They were given a psychometric test of social
network that combined marital status, contact
with friends and family and church
membership.
Psychology
Procedure (cont.)
• The details of their diagnosis was abstracted
from their medical records between June 1980
and May 1981, and then their survival and
recurrence rates were checked in their medical
records in January 1985.
Psychology
Findings
• Six aspects of social network were significantly
linked with survival. These were: marital
status, support from friends, contact with
friends, total support, social network and
employment.
• The qualitative data from the interviews
showed that practical help such as childcare,
cooking and transport to hospital were the
concrete aspects of support.
Psychology
Findings (cont.)
• Married women who survived tended to report
supportive spouses.
• Jobs were seen as important, even if they were
not financially important, as they were a source
of support and information.
Psychology
Conclusions
• The more social networks and support, the
higher the survival rate of women with breast
cancer, although type of cancer was still the
main factor in survival.