Motivation and emotion/Book/2013/Stress reduction

Overview
Stress is an unavoidable part of life. In small amounts, stress can be beneficial - it can provide us with a burst of energy and it can motivate us to achieve our goals (Gruner, 2006). On the other hand, too much stress is associated with adverse emotional and health outcomes (Gruner, 2006; Jacobs, 2001). Through an exploration of psychological theory and research, this chapter of Motivation and emotion: Improve your life aims to provide you with an understanding of what stress is, why it is important to manage stress, and effective methods to reduce and manage stress.

What is stress?
There is no unanimously accepted definition of stress, although popular definitions describe stress as an event or situation that challenges an individual’s mental and physical resources required to cope with the demands they are faced with (Cohen, Janicki-Deverts & Miller, 2007). The difficulty with defining stress is that it is largely subjective. There are events that would be considered stressful for most people, for example the death of a close family member. Although major differences exist between individuals in terms of the way they react and the way they are affected by similar potentially stressful events (Hickle & Anthony, 2013). People commonly associate stress with negative events, for example, getting divorced or being fired from their job, although stress can arise in response to positive events too, for example getting married, or starting a new job (Kemeny, 2003; Selye, 1950).

Why manage stress?
Stress is associated with a number of emotions including anxiety, depression, fear, anger and sadness (Gruner, 2006). Individuals who feel stressed commonly report suffering from headaches, shortness of breath, nausea, muscle tension, fatigue, difficulty concentrating and difficulty sleeping (Gruner, 2006). Behavioural manifestations associated with stress include excessive eating, drinking alcohol and smoking (Gruner, 2006). Furthermore, research suggests a correlational relationship between stress and autoimmune disease, coronary heart disease, gastrointestinal disease, chronic pain, psychological illnesses including Generalised Anxiety Disorder, Major Depressive Disorder and Post-Traumatic Stress Disorder, in addition to a number of other medical disorders (Gruner, 2006; Jacobs, 2001). For these reasons it is important to effectively manage and reduce stress to minimise its adverse consequences.

Types of stress
A stressor is any event that evokes a stress response (Kemeny, 2003). Stressors differ in terms of their duration, their levels of intensity in addition to the impact and consequences they have on people (Segerstrom & Miller, 2004). It is thought that particular types of stressors are more likely to result in adverse emotional and health outcomes (Segerstrom & Miller, 2004). As described by Segerstrom and Miller (2004) stressors can be categorised as:

Acute time-limited stressors Acute time-limited stressors occur in artificial settings, for example, in a laboratory. They are generally used for research purposes (Segerstrom & Miller, 2004). Examples include public speaking or mental arithmetic. Acute time-limited stressors persist for only a few minutes and have trivial, if any, consequence on an individual’s emotional state (Segerstrom & Miller, 2004).

Brief naturalistic stressors Brief naturalistic stressors occur in real life settings and generally last up to a few hours (Segerstrom & Miller, 2004). An academic examination would be categorised as a brief naturalist stressor. Brief naturalistic stressors cause real but not overwhelming emotional responses (Segerstrom & Miller, 2004).

Stressful event sequences Stressful event sequences occur when an initially stressful experience gives rise to a series of related challenges, for example a major natural disaster (Segerstrom & Miller, 2004). Stressful event sequences have serious and long-term emotional and health consequences for people (Segerstrom & Miller, 2004).

Chronic stressors Chronic stressors are stable. People do not know when the stressful event will end or if it will end (Segerstrom & Miller, 2004). Examples of chronic stressors include unemployment, injury that results in a disability or caring for a terminally ill relative. Chronic stressors have major emotional and health consequences for individuals (Segerstrom & Miller, 2004).

Distant stressors Distant stressors are events that have occurred in the distant past and continue to cause an individual to experience stress (Segerstrom & Miller, 2004). An example of a distant stressor is childhood sexual abuse. Distant stressors have major long-term emotional and health consequences for individuals (Segerstrom & Miller, 2004).

Fight-or-flight response
Walter Canon’s description of the fight-or-flight response was an early contribution to understanding the physiological response of stress. The fight-or-flight response is an acute physiological reaction evoked by a dangerous and potentially life threatening event, for example, a physical assault or a motor vehicle accident (Jacobs, 2001). The fight-or-flight response prepares an individual to either fight or flee (Jacobs, 2001). During the fight-or-flight response a number of reactions occur involving the central nervous system, circulatory system, endocrine system, respiratory system, musculoskeletal system and the immune system (Jacobs, 2001). These reactions result in a number of changes that promote survival which include increased blood circulation, increased availability of blood to skeletal muscles, enhanced blood clotting ability, increased oxygen availability and decreased pain perception, among many other changes (Jacobs, 2001). Cannon hypothesised that if the stressor does not abate, then the fight-or-flight response will remain activated (Jacobs, 2001). It is thought that this excessive activation of the fight-or-flight response leads to increased morbidity and mortality (Jacobs, 2001).

Cannon’s concept of the fight-or-flight response has been critiqued. It has been argued that commonly experienced stressors that occur in every day situations are not of the intensity of those that evoke the fight-or-flight response (Jacobs, 2001). As a result these stressors produce a less intense physiological response and are less likely to cause morbidity and mortality (Jacobs, 2001).

General adaptation syndrome


Hans Selye developed the general adaptation syndrome (GAS) model to explain the physiological stress response. The GAS model consists of three distinct phases, the alarm phase, the resistance phase and the exhaustion phase (Selye, 1950).

Alarm Phase During the alarm phase the fight-or-flight response is evoked, preparing the individual for survival (Selye, 1950). The alarm phase is brief and if the stressor continues the body will transition into a state of resistance (Selye, 1950). Short-term stressful events, for example acute time limited stressors are likely to abate during the alarm phase.

Resistance Phase During the resistance phase, the body adapts to the stressor in attempt to reduce its effects on the body (Selye, 1950). If the stressor remains present, the body’s resources used to adapt to the stressor become depleted and the individual progresses into the exhaustion phase (Selye, 1950). Brief naturalistic stressors are likely to abate by the resistance phase, if they have not already during the alarm phase.

Exhaustion Phase During the exhaustion phase, the individual’s resources are depleted and they are at increased risk of serious illness and in some cases life threatening diseases (Selye, 1950). The exhaustion phase can be avoided if the stressor abates in either the alarm or resistance phase (Selye, 1950). Stressful event sequences, chronic stressors and distant stressors are likely to result in the exhaustion phase.

Selye categorised stress as either eustress, a response evoked by a positive stressor, for example getting married, or distress, a response evoked by a negative stressor, for example the death of a family member. Both eustress and distress have the potential to progress to the exhaustion phase, resulting in adverse emotional and health outcomes (Seyle, 1950).The GAS model of stress has been critiqued as it does not take into consideration the way in which stressful events are perceived.

Transactional model of stress
Richard Lazarus’s transactional model of stress states that stress is a transaction that occurs between the individual and the environment (Hickle & Anthony, 2013). The amount of stress an individual will experience is a result of how the stressor is appraised and how the individual appraises their resources required to cope with the stressor (Hickle & Anthony, 2013). There are two processes involved in the transactional model of stress, primary appraisal and secondary appraisal (Hickle & Anthony, 2013).

Primary appraisal During primary appraisal the individual evaluates the event and decides whether it is benign, stressful or irrelevant (Hickle & Anthony, 2013).

Secondary appraisal During secondary appraisal the individual assesses the efficacy of their resources available for coping (Hickle & Anthony, 2013).

If the demands of the stressor are perceived as greater than the individual’s available resources, the event will be identified as stressful (Hickle & Anthony, 2013). The stressor will then be categorised as a threat, a harm or loss, or as a challenge. A stressor categorised as a harm or loss represents an event that has already caused damage, for example, the loss of a loved one or something of great importance such as a job (Hickle & Anthony, 2013). A stressor categorised as a threat has the potential for future harm or loss (Hickle & Anthony, 2013). While a stressor categorised as a challenge represents a situation that has the potential for personal growth and achievement for example getting married or starting university (Hickle & Anthony, 2013).

The transactional model of stress can be used to explain individual differences in reactions to stress, which other models have failed to do.

Yoga
There are many types of yoga, they often encompass breathing techniques, postures, strengthening exercises and meditation.{{grammar} Yoga has been found to be effective in reducing and managing stress. Smith, Hancock, Blake-Mortimer and Eckert (2006) conducted a study investigating the efficacy of yoga in stress reduction. The study found that following 10 one hour weekly sessions of Hatha yoga, participants' scores on a self report scale of stress, anxiety and quality of life had significantly improved, supporting the use of yoga for stress reduction and management (Smith et al., 2006).

Research has found that yoga is associated with decreased levels of cortisol (McCall, 2013). Cortisol is released during the stress response, this is beneficial for stress reduction as decreased cortisol levels are associated with decreased perceived stress and decreased anxiety (McCall, 2013). There is also evidence to support that yoga reduces sympathetic nervous system activity, the sympathetic nervous system activates the fight-or-flight response (McCall, 2013). Therefore, by decreasing or stopping fight-or-flight activation through yoga, an individual is able to avoid the negative emotional and health outcomes associated with excessive fight-or-flight activation (Jacobs, 2001; McCall, 2013).

Mindfulness based stress reduction
Mindfulness based stress reduction (MBSR) employs mindfulness meditation to manage and reduce negative emotions caused by stress (Varvogli & Darviri, 2011). MBSR is used to enhance awareness of the moment-to-moment experience of an individual’s mental process (Carmody & Baer, 2008). It is thought that enhanced awareness enables more accurate perception, reduces negative affect and improves coping (Carmody & Baer, 2008). As described by Lazarus’ transactional model of stress, the way in which a stressor is perceived is critical in determining the impact it will have on the individual (Hickle & Anthony, 2013). Therefore MBSR may reduce the impact a stressor has on an individual, by enabling more accurate perception of the event.

Carmody and Baer (2008) investigated the relationship between mindfulness meditation and levels of mindfulness, perceived stress and psychological wellbeing. The study found that mindfulness meditation was associated with increased mindfulness, decreased stress, improved well-being and psychological functioning following participation in MBSR over an eight week period (Carmody & Baer, 2008). Research has found that MBSR can influence brain structures responsible for regulating attention, awareness and emotion, thereby improving outcomes for individuals experiencing stress (Greeson, 2008).

Progressive muscle relaxation
Progressive muscle relaxation (PMR) is an effective method for reducing stress and related feelings of anxiety (Varvogli & Darviri, 2011). PMR involves tensing and relaxing major muscle groups for a specific amount of time in a specific order (Varvogli & Darviri, 2011). The individual is directed to focus on the difference between feelings of tension and feelings of relaxation (Varvogli & Darviri, 2011). Through the use of PMR individuals learn how to manage and reduce stress by relaxing and reducing muscle tension (Varvogli & Darviri, 2011).

Research conducted by Pawlow and Jones (2002) found PMR to be effective in reducing stress. This was indicated by decreased heart rate, decreased levels of perceived stress and anxiety and decreased levels of cortisol, which is released in the fight-or-flight response (Pawlow & Jones, 2002). By engaging in PMR an individual is able to reduce or cease the fight-or-flight response and avoid the adverse health outcomes associated with excessive fight-or-flight activation and the exhaustion phase of the GAS model (Jacobs, 2001).

Exercise
Participating in exercise is an extremely effective method to reduce and manage stress. Research conducted by Guszkowska (2004) found reductions in anxiety and depression, in addition to improved mood states in subjects after one single session of exercise. Greatest results were found in individuals who participated in low to moderate intensity jogging, swimming, cycling and walking. For effective stress management, Guszkowska (2004) recommend engaging in exercise for 15 to 30 minutes at least three times a week.

Research has shown that regular aerobic exercise results in lower sympathetic nervous system and hypothalamic-pituitary axis (HPA) reactivity, both of which are activated during the fight-or-flight response (Guszkowska, 2004). Decreasing sympathetic nervous system and HPA activity, results in a decreased stress response (Guszkowska, 2004). According to the GAS model, by reducing the stress response, the exhaustion phase can be avoided and subsequently the adverse emotional and health outcomes associated with reaching this phase (Selye, 1950).

Postpone major life changes
Research has shown that both positive and negative events have the potential to cause stress and consequently cause adverse emotional and health outcomes (Kemeny, 2003; Selye, 1950). Any change in an individual’s life has the potential to cause stress (Thoits, 2010). If an individual is currently feeling stressed, it is recommended, where possible, to postpone major life changes until a more appropriate time (Thoits, 2010). By postponing major life changes, one is reducing the number of stressful sources in their life that they are required to adapt to (Selye, 1950). In doing so they reduce the likelihood of their resources being exhausted and consequently decrease the risk of the negative and emotional outcomes associated with reaching the exhaustion phase of the GAS model (Selye, 1950).

Controlled breathing activity
People commonly experience shortness of breath when they are feeling stressed (Gruner, 2006). Deep breathing exercises are often used in yoga and meditation to help evoke a relaxation response and reduce stress.

Below is a step by step guide to achieve controlled breathing and to reduce stress (Reducing stress, 2010).


 * 1) Sit up straight with your eyes closed and focus on your breathing.
 * 2) Breath in a six second cycle. Breath in through your nose for three seconds and out through your mouth for three seconds.
 * 3) As you exhale say the word 'relax'.
 * 4) Continue this exercise for five minutes.
 * 5) Repeat this exercise when you are feeling stressed or anxious.

Learning quiz
{Stress is associated with adverse emotional and health outcomes. + True - False
 * type=""}

{Caring for a terminally ill relative would be categorised as what type of stressor? - Brief naturalistic - Distant stressor + Chronic stressor - Acute time limited
 * type=""}

{ The fight-or-flight response prepares an individual to either fight or { flee }.
 * type="{}"}

{ The three phases of the general adaptation syndrome model of stress are alarm, resistance and { exhaustion }.
 * type="{}"}

{According to the transactional model of stress a challenging stressor has the potential for personal growth and achievement. + True - False
 * type=""}

{Which of the following is NOT an effective way to manage stress? - Yoga - Exercise + Drinking alcohol - Progressive muscle relaxation
 * type=""}

Conclusion
Stress refers to an event that challenges an individual’s mental and physical resources required to cope with the demands they are faced with. Stress has both physiological and psychological components which can be explained by the fight-or-flight response, the general adaptation syndrome model of stress and the transactional model of stress. It is important to manage stress as it can lead to a number or adverse emotional and health outcomes. Effective methods to reduce and manage stress include yoga, mindfulness based stress reduction, progressive muscle relaxation, exercise and postponing major life changes.