Stress
The physiology of stress refers to the biological processes that occur in the body
when a person perceives a threat or challenge. It involves the activation of the
nervous system and endocrine (hormone) system to prepare the body for a “fight or
flight” response.
Sources of Stress
General Adaptation Syndrome (GAS) is a 3 stage process that describes the
biological changes the body goes through when it is under stress.
This theory was proposed after Selye conducted a study on lab rats by observing
them going under physiological changes hen they are exposed to stress
Stages of Stress :
Alarm Reaction stage : The
initial symptoms the body
experiences when faced with
a stressful situation. In this
stage, cortisol which is a
stress hormone along with
adrenaline is released to
increase the energy
Physical Effects : increase in
heart rate, faster breathing ,
Increased heart rate and
blood pressure and digestion
slows down
Resistance Stage : After the
initial shock of stress the
body starts to return to it normal position and repair but is still on high alert , when
the stressor is passed the body will repair and recover but if the stressful event is
ongoing the body continues to be on high alert The stress hormone cortisol will
continue to be secreted and the blood pressure will continue to stay high If the
resistance stage prolongs for a long period of time , it will lead to exhaustion
Indicators : Irritability , frustration and poor concentration
Exhaustion Stage : Expected or prolonged chronic stress can drain one
emotionally , mentally and physically and the body won’t be able to fight the stress
effectively
Physical Effects : Fatigue, depression , anxiety and decreased tolerance of stress
Effects of stress on health :
● Headaches
● Insomina
● Nausea
● Heartburn
● Muscle aches and pains
Chronic stress leads to chronic
health problems :
● Types 2 diabetes
● Alcohol or substance
abuse
● High blood pressure
leading to an increased
risk of heart attacks or
strokes
● A weak immunity
system
Causes of stress
Life events :
Holmes and Rahe proposed the theory that life events are the main cause of stress
Life events can be defined as any major changes in a person's life either positive or
negative that causes a transition in one’s life
Inorder to measure the effect of life events on health , they constructed the
Social Readjustment Rating Scale (SRRS)
Description of the Social Readjusting Rating Scale
● They created a list of 43 life events, each assigned a “Life Change Unit”
(LCU) score, based on how stressful people generally find them.
● The more life events a person experiences (and the higher their total LCU
score), the greater the risk of stress-related illness.
● Individuals check which of the 43 events they have experienced in the past
year.
● The LCU values for each event are added together.
● The total score predicts the likelihood of developing stress-related health
problems.
○ Less than 150 LCUs: Low stress – about 30% chance of illness
○ 150–299 LCUs: Moderate stress – about 50% chance of illness
○ 300+ LCUs: High stress – about 80% chance of illness
✅
✅ Provides a standardized and objective measure of stress.
✅
❌
Useful in research linking life events to physical and mental health.
Simple and easy to administer.
❌ Doesn’t account for individual differences in how people perceive stress.
Focuses only on major life events, ignoring daily hassles that can also cause
❌
stress.
Some events (like marriage or pregnancy) can be positive, but still rated as
❌ Developed using mainly Western samples, so may lack cultural validity.
stressful.
Work-life :
Work is another cause of stress as there are many aspects of work that are
responsible for causing stress like physical and mental environment of workplace ,
interpersonal relationships and pressure of meeting certain career goals
➢Example study : Chandola et al. (2008)
Aim : To investigate the link between workplace stress and Coronary heart disease
Design :
● Longitudinal study
● 10000 males and female civil servants in London from 1985-2004
● Analysed over 7 phases involved postal questionnaire and alternates like
clinical interviews
● Assessed using the Job-strain questionnaire
Results :
● A total work stress score was assigned to each participant based on the total
number of reported incidents of work strain in phases 1 and 2
● People aged between 37-49 at phase 2 there was a significant association
between greater reports of work stress and higher risk of CHD events
● There is a little association between work stress and CHD incidents for those
aged 50 and above
● For younger people , greater work stress was associated with poorer health
● Appox. 32% of the effect of work stress on CHD can be explained by the
effect of work stress on unhealthy behaviours
Conclusion : The study shows that work stress is a significant indicator of
CHD events in those of the age of 50 particularly due to the increase in
unhealthy behaviours but also because of physiological changes
✅
Strengths and weakness
Longitudinal Design → ⬆️ Validity : The study follows participants over many
years, showing how stress leads to CHD over time, not just at one moment.
✅ ⬆️
This gives high temporal validity and stronger evidence for associations.
Large, representative sample was used (large occupational cohort);
❌
generalisation to working adults and increases population validity.
Sample bias as the study mainly included civil servants so results may not
generalise to:
● unemployed individuals
● manual labour workers
Issues and debates ☯️
● different cultures or income groups
:
Nature vs Nurture: The study focuses on environmental (nurture) factors such as
workplace stress. It does not fully consider biological (nature) influences such as
genetics, cholesterol levels, or family history of CHD.
Suggests nurture plays a large role, but CHD is influenced by both nature and
nurture.
Reductionism vs Holism : The study is holistic, looking at work stress, health
behaviours, biological markers, and long-term outcomes over many years.
However, some stress measures (e.g., job strain questionnaires) may be
reductionist, simplifying stress into narrow categories.
Determinism vs Free Will : Results may imply environmental determinism:
stressful workplaces lead to poor health and CHD.
However, individuals still have free will to manage stress (lifestyle choices, coping
strategies), meaning outcomes are not fully determined.
Individual vs Situational : Strong focus on situational factors (work environment,
job demands, low control).
Less emphasis on individual differences, such as personality, coping style,
resilience, or health consciousness.
🌍
Suggests CHD risk partly depends on the workplace situation, not just the person.
Application to daily life :
● Improving Workplace Stress Management Programmes : Employers can use
the findings to introduce stress-reduction strategies such as:
○ workload balancing
○ increasing employee control and decision-making
○ offering flexible hours
○ providing mental health support
This reduces long-term risk of CHD.
● Training for Managers and Leaders : Managers can be trained to recognise
signs of stress and reduce harmful work practices. Promotes more supportive
and psychologically healthy workplaces.
Personality types :
Friedman and Roseman identified 2 personality types :
Type A : Somebody who is
prone to competitiveness , time
urgency and hostility and as a
result has a higher risk of
stress related illnesses.
Type B : someone who is
relaxed, patient, and
[Link] as a result
have lower stress levels than
Type A individuals.
They conducted a longitudinal study to test their hypothesis that Type A
personality can predict heart diseases :
● They gave a questionnaire to 3000 men between the ages of 39-59 and based
on the responses classified them as Type A or Type B
● They were followed for 8 and a half years and the findings showed that more
than twice as many Type A men developed CHD
● 257 patients developed CHD and 70% was Type A
Measures of Stress
Biological :
fMRI : It is a scanning technique used to measure activity in the brain by tracking
the changes in the flow of oxygenated blood , it allows to see how different part of
the brain respond to different stimulus or activity which gives a scientific and
objective illustration of what occurs in the brain
When a person is under stress the parts that will be the most active are the
Amygdala , hippocampus and the hypothalamus
➢Example Study : Wang et al. (2005)
Aim : To investigate the use of fMRI to measure cerebral blood flow changes in
response to mild to moderate stress as a result of a math task
Design :
● 30 American participants
● Experimental group : 11 female ; 12 male avg. age of 24
● Control group : 4 female ; 3 male avg. age of 23
Procedure
● Participants were given 4 MRI scans
○ The first and the last scan were baseline
○ The second was during a low stress task : The participant has to count
aloud backwards from a 1000 ; was designed to control the auditory
and verbal centres
○ The third was during a high stress task : The participant had to
subtract 13 from a 4 digit number answering aloud and receiving
prompts to speed up and if any errors were made they were told to
begin from the top
● Self report stress and anxiety [on a scale of 1-9] and saliva samples to test
for cortisol were collected straight after entering the scanner and after each
scan
● Heart rate was recorded throughout the study using a pulse oximeter
● The control group didn’t have to perform any tasks but they sill gave the self
report and saliva tests were taken
Results:
● Self-reported stress and anxiety , heart rate and cortisol levels were all
increased with the high -stress task and then reduced to the second baseline
● The ventral right prefrontal cortex (RPFC) is a part of the brain previously
shown to be associated with negative emotions such as sadness and fear as
well as increased vigilance to threat-related cues
● This means that the more stressful the participant was the more activity is in
the RPFC part of the brain
● Cerebral blood flow was high for those who had higher salivary cortisol
levels and those who reported higher anxiety levels
✅
Strengths and weaknesses
fMRI provides highly objective data by measuring real brain activity through
blood flow.
❌
Reduces researcher bias and increases scientific credibility.
fMRI scans occur in artificial, noisy machines where people lie still. Behaviour
❌
in the scanner does not always reflect real-life behaviour.
fMRI can show brain activity but cannot prove cause and effect. We cannot say
Issues and debates ☯️
the brain activity caused the behaviour.
::
Nature vs Nurture: Strongly nature-focused because it links behaviour to biological
structures.
Does not address environmental influences, experiences, or learning.
Gives an incomplete understanding of behaviour if nurture factors are ignored.
Reductionism vs Holism: The study reduces complex cognitive or emotional
processes to patterns of brain activation.
Oversimplifies behaviour by assuming activity in specific brain areas fully explains
psychological experiences.
Ignores social, cognitive, and emotional influences that also shape behaviour
Determinism vs Free- Will: Suggests that behaviour is determined by brain
activity, not free choice.
Implies individuals have limited control if behaviour is rooted in neural responses.
Can lead to over-reliance on biological explanations in psychology.
Individual vs Situational : Focuses heavily on individual (biological) differences,
not the situation.
Assumes neural activity differences reflect inherent traits rather than environmental
context.
Application to daily life
● Improved Diagnosis of Mental Disorders : fMRI can help identify abnormal
brain activity patterns linked to disorders such as:
○ Depression
○ Schizophrenia
○ Anxiety disorders
This allows earlier and more accurate diagnosis in clinical settings.
● Development of Targeted Treatments : Understanding which brain regions
are involved in certain behaviours helps doctors design:
○ Better medications
○ Improved psychological therapies
Can guide personalized treatment plans based on an individual’s brain activity.
Pulse Oximeter : It is a small clip that is placed on the finger and passes small
beams of light through the finger to measure the amount of oxygen in the blood
It notes the oxygen saturation and the heart rate
Sample test for Salivary cortisol : It can be used to measure the level of stress as it
has cortisol which is a stress hormone so levels can associate with stress
➢Example Study : Evans and Wener (2007)
Aim : They wanted to use salivary cortisol to investigate the effects that overall
crowding of a train and in immediate space do with stress levels
Design :
● 139 adults Travelled from New jersey into Manhattan,New york for work
everyday
Procedure :
● Saliva sample was collected from each participant at the end of their
morning trip to work and at the sam time at the home of the following
weekend
Results :
● The difference in the salivary cortisol levels in different situations was found
as a reliable source and valid marker of stress
● Motivation was measured near the end of the commute by persistence in a
proofreading task
● Mood was assessed during the commute by the completion of 2 five-point
scales
● Crowding was assessed at the distal level ( The density of crowding across
the whole train) at the proximal level ( The number of people who were
sitting on the same row as the participant)
● Distal crowding did not have a effect on any measures of stress
● Proximal crowding had a significant effect on stress according to all 3
measures ; cortisol level, proofreading and mood
Conclusion : If the area is very crowded immediately around the seat has a
higher effect of stress not the number of people in the carriage as a whole
✅ ⬆️
Strengths and weaknesses :
ecological validity : Study took place in real commuting environments →
findings reflect genuine stress responses.
❌
Makes results highly generalisable to real-world settings.
⬇️
Real-life settings mean other factors (weather, personal issues, noise levels)
may influence stress. internal validity.
Issues and debates
Nature vs Nurture
☯️ :
Nurture: The study emphasises environmental influences (crowding, noise,
commuting conditions) on stress.
Nature: Biological responses such as cortisol levels show physiological reactions,
but these are triggered by the environment.
Overall → the study leans heavily toward nurture.
Reductionism vs Holism
Reductionist: Measuring stress through cortisol and self-report focuses on specific
variables.
Holistic: Considers multiple factors—crowding, duration of commute,
predictability, control—giving a broader picture.
Overall → multifactorial but slightly reductionist.
Determinism vs Free Will
Deterministic: Suggests that environmental conditions (crowding, lack of control)
directly cause stress responses.
Free Will: Commuters can sometimes choose coping strategies, but the
environment strongly limits this.
Overall → environmental determinism is dominant.
Individual vs Situational
Situational: Stress is mostly explained by the situation (crowded trains, long
commutes).
Individual: Personality differences are not the main focus.
Overall → strongly situational explanation.
🌍
Application to daily life :
● Improving public transport design : The study shows that crowding increases
stress, so transport authorities can use this evidence to:
○ increase the number of carriages
○ improve seating availability
○ widen aisles
○ reduce overcrowding during peak hours
Leads to a more comfortable, less stressful commute for the public.
● Helps employers understand the impact of commuting stress
● Employers can use these findings to recognise that long, crowded commutes
increase stress and reduce productivity.
This may encourage:
○ flexible working hours
○ remote working days
○ staggered start times
Resulting in improved employee well-being.
Strengths of using a biological Weakness of using biological measure to
measure to measure stress measure stress
Biological measures (e.g., cortisol May lack ecological validity : Lab settings
levels, heart rate, blood pressure) can create artificial stress that does not
are not influenced by personal reflect real-life [Link] may not
This ⬆️
bias, mood, or exaggeration.
reliability and validity.
generalise well to everyday life.
Psychological
There are 2 types of self report questionnaires that are used to measure stress :
1. Friedman and Rosenman’s personality test
● They constructed a personality test where a series of questions were divided
in order to classify if the respondent is Type A or Type B
● Answers showcased that a tendency towards competitiveness , time urgency
and hostility would lead to a classification of type A personality
● Question examples :
○ Do you feel guilty if you use your spare time to relax ?
○ Do you need to derive enjoyment from games and sports
○ Do you generally move, walk and eat rapidly ?
○ Do you often try to move more than one thing at a time ?
2. Holmes and Rahe’s Life events questionnaire
● They constructed the Social Readjustment Rating scale to measure life
events
● They examined over 5000 medical records to determine whether stressful
life events caused illnesses
● The SRRS consisted of 43 life events which were ranked according to the
amount of change they cause and each life event was given a score in terms
of life changing units
Strengths of using psychological Weaknesses of using psychological
measures measure
Easy and quick to administer Subject to bias
● Questionnaires can be given to ● Social desirability bias → people
large groups at once. may underreport stress to seem
● Saves time and money compared “strong”.
to biological methods. ● Demand characteristics →
participants may guess the aim.
● Memory distortion → forgetting
or misreporting events.
⬆️●ecological validity
Many psychological measures
Lack of objectivity
● Responses rely on personal
ask about real-life stressors and interpretation, mood, and
feelings. honesty.
● They capture how people ● Makes results less reliable than
actually perceive stress in daily biological measures.
situations
Management of stress :
2 methods to use in order to manage stress :
1. Biofeedback
● Biofeedback is a stress management technique that teaches individuals to
control their body’s physiological responses (like heart rate, muscle tension,
and breathing) using real-time feedback from monitoring devices.
⬆️
● When people are stressed, their autonomic nervous system (especially the
sympathetic branch) becomes active heart rate, muscle tension, and blood
pressure.
● In biofeedback, a person is connected to sensors that measure these physical
signs of stress.
● The sensors provide visual or auditory feedback
● By watching or hearing this feedback, the person learns how to voluntarily
control these functions , for example, by using deep breathing, relaxation, or
mindfulness to lower their heart rate.
How Biofeedback Helps Manage Stress:
● Awareness: Makes people aware of how their body responds to stress.
● Control: Teaches them how to control these responses using relaxation or
breathing.
● Reduction: Leads to reduced physical symptoms of stress like headaches,
high blood pressure, and muscle pain.
➢Example Study 3: Budzynski et al.
Aim : To carry out an experiment to measure muscle tension in the forehead by
using an analog machine
Design :
● 18 participants
Procedure :
● Asked the participants to lie quietly with their eyes closed and to concentrate
on deeply relaxing their forehead muscles
● It took place over 20 one minute trails , with the trials being being between
one to three days apart but at the same time
● They were randomly assigned to one of three experimental conditions :
○ Feedback group : The monitor would sound a different pitched tone to
indicate muscle relaxation so the participants know the right time and
be able to repeat the behaviour to master the muscle relaxation
○ Irrelevant feedback group : The monitor would give a constant low
tone and the participant were told that the constant low tone would
help them relax
○ No feedback group : No feedback was given and the participants were
told to relax in silence
Results :
● There is a clear difference between the 3 groups in terms of reduction of
muscle tension over time
● Experimental group those who received biofeedback showed less muscle
tension than the other 2 groups
⬇️ ⬇️
● The feedback group showed a 50% in muscle tension
● The no-feedback group showed a 24% ⬇️
● The irrelevant feedback group showed a 28% in muscle tension
in muscle tension
✅
Strengths and weaknesses:
Scientific and objective measurements : The study used EMG recordings to
⬇️
measure muscle tension, providing objective and reliable data.
✅ ⬆️
researcher bias because results are based on physiological readings.
internal validity : Used control groups (placebo + waiting list control).
This helps establish cause and effect, showing that biofeedback
✅
Small sample size : A small number of participants limits generalisation.
❌⬇️Results may not represent the wider population or all headache sufferers.
Ecological validity : Biofeedback took place in a laboratory-like setting.
Participants’ behaviour under artificial conditions might differ from real-life
coping situations.
🌍
Application of daily life :
● Non-drug pain management : Biofeedback provides a non-invasive,
drug-free treatment for tension [Link] for people who cannot take
medication or want to avoid side effects.
● Stress management in everyday life : Techniques taught in biofeedback (e.g.,
muscle relaxation, controlling physiological responses) can be used in:
○ Work-related stress
○ Academic stress
Issues and debates ☯️
○ Daily life situations to reduce tension
Reductionism vs Holism :
:
Reductionist: Focuses mainly on physiological responses (muscle tension) as the
cause of headaches.
Holistic perspective: Ignores psychological, social, and environmental factors
contributing to chronic pain.
Nature vs Nurture : Emphasises learned control over physiological responses
(biofeedback skills), highlighting nurture.
Does not address possible biological predispositions to tension headaches.
Determinism vs Free Will : Suggests individuals can exercise control over
involuntary physiological processes.
This supports free will and self-regulation, contrasting with purely deterministic
views of stress responses.
Individual vs Situational : Focuses on individual skill acquisition and personal
control over tension.
Less consideration of situational stressors that may trigger headaches (e.g., work
stress, noise, posture).
2. Imagery
● Imagery (also called guided imagery or visualisation) is a stress management
technique that involves mentally creating calm, peaceful, and positive
images or scenarios to help the mind and body relax and reduce stress.
● The technique is based on the idea that the mind and body are connected
what you imagine mentally can produce real physical effects.
● When someone imagines a peaceful scene (like lying on a quiet beach or
walking through a forest), their body often responds as if it were really there:
○ Heart rate slows down
○ Muscle tension decreases
○ Breathing becomes slower and deeper
○ Stress hormones (like adrenaline and cortisol) decrease
How It Works (Process):
● The person sits or lies down in a quiet place.
● Closes their eyes and visualises a calming, pleasant image — such as a
mountain, ocean, or safe place.
● Focuses on sensory details what they can see, hear, smell, and feel in that
place.
● This mental imagery triggers relaxation responses in the body, helping
reduce stress and anxiety.
★ Key study : Bridge et al. (1988)
Aim : To investigate the effect of the relaxation and imagery on the stress
experienced by cancer patients
Design :
● 139 women
● Undergoing 6 week course of radiotherapy following an early diagnosis of
early breast cancer
● Women were under the age of 70
● Attended a hospital in London UK
● Randomly assigned to one of the three conditions :
○ Relaxation + Imagery : Taught a relaxation technique involving
directing sensory awareness on certain muscle groups and instructed
for deep breathing + taught to imagine a peaceful scene as a way to
enhance their experience
○ Relaxation : Taught a relaxation technique involving directing sensory
awareness on certain muscle groups and instructed for deep breathing.
○ No treatment
Procedure :
● Experimental group was given a tape to listen to for 15 mins everyday which
repeated the relaxation instructions
● All the women were seen by a researcher for half an hr once a week for 6
weeks during which in the treatment groups practised their exercises
● The control group were encouraged to talk about themselves and their
interests
Results :
● Change in the total mood disturbance score was different for each group
● Changes in mood state were expected for patients in the relaxation group
and the relaxation + imagery group
● They were more effective in reducing total mood disturbance in women aged
55 compared to younger woman
● Women who scored higher on the anger in the initial assessment did not
respond well to the relaxation or relaxation + imagery group compared to
those of the lower anger levels
Conclusion : The results show that relaxation in particular relaxation +
imagery have a positive effect on mood state
✅
Strengths and weaknesses :
The sample had all been diagnosed with the same cancer at the same stage =
✅
the illness didn’t act as a confounding variable affecting the results
⬆️ ⬇️
The participants were randomly allocated to one of the 3 conditions present ;
✅
Internal validity and effect of participant bias
Use of self - report questionnaires as the method was quick and easy for the
patients to complete making results objective and making the experiment easily
❌
replicable.
⬇️
Sample isn’t representative of the male population with cancer and other
☯️
patients with different types of cancers ; generalisability of study
Issues and debates ::
Nature vs Nurture : Study shows coping strategies depend on environmental
support, family relationships, and psychological background (nurture).
But biological aspects of cancer (nature) also influence mental health, which the
study may underplay.
Reductionism vs Holism : Focuses on psychological coping and emotional factors,
which may oversimplify breast cancer experiences.
Ignores biological differences, socio-economic pressures, cultural beliefs, and
treatment variations that also affect coping.
Determinism vs free -will : Suggests that diagnosis automatically leads to
predictable emotional reactions (e.g., depression, anxiety).
This underestimates free will and personal agency in choosing coping styles.
Application to daily life
● Improving Psychological Support in Hospitals : The study highlights
emotional reactions (e.g., anxiety, depression, fear), so hospitals can create:
○ Better counselling services
○ Specialised oncology psychologists
○ Emotional screening during treatment
Helps healthcare professionals identify which women need extra psychological
support.
● Development of Support Groups : Shows the importance of coping strategies
and social support. Can lead to the creation of breast cancer support groups,
where women share experiences and reduce feelings of isolation. Helps
build community and emotional resilience.
Prevention of stress : ([Link])
Stress innoculation training (SIT)
● A type of cognitive -behavioural therapy which specifically helps people to
cope with stress
● The idea is to expose people to increased levels of perceived stress and allow
them to practise the coping skills and develop an increased tolerance for
stress
● SIT design will be different for everyone but will tend to include several
weekly sessions between 8-40 sessions
● Phases of SIT
○ Conceptualisation : The client and the therapist will work together to
get an understanding of the clients source of stress and the therapist
teaches them how to reframe a stressor as a problem that can be
solved . This allows clients to understand that there are some parts of
a stressor that can be changed and some that cannot
○ Skill acquisition and rehearsal : Clients will learn new coping skills
which are designed to suit their unique set of circumstances . A range
of cognitive and behavioural coping skills are taught like problem
solving , relaxation techniques , mindfulness training and diversion
techniques
○ Application and follow through : This time the clients have to apply
what they have been taught into the real world in increasingly more
✅
stressful situations
SIT can be an effective way of dealing with stress because it is tailered to meet
❌
the specific needs of the individual and several coping strategies are taught
Requires a significant amount of commitment as it does take time for the coping
❌
skills to be taught and applied in the real world
It doesn’t work for everyone as it relies on the individuals being willing to be
able to change the way they think about and deal with things