CAUSES

The Top 10 Daily Hassles

Jerry Kennard Health Pro April 01, 2009

 We become stressed for a number of reasons and there's a general consensus that major events in
our life contribute to this. But many of us feel the effects of stress daily, so it's clear that something must
be causing this. In this sharepost I look at a couple of approaches to the identification and measurement of
things that make us stressed.

One of the most influential approaches to the measurement of stress was devised by Holmes and Rahe in
1967. Their approach was to consider a series of life events that require most people to make
psychological adjustments. The resulting Social Readjustment Rating Scale provided a list of life events,
against which a points value was allocated depending on the perceived level of stress. For example, 100
points was allocated for the death of a spouse whereas 12 points was allocated for the effects of a
vacation, such as Christmas.

The popularity of this and subsequent scales remains high, but they are not without problems. For
example, many of the higher scores involve events and situations that most average people are unlikely to
encounter regularly. The top five stressful situations on the 1967 Holmes and Rahe scale include death of
a spouse (100 points), divorce (73 points), marital separation (65 points), jail term (63 points) and death
of a close family member (63 points). Leaving aside the comparatively low likelihood of such encounters,
if we consider just one of these (death of a spouse), the uniformity of the score suggests that everyone
responds in exactly the same way. We know this simply isn't the case.

The desire to devise something that reflected the day-to-day experiences of people, prompted Allen
Kanner and colleagues to examine the variation of activities to which people are exposed and the stress
they experience as a result. From this, Kanner produced two scales. The hassles scale, which reflected
daily annoyances and frustrations and the uplifts scale, reflecting things that make people feel better.

Subsequent research has provided a number of profiles from different populations (e.g. adults, students)
in various countries. In one survey by Kanner at al (1981), 100 middle-aged adults were tested over a nine
month period. The top six most frequent hassles to emerge were:

Concerns about weight.

 Health of a family member.
Rising price of common goods.
Home maintenance.
Too many things to do.
Misplacing or losing things.

A later survey conducted by Chamberlain and Zika (1990) in New Zealand, found a slightly different
picture. In order of priority, their results revealed the following top ten daily hassles:

Not enough time.

Too many things to do.
Troubling thoughts about the future.
Too many interruptions.
Misplacing or losing things.
Health of a family member.
Social obligations.
Concerns about standards.
Concerns about getting ahead.
Too many responsibilities.

Does the hassles scale do better than the Readjustment Rating Scale? Well, yes and no. The hassles
scale certainly appears to come closer to the everyday stressors most of us experience. The drip-drip
effect of stress is well accepted and seems, to some extent, to be reflected in such a scale. However, the
theoretical problems have not gone away. Some argue that the items on the scale remain rather vague and
arbitrary and more likely to assess neuroticism rather than stress. In turn, this leads to problems in how to
properly interpret the results of such a scale.

Although still used, recent trends suggest a move away from standardized scales and more towards
structured interviews. Scales might be helpful to form an initial impression, but proper interpretation
requires a more detailed examination with the person concerned, in order to see the world through their
eyes.

Sources:
Chamberlain, K. and Zika, S. (1990) The minor events approach to stress: support for the use of daily
hassles. British Journal of Psychology, 81: 469-81.

Kanner, A.D., Coyne, J. C., Schaefer, C., & Lazarus, R.S. (1981). Comparison of two modes of stress
measurement: Daily hassles and uplifts versus major life events. Journal of Behavioral Medicine, 4, 1-39.



- See more at: http://www.healthcentral.com/anxiety/c/1950/65521/top-daily-
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- hassles/#sthash.4YGSuhlK.dpuf

1 Stress as a bodily response

It is difficult to define stress and there are some definitions that have become accepted

Stress is defined in 3 ways

1. response or reaction to something in environment

2. stimuli or stressors and/or features in environment producing a stress response

3. lack of fit between perceived demands of environment and the perceived ability to cope, this is
also known as the transactional model (Which will be explained in more later in this article.)

It has to be agreed what stress is between psychologist and others in order to make the research reliable
and valid to that particular phenomenon.

Selye (1956) was one of the pioneers of research into stress as a bodily response. He carried out research
on rats, to see what happened to them if they were subjected to frequent injections, he found they ended
up with gastric ulcers. He then wondered if the ulcers were due to the substance injected, or just the fact
they were injected. After several trials, he found it was actually the injections that were the cause of the
ulcers and therefore determined stress was actually a bodily response to stressful stimuli (stressors). He
also found that the response was the same, no matter what the stressor, and therefore became known as
the 'stress response'.

It seems like common sense to say that if we are exposed to a stressor, such as a cut to the head or
bereavement, we will have a physiological response.

The common sense view and Selye's are both examples of the stimulus-based response view of stress.

The only problem with this type of view of stress is that it does not take into account that there are
variations in the responses people give to the same stressor, in other words individual differences, i.e. if
a person changed job, home, way of life, then found it wasn't going to work and then had just two weeks
to sort it out, find a new job, new home, new way of life. To some people this would create an intolerable
level of reaction, but to others it would be dealt with easily, with only a small physiological response.

So now the view that is mostly accepted by psychologist is that of the transactional theorists such
as Cox & Mackay (1978) and Lazarus & Folkman (1984). This theory takes into account individual
differences as the major part of how a person is likely to respond to stress. The theory suggests that there
is a 'lack of fit' between what the stress is and how a person perceives the threat. (See below for an
illustration)
Diagram: The transaction model of stress as a bodily response

The transactional model then, accounts for the major role of cognitive processes. It is clear from the
above diagram, the model has a lot of dependence on individual perception of a specific possible
stressor. The model is based on primary and secondary perceptual appraisal. The primary aspect is
how we perceive the world and the context of the stressor, this is coupled with the secondary aspect of
how we perceive ourselves and our own ability to cope. Combining these two appraisal processes leads
to a definition of stress that caters for the individual. The stress occurs when there is
an imbalance between perceived demands and perceived ability to cope. This stress can be to varying
degrees, in fact a little stress can be beneficial, so a minimal degree of lack of fit would be useful in order
to motivate a person into action.

This model is very useful because it takes the individual into account i.e. some people perceive exams
(demand) as a scary experience and feel they are completely unable to do them (ability). Using the
model, one student may see exams as insurmountable and feel their coping ability is inadequate, so this
leads to assessing the situation in a logical way (cognitive appraisal), which leads to the conclusion,
exams are scary and that individual cannot cope (mismatch between demands and coping ability), this
then causes feelings of stress (worry) and bodily stress responses, such as palpitations, sweating, nervous
twitches or even illness leading up to exams and beyond.

One of my past students (Student A) became highly erratic, losing weight and having endless headaches,
due to her mismatch of ability and demand. She had crazy outbursts of nervous energy. Another student
(student B) though, looked at the exams with a degree of positive expectation, she saw this as the finale of
her consistent work effort (cognitive appraisal). She was still aware the success of her exams would
directly correlate with her efforts, therefore seeing exams as a surmountable challenge, which had to be
worked on, so there was a little bit of stress (good stress, which Selye termed as 'eustress').

When comparing these students, it is clear that a particular demand will cause different degrees of stress,
due to perception of the individual. It is useful to have some stress, as in student B's case, because it
helped her to achieve her goals, but if student B had over-estimated her ability to cope, this would have
caused no particular stress, but it would have taken any motivation away to work hard to achieve her
goals, which she did.

As is evident from the example given with the students, there are not only physiological responses from
the autonomic nervous system (ANS), you will hear more about this later, but there are
also emotions and behaviours involved. For student A there was clearly anxiety, erratic and
extraordinary behaviour, eating disruption and illness. Stress is also responsible for depression, burn-out
and even suicide. As we saw in student B mild good stress, motivated the student to work consistently
and diligently.
- See more at:
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dex.php#sthash.aUWe8d7A.dpuf
 Daily Hassles and Uplifts
Daily hassles are relatively minor events arising out of day-to-day living such as losing your house keys
and missing the college bus.
Uplifts are positive everyday events

A01: Describe how daily hassles and uplifts are used as a measure of stress (6 marks)

1. The Daily Hassles and Uplifts Scale was devised by Lazarus et al (1981).
2. It is a Questionnaire that contains 117 items.
3. Each item is a daily event.
4. Participants are asked to complete the questionnaire individually at the end of their day.
5. The items are rated as an uplift and a daily hassle on a scale of 0-3 (0= not applicable, 1=
Somewhat, 2= Quite a bit, 3 = a great deal).
6. The total daily hassles score and uplifts score are used as an indicator of stress.

A02: Evaluation of the daily hassles and uplifts scale

Small Elephants Eat cheese Individually

Self-report
Ethnocentric
Ethical issue
Correlational
Individual Differences

 ›
A01 Key Study:
Delongis et al (1982) tested the hypothesis that daily hassles are a better predictor of later ill health than
life events. 100 participants (all over 45) were asked to complete four questionnaires each:

1) Hassles scale (117 items)

2) Uplifts scale (135 items)
3) Life events questionnaire
4) Health questionnaire

The results were probably not expected: hassles were significantly positively correlated with ill- health,
whereas uplifts and most surprisingly life events were not.

A01 Key study: Kanner et al

•Aim: To investigate an association between daily hassles, uplifts and symptoms of stress AND
compare the outcome with the use of the SRRS as a predictor of stress symptoms
•Procedure: 100 men and women, aged 45-64 were studied. They completed the “Hassles &
Uplifts” questionnaire once a month, for 10 months. They were also assessed each month using the
SRRS, and completed a health questionnaire
•Findings: Daily Hassles were positively correlated with psychological symptoms associated with
stress. There was a negative correlation between uplifts and stress symptoms. The Daily Hassles
predictor of stress symptoms than the SRRS
•Conclusions: Everyday stressors are a better predictor of stress, and vulnerability to illness, than
life events

Supporting study Courtois at al (2007)

•In support of the research conducted by Kanner et al. (1981), Courtois et al (2007) investigated the
influence of both life events and daily hassles on adolescent drinking and smoking. They did find a
correlation between these problems and life events, BUT the relationship with daily hassles was stronger.
•Important daily hassles related to family problems, issues at school and self-perception. Having more
daily hassles affected drug use in two ways: stressed adolescents started using alcohol and tobacco earlier
(1) and became dependent on them (2)
 A02: Evaluation of daily hassles and life events research
Correlational Cultural variations in amount of social support
data Social support is a protective factor against stress and
We cannot draw causal conclusions between daily it varies amongst different cultures.
hassles and stress related problems. Therefore there are cross-cultural differences in the
However, the correlations show that there is an statement that daily hassles contribute to health and
association and therefore a possibility that daily social problems.
hassles can have negative effects on our health and
wellbeing.
Retrospective data
Furthermore, research into daily hassles and stress related illness is based upon the collection of
retrospective data, whereby participants are usually asked to rate hassles that have occurred over the last
month.
This relies upon peoples’ memories being a) accurate and b) consistent and we know that memory is, over
time, neither of those things.
This is a problem because it means that the data collected from participants is neither valid (since the
recall of events is not accurate), nor reliable (as the recall of events is not consistent), thus challenging
how useful such research is.
Supporting research
Despite such criticism, a further strength of research into daily hassles and uplifts is that it is now largely
accepted that they are a better predictor of later health/ill health than life events and this is supported by
research.
For example, Flett et al (1995) found that major life-changing events may differ from daily hassles in the
extent to which a person would seek social support. 320 students read a scenario describing an individual
who had experienced either a life event or daily hassle. They then rated the support of support that person
would receive and would seek from others. Those who had experienced a life event were rated as needing
and receiving more social support.
This presumably means that one reason why daily hassles are such a negative influence on later health is
that we don’t receive adequate social support to deal with them.
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Stress Management for Health Course
Causes of Stress

"Situations, circumstances or any stimulus that is perceived to be a threat is

referred to as a stressor, or that which causes or promotes stress."

(Brian Luke Seaward)

The causes of stress are known as stressors and there are literally hundreds of
different types of stressors. Any event in life that a person finds threatening, difficult
to cope with or causes excess pressure can be a potential cause of stress. It is
important to bear in mind that stress is an individualistic, subjective experience and
therefore what one person finds stressful another may not. Stressors can be broken
down roughly into either external or internal (or a mixture of both.)
 1. External Stressors

a) Major Life Events

Research by Psychiatrists Drs Thomas Holmes and Richard Rahe revealed a list of
common causes of stress that most people would find stressful. They called this scale
the Holmes and Rahe Social Readjustment Scale. The scale is a list of 45 stressors
each given a number of points, with the most stressful at the top of the list (death of a
spouse) and the least stressful at the bottom of the scale (a minor violation of the
law). The research indicates that if your total score is more than 150 points the
chances are that it could have an impact on your health. A score of over three
hundred points in one year indicates that you have a high risk of developing a stress
related health problem.

One of the weaknesses of the Holmes and Rahe Social Readjustment scale is that it
doesnt take into account the individuals personality, their perception of how difficult
the stressor is, nor does it take into account how long the stressor continues for; the
scale just gives a single number for each stressor. However, it s known that the
longer a stressor continues, then the more likely it is to cause stress and that the
individuals perception of an event is the key to whether they will find a situation
stressful or not.

For example, if a person is happy living in their house, theyve lived there for a
number of years, have developed close friends in the area and do not want to move
but are forced to move because their home is being repossessed, then they are going
to find the event of moving infinitely far more stressful than a person who has lived
in their home for a short time, next to a very noisy, difficult neighbour and who wants
to move to get away from the noise.

To help overcome some of the drawbacks of the Holmes and Rahe Social
Readjustment scale Professor Cary Cooper, of The University Manchester Institute of
Science and Technology (UMIST), has upgraded it by allocating a scale of 1 - 10
points for each event, so allowing a persons perception of how stressful the event is,
to be taken into account. We have included a copy of Professor Coopers modified
version in the course materials for you to view and use.

Click here for Cooper's Life Stress Inventory

b) Daily Hassles

"Any idiot can face a crisis its this day-to-day living that wears you
out." (Anton Chekov)

The majority of causes of stress that we face on a day-to-day basis are not as extreme
as life events. The day-to-day causes of stress are called daily hassles; they are those
daily, minor irritations such as misplacing our car keys, traffic jams, minor arguments
with family/colleagues, etc. Research by Lazarus and Folkman (1984), at the
University of California, indicated that it was the daily hassles rather than the major
life events that affected us the most. Life events do not occur every day, but daily
hassles do; its the constant, daily frustration caused by these hassles that cause us the
most stress, because they occur so regularly and therefore can undermine our health.

Some Examples of Daily Hassles

Misplacing keys Bureaucracy Excess noise

Arguments Waiting Inconsiderate people

Traffic jams Loneliness Difficult neighbours

Time pressures Queuing Car breakdown

Lack of sleep Pollution Meal Preparation

Fear of Crime Gossip Job dissatisfaction

Shopping Relatives Office Politics

Problems with children

2. Internal Stressors

"Stress resides neither in the situation nor in the person; it depends on a

transaction between the two."

(Dr Richard Lazarus PhD)

We tend to think that stress is solely caused by external events, situations and people,
yet this is not strictly correct. Research has found that the Transactional Model of
Stress is more accurate. This model says that stress is caused by a transaction, ie
there is an interaction between the stressor, our view of the stressor and our perceived
ability to cope with it. Its our own internal beliefs, attitudes, interpretations,
perceptions and other factors, in combination with the external events that tend to
create stress. Internal factors which influence how we perceive stress include our:

Beliefs Low assertion Perception

Expectations Low self esteem Perfectionism

Locus of control People pleasing Personality

Examples of Some Causes of Stress

Physical Stressors Work Stressors

Sleep debt Commuting

Excess/to little exercise Time pressures

Poor diet Job insecurity

Drug misuse Excess working hours

Alcohol misuse Workplace bullying

Excess heat Company takeovers

Excess caffeine Understaffing

Chronic hyperventilation Conflicts with colleagues

Excess cold Low pay

Illness Role ambiguity

Smoking Delegation problems

Hypoglycaemia Lack of work recognition

Lack of relaxation Poor support/supervision

Surgery Workaholic

Chronic pain Family Stressors

Psychological Stressors Caring for a chronically ill

relative
Excess anger
Partner with health problems
Unrealistic beliefs
Partner with alcohol/drug
Excess pessimism problems

Health worries Relationship difficulties

Unrealistic expectations Arguments with children

Excessive worrying Bereavement

Unhappy childhood Children leaving home

Unemployment Social Stressors

 Financial problems Fear of crime

Perfectionism Living in an urban area

Loneliness Poverty

Low self esteem Low social support

Low levels of assertion Bureaucracy/red tape

People pleasing Rude, aggressive, unhelpful

people
Boredom
Victim of crime
Negative self talk
Problem neighbours
Personality
Racial harassment
Rigid thinking style

Excessive self criticism

Exams

Giving talks/presentations

Environmental Stressors

Pollution

Excess noise

Poor housing

Damp conditions

Traffic jams

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Stress Management for Health Course

Stress - Introduction

"Stress, like Einstein's theory of relativity, is a scientific concept which has

suffered from the mixed blessing of being too well known and too little
understood." (Dr Hans Selye)

Stress, or to be more accurate pressure, is an unavoidable part of everyday life,

meaning different things to each of us. You only have to pick up a newspaper, read a
magazine, watch television, listen to the radio or walk into any High Street bookshop
and see the many books written on the subject of stress, to realise that we perceive it
to be a big problem. Stress is much more recognized than it used to be, we have
become very aware of the potential negative impact of stress on our health. Yet
despite all of this information and wealth of knowledge, the subject of stress still
remains vague and not very well understood. There are also many myths about stress
that are not accurate and this further confuses the subject.

Life in the 21st Century is infinitely far more complex than it has ever been. We were
never designed to live in this complex, modern world with its many demands on
us. We live in a crowded, noisy society that we often refer to as the rat race. Our
lives are run by deadlines, the clock, modern technology, mobile phones, pagers,
faxes, computers, satellites and a hundred and one other demands and pressures.

Many of us have too many tasks and too little time. We drive our children through
traffic-clogged roads to maybe two or three different schools. We then try to get to
work on time, through more congested roads with millions more cars than there used
to be, or we deal with delayed trains as some of us may have to commute hundreds of
miles to work. While we are at work we have to operate computers, learn newer
versions of software, deal with faxes, phones, manage many tasks and people, often
without adequate training or support. There are no longer jobs for life and many
people are working under temporary or short-term contracts.

Research has shown that today we have fewer friends than we used to and live in a
more fragmented, isolated society with lower levels of social support, which is an
important buffer of stress.

We are less physically active, eat poorer diets, there is a greater amount of pollution,
higher crime rates, greater urbanisation (it is known that there is a higher incidence of
stress related problems like stress, anxiety and depression in urban areas than in rural
areas), increased drug and alcohol misuse, we see daily the many world tragedies of
famine, flood and war beamed directly into the television in our homes, we have
higher levels of debt and we no longer have a religious faith to rely on.

Even our children are not immune from the effects of excessive pressure Dr Lori
Buffa, an American Paediatrician said, the 21st Century has:

"A lot of stressors that 30, 40 and even 50 years ago children did not have to
deal with. Everything is very fast paced. The level of stimuli they are
exposed to is so much higher than it used to be."

However, contrary to popular myth, stress is not a unique problem to the 21st
Century, human kind has suffered stress since the dawn of human evolution. Modern
society however, has undergone more complex, radical change in the span of a few
short years than in the whole of human evolution, and this is partly why stress is more
of a problem today.

There are many benefits to living in our fast paced, modern industrialized world,
however the same society has created complex demands on our psychological and
physiological health. We dont need to return to the stone age to regain our health and
its impossible to remove all stress (pressure) from our lives, but what we do need to
do is learn to deal with it in a more positive, less destructive manner, using our skills
and knowledge of stress to learn how to reduce its impact on our lives.

We are often told of the harmful effects of stress on our health and well being, but we
are not powerless in the face of stress, stress management training is a powerful
tool. It is impossible to remove all the pressures from life but we can learn strategies
to stop excessive pressure developing into stress; the strategies you will need are
taught to you through this course.
What is Stress

"Stress is a reaction people have when excessive pressure or demands are

placed upon them, and arises when an individual believes they are unable to
cope."

(The Health and Safety Executive)

There are many definitions of the word stress, but it is often used loosely to mean
distress. In order to help us understand the concept of stress and to remove any
ambiguity and misunderstandings, it is important to clarify what we actually mean by
the term stress. The Health and Safety Executive quote as outlined above is one good
definition.

Stress is a somewhat difficult concept to define largely because it is such a unique,

individual and subjective experience. What one person may regard as stressful
another person may not. The word stress has become an umbrella term, overused and
misunderstood, meaning different things to different people. It is used at one extreme
to describe minor events like being caught up in a traffic jam or having an argument,
right up to the other extreme where some people use it, incorrectly, to describe
clinical depression (which is not stress). This is partly the cause of some of the
confusion that surrounds the subject of stress. To complicate the matter further some
people use the term stress to describe the causes of their stress and others use the term
to describe their physiological, psychological and behavioural reactions in response
to the external event.

Stress versus Pressure

"Research has shown that there is a physiological difference between stress

and pressure. A person experiencing stress has higher levels of the various
hormones in their blood stream than a person who is merely
challenged." (Professor Cary Cooper, PhD)

It used to be thought that there were two types of stress Eustress (good stress) and
Distress (bad stress) and that a certain amount of good stress was required to stimulate
and challenge us. However recent research has indicated that this view of good/bad
stress is incorrect and that allstress is bad. It is correct however to say that we do
need a certain amount of stimulus to make life interesting and to be at our most
efficient, but this stimulation should be called Pressure which is different from
stress. However if pressure is excessive for too long it can develop into stress. The
point at which pressure develops into stress can be different in different
people. Research by Yerkes and Dodson, who developed the Human Performance
Curve, indicates that a small amount of pressure improves our performance, but
excess pressure reduces our performance and efficiency.

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Stress Management for Health Course
The Fight Flight Response

".....the 60 pounds of gear I was wearing suddenly weighed nothing....."

(New York Fire Fighter talking about his experience when a building near
the World Trade Towers started to collapse and he had to start running for
his life)

Humanity has survived and thrived on this earth for hundreds of thousands of years,
through some of the most difficult and stressful of times. One of the factors that has
enabled us to survive is a system called the fight/flight response. Whenever we
perceive we are physically or psychologically threatened an inbuilt, reflex, alarm-
system in our brain triggers the release of electrical impulses and a variety of
hormones. There is a complex hormonal cascade of over 30 stress hormones, such as
adrenaline, noradrenaline and cortisol, which have a powerful and widespread effect
on our body's biochemistry, physiology and psychology, giving us the extra strength
and speed we need to deal with the threatening situation. If a wild animal attacks us,
we can either run away (flight) or if trapped, stand our ground and fight.

The fight/flight response is a 40,000-year-old model, its alarm reaction is designed for
short-term use to deal with physical threats in which the emergency resolves very
quickly in a few seconds or minutes; either we kill the wild animal or it kills us! But
life in the 21st Century is infinitely far more complex than it was 40,000 years ago (or
even 50 years ago for that matter). Many of the stressors today are psychological in
origin, and they are chronic, lasting days, weeks, months, even years in some
cases. Modern stressful events such as financial problems, health worries, work
problems, difficult neighbours, relationship problems, etc. can not be resolved by
fighting or running away; never the less these psychological stressors still trigger the
fight/flight response.

The fight/flight response is designed to be triggered occasionally. However modern

living keeps tripping it, making it overactive and this can be a factor in causing stress
related health problems. These problems are then made worse by the typical western
diet, full of fat and sugar which can cause increased blood clotting, increased blood
pressure and can stimulate higher levels of stress hormones in the blood stream.

This is then complicated by the fact that we do not get enough physical
exercise. Exercise can help to counter the stress response by - reducing blood
clotting, boosting immune function, reducing blood pressure, relaxing muscles,
increasing metabolism which burns up stress hormones and making the sympathetic
nervous system (which triggers the stress response) less sensitive.
When the fight/flight response is triggered over 1400 different physiological and
biochemical changes occur in the body. But there are also psychological effects
making us more alert, aggressive, angry, fearful etc., which all motivate us when we
are physically threatened, but have to be suppressed during a meeting with the Bank
Manager that doesn't go so well!

Having said this, the fight/flight response is still an important part of our body's vital
defence systems. Even though the majority of physical threats have gone, there are
still situations today where the fight/flight response can be life saving; such as
escaping a house fire or speeding up the reflexes to avoid an accident on the
motorway.

For example, a few years ago a farm worker had his arm torn off by a bailing
machine, yet he was able to pick up his severed arm, carrying it for two miles, to get
help. It was the fight/flight response that enabled him to do this.

The Two Stages of the Fight/Flight Response

There are 2 co-ordinated stages to the fight/flight response:

1. Short Term Fight/Flight Response

2. Long term Fight/Flight Response

1. Short Term Fight/Flight Response (SAM Sympathetic Adreno Medullary) Axis

The SAM or Short-term response is the primary system that is triggered within us
in response to short-term threats. This is a reflex response, which is electrically
triggered. Electrical impulses from the hypothalamus, a gland located in the
brain, travel along nerves that directly connect to the adrenal glands (these sit on
top of the kidneys) and stimulate the release of stress hormones adrenaline and
noradrenaline. The body cant sustain this short-term fight/flight response for long
because it would become exhausted. If the stressor is a more chronic one then this
triggers the secondary, longer-term fight/flight response to take over.

2. Long Term Fight/Flight Response (HPAC Hypothalamic Pituitary Adreno

 Cortical) Axis

The longer-term fight/flight response is triggered hormonally. This time the

hypothalamus secretes a hormone called CRF (Corticotrophin Releasing Factor),
which stimulates the pituitary gland (also located in the brain) to produce ACTH
(Adrenocorticotropic Hormone), which in turn stimulates the adrenal cortex (outer
part of the adrenal glands) to release stress hormones like cortisol. This longer-
term fight/flight response is affected by our perception of the event, which decides
the type and amount of stress hormones that are secreted. Research has shown that
chronic activation of this longer-term HPAC fight/flight response can be a factor
in causing a number of psychological and physiological health problems.

Nerve impulses travel at 150 metres per second so the first stage of the fight/flight
response the short-term response - occurs very quickly, literally in milliseconds;
whereas the second, long-term (HPAC) response takes several minutes to kick in and
lasts longer.

Fight/Flight Response and The Autonomic Nervous System

The fight/flight response is controlled by the Autonomic Nervous System (ANS)

which is the part of our nervous system that controls the automatic functions of the
body (those not under our conscious control such as regulating heart beat,
digestion etc.)

The Autonomic Nervous System is made up of two branches:

1. The Sympathetic Nervous System (SNS). This is the system which triggers the
biochemical and physiological changes brought about by fight/flight. Think of it
as the accelerator on a car or a supercharger on an engine which pump in more air
and fuel to increase speed.

2. Parasympathetic Nervous System (PNS). The second part of the ANS is the
Parasympathetic Nervous System, which helps to switch off the fight/flight
response and return all hormones, organs and systems, back to pre-stress levels.

Our body's organs such as the brain and heart, and systems such as the endocrine,
immune and digestive systems, are all hard-wired into the Autonomic Nervous
System. As a result the Sympathetic branch can speed-up an organ or system and the
Parasympathetic branch can slow-down an organ or system.

When the Stress is Over

The fight/flight response is triggered by the Sympathetic branch of the Nervous

System, but three minutes after we perceive that the threat is over, the brain, via the
hypothalamus, stimulates the Parasympathetic nervous system which switches off the
fight/flight response. The stress hormones fall back to pre-stress levels, reversing all
the biochemical and physiological responses; blood pressure falls, heart rate slows
down, digestion is stimulated again. However if the stress becomes chronic the
fight/flight response can become overactive and maintaining factors can leave us with
heightened stress levels even though the original stress may be over.

Threats Real or Imagined

The brain cannot distinguish between a real or potential threat. It can only respond to
both, by triggering the fight/flight response. For example research has shown that our
levels of stress hormones rise when we watch a horror film even though we are not
physically experiencing the stressor.

Biochemical and Physiological Changes caused by the Fight/Flight Response

All the biological, psychological, chemical and physiological changes brought about
by the fight/flight response are designed to give us extra strength and speed to help us
fight or run away. They are vital in the short-term but in the long-term they can have
a potentially negative impact on our physical, psychological and social well-
being. Some of the changes that occur include:

 Blood Flow

Our muscles are a vital part of fight-flight. Blood flow to our muscles is increased
by 300%, by being diverted from less important areas like the skin.

 Blood Pressure

In order to pump the extra blood, oxygen, fats and sugars to the muscles to supply
energy, our blood pressure and heart rate increase.
  Blood Sugar and Fats Increase

Stored reserves of fats and sugars are converted and released into our blood
stream to supply extra energy to fight or run away.

 Blood Clotting

The blood clots more quickly, to help reduce the risk of blood loss if we are
injured in fighting or fleeing.

 Red Blood Cells Increase

The spleen manufactures more of the oxygen-carrying, red blood cells and
releases them into the blood stream in order to get more oxygen to our muscles.

 Breathing Rate Increases

The muscles need extra oxygen for fight-flight. To supply this extra oxygen
requirement our breathing rate speeds up and the airways in the lungs
widen. Breathing switches from relaxed, slow, diaphragmatic breathing, to fast,
shallow, chest breathing.

 Muscles Tense

In order to give us extra speed and strength the muscles of our body tense.

 Digestion slows

Blood is diverted from less vital areas such as digestion, to more vital areas such
as muscles; digestion slows and stomach acidity increases.

 Pupils Dilate

In order to help us see more clearly, our pupils widen to let in more light.

 Hearing

Our hearing becomes sharper.

 Perspiration Increases

During fight/flight our metabolic rate increases and so we get hotter because of all
 the biochemical reactions going on in the body; to help prevent us from over-
heating we need to cool down so perspiration increases.

 Dry Mouth

Our mouth dries up and digestive juices reduce as blood is diverted from less
important areas to provide energy needed elsewhere in the body.

 Fear/Anxiety

The stress hormone adrenaline, primes an area of the brain called the Amygdala to
feel increased anxiety and fear, our thoughts race and we can think more quickly.

Factors which Influence the Fight/Flight Response

Stress is not simply a case of cause and effect. There are a variety of factors that
influence - whether the fight/flight response is triggered, how long it remains
switched on and the degree to which it has a negative effect on us. We can have an
affect on these influencing factors and so therefore can have a major influence over
how severely stress affects us.

Factors which influence the fight/flight response, some of which we can influence to
reduce our stress, include:

 Perception of the event

 Social support  Previous experience of stressor
 Genes  How sensitive our nervous system is
 Beliefs  Degree of control over stressor
 Personality traits  Unpredictability of the stress
 Diet  Duration of the stressor
 Stress threshold  Our exercise patterns
 Cumulative stressors  Our thinking style

Stress Management for Health Course

Signs and Symptoms of Stress
 "The warning signs that stress may be affecting your health vary
considerably from person to person. Most of us, however, tend to have our
own usual stress response or fingerprint. This might be headaches in one
person, or an outbreak of eczema or diarrhoea in another . . ." (Professor
Greg Wilkinson)

When we experience stress we can develop a wide variety of physical, psychological

and behavioural symptoms. These symptoms are not a sign of disease because stress
is not a disease; they are brought about by the bodys Fight-Flight Response, which is
designed to give us extra energy and speed to cope with the threat.
When under stress we may experience a pounding, speeding heart. This is not a sign
of heart disease, but is in fact, caused by stress hormones stimulating the heart to
pump harder and beat faster to get extra oxygen to vital muscles and organs so we can
fight or run away. Once the stressful event has passed, the levels of stress hormones
in our blood stream will fall again and our heart will return to its normal rhythm.
The heart and the rest of our bodys organs and systems can cope with this speeding up
and working harder; they are designed to be able to do this, just as a car can speed up
or slow down with extra pressure on the accelerator and less pressure on the
brake. Our sympathetic and parasympathetic nervous systems, which deal with the
fight/flight response, work in a similar manner. Stress stimulates the
sympathetic nervous system (the accelerator) and increases the levels of stress
hormones in the blood stream, whereas relaxation stimulates the parasympathetic
nervous system (the brake), which reduces the levels of stress hormones in the blood
stream.
One of the problems with stress is recognising it. Once you are aware of it we can
take action. However stress can be stealthy, it can slowly creep up on us without us
being immediately aware of it.
There are numerous signs and symptoms of stress that many of us are unaware
of. Not everybody develops exactly the same symptoms and research has indicated
that, although there are common symptoms of stress, individuals vary in the
symptoms they present some of us may have mainly physical symptoms such as
muscle pain/tension, others may present with symptoms such as crying or anger.
Learning the signs and symptoms of stress can help us become more aware of the
problems stress can cause in our lives. The table included here lists many of the
physical, psychological, and behavioural symptoms of stress. We have also included
a few work related symptoms. Look at the table and tick the ones that are applicable
to you, using it as a record of your level of stress.

Physical Stress Symptoms (How Our

Body Reacts)

 Breathlessness
 Churning stomach
 Diarrhoea/Constipation  Impotence
 Dizziness  Nausea
 Dry mouth  Palpitations
 Excess perspiration  Pre Menstrual Syndrome
 Fatigue  Sense of heart pounding
 Headaches  Shallow breathing
 Hyperventilating  Sleeping problems
 Increased colds/flu  Tension headaches
 Increased heart rate  Tingling in hands/legs
 Tremor in hands/legs
  Indigestion  Weight loss/gain

Psychological Stress Symptoms (How We

Think and Feel)

 Abrasive
 Anxious  Increased worrying
 Blaming others  Indecision
 Catastrophising  Irritability
 Cynical  Jealousy
 Depression  Lack of concentration
 Depressed/Anxious thinking  Loss of confidence
 Excess guilt  Lower self-esteem
 Excess worries over health  Mind in a whirl
 Feeling a failure  Mood swings
 Feelings of fear  Negative thinking
 Feeling unable to cope  Pessimistic thinking
 Frustration  Rumination
 Hopelessness/helplessness  Sensitivity to criticism
 Hostile  Snappy
 Hypercritical of self/others  Stressful thinking
 Impatience  Tense
 Worrying a lot

Behavioural Stress Symptoms (How We

Behave)

 Aggression  Losing temper

 Agitation  Making mistakes
 Avoidance behaviour  Nail biting
 Crying  Outbursts of anger
 Decreased/increased sexuality  Poor eye contact
 Difficulty relaxing  Poorer personal hygiene
 Difficulty with relationships  Poor time management
 Eating fast  Restlessness
 Eating too much/too little  Risk taking
 Gambling  Substance abuse
 Hostile behaviour  Talking fast
 Impatience  Walking fast
 Increased alcohol  Withdrawal from relationships
 Increased caffeine  Withdrawal from activities
 Increased smoking

Work Related Stress Symptoms (How we

may be affected in our work)
  Absenteeism/presenteeism
 Accidents
 Inability to delegate
 Increased sick days
 Inefficiency  Poor decision making
 Persistent lateness  Poor interaction with colleagues
 Procrastination  Reduced work performance
 Resentment/anger/irritability

Click here for Causes of Stress

Causes of Stress

"Situations, circumstances or any stimulus that is perceived to be a threat is

referred to as a stressor, or that which causes or promotes stress."

(Brian Luke Seaward)

The causes of stress are known as stressors and there are literally hundreds of
different types of stressors. Any event in life that a person finds threatening, difficult
to cope with or causes excess pressure can be a potential cause of stress. It is
important to bear in mind that stress is an individualistic, subjective experience and
therefore what one person finds stressful another may not. Stressors can be broken
down roughly into either external or internal (or a mixture of both.)

1. External Stressors

a) Major Life Events

Research by Psychiatrists Drs Thomas Holmes and Richard Rahe revealed a list of
common causes of stress that most people would find stressful. They called this scale
the Holmes and Rahe Social Readjustment Scale. The scale is a list of 45 stressors
each given a number of points, with the most stressful at the top of the list (death of a
spouse) and the least stressful at the bottom of the scale (a minor violation of the
law). The research indicates that if your total score is more than 150 points the
chances are that it could have an impact on your health. A score of over three
hundred points in one year indicates that you have a high risk of developing a stress
related health problem.

One of the weaknesses of the Holmes and Rahe Social Readjustment scale is that it
doesnt take into account the individuals personality, their perception of how difficult
the stressor is, nor does it take into account how long the stressor continues for; the
scale just gives a single number for each stressor. However, it s known that the longer
a stressor continues, then the more likely it is to cause stress and that the individuals
perception of an event is the key to whether they will find a situation stressful or not.

For example, if a person is happy living in their house, theyve lived there for a
number of years, have developed close friends in the area and do not want to move
but are forced to move because their home is being repossessed, then they are going to
find the event of moving infinitely far more stressful than a person who has lived in
their home for a short time, next to a very noisy, difficult neighbour and who wants to
move to get away from the noise.

To help overcome some of the drawbacks of the Holmes and Rahe Social
Readjustment scale Professor Cary Cooper, of The University Manchester Institute of
Science and Technology (UMIST), has upgraded it by allocating a scale of 1 - 10
points for each event, so allowing a persons perception of how stressful the event is,
to be taken into account. We have included a copy of Professor Coopers modified
version in the course materials for you to view and use.

Home | Session 1: The Science of Stress | Session 2: Relaxation and

Stress | Session 3: Exercise and Stress |Session 4: Stress Resistant
Eating | Session 5: Stress Resistant Thinking
Stress Management for Health Course
Causes of Stress

"Situations, circumstances or any stimulus that is perceived to be a threat is

referred to as a stressor, or that which causes or promotes stress."

(Brian Luke Seaward)

The causes of stress are known as stressors and there are literally hundreds of
different types of stressors. Any event in life that a person finds threatening, difficult
to cope with or causes excess pressure can be a potential cause of stress. It is
important to bear in mind that stress is an individualistic, subjective experience and
therefore what one person finds stressful another may not. Stressors can be broken
down roughly into either external or internal (or a mixture of both.)

1. External Stressors

a) Major Life Events

Research by Psychiatrists Drs Thomas Holmes and Richard Rahe revealed a list of
common causes of stress that most people would find stressful. They called this scale
the Holmes and Rahe Social Readjustment Scale. The scale is a list of 45 stressors
each given a number of points, with the most stressful at the top of the list (death of a
spouse) and the least stressful at the bottom of the scale (a minor violation of the
law). The research indicates that if your total score is more than 150 points the
chances are that it could have an impact on your health. A score of over three
hundred points in one year indicates that you have a high risk of developing a stress
related health problem.
One of the weaknesses of the Holmes and Rahe Social Readjustment scale is that it
doesnt take into account the individuals personality, their perception of how difficult
the stressor is, nor does it take into account how long the stressor continues for; the
scale just gives a single number for each stressor. However, it s known that the
longer a stressor continues, then the more likely it is to cause stress and that the
individuals perception of an event is the key to whether they will find a situation
stressful or not.

For example, if a person is happy living in their house, theyve lived there for a
number of years, have developed close friends in the area and do not want to move
but are forced to move because their home is being repossessed, then they are going
to find the event of moving infinitely far more stressful than a person who has lived
in their home for a short time, next to a very noisy, difficult neighbour and who wants
to move to get away from the noise.

To help overcome some of the drawbacks of the Holmes and Rahe Social
Readjustment scale Professor Cary Cooper, of The University Manchester Institute of
Science and Technology (UMIST), has upgraded it by allocating a scale of 1 - 10
points for each event, so allowing a persons perception of how stressful the event is,
to be taken into account. We have included a copy of Professor Coopers modified
version in the course materials for you to view and use.

Click here for Cooper's Life Stress Inventory

b) Daily Hassles

"Any idiot can face a crisis its this day-to-day living that wears you
out." (Anton Chekov)

The majority of causes of stress that we face on a day-to-day basis are not as extreme
as life events. The day-to-day causes of stress are called daily hassles; they are those
daily, minor irritations such as misplacing our car keys, traffic jams, minor arguments
with family/colleagues, etc. Research by Lazarus and Folkman (1984), at the
University of California, indicated that it was the daily hassles rather than the major
life events that affected us the most. Life events do not occur every day, but daily
hassles do; its the constant, daily frustration caused by these hassles that cause us the
most stress, because they occur so regularly and therefore can undermine our health.

Some Examples of Daily Hassles

Misplacing keys Bureaucracy Excess noise

Arguments Waiting Inconsiderate people

Traffic jams Loneliness Difficult neighbours

Time pressures Queuing Car breakdown

 Lack of sleep Pollution Meal Preparation

Fear of Crime Gossip Job dissatisfaction

Shopping Relatives Office Politics

Problems with children

2. Internal Stressors

"Stress resides neither in the situation nor in the person; it depends on a

transaction between the two."

(Dr Richard Lazarus PhD)

We tend to think that stress is solely caused by external events, situations and people,
yet this is not strictly correct. Research has found that the Transactional Model of
Stress is more accurate. This model says that stress is caused by a transaction, ie
there is an interaction between the stressor, our view of the stressor and our perceived
ability to cope with it. Its our own internal beliefs, attitudes, interpretations,
perceptions and other factors, in combination with the external events that tend to
create stress. Internal factors which influence how we perceive stress include our:

Beliefs Low assertion Perception

Expectations Low self esteem Perfectionism

Locus of control People pleasing Personality

Stress and Personality

We all have certain features to our personality that make us unique as people;
however there are many aspects of our personality that are similar to other
people. These similar personality factors are called Personality Traits. Research has
indicated that certain personality traits can make us more vulnerable to stress. People
with such traits are known as Type A personalities. Type A's tend to be more
competitive, more impatient, have time urgency when compared to the more relaxed
and laid back Type B personalities. It's important to realise that we are all a mixture
of type A and B personality traits but if we are excessively type A this can make us
more vulnerable to stress. We have included a Stress and Personality Self Test at the
end of session one in the course materials for you to fill in. We can reduce our Type
A personality traits through the techniques taught on this course. Here are some Type
A and some Type B Personality Traits:

Type A Personality Traits Type B Personality Traits

 Must get things finished Do not mind leaving things
unfinished for a while

Never late for appointments Calm and unhurried about

appointments

Excessively competitive Not excessively competitive

Can't listen to conversations, Can listen and let the other

interrupt, finish others sentences person finish speaking

Always in a hurry Never in a hurry even when busy

Do not like to wait Can wait calmly

Very busy at full speed Easy going

Trying to do more than one thing Can take one thing at a time
at a time

Want everything to be perfect Do not mind things not quite

perfect

Pressurised speech Slow and deliberate speech

Do everything fast Do things slowly

Hold feelings in Can express feelings

Not satisfied with work/life Quite satisfied with work/life

Few social activities/interests Many social activities/interests

If in employment, will often take If in employment, w

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