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Stress Management Among Adolescents

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DOI: 10.2139/ssrn.2674512

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The International Journal of Indian Psychology
ISSN 2348-5396 (e) | ISSN: 2349-3429 (p)
Volume 3, Issue 1, DIP: C00112V3I12015
http://www.ijip.in | October – December, 2015

Stress Management among Adolescents

Deepa K Damodaran 1, Varghese Paul K 2
ABSTRACT

Childhood experiences deeply influence a young person and profoundly affect emotional and
physical health later in life. The present study aims to determine the stress and the stress
manifestations among adolescents (N= 46), and the effect of Progressive Muscle Relaxation
Technique on stress. Data were collected using stress rating scale and stress manifestation
checklist from adolescents (N= 46) who were selected through convenience sampling from a
selected school in Udupi, Karnataka. Results revealed that majority of adolescents (63%)
experienced moderate stress specifically in the interpersonal domain. Psychological
manifestations were more and depression (70%) was the most common manifestation
experienced. Analysis using paired sample t test showed that there was significant reduction in
stress and stress manifestations after the intervention revealing the effectiveness of Progressive
Muscle Relaxation Technique on stress. Results suggest the need for early recognition and
management of adolescent stress.

Keywords: Adverse childhood experiences, Stress, Progressive muscle relaxation, Adolescence,

Stressors, Mental health

Stress is a way of life in the present world. Childhood experiences deeply influence an
individual and profoundly affect emotional and physical health later in life. It is learnt that
childhood adversities and the associated stress are very common and early trauma and stress lead
to predictable patterns of brain development, traits and behaviours. Adolescence is the transition
period between childhood and adulthood and it is a period of stress and strain (Byrne, Davenport,
& Mazanov, 2007).

A number of biologic and environmental stressors such as demands of school, physiologic

changes, and adversities like family conflicts and responsibilities, and an uncertain future place
adolescents at risk for emotional problems (Lamb, Puskar, Sereika & Corcoran, 1998). The
impact of unresolved stress may be manifested as depression, eating disorders, elimination
disorders, suicidal behaviour and dissociative disorders (Bhola & Kapur, 2000), anxiety, poor
concentration, aggression, physical illness, substance abuse etc. Identification of adolescents’
stress and stressors is very important and helpful for planning and implementing health
promotion as well as prevention programmes in the natural setting of the school. Interventions to
1
Research Scholar, Research and Development Centre, Bharathiar University, Coimbatore, Tamilnadu. India
2
Head, Department of Psychology, Prajyoti Niketan College, Pudukad, Thrissur, Kerala, India
© 2015 I D Damodaran, Paul K; licensee IJIP. This is an Open Access Research distributed under the terms of the
Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted
use, distribution, and reproduction in any Medium, provided the original work is properly cited.
 Stress Management among Adolescents

manage stress include relaxation techniques which require little effort and may be used at any
time. There are several forms of relaxation techniques that include a number of practices such as
progressive relaxation, guided imagery, biofeedback, self-hypnosis, deep breathing exercises etc.
Adolescents are often helped by interventions to deal constructively with stressors in their lives.
It is very much necessary to understand the stressors faced by them and their management of
stress. A self controlled stress management technique such as relaxation technique that
adolescents can use themselves is thought to be very much beneficial for them. Progressive
Muscle Relaxation Technique focuses on tightening and relaxing each muscle group of the body
with the goal of consciously producing the body’s natural relaxation response, characterized by
slower breathing, lower blood pressure, and a feeling of wellbeing.

The present study was conducted with the following objectives: - to determine the adolescent
stress, identify manifestations, and also to determine the effect of Progressive Muscle Relaxation
Technique (PMRT) on stress and stress manifestations. It was hypothesized that the mean stress
and stress manifestations after PMRT will be significantly lower than that of their mean pretest
measurement values as measured after one month of supervised practice. The conceptual frame
work was developed based on Betty Neuman’s model (Memmott, Marett, Bott, & Duke, 2000).

MATERIALS AND METHODS

An evaluative approach with one group pre-test post test design was adopted for the current
study. The target population was adolescent students in Schools. Samples from adolescents who
met the inclusion criteria were included in the study.

Participants
Sample for the present study was constituted by 46 ninth standard boys (N = 25) and girls (N
=21) between the age range 13 and 15 selected through convenience sampling from an English
Medium Higher Primary School in Udupi District of Karnataka.

Measures
The following arbitrarily constructed and validated tools in English language tested for reliability
(test-retest method) were used to collect data: Stress rating scale (γ(30) = 0.9) prepared based on
the stress scale for children by Saunders and Remsberg (Hockenberry & Wong, 1995) and Stress
manifestation checklist (γ(30) = 0.84) to identify manifestations of stress. Demographic proforma
to obtain information on age, sex, birth order, type of family and number of members in the
family, and modified Srivastava’s socio economic status scale to collect information on
educational and occupational status of parents and monthly income of the family were also used.

The stress rating scale consists of 38 items with alternative responses such as “almost always”,
“usually”, “rarely” and “never”, and the total score ranges from 47 to 143. The total score

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 Stress Management among Adolescents

determines the stress level. The stress manifestation checklist consists of 56 items with responses
of “yes” or “no”. The total score is the sum of all positive responses.

Procedure
The needed data were collected after obtaining formal administrative permission from
authorities, consent from parents and assent from subjects. After explaining the purpose,
importance and the nature of the study, assent was taken. Subjects were assured about the
confidentiality of the information. On the first day pre-test was conducted by administering tools
after giving necessary instruction that was followed by demonstration of PMRT. Following that
there was supervised practice of it for thirty days, which was followed by a post test.
Participation was voluntary and no compensation was given for participation.

Statistical Analysis
Data were analyzed based on objectives and hypotheses using descriptive and inferential
statistics with SPSS 11 for Windows and Epi info 2000. Paired sample t test to test the difference
in pre-test and post test mean scores of stress and stress manifestations, and Chi square test to
find the association between stress and the selected demographic variables were used to analyze
the data.

RESULTS
In the present study, majority of adolescents were 14 year old (80%) first born children (40%)
from nuclear families (92%). As indicated in Figure.1 comparison of pre PMRT and post PMRT
stress scores reveals that most of them experienced moderate stress.

Figure 1: Comparison between pre PMRT and post PMRT stress scores of adolescents

The mean percentage stress score was highest in the interpersonal domain as shown in Figure 2.

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 Stress Management among Adolescents

Fig 2: Domain wise comparison of pre PMRT and post PMRT mean percentage stress scores of
adolescents

These findings can be interpreted based on supportive evidences from previous studies. Studies
examined adolescent stress revealed that overall levels of stress tend to increase from
preadolescence to adolescence (Rudolph, 2002) and this is specifically related to interpersonal
stressors (Hampel & Peterman, 2006; Hankin, Mermelstein, & Roesch, 2007). Stress within an
interpersonal context may be especially strongly related to emotional distress (Rudolph, 2002,
Charbonneau, Mezulis, & Hyde, 2009, Hankin et al, 2007). Maladaptive functioning in peer,
family, romantic, and parenting roles in adulthood is predicted by the interpersonal dysfunction
in early adolescence (Hammen, 2000).

Academic stress is a significant source of stress for many students (Hashim, 2003) and academic
failure and low achievement are found to be associated with depression (Fauber , Forehand ,
Long , Burke , Faust, 1987; Kellam , Brown , Rubin , Ensminger, 1983; Hilsman , Garber,
1995; Kaslow , Rehm , Siegel, 1984). Appearing for examinations, lagging behind in the home
work, writing assignment, working on individual and group projects, time pressure, lack of
financial support, concern about academic ability, scheduling classes are also identified as
stressors for students (Tyrrel, 1992). There is sufficient empirical evidence established on the
impact of multiple independent and cumulative stressors, especially in the interpersonal context
(Rudolph, 2002) during adolescence. Psychological symptoms including symptoms of
depression (Charbonneau et al, 2009; Compas, Connor-Smith, & Jaser, 2004; Shih, Eberhart,
Hammen, & Brennan, 2006; Waaktaar, Borge, Fundingsrud, Christie, & Torgersen, 2004) and
anxiety (Kim, Conger, Elder, & Lorenz, 2003; McLaughlin & Hatzenbuehler, 2009) are found to
be related to it.

In the present study as shown in Figure.3 adolescents exhibited more psychological

manifestations than physical manifestations. Majority (70%) of them reported depression as the
most commonly occurring manifestation.

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 Stress Management among Adolescents

Fig.3 Comparison between pretest and posttest mean percentage stress manifestation scores

Several research studies support this finding through similar observations. Academic stress result
in serious psycho-social-emotional health consequences (Scott, 2008) such as depression, anxiety
and physical illness (including headache, stomach ulcer, renal problems) in children. Depressive
mood is associated with academic problems or low academic achievement (Hilsman & Garber,
1995; Kaslow, Rehm & Siegel, 1984). Reinhold, Laessle & Lindel (2011) revealed that
physical symptoms of stress reflect as somatic complaints co-occurring frequently with
depression.

Chi square analysis did not show any significant association between stress and selected
demographic factors. Thus we accept the null hypothesis that there is no significant association
between stress and selected demographic variables under study. This finding is contradictory to
the findings from other studies. Costello, Angold, Burns, Stangl, Tweed, Erkanli & Worthman
(1996) and Goodman, Huang, Wade & Kahn (2003) reported that children from families with a
low social status are at higher risk to suffer from psychological problems. The present finding
would have been resulted from peculiarities of the sample.

Table .1 Summary of t test on effectiveness of PMRT on stress

N = 46
Stress
M SD MD SDD SEMD t value p
scores
Pretest 90.09 12.44 7.94 0.34 1.83 8.8 0.05*
Posttest 82.15 12.78 1.88
*p < .05 level
Table .2 Summary of t test on effectiveness of PMRT on stress manifestations
N = 46
Stress t
manifestations M SD MD SDD SEMD
value
p
scores
Pretest 20.93 5.06 5.28 0.04 0.75 10.73 0.05*
Posttest 15.65 5.46 0.80
* p <.05 level

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 Stress Management among Adolescents

As shown in the Table.1 and Table. 2 it was observed that the difference between pretest and
post test mean scores was significant at 0.05level indicating that PMRT was effective in terms of
reduction in stress (t (45) =8.8, p < .05 level) and stress manifestations (t (45) =10.73, p < .05
level). PMRT was used as a secondary prevention.

The present findings replicate the findings of other studies and have supportive evidences from
them. Rasid and Parish (1998) examined the effects of two types of relaxation training with 55
high school students' levels of anxiety and found that both behavioral relaxation and progressive
muscle relaxation techniques produced significantly lower anxiety scores in the experimental
group as compared to the control group. The relaxation techniques are effective in reducing the
academic as well as social stress of adolescents as established by Nangia and Sareen (2011) and
results in the greatest effects on behavioural and self-reported measures of relaxation (Scheufele,
2000). In another study (Lohaus & Hessling, 2003), progressive muscle relaxation technique
was found to have a more significant calming effect in children over the short-term (i.e., five
sessions) as compared to additional training sessions (i.e., ten sessions). These results suggested
that children are capable of learning relaxation techniques over a relatively short period of time.
It is an economically and organizationally feasible method also (Cheung et al, 2003; Scheufele,
2000).

Although the findings of the study have significant implications in training parents on effective
parenting, training of school authority in early detection and management of stress among
students, equipping children in handling stressors and managing their stress, and for mental
health professionals to devise ad implement child friendly measures to protect children from ill
effects of stress, these findings have to be interpreted in the light of following limitations. First of
all, the method of sample selection was not random. Secondly, results cannot be generalized as
only one setting was involved. Thirdly, the investigator exclusively used self constructed, self
rating scales for children. Fourthly, parents’ or teachers' ratings on stress could not be evaluated.
Fifthly, there was no control group in the study. Lastly, there was no follow up evaluation
conducted.

CONCLUSION
The present study reveals that adolescents experience moderate stress and an economic, easy
intervention like PMRT is useful to relieve it. Of all life-stages adolescence is the potentially
tumultuous transition period. Chronic stress in childhood and adolescence can lead to lasting
changes in the structure and function of the brain because it occurs during sensitive periods of
brain growth and development. There is empirical evidence that stressful life experiences predict
increases in psychological problems over time. Unresolved stress in childhood and adolescence
leads to physical and psychological problems and risk taking behaviour and poor coping skills in
adulthood. Thus, investigating more on the stress, stressors and its outcomes are helpful for
planning and implementing health promotion as well as preventive strategies during adolescence.

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 Stress Management among Adolescents

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