U U N IT

2
Exploring the Sources, Impact
and Measurement of Stress

Stress, Mother, Baby, Woman, Parent

Source: https://pixabay.com/en/photos/?image_type=&cat=&min_width=&min_
height=&q=stress&order=popular

Unit Overview

In this Unit we will explore the sources, impact and measurement of stress. We will
come to understand some personal, psychosocial and environmental sources of stress.
Additionally, we will consider toxic stress and traumatic stress. Furthermore, in
this Unit we will consider stress, the brain and the body. We will therefore explore
the neurophysiological response to stress. We will also discuss stress related health
problems. In so doing we will learn about the psychological, medical and behavioral
consequences of stress; the differential susceptibility hypothesis and a brief overview
on the various ways stress can be measured.

Unit Objectives

By the end of this Unit, you will be able to:

1. Outline the various sources of stress and categorize them according to

personal sources, psychosocial sources and environmental sources.

2. Examine the terms “toxic stress” and ‘traumatic stress’.

27  © 2016 University of the West Indies Open Campus

 3. Examine the neurophysiological responses to stress and apply this
understanding to situations.

4. Use information on stress related health problems to obtain a better

understanding of situations.

5. Apply knowledge of psychological, medical and behavioral consequences of

stress to interpret new situations.

6. Explain the “differential susceptibility hypothesis”.

7. Examine ways in which stress can be measured.

This unit is divided into three sessions as follows:

Session 2.1: Stress Sources

Session 2.2: Stress, the Brain and the Body

Session 2.3: Stress Related Health Problems

Readings & Resources

Required Readings
Bickford M. (2005). Stress in the Workplace: A General Overview of the Causes, the
Effects and the Solutions. Canada: Canadian Health Association. http://www.
cmhanl.ca/pdf/Work%20Place%20Stress.pdf

Centre for Studies on Human Stress. (2007). How to Measure Stress in Humans?
Canada: Fernand-Sequin Research Centre of Louis-H, Lafontaira Hospital.
http://www.stresshumain.ca/documents/pdf/Mesures%20physiologiques/
CESH_howMesureStress-MB.pdf

Miller J.W. and Spriddle T. (2004). Sources of Stress, Stress Reactions and Coping
Strategies used by Elite Female Golfers. Canada: University of Lethbridge. https://
www.uleth.ca/dspace/bitstream/handle/10133/229/MR03041.pdf?sequence=3

Selye H. The general adaptation syndrome and the disease of adaptation. Journal
of Clinical Endocrinology, 6:117-231 1946 http://garfield.library.upenn.edu/
classics1977/A1977DM03500001.pdf

Wegdan K., Akhu-Zahayo L. and Shaban I.A. (2014). Sources of Stress and Coping
Behaviors in Clinical Practices among Baccalaureate Nursing Students. International
Journal of Humanities and Social Sciences Vol 4. No 6. http://www.ijhssnet.
com/journals/Vol_4_No_6_April_2014/20.pdf

28  SOWK3040 Stress Management Theory and Practice – UNIT 2

 Suggested Reading
Unknown. (2016). Post-Traumatic Stress Disorder. USA: National Institute of
Mental Health. http://www.nimh.nih.gov/health/topics/post-traumatic-stress-
disorder-ptsd/index.shtml

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 SSession 2.1

Stress Sources

Introduction
In the previous Unit, we defined stress as “the condition that results when person-
environment transactions lead the individual to perceive a discrepancy – whether real
or imagined – between the demands of the situation and the resources of the person’s
biological, psychological or social systems” (Sarafino 1994, p.70). This definition
was derived from an understanding of stress as a response, stimulus or transactional
process. However we choose to conceptualize stress, we must understand that it is a
result of something or some situation existing in the environment. Thus, stress comes
from one of three major categories of stress sources. They are as follows:

1. Personal Sources of Stress

2. Psychosocial Sources of Stress

3. Environmental Sources of Stress (Floyd et al 2008)

In this session, we will explore these sources of stress. Additionally, we will also
consider the terms “toxic stress” and “traumatic stress” as categories of stress.

Personal Sources of Stress

Personal or individual stress as it is also known can be placed into two major categories:

• Psychological stress: stress to the psyche caused by every day hassles

• Physiological stress: stress caused by something directly affecting the body.

Table 2.1 outlines some major stressors, which fall under these two categories.

Table 2.1: Personal/Individual Sources of Stress (Floyd et al 2008)

Psychological Sources Physiological Sources

Missing the bus Injury
Financial lack Illness
Losing car keys Surgery
Missing an exam Genetic weaknesses

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 Psychological Sources Physiological Sources
Traffic jam Prolonged exercise
Rising consumer prices Physical disability
Living in a dangerous neighborhood Inadequate nutrition

Psychosocial Sources of Stress

Psychosocial stressors are stressors “that arise from interpersonal relationships, from
living, working and playing with other people” (Floyd et al 2008 p56). Some examples
of this can be seen in Figure 2.1.

Intense
Discrimination
Social
and Racism
Interaction

Conflict
Social
Isolation

Figure 2.1: Psychosocial Stressors

Environmental Sources of Stress

Environmental Stressors are those stressors that come from the state of the actual
environment. They include:
• Air pollution
• Temperature extremes
• Over crowding
• Unsanitary conditions
• Lack of security
• Water pollution
• Hurricanes
• Tornados
• Tsunamis
• Earthquakes
• Forest fires

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 Environmental stressors, while they can be devastating in the short term are not
necessarily the most damaging in the long term (Floyd et al 2008) but this can be a
source of a great amount of immediate stress.

Toxic Stress and Traumatic stress

According to Corcoran and Roberts (2015), “toxic stress refers to strong, frequent,
and/or prolonged activation of the body’s stress response systems in the absence
of buffering protection of stable adult support” (p.294). Some major risks factors
for toxic stress can be seen in Figure 2.2. It is important to note that toxic stress
“disrupts the architecture of the brain, adversely affects other organs, and leads to
stress management systems that establish a lower threshold for responsiveness that is
persistent throughout life. [It therefore increases] … the risk of stress related disease
or disorder as well as cognitive impairment well into adult years” (Shonkoff 2010, p
360). This toxic stress includes the concepts of genetics, environmental conditions and
the impact of childhood stress responses on the adult

Extreme Poverty

Recurrent Physical and/or Emotional Abuse

Chronic Neglect

Severe Maternal Depression

Parental Substance Abuse

Family Violence

Figure 2.2: Some Major Risks Factors for Toxic Stress

The American Psychiatric Association (1980) defines the term trauma as a “recognizable
stressor that would evoke significant symptoms of distress in almost anyone” (p.238).
Traumatic stress is in turn stress brought on by a traumatic event. Corcoran and
Roberts (2015) note that “the type of trauma, age at trauma exposure, duration of
events, relational factors, prior trauma exposure, social ecological conditions and
cultural beliefs are only some of the variables that make differential contributions to
one’s individual bio-psychological experience of trauma” (293).

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 LEARNING ACTIVITY 2.1
Let’s do Research
In this session, we learned about the various sources of stress
including toxic and traumatic stress. Stress can be caused by sources
in the workplace, sources in the family, sources in sport competitions
etc. There are articles on the internet that address these specific
areas of stress. Select any article that you may find informative and
write a brief note about it to encourage your colleagues to visit the
site. Post the link in the forum together with the note. Visit at least
two of your classmates suggested links on a different topic to your
own.

Session Summary

In this session, we looked at the various categories of sources of stress. That is, we
noted that sources of stress can either be personal, psychosocial or environmental. We
also came to understand the concepts of toxic and traumatic stress, noting briefly that
they can have physiological and neurological complications for the human being. It
the next session, we will take a deeper look at the neurophysiological impact of stress
and the implications for individuals experiencing it.

tivity 5.2

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 SSession 2.2

Stress on the Brain and the Body

Introduction
In the previous session we learned about some of the sources of stress, broken down
into three major categories—personal stress sources, psychosocial stress sources and
environmental stress sources. We also learned about toxic and traumatic stress. The
previous session indicated that stress can have some effects on the brain and the body.
In this session we will look more closely at the neurophysiological effects of stress and
we will explore Post Traumatic Stress disorder in Figure 2.3.

The Neurophysiological Effects of Stress

As demonstrated in the previous session, stress can be caused by physiological and
psychological stressors and, in turn, stress can have various damaging physiological and
neurophysiological consequences to the human being. The term ‘neurophysiological’
when broken down simply means the brain (neuro) and the body (physiological).
Table 2.2 outlines the various parts of the body and the stress responses associated
with them. It is important to note that when stress occurs, it is normal for the body
to respond by releasing hormones, increasing the heart rate and the breathing rate; it
becomes unhealthy when the stressors are not removed and chronic stress takes place.

Table 2.2 The Neurophysiological Responses to Stress

Body Part Normal Body Function Chronic Stress Body Response

• When stressors arise the CNS
causes a release of hormones which
causes the adrenal glands to release
Central
adrenaline and cortisol. When the
Nervous
stressor is removed, the body goes
System (CNS)
back to normal functioning
and Endocrine
• Stress triggers the fight or flight
System
response that aids in saving you
from danger.
• Prolonged headache
• Stress can cause insomnia if it
continues to interfere with sleep
• Chronic Stress can cause anxiety,
leading to depression
• Chronic stress can cause addictive
behaviors such as over or under
eating or alcohol/drug abuse
• Social withdrawal can be caused by
chronic stress

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 Body Part Normal Body Function Chronic Stress Body Response
• Stress can cause you to breathe • If you have respiratory problems,
faster in order to take more oxygen chronic stress can cause you to have
in trouble breathing
Respiratory • Stress can cause your heart to pump • Stress hormones can cause
and faster so that blood can reach organs constricted blood vessels and a raise
Cardiovascular and limbs more quickly in blood pressure
System • Chronic stress can over time take
a toll on your heart as it causes a
pounding heart; this can increase the
risk of heart attack and stroke
• Your liver causes your glucose • When too much glucose is released
production to increase when into the bloodstream as a result of
stressors occur to provide energy for chronic stress the individual can
Digestive the fight or flight response develop type 2 diabetes
System • Chronic stress can cause heartburn
and acid reflux
• Chronic stress can cause stomach
aches, diarrhea and constipation
• Stress causes your muscles to tense • Chronic stress prevents your muscles
Muscular
in order to protect them from injury from relaxing causing headaches,
System
back aches and shoulder pain.
• Stress can increase arousal in a man • Chronic stress prevents arousal,
due to an increase in testosterone causes erectile dysfunction or
impotence.
Sexual and • Chronic stress can cause fluctuating
Reproductive hormones, which can throw off the
System menstrual cycle or cause it to stop.
• Chronic stress can prevent both men
and women from doing what their
body needs to do to conceive.
• Stress stimulates the immune system • In the long term chronic stress causes
Immune causing it to stave off infection and your immune system to lose its full
System heal wounds in the short term working capacity and increases the
risk of infection and disease

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 Definition
Post-Traumatic Stress Disorder is a mental health disorder that is triggered by
either witnessing or experiencing a traumatic event. PTSD may be recognized
when subsequent to witnessing or experiencing this event an individual has/
experiences the following:
• Flashbacks
• Nightmares
• Severe anxiety
• Uncontrollable thoughts about the event
Simply displaying these symptoms in the short term is not necessarily an indication
that you have PTSD, as many people who go through or witness trauma may
show these symptoms and then get over it eventually. However, if it persists over
months or years, then the individual may have PTSD.

Symptoms
Symptoms of PTSD include the following:
• Intrusive memory
• Avoidance
• Negative Changes in Thinking and Mood
• Changes in emotional reactions
• Suicidal thoughts

Treatment
PTSD can be treated through psychotherapy including:
Cognitive therapy
Exposure therapy
Eye Movement Desensitization and Reprocessing

Figure 2.3: Post-Traumatic Stress Disorder

The General Adaptation Syndrome

We cannot consider the neurophysiological responses to stress without looking at
Hans Selyne’s (1986) General Adaptation Syndrome (GAS). GAS is characterized as
the situation in which the body attempts to restore itself to the state of homeostasis
in which it existed before the stressor arrived. Simply explained, prior to the advent
of a stressor, the body is in a state of homeostasis in which all systems are working

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 seamlessly to maintain equilibrium. When the stressor occurs and is removed, the
body’s adaptive response is to try to get back to that previous state of homeostasis.
It is at this point GAS occurs. GAS has three phases and depending on how they are
handled, positive or negative effects can occur. The three phases of GAS are as follows:

• Alarm Phase: This is the fight or flight response in which we physiologically revert
to our basic survival instincts. In this phase stressors temporarily lower the body’s
resistance by disrupting its stability.

• Resistance Phase: In this phase the body resists the alarm phase in an attempt to
return to homeostasis. It therefore mobilizes adaptation resources as a means of
combating stressors, thereby increasing the body’s resistance.

• Exhaustion Phase: In this phase the body becomes tired of trying to adapt, leading
to an ‘allostatic’ load. This means that there is excessive exhaustive wear and tear
on the body. This is the result of too much cortisol in the bloodstream leading to a
slower response rate and a weakened immune system.

LEARNING ACTIVITY 2.2

From the information in Figure 2.3 we learned that there are three
psychotherapy treatments for PTSD. Identify briefly the tenets of
one of these three treatments. Post this in the discussion forum and
comment on at least two other postings of each of the topics that you
did not write about.

Session Summary

In this session, we learned about the neurophysiological responses to stress and

we focused on PTSD and GAS as components of these responses. In the upcoming
Session we will further explore stress related health problems. That is, we will look
at the psychological, medical and behavioral consequences of stress, the differential
susceptibility hypothesis and a brief overview on ways stress can be measured.

37  SOWK3040 Stress Management Theory and Practice – UNIT 2

 SSession 2.3

Stress Related Health Problems

Introduction
In the previous session, we learned about stress and its impact on the brain and the
body. We learned that there are several neurophysiological effects of stress that can
be damaging to the body in the end. Of import in the last session is the fact that the
neurophysiological responses to stress in the short term are not necessarily harmful;
but if stress becomes chronic and therefore continues to persist, the long-term effects
can be very damaging. In this session therefore, we will take a more in depth look at
those long-term effects of chronic stress. We will learn about the psychological, medical
and behavioral consequences of stress, the differential susceptibility hypothesis and
we will go through a brief overview on the ways stress can be measured.

The Psychological, Medical and Behavioral Consequences

of Stress
Landy and Comte (2010) noted that “the negative consequences of chronic stress [for
the individual] can be divided into three categories: behavioral, psychological and
[medical]” (p456). Behavioural consequences of stress occur when stress causes us to
display certain behaviours outside of our normal functioning. Some of these behaviours
include “absenteeism, accidents, alcohol and drug abuse, poor job performance, and
counterproductive behaviors including workplace violence” (Landy and Comte
2010, p 456). It is important to note that some behavioral consequences of stress can
be harmful not just to the individual but to others. For example, stress may cause
a person to smoke more often and this may lead to greater occasions of secondary
smoke exposure to persons who are constantly in their company.

The psychological consequences of stress are those that are related to an individual’s
mental health and wellbeing. Psychological consequences include lack of sleep or too
much sleep, depression, forgetfulness or memory loss, sexual difficulties and family
problems. Medical consequences on the other hand are those that affect physical health
and wellbeing such as heart disease and stroke, cancer, headaches, muscle pains, ulcers
and related stomach and intestinal disorders, back pain and skin conditions (acne and
hives).

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 The Differential Susceptibility Hypothesis
The differential susceptibility hypothesis comes out of a variation of the G x E theory. In
this theory the G stands for genetics and the E for environment. It therefore “proposes
that specific genotypes may make some children show enhanced negative effects
when interacting with environmental risk factors, but also show enhanced positive
effects when interacting with environmental protective factors” (Hood et al 2010, p
534). The differential susceptibility hypothesis postulates therefore that “individuals
with a specific genotype are proposed to be more susceptible than other children to
environmental influences, whether those influences act as risk or protective factors”
(Hood et al 2010, p534). This hypothesis is of particular importance to stress related
medical problems and understanding one way in which they may be developed or
even exacerbated.

Brief Overview of the Ways Stress Can Be Measured

It is important when considering stress related medical problems to understand how
to measure stress. The impact of how we measure stress is that if incorrectly measured,
the diagnosis can be negatively affected. Stress can be measured in a number of ways.
They are as follows:

• Psychological Measure of Stress:

»» Psychological questionnaires

»» Autonomic measure such as blood pressure, vagal tone or salivary alpha-

amylase

»» Measuring salivary cortisol, diurnal cortisol secretion or awakening cortisol

response

• Using Reactivity to Measure Stress. In this case reactivity to:

»» Real life stressors

»» Pharmacological challenges

»» Laboratory induced stressors

• Population Studies

It must be noted when measuring stress that there are factors that can bias a measure
of stress. These biases include but are not limited to the time of day; the compliance
of the participants to the stress measurement exercise and stimulants to the nervous
system such as food and drink.

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 LEARNING ACTIVITY 2.3
Let’s do Research
In this session we learned that there are different ways to measure
stress. Choose one of the ways and do a research on the techniques
involved in that method of stress measurement. Write a short essay
on your findings of no more than 500 words. Post your essay in the
discussion and comment on two other posted essays on different
methods than the one you selected.

UNIT SUMMARY

In this Unit, we learnt about the sources of stress (personal, environmental and
psychosocial) and toxic and traumatic stress. We also looked at stress on the brain
and the body, noting the neurophysiological responses to stress. We considered GAS
and PTSD. Furthermore, we looked at health related problems, categorizing the
psychological, medical and behavioral consequences of stress to health. We came to
know what the differential susceptibility hypothesis was noting and that it can be
an explanation about why some people are more predisposed to some stress related
illnesses than others. Finally, we looked briefly at the ways in which stress can be
measured. In the following Unit (Unit 3a) entitled Introducing Stress Management and
Coping, we will begin to understand the concepts of stress management and coping,
and consider a mindful approach to living and meditation as coping mechanisms of
stress.

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 References

Bickford M. (2005). Stress in the Workplace: A General Overview of the Causes, the
Effects and the Solutions. Canada: Canadian Health Association. http://www.
cmhanl.ca/pdf/Work%20Place%20Stress.pdf

Centre for Studies on Human Stress. (2007). How to Measure Stress in Humans?
Canada: Fernand-Sequin Research Centre of Louis-H, Lafontaira Hospital.
http://www.stresshumain.ca/documents/pdf/Mesures%20physiologiques/
CESH_howMesureStress-MB.pdf

Corcoran K. and Roberts A. R. (2015). Social Workers’ Desk Reference. NY: Oxford
University Press.

Floyd A., Mimms S.E., and Yelding C. (2008). Personal Health: Perspectives and
Lifestyles. Asia: Thomson Wadsworth.

Hood K. et al. (2010). Handbook of Developmental Science, Behavior and Genetics. UK:
Blackwell Publishing Ltd.

Landy F.J and Comte J.M. (2010). Work in the 21st Century: An Introduction to
Industrial and Organizational Psychology. NY: Wiley-Blackwell.

Miller J.W. and Spriddle T. (2004). Sources of Stress, Stress Reactions and Coping
Strategies used by Elite Female Golfers. Canada: University of Lethbridge. https://
www.uleth.ca/dspace/bitstream/handle/10133/229/MR03041.pdf?sequence=3

Selye H. The general adaptation syndrome and the disease of adaptation. Journal
of Clinical Endocrinology. 6:117-231 1946 http://garfield.library.upenn.edu/
classics1977/A1977DM03500001.pdf

Unknown. (2016). Post-Traumatic Stress Disorder. USA: National Institute of

Mental Health. http://www.nimh.nih.gov/health/topics/post-traumatic-stress-
disorder-ptsd/index.shtml

Wegdan K., Akhu-Zahayo L. and Shaban I.A. (2014). Sources of Stress and
Coping Behaviors in Clinical Practices among Baccalaureate Nursing Students.
International Journal of Humanities and Social Sciences, Vol 4. No 6. http://www.
ijhssnet.com/journals/Vol_4_No_6_April_2014/20.pdf

41  SOWK3040 Stress Management Theory and Practice – UNIT 2