Sources of Stress: Workplace Stress

Two factors have been identified as being key sources of stress in the workplace- workload (the amount of work a person needs to do in a given time) and control (the degree of freedom a person has in their job, e.g. the ability to make decisions about their working conditions).

Job demands-control model: Karasek (1979) suggested that stressful elements of a job, including high workload and demand, can lead to stress-related illness and absenteeism (time off work). However, the effects of this are reduced when a person has control over their work. This has been investigated in research.

Marmot et al (1997): This study aimed to investigate the effects of control on stress and illness. 10,000 UK civil service employees were studied. They were of varying ‘grades’ (levels of importance) so had varying levels of workloads and control. Participants completed a questionnaire to measure workload and control, and were examined for signs of coronary heart disease (CHD). There was a follow up after 5 years. The findings were that there was no correlation between workload and illness, however a lack of control was strongly associated with CHD developing, even accounting for lifestyle factors, and personality differences. The conclusion was that workload does not seem to affect stress and illness, but a lack of control in a job does affect stress and illness.

Johansson et al (1978): This study looked at Swedish sawmill workers, comparing the ‘finishers’, who prepared finished timbers, to ‘cleaners’, who cleaned the sawmill. The finishers had a lack of control over their work (it was determined by machine), but also a high responsibility and demand, as if the finishers fell behind schedule the production rate slowed. Cleaners were able to work at their own pace and had less responsibility. Measures of illness and absenteeism were collected from both groups, along with levels of stress hormones adrenaline and noradrenaline during the day. The findings were that the finishers group had higher levels of stress hormones (even before starting work) than the cleaners, and these levels increased during the day. Illness and absenteeism rates were also higher amongst the finishers. The conclusion was that high demand, together with a lack of control, is linked with stress-related illness.

Evaluation:

The job demands- control model is likely to be over-simplistic. There are a range of factors, including support from colleagues, the kind of work done, and how the person perceives the amount of workload and control they have, which are not really considered, lowering the validity of the explanation.
Some research has suggested that, in collectivist cultures, having control at work is actually seen as less desirable, potentially meaning that research in this area is culturally biased- it may not be appropriate to class control as a source of stress in the workplace everywhere. However, Liu et al (2007) found that there were no significant cultural differences in perception of workload as stressful, meaning that this concept is likely to be applicable across all cultures.
Meier et al (2008) found that people with low self-efficacy (confidence in the ability to carry out actions and successfully complete tasks) experienced more stress, not less, when they had more control at work. People with high self-efficacy found a lack of control stressful. Therefore, it is not the amount of control that may be important, but the personality of the individual, which weakens the original suggestion that a lack of control is associated with stress.

Self-Report Measures: the SRRS

Holmes and Rahe developed the Social Readjustment Rating Scale (SRRS) in 1967 to measure the effect of life changes. Medical records of hospital patients were studied, looking for instances of major life events that they had experienced before becoming ill. 43 of these events were put into a list, and this list was given to hundreds of participants. The participants rated how much readjustment they thought would be needed for each event, out of 1000. Marriage was given an arbitrary score of 500 to help guide the participants. The mean scores were calculated for each event, and this was divided by 10. This created a life change unit (LCU) score for each event. For example, death of a spouse was given the highest score of 100, followed by divorce (73). Christmas was rated as the event requiring least readjustment (12). The list included positive and negative events, as the amount of readjustment was what was seen as important in determining the stress it caused. An LCU score is calculated by asking participants to indicate how many events they experienced over a few months, then adding up the scores from those events.

Self-Report Measures: Hassles & Uplifts Scale

Kanner et al (1981) developed the Hassles and Uplifts Scale to measure the effects of daily hassles on stress and illness. This consists of 117 items selected from seven categories: work, health, family, friends, environment, practical considerations and chance occurrences. Examples include disliking work colleagues, having to plan meals, and so on. The severity of these is measured on a three-point scale- somewhat, moderately, extremely severe, so the participant can select how severe that hassle is for them. The Uplifts Scale works in a similar way, consisting of 135 items from the same seven areas. For example, getting enough sleep, liking a colleague, and so on. Participants identify how often they experience particular uplifts over, for example, one day. DeLongis et al (1988) modified the scales to create the Hassles and Uplifts Questionnaire.

Skin Conductance Response

This utilises one element of the fight or flight response, that of increased perspiration. The participant has electrodes attached to their fingers, and a tiny electric current is applied to the electrodes. As the person sweats more, more electricity is conducted, suggesting the person is becoming increasingly stressed. ‘Tonic conductance’ is the baseline skin conductance level, against which ‘phasic conductance’ is measured- this occurs in response to a stimulus. The response is known as the skin conductance response. It typically lasts for just a few seconds- there is an initial spike in conductance, followed by a gradual decay. This can be used alongside other physiological measures such as heart rate and blood pressure to make up a lie detector test (polygraph).

Evaluation:

Self-report measures mean that the categories are open to interpretation by participants. For example, ‘illness’ could mean anything to a mild cold to a broken leg or cancer. This brings into question the validity of self-report measures to measure stress.
Using the SRRS and the Hassles and Uplifts Scale to measure stress-related illness is problematic as the things being measured may overlap. For example, experiencing a stress-related illness is in itself a life event. Therefore, there are serious methodological problems in using such scales to try to measure the effect of stress.
Skin conductance responses vary significantly from person to person. This remains a problem even if a baseline measure is taken, as some individuals’ SCRs vary without exposure to any stimulus. This means it is hard to use SCR as a valid and reliable measure of stress for everyone.

Personality Type

Type A personality: In the 1950s, cardiologists Friedman and Rosenman noticed that many of their patients had similar personality traits, so suggested that personality is a factor in coronary heart disease (CHD). From this, the concept of the __Type A __personality was developed. Which had the following key features:

Competitiveness: achievement-motivation, ambition, aware of status, view life as a series of challenges
Time urgency: fast-talking, impatience, very proactive, like multi-tasking, dislike creative pursuits
Hostility: aggression, intolerance, anger, inflexibility

Type B personality: Friedman and Rosenman suggested that a Type B person is essentially the opposite to Type A- laid-back, relaxed, not time-urgent, tolerant, not competitive.

Research: Friedman and Rosenman (1974): 3000 males were assessed as being free of CHD at the start of the study. Their personality type was assessed through an interview and questionnaire (questions such as, ‘how do you feel when you have to wait in a queue?’) The interviewer spoke deliberately slowly, or was quite aggressive, and this was another way of drawing out Type A behaviour. Participants were classified as Type A or B as a result. The findings were that eight years later, 70% of the men who had developed CHD were classed as Type A, and 30% with CHD were Type B. CHD risk factors were accounted for in the results. The conclusion was that the features of a Type A personality, such as impatience and hostility, raised the physiological stress response (high blood pressure and stress hormone levels), so increasing the likelihood of CHD.

Type C personality: This was proposed as an alternative to A and B. Type C personalities are characterised by ‘pathological niceness’, meaning they are very patient, compliant, passive, put others first, and strive to avoid conflict. This may involve repressing their true feelings and emotions, so Temoshok (1987) proposed that this makes them vulnerable to illness, especially cancer.

Research: Dattore et al (1980): 200 Vietnam War veterans completed scales to measure how much they repressed emotions and how vulnerable to depression they were. 75 of the sample went on to develop cancer. The findings were that the cancer patients reported greater levels of emotional repression, but fewer depression symptoms, than those without cancer. Repression is likely to involve not accepting depression symptoms, which may explain the findings. The conclusion is that elements of a Type C personality are linked with cancer-proneness.

Evaluation:

Edigo et al (2012) found that men and women who had had a stroke were more likely to have Type A personalities than a matched control group, and the difference could not be explained by lifestyle factors (such as smoking). This supports the link between Type A behaviour and stress.
Type A may be too brad a behaviour category to clearly establish a link with stress-related illness, as it encompasses a range of behaviours. It is thought that hostility is the key factor linking with stress- Carmelli et al (1991) found a strong link with hostility in particular and CHD death rates. This means that it is not accurate to say that Type A personalities generally are linked with illness, as it is perhaps a particular aspect of Type A where a link can be seen.
Research into the link between Type C behaviour and cancer is mixed, with inconsistent, unreliable findings from research studies. The relationship is therefore likely to be moderated by other factors, weakening the link between Type C behaviour and illness.

Hardiness

Kobasa (1979) proposed that hardiness is a key personality factor in being able to resist stress. Maddi (1986) suggested that this is because ‘hardy’ people have the determination to keep going in the face of setbacks such as life events and daily hassles. Hardiness consists of three elements (the ‘three Cs’):

Commitment: a deep involvement in life- for instance, relationships, activities, and own feelings. For instance, becoming fully involved in a project, in the optimistic expectation it will be worthwhile.
Challenge: a tendency to see change and other potentially stressful situations not as stressors but as challenges that need to be overcome. These challenges are viewed positively, as they are chances to grow and develop and learn about oneself.
Control: a bit like having an internal locus of control, this is a tendency to believe that people can control what happens to them, so can actively strive to influence the environment and conditions they are in.

Research: Kobasa (1979): 670 American middle managers completed an early version of the SRRS, considering a three-year period. Absenteeism and illness records for the participants were also checked. Some of the participants experienced high levels of stress and also high levels of illness and absenteeism, but there was a group who, despite similarly high levels of stress, did not display signs of illness. When this group completed a hardiness questionnaire, they scored highly on the ‘three Cs’. This suggests that a hardy personality helps to resist stress.

Maddi (1987): 400 employees at an American telephone company were studied, during a time when the company was being restructured and thousands of people’s jobs were at risk, creating an extremely stressful working environment. In two-thirds of the participants, job performance and health significantly worsened. One-third had the opposite experience- job performance increased and there were no significant signs of illness. This third scored highly on measures of the three Cs, again suggesting that a hardy personality resists stress by seeing major changes as challenges to overcome.

Evaluation:

Contrada (1989) found that participants who scored highly on hardiness measures had lower levels of blood pressure in response to a stressful lab-based task. This supports the other research into hardiness and suggests it does help to reduce the effects of stress.
The hardy personality may have more of an indirect effect on illness- for example, hardy people are likely to smoke less, exercise more and live healthy lifestyles, due to their personality traits. This questions whether hardiness is having a direct effect on the physiological stress response. However, direct or indirect, hardiness does seem to have an effect on stress resistance.
The three Cs of hardiness may not all be equally important. Research suggests that control is the key element, and other studies have just considered control and commitment. Therefore, the concept of hardiness, and what its relationship to stress is, is open to debate.

Drug Therapy

Drug therapy involves taking drugs which have a chemical effect on the body, aiming in this case to reduce the physiological effects of stress.

Benzodiazepines (BZs): BZs such as diazepam aim to reduce arousal in the central nervous system, by enhancing the body’s natural response to anxiety. Gamma-aminobutyric acid (GABA) is a neurotransmitter which inhibits neuronal activity. Activity of the post-synaptic neuron is lessened, meaning messages are less likely to be passed from one neuron to another. BZs combine with GABA receptors on neurons to open the receptors, allowing chloride ions to flow in to the neuron. This makes it more responsive to GABA and less responsive to other neurotransmitters, leading to a reduction of neural activity and a reduction of anxiety.

Beta-blockers (BBs): These act on the sympathetic nervous system and are working around the body, not just in the brain. In the stress response, hormones such as adrenaline and noradrenaline combine with ‘beta-adrenergic’ receptors on cells, leading to increased heart rate, blood pressure and so on. BBs block these receptors, reducing the effect of the stress hormones. This leads to lowered heart rates and reduced blood pressure. Different BBs have been developed which can have effects on specific organs. As they reduce anxiety without directly affecting the brain, the person remains fully alert, so they can be used as performance-enhancing drugs in sports which require precision, such as shooting. For this reason, they are banned substances according to the International Olympic Committee.

Evaluation:

Baldwin et al (2013) reviewed studies involving BZs or placebos, and found that BZs were significantly better at reducing anxiety. This suggests the chemical effect the drug is having works, so is an effective treatment for stress.
Kelly (1980) found that BBs are an effective treatment for everyday anxieties, and can be used to manage social anxiety disorder. This therefore supports the use of BBs to manage stress.
Drugs can have side effects, which can be quite serious. BZs are associated with drowsiness, weight gain, and even criminal behaviour in some cases. BBs are not suitable for people with severe depression or diabetes. Therefore, the use of drug therapy is limited, as the side effects may mean that many people may stop taking the medication.
Drugs treat the physiological symptoms of stress, but do not address the cause, as when the drug is stopped the symptoms of stress reappear. Therefore, a psychological therapy may be a better long-term solution.

Stress Inoculation Therapy

Stress inoculation therapy (SIT) is a psychological method of stress management which aims to change the way a person thinks about or perceives a potentially stressful situation- so it is based on the cognitive approach. Meichenbaum and Cameron (1973) identified three stages of SIT.

Conceptualisation phase: The client is educated about the causes and types of stress, and works with the therapist to identify particular stressors in their life. The aim is to get the client to see that stressors can be overcome, by accepting that they can change aspects of their situation (even if there are other aspects that can’t be changed).

Skills acquisition/rehearsal phase: The client is taught skills to cope with stressors. For example, relaxation, social skills, and cognitive restructuring- thinking about the stressor in a more positive way. They are taught to avoid negative thoughts and be more positive with themselves, and what to do when they face a stressful situation.

Real-life application/follow-through phase: Having practiced the above skills, the client puts them into practice in a safe environment- for example through role-playing their response to a stressful situation. They may be set tasks to apply the techniques in mildly stressful situations. The client gradually takes more responsibility for this as time goes on. Any setbacks are cognitively restructured as ‘learning opportunities’ rather than ‘failures’. The client is encouraged to see things as in their control (an internal locus of control).

SIT tends to last for 9-12 sessions of around 90 minutes, over a period of a few weeks or months. There will be follow-up sessions after the therapy ends.

Evaluation:

Saunders et al (1996) found in a meta-analysis of 37 studies that SIT is effective for reducing anxiety and enhancing performance in situations such as exams. It was as effective for extreme anxiety as moderate anxiety. This supports the use of SIT in managing stress, and suggests it can be used in a range of situations.
SIT takes quite a lot of time and cognitive effort, as it involves fundamentally changing the way a person thinks. Clients need to be highly motivated to take part. This potentially weakens the use of SIT, as it may not be suitable for all people. Drug therapy, on the other hand, involves no effort besides remembering to take a pill.
Although SIT can be a difficult and involved therapy, the strength of this is that is can be used for future stressors, as the techniques and skills learned can be put into practice before a stressor can have an effect. This makes SIT more effective than drug therapy, for instance, as it is treating the causes of stress rather than just managing the physiological response.