Notes · PsychologyUK · A-Levels

Stress

This optional topic examines stress as a psychological and physiological response. It covers the body's stress systems and the general adaptation syndrome, the link between chronic stress and illness, the sources and measurement of stress, individual differences in how people respond, and the drug, psychological and social methods of managing and coping with stress. It is one of the three choices in the second option block of Paper 3.

5 sections~16 min reading time3 competenciesLevel Standard 2 · Advanced 3

T·141414 / 17

Exam profile

AO1 · Describe the physiology of stress, its links to illness, the sources and measures of stress, individual differences and coping methodsAO2 · Apply the models and measures to novel scenarios and dataAO3 · Evaluate the physiological account, the stress-illness evidence, the measures and the coping methods

Operators:describeexplainapplyevaluatediscuss

basic level

This is a full A-Level (A2) optional topic, not part of AS; on Paper 3 students study one topic from this option block (Schizophrenia, Eating behaviour or Stress).

higher level

The full A-Level requires description, application and evaluation of the physiology of stress, its links to illness, its sources and measurement, individual differences and methods of coping.

Depth

Text

Contents · 5 sections

Stress

The physiology of stress: GAS, the HPA axis and the SAM pathway#

AdvancedAQA 7182 3.3.7DfE GCE Psychology - the physiology of stress

The HPA axis

Fig. 1The HPA system: the hypothalamus (CRH), pituitary (ACTH) and adrenal cortex release cortisol, which raises energy but suppresses immunity.

The body responds to stressors through two systems that operate over different timescales. The sympathomedullary (SAM) pathway is the fast, acute response: the hypothalamus activates the sympathetic branch of the autonomic nervous system, which stimulates the adrenal medulla to release adrenaline and noradrenaline, producing the immediate fight-or-flight changes (raised heart rate, blood pressure and breathing). This is the same pathway met in biopsychology, and it deals with short-term, acute stress.

The hypothalamic-pituitary-adrenal (HPA) system is the slower response to chronic (ongoing) stress. The hypothalamus releases a hormone (CRH) that stimulates the pituitary gland to release ACTH, which travels in the blood to the adrenal cortex and triggers the release of cortisol. Cortisol has useful short-term effects (it releases stored energy and reduces inflammation), but when it is chronically elevated it has harmful effects, including the suppression of the immune system. Cortisol levels are regulated by negative feedback, so that high cortisol eventually reduces the release of CRH and ACTH.

Selye's general adaptation syndrome (GAS) describes how the body responds to prolonged stress in three stages. In the alarm stage, a stressor triggers the fight-or-flight response and the body's resistance briefly dips before rising. In the resistance stage, the body adapts and copes with the ongoing stressor, maintaining an above-normal level of resistance (mainly via cortisol), so the person may appear to be coping. In the exhaustion stage, if the stressor continues, the body's resources are depleted, resistance collapses below normal, and stress-related illnesses (and adrenal problems) can appear.

The physiological account is evaluated as well evidenced but limited. Its strengths are strong biological support and the useful distinction between acute (SAM) and chronic (HPA) responses. Its limitations are that Selye's GAS was based largely on animal (rat) studies and assumes a single, uniform response to all stressors, whereas humans show important psychological and individual differences (the same event is stressful for one person and not another); it also underplays the role of cognitive appraisal (how we interpret a stressor) and, being based on male-dominated research, may miss gender differences such as the proposed 'tend and befriend' response in females.

The general adaptation syndrome

Fig. 2Selye's GAS: resistance dips (alarm), rises above normal (resistance), then collapses (exhaustion) under prolonged stress (illustrative pattern).

Worked example

Applying the GAS stages

A student under exam pressure copes well for weeks but then, near the end, becomes constantly ill and exhausted. Explain this using the general adaptation syndrome.

Alarm and resistance
The initial pressure triggers the alarm reaction; the student then enters the resistance stage, coping with above-normal resistance sustained by cortisol.
Prolonged stress
Because the stressor continues for weeks, the body's resources are gradually depleted.
Exhaustion
Eventually resistance collapses into the exhaustion stage, and, with cortisol having suppressed the immune system, the student becomes ill and exhausted.

Result: Sustained stress moves the student from resistance into exhaustion, where depleted resources and immune suppression cause illness.

Typical mistakes

Confusing the SAM pathway (adrenaline, fast) with the HPA system (cortisol, slow).
Saying resistance is highest in the alarm stage - it dips first, then rises in the resistance stage.

Active revision

Describe the role of cortisol in the body's response to chronic stress, and one harmful effect of prolonged high cortisol.

Active recall

Recall the key points — then reveal.

Sources: GCE AS and A level subject content for psychology (Department for Education) · AQA A-level Psychology 7182 specification (AQA)

Stress and illness: the immune and cardiovascular systems#

AdvancedAQA 7182 3.3.7DfE GCE Psychology - the role of stress in illness

Chronic stress is linked to physical illness, and two systems are on the specification. Stress affects the immune system: the sustained high cortisol of prolonged stress suppresses the activity of the immune system (for example, reducing the production and activity of white blood cells such as natural killer cells), so a chronically stressed person is more susceptible to infection and slower to recover.

The classic evidence comes from Kiecolt-Glaser's research. In one study, medical students' immune function (measured by natural killer cell activity) was lower during the high-stress period of their exams than a month earlier during the holidays, showing that a real-life stressor reduced immune activity. In another, the wounds of highly stressed carers healed more slowly than those of matched controls, linking stress to slower physical healing.

Stress also affects the cardiovascular system. Repeated activation of the stress response raises heart rate and blood pressure, and over time this can damage blood vessels and contribute to cardiovascular disorders such as hypertension and coronary heart disease. Stress also promotes unhealthy behaviours (smoking, poor diet) that add to cardiovascular risk, so its effect on the heart is both direct (physiological) and indirect (behavioural).

The stress-illness link is evaluated for its evidence and its complications. The immune research has good real-world relevance and uses objective physiological measures. However, much of the evidence is correlational (stressed people also differ in other ways, such as diet and sleep, which confound the link), individual differences are large (not everyone who is stressed becomes ill), and the relationship is not simple - short-term stress can actually enhance immune function, so it is chronic stress that is harmful. Establishing that stress causes illness (rather than merely being associated with it) is therefore methodologically difficult, which is important for evaluating any claim in this area.

Worked example

Interpreting an immune-function study

Medical students show lower natural killer cell activity during exams than during the holidays. Explain what this suggests and one limitation.

State the finding
Immune activity (natural killer cells) was lower during the high-stress exam period than during the low-stress holiday period.
Draw the inference
This suggests that a real-life stressor suppresses immune function, plausibly via chronically raised cortisol, increasing vulnerability to illness.
Note a limitation
The design is correlational and other exam-period factors (poor sleep, poor diet) could also lower immune function, so stress cannot be isolated as the sole cause.

Result: The study links a real stressor to reduced immune activity, though confounds mean causation is not proven.

Typical mistakes

Saying all stress harms the immune system - short-term stress can enhance it; chronic stress suppresses it.
Treating correlational stress-illness findings as proof that stress causes illness.

Active revision

Explain why highly stressed carers might heal more slowly from a small wound than matched controls.

Active recall

Recall the key points — then reveal.

Sources: GCE AS and A level subject content for psychology (Department for Education) · AQA A-level Psychology 7182 specification (AQA)

Sources of stress: life changes, daily hassles and the workplace#

StandardAQA 7182 3.3.7DfE GCE Psychology - sources of stress

Life change and illness

Fig. 3Higher life-change scores tend to be associated with more illness - a positive correlation (illustrative data reflecting Holmes and Rahe's pattern).

The specification identifies several sources of stress. Life changes are major events that require significant adjustment, whether negative (bereavement, divorce) or positive (marriage, a new job): the demand to readjust is itself stressful. Holmes and Rahe argued that the accumulation of such changes over a period raises the risk of stress-related illness, and built the Social Readjustment Rating Scale to measure it (see the next section).

Daily hassles are the minor, everyday irritations of life - traffic jams, misplaced keys, disagreements - which, though individually trivial, may accumulate and, some argue, predict stress and ill health better than major life changes because they are so frequent. The 'uplifts' that accompany them (small pleasant events) may buffer their effect. The debate over whether life changes or daily hassles are the more important source of stress is a key evaluation point.

Workplace stress arises from features of the working environment. Two are highlighted: workload (having too much - or too little - to do, and unrealistic deadlines) and control (the degree to which a worker feels they have control over their work). Research (e.g. Marmot's Whitehall studies of civil servants) found that workers in lower-status jobs with less control over their work had higher rates of stress-related illness, suggesting that low control is a particularly important workplace stressor.

The sources of stress are evaluated for how they are measured and for individual differences. Much of the evidence relies on self-report scales, which are open to bias and to the problem that life changes and daily hassles overlap. The relationships found are correlational, so a stressor and illness may be linked without one causing the other, and the same event affects people very differently depending on how they appraise it and their personality - which is why the topic goes on to consider individual differences and coping.

Worked example

Comparing sources of stress

One person points to a recent divorce as their main source of stress; another points to daily commuting and constant small frustrations. Discuss which source research suggests is more predictive of ill health.

Identify the two sources
The first is a major life change; the second is an accumulation of daily hassles.
Weigh the evidence
Some research finds that daily hassles predict stress and illness better than major life changes, because they are so frequent and their effects accumulate (and lack the buffering of uplifts).
Reach a balanced conclusion
Both are valid sources; the evidence gives daily hassles a strong claim, but the two overlap and individual appraisal matters, so neither can be declared the sole important source.

Result: Research gives daily hassles a strong claim to predict ill health, though life changes and individual appraisal also matter.

Typical mistakes

Assuming only negative life changes are stressful - positive changes (marriage, a new job) also require readjustment.
Treating a correlation between life changes and illness as proof that life changes cause illness.

Active revision

Explain why low job control might be a more damaging workplace stressor than a heavy workload, using research evidence.

Active recall

Recall the key points — then reveal.

Sources: GCE AS and A level subject content for psychology (Department for Education) · AQA A-level Psychology 7182 specification (AQA)

Measuring stress and individual differences#

StandardAQA 7182 3.3.7DfE GCE Psychology - measuring stress and individual differences

Stress is measured in two broad ways. Self-report scales ask people about the stressors they have experienced: the Social Readjustment Rating Scale (SRRS) assigns each life event a number of 'life change units' (LCUs) reflecting how much readjustment it requires (death of a spouse is the highest), and a person's LCUs over a period are summed to estimate their stress; the Hassles and Uplifts Scale measures the minor daily stressors and pleasures instead. Physiological measures assess the body's stress response directly, such as the skin conductance response (which rises with sweating during arousal) and levels of cortisol.

The two kinds of measure have complementary strengths and weaknesses. Self-report scales are quick and easy and capture the person's own experience, but they rely on memory and honesty, may be affected by social desirability, and (for the SRRS) treat an event as equally stressful for everyone, ignoring individual appraisal. Physiological measures are objective and not open to deliberate bias, but they are affected by other factors (exercise, caffeine, illness) and cannot tell us what the person is stressed about.

Individual differences mean the same stressor affects people very differently. Personality types A, B and C are one factor. Type A people are competitive, impatient and hostile and are associated (in the classic Friedman and Rosenman research) with a higher risk of coronary heart disease; Type B people are relaxed and easy-going and at lower risk; and Type C people are described as suppressing their emotions, which some link to cancer. Hardiness (Kobasa) is a personality style that buffers stress, made up of the 'three Cs': commitment (being involved), challenge (seeing change as an opportunity), and control (believing one can influence events).

The measures and individual differences are evaluated for validity and evidence. The SRRS has been influential and has predictive value, but treating events as objectively equal and ignoring positive/negative differences is a weakness, and its correlations with illness are modest. The Type A-CHD link has mixed support (some later studies find hostility, rather than the whole Type A pattern, is the key risk factor), and hardiness research is largely correlational and based on self-report. The overall message is that stress is not a fixed property of an event but depends on the person - which is why coping strategies matter.

Worked example

Using life change units

Over the past year a person experienced a divorce (73 LCUs), a change of job (36 LCUs) and a move of house (20 LCUs). Calculate their total life-change score and comment on its interpretation.

Sum the units
Total LCUs = 73 + 36 + 20 = 129.
$73 + 36 + 20 = 129 \ \text{LCUs}$
Interpret against the scale
On the SRRS a higher total is associated with a greater risk of stress-related illness, so 129 LCUs indicates a moderate accumulation of readjustment demand.
Add a caution
The scale treats each event as equally stressful for everyone and ignores how the person appraised it, so the score is only a rough, self-report estimate.

Result: A total of 129 LCUs indicates moderate life-change stress, but the SRRS ignores individual appraisal.

Typical mistakes

Saying the SRRS measures daily hassles - it measures major life changes in life change units.
Forgetting one of Kobasa's three Cs (commitment, challenge, control).

Active revision

Explain one strength and one weakness of using the Social Readjustment Rating Scale to measure a person's stress.

Active recall

Recall the key points — then reveal.

Sources: GCE AS and A level subject content for psychology (Department for Education) · AQA A-level Psychology 7182 specification (AQA)

Managing and coping with stress#

AdvancedAQA 7182 3.3.7DfE GCE Psychology - managing and coping with stress

Methods of coping with stress

Fig. 4Biological methods (drugs) act fast but superficially; psychological methods (SIT, biofeedback) are more lasting but demanding; social support buffers stress.

Methods of managing stress divide into biological and psychological approaches. Drug therapy targets the physiology of the stress response. Benzodiazepines (BZs) enhance the action of the neurotransmitter GABA, which has a general inhibitory (calming) effect on the brain, reducing anxiety. Beta blockers reduce the physical symptoms of stress by blocking the action of adrenaline on the heart and blood vessels, lowering heart rate and blood pressure. Drugs act quickly and require little effort, but they treat symptoms rather than the source of stress, can have side effects and cause dependence (BZs), and their effects stop when the drug stops.

Stress inoculation therapy (SIT), developed by Meichenbaum, is a cognitive-behavioural approach that 'inoculates' a person against future stress in three phases. In the conceptualisation phase the therapist and client identify and analyse the sources of stress. In the skills acquisition phase the client learns coping skills (relaxation, positive self-talk, problem-solving). In the application phase the client practises these skills, first in imagined or role-played situations and then in real life, building resilience. SIT tackles the cause and gives lasting skills, but it is time-consuming, requires effort and motivation, and may be more than is needed for a specific, short-term stressor.

Biofeedback is a technique in which a person is given real-time information (feedback) about a physiological process - such as their heart rate or muscle tension - via a monitor, and learns, through operant conditioning and relaxation, to bring that process under voluntary control, so reducing the physical stress response. It gives the person genuine control and no side effects, but it requires equipment and training and may work mainly through the relaxation it teaches rather than the feedback itself.

Individual and social factors also affect coping. Gender differences are proposed - the 'tend and befriend' response suggests women may respond to stress by seeking social contact and caring for others rather than by fight or flight - though this is debated. Social support (emotional, instrumental and informational support from others) buffers the effect of stress and improves coping and health. The methods are evaluated on effectiveness and appropriateness: biological methods are fast but superficial and risk dependence, psychological methods are more lasting but demanding, and combining them - together with strong social support - is generally most effective.

Worked example

Recommending a coping method

A person wants a long-term way to handle recurring work stress and dislikes the idea of medication. Recommend a method and justify it.

Rule out the rejected option
The person dislikes medication, and drugs treat symptoms rather than the source, so a psychological approach is preferable.
Recommend SIT
Stress inoculation therapy teaches lasting coping skills (through conceptualisation, skills acquisition and application) that tackle the source of the stress and build resilience against future stressors.
Add social support
Encouraging the use of social support would further buffer the work stress, complementing the skills learned in SIT for a durable, non-pharmacological plan.

Result: Stress inoculation therapy, reinforced by social support, gives a lasting, drug-free way to manage recurring stress.

Typical mistakes

Confusing benzodiazepines (enhance GABA, reduce anxiety) with beta blockers (block adrenaline, reduce physical symptoms).
Omitting a phase of stress inoculation therapy (conceptualisation, skills acquisition, application).

Active revision

Compare drug therapy and stress inoculation therapy as methods of managing stress, referring to effectiveness and appropriateness.

Active recall

Recall the key points — then reveal.

Sources: GCE AS and A level subject content for psychology (Department for Education) · AQA A-level Psychology 7182 specification (AQA)

References & sources

Sources

Department for Education

GCE AS and A level subject content for psychology

AQA

AQA A-level Psychology 7182 specification

Stress

5 sections~16 min reading time3 competenciesLevel Standard 2 · Advanced 3

Stress

Key points

Applying the GAS stages

Key points

Interpreting an immune-function study

Key points

Comparing sources of stress

Key points

Using life change units

Key points

Recommending a coping method

Sources

Stress

Key points

Applying the GAS stages

Key points

Interpreting an immune-function study

Key points

Comparing sources of stress

Key points

Using life change units

Key points

Recommending a coping method

Sources