eliseahoward.files.wordpress.com€¦ · web viewthere are also a few well-established and...
TRANSCRIPT
![Page 1: eliseahoward.files.wordpress.com€¦ · Web viewThere are also a few well-established and effective programs that help college students in general to reduce stress during times](https://reader038.vdocuments.us/reader038/viewer/2022100911/5aeb7b257f8b9a3b2e8e0801/html5/thumbnails/1.jpg)
Literature Review:
Stress
Stress 2: Gladys Galvez, Elise Howard, Meena Larijani, Rosa Michos, Abby Schwartz, Stephanie Serrano, Annie Yeung
BBH 416, Section 001
Instructor: Dr. Linda Wray
January 24, 2013
![Page 2: eliseahoward.files.wordpress.com€¦ · Web viewThere are also a few well-established and effective programs that help college students in general to reduce stress during times](https://reader038.vdocuments.us/reader038/viewer/2022100911/5aeb7b257f8b9a3b2e8e0801/html5/thumbnails/2.jpg)
Introduction
Every individual has fallen victim to the draining and tiring attributes of stress, regardless
of its cause. Whether driven from school or work responsibilities, stress seems to be a universal
phenomenon. Yet the ways in which one copes with these events are subjective and instinctive.
Modern day-to-day living is full of grueling demands and persistent deadlines that cause us to
constantly feel “stressed” and, nonetheless, we continue to follow the same patterns and routines,
keeping stress a normal feature of life. While there is a positive side to stress—eustress, defined
as “psychological stress interpreted as being beneficial for the experiencer”—we more often than
not think of the negative side of stress, which is the body’s normal response to threatening and/or
upsetting events that upset the balance of the body (Merriam-Webster dictionary, 2012).
Regardless of age, modern day-to-day life entails social, physical, emotional and
intellectual demands, and our bodies produce biological responses to compensate for this change
in our lives. The stress response is a biological process, in which the brain and the nervous
system release hormones and chemicals to alert the body to prepare for action. For example, the
nerves you feel before a final exam are a part of the natural stress response of the body; the sweat
you produce in a life-threatening situation is also a part of the natural stress response. Many
people do not recognize the signs and symptoms of being overly stressed, which can be
detrimental to your not only your current state of health but especially to your future state of
health (“The University Health”, 2012). It is crucial for all individuals, including college
students, to recognize the triggers of stress and formulate ways in which to cope with them and
eventually eliminate the stressful feeling from your mind.
The Problems with Stress
![Page 3: eliseahoward.files.wordpress.com€¦ · Web viewThere are also a few well-established and effective programs that help college students in general to reduce stress during times](https://reader038.vdocuments.us/reader038/viewer/2022100911/5aeb7b257f8b9a3b2e8e0801/html5/thumbnails/3.jpg)
Everybody experiences stress at some point in their lives, and college students perhaps
more so. Studies have documented that stress has been a problem in college students in the past
and that it is growing. A 1999 study of United States college freshmen found that 30% of the
students reported feeling overwhelmed during their college experience, up from 16% in 1985
(Egan & Moreno, 2011). This same study found that 28% of females and 27% of males reported
that their stress levels were high enough that it negatively affected their academic work. More
recently, a study by the same researchers conducted on the interactions and statuses on Facebook
found that 36.8% of the 300 profiles of college freshmen referred to being stressed. Interactions
referring to stress occurred mostly around the months leading up to their first semester in college
and continued to remain at high levels through to returning from winter break. These stress
references were predominantly taken from status updates and centered around ambiguous
stressors and depressive references as well as weight concerns (Egan & Moreno, 2011).
But what is the cause of this clear increase in stress during the college years? Two types
of stressors may contribute to a person’s overall stress level: life events or experiences with
change accumulated over one’s lifespan, and chronic strains resulting from role overloads
(Pearlin, 1989). Although college students certainly experience changes in their lives as they
transition from high school to greater independence in college, Hudd and colleagues (2000),
indicate that the most common stressors experienced by college students are chronic strains
For example, Ross, Niebling & Heckery (1999) created the Study Stress Survey to
identify why college students were feeling more stressed and identified four categories of
stressors: Intrapersonal (e.g., change in sleeping and eating habits, new responsibilities),
interpersonal (e.g., roommate conflicts, fights with a significant other), environmental (e.g.,
vacation/breaks, longs lines, computer problems), and academic (e.g., increased workload,
![Page 4: eliseahoward.files.wordpress.com€¦ · Web viewThere are also a few well-established and effective programs that help college students in general to reduce stress during times](https://reader038.vdocuments.us/reader038/viewer/2022100911/5aeb7b257f8b9a3b2e8e0801/html5/thumbnails/4.jpg)
searching for graduate schools or jobs). Nearly 4 in 10 (38%) of the survey respondents reported
that their stress was mainly due to intrapersonal reasons, while 28% reported environmental
reasons, 19% interpersonal reasons, and 15% academic reasons. Importantly, all of the 19% who
reported that interpersonal reasons were the cause of their increased stress levels described them
as daily. These interpersonal stressors could underlie why college students not only experience
more stress, but also experience high levels of it regularly. The top five stressors reported in the
Student Stress Survey were: change in sleeping habits, vacation/breaks (as they are difficult to
transition from), change in eating habits, increased workload, and more responsibilities (Ross,
Niebling & Heckery, 1999).
Prolonged exposure to stressors can result in negative behavioral, psychological, and
physiological outcomes. The behavioral aspect is very concerning especially regarding students
enrolled in majors with curricula centered on health and caring; they tend to have higher rates of
burnout and other stress-related issues. Burnout or, emotional exhaustion may lead to ineffective
academic and professional behaviors. Ultimately, this could lead to poor grades and a decline in
the quality of care that the student may provide to patients (Murff, 2005). Studies have also
shown that prolonged exposure to stressors are more likely to lead to negative health behaviors
like smoking, drinking, and illicit drug use, which may be used as coping mechanisms (Sinah,
2008). Along with higher affinity to abusing alcohol and illicit drugs, stress has been shown to
increase poor diet habits and decrease physical exercise which can lead to related diseases.
On the topic of stress and psychology, studies have shown a positive correlation with
prolonged exposure to high amounts of stress and mental illnesses. In particular, high levels of
stress has been linked to mental health issues like depression, anxiety, and suicide ideation
(Hudd et al., 2000). Stress also affects physiological processes within the body. High levels of
![Page 5: eliseahoward.files.wordpress.com€¦ · Web viewThere are also a few well-established and effective programs that help college students in general to reduce stress during times](https://reader038.vdocuments.us/reader038/viewer/2022100911/5aeb7b257f8b9a3b2e8e0801/html5/thumbnails/5.jpg)
stress has been associated with the development of gastric ulcers, which may be caused by long
exposure time to higher amounts of adrenaline released during a stress response.Stress responses
also raise blood pressure which can cause lasting damage to the circulatory system, especially to
the heart. Another pressing problem with increased exposure to stress is the possible suppression
of the immune system. There is a delicate balance between a beneficial amount of stress and a
detrimental amount. When the body is overwhelmed with the amount of stress, immune defenses
decrease and make the body more susceptible to infections and decrease internal homeostasis
(McLeod, 2010).
The American Psychology Association (2010) reported on the frequency of negative
health outcomes due to stress. Nearly 3 in 10 (reported having stress-related high blood pressure
(29%), high cholesterol (28%); 25% reported being overweight or obese and 14% showed
clinical signs of depression. The report’s consensus was that stress is related to many diseases
and illnesses experienced by the population (American Psychological Association, 2010).
The literature on stress management is largely comprised of information on programs
aimed at helping students manage stress, but there is a dearth of studies examining the
effectiveness of stress management programs in populations of healthy college students. Many
stress reduction intervention programs range from workshops based on ways to develop
problem- and emotion-focused coping strategies to online stress management programs.
Few existing studies describe successful stress management interventions in college
students. In 2007, a stress management program attempted to lessen the mounting pressures and
rigors of medical school. Researchers at the Oklahoma State University Center for Health
Sciences created a rather revolutionary mentor-based program called the Stress Management
![Page 6: eliseahoward.files.wordpress.com€¦ · Web viewThere are also a few well-established and effective programs that help college students in general to reduce stress during times](https://reader038.vdocuments.us/reader038/viewer/2022100911/5aeb7b257f8b9a3b2e8e0801/html5/thumbnails/6.jpg)
Program. This program is essentially a voluntary intervention that involved small groups of first-
year medical students meeting with second-year student co-leaders who were trained by
Psychology faculty members who also served as program coordinators (Redwood, 2007). At the
beginning of the fall semester, each group met one hour per week for seven consecutive weeks.
The objectives of the Stress Management Program included easing the transition of first-year
students to medical school, promoting personal stress management skills, maintaining a peer
support system, and creating a confidential outlet for discussing any concerns. Most participants
agreed that the program enabled them to manage stress more effectively. After 16 years, the
program remains an important part of the medical school curriculum and culture (Redwood,
2007). Its use of small groups, transition-timing considerations, validation of importance of
stress management from faculty, and student feedback are key factors in the success of the Stress
Management Program.
Other programs have also been successful in alleviating the harmful effects of stress.
Computer-based programs offer students a confidential, nonjudgmental forum to disclose
personal information. This increased honesty may positively impact knowledge, attitudes, or
behaviors (Chiauzzi, Brevard, Thurn, Decembrele, & Lord, 2008). Studies comparing
questionnaires delivered through interviews, self-administration, and computer-assisted
administration have found that respondents are more likely to self-disclose sensitive information
regarding risk behaviors (Hamby, Sugarman, & Boney-McCoy, 2006). One such study explored
the use of a computer-based program called MyStudentBody-Stress, which was developed to
provide students with individualized motivational feedback about stress management, online
stress management tools, peer stories, and stress management strategies (Chiauzzi et al., 2008).
MyStudentBody-Stress allowed college health educators to connect with the entire student body
![Page 7: eliseahoward.files.wordpress.com€¦ · Web viewThere are also a few well-established and effective programs that help college students in general to reduce stress during times](https://reader038.vdocuments.us/reader038/viewer/2022100911/5aeb7b257f8b9a3b2e8e0801/html5/thumbnails/7.jpg)
to offer stress management education as well as intervention. However, the computer-based
program alone is not enough.
Some researchers have suggested that future studies explore the combination of
computer-based intervention and face-to-face intervention in order to achieve greater effects. In
one study that explored the effectiveness of blending online and person-to-person interaction, the
authors maintained that this combination may lead to more behavior change than traditional face-
to-face interaction (Williams, 2011). On an individual level, future research must determine
which individual characteristics, such as self-efficacy, might predict a positive response to online
intervention alone, or in accordance with face-to-face counseling intervention. Due to college
students' apparent lack of interest in formal intervention, the population-based dispersal of
information available via the Internet overcomes traditional outreach barriers (Chiauzzi, Brevard,
Thurn, Decembrele, & Lord, 2008). Interventions such as MyStudentBody–Stress can overcome
other logistical barriers, since the intervention is available at any time of day, can be accessed
confidentially, and can help students take more responsibility for their personal health.
The most commonly tested stress interventions are based on the influential work of
Lazarus and Folkman (1984), who developed a cognitive-behavioral theory that emphasizes the
importance of cognitive appraisals and coping responses. This theory uses the Transactional
Model of Stress and Coping as a framework for evaluating the processes of coping with stressful
events. Stressful experiences are interpreted as person-environment transactions. These
transactions depend on the impact of the external stressor. First, this is mediated by the person’s
appraisal of the stressor and secondly on his or her social and cultural resources (Lazarus &
Folkman, 1984). Generally any cognitive therapy technique, such as modeling or role-playing,
can be integrated into a stress management program.
![Page 8: eliseahoward.files.wordpress.com€¦ · Web viewThere are also a few well-established and effective programs that help college students in general to reduce stress during times](https://reader038.vdocuments.us/reader038/viewer/2022100911/5aeb7b257f8b9a3b2e8e0801/html5/thumbnails/8.jpg)
Unfortunately, a majority of these studies have limitations that lessen effectiveness. For
instance, the counseling staff in workplaces and college campuses is often not able tend to the
needs of the population (Gallagher, Gill, & Zhang, 2001). In addition, college counseling
budgets have fallen due to the economy, which have made stress management interventions
difficult to implement (Kitzrow, 2003). Furthermore, students tend to not make the effort to
attend stress management seminars or clinics. The Stress Management Program at the Oklahoma
State University Center for Health Sciences may provide volunteer, peer-led counseling, but it
only addresses the needs of first-year medical students. Stress is likely to accumulate throughout
the undergraduate years—long before the first stressful year of medical school, law school, or
other graduate school programs.
What is not known about the problem with stress?
Today, students at all levels of education face increased pressure and stress to succeed
while managing studies, examinations and free time, all the while being continually plagued by
the pressure to pull through it all. Stress may in some aspects be good because it compels you to
continually take the action of reaching your personal goals but the constant wear and tear on your
body does take its toll. According to a study conducted by Behere and colleagues in nursing and
medical students, they measured stress on a yes or no questionnaire that would evaluate the
nature of the demand, the available resources, personal skills, and the presumed outcomes, that
will determine whether stress is experienced (Behere 2011). They found that female students had
better stress-coping skills compared to male sudents but the intervention itself did not result in
the students experiencing stress reduction. Behere’s explanation is simple: everyone responds
differently to stress and one-size-fits-all methods to reduce stress may not be effective.
![Page 9: eliseahoward.files.wordpress.com€¦ · Web viewThere are also a few well-established and effective programs that help college students in general to reduce stress during times](https://reader038.vdocuments.us/reader038/viewer/2022100911/5aeb7b257f8b9a3b2e8e0801/html5/thumbnails/9.jpg)
Another study found that, “participants only exhibited gains over controls in perceived
improvements, yet engagement in the intervention predicted benefits across all outcomes
assessed (Chen, 1999).” In addition, Conley found that her intervention increased students’
psychosocial skills and stress management skills just by attendance; however, the variability in
attendance could explain inconsistencies in effectiveness and differences in her own and other
mental health prevention initiatives. Conley recommends that, “future research should build on
this use of various assessment methods, to determine which measures of engagement most
effectively capture participants’ involvement in the intervention. In addition, research should
continue to assess multiple aspects of engagement, to determine which aspects most effectively
contribute to beneficial outcomes (Chen, 1999).” Heeding Colleen and Behere’s words, it is
apparent why most stress management programs fail: It is difficult to attract participants and
encourage them to be involved in an intervention; others may choose not to participate because
they feel they have their mental state under control and do not need help responding to stress.
Every human experiences stress at all stages of life, it is just a matter of the stress being good
or bad and how often or how little you experience the stress. Many efforts have been made to
understand and deal with stress related to pregnancy, wor, and school, as well as post-traumatic
stress disorders and depression. Most studies cover how stress affects you but does not maintain
efforts to encourage participation in the study and also does not consider factors of how
differently everyone responds to their own stressors.
When it comes to stress, we feel it is very important to learn various ways to relieve the
anxiety of stressors through ways that suit the individual person. Every person is different so not
every initiative or stress relieving effort will work for everyone. As noted by Charles Chen: in
his statement that, “researchers tend to focus more on the stressor phenomena than on probing
![Page 10: eliseahoward.files.wordpress.com€¦ · Web viewThere are also a few well-established and effective programs that help college students in general to reduce stress during times](https://reader038.vdocuments.us/reader038/viewer/2022100911/5aeb7b257f8b9a3b2e8e0801/html5/thumbnails/10.jpg)
and explaining the psychological dynamics involved in the appraisal process. The Impact of a
stressor is mediated by the person's appraisal of the stressor in terms of risk to the person and his
or her ability to cope with the situation (Chiauzzi, 2008).” Everyone has different skills in
assessing their stress and need to find outlets in order to cope and relieve the tension. In Chen’s
research article, we felt he covered a lot of aspects that would be important in a stress relieving
initiative such as: counseling, building a support group, facilitating self-validation, and
enhancing adaptation competence (Chiauzzi, 2008).
We feel “De-Stress to Be Your Best” will be an improvement on existing stress-reduction
programs because we expect to follow Chen’s recommendations while also incorporating our
own ideas of personalized stress relief activities. We would also incorporate ideas such as: free
exercise classes in the afternoon when cortisol levels are at their highest, nutrition classes for
stress eaters, quiet rooms to conduct school work, free art classes ranging from drawing to
sculpting, as well as guided meditation classes. These are just a few ideas that we would like to
incorporate into a program targeted to relieve the stress levels of our college population.
We would like to know more about the psychological implications that trigger episodes of
stress and methods to relieve stress sooner and more effectively.
Summary
Most studies on stress in college students have demonstrated that college students
experience stress more often than others and experience it chronically and at higher levels.
Stressors experienced from chronic strain of interpersonal stress may cause college students to
experience those stressors on a daily basis. Therefore, it could have more damaging effects
![Page 11: eliseahoward.files.wordpress.com€¦ · Web viewThere are also a few well-established and effective programs that help college students in general to reduce stress during times](https://reader038.vdocuments.us/reader038/viewer/2022100911/5aeb7b257f8b9a3b2e8e0801/html5/thumbnails/11.jpg)
because of constant and prolonged exposure, leading to negative outcomes that are not only
psychologically harmful but behaviorally such as drug and alcohol abuse.
The literature largely describes programs or interventions that aim to help
students manage or coping with stress, finding some success in medical school students. There
are also a few well-established and effective programs that help college students in general to
reduce stress during times of chronic strain that cause changes in sleep or diet or strain from
taking on new responsibilities. Most studies find limited success from stress counseling, classes
or workshops as well as a lack of student participation. The reason may be that every individual
has different ways of assessing and dealing with stressful situations. Therefore, stress relieving
initiatives as well as an incorporation of personalizing stress relief activities would improve
stress levels among students. Such personalizing stress relieving activities would include art,
mediation, nutrition and exercise classes while making it accessible to students. In addition,
promoting and offering stress relief during final exams can be useful, especially because it is a
time when stress is deemed to be the most apparent for college students. A possible strategy
could be animal therapy, in which a puppy visiting center is offered to students during finals
week where students could simply have access to play with the puppies. This gives students a
break and lifts their spirits during that strenuous time of constant studying. Ultimately, a well-
established, effective program to help college students relieve their stress will assist in student’s
attempts to adapt to the stressors of college life.
![Page 12: eliseahoward.files.wordpress.com€¦ · Web viewThere are also a few well-established and effective programs that help college students in general to reduce stress during times](https://reader038.vdocuments.us/reader038/viewer/2022100911/5aeb7b257f8b9a3b2e8e0801/html5/thumbnails/12.jpg)
![Page 13: eliseahoward.files.wordpress.com€¦ · Web viewThere are also a few well-established and effective programs that help college students in general to reduce stress during times](https://reader038.vdocuments.us/reader038/viewer/2022100911/5aeb7b257f8b9a3b2e8e0801/html5/thumbnails/13.jpg)
References
American Psychological Association. (2010, November 09). Stress in America. Retrieved from
http://www.apa.org/news/press/releases/stress/briefing-presentation.pdf
Chen, Charles P., Common Stressors among International College Students: Research and
Counseling Implications, Journal of College Counseling, 1999 Spring, Vol. 2 Issue 1,
p49,
Chiauzzi, Emil. "MyStudentBody-Stress: An Online Stress Management Intervention for College
Students". Journal of Health Communication (1081-0730), 13 (6), p. 555. 2008.
Accessed at http://www.ncbi.nlm.nih.gov/pubmed/18726812 on January 19, 2013.
Conley, Colleen S., Traversa, Lea V., Bryanta, Fred B., Promoting Psychosocial Adjustment and
Stress Management in First-Year College Students: The Benefits of Engagement in a
Psychosocial Wellness Seminar, Journal of American College Health, 13 Dec 2012
http://www.tandfonline.com/doi/full/10.1080/07448481.2012.754757
Egan, K., & Moreno, M. (2011). Prevalence of stress references in college freshmen Facebook
profiles. Computers, Informatics, Nursing, 29(10), 586-592. doi:
10.1097/NCN.0b013e3182160663
Gallagher, R., Sysko, H., & Zhang, B. (2001). National survey of counseling center directors.
Alexandria, VA: International Association of Counseling Services. P112~147. Accessed
at http://www.nacada.ksu.edu/Resources/Clearinghouse/View-Articles/Mental-health
issues-in-advising.aspx on January 19, 2013.
Hudd, S., Dumlao, J., Erdmann-Sager, D., Murray, D., Phan, E., Soukas, N., & Yokozuka, N.
(2000). Stress at college: Effects on health habits, health status, and self-esteem. College
Student Journal,34(2), 217-228. Retrieved from
http://web.ebscohost.com/ehost/detail?sid=ea8e3b2c-40c7-468e-8a86-
391732ff5593@sessionmgr12&vid=1&hid=9&bdata=JnNpdGU9ZWhvc3QtbGl2ZQ
Kitzrow , M. A. “The Mental Health Needs of Today's College Students: Challenges and
Recommendations.” NASPA Journal, 41 , 167–181 . 2003.
![Page 14: eliseahoward.files.wordpress.com€¦ · Web viewThere are also a few well-established and effective programs that help college students in general to reduce stress during times](https://reader038.vdocuments.us/reader038/viewer/2022100911/5aeb7b257f8b9a3b2e8e0801/html5/thumbnails/14.jpg)
McLeod, S. A. (2010). Stress and the Immune System. Retrieved from:
http://www.simplypsychology.org/stress-immune.html
Merriam-webster dictionary. (2012). Stress. Retrieved from http://www.merriam
webster.com/dictionary/stress
Murff, S. (2005). The impact of stress on academic success in college students. ABNF Journal,
16(5), 102-104. Retrieved from:
http://web.ebscohost.com/ehost/pdfviewer/pdfviewer?sid=cab8b139-870d-4165-a48c
e1719185583b%40sessionmgr104&vid=2&hid=112
Pearlin, L. (1989). The sociological study of stress. Journal of health and social behavior, 30(2),
241-256. Retrieved from http://www.jstor.org/stable/2136956?seq=1
Redwood, Susan K. "Student-led stress management program for first-year medical students".
Teaching and learning in medicine (1040-1334), 19 (1), p. 42. January, 2007. Retrieved
From http://www.tandfonline.com.ezaccess.libraries.psu.edu/doi/full/10.1080/10401330
0933622 on January 19, 2013.
Ross, S., Niebling, B., & Heckery, T. (1999). Sources of stress among college students. College
student journal, 33(2), 6. Retrieved from
http://web.ebscohost.com/ehost/detail?sid=a7646fc7-8e45-4242-86a7
8ff7a90c334a@sessionmgr110&vid=1&hid=122&bdata=JnNpdGU9ZWhvc3QtbGl2Z==
Shashank P. Behere, Richa Yadav, and Prakash B. Behere, A Comparative Study of Stress
Among Students of Medicine, Engineering, and Nursing, Indian Journal of Psychological
Medicine. 2011 Jul-Dec; 33(2): 145
148.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3271488/
Sinha, R. (2008), Chronic Stress, Drug Use, and Vulnerability to Addiction. Annals of the New
York Academy of Sciences, 1141: 105–130. doi: 10.1196/annals.1441.030
The university health center. (2012, April 2). Retrieved from http://www.uhs.uga.edu/stress/
Williams, R.A, Gatien, G, Haggerty, B. “Design Element Alternatives for Stress-Management
Intervention Websites.” Nursing Outlook. Volume 59, Issue 5. September-October 2011.
![Page 15: eliseahoward.files.wordpress.com€¦ · Web viewThere are also a few well-established and effective programs that help college students in general to reduce stress during times](https://reader038.vdocuments.us/reader038/viewer/2022100911/5aeb7b257f8b9a3b2e8e0801/html5/thumbnails/15.jpg)
Pages 286-291.e3. Accessed at
http://www.sciencedirect.com.ezaccess.libraries.psu.edu/science/article/pii/S002965541
000868 on January 19, 2013.