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STRESS MANAGEMENT

Module Overview

 What is Stress

 Body Responses to Stress

 Benefits and Costs of Stress

 Stress Management

 A Prescription for Stress Management

 e-Resources

Module Objectives:

This module will provide you the opportunity to:

 Define key terms related to stress, the stress response, and stress management.

 Explain the physiological and psychological changes that occur in response to stress.

 Identify the positive and negative effects of stress.

 Identify various stress management techniques and the benefits of each technique.

 Explore and apply the content in a personally meaningful manner.

Key Terms

Cognitive restructuring

A technique that involves the identification, challenging, and replacement of irrational or maladaptive

thoughts with more rational, adaptive, or positive thoughts.

Diaphragmatic breathing

A relaxation technique consisting of deep abdominal breathing designed to expand and contract the

diaphragm, slow breathing, and regulate oxygen intake.

Fight-or -flight response

Activation of the sympathetic nervous system that occurs in response to a stressor and prepares the organism

for dealing with a stressor.

Guided imagery

A relaxation technique involving the use of language to create calming, sensory rich experiences in one's

imagination.

Homeostasis

A return to equilibrium following activation of the stress response system.

Meditation

A relaxation technique that combines focusing on a specific object or sensation while disengaging from other

distracters and regulating internal experiences through non-judgmental acceptance.

Progressive muscle relaxation (PMR)

A relaxation technique involving the repeated tensing and relaxing of various muscle groups throughout the

body.

Stress

Emotional, cognitive, behavioral, and physiological reactions a person experiences in response to

environmental threats or demands.

Stress hormones

Hormones, including Cortisol and Norepinephrine, that are released by the body during a fight-or-flight

response.

Stressor

Any event or stimulus that causes stress.

Yerkes-Dodson Law

Law dictating that physiological and mental functioning is optimal at mild to moderate levels of arousal, but

diminishes as arousal becomes extreme (high or low).

What is Stress?

Although "stress" is a commonly used term in today's vernacular, and most people appear to have an intuitive

sense of what it means, stress is difficult to precisely define as it is often used interchangeably with a variety of

other terms, such as anxiety, pressure, or strain. In a general sense, stress refers to a collection of

physiological, emotional, behavioral and cognitive reactions that occur in response to environmental

demands. As we interact with the world around us, we must make constant appraisals of environmental

threats, challenges, and demands and attempt to cope with any issues that arise. At times, environmental

demands are easily handled, such as when you have to press a button on a key to unlock your car. However, at

other times, the demands of the environment can seem daunting or unmanageable, such as when you have to

take three exams on the same day, and result in feelings of physical tension, negative thought patterns, and

unpleasant emotional experiences. Lazarus and Folkman (1984) suggested that stress results when the

demands of the environment are greater than the individual's perceived coping resources.

A "stressor" is any event or stimulus that causes stress. However, what serves as a stressor for one person

may not be the same for another. For example, being asked to attend a social event may create stress for

someone who perceives that they lack the necessary social skills to fit in, whereas another person who feels

comfortable in social situations may not experience any stress. Stressors can take many forms, ranging from

the daily hassles of life to significant life changes. Daily hassles are the regularly occurring events or situations

that we experience in everyday life, such as misplacing items, concerns about weight, or having to wait your

turn. Any one of these events is unlikely to have a major impact on our overall quality of life. In contrast, life

changes, such as death of a family member, getting married, or a negative health diagnosis are more

significant. Notice that not all stressors are negative. Getting married, having children, and starting a new job

are often positive experiences, though they can create a significant amount of stress because they require us

to alter our lives and adjust to new circumstances.

College is a transitional time of life when new and unique stressors are often being encountered. Not only are

college students often away from home for the first time and forced to be more self-sufficient, but they must

also cope with the increasing demands of the academic environment. Changes in sleep and eating habits,

increased financial responsibilities, having to share living space and possessions with strangers, and increased

exposure to alcohol, drugs, and sex are only a few of the additional stressors often encountered by college

students. To exacerbate matters, college students are often forced to cope with the challenges of college

stressors with reduced access to their traditional support systems, such as family and long-time friends. Thus,

it is important for college students to increase their awareness about stress, the impact that excessive stress

can have on physical and mental health, and various coping strategies and techniques available to help cope

with the challenges of the college environment.

Body Responses to Stress

When threatened by environmental dangers, changes, or demands, humans experience a variety of

physiological and psychological changes. Once a threat has been recognized and appraised as dangerous, the

individual evaluates available coping resources. If the demands of the situation are deemed to be greater than

the available coping resources, an " a larm" or "Fight -or- Flight Response" is generated. During the fight-or-flight

response, the body prepares for action, generally consisting of either confrontation or avoidance of the threat.

The sympathetic nervous system is activated, and hormones, including adrenaline and noradrenaline, are

released into the blood stream. Heart and respiration rates accelerate and blood pressure increases, enabling

the body to quickly circulate oxygen-rich blood to the brain and large muscles of the body. Blood is redirected

away from the extremities to the core, and digestive processes are slowed. Muscles tend to become tense,

eyes dilate, and hearing becomes more acute. Sweat glands activate to cool the body, and the skin often

becomes paler or flushed.

Concurrent with these physiological changes, the fight-or-flight response tends to generate various

psychological processes. Attention becomes heightened and narrowed, with particular focus on threat

relevant cues, and one's ability to attend to and concentrate on other tasks can be impaired. Short-term

memory and decision-making abilities can also be negatively affected by high stress, and, emotionally, people

tend to report feeling jittery, "on edge", fearful, anxious, and restless. Pacing, fidgeting, and avoidance

behaviors are common behavioral manifestations of a stress-induced alarm reaction, and many people

experience an urge to avoid the stressor or to flee from the situation.

If the person is able to successfully manage or avoid the stressor, the body begins to return to homeostasis.

However, chronic exposure to stress or recurrent confrontations with stressful stimuli can begin to take a toll

on the individual.

Benefits and Costs of Stress

Although we generally think of stress as something to avoid, stress is a natural, adaptive response that serves

a protective function. At moderate levels, stress helps alert us to potential threats in the environment and

enables us to focus our attention on resolving the threat. Stress also provides us with the energy needed to

confront or retreat from the threat via the "fight - flight" response.

Although some stress is beneficial, prolonged or intense stress can be associated with a variety of negative

physical and psychological outcomes. For example, whereas moderate amounts of stress helps to focus our

attention, excessive stress leads to diminished attention, concentration, decision-making, and short-term

memory. High stress can also lead to a variety of emotional disturbances, including irritability, depression, and

anxiety disorders. Indeed, many researchers consider stress a core component of the cause of emotional

disorders. Chronic high stress is associated with serious physical health concerns, including cardiovascular

disease, hypertension, immunosuppression and more frequent illnesses, sexual dysfunction, gastrointestinal

disorders, and recurrent headaches.

High levels of stress are also associated with a variety of behaviors and lifestyle choices that can have negative

health outcomes. Research indicates that individuals experiencing high stress are more likely to engage in

excessive alcohol consumption and increased use of drugs and tobacco products. Ironically, alcohol increases

cortisol levels, which can prolong the feeling of tension generated by stress responses. Stress can change the

way the body processes alcohol, resulting in a reduction in the pleasant effects of alcohol and increased

craving for more alcohol. In addition, chronic alcohol consumption and tobacco use are leading causes of a

variety of chronic health problems, including lung and liver cancer, cirrhosis of the liver, emphysema, coronary

heart disease, and stroke.

It is important to recognize that exceptionally low levels of stress can have negative consequences as well. For

example, when arousal levels are too low, people generally experience boredom, poorer cognitive and

physical performance, procrastination, and lack of attention to detail. The Yerkes-Dodson Law, developed by

psychologists in the early 1900's, holds that organisms' physiological and mental functioning tends to be

optimal when experiencing mild to moderate levels of arousal. Although the level of stress and arousal

required for optimal functioning varies depending on the type of task, research over the past century has

generally been supportive of this notion, which has shaped how stress and anxiety are conceptualized and

treated.

Stress Management

Given the beneficial nature of mild to moderate levels of stress, the goal of stress management is not to

eliminate all stress. Rather, stress management techniques are designed to keep stress levels within an

optimal range. Engaging in healthy lifestyle behaviors can help to reduce stress and maximize the likelihood of

living a long, healthy life. The following stress management techniques have been consistently supported by

empirical research: physical activity and exercise; healthy eating; adequate sleep; relaxation, mindfulness and

meditation; laughter, self-expression and social support; and cognitive restructuring.

Physical Activity and Exercise

Considerable evidence has accumulated indicating that regular physical exercise is associated with numerous

physical and psychological health benefits. For example, regular engagement in moderate exercise, such as a

brisk walk, strengthens the immune system and decreases rates of illness. Exercise also strengthens body

muscles, including the heart, preserves muscle mass, and helps with weight management. Individuals who

exercise regularly are also at a reduced risk for some chronic diseases, such as diabetes and hypertension.

Although exercise is, technically, a stressor itself, requiring the body to adapt to the demands of the activity,

research suggests that regular physical exercise can help to reduce the body's reactivity to other stressors. In

fact, several studies have demonstrated that individuals who exercise demonstrate lower physiological (e.g.,

blood pressure, heart rate) markers of stress and report less anxiety in response to a stressful situation than

those who do not exercise. This finding is particularly important given that stressful events precede

approximately 80 percent of major depressive episodes, and stress is a central risk factor for the development

of panic attacks, generalized anxiety, posttraumatic stress, social anxiety, and phobias. Thus, involvement in

regular exercise may help protect against or prevent the onset of anxiety and mood disturbances. In addition,

accumulating research suggests that regular physical activity is effective in treating many of these conditions

once they develop. In fact, some studies suggest that exercise is as effective as psychotherapy or medication in

treating some anxiety and mood disorders. For example, in one study, individuals who experienced recurrent

panic attacks responded to 12 weeks of aerobic exercise in a comparable manner to those taking psychiatric

medication. Other research has suggested that aerobic exercise reduces symptom severity among individuals

with obsessive compulsive disorder, and a recent review of 11 studies comparing the effects of regular

exercise with psychotherapy for depression revealed that two to four sessions of exercise per week was just as

effective in treating depression as psychotherapy. Furthermore, although most professionals recommend

regular involvement in an exercise regimen to maximize benefits, research suggests that even a single bout of

aerobic exercise or weightlifting can reduce perceived stress levels and improve mood. It appears that exercise

is medicine!

Healthy Eating

When experiencing high levels of stress, research suggests that many people change their eating patterns.

One of the most common dietary changes associated with stress involves the increased consumption of

caffeine in an effort to improve early morning or late night productivity. Ironically, although caffeine is

associated with short term increases in alertness, caffeine can also exacerbate the stress response. For

example, caffeine stimulates the body to release various stress hormones, including cortisol and

glucocorticoids, as well as catecholamines, which include epinephrine (adrenaline), norepinephrine, and

dopamine. The release of these chemicals is associated with heightened levels of stress for hours after

ingestion. In addition, caffeine consumption can lead to other conditions that can affect the body's ability to

respond to stress, including insomnia, hypertension, increased risk of heart disease, gastrointestinal problems,

and immune system suppression, making you more prone to infections.

As noted earlier, high levels of stress are also associated with increases in cortisol, which tend to lead to

cravings for high fat or sugary foods. In addition, when busy, people often resort to skipping meals or eating

fast foods. These dietary changes can actually make it more difficult for our bodies to manage stress.

Eating a healthy diet full of nutrient rich foods can help you mange stress in several ways. For example,

complex carbohydrates, like oatmeal and whole grain breads and cereals, cause your brain to release

Serotonin, a neurotransmitter associated with positive mood. Even simple carbohydrates, such as candy or

chocolate can be good for a quick spike in Serotonin. Research suggests that foods rich in Vitamin C (e.g.,

oranges) and Omega-3 fatty acids (e.g., salmon) can help reduce levels of stress hormones and improve

immune functioning. A well balanced diet improves one's ability to manage stress.

Adequate Sleep

Research suggests that the relationship between stress and sleep is bidirectional in that high levels of stress

tend to be associated with impaired sleep, and lack of sleep tends to exacerbate the experience of stress.

Numerous studies have indicated that excessive stress tends to lead to diminished ability to fall and stay

asleep, increased rate of nightmares, and poorer sleep quality. In addition, various emotional disorders

associated with stress and anxiety, such as posttraumatic stress disorder and generalized anxiety disorder, are

often associated with significant sleep disruption. On the other hand, lack of sufficient sleep often leads to

suboptimal physiological and psychological functioning. For example, sleep deprived individuals report higher

levels of stress, anxiety and anger in response to even low-level psychological demands. Further, some

evidence suggests that sleep deprivation affects cortisol (a stress hormone) levels, and neuroimaging studies

indicate that sleep deprivation is associated with impaired neurological functions, including increased

amygdala (part of the brain associated with emotional responses) reactivity and pre-frontal control regions of

the brain. In addition, considerable evidence indicates that poor sleep is associated with poorer immune

functioning. Epidemiological research suggests that most individuals require 7 to 8 hours of sleep nightly to

obtain the maximum physiological and psychological benefits from sleep.

Relaxation, Mindfulness, and Meditation

Relaxation, or easing of physical or mental stress, is often thought to be the antidote to stress. Relaxation and

anxiety are thought to be opposing emotions, in that one cannot be relaxed and anxious at the same time.

Indeed, the achievement of a state of relaxation during a period of stress is often a challenging task. However,

a variety of techniques have been devised with the intention of helping one to reach a state of relaxation,

several of which have demonstrated reliable efficacy in psychological research: Diaphragmatic breathing,

progressive muscle relaxation, guided imagery, and meditation exercises.

Diaphragmatic breathing, or deep abdominal breathing, is a technique designed to slow one's breathing and

regulate oxygen intake. Diaphragmatic breathing involves taking slow, deep breaths with the intention of

expanding and contracting the diaphragm, which is a muscle separating the chest and abdominal cavities.

Typically, diaphragmatic breathing exercises involve sitting in a comfortable chair or lying down and taking

slow, deep breaths with the intention of breathing so that the air expands the abdomen more than the chest.

Research suggests that practicing diaphragmatic breathing can significantly reduce perceived stress. In one

study, a sample of medical school students participated in a deep breathing program for 5 minutes per day

prior to class over a 10-month period. After six weeks, students engaging in the deep breathing exercises

reported significantly less test anxiety, self-doubt, nervousness and increased concentration during exams.

Progressive muscle relaxation (PMR) refers to a series of techniques that involves the repeated tensing and

relaxing of various muscle groups in the body. Often, deep breathing is integrated, whereby an individual

undergoes a deep breathing exercise while also tensing and relaxing muscle groups. The goal of PMR is to

affect the autonomic arousal component of stress and anxiety via a reduction in skeletal muscle tension. It is

believed that as skeletal muscle tension diminishes, other aspects of autonomic arousal, such as blood

pressure and heart rate, also decrease. Although the original progressive muscle relaxation paradigm was

extremely time-intensive (i.e., involving nearly 30 muscle groups and as many as 100 individual practice

sessions carried out over months or years), subsequent research has suggested that comparable effects can be

generated with far fewer sessions. Similar to diaphragmatic breathing, PMR sessions typically involve

assuming a comfortable position and taking deep breaths while tensing and relaxing 16 different muscle

groups (e.g., starting with the head muscles and working down the body before ending with the feet). As part

of the Personal Discovery Assessment (PDA) within this module, you will have the opportunity to experience

PMR for yourself.

Guided imagery, or visualization, refers to a type of relaxation training that involves the use of language to

create calming, sensory rich experiences in one's imagination. Although guided imagery techniques can vary

widely, most involve guiding an individual toward places or situations in which they feel calm and comfortable,

and individuals are encouraged to free their minds of any interfering thoughts or daily concerns. For example,

a session might consist of having an individual imagine that they are sitting on a quiet beach on a perfect

weather day or in the woods next to a gentle flowing stream. Research suggests that guided imagery

techniques are effective in reducing stress and enhancing positive mood states. Guided imagery has also been

shown to enhance feelings of well-being and calmness among individuals with a variety of chronic diseases.

Similar to diaphragmatic breathing, meditation exercises combine focusing on a specific object or sensation

(such as breathing) while disengaging from other distracters and regulating internal experiences (i.e.

emotions, thoughts) through non-judgmental acceptance. Research suggests that meditation is negatively

correlated with perceived stress and decreases in serum Cortisol levels (a stress hormone). Further,

meditation is positively associated with a variety of relaxation markers, such as reduced skeletal muscle

metabolism, higher skin resistance, decreased heart rate, and increased alpha wave activity. It is also

associated with enhanced sociability, empathy, and positive thinking.

In sum, a variety of relaxation exercises have been shown to reduce stress and improve emotional well-being.

Whether it is diaphragmatic breathing, PMR, guided imagery, meditation, or a host of others not discussed

here, it only takes a few minutes per day to improve stress levels.

Laughter, Self-Expression, and Social Support

It has long been said that, "laughter is the best medicine ." Indeed, we now know that laughter produces many

positive physiological and psychological changes in the body. Research indicates that laughter increases

oxygen intake and stimulates various muscles and organs, including the heart and lungs. Laughter also reduces

blood pressure and blood sugar levels, increases blood flow, and improves energy levels. In addition, laughter

causes the release of endorphins, which can increase pain tolerance and induce feelings of euphoria. Humor

provides a psychological distance from the current state and enables us to replace our negative appraisals

with more positive ones. In fact, some research suggests that laughter may be as effective as mild aerobic

exercise or relaxation training at improving mood.

Suppressing negative feelings can increase stress, and, in turn, be detrimental to one's heal th. However,

research suggests that expressing negative emotions in an adaptive and socially acceptable manner can serve

to reduce stress and improve immune function. For example, one study found that a sample of international

students who wrote about their most traumatic or stressful experiences for 20 minutes per day over three

days reported significantly less stress at the end of the study than their counterparts who wrote on neutral

topics. The physical and psychological benefits of disclosure are not limited to writing. Talking about

emotionally disturbing or traumatic events has also been shown to reduce anxiety, stress, and dysphoria. In

fact, one of the most effective forms of psychological treatment for stress disorders involves intentionally

recalling and talking about traumatic events repeatedly until the recollection of the event is less distressing.

Much like humor, emotional disclosure allows an individual to step back and gain perspective on the stressful

event and can transform how the individual views and makes sense of the situation.

A strong social support system is also helpful when coping with stress. Research suggests that the strength of

one's social support network is a predictor of health and is negatively associated with many mental health

problems. In contrast, loneliness is associated with a variety of health problems, including high blood pressure,

and lonely individuals have more stressful experiences and are more likely to assess situations as stressful.

Researchers theorize that higher levels of perceived stress may explain the poorer health conditions of lonely

individuals. Further, they have found that loneliness mediates the relationship between social support and

health. Loneliness is best protected against with the quality, or closeness, of relationships over quantity, or

number of relationships. Thus, effort should be put towards meaningful relationships rather than countless

peripheral ones.

Cognitive Restructuring

Often, we presume that the events that we experience have a direct effect on our emotions. For example,

finding out that you made a poor grade on an exam or that your partner wants to break up with you CAUSES

you to feel sad. However, it is not the event itself that leads to the emotion. Rather, it is the meaning that you

give to the event or your interpretation of the situation that determines the event's emotional impact. If you

interpret the poor grade to mean that you are not very intelligent or that you will never succeed in school no

matter how hard you try, you will likely experience a depressed mood. In contrast, if you interpret the grade

as a fluke or the wake-up call you have needed to enhance your motivation for school, your mood will likely be

much less negative.

As you can see, the way that we perceive or think about a situation or event can dramatically affect the

emotions we experience. Cognitive restructuring involves learning to recognize the irrational or maladaptive

thoughts we experience that contribute to negative mood states and then altering them to more accurately

reflect the situation. For example, if you are preparing for a presentation, and you repeatedly think, "I know

I'm going to say something stupid, and everyone will laugh at me" or "Everyone is going to be able to see how

anxious I am, and they will think I'm an idiot", you will likely be fairly anxious. However, are these rational

thoughts? Unless you are particularly adept at foretelling the future (in which case, I would appreciate some

help selecting my lottery numbers!), these thoughts are likely examples of catastrophizing thoughts, which

serve to increase anxiety. Although it is possible that you will say something stupid, what are the chances if

you thoroughly prepare and rehearse your presentation? How many times have you given a presentation in

the past and NOT said anything stupid? Even if you do say something that does not sound particularly

intellectual, is it possible that some, most, or all of the people in the class might not notice or think negatively

about you? If people do notice your anxiety, is it possible that they might interpret it in a different way than

assuming you're "an idiot? " Might some people not have empathy for you considering that public speaking is

one of the greatest fears among college students? After challenging the irrational or maladaptive thoughts in

this manner, it is important to select a rational alternative to substitute. A more rational alternative to the first

assumption might be, "If I prepare well and know what I am going to say in advance, I will probably do a fine

job of delivering the presentation." For the second statement, you might substitute, "most people will be

anxious when they present, and even if they do notice my anxiety, they will probably be able to relate to it."

Research suggests that cognitive restructuring or learning to recognize maladaptive thoughts and change

them to reflect more adaptive, rational thought patterns can significantly improve mood, reduce stress, and

decrease negative emotions.

A Prescription for Stress Management

To maximize your ability to cope with stress, try the following:

1. Exercise Regularly. Engage in 3-5 sessions of moderate intensity exercise each week to enhance your

immune system and reduce your risk of developing anxiety and mood disorders. However, even if you

cannot exercise regularly, remember that even a single episode of exercise can be a great way to

relieve stress and improve mood.

2. Eat a Healthy Diet. Eat plenty of fruits, vegetables, whole grains, and fatty fish to maximize your

physical health and your body's ability to manage stress.

3. Sleep . Get 7-8 hours of uninterrupted sleep per night to improve your mood and boost your immune

functioning.

4. Practice Relaxation. Engage in relaxation exercises on a regular basis or during periods of moderate to

high stress. Progressive muscle relaxation (PMR), guided imagery, and meditation are great ways to

reduce your overall level of arousal. Or, combine exercise with meditation or mindfulness by engaging

in yoga two to three times per week!

5. Express Yourself. Look for the humor in stressful situations, and find ways to express your emotions

through writing, art, or talking with friends and family.

6. Reframe. Attend to the ways in which you think about and interpret stressful situations and look for

opportunities to reframe the situation in a more rational or positive manner. Remember, the test at

the end of this chapter is not something to be feared. Instead, it represents an opportunity for you to

demonstrate how much you have learned about stress and stress management!

e-Resources

University

 ASU University Recreation

www.urec.appstate.edu/

 ASU Counseling Center

www.counseling.appstate.edu

 ASU Learning Assistance Program

www.lap.appstate.edu/stress-management

Local/Community-based

 Daymark Recovery Services

www.daymarkrecovery.org

 ASU Psychology Clinic

www.psychclinic.appstate.edu

State/Regional

 North Carolina Psychological Association

www.ncpsychology.org

 Healthy Place Online Psychological Screening Tests

www.healthyplace.com/psychological-tests

National/Federal

 American Psychological Association

www.apa.org/topics/stress/index.aspx

 Anxiety Disorders Association of America

www.adaa.org

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STRESS MANAGMENT

Personal Discovery Assessment

Overview: In this PDA you will engage in activities aimed at helping you manage your personal

level of stress effectively. The PDA is divided into three parts.

 Part 1 focuses on evaluating your current level of stress

 Part 2 focuses on evaluating your current use of stress management techniques

 Part 3 focuses on a specific technique for managing your stress.

Note: You must complete all three parts in order to receive credit for this PDA.

Part 1: General Well-Being Assessment

Part 2: Stress Management Techniques Assessment

Part 3: Progressive Muscle Relaxation Exercise

Part 1. General Well-Being Assessment

In this part you will be required to:

 Assess your personal stress state and

 Reflect upon your stress state as it relates to your wellness

Directions

1. For each question, select the one choice that best applies to you.

2. Compare your result to the norms in the ' National Norms' table.

3. Respond to the reflection questions

GENERAL WELL-BEING ASSESSMENT

INTERPRETING YOUR SCORE

REFLECTIVE QUESTIONS

What was your Total Stress Score?

Based on your Total Stress score, what is your current Stress State?

 Positive well-being (81-110)

 Low Positive (76-80)

 Marginal (71-75)

 Stress Problem (56-70)

 Distress (41-55)

 Serious (26-40)

 Severe (0-25)

How does your current Stress State impact your overall wellness?

Insert Health and Fitness 11.1 here

(modified from Live Long & Healthy Neiman Fitness 11 11.1)

Enter questions with radio buttons for each option and delete values on left from sight

GWB Assessment score should be auto-calculated upon completion

Insert 'National Norms' table here

(From Live Long & Healthy Neiman Fitness 11 11.1)

 My stress state has a very positive impact

 My stress state has a positive impact

 My stress state has a negative impact

 My stress state has a very negative impact

Part 2. Stress Management Techniques Assessment

In this part you will be required to:

 Assess your current use of stress management techniques,

 Reflect upon your use of stress management techniques and their contribution to your

wellness, and

 Plan to maintain or improve your use of stress management techniques to meet your

wellness goals.

Directions

1. Rate your current use of each stress management technique

(see text for technique descriptions)

2. Respond to the reflective questions

Stress Management Techniques

How does your current use of stress management techniques impact your overall wellness?

 My use of stress management techniques has a very positive impact

 My use of stress management techniques has a positive impact

 My use of stress management techniques has a negative impact

 My use of stress management techniques has a very negative impact

What will you do in the future regarding your use of stress management techniques to better

manage your level stress?

Part 3. Progressive Muscle Relaxation Exercise

In this part you will be required to:

 Rate your current level of stress,

 Engage in a Progressive Muscle Relaxation (PMR) exercise for 5 consecutive days,

 Reflect upon your level of stress after completing the 5-day PMR exercise.

Directions

1. Just prior to engaging in the Day 1 PMR exercise, rate your level of relaxation using the

Relaxation Scale

2. To being PMR exercise, find a quiet place where you will be undisturbed

3. Assume a comfortable and relaxed position where your body is supported (e.g., lying on a

bed, sitting in a soft chair that offers neck support)

4. Listen and follow the directions of the audio recording PMR exercise

5. Complete the PMR on 5 consecutive days. It is recommended that you do the PMR at the

same time each day, preferably just before going to sleep.

6. After completing the 5-Day PMR exercise, rate your level of relaxation and respond to the

reflection questions

Pre Day 1 PMR Relaxation Rating:

Post Day 5 PMR Relaxation Rating:

DAY 1 PMR

Date:

Time of Day:

Location:

DAY 2 PMR

Date:

Time of Day:

Location:

Insert 'PMR Relaxation ' audio recording here

DAY 3 PMR

Date:

Time of Day:

Location:

DAY 4 PMR

Date:

Time of Day:

Location:

DAY 5 PMR

Date:

Time of Day:

Location:

REFLECTIVE QUESTIONS

How has PMR impacted your overall wellness?

 PMR has had a very positive impact

 PMR has had a positive impact

 PMR has had a negative impact

 PMR has had a very negative impact

What is your plan for achieving a state of relaxation on a regular basis?

STRESS MANAGEMENT EXAM POOL

The collection of physiological, emotional, behavioral and cognitive reactions that occur in response

to environmental demands is known as:

b. Interpersonal Problems

An event that causes stress is known as a:

What system is activated when the demands of a situation are greater than the available coping

resources?

a. Parasympathetic nervous system

b. Peripheral amygdala system

Sympathetic nervous system

Activation of the sympathetic nervous system during the stress response cycle is also known as:

The Fight-or-Flight Reaction

Which of the following physiological changes occur during activation of the sympathetic nervous

system?

a. Less norepinephrine is available in the blood stream than normal

b. Respiration rate decreases

Blood is redirected toward the extremities

Activation of the sympathetic nervous system does not cause:

a. Hearing to become more acute

b. Blood to be redirected to the extremities from the core

Activation of sweat glands

Which of the following psychological changes is most likely to occur during a period of high stress?

a. Short-term memory is enhanced

b. Decision-making abilities are enhanced

Avoidance behaviors are increased

Attention is diverted from threat-relevant cues

a. Prolonged stress strengthens the immune system

b. Stress diverts attention from stress-relevant cues

High stress enhances short-term memory

Stress provides energy needed to address a threat

Intense or prolonged stress negatively impacts which of the following cognitive functions?

Intense or prolonged stress is not associated with the onset of which of the following emotional

disturbances?

a. Posttraumatic stress disorder

b. Attention Deficit Hyperactivity Disorder

Chronic high stress is associated with all of the following negative physiological effects except:

Persons experiencing high levels of stress are more likely to engage in:

Excessive alcohol consumption

Alcohol increases Cortisol levels, which produces what type of effect?

a. Prolonged tension generated by the stress response

Decreased stress by reduction in stress hormones

b. Increase in pleasant effects of alcohol

Decreased cravings for more alcohol

Chronic alcohol and tobacco consumption leads to all of the following health problems except:

b. Cirrhosis of the liver

Extremely low levels of stress are associated with all of the following except:

a. Lack of attention to detail

Which of the following are not stress management techniques discussed in this chapter?

a. Physical exercise, healthy eating, and sufficient sleep

b. Relaxation exercise, cognitive restructuring, and mediation

Using humor, self-expression, and social support

Catharsis, supplements and acupuncture

Exercise produces all of the following physical health benefits, except:

Improves immune system function

The physical health benefits of exercise include:

Increased Body Mass Index (BMI)

a. Stronger immune system

Decreased range of motion

Research demonstrates that those who exercise regularly experience:

Higher anxiety in response to stressful events

b. Lower physiological markers of stress

Regular physical exercise has been shown to be an effective treatment for:

Obsessive-compulsive disorder

Regular exercise is just as effective as psychiatric medication in treating individuals with:

b. Schizoaffective disorder

A single bout of aerobic exercise or weight lifting has been shown to:

Have little effect on perceived stress and mood

a. Reduce perceived stress and improve mood

b. Increase perceived stress in the short term but improve mood in the long term

Reduce perceived stress in the short term but diminish positive mood in the long term

Caffeine consumption can exacerbate the stress response by:

a. Increasing short-term alertness

b. Stimulating stress hormones

Increasing urine production

Stress hormones stimulated by caffeine are associated with:

a. Heightened levels of stress for days after ingestion

b. Heightened levels of stress for minutes after ingestion

c. Heightened levels of long-term alertness

Heightened levels of stress for hours after ingestion

Caffeine consumption can lead to all the following conditions, except:

a. Hypertension and increased risk of heart disease

b. Gastrointestinal problems and immune system suppression

High levels of stress are associated with increased cortisol levels, which can induce cravings for:

b. Foods high in fat and sugar

Foods low in fat and sugar

Which of the following when consumed can cause your brain to increase in levels of Serotonin?

c. Foods rich in Vitamin C

Research suggests that the relationship between sleep and stress is:

Sleep deprivation is associated with which of the following except:

a. Higher levels of stress

b. Impaired neurological function

Anxiety and mood disorders

Most individuals need how many hours of sleep nightly to obtain the maximum physiological and

psychological benefits of sleep?

Diaphragmatic breathing does not involve:

a. Taking quick, shallow breaths

Attempting to slow one's breathing regulate oxygen intake

b. Sitting in a comfortable chair or lying down

Breathing so that the abdomen expands more than the chest

A study of medical students who practiced deep breathing for 5 minutes daily, found that the

medical students experienced:

a. Less test anxiety and self-doubt

b. Decreased concentration

Progressive muscle relaxation involves:

a. Electrodermal stimulation to relax smooth muscles

An increase in skeletal muscle tension

b. Repeated tensing and relaxing of various muscle groups in the body

Heightened blood pressure and heart rate

In contrast to the original PMR protocol, research suggests that shorter session's involving _______

generates comparable effects.

Guided Imagery, or visualization, is not described by which of the following:

Focusing on daily concerns and addressing interfering thoughts

a. Use of language to create calming, sensory rich experiences in one's imagination.

b. Guiding an individual towards places or situations in which they feel clam and comfortable

A type of relaxation training

a. A combination of focus on a specific object or sensation while engaging with distracters and

regulating internal experience through non-judgmental acceptance.

A combination of focus on a specific object or sensation while disengaging from other distracters

and regulating internal experience through non-judgmental acceptance.

A combination of focus on a specific object or sensation while disengaging with distracters and

regulating internal experiences through non-judgmental rejection.

A combination of focus on many objects or sensations while engaging with distracters and

regulating internal experiences through non-judgmental acceptance.

Meditation is associated with decreases in what stress hormone?

Meditation is associated with what relaxation marker?

a. Increased skeletal muscle metabolism

Increased alpha wave activity

Laughter produces all of the following positive physiological effects except:

a. Increased oxygen intake

b. Decreased blood pressure

Decreased blood sugar levels

Research has demonstrated that laughter is as effective as which of the following at improving mood

and reducing anxiety?

a. Mild aerobic exercise or relaxation training

b. Cognitive-behavioral therapy

Research suggests that expressing negative emotions in an adaptive and socially acceptable manner

can serve to:

a. Lower diastolic and raise systolic blood pressure

b. Reduce gastrointestinal problems

Improve immune functioning

c. Moderate sleep disturbances

Research indicates that written disclosure and which of the following are effective forms of self-

expression for reducing stress?

b. Behavioral modification

Strength of social support has many benefits except:

a. Increasing blood pressure

b. Being a predictor of good physical health

Having a negative association with mental health problems

Helping in coping with stress

People often make the mistake of attributing their emotions to events that precede them. However,

it is not the event that causes the emotion. Rather, the emotion is caused by:

a. The person's stress level

b. The person's interpretation of the event

The person's family history

When it comes to friendship, what best protects against loneliness?

b. Having a few acquaintances

Having a few close friends

Having many acquaintances

After challenging irrational maladaptive thoughts, it is best to:

a. Avoid anxiety-provoking situations in the future

b. Clear the mind of distracting thoughts

c. Accept them and embrace subsequent negative mood states

Select a rational alternative as a substitute

Learning to recognize maladaptive thoughts and replace them with more adaptive thoughts is known

as:

a. Behavioral modification

b. Behavioral restructuring

Which law posits that physical and mental functioning tends to be optimal at mild to moderate levels

of arousal?

A return to equilibrium following activation of the stress response system is known as:

c. Fight-or -flight response

The primary hormones released by the body during a fight-or-flight response are:

Testosterone and Epinephrine

Cortisol and Norepinephrine

Erythropoietin and Glucagon

ResearchGate has not been able to resolve any citations for this publication.

This chapter provides a review of current issues in organizational stress in competitive sport. Two main areas are addressed: (a) conceptual and operational considerations, culminating in definitions of stress-related constructs, and (b) theoretical relationships among stress, emotions and performance, based on a meta-model outlining key processes, moderators and consequences. As the chapter progresses, attention focuses on the practical implications and research directions emanating from the literature review.

• SABINA WHITE
• ANDREW WINZELBERG

The effectiveness of laughter in reducing physiological and psychological measures of stress is compared with relaxation training and control groups. Personality factors of sense of humor and use of humor to cope as well as group size are also compared. Subjects were 74 college students randomly assigned to either a humorous or control videotape, or an audiotaped relaxation program. While laughter was not found to be as effective as relaxation training in reducing physiological measures of stress, it did appear to reduce psychological measures. Personality factors were found to be significantly correlated with stress reduction, especially with women.

• SABINA WHITE
• PHAME CAMARENA

To investigate the effectiveness of laughter as a stress reducer, 93 students were randomly assigned to one of three groups: laughter, control, and relaxation training. Each group met for 1.5 hours each week for six weeks. Measures of heart rate, blood pressure, mood, and anxiety were taken as indices of changes in stress level. While the laughter group did not experience significantly reduced stress, it did show consistent decreases in stress levels for the two psychological measurements as compared to the control group.

• James W. Pennebaker

For the past decade, an increasing number of studies have demonstrated that when individuals write about emotional experiences, significant physical and mental health improvements follow. The basic paradigm and findings are summarized along with some boundary conditions. Although a reduction in inhibition may contribute to the disclosure phenomenon, changes in basic cognitive and linguistic processes during writing predict better health. Implications for theory and treatment are discussed.

• Sunayana Nandagopal

The written emotional disclosure procedure, developed by Pennebaker and Beall in 1986, has been used as a therapeutic tool since its conception. The very act of getting the participants to write about the most traumatic or stressful events of their lives for about 20 minutes, over a period of three consecutive days, has resulted in improvements on measures of physical and psychological well-being. The objective of this study was to determine whether the written emotional disclosure procedure could be used as a tool to reduce stress among international university students. Baseline measures of perceived stress, alexithymia and limbic languidness of the participants were measured before and after the writing intervention procedure. The investigation found evidence to support the hypothesis that the written emotional expression procedure could be used as a tool to reduce perceived stress among university students. However, recommending the use of this method as a lone intervention still seems a little premature.

• Attila Szabo

The hypothesis that 20-minutes of humour would result in affective benefits that are comparable to those of a 20-minute bout of aerobic exercise was analysed by using a within-participants research design. 39 university students [from the UK] were tested, at weekly intervals, three times: running or jogging at self-selected pace; watching a humorous stand-up comedy; and watching a documentary video. Mood and state anxiety were determined 5-minutes before and after each treatment by using the Subjective Exercise Experience Scale and the Spielberger State Anxiety Inventory. Both humour and exercise had an equally positive effect on psychological distress and positive wellbeing. However, humour exerted greater anxiety-lowering effect than exercise. Based on these results, it is tentatively concluded that humour could induce positive psychological changes that are at least comparable if not superior to the effects of exercise.

Source: https://www.researchgate.net/publication/273946086_Stress_Management

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