1 stress, coping, and adaption february 25, 2008 measuring stress curry college eric weiser

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Stress, Coping, and Stress, Coping, and AdaptionAdaption

February 25, 2008February 25, 2008

Measuring Stress Measuring Stress

Curry CollegeEric Weiser

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Measuring Stress Measuring Stress

Stress can be measured three different Stress can be measured three different waysways Paper-and-pencil scalesPaper-and-pencil scales InterviewsInterviews Physiological measurements Physiological measurements

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Measuring Stress: Paper and Measuring Stress: Paper and Pencil ScalesPencil Scales

Social Readjustment Rating Scale (SRRS)Social Readjustment Rating Scale (SRRS) Holmes & Rahe (1967)Holmes & Rahe (1967) Checklist of events, stressfulness ratings are fixedChecklist of events, stressfulness ratings are fixed

Life Experiences Survey (LES)Life Experiences Survey (LES) Sarason, Johnson, & Siegel (1978)Sarason, Johnson, & Siegel (1978) Checklist of events, inquiry into desirability of each event Checklist of events, inquiry into desirability of each event

Assessment of Daily Experiences (ADE)Assessment of Daily Experiences (ADE) Stone & Neale (1982)Stone & Neale (1982) Monitor and record thoughts and events Monitor and record thoughts and events

Daily Hassles and Uplifts Scale (DHUS)Daily Hassles and Uplifts Scale (DHUS) Kanner, Coyne, Schaefer, & Lazarus (1981)Kanner, Coyne, Schaefer, & Lazarus (1981) Measure of minor stresses and pleasures of everyday lifeMeasure of minor stresses and pleasures of everyday life

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Measuring Stress: Measuring Stress: Interviews Interviews

Life Events and Difficulties Schedule Life Events and Difficulties Schedule (LEDS) (LEDS) Brown & Harris (1978)Brown & Harris (1978) A semi-structured interview technique, it A semi-structured interview technique, it

attempts to evaluates life experiences within attempts to evaluates life experiences within context of each person’s unique circumstances context of each person’s unique circumstances

e.ge.g., “Birth of a child” would have a different ., “Birth of a child” would have a different meaning to an 20-year-old woman who is poor and meaning to an 20-year-old woman who is poor and unemployed than it would to a 35-year-old woman unemployed than it would to a 35-year-old woman with a good job and no other stressors with a good job and no other stressors

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Measuring Stress: Measuring Stress: Physiological MeasuresPhysiological Measures

This involves taking blood, urine, or saliva This involves taking blood, urine, or saliva assaysassays (samples) to determine the presence of: (samples) to determine the presence of:

Catecholamines Catecholamines Epinephrine and norepinephrine Epinephrine and norepinephrine

Cortisol Cortisol Usually measured via a cortisol metabolite often referred to Usually measured via a cortisol metabolite often referred to

as 17-OHCS (that is, 17-hydroxycorticosteriod)as 17-OHCS (that is, 17-hydroxycorticosteriod) Normal ranges for urinary 17-OHCS are 2.5 to 12 mg/24 Normal ranges for urinary 17-OHCS are 2.5 to 12 mg/24

hours hours During extreme stress, urinary 17-OHCS exceeds 15 mg/24 During extreme stress, urinary 17-OHCS exceeds 15 mg/24

hours hours

6Social Readjustment Rating Social Readjustment Rating ScaleScale

(SRRS)(SRRS) The Social Readjustment Rating Scale The Social Readjustment Rating Scale

(SRRS) was developed in 1967 by Thomas (SRRS) was developed in 1967 by Thomas Holmes and Richard Rahe. Holmes and Richard Rahe.

In many ways, their work was influenced In many ways, their work was influenced by earlier work by Adolph Meyer. by earlier work by Adolph Meyer.

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Adolph MeyerAdolph Meyer(1866-1950)(1866-1950)

In the 1930s, Meyer proposed that In the 1930s, Meyer proposed that life events were related to health life events were related to health These events need not be negative, These events need not be negative,

bizarre, or catastrophic; they must bizarre, or catastrophic; they must simply be interpreted as important simply be interpreted as important life changeslife changes, requiring some degree , requiring some degree of coping of coping

e.ge.g., marriage, moving to new city, ., marriage, moving to new city, changing jobs, death in family changing jobs, death in family

Life chartsLife charts Although he noted the effects these Although he noted the effects these

life changes had on patients with life changes had on patients with diseases, he did not document his diseases, he did not document his findings with empirical research findings with empirical research


(SRRS)(SRRS) Holmes and Rahe (1967) Holmes and Rahe (1967)

Hypotheses:Hypotheses:1.1. The impact (slings and arrows) of life events build up over The impact (slings and arrows) of life events build up over

time.time.

2.2. Stress = Stress = social readjustmentsocial readjustment (amount of change in one’s (amount of change in one’s normal pattern of life as a result of a life event), regardless of normal pattern of life as a result of a life event), regardless of desirabilitydesirability

3.3. Stress varies in intensity, but the intensity is consistent Stress varies in intensity, but the intensity is consistent among groups.among groups.

Death of spouse = MAJOR, MAJOR stressDeath of spouse = MAJOR, MAJOR stress Divorce = major stressDivorce = major stress Lose job = very stressLose job = very stress Christmas = little “blast” of stressChristmas = little “blast” of stress


(SRRS)(SRRS) Holmes & Rahe (1967)Holmes & Rahe (1967)

A total of 394 respondents read a list of 43 life eventsA total of 394 respondents read a list of 43 life events

Respondents asked to rate, in their opinion, how much Respondents asked to rate, in their opinion, how much average “readjustment” each life event entailsaverage “readjustment” each life event entails

Marriage given an arbitrary value of 500; all other items Marriage given an arbitrary value of 500; all other items were then evaluated using this reference point. For were then evaluated using this reference point. For example, an event requiring twice as much readjustment as example, an event requiring twice as much readjustment as marriage would be assigned a value of 1,000, whereas one marriage would be assigned a value of 1,000, whereas one requiring one-fifth as much readjustment as marriage would requiring one-fifth as much readjustment as marriage would be assigned a value of 100be assigned a value of 100

The mean value for each event was later divided by 10 The mean value for each event was later divided by 10 (Table 3); Ratings were highly correlated between groups of (Table 3); Ratings were highly correlated between groups of people (Table 2). people (Table 2).


(SRRS)(SRRS) From this study the From this study the Social Readjustment Rating Social Readjustment Rating

ScaleScale (SRRS) emerged (SRRS) emerged

A respondent checks off each item that has A respondent checks off each item that has happened in a certain period of time (e.g., one happened in a certain period of time (e.g., one year)year)

Ratings then totaled to produce a Life Change Ratings then totaled to produce a Life Change Unit (LCU) scoreUnit (LCU) score

High LCU scores are hypothesized to be High LCU scores are hypothesized to be positively correlated to physical illness positively correlated to physical illness

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LCU Scores and Health LCU Scores and Health ProblemsProblems

Holmes & Holmes (1970)Holmes & Holmes (1970) A total of 55 respondents (37 men, 18 women) given A total of 55 respondents (37 men, 18 women) given

Schedule of Recent Events (SRE), which is a version Schedule of Recent Events (SRE), which is a version of the SRRS adapted for daily useof the SRRS adapted for daily use

Respondents record which event happened to them Respondents record which event happened to them on a particular day, each day for around two weekson a particular day, each day for around two weeks

Respondents also record day to day health changes Respondents also record day to day health changes they may have experienced they may have experienced

Would LCU scores be positively correlated with self-Would LCU scores be positively correlated with self-reported health problems during the study period? reported health problems during the study period?

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LCU Scores and Health LCU Scores and Health ProblemsProblems

Results:Results: Events with relatively low magnitude of life change Events with relatively low magnitude of life change

were the most frequently reported (Table 1)were the most frequently reported (Table 1)

The most frequently reported health problems were: The most frequently reported health problems were: skin, eye, ear, nose, and throat problems (i.e., colds skin, eye, ear, nose, and throat problems (i.e., colds and fevers); gastro problems, and muscle problems and fevers); gastro problems, and muscle problems (e.g., strain)(e.g., strain)

People with many symptoms tend to have them People with many symptoms tend to have them continuously, not all at oncecontinuously, not all at once

A positive relationship was found between LCU A positive relationship was found between LCU scores and symptoms (Table 3). scores and symptoms (Table 3).

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A

B C

Correlation of .45 (r = .45) between LCU score and average symptom frequency (A and B). This means that respondents with higher mean LCU scores tended to have more symptoms.

Correlation of .48 (r = .48) between LCU score and proportion of days symptomatic (A and C). This means that respondents with higher mean LCU scores tended to have symptoms most of the times (chronically symptomatic).

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There was a higher amount of life change on the day in which (as well as the day before and the day after) symptoms tended to be

reported.


(SRRS)(SRRS) The SRRS has had an enormous impact on the study of The SRRS has had an enormous impact on the study of

stress and illnessstress and illness

Only a decade or so after it was first developed, it had Only a decade or so after it was first developed, it had been used in more than 1,000 studies. been used in more than 1,000 studies.

Generally, people with LCU scores higher than 150 in Generally, people with LCU scores higher than 150 in any one year tend to have more physical and any one year tend to have more physical and psychological ailments than do less stressed people. psychological ailments than do less stressed people.

These ailments include heart disease, diabetes, cancer, These ailments include heart disease, diabetes, cancer, leukemia, various kinds of accidents, athletic injuries, leukemia, various kinds of accidents, athletic injuries, fractures, colds and fever, major depression, and fractures, colds and fever, major depression, and schizophrenia.schizophrenia.

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Life Experiences Survey Life Experiences Survey (LES)(LES)

Sarason, Johnson, & Siegel (1978) Sarason, Johnson, & Siegel (1978) Similar to SRRS Similar to SRRS

Respondent checks off items that they have Respondent checks off items that they have experienced in the “recent past” (0-6 months or 7-12 experienced in the “recent past” (0-6 months or 7-12 months) months)

The difference between this and the SRRS is that the The difference between this and the SRRS is that the respondent also indicates how positive or negative of respondent also indicates how positive or negative of an impact each event has had on their life an impact each event has had on their life

Scale ranges from -3 (Scale ranges from -3 (extremely negativeextremely negative) to +3 () to +3 (extremely extremely positivepositive) )

Includes: Includes: 47 core items 47 core items 3 items that the respondent includes 3 items that the respondent includes 10 “student only” items 10 “student only” items

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ScoringScoring Sum the impact ratings of items the Sum the impact ratings of items the

respondent has designated as positiverespondent has designated as positive Positive change scorePositive change score

Also, sum the impact ratings of items the Also, sum the impact ratings of items the respondent has designated as negative respondent has designated as negative Negative impact score Negative impact score

By adding both scores, you get a By adding both scores, you get a total change total change scorescore An estimate of the total change the respondent has An estimate of the total change the respondent has

experienced (good and bad) experienced (good and bad)

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Problems with Checklist Problems with Checklist Approaches Approaches

Studies finding a correlation between the Studies finding a correlation between the experience of life events and illness does not experience of life events and illness does not mean that stress causes illnessmean that stress causes illness For example, poorer people (who tend to have poor For example, poorer people (who tend to have poor

health care) may lead lives in which more changes health care) may lead lives in which more changes take place, due to financial problems; thus, stress take place, due to financial problems; thus, stress may only be coincidental to health problems for this may only be coincidental to health problems for this group, not the cause of it. group, not the cause of it.

Studies using the SRRS and the LES use a Studies using the SRRS and the LES use a retrospectiveretrospective design (i.e., respondents asked to design (i.e., respondents asked to recall illness and stressful life events at some recall illness and stressful life events at some point in time). Such reports are subject to point in time). Such reports are subject to considerable bias and distortion. considerable bias and distortion.

24Assessment of Daily Assessment of Daily ExperiencesExperiences

(ADE)(ADE) Stone & Neale (1982) Stone & Neale (1982)

Designed to address some of the inadequacies of the Designed to address some of the inadequacies of the SRRS and LES (SRRS and LES (e.ge.g., bias in retrospective reports)., bias in retrospective reports)

Each day over a period of time (e.g., two weeks), Each day over a period of time (e.g., two weeks), respondents check which of 66 items happened to respondents check which of 66 items happened to them on that day. If an event happened, they rate them on that day. If an event happened, they rate the event in terms of its the event in terms of its desirability, desirability, meaningfulness, changemeaningfulness, change, and , and controlcontrol. .

Work-Related ActivitiesWork-Related Activities Leisure ActivitiesLeisure Activities Financial ActivitiesFinancial Activities Family and Friend Activities Family and Friend Activities Other Activities Other Activities

25Sample Section of Sample Section of Assessment of Daily Assessment of Daily Experience Scale Experience Scale (ADE)(ADE) Respondents indicate if an event occurred by circling arrow on left.

If an event occurred, respondent rates in on dimensions of desirability, change, meaningfulness, and control using the geometric spaces on the right.

26Assessment of Daily Assessment of Daily ExperiencesExperiences

(ADE)(ADE) Stone, Reed, & Neale (1987)Stone, Reed, & Neale (1987)

Using the ADE, studied the relationship between Using the ADE, studied the relationship between desirable and undesirable life events and the onset of desirable and undesirable life events and the onset of episodes of respiratory illness. episodes of respiratory illness.

Of 30 subjects who experienced episodes of Of 30 subjects who experienced episodes of respiratory infection, the daily frequency of desirable respiratory infection, the daily frequency of desirable and undesirable life events that occurred from one to and undesirable life events that occurred from one to ten days prior was examined. ten days prior was examined.

Also, the daily frequency of desirable and Also, the daily frequency of desirable and undesirable life events was determined for one to ten undesirable life events was determined for one to ten days before a control day (i.e., a day in which no days before a control day (i.e., a day in which no respiratory infection occurred. respiratory infection occurred.

27Mean Number of Desirable Events Mean Number of Desirable Events

Preceding IllnessPreceding Illness(Stone et al., 1987)(Stone et al., 1987)

28Mean Number of Undesirable Mean Number of Undesirable

Events Preceding IllnessEvents Preceding Illness(Stone et al., 1987)(Stone et al., 1987)

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Daily Hassles and Uplifts Scale Daily Hassles and Uplifts Scale (DHUS)(DHUS)

Kanner, Coyne, Schaefer, & Lazarus (1981)Kanner, Coyne, Schaefer, & Lazarus (1981) Assumes that the minor stressors and pleasures Assumes that the minor stressors and pleasures

of everyday life have a bigger effect on health of everyday life have a bigger effect on health than the big, traumatic events assessed by SRRSthan the big, traumatic events assessed by SRRS

Checklist scaleChecklist scale Originally given to 100 adults once a month for 10 Originally given to 100 adults once a month for 10

months months Subjects rate how much of a hassle (or uplift) Subjects rate how much of a hassle (or uplift)

numerous items were in a particular month numerous items were in a particular month Ratings were on a 4-point scale ranging from 0 (none or not Ratings were on a 4-point scale ranging from 0 (none or not

applicable) to 3 (a great deal) applicable) to 3 (a great deal)

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Daily Hassles and Uplifts Scale Daily Hassles and Uplifts Scale (DHUS)(DHUS)

Hassles Hassles Uplifts Uplifts 1. Concerns about weight1. Concerns about weight2. Health of a family member2. Health of a family member3. Rising prices of common 3. Rising prices of common goodsgoods4. Home maintenance4. Home maintenance5. Too many things to do5. Too many things to do6. Misplacing or losing things6. Misplacing or losing things7. Outside home maintenance7. Outside home maintenance8. Property, investment of 8. Property, investment of taxestaxes9. Crime9. Crime10. Physical appearance10. Physical appearance

1. Relating well to spouse or lover1. Relating well to spouse or lover2. Relating well with friends2. Relating well with friends3. Completing a task3. Completing a task4. Feeling healthy4. Feeling healthy5. Getting enough sleep5. Getting enough sleep6. Eating out6. Eating out7. Meeting your responsibilities7. Meeting your responsibilities8. Visiting, phoning or writing to 8. Visiting, phoning or writing to someonesomeone9. Spending time with the family9. Spending time with the family10. Home pleasing to you10. Home pleasing to you

The Hassles scale was found to be a better predictor of psychological problems than life event scores, both at the time and later.

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Life Events and Difficulties Life Events and Difficulties Schedule (LEDS) Schedule (LEDS)

Brown & Harris (1978)Brown & Harris (1978) Includes a semistructured interview, covering over 200 Includes a semistructured interview, covering over 200

kinds of stressors (death, illness, role changes, etc)kinds of stressors (death, illness, role changes, etc) The interviewer and the respondent work together to The interviewer and the respondent work together to

establish a establish a timelinetimeline of each of the major life events of each of the major life events within a given period of timewithin a given period of time

After the interview, raters evaluate the event in terms After the interview, raters evaluate the event in terms of severity, short-term threat, long-term threat, and of severity, short-term threat, long-term threat, and other dimensionsother dimensions

The LEDS was designed to evaluate the importance of The LEDS was designed to evaluate the importance of an event an event in terms of a person’s unique life in terms of a person’s unique life circumstancescircumstances

e.ge.g., pregnancy would have quite a different meaning for an ., pregnancy would have quite a different meaning for an indigent 19-year-old woman than it would for a 35-year-old indigent 19-year-old woman than it would for a 35-year-old woman who had been trying to conceive for a long timewoman who had been trying to conceive for a long time

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Example of a Life Events Example of a Life Events Timeline Timeline

1 stress, coping, and adaption february 25, 2008 measuring stress curry college eric weiser

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