Up the Tower of Psychobabel: does lexical anarchy impede research into 'psychological stress'?

The terminology relating to 'psychological stress' is so confused and ambiguous that research in this field - and application of its results - must surely be hampered. Relevant words with conflicting usages and scientific definitions include 'stress' itself, 'stressor', 'strain', 'challenge', 'demand', 'threat', 'resource', 'coping' and 'mental load'. 'Stress' and 'anxiety' are often confounded. Because of this confusion it can be hard to decide how closely one view of stress matches another and to integrate the variety of published conceptual frameworks. The word 'stress' is therefore useful only as a deliberately vague umbrella term. Nevertheless there is moderate consensus in the literature that the mental state characterizing 'stress' (which, to avoid ambiguity, we call 'psystress') results from awareness that one is not coping with something, a perceived stressor, that relates to a need that is deemed personally important. Other definitions and models of 'stress' are compared. 'Stress' is often applied to situations that actually cause pleasurable excitement. We propose the unambiguous term 'euchallenge' for such enjoyable demands, because 'eustress' and 'challenge' also have other meanings. Supposedly adverse stress responses are sometimes studied using tasks or situations, which are assumed to be stressors, but which for some individuals might be euchallenges or in others produce apathy through perceived irrelevance to personal needs. Much research utilizes self-report stress questionnaires and many of these are composed with poor regard to theory. Some, for example, mix psystress causation with a variety of response factors or pay inadequate attention to 'chronic' and 'acute' time scales. Testees may even be required to interpret words on which psychologists themselves disagree - notably 'stress' itself. It is important, therefore, to evaluate carefully every test in the context of its purpose, but, most importantly for scientific advance, to relate it to a comprehensive testable theoretical model.

Effectiveness in learning complex problem solving and salivary ion indices of psychological stress and activation.

Following Hinton et al. (1992, Biol. Psychol. 33, 63-71) and Richter et al. (1995, Biol. Psychol. 39, 131-142) ionic concentration of [K+] in unstimulated saliva was predicted to rise with perceived challenge, while lowered [Na+] was expected when experiencing psychological stress (PS). Subjects had to learn an engaging complex problem-solving 'game', via positive and negative feed-back on three 'games' lasting 2.5-3.0 h overall. Comparisons were made between three groups: (1) high success; (2) partial success ('strugglers'); and (3) total failure to learn. Saliva was sampled after resting and after each of three 'games'. Successful learners had a significant rise in [K+] on the first 'game' followed by a significant fall, consistent with task-challenge reaction followed by fast autonomic adaptation with successful learning. The 'strugglers' [Na+] fell significantly over the 'games', indicating mineralocorticoid-induced PS response of Na+ reabsorption. The 'total failure' subjects had generally significantly higher [K+] than the successful ones, showing raised tonic sympathetic relative to parasympathetic activity--this outcome being interpreted from interference theories. The 'failures' also had significantly higher tonic [Na+] on 'games'--indicating low PS as predicted from McGrath's (1976) theory.

Concentrations of sodium, potassium and cortisol in saliva, and self-reported chronic work stress factors.

One hundred and fifteen electronics factory employees completed questionnaires relevant to work stress, and gave unstimulated saliva samples. As previously found, Perceived Coping Incapacity correlated very significantly with self-reported emotional upset and psychosomatic complaints. Salivary [Na+] correlated significantly with Perceived Coping Incapacity (rho = -0.30, p < 0.01), and also with emotional upset (rho = -0.19, p < 0.05). Raised [K+] tended to be associated with reduced fatigue (rho = -0.21, p < 0.05) and lower self-medication (rho = -0.21, p < 0.05) together with a greater perceived personal work responsibility (rho = 0.19, p < 0.05)-all consistent with the perception of work demands as positive challenges rather than stressors. Self-reported fatigue and emotional upset at work gave higher correlations with [K+] and [Na+] than either did on its own. Salivary [cortisol] was uncorrelated with self-reported work stress indices, and with [K+] and [Na+].

Changes in salivary [K+], [Na+] and [K+]/[Na+] with varied test demands.

It was hypothesised that choice reaction-time (CRT) testing would cause salivary [K+]/[Na+] to increase. Relative contributions of [K+] and [Na+] to ratio changes were investigated in 23 hypertensives and ten hospital staff. Changes in post-rest and post-test ionic concentrations and [K+]/[Na+], replicated earlier studies. Phasic [K+]/[Na+] changes were mainly due to [K+] changes. Significant increases in [K+] and decreases in [Na+] from a relaxed session, the day before CRT testing, to the testing session per se indicated test anticipation effects. In both groups, changes from pre-test "rest" to "on test" were significant only for [K+]. [K+] discriminated well between conditions in hypertensives. This was interpreted in terms of adaptive changes in sympathetic activation. Results show the robustness of salivary ion indices (especially of [K+]) as indicators of within-subject response to mental task demands.

Relative changes in salivary Na+ and K+ concentrations relating to stress induction.

Three independent studies are reported in which periods of "relaxation" (A) and presumed stressors (B) were given to female students in an ABA design. The "stressors" were: (1) obligatory time-wasting activity; (2) a mental "IQ" test; and (3) delivering a speech. Saliva was collected immediately after "relaxation" and "stress" periods. "Stress" and "arousal" state were retrospectively assessed in experiments (1) and (2) by subject self-rating and in experiment 1 also by trained observers for the periods A and B. The molar [K+/Na+] ratio was determined for each saliva sample. The prediction that [K+/Na+] would increase with stress induction was supported by statistically significant results with stressors 1 and 2 (p less than 0.01), but speech delivery (3) resulted in a significant rise of [K+/Na+] after the stressor period. Correlations between [K+/Na+] and "stress" and "arousal" ratings also substantiated the prediction.

Clarification of the concept of psychological stress ("psystress").

The concept of "stress" in the current academic literature is unstandardized, and therefore confusing. The theoretical approach of regarding stress as an intervening variable seems most generally agreed on by researchers; the unambiguous term "Psystress" proposal to denote the mental state involved. Aspects of vocabulary concerning psystress production and response are also discussed.

Heart rate, anxiety, anger, and arousal reactions to enforced time-wasting: dependence on reactive uncontrol, work involvement, and dominance factors of 'type A'.

The factor structure of 'Type A' was examined in an experiment derived from the observation of Frankenhaeuser et al. (1980) that 'Type A' people are abnormally 'aroused' when deprived of work. Questionnaire scales were used which dissected 'Type A' (based on replicated factor analyses). The sample statistics for 21 female volunteers approximated the parent population statistics on orthogonal scales of Work Involvement (WI), Reactive Uncontrol (RU) and Dominance (D). The laboratory session involved reading for 15 min: (a) self-chosen 'useful' work material and (b) material judged by subjects (Ss) to be 'useless'. Ss and trained observers used the same scales for rating anxiety, arousal and anger states during reading periods. Observers interpreted facial expressions from video-tapes. Finger pulse amplitude and tonic heart rate (HR) were recorded during reading periods. RU (but not WI or D) correlated negatively with HR level and positively with increases in both HR and observed arousal under time-wasting conditions. Combination of changes in HR and observed arousal in a multiple R gave optimum 'prediction' of RU. While much evidence supported Frankenhaeuser's (1980) hypothesis, the multifactorial nature of 'Type A' was demonstrated.

Can stress be measured with an anxiety questionnaire?

The general problem of stress assessment and the role of anxiety state is considered using a widely accepted theoretical model of stress. The need for clear conceptualizations of stress production and stress response factors is indicated, to avoid confusion between measurements taken from instruments assessing anxiety state and emotional stress response.

Stress, health and performance in university students.

The hypothesis tested was that cognitive factors in the generation of stress, namely perceived coping incapacity (PCI), relate to the extent of psychosomatic ailments. We developed a new scale, CAST (Cognitive Appraisal Stress Test), with a 10 point self-rating of PCI using 16 questions on different aspects of perceived demands versus perceived capabilities. For the assessment of ailments relevant to stress we constructed a scale (PSYSOM) based on a translation of the Scheuch-Vogel symptom list (developed in the GDR from self-report of teachers who could not work as a result of work stress). A special scoring system combined duration, intensity and frequency of 30 symptoms and provided normalisation of distributions. The scales were administered on separate days to 75 female students in their second year (working to obtain admission to an honours degree course). The hypothesis was strongly supported, since the overall scale of PSYSOM correlated with CAST: r = 0.42, p less than .001. The physiologically defined subscale of 'skeletal muscle tension' correlated r = 0.65 with CAST. Subsequently CAST and PSYSOM have been shortened and factor analysed to give, in each case, a general principal component scale and several identifiable varimax subscales. Research using these scales on employees has now provided cross-validation of the first findings reported here.

Titanium in reconstructive surgery of the skull and face.

Titanium is widely used as an implant material. This report describes its use for cranioplasty and malar defects and the technique used to fashion these prostheses in a centre which does not have the facility for producing computer-generated full-size craniofacial models. The use of these prostheses has produced very satisfactory results with minimal morbidity and no complications.

Can different types of anxiety states be differentiated electrodermally?

Increased electrodermal spontaneous fluctuation and decreased skin conductance OR recovery time were related to short duration increases in test anxiety. These electrodermal indices were unrelated to long-term worry associated with an impending stressful event. Amplitudes of responses were not related to short-term (or test) anxiety. Amplitude of the startle response was found to increase over a period of one week, as anxiety provoking events approached, where the subjects were in a position of helplessness. However, when an effective coping was subjectively perceived, 'startle response' appeared to be 'inhibited' to a significant degree. Amplitude of startle response may be a useful index for monitoring subjective 'worry' versus 'coping'.

Psychophysiological assessment of sex offenders in a security hospital.

A study on the sexual orientation and responsiveness of sexual offenders in a maximum security hospital who had been referred to the Psychology Department for sexual assessment is described. Correlations between "felt sexual arousal" ratings and penis diameter increase were calculated to assess validity, but a high proportion of detained patients gave results which could be interpreted as indicating defensiveness or faking. Groups of sexual offenders (against women, girls, boys, and men), nonsexual attackers of women, and typical heterosexuals were compared on their profiles of response to films showing consenting adult heterosexual, adult homosexual, and boy homosexual activity, girl abduction, and girl rape. Groups did not differ on the consenting heterosexual activity film, but typical heterosexuals and nonsexual attackers of women showed significantly less response to the film of girl abduction (p less than 0.001) and rape (p less than 0.001) than did groups of sex offenders generally.

Anomalies of cyclic AMP excretion in some abnormal offenders.

It is now well established that the metabolic sequeale of catecholamine secretion are mediated via cyclic nucleotides. Recent studies have indicated changes in the pattern of catecholamine secretion correlating with convictions for violence in maximum security hospital detainees. This study of the excretion rate of urinary cyclic AMP in this group of patients failed to show a correlation between adrenaline or noradrenaline and cyclic AMP secretion. However, subjects convicted of sexual offences showed a significantly greater cyclic AMP excretion than other patients and normal controls. These results are discussed in terms of the possible modification of receptor sensitivity and influence of alternative agonists such as testosterone.