With the endless amounts of information technology provides us these days, it is relatively easy to find a handful of techniques for managing stress. A quick google search revealed that in order to manage stress I should “avoid caffeine and alcohol, exercise, get more sleep, use relaxation techniques, talk to someone, keep a stress diary, take control and manage my time”…to name a few. From our various readings throughout the semester, we are now well-aware of the multitude of negative impacts stress can have on our bodies, both physically and psychologically and know we should probably adopt a strategy or three to manage this stress…but where does one start? Turns out sometimes getting a little help from others (in this case, in the form of mail-delivered research study) is beneficial in progressing from not even considering a change, to thinking about it, to taking action to manage stress. Evers and colleagues (2006) demonstrated that an individualized TTM-tailored intervention delivered via mail was effective in increasing stress management in a large population-based sample. Participants received communications regarding behavioral changes they could make to better manage stress, including regular relaxation, physical activity, talking with others, or taking time for social activities. Practice of these healthy behaviors increased during and following the guided intervention, along with a decline in practice of unhealthy behaviors and overall levels of stress. Importantly, as Sapolsky (2004) notes, 80% of stress management is accomplished with the first 20% of effort- that is, deciding to make a change. Thus, these types of individualized interventions might provide people with that initial awareness and motivation needed to prompt a change within themselves.
One of the behaviors targeted in Evers and colleagues (2017) stress management intervention was physical activity. Exercise is effective at countering the negative effects of stress for a variety of reasons- it decreases risk for metabolic and cardiovascular diseases, which are worsened by stress (Sapolsky, 2004). Exercise also improves mood. Though colloquial wisdom point to a relationship between regular exercise and stress reduction, how, and if, it reduces reactivity to real life stressors remains unclear in the scientific literature. Using ambulatory assessment Von Haaren (2015) and colleagues attempted to measure the influence of a 20-week exercise intervention in stress reactivity during a relevant real-life stressor in sedentary college students. Results revealed that those who completed the exercise intervention had lower levels of negative affect under conditions of high perceived stress, indicating a reduced level of stress reactivity during final exams. Over time, enhanced stress reactivity, or negative affect, can lead to increased risk for physical and psychological disorders (Sapolsky, 2004). Regular exercise may help to reduce negative emotional reactivity to daily stressors, reducing such health risks. Yet, I also wonder how exercise influences not only stress reactivity, but stress recovery. Does this lower accumulation of negative affect in response to a stressor also influence our physiological and psychological recovery following said stressor? And how might this influence our preparedness to deal with a subsequent stressor?- questions I hope to address in future research!
Another beneficial strategy for stress reduction that has gained significant attention more recently is mindfulness. Last week we examined the degree to which mindfulness mediated the relationship between PTSD symptoms and severity of substance use. Interestingly, Mindfulness Based Cognitive Therapy (MBCT) and Mindfulness Based Stress Reduction (MBSR) have been shown to elicit positive effects on a wide variety of physical and psychological conditions, such as depression and anxiety, as well as fibromyalgia and arthritis. However, the mechanisms behind these positive improvements remain relatively unknown. Alsubaie and colleagues (2017) sought to understand the mechanisms of action through which these mindfulness interventions bring about change, in addition to exploring whether there are universal and/or specific mechanisms of mindfulness interventions that apply to populations suffering from physical and/or psychological disorders. To do this, they employed a systematic review utilizing strict criteria from Kazdin for identifying mechanisms and/or mediators of action. Results indicated that effects of mindfulness interventions (MBCT and MBSR) are mediated through mechanisms of enhanced mindfulness or reduced rumination. However, lack of consistency in theoretical framework, lack of examination of mechanisms involved in physical conditions and reliance on self-report measures yielded equivocal conclusions regarding mechanisms of action for these interventions. Although, the studies included in the review demonstrated the potential for positive outcomes, further research is needed to determine exactly how or why. As scientists we are trained to adopt a skeptical approach to critically evaluate the “how” and “why” of observed relationships. When it comes to stress reduction, if the method through which change is occurring is not harmful or dangerous to the individual then some might wonder- who cares how it works? However, understanding the process that is responsible for change will help us to better understand how these conditions that we are trying to treat arise in the first place. Thus, although we don’t quite understand how MBST and MBSR elicit change, it is important that research examines these questions as it will foster more potent and effective interventions in the future.