Open Collections

UBC Theses and Dissertations

UBC Theses Logo

UBC Theses and Dissertations

A description of healthy adolescents’ perceptions of stress : causes, symptoms, responses and outcomes Bowering, Alice Jean 1984

Your browser doesn't seem to have a PDF viewer, please download the PDF to view this item.

Item Metadata

Download

Media
831-UBC_1984_A5_7 B69.pdf [ 7.14MB ]
Metadata
JSON: 831-1.0096002.json
JSON-LD: 831-1.0096002-ld.json
RDF/XML (Pretty): 831-1.0096002-rdf.xml
RDF/JSON: 831-1.0096002-rdf.json
Turtle: 831-1.0096002-turtle.txt
N-Triples: 831-1.0096002-rdf-ntriples.txt
Original Record: 831-1.0096002-source.json
Full Text
831-1.0096002-fulltext.txt
Citation
831-1.0096002.ris

Full Text

A DESCRIPTION OF HEALTHY  ADOLESCENTS'  PERCEPTIONS  CAUSES, SYMPTOMS, RESPONSES AND  OF  OUTCOMES  by  A L I C E J E A N BOWERINO B.S.N., U n i v e r s i t y  of B r i t i s h  A T H E S I S SUMBITTED  IN P A R T I A L F U L F I L L M E N T OF  THE REQUIREMENTS FOR MASTER OF S C I E N C E  Columbia,  THE DEGREE OF IN NURSING  in  THE FACULTY OF GRADUATE <School  We  accept to  this  of  STUDIES  Nursing)  thesis  the requ i r e d  as  conforming  standard  THE UNIVERSITY OF B R I T I S H COLUMBIA September (£), A l i c e  Jean  1984  Bower i n g ,  1984  1962  STRESS:  In p r e s e n t i n g  t h i s t h e s i s i n p a r t i a l f u l f i l m e n t of  requirements f o r an advanced degree a t the  the  University  o f B r i t i s h Columbia, I agree t h a t the L i b r a r y s h a l l make it  f r e e l y a v a i l a b l e f o r reference  and  study.  I  further  agree t h a t p e r m i s s i o n f o r e x t e n s i v e copying o f t h i s t h e s i s f o r s c h o l a r l y purposes may  be  department o r by h i s o r her  granted by  the head o f  representatives.  my  It i s  understood t h a t copying o r p u b l i c a t i o n o f t h i s t h e s i s f o r f i n a n c i a l gain  s h a l l not be  allowed w i t h o u t my  permission.  Department o f The U n i v e r s i t y of B r i t i s h 1956 Main Mall Vancouver, Canada V6T 1Y3 Date  DE-6 (3/81)  Columbia  written  i i  Abstract  This  exploratory  perceptions outcomes. sex  of s t r e s s , Differences  are described  between  study  describes  the causes, in their  as w e l l  was d e v e l o p e d  Forty-six  individuals,  responded  to the questionnaire.  experience  with  Results perceived  of the study  identified  and p e r s o n a l  of behaviors,  uere r e p o r t e d  literature,  uere  Participants  on t h e i r  age and  of the r e l a t i o n s h i p  identified  uere  noted  causes  explained  i n terms  Further  peers,  concern.  interpersonal  symptoms  of s t r e s s ,  the l e a s t .  health  The r e s u l t s a r e  influence  and t h e c o n c e p t  recommended and s t r e s s management  be  warranted.  on s e x and  also a trend f o r  t o s e x and a g e .  is  in the  When t h e  d i f f e r e n c e s based was  behaviors,  of p a r t i c i p a n t s .  of s t r e s s outcomes.  There  A  resources  described  by t h e m a j o r i t y  development  of  P h y s i o l o g i c a l symptoms  i n v e s t i g a t i o n of adolescents'  evaluation  of respondents  The r e s p o n s e  of t h e f a c t o r s which  Further  reported  of s t r e s s r e l a t e d to  to s t r e s s .  Knowledgeable  according  study.  <9%)  and as a t o p i c  affective  physical state, experience,  management  respondents  sensitivity.  f o r s i x items.  to vary  of t h i s  class.  to health  t h e management  responses  time,  Four  were c o m p a r e d , s i g n i f i c a n t  uere  as a p a r t  i n c l u d i n g some n e g a t i v e  as r e s p o n s e s  facilitate  answers  and  14 t o 18, i n Y.M.C.ft. g r o u p s ,  t h e most f r e q u e n t l y n o t e d ;  which  perceptions  the f a m i l y , a u t h o r i t y f i g u r e s ,  relationships,  variety  based  indicate the majority  s t r e s s as r e l a t e d  school/uorK,  age  ages  a s t r e s s mangement  respondents  uere  symptoms, r e s p o n s e s ,  perceptions  as t h e i r  adolescents'  s t r e s s and h e a l t h .  ft q u e s t i o n n a i r e  The  healthy  perception: of the s e l f .  perceptions  education  f o r adolescents  of the q u e s t i o n n a i r e  or f o r s t r e s s c o u n s e l i n g  of stress  is  may  for stress  suggested.  i ii  Table  of Contents  Abstract Table  1  of Contents  List  of Tables  List  of Figures  i i * v i i x  Acknowledgements. CHAPTER  I  xi  INTRODUCTION  Background Statement  1  1  of the Problem....  1  of the Problem  •  4  Purpose o f the Study  4  Theoret i c a l  5  Framework  Def i n i t i o n o f Terms  ••  Assumpt i o n s  11  Limitations  of t h e Study  Organization CHAPTER  11  of the Study...  11  II REVIEW OF THE L I T E R A T U R E  Factors  Influencing  13  Perception  13  State of the Individual Exper ience Time The S e l f Historical  9  Development  Causes of S t r e s s Research P e r t a i n i n g Research P e r t a i n i n g Summary  of the Stress  13 14 14 15 Concept  17  to the Adult to the Adolescent  Symptoms o f S t r e s s Research P e r t a i n i n g to the Adult Research P e r t a i n i n g to the Adolescent Summary  ••• -  20 20 21 25 26 26 29 29  iv  R e s p o n s e s -to S t r e s s Research P e r t a i n i n g to the Adult Response b e h a v i o r s Response r e s o u r c e s Research P e r t a i n i n g t o the Adolescent Summary  •  30 30 30 32 35 3?  Outcomes o f S t r e s s Research P e r t a i n i n g to the Adult Research P e r t a i n i n g t o the Adolescent Summary  37 37 38 40  Summary  40  CHAPTER  of the L i t e r a t u r e  Review  I I I METHODOLOGY  42  Subjects  42  Population.... Sample Cr i t e r i a f o r P a r t i c i p a t i o n . . . . . . . . . . S e l e c t i o n Procedure Ethical Considerations Questionnaire Process Content Format Pilot  -  ••  Development.......  42 43 43 43 44 44 45 45 46  Study  47  Data C o l l e c t i o n  47  Data A n a l y s i s  48  Summary  49  CHAPTER  o f t h e Methodology  IV  STUDY RESULTS AND D I S C U S S I O N  Description Responses  50  o f t h e Sample  50  to the Questionnaire  52  Adolescent  Perceptions  of the Stress Topic  53  Adolescent  Perceptions  of t h e Causes  55  D e s c r i p t i o n o f T o t a l Sample Open-ended r e s p o n s e s Closed-ended responses Discussion  of S t r e s s ••  •  55 55 57 57  D e s c r i p t i o n o f Subgroups Variables Sex Age Sex and a g e . . Summary •  Based  •  on  Demographic  • •  68 60 64 68 7  1  A d o l e s c e n t P e r c e p t i o n s o f t h e Symptoms o f S t r e s s D e s c r i p t i o n o f T o t a l Sample Open-ended r e s p o n s e s Closed-ended responses Discussion. D e s c r i p t i o n o f S u b g r o u p s B a s e d on D e m o g r a p h i c Variables Sex Age Sex and age Summary  72 72 72 73 75  A d o l e s c e n t P e r c e p t i o n s of t h e Responses t o S t r e s s . . . . . . . . D e s c r i p t i o n o f T o t a l Sample............... Open-ended r e s p o n s e s Closed-ended responses.. Discussion D e s c r i p t i o n o f S u b g r o u p s B a s e d on D e m o g r a p h i c Variables Sex Age Sex and age . Summary  85 86 86 88 89  A d o l e s c e n t P e r c e p t i o n s o f t h e Outcomes o f S t r e s s D e s c r i p t i o n o f T o t a l Sample Open-ended r e s p o n s e s Closed-ended responses Discussion. D e s c r i p t i o n o f S u b g r o u p s B a s e d on D e m o g r a p h i c Variables Sex Age Sex and age Summary Summary  of the Study R e s u l t s  and D i s c u s s i o n  76 76 79 82 34  93 93 98 103 107 109 109 109 110 I l l 113 113 115 117 119 120  vi  CHAPTER V SUMMARY, CONCLUSIONS,  IMPLICATIONS AND  RECOMMENDATIONS Summary  123  and C o n c l u s i o n s . . . . . . . .  123  Implications........ Recommendations  f o r Further  ••• 138 Research....  132  REFERENCES  135  Appendix  A-  Letter of Explanation  Appendix  B:  Request  Appendix  C-  Agency  Consent....  Appendix  D-  Review  Comments t o Q u e s t i o n n a i r e  Appendix  E:  Sample  Questionnaire  Appendix  F:  Open-Ended R e s p o n s e s t o C a u s e s F r e q u e n c y and C a t e g o r i e s  Appendix  Appendix  Appendix  6:  H:  I!  and C o n s e n t . . .  t o Agency.....  152 154 Draft..  156 159  of Stresss  Open-Ended R e s p o n s e s t o Symptoms F r e q u e n c y and C a t e g o r i e s Open-Ended A n s w e r s t o R e s p o n s e s F r e q u e n c y and C a t e g o r i e s  150  170 of S t r e s s ! 173 forStress!  Open-Ended R e s p o n s e s t o Outcomes o f S t r e s s : F r e q u e n c y and C a t e g o r i e s . . .  175  173  v ii  List  of Tables  Table 1  Description  o f Respondents:  Age by Sex <N=45)  51  £  Description  of Respondents:  Grade  51  3  Causes  of Stress:  Content  Summary  4  Causes  5  Selected  6  Summary  Tabulation  and  ( N=46) . . .  of Stress: Causes  Categories,  by Sex <N=45>  56  Frequency  of Stress:  of C h i Square  i n Rank O r d e r <N=46> F r e q u e n c y by Sex  58 61  Analysis:  Selected  Causes  by Sex <N=45>  6£  7  Selected  Causes  of Stress:  65  8  Summary o f C h i S q u a r e A n a l y s i s : S e l e c t e d C a u s e s o f S t r e s s by Age <N=45> S e l e c t e d Causes o f S t r e s s : F r e q u e n c y by Sex and by A g e . . . . .  9  F r e q u e n c y by Age  66 69  10  Summary o f C h i S q u a r e A n a l y s i s : S e l e c t e d C a u s e s o f S t r e s s by Sex and by Age <N=45).... 70  11  Symptoms o f S t r e s s : Content  Summary  Categories,  Tabulation  <N=46)  1£  Symptoms o f S t r e s s :  13  Selected  14  Summary  73  Frequency  Symptoms o f S t r e s s : o f C h i Square  i n RanK O r d e r <N=46>... 74 F r e q u e n c y by S e x .  Symptoms o f S t r e s s  15  Selected  Symptoms o f S t r e s s :  16  Summary o f C h i S q u a r e A n a l y s i s : S e l e c t e d Symptoms o f S t r e s s by Age <N=45) S e l e c t e d Symptoms o f S t r e s s : F r e q u e n c y by Sex and by Age  18  77  Analysis:  Selected  17  and  by Sex <N=45)  78  F r e q u e n c y by A g e . . . . . . . . 80  81 83  Summary o f C h i S q u a r e A n a l y s i s : S e l e c t e d Symptoms o f S t r e s s by Sex and by Age <N=45).. 84  vi i i  Table 19  20  21  22  23  24  25  26  27  28  29  30  31  32  33  Responses t o S t r e s s ! Categories, C o n t e n t Summary <N=46>  T a b u l a t i o n and 87  Response B e h a v i o r s t o S t r e s s : F r e q u e n c y i n RanK O r d e r <N=46>  88  Response Resources f o r S t r e s s : F r e q u e n c y i n RanK O r d e r <N=46)..  S0  S e l e c t e d Response F r e q u e n c y by Sex  94  Behaviors to Stress:  Summary o f C h i S q u a r e A n a l y s i s : S e l e c t e d Response B e h a v i o r s t o S t r e s s S e l e c t e d Response F r e q u e n c y by Sex  Resources  by Sex <N=45>... 95  for Stress: 96  Summary o f C h i S q u a r e A n a l y s i s : S e l e c t e d Response Resources f o r S t r e s s S e l e c t e d Response F r e q u e n c y by Age  Behaviors to Stress: SS  Summary o f C h i S q u a r e A n a l y s i s : S e l e c t e d Response B e h a v i o r s t o S t r e s s S e l e c t e d Response F r e q u e n c y by Age  by Sex <N=45>.. 97  Resources  by Age <N=45)...100  f o r Stress:  Summary o f C h i S q u a r e A n a l y s i s : S e l e c t e d Response Resources f o r S t r e s s  101  by Age <N=45>..102  S e l e c t e d Response B e h a v i o r s t o S t r e s s : F r e q u e n c y by Sex and by Age  104  Summary o f C h i S q u a r e A n a l y s i s : Selected Response B e h a v i o r s t o S t r e s s by Sex a n d by Age <N=45>  105  S e l e c t e d Response Resources f o r S t r e s s : F r e q u e n c y by Sex and by Age  106  Summary o f C h i S q u a r e A n a l y s i s : Selected Response R e s o u r c e s f o r S t r e s s by Sex and by Age <N=45)  107  ix  Tab 1 e 34  Outcomes o f S t r e s s ! Categories, C o n t e n t Summary <N=46)  35  Outcomes  of Stress!  36  Selected  Outcomes  37  Summary  Frequency  of Stress:  o f C h i Square  T a b u l a t i o n and 110  i n RanK O r d e r Frequency  by Sex  Outcomes  of Stress  38  Selected  Outcomes  of Stress:  39  Summary o f C h i S q u a r e A n a l y s i s : S e l e c t e d Outcomes o f S t r e s s by Age <N=45) S e l e c t e d Outcomes o f S t r e s s : F r e q u e n c y by Sex a n d by Age  41  113  Analysis!  Selected  40  <N=46)...111  by Sex <N=45> Frequency  114  by A g e . . . . . . . . 115  116 118  Summary o f C h i S q u a r e A n a l y s i s : S e l e c t e d Outcomes o f S t r e s s by Sex and by Age <N=45)..119  List  of  Figures  F igure 1  Diagram of  Stress  Components  xi  ftcKnowl edge merits  Sincere members:  appreciation  t o Dr. Kathleen  availability, for  its  staff  Simpson,  and g u i d a n c e ;  h i s patience  for their  t h e Y.M.C.ft. o f G r e a t e r  cooperation,  cooperation,  this  study  also  1 i K e t o thanK  and t o  would  R. J . C r a i g  member,  V a n c o u v e r and  and t h e many y o u n g  t h e impetus f o r t h i s  assistance  f o r her encouragement,  assistance.  who p r o v i d e d  I would  committee  and t o Ray Thompson, c o m m i t t e e  and e d i t o r i a l  1 i K e t o thanK  I would  i s e x t e n d e d t o my t h e s i s  study.  n o t have those  Without  been  participants  their  possible.  who o f f e r e d  for his critical  their  review  advice of the  manuscr i p t . Finally, especially,  credit  must  f o r tolerance  be g i v e n  t o my  family,  and u n e n d i n g f a i t h .  and t o L o m e ,  and  1  CHAPTER I  Introduct ion  Stress constant is  demand  1inKed  seen  as  for adolescents  to  f o r change  physical  a f u n c t i o n of  illness  and  behaviors  nurses  h a v e an  adolescents  role  of  the of  Health  causes,  have may  limited not  ft  increase associate  their  Stress  adolescent  physical, 1976;  this and  difficulty  by  cognitive,  ftdelson,  1980;  and  p.  3;  of  lifestyling  Lalonde,  & Welfare, healthy  achieve  1974;  1979),  lifestyling  and  maintain  intervention  have  towards  b r i n g about  and  of  the  to  i s an  stress.  be  a change of  outcomes.  in  four  Each,  in  Problem  suggests of  that  stress.  stress;  with  they  responses may  a stressful  not  Adolescence  1981).  may  even  is  i n d i v i d u a l 1 y - t i m e d changes  Rogers,  they  situation.  p s y c h o s o c i a l f u n c t i o n i n g <J. D.  adolescents  Because  i t s symptoms, t h e i r  is s i g n i f i c a n t .  Howe, 1980;  be  perceptions.  in managing  growth  stress  can  construct consisting  in h e a l t h s t a t u s with  rapid  of  a  includes helping  which  investigator  or  with  h e a v i e s t burdens  is considered  understanding  for adolescents  characterized  this  stress  i s a broad  i t s causes,  a change  1982,  symptoms, r e s p o n s e s ,  of  concept  basis for nursing  study,  living  individual  Education  occurrences  It  Knowledge  identify  to  adolescents  BacKground  experience  the  in f a c i l i t a t i n g  help  this  i n f l u e n c e d by  The  The  perspectives adolescents  or  functioning.  is  to  related  from  i t s management  Because  More s p e c i f i c a l l y ,  events,  components: turn,  goal  purposes  situations,  health;  & Parron,  integral  manage s t r e s s .  understanding For  are  of  optimum h e a l t h .  adaptation.  lifestyle.  Department  in t h e i r  adults results  mental  (Hamburg, E l l i o t t  States  patterns  and  m o r t a l i t y today  United  normal  and  and  F.  in  ftdams,  Moreover,  £  changes  in p h y s i c a l c h a r a c t e r i s t i c s  image and  a change  think  in a b s t r a c t  1980)  may  Changes  be in  at  striving  (Petersen changes  interest,  & Spiga,  additional  privileges  experiential  substance of  to  p.  p.  or  plan  one's  move  a l t e r e d body  The  ahead own  a of  and  & Valletutti,  developing peers,  and  tension  into high  are  to  (Keating,  with  produces  responsibilities  ability  expectations.  importance  Environmental  (Greenberg  and  s t r e s s of  activity school  1980)  granted,  developmental  change  <LeBou,  as may  is a  In s i t u a t i o n s where t h e r e  such  525).  be  as  driving,  been  interpersonal relationships,  in s k i l l  Limited  has  limited  and  judgment  efficacy,  experience  and  may  may  result  in  stress (Petersen  also  affect  &  the  manage s t r e s s . debate  of  part  Ostrov  & Howard, 1974;  1981;  choices  stress-producing. interaction  with  adolescence  conflict  adolescent  Stanton,  occupational  whether  whether  normal  Roll, 1974).  and  1980;  limited  stress (Toffler,  Adolescents' been  & Bryan,  perspectives  of  social  change.  perspectives sought  1979; health  (Coleman,  Rutter,  that These  of  "storm  a necessary 1978;  and  Offer,  Graham, C h a d w i c K such  as  & future  f o r employment,  development  also  is undergoing changes  occurs  p e r t a i n i n g to  themselves  1981;  illness  their  & Goodale,  Smith,  1980)  (Benjamin  needs  and  1979;  House,  as  & Fink,  are in  accelerating  1974).  (Erne, M a i s i a K  Levine, and  are  opportunities  itself  contribute  have  turmoil  Moreover, adolescent a society  is a period  Societal ambiguities,  and  to  and  development  technological  Durfee  to  in the  519).  inadequacy, decreased  198£,  concerns  others.  from parents,  abuse, d e f i c i t s  s t r e s s " and  Yule,  increase  background.  Theorists and  the  preparation,  ability  others'  i n an  of s t r e s s .  Compounding  Spiga,  an  expansion  sources  feelings  of  and  when a d o l e s c e n t s  role  or  with  1982,  1 9 7 6 ) ; and  little  reason,  for emancipation  experienced  further  expectations  terms, to  variance  result  i n t e r p e r s o n a l r e l a t i o n s h i p s , combined  heterosexual a  in the  may  have  their  1876;  3  BrunswicK Radius,  1969; B r u n s u i c K  Dillman,  Munan,  BecKer, RosenstocK  1972; W a l K e r  adolescents  are concerned  h e a l t h (Benjamin  1981;  Parcel  about  & FinK  e t a l . , 1977).  t o do t h i n g s , "  These  their  the adolescent  "feelings  of depression  Sternlieb  & Munan,  Such  to  would  These  specifically Health researchers  adolescent information (Benjamin  1972).  & FinK,  health  information  responsibility  that  the  ability  bring  about  1976, P P .  youth  positive  behavioral  Biener tobacco Raines  (1875),  (1982),  who  change. found  may  with  The  i s n o t Known. n e e d by  e t a l . , 1980; W a l K e r e t &  of appropriate  be made.  personal  The more  h e a l t h , t h e more a b l e  one w i l l  be t o  1978) and e n g a g e i n  (Cummings, BecKer may  & Maire,  1980).  be e n h a n c e d  management a r e h e a l t h and s t r e s s  This  and  With thus  a reduction  programs  and E l i t z u r  behavioral  concepts.  management may  i s confirmed  boys r e c e i v i n g  found  o f smoKing;  adolescents  however,  decisions concerning  lifestyling  by a d o l e s c e n t  prevention to  about  who  176-178).  self-esteem.  and s t r e s s  Teaching  and  are s i m i l a r  a s an a d o l e s c e n t  t o maKe d e c i s i o n s , e f f i c a c y  Lifestyling  identified  s t r e s s e d which a r e  the a c q u i s i t i o n  and s e 1 f - m a n a g e m e n t  greater  i n my  ( P a r c e l e t a l . , 1977," S t e r n l e i b  sound  health behaviors  "Knots  and p r o b l e m s  of being  make r e s p o n s i b l e d e c i s i o n s ( S h i r r e f f s , effective  and  are "nervousness"  1976; R a d i u s  with  K n o w l e d g e one h a s c o n c e r n i n g  "headaches,"  frequently  concerns  is identified  It i s only  e m o t i o n s , and  ( P a r c e l e t a l . , 1977;  of s t r e s s ,  a l . , 1982) and by a d o l e s c e n t s Munan,  Two  (Selye,  view  as  concerns,"  and s a d n e s s "  in the l i t e r a t u r e  &  indicate  selves, their  1iKe s o l v e d  the a d u l t s ' s u b j e c t i v e f e e l i n g s  identified  studies  concerns  "emotional  1972).  1880; 5-ternl i e b  1976; House e t a l . , 1979; L e v i n e ,  stomach" are f r e q u e n t l y expressed. problems  & M e y e r , 1977;  & Horvath,  e t a l . , 1982).  their  "pressures  1980; P a r c e l , N a d e r  produce  i n s t u d i e s by  i n t h e u s e o f a l c o h o l and health  education;  t o be e f f e c t i v e (1976),  disturbances  who  E v a n s and  in the  taught  relaxation  and o b t a i n e d  positive  4 results. stress five  Richardson,  and  management b e h a v i o r s  ueeKs  f o l l o w i n g the  management. similar  were u s e d  or  results.  The  se1f-awareness  perceptions  unknown. stress  Yet,  <J.  What causes,  of  are  with  to  the  youth,  differ  based  perceive  purpose  perception  of  of  1980;  Problem  have  towards  may  have  management  Hartl,  of  must  Know  and on  stress.  adolescents outcomes of  1985,  is p.  are c u r r e n t l y  and  to  facilitate  adolescents'  study  The  of  the  i s to  specfic  adolescents' and  to  adolescents'  describe healthy  and  age,  in s t r e s s  describe healthy  relationship  between  the  stress?  between  Do  and  and  illness?  adolescents'  o b j e c t i v e s ares perceptions their  their  of  stress  the  the  causes,  of  causes,  based  class.  perceptions illness.  of  stress.  perceptions  management  adolescents'  stress  describe healthy  outcomes of  stress  their  as  Study  outcomes of  symptoms, r e s p o n s e s experience  perceive  s e l e c t e d demographic v a r i a b l e s ?  a relationship  this  describe healthy  and  stress  effectively  nurses  symptoms, r e s p o n s e s  to  management  the  v a r i a b l e s which  symptoms, r e s p o n s e s ,  responses  The  3.  for  stress  to s t r e s s  Adams,  intervene  Purpose  2.  on  students  stress.  adolescents  to  step  D.  school  a unit  in s t r e s s  first  adolescents  in order  management  perceptions  1.  high  effective  S u t t e r l e y , 1979).  The  Do  <1983> n o t e d by  c o n c l u s i o n of  Statement  their  Jessup  Training adolescents  positive  recognition 257;  Beal1  the  on  sex,  5  Theoretical  Nursing branch  direction  of psychology  psychology 1976;  taxes  nursing  1951).  philosophies  Perceptual  in viewing  in seeing  pp.  5 4 - 5 5 ) . ft b a s i c p r e m i s e  is  man a s w o r t h y  The  nursing  complementary adaptation central  concern  theory.  & Thompson,  and  behaves  tenet  in response  relation  the  o f which  Richards  are  They  organism, time,  maintenance  into  nursing  (Byrne study  perceptual  i s how one s e e s  to oneself in  i t i s the i n t e g r a t i o n of  the perceptual  a t t h e moment  1976, p . 2 2 ) .  i s t h a t one  According  The p e r c e p t u a l  of perceptions  Perceptions  these  from  models  This  psychology  situation;  i s the s e l f .  and i s b a s e d  learned.  Given  of nursing  t o what one p e r c e i v e s .  the senses  & Richards  selective needs.  of perceptual  to a particular  sum t o t a l  perception is  o f t h e t h e o r i e s of both  psychologists, perception  Phenomena t h r o u g h center  to the  adaptation.  major  perceptual  only  is derived  1978; Neuman, 1982; R o y , 1 9 7 4 ) .  psychology  behavior  t o h i s environment i s  o f a number  s e l e c t e d elements  The  because  are meaningful  o f s t r e s s which  considered  isto  1982).  Man's a d a p t a t i o n  t o t h e development  < H i t t , 1971,  practice  f o r the individual's  to the study  with  and u n i q u e l y  and r e s p e c t  i n f l u e n c e d by some v a r i a b l e s w h i c h  that  Richards,  i s congruent  of the individual  ( R o y , 1974; Neuman,  &  man h o l i s t i c a l l y  in nursing  from  or p e r c e p t u a l  psychology  of value  the perspectives  individual  behavior  1359; Combs, R i c h a r d s  and  understand  in understanding  Known a s p h e n o m e n o l o g y  <Combs & S n y g g ,  C. R o g e r s ,  FrameuorK  field  may be a t d i f f e r e n t  i s d e f i n e d as  of behaving  The p r o c e s s  on p h y s i c a l , s o c i a l ,  f i e l d , the  (Combs,  of perception i s  and p s y c h o l o g i c a l  levels  o f a w a r e n e s s and  a r e a f f e c t e d by t h e p h y s i c a l s t a t e o f t h e  experience,  and t h e s e l f  parameters, there and e n h a n c e m e n t  (Combs  i s an i n s a t i a b l e  of the s e l f ;  growth  1971, p . 1 1 9 ) . need  f o r the  i s the  6  development  of the s e l f .  Guided are  sought  by t h e s e  tenets, the perceptions  t o determine  nursing  intervention.  aspects  of i l l n e s s ,  o f an  individual  t h e n e e d , mode, and e f f e c t i v e n e s s o f Wu  <1973>, i n d e s c r i b i n g t h e b e h a v i o r a l  makes t h e f o l l o w i n g  statement:  How t h e i n d i v i d u a l e x p e r i e n c e s h i s [ s t r e s s ] i s t h e i m p o r t a n t d e t e r m i n a n t o f h i s b e h a v i o r and as s u c h becomes content f o r nursing. When t h e i n d i v i d u a l ' s p e r c e p t i o n o f his [ s t r e s s 1 i s incongruent with the o b j e c t i v e data given t o us e f f o r t s may be d i r e c t e d , when a p p r o p r i a t e , t o w a r d c h a n g i n g h i s p e r c e p t i o n s o t h a t i t i s more c o n s i s t e n t with r e a l i t y ( p . 3 1 ) . Wu's  remarks  behavioral defined  aspects  in this  dL±s_-ease.  background  env  study,  i s t o reduce  the nurse (Steele,  the nurse's  nursing  may  have  both the  subjective states  identifying  between t h e  of the i n d i v i d u a l .  knowledge  and  a different  1981, p . 4 6 5 ; Neuman,  intervention  because  the d i s p a r i t y  and t h o s e  of s c i e n t i f i c  study  as d e f i n e d by Wu , and s t r e s s , as  are s i m i l a r  of the nurse  experience, individual  of i l l n e s s ,  The t a s k  perceptions  of  are a p p l i c a b l e to t h i s  i s concern  With  a  clinical  p e r s p e c t i v e than t h e  1982, p . 1 8 ) .  The f o c u s  f o r man's a d a p t a t i o n  toh i s  ironment. Adaptation  people,  their  environment. adaptation health  theory  life  and d i s e a s e  failure  experienced  adaptively  situations  Change  (Oubos,  addresses  (Mechanic,  is considered  1865, p . x v i i i ;  to adaptation  p. 256; M a r g e t t s ,  dynamic  state  confronted adapts  with  by s t i m u l i change  with  with  in h i s quest  to maintain  1982, p . 2 0 ) ;  the success or to  respond  1965, p .  xviii).  i s the notion of  or maintaining  1975; S e l y e ,  in i n t e r a c t i o n  & Bush,  in e f f o r t s  theory  between  and i n h e r e n t i n  c h a l l e n g e s (Dubos,  t b io -psycho -soc io 3 h o m e o s t a s i s , 1965,  Goosen  by t h e i n d i v i d u a l  process  1 9 7 6 a ) , and t h e  constant  s t a t e s a r e synonymous  to environmental  Also, central  the t r a n s a c t i v e  equilibrium  1976, p . 1 3 ) .  the environment f o r growth  equilibrium  Man  (Dubos,  lives  in a  and i s  and s u r v i v a l .  (Margetts  1975).  He Man  7  responds  to  his  alternatives his  and  responses i s the  These  responses  the  (Holroyd is  of  variables 1966;  of  occurs  in t h i s  under may  which  be  need  self  by  the p.  as  £64;  threatening  1.  How  1982).  the  or  xviii-xix).  individual p.  137).  insufficient,  <Margetts,  or  has  harmful no  is t h i s  1975).  (Lazarus,  longer  stress  useful  state  which  study. a broad  a number  construct  of  The  consisting  more p r e c i s e l y  components  & Eisdorfer, of  stress  of  several  defined 1982;  are  Lazarus,  diagrammed  in  1.  cause  stress  p.  1974,  maKes a r e  r e a c t i o n ( symptom)  Figure  Furthermore,  1965,  stress  identified (Elliott  1975a).  Roy,  It  between  for self-actualization  is excessive  123).  choose  action.  perception  usually  p.  of  to  (Dubos,  resulting  one  1982,  ability  a course  the  stimuli with  his  the  1965,  is considered  Mason,  Figure  of  responses  concern  components  fulfill  <Dubos,  & Lazarus,  Stress  upon  is perceived  the  with  affected  input  situation and  to  are  situation  disequilibrium  1966)  decide  development  When t h e  The  to  serve  which  of  environment  views  experience The  initiating occurring  outcome  «  Diagram of  one  causes  and  stress  interacts  (HinKle, of  components.  1958;  stress,  with  a situation  Lazarus,  or  stress  state  or  life  events  which  are  perceived  1966)  and  cause  (Lazarus,  1966;  stressors,  the  threatening  *. r e s p o n s e  are  disequilibrium. as  change  influences  Hyman &  Woog,  situations These  being in  the  are  harmful  normal  normally or  8  functioning.  They  may  undesirable.  With  disequilibrium,  result  real  in p s y c h o l o g i c a l ,  manifestations. "non-specific are  be  the  Selye response  influences  interpretation labelling  of  the  imagined, d e s i r a b l e a reaction  p h y s i o l o g i c a l , or  < 1976,  p.  of  body  s e l f - r e p o r t s of  perception,  or  the  the the  1)  to  reaction.  symptoms  equilibrium,  man  responds  incorporate Schooler, what  one  real  1978;  of  doing  may  be  state  Matthew-Simonton defined more or  but  accumulated  1982;  Selye,  adaptation  Challenges  and and  effects P.48; be  or  adaptation  overcome.  effects  and  that  promote  may  the  one  premise  that  outcome  1982;  & by  perceives that  outcome may  there be  an  outcome  (Simonton, outcome  is  i s presumed  prolonged, chronic,  mastery  Elliott  &  to  be  severe,  Eisdorfer,  equilibrium  for  is  be  life  stress  tolerated  be  growth.  positive effects.  deleterious  totally,  reduce  the  for  is  & Trygstad,  avoided to  that  without  (Jasmin  managed  and  i n man's s t r i v i n g  amount o f  person  be  Pearl in  1976).  cannot  i t must  or  determined  what  the  how  essential  for  each  Stress  Rather, to  are  regain  F u r t h e r m o r e , the  regained  However, the  amount  1974).  of  Selye,  allow  is d i f f e r e n t for  Selye,  illness  state  1966;  threats  the  The  (Bie1iausKas, The  on  are  s t r e s s , the  and  stress  se1f-actualization. optimal,  1978)  necessary, with  1976).  and  1966;  individual believes  not  (Lazarus,  Stress  the  1972).  responses  illness.  & Creighton,  (Mechanic,  liKely,  what  or  to  to  the  particular  (Lazarus,  Based  reaction  1 9 6 4 ? , and  minimize, reduce,  resources  1966).  in w e l l - b e i n g by  These  of  the  order  employing  threat  available  In  symptoms  facet  & Singer,  1972).  to  may  a  The  Knowledge, a  by  serve  1982).  bodily  influenced  copes  imagined  (Lazarus,  a non-specific  altered  or  are  or  which  Ziemer,  perceives  capable is  the  demand."  (Schachter  symptoms ( M e c h a n i c ,  resources  t h i s as  symptoms e x p e r i e n c e d ,  the  and  any  which  behavioral  described  of  behaviors  occurs  or  nor  1979, can  negative  it  9  A major management about  stress  i s the  stress  stressful  determinant  may  of  stress  and  individual's perception influence  how  s i t u a t i o n s which,  (Meichenbaum  one  in t u r n ,  & Cameron,  those  or  will  1983,  those  responses  on  the  Knowledge with  experience  of  118>.  and  to  Knowledge h e l d  by  the  a particular situation.  definition  perceptions  interacts  its  Terms  in r e l a t i o n  operational  for  a f f e c t the  p.  of  point  Knowledge.  and  attitudes, beliefs  individual The  or  views  Definition  Perception:  a focal  is:  indicated  questionnaire  that  perception  by  the  individual's  or  in the  interview  schedu1e.  Adolescent:  an  i n d i v i d u a l age  major  Disequilibrium:  the  dynamic  normal and  health  or  Cause:  the as  state usual  with  no  identified  there  functioning as  for  threatening,  i s a change the  harmful  p r e c i p i t a t i n g event,  threatening  or  harmful  be  real  causes  I t may or  the  questionnaire  the  non-specific  disequilibrium  which  be  imagined  definition  indicated  by or  or  1366).  or  may  in  individual  initiating  operational  Reaction:  19  in which  (Lazarus,  disequilibrium. it  to  problem.  is perceived  upsetting  14  the  is:  (Selye,  pleasant  or  (Lazarus, that  change  unpleasant;  1966).  cause  or  or  The  those  i n d i v i d u a l ' s responses  in the  bodily  causes  perceived  interview  response 1976).  which  on  schedule.  occurs  with  10  Symptom:  that  effect  occurs is:  that  the in  Response i  with  experienced reaction.  symptom o r  the  The  the  that  interview  method or  (Lazarus, that  those  symptoms  1966). or  interview  the  state  The  operational  of  on  the  definition  indicated  by  questionnaire  or  i n d i v i d u a l to the  perceived  The  operational  those  responses  on  eliminate,  the  threat  definition indicated  is:  by  questionnaire  the  or  in  schedule.  health  outcomes  responses  an  answers  the  those  by  incorporate  individual's  on  which  schedule.  used  response  individual  operational  i n d i v i d u a l ' s responses  minimize  Outcome  by  as  defined  definition indicated  the  by  is:  by  that  the  questionnaire  the  individual. outcome  or  individual's or  in the  at  the  interview  schedu1e .  Age :  the  chronological  birthday on  Gradei  Experience  the  indicated  attained by  last  the  i n d i v i d u a l ' s response  in s t r e s s  of  the  the  last  i n d i v i d u a l ' s response  questionnaire.  the  grade  completed  management:  least  Adaptation:  as  age  one  on  the  dynamic to  state change  as  indicated  attending  in which  the  which  the  individual  results  in  system  at  topic  stress.  in which  by  questionnaire.  s e l f - r e p o r t of  instructional period  i n s t r u c t i o n was  adjusted  the  in school  has  11 b a l a n c e , h o m e o s t a s i s , or situation as  i s no  longer  threatening,  equilibrium.  perceived  h a r m f u l , or  by  The  the  individual  upsetting.  fissumptions It  uas  assumed  that  every  It  Mas  assumed  that  an  reduce  best  the  adolescent  was  of  his  ability.  It  was  assumed  assumed  the  respondent  the  goal  in p e r c e i v e d  of  may  age  to  There complete  stress.  responses  in order  to  a  between  limitation.  communicate  are  no  on  the  of  the  The  openly  objective  dependence  would  answer  accurately  management  class  to  the  is a  stress.  difference  have been  reluctant  uses  stress  Limitations  The  experiences  disequilibrium.  It  reduction  adolescent  the  Study  researcher  adolescent  and  may  the  have  with  an  adult.  measures  of  perceptions.  respondents'  accurate  adolescents  been  There  reporting  was of  the i r p e r c e p t ions . Ability is the  to  generalize  l i m i t e d based  on  the  r e s u l t s of  beyond  the  sample  selection  of  sample.  Chapter  One  addresses  the  theoretical organization,  adaptation  and  definitions, and  study  non-probabi1ity, convenience  Organization  The  the  perceptual  assumptions,  its organization  of  Study  p r o b l e m and based  psychology and  the  on  purpose  selected  is outlined.  the  this  theories  is outlined.  l i m i t a t i o n s of  of  study.  of  The study  are  stated  12  Chapter influencing concept.  Two  reviews  perception  Studies  outcomes of  the  and  related  stress  for  l i t e r a t u r e with  an to  the  historical the  adult  reference  development  to  of  factors  the  stress  c a u s e s , symptoms, r e s p o n s e s , and  for  the  the  adolescent  and  are  c ited . Chapter  Three  d e s i g n , sample data  results  discussed  s a m p l e , and the  illness.  Both  considered and  The presented are  an  data  the  Four.  The  overview  of  the  and  discussion  of  basis  participants'  Five.  to  stress  and  are  study,  the  topic  components sex  and  implications  Recommendations  for  and  questionnaire, are  perceive  presented  outlined,  between  stress  questions  c a u s e s , symptoms,  The  in Chapter  analysis  c1osed-response the  research  outlined.  stress  stress. of  The  development, p i l o t  responses  adolescents  summary, c o n c l u s i o n s ,  stated.  are  c o l l e c t i o n and  open-response  in the  on  methodology.  analysis  relationship  outcomes of  analyzed  of  data  in Chapter  including  the  selection, questionnaire  c o l l e c t i o n , and The  the  describes  are  and  are  responses,  then  further  age. of  this  further  study  are  research  13  CHAPTER  Review  Literature reviewed the  in this  historical  outlined. are  pertinent  I I  of the L i t e r a t u r e  to adolescents'  chapter.  Factors  development  that  perception  influence perception  of the s t r e s s concept  The c a u s e s , s y m p t o m s , r e s p o n s e s ,  considered  from both  the adult  of s t r e s s i s and  are also  and o u t c o m e s o f s t r e s s  and a d o l e s c e n t  perspective.  Factors Influencing Perception In o r d e r necessary  to consider  perceived. than  to understand  Things  t h e ways  or events  as f o r m s , q u a l i t i e s ,  (Allport,  1955, p . 1 0 4 ) .  represent  meaning  individual which 114;  and  the  by Combs  the s e l f .  State  these  of  rather  mind  objects  specific  to the  and t h e r e a d i n e s s  with  1955, p . 104; Combs, Four  selected  for consideration. experience,  a r e common t o most  1971, p . 1 1 9 ) , w h i l e  1971, p .  v a r i a b l e s , as  s t a t e of the i n d i v i d u a l , three  objects  concrete  Factors  is  or events are  i n t h e human  1976).  ( 1 9 7 1 ) , have been  of s t r e s s , i t  as c o n c r e t e  (Allport,  & Richards,  The f i r s t  <Combs,  study  Further,  views things  or dimensions  are perceived  are the physical  theories  appear  to the i n d i v i d u a l .  Combs, R i c h a r d s  These  i n which  i n f l u e n c e yJiajL i s p e r c e i v e d  things  outlined  adolescents'  the fourth  time,  psychological is appropriate  to  adolescents.  o f t h e Ind i v i d u a l  The level,  state  o f an i n d i v i d u a l ' s h e a l t h  the focus  individual Richards,  determines  o f a t t e n t i o n , and t h e e n e r g y  t o seeK  further perspectives  1976, p . 8 0 ) .  Adequate  the  interest  a v a i l a b l e to the  (Combs, R i c h a r d s  f u n c t i o n i n g of the  &  sensory  14  apparatus  and  process.  Conversely,  system, such  the  as  visible  aspect  contributes behavioral  body of  system  s t a t e s or  illness  Further, general the  nervous  or  is necessary substances  drugs,  alter  the  the  body  to se1f-concept. r e a c t i o n s and  the  Furthermore,  responses  which,  perceptual  affect  perceptual  the  How  the  which  structure reflects self.  to  physical  this process.  state  i s viewed  genetics  and  and  is  valued  affect  in t u r n , influence  p e r c e p t ion .  Exper ience  Another Experiences  factor may  communication indirect be  of  i s the  experiences  expected  Richards  be  influencing  and  become c o n s t a n t are  and  through  PP.  109-123).  and  types:  direct the  possible.  which  as  1976, serve  maintained  significant  That  a result pp. as  of  is experience  or  l i n k a g e between  learned  & Richards,  constants  two  perception  indirect,  two.  past  Communication  experiences some  a r e f e r e n c e f o r new  others  culture  or  and  i s p e r c e i v e d tends  96-98), while  in the  itself.  to  (Combs,  experiences stimuli.  These  s u b c u l t u r e , the  (Combs, R i c h a r d s  makes  family,  & Richards,  1976,  Time  Experience perception. perceiving one  facet  (Allport, in  has  of  time;  1955,  p.  repetition 65>.  experiences are  is required to  Richards,  1976,  the  and  p.  w i t h i n the  make t h e s e 127).  and  Age  new  affect  available of the  d u r a t i o n of  M o r e o v e r , as  necessary  these  opportunity  influences perception.  differentiations Time  parameters  Time r e f l e c t s and  previous  time  an  i f new  event  are are  is another  embedded  field,  perceptions  differentiations  for  individual  perceptions  perceptual  individual  are  to  occur.  (Combs, R i c h a r d s  &  15  The Self Finally, perceptions self,  i t i s important  in considering  t o include the concept  t h e "me,"  o r phenomenal  the adolescents'  of the s e l f .  self  is described  The p e r c e i v e d by Uiyl i e  (1974)  as : ...an o r g a n i z e d c o n f i g u r a t i o n o f p e r c e p t i o n s o f t h e s e l f uhich are admissible to auareness. I t i s composed o f such e l e m e n t s as t h e p e r c e p t i o n s o f one's c h a r a c t e r i s t i c s and a b i l i t i e s ; t h e p r e c e p t s and c o n c e p t s o f t h e s e l f i n r e l a t i o n t o o t h e r s and t o t h e e n v i r o n m e n t ; t h e v a l u e q u a l i t i e s w h i c h a r e p e r c e i v e d as a s s o c i a t e d w i t h e x p e r i e n c e and o b j e c t s ; and g o a l s and i d e a l s which a r e p e r c e i v e d as h a v i n g p o s i t i v e o r negative valence ( p . 9 ) . The  perceived  experiences oneself  threats  to the s e l f  behavior  stress  and R i c h a r d s ,  functioning  and i s r e f e r r e d  personal  i s the prime  According  hierarchical  change.  of the perceptual  In C. R o g e r ' s  (Combs, (1951) view,  i n human  order:  (Maslou,  1951), o r " s t r i v i n g f o r  & Richards,  ( 1970) b a s i c  field  The m a i n t e n a n c e and  objective  is basic  and  Therefore,  t o as " s e l f - a c t u a l i z a t i o n "  a t t h e moment  t o Maslou  The way one s e e s  and d e f e n s i v e  and b e c o m i n g " ( C . R o g e r s ,  need  out of  (Combs, R i c h a r d s  i s threatened.  a d e q u a c y " (Combs, R i c h a r d s  individual's  following  in a narrowing  when t h e s e l f  and a r i s e s  people.  resists  1976, p . 2 5 2 ) .  of the s e l f  "being  other  t o be made r i g i d  enhancement  1976),  with  The s e l f  result  is liKely  results  i s learned  influences perception  1976, p . 1 8 4 ) .  Richards  self  and i n t e r a c t i o n s  selectively  Richards  and  o r phenomenal  1976, p . 5 7 ) .  The  to perception.  needs  are organized  in the  16  1. P h y s i o l o g i c a l n e e d s - - f o o d , w a t e r , o x y g e n S. S a f e t y n e e d s — s e c u r i t y , s t a b i l i t y , f r e e d o m f r o m f e a r 3. Be 1 o n g i n g n e s s and l o v e n e e d s - - a f f e c t i o n a t e relationships w i t h p e o p l e and t h e f e e l i n g t h a t one b e l o n g s i n some s o c i a l c o n t e x t 4. S e l f - E s t e e m n e e d s - - a c h i e v e m e n t , a d e q u a c y , m a s t e r y , recognition, importance 5. S e 1 f - A c t u a l i z a t i o n n e e d s - - s e l f - f u 1 f i 1 l m e n t , t o a c t u a l i z e o n e ' s p o t e n t i a l , t o become e v e r y t h i n g t h a t one i s c a p a b l e o f b e c o m i n g (Mas l o w , 1970, p p . 35-58> Combs, R i c h a r d s needs  and R i c h a r d s  i n a more g l o b a l  personal  adequacy  ( 1976> on t h e o t h e r  f a s h i o n and m a i n t a i n  i s t h e b a s i c human n e e d  hand,  address  that s t r i v i n g f o r  from  birth  to  death:  ...each person seeks not merely t h e maintenance o f a s e l f , b u t t h e d e v e l o p m e n t o f an a d e q u a t e s e l f - - a s e l f c a p a b l e o f d e a l i n g e f f e c t i v e l y and e f f i c i e n t l y w i t h t h e e x i g e n c i e s o f l i f e , b o t h now and i n t h e f u t u r e . To a c h i e v e t h i s se1f-adequacy r e q u i r e s o f each p e r s o n t h a t t h e y seeK n o t only t o m a i n t a i n h i s e x i s t i n g o r g a n i z a t i o n , but a l s o t h a t he b u i l d up and maxe more a d e q u a t e t h e s e l f o f w h i c h he i s aware <pp. 56-57>. This  striving  significant  f o r personal  during  Adolescence development  These  the adolescent  i s a developmental  of the s e l f .  developmental  adequacy  tasKs  o r enhancement  life  stage.  period, critical  Psychosocial  or goals  of the s e l f i s  literature  t o be a c c o m p l i s h e d  to the  proposes  by t h e a d o l e s c e n t .  include: - A c h i e v i n g a s e l f - i d e n t i t y , a s e x u a l i d e n t i t y , and a c c e p t i n g one's s e l f - A c h i e v i n g new and more m a t u r e r e l a t i o n s w i t h p e e r s of b o t h s e x e s - A c h i e v i n g i n d e p e n d e n c e o f p a r e n t s and o t h e r a d u l t s w i t h formation of interdependent r e l a t i o n s h i p s with parents - P r e p a r i n g and a c h i e v i n g f o r s e l f - s u f f i c i e n t r o l e i n soc i e t y  17  - P r e p a r i n g f o r m a r r i a g e and f a m i l y l i f e - A c q u i r i n g a s e t o f v a l u e s and an e t h i c s y s t e m as a guide to behavior - Developing f u r t h e r c o g n i t i v e a b i l i t i e s , to think a b s t r a c t l y , t o p l a n ahead < H a v i g h u r s t , 1 3 5 3 ; Nelms, 1 9 8 1 ; Rabichou Sklansky, 1 9 8 0 , P P . 1 6 - 1 7 ) In  addition,  a sense  these  tasks are  of p e r s o n a l  stress  fragmented  reports life  of  Development  concept  manner.  association  of the s t r i v i n g  has  stress  illnesses  that  of the  developed  Current  between  interest and  in the which  to occur  ( B i e 1 i a s u s k a s , 1 9 8 2 , p. 6 ) .  Initial  work  biological disorders  is attributed  a  develop  life  histories  chart  and  frequently  of p a t i e n t s ' that  followed a cluster  and  concept arose  in a  stems from from  1 9 4 8 ) who,  social,  and  major  in  personal  psychiatric  the  anecdotal  d u r i n g p e r i o d s of  t o Meyer ( L i e f ,  observed  Concept  sporadically  illness  seemed  Stress  changes  1 9 1 9 , developed  to  adequacy.  Historical  The  inclusive  &  and  physical  o f p e r s o n a l and  social  changes.  ( 1 9 7 6 ) f u r t h e r d e v e l o p e d the i d e a of h o m e o s t a s i s  Selye the  fight-flight  which of  he  the  stage  d e f i n e d as  body  resistance,  Dunbar to  t o any  General  In  the  a  h i s use  of the  "general n o n - s p e c i f i c  demand."  He  a final  field  stage  concept  of  of  "stress,"  [biological]  elaborated further  A d a p t a t i o n Syndrome a s t a g e  and  in the  time  the  medicine,  Alexander  d i s e a s e s such  as  mind  were c o n s i d e r e d s e p a r a t e .  body  three of  exhaustion.  of psychosomatic  and  response  alarm, a stage  ( 1 9 5 0 ) and  ( 1 9 5 5 ) related s p e c i f i c unresolved psychological  particular  that  mechanism with  and  asthma or u l c e r a t i v e  conflicts  colitis. More  At  18  recently, with may  h o w e v e r , man  mind-body result  -from a p a r t i c u l a r  Wolff  the  environment,  ( 1 9 5 3 ) and  1957)  health.  individual's was  determinant  viewed  (Leigh,  organ  paradigm,  impact  of h e a l t h  or  of  illness  man  Disease  responds  current  life  to  HinKle  occurrences  related  environment.  How  the  than  the  a more  actual  &  on  was  was  the  paradigm.  H i n K l e , 1974;  daily  individual  illness  735).  system  susceptibility  to the  the  a general  p.  w e a k n e s s as  a c c o r d i n g to the  relationship  p e r c e i v e d by  as  1982,  H i n K l e ( H i n K l e , 1958;  r e c o g n i z e d the  In t h e i r  situation  come t o be  interrelatedness  demands o f t h e  Wolff,  has  to  important  life  situations  exper ienced . Caplan simple  (1964) viewed  stimu1 u s - r e s p o n s e  situations  with  Lazarus and  learned  stress approach  coping  (1966) developed  emphasized  perception.  the  an  importance  d i s c r e p a n c y between  responses  available  psychological  quantifying influence various  Volicer,  and  In  opposed  which  the  cause  Other  methods  has  variables RabKin  contrast  are  to g e t t i n g  sick.  stressful  to  stress  and  when t h e r e  required  is a  and  the  considered that  determined  also  worK o f  life  the  the  stress  and  studies  have  also  events  between  established;  and  were t h o u g h t  illness  1972a;  life  change  environmental  (Mason,  to  used  to  Coddington,  link  influential  1975a,  and  1975b;  1976). linking  s t u d y i n g why  Those  identifying  change  1975;  linear  been  (1979) advocated  to  approach  investigators  & Streuning,  to these  He  stress  linking  not  reacts  a  1988).  Yet, a simple  illness  results  effectiveness  changes.  described  appraisal  the responses  M a s u d a , Wagner & H o l m e s ,  1981;  Antonevsky  events  and  1977).  individual Miller,  life  scales  stress  Rahe ( 1 9 6 7 ) b e g a n  health  (Bramwell,  events  and  man  interactional  individual.  outcome ( R o s k i e s & L a z a r u s , Holmes  in which  of c o g n i t i v e  perceived  to the  a s t i m u l u s and  mechanisms.  A c c o r d i n g to him,  individual's  as  factors  life  events  people  stay  which  to  illness,  healthy  facilitate  as  people  19 coping Yet,  with  relatively  the  healthy  tuo  faces  viewed  the  the  stress  1982;  extensive stress quote  of  of  (Elliott  & Struening, of  i s a complex BieliausKas  There an  Studies  & Eisdorfer,  1976).  research  the  I t may  (Elliott  construct  with  of  and  stress  defined  is there  1982).  of  maintained.  issue  & Lazarus,  reflects been  the  he  "Coping  model  both.  s t r e s s , nor  stress  review  any  <RosKies  It has  & Eisdorfer,  of  RabKin  is claimed, and  a combination  investigated,  addressed  literature  concept.  Elliott  complexity  It  coping"  summary, t h e  a definition  1978;  of  be  worK has  same c o i n  a model  r e s p o n s e , or on  little  should  population.  of  as  In of  adversities  stress must  1980,  p.  1982;  to  a consensus  model  Hyman &  & Eisdorfer,  (Cox,  for  the  Uioog,  from  1982)  influencing  be  45).  account  concluded  but  complexity  general  explanatory fail  are  a stimulus,  i s no  for  also  increasing as  be  many  coping  an  that  variables.  To  (1982):  In g e n e r a l , c u r r e n t r e s e a r c h s u g g e s t s t h a t t h e s t r e s s r e s p o n s e i s not a s i m p l e b i o l o g i c a l r e s p o n s e to n o n s p e c i f i c s t r e s s o r s but r a t h e r a complex, i n t e r r e l a t e d p r o c e s s i n c l u d i n g t h e o c c u r r e n c e o f a s t r e s s o r , how i t is s e e n p s y c h o l o g i c a l l y by t h e o r g a n i s m , u n d e r what c i r c u m s t a n c e s t h e s t r e s s o r o c c u r s , how the o r g a n i s m c h a r a c t e r i s t i c a l l y r e a c t s , and what t h e r e s o u r c e s a r e t h a t t h e o r g a n i s m has a v a i l a b l e f o r d e a l i n g w i t h t h e s t r e s s o r . The c o n c e p t o f a g e n e r a l s t r e s s r e a c t i o n may be v i a b l e , b u t o n l y i f we assume t h a t i t r e p r e s e n t s t h e sum o f a g r e a t many p s y c h o l o g i c a l and p h y s i o l o g i c a l f a c t o r s r a t h e r than a s p e c i f i c a l l - o r - n o n e response to the o c c u r r e n c e of a s t r e s s i n g event (pp. 5-6). There Eisdorfer, studies based  on  are  many u n a n s w e r e d  1982;  have  Goldberg  involved  research  pertaining  to  the  relation  to  point  v i e w , has  of  the  & Breznitz,  adults.  with adult  be  i t is  reviewed  about  1982)  Because  adults,  adolescent. not  questions  current  important  most  the  researched  from a (Rutter,  (Elliott of  stress  when c o n s i d e r i n g  However, s t r e s s  been w e l l  and  stress  &  the  theory  is  literature stress  in  developmental 1981).  20  Causes of Stress Research  Pertaining  Causes events they  of s t r e s s  have been  uere  to the Adult  are equated  studied  directly  uith  extensively,  related  to  life based  illness.  change  events.  on  assumption  the  Change Mas  These  equated  that  uith  stress . Identification  of the  Holmes and  Rahe <1S67) and  uere  to  asKed  illnesses. changes  The  in the  financial  43  reflected  occupation,  items  which  American  and  personal  modifications Lists  events  events  of t h i s  have  been  done o f d i f f e r e n t  uere  list  have  developed  groups  an  ethnic  1977),  were s o c i a l l y such  groups  (Coddington, events  address  (Holmes as  1972b). major  & Rahe,  fired  from  been  made.  uorK  daily  times  element  list  items  (Cochrane,  of change  and  1973;  as  events as  the  fashion  Lazarus,  maKe demands on  such  of  and of  the  and  as  a  jail  studies athletes  racial  and  children  of a parent  The or  spouse  situation  C h r i s t m a s , or  arguments  1981).  as  patients  1974),  to a s p e c i f i c  the  as  is different.  death  family  onset  part  and  hospital  such  patients  Numerous  5 6 ) , and  of events  related  o c c u r r e n c e s such  p.  of  marriage, education,  <PayKel,  1974,  uorK  occurring  desirable  worK.  1975),  such  infrequent  on  situations  patients  upheavals  1967),  hospitalization,  frequent  Each  as  in a s i m i l a r  <Holmes & M a s u d a ,  5000  were u n d e s i r a b l e s u c h  in s p e c i f i c  psychiatric  the  occupational,  adjustment  ( B r a m u e l l , M a s u d a , Wagner & H o l m e s , (Volicer,  Over  normally  familial,  Others  from  occurred before the  value system  or being  stems  colleagues.  identified  economics. injury,  of s t r e s s  which  required  Many o f t h e  the  their  personal, social,  spheres  individual.  term,  identify  causes  more  or changes  A l l events  individual  such  to  in  involve  an  achieve  adaptat ion. Life  events  uhich  impact  differently  on  individuals  have  been  21  compared  according  ueighted  score  Scales  have  impact  of  to  frequencies  stress.  of  to  These  scaling  of  causes  different  groups  and  stressors  may  addressed.  to  another  be  uould  which  common  are  Research  Adolescent purpose  of  to  life  the  of  adult  used  Scale  to  Gooduin  <1980).  "hassling  uith  ( 8 4 X ) , and higher those  The  "hassling  related  family  or  "family  to  failures  suggested  to  by  or  uith  death  or  problems  member h a v i n g in s c h o o l .  additional  already  list  an  are  of  of  the  stressors  inclusive  some c a u s e s  also  been  list of  studied  identifying potential  age  and  physical  listed  of  items  state,  items  originated  uith  uhich  that  of  stress  most  frequently  sister"  <87JO,  parents"  cause  Life  not  separation such  as  trouble  in the  "family uith  Seventy-one of  them  Change  Items u h i c h  and uere  friends"  of  uere  and  getting and  the  stress Event  Ingle  neu  family  member  percent  revieu  originated  uere  experienced,  drinking,"  uhich  this  Items u h i c h  necessarily  the  stressors.  experienced  "making  <75X).  for  adults.  Y e a u o r t h , YorK, Hussey,  i t e m s , most  included.  one  31-item Adolescent  events  brother  Dimensions  of  have  and  that  weightings, although  friends,  those  those  CALCES) d e s c r i b e d  s p e c i f i c for  situations.  events  stress  the  the  Adolescent  self-reports  develop  are  Although  and  or  factors.  stress  Comparison  considers  uere  scores,  influencing  events  Adolescents'  change  doing  of  and  amount o f  event.  or  uith  adolescents  the  ueighted  varies  uith  of  assigned  summing  Because p e r c e p t i o n life  the  f e a s i b l e , there  change  quantifying  adolescent  duration  an  by  many g r o u p s  Pertaining  or  have been s c o r e d  difficult.  seem n o t to  order  different situations.  is therefore  stressors  ranK  quantify  events, adding  summary, t h e  and  i n t e n s i t y or  developed  multi-dimensional In  frequency  address  been  life  to  uere  close very  those  sicK"  related  respondents  elaborations  d i f f e r e d , such  given  as  of  "getting  22  pregnant,"  "screwing  were r e l a t e d  t o sex  girls," and  study  the  influence  the  change e v e n t s  who  had  police,"  "failing rated  experienced weighting items  as  an  being  increase  with  such  "getting  38  Females  than  as  than  "getting  who  was  not  grade  life  Those  change  items  "making  used  events  most  new  to  illness  frequently  items  s c h o o l were f o u n d  associated  school.  worse  arguments  or  problems,"  "starting  many a c t i v i t i e s  reported  relations tenth  "problems  and  a greater  rated  more  variable, experienced  "major  than  not  change  assignments  In t h e  by  more f r e q u e n t l y items  such  "financial  analysis  life  <42JO,  due  Events  events  girl  of  change  "close  money having  for classes" "getting  related  to by  life  events  girl  Less  change and  friend  these  getting  parents"  < 65JO .  acne"  at  as  t i m e " were more f r e q u e n t .  a j o b " < 5350 and  females.  with  " i n c r e a s e in p r e s s u r e of  enough  size"  life  parents,"  r e p o r t e d more  with  the  " b r e a k i n g up  grades,  were r e p o r t e d more f r e q u e n t l y  Males  < 35'A> more  interpersonal girls  in n i n t h  and  grades. British  to  a c r o s s a l l age  " i n c r e a s e d or worse arguments w i t h  "starting  frequently  with  grounded."  females  <24JO,  < 4 9 J O , and  and  < 87>0 and  In l a t e r  a j o b , " and  "getting  sex,  pregnant"  with  to high  "increased  on  friends"  experienced  grade,  centered  by  in high school  In c o m p a r i n g  by  or  arrested  a m o d i f i e d ALCES t o s t u d y  or b o y f r i e n d " < 46JO.  events  Those  age.  of  was  on  not  of events  friend  frequent  had  used  age  drugs  a significant  number  been  and  students  were  too  into  "getting  those  Ninth  a t r e n d f o r the  <1982) a l s o  entrance  up,"  1980>.  r e p o r t e d more e v e n t s  males. Age  sex,  & Goodwin,  levels  the  beat  i t e m s , has  status,  in s c h o o l , " or  stressful  stressful.  t h e r e was  students.  event,  event.  although  relationship  ALCES w i t h  socio-economic  a subject  f o r events  JacKson  of  i t less  the  of the  <Mendez, Y e a w o r t h , YorK  experienced  alcohol,"  and  violence.  A modified version to  "stealing,"  studies  of a d o l e s c e n t  life  change  events  have  also  23  been to  identified.  high  A modified version  school students  years.  Common  sources  school, the family,  a t t h e end p o i n t of s t r e s s  l o t of stress.  students uas  "letting as  uith  in a study  senior  study  years  healthy to unhealthy  stress,  using  a scale  scale  identified  "examinations" cited  control  lists  scales then  as t h e s e  developed  quantify  uith  health  a matched life  The most  and p a t i e n t  items  of  I n f o r m a t i o n on  houever.  uere uere  o f items  advancing  to the grouth items  uere  number o f a r g u m e n t s  originating  by u s i n g  items  groups  uere  similar to t o t a l l e d , the  as c o m p a r e d t o  that  f o rchildren  and f o u n d  curve.  originated  uith  (1972a).  uith  parents,"  and a d o l e s c e n t s .  ages  involved.  life  change  Four  Coddington  event  scores  a g e - r e l a t e d c u r v e uas  He f o u n d  "break-up  adolescents,  ( 1 9 7 2 a ) had p r o f e s s i o n a l s  age and t h i s  uith  uith  by C o d d i n g t o n  Coddington  healthy children  analogous  "beginning  When  f o r the d i f f e r e n t  uith  experienced  items  of s t r e s s  developed  surveyed  In  as  Tyerman and  in the investigation  frequency  uas used  stress,  the causes  uere  patients  report,  studies.  list  increased  in  as u e l l  group.  T h i s approach  identify  school  own g e n e r a l  and "change t o neu s c h o o l " u h i c h  have been  To  their  by t h e c o n t r o l  had a t h r e e - f o l d  uell  adults.  Over  them extreme o r  problems,  by t h e a u t h o r s .  in t h e i r  items  i n t h e Dobson  group  As  developed  uas not i n c l u d e d  frequently  the  1980).  1983, p . 3 5 1 ) s t r e s s  subjects,  <1983) c o n t r a s t e d p s y c h i a t r i c of healthy adolescents  patient  (Dobson  about  group  those  (Dobson, caused  school  related to  o f male h i g h  and e x a m i n a t i o n  control  the  items  senior  stressors.  comparing  Humphrey  uere  a student  doun p a r e n t s " and u o r r i e s  common In  Similarly,  in the e a r l i e r  associated  cited  of t h e i r  and s e p a r a t i o n o r l o s s  66'A o f s t u d e n t s c o n s i d e r e d b e i n g a  o f t h e ALCES u a s a d m i n i s t e r e d  t h e most  frequently  boy/girlfriend,"  "increase  " b e g i n n i n g h i g h s c h o o l , " and  to date."  an a t t e m p t  to develop  a more  inclusive  list  of potential  24  stressors.  Palmer  inventory  which  presented  as  Trends  friend."  good  m a j o r i t y of 36  support,  and  and  Females  with  difference The  children weight  those  and  items  "peer  of  which  concerned  tasks  by  establishment  of  and  with  those  identity,  heterosexual of  as  healthy  boys,  but  similar.  ft  social  i n male and  in seven stress  the  female  categories.  in the  four  "difficulties  sex."  The  b a s i s of  chronic  adolescents. diabetes  peers," and  a  or the and  were a s k e d  were  with  items  the  To  with  others to  die," sex."  would  be  illness  adolescent independence,  development  relationships.  19827.  opposite  related  also  and  a close friend  struggle for  individuals,  list  "arguments  d i s e a s e , but  a t h r e a t to  the  to  may  study,  <Kosub & K o s u b ,  "relations  The  illness  In a n o t h e r  "having  to the  children.  such  was  females.  items,  opposite on  parents"  and  "isolation,"  with  them s t r e s s  were s p e c i f i c  developmental  life  with  frequently identified  to healthy  than  responses.  well-being  greater  females.  than  stress  were g r o u p e d  of  experiences.  with  i n t e r f e r e n c e with  peer  life  adolescents  caused  "death  10% were  in open-ended  were e x p l a i n e d  authority figures,"  applicable  bottom  acceptance,"  healthy  "nonacceptance  Some r e s p o n s e s  or  "relationships  adolescents  most  top  items  as  and  for girls  were  stressful."  identified  f o r males  item  results  "least  of p a r e n t "  differed  significantly  or  108  Study  adults other  emotional  in s o c i a l i z a t i o n  items  of  and  p e r s p e c t i v e s of  parents," "fear  in the  to a  more f r e q u e n t l y by  with  events  in responses  from  "death  more s t r e s s f u l  stress  and  Items  <1978) e x a m i n e d  labelled  differences  Those  Life  parents,"  differ  Weir  reported  categories  were  were s u g g e s t e d  physical  adolescents.  indicated.  of  events  items  BurKe  "most s t r e s s f u l "  relationships  order  respond  professionals.  were n o t e d  potentially  M o r e o v e r , ranK  adolescents  with  stressful  Eight events  considered  further  of  were n o t  most  "Developing  the  originated  frequency  in data  potentially  <19S1) had  and  maintenance  contrast these  items  the of  responses  were c o m p a r e d  to  25 Coddington's s c a l e s .  There uas a s i g n i f i c a n t c o r r e l a t i o n  betueen  C o d d i n g t o n ' s rank o r d e r s c a l e and t h e d i a b e t i c s ' rank o r d e r o f stress.  However, Coddington's s c a l e accounted f o r o n l y 6 6 X o f t h e  rank o r d e r i t e m s .  The a u t h o r s s u g g e s t e d Coddington's s c a l e  might  not be r e p r e s e n t a t i v e o f d i a b e t i c a d o l e s c e n t s ' p e r c e p t i o n s o f s t r e s s nor o f s t r e s s  i n t h e normal a d o l e s c e n t .  Nevertheless, the  r e s u l t s d i d s u p p o r t t h e c o n t e n t i o n t h a t a d o l e s c e n t s have a unique p e r s p e c t i v e and o p t i o n s must o r i g i n a t e u i t h them t o be representat ive. Summary  S t r e s s o r s o r causes o f s t r e s s have been 1 inked t o 1 i f e change e v e n t s and have been s t u d i e d e x t e n s i v e l y , as have t h e i r l i n k s illness  inadults.  and d i f f e r e n t  These s t r e s s o r s v a r y among d i f f e r e n t  uith  groups  situations.  A d o l e s c e n t s t r e s s o r s , as d e r i v e d from the p e r s p e c t i v e s o f a d o l e s c e n t s and p r o f e s s i o n a l s , uere s t u d i e d u i t h t h e i n t e n t i o n o f quantifying s t r e s s or i d e n t i f y i n g p o t e n t i a l s t r e s s o r s .  The causes  i d e n t i f i e d r e f l e c t t h e e n v i r o n m e n t , d e v e l o p m e n t a l t a s k s , and a c t i v i t i e s o f t h e age g r o u p . major s o u r c e o f s t r e s s .  School has been i d e n t i f i e d as a  Relationships uith peers, parents, family  and members o f t h e o p p o s i t e sex have been f r e q u e n t l y  i d e n t i f i e d as  common s o u r c e s o f s t r e s s , uhereas d e s c r i b e d d i f f e r e n c e s based on age, g r a d e , and sex v a r y .  G i r l s uere noted t o r e p o r t more causes  of s t r e s s .  Symptoms of Stress Research  Pertaining  to the Adult  The symptoms, o r s e 1 f - p e r c e p t ions o f s t r e s s , a r e a complex i n t e r t u i n i n g o f emotions and p h y s i o l o g i c a l a c t i v i t y  involving the  immune, e n d o c r i n e , and claims  the  emotions,  maladaptation  or  autonomic  or  nervous  "feeling"  stress.  These  states,  feeling  affective,  and  physiological  There  are  inherent d i f f i c u l t i e s  stress body  s i n c e the  happening, PP.  1983, verbal  person  tends  and  to  development  influence  the  complaints The  emotion  stress  emotions  such  1979,  £85).  p.  as  relate  the  visceral  system  activity  & Singer,  The  Further, hou  one  1978,  196£)  uill  PP.  labels. prior  Moreover,  and  social use  learning  to define  labelling  influence  hou  stress  emotions  and  i s no  and  various  James  Lange,  experience  and  central  and nervous  (1964;  arise  from  the  autonomic a r o u s a l .  presently emotions,  emotion  one  (Parrino,  by  Schachter  situation past  those  autonomic  claimed  of the  to  the  There  anxiety  as  the  31-37).  activity  is related  Selye  (1976) d e s c r i b e d a general  stage  General  Adaptation  and  a  will  available he be  claims. experienced  respond.  Physiological  resistance,  As  against  encompasses  and  such  to e x p l a i n  c o g n i t i o n s on  labels  from  behavior.  language  one.  stress  emotion,  has  give direction  these  emotional  Rather,  of  (Mechanic,  591).  p.13)  in  is  is inferred and  of  197£). i s an  serve  cognition  individual's  information  and  of  p.  £5).  change  what  experiences  1983,  p.  symptoms  by  v o c a b u l a r i e s people  a r o u s a l , and  (Cox,  bodily  depression, fear  Theories  Schachter,  integration  the  "stress."  and  Schachter  and  (Mechanic,  Cannon  feels  appearance  (Mechanic,  anger,  about  f o r s t a n d a r d i z a t i o n of  experience  labelled  from  ( L e v e n t h a l , 1979,  symptoms  i s shaped  individual  of  include behavioral,  in s t u d y i n g the  definition  a p p r a i s e neu  experience  symptoms  tolerance for stress  What t h e  i s concern  the  states  symptoms  cognitive  individual  cognitive  their  of  w r i t t e n r e p o r t s or  there  learning  the  596-598).  and  result, Each  and  the  are  P a r r i n o <1979)  m a n i f e s t a t i o n s <Cox, 1978,  attribution  functioning,  systems.  p a t t e r n of  Syndrome.  exhaustion.  to the  During  stress  reaction  The  three stages  the  alarm  emotion. in the are:  stage, there  three alarm, i s an  27  initial  activation  of defense  sympathetic-adrenomedu11ary the  hypothalamus.  tropic  depression  strives  During  i n body  structural  Individual  differ  response  have been  in males  stress,  response  individual stressors respond that  tends  & Lacey,  determined  (Shields  & Stern,  influence  females identify  (Stern  more symptoms  response  individual  I t has been  factors  of s t r e s s  proposed  reactions  related  auareness related  more  Females than  are factors  t o emotion  increased  males  o f symptoms  to the individual also  in a study of  "sweating  uere  has  physiological  and f e m a l e s  For example,  reported  may  1966).  increased  1969).  been  to d i f f e r e n t  of the psychological  suggested  symptoms.  & Higgins,  1978).  age h a v e a l s o  fashion  F u r t h e r m o r e , males  symptoms, m a l e s  reactions  P h y s i o l o g i c a l l y , an  activity  1979) and t h a t  in t h e i r s t r e s s  physiological  an  stress  in their  in the p h y s i o l o g i c a l  uith  t h e symptoms.  uith  stressor.  I t has been  is associated  s t r e s s , the  in death.  adrenalin  in a s i m i l a r  by t h e i n t e r f a c e  activity  differ  1982).  of p h y s i o l o g i c a l  studied.  may  sympathetic-adrenomedu11ary  ( C o x , 1978, p . 7; L a z a r u s ,  Awareness been  more  stress,  This  severe  stress  1858), h o u e v e r , each  variations  u i t h i n the  & FranKenhaeuser,  Differences  & Spiga,  to respond  (Lacey  individual  stress  also  to secrete  d i f f e r e n t l y t o t h e same  largely in  <Col i n s  and a  sustained  in physiological  Physiological  of  the organism  chronic end  by  in  is stimulated  With  a n d may  variation  1978, p . 6 5 ) .  (Petersen  increase  system occurs  With  occur  indicating a greater  <Cox,  suggested  gland  is release  of a l l the processes.  studied.  found  of stimulation  there  of r e s i s t a n c e ,  change.  and f e m a l e s  Males have been to  activation  and f o r a d a p t a t i o n .  s t a g e , e x h a u s t i o n , may  reactions  as a r e s u l t  The t h y r o i d  activation  in  p i t u i t a r y and an  the stage  for resolution  i s continued  result  increase  o f t h e thymus and l y m p h a t i c  immune s y s t e m .  final  continued  activity.  an  activity  hormones by t h e a n t e r i o r  adrenocortical  there  With  uith  palms"  reported  (Stern  &  to  Higgins,  than  28  1869)  as a s s e s s e d  using  the Somatic  Perception  measures  p h y s i o l o g i c a l symptoms.  Mechanic  reported  more symptoms  and d i s t r e s s  study and  of health  illness  increase  complaints.  have been  with  found  age ( L e u i s .  1983,  P . 5 9 4 ) . With  found  c o l l e g e students  incidence Culture  One  study  college  greatest  reported  reported  musculoskeletal individual  endocrine  each  Selye  (1976, P P .  signs  of stress.  inventories, Inventory  developed  Examples  tested.  (Cooper,  such  of stress to  stress reactions in  From f a c t o r  found  reported  uere  f o r each  analysis, s e x . The  affective  items  although the  not s i m i l a r . of emotions,  system a c t i v i t y , foradults.  o f such  a list  They  numerous s t r e s s vary  in length.  o f 31 s e 1 f - o b s e r v a b 1 e  questionnaires  are the "Signal  1980, p . 174) and t h e "Symptoms 1980, p p . 1 6 4 - 1 6 5 ) . Stress  inclusive  1 9 7 9 ) , have than  of Stress  Some s t r e s s Tension  1980, p . 2 5 3 ) and t h e S o m a t i c  (Shields & Stern,  reaction  in the active  interplay  as t h e P s y c h o s o m a t i c  Some a r e more  1969) a l s o  in the g a s t r o i n t e s t i n a l  173-177) i d e n t i f i e d  (Wallace,  Questionnaire  perceived  of this  nervous  S t r e s s " ( J . D. Adams,  Questionnaire"  & Higgins,  and t h e n e g a t i v e  sexes  the perception  have been  higher  Questionnaire.  symptoms  scale.  sex r e p o r t e d  and a u t o n o m i c  inventories  noted  Both  a  (1969)  1977) and s i m i l a r i t y t o  and c a r d i o v a s c u l a r g r o u p i n g s ,  items  assess  reported  (Stern  f a c t o r s uere  by m a l e s  by f e m a l e s .  1977; M e c h a n i c ,  and p h y s i o l o g i c a l m a n i f e s t a t i o n s .  an a n x i e t y  independent  f o u r and  and H i g g i n s  Perception  the perceived  d i f f e r e n c e s uere  sensitivity  of  using  in h i s  reactions to stress.  and E v e r l y ( 1 9 8 0 ) e x a m i n e d students  females  males  by g r a d e  1979; Z b o r o u s K i ,  somatic  than  & Palmer,  siblings  of perceptions  addressed  statistically  To  and t h e i r  behavioral, affective,  Humphrey  Lorimer  on t h e S o m a t i c  self-reports perceived  t o be a p p a r e n t  increasing age. Stern  o f symptoms  influence  <1976b) f o u n d  uhich  Sex d i f f e r e n c e s i n r e a c t i o n s t o p a i n  Leu i s ,  (Shields & Stern,  parent's  include  of i l l n e s s  Questionnaire  Relaxation  Perception  been e m p i r i c a l l y  others.  They  may  address  29  peoples' they  affective  feel The  are  happens stress  a mixture  influenced  by  affective,  and  f e e l i n g s , what to  their  emotions  learning;  feel  1 iKe  doing,  and  what  body.  symptoms, t h e n ,  of  people  and  and  as  studied  primarily  physiological  are  physiological  evidenced  in  activity;  as  adults,  are  behavioral,  manifestations.  Research Pertaining to the Adolescent A  lacK  symptoms  of  of  research  stress  is noted  Furthermore, there from a  one  study,  Questionnaire asKed most  to  was  report  a  used  There  and  girls  are  not  of  Known.  adolescent  the  stress  of  and  literature.  &  Stern,  the  age  the  lacK  which  adolescent  self-reports of  of  to  of  been  lacK  symptoms, t h u s , w a r r a n t s  10  who  were  heart  The  rate"  activity"  in responses  address  and  104).  Perception  heart  between  ages.  the  symptoms  identified  adolescent  Knowledge  p.  a story.  different  have  of  1979,  7 to  "increased  "awareness  experience  Somatic  reactions  were  adolescents'  emotional  boys  individuals  inventories  by  The  and  of  to  significant differences  between  experienced  investigation  symptoms  <77JO,  were no or  version  girls  the  (Shields  physiological  F u r t h e r m o r e , no stress  with  reported  of  self-reports  modified  "restlessness"  <77>0.  few  pertaining  in review  perspective  their  frequently  (87%),  boys  are  developmental  In  information  stress of  of  and  reactions  investigation  exploration.  Summary. The  present  primarily symptoms  from studies of  alteration stress,  Knowledge  and  stress  are  concerning  with an  emotional  in p h y s i o l o g i c a l cognitive  adults.  These  symptoms  studies  experience  activity,  d e f i n i t i o n s of  stress  derived  indicate  attributed  individual the  is  tolerance  situation.  These  the  to for  of  30  symptoms  may  be m a n i f e s t e d  Physiological are  noted  feeling states.  based  t h e number  Self-reports identified,  o f symptoms  of stress  More symptoms  reported  reactions  nor are i n v e n t o r i e s  adolescent  identified.  the  adolescent  i s warranted.  Stress upheavals events  responses  have  as n e a r  been  of stress  Investigation  1979)  and e n t e r i n g  Rosenberg  to the stress  influential for  actions  develop  disability  have  and m a j o r  been  o f such  surgery  (Jan i s ,  (Adams & L i n d e m a n  1974;  1979; G a r f i e l d ,  ( S i l b e r , Hamburg, C o e l h o , M u r p h y ,  of d a i l y  with  living  experience  responses  resources.  to reduce, avoid  Resources  their  symptoms f o r  situations  and L a z a r u s ,  individuals  study,  and a v a i l a b l e  employed  situation.  specific for  & Murphy,  1963).  s e l f - r e p o r t s of  a r e few.  As r e s p o n s e s a r e  and o u t c o m e , t h e r e  i s need  research.  the present  behaviors  a r e not  of s t r e s s  1971), undergoing  (Cohen  in the s t r e s s  additional In  of well  age.  symptoms  The s t u d i e s  (Janis,  college  f o r each s e x ,  Stress  & P e r l i n , 1961; C o e l h o , Hamburg  However, s t u d i e s responses  described.  illness  with  by  Adult  t o permanent  1975;), or  to  to 1ife-threatening  drowning  1958), a d j u s t i n g Shontz  to the  varies  increases  i n symptoms  are reported  by t h e a d o l e s c e n t  Responses  Pertaining  differences  o f d i f f e r e n t symptoms  the  Research  a f f e c t i v e and  For a d u l t s ,  on age and s e x .  females, the frequency and  as b e h a v i o r a l ,  coping  are f a c t o r s  or c o p i n g Behaviors  are subdivided  into  are the s p e c i f i c  o r manage  the s t r e s s f u l  available  to people  as they  repertoire.  Response  behaviors.  Response  behaviors  have  been  categorized  according  to t h e i r  31  primary  focus:  appraisal to  find  the  such  and  Cognitive  p e r c e p t i o n of the  cause,  or s o l u t i o n  mentally  stress  event  response  identified  samples  & Lazarus,  P e a r l i n and derived  pathology 1932).  as  from  1980;  opposed  Questions  interviews uith  s t u d e n t s hou  stressful discrete of  the  information, talk reduce  accept age.  the  event.  they  uould  The  items  uere  uorst.  There  Thirty-tuo  someone" uas  the  everyday  respond on  the and  found  uere  males. no  uhat  they  of the  the  preferred  meaning,  in u e l l  been  (Billings  & Moos, Except  f o r these  events  involved uere  significant Ziemer  Moos, Adams by  of to  be  for five  out  additional in other  activities  more p r e p a r e d  differences  d i d uhen c o n f r o n t e d u i t h that  b e h a v i o r , seventeen  and  asking  found  ( 1 9 8 2 ) , 61  stated  or  sample.  differed  t o seek  studies  developed  to d e s c r i p t i o n s  girls  for  Billings,  uere  scale  uere  1981;  situations  (Moos &  community  scale  affect  e x p e r i e n c e s ; or  studied  items  Males  respondents  upheaval  situations.  population. Sidle,  s t u d y , r e p o r t e d by  asked  of  concerning c r i s i s  o t h e r s , become  more t h a n  uere  upon p a s t  consequences  of boys  Females uith  to d e f i n e  item coping strategy  tension  In a n o t h e r  students  10  responses  ten s t r a t e g i e s .  and  a  situations. and  drawing  a uell  in  or r e s i g n e d  P e a r l in & S c h o o l e r s t u d y  In a d d r e s s i n g a p a r t i c u l a r  college  emotional  P e a r l i n & S c h o o l e r , 1978).  f o r the  action  coping serves to  t h e community  to normal,  serves  activities.  o f c o p i n g b e h a v i o r s have  literature  (1969) developed  direct  b e h a v i o r s have been  within  the  the  attempting  and  coping  i n f o r m a t i o n , a d v i c e , or  Schooler study, question  from exploratory  Cady  entails  seeking  to problems;  Self-reports  FolKman  and  r e u a r d s ; or changing  by  cognitive  Problem-focused  appraisal-focused  populations. by  the  d i s c h a r g e of f e e l i n g s  rehearsing actions  These  uere  as  and  coping serves to regulate  control  acceptance.  emotion,  1982).  developing alternative  through  the  the  to a d i f f i c u l t y  to a s i t u a t i o n  Emotion-focused  the  problem,  (Moos & B i l l i n g s ,  a solution  relation help;  the  based  on  college a  stressful  "talking  claimed  to  to  "doing  32  something "engage to  else,"  in p h y s i c a l  5 behaviors  were s i m i l a r comparative those  sixteen  with  with  mental  short term  used  more s h o r t t e r m  the  stress  outlined  individuals emotion be  control  to  are  avoid  more  likely  situations,  Moos & B i l l i n g s , of  responses  1982,  responses  may  suggest  variety  use  items  from  individuals  with  1  listed  Furthermore,  < 197?> d i f f e r e n t i a t e d  behaviors FolKman  each each  t o use  in a  and  between  mental  long  illness  skills  problem and  solving  & Parron, et  a l . , 1969,  in t h e i r  effect.  particular  used  p.  lead  the  stress  77;  230)  to p a t t e r n s Moos  and  behavior  to s u c c e s s f u l  to  1977;  &  additional  P e a r l i n and  coping  which  likely  (Bell,  p.  may  Persons  less  durability  1882,  and  behaviors  1983). and  of  found  these  strategies  is a certain  in terms  < 1980)  a d a p t a t i o n outcomes  Sidle  the  Lazarus  <Cohen & L a z a r u s ,  There  cumulative  summarized  event,  cognitive  show b e t t e r  be  serving  stressful other  i t i s not  may and  behaviors  P . 220;  of coping  they  coping.  1982).  be  scale.  in healthy  replied  identified  Many  Those r e s p o n d e n t s  (Hamburg, E l l i o t t  Billings,  < 1978)  Bell  each.  Sidle  methods  coping.  with to  the  thirteen  participants  o f 2.3  on  coping  categories.  complementary  who  noted  response  tend  The  average  illness.  and  The  an  of  term  " e a t , " and  activity."  to those study  stated  Schooler  but  the  coping.  Response r e s o u r c e s ! Resources These  may  be  which  influence  personal, social,  amenable to m a n i p u l a t i o n stress  are  material variables.  some may  be  enhanced  as  identified. Some  are  part of  the  response.  Several  enduring  coping.  ft  &  1982)  Kahn,  deleterious which  and  or  response  personality called  effects  i s a sense  control,  traits  which  of  i s to  have been  variable  which  " h a r d i n e s s " has of s t r e s s .  It  meaningfulness feel  and  a s s o c i a t e d with  K o b a s a <1979; K o b a s a , M a d d i been  linked  to b u f f e r i n g  is comprised  of  and  to get  a c t as  effective  a desire  i f one  can  the  commitment, involved;  influence  events;  33  and  challenge, uhich  needed of  f o r grouth.  i s t h e view AntonevsKy  coherence," uhich  that  his internal  things may  uill  uorK  be v i e w e d  refers  to the extent  Another  personality  i n an a m b i v a l e n t  of  In one s e n s e ,  achievement  1inKed  manner.  Good as  disease  physical  exercise  is a buffer  reactions. reaction  increase  to greater  trait.  associated  There  sense  uith  Behavior,  effects  is a decrease An  by  o f time  societal  values  i t has been  health  products  of stress  and  1978).  n u t r i t i o n , and  in self-esteem.  tolerance  Type A  uith  & Rosenman,  exercise,  confident  It i s c h a r a c t e r i z e d  f o r the deleterious  physical  t o "a s e n s e  feels  but i n a n o t h e r ,  ue11-balanced  are u t i l i z e d .  resulting leads  With  (Friedman  and  are p r e d i c t a b l e  and a c o m p e l l i n g  ethic,  condition  s u f f i c i e n t sleep,  attention  i t i s a uay o f c o p i n g  and t h e uorK  to heart  is a challenge  a person  environments  compu1siveness, competitiveness, urgency.  change  <1979) c a l l e d  and e x t e r n a l out.  that  practices  such  physical of  stress  of the s t r e s s in anxiety  improved  (Everly  and a  fitness  level  & Rosenfeld  1981, p p .  159-161>. Factors resources. the  related  B a n d u r a <1977) f o c u s e d  b e l i e f that  self-efficacy is  facilitated  se1f-efficacy handle are  stress,  predictability  result. a  is necessary  situation  those  in t h e i r  occurs  and c e a s e  uhen  control,  any e f f o r t .  control  as t h e y  successful  coping.  These  uith  avoid  Related  control  "learned believes  or derogatory  thoughts  noted  a tasK  and  higher e f f o r t s to  situations  over  or  helplessness" they  have  about  may  no e f f e c t on  related  freedom  is a  a situation  P e a r l i n and S c h o o l e r  uere:  He  to se1f-efficacy  i d e n t i f i e d resources  resources  a tasK.  in t h e i r  levels  of perceived  a person  considered  self-denigration  lower  response.  Without  Persons  coping  of s e 1 f - e f f i c a c y ,  e f f o r t s t o manage  and p e r s i s t e n t  with  and a d e g r e e  1975).  This  coping.  a r e more a c t i v e while  accomplish  for active  by s u c c e s s f u l  a r e i d e n t i f i e d as  on t h e n o t i o n  one c a n s u c c e s s f u l l y  more p a s s i v e  (Seligman,  to the self-concept  < 1978) to  from  oneself,  positive  34  s e 1 f - e s t e e m , and These  personal  successful  1974;  support,  1976; social  support  effects  stress  (Lieberman,  enduring values  interpersonal ties  <Caplan,  difficult stress,  1974).  experiences  offering  community  resources,  interaction, hindrance  the  roles  in managing three  exacerbate  stress.  characterized  by  status which  are  selection  tends  to  1982,  pp.  thought  1982,  RabKin in the  similar promote  about  social  as  and  mastery  of  effects  personal  of  and  behavior In  social or <  a  1976)  s y s t e m which  ares  s t a t u s or  status  the  Streuning  social  functioning alone;  low  is defined  a resource  and  of  isolation,  social  a numerical  may  marginality,  minority  maintaining  two  group; or  more  incompatible. can  of  affect  coping  facilitate  to b r i n g  the  perception  behaviors.  &  improved  Lazarus, skills  and  a situation success  at  (Hamburg, E l l i o t t  1977,  studies related  identified.  of  Previous  s u c c e s s f u l coping  77-78; Monat  were n o t  support  identifying  be  <Caplan,  availability  297-300).  impairments  and  in a  pp.  assumes may  stress.  These  Phenomeno1ogical adults  guidance,  position  in m i t i g a t i n g the  systems  i n c o n s i s t e n c y , c h a r a c t e r i z e d by  Resources the  one  living  social  sharing  p r o v i d i n g feedback  impairments  i s membership  roles  and  and  for  situations  providing a buffer against  & Parron,  identified  and  by  in  The  Social  a group  situation.  important  reduction  is a factor  1982).  to  and  1976).  These s u p p o r t  direction  (Hamburg, E l l i o t t  which  network  the  control.  in s t r e s s  & Struening,  a reliable of  action  participation,  and  more  for direct  influential  RabKin  t o be  direct  opportunity  as  for oneself  were c l a i m e d  social  identified  Cobb,  control  management t h a n  is l i t t l e  Social  of  resources  stress  where t h e r e  have been  a sense  p.  213)  increased to  coping  and  as  well  as  coping and  mastery  self-esteem. resources  in  Parron is  35  Research  P e r t a i n i n g to  In a m a j o r Offer, uhich  Ostrov  the  Adolescent  phenomeno1ogical  and  addressed  Houard  (1381)  d i d not  adolescents  uere  found  to  Differences  uere  noted  with  than  generate  feelings  boys.  and  Younger  items  a  adolescent  10  themselves  age  and  expressed  scale.  Oirls to  scale  adjustment.  uithout  sex.  self.  item coping  for this  more a t t a c h m e n t  girls  the  m a s t e r y , and  the  see  of  included  psychopathology,  Adolescents  empathetic  study  Healthy  major  problems.  reported  relatives  more c o n c e r n s  more  and  friends  related  to  their  self-concepts . Longitudinal adaptation  in adolescence.  addressed. Toussieng styles  s t u d i e s have  In a s t u d y  ranged  on  styles  to  adolescence.  He  of  identified  From a  as  clear  advocated  levels  effective  behaviors disability  the  disease  uas  and  progress  class  also provided  an  coping by  The  cope.  level  of  patterns  the  have been  uas  the  child  and coping  definition  a challenge  "inoculation"  stress  for  the  and  of  uhich  Moriarty  351). youth  d e s c r i b e d , based  1972;  Murphy  and  (p.  the  progressive.  Murphy  d e s c r i p t i o n s uere  (Mattsson,  on  adulthood.  c o n t r i b u t e d to and  uith on  chronic  observations  particular  S t e e l e , 1971)  as  and  to  families.  holds  These  based  deve1opmental1y  as  optimal  used  sought.  seen  to  individual  styles  and  These  childhood  conditions uhich  ability  l o o k i n g f o r an  or  adolescents  Furthermore, stress  of  change  middle  and  been  styles.  the  explore, support,  health professionals.  managing  of  coping  have not  coping  those  considered  study  a resulting  Coping illness  as  f u r t h e r energy  development  general  uhere  of  adolescents, Moriarty  (1977) s t u d i e d coping  o p p o r t u n i t i e s to  uith  and  c o n s i s t e n t throughout  mechanisms four  limits.  effect  those  (1976) d e s c r i b e d  stimulated  by  remain  longitudinal  Moriarty such  and  vaillant  defense  four  patterns  behaviors  a continuum betueen  values  tend  Specific children  (1976) described  established  use  of  addressed  and  a  to number  36  of  behaviors  Mattsson,  i n v o l v e d the  by  with  to  seriousness  to the  of  goals  Kosub and  and  effects  1982). and  in the  Boll  youth, chronic  (1977).  but  not  illness  disruption,  and  in those have  Moriarty ability  Studies responses  to  have  Zeltzer,  was  with  (1976) that  to  are  related  to the  problem  requesting reassurance  with  to  chronic  life  uith  uould  and  category. illness  &Rigler,  stress The  support  for  youth  with  mechanisms the  been  undertaken.  1980),  healthy with of and  contention  stress  adolescents' self-reports  and  Tavormina  v a r y i n g degrees  coping  experience  are  E l l e n b e r g , Dash  G i o r d a n i . Amour,  adequate  the  the  provides  cope.  identify not  identified  in the c o g n i t i v e  chronic disease.  t o l e r a n c e which  relationships  tasks  E l l e n b e r g , Dash  live  emotional  information, setting  Kellerman,  related  learned to  stress.  minimizing  skills  time  Bedell,  have d e v e l o p e d  Murphy  uere:  relevant  and  Zeltzer,  and  categories described for  specific  and  and  uncertain future.  rehearsing  seeking  experience  Anxiety  stress  and  mentally  ( 1 9 8 1 ) and  heightened  increased  1377;  illness of  identified  emotion-focused  i n s t u d i e s by  Cerreto  f o r an  skills  to  and  developmental  These  category;  (1988; K e l l e r m a n , and  prepare  tasks  types  a reasonable  behavior  learning  of  to  coping  category;  support  exemplified Rigler  related  self-image  adolescent  coping  problem-focused  emotional  and  The  illness  appraisal-focused  The  adaptive  Some u e r e  to preserve  the  (Moos & B i l l i n g s ,  the  mechanisms ( D a n i e l ,  major  a satisfactory  (1958?.  complementary  in  illness.  friends,  similar  Havighurst  concrete  identified  uere  to maintain  are  adult  (1977)  tasks  f a m i l y and  These  defense  more g e n e r a l , r e l e v a n t t o d i f f e r e n t  general  balance, with  Tsu  f o r those  some u e r e These  of  1972).  Moos and skills  use  of  stress  of an  37  Summary  Present behaviors  stress  and  theory  resources  related  to  adaptive  the  of  cognitive  use  a v o i d a n c e , and  the  indicates  relate  outcomes and  use  to  are  of  in c o p i n g  hardiness  and  of  positive  se1f-deprecation; position; sleep,  and  regular  addressed is  noted  coping  that  or  responses  control;  physical  experience  good  and  for  the  experience are  at  an  disorder The studied  arising  has  been  Adult  linked  uith  course, for  of  sicK  increased (Elliott  and  may  disease  effect  developing  outcome.  coping.  i n more  1982;  It  adequate  stress  D.  & Eisdorfer,  of  spite  1982) not  uho  stressful  a physical A.  is  individuals  range  responses In  of  relationship  a uide  to  have  predisposition,  or  and  social  Stress  chronic,  causes, reactions,  as  lacking.  concluded  & Eisdorfer,  in r e l a t i o n  are  be  of  of  adolescents  result  i t can  risk  Response  and  in a d o l e s c e n t  outcome ( E l l i o t t  a cause  Houever, intense,  and  to  from s u f f i c i e n t  adolescent  the  opposed  from  support  healthy  evidence  conclusive.  social  skills,  traits  freedom  the  precipitation, but  and  specific self-reports  to  as  strategies.  concern  Pertaining  Stress  strategies  of  stress.  Outcomes o f  Research  a variety  that  for  Behaviors  nutrition.  stress  tolerance  coping.  of  of  behaviors  uith  response  s e l f - f a c t o r s such  studies  of  of  personality  condition  and  patterns  increased  Studies  of  studies  general  ares  coherence;  exercise,  Longitudinal  use  self-esteem,  locus  good  the  a combination  influential  se1f-efficacy,  successful  problem-focused  resources  a sense  a variety  or  Hamburg,  events  mental 1982,  p.  have  been  of  stress  of  many v a r i a b l e s ,  xix).  a  38  consistent, been  found  1982).  The  of  affect  not  relating  endocrine, onset  although  change  events  to  stress  a l t e r the  reactions  disease  the  physiological  <Zegans,  maintained  uhen  alcohol  tobacco  or  an  as  physiological  symptoms  an  copes  and  illnesses disease, as  such  cold  Cox,  p.  with  illness  (Nucholls, 243);  accidents  minor  (Cassidy such  as  1975).  1972;  athletic  Stress  has  asthma, c a n c e r , rheumatoid <BieliausKas,  Research  1975)  and  have a l s o uere  found  to  the  as a  as cope. of  & Eisdorfer,  artery  illnesses  such  <BieliausKas, of  (Dobson,  stomach 1982);  aches,  in  and  and  M a s u d a , Wagner  implicated and  that  major  coronary  "colds,"  Hou  26).  have been  suicide  or  &  tuberculosis,  hyperthyroidism  Adolescent  for  for  adolescent  to  as  been  such  course  p.  by  the  to  1972); o b e s i t y  arthritis,  changes  been  the  i n j u r i e s < Br annuel 1, also  used  mental  and  of  1982); c o m p l i c a t i o n s  & Kaplan,  Elliott  are  ulcers,  may  disease  maintained  stress  the  1982).  Pertaining  Life  of  of  maintain  1882,  diabetes;  i l l n e s s e s such  the  precipitated  thus  be  & Lazarus  & Eisdorfer,  Woog,  facilitate  agents  influence  schizophrenia,  Cassel  be  and  behaviors  hypertension, peptic  Elliott  may  also  can  (Holroyd  neurosis,  1978;  sores  Holmes,  illness  a s t h m a , a l c o h o l i s m , and  pregnancy 1983,  response may  of  patterning  injurious  i d e n t i f i e d outcomes  as  depression,  1982;  or  i t s outcome  adults,  Disease  Disease  may  maintenance  i n t e n s i t y , and  a stress  (Hyman &  functioning which  has  Coping, moreover,  and  choses  relationship  illness  150).  illness  individual  reaction.  individual  p.  reactions.  physiological  For  1982,  frequency,  stress  to  immune s y s t e m s  p r e c i p i t a t i o n of  influencing  strong,  life  a u t o n o m i c , and  the  illness  convincingly  the  related be  college  to  pregnant  freshmen <CIine  health at  a  (Marx, G a r r i t y  & Chosey,  change.  family  1972;  Those  planning  &  Bowers,  Jackson,  adolescents clinic  had  1982) who  both  a  39  greater than  weighting  and a g r e a t e r  non-pregnant  reported control  more  life  groups  threatened control  change  or actual  increased  (Robbins,  loss  Athletes  rate  of injury  Stressful  life  girls  events,  uere  more o f t e n  patients  than  by a c o r r e s p o n d i n g  1983).  upsetting  events  uho  developed  infections healthy  on  uithin  (Heisel,  a year  frequent  have  been  (Heisel,  1972),  The varying  frequent  surgical,  and more  reported  <Tyerman an  1 9 8 0 ) , and d i a b e t e s  Hudgen ( 1 9 7 4 ) f o u n d  adolescents.  He c l a i m e d ,  psychiatric  illness  life  1962).  the  diagnosis  medical  precipitation  uere  t o be c o r r e l a t e d u i t h  exacerbation  o f t h e symptoms  life  events  events,  arthritis  & Miller,  & Charles,  family  life  a decrease of chronic  change  1958;  1871).  present  a  betueen  life  of medically i l l  history  forces  a  chronic  as r h e u m a t o i d  in h i s study  youth  Within  of  and s e v e r i t y a s s o c i a t e d  Higher  ( B e d e l l e t a l . , 1977; Kosub  Compared t o  1973).  (Greene  the i n f l u e n t i a l  of depression.  adolescents  service  a relationship  houever, that  and c h r o n i c i t y  increase in  f o r c h i l d r e n and  (Stein  illness  &  and s t r e p t o c o c c a l  & Coddington,  and lymphomas  and d e p r e s s i v e  youth  psychiatric  and p s y c h i a t r i c  such  et a l . ,  perceived  and more s e r i o u s  to occur  change e v e n t s  found  less  study,  & Haggerty,  serious  more  to the  (Bramuell  outcomes o f s t r e s s f o r t h e i l l a d o l e s c e n t impact.  in a  o f c h i l d r e n and  of h o s p i t a l i z a t i o n  leuKemias  & Charles,  change  c o n t r o l group  in f a m i l i e s  Ream, R a i t z , R a p p a p o r t  diseases  Jacobs  more  than  t o h a v e an  by o u t p a t i e n t  1880; Meyer  pediatrics,  o f more  life  found  respiratory infections  (Haggerty,  ( 1979)  members as c o m p a r e d  in a prospective  uas found  upper  a general  year  Further,  individuals,  occurred  reported  events  significantly  associated uith  support,  Humphrey,  adolescents  in c o l l e g e uere more  change  Coddington  experienced  of family  uith  of l i f e  1981).  in pregnant  the pregnant  group.  1975).  girls  frequency  uith  in the scores  have  been  i n s e l f - c o n c e p t and an disease  & Cerreto,  i n c h i l d r e n and  1981).  40  Summary  In r e v i e w may  be  concluded  relationship stress and  of  the  literature  that  a consistent,  is found  relating  o u t c o m e s h a v e been  physical  disease.  to  of  those  the  Stress  adult  Pregnancy, chronic infections,  and  stress  They  vary  outcomes  and  are  illness,  accidents  outcomes  although  identified  functioning.  coronary  concerning  to  not  ft  from  for adolescents with  examples  of  it  health  of  social,  "colds"  are  p s y c h i a t r i c problems,  are  variety  a f f e c t mental,  in s e v e r i t y  associated  stress  strong,  illness.  which  of  to  comparable  problems.  streptococcal  outcomes noted  for  the  ado 1 e s c e n t .  Summary  Literature perceptions the  self  of  are  perception. concern  for  has  been  stress.  described The  of  the  reviewed The  as  which  physical  selected  development  construct  Literature  of  validity  and  the  c a u s e s , symptoms, r e s p o n s e s , and  experience  causes  there  devoted  or  life  may to  be  different  situations.  relate  school,  to  Reported It  was  than  boys.  affective,  The and  events For  noted  in turn  the  needs with  that  symptoms o f physiological  of  stress  girls stress  on  age  report are  the  the  or  of  more c a u s e s  manifested  feeling states.  In  as  stress  results  of  Stress in  stress  their  grade  to  and  adolescents.  causes  of  relates  age  influences  r e l a t i o n s h i p s , and based  a  concerning  d i f f e r e n t groups the  and  complexity  literature  outcomes of  adolescents,  in causes  the  c o r r e l a t i o n between  vary  interpersonal  differences  generally  and  the  of  reveals  Moreover, s i n c e  which  little  adults  change  Much o f  adolescents.  affect perception,  experience, research  to  adolescents'  influence  concept  criticism  s t r e s s concept  than  to  s t a t e , time, experience,  stress  the  adults, rather  pertains  factors that  the  in r e s e a r c h .  Review  and of  selves. sex  vary.  stress  behavioral,  adults,  symptoms  41  vary  according  adults, using  Response  and  to  results  and in  prolonged,  good  of  or  stress  avoidance in the  or  of  of  the  stress  has  is j u s t i f i e d .  but  there  are  adolescent  and  stress.  component, the of  and  stress  adolescents  outcomes  methodology  investigation  relatively  feu  and  of  have or  research  is described  in the  stress design  include  uith  social  stress  outcome  of effect  physical functioning. adolescents'  uhere f u r t h e r many s t u d i e s  concerning  the  of  s o u g h t , but  identifying  perceptions  their  stress  a deleterious  perceptions  been  a  strategies.  of  The  has  have been  Adolescents'  measuring  Houever, h e a l t h y  areas  using  self-esteem,  p e r t a i n i n g to  There  causes,  and  to  cognitive  Experience  stress  revealed  and  management  for  is related  escape  hardiness, positive  literature  described  r a t h e r than  problem s o l v i n g  mental, s o c i a l  stress,  The  aid  As  of b e h a v i o r s ,  accumulated  affects  investigation  responses,  using  to  physical condition.  severe,  A review  intention  response  age.  increased tolerance for s t r e s s .  h e a l t h and  perception  or  using  uhich  personality trait  stress  increase uith  combination  r a t h e r than  resources  support,  to  and  s t r a t e g y ; and  behaviors,  on  sex  s u c c e s s f u l coping  a variety  single  the  to  of  a  have not  single  u i t h the stressors.  causes, been  selected for  following  healthy  potential the  chapter.  related  symptoms, identified.  this  42  CHAPTER I I I  Methodo 1ogy  A d e s c r i p t i v e survey study  of adolescents'  questionnaire study  to test  methodology.  methodology  This  in the follouing  development, p i l o t  was s e l e c t e d f o r t h i s  perceptions  uas developed  uas conducted  research  design  study,  of stress.  as a p a r t  A  of t h i s  exploratory  se1f-administered  study  and a p i l o t  the questionnaire  and t o r e f i n e t h e  chapter  t h e study  describes  sections:  data  subjects,  collection,  questionnaire  and d a t a a n a l y s i s .  Subjects Populat ion The the  subjects  Young  uere  s e l e c t e d f r o m group  Men's C h r i s t i a n  Vancouver.  The Y.M.C.A.  facilities  and o f f e r s  metropolitan philosophy  area.  t o t h e growth  Membersh i p  i s open  Greater  t o each  f o r a l l ages  uho j o i n  i s a uorlduide in s p i r i t ,  Many  Y.M.C.A. t e n d  mind  and t h e human  Y.M.C.A. S t a t i s t i c s o f both  sexes,  in the fellowship a n d body  in a  community."  o f 1982 i n d i c a t e t h e r e  ages  o f the p a r t i c i p a n t s uere 72 y o u t h  t o be s e a s o n a l  t h e summer  in the  accept the  i s summarized  other  operates  to a l l .  Vancouver  an i d e n t i f i e d  During  uhich  13 t o 17, i n v o l v e d i n  e d u c a t i o n a l , r e c r e a t i o n a l , and p h y s i c a l  activities. of  of persons  5,655 p a r t i c i p a n t s ,  social,  those  "The Y.M.C.A.  of r e s p o n s i b i l i t y  agency  o f programs  of the organization uhich  dedicated  uere  i s a community  I t i s assumed  of purpose:  sense  A s s o c i a t i o n (Y.M.C.A.) o f G r e a t e r  a variety  statement  program p a r t i c i p a n t s in  group  involved  programs.  and c o r r e s p o n d  months, outdoor  education  recreation  Youth  i n 1 o r more programs  to the school i s a major  in the  year. activity  43  uith  emphasis  on l e a d e r s h i p  development  and uorK  experience.  Sample  A convenience involved  n o n - p r o b a b i 1 i t y sample  i n Y.M.C.A. o u t d o o r  August,  1983.  conduct  an e x p l o r a t o r y  Sudman,  1976, p.87>.  recreation in  groups  uere  uere  ( D a v i s , 1971, p . 3 ;  individuals  47 i n d i v i d u a l s individual  required to  in these  outdoor  for participation  uho u e r e  eligible for  uas n o t a v a i l a b l e  Q u e s t i o n n a i r e s uere  collected  at the from  46  for Participation  following  uho v o l u n t a r i l y  participated  14 t o 18 y e a r s  signed a consent  health  form ( s e e Appendix  willingness  to participate  indicating  able to understand  had n o t p r e v i o u s l y  A f o r the l e t t e r of their  u n d e r s t a n d i n g and  i n t h e s t u d y , a n d , i f under  19, o b t a i n e d t h e s i g n e d c o n s e n t  The  met  problem,  and c o n s e n t )  Selection  study  of age,  explanation  4. u e r e  in this  criteria:  2. had no Known m a j o r  of  77  nature  youth  individuals.  1. u e r e  5.  uere  and 1 e l i g i b l e  Individuals  3.  of this  from  programs d u r i n g  b u t n o t a l l met t h e c r i t e r i a  of data c o l l e c t i o n .  Criteria  the  study There  There  participation  (N=46>  group  T u e n t y - f i v e t o 50 p a r t i c i p a n t s  the study.  times  recreation  uas s e l e c t e d  verbal  of t h e i r  and w r i t t e n  participated  in this  parent  t h e age  or guardian,  E n g l i s h , and  study.  Procedure  investigator  met u i t h  explained  the purpose  requested  to participate.  each  and f o r m a t Full  s m a l l group  of the study. disclosure  o f i n d i v i d u a l s and Individuals  of the necessary  uere  44  criteria  and t h e n a t u r e  explanation  and c o n s e n t  as  purpose.  to their  next  group  uere  reminded  of p a r t i c i p a t i o n  u a s made.  uere  and an e x p l a n a t i o n  These  meeting.  distributed letters  Fit s u b s e q u e n t  uere  t o be r e t u r n e d  group  t o r e t u r n the consent  Letters of  meetings,  made  at the  individuals  form.  Ethical Considerations Consideration uas 1.  done  The a p p r o v a l  before  3.  and t h e p r o t e c t i o n o f human  of the U n i v e r s i t y of B r i t i s h  f o r Research  commencing  The a p p r o v a l  with  I n v o l v i n g Human  of the p a r t i c i p a t i n g  of request)  Appendix  C f o r t h e agency  consent).  project,  assured  affecting 4. Y o u t h  they  their  under  consent.  informed  and s i g n e d  Subjects  agency  B f o r the letter  I n d i v i d u a l s uere  Columbia  Screening  uas o b t a i n e d  the study.  Appendix  uere  rights  i n t h e f o l l o w i n g way:  Committee  2.  f o r ethics  verbally  consent  forms  may c h o o s e  age 19 u e r e  The r e s e a r c h e r  and o b t a i n e d ( s e e  and i n w r i t i n g a b o u t t h e uere  or r e f u s e  participation  was r e q u e s t e d ( s e e  obtained.  Individuals  to participate  without  i n t h e Y.M.C.A. i n any way.  required to obtain uas a v a i l a b l e  signed  parental  by phone t o d i s c u s s t h e  project. 5. The q u e s t i o n n a i r e r e s p o n s e s 6. D a t a u e r e 7.  Raw  data  reviewed  answer the  the research  process,  at the completion  of the study.  Questionnaire  Development  uas d e v e l o p e d  that  questions.  content,  anonymous.  by t h e r e s e a r c h e r , and c o n s u l t a n t s .  were d e s t r o y e d  A questionnaire  were  and f o r m a t  uould  In d e v e l o p i n g f o r the tool  gather  data to  the questionnaire, were  addressed.  4 5 Process  ft d r a f t interviews informal The  questionnaire  uith  in  questionnaire  sample  of uas  and c l a r i t y  <see A p p e n d i x  draft seven  obtained  t h e s i s committee  from  adolescents. content,  members, an  an e x p e r t  in nursing  expert care of  r e p r e s e n t a t i v e of the study  uas p r e t e s t e d Based  uith  f o r ambiguity,  D f o r r e v i e u comments  adolescents. There  by:  revieued  considered  questionnaire  revised.  p r o f e s s i o n a l s uho uorK  f o r adolescents,  and y o u t h  from d e t a i l s  r e v i e u o f t h e l i t e r a t u r e , and  uas c r i t i c a l l y  s t r e s s management  adolescents,  The  adolescents,  discussions uith  organization,  was p r e p a r e d  uith  to the q u e s t i o n n a i r e ) . a representative  group  on t h e r e v i e u and p r e t e s t , t h e t o o l  uas f u r t h e r t e s t i n g  of the tool  in the p i l o t  study . Finally, tabulation personal  the questionnaire  in consultation uith  communication,  June,  uas  preceded f o r c o m p u t e r  a computer  consultant  <C. L a i ,  1983).  Content For include  this  exploratory  content  questions,  distribution  the  data,  checklist  of questions  topic  components  ft  content  stemmed  literature,  the questionnaire  the general  demographic  questionnaire.  general  about  study,  topic  of s t r e s s ,  and r e s p o n d e n t s ' uas used  by c o n t e n t  to ensure area.  and t h e o p t i o n s  and d i s c u s s i o n s u i t h  to  the research  r e a c t i o n s to the a  balanced  D e r i v a t i o n of the  f o r each  from the i n t e r v i e u s u i t h  uas d e s i g n e d  of the s t r e s s  youth,  the r e v i e u of  p r o f e s s i o n a l s uho u o r K  uith  ado 1 e s c e n t s . Because uas  of the e x p l o r a t o r y  introduced  addressed health.  uith  uhether  general  stress  Respondents  uere  nature  topic  questions.  is a concern, asKed  of the study, These  the subject questions  m a n a g e a b l e , and r e l a t e d  to rate their  present  stress  to  level  4 6  and  i n d i c a t e hou  addition, stress  uere  to  asKed  management  by  completing  Construction  of  each  frameuorK  open-response  guided  by  related  the  to  data  this  for  uere  the  grade  study  and  gained  new  on  uas  uas  question  in the and  peers.  In  ideas  about  questionnaire.  frameuorK.  in school  their  question  inclusion  cited  of  i f they  research  theoretical  school  identified,  of  that  c1osed-response  and  demographic  also  compared  respondents  theoretical  the  this  the  format.  Selection  causes as  uas  of  of  also  stress  being  academic  the  in  questionnaire  literature of  by  presented  Because  level  guided  frequently  achievement  uere  inc1uded . Questions  an  indirect  P.  8 4 ) .  concerning  measure  of  the  response  P a r t i c i p a n t s uere  occurred  only  during  perceived  the  validity  asked  last  level  to  of  uneasiness  <Sudman  recall  uere 1982,  & Bradburn,  s t r e s s causes  uhich  year.  Format  The  questionnaire  eliminate of  bias.  to  responses  research  f o r the  for  Bradburn,  198H,  (Pol i t &  uniformity  in the  therefore,  & Cook,  5 8 ) ,  tabulation  Demographic  data placed  uhich  at  facilitated  Hungler,  1978,  stimulus  considered the  The  end.  have  uas  and  been  from  closed-ended  the  inclusive The  3 1 5 - 3 1 6 ) .  risk  3 2 8 ) ,  salient  and  (Sudman  &  and  achieved  (Kerlinger, 1 9 7 3 , ansuer  questionnaire  provision  of  in response  e a s i e s t to The  definition  provision for  aluays  ease p.  the  and  in e x p l o r a t o r y d e s c r i p t i v e  not  pp.  i s not  on  open-ended  minimized  uhich  question uas  may  1 8 7 6 ,  questions  p.  both  response  Organization  flexibility  for options  material  facilitate  clarification  questions.  alloued  c1osed-response  to  enquiry.  included  research  Urightsman  under-reporting  topic  and  response  design  <Selltiz,  the  specific  open-ended  organized  I n s t r u c t i o n s and  s t r e s s preceded  general  uas  and uas  p.  4 8 7 ) .  uas designed  to  4 7  be  completed  in approximately  20 m i n u t e s  Pilot  To  refine  instrument sample  the planned  utility,  Study  methodology  a pilot  time.  study  and t o d e t e r m i n e t h e  uas c o n d u c t e d  < bt= 11 > o f r e p r e s e n t a t i v e a d o l e s c e n t s .  volunteered  first  uere  draun  uith  a small  T h o s e uho  f r o m Y.M.C.A. o u t d o o r r e c r e a t i o n  groups. The that  process  described  collection  the  f o r data  options  study  uere  in the questionnaire resulting  <see A p p e n d i x  the p i l o t  collection  f o r the p i l o t  Response made  f o r conducting  study  and d a t a  analysis.  uas c o m p l e t e d  added  and s e v e r a l  following the p i l o t  questionnaire  used  in data  u a s t h e same a s Data  i n one d a y . minor  r e v i s i o n s uere  study.  collection  A copy o f i s included  E>.  Data Collection Data uas c o l l e c t e d adolescents personal in  opinions  a group  explanation and  might  (Sudman  and f a c t s ,  situation  to y i e l d  & Bradburn,  to  a higher  the  response  during  questionnaire.  expressing questionnaire  permitted  to p a r t i c i p a n t s '  a common  questions,  o f a d m i n i s t r a t i o n uas  rate  the period  and l e s s  August  f o r the group.  questionnaire  uith  some  inherent  bias  1982).  and n e c e s s a r y  by t h e i n v e s t i g a t o r .  communicate  support,  The m e t h o d o l o g y  of convenience  se1f-administered distributed  f o r peer  o f d i r e c t i o n s and a n s u e r s  at a time  Because  the a d m i n i s t r a t i o n of a  provided  Data uas c o l l e c t e d 1983,  situation.  be s e l f - c o n s c i o u s and s e n s i t i v e  o f f e r e d anonymity.  considered  i n a group  one a n o t h e r ,  16 t o A u g u s t  The uriting  tools  The p a r t i c i p a n t s u e r e and n o t t o u r i t e  The q u e s t i o n n a i r e  28,  uas r e v i e u e d  their uith  uere  asKed not names on t h e group  48  and to  necessary c l a r i f i c a t i o n s ansuer  questions uhile  questionnaire. participants  made.  The i n v e s t i g a t o r  the respondents  uere  completing the  Upon c o m p l e t i o n , q u e s t i o n n a i r e s  told  hou t h e y  might  obtain  uas a v a i l a b l e  uere  c o l l e c t e d and  the forthcoming study  resuIts . Eligible complete those  participants  uere  the questionnaire.  uho u e r e  absent  given three o p p o r t u n i t i e s to  No p r o v i s i o n  a l l three  u a s made t o  involve  days.  Data Analysis Answers to  to the open-response  c o n t e n t by t u o i n d i v i d u a l s  adolescents process uere  and i n t e r r a t e r  (Pol i t & Hungler,  derived  uere  questions  in discussion  Data the  statistics frequency  component  demographic  C h i Square  calculated statistical confidence Reliability assessed  used  categories  and r a u d a t a .  These  c1osed-response  q u e s t i o n s uas a n a l y z e d  Package  f o r the Social  program ( L a i ,  to present the data. based  on t h e number  o p t i o n s uere variables  significance  Confidence  Cronbach's  uere  identified  uas s e l e c t e d  f o r the l i s t  cross  Descriptive  The p e r c e n t a g e of obtained responses.  tabulated  intervals used  through  Sciences:  1983).  and c o m p a r a t i v e  by t h e i n v e s t i g a t o r ,  using  for this  of the data.  Analysis.  level  according  uith  The c o n t e n t  to the corresponding  MTS) c o m p u t e r  s c o r e s uere  stress  selected by  uere  in working  of the l i t e r a t u r e  from the c1osed-response  9 (under  grouped  uas d e t e r m i n e d  1978, p . 4 3 1 ) .  a i d of the S t a t i s t i c a l  Version  The  compared  experienced  reliability  from a revieu  groupings  q u e s t i o n s uere  uith the  analysis  obtained  for proportions,  to v e r i f y the  by C h i S q u a r e  Analysis.  as b e i n g a c c e p t a b l e f o r t h i s  o f o p t i o n s f o r each Alpha ( K e r l i n g e r ,  stress  A 95X study.  component uas  1973, p . 4 5 2 ) .  49  Summary  Survey and  methodology  a se1f-administered  collect  data  in a group  uas  uith  Y.M.C.ft.  selection  of  the  collection  The  of  discussed  selected  14  study  to  19,  in Chapter  data  for this  of  data,  and  collection  Four.  uas  The  of  exploratory  developed  of the  several  study  used  sample  in group  to  uas  programs  stages:  the  questionnaire,  a n a l y s i s of and  and  convenience  involved  consisted  sample, development  Pilot-study,  results  Methodology  situation.  f r o m y o u t h , ages This  the  questionnaire  selected the  of  data.  a n a l y s i s are  presented  and  58  CHAPTER IV  Study  The this  perceptions  chapter  responses  uith  about  Results  adolescents  a description  the r e s u l t s  the  are  t o each  on r e s p o n d e n t ' s Because  scores  are  o f t h e sample  also presented  and i l l n e s s  questions  adolescents are included  are discussed  The c 1 o s e d - r e s p o n s e  a description  o f t h e sample  characteristics,  uith  options subgroups  For t h i s  the reported  percentages.  frequency  Significant  exploratory study,  at the o u t s e t , houever,  occurred  of the  In a d d i t i o n , r e s u l t s f o r  to reveal possible variations  be n o t e d  variations  topic.  as a d j u s t e d  are reported.  should  stress  component.  uith  and a summary  s e x and a g e .  are presented  findings  It  stress  are presented in  The p e r c e p t i o n s  and c 1 o s e d - r e s p o n s e  further considered  based  of stress  o f t h e sample  betueen  f o r the general  open-response  reference  have  the questionnaire.  have o f t h e r e l a t i o n s h i p in  and D i s c u s s i o n  trends  uhich  may  i t is possible  in data exist. these  by c h a n c e .  Description o f the Sample Forty-six One  q u e s t i o n n a i r e uas r e t u r n e d  Therefore, age,  a sample  respondents  19 y e a r s .  deviation Table  to  <n_=45>  in stress boys  1 describes  Both  is described  management  and g i r l s  t h e median  t h e sample  tuice  the questionnaire.  to the questionnaire.  t h e demographic  data. b a s e d on  training.  uho r a n g e d  T h e i r mean age u a s 16.04 y e a r s  o f 1.35.  More t h a n  uere  responded  missing  of f o r t y - f i v e  s e x , and e x p e r i e n c e The  to  <ti=46) a d o l e s c e n t s  uith  a  i n age f r o m  14  standard  and t h e mode u e r e  16 y e a r s .  by age and s e x .  a s many b o y s  <n_=31) as g i r l s  <o_=14) r e s p o n d e d  51  Tab 1e 1  Description of Respondents:  by  flge  sex  Age  The  last  The  15  16  17  18  19  Males  2  9  11  6  1  2  31  Females  3  3  2  3  2  1  14  Total  5  12  13  9  3  3  45  school  13 i n t h i s  mode u a s G r a d e  description Table the  2.  upper  middle  grade  Table  Thirteen  completed  study).  by t h e p a r t i c i p a n t s  The mean and m e d i a n  9 and t h e s t a n d a r d d e v i a t i o n  <29JO  achievement  Total  ranged  year post-secondary education ( r e f e r r e d to  o f t h e sample  level,  in years  14  f r o m Grade 8 t o f i r s t as G r a d e  <N=45>  based  on g r a d e  of their  and 4 < 9 J O u e r e  10.  u a s 1.31.  The  and s e x i s p r e s e n t e d i n  of the respondents  level  uas Grade  reported  classes,  in the louer  they  2 6 <59X>  uere i n  uere  inthe  level.  2  Description of Respondents'  Grade by Sex (N=45? Grade  in school  8  9  10  11  12  13  Total  Males  0  9  11  6  2  2  31  Females  1  5  2  3  2  2  14  Total  1  14  13  8  4  4  45  52  Participation  in a stress  O'S.) r e s p o n d e n t s : boy,  age  class  17.  tuo boys,  Because  age  meaningful  and u i l l  The  uho p a r t i c i p a t e d  reflect  the status  class  16; one g i r l ,  o f t h e s m a l l number  experience, comparative  number  management  be e x c l u d e d  age  uith  statistical  u a s r e p o r t e d by 4  stress  analysis  from the r e s u l t s  management  i s not  of this  in a stress  management  management  education  of stress  15; and one  study.  class  may  in the s c h o o l s .  Responses to the Questionnaire All rate  distributed  f o r both Of  q u e s t i o n n a i r e s uere  open-response  the ten questions  participants,  nine uere  c1osed-response  format.  and c 1 o s e d - r e s p o n s e identified  Respondents  of the s t r e s s  component  each  component  uas  in the " s l i g h t l y  five  boys each  rated  responses  described Six  in Chapter  from  "pleasant  or unpleasant  change  stress  uith  associate  <Cox,  definition  of  the  content  reliability  The a v e r a g e  about  score f o r  category, although  f o r t h e r e s e a r c h d e s i g n as  claimed  a definition  situations,  normal  1S78, P P .  for stress  on t h e q u e s t i o n n a i r e u h i c h u a s e v e n t s , or o c c u r r e n c e s uhich  functioning."  Participants  o n l y ; they  p l e a s a n t n e s s and c h a n g e . l-25>,  there  associated  d i d not  As s t a t e d  in the  i s no c o n s e n s u s  on a  stress.  reliability  Cronbach's  feelings  q u e s t i o n as b e i n g " p e r s o n a l . "  p r e s s u r e and u n p l e a s a n t n e s s  literature  The  stated  in your  i t uith  one u a s  Three.  different  cause  response  by one o r more  uhile  their  uneasy"  the r a t i o n a l e  < 14X> r e s p o n d e n t s that  rated  questions.  a different  support  format  The  q u e s t i o n s u a s 39'A.  as d i f f i c u l t  open-response  each  These  returned.  Alpha  f o r the closed  .73 t o A l p h a  grouping  .85.  responses The  of the open-response  s c o r e f o r each  stress  ranged  interrater items  component  uas  from  reliability for .78.  The  uas a s s e s s e d u s i n g  53  responses, Alpha level  of r e l i a b i l i t y Eight  stress such  .73; and o u t c o m e s . A l p h a  individuals  management  as p r o b l e m  causes  uas found  by c o m p l e t i n g  and management  back  and l o o k a t uhy  uhen  lots  uere  receptive  of stress  uas  respondents. than  Girls  increasing being  uith  responded  The  response  as a c o n c e r n  events  to these  f o r t h e items  increased  uith  on h e a l t h ,  health,"  " g e t d e p r e s s e d , n o t 100% w i l l i n g  respondents  pressure," "think  lethargic  anything, everything is t e r r i b l e . " did  not ansuer  or responded  uas  p e r c e i v e d as h a v i n g  uith  (85%).  "don't  as r e l a t e d  time  as  (93%),  Girls than  boys.  to health.  sexes.  the e f f e c t s  "high blood  you f e e l  frequently  perceived stress  age f o r b o t h  as  replied  uith  such  i t u o u l d ueaken to function  and d o n ' t  Seven  of prolonged or  uant  properly," t o do  individuals  (15%) either  know" t o t h e q u e s t i o n .  a negative effect  on h e a l t h  ones  Stress  by t h e  (85%) of respondents. appears  relationship effects  youth  " b e i n g m a n a g e a b l e " and  comments  It  these  i t e m s more f r e q u e n t l y  stress  majority  carefully  i t e m more  to health  t o t h e q u e s t i o n about  "you g e t s i c k ,  "to s i t  Topic  (91%), varying  (100%) perceived s t r e s s  to health"  to the  by 26 ( 5 6 % ) o f t h e  accumulated  and  be assumed  to this  ( 7 8 % ) , and r e l a t e d  frequency  In a n s u e r  " t o l o o k more  I t may  <64%) r e s p o n d e d  affirmatively  of the g i r l s  and  about  ideas,  related  included  Perceptions of the S t r e s s  accumulated  All  "related  stress"  comments  ideas  Their  uere  The m a j o r i t y o f p a r t i c i p a n t s  manageable  neu  ideas.  identified  boys ( 5 2 % ) .  Their  accumulates."  Adolescent  Stress  gained  or r e l a x i n g ,  of s t r e s s .  t o neu  they  the questionnaire.  talking,  I have  An a c c e p t a b l e  t o be p r e s e n t .  (18%) indicated  solving,  .73.  that  betueen  of s t r e s s  most  of the p a r t i c i p a n t s  stress  on h e a l t h .  moreover, c o n s i d e r e d s t r e s s  and h e a l t h  understood the  because  they  described the  The m a j o r i t y o f r e s p o n d e n t s , manageable  and u e r e  knowledgeable  of  54  the  general  even  though  popular  may  stress.  2.81. as  uere  scale.  compared  training. of  having  of d i f f e r e n t  The  significant  had  experience  l e v e l s of  uho d i d n o t r e s p o n d  to rate level  uere  their  present  not auare  and g i r l s ,  t u i c e as h i g h girls  the sexes  may  1968) t h a n  tend  a l l events  past  experiences,  level  o f s t r e s s uas r a t e d  (BurKe  of s t r e s s ( S h i e l d s boys.  This  or t h e i r  of  of  more s t r e s s  be r e l a t e d t o d i f f e r e n c e s  their  level  level  to rate  on  When t h e  as t h e b o y s '  more symptoms  & Higgins,  level  the s t r e s s  ( Mendez e t a l . , 1 9 8 2 ) , r e p o r t identify  stress  o f s t r e s s u a s 3.87.  in the l i t e r a t u r e ,  1979; S t e r n  constitution,  reported  f o r boys  uas 5.57, n e a r l y  1 9 7 8 ) , and  betueen  asKed  The mean  more s t r e s s f u l  Stern,  evident,  s t r e s s , houever.  As n o t e d  & Weir,  Because  i t i s p o s s i b l e those  mean r a t i n g s u e r e girls  uas  information.  accumulated  10 p o i n t  the  this  i n d i v i d u a l s <56JO  accumulated  and u n d e r s t a n d i n g  the media, or the experiences  Tuenty-five  Participants a  Knowledge  had n o t had s t r e s s management  have p r o v i d e d  auareness, of  they  Their  literature,  others  uith  topic.  &  difference  in t h e i r  genetic  r e a c t i o n to  present  s ituat ions. The to  mean  19 <4.20) a s c o m p a r e d  divided uhich  into three  increased  experience change. uith  Peers reference having  individuals reported  This  d i f f e r e n c e may  activities,  experience  and  uith  are important  greater  increased  as h a v i n g  less  measure o f t h e i r  s t r e s s than stress  e t a l . <1977), uhere oun h e a l t h  to that  their  of t h e i r  peers,  stress  factors  and may  levels  associated  1979). serve  as a  themselves  as  14 ( 3 0 % ) r a t e d peers.  and c o n c e r n .  adolescents  When  demands, and more  (305O r a t e d  level  17  be r e l a t e d t o  age ( S h i e l d s & S t e r n ,  respondents  ages  recognition of bodily  to the adolescent  Fourteen  by t h o s e ,  14 t o 16 < 3 . 6 3 ) .  more s t r e s s ; 18 ( 3 9 X ) , t h e same; and  indirect Parcel  ages  be r e l a t e d t o p e r c e p t u a l  increase  point.  themselves  their  also  a broadened uhich  age.  increased  I t may  symptoms  age g r o u p s ,  uith  uith  to those,  higher  compared SB'S, o f  This  may  be an  In a s t u d y  perceptions adolescents  of  by  5 5  considered  themselves  health,  and  peers.  Unl i K e t h e  al.  study,  study, their  11% c o n s i d e r e d  a  peers.  themselves  on  having  more o r  h e a l t h and  stress  are  presented  and  Description  "What c a u s e s Appendix  F  Total  content  The and in  most  uere  appropriate  Loss,  in each and  generated  stress?"  uere  open-ended  categories). f o r the  and  open  Peers  recorded  of  of  the  et  present  stress this  than may  health.  Stress  the  causes  of  open-response question  sample.  and  formats  are  D e s c r i p t i o n of  the  respondent's  in response  grouped  The  to  sex  the  according  responses  and  age.  to  question,  to content  causes  of  to causes  of  <see  stress:  categories, tabulation,  responses  frequently listed  of  tuo  of  Parcel  and  stress  are  3.  in e i t h e r  frequency  that  these  items  uere  Interpersonal relationships  Family  category  The  you  and  Causes  formats,  total on  less  their  Sample  items  in Table  peers. the  of  summary  presented  to  in the  same  responses.  f o r the  frequencies  responses  in the  to them than  the  question  i s made b a s e d  Open-ended list  tuo  d i s c u s s e d f o r the  of  of  the  than  related,  adolescents' perceptions  The  c1osed-responses  The  Perceptions  d e r i v e d from  c1osed-response.  healthy  h e a l t h noted  i s of g r e a t e r concern  Information uas  of  less  as  Adolescent  stress  reported having  p r o p o r t i o n of respondents  Since  stress  61%  themselves  perceptions  larger  perceived  indicate  healthier,  categories. separately.  the  Family  responses the  in the  uere  or  Items r e l a t e d  category  school  identified  to the items  Authority Figures  Emotions  categories.  to uorK,  a concern  Houever, these  Parents, Family,  Time D e a d l i n e s  related  Parents uould  category.  i s equal  Self-Concept, Authority,  to  be  56  Table  3  Causes  Pf S t r e s s :  C a t e g o r i e s , T a b u l a t i o n and Con-tent  Actual frequency  Category  Content  3  summary  UiorK  36  job, performance,  Peers  34  interpersonal inclusion,  Summar v( N=46 >  t a s K s , uorK  load  relationships,  peer  pressure,  sexuality Schoo1  33  school,  studying,  performance,  tasKs Fami1y  10  family  members, a r g u m e n t s ,  marital  p r o b 1 ems Parents  10  parents, parent  Author i t y f igures  10  being  pressure  personally  associated  uith  in trouble, authority,  urong-doing Se1f-concept  10  body  image, s e l f e x p e c t a t i o n s .  "put-douns" Time dead 1 i n e s  10  d e a d l i n e s , time  Loss  10  lost  personal a r t i c l e s ,  illness , Emot i o n s  10  pressure  injury  affective  states  such  moments, d e p r e s s i o n , Change  9  doing uhat  death,  something  as s a d nervousness  n e u , n o t Knowing  t o do, problem  F inane i a i  7  money  Cars  5  car  problems  trouble,  travelling,  driving,  traff ic S i t u a t i o n < spec i f ic > 5  alcohol, in  Compet i t i o n  3  drugs, noise,  being  Kept  darK  win/lose  situations  including  s p o r t s , games Other More t h a n  3 1 response  headaches, may be 1 i s t e d  monthly  by e a c h  periods,  respondent  fatigue  57  items.  Closed-ended Responses format,  options.  specific The  of  frequently  rated  relations,  self-concept put-douns," items and  causes  to 89%  uere  <11X>  less  liKely  yet  not  are  response  of  frequency  uith on  in Table ranged  loss  "death  may  and  be  grouped  of a c l o s e  experienced  The these  items  and  uith  7Y. f o r most  involved  the  feeling "clothes."  The  teacher/principal,"  under  Authority.  such  as  Those  "death  or r e l a t i v e "  individuals  in ranK  pressures,  of s t r e s s  upheaval, friend  4  from  "personally  "trouble  major  frequently.  The  appearance,"  bacK,"  law"  cause  items  size,  Participants  to s c h o o l , time  Another  in the  different  stress-causing  displayed  related  parents.  to  or  identified  stress  those  the  a selection  in a  items.  "school uorK, t e s t s . "  getting  pertaining  c1osed-response  from  evidenced  "hassles uith  parent"  for  "problems  "parents  items  of The  and  as  in the  items  frequency.  "pregnancy"  peer  same q u e s t i o n , e x p r e s s e d  were o b t a i n e d  identified  order  to the  in the  of  <28X),  sample  a uere  had  traumas.  Discuss ion. The school  as  Tyerman data  responses a major  and  to both source  Humphrey  f o r the  present  of s t r e s s ,  Dobson  study  collected  was  involves their  being  the  adolescents' interact also of  be  anticipated.  activity  their  dominant. in the  schoo1-re 1ated  items  comp1ete.  and,  and  uere  to uorK.  most  The  Even  end  of  the  summer  for adolescents  WorK/1eadership stress  occurs  i t was  expected  uorK  is supported  list  by though  s e r v e s t o meet  though  of  because  because  In t h e  impact  identified  perhaps  activity  year  the  1983).  at the  prominent,  UlorK c a t e g o r y , e v e n School.  also  <1988;  tasKs.  This expectation  than  related  their  environment,  more r e s p o n s e s  items  of  are  School  developmental  major  uith  responses  items  greater part  identified  uere  support  a result  ( 1 8 8 2 ) and  v a c a t i o n , schoo1-re 1ated school  question formats  many  was as  the people  items  uould  by  the  frequency  UtorK  had  only  three  of o p t i o n s ,  frequently  c1osed-response  of  identified, list  was  uith  feuer  liKely  not  58  Table  4  Causes  of S t r e s s : Frequency  i n Rank O r d e r  Actual frequency  Cause SchooluorK , t e s t s Pressure  t o do t h i n g s u i t h i n  Relationships Living  uith  "getting  Pressures  from  Personally Starting  time  o p p o s i t e sex  up t o p a r e n t s '  Parents  on  expectations  back"  friends  feeling  "put-douns"  a neu j o b  Team p r e s s u r e s Problems  uith  to uin in sports size,  appearance  Clothes Trouble  uith  Routines, Hassles Loss  <N=46)  teacher/principal  same  uith  old thing  t h e 1 au  of a pet  Parent/relative  very  sick  frame  A d j u s t e d * %> frequency  41  89  37  80  38  70  33  70  31  67  29  63  29  63  28  61  23  50  20  43  20  44  20  43  19  41  18  33  18  39  18  39  Failing  a subject  16  36  Hassles  uith  13  28  13  28  Death  brother/sister  of close f r i e n d  or  relative  Changing  school  13  28  Wrecking  the car  12  26  Problems  uith  acne  12  26  or hurt  10  22  10  22  10  22  9  20  7  15  7  15  6  13  6  13  5  11  3  7  Badly  sick  Parent  losing job  Parents  divorced or separated  Flunking Losing  a grade  a job  Finishing  school  Getting, maintaining Family Death  a car  member d r i n k i n g of parent  Pregnancy  59  Interpersonal peers,  including  causes  of  a l . , 1980>.  as  stressors, reflect  determined p.  9),  uith  a result  the  Concerns uere  the by  also  with  1982;  related noted  developing  reflection  parents, s i b l i n g s ,  opposite  similarly  1973b; J a c K s o n ,  et  and  those  stress,  <Coddington,  relationships  noted  Kosub  to  the  in the  self.  sex,  in the  1982;  in i n t e r a c t i o n  as  Yeauorth  se1f-concept,  the  are  identified literature  & Kosub,  literature  As  interpersonal relationships  uere  and  identified  <JacKson,  1982)  self-concept is uith  of  others  utmost  (Wylie,  1974,  importance  to  the  ado 1 e s c e n t . "Living "letting in  the  the  Dobson  list  study  uhich  The  results  uith  identified Those  items  "parent/relative items as  liKely  very  et  sicK  by  difficulties The  or  results to  those  for  the  f o r the  of  item stress  a reflection relate  to  of  the  the  uell-being noted  to  related  "fear  of  noted  of  bacK"  and  as f r e q u e n t l y  o t h e r s , such  state  uas  experience  liKely  of  to r e a c t to  they  are  uere  noted  respondents  uith  illness  or  difficulties  to react  authority figures  authority figures"  by  are  to  themselves. to  as  well-being,  similarly  a d u l t s , the  a d u l t s than  experience  on  oun  more f r e q u e n t l y t h a n  This result  more  or  a l . < 1980).  personal  are  back,"  their  getting  been  to  independence  f u t u r e and  also  relate  on  divorced  "parents  have  responses  struggle for  f o r the  Compared  items  the  source  getting  a d o l e s c e n t s ' oun  hurt."  might  also  "parents  items,  the  significant  they  and  indicate  limited  I t may  "parents  s i c K , " uere  T h e r e f o r e , they  experienced  include  concern  a l . <1980).  t o h a v e had  injury.  similar  uhich  be  open-ended  Mendez e t  a p p l i c a b l e to  "badly  Yeauorth  in the  Tuo  by  a frequent  to  described previously.  brother/sister,"  stressors  is similar  T h i s may  oneself.  a concern  life.  as  351).  brother/sister,"  married  "hassling  of  items  f o r some, p e r h a p s ,  possible  identified  has  options  uith  expectations"  <1983, p .  category  separated."  such  doun,"  s e l f - c o n c e p t as  of  "hassles  the  parents'  e x p e c t a t i o n one  Family  and  to  parents  reflective  the  up  are  noted  by  60  Kosub task  and Kosub  (1982).  t o develop  a code  The r e s u l t s of e t h i c s  may  reflect  and m o r a l  the adolescent  standards  and t o become  independent. Time p r e s s u r e , d e a d l i n e s , c h a n g e , and f i n a n c i a l consistent change  uith  event  concerning expanding uith  societal  inventories.  cars, role  desirable  alcohol,  individual.  respondents  identified  of  For these  The cause  listing  is similar  identified  developmental  of the  level  of stress  percent of the as b e i n g  i t is possible change  their  and  to the i d e n t i f i c a t i o n  reflect  are excluded, those  tasks of the adolescent p e r i o d .  correspond  to the premise  that  threatened  ( C . Rogers,  experience  o f t h e a d o l e s c e n t and t h e i r  1951).  stress The  items  also  as a  in the  1972). items  most  and t h e  These  o c c u r s uhen  life  of emotions  & Munan,  the developing s e l f  cause  i t e m s , as a  by t h e a d o l e s c e n t d e s c r i b e d  items  a  stimulation.  i n the open-response  e t a l . , 1977; S t e r n l i e b  When s c h o o l and uorK frequently  as t h o s e  same o l d t h i n g "  sufficient  of emotions,  (Parcel  Forty-one  respondents,  or personal concern  literature  life  of the adolescent  i s an o p t i m u m  "routines,  uas n o t p r o v i d i n g  of stress  health  responsibility  of the  stress.  f o r each  experience  i t e m s , as u e l l  and d r u g s , a r e i n d i c a t i v e  (1974) claimed there  stress.  and a r e common t o many  These  and i n c r e a s i n g  concomitant Selye  stress  items a r e  findings  the s e l f i s  r e f l e c t the  age o r t i m e f o r  opportun i t ies .  Description  o f Subgroups  Based  on D e m o g r a p h i c  Variables  Sex. To  further  describe  causes, comparisons  the adolescent perceptions of the s t r e s s  of boys'  Frequency  scores f o r selected  displayed  i n T a b l e 5.  these  causes  of s t r e s s  and g i r l s ' causes  The summary  p e r c e p t i o n s uere  of s t r e s s  by s e x a r e  o f C h i Square  by s e x i s p r e s e n t e d  made.  Analysis f o r  in Table  6.  61  Table  5  Selected  Causes  of S t r e s s : Frequency  bv Sex  adjusted Males 0_=31  Cause o f s t r e s s Frequency Starting  higher for  t o win  Females n.= 14  males 64  050  in sport  55  36  a new j o b  Team p r e s s u r e s  f r e q u e n c y * Y.~>  Trouble  with  teacher/principal  58  21  Hassles  with  t h e law  45  21  Failing  a subject  40  21  the car  33  14  29  7  26  7  19  7  Wrecking Parent  losing job  Flunking Losing  a  grade  a job  Frequency Relationships Parents  "getting  Personally Living  with  f e ma1e s  o p p o s i t e sex  on  feeling  higher for  back" "put downs"  up t o p a r e n t s '  expectations  Clothes Hassling  with  brother/sister  Parent/relative  very  sick  Pregnancy  Significance  using  C h i Square  A n a l y s i s : * p_< .05.  55  100 **  53  86  58  78  64  78  37  57  19  50  32  50  0  21  ** p_<.01.  *  62  Table  6  Summary  Cause  of C h i Square  of  a neu  Trouble  with  Hassles  uith  Failing  a  Wrecking  to uin in  sports  teacher/principal the  1 au  subject the c a r  losing  Flunking  job  a grade  a job  Relationships Parents  uith  "getting  Personally Living  Chi  job  Team p r e s s u r e s  Losing  Selected  stress  Starting  Parent  Analysis:  up  opposite  on  feeling  sex  back" put  to parents'  douns expectations  Clothes Hassling  uith  brother/sister  Parent/relative  very  sick  Pregnancy  Note t C h i Square a  C h i Square  frequencies * p_< . 0 5 .  uas  calculated  uas  calculated  uhich  results  * * p_< . 01 .  uith  i n an  using less  Causes  Square  bv  Sex  Degrees  <N=45)  of  0.35  1  0.75  1  2.47  1  1.41  1  0.75  l  a  0.92  l  a  1.56  l  a  1.09  l  a  0.36  l  a  7. 19  l  a  2. 19  l  a  0.99  l  a  0.35  l  a  0.90  1  3.04  l  0.65  1  4.09  1  Yates  freedom  a  a  Correction.  than  the expected  cell  optimistic  significance  value.  63  One  item,  identified compared  significantly  u s i n g both  comparisons, BurKe  and W e i r  girls  difference intervals With  sexes  their  activity,  identified  relationships,  traditional some  childhood.  items be  item uere  interval  r e p o r t e d by  may  uith  of confidence  a t p.<.05.  and h e t e r o s e x u a l be s e x u a l l y  only g i r l s  older  of  identified the female  boys  uho u e r e n o t  pertaining  be b a s e d  than  girls,  uhereas  to the family,  more f r e q u e n t l y  be d i f f e r e n t roles.  a sexual  than  c a r s , and girls  boys.  in responses  between  boys  constitution.  The  for individuals  be  and a s s u m i n g  identified  sources of s t r e s s .  may  uith  a particular  concomitant  tasKs of  a sexual r o l e ,  be c o n t r a d i c t o r y  that  orientation in  sex r o l e  At a d o l e s c e n c e , t h e s o c i e t a l  f o r females  of identity  uith  raised in  However, i t i s p r o b a b l e  experienced a bisexual  identity  that  interpersonal  on e x p e r i e n c e o r g e n e t i c  or female  indicate  to a j o b , school,  f o r the v a r i a t i o n s  p a t t e r n s may  have  trends uhich  For the a d o l e s c e n t , with the developmental  expectations  active.  the consequences  It i s p o s s i b l e  more f r e q u e n t l y  reasons  male  identity  frequently  revealed the  insignificant  that  dating  more  a comparison  sexes  pertaining  and t h e s e l f  u h i c h may  diffusion  t o be  of data r e v e a l s  stressors  individuals  achieving  Analysis  of s t r e s s .  stressors  socialization  when  study.  figures  may  to that  C h i Square  i t i s of concern  examination  girls  boys  and c o n f i d e n c e  identified  the r e s u l t s  to this  Possible  than  uas a l s o  s h o u l d be c o n c e r n e d  in t h i s  identified  and  Although  as a c a u s e  respondents  by g i r l s  uas s i m i l a r  a d o l e s c e n t s of both  both  authority  result  of developing a sexual  Since  boys  Analysis  i n s c o r e s t o be s i g n i f i c a n t ,  relationships,  An  This  boys.  the tasK  involved  more f r e q u e n t l y  "pregnancy"  revealed  pregnancy  t h e o p p o s i t e s e x " uas  <1979>.  item,  than  uith  C h i Square  p.<.05.  Another by  "relationships  and  and r e s u l t  uncertainties  those may  also  familial in a  and l a c K o f  64  control. others the  Consequently,  for their  Another betueen  may  s e 1 f - d e f i n i t ion.  same a m b i g u i t y  competitive,  females  looK  to relationships  Males,  in d e f i n i t i o n  c o n v e r s e l y , may  of the s e l f  and t h u s  a g g r e s s i v e and  independent.  possible  f o r the v a r i a t i o n s  the sexes  may  reason arise  from t h e i r  uith  inherent  n o t have  c a n become  in responses biological  d ifferences. There <38JO  uas l i t t l e  difference  i n t h e mean t o t a l  stress.  Although  girls  percentage and b o y s  different  i t e m s , t h e number  similar.  This  al.  < 1986) and J a c K s o n  than may  finding  boys.  Differences  account  betueen  responded each  in contrast  < 1982) uho f o u n d in the l i s t  f o r the discrepancies  ( 3 9 % ) and b o y s  f r e q u e n c i e s f o r a l l causes of  o f items  stands  girls  differently identified to those  girls  to  uas v e r y  o f Mendez e t  r e p o r t e d more  of o p t i o n s or i n each  betueen  study  events  sample  findings.  Age . Adolesents' based of  on t h e r e s p o n d e n t ' s  stress  Square  p e r c e p t i o n s of s t r e s s  by age  Analysis  presented  age.  i s summarized  The f r e q u e n c y in Table  f o r the selected  in Table  8.  causes  causes  7.  uere  also  compared  of s e l e c t e d  The summary  of s t r e s s  causes  of C h i  by age i s  65  Table  7  Selected  Causes  of S t r e s s ;  Frequency  bv  Age  Frequency  Adjusted  Cause  of  Age:  stress Frequency  Pressures  t o do  Finishing  school  increase  u i t h i n time  things  14-15 11=17 uith  frame  Personally Pressures  feeling from  Team p r e s s u r e s Loss  "put  friends to u i n  in  sports  of pet  Trouble  uith  teacher/principal  Parent/relative Hassles  uith  Hassling Failing Losing  sicK  1au  uith a  very  brother/sister  subject  a job  Problems  uith  acne  Frequency  age 82  100  6  14  50  6  8  17  71  68  33  71  64  33  65  45  17  53  36  0  47  45  17  47  36  17  47  36  17  47  23  0  44  32  17  23  14  0  29  27  0  decrease uith  douns"  higher  18-19 0_=6  71  Pregnancy  Frequency  16-17 0_=2£  *  age  at a p a r t i c u l a r  age  Starting  a job  53  73  33  Wrecking  the car  18  41  0  Significance  using  C h i Square  Analysis:  * E.< .85.  66  Table  8  Summary  o-f C h i S q u a r e  Analysis:  Selected  Causes  of Stress  by Age  <N=45>  Cause  of s t r e s s  Pressure  C h i Square  t o do t h i n g s  within  time  Degrees  of  freedom  2.49  2  6.69  2 *  2.39  2  2.95  2  friends  2.65  2  to u i n in sports  4.30  2  5.32  2  1.86  2  1 .78  2  1.78  2  5.58  2  1 .53  2  2.26  2  1 .99  2  S t a r t ing a j o b  3.62  2  Wrecking  4.90  2  Finishing  school,  graduating  Pregnancy Personally Pressures  f e e l i n g p u t downs from  Team p r e s s u r e s Loss  of pet  Trouble  uith  teacher/principal  Parent/relative Hassles  uith  Hassling Failing Problems Losing  Note:  sicK  t h e 1au  uith a  very  brother/sister  subject uith  acne  a job  the car  C h i Square  frequencies  uhich  uas c a l c u l a t e d results  uith  l e s s than  i n an o p t i m i s t i c  the expected  significance  cell  value.  * p_< . 0 5 .  There age. age  u e r e no s i g n i f i c a n t d i f f e r e n c e s  "Finishing school" group.  Analysis, intervals,  Although  u a s n o t e d most  statistically  this difference p_<.05.  This  f o r r e s p o n s e s based  frequently  stressor  by t h e o l d e r  s i g n i f i c a n t using  uas n o t s i g n i f i c a n t u s i n g uas  identified  by  on  C h i Square confidence  1 0 0 % o f t h e 18  67  year  olds,  a fact  Trends uhich  stressors  i s t o be  in d i f f e r e n c e s ,  increased  "pressures  uhich  uith  t o do  age  the  developmental  developing  a sexual  plan  given  ahead.  time  The  frame"  uas  also and  relationships,  to uin  than  by  grade  shou  uith  age  school,  age  u o r k i n g and  and  The  subject"  uere  rated  reported uith  may  Lack  a  reflect  demands,  peer  noted  items  uhen t h e  related  by  frequency  as  and "team  secure  from o t h e r s .  by  a  "urecking the c a r "  16 and  13.  entrance  t o h i g h s c h o o l by  Similarily,  a change  less  17 y e a r  olds  stressful. uere  related  "changing and  "failing  i n Grade  in s u c c e e d i n g  an  uith  With  responses  a grade,"  of schoo1-re 1ated  to  a more  influences  by  and  relationships,  respondents  decreasing frequency  related  authority  independence,  to s c h o o l ,  "flunking  frequently  to  pressure  reflect  a c a r become  i n Grade  be  related  of e x p e r i e n c e , a s s o c i a t e d  for  may  may  consequent  j o b " and  frequency  and  ability  things uithin  is stress-producing.  tests,"  most  a neu  Houever , the  < 1982)  and  in c o m p e t i t i o n such  more f r e q u e n t l y  driving  p a t t e r n s uere  in s c h o o l .  at the  uere  v u l n e r a b l e to  groups.  "school uork,  noted  uith  a higher response  responsibility,  students  uith its  <1982) and  achieving  as u e l l ,  "Starting  school,"  uere  as  stressors  other  Similar to  i s not  group.  r e p o r t e d as  experience,  Jackson  Decrease  in s p o r t s , "  items  increased  These  auareness  o c c u p a t i o n , d e v e l o p i n g peer  that  uere  an  by  t a s k s of  pressures  the  noted  uhich decreased  a se1f-identity.  age  group  and  p r e p a r i n g f o r an o c c u p a t i o n ,  opportunities,  achieving  particular  age  " p r e s s u r e t o do  f o r an  Several  of the  "pregnancy,"  frame."  for  developmental  of s e l f  a g i v e n time  tasKs:  preparing  sense  school,"  Stressors  maturity.  family the  "finishing  graduates.  indicated.  frequency  uith  reflect  are  increasing  that  figures,  age  school  and  activities  Stressors  on  uith  identity,  increasing occur  uere  activities  particular  to  based  things uithin  reflect  expected  9  a  and  grades.  stressors  increased  again  increase  in s t r e s s  uas  LeBou  <1976) and  in a c t i v i t y  format  Jackson and  68  expectations  uith  high  teacher/principal" Grade  in  e t a l . , 1830).  reach  The stress to  a climax  frustration  a t ages  uith  to those  the  of s t r e s s o r s  no  linear  15 t o 16 <B.  lends  Hamburg,  increased  uith  t o Maccoby's  age;  there  change.  also  be due t o t h e d i f f e r e n t  1882;  and autonomy  1974) and  result  in a u t h o r i t y . causes of  These  ages  results  14 t o 16,  are in  by Mendez e t a l . C 1 9 8 0 ) , uho  or decrease  i s only  <JacKson,  of a l l reported  17 t o 19.  reported  support  increase  by t h o s e  frequency  ages  opposition  results  f r e q u e n t l y by r e s p o n d e n t s i n  age f r o m 4 6 % f o r i n d i v i d u a l s  37% f o r i n d i v i d u a l s  in  uith  The s t r u g g l e f o r i n d e p e n d e n c e  mean p e r c e n t a g e  number  most  "Trouble  in the l i t e r a t u r e  uhen t h w a r t e d  decreased  entrance.  uas r e p o r t e d  10 and u a s a l s o n o t e d  Mendez may  school  age.  Perhaps  the c o n f l i c t  t h e s i s (1983) that  in v u l n e r a b i l i t y  The v a r i a t i o n  there i s  to s t r e s s  in study  questionnaires  noted  used  uith  results  i n each  may  study.  Sex and a g e . Adolescents'  perceptions  compared  on t h e b a s i s  patterns  f o r s e l e c t e d causes  age. of  The summary  further an  of C h i Square  elaborated.  older  age  identified  girls  uas  statistically  not  significant  Compared may  Trends  identified  confidence  to boys, g i r l s experience  more  Furthermore, the d e t a i l s date,  may  ambivalence  to g i r l s ,  than  frequently. C h i Square  of  be  sexes at stress,  This d i f f e r e n c e A n a l y s i s , but uas  c o m p a r i s o n s , p_< .05.  goal-oriented about  their  of the graduation  boys.  both  s c h o o l " as a c a u s e  activities  causes  10.  Although  interval  be l e s s  c l o t h e s , and p a r t i c u l a r  interest  using  selected  f o r s e x and age may  are evident.  i t e m more  by s e x and by  in Table  patterns  further  9 reports the  f o r these  is displayed  significant  using  Analysis  "finishing  this  Table  uere  of s t r e s s considered  d e s c r i p t i o n of response  the  and  o f s e x and a g e .  s t r e s s by s e x and by age The  of s t r e s s causes  event  may  in seeking  a job  future. such  as  their  be o f g r e a t e r  63  Table  9  Selected  Causes o f S t r e s s :  Frequency  bv Sex and bv flae  Adjusted  frequency  Male  Age:  Cause o f s t r e s s  Frequency Pressures time  t o do t h i n g s  Pressures  school  from  Team p r e s s u r e s Personally  expectations  t o win i n s p o r t  feeling  Trouble  uith  Failing  a subject  p u t douns  teacher/principal  of pet  Hassles  uith  brother/sister  Frequency Parent/relative  very  sicK  Pregnancy  Significance ***£_< .001 .  using  17-19 D_=9  14-16 D_=8  17- 19 D_=lB  u i t h age  C h i Square  73  89  75  100  9  22  0  50  decreased  friends  up t o p a r e n t s '  Female  uithin  Frequency  Loss  increased  frame  Finishing  Living  14-16 n_=22  < Y.)  *  w i t h age 73  33  75  17  68  55  87  67  59  44  50  17  59  55  87  67  59  33  25  17  48  22  25  17  45  33  39  17  75  17  62  33  27  0  **  dissimilarities 32  33  0  0  Analysis:  *p_< .05.  0  **&_<.01.  50  ***  70  Table  10  Summary and  Chi Square Analysis'  of  selected  of  stress  Pressures time  Chi  t o do t h i n g s  by Sex  school,  Pressures  from  Living  up t o p a r e n t s '  Personally  expectations  to u i n in sports  f e e l i n g p u t douns  Trouble  with  Failing  a  Loss  graduating  friends  Team p r e s s u r e s  teacher/principal  subject  of a pet  Hassles  uith  brother/sister  Parent/relative  very  C h i Square  frequencies  sicK  P_<.05.  girls.  girls  uith This  intervals,  e_<.05.  more s e n s i t i v e  3  7.90  3  5. 16  3  2.06  3  3.48  3  2.45  3  5.44  3  3.38  3  1 .76  3  uith  2.54  3  20.88  3  less  **  3  than  ***  the expected  significance  identified  both  "parent/relative more  frequently  in the l a t t e r C h i Square  Compared  to family  item uas  Analysis  to other  members t h a n  and  very  cell  value.  than  sicK" boys  is sicK.  Girls  may  also  or  older  confidence  groups, younger other  and  statistically  persons  more f r u s t r a t i o n f r o m s i b l i n g s and more c o n c e r n  relative  *  * * * p_<.001.  difference using  of freedom  2.80  i n an o p t i m i s t i c  brother/sister"  significant  feel  results  * * p_<.01.  Younger "hassles  uas c a l c u l a t e d  uhich  Degrees  12.40  Pregnancy  Note;  Square  uithin  frame  Finishing  or  of s t r e s s  bv Age ( N=45>  Cause  *  causes  girls  may  be  a r e , and h e n c e uhen  be more s e n s i t i v e  a parent  to the  71  remarks  of others,  particularly  younger  a g e , a r e more v u l n e r a b l e  "Pregnancy" f o r o l d e r Analysis  as a c a u s e  reason  girls  members, and a t a  with  uas s i g n i f i c a n t using  siblings.  using  confidence  about  c o n c e r n ing pregnancy  uas  by y o u n g e r  It i s p o s s i b l e younger  pregnancy, or perhaps  C h i Square  interval  "Pregnancy" uas n o t i d e n t i f i e d  of s t r e s s .  f o r concern  of family  to c o n f l i c t s  but uas n o t s i g n i f i c a n t  c o m p a r i s o n s , p_<.05. girls  those  girls  their  had no  Knowledge  inadequate.  Summary In summary, t h e most participants uorK the  uere  uere  also  activities  relate  stressors  frequently  feeling reflect  opposite  listed  Other  than  identified  by o l d e r  reflect  stressors  from f r i e n d s .  perceptions  of s t r e s s  These  causes  statistically  "Relationships  more f r e q u e n t l y  identified  girls  and uorK  self.  of adolescents'  b r o t h e r / s i s t e r " uas  by g i r l s  more f r e q u e n t l y  by  uith the and  "hassles  younger  o r any b o y s .  not s i g n i f i c a n t ,  a trend  in differences  in responses  on t h e s e x and age o f t h e p a r t i c i p a n t s i s a p p a r e n t . of s t r e s s o r s concerning  pressures  from  reflecting maturing  self.  With  responsibilities, considered, difference  between  uith  increase  in age, houever, the pressure  reflecting  patterns  boys  developmental  age,  uith  and demands.  response  decreased  facility  u a s more f r e q u e n t ,  The  the f a m i l y , authority f i g u r e s ,  f r i e n d s , and t h e s e l f  increased  by  pertaining to  identified  " p u t d o u n s , " and p r e s s u r e the developing  s e x " uas  school  identified  figures, interpersonal relationships,  frequency  time  Stressors  and b o t h  d i f f e r e n c e s f o r tuo items.  Although based  items.  of s t r e s s  on r e s p o n d e n t s ' age and s e x r e v e a l e d  significant  girls  causes  in the environment.  Comparisons  uith  schoo1-re 1ated  to family, authority  personally  based  frequent  increased  tasks  and a of  opportunities,  When s e x o f t h e p a r t i c i p a n t u a s uere  and g i r l s  also  found.  There  was  little  i n t h e mean f r e q u e n c i e s f o r  72  causes  of s t r e s s .  However, t h e r e uere  individual  items  identified  items r e l a t e d  and  pregnancy  identified and  as  girls  than  identified  "pregnancy"  average  number  Moreover, s e v e r a l particular  age,  School-related  as  the  item  reflecting  boys,  uhereas  job-related  "parent/relative  very  uhereas than  older the  other  decreased  boys  concerns, girls. s i c K " more  girls subgroups.  uith  age.  r e p o r t e d more f r e q u e n t l y  the  items uere  relationships,  than  of s t r e s s  uere  than  school,  more f r e q u e n t l y  items  self,  Girls  more f r e q u e n t l y  other subgroups,  of causes  in the  identified.  the  more f r e q u e n t l y  stressors  identified  frequently  The  family,  i n team s p o r t s ,  figures  the  more f r e q u e n t l y  to the  stressors  pressures  authority  Younger  u h i c h each  differences  at  a  adolescent's a c t i v i t i e s .  most  frequently  noted  by  those  Symptoms  of  Stress  in Grade  9.  Adolescent  Information stress The  uas  derived  responses  discussed  on  ansuers  age  of the  uhat from  to these  f o r the  the  P e r c e p t i o n s of the  open-ended tuo  total  to the  a d o l e s c e n t s p e r c e i v e as and  closed-ended  question formats  sample.  the  symptoms questions.  are p r e s e n t e d  Further consideration  c1osed-response  q u e s t i o n s based  of  on  and  is given the  sex  and  respondents.  Description of Total Sample Qpen-ended responses. The uere  symptoms  categorized  Appendix  and  tabulation of  and  in response  to the  open-ended q u e s t i o n  a c c o r d i n g to c o n t e n t , counted,  G f o r the  frequency  symptoms  listed  open-ended  categories). content  stress.  responses  Table  summary  and  t o symptoms o f  11 c o n t a i n s t h e  to the  recorded  open-ended  <see  stress!  categories, responses  f o r the  73  Tab 1e  11  Symptoms  of S t r e s s ;  C a t e g o r i e s . T a b u l a t i o n and C o n t e n t  Summary  <N=46?  Actual frequency  Category  Phys i o 1 o g i c a l  Content  3  5S  bodily  summary  symptoms  pounding,  such  sweating,  as h e a r t tense  muse 1es Behavioral  SB  feelings such  A f f e c t ive  2£  as  related "feel  emotional  to actions,  1iKe h i t t i n g "  feelings  such  as  sadness , depress ion  a  More t h a n  1 response  Physiological "nervous," frequently. Behavioral in  Less  respondent  such  "tense  as  identified "short  c a t e g o r y such least  by e a c h  as  and h e a d a c h e s " u e r e  frequently  c a t e g o r y , such  uere  be 1 i s t e d  c a t e g o r y symptoms  "jump e a s i l y , "  the A f f e c t i v e  "irritable"  may  as  frequently  items  listed uere  t e m p e r " and  "feeling  muscles," most  in the  "bad mood."  Items  depressed" or  listed.  Closed-ended responses. Stress a range 83%  symptoms,  from  a list  of o p t i o n s , revealed  o f f r e q u e n c i e s f r o m 5% f o r " f r e q u e n t need  for "irritability  order  identified  of frequency  or d e p r e s s i o n . "  are l i s t e d  The s t r e s s  i n T a b l e IS.  t o go p e e " t o symptoms  i n ranK  74  Table  12  Symptoms  of S t r e s s '  Frequency  i n RanK  Order  Actual frequency  Symptom o f s t r e s s  Irritability  83  36  82  35  80  33  75  34  74  27  63  26  59  26  59  25  57  25  57  23  52  23  52  21  48  21  46  openly  20  45  and mouth  17  38  16  37  15  35  15  33  12  27  Weakness o r d i z z i n e s s  9  20  Stuttering,  8  18  7  15  2  5  aggressive,  Feeling  1iKe h i t t i n g  of wanting  Pounding Being  depression  Adjusted(X) frequency  38  Feel  or  <N=46?  of  something  t o be a l o n e ,  not t a l K  heart  uptight  Sweat i n g Stomach  upset...diarrhea,  Inability Constant  constipation  to concentrate fatigue  or  restlessness  Insomnia, d i f f i c u l t y  sleeping  Headaches Craving  to eat or loss  Shaking  legs, trembling,  Being  Dryness  Feel  appetite nervous  afraid  Inability  Urge  of  t o laugh  of throat  to cry impulsive  Indec i s i o n Overpowering  urge  speech  to run or hide  disturbance  Nightmares Frequent  need  t o "go p e e "  75  The  g r e a t e r p r o p o r t i o n of  respondents included  were p h y s i o l o g i c a l  "pounding  loss  by  35  of the  symptom was "Constant  o r symptoms  constipation,"  of a p p e t i t e . "  <S0%)  identified  of h e a r t , " "sweating,"  upset...diarrhea, or  items  "Feeling  of wanting Another hitting  fatigue  or r e s t l e s s n e s s "  was  was  "insomnia,  m a j o r i t y of  states.  "craving  t o be  These  eat noted  identified  something"  identified  difficulty  to  a l o n e " was  frequently  a g g r e s s i v e , 1iKe  as  o f body  "headaches," or  participants.  the  "stomach  "feel  respondents,  by  <8S%).  by  57%  of  the  sleeping."  D i s c u s s ion. The yielded  content similar  identified least  or  the  open-response  information.  most  frequently;  content  frequently  in the  affective  of wanting  t o be  a l o n e , not  corresponding  c1osed-response  verbalize  Furthermore,  their they  "Pounding may  and  frequently  may  were  items  uere identified  to the study  in a study  of r e s t l e s s n e s s  correspond  stress  not  be  auare  reaction  less  as  by  uas  items  also  <Selye,  are  As  by  in the  in the  item  indicative  1874).  "irritability and  the than not  the be  recognize  of the  able them.  participants  noted  in the  i t e m uas by  the  children,  S t e r n <1979).  noted  the  symptoms.  this  response  and  can  oun 75%  may  grouping  uell,  stress  Shields  frequently  of t h e i r  cardiovascular <1880).  Houever,  they  to  something,"  Adolescents  identified  to r e s t l e s s n e s s , These  noted  corresponds  hitting  readily  r e c o g n i z e d autonomic  restlessness." the  symptoms  options,  talK."  items.  as  o f h e a r t " uas  Everly  to t e n ,  frequency  uere  symptoms  correspond  Humphrey  items  may  items  a g g r e s s i v e , 1iKe  listed  seven  c1osed-response  symptoms  c1osed-response  spontaneously  and  Physiological  open-response  identified  depression," "feel  "feeling  to  and  frequently. The  most  from  A  of the  ages  high  same s t u d y  "constant  most  uhich  fatigue  or  arousal state  in  76  It  i s worth  wanting  may  that  some symptoms  t o be a l o n e , n o t t a l K , "  something," forth  noting  into  or those  noted  b e h a v i o r s may  be f u r t h e r  relationship  "short  t h e symptoms  premises  as  t e m p e r , bad mood," t o managing  I t i s n o t Known  to explain  on t h e i r  l a c K o f e x p e r i e n c e , a d o l e s c e n t s may  about  emotions  and t h u s  n o t be a b l e t o v e r b a l i z e  may  to identify.  be e a s i e r  background, Some may social  With  a d o l e s c e n t s may  be r e l u c t a n t  Description  of Subgroups  a limited  feeling  and  is a  stress.  results.  lacK  Knowledge  their  are less  not understand  t o admit  norms and c u l t u r a l  symptoms  stress  to  these  Based  The p h y s i o l o g i c a l  of  i f carried  i f there  and t h e r e s p o n s e s  are suggested  experiences.  "feeling  a g g r e s s i v e , 1iKe h i t t i n g  n o t be c o n d u c i v e  stress-producing.  between  Several  as  "feel  such  subjective  and  experiential their  states  own  emotions.  because  of  imposing  expectations.  Based  on D e m o g r a p h i c  Variables  Sex. To  further  describe  symptoms, c o m p a r i s o n s respondent's by  summary  stress  respect  based  13 p r e s e n t s s e l e c t e d  "craving  appetite  proportion  "urge  difference  interval  Analysis in Table  betueen  boys  comparisons,  to eat or loss  frequently  may  o f C h i Square  to tuo items, using both  confidence  It  Table  made o f s u b g r o u p s  by s e x i s d i s p l a y e d  significant  to  uere  stress  on t h e  symptoms  of s t r e s s  sex . The  of  sex.  the a d o l e s c e n t s ' p e r c e p t i o n s of  than  boys.  d i s t u r b a n c e than o f a n o r e x i a found  be s o c i a l l y to c r y " .  more  A  and  was  identified  Analysis  in females  reported the  "urge  t o c r y " more more  i s suggested (Marlon,  acceptable f o r g i r l s  with  and  Girls  are p h y s i c a l l y  uhich  symptoms  statistically  and g i r l s  P_< .85.  girls  boys  14.  C h i Square  of a p p e t i t e " Perhaps  f o r the s e l e c t e d  items  subject  by t h e h i g h e r  1977, p . 8 8 4 ) .  t o admit  t h e symptom  77  Table  13  Selected  Svmp-toms  of S t r e s s : Frequency  bv Sex  F r e q u e n c y * JO  Adjusted  Symptom  of  Frequency Pounding  higher for  mal es  of heart  Sueat ing Shaking,  trembling  Frequency Irritability  Females n_=14  Males 0_=31  stress  higher for  80  61  65  54  50  39  females  or depression  77  93  68  36  77  85  40  85 *  £4  69  Headaches  43  63  Being  39  64  43  54  26  50  Being  uptight  Feeling  of uanting  Craving  to eat or l o s s  Urge  t o be a l o n e , n o t t a l k of appetite  to cry  afraid  Inability  to  laugh  Indec i s i o n  Significance  using  Furthermore, reported  more  pounding," such  as  "feeling  C h i Square  trends  Analysis:  uere  evident.  f r e q u e n t l y by b o y s  uere  physiological  "irritability of uanting  "shaking,  or d e p r e s s i o n , "  t o be a l o n e "  girls.  Interestingly,  Humphrey  college  girls  more  reported  * p_< .05.  in data  " s u e a t i n g , " and  reported  more p h y s i c a l  uere  symptoms  Those  trembling." "being  symptoms  such  such  as  Feeling  "heart  states  u p t i g h t , " and  more r e a d i l y  identified  and E v e r l y <1980) a l s o  affective  *  symptoms, u h e r e a s  by  found males  as g a s t r o - i n t e s t i n a l  upsets.  78  The  item  reflect  "indecision,"  reported  the ambivalence  felt  more f r e q u e n t l y  in response  by g i r l s ,  to unclear  may  role  expectat ions.  Table  14  Summary  of C h i Square  ftnalvsiss  Selected  Symptoms  of Stress  bv Sex  <N=45>  Symptom  of  Pounding  stress  Chi  of heart  Square  Degrees  of freedom  0.80  l  a  0. 14  l  a  0. 13  1  0.68  l  a  0.81  l  a  0.03  l  a  5.57  1 *  Urge t o c r y  5.94  l  Headaches  1.51  1  Being  1.61  1  0.09  1  1 .57  l  Sweating Shaking  legs,  Irritability Being  trembling or depression  uptight  Feeling  of uanting  t o be  Craving  t o e a t or l o s s  alone  of  appetite  afraid  Inability  to laugh  openly  Indec i s i o n  Note; a  C h i Square  C h i Square  frequencies *  P_<  . 05.  uas c a l c u l a t e d  uas c a l c u l a t e d uhich  results  uith  using less  Yates  a  *  a  Correction.  than  the expected  cell  i n an o p t i m i s t i c  significance  value.  79  A greater by  girls  number  than  by b o y s , a r e s u l t  <BurKe & W e i r , Perhaps  health  than  differences  acceptable to  c r y " than  problems  or hard  conditions, or  may  such  s u e a t i n g , may  interested  as g a s t r o - i n t e s t i n a l readily  in  may states, to the  Mechanic  more r e a d i l y  feeling states  The  symptoms  incidence  may  of  be more  health as  ulcers  prestigious  associated complaints,  acknowledged  o r may  t h e "urge  from s t r e s s , such uith  than  more  a f r a i d " or having  associated  The symptoms  by  be s o c i a l l y  Physiological  derived  boys  contribute  symptoms  i t may  for girls.  stress  more r e c o g n i t i o n f o r  to ignore  "being  are often  be more  also  As s u g g e s t e d  Thus,  to  f e e l i n g and b o d i l y  be g i v e n  learn  t o admit  uorK.  be more  may  to recognize  i d e n t i f i e d as b e i n g disease,  about  patterns  may  them.  than  may  1969).  reacting  t o symptoms, u h e r e a s  i t i s f o r boys.  f o r boys  coronary  positions  t o admit  for girls  acceptable  or  learn  & Higgins,  for girls  girls  identified  in the l i t e r a t u r e  1976b; S t e r n  symptoms.  1976b), g i r l s  more f r e q u e n t l y  noted  accounts  rearing  C o n v e r s e l y , boys  reluctant  also  Perhaps  in perceived  and t h u s  uere  t o be u o r r i e d  in c h i l d  1976a;  complaints  be  boys.  i t unmanly  ft d i f f e r e n c e  boys.  constitution  and be more s e n s i t i v e  consider  < 197S;  1878; M e c h a n i c ,  genetic  differently  o f symptoms  by  uith  these  heart  activity  boys.  Age. Adolescents' compared  based  selected  symptoms  perceptions  of stress  symptoms  on t h e age o f t h e r e s p o n d e n t s . of s t r e s s  by a g e .  uere  Table  also 15  displays  80  Table  15  Selected  Symptoms  o-f S t r e s s : F r e q u e n c y  by  flae  Adjusted  Symptom  Age:  of s t r e s s Frequency  trend to  increase  Fat i g u e / r e s t l e s s n e s s  of wanting  trend  to decrease  t o be a l o n e  Insomn i a t o e a t or l o s s o f appet i t e  Craving Being  afraid  Indec i s i o n Urge  t o run or  hide  Frequency Heart  higher  at  a  pounding  Sweat i n g Stomach  upset  Inability Shaking  Th i s  score  concentrate  trembling  Inability  a  to  to  laugh  increase  in score  calculated uith  Significance  using  uith  16-17 o_=21  may  C h i Square  sample  62  67  u i t h age  87  76  67  75  57  20  62  52  33  59  45  17  41  32  17  31  33  a  0  p a r t i c u 1 a r age 50  90  83  40  76  67  58  76  17  53  68  50  37  62  17  44  52  23  be a c c o u n t e d  a small  18-19 Q_=6  age  50  Frequency Feeling  14-15 D_=16  f r e q u e n c y <.'/.')  f o r by t h e p e r c e n t a g e  size.  Analysis:  * P_<.05.  81  Table selected  16 d i s p l a y s  symptoms o f s t r e s s  differences identified upset"  t h e summary  in stress less  by a g e .  symptoms b a s e d  frequently  uas i d e n t i f i e d  less  significant  u s i n g C h i Square  Table  16  Summary  interval  Of C h i S q u a r e  uere  on a g e .  frequently  in responses  confidence  There  by 14 and 15 y e a r  differences  using  o f C h i Square  f o rthese  comparison,  Analysis:  no  "Heart olds  uere  but uere  f o r the  significant p o u n d i n g " uas  and "stomach  by 18 and 18 y e a r  t u o items  Analysis  Analysis  olds.  The  statistically  not s i g n i f i c a n t  P_<.05.  Selected  Symptoms  o f S t r e s s bv  <=>qe <N=45)  Symptom  Fat  of stress  Chi  igue/restlessness  Square  Degrees  o f freedom  0.74  2  1.35  2  4.88  2  1.51  2  3. 18  2  Indec i s i o n  1 .24  2  Urge  2.72  2  8.11  2  4.33  2  7.43  2  1 .22  2  Shaking, trembling  4.67  2  Inability  0.76  2  Feeling  o f u a n t i n g t o be a l o n e  Insomn i a Craving Being  Heart  to eat or loss  of appetite  afraid  t o run or hide pounding  Sueat ing Stomach  upset  Inability  Note:  to concentrate  t o laugh  C h i Square  frequencies  * E _ < .0 5 .  uas c a l c u l a t e d  uhich r e s u l t s  using  less  i n an o p t i m i s t i c  than  * *  the expected  significance  cell  value.  82  Trends item, the  i n d a t a may  "fatigue  response  combination  of time  capabilities  run in  food  uere of  pounding,"  indicated  symptoms. become  cognitive  stress  age.  16 and  17 y e a r The  such  levels  affect  and  The  comparisons  16 and  that  their  than  of  17 y e a r <53%)  olds  for a l l  increased and r e l a t e  It i s a l s o  ages  an i n c r e a s e  individuals  the p h y s i o l o g i c a l  at these  to  olds, regardless  can l a b e l  as s t r e s s .  "urge  to concentrate"  frequency  period  and, u i t h  and  of  the importance  "inability  ( K e a t i n g , 1980),  or concepts  Sex  to  possible, reaction  to  at others.  age•  based  betueen  the frequency  of selected  o f C h i Square  by s e x and by age  significant  respondents'  perceptions of  on s e x and age a r e f u r t h e r  The summary  symptoms  reflect  " s u e a t i n g , " and  symptoms  "feeling  appetite,  period.  by  and  reflect  adolescent grouth  i t is during this  of bodily  as  may  The  overextend the  item concerning may  age.  of g r e a t e r  "indecision,"  age and t h e s e  of appetite"  to a g r e a t e r degree  reports  such  t h e h i g h e s t mean p e r c e n t a g e  i n hormone  symptoms  symptoms  The  may  f o r one  Conversely,  uith  in fatigue  trend f o r frequencies.  functioning  situations changes  uith  frequently  Perhaps  auare  resulting  "being a f r a i d , "  during the early  r e p o r t e d most  age.  decreased  and demands  of other  to eat or loss  the d i r e c t i o n a l  also  no  A number  and e x p e r i e n c e .  "Heart  increased uith  responsibilities,  or h i d e , " decreased  "craving  frequency  p r e s s u r e s and t h e p o s s i b i l i t y  t o be a l o n e , "  maturity  The r e s p o n s e  f o r "insomnia"  of the i n d i v i d u a l ,  restlessness. uanting  and r e s t l e s s n e s s "  frequency  opportunities,  be n o t e d .  differences  Although  the item,  majority  of younger  "dryness boys  elaborated.  symptoms  Analysis  is displayed  of s t r e s s  f o r these in Table  i n the subgroups i n mouth" uas  17  by s e x and by  There  stress uere  on age and s e x .  identified  and t h e m a j o r i t y o f o l d e r  Table  selected  18.  based  stress  by t h e  girls,  i t uas  83  not  identified  by any o l d e r  statistical  significance  significant  using  Tab 1e  boys.  using  This  difference  C h i Square  confidence interval  showed  Analysis,  comparisons,  b u t uas n o t P_<.05.  17  Selected  Symptoms  of S t r e s s :  Frequency  bv Sex and bv  Adjusted  Age  f r e q u e n c y * JO  Males 14-16 n_=22  Symptom o f s t r e s s Frequency Fatigue,  t r e n d to  restlessness  Females 17-18 o_=9  14-16 o_=8  17-19 n_=G  i n c r e a s e u i t h age 52  56  43  100  71  100  57  67  Sueat ing  60  78  29  83  Be i n g u p t i g h t  64  78  75  100  Heart  pounding  Frequency Feeling Being  o f u a n t i n g t o be  t r e n d to alone  86  56  86  77  41  33  75  50  62  50  71  50  to laugh  52  22  57  50  trembling  57  33  43  33  62  41  71  50  afraid  Insomn i a Inability Shaking, Stomach  upset  Frequency Dryness  d e c r e a s e u i t h age  i n mouth  Indec i s i o n  Significance  using  Chi  dissimilarities 52  0  29  67  32  11  50  50  Square A n a l y s i s :  p_< .05.  84  T a b l e 18 Summary  of C h i Square A n a l y s i s :  S e l e c t e d Symptoms  o f S t r e s s bv  Sex and by ftqe <N=45?  Symptom  of s t r e s s  C h i Square  Degrees of freedom  5.3©  3  4.48  3  Sueat ing  5.46  3  Being  3.34  3  3.8S  3  3.54  3  0.93  3  laugh  a . 77  3  trembling  a . 04  3  Fatigue, Heart  restlessness  pounding  uptight  Feeling Being  of u a n t i n g  t o be  alone  afraid  Insomn i a Inability Shaking,  to  Stomach  upset  1.49  3  Dryness  i n mouth  9.53  3 *  3.77  3  Indec i s i o n  Note: C h i Square expected  cell  significance *  P_<  A n a l y s i s uas c a l c u l a t e d  frequencies uhich  results  uith i n an  less  than the  optimistic  value.  . 05.  Summary  Physiological upset"  uere  noted  such  as  "heart pounding"  t h e most f r e q u e n t l y i d e n t i f i e d  participants uere  symptoms  in t h i s  less  "irritability  study.  frequently.  or d e p r e s s i o n , "  Affective  stress  "feel  "stomach  symptoms by  and b e h a v i o r a l  F r e q u e n t l y chosen  and  items  aggressive, like  symptoms uere hitting  85  some-thing,"  and  "feeling  of wanting  When r e p o r t e d symptoms sex  and a g e , t h e r e u e r e  the  items  These  "urge  uere  of  symptoms.  for  be n o t e d .  Girls  "sueating," there  "inability  uere  ages  to stress  Responses  responses of  may  age.  be  uas a t r e n d pounding,"  age.  Houever,  o f u a n t i n g t o be  "insomnia," uith  boys  "heart  uith  frequency  "stomach  upset,"  Individuals  frequency  of the respondent  relationship  uho  of  may  stress  uas q u e r i e d .  are both  of s t r e s s .  aids  to Stress  b e h a v i o r s and r e s o u r c e s u h i c h Behavioral responses  t o r e d u c e , a v o i d , o r manage  are the a v a i l a b l e  stress;  uhich f a c i l i t a t e  are the  resource  t h e management  stress. Adolescents'  perceptions of s t r e s s  r e s o u r c e s , as d e r i v e d  from  open-response  question  formats, are presented  sample.  The d a t a a r e f u r t h e r  and  There  P e r c e p t i o n s of t h e Responses  to s t r e s s  employed  A possible  responses  t h e management  actions  results  of "feeling  The e x p e r i e n c e b a c k g r o u n d  Adolescent  affect  These  to increase  "indecision,"  trends.  appetite."  participants'  symptoms;  learning.  to laugh" to decrease  f o r these  symptoms  on  16 t o 17 r e p o r t e d a g r e a t e r mean p e r c e n t a g e  symptoms.  account  based  restlessness,"  f o r the frequency  "being a f r a i d , "  of  girls.  symptoms.  "being u p t i g h t "  uas a t r e n d  alone," and  and  by  r e p o r t e d more a f f e c t i v e  for "fatigue,  in responses f o r  r e p o r t e d a g r e a t e r mean  t o e x p e r i e n c e and s o c i a l  the frequency  on r e s p o n d e n t s '  t o eat or l o s s  in responses  Girls  more p h y s i o l o g i c a l  attributed  for  to differences  based  differences  "craving  r e p o r t e d more f r e q u e n t l y  and age may  reported  compared  significant  t o c r y " and  A tendency sex  uere  t o be a l o n e , n o t t a l K . "  sex .  response and  b e h a v i o r s and  c1osed-response  and d i s c u s s e d f o r t h e t o t a l  described  based  on r e s p o n d e n t s ' age  86  Description  Open-ended The and  Sample  responses.  open-ended  uhat  questions uhich addressed  h e l p s t h e m manage s t r e s s  information. for  of Total  The a n s u e r s  t h e open-ended  uere  ansuers  The c a t e g o r i e s ,  the  to stress  The  most  Relaxation to  mellow  "drinKing," "Using  " s m o K i n g , " o r "smoKing  social  frequently sources  s u p p o r t " and " h a v i n g  listed  of s o c i a l  items  uere  "stop  thinking  noises," items  as s t r e s s support  related  uere  or "playing  it."  in the c a t e g o r y . Music Activity  items,  pillow,"  "do s o m e t h i n g  really  madder t h a n  stink"  uere  Techniques,  Social  Support,  items. uere  Although  similar  based  some  to those  on s p e c i f i c i t y  listed  items  Less  physical,"  or Music  available" frequently  frequently  uere listed  listed  to music,"  "other  Activities.  " j o g g i n g , " " h i t my  "get v i o l e n t , "  frequently  in Problem S o l v i n g ,  or "get  than R e l a x a t i o n  and D i v e r s i o n a r y  in the Cognitive  of a problem  included.  f o r the majority of the  hockey,"  less  also  as  as " b e i n g a l o n e " o r  and D i v e r s i o n a r y  "playing  related to  b e h a v i o r s such  "listening  accounted  summary f o r  o r " l i e down," " t r y  The most  "friends."  "Music",  uere  support  c a t e g o r y such  guitar"  Physical  social  H  f r e q u e n c i e s and  drugs" uere  responses.  t o Escape  about  health  mild  ( s e e Appendix  13.  items  as " s i t "  Negative  content  and c o n t e n t  in Table  response  category such  a d o l e s c e n t s do  and c o u n t e d  tabulation,  listed  o u t , " or "relax."  similar  responses:  are presented  frequently  Techniques  grouped  to s t r e s s  categories). responses  yielded  uhat  Activities  Thinking category  differentiation  f o r the Problem S o l v i n g  uas category  items . Respondents stress many  difficult.  activities,"  those  1isted  interpersonal and  loss.  uere  asked  Ansuers,  to identify such  and " f i n d i n g  as t h e c a u s e s problems,  that  make  managing  as " p e r s o n a l f r u s t r a t i o n s , " " t o o  no s o l u t i o n s , "  of s t r e s s  added  factors  uere  and i n c l u d e d  external  s i m i l a r to items  p r e s s u r e s , peer  related to pressure,  87  Table  19  R e s p o n s e s -to S t r e s s ; C a t e g o r i e s .  Tabulation  and C o n t e n t  Summary  <N=46)  Actual frequency  Category  Relaxation  techniques  47  Content  3  relaxation,  summary  s i t o r l i e down  smoKe, d r i n K , Social  Music  support  and  35  diversionary  £3  to f r i e n d ,  activity  15  pets  Playing  or l i s t e n i n g to  Cognitive/thinKing  14  activities  jogging,  walking,  14  reading as  sports  aggression  t h i n k , worry, covering i t up  Escape  hobby,  physical  venting  sleep  parents,  family,  music, doing  act iv it ies Physical  talK  meditate,  and K e e p i n g  i t inside  behaviors  used  situation  as s t o p  about  to avoid the  i t , being  thinking  alone, get  drunK Problem s o l v i n g  9  assessing, planning  Symptoms  3  Other  a  More t h a n  1  1 answer  may  be l i s t e d  to find  sweat, f e e l feel  solution  t i c k e do f f ,  disoriented  personal  by e a c h  analyzing,  problem  respondent.  88  Closed-ended responses. Participants from a l i s t behaviors  Table  selected  of options.  to stress  b e h a v i o r s used  T a b l e 20 r e p o r t s  i n ranK  in response  to stress  the i d e n t i f i e d  response  order frequency .  20  Response Behaviors to Stress' Frequency in RanK Order <N=46?  Response  Try  to figure  Play  music,  Involve  Play  87  34  74  32  71  30  67  28  61  situation  27  61  "real  mean"  24  52  situation  24  52  20  43  17  37  1 1  24  11  24  10  23  activities  from  team s p o r t s  not t o t h i n K about or "steu"  DrinK  alcohol,  activity else  do  uell  "hard"  about  problem  smoKe  for satisfaction  Drive  fast,  squeal t i r e s ,  make  smoKe  "Act o u t " Use  medicines  Use  relaxation or  t e c h n i q u e s such  progressive  A d j u s t e d <%> frequency  40  in something  •uell  Eat  the problem i s  t o someone  Remove s e l f  Try  out uhat  read or other  self  Do a t h l e t i c TalK  Actual frequency  behavior to stress  muscle  as Yoga,  relaxation  5  1 1  1  2  T.M.  39  The for  identified  response  "use r e l a x a t i o n  muscle is."  relaxation"  t e c h n i q u e s such to 87% for  Items r e l a t e d  talking uere  r e s o u r c e s ranged  activity,  t o s o m e o n e , and r e m o v i n g  identified  self  o u t what  or thought  by o v e r  half  the p a r t i c i p a n t s .  smoke,"  "use m e d i c i n e s , "  alcohol,  tires,  make smoke," and " e a t f o r s a t i s f a c t i o n "  are  least  from a  situation  Several  "drive  behaviors.  identified  by n e a r l y  relaxation  t e c h n i q u e s . . . " uas i d e n t i f i e d  Participants helpful  activities,  fast, uere  items,  squeal  identified  2 4 % o f t h e a d o l e s c e n t s as a uay o f c o p i n g u i t h  considered negative health  i n managing  presents  selected  stress  the response  response  from a l i s t  by  s t r e s s and  "Act o u t " uas  one q u a r t e r o f t h e r e s p o n d e n t s .  also  2%  the problem  diversionary  "drink  at  from  a s Y o g a , T.M. o r p r o g r e s s i v e  "try to figure  to a t h l e t i c  in frequency  by o n l y  "Use  one p a r t i c i p a n t .  r e s o u r c e s uhich they  of options.  resources f o r stress  in rank  find  T a b l e 21 order  frequency. The  identified  65%  t o 97%.  the  self,  response  The most  including  frequently  "feel  confidence  in s e l f "  frequently  identified.  as  "getting  diet"  regular  <67%), uere  anticipate  uhat  r e s o u r c e s ranged  good  <91%).  about  "Getting  Other  not rated  self"  items uere  from  related to  < 9 7 % ) , and "have  enough  sleep"  items r e l a t e d  exercise"  uill  identified  in frequency  to health  <70%) and " e a t i n g  as f r e q u e n t l y .  <93%> u a s a l s o habits,  such  a uel1-balanced  "Being a b l e t o  happen" uas i d e n t i f i e d  least  frequently.  Discuss ion • Differences open-response  are noted  and c 1 o s e d - r e s p o n s e  q u e s t i o n s , t h e most Techniques  frequently  category.  Houever,  Y o g a , T.M. o r p r o g r e s s i v e frequently items.  identified  Those  behaviors  such  in the r e s u l t s  items  In t h e o p e n - r e s p o n s e  items uere  "use r e l a x a t i o n relaxation"  from the l i s t  spontaneously  as " s i t "  questions.  listed  muscle  option  betueen the  listed  in the Relaxation  t e c h n i q u e s s u c h as  uas t h e l e a s t  of c1osed-response  included  o r " l i e down," " m e d i t a t e , "  a variety of  90  Table  £1  Response Resources for Stress'  Response  Feeling Having  resource  good time  Getting  self  for self sleep  Having  confidence  Having  close  Having  a say or c o n t r o l  able  Having  friend  Being  range  physical  "...such  perceived  Some or  mild  stress  stress  drugs  stress.  associated drivers.  as b e i n g  uith There  uill  happen  the choice specific  r e s p o n s e s , such  behaviors  may  A d j u s t e d < %) frequency  44  97  44  97  43  93  42  91  33  85  36  78  36  78  36  78  35  76  32  70  31  67  30  65  muscle  are also  fast,  described  the high i s a need  in the  proportion  may,  tires,  cigarettes These  literature  1982) and in t u r n ,  although  cause  make smoke" may  of t r a f f i c  to s u b s t i t u t e  included  behaviors.  1383; Z i e m e r ,  squeal  may  relaxation."  health  r e l i e v e s t r e s s , they  "Drive  of options  as d r i n k i n g , s m o K i n g  are negative  <Oobson,  in the l i s t  t o t h e examples  or p r o g r e s s i v e  to the adult  responses  further  uhereas  and e a t i n g ,  response  pertaining these  diet  as Y o g a , T.M.  <N=46)  being  exercise  t o a n t i c i p a t e uhat  "smoke," o r " d r i n K , " have been  feeling guilty  o f i n t e r e s t s and  ue11-balanced  Order  a similar  i n some  regular  able  in s i t u a t i o n  t o s a y "no" u i t h o u t  accomplished  Eating  i n uhom c a n c o n f i d e  and manag i n g  broad  Getting  in s e l f  experiencing  s i t u a t ion Being  i n RanK  Actual frequency  for stress  about  enough  Previously  Frequency  accidents  behaviors  more  be  i n young  conducive  31  to  health,  a c c e p t a b l e t o t h e a d o l e s c e n t , and more e f f e c t i v e  management  of  stress.  Problem s o l v i n g option  least  direct  response  awareness The  that  results  by  item  may  f o r physical Although  h a r d " and  physical  identified  "play  problem  literature, those  (Bell,  may  closed-ended  team s p o r t s  items  further  items,  real  "do  athletic  mean," u e r e  15 comments  identified  uere  listed  frequently  uere  listed  more f r e q u e n t l y  items.  As n o t e d  In  or d e l i b e r a t e response  and more p r o b l e m  1982).  Is t h i s  experience  to stress.  solving  premise  behaviors  supported  behavior r e s u l t  response  and may  In f a c t ,  Houever, the p r e c i s e  in the  in  is lacking?  as a s t r e s s  misbehavior  than  reported f o r adults  Or d o e s e s c a p e / a v o i d a n c e  out," identified  stress.  be e x p l a i n e d as a  u a s one o f t h e l e s s  avoidance  more a d a p t i v e o u t c o m e uhen  appropriate  as a m a j o r  responses.  & Billings,  the a d o l e s c e n t ?  impulsive  also  more a d a p t i v e o u t c o m e s h a v e b e e n  uho u s e l e s s  "Act  solving  i n t h e open-ended  i n t h e open-ended  1977; Moos  in the f i n d i n g s of  resources.  category  Problem S o l v i n g  of  i t c a n be r e c o g n i z e d .  i s supported  activity  activity  activity  response  Escape  but the  not c o n s i d e r i t a  n o t be a t a l e v e l  although  noted  option  for adults.  to physical  addition,  for  recalled,  ( 1 9 3 0 ) , who  chosen  A d o l e s c e n t s may  the m a j o r i t y of the respondents, only  relating  by  frequently  It also  for this  of awareness.  activities  listed.  is easily  to stress  The  t h e most  to stress.  and L a z a r u s  response  lacK  was  frequently  high frequency  FolKman  in the  b e h a v i o r , may  mean  n o t be t h e most  i t may  meaning  precipitate  i s open t o  interpretation. "Music" is  not n e c e s s a r i l y  serve of  or "other n o i s e , "  as a f o c a l  a subtle Seeking  as a m a j o r  a behavior t y p i c a l l y  point  stressful  for relaxation situation  and h a v i n g  diversionary  adolescent.  b u t may  also  be  activity,  Music  may  indicative  f o r the adolescent.  available  social  support  from  friends  and  92  family The  uas  identified  importance  literature  of  social  <Caplan,  Tyerman  & Humphrey,  related  to  social  support  uhy  uith  is also  1 9 7 4 ;Lieberman,  that  time  I'm  on  Perhaps  under  my  the  available  t o whom one  period  or sequence  f o r most  oun"  may  support  suggest  the  et a l . ,  not  their  are  also  or  parameters  support  social  1 9 6 9 ;  H o w e v e r , comments  there  from oun.  may  be  a  time  With  the  the What  to problem s o l v i n g  to  i s hawing  support.  benefit  on  response.  "hassling,"  There  may  in  "people  in s o c i a l  advantageous  and  as  stress,"  to t r y to s o l v e problems to s o c i a l  such  call.  f o r autonomy, a d o l e s c e n t s  parameters  described  1 9 8 2 ;Sidle  strength  persons  opportunity  management  1 9 8 3 ; Ziemer, 1 9 8 2 ) .  or  "no  support.  struggle  a stress  interpersonal relationships  understanding "bugging"  f r e q u e n t l y as  for  are  the  the  ado 1 e s c e n t ? The  study  concerning for  the  level  adolescent?  betueen  the  related  behaviors.  If  i t can of  identified  response  be  The  resources  adults:  Lazarus,  uith  Does t h e presumed  adaptation,  the  that  exist  a perceived a  stress  relationship  variables  described  behaviors  identified  in the  self-esteem <Pearlin  <AntonevsKy,  1 9 7 7 , p.  Houever, the are  not  remedy The  list  and  perceived  of  least  options  uhat  background  of  the  adolescents  response correspond  uill  the  to  f o r s u c c e s s f u l coping  & Schooler,  1 9 7 8 ;a  in  sense  health habits <Everly  does  not  support  &  Rosenfeld,  1 9 7 4 ; Cobb, 1 9  <Caplan,  d i s c r i m i n a t e those  Additional  items  in the  list  of  identified  item,  "being  able  to  items options  situation. frequently  anticipate  are  1 8 7 9 ) , p r e v i o u s e x p e r i e n c e <Monat &  2 1 3 ) , good  resources.  this  by  literature  1 9 8 1 , P P . 1 5 9 - 1 6 1 ) , and s o c i a l  may  literature  same p a t t e r n  is there  behavior  response  resources  positive  coherence  uhich  to the  level?  resources.  of  been  indication  Associated  the  have  adult coping  i s an  stress  results  h a p p e n , " may  adolescent  uho  reflect  the  experiential  is constantly experiencing  neu  33  situations. the  With  adolescent  limited  may  experience  not r e c o g n i z e  The  most  frequently  "feeling  good  about  confidence  in s e l f . "  developing  self  this  identified  self,"  "having  These  may  in being  able  as a r e s p o n s e  resources  resource.  p e r t a i n to the s e l f ,  time  for self,"  reflect  t h e impact  and t h e i m p o r t a n c e  to anticipate,  "having of the  of the s e l f - c o n c e p t a t  ado 1 e s c e n c e . "Getting health  habit  pressures,"  enough  i t e m and may  to  be r e l a t e d  of uhich  recognize  their  rapid  grouth  to the cause  sleep  as a  than  facilitated? others  Description  "time  social  may  be  sphere, expected  resource. as s t r e s s  response  perceive  A r e some more c o n d u c i v e  f o r the  of s t r e s s ,  and e x p a n d i n g  a d o l e s c e n t s , b u t hou do a d o l e s c e n t s  being  identified  "fatigue, restlessness."  are f a t i g u e - p r o d u c i n g , adolescents  These v a r i a b l e s a r e i d e n t i f i e d by  frequently  o r t o t h e symptom o f s t r e s s ,  Furthermore, uith both  s l e e p " u a s t h e most  these  to stress  resources resources management  adolescent?  of Subgroups  Based  on D e m o g r a p h i c  Variables  Sex . Adolescents' resources  uere  subgroups  based  Response girls.  perceptions  further described  behaviors  i n response  to stress  Chi  Square  sex  i s presented  uere  behaviors  perceived  behaviors  uas no  of  betueen  b o y s and  significant  by e i t h e r  sex.  Table  by s e x and t h e summary o f  A n a l y s i s f o r s e l e c t e d response S3.  response  the responses  compared  there  in Table  and  sex.  analysis,  S2 d i s p l a y s s e l e c t e d r e s p o n s e  behaviors  by c o m p a r i n g  on t h e r e s p o n d e n t ' s  In t h e p r e s e n t  difference  of response  behaviors  to stress  by  94  Table  22  Selected  Response  Behaviors to Stress;  Frequency  bv Sex  Adjusted  Response  Try  to figure  Do a t h l e t i c Play  Act  out uhat  or steu  71  hard  74  50  mean  58  36  problem  45  36  31  7  55  64  35  43  7  14  Frequency  DrinK Use  self  from  alcohol,  identified  sports "act  real  in the data are noted more f r e q u e n t l y  mean,"  contrast,  revealed  uith  Using  active  strategies adults long  approaches  "drinK  approaches  i s suggested  <Bell,  or " p a r t i c i p a t i n g  uhich  as " p l a y  the problem  i s , " and  a situation.  approach  in t h e i r  of the options  team  Girls,  response  "remove  self  solving  rather  than  avoidance  i n more a d a p t i v e o u t c o m e s f o r  1977; Moos & B i l l i n g s ,  term c o p i n g such  such  Items  smoKe," and "use m e d i c i n e s . "  and p r o b l e m to r e s u l t  girls,  t o managing  choice  alcohol,  as t r e n d s .  out uhat  a more p a s s i v e  more f r e q u e n t  from s i t u a t i o n , "  than  "try to figure  out," are active  behaviors  is"  situation  med i c i n e s  boys  be  higher f o r females  smoKe  Differences  in  h i g h e r f o r males  o u t i n some uay  Remove  Females n_=14  93  real  about  <%>  problem i s  activities  team s p o r t s  Duell  Males n_=31  behavior to stress  Frequency  frequency  1982).  as " t r y t o f i g u r e  in a t h l e t i c s "  also  Items out uhat  lead  considered to the problem  t o more a d a p t i v e  95  Table  23  Summary Stress  of C h i Square  behavior  to figure  Do a t h l e t i c Play  Act  activities  or steu  real  about  Chi  DrinK Use  from  alcohol,  problem i s  2.39  hard  1.5?  mean  1.93  problem  0.07  situation  Degrees  of  freedom  ia  0.07  smoKe  0.02 0.06  C h i Square  C h i Square  cell  B e h a u i n r s -to  1.33  medicines  Note:  Response  Square  o u t i n some uay  Remove s e l f  a  for stress  out uhat  team s p o r t s  Duell  Selected  by Sex (N=45>  Response  Try  Analysis!  uas c a l c u l a t e d  Analysis  u s i n g Yates  uas c a l c u l a t e d  frequencies uhich results  uith  correction.  less  than  i n an o p t i m i s t i c  the expected  significance  value.  coping by  in a d u l t s .  boys.  "use  These  The s h o r t  term  behaviors uere methods s u c h  m e d i c i n e s , " o r "remove s e l f  effective  (Bell,  mean o f t h e p e r c e n t a g e  uas  4 7 % f o r boys  from the s i t u a t i o n "  frequency  perceived response  betueen  response  r e s o u r c e s by s e x .  selected  as "dr inK a l c o h o l ,  are less by  girls.  scores f o r response  behaviors  resources to stress  also  boys  and g i r l s .  T a b l e 24 d i s p l a y s  25 p r e s e n t s t h e summary o f C h i S q u a r e  response  smoKe,"  and 4 2 % f o r g i r l s .  compared  Table  frequently  1977) and a r e r e p o r t e d more f r e q u e n t l y  The  Adolescents'  r e p o r t e d more  r e s o u r c e s by s e x .  Boys  selected  Analysis  reported  uere  f o r the  "being able to  36  Table  24  Selected  Response  Response  Resources  resource  for Stress:  good  about  Having  confidence  Having  previous  Having  broad  higher  for  Males rj_=31  Females D_=14  males  in s e l f  range  of  and  managing  interests  able  to  anticipate  Frequency Having  time  Having  friend  Getting Eating  what  will  higher  happen  frequency  confide  in  regular exercise uell  balanced  Significance  using  diet  Chi  Analysis:  what  difference  uas  confidence  interval  c o m p a r i s o n s , g_<.05.  autonomous  and  control  than  control  uhich 1978;  the  to  speculated  vieu  has  this  significant  as  a response  Furthermore, t h i s been  related  to  93  86  84  64  81  64  81  36  83  100  81  83  68  78  64  71  *p_<.0i.  autonomy  relationship  using Boys  girls.  both may  during  Chi  be  resource  Seligman,  adolescence,  is also true  for  The  Square  more  to  a  item p e r t a i n s to  1978;  #  females  successful coping  P e a r l in & S c h o o l e r ,  achieve  86  h a p p e n , " more f r e q u e n t l y t h a n  statistically  girls.  <Kobasa, tasK  uill  Square  anticipate  extent  for  for self to  100  and  accomplishments Being  Sex  <'/.">f r e q u e n c y  self  experience  bv  Adjusted  for stress  Frequency Feeling  Frequency  greater locus  of  in a d u l t s 1975).  i t may  be  adolescents.  With  and  97  Table  25  Summary Sex  of C h i Square  Selected Response Resources  Analysis;  by  CN=45)  Response  Feeling  resource f o r stress  good  about  C h i Square  self  Having  confidence  in s e l f  Having  p r e v i o u s e x p e r i e n c e and  manag i n g Having  broad  and Being  range  of  able to anticipate  uhat  time  Having  friend  Note;  uhich  for self to confide  regular uell  balanced  diet  uas c a l c u l a t e d  uas c a l c u l a t e d results  in  exercise  C h i Square  Square  1.88  1  0.88  1  1.16  1  0.65  1  6.86  Having  freedom  will  happen  Eating  of  interests  accomplishments  Getting  Degrees  uith  i n an o p t i m i s t i c  0.04  1  0.36  1  0.15  1  0.01  1  u s i n g Yates  less  than  1*  Correction.  the expected  significance  cell  Chi frequencies  value.  * P_< . 01 .  Variations response than or  in the ansuers  resources.  girls  relate  such  in s e l f , "  "having related  time  health  may  rated  as " f e e l i n g  be n o t e d f o r  more  good  Girls  more  "a f r i e n d  habits.  frequently  about  and t o e x p e r i e n c e s u c h  for self,"  t o good  and g i r l s  u h i c h boys  e x p e r i e n c e and m a n a g i n g . "  identified variables  items  to the s e l f ,  "having c o n f i d e n c e  previous  Those  of boys  as  self" "having  frequently  to confide  The mean  i n , " and  response  98  resource •these  feelings boys.  u a s 8 3 % and f o r g i r l s ,  girls  in others.  Houard  may  This  is reported  ( 1 8 8 1 ) uho f o u n d  Another  variation,  e x e r c i s e " and  boys.  They  health  concerns  girls  health  (Radius  experiences  girls  identified  boys  to find Ostrov,  empathetic  and f r i e n d s "getting diet"  a greater  in a survey  s e x may  and a b l e  more  balanced  t o note  e t a l . , 1880).  f o r each  indicated  "eating uell  To e x p l a i n  i n s t u d i e s by O f f e r ,  to r e l a t i v e s  are reported than  76%.  be more c o n c e r n e d  and more a t t a c h m e n t  physical than  f o r boys  differences,  support and  score  than d i d  regular more f r e q u e n t l y  frequency  of adolescent  of  v i e u s on  D i f f e r e n c e s in s o c i a l i z a t i o n account  f o r these  variations.  Age Response respondent's displayed  response  noted  age  groups.  group is  This because  n o t known  adaptive Tuo  other  This  behaviors  t h e summary  behaviors  of C h i Square  by a g e .  difference  of t h e i r whether  "Remove  may  be p r e d o m i n a n t  behavior  "talk  uere  but uere  comparisons,  most  than  by  and  "drive  significant using  using  f o r t h e y o u n g e r age  f r e q u e n t l y by  statistically  other  approaches,  immature  self.  fast,  squeal  16 t o 17 y e a r using  confidence  It  in feuer  f o r a d u l t s (Moos & B i l l i n g s ,  not s i g n i f i c a n t  p_<.05.  situation,"  significant  pattern results  t o someone" and  reported  from  olds  interval  lack' o f e x p e r i e n c e  this  Analysis for  self  uas s t a t i s t i c a l l y  o u t c o m e s , as r e p o r t e d items,  by age a r e  86.  avoidance  differences  Analysis  on t h e b a s i s o f t h e  A n a l y s i s and c o n f i d e n c e  make smoke," u e r e The  compared  more f r e q u e n t l y by t h e 14 t o 15 y e a r  C h i Square  P_<.05.  uere  S e l e c t e d response  £7 presents  uas  both  age.  in Table  Table selected  behaviors  198£). tires, olds.  C h i Square  interval  99  Table  £6  Selected  Response  Behaviors  to Stress;  Frequency  bv flae <N=45)  Adjusted  Response  behaviors  Frequency Remove s e l f Try  from  trend  14-15 11=17  to decrease  about  59  54  33  smoKe  47  41  0  for satisfaction  35  18  17  31  £3  0  alcohol,  to figure  situation  out uhat  higher  self  the problem i s  Do a t h l e t i c  in something activities  else  do  uell  hard  Dr i v e f a s t , s q u e a l  t i r e s , maKe smoke  Significance  C h i Square A n a l y s i s :  using  Frequency observed. age.  related  No  95  83  53  77  17  71  76  67  65  73  50  6  41  17  *  *  ##p_< .001 .  p<.05  response  behaviors  may  shoued  a trend  to increase  in frequency  Items u h i c h  shoued  a trend  to decrease  uith  behaviors,  " A c t o u t " may  immaturity. increased  f o r the perceived  such  and " t r y n o t t o t h i n K  behaviors.  *  76  items  to avoidance  situation"  impulse  patterns  **  a t a p a r t i c u l a r - age  t o someone  Involve  uith  u i t h age 17  Frequency  be  18- 18 0_=i 6  45  Act out  TalK  16-17 D_=££  83  DrinK  Try  frequency  situation  not to thinK  Eat  Age :  for stress  <%>  With  socialization  control  about  be r e l a t e d  maturity,  there  experience  (Lazarus,  as "remove s e l f situation,"  to impulsive  age a r e  from  and a c t i n g o u t behavior  and  i s i n c r e a s e d ego s t r e n g t h and uhich  results  1366, p p . 2 3 0 - 2 3 1 ) .  in greater  100  Table  27  Summary  of C h i Square  Stress  bv  Response  Age  Try  not  DrinK  for  Act  out  Try  to  TalK  2  smoKe  4. 36  2  satisfaction  1. 75  2  2. 09  2  3. 06  2  7. 78  2  0. 28  2  1 .14  2  6. 60  2  self  out  what  problem  in something  squeal  Chi Square cell  * p_< .05.  to  is  else  hard  tires,  make smoke  Analysis  uas  calculated  frequencies uhich  results  using  i n an  less  freedom  **  *  *  than  the  optimistic  value.  ** p_< .01 .  Negative  health  satisfaction," may  be,  are  found  uith  may  behaviors and  time  t o be  Those  group.  situation  activities  significance  may  about  someone  expected  olds  of  1. 18  fast,  Note:  Degrees  2  athletic  Drive  Behaviors  1 1. 39  figure  Involve Do  Chi Square  situation  to thinK  to  -for s t r e s s  from  alcohol,  Eat  S e l e c t e d Response  <N=45)  behavior  Remove s e l f  Analysis:  items  reflect Hormonal  account  107-108>.  "use and  such  the  "drink a l c o h o l ,  medicines"  also  are  frequently activities  levels  tend  no  t o be  uith  "eat f o r  age.  behaviors  It uhich  used.  r e p o r t e d by physical  the  16 t o  state  of  17  year  this  age  h i g h e s t at mid-ado 1escence  for aggressive behaviors Furthermore,  response  longer  and  smoke,"  decreased  experience, those  ineffective most  as  <B.  i t is possible  Hamburg,  uith  1874,  cognitive  and  pp.  development  101  there  i s an  increased  awareness  of response  b e h a v i o r s at  these  ages . The of  the  identified  respondent's  displayed  Table  response  in Table  age.  r e s o u r c e s uere  Selected  response  compared  r e s o u r c e s by  basis  age  are  S3.  Response  Resources  for Stress;  Frequency  Adjusted  Response  resource for  stress  Frequency Having  time  Having  broad  for  Age:  trend to  14-15 n=17  increase  self  range  of  interest  Frequency Having  confidence  Feeling  good  about in  in  t r e n d to  self  control  Having  previous experience  situation  Frequency Getting  enough friend  and m a n a g i n g  h i g h e r at  a  to c o n f i d e  using  no  in  uithout  Chi Square  (%>  flge  frequency  16 -1? a.=22  18-18 D_=6  u i t h age 83  100  100  71  77  83  100  81  67*  100  100  88  73  67  82  77  67  34  95  83  76  35  67  feeling  71  86  67  u i t h age  67**  p a r t i c u l a r age  sleep  a b l e t o say  Significance  decrease  self  Having  by  and  accomplishments  Being  the  23  Selected  Having  on  guilty  Analysis:  * P_<,05.  ** p_<.01.  108  The by  summary age  of C h i Square  is presented  Analysis  in Table  differences  betueen  differences  f o r tuo items,  "feeling Square  good  confidence  There  t h e age g r o u p s  about  Analysis  £9.  self"  but uere  intervals,  for selected uere  no  f o r response  "having c o n f i d e n c e uere  statistically  not s i g n i f i c a n t  response  significant resources.  in s e l f "  The  and  significant  uhen  resources  compared  using Chi  using  P_<05.  T a b l e 29 Summary Stress  of C h i Square  Selected  resource f o r stress  Having  time  Having  broad  Chi  range  confidence  Feeling  of  good  in s e l f  about  Having  p r e v i o u s e x p e r i e n c e and  in s i t u a t i o n  managing enough friend  sleep to confide  in  a b l e t o s a y no w i t h o u t  * e_< . 0 5 .  freedom  0.46  2  6.09  2 * 2 **  1.83  2  0.64  2  1.14  2  4.30  2  1.87  C h i Square  frequencies  of  feeling  guilty  Note;  Degrees  13.60  self  control  Getting  Square  interests  Having  Being  Resources f o r  3.45  for self  accomplishments  Having  Having  Response  bv Age <N=45>  Response  and  Analysis;  was c a l c u l a t e d  uhich results ** e_< . 0 1 .  uith  less  i n an o p t i m i s t i c  than  the expected  significance  cell  value.  103  Although noted.  "Hawing c o n f i d e n c e  reported  more  reflection items  of a f r a g i l e ,  by  support,  comparison  behaviors  uere  behaviors  as c o m p a r e d  more demands  an a w a r e n e s s  at a  of the  self.  statistical  both  sexes,  not  to thinK  management  complementary management  & Billings, able  management.  188S).  With  to identify Again, group  older  may  reflect  This  no The  shoued  A n a l y s i s b u t when  items  age  i s " and " t r y  and c o g n i t i v e  in the l i t e r a t u r e  1983> and b o t h  significant.  increased with  Problem s o l v i n g  as b e i n g facilitate  f o r a d u l t s (FolKman  & Lazarus,  1980; Moos  age and e x p e r i e n c e ,  individuals  behaviors  as  uere  to  frequency  such  30.  and o l d e r g i r l s b u t  p_<.05, u a s n o t Two  in Table  the subgroups.  o u t what t h e p r o b l e m  & Lazarus,  of stress  particular boys  are evident.  is described  <Cohen  girls.  intervals,  situation."  of s t r e s s  response  There  boys  C h i Square  " t r y to figure  about  betueen  by y o u n g e r  using  confidence  i n answers  for  differences  response  A n a l y s i s f o r these  by s e x and by a g e .  or younger  significance  Trends  o f C h i Square  identified  o l d e r boys  using  Selected  of  by s e x and by age a r e d i s p l a y e d  significant  by e i t h e r  better  indicate the  physical  vulnerable  self,"  resource  reported  sphere,  be  a  Those  of adolescents' perceptions  behaviors  " a c t o u t " uas  compared  items  reflect  social  and a l e s s  t h e summary  response  statistically item,  Those  o l d s may  about  age, are perhaps  made by s e x and by a g e .  31 p r e s e n t s  selected  good  may  and a g e .  Further  Table  "feeling  in data  f r e q u e n t l y a t an o l d e r age may  16 t o 17 y e a r  of s o c i a l  Sex  and  trends  more v u l n e r a b l e s e l f .  of growth, the developing  walue  the  in s e l f "  for self-actualization.  frequently  not  differences,  f r e q u e n t l y a t a younger  r e p o r t e d more  struggle  time  not s i g n i f i c a n t  which  results  are conducive  which  "play music, read  the a c t i v i t i e s  serve  show  of that  group.  be  to stress  a trend  or other  may  for a  activity" for  104  Table  30  Selected Response Behaviors to stress'  Frequency bv Sex and by  Age  Adjusted  <'/.">f r e q u e n c y  Males  Response  behaviors to stress  Frequency Try  to figure  out uhat  Try  not to thinK  about  trend  Age:  14-16 rj_=22  to increase  Females  17-19 n_=9  uith  14-16 rj_=3  17-19 CL=6  age  problem i s  91  100  62  83  situation  50  56  50  67  Frequency  trend  to decrease u i t h  age  77  67  62  33  64  44  37  33  64  56  62  50  64  33  75  50  smoKe  41  22  50  33  Eat  for satisfaction  32  1 1  37  0  Use  medicines  0  £5  0  1 1  12  33 12  Do a t h l e t i c  activities  Play  team s p o r t s  TalK  t o someone  Remove s e l f DrinK  from  alcohol,  real  hard mean  situation  9  Frequency Drive Play  fast, music,  squeal t i r e s read or other  maKe smoKe  32  activity  64  100  75  43  0  0  Act out  Significance  using  dissimilarities  C h i Square  Analysis:  *e_<.05.  17 *  105  Table  31  Summary  Of C h j  Square Analysis'  S e l e c t e d Response  Behaviors to  Stress by Sex and by Age <N=45> Response  behavior  Try  to figure  Try  not to thinK  to stress  Degrees  of freedom  problem i s  5. 83  3  situation  0. 58  3  hard  4. 18  3  2. 83  3  0. 4?  3  3. 63  3  smoKe  1 .58  3  Eat  for satisfaction  4. 13  3  Use  med i c i n e s  3. 85  3  activity  4. 48  3  maKe smoKe  2. 33  3  3. 51  3 *  Do a t h l e t i c  o u t uhat  C h i Square  about  activities  Play  team s p o r t s r e a l  TalK  t o someone  Remove s e l f DrinK  Play Drive  from  alcohol,  situation  music, read fast,  mean  or other  squeal  tires,  Act out  Note: C h i Square frequencies  uas c a l c u l a t e d  uhich  results  uith  less  i n an o p t i m i s t i c  than  the expected  significance  cell  value.  * p_< .85.  As  uell  perceived Selected  response response  presented these in  as t h e r e s p o n s e  resources  i n Table  selected  Table  resources  33.  subgroups.  32.  response There  Older  uere  girls  anticipate  uhat  uill  frequently  than  other  behaviors,  further  comparisons  by s e x and by age u e r e considered  differences  t h e items  h a p p e n " and " f e e l i n g subgroups.  Analysisfor  by s e x and by age i s d i s p l a y e d  no s i g n i f i c a n t identified  made.  by s e x and by age a r e  The summary o f C h i S q u a r e resources  of the  These  "being  good  about  differences  between  these  able to self" uere  less  106  statistically  significant  significant  using  older  girls  have  Table  32  Selected  using  C h i Square  confidence interval  comparisons,  a more s e c u r e f e e l i n g  Response  Resources  Analysis  about  f o r Stress;  but uere not p_<.05.  Perhaps  themselves.  Frequency  bv Sex and bv  Age  Adjusted  <.'/.> f r e q u e n c y  Males  Response  Frequency Having  broad  and  Age s 14-16 n_=22  resources f o r stress  range  of  t r e n d to  increase  Frequency enough  t r e n d to  decrease  sleep  able  will  u ith  62  67  age  95  33  100  67  36  78  75  50  in s i t u a t i o n  32  78  75  67  to confide in  82  78  100  83  82  78  50  17  100  100  to a n t i c i p a t e  uhat  happen  Frequency Feeling  88  83  manag i n g  Being  age  100  p r e v i o u s e x p e r i e n c e and  friend  17D_=6  88  Having  Having  14-16 D_=3  95  confidence in s e l f  control  uith  77  Having  Having  17-19 D_=9  interests  accomplishments  Getting  Females  good  about  self  Significance  using  C h i Square  dissimilarities 100  Analysis:  * p_<.Bl.  68 *  107  Table  33  Summary Sex  of C h i Square  Analysis  Selected  Response Resources  by  and by Age (N=45J  Response  Having  resource f o r stress  broad  and Getting  range  of  Chi  1.30  3  enough  1 .38  3  5.77  3  3.65  3  in s i t u a t i o n  0.67  3  to confide in  1 .90  3  sleep  Having  p r e v i o u s e x p e r i e n c e and  manag i n g Having  control  Having  friend able  Feeling  Note:  of  accomplishments  confidence in s e l f  u i11  Degrees  to anticipate  uhat  happen good  about  C h i Square  frequencies  freedom  interests  Having  Being  Square  self  uas c a l c u l a t e d  uhich r e s u l t s  uith  10.52  3 *  13.60  3 #  less  i n an o p t i m i s t i c  than  the expected  significance  cell  value.  * e_< . 0 1 .  Summary  Adolescent  respondents  reported  behav i o r s  and r e s o u r c e s f o r s t r e s s .  behaviors  included  support, doing  problem  athletic  solving  activities,  a variety  The r e p o r t e d and t h i n k i n g , using  in  activity  frequencies  attributed  uas r e p o r t e d  f o r t h e open  to variations  using  Music  frequently.  and c l o s e d - e n d e d  in levels  response  a variety  t e c h n i q u e s , and e s c a p i n g f r o m t h e s i t u a t i o n . diversionary  of response  The  format  o f awareness.  social  of relaxation as a discrepancies ansuers  Negative  may be health  108  behaviors  uere  Stress helpful  experience,  1874;  social  frequently  The  behavior  more  As uere  managing  passive  trends  stress,  "being  in the item indicate  identified girls  A l s o , boys  Age-related  identified  behaviors, uith  and  age u e r e  experience.  to confide  trends  problem s o l v i n g  uere  "acting related  Previous  Several  frequent  a t ages  adolescent's It  to the s e l f ,  as uas  behaviors  more  an  situation."  term  approach  term,  concerning girls,  h e a l t h h a b i t s and boys. in age,  behaviors, negative  health  The r e s o u r c e s  varied  about  and t h e i r  uhich  and  less self"  and r e s o u r c e s  experience  maturing  previous  f r e q u e n t l y by by t h e o l d e r  uere  more  explained  p a t t e r n s of response  f o r the a d u l t .  as a  on age and  increase  identified  correspond  uill  short  locus of c o n t r o l  good  based  f r e q u e n t l y than  D i f f e r e n c e s uere  outcomes  long  uhen  more  from  resources  16 t o 17.  whether  uhat  based  t o good  With  items  compared  f r e q u e n t l y than  uas  "feeling  f o r the adolescent  adaptive  related  out" decreased.  response  i s queried  behaviors  more  1882,  avoidance/escape  active,  identified  noted.  experience  uere  as a r e s o u r c e  identified  i n " more  also  f o r two  differences  i n c r e a s e d but avoidance  o l d e r age g r o u p  girls.  factors  & Parron,  "remove s e l f  a more  (Caplan,  1978).  noted  identified  control,  resources  for adults  to anticipate  s e l f - c o n c e p t and l o c u s o f c o n t r o l  a friend  response  responses  able  r e p o r t e d as  to the s e l f ,  Elliott  control  olds  uhereas  approaches.  "having  of  These  e_<.05, u e r e  of stress  uhich  Boys  girls  the  related  1881; Hamburg,  identified  frequently  whereas  the  the adolescent  factors  differences,  Boys  noted.  stress.  in the l i t e r a t u r e  14 t o 15 y e a r  uell,  to  1373; P e a r l i n & S c h o o l e r ,  in the item  happen."  the  noted  perceptions  s e x and a g e .  uhich  health habits.  Everly & Rosenfeld,  adolescents'  to  support,  to those  Significant  sex  as a r e s p o n s e  resources  and good  PP. 77-78; K o b a s a ,  on  noted  response  uere  correspond  also  in terms of  self. r e s o u r c e s and  to the patterns  described  109  Adolescent  Information stress  uas  on  derived  c1osed-response. and  uhat from  The  from the  The  sex  by  content  open-ended  responses Table  summary  The involved  span,"  or  and  counted  34  f o r the  made s u c h  as  "hypertension." i n one  conditions nervous  respondents  One  listed  "don't  as  of  the  based  on  item, such  health.  General  A positive  "brain  and  participants statements  not  as  outcome  "heart  anyone."  made  attack," uas  Mental and  frequently.  Knou" or  to s o c i a l  life  uere  to s t r e s s  "insanity," as  about  "shortened  muscular."  listed  "don't  a n y t h i n g or  and  tabulation  statements  such  damage,"  listed  in four  I f o r the  goes d o u n h i l l , "  breaKdoun" uere  like  by  more s p e c i f i c  response, related  grouped  stress.  "become s t r o n g and as  uhat  frequency  categories,  disease conditions  spontaneously  health."  of s t r e s s !  "health Also,  uere  <See A p p e n d i x  outcomes noted  on  "ulcer,"  "possible  and  are presented  is presented  q u e s t i o n s about  outcomes of  specific  health  formats  Further description  presents the  identifying  identified  tuo  questions  t o outcomes  "burnt o u t . "  or  sample.  open-ended  negative effects  uere  to these  of  age.  majority of s t r e s s  health  outcomes  Sample  to the  categories  content  the  q u e s t i o n formats, open-response  p e r c e i v e are outcomes of s t r e s s  categories).  Stress  responses.  ansuers  adolescents  total  and  of T o t a l  Open-ended  tuo  c1osed-response  respondent's  Description  a d o l e s c e n t s p e r c e i v e as  responses  d i s c u s s e d f o r the  ansuers the  P e r c e p t i o n s o f t h e Outcomes o f  "doesn't  relationships,  Five affect  uas  110  Table  34  Outcomes o f S t r e s s : C a t e g o r i e s . T a b u l a t i o n  and Content  Summary  <N=4e>  Category  Actual •frequency  Phys i c a l  46  Mental  Content  3  related  10  summary  to bodily  health,  specific  conditions,  fatigue,  behaviors  depress ion , nervousness , insan i t y  Don ' t Know  5  statement or  Soc i a i  that  related  1  that  doesn't to  involving  More t h a n  1 answer  may be 1 i s t e d  by e a c h  affect  Know health  interpersonal  relationships  a  doesn't  and a t t i t u d e s  others  respondent  Closed-ended responses. Respondents stress  from  stress  presented  The frequency abuse." of  identified  a list  answers from Nine  of o p t i o n s .  i n ranK  order  identifying  of the t h i r t e e n Those  "allergies."  they Table  p e r c e i v e d as outcomes t o 35 d i s p l a y s  t h e outcomes o f  frequency.  t h e outcomes o f s t r e s s  13% f o r a l l e r g i e s  the respondents.  " a s t h m a " and  what  to 76% f o r  items uere  items  rated  " a l c o h o l i s m or drug  identified  less  ranged in  by o v e r  frequently  were  half  111  Table 3 5  Outcomes of Stress: Frequency  Outcome  of  i n Rank  Order  Actual frequency  stress  A l c o h o l ism,  <N=46>  drug  abuse  A d j u s t e d ( X) frequency  35  76  Headaches  34  74  Stomach  33  72  32  70  31  67  30  65  23  63  Depress ion  28  61  Acc i d e n t s  26  57  Colds  21  46  13  28  10  22  6  13  ulcers  Hypertension Heart  pressure)  attack  Mental Lack  (high blood  illness  of  Sports  caring  (freak about  out)  self  and  others  injuries  Asthma A l 1 erg ies  D i s c u s s ion . The outcomes they  participants of  listed  stress  in the  identify  the  or  m a j o r i t y of  drug  stress abuse."  behavior  and  a result  of  statements  generally perceived  be  question  maladaptive  format,  the  health.  Although  h e a l t h as  stress  they  able  uere  concerning  to  h e a l t h in  ansuers.  most  the  on  concerning  frequently identified  This h e a l t h problem  i t may  effect  spec i f i c statements  format  outcome  study  a negative  open-response  c1osed-response The  t o have  many g e n e r a l  outcomes  the  in t h i s  adolescent  is a direct  held  "alcoholism  consequence  participants  c o p i n g , a commonly  uas  viewed  idea.  of  this  as  Adolescents  1 12  may  be  their  more aware o f exposure  The  stress. may  not  also to  t o , and  items  "allergies,"  uhich  are  These have  may  items  be  results  of  substance  dec i s i o n - m a K i n g  uere  identified  probably  the  not  the  less  affect  Knowledge auare  of  are  more  about, a l c o h o l or  less  commonly  the  of  drugs.  f r e q u e n t l y , "asthma"  understood  immune s y s t e m and  to understand  the  abuse because  these  relationship  of  as  related  the  and to  participants  conditions.  a s t h m a and  They  allergies  stress. Adolescents  "colds,"  "sports  they  to  are  injuries,"  experience  "hypertension." uere  less  Knowledge probably  they  are  "stomach more  Furthermore,  not  outcomes.  commonly  Known as  "heart  be  reluctant  This  may  reflect  the  related  attacK," to  and  occur  or  lacK  outcomes  are  are  h e a l t h problems  expectations.  uith  they  as  than  experience,  ulcers."  developing, vulnerable self  as  to  these  stress  "stomach  acknowledge  to d i s c r e p a n c i e s in s e l f image, such  because  to  "asthma"  ulcers,"  liKely  about  these  "accidents,"  perhaps  perhaps  may  body  items  attacK,"  and  frequently identified,  also  the  to experience  allergies,"  "heart  Those  "hypertension,"  sensitive  liKely  Adolescents do  uhich  occur. is  Imperfections  health problems, r e f l e c t  in  the  self . "Depression," and  o t h e r s " as  the  respondents.  might  be  a stress  expected  Conversely, item  i f they  They  also  "mental  outcome  Auareness  of  may  items  have  perceive a stigma not  uas  c o n s i d e r i n g the  adolescents  may  illness,"  Knou  the  or  "lacK of  identified related  r a t e of  61%  about  to 65%  to mental  adolescent  difficulty  mental  self of  health  suicide.  acKnou1edging  associated uith  ansuer.  by  caring  this  illness.  113  Description  of Subgroups  Based  on  Demographic  Variables  Sex . Adolescents' based  on  the respondent's  outcomes of s t r e s s selected  outcomes  There  uere  Table  36  Selected  p e r c e p t i o n s of s t r e s s  no  by  sex.  sex.  The  of s t r e s s  significant  T a b l e 36  by  summary sex  bv  on  Higher  frequency  37.  Sex  <'/.)f r e q u e n c y  Females D_=14  f o r males  Hypertens ion  71  64  Me n t a l  68  57  Acc i d e n t s  61  43  Sports  35  14  74  79  Headaches  71  79  Ulcers  68  78  64  71  Asthma  16  36  Al1erg ies  10  21  illness  injuries  Frequency Alcoholism  Heart  or  attack  drug abuse  for  sex.  Males D_=31  stress  Analysis  in Table  Adjusted  Outcome o f  compared  selected  of Chi Square  based  Frequency  uere  presents  is displayed  differences  Outcomes o f S t r e s s :  outcomes  higher f o r females  1 14  Table  37  Summary Sex  of Chi Square  Analysis:  Selected  Outcomes o-f S t r e s s  <N=45?  Outcome o f s t r e s s  C h i Square  Degrees  of  freedom  Hypertens ion  0.,01  l  a  Mental  0.. IS  l  a  flee i d e n t s  0,.69  1  Sports  1,,20  l  a  0..00  l  a  Headaches  0.,03  l  a  Ulcers  0,. 15  l  a  0.,01  l  a  Asthma  1,. 16  l  a  Al1 e r g i e s  0.,36  l  a  illness  injuries  A l c o h o l ism, drug  Heart  abuse  attack  Note: a  C h i Square  C h i Square  frequencies  differences sports reflect  uas  uas  not  based  injuries their  calculated  calculated  uhich  Although  results  on  and  frequently  than boys.  and  contributes  Perhaps to t h i s  cell  optimistic  significance  value.  Girls  in data reveal  to g i r l s ,  uhich  identified as  about  the e x p e r i e n t i a l  There girls  the  frequently  t o o t h e r s and  Knowledge.  boys  some  identified  outcomes of s t r e s s .  experience.  Knowledgeable  more s e n s i t i v e  problems.  the expected  trends  as  correction.  than  o f t h e outcomes  more t h a n t u i c e  more s e n s i t i v e be  and  Yates  less  Compared  accidents  in four  "allergies"  i n an  sex.  activities  using  uith  significant,  difference  also  bv  uas  boys.  health  a  than  bacKground  more  "asthma" Girls boys.  t h u s , more a u a r e of the  may  negligible  perceived  items  as  This  more  of  and may They  be may  others'  respondents  1 15  Furthermore, the stress  outcomes  mean p e r c e n t a g e  reported  uas  55%  frequency  for girls  as  score  for a l l  compared  to  54%  for  boys .  ftqe , Adolescents' compared  based  frequency  Table  on  patterns  perceptions the  of  s t r e s s outcomes  respondent's  age.  f o r s e l e c t e d outcomes  Table of  uere  38  also  outlines  s t r e s s based  on  the age.  38  Selected  Outcomes  of  Frequency by Age  Stress:  Adjusted  Outcome  of  Age:  stress Frequency  Alcoholism  or  drug  trend  to  increase  abuse  14-15 n_= 17 uith  <%>  frequency  16-17 rj_=2£  18-18 n_=6  age  71  73  Headaches  71  73  Heart  65  64  41  64  67  12  27  33  59  73  50  attacK  Acc i d e n t s Asthma  Frequency LacK  of  caring  about  self  or  100 83 a  83  dissimilarities  others  Sports  injuries  41  3  67  Mental  illness  53  73  67  a  This  score  decrease  in score  calculated uith  Significance  using  Chi  may  a small Square  be  accounted  sample  f o r by  size.  Analysis:  * P_<.01.  the  percentage  1 16  The outcomes  summary o f C h i S q u a r e  o f s t r e s s by age i s p r e s e n t e d  significant The  olds  uas s t a t i s t i c a l l y  uas n o t s i g n i f i c a n t  P_<.85.  Moreover, u i t h  item  uould  Table  33  Summary  than  increase  f o r these  in Table  in the reported identified  less frequently  difference but  differences  16 t o 17 y e a r  outcome  Analysis  39.  There  outcomes based  "sports  the other  selected  injuries"  age g r o u p s .  significant  uhen c o n f i d e n c e  using  on a g e .  as a s t r e s s This  C h i Square  i n t e r v a l s uere  age and e x p e r i e n c e ,  u e r e no  Analysis  compared,  i t uas e x p e c t e d  this  u i t h age.  of C h i Square  Analysis;  Selected  Outcomes  of Stress  bv Age  <N=45?  Outcome o f s t r e s s  Alcoholism,  abuse  Degrees  of freedom  2.26  2  Headaches  0.38  2  Heart  0.87  2  Acc i d e n t s  2.30  2  Asthma  1 .83  2  1.44  2  LacK  drug  C h i Square  attacK  of c a r i n g  about  self  Sports  injuries  9.61  2 *  Mental  illness  1 .65  2  Note;  C h i Square  frequencies * p_< . 0 1 .  uhich  was c a l c u l a t e d u i t h results  l e s s than  the expected  i n an o p t i m i s t i c s i g n i f i c a n c e  cell  value.  11?  Trends  in data  Houever, f i v e age.  items  may uere  I t uas e x p e c t e d  background  items  No  items  r e p o r t e d more  that  uith  associated uith  more o u t c o m e s . The  be n o t e d .  The s t u d y  the broadened  support  to other  stress  component  frequently  at these  ages.  Further study  17 y e a r  reported  may  uould  Knou  expectation.  16 and  items  increased  reveal  olds  may  more a  relationship  components.  The  mean p e r c e n t a g e  increased to  this  r e p o r t e d more f r e q u e n t l y by  age.  experience  i n c r e a s e d age, i n d i v i d u a l s results  uith  frequently uith  correspond  betueen  decreased  uith  18 y e a r  age f r o m  olds.  With  frequency  of a l l s t r e s s  5 2 % f o r 14 t o 15 y e a r experience  and t i m e ,  outcomes  o l d s t o 6 2 % f o r 18  individuals  knou  more  outcomes o f s t r e s s .  Sex  and a g e .  Adolescents' compared stress  perceptions of stress  on t h e b a s i s o f b o t h  outcomes uere  s e x and a g e .  S e l e c t e d outcomes o f  a r e c o n s i d e r e d by s e x and by age as p r e s e n t e d  Table selected  41 d i s p l a y s  outcomes  t h e summary  of stress  significant  differences  to  "asthma" l e s s  the item  difference significant  subgroups.  f r e q u e n t l y than  uas s i g n i f i c a n t uhen  of C h i Square  by s e x and by a g e .  betueen  confidence  uere  in Table  other  40.  Analysis for There  uere  Younger boys  u s i n g C h i Square intervals  further  groups.  no responded  This  A n a l y s i s but uas n o t compared,  e_<.05.  1 18  Table  40  Selected  Outcomes  of  Sii-ess!  Frequency  bv  Sex  bv  flae  Adjusted  Males  Outcome o f  Age:  stress Frequency  trend to  14-16 n_=22  increase  17-13 n_=8  <y.)  frequency  Females  14-16 n_=8  17-18 n_=6  u i t h age  73  78  62  100  64  78  75  83  64  78  50  67  Acc i d e n t s  58  67  25  67  Heart  58  78  62  83  32  44  12  17  68  78  67  67  4  44  37  33  Alcoholism  or  drug  abuse  Ulcers Mental  Sports  Illness  attack injuries  Frequency  dissimilarities  Headaches Asthma  Significance  using  Chi  Square  Analysis:  e.< .05.  1 19  Table  41  Summary Sex  of C h i Square  Final vs i s :  Selected  Outcomes o f S t r e s s bv  bv ftqe <N=45?  Outcome o f s t r e s s  C h i Square  Degrees  of freedom  S.80  3  1 .S9  3  1.45  3  Acc i d e n t s  3.89  3  Heart  1.88  3  S.63  3  Headaches  1.35  3  Asthma  8.06  3  A l c o h o l ism,  drug  abuse  Ulcers Mental  illness  attacK  Sports  injuries  Note:  C h i Square  frequencies  which  was c a l c u l a t e d w i t h results  l e s s than  *  the expected  i n an o p t i m i s t i c s i g n i f i c a n c e  cell  value.  * P<.05.  Summary The stress  participants  t o have a n e g a t i v e  specific  outcomes  respondents. identified those  uhich  "colds," uere  outcome.  scores  between  injuries,"  uith  frequently  girls  on h e a l t h  identified  or drug  liKely  t h e outcomes o f  and t h e m a j o r i t y o f  by t h e m a j o r i t y o f  a b u s e " u a s t h e most  t o occur  identified  in this  "allergies,"  differences  outcomes based  frequently  uere  perceived  The l e s s f r e q u e n t l y  a r e more  in data  study  effect  "Alcoholism  "sports  Trends  less  listed  no s i g n i f i c a n t  stress  in t h i s  frequently  outcomes  uere  age g r o u p , s u c h a s  and " a c c i d e n t s . "  in the adolescents'  There  perceptions  of  on s e x and a g e .  reveal  little  and b o y s .  increasing  difference  Some  items  age. "Sports  by t h e 16 t o 17 y e a r  in the frequency  uere  identified  injuries"  olds.  uas  more  identified  120  Summary o f S t u d y R e s u l t s and D i s c u s s i o n  Questionnaires of  31 b o y s  management 99%.  (56%) the  class.  Assessed The  subgroups  Eight about  The  friends.  f o r t h e q u e s t i o n n a i r e uas  perceived stress  oun s t r e s s  girls  time  differences  noted  in data  stressor  more f r e q u e n t l y  pressures  i n team s p o r t s ,  frequently stressors  than  girls.  related  t o time  The  than  betueen  stress  physiological frequently sexes  appetite,"  girls  symptoms  symptoms.  identified. f o r "urge  "relationship by g i r l s ,  uith  an  from based  on  uith the  and " h a s s l e s  by y o u n g e r pregnancy  boys  girls.  as a  identified  j o b c o n c e r n s , and a u t h o r i t y increase  figures  more  in age,  t a s k s d e c r e a s e d , but those  increased. most  frequently  Affective There  uere  t o c r y " and  r e p o r t e d more  sensitivity,  the subgroups,  uhereas  in the  identified  personal  identified  to the developmental  pressures  g a i n e d neu  the a c t i v i t i e s  frequently  boys,  Moreover,  of both  d e a d l i n e s , and p r e s s u r e  f o r t h e items  that  they  Other  figures,  r e p o r t e d more  indicate  olds  their  the questionnaire.  reflect  s e x , " r e p o r t e d more f r e q u e n t l y  brother/sister,"  h i g h e r than  indicated  by c o m p l e t i n g  of stress  relationships,  and s e x , u e r e  level  Individuals in  1? t o IS y e a r  and  authority  as a c o n c e r n  on h e a l t h .  t o s c h o o l and u o r k .  to family,  Significant  opposite  the  their  causes  in s t r e s s  uas c o n s i d e r e d r e a s o n a b l e .  management  and r e l a t e  relate  related  rate  consisting  completed  had e x p e r i e n c e  <18%) o f t h e r e s p o n d e n t s  stress  interpersonal  Trends  respondents  a negative effect  uho r a t e d  identified  environment  uith  reliability  c o u n t e r p a r t s uere  sexes.  causes  Four  14 t o 13 y e a r s , uho had  The r e s p o n s e  and a s h a v i n g  ideas  ages  majority of respondents  subgroup  age  13.  -from 46 r e s p o n d e n t s ,  collected  14 g i r l s ,  and  8 t o Grade  Grade  uere  symptoms  uere  significant  "craving  frequently  identified  uere  the  least  differences  betueen  to eat or loss of  by g i r l s .  Trends  in data  121  indicate and  that g i r l s  identified  more  more p h y s i o l o g i c a l participant, pounding", "being  using  ages  considered  and  negative  age long  term  items  related  frequently escape  less  identified queried those The  decreased.  percentage  of stress  symptoms t o  activities,  The  identified  differences  Boys  indicate  behaviors  more  noted  that  boys  Moreover, u i t h  "acting  o u t , " and n e g a t i v e In a d d i t i o n ,  response  patterns  an  items  of coping  betueen  t h e age  control  as a  14 t o 15 y e a r the other  identified  active,  to the s e l f  Girls  and  identified  support  more  increase  in age,  health behaviors  16 t o 17 y e a r  more  those  previous  related  girls.  resources  included  The  h e a l t h h a b i t s and s o c i a l  d i d boys.  responses  f r e q u e n t l y than  and r e s o u r c e s  f r e q u e n t l y than  and  girls.  relaxation  response  identified  f r e q u e n t l y than more  as  and h a v i n g uere  solving,  using  as u e l l  in the l i t e r a t u r e  in data  some s t r e s s  olds  frequently.  f o r the adolescent  uere  It uas correspond  described f o r the a d u l t . majority  the  majority  the  most  more  a g r e a t e r mean  locus of control  frequently.  whether  t o be a l o n e "  the s i t u a t i o n ,  cited  t o good  than  "heart  i n c r e a s e d , uhereas  athletic  avoidance/escape  behaviors,  reported  to  from  more  response  of control  perceived  i n t h e age o f t h e  included problem  behaviors.  Trends  locus  Boys  reported  f o r tuo items.  resource  groups.  uptight"  The r e l a t i o n s h i p  Significant  identified  increase  of uanting  doing  to those  sex subgroups  olds  "being  behaviors  to the s e l f ,  response  boys.  uas q u e r i e d .  escaping  experience.  than  o f symptoms  of " f a t i g u e , r e s t l e s s n e s s " ,  "feeling  support,  similar  U i t h an  16 t o 17 r e p o r t e d  response  social  related  and  o f symptoms.  techniques,  uere  symptoms  symptoms.  and  responses  The  affective  "sweating"  Individuals  stress  a g r e a t e r mean f r e q u e n c y  the frequency  afraid"  frequency  perceived  of s p e c i f i c  of the respondents.  frequently  liKely  stress  to occur  identified uith  outcomes  listed  " A l c o h o l i s m or drug item.  Health  the adolescent  problems  age g r o u p  uere  noted  a b u s e " uas that are  uere  less  by  128  •frequently  identified  significant  differences  based  on s e x and a g e .  there  uas a t e n d e n c y These r e s u l t s  influence  as s t r e s s  in reported With  an  explained  There uere  stress  increase  f o r reported  uere  perception:  outcomes.  no  o u t c o m e s uhen  compared,  i n age o f t h e r e s p o n d e n t ,  outcomes t o  increase.  on t h e b a s i s  of variables  time, experience, physical  state  uhich  and t h e  self. From t h e s e are  presented  results,  in the next  Recommendations  the s t a t e d chapter  for further  conclusions  following  research  are  and  a brief  outlined.  implications summary.  123  CHAPTER V  Summary, C o n c l u s i o n s , and  This derived and  last  chapter  recommendations  Recommendations  presents  from the research  study  adolescents'  for further  uas d e s i g n e d  perceptions  perceive  as t h e c a u s e s ,  stress?  Do t h e i r  experience the  theory. and  to explore  vary  What  based  class?  s t r e s s and  of perceptual  to address  the healthy  do h e a l t h y  and o u t c o m e s o f t h e i r  on t h e i r What  adolescents  s e x , a g e , o r an  do t h e y  perceive  as  illness?  for this  A s t r e s s m o d e l , composed  outcomes uas used  and d e s c r i b e  symptoms, r e s p o n s e s ,  frameuorK  from s e l e c t e d elements  Conclusions  of s t r e s s .  betueen  conclusions  It also o u t l i n e s implications  and  perceptions  theoretical  and  research.  i n s t r e s s management  relationship The  t h e summary  study.  Summary  This  Implications  nursing  psychology  of causes, construct  study and  uas d e r i v e d  adaptation  symptoms,  responses,  valid ity.  A q u e s t i o n n a i r e , c o n s i s t i n g o f o p e n - r e s p o n s e and c1osed-response youths, the  consultation uith  literature.  conducted tool. 46  questions,  to refine  and g i r l s ,  programs.  Because  health  uere  from  intervieus uith  p r o f e s s i o n a l s , and a r e v i e u o f  uas p r e t e s t e d  the research  Questionnaires  boys  uith  The t o o l  uas d e v e l o p e d  design  distributed  and a p i l o t  to a convenience  14 t o 19, i n Y.M.C.A. y o u t h  only  four  participants reported  class,  this  uas  and t o f u r t h e r t e s t t h e  ages  s t r e s s management  study  sample o f  group an  experience  v a r i a b l e uas n o t c o n s i d e r e d f o r  further analysis. Open-ended  responses  uere  grouped  and t a b u l a t e d  by  content  124  and  c1osed-response  for  the Social  Descriptive  items  Sciences:  statistics  the  exploratory nature  uell  as s t a t i s t i c a l l y  Analysis results  of  related stress & FinK,  are  to experience  2. Most  healthy  continued,  stress,  on t h e i r  adolescent  health.  health  Knowledge o f t h i s  understanding significant  3. M a j o r  class,  come  as  The  a variation  manageable and v i e u s  literature & Munan,  topic and as  on t h e (Benjamin  1972).  and more  meaning  a r e more  in a d a p t a t i o n , than  they  in h e a l t h .  stress  less  as a  perceive uill  the fact  have  are able  a  that  negative  to describe i t s  f r e q u e n t l y noted  i t s soec i f i c  ( 1 5 5 0 d i d n o t Know any o f i t s  be c o n c l u d e d  management  noted,  from C h i Square  are h e a l t h y , they  Moreover, they  Knowledge o f t h e r e l a t i o n s h i p specific  they  Participants  I t may  Because of  uere  stress  o f more r e l e v a n c e  or extreme  and some r e s p o n d e n t s  family,  vieu  interest  participants  effects effects.  program.  a t p_< .05.  s e e i t as b e i n g  d_is_ease, a v a r i a t i o n  effects.  relate  comparisons  in related  general  stress  findings derived  respondents  Because  accumulated  in data  Package  f r o m t h e a n a l y s i s a r e as f o l l o w s :  be a t o p i c  health.  the data.  trends  The p a r t i c i p a n t s '  may  to experience  effect  MTS) c o m p u t e r  1976; House e t a l . , 1979; S t e r n l i e b  them than  liKely  interval  are supported  However, s t r e s s to  the S t a t i s t i c a l  to present  significant  Furthermore, they  topic  9 (under  used  of adolescent  to health.  through  of the study,  and c o n c l u s i o n s  concern.  Version  uere  and c o n f i d e n c e  1. The m a j o r i t y  analyzed  that  participants  of stress  relationship.  have  t o h e a l t h , b u t may Without  literature,  lacK  experience  i t i s p o s s i b l e the sources  from popular  a general  in  of t h e i r  the media, or  others.  causes  to school  of stress  perceived  and worK, t h e s e l f ,  authority figures,  time  by a d o l e s c e n t  respondents  interpersonal relationships,  d e a d l i n e s , r o u t i n e s , and e m o t i o n s .  125  School  was  <1980;  1983,  are  identified  major  reflect  p.  their  with  sex,  reported  in the  Yeaworth  et  the  the  a l . , 1980)  with  activity  suggests  factor  Selye  stress  is corroborated  self. produce  4. are  these  ( 1974)  The  Those  and  stress  <C.  physiological feeling  is reported  1980).  Because  adolescents behavioral  and  Adolescents situation  Physiological  a  be  able  uere  JacKson and  the  results 1982;  with  others. reflect  reported (1982),  uidening  more and  social  respondents.  have enough  Emotions  in the stress  uith  as  uas This  change,  a cause  a  of  literature. reflect and  the  the a  environment,  developing  developing  recognized  pounding."  noted  less  are  their  to express be  may  and  not  feelings their  The  self  A  to  a  less  be  or  similar  & Everly,  Knouledge  aluays  adolescents  behavioral  (Mechanic,  feelings  considered  these  (Humphrey  learned  experiential  by  frequently.  students  symptoms  may  to  the  1951).  college  relate  symptoms  of  d i d not  of  "heart  limited  not  41%  stress.  symptoms  affective  may  or  uith  stress  have  by  symptoms  as  similar  with  " r o u t i n e s , same o l d t h i n g "  interfere  s t a t e s are  finding  by  struggle f o r maturity  stress such  to  stress  Stressors  interaction  responsibility  causes  uhich  of  authority figures,  noted  findings  Rogers,  m a j o r i t y of  affective  the  factors  during  also  individuals  the  causes  developing self-concept  Time p r e s s u r e s  stress  by  are  Dobson  School/worK  1972b; J a c K s o n ,  the  f a m i l y and  related  many o f  activities,  to  of  these  peers  to  Conversely,  result  the  and  relate  increasing  a cause  and  (1882).  interpersonal relationships  a result  spheres.  being  Humphrey  (Coddington,  and  i n s t u d i e s by  environment.  in r e f l e c t i o n ,  age,  and  Furthermore,  the  independence.  associated uith  as  and  related  are  noted  with  literature  struggle for  frequently  and  parents, s i b l i n g s ,  stress  stressor  for adolescents  self  is determined of  Tyerman  interaction  opposite  Causes  a frequent  and  activities  associated  uhich  351)  as  1972)  and  base,  recognized.  particular in v e r b a l  terms.  s u b j e c t i v e and  thus.  126  easier uas  to d e s c r i b e .  "irritability  The  or  single  depression."  "feel  a g g r e s s i v e , 1iKe  hitting  to  alone,  uere  be  these  not  5.  Adolescent  in  response  out,"  and  behave  problem-solving their  of  uell,  out"  of  "acting  this  stress. or  Adolescents others'  and  may  also  of  and  auareness  adaptive  1982;  the  may  stress  to  an  these  not  uhether  feel.  behaviors  as  not  than  stress.  behavior  "smoKing," response from  As  and  use  further  "drinKing,"  behaviors. ro1e-mode 1 i n g  d i s p l a y e d through conducive  items.  be  managing  behaviors  be  "acting  open-response may  use  using  s e l f - e s t e e m and as  they  escaping,  immature  such  media.  to s t r e s s  management  stress.  f r e q u e n c i e s of  account  of  adolescents  examples  items  outcomes a r e  Billings, whether  from  further  chosen  in the  in decreased  t o use  Known  behaviors  activity,  perceived  uanting  they  of  as  1 iKe  problem-solving,  approaches  uere  in the  may  Patterns  also  or  cause  the  noted  considered  result  behaviors  Differences items  be  learn  behaviors  However, t h e s e  may  uay  More e s c a p e  health behaviors  fast," may  uere  experience,  may  Negative  "driving  support.  more d i r e c t  response  include:  "feel  i s not  to the  in p h y s i c a l  behaviors  Knowledgeable  It  most f r e q u e n t l y  symptoms s u c h  s o m e t h i n g , " or  identified.  These  social  limited  Behavioral  perceive a variety  participating  seeking  identified  in response  respondents  to s t r e s s .  relaxation,  With  talK"  adolescents  item  on  the  the  spontaneously  q u e s t i o n n a i r e uere  listed  noted.  LacK  f o r the d i s c r e p a n c i e s . response  described  behaviors  for adults ( B e l l ,  P e a r l in & S c h o o l e r ,  same b e h a v i o r  uhich  1978).  p a t t e r n s by  It  are  1977;  i s not  adolescents  conducive Moos  to  &  Known  yield  similar  results.  6.  The  adolescent  resources control  t o be  over  respondents  social  self  and  p e r c e i v e the  support, situation,  positive and  stress  response  s e l f - e s t e e m , sense  previous  experience.  of These  127  are  similar  literature Parron,  to the  (Bandura,  1982,  Although  pp.  from  spontaneously  Items r e l a t e d reflects  the  to the impact  self-concept  manage t h e  among t h e specific these  the  self  list  uere  of  the  least  frequently  Knowledge  response  about  resources.  also  may  for this  account  7.  The  be  a negative  less  effect,  they  abuse,"  "headaches,"  attacK," more  and  liKely  injuries," items  frequently  are  "stomach suggest stress  and  on  frequently and  good  &  of  resources  nutrition  and  the  anticipate  identified.  A  to  Rosenfeld, uere  A d o l e s c e n t s may  reaction  not  uhich  importance  as  <Everly  resources.  able to  the  cited  p e r c e i v e the  lack  influence uhat  lacK of  specific  c o n d i t i o n s as  ulcers,"  illness."  uere  less  of  uill  experience  identified as  Knou  described a general " a l c o h o l i s m , drug  "asthma,"  less  they  frequently.  These  than  "heart a t t a c K . "  The  health  might  "sports  s t r e s s - r e 1ated  these  to  "hypertension," "heart  "allergies,"  understood  not  they  stress  Those c o n d i t i o n s u h i c h  " h y p e r t e n s i o n , " or  a d o l e s c e n t s do  outcomes of  Although  "stomach  "colds"  ulcers,"  and  lacK of  health.  to e x p e r i e n c e ,  probably  most  a  uere  result.  identified  "mental  auareness.  stress  adolescent respondents effect  suggest  reaction  "Being  1978).  items  exercise  the  &  Pearl in & S c h o o l e r ,  Although  noted  in the  Hamburg, E l l i o t t  developing self  stress  described  of o p t i o n s , these  noted  at a d o l e s c e n c e .  effects  1974;  1979;  u h i c h may  of the  h a p p e n " uas  8.  Caplan,  P P . 159-161), p h y s i c a l  1981,  be  1977;  resources for adults  77-78; K o b a s a ,  identified  perceived  the  response  are results  c o n d i t i o n s may  be  outcomes.  These  a d o l e s c e n t s ' p e r c e p t i o n s of  Significant four  items.  sex"  as  differences, Girls  a cause,  appetite"  as  p_<.05, b e t u e e n  identified and  stress  "urge  to  the  "relationships c r y " and  symptoms, more f r e q u e n t l y  vary sexes uith  "craving than  boys,  uith  sex.  uere the  noted  for  opposite  to eat  or  uhereas  loss boys  of  128  identified resource  "being  able  t o a n t i c i p a t e uhat  response  more  f r e q u e n t l y than  Trends stress,  based  frequently and  uhich  on s e x , a r e i n d i c a t e d .  perceive  active,  as  causes  "heart  self-esteem  for stress.  Girls  of s t r e s s a s s o c i a t e d  approaches self,  and good  girls  perceived noted  to a j o b , s c h o o l ,  using  tended  t o more  a higher  long  term  locus of  frequently  perceive  more s t r e s s symptoms  using  more s h o r t  as r e s p o n s e  having  term,  than  < BurKe & W e i r ,  As  and  passive  friends,  resources.  mean s t r e s s l e v e l  in the l i t e r a t u r e  cars  the f a m i l y , interpersonal  perceived  habits  more  and p e r c e i v e d  s t r e s s and p e r c e i v e d  health  t o more  and s e l f - c o n f i d e n c e a s r e s p o n s e  symptoms; r e p o r t e d  t o manage  of  stress uith physiological  stress;  uith  and t h e s e l f ;  more a f f e c t i v e  Boys t e n d e d  pounding;" reported  positive  relationships  girls.  related  recognized  t o manage  resources  also  s t r e s s causes  approaches  control,  h a p p e n " as a  i n d i c a t e d i f f e r e n c e s in the perceptions  authority figures;  symptoms  uill  time f o r  uell,  boys, a  result  1378," Mendez  et al . ,  1980). Social  and l e a r n i n g e x p e r i e n c e s  the  respondents  the  sexes  may  in perceptions  8. The a d o l e s c e n t s ' sex  account  f o r the r e p o r t e d  of  perceptions  "remove s e l f  frequently  than  partitioned  o u t , younger  significantly Trends stress  causes  on a g e .  Perceived relating  pressure  uere  14 t o 15, r e p o r t e d  girls  noted  suggest  With  level  perceived  uith  the response more  girls  uith brother/sister" o r any  boys.  d i f f e r e n c e s in the perceptions  of s t r e s s  less  age and  When age and s e x u e r e  "hassles  older  increase  to the s e l f ,  uith  significantly  t u o age g r o u p s .  f r e q u e n t l y than  in the data  based  noted.  more  of  d i f f e r e n c e s betueen  of s t r e s s vary  from s i t u a t i o n "  the other  constitution  stress.  by a g e . The g r o u p , a g e s  behavior  and g e n e t i c  i n age t h e f o l l o w i n g  increased  uith  age.  family, authority figures, f r e q u e n t l y but those  of  uere  Stress and p e e r  relating  t o time  123  p r e s s u r e s , p r e g n a n c y , and f i n i s h i n g frequently.  Symptoms, s u c h  afraid,"  "urge  age,  and  pounding"  behaviors age.  uith  increased.  more "being  in frequency  experience,  groups.  perceive  and t h e s e l f More s t r e s s  uas a t e n d e n c y  of stress  than  other  responsibilities, physical  uere  similar  Grade  school  to those  9 and  more  10.  Although  concerning respondents management  neu  perceived  16 t o 17, t o their  stress  in other  change i n  on g r a d e  causes  in school Individuals  related  grades.  This  to  result  uas t o c o l l e c t  they  neu  ideas  the q u e s t i o n n a i r e . about  results.  format.  use o f the t o o l  Knowledge  activities,  response  tuo e x c e p t i o n s .  of s t r e s s ,  lacked  and t h e  f o r these  perceptions  by c o m p l e t i n g  by t h e o l d e r  trends.  ages  based  in school  gained  having  data  18% o f t h e a d o l e s c e n t about  stress  I t may  stress  be  assumed  and u e r e  receptive  ideas.  The limited. group  the intended  individuals  those  uith  increase in  account  of s t r e s s  t o a change  adolescent  may  13 p e r c e i v e d  f r e q u e n t l y than  be a t t r i b u t e d  self,  and more  Their  as  frequently  noted  e x p l a i n these  f o r age, u i t h  i n Grade  uere  less  in c o g n i t i v e a b i l i t i e s ,  in perceptions  may  these  increase  to decrease  associated uith  age g r o u p s .  s t a t e and e x p e r i e n c e  Patterns  outcomes  behaviors,  such  avoidance  perceived  for individuals,  more symptoms, more r e s p o n s e resources  uere  uith  locus of c o n t r o l ,  the developing  of the adolescent  more c a u s e s  tended  associated uith  The e x p e r i e n c e s ,  grouth  There  Immature b e h a v i o r ,  health behaviors  resources  i n c r e a s i n g age.  physical  to  noted  t o be a l o n e , "  to run or h i d e , " decreased  and n e g a t i v e  As u e l l ,  previous  in  "uanting  uere  b u t " f a t i g u e o r r e s t l e s s n e s s " and p h y s i c a l symptoms  "heart  age  as  school  ability  to generalize the r e s u l t s  It i s p o s s i b l e that  programs  have  a unique  adolescents  beyond involved  s e t of c h a r a c t e r i s t i c s  this  study  is  i n Y.M.C.A. uhich  may  130  influence  their  perception  of s t r e s s .  convenience  s e l e c t i o n and s m a l l  uhich  the a b i l i t y  limit  participants for  participation.  summer  uhen worK  pending. factors or  uho u e r e  This such  interested  activities  timing  uere  may have  might  are factors  It i s p o s s i b l e  in the s t r e s s topic tooK  place  concluding  only  volunteered  a t t h e end o f t h e  and s c h o o l u a s  influenced the r e s u l t s .  as f a t i g u e , as u e l l  the other  o f t h e sample  to generalize.  Data c o l l e c t i o n  of the environment On  size  Furthermore, the  as t h e n a t u r e  have  hand, because  also  Individual  of the a c t i v i t i e s ,  influenced  the study.  t h e Y.M.C.A. p r o g r a m s  tend  t o be  seasonal,  a n d p a r t i c i p a n t s i n t h e Y.M.C.A. a r e i n v o l v e d  throughout  the  this  Y.M.C.A.  year,  youth  groups.  participating  sample  may be s i m i l a r  The s t u d y  to other  Vancouver  f i n d i n g s may be a p p l i c a b l e t o y o u t h  in Vancouver  Y.M.C.A. g r o u p  programs.  Implicat ions  The  facilitation  adolescence,  before  change, uould support  this  majority  and  seem u o r t h y  of the nurse's  outcomes  and d i f f i c u l t t o  effort.  To f u r t h e r  as a c o n c e r n  an i n i t i a l  step  <Hartl,  must  appreciate  the nurse  to stress  1 3 3 2 ) , and a ofthe the adolescent  K n o w l e d g e o f t h e c a u s e s , symptoms,  o f s t r e s s may g u i d e  by t h e  responses,  in a s s i s t i n g the  t o manage s t r e s s .  give  direction  in this  the questionnaire  practical  implications.  a frameuorK  evaluating  patterns at  i s an u n d e r s t a n d i n g  the nurse  including  provide  Because  behavior  perspective,  of s t r e s s .  individual  are ingrained  p r e m i s e , s t r e s s uas i d e n t i f i e d  for influencing  To  habits  s t r e s s management  i s r e c o g n i t i o n or self-awareness  individual's vieus  poor  of the p a r t i c i p a n t s .  management basis  of healthy  nursing  quest,  t h e model  method, as used  The f o u r  Each  in this  s t r e s s components  f o rassessing, planning, care.  of s t r e s s ,  component  s t u d y , has studied  i n t e r v e n i n g , and  may be c o n s i d e r e d  a point  131  of  intervention.  component  will  "at  and  risK"  K n o w l e d g e o-f t h e  help  the  nurse  pattern  more e a s i l y  to  a s s i s t adolescents  effectively.  As  uell,  assessing  expanding  and  as  and  a tool  This  preliminary  frequently  perceive  uhich  recognize  help  they  stress.  It f u r t h e r  based  on  sex  and  patterns  and  trends,  other  in  this  the  stress  causes  i d e n t i f y those  method  of  uho  are  more an  aid  se1f-auareness  of  stress,  such  they  in  for  the  has  or  responses  of  for  class  the  some  are  uith  related  variables  is needed. illness  Furthermore, uhile  management  symptoms  that  to  to  differ  i d e n t i f i e d some  investigation culture  adolescents  respond, factors  believe  t h i s study  as  variables  s t r e s s , the  a trend  further  and,  may  each  be  those  s t r e s s , hou  While  in a s t r e s s  of  indicates  outcomes they  patterns.  for  understanding.  indicates  age.  s t u d y , the  auareness  individual's  the  variables,  response  experience  an  their  t h e m manage and  demographic  questionnaire  study  as  variables  manage t h e i r s t r e s s  the  in e v a l u a t i n g  of  the  could  may  produce  variable,  not  adolescents  Other  be  investigated  indicate  individuals, a desire  a  lacK  to  of  Knou  more . To and  further  other  health  c o n c e r n , as  they  assistance,  and  stress. they  expand  this  information  professionals recognize as  Different  they  they  individuals  help  groups  as  uill  differ  useful  to  identify potential who  individuals  may  be  are  i n need  recognize  in the  Kind  areas  of  of  their  of  nurses  oun  information  need . Many o f  the  stress  adolescents  are  adults.  i s not  It  variables same uay variables The larger  similar  influence as  component to  Known  i f the  adaptive  described  for  the  is questionable. results  survey  of  uhich  those  this might  variables described  variables  i d e n t i f i e d by in the  literature for  and  patterns  adolescent  outcomes  for  the  adult.  The  relationship  Further  preliminary  study study  substantiate  the  is  the  of  these in  the  of  uarranted.  give  direction  present  study  for  a  results.  132  Recommendations  Recommendations  1.  Conduct  research  a  larger  design  used  test  instrument,  a.  in t h i s  Delete  for further research  survey  uith  tool  the  of  healthy  a t t e n t i o n to  study  i t is suggested  and  i n c o r p o r a t e the  the  open-response ftn  respondent,  may  be  and  questions  to  sampling  a  similar  after  To  facilitate  in the  to  follows:  the  modify  the  one!  each  data a n a l y s i s  identified lists  "other," to  added  as  pretested.  more f r e q u e n t l y  option,  are  adolescents, using  that  questions  Research  probability  is modified  open-ended  questions.  for Further  be  of  options  c1osed-response  completed  1 i s t to  from  by  the  address  inc1 us i v e n e s s . b.  Reconsider from the is  a duplication  about  Divide  those  discrete  may e.  be  Expand  entrance items  items  and  and  uhich  response  may  be  to  high  are  as  to  school  uill  information  Consider  example: may  be  i n an  alcohol,  a  question  added  to  option smok'e"  such  as  into  " r e s t l e s s n e s s , " "drinK  facilitate discrimination.  f o r the  s c a l e so  them  school.  "fatigue,"  This  exclude  birthdate  For  combined  "dr inK  and  deleted.  inclusion.  options  a rating  repetitive  example:  related  "smoKe."  Knou" t o  lists  that  from  "yes,  no,  ordinal/interval  data  collected. the  facilitate detail  for  v a r i a b l e s such  Change t h e don't  age  are  For  r e s t l e s s n e s s " or  alcohol," d.  of  explore  "fatigue,  of  questions  timing  further  uhich  questionnaire.  additional  c.  questions  list  options  discrimination.  derived  additional  of  for stress Further  f r o m r e v i e u of  interviews uith  the  response  expand  the  literature  adolescents.  resources  to  list  more  and  uith  from  133  S.  Initiate  response culture  a similar  differences or  3.  based  illness.  theoretical  study  the  on  as  relationship  situations.  For  volunteer  information  about  they  uould  responses D a t a may  recognize  they be  other  factors  stressful  hou  a different  might  uhich  e m p l o y , and  collected  using  influence  may  cause  in t h a t  uhich  by  components  situations  or  as  to  specific  be  asked  to  stress,  situation,  an  such  the  them  outcome t h e y  intervieus,  assess  perception.  respondents  stress  to  variables,  suggested  stress  example:  their  are  uhich  of  sample  demographic  These v a r i a b l e s  frameuorK  Investigate  uith  uhich  uould  open-ended  expect. response  questionnaire.  4.  Investigate  component relation betueen  the  such to  as  patterns  Conduct  further stress  of  symptoms as  of  social  s u p p o r t , or  Further  stress each  develop  management.  stress  as  relaxation  the  component  using of  uould  list  and  behavior  such  as  the  stress  for  Further  develop  the  in  use  of  as  further  in-depth  example:  symptom,  stress  school  an  as  assessment  further  for  use  as  a  problem-solving,  development  attending  questionnaire  as  responses.  as  include  component, such coping  for  a stress  provide  example:  Conduct  variable,  to  to  of  tool  an  for  scales  for  validity  and  re 1iab i 1 i t y .  7.  a  relationship  intervieus,  each  questionnaire  This  the  and  outcome.  component.  upset  response  a component  responses,  a particular  cause, f e e l i n g  and  studies,  stress  specific variables  investigate  and  investigation or  betueen  a particular  uell,  behaviors  stress  6.  of  variables  a stress  investigation  use As  qualitative  in-depth  behaviors  the  outcome.  avoidance/escape  5.  relationship  aid  to  134  counseling deleting  by  changing  questions  the  about  developing  a scoring  8.  questionnaire  Use  and  after  the  9.  the  response  the  options  sensitivity  to  system s u i t a b l e f o r  to  s t r e s s management  compare  to  a rating  the  questionnaire,  to  and  se1f-administration.  perceptions  training  system,  of  stress  further test  and  before refine  instrument.  Employ  a pretest  and  posttest  study  to  assess  about  s t r e s s gained  from completing  the  uhich  uas  to  present  The  suggested  information  occur  in the  derived  understanding  from t h i s  study  uill  perceives  s t r e s s , i t s c a u s e s , symptoms, r e s p o n s e s , i n v e s t i g a t i o n of  greater  Knowledge, nurses  able  more e f f e c t i v e l y  adolescents. healthy  This,  lifestyling  and  the  the  other  facilitate  in t u r n , uould patterns  for  healthy  topic  health  youth.  a  expand  result  the  adolescent and  outcomes.  is uarranted.  With  p r o f e s s i o n a l s may  s t r e s s management promote  understanding  study.  and  to  hou  questionnaire,  Knowledge  Houever, f u r t h e r  of  neu  the  be  for  enhancement  of  135  References  Adams, J . D. (1880). Understanding norKbpgK i n c h a n g i n g l i f e s t y l e s . Assoc i a t e s .  and m a n a g i n g s t r e s s ; A San D i e g o ! U n i v e r s i t y  Adams, J . E . & L i n d e m a n , E . (1374). Coping u i t h long-term disability. In G. V. C o e l h o , D. A. Hamburg, & J . E . Adams (Eds.). C o p i n g and a d a p t a t i o n ( P P . 1 2 7 - 1 3 8 ) . Neu Y o r K ' B a s i c B O O K S  .  Adams, J . F.  <Ed. ) . (1376). Understanding adolescence! Current in a d o l e s c e n t psychology ( 3 r d e d . ) . Boston: A l l y n  deve1OPmentS and  Bacon.  Adelson, J . (Ed.). (1380). Handbook Neu Y o r K : J o h n W i l e y & S o n s .  adolescent  A l e x a n d e r , F. Norton .  (1850).  A l l p o r t , F. H. structure.  (1855). T h e o r i e s o f p e r c e p t i o n and Neu Y o r K : J o h n W i l e y & S o n s .  A n t o n e v s K y , A. ( 1 3 7 3 ) . Jossey-Bass. B a n d u r a , A. (1377). b e h a v i o r a l change.  Psychosomatic  of  medicine.  Health, stress  Se1f-efficacy:  and  Touard  Neu  coping.  psychology.  Y o r K : W.  W.  the  concept  San  Francisco:  a unifying theory 8A, 131-215.  Psychological Review,  of  of  B e d e l l , J . R., G i o r d a n i , D., Amour, J . L . , T a v o r m i n a , J . , & B o l l , T. (1377). L i f e s t r e s s and t h e p s y c h o l o g i c a l and m e d i c a l adjustment of c h r o n i c a l l y i l l c h i l d r e n . J o u r n a l of Psychosomatic Research, 2JL, 2 3 7 - 2 4 7 . B e l l , J . M. (1377). m e n t a l - i 1 1 n e s s and 136-141.  S t r e s s f u l l i f e e v e n t s and c o p i n g methods i n wellness behaviors. N u r s i n g R e s e a r c h . £S_,  B e n j a m i n , R. R. & F i n k , R. (1376). S c r e e n i n g and c o u n s e l i n g : A unique approach to a d o l e s c e n t h e a l t h . Ado 1 e s c e n c e . AJ_, 181-133. B i e l i a u s K a s , L . A. ( 1382). Stress h e a l t h and i l l n e s s . B o u l d e r , CO:  and  it's relationship Westvieu P r e s s .  to  B i e n e r , K. J . ( 1375). The i n f l u e n c e o f h e a l t h e d u c a t i o n on u s e o f a l c o h o l and t o b a c c o i n a d o l e s c e n c e . Prevent ive M e d i c i n e . 4_, 2 5 2 - 2 5 7 .  the  136  B i l l i n g s , A. G. & Moos, R. H. <1981). The r o l e o f c o p i n g r e s p o n s e s and s o c i a l r e s o u r c e s i n a t t e n u a t i n g t h e s t r e s s o f l i f e events. Journal of Behavioral Medicine, 4_, 133-157. B r a m u e l l , S. T. , M a s u d a , M. , Wagner, N. N. , & H o l m e s , T. H. (1975). P s y c h o s o c i a l f a c t o r s in a t h l e t i c i n j u r i e s . Journal  Human Stress , 3_< l >,  of  6-20.  B r u n s u i c K , A. F. (1969). a d o l e s c e n t s e e s them. 1730-1745.  H e a l t h needs of American Journal  B r u n s u i c K , A. F. of u r b a n b l a c K 504-513.  Health, American  s t a b i l i t y and c h a n g e : A s t u d y J o u r n a l o f P u b l i c H e a l t h . 7J0_,  B u r K e , R. J. & W e i r , T. <1978). l i f e s t r e s s , s o c i a l s u p p o r t and Psychology, 93., 2 7 7 - 2 8 8 .  Sex d i f f e r e n c e s i n a d o l e s c e n t well-being. Journal of  (1980). youth.  a d o l e s c e n t s : Hou the o f P u b l i c H e a l t h . 5J=L,  B y r n e , M. J. & Thompson, L . F. (1378). Key s t u d y and practice o f nursing ( 2 n d e d . ). Mosby .  concepts f o r S t . L o u i s : C.  Caplan,  Neu  B O O K S  G.  (1364).  Preventive  psychiatry.  YorK:  the v.  Basic  .  C a p l a n , G. (1374). Support systems and Neu Y o r K : B e h a v i o r a l P u b l i c a t i o n s .  community mental health.  C a s s i d y , C. A. <1972). The r e l a t i o n s h i p b e t w e e n d a i l y life c h a n g e s , p h y s i c a l symptoms and body t e m p e r a t u r e r a n g e and temperature changes r e l a t e d to adjustments to l i f e e v e n t s . F. S. Douns & N. A. Neuman <Eds. ) , A s o u r c e book o f n u r s i n g r e s e a r c h ( P P . 120-128). P h i l a d e l p h i a : F. A. D a v i s .  In  CI i n e , D. W. & C h o s e y , J. J. < 1 3 7 2 ) . A p r o s p e c t i v e study of l i f e c h a n g e s and s u b s e q u e n t h e a l t h c h a n g e s . A r c h i v e s of General P s y c h i a t r y . £7_, 5 1 - 5 3 . C o b b , S. (1976). S o c i a l s u p p o r t as a m e d i a t o r P s y c h o s o m a t i c M e d i c i n e . 3_SL, 3 0 0 - 3 1 4 . C o c h r a n e , R. & R o b e r t s o n , A. (1373). A measure of t h e r e l a t i v e s e v e r i t y J o u r n a l of Psychosomatic Research.  of  life  The l i f e e v e n t s of p s y c h o - s o c i a l I X , 135-133.  stress.  inventory: stressors.  137  C o d d i n g t o n , R. D. (1872a). The s i g n i f i c a n c e o f l i f e e v e n t s a s e t i o l o g i c f a c t o r s in the d i s e a s e s of c h i l d r e n : I--a survey of p r o f e s s i o n a l workers. J o u r n a l o f P s y c h o s o m a t i c R e s e a r c h , 16_, 7-18. C o d d i n g t o n , R. D. (1972b). The s i g n i f i c a n c e o f l i f e e v e n t s as e t i o l o g i c f a c t o r s in the d i s e a s e s of c h i l d r e n : l l - - a study of a n o r m a l p o p u l a t i o n . J o u r n a l o f P s y c h o s o m a t i c R e s e a r c h , ±B_, 205-213. C o d d i n g t o n , R. D. (1979). L i f e events associated u i t h adolescent pregnancies. J o u r n a l o f C l i n i c a l P s y c h i a t r y . 4_0_, 180-185. C o e l h o , G. V., Hamburg, D. ft., & M u r p h y , E . B. (1963). Coping s t r a t e g i e s i n a new l e a r n i n g e n v i r o n m e n t : ft s t u d y o f A m e r i c a n c o l l e g e freshmen. A r c h i v e s o f G e n e r a l P s y c h i a t r y , 3., 4 3 3 - 4 4 3 . C o h e n , F . & L a z a r u s , R. S. (1979). Coping u i t h the s t r e s s e s of illness. In G. C. S t o n e , F . C o h e n , N. E . A d l e r , and A s s o c i a t e s (Eds.). Health psychology ( P P . 217-254). San F r a n c i s c o : Jossey-Bass. C o h e n , F . & L a z a r u s , R. S. (1933). C o p i n g and a d a p t a t i o n i n h e a l t h and i l l n e s s . In D. M e c h a n i c ( E d . ) , Handbook o f h e a l t h , h e a l t h c a r e , and t h e h e a l t h p r o f e s s i o n s ( p p . 6 0 8 - 6 3 5 ) . Neu Y o r k : The F r e e P r e s s . C o l e m a n , J . C. ( 1 8 7 8 ) . Current contradictions in adolescent theory. J o u r n a l o f Y o u t h and A d o l e s c e n c e . Z, 1-11. Col  i n s , A. & F r a n k e n h a e u s e r , M. ( 1978). S t r e s s r e s p o n s e s i n male and f e m a l e e n g i n e e r i n g s t u d e n t s . J o u r n a l o f Human S t r e s s , 4., 43-48.  Combs, A. W. (1971). Some b a s i c c o n c e p t s i n p e r c e p t u a l psychology. In D. L . A v i l a , A. W. Combs, & Ul. W. P u r k e y (Eds.), Helping r e l a t i o n s h i p sourcebook. Boston: A l l y n & Bacon. Combs, A. W. , R i c h a r d s , A. C , & R i c h a r d s , F . p s y c h o 1ogy . Neu Y o r k : H a r p e r & Row.  ( 1976).  Perceptual  Combs, A. W. & S n y g g , D. (1959). Individual behavior: A perceptual approach t o b e h a v i o r . Neu Y o r k : H a r p e r & Row. C o o p e r , G. L . ( 1 9 8 0 ) . P r e n t i c e - H a l 1. Cox,  T.  (1978).  The s t r e s s  Stress.  check.  Engleuood  Baltimore: University  Park  C l i f f s , NJ:  Press.  138  Cummings, K. M., B e c k e r , M. H., & Ma i r e , M. C. < 1380>. Bringing t h e m o d e l s t o g e t h e r : An e m p i r i c a l a p p r o a c h t o c o m b i n i n g v a r i a b l e s used to e x p l a i n h e a l t h a c t i o n s . J o u r n a l o-f B e h a v i o r a l M e d i c i n e . 3., 1 2 3 - 1 4 5 . D a n i e l , W. A . <1977>. Adolescents S t . L o u i s : c. V. Mosby. D a v i s , J . A. <1971>. Elementary C l i f f s , NJ: Prentice-Hall. D o b s o n , C. B. < 1980). Sources A d o l e s c e n c e , 3_, 6 5 - 7 5 . D o b s o n , C. B. <1883). N J : G. A . B o g d e n . D u b o s , R. Press.  <1865).  Man  survey  of  S t r e s s , the  adapting.  D u n b a r , H. F. <1955>. Mind Neu Y o r k : Random H o u s e .  and  in h e a l t h  6th  disease.  analysis.  Engleuood  form s t r e s s .  hidden  Neu  and  Journal  adversary.  of  Ridgeuood,  Haven: Y a l e U n i v e r s i t y  body: P s y c h o s o m a t i c  E l i t z u r , B. <1976>. S e l f r e l a x a t i o n program f o r adolescents. Adol escence , l i . , 563-572.  medicine.  acting-out  E l l i o t t , G. R. & E i s d o r f e r , C. <Eds. ). <1932>. S t r e s s and human health: A n a l y s i s and i m p l i c a t i o n s o f r e s e a r c h . A s t u d y by t h e I n s t i t u t e o f M e d i c i n e , N a t i o n a l Academy o f S c i e n c e s . Neu York: Spr i n g e r . Erne, R. , M a i s i a k , R. , & G o o d a l e , Ul. <1979>. Seriousness adolescent problems. A d o l e s c e n c e . 14., 9 3 - 3 8 .  of  E v a n s , R. I. & R a i n e s , B. E . <1382>. C o n t r o l and p r e v e n t i o n o f smoking in a d o l e s c e n t s : A p s y c h o s o c i a l p e r s p e c t i v e . In T. J . Coates, A . C. P e t e r s e n & C. P e r r y < E d s . > , Promot i n g a d o l e s c e n t h e a l t h : A d i a l o g u e on r e s e a r c h and p r a c t i c e < p p . 101-136>. Neu Y o r k : A c a d e m i c P r e s s . E v e r l y , G. D. & R o s e n f e l d , of the s t r e s s r e s p o n s e .  R. <1931>. The n a t u r e and Neu Y o r k : P l e n u m P r e s s .  F o l k m a n , S. & L a z a r u s , R. S. (1980). An m i d d l e - a g e d community s a m p l e . Journal Behav i o r . 2JL, 2 1 3 - 2 3 8 .  treatment  a n a l y s i s of coping in a o f H e a l t h and S o c i a l  133  F r i e d m a n , M. & Rosenman, R. H. ( 1978). The Key c a u s e r — t y p e A behavior pattern. In ft. Monat & R. L a z a r u s <Eds. ) , S t r e s s and c o p i n g : fin a n t h o l o g y ( P P . £ 0 3 - 2 1 2 ) . New YorK : C o l u m b i a University Press. G a r f i e l d , C. ft. ( E d . ) . (1878). S t r e s s and s u r v i v a l r The emotional r e a l i t i e s of l i f e threatening i 1lness. St. Louis' C. V. Mosby. G o l d b e r g e r , L . & B r e z n i t z , S. (Eds.). (1832). Handbook o f s t r e s s ! T h e o r e t i c a l and c l i n i c a l a s p e c t s . Neu Y o r K ! The F r e e Press . G o o s e n , G. M. & B u s h , H.  ft.  (1382).  Adaptation:  A  feedbacK  process. In D. C. S u t t e r l e y & G. F . D o n n e l l y ( E d s . ) , C O P i n g u i t h s t r e s s ' A n u r s i n g p e r s p e c t i v e ( P P . 13-33). R o c K v i i i e , MD: Aspen Systems. G r e e n b e r g , S. F . & V a l l e t u t t i , P. J . ( 1 8 8 0 ) . Stress helping professions. B a l t i m o r e : P a u l H. B r o o K e s .  and t h e  G r e e n e , W. A. & M i l l e r , G. (1358). P s y c h o l o g i c a l f a c t o r s and reticu1o-endothe1iai d i s e a s e . IV. O b s e r v a t i o n s on a g r o u p o f c h i l d r e n and a d o l e s c e n t s u i t h l e u K e m i a : An i n t e r p r e t a t i o n o f d i s e a s e development in terms o f the m o t h e r - c h i l d unit. P s y c h o s o m a t i c M e d i c i n e , £0_, 124 - 144 . H a g g e r t y , R. J . ( 1 9 8 0 ) . L i f e s t r e s s , i l l n e s s and s o c i a l supports . D e v e l o p m e n t a l M e d i c i n e and C h i l d N e u r o l o g y , ££., 391-400. Hamburg, B. (1974). E a r l y a d o l e s c e n c e : A s p e c i f i c and s t r e s s f u l stage of the l i f e c y c l e . In G. V. C o e l h o , D. A. Hamburg, & J . E . Adams ( E d s . ) , C o p i n g and a d a p t a t i o n ( P P . 1 0 1 - 1 £ 4 ) . Neu YorK: B a s i c BooKs. Hamburg, D. A. (198£). F o r w a r d ! An o u t l o o K on s t r e s s r e s e a r c h and h e a l t h . In G. R. E l l i o t t & C. E i s d o r f e r ( E d s . ) , Stress and human h e a l t h : A n a l y s i s and i m p l i c a t i o n s o f r e s e a r c h ( P P . ix-xxii). I n s t i t u t e of Medicine. Neu Y o r K : S p r i n g e r . Hamburg, D. A., E l l i o t t , G. R., & P a r r o n , D. L . (Eds.). ( 1982). H e a l t h and b e h a v i o r : F r o n t i e r s o f r e s e a r c h i n t h e b e h a v i o r a l sc i e n c e s . W a s h i n g t o n , D. C.: N a t i o n a l Academy P r e s s . H a r t l , D. E . ( 1982). S t r e s s management and t h e n u r s e . In D. C. S u t t e r l e y & G. D o n n e l l y ( E d s . ) , C o p i n g u i t h s t r e s s : A n u r s i n g p e r s p e c t i v e ( P P . 255-264). R o c K v i i i e , MD: A s p e n S y s t e m s .  140  Hav ighurs-t , R. J . ( 1 3 5 3 ) . Human d e v e 1 opment YorK : Longmans, G r e e n & C o .  and e d u c a i i o n .  Neu  H e i s e l , B. A., Ream, A. B., R a i t z , B. S. , R a p p a p p o r t , L . , & C o d d i n g t o n , R. S. (1373). The s i g n i f i c a n c e o f l i f e e v e n t s as c o n t r i b u t i n g f a c t o r s in the diseases of c h i l d r e n . Journal of Ped iatr ics , 8_3_, 119-123. H e i s e l , J . S. (1372). L i f e changes as e t i o l o g i c f a c t o r s i n j u v e n i l e rheumatoid a r t h r i t i s . Journal of Psychosomatic Research, 16_, 4 1 1 - 4 2 © . H i n K l e , L. E . <1358). An i n v e s t i g a t i o n o f t h e r e l a t i o n b e t w e e n l i f e e x p e r i e n c e , p e r s o n a l i t y c h a r a c t e r i s t i c s , and g e n e r a l s u s c e p t i b i l i t y to i l l n e s s . Psychosomatic Medicine, £0., 278-235. H i n K l e , L. E . <1374). The e f f e c t o f e x p o s u r e t o c u l t u r e c h a n g e , s o c i a l c h a n g e , and c h a n g e s i n i n t e r p e r s o n a l r e l a t i o n s h i p s on health. In B. S. O o h r e n u e n d & B. P. D o h r e n u e n d <Eds. ) , S t r e s s f u l l i f e e v e n t s ; T h e i r n a t u r e and e f f e c t s < P P . 3 - 4 4 ) . Neu Y o r K ; J o h n W i l e y & S o n s . H i n K l e , L . E . & W o l f f , H. E . < 1 9 5 7 ) . The n a t u r e o f man's a d a p t a t i o n t o h i s t o t a l e n v i r o n m e n t and t h e r e l a t i o n o f t h i s t o illness. A r c h i v e s o f I n t e r n a l M e d i c i n e . 39., 4 4 2 - 4 6 0 . H i t t , W. D. <1971). Tuo m o d e l s o f man. In D. L . A v i l a , A. W. Combs, & W. W. P u r K e y < E d s . ) , Helping relationship sourcebook (PP. 51-65). Boston: A l l y n & Bacon. H o l m e s , T. H. & R a h e , R. H. <1967). The s o c i a l r e a d j u s t m e n t rating scale. J o u r n a l o f P s y c h o s o m a t i c R e s e a r c h . .LL, 2 1 3 - 2 1 8 . H o l m e s , T. H. & M a s u d a , M. <1374>. L i f e c h a n g e and i l l n e s s susceptibility. In B. S. D o h r e n u e n d & B. P. D o h r e n u e n d ( E d s . ) , s t r e s s f u l l i f e events T h e i r nature and effect ( p p . 45-72). Neu Y o r K : J o h n W i l e y & S o n s . H o l r o y d , K. A. & L a z a r u s , R. S. (1982). S t r e s s , c o p i n g and somatic a d a p t a t i o n . In L . G o l d b e r g e r & S. B r e z n i t z <Eds.), Handbook o f s t r e s s : T h e o r e t i c a l and C l i n ical aspects < PP. 21-35). Neu Y o r K : F r e e P r e s s . H o u s e , E . A., D u r f e e , M. F . , & B r y a n , C. K. (1373). A survey of p s y c h o l o g i c a l and s o c i a l c o n c e r n s o f r u r a l a d o l e s c e n t s . A d o l e s c e n c e . 14_, 3 6 1 - 3 7 6 . Houe, J . ( 1 3 8 0 ) . McGrau-Hil 1 .  Nursing  care of adolescents.  Neu  York:  141  H u d g e n , R. W. (1974). P e r s o n a l c a t a s t r o p h e and d e p r e s s i o n : a consideration of the subject u i t h respect to medically i l l a d o l e s c e n t s , and a r e q u i e m f o r r e t r o s p e c t i v e l i f e - e v e n t studies. In B. S. D o h r e n u e n d & B. P. D o h r e n u e n d < E d s . ) , S t r e s s f u l l i f e e v e n t s : T h e i r n a t u r e and e f f e c t s ( P P . 1 1 9 - 1 3 4 ) . Neu Y o r K : J o h n W i l e y & S o n s . Humphrey, J . & E v e r l y , G. S. (1380). Perceived dimensions of stress responsiveness i n male and f e m a l e s t u d e n t s . Health Educat ion , l i _ ( 6 ) , 38-39. Hyman, R. B. & Woog , P. (1982). S t r e s s f u l l i f e e v e n t s and i l l n e s s o n s e t : ft r e v i e u o f c r u c i a l v a r i a b l e s . R e s e a r c h i n N u r s i n g and H e a l t h . 5., 155-163. J a c K s o n , B. ft. ( 1 3 8 2 ) . S t u d e n t s t r e s s : The r e l a t i o n s h i p b e t w e e n l i f e c h a n g e e v e n t s and h e a l t h c h a n g e s f o r s e n i o r h i g h s c h o o l s t u d e n t s ( D o c t o r a l d i s s e r t a t i o n , S e a t t l e U n i v e r s i t y , 1382). D i s s e r t a t i o n Abstracts Internat ional • &3_, 750A. J a c o b s , T. J . & C h a r l e s , E . ( 1 3 8 8 ) . occurrence of cancer in c h i l d r e n . 11-24. J a n i s , I . L . ( 1371 ) . Brace Jovanovich. Jan is , I. L. behav i o r a l & Sons.  Stress  L i f e e v e n t s and t h e P s y c h o s o m a t i c M e d i c i n e . 4j£_,  and f r u s t r a t i o n .  Neu Y o r K :  Harcourt  P s y c h o l o g i c a l s t r e s s : P s y c h o a n a l y t i c and ( 1858) . Neu Y o r K : J o h n W i l e y s t u d ies of s u r g i c a l pat i e n t s •  J a s m i n , S. & T r y g s t a d , L . ( 1 3 7 3 ) . Behav i o r a l c o n c e p t s and t h e nurs ing p r o c e s s ( p p . 47-84). S t . L o u i s : c. V. Mosby. K e a t i n g , D. P. (1980). Thinking processes J . A d e l s o n ( E d . ) , HandbooK o f a d o l e s c e n t 211-246). Neu Y o r K : J o h n W i l e y & S o n s .  in adolescence. psychology ( P P .  In  K e l l e r m a n , J . , Z e l t z e r , L . , E l l e n b e r g , L . , D a s h , J . , & R i g l e r D. (1988). P s y c h o l o g i c a l e f f e c t s of i l l n e s s in adolescence I: A n x i e t y , s e l f - e s t e e m and p e r c e p t i o n i n c o n t r o l . Journal of Ped i a t r i c s , 97 . 126-131. K e r l i n g e r , F . H. (1373). Foundations of b e h a v i o r a l ed.). Neu Y o r K : H o l t , R i n e h a r t & W i n s t o n .  research (2nd  K o b a s a , S. C. (1373). S t r e s s f u l l i f e e v e n t s , p e r s o n a l i t y , and h e a l t h : An i n q u i r y i n t o h a r d i n e s s . J o u r n a l o f P e r s o n a l i t y and S o c i a l P s y c h o l o g y . 3_Z, 1-11.  14a  K o b a s a , S. C , M a d d i , S. R. , & K a h n , S. h e a l t h : ft p r o s p e c t i v e s t u d y . Journal Psychology, 168-177.  (1983). Hardiness and o f P e r s o n a l i t y and S o c i a l  K o s u b , S. M. & C e r r e t o , M. C. (1981). Juvenile trends in psychosocial research. S o c i a l WorK 6_, 9 1 - 1 0 1 . K o s u b , S. M. & K o s u b , C. in d i a b e t i c c h i l d r e n .  diabetes: in H e a l t h  (1982). A s s e s s i n g p e r c e p t i o n s of C h i l d r e n ' s H e a l t h C a r e , i_L, 4 - 6 .  Current Care,  stress  L a c e y , J . I. & L a c e y , B. C. (1958). V e r i f i c a t i o n and extension o f t h e p r i n c i p l e o f a u t o n o m i c r e s p o n s e s t e r e o t y p y . ftmer i c a n J o u r n a l o f P s y c h o l o g y . ZX, 5 0 - 7 3 . L a i , C. (1983). S t a t i s t i c a l package f o r the s o c i a l s c i e n c e s : V e r s i o n 9.00 ( u n d e r MTS). V a n c o u v e r , B. C.: Computer C e n t r e , U n i v e r s i t y of B r i t i s h Columbia. L a l o n d e , M. ( 1 9 7 4 ) . ft neu p e r s p e c t i v e on t h e Canad i a n s . Ottaua: Information Canada. L a z a r u s , R. S. ( 1966). Psvcholog i c a l p r o c e s s . Neu Y o r K : M c G r a u - H i l l . L a z a r u s , R. health.  s t r e s s and  S. (1981). L i t t l e h a s s l e s can be P s y c h o l o g y T o d a y , ±5.(7), 5 8 - 6 a .  L e B o u , J . ft. adjustment  health  the  of  coping  dangerous  (1376). E v a l u a t i n g the s e r i o u s n e s s of problems. P r i m a r y C a r e , £_, 3 8 1 - 3 8 7 .  to  your  adolescent  L e i g h , H. (1883). E v a l u a t i o n and management o f s t r e s s i n g e n e r a l medicine: The p s y c h o s o m a t i c a p p r o a c h . In G. G o l d b e r g e r & S. Breznitz (Eds.), Handbook o f s t r e s s : T h e o r e t i c a l and C l i n i c a l aspects ( P P . 733-744). Neu Y o r K : The F r e e P r e s s . L e v e n t h a l , H. ( 1 9 7 9 ) . ft p e r c e p t u a l - m o t o r p r o c e s s i n g model o f emotion. In P. P I i n e r , K. R. B l a n K e s t e i n , & I. M. S p i g e l ( E d s . ) , P e r c e p t i o n o f e m o t i o n i n s e l f and o t h e r s ( P P . 1 - 4 6 ) . Neu Y o r K : P l e n u m P r e s s . L e v i n e , S. (1991). Adolescent Health  The a n x i e t i e s o f a d o l e s c e n t s . C a r e , £., 1 3 3 - 1 3 7 .  Journal  of  L e u i s , C. E . , L e u i s , M. ft., & L o r i m e r , ft. & P a l m e r , B. ft. ( 1 3 7 7 ) . C h i 1 d - i n i t i a t e d c a r e : The use o f s c h o o l n u r s i n g s e r v i c e s by c h i l d r e n i n an a d u l t - f r e e s y s t e m . Ped i a t r i c s . 6_0_, 4 3 3 - 5 0 7 .  143  L i e b e r m a n , M. ft. ( 1 3 8 £ ) . The e f f e c t s o f s o c i a l s u p p o r t s on responses to s t r e s s . In L . G o l d b e r g e r & S. B r e z n i t z <Eds. ) , Handbook o f s t r e s s : T h e o r e t i c a l and c l i n i c a l a s p e c t s ( pp . 764-783). Neu Y o r k : The F r e e P r e s s . L i e f , ft. ( 1 8 4 8 ) . The commonsense Neu Y o r k : McGrau-Hill.  psychiatry  of Dr.  ftdolf  Meyer.  Maccobv, E . E. (1383). S o c i a l - e m o t i o n a l d e v e l o p m e n t and r e s p o n s e to s t r e s s . In N. Garmezy & M. R u t t e r ( E d s . ) , S t r e s s , COPing and d e v e l o p m e n t i n c h i l d r e n ( P P . £ 1 7 - 2 3 4 ) . Neu Y o r k : McGrau-Hil1. M a r g e t t s , E . L . <1975>. S t r e s s , h o m e o s t a s i s , and t h e human e c o l o g i c a l c o n t i n u u m i n time--some i m p l i c a t i o n s f o r p s y c h i a t r y , i n L . L e v i ( E d . ) , S o c i e t y , s t r e s s and d i s e a s e : V o l . 2. Childhood and a d o l e s c e n c e <pp. 7 8 - 7 9 ) . London: Oxford University Press. M a r l o u , D. R. (1977). Textbook T o r o n t o : ul. B. S a u n d e r s .  of p e d i a t r i c nursing  (5th ed.).  M a r x , M. B., G a r r i t y , T. F . , & B o u e r s , F . R. (1975>. The influence of recent l i f e experiences on t h e h e a l t h o f c o l l e g e freshman. J o u r n a l o f P s y c h o s o m a t i c R e s e a r c h . 19_, 8 7 - 9 8 . M a s l o u , A. H. ( 1970). Y o r k : H a r p e r & Rou.  Motivation  and p e r s o n a l i t y ( £nd  ed . ) .  Mason, J . Ul. ( 1 9 7 5 a ) . An h i s t o r i c a l v i e u o f t h e s t r e s s Part I. J o u r n a l o f Human S t r e s s . 1_< £ ) , 6 - I E .  field.  Mason, J . Ul. ( 1 9 7 5 b ) . An h i s t o r i c a l P a r t I I . J o u r n a l o f Human S t r e s s ,  field.  vieu of the stress !.(£>, £ £ - 3 6 .  M a t t s s o n , A. (197£). Long-term p h y s i c a l challenge to psychosocial adaptation.  Neu  i l l n e s s in childhood: A Ped i a t r i e s . 5J0_, 8 0 1 - 8 1 1 .  M e c h a n i c , D. (197£). S o c i a l psychologic f a c t o r s a f f e c t i n g the presentation of bodily complaints. Neu E n g l a n d J o u r n a l c_f_ Medicine, £S£, U3£-ll33. M e c h a n i c , D. (1376a). Stress, illness, J o u r n a l o f Human S t r e s s . £_(£), £ - 6 .  and i l l n e s s  behavior.  M e c h a n i c , D. (1876b). S e x , i l l n e s s , i l l n e s s b e h a v i o r , and t h e use o f h e a l t h s e r v i c e s . J o u r n a l o f Human S t r e s s . £.(4), £ 8 - 4 0 .  144  M e c h a n i c , D. (1983). The e x p e r i e n c e and e x p r e s s i o n o f d i s t r e s s : The s t u d y o f i l l n e s s b e h a v i o r and m e d i c a l u t i l i z a t i o n . In D. M e c h a n i c ( E d . ) , Handbook o f h e a l t h , h e a l t h c a r e , and t h e h e a l t h p r o f e s s i o n s ( P P . 591-607). Neu Y o r K s The F r e e P r e s s . M e i c h e n b a u m , D. & C a m e r o n , R. ( 1 9 8 3 ) . Stress inoculation training. In D. M e i c h e n b a u m & M. E . JaremKo ( E d s . ) , S t r e s s r e d u c t i o n and p r e v e n t i o n ( p p . 1 1 5 - 1 5 4 ) . Neu Y o r K : P l e n u m Press . M e n d e z , L. K., Y e a u o r t h , R. C , Y o r K , J . A., & G o o d w i n , T. (1980). F a c t o r s i n f l u e n c i n g a d o l e s c e n t s ' p e r c e p t i o n s of change e v e n t s . N u r s i n g R e s e a r c h . £3_, 3 8 4 - 3 8 8 . M e y e r , R. J . & H a g g e r t y , R. J . ( 1962). Streptococcal in f a m i l i e s . Ped i a t r i e s . £9_, 5 3 9 - 5 4 9 .  life  infection  M i l l e r , T. W. (1981). L i f e events s c a l i n g : C l i n i c a l methodological issues. N u r s i n g R e s e a r c h . 3J3., 3 1 6 - 3 2 0 . M o n a t , A. & L a z a r u s , R. ( E d s . ) . ( 1377). S t r e s s and anthology. Neu Y o r K : C o l u m b i a U n i v e r s i t y P r e s s .  coping:  An  Moos, R. H. & B i l l i n g s , A. G. (1982). C o n c e p t u a l i z i n g and m e a s u r i n g c o p i n g r e s o u r c e s and p r o c e s s . In L. G o l d b e r g e r & S. Breznitz (Eds.), Handbook o f s t r e s s : T h e o r e t i c a l and c l i n i c a l aspects ( P P . 212-230). Neu York': The F r e e P r e s s . Moos, R. H. & T s u , V. D. (1977). The c r i s i s o f p h y s i c a l An o v e r v i e u . In R. H. Moos ( E d . ) , C o p i n g u i t h P h y s i c a l ( P P . 3-21). New Y o r K : P l e n u m M e d i c a l BooK. M o r i a r t y , A. E . & T o u s s i e n g , P. Neu Y o r K : G r u n e & S t r a t t o n . Murphy, L. grouth.  W.  (1976).  Adolescent  B. & M o r i a r t y , A . E . ( 1976). Vulnerability, Neu H a v e n : Y a l e U n i v e r s i t y P r e s s .  N e l m s , B. C. 402-406.  (1881).  What  i s a normal  Neuman, B. J . (1982). The Neuman n u r s i n g e d u c a t i o n and p r a c t i c e . App1eton-Century-Crofts.  adolescent?  systems model: NorualK CN:  MCN.  illness: i 11ness  coping.  coping  and  6_,  Application to  N u c h o l l s , K. B., C a s s e l , J . , & K a p l a n , B. H. (1972). P s y c h o s o c i a l a s s e t s , c r i s i s and t h e p r o g n o s i s o f p r e g n a n c y . A m e r i c a n J o u r n a l o f E p i d e m i o l o g y . 9_5_, 4 3 1 - 4 4 1 .  145  Offer, New  D. , O s t r o v , YorK: B a s i c  E.,  & H o w a r d , K.  I.  (1981).  The  adolescent.  B O O K S .  P a l m e r , F. B. (1981). events . Responding 'SB's <NLN Pub. No. Nurs i n g .  Adolescent perception of s t r e s s f u l life t o s t r e s s : Comrnunitv m e n t a l h e a l t h — i n the 52-1870). Neu Y o r K : N a t i o n a l L e a g u e f o r  P a r c e l , G. S. , N a d e r , P. R., & M e y e r , M. P. ( 1977). Adolescent h e a l t h c o n c e r n s , p r o b l e m s , and p a t t e r n s o f u t i l i z a t i o n i n a t r i - e t h n i c urban p o p u l a t i o n . Ped i a t r i c s . £ & , 157-164. Parrino, J. J. ( 1979). From p a n i c to p o u e r : stress. T o r o n t o : John W i l e y & S o n s .  use  of  P a y K e l , E . S. ( 1974). L i f e s t r e s s and p s y c h i a t r i c d i s o r d e r . B. S. D o h r e n u e n d & B. P. Dohrenwend ( E d s . ) , S t r e s s f u l 1 ife  In  events: Wi1ey &  Their nature Sons.  and  effects  The  positive  ( P P . 135-149).  Neu  P e a r l i n , L. I. & S c h o o l e r , C. ( 1978). The s t r u c t u r e o f J o u r n a l o f H e a l t h and S o c i a l Behav ior , 19_, 2 - 2 1 .  YorK:  John  coping.  P e t e r s e n , A. C. & S p i g a , R. (1982). Adolescence and s t r e s s . L. G o l d b e r g e r & S. B r e z n i t z ( E d s . ) , Handbook o f s t r e s s : T h e o r e t i c a l and c l i n i c a l a s p e c t s ( P P . 5 1 5 - 5 2 8 ) . Neu Y o r k : Free Press.  In  P o l i t , D. & H u n g l e r , B. (1378). methods . P h i l a d e l p h i a : J . B.  and  Nursing research: Lippincott.  Principles  R a b i c h o u , H. G. & S K l a n s K y , M. A. (1980). Effective of a d o l e s c e n t s . Chicago: A s s o c i a t i o n Press. R a b K i n , J . G. & S t r e u n i n g , E . L . (1976). illness. Sc i e n c e . 194 . 1013-1020.  Life  The  counseling  events,  stress  and  R a d i u s , S. M. , D i l l m a n , T. E . , B e c K e r , M. H. , R o s e n s t o c K , I . M. , H o r v a t h , Ul. J . ( 1 3 8 0 ) . A d o l e s c e n t p e r s p e c t i v e s on h e a l t h and illness. A d o l e s c e n c e . 13., 375-384. R i c h a r d s o n , G. E . , B e a l 1 , S., & J e s s u p , G. T. ( 1983). The e f f i c a c y o f a t h r e e - u e e K s t r e s s management u n i t f o r h i g h students. Health Education. 14.(1), 12-15.  school  R o b b i n s , R. (1981). A study of the r e l a t i o n s h i p betueen a d o l e s c e n t p r e g n a n c y and l i f e - c h a n g e e v e n t s . Issues in Mental  Health Nursing,  a,  219-236.  &  146  R o g e r s , C. R. <1951>. Houghton-Miff 1 in . R o g e r s , D. Cliffs,  Client  centered therapy.  (1381). A d o l e s c e n t s and NJ! Prentice-Hal 1 .  youth  Boston!  ( 4 t h ed . ) .  Engleuood  R o l l , E. J . <1880). P s y c h o l o g i s t s ' c o n f l i c t s about the i n e v i t a b i l i t y o f c o n f l i c t d u r i n g a d o l e s c e n c e : An a t t e m p t reconciliation. Ado 1 e s c e n c e . 15_, 6 6 1 - 6 7 0 . R o s K i e s , E . & L a z a r u s , R. S. (1380). C o p i n g t h e o r y and teaching of coping s k i l l s . In P. 0. D a v i d s o n & S. M. ( E d s . ) , B e h a v i o r a l medicine: Changing l i f e s t y l e s ( D P . New Y o r k : B r u n n e r / M a z e 1 .  at  the Davidson 38-63).  Roy, S i s t e r C. (1374). The Roy a d a p t a t i o n m o d e l . In J . P. R i e h l & S i s t e r C. Roy ( E d s . ) , C o n c e p t u a l m o d e l s f o r n u r s i n g p r a c t i c e (PP. 135-144>. New Y o r k : A P P 1 e t o n - C e n t u r y - C r o f t s . R u t t e r , M. (1381). S t r e s s , c o p i n g and d e v e l o p m e n t : Some and some q u e s t i o n s . Journal o f C h i l d P s y c h o l o g y and P s y c h i a t r v . ££., 3 2 3 - 2 5 6 .  issues  R u t t e r , M. , Graham, P., C h a d w i c k , O. F. D., & Y u l e , Ul. ( 1 3 7 4 ) . A d o l e s c e n t t u r m o i l : F a c t or f i c t i o n ? J o u r n a l of C h i l d P s y c h o l o g y and P s y c h i a t r y , 1Z., 3 5 - 5 6 . S c h a c h t e r , S. S. ( 1 8 6 4 ) . The i n t e r a c t i o n o f c o g n i t i v e and p h y s i o l o g i c a l determinants of emotional s t a t e . In L. Berkowitz ( E d . ) , Advances in e x p e r i m e n t a l s o c i a l p s y c h o l o g y . vol. 1. ( p p . 4 3 - 3 0 ) . New Y o r k : A c a d e m i c P r e s s . S c h a c h t e r , S. S. & S i n g e r , J . E. ( 1 3 6 2 ) . p h y s i o l o g i c a l determinants of emotional Rev iew . 63., 3 7 3 - 3 3 3 .  C o g n i t i v e s o c i a l and state. Psycho l o g i c a l  S e l i g m a n , E . P. (1875). H e l p l e s s n e s s : On d e p r e s s i o n , d e v e l o p m e n t and d e a t h . San F r a n c i s c o : w. H. F r e e m a n . Selltiz, C, U l r i g h t s m a n , L . , & C o o k , S. Ul. ( 1 3 7 6 ) . methods i n s o c i a l r e l a t i o n s ( 3 r d e d . ) . New Y o r k : Rinehart & Winston. Selye,  H.  (1374).  S e l y e , H.  (1876).  Stress The  without  stress  of  distress.  life.  New  Toronto:  Research Holt,  York:  Signet.  McGraw-Hill.  147  S h i e l d s , S. ft. & S t e r n , R. M. (1373). E m o t i o n : The p e r c e p t i o n b o d i l y change. In P. P l i n e r , K. R. 6 1 a n K e n s t e i n , & I . M. S p i g e l ( E d s . ) , P e r c e p t i o n o f e m o t i o n i n s e l f and o t h e r s ( P P . 85-106). Neu Y o r K : P l e n u m P r e s s . S h i r r e f f s , J . H. (1978). The r e l e v a n c e h e a l t h a c t i v a t i o n and s e l f - c a r e . The 48 . 4 18-422. S h o n t z , F. illness  C. (1975). The and d i s a b i l i t y .  of  of h e a l t h e d u c a t i o n in Journal of School Health.  psychological aspects Neu Y o r K : M a c m i l l a n .  S i d l e , ft.. Moos, R. H., ftdams, J . , & C a d y , P. Development of a c o p i n g s c a l e . A r c h i v e s of £ a , 226-232.  of  Physical  (1969). General Psych i a t r y ,  S i l b e r , E. , Hamburg, D. ft., C o e l h o , G. V., M u r p h y , E . B., R o s e n b e r g , M. , & P e r l i n , L. I. (1861). Adaptive behavior in competent a d o l e s c e n t s . A r c h i v e s o f G e n e r a l P s v c h i a t r y , 5., 354-365. S i m o n t o n , O. C., M a t t h e u - S i m o n t o n , S., & C r e i g h t o n , Getting uell again. T o r o n t o : Bantam B O O K S .  J . L.  (1878).  S m i t h , J . A. (1380). A survey of a d o l e s c e n t s ' interests: C o n c e r n s and i n f o r m a t i o n . Ado 1 e s c e n c e . JJ5., 4 7 5 - 4 8 2 . S t a n t o n , M. (1874). The c o n c e p t A d o l e s c e n c e . a , 537-546.  of  conflict  at  adolescence.  Steele, s. (1371). Nursing care of the c h i l d u i t h i l l n e s s . Neu Y o r K : App1eton-Century-Crofts.  long  term  S t e e l e , S. (Ed.). (1381). Nursing care of the c h i l d u i t h term i l l n e s s . Neu Y o r K : App1eton-Century-Crofts.  long  S t e i n , S. P. & C h a r l e s , E . (1371). Emotional f a c t o r s in j u v e n i l e d i a b e t e s m e l l i t u s : A study of e a r l y l i f e e x p e r i e n c e s of adolescent d i a b e t i c s . American J o u r n a l of P s y c h i a t r y . 1££, 700-704. S t e r n , R. M. & H i g g i n s , J . D. ( 1363). Perceived somatic r e a c t i o n s to s t r e s s : S e x , age and f a m i l i a l occurrence. J o u r n a l o f P s y c h o s o m a t i c R e s e a r c h . 1_3_, 77-82. S t e r n l i e b , J . J . & Munan, L. (1372). A survey of h e a l t h p r o b l e m s , p r a c t i c e s and n e e d s o f y o u t h . Ped i a t r i e s , 43., 177-186. Sudman, S.  ( 1 3 7 6 ) .  APPIied  sairoling.  Neu  YorK: Academic  Press.  148  Sudman, S. & B r a d b u r n , N. M. F r a n c i s c o ! Jossey Bass.  <188S>.  flsKing  questions.  San  S u t t e r l e y , D. C. <1979). S t r e s s and h e a l t h : A s u r v e y o f self-regulation modalities. Top i c s i n C l i n i c a l N u r s i n g , 1-22. Toffler,  A.  <1974).  Future  shock.  New  YorK: Bantam  ±< l ) ,  Books.  T y e r m a n , A., & Humphrey, M. <1983). L i f e s t r e s s , f a m i l y support and a d o l e s c e n t d i s t u r b a n c e . J o u r n a l o f A d o l e s c e n c e , 6_, 1-12. U n i t e d S t a t e s Department of H e a l t h E d u c a t i o n & W e l f a r e . (1979). H e a l t h y p e o p l e <DHEW Pub. No. PHS 7 8 - 1 2 3 2 ) . W a s h i n g t o n , DC: u. S. G o v e r n m e n t P r i n t i n g O f f i c e . Vaillant, & Co.  G.  < 1977).  Adaptat ion to  1 ife .  Boston:  Little,  Broun  V o l i c e r , B. J . <1977). P a t i e n t ' s p e r c e p t i o n s of s t r e s s f u l associated uith hospitalization. N u r s i n g R e s e a r c h , £3_, 235-238.  events  W a l k e r , D. K. , C r o s s , A. W. , Heyman, P. W., R u c h - R o s s , H. , B e n s o n , P., & T u t h i l l , J . W. G. <1372). Comparisons betueen i n n e r - c i t y and p r i v a t e s c h o o l a d o l e s c e n t s ' p e r c e p t i o n s of health problems. J o u r n a l o f A d o l e s c e n t H e a l t h C a r e , 3_, 8 2 - 9 0 . W a l l a c e , J . M. (1980). B e h a v i o r a l h e a l t h change through t e n s i o n c o n t r o l l e a r n i n g in a d u l t education c l a s s e s . In F. J . M c G u i g a n & W. E . Sime < E d s . ) . S t r e s s and t e n s i o n c o n t r o l <PP . 2 4 2 - 2 6 1 ) . Neu Y o r k : P l e n u m P r e s s . W o l f f , H. G. C h a r l e s C.  <1953). Thomas.  S t r e s s and  Wu , R. < 1973>. Behavior P r e n t i c e - H a l 1.  and  disease.  illness .  Springfield,  Engleuood  IL:  Cliffs,  NJ:  W y l i e , R. C. < 1374). The s e 1 f - c o n c e p t . V o l 1. A r e v i e u of m e t h o d o l o g i c a l c o n s i d e r a t i o n s and m e a s u r i n g i n s t r u m e n t s . L i n c o l n : U n i v e r s i t y of Nebraska P r e s s . Y e a u o r t h , R. C , Y o r k , J . , H u s s e y , M. T. <1380). The d e v e l o p m e n t o f an scale. A d o l e s c e n c e . 13., 3 1 - 9 3 .  A., I n g l e , M. E . , & G o o d u i n , a d o l e s c e n t l i f e change event  149  Z b o r o u s K i , M. <1977>. D i f f e r e n c e s and s i m i l a r i t i e s . In ft. Monat & R. L a z a r u s ( E d s . ). S t r e s s and c o p i n g ; ftn a n t h o l o g y ( p p . 95-107). Neu Y o r K : C o l u m b i a U n i v e r s i t y P r e s s . Z e g a n s , L . S. (1382). S t r e s s and t h e d e v e l o p m e n t o f s o m a t i c disorders. In L . G o l d b e r g e r & S. B r e z n i t z ( E d s . ) , Handbook s t r e s s : T h e o r e t i c a l and c l i n c a l a s p e c t s ( P P . 1 3 4 - 1 5 2 ) . Neu Y o r K : The F r e e P r e s s . Z e l t z e r , L., K e l l e r m a n , J . , E l l e n b e r g , L., Dash, J . , & R i g l e r , (1980). P s y c h o l o g i c e f f e c t s of i l l n e s s in adolescence I I : Impact o f i l l n e s s i n ado 1 e s c e n t s — c r u c i a l i s s u e s and c o p i n g styles. J o u r n a l o f P e d i a t r i c s . 9_Z, 132-138. Z i e m e r , M. M. (1382). C o p i n g b e h a v i o r : ft r e s p o n s e T O P i c s i n C l i n i c a l N u r s i n g , 4.(2), 4-12.  to  stress.  of  D.  150  Appendix  As  Letter  t  of Explanation  and  Consent  152  Appendix  B:  Request  to  Agency  Appendix  Cs  Agency  Consent  156  Appendix  Ds  Revieu  Comments t o  Questionnaire  Draft  159  Appendix  E:  Sample  Questionnaire  160  VIEWS  This stressful  survey  ON  i s about  STRESS  how p e o p l e  feel,  t h i n k , and r e s p o n d to  situations. You  may f i n d  Completion minutes o f your  the topic  interesting.  of the questionnaire w i l l  take approximately 2 0  time.  THIS INFORMATION  IS CONFIDENTIAL  Y o u r r e s p o n s e s t o t h i s q u e s t i o n n a i r e a r e c o n f i d e n t i a l and you w i l l n o t be i d e n t i f i e d p e r s o n a l l y . You may r e f u s e t o p a r t i c i p a t e o r w i t h d r a w f r o m t h e s t u d y w i t h o u t a f f e c t i n g y o u r p a r t i c i p a t i o n i n t h e Y.M.C.A. g r o u p i n any way.  Completion to p a r t i c i p a t e  of the questionnaire w i l l  A  to the next.  willingness  question.  Be a s t r u t h f u l  Complete  each  one b e f o r e  going  a s y o u c a n . THERE ARE NO RIGHT OR WRONG ANSWERS.  POINT OF C L A R I F I C A T I O N : For  or  your  i n the study.  P l e a s e answer each on  indicate  purposes  occurrences  of this  which cause  study,  change  " s t r e s s " means s i t u a t i o n s ,  i n your  situations  may b e p l e a s a n t o r u n p l e a s a n t  situations  cause  us t o f e e l  If  yes,  or both.  These  Our r e a c t i o n s t o t h e s e  any d i f f e r e n t l y ?  .  No  how?  NOTE: I n t h e s u b s e q u e n t computer  functioning.  "stressed".  Would you d e f i n e " s t r e s s " Yes  normal  events,  pages,  tabulation.  the content  i n the r i g h t  P l e a s e do n o t w r i t e i n t h i s  hand area.  column  i s coded f o r  161  S t r e s s i s o f t e n a t o p i c one d o e s n o t c o n s i d e r ; p e r h a p s b e c a u s e o f l a c k o f k n o w l e d g e o r l a c k o f a w a r e n e s s o r p e r h a p s b e c a u s e i t i s n ' t an i m p o r t a n t topic. Please  c h e c k you  1.  stress  Is  a  answer topic  to of  the  following  concern  for  questions.  you?  10  19  11  20  12  21  Yes. No  2.  In  your  opinion,  do  you  think  you  can  do  anything  about  stress?  Yes No Don't 3.  Do y o u t h i n k i l l health?  prolonged  Know  stress  or  accumulated  stress  is  related  to  Yes No Don 1  Know  1  P l e a s e answer  the  The  stress  causes  4.  What as  5.  6.  of  causes  you  following are  stress  number  above  of  i n order  can  different f o r you?  as  briefly  f o r each  and  specifically  as  you  person.  List  as  many s i t u a t i o n s o r  most  stressful,  events  can.  Beginning with  How  questions  you  tell  1 as  the  priority.  that  you  are  under  stress?  number  the  items  listed  cai  lea 7.  The f o l l o w i n g i s a l i s t o f n a t u r a l l y o c c u r r i n g e v e n t s w h i c h may cause stress. F o r each i t e m i n d i c a t e i n the a p p r o p r i a t e column whether t h e i t e m has b e e n a c a u s e o f s t r e s s f o r y o u w i t h i n t h e p a s t y e a r . If you h a v e n o t e x p e r i e n c e d t h e i t e m , y o u may n o t know t h e a n s w e r . YES a. • death  of  b.  loss  of a  c.  changing  school  d.  starting  a new  e.  finishing  f.  parents  pet  g.  pressures  school  to do  a given  h.  s c h o o l work,  i.  death of relative  on  time  frame  badly h u r t / s i c k  1.  team p r e s s u r e s  m.  parent/relative  n.  relationships sex  o.  flunking  p.  r o u t i n e s - "same o l d  q.  pressures  r.  losing  s.  personally feeling  t.  hassling  u.  trouble with  v.  pregnancy wrecking  x.  failing  y.  parent  23  15  24  16  25  17  26  18  27  19  28  20  29  21  30  22  31  23  32  24  33  25  34  26  35  27  36  28  37  29  38 •  30  39 •  31  40 -  32  41 -  33  42 -  34  43 -  35  44 -  36  45 -  37  46 -  tests  k.  ,  14  things  hassles with  a  22  back"  close friend  a  13  (graduating)  j.  w  DON'T KNOW  job  "getting  within  NO  parent  the  or  law  to w i n very  with  i n sports sick  opposite  grade  from  your  thing" friends  job  with  the  "put  downs"  brother/sister teacher/principal  car  a subject losing  job  163 YES z.  getting  and m a i n t a i n i n g  aa.  f a m i l y member d r i n k i n g  bb.  problems w i t h  size,  cc.  problems w i t h  acne  dd.  clothes  ee.  parents  ff.  living  NO-  DON'T KNOW  a car  appearance  divorced/separated up to p a r e n t s  expectations  3. W o u l d y o u be more l i k e l y to f e e l events occurred ' together?  more s t r e s s e d i f a number  of  38  47  39  48  40  49  41  50  42  51  43  52  44  53  45  54  46  55  47  56  these  Yes No Don't Know 9. A r e t h e r e s o m e t i m e s when s u c h n a t u r a l l y o c c u r r i n g e v e n t s more s t r e s s a t one t i m e t h a n a t o t h e r t i m e s ?  g i v e you  Yes  Mo Don' t Know 10. What  11.  do y o u u s u a l l y  Compared t o o t h e r  do when  persons  reaction  to s t r e s s ,  reaction  to s t r e s s  less  y o u .are f e e l i n g  your  stressed?  a g e , do y o u t h i n k y o u e x p e r i e n c e  reaction  as o t h e r s ? More  reaction  Same  reaction  Less  reaction  to s t r e s s  more  o r t h e same amount o f  164 We a r e n o t a l w a y s aware o f how we r e a c t appropriate 12.  box f o r those  When y o u a r e f e e l i n g  items  to s i t u a t i o n s .  which d e s c r i b e your  s t r e s s e d , what  do y o u f e e l YES  a.  overpowering  b.  urge  c.  feeling hitting  d.  craving to eat or loss appetite  e.  urge  Please  check the  experience. like  doing?  XO  DON'T KNOW  to runo r hide  to c r y aggressive, something  inability  to laugh  feel  like  •  of  openly  or  honestly f.  s t u t t e r i n g or other disturbance  g.  feeling alone,  13.  h.  feeling  i.  other  of wanting not talk  In stressful  speech  t o be  ____  situations,  what k i n d s  o f t h i n g s happen YES  a.  dryness  b.  pounding  c.  shaking nervous  d.  insomnia,  e.  constant  fatigue  f.  frequent  need  g.  sweating  h.  headaches  i.  stomach u p s e t , q u e a s i n e s s , " b u t t e r f l i e s " i n stomach, diarrhea, constipation other  57  49  58  50  59  51  60  52  61  53  62  54  63  55  64  56  65  57  66  58  67  59  68  60  69  61  70  62  71  63  72  64  73  65  74  66  75  t o anyone  impulsive  o f t h r o a t and mouth of heart legs,  48  trembling,  difficulty  sleeping  orrestlessness  t o "go p e e "  co y o u r  ' NO  body?  DON'T KNOW  165 14.  When y o u a r e  i na stressful  siruation,  what k i n d s YES  a.  general  o f t h i n g s do y o u f e e l ' NO  DON'T KNOW  i r r i t a b i l i t y or  depression  67  5  68  ' 6  b.  inability  c.  i n a b i l i t y to concentrate or to complete a task b e f o r e going on t o a n o t h e r  69  7  d.  nightmares  70  8  71  9  e.  feelings  t o make d e c i s i o n s  ( c a r d 2) 1- 13 2 4  of u n r e a l i t y ,  weakness  or d i z z i n e s s f.  f e e l i n g of being a f r a i d d o n ' t know what y o u a r e  though a f r a i d of  72  10  feeling  up" o r  73  11  74  12  p l a y m u s i c , r e a d , o r do o t h e r diversionary activity  75  13  b.  play  76  14  c.  do a t h l e t i c a c t i v i t i e s "hard" such as j o g g i n g , w e i g h t l i f t i n g  77  15  d.  talk  78  16  e.  t r y n o t t o t h i n k about  79  17  f.  d w e l l o r "stew" about  80  18  g.  use s p e c i f i c r e l a x a t i o n techniques s u c h a s Y o g a , T.M., p r o g r e s s i v e muscle r e l a x a t i o n  8.1  19  h.  remove y o u r s e l f f r o m  82  20  i.  t r y to f i g u r e  83  21  j.  drink alcohol,  84  22  k.  eatfor  85  23  1.  use medicines  86  24  g.  of being  "keyed  "uptight" h. 15.  other  P l e a s e i n d i c a t e whether o r n o t y o u do each when y o u a r e f e e l i n g s t r e s s e d .  of the following YES  a.  team s p o r t s  "real  mean"  t o someone  o u t what  situation problem  situation the problem i s  smoke  satisfaction  m. i n v o l v e y o u r s e l f i n s o m e t h i n g do w e l l s u c h a s a hobby n  -  o.  drive fast, a c t out  squeal  i n some way  tires,  e l s e you  make smoke  NO  activities  DON'T KNOW  i 87  25  88  26  89  27  166 16.  What h e l p s  you deiil  with-stress?  17.  What makes i t more d i f f i c u l t  18.  The f o l l o w i n g i s a l i s t o f a l t e r n a t i v e s which e x p e r t s i n s t r e s s suggest influence the - response to s t r e s s . Please indicate i n the appropriate column whether each a l t e r n a t i v e h e l p s you o r h i n d e r s you i n your response to stress.  f o r y o u t o manage s t r e s s ?  HELPS a.  b.  c.  having a close f r i e n d can c o n f i d e having and of  DON'T KNOW  a broad  feeling  90  28-  91  29_  92  30  93  31_  94  32_  i n whom y o u  range o f i n t e r e s t s  accomplished  i n some  these  d.  g e t t i n g enough s l e e p  e.  having  f.  b e i n g a b l e t o s a y "no" w i t h o u t feeling guilty  95  33_  g.  eating a well-balanced  96  34_  h.  getting regular physical exercise a t l e a s t t h r e e t i m e s a week  97  35_  having  98  36_  99  37_  i.  time  at night  foryourself  confidence  situation k.  being going  1.  feeling  How d o e s  diet  i nyourself  j . previously experiencing  19.  HINDERS  h a v i n g a s a y o r some c o n t r o l i n the s i t u a t i o n  a  similar  and managing  a b l e t o a n t i c i p a t e what i s t o happen next good about  prolonged,  100 38_  101  yourself  accumulated  or severe  stress  affect  health?  39  167 20.  21.  What do y o u t h i n k w i l l accumulated, prolonged  Do y o u h a p p e n prolonged  happen to y o u r h e a l t h or severe s t r e s s ?  to r e c a l l  having  experienced  i f you  experience  accumulated,  severe or  stress?  102  40  103  41  Yes No Don't If  22.  y e s , what was  the e f f e c t  on y o u r  health?  In y o u r o p i n i o n , w h i c h o f t h e f o l l o w i n g f r e q u e n t l y i d e n t i f i e d p r o b l e m s might be r e l a t e d to a c c u m u l a t e d or prolonged stress? YES . NO DON'T KNOW a. h e a d a c h e s — ; b.  stomach u l c e r s  104  42  c.  accidents  105  43  d.  depression;, r e q u i r i n g  106  44  e.  asthma  107  45  f.  sports  108  46  109  47  110  48  111  49  112  50  113  51  114  52  115  53  medical  care  injuries  g. m e n t a l  illness  (freak out)  h.  colds  i.  hypertension  j.  heart  k.  allergies  1.  a l c o h o l i s m , drug  m.  l a c k o f c a r i n g about  (high blood  pressure)  attack  family,  23.  Know  abuse self,  parents,  others  On a s c a l e i n d i c a t i n g t h e l e v e l o f s t r e s s y o u a r e f e e l i n g p r e s e n t time, where would you p l a c e y o u r s e l f ? (0)  i s no s t r e s s  Circle 0  1  2  to  (9) i s much  the appropriate 3  4  5  6  response 7  a t the  stress  i 16 54  f o r you 8  9  i  168 The 24.  f o l l o w i n g are  few  Which q u e s t i o n ( s ) unclear Please  25.  a  Which  or hard indicate  indicate  d i d you  to  about  find  your  r e a c t i o n s to  difficult  Co  the  previous  answer b e c a u s e  they  questions.  were  understand?  the  questions,  Please  questions  question  i f any,  number(s)  were  the q u e s t i o n  too  1.17  5562  118  63-  personal?  number(s) 66  26.  Questions  have d i f f e r e n t  following  questions  (1)  on  people.  the  a p p r o p r i a t e number  questions  concerning  uneasy  i n the blank  what  Please  indicate  whether  causes  (3) s l i g h t l y  f o l l o w i n g the  stress  uneasy  questions  about  the  effect  stress  has  f o r you  27.  questions s cress.  a b o u t what  you  do  i n response  No  If  yes,  please  specify  67-.  120  68  121  69  122  70  123  71  to  In d o i n g c h i s q u e s t i o n n a i r e , w a s t h e r e a new i d e a o r an a s p e c t s t r e s s management p r e s e n t e d t o y o u w h i c h m i g h t be h e l p f u l ? Yes  119  on  health. d.  or  line  q u e s t i o n s a b o u t how y o u f e e l , how y o u f e e l l i k e b e h a v i n g and how y o u r body r e s p o n d s t o s t r e s s . c.  the  people  v e r y uneasy (2) m o d e r a t e l y (4) n o t a t a l l u n e a s y  Record a.  efrects  w o u l d make most  of  163 (card Now a few q u e s t i o n s  which  will  Remember, a t no t i m e w i l l  a i d i n c a t e g o r i z i n g the information.  any o f t h i s  information  be u s e d , t o  identify  1  13  you.  Please  i n d i c a t e the appropriate  Male  28. Sex  response  f o r you.  _  2  4  3  5  Female  29. Age  67  30.  Date  of Birth  31.  Last  Grade  Day  Year  Month  13 completed  i n school 6  1415  7  16  8  17  32. When c o m p a r i n g y o u r s e l f t o o t h e r s i n y o u r g r a d e i n t e r m s o f academic achievement, would you c o n s i d e r y o u r s e l f a t t h e upper t h i r d of the c l a s s , middle t h i r d , o r lower t h i r d o f the c l a s s ? Upper  third- _  Middle Lower  33.  third third  Have y o u p a r t i c i p a t e d i n s t r e s s management  class?  Yes No  This  concludes  much  appreciated.  Thankyou the  1)  the q u e s t i o n n a i r e .  f o r g i v i n g your  ever present,  time  Your  participation  and thought  and s h a r i n g  but e l u s i v e subject, s t r e s s .  THANKS AND GOOD STRESS MANAGEMENT  TO YOU!  i n this  your  study  i s very  p e r s p e c t i v e on  1  Appendix  F:  Open-Ended  Responses  Frequency  t o Causes  and  of  Categories  Stress  171  Open-Ended Responses to Causes of stress: Frequency  and  Categories  UlorK £1 6  w o r k i n g , j o b , s t a r t i n g neu j o b , e m p l o y e r emergencies, t e a c h i n g . K i d s , having sicK Kids def iance performing, performing in c r o u d , p u b l i c speaking uorK o v e r l o a d e x c e s s i v e demands  5 3 1  Peers  9 3 6 5  r e l a t i o n s h i p s , e n e m i e s , when p e o p l e bug me s e x , l o v e , g i r l o r boy f r i e n d s peer p r e s s u r e , peer group s o c i a l l i f e , a s k i n g someone o u t , d a n c e s , m e e t i n g neu p e o p l e , l a r g e c r o u d s arguments f r iends not b e i n g i n c l u d e d i n a c t i v i t i e s u i t h f r i e n d s  2 2 1 Schoo1  school before t e s t , tests homeuorK, c o n c e n t r a t i o n , s p e l l i n g , s t u d y i n g f a i l i n g t e s t , bad m a r k s , d o i n g b a d l y i n s c h o o l  16 9 4 4 Fami1v  f a m i l y , f a m i l y arguments, m a r i t a l conflicts uith sister pets  9 1  Parents  10  Authority  2 2  Self  parents,  parent  difficulties,  pressure  Figures uhen I've done s o m e t h i n g w r o n g , b e i n g i n t r o u b l e , g e t t i n g in t r o u b l e from higher author i t y lying , untruth r e s t r i c t ions  -Concept 4 3 1 1 1  a p p e a r a n c e , age, h e i g h t uhen p e o p l e h u m i l i a t e me. s h o u t n o t do i n g u e l l pushing s e l f to l i m i t c1ean1iness  at  me  Time Deadl lines 1  time, deadlines f r u s t r a t i o n over a s s i g n m e n t s due  5 3 £  i l l n e s s , injury d e a t h o f someone c l o s e belongings, lost personal  7  a  time  LPS-S  Empt ions  articles  sad moments, d e p r e s s e d , f r i g h t , b e i n g p a r a n o i d anger, excitement, nervousness i g n o r a n c e o f neu e m o t i o n  Change 5 £ 1 1  F inane iai  7  something urong, can't f i g u r e not K n o u i n g u h a t t o do uhen t h i n g s d o n ' t go r i g h t d o i n g s o m e t h i n g neu routines  financial  problems,  lacK  something o u t ,  o f money,  debt  Cars car S i t u a t ion £ £ 1  Compet it ion 3  trouble,  travelling,  driving,  traffic  excessive noise alcoho 1 , drugs b e i n g Kept i n darK  competition,  competitive  Other headaches monthly p e r i o d s f a t igue  sports,  games  Appendix  G*  Open-Ended  Responses Frequency  t o Symptoms o f and  Categories  Stress  174  Open-Ended R e s p o n s e s t o Symptoms o-f S t r e s s ! F r e q u e n c y and C a t e g o r i e s  Phvs iolpqical 18 7 6 5 5 4 3 2 1 1 1  n e r v o u s , j i t t e r y , t e n s e , jumpy e a s i l y , edgy u p t i g h t , t i g h t e n e d muscles headaches feel i l l , sick, shitty t i r e d , s1eepy sueaty , p e r s p i r a t i o n Knots in stomach, u l c e r a c t s up, stomachache b u t t e r f 1 i e s i n stomach e x h i 1 e r a t i o n , a d r e n a l i n s t a r t s pumping t h r o u g h blush higher pulse rate f e e l hot t i g h t f e e l i n g i n my c h e s t and my b r a i n i s l o o k i n g f o r a uay o u t o f t h e s i t u a t i o n subconsc i o u s l y  body  Behav i o r a l 15 4 2 2 1 1 1 1 1  a r g u e , g e t mad f o r no r e a s o n , i r r i t a t e d , b a d mood ready t o e x p l o d e , a n g r y , s h o r t tempered l o s e a p p e t i t e , e a t l e s s because of l e s s time make m i s t a k e s , make i r r a t i o n a l move o r m i s t a k e feel l i k e c r y i n g , screaming require less sleep fidgeting in trouble at school smokemore untruthful  Affect ive 7 4 4 2 2 1 1 1  pressure, lots of pressure, u o r r i e d change i n e a t i n g h a b i t s f e e l i n g depressed upset, uncomfortable f e e l alone t r o u b l e s o r t i n g o u t a l l t h a t i s on m i n d , think c l e a r l y f e e l t h i n g s come doun on you f e e l u n c e r t a i n about myself e v e r y t h i n g t h a t c a n go w r o n g , u i l l  can't  Appendix  Hs  Open-Ended  Responses Frequency  to Responses and  Categories  to  Stress  176  Open-Ended A n s w e r s t o R e s p o n s e s "to S t r e s s : F r e q u e n c y and C a t e g o r i e s  Relaxation Techniques 15 8 6 5 3 2  t r y t o mellow o u t , r e l a x , r e s t sleep smoKe, s m o K i n g m i l d d r u g s s i t doun drinking, a cider do s o m e t h i n g t o r e l a x and g e t my mind o f f my p r o b l e m s , do what I f e e l l i k e d o i n g l i e down, go t o bed t a k e a few deep b r e a t h s , b r e a t h e i n one nostril, out the o t h e r meditate go on v a c a t i o n party  2 2 2 1 1  Social Support 31 1 1 1 1 Music  t a l k t o c l o s e f r i e n d , c a l l my f r i e n d , t a l k i n g about i t u i t h p a r e n t s good company u i t h o t h e r p e o p l e my c a t family support  girlfriend  and D i v e r s i o n a r y A c t i v i t i e s 10 1 i s t e n t o mus i c , mus i c 3 play instrument, play g u i t a r 3 o t h e r n o i s e s t o t a k e my mind o f f 2 uatch T.V. 2 read 2 d o i n g s o m e t h i n g , d o i n g a hobby 1 be c r e a t i v e  Physical 5  3 2 2 1 1 1  Activity go  i n t o r e a l l y bad and a g g r e s s i v e mood, g e t mad, h i t my p i l l o w , r i p t h i n g s u p , g e t v i o l e n t , g e t madder t h a n s t i n k cry go b i k e r i d i n g p l a y hockey go f o r a u a l k jogging stop eating  Cognitive Thinking 11 2 1  think alone, think, think worry  be a l o n e , s i t a l o n e c l e a r l y and r a t i o n a l l y  177  Escape 9 3 1 1 Problem  being alone g e t t i n g r i d of i t , g e t t i n g go o u t and g e t d r u n k s t o p t h i n g about i t  auay  Solving 7 r e s o l v e p r o b l e m , d e c i d e hou t o h a n d l e , a n a l y z e and p l a n , t h i n k i f I r e a l l y have a p r o b l e m 2 b e l i e v e t h a t I am r e s p o n s i b l e f o r my p r o b l e m s and able to s o l v e " t h e m  Symptoms 1 1 1  sweat feel disoriented feel ticked off  Other 1  personal  problem  Appendix  Is  Open-Ended  Responses Frequency  t o Outcomes  to  and C a t e g o r i e s  Stress  179  Open-Ended R e s p o n s e s t o Outcomes o-f S t r e s s i F r e q u e n c y and C a t e g o r i e s  Phvs ical 14 7 5 3 3 2 2 2 2 1 1 1 1 1 1  s i c K , h e a l t h goes d o w n h i l l , d e c r e a s e , f a t i g u e , get very t i r e d , l e t h a r g i c ulcers not able to sleep l o s s of a p p e t i t e , weight l o s s stomach aches headaches h y p e r t e n s ion heart problems overeat one c a n f o r c e y o u r s e l f t o be i l l sweat ing makes me t h r o w up cold hurt  deteriorate  Mental 2 2 2 1 2 1  u p s e t , s t a y s K n o t t e d up i n s i d e and t h e n b r e a k s down, s o r t o f b u r n s y o u o u t depressed edgy, too nervous self-conscious t i r e s m e n t a l l y , body g i v e s o u t on mind mental problems  Don ' t Know 2 2 1  don ' t know noth ing become s t r o n g  1  don't  and m u s c u l a r  Soc iai like  anything  or anyone  one day  

Cite

Citation Scheme:

        

Citations by CSL (citeproc-js)

Usage Statistics

Share

Embed

Customize your widget with the following options, then copy and paste the code below into the HTML of your page to embed this item in your website.
                        
                            <div id="ubcOpenCollectionsWidgetDisplay">
                            <script id="ubcOpenCollectionsWidget"
                            src="{[{embed.src}]}"
                            data-item="{[{embed.item}]}"
                            data-collection="{[{embed.collection}]}"
                            data-metadata="{[{embed.showMetadata}]}"
                            data-width="{[{embed.width}]}"
                            async >
                            </script>
                            </div>
                        
                    
IIIF logo Our image viewer uses the IIIF 2.0 standard. To load this item in other compatible viewers, use this url:
http://iiif.library.ubc.ca/presentation/dsp.831.1-0096002/manifest

Comment

Related Items