CHAPTER II REVIEW OF RELATED LITERATURE AND STUDIES

This Chapter presents the theoretical orientation and review of related literature and studies by the researchers that are relevant to the present investigation.

According to Joyce M. Black and Hawk (2009) stress is a particular relationship between the person and the environment that is appraised by the person as taxing and or exceeding his or her resources and endangering his or her well-being. In addition to external stressful events, people may define stress in different ways because it is the perception of the event, not the event itself that stimulated the response. Physical demands for adaptation are compounded by the adaptive response required by the volume of information and the decisions required for existence in todays society. Stress is result of an imbalance between the demands placed on a person and ones ability to adapt. Stress is a complex reaction that affects ones physiology, behavior, thinking and emotions. It arises in situations where people believe that the demands they face are greater than their abilities to handle those demands (Hiebert, 2000, cited in Malec et al.,2000). Stress can result from environmental factors (task difficulty) and internal factors (repertoire of coping skills, perceptions, and genetic predisposition) or from an interaction between the two (Hiebert, 1983). The external environmental factors are generally termed

"stressors," while a person's reaction to an external stressor is termed "stress" (Albrecht, 1979; Hiebert, 1983). Lazarus and Folkman (1984) use an outcome neutral way to describe people's attempts to deal with the demands or stressors that they encounter. They suggest that stressors have the potential to elicit different reactions among individuals due to their subjective experience of the stressor. These different reactions are based on individuals using two forms of cognitive appraisal: primary appraisal, which involves evaluating the threat of the situation (e.g., irrelevant, benign, threatening), and secondary appraisal, which involves evaluating one's available resources for coping with the stressful situation (e.g., seek more information, control impulsivity). Stress arises not from the demands people face per se, but from people's perceived inability to deal with those demands to their own satisfaction (Hiebert, 1983; Lazarus & Folkman, 1984). Sometimes a person's coping attempts are successful and the demand is handled satisfactorily. Other times, coping attempts are not as successful as one desires and, if the demands or stressors persist, the person begins to feel stressed. When an individual engages in a situation, there is an initial appraisal, or in some cases a mis-appraisal, of the demand characteristics of the situation, the individual's resources for coping with the demand, and the consequences likely to result from the way in which the situation is handled. As the individual remains engaged in the situation, there is subsequent ongoing appraisal regarding the continuing nature of the demand and the adequacy of the individual's coping attempts (Lazarus & Folkman, 1984). Regardless of the accuracy of the person's appraisal of the situation and the

coping resources available, a perceived inequity between demand and coping resources produces an increase in stress level (Hiebert, 2002, p. 228). For example, an athlete who makes a mental or physical error during competition may appraise the stressor as threatening to self-esteem, while another athlete experiencing the same stressor may appraise it as merely challenging. If an athlete has appraised a situation as stressful, his or her coping processes then work to manage the stress reaction. These processes influence the athlete's

subsequent appraisal and, therefore, the type and intensity of the stress reaction. Studying the relationship between perceived stress and burnout among high school basketball coaches, Kelley and Gill (1993) found that lower perceived stress and reduced burnout were correlated with greater social support and more years of coaching experience. Lazarus described the stress reaction as having three components: behavioral, physiological and cognitive (Lazarus, 1974). Recent work by Hiebert, as described in Malec, Hiebert, Young, Rose, Blackshaw, Felsky-Hunt, and Lea (2000), includes an emotional component to the stress reaction. The behavioral component of a stress reaction can be demonstrated through random tics and tremors along with hyperactivity (Hiebert, 1983). The increase in muscle activity that accompanies stress tends to be demonstrated in more "hyper" types of behavior. According to Malec et al. (2000), individuals tend to speed up when they are stressed. Examples of "hyper" or speedy behaviors demonstrated when individuals are under stress include walking, talking and eating fast, using punctuated hand gestures when talking, turning events into

competitions, and getting impatient with people who are slower (Malec et a l , 2000). Increased heart rate, respiration rate, and muscle tension are common indicators of the physiological component of a stress reaction. Other physiological reactions demonstrated by individuals when under stress include increased sweat gland activity and increased blood pressure (Hiebert, 1983; Malec et al., 2000). People's hands get cooler when they are under stress, due to the shunting of the blood away from the extremities and towards the large muscle groups, which is indicative of the fight or flight response. Lastly, blood in the brain is shunted away from the rational problem-solving centers of the brain towards the parts of the brain that control the muscle movement. This causes individuals to think less clearly when under stress (Malec et al., 2000). The cognitive component of a stress reaction often exaggerates the degree of threat or demand involved and minimizes the individual's coping attempts (Hiebert, 1983; Lazarus, 1974). Typically, as stress levels increase, there is increasing interference with people's abilities to engage in accurate cognitive appraisal. For example, when people feel stressed, they tend to exaggerate the nature or intensity of the demands they face, catastrophize about the consequences of not responding optimally in that situation, and thus lessen their coping abilities. Excessive negative thinking and negative self-talk often accompany this unproductive thinking, a combination that tends to interfere with performance and result in less-than-optimal performance. This in turn feeds into

the cycle of exaggeration and catastrophization being experienced by the individual. The cognitive, physiological, behavioral, and emotional components of a stress reaction tend to occur simultaneously as one integrated response involving heightened arousal, inappropriate cognitive activity, and hyperactivity (Hiebert, 1983; Malec et al., 2000). According to Malec et al., one component of the stress reaction is often more exaggerated than the rest. Some people tend to notice their stress physiologically, while others may tend to notice their behavioral or cognitive reactions to stress more readily. Because we react to stress differently, Malec et al. argue that it is possible for individuals to pay attention to their stress reactions, discover which component seems to be the most reactive, and use that as an early warning of stress. If stress is recognized early, steps can be taken to manage or control the stress reaction. Once a person encounters a demand, reacts, and perceives the coping attempts as to work, or the demand decreasing, the system returns to normal with very little harm done to the person (Hiebert, 1983). If the coping attempts are perceived as inadequate, the arousal is sustained or even increased, and over exaggerated cognitive activity occurs along with hyperactivation of the motor system. These stress responses indicate that the demand has become a stressor and that the person is experiencing stress. At this point, if the demand decreases and/or if the person's coping attempts are perceived as adequate, the stress response will begin to decrease and the system will return to normal. If the demand persists, however, and/or if

the person's coping attempts are perceived to be inadequate and continue to be perceived as inadequate, a chronic stress reaction will develop. According to Krames (1993), if someone is under stress, the bodys response can be harmful. The body releases hormones that trigger many changes in the body: heart pounds, blood pressure rises, stomach becomes tense, and muscle clench. He also said that frequent stress can affect the well-being. Thats why there is a need to learn to manage stress well. According to Nan Little that stress has a negative and positive ramifications of the body .Positively, it may be the driving force for improvement and negatively it may show the following symptoms: Physical- frequent colds or flu, headaches, difficulty sleeping, muscle tension, skin problem, trouble with digestion, poor concentration, forgetfulness, learning problems, frequent negative thoughts, speech problems , anxiety,

depression, anger, irritability, feelings of helplessness, lack of purpose, relationship troubles , poor appetite, reckless driving, alcohol or drug use, susceptibility to accidents, and aggression. With the many potential detriments that stress can induce in a person, an individual is coerced to utilize his faculties and abilities in order to cope with the demands that the stress is imposing upon him; this event is central to the process called stress management. Stress management is defined by Black and Hawks (2009) as the ability to cope with the adaptive demands of the external phenomena effectively. A comprehensive description on stress management found in Websters Dictionary

states that stress management are methods of controlling factors that require a response or change within a person by identifying the stressors, eliminating negative stressors, and developing effective coping mechanisms to counteract the response constructively. Examples include progressive muscular relaxation, guided imagery, biofeedback, breathing techniques, and active problem solving. Various authors and researches have presented different methods and strategies for dealing with stress. Krames (1993) of Health today proposes a stress management that includes recognizing stress, managing day to day pressures and little hassle, and identifying stressors. He also added that how one perceives the threat affects how the way he deals with stress. This includes putting a positive spin on stress, forming a network like friends, family members, or mentors, living a healthy lifestyle to face stressors, get enough sleep, eat right, exercise, and nourishing the spirit. Woolfolk and Lehrer (1984), added stress management technique that could be applied; this includes progressive relaxation to eliminate unnecessary tension by relaxing and thereby reduce or eliminate headache, neuralgia, excessive physiological arousal, or other stress related disorders .Modified progressive relaxation by using of a relaxing environment, deep breathing, and cycles of tensing and relaxing muscles. Another is yogic therapy which includes progressive relaxation combined with meditation. The technique often contains elements of the Hindu religion. The therapeutic benefits the therapy helps alleviate muscle tension, excessive autonomic arousal, and hypertension. People who like the yoga exercises especially enjoy it.

Furthermore, Elizabeth Scott (2011), in her article Have a Truly Relaxing Staycation, offered a new method of stress management which she described as one of the stress management which underscores rest and relaxation, and enjoying the place that one is often too stressed and busy to really enjoy: home. She states:
The key to a refreshing staycation is the same as the key to a restful vacation, though somewhat trickier to pull off: don't overdo it, and don't let work creep in. That means no cleaning, office work, or dealing with regular responsibilities. Can turn off the phones, ignore email, and make it a point to both rest and play, or go to a nearby hotel to make it easier.

In addition Dworetzky, John P.also emphasized other coping strategies such as: trust in time, trying not to be alone much of the time, think positively and rationally, and think as relaxed person. Selected stress management also includes autogenic training which teach the body and mind to respond to verbal command, allowing the person to achieve a deep state of relaxation through selfsuggestion (or self hypnosis), affirmation to have a feeling- rich statement about a desire change to reinforce and increase the effectiveness of visualization, meditation, biofeedback, therapeutic touch, massage and yoga. Black and Hawks (2009) also cited that stress management has three components: stress resistance, cognitive reappraisal, and effective coping skills and provided a detailed description of each component and its role in stress management. Stress resistance involves decreasing the bodys response to stress: adopting healthy eating patterns. Engaging in physical activity and using relaxation techniques can help reduce the stress response. Physical activity a positive stressor that is activity requires an adaptive response and when

performed properly, it result in physical changes that counter the normally negative effect of stress. Physical activity helps improve mental function, decrease depression and increase physical endurance. Cognitive reappraisal or restructuring is to change the perception or interpretation of events as stressors. Cognitive reappraisal is based on the assumption that major factoring stress is the individuals perception of the events or experience as a stressor. Effective Coping Skills involves recognition of the problem causing stress and, through problem-solving skills, development and implementation of an effective strategy to cope with or solve the problem. Effective coping skill includes time management, assertiveness, solution-oriented therapy and development of a support system. In the broad discussion of coping with stress, a dominant model that is widely used today is the transactional perspective of stress. In this perspective, stress results from the interaction of peoples physiological, cognitive, and behavioral systems and occurs when people perceive that the demands of a situation exceed their coping resource (Lazarus and Folkman, 1984). The stressor or demand itself does not cause stress; rather, individuals resources for handling the demand satisfactorily will determine the stress that they will experience within that situation. If the demand is intense but people believe they can handle the demand, they will experience little stress. If, however, people think that they cannot handle the demand, no matter how trivial it is, their stress levels may be quite high (Spriddle, 2004).

Furthermore, Malec et. al. (2000) emphasized the self-efficacy theory of stress management which states that self-efficacy is one factor that affects individuals perceptions of a situation. He stated that individuals make judgments about the nature and intensity of the demands required of them in stressful situations. Individuals with high self efficacy may perceive a stressful situation as non-threatening due to their confidence in their ability to perform or to meet the demands of the situation. This notion is supported by Scott (2012) who stated that optimism and positive frame of mind provide huge benefits; accordingly, optimists enjoy better health, stronger relationships and more productive experience and less stress among other things. This is because optimists tend to take more risks, and blame external circumstances if they fail, maintaining a 'try again' mindset; this makes them more likely to succeed in the future, and less upset by failure in general. Hieberts (2000) framework for stress recognizes that mediating factors affect individuals appraisal of a situation. One important personal factor that mediates appraisal in a competitive or threatening sporting environment is selfefficacy. If individuals are confident that they have the resources to handle a particular situation, they may view it as challenging and exciting. If they do not perceive themselves to have the resources to cope with the situation, they may perceive it as very stressful. According to Bandura, people fear and tend to avoid threatening situations that they believe exceed their coping skills, yet they get involved in activities and

behave with assurance when they judge themselves capable of handling situations that would otherwise be intimidating (Spriddle, 2004).

Hiebert (1983) maintains that stress control is best approached by developing a wide range of coping skills, some aimed at dealing with the demands people face (stressor management strategies) and others aimed at helping people calm their stressful reactions (stress management strategies). According to Hiebert (2002), stressor management strategies can be used in a preventive manner. For Hiebert, people with good skills, or other resources for dealing with the demands they face, are less likely to be overtaxed and will experienced less stress.

Successful coping requires a set of skills and knowledge that are adequate for dealing with a variety of situations (Hiebert, 2002). In addition, people need to be able to feel they are in control of their personal situations, rather than victims of circumstance with no feelings of control over the situations.

Numerous literatures have presented evidence that the means by which an individual copes with stress varies from person to person. This is because people view the same situation differently thus, their reactions to the same stimulus may not necessarily be the same but instead differ, in terms of their assessment of the situation as either threatening to their integrity or challenging to them. Thus, the use of any form of coping management is influenced by a multitude of factors.

Many researchers today study possible factors that affect stress management which includes: age, sex, ordinal position, year level and monthly income. Nwamaka (2011), in her study The Mediating Impact of Personality and Socio-Economic Status in the treatment of Stress in Adolescents emphasized that the coping styles of an individual to stress is influenced primarily by his/her personality. She presented an extensive literature in this context citing various authorities.
Eysenck (1970) in Cole (1995) and Larsen & Buss (2005) described personality as the more or less stable and enduring organization of persons characteristics, temperament, intellect and physique which determine his unique adjustment to the environment. Adolescents that have stable, enduring and united characteristics are able to device coping strategies in a given situation. On the other hand, adolescents with less enduring traits are quick to perceive an event or situations as stressful. Herbert and Cohen (1994) agreed that stress is a persons perception of environment events. The perception may include the appraisal of a situation or events as being dreadful, harmful, threatening and challenging (Chen, Langer, Raphaelson, and Mathews, 2004, Naughton, 1997; Okorodudu, 2004). . . Personal characteristic or traits are commonly referred to as stress-buffering resource because they can protect or buffer people from the pathogenic effects of stress. Cole (1995) also features Cattells (1950) view of personality as the organization, which permits a prediction of what a person will do in a given situation. Some researches carried out indicated that coping is a complex process, influenced by both personality characteristics and situational demands (Friedman, Nelson, Baer, Smith, & Dworthkin, 1992).

Aldwin, et.al (1996) conducted assessed the age differences in Stress, Coping, and Appraisal and came with the following findings:
We examined age differences in stress, appraisal, and coping . . . in middle-aged, young-old, and old-old men. Despite extensive probing, nearly a quarter of the old-old reported having had no problems and they expended less coping effort even when they did have problems. The types of problems reported varied systematically with age. Middle-aged men were more likely to appraise their problems both as challenges and as annoyances than the older men. . . However, there were no age differences in perceived stressfulness of the problem, appraisals of harm/loss, or helpless appraisals, number of emotions reported, or coping efficacy. One interpretation of these results is that the nature of stress changes with age, from episodic to chronic, which in turn affects appraisal and coping processes.

He adds; it is not coping strategies per se that change, but rather management strategies. Older adults tend to use more concrete strategies they tend to use less interpersonal hostility and escapism. It may be that they have tried these strategies and found them impractical or ineffective. On the other hand most teenagers respond to stressful events in their lives by doing something relaxing, trying positive and self-reliant problem solving or seeking friendship and support from others. Common examples include listening to music, trying to make their own decisions, daydreaming, trying to figure out solutions, keeping up friendships, watching television and being close to people they care about. These behaviors are appropriate for adolescents who are trying to become independent, taking responsibility for themselves and drawing on their friends and family for support.

http://www.extension.umn.edu/distribution/youthdevelopment/da3083.html According to Erik Eriksons theory of psychosocial development, adolescence is the period of identity development. Changes in the adolescents body are taking place rapidly and highly preoccupied with how he looks and how others view him. While trying to meet the expectations of his peers, hes also trying to establish his own identity. Furthermore, conformity to standards is of utmost importance at this time which may lead to rebellion and questioning of parental or other adult authority. These changes or development pose a great amount of stress on the adolescent (Lippincott, Williams and Wilkins (2005). In addition, Walker ( 1985) points that the primary sources of tension and trouble for teens and their friends are: relationships with friends and family; the pressure of expectations from self and others; pressure at school from teachers, coaches, grades and homework; financial pressures; and tragedy in the lives of family and friends (described as death, divorce, cancer). According to Shelley E. Taylor, PhD, a professor of psychology at UCLA and lead author of the study of behavioral studies, they analyzed the data from hundreds of biological and behavioral studies (both human and animal), they concluded that females were more likely to deal with stress by "tending and befriending" -- that is, nurturing those around them and reaching out to others. Men, on the other hand, were more likely to sequester themselves or initiate a confrontation, behavior in line with the "fight or flight" response that's long been associated with stress.

She also added that men and women's different reactions to stress might be more than just an interesting observation; it could account for differences in their longevity and health. "Women enjoy a greater life expectancy than men as she said. One reason may be that the tend-and-befriend system protects them from some of the damaging effects of stress."The researchers found out that oxytocin, a hormone that promotes both maternal and social behavior and enhances relaxation, as the key factor behind the gender difference. Initially, women have the same response to stress as men, leaving them somewhat vulnerable to cortisol and adrenaline. But then women also begin secreting oxytocin from the pituitary gland, which helps scale back the production of cortisol and adrenaline, minimizing their harmful effects. Interestingly, men also secrete oxytocin when under stress, but they produce it in lesser amounts than women do, and its effects are inhibited by male hormones such as testosterone. The more relaxed behavior that oxytocin promotes also seems to offer some protection of its own. "Hostility has been shown over and over again to be health-damaging," says Williams. As another example of how women's convivial nature may be protective, William cites the fact that an older man's chance of dying after the death of his spouse rises substantially while a woman's risk increases only slightly. "That's probably because women access a social network to help them get through the ordeal." Taylor and her colleagues also believe that men and women's differing responses to stress may have evolved to suit the needs of earliest ancestors.

The researchers theorize, that females were probably better off laying low and tending to their offspring in the face of danger than fighting, which would have put both themselves and their children in harm's way. Likewise, affiliating with others might have been a more valuable strategy -- a kind of safety in numbers defense -- than fleeing and leaving their offspring without protection. Folkman and Lazarus(1988) postulated that gender differences in the sources of stress may explain different coping styles between men and women(e.g., hostile reaction, expression of feeling, distraction, passivity, wishful thinking, and use of sedation) when coping when coping with stressful situation. Folkman, Lazarus, Pimley,and Novacek (1987) noted that men use more selfcontrol(e. g., keeping feelings to oneself) that women, while women use more positive reappraisal than men. In a 1997 study published in the Journal of Family Psychology, UCLA psychologist Rena Repetti found that on days that women reported their stress level at work was highest; their children reported that their mothers had been especially loving and nurturing. In an earlier study, published in the Journal of Personality and Social Psychology, Repetti found that fathers who had conflict at work were likely to also have conflict at home on the same day. Likewise, when the fathers had highly stressful days, they tended to withdraw from their families. An article in the American Psychological Association presented disparities in the way men and women deal with stress. Accordingly, men are more likely than women to say they play sports as a way of managing stress. Furthermore,

women are less likely to exercise frequently (usually once a week) than men saying that they are too tired to engage in any form of physical activity. Additionally, women are far more likely than men to say they read to manage stress and overall, tend to report more stress management activities that connect them with other people, like spending time with friends or family

(http://www.apa.org/news/press/releases/stress/gender-stress.aspx.) Kottan & Johnson (1993) who conducted a study on birth order dynamics and stress stated that birth order is one also of the factor that influence stress management. Family roles govern the perceived expectations and

responsibilities placed on children by parents and siblings. Children's perception of their place in the family constellation influences how they feel about themselves, and how they interact with others. Components of family structure during formative years that reflect emotional and affiliative ties are implicated in the psychological status, coping and relating styles of mature individuals (Fullerton, Ursano, Wetzler&Slusarcick, 1989). Although many genetic and environmental factors contribute to differences between siblings, some differences in behavior of siblings have been attributed to the effects of birth order (Claxton, 1994), an individual's rank by age among siblings (Steelman, 1985 in Claxton, 1994). The place of the individual within the family, the first social structure encountered, has been suggested as a contributing factor in shaping human personalities (Gould, 1997), and influencing interactions in subsequent social structures.

Although the view that birth order is the sole predictor of development across the lifespan has never been widely accepted, an individual's birth order is a possible influence on relationships with parents and siblings, which may affect personality formation and social behavior across the lifespan (Buckley, 1998). Socialization differences experienced by individuals due to their ordinal position of birth may result in overt personality and behavior differences. In the absence of siblings, first borns tend to be socialized by adults, whereas later borns are exposed to the socializing influences of older siblings (Claxton, 1994). Adults socialized as first borns, are sometimes theorized to be more achievement oriented, while their younger siblings are often believed to be more successful in social endeavors, experience greater enjoyment during risk taking behavior and be more independent of authority (Claxton, 1994). It is acknowledged that such characterizations are general and imprecise at best (Claxton, 1994). Birth order research has always been controversial. One of the first modern psychologists to address the influence of birth order on personality development across the lifespan was Alfred Adler in the 1920's. Since his description of the effects of ordinal position of birth on personality (Claxton, 1994), many theories have been suggested to explain apparent differences. These include dethronement of the first born, parental anxiety, economic factors, intrauterine conditions (Claxton, 1994) and historical cohort effects. Much of the debate of possible effects of birth order has focused on intellectual abilities, academic achievement (Bohmer & Sitton, 1993; Morjoribanks, 1997), economic

resources (Travis & Kohli, 1995) and family intellectual environment (Travis & Kohli, 1995). The transient enthusiasm with which birth order research is investigated is partly caused by the accompanying revival of the nature versus nurture in the formation of human personality debate, and partly by inconsistent and conflicting findings in this area (Claxton, 1994). Walter Toman analyzed different patterns of sibling order and gender stressors encountered in relationships in adult life may replicate those experienced in the first and most significant relationships of childhood - those between family members. Some adult relationships closely mirror the dynamics of those from childhood. The more closely facets of an adult interpersonal relationship mirrors sibling, or parent and child relationship dynamics, the greater the chance that the individual will apply the coping skills learnt in the childhood scenario (Buckley, 1998). In the book McEwen 2002&Clarke 2008, it states that academic stress among college students has been a topic of interest for many years. College students are prone to stress due to the transitional nature of college life. For example, many college students move away from home for the first time, which can necessitate leaving all previously learned support systems such as parents, siblings and high school friends. Accordingly, stress among nursing students has been well documented; a study by Trockel, (2000) found that nursing students suffer from long hours of

study, multiple assignments, lack of free time, lack of timely feedback and lack of faculty response to student needs.(Beck 1999 &Trockel 2000). During their college years, students experience constant challenges and demands for adjustment and change. Along with academic pressures, students must take responsibility for themselves, must seek acceptance from their peers in a world of mixed values, and begin more intimate relationships. Mahat (1998) found that negative interpersonal relationships were the most frequently reported stressful event , while Ross (1999) found that intrapersonal sources of stress were the most common . Among a cohort of students, the four least frequently reported stressors were divorce between parents, quitting a job, severe injury, and transferring schools, in agreement with Ross (1999). In comparison, Evans & Kelly (2004) found that examinations, the intense amount of work, and finding the academic work difficult were the most important source of stress. Nigerian nursing students have high levels of stress, with the most common stressors including excessive schoolwork, financial problems, inadequate recreational facilities, and overcrowded accommodations. These findings indicated a need for counseling and other support services among nursing students. The researchers found that first-year students experienced greater stress than students in subsequent years, findings in agreement with those reported previously (Walton, 2000). In addition, Misra&McKeen (2000) found that students at the freshman and sophomore levels experienced more stress than juniors or seniors due to the fact that they are in the alarm stage (Selyes theory of General

Adaptation Syndrome).In the alarm stage, the body's first stage of response to a stressor, during which its defenses prepare for action. Fourth year level students are already capable of adjusting to the stressors, due to the fact that they have already accumulated many experiences, learned from it, adjusted to it, and find stress management. The researchers found that first-year students experienced greater stress than students in subsequent years, (Walton, 2000). In another article by Elizabeth Scott, entitled Stress In College: Common Cause of Stress in College, dated September 24, 2012, she motioned that, college freshmen face the most obvious social challenges that usually involve leaving ones entire support structure behind, creating a new social network, dealing with being away from home for the first time and finding less parental support, most students face social stress. Finding and living with a roommate, balancing friends with school work (and often part-time jobs), and dealing with the dynamics of young adult relationships can all be difficult, and these challenges can lead to significant stress

An article featured in the Carnegie Mellon News Service featured an article written by Psychology Professor Sheldon Cohen showed that a lack of income can increase stress levels in individuals who do not have enough money to pay for their expenses. Low income groups suffer from higher stress levels, followed by the middle class and then the higher income earners. High stress can cause several health issues, including heart problems, balding and diabetes complications.

In another study published in Psychosomatic Medicine, mentioned by Scott (2006) it's those in the lower socio-economic levels who experience greater levels of stress and experience more stress-related health problems as well. Higher stress hormone levels were found in those with higher levels of socioeconomic status. People of lower socioeconomic status may experience greater levels of stress and poorer health outcomes for several reasons: Higher paying jobs bring greater personal control thus allowing people in high offices to have more personal choices in their lifestyles and more resources at their disposal leading to lower stress levels; those in higher socio-economic levels make healthier choices while people in lower socio-economic status tend to make health damaging choices (e.g. smoking, skipping breakfast or

meals).Lastly, higher socio-economic status brings greater resources for health; those in the lower levels of socio-economic stats tend to have poorer health outcomes because they are less able to take care of their health and even afford health care, among other things which consequently contributes to greater levels of stress. http://stress.about.com/od/stresshealth/a/socioeconomic.htm

In studies concerning the role of socio-economic status to the stress levels of an individual, it has been noted that people from higher socio-economic groups differ significantly from those in the lower socio-economic stratum in terms of cognitive reappraisal particularly because some children from lower socioeconomic status backgrounds get less training in critical thinking and in anticipating crises. This is significant, because stress can be managed in large part by anticipating stressful events and making plans to reduce their stressful

impact. Making healthier choices and planning ahead are behaviors that can be taught, but they may not be taught as much in every family.

(http://stress.about.com/od/stresshealth/a/socioeconomic.htm)