Stress-Related Illness: Chronic Stress and Strokes

AS Psychology: Stress related illness

As part of Unit 2 (AQA A) students are expected to know about research into the impact of stress on health and although students must consider the stress and the “immune system”, there are a number of other ways in which stress can lead to illness; the most obvious group of stress-related illnesses being cardiovascular disorders.

New research suggests, however, that stress might impact more than the heart. Thanks to a tweet from the BPS (@BPSofficial) this week, I came across a piece of research suggesting that those who have experienced chronic stress (operationalised as a major life event in the last year) were more at risk of having a stroke. The research is summarised on the BPS website with a short expert commentary.

“Life changes” and “Type A behaviour”

This piece of research has multiple uses as the link between major life events (or life changes) and the role of personality characteristics is supported by this study (those who were classified as Type A had an increased risk of a stroke) as well as simply demonstrating the negative impact of stress on health.  Any study that fulfils several purposes is bound to be welcomed by students, cutting down on the memory load often perceived to be overwhelming to students as they become exposed to more and more studies as the course goes on.

Activity idea: drawing conclusions and the need for responsible reporting

The BPS summary provides a link to the abstract of the published study which has the potential to be used in a number of ways as a learning resource.

You could ask students to draw logical conclusions from the information available, perhaps by providing a set of conclusion statements. For example, ask students whether the following statements are true or false (or not possible to say) from the information provided about the study in the summaries:

  1. If you experience stressful life events such as a divorce, you will have a stroke in the next year. False, use the term “will” is too strong
  2. People who are impatient are more likely to have a stroke than people who are laid back most of the time. False, Type A is more than just being impatient and the study didn’t assess, as far as we are aware, the impact of individual Type A characteristics.
  3. There is a correlation between life change units and stroke risk. The summaries do not refer to the statistical techniques used so we have to assume this is false but this could be discussed, the summaries report that having a life event increased the risk but did not imply that more life events increase the risk further. This could lead into a discussion about possible follow up studies.
  4. If you have Type A characteristics and experience a life change you will be more likely to experience a stroke in the next year. False, the study said that the factors were independently linked, not that these were cumulative.
  5. The more Type A you are the more likely you are to have a stroke. This also refers to the absence of correlation reported in the summaries.
  6. Experiencing a major life change and/or having Type A characteristics are risk factors for the incidence of a stroke. True. The factors were found to be independently linked hence the and/or.

Students could decide what additional information they would require about the study to support some of the conclusions. This could be presented as a sort task (moving cut out statements on individual cards into piles according to their classification) or by simply displaying statements, such as these or your own, for class or group discussion.

Research methods

There is scope in the detail provided in the abstract to explore internal validity (including confounding variables), external validity (population and ecological), the use of non-experimental methods and self report measures (e.g. the ERCTA scale).

Ask students to devise their own short Type A scale and consider how they would assess and improve the reliability and validity as a measure (follow this link to view the scale in a paper comparing Type A scales). The scale used in the study discussed in this post requires a score of 24 or higher to classify an individual as Type A. You could ask students to consider whether a person who scores 23 and a person who scores 24 are really that different and discuss the impact of “cut off points” on the validity of the measure.

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