Category Archives: Stress Solutions

BASS: The Beliefs about Stress Scale

by Susan Andrews, PhD

Do laypersons’ beliefs about stress influence their mental and physical health? In 2016, German psychologists from Berlin addressed this question and developed The Beliefs About Stress Scale (BASS), which is a standardized questionnaire to assess stress beliefs. The BASS consists of an item pool of 24 statements. To standardize the instrument, it was administered online to 455 university students at the start of term. Other information about students’ subjective stress levels, optimism, pessimism, neuroticism and somatosensory amplification was collected. A sub-group of these students were reassessed at the end of term exams 6 to 8 weeks later.

Analysis included factor analysis which suggested 3 dimensions of stress beliefs: negative stress beliefs, positive stress beliefs, and controllability. The item pool of 24 statements is given in the appendix of the publication. Some of the statements include:

“Being Stressed …
1 . . . is, for me, a sign of weakness 2 . . . impacts negatively on my ability to perform 3 . . . causes damage to my health in the long run 4 . . . is something I am able to influence through my actions 5 . . . enables me to work in a more focused manner 6 . . . makes me more productive 7 . . . makes my life more exciting in a positive sense 8 . . . causes damage to my health in the short-term

One study in 2016 by Drs. Johannes Laferton and Susanne Fischer, published in the International Journal of Behavioral Medicine, showed that students who held negative beliefs about stress being dangerous to one’s health did, in fact, complain of more somatic symptoms during a stressful period.

It is interesting to see the wide range of negative to positive statements included in the BASS questionnaire. Further research using the BASS with differing populations is needed.

In the light of these self-fulfilling and predictive beliefs, I might behoove all of us who are active and busy to take time to examine our own beliefs about stress. And, our beliefs about how well we believe we manage our stress is also critical. We may need to decide that Stress is NOT the “Bad Guy” after all. Dr. Kelly McGonigal, a health psychologist, gave a TED talk in which she said, “For years I’ve been telling people ‘stress makes you sick!’ …But I’ve changed my mind.” And, she quoted several large N studies to prove her point that changing how you think about stress can change the outcome.

Americans Are Officially Freaking Out

by Susan Andrews, PhD

The above headline is the conclusion of the 2017 Stress in America survey
conduced by the Harris poll for the American Psychological Association. Nearly
two-thirds (63 percent) of the people who responded say that this is the lowest
point in US history – and it is keeping a lot of them up at night. The poll, which is
the 11th annual Stress in America survey done by the APA, was conducted
online between August 2 and August 31. Only Americans who are 18 and over
and living in the United States responded. Interviews were conducted in English
and in Spanish.

The group of 3,440 respondents was proportioned in the following manner:
1,376 men; 2,047 women; 1,088 whites; 810 Hispanics; 808 blacks; 506 Asians;
and 206 native Americans

The data was weighted by age, gender, race/ethnicity, region, education and
household income to reflect America’s demographics accurately.
Those who are being kept up at night reported that they are worried about
health care, the economy and an overall feeling of divide between them and
their neighbors. One comforting thought is that their neighbors very well may be
lying awake and worrying too. Many people reported being stressed about the
future of the nation. Past surveys have reported that the top stressors were
money (62 percent) and work (61 percent). This year 63 percent report that their
top concern is the fate of the nation. Of interest, more Democrats (73 percent)
agreed that this was their top concern than Republicans (56 percent).
Nonetheless, the sentiment that this is the lowest point in our nation’s history
spanned generations, which includes World War II, Vietnam, and 9/11. Only 30
percent said that terrorist attacks are a source of concern.

Even though politics and specific names were not directly questioned, many of
the issues identified as significant sources of stress, are policy issues.
Bloomberg generated a chart that is reproduced below.

Health Care ___________________________________________ 43%
Economy ___________________________________ 35%
Trust Gov? _________________________________ 32%
Hate Crimes ________________________________ 31%
Crime ________________________________ 31%
Wars _______________________________ 30%
Terrorist Att _______________________________ 30%
High Taxes _____________________________ 28%
No Job/LoWage_________________________ 22%
Climate Change________________________ 21%

However, keeping up with the latest developments is an even larger source of
stress for 56 percent. Further, sources of news which include social media, cell
phone news apps, and network news media blowing things out of proportion
causes them even more distress, a whopping 72 percent.

Dr. Anthony Rustain, a professor of psychiatry at U. of Penn. suggests the
following ways to cut down on stress. 1.) Set guidelines for Social Media time
and time spent watching/reading about the news. 2.) Complete all other
important tasks before checking with social media or with other new sources.
3.) Don’t lie in bed with your cell phone in your face, scrolling through the social
media and news sources. 4.) Don’t check your messages, social media, or
news frequently during the day. 5.) Balance your day with relaxation methods,
such as meditation, music, entertainment, and physical exercise.

And, above all, remember to breathe.

Stress Comes of Age

by Susan Andrews, PhD

For generations traditional medicine has refused to consider “stress” and
other emotional problems as having a direct effect on our body and health.
The doctor might nod sagely and say things like, “it’s all in your head or that
is just your imagination.” Slowly, persistently, the evidence built up showing
many direct effects of stress on the body. Then, the stress was shown to be
transmitted across generations – from a parent to the child, not just
environmentally, but also physically – in the developing brain of the neonate.

But, today, it appears as if stress as a topic of real consideration has come
of age. Cardiologists and internists are now overheard as saying, “next visit
we will talk about stress.” It is like the physicians have decided that stress
and its many “physical friends and relations” really should belong to
medicine, as much as if not more than it does to psychologists. This may
afford psychologists an opportunity to build working relationships with
medical practices. Medical professionals may be able to talk about stress in
physical and medical terms but stress is still best treated without medication
and before it causes illness.

Not only can physicians now be heard talking about stress to their patients,
but also more and more continuing education programs are focusing on the
topic. Most recently, the serious connection between stress and
inflammation is being taught around the world. This is hugely important as
unresolved inflammatory responses are fingered as the root cause of many
chronic illnesses and dis-eases, such as diabetes, metabolic syndrome,
age-related changes and neurodegeneration, heart disease, cancer, MS,
ulcerative colitis, Crohn’s Disease, and Rheumatoid arthritis.

You can appreciate how close the relationship between chronic stress and
chronic inflammation is when you look at the potential causes of just one
chronic inflammatory illness, such as chronic inflammation in the digestive
tract. The #1 cause is often listed as Emotional Stress in the form of panic
attacks, rapid pulse, with night sweats. This constellation of symptoms is a
sign of a cortisol-prompted inflammation. When cortisol remains high in the
blood (immune system and adrenals on overdrive), it results in dilated blood
vessels that force blood to your organs in preparation of an attack. The #2
cause is Physical Stress.

Another indicator that Stress has come of age is the number of related hits
Google gives you for a search on “stress.” Any guess between 115,000,000
and 150,000,000 is acceptable. Actually, today the result was 131,000,000.
The results range from causes and triggers of stress to Symptoms of
Anxiety and Stress to things stress is associated with to ways to manage

It is the ways to manage stress that we do best as psychologists. The bulk
of the 131 million websites that came up are focused on ways to reduce,
manage, get rid of, or lower stress. Many of these websites are very
superficial and even misleading. Or, they are aimed at selling their product.
Stress can almost never be properly managed by simply reading an article
or book or looking at a website. It takes time, determination and good
coaching or therapy for a person to begin to drop bad habits, learn how to
live a more healthy life, and then finally put what they learned into real
action. The techniques to reduce stress only work if you use them.

The Traumatic Stress of Harvey Can Have Unrecognized Long-Term Consequences

Psychologists well understand the consequences of trauma and forms of severe stress. And, even though they may not have all the words to describe what happens to them, almost every person who is intimately involved with a crisis, such as Harvey, knows the effects – “first-hand.” Property loss, health consequences for some, environmental devastation, and likely changes in schedule and lifestyle are just some of the more physical consequences. The
dollar cost of Harvey will be staggering.

However, the emotional impact will be far greater and impossible to place a “price tag” on. There is no recovering a lifetime of memories when your family photobooks or your mom’s china or your child’s school records are swept away by floodwater. I remember friends and family digging through the stench after Katrina’s floodwaters finally subsided, looking for anything that might have survived. Some of us can set that aside and not let the grief and
traumatic memories of the losses evolve into depression and anxiety-related disorders. Others are not that resilient.

But, there is another less known and understood consequence of trauma that I want to talk about today. Research I found when I was writing Stress Solutions for Pregnant Moms indicated that an unnamed group of victims can be the unborn children of women who are pregnant in the midst of a crisis. Medical historians long ago identified that war and natural disasters have significant effects on the children born to women who were pregnant during such events. The van Os study (British Journal of Psychiatry 1998) revealed an increase in schizophrenia among children born to women who were pregnant during the May 1940 invasion of the Netherlands. Laplante et al (Journal of the American Academy of Child and Adolescent Psychiatry 2008) explored the cognitive and linguistic functions of 5-year-old children whose mothers had been stranded in a Quebec ice storm. There are several important findings from this study: (1) Children of mothers who experienced high stress during the severe ice storm scored significantly lower on Full Scale IQ and on scales that measure verbal abstract reasoning and information as compared to children of mothers who experienced moderate or low stress during the same natural disaster. (2) The study suggests that timing of the exposure to the natural disaster is important, with poorer outcomes associated with first and second trimester exposure. (3) The negative effects associated with prenatal stress were seen at 2 years, 5 ½ years, and 8 ½ years of age, indicating relatively long-lasting effects.

Countless articles are being published in international journals on this topic leading the American Academy of Pediatrics to issue a landmark warning on January 1, 2012. In their report entitled “The Lifelong Effects of Early Childhood Adversity and Toxic Stress,” they reviewed converging lines of scientific evidence that illustrate how different types of stress can leave a lasting mark on a child’s developing brain and long-term health. The American Academy of Pediatrics’ position paper acknowledges that the period of time from conception through early childhood is critical. They include prenatal stress in their definition of toxic stress and say that children exposed to early stressful conditions are more likely to struggle in school, have short tempers, manage stress poorly, and tangle with the law.

And, while we know how damaging natural disasters are, we do not really know how to mitigate the consequences to people. I hope people can at least be conscious of the effects and work on solutions

Why Stress Causes Us to Overeat

by Susan Andrews, PhD

Researchers have long linked weight gain to stress, and according to an American Psychological Association survey, about one-fourth of Americans rate their stress level as 8 or more on a 10-point scale. Stress eating or “emotional eating” seems to be triggered almost automatically when stressed. A 2010 study from the University of Michigan indicated that when levels of the stress hormone, cortisol, are up because you are stressed, you eat more snack foods.

We increase fat, salt, sugar, and caffeine intake. • We skip meals regularly. • We eat more fast food, mindlessly munching. • We tend to seek out foods that we consider “comfort food.” • We drink less water. • We may drink more alcohol. • And, some who still smoke, will smoke more cigarettes.

Stress does not always cause us to overeat or to eat more high-fat, sugary comfort-foods. The first reaction of our brain and body to high stress is to shut down appetite. The hypothalamus produces corticotropin-releasing hormone, which suppresses appetite. The brain then sends a message to the adrenal glands to release epinephrine or adrenaline. This triggers the body’s fight-or-flight response and – once again – eating is put on hold.
Fortunately, or unfortunately, this does not last if the stress persists, then the adrenal glands release cortisol. Cortisol immediately increases your appetite. As long as the cortisol levels remain elevated, the fat and sugar cravings continue.

Women are more likely than men to turn to food, while men are more likely to turn to alcohol and smoking. In 2007, an ingenious study in Britain showed that people who responded to stress with high cortisol levels were more likely to snack in response to daily hassles in their regular lives than low cortisol responders.

WebMD offers some interesting thoughts on breaking the stress eating cycle and enjoy a healthy diet.

  • Prepare your brain and body in advance of a known period of stress and you will be better able to handle stress when it happens. Keep your emotions in better balance by eating regularly every four or five hours.
  • Eat Complex Carbohydrates, like oatmeal, bran, brown rice, vegetables, beans, and fruits. Complex carbs help your brain synthesize serotonin.
  • Eat healthy fats, like avocado, nuts, seeds, fatty fish, nut butters, and olive oil.
  • Recognize the stressful event or thoughts that trigger the urge to eat. Stop first and decide if you are really hungry. Remind yourself when you last ate.
  • Try a little Mindfulness.
  • Always keep healthy snacks available wherever you go. Small packets of nuts or trail mix. • Eat good protein in the morning and complex carbs during the day.
  • Please do not forget your small piece of dark chocolate (72% cocoa is good).
  • Have cut up celery and carrots in the refrigerator.
  • Avoid driving or walking past snacks and vending machines.
  • Put that music on and do some breathing!


One Way to Calculate Your Daily Stress Level

by Susan Andrews, PhD

Think about your day today or any day. Is anything causing you to be upset or worried? Are you  working on a timeline, for example, or have a deadline? Is today one of those days that you have too many things on your list? Check the list below and assign a value based on the duration of the aggravation or situation. If the situation or problem lasts less than an hour, assign a number value of 1. If it lasts for several hours, give it a 3. If the situation is chronic, assign a value of 5. Continue reading

Can a Single Stressful Event Cause Long-term Effects in the Brain?

Dr. Daniela Kaufer and her colleagues at the University of California, Berkeley, have found that Chronic stress triggers long-term changes in brain structure and function. (Molecular Psychiatry 2014) Kaufer’s research proposes a mechanism that could explain some changes in the brains of people with PTSD. She found that PTSD patients develop a stronger connectivity between the hippocampus and the amygdala (the seat of the brain’s fight or flight response). And, they develop a lower connectivity between the hippocampus and the prefrontal cortex, which moderates our responses. For the most part, it has been generally accepted that brain changes as a function of stress are based on repeated or chronic stress. Continue reading

Technology to the Rescue

It’s about Time! Instead of technology increasing our stress, new apps are coming out that aim at helping us stay healthy and combat stress. In the last operating system upgrade (iOS 10) for MAC iPhones and iWatches, there is attention paid to reminders and apps that remind you to breathe or spend a few minutes of Mindfulness time. Continue reading

Are you one of those people who routinely over commits yourself?

If you are one of us who says “Yes” every time someone asks if you want to do something, then you are your own worst enemy. A primary cause of stress is feeling the pressure of time. The more we try to cram into a day, the more we become aware of how time can fly by or how much longer it takes to do something than we thought it would. Continue reading

Stress Linked to Increased Risk of Dementia

Chronic stress has become not only a #1 health risk , but also a major way of life for too many of us. If you are honest with yourself, the risk of dementia is more frightening than a heart attack. We can survive a heart attack but once dementia sets in, there is no escape – to date. The important link for all us neuroscientists is how anxiety, fear, and stress affect the brain. Continue reading

Two New Studies on Stress May Surprise

Stress is contagious. Research from St. Louis University suggests that other people’s anxiety and behavior may be harmful to your health. The negative effects of stress, such as increased levels of cortisol, can be triggered by merely observing another person who is acting stressed. Empathy – usually thought of as a good attribute – can be a drain if you watch someone else get negative feedback. Continue reading

Reducing the Room’s Temperature can Increase the Quality of Your Sleep

You probably know how important good sleep is to your overall health. Not only getting enough sleep but the QUALITY of your sleep is the key factor in your protection against many diseases, such as heart disease, diabetes, and cancer. A 2010 study published in the Annals of Epidemiology showed that regularly getting less than six hours of sleep per night can lead to a higher risk of both heart disease and type 2 diabetes. For their study, researchers asked participants to fill out questionnaires about their health and sleep patterns. The researchers analyzed six years’ worth of data from just under 1,500 participants, all between the ages of 35 and 79. They identified several ways to improve the quality of sleep. One of the most surprising findings was the effects of room temperature on the quality of sleep.

It is best to sleep cool. Have you ever noticed how difficult it is to sleep when it gets too hot? That’s because the core temperature of your body needs to be cool in order for you to sleep well. The optimal room temperature for sleep is between 60 and 70 degrees Fahrenheit. Any warmer than that, and your body may not be able to cool as much as it needs to for truly restful sleep. Sleeping cool may even help relieve insomnia.

A body of research is finding that regulating sleep temperature may bring some relief to sufferers of insomnia. According to Dr. Cameron Van den Heuvel, a research fellow involved in a 2009 study of body temperature and sleep performed by the University of South Australia’s Centre for Sleep Research: “Temperature regulation is a significant factor in each of the two types of insomnia. The difference is when the insomnia occurs. People with sleep onset insomnia have difficulty initiating sleep at the beginning of the night, taking two to four hours each night in the worst cases; while people with sleep maintenance insomnia fall asleep easily but have trouble staying asleep, waking up multiple times during the night… In both types of insomnia, sleep is not restful and sufferers are tired during the day.”

Studies of sleep onset insomniacs show that they have consistently warmer core body temperature immediately before initiating sleep, when compared with normal healthy adults. This results in a state of heightened arousal that prevents them from falling asleep when they go to bed, probably because they have to wait for their bodies to lose the heat that’s keeping them awake. We’re only talking about a half to one degree but that small temperature change can result in significant differences in arousal between insomniacs and people without sleeping problems.”

If you are slow to fall asleep at night, try cooling down your room.

Stress Solutions

by Susan Andrews, PhD