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Stress Reduction 3
be determined that modifiable factors in the social environments of
organizational units have powerful stress-inducing effects, it is not prudent
to rely on person-based, intrapsychic stress reduction approaches.
The organizational mission of the military is combat. That, of course,
involves stressful conditions. Consequently, it might seem odd to suggest
that stress be lowered for military personnel in their training. A critic
here might ask, show can soldiers be prepared for combat if they do not know
how to deal with stress, and how can they learn how to deal with stress if
they are not exposed to it?" The succinct reply involves a conceptual
clarification, namely that stress can be understood as a state of imbalance
between environmental demands and resources for coping. Therefore, stress can
be mitigated by augmenting coping skills. When environmental demands or
pressures are a given inevitability, stress can be reduced nonetheless by
enhancing the person's cognitive, behavioral, and social resources for coping
with the stressors.
An overview of the stress field and an elaboration of the above concept
will be set forth in the next section, which will discuss determinants and
mediators of stress in environmental, cognitive, behavioral, and social
domains. Given the scope of this paper, coverage of these areas will
necessarily be abbreviated. The aim will be to provide a basic conceptual
background for what is to be presented on stress diagnostic procedures, stress
reduction, and prospects for implementation in military se~ctings.
OVERVIEW OF THE STRESS FIELD
Contemporary research on human stress tracks a number of main areas of
investigation, these being (a) conditions of the physical and social
environment that function as stressors, (b) stressful life events and the
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moderating influences of supportive relationships, (c) physiological processes
ant health impairments that accompany ant follow from the experience of
stress, (a) cognitive ant personality mediators of stress, (e) processes of
coping ant adaptation; and (f) stress reduction strategies. Each of these
areas is relevant to military settings and the well-being of military
personnel. In order to present a coherent synopsis of this vast literature in
such a broad field, a theoretical framework will be set forth with its gutting
concepts.
Human Stress: Conceptual Framework
The field of human stress contains many contextually focuses theories or
motels. Some examples are those concerned with stressful life crises
(Dohrenwent, 1978), attention overload and task performance (Cohen, 1978),
perceived controllability of stressors (Glass & Singer, 1972), person-
environment congruence (Stokols, 1979), physiological mechanisms and disease
(Novaco' 1979), and
& Schooler, 1978).
stress to adequately
in stress research' a
the preponderance of
(1985)' and the basic
(Levi' 1974; Selye, 1976)' the regulation of emotion
coping processes (Lazarus & Launier, 1978; Pearlin
Although there is no single, all-embracing theory of
represent and explain the diversity of phenomena studied
basic model can be set forth that is compatible with
existing theory. This was attempted by Novaco and Vaux
propositions of that model will guide this paper.
The concept of stress, as a condition of the organism or system that
constitutes a state of imbalance between demands and resources, is defined by
relationships between environmental demands (stressors) and adverse health and
behavioral consequences (stress reactions) resulting from exposure to those
demands. The association between stressors and stress reactions is not
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uniform, as it is mediated by cognitive, behavioral, and social factors which
influence whether environmental demands function as stressors and also
influence the course of stress reactions. Importantly, environmental
conditions and person characteristics~oehaviors are thought to be reciprocally
related in ongoing processes of stress and adaptation.
The general model of stress (Novaco & Vaux, 1985) can be understood in
terms of its basic postulates given below with brief elaborations. The
central propositions pertain to the sources of stress, impact mechanisms,
mediational factors, and transactional influence processes.
1. Stress is induced by environmental demands that exceed coping
resources,_thus disturbing homeostatic balance.
Environmental demands or "stressors~ are elements or conditions of
environmental fields that require an adaptive response from the organism or
system. The stress inducing potential of environmental demands is a function
of their patency and persistence. Potency refers to the degree of disturbance
caused to homeostatic balance as a result of a stressor's intensity, severity,
and multiplicity. Persistence refers to the temporal exposure to the stressor
in terms of its frequency and duration.
2. Stress is manifested by adverse cart lisp behavioral and
physiological consequences resulting from the exposure to environmental
demands.
Stress reactions consist of physiological disturbances, negative affect,
and impairments to cognitive ant behavioral functioning. Stress reactions
vary in their magnitude and extension, which determine their severity.
Magnitude refers to the degree of homeostatic disturbance and impairment to
functioning. Extension refers to the temporal duration of the disturbance or
impairment.
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3. Environmental demands operate in transaction with the behavior of
persons or systems.
Stress is viewed in terms of dynamic influence processes involving
reciprocal causal relationships between persons and environments.
Transactionality assumes that the organism and the environment are
interconnected components of a system in motion over time.
4. The effects of exposure to specific environmental demands are not
uniform across individuals or systems but are mediated by cognitive,
behavioral and social factors.
4.1 The cognitive representation of environmental demands and of
response capabilities, on an initial and ongoing basis, is a primary
determinant of stress.
The human organism primarily responds to cognitive
representations of the environment, not to the environment per se .
Attention to environmental demands and response sensitivity to them
are a function of expectation and appraisal structures pertaining to
both environmental demands and coping resources.
4.2 Behavioral transactions with the environment influence the
probability and degree of exposure to environmental demands and the
course of stress reactions.
While stressors vary in their controlability, some proportion
of stressor exposure is a result of the person's behavior.
Conditions of stress are often the products of the person's own
activities. Similarly, the experience of stress inevitably leads to
coping behavior Which may be directed at the environmental
circumstances or at the stress reactions resulting from them.
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4.3 Social relationships moderate stress by reducing exposure to
environmental demands, by decreasing sensitivity to them, increasing
resources for dealing with them, and by containing subjective
distress.
. .
Supportive social relationships mitigate the impact of
environmental demands. Social support insulates the person from
otherwise debilitating forces in the environment and facilitates
coping with life crises. The importance of social support is such
that the loss of supportive relationships is stress-inducing.
5 Stress is a product of contextually linked person-environment impact
.
mechanisms which determine how environmental demands are experienced
.
Stress arises in conjunction with clusters of situationally-relevant
factors. Behavior occurs in context, and its understanding requires analysis
of the ecological setting, identifying the network of variables that are
functionally related to the behaving organism or system. The mechanisms by
which stress is induced and ameliorated are contextually linked.
The implications of this model for the subject of stress reduction are
that stress can be prevented, mitigated, regulated, and remedied in a number
of ways. In simplified form, the strategies principally involve (1) modifying
environmental demands and their context of occurrence, (2) enhancing
cognitive-behavioral skills so as to prevent exposure to stressors or moderate
their influence, and (3) regulating stress reactions once they have become
manifest.
It should be noted that this way of understanding stress represents it as
an undesirable condition. By definition, it avoids the confusion and
inconsistencies routinely found in ideas of positive stress and negative
stress. The latter concepts followed from Selye's (1976) late-career notions
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Stress Reduction 8
of "eustress" and "distress," ironic in their ambiguity, because Selye began
his distinguished career by advocating clarity in stress concepts. Despite
its appeal to management consultants, no one has ever substantively developed
the concept of "eustress.~ Quick and Quick (1984), for example, advocate the
dual concept, but then throughout their book use the term "stress" to refer
almost exclusively to adverse conditions and consequences.
This is not to be fussy about definitions, which tell us nothing about
the nature of things. Definitions inform us about rules for the use of words,
but once the language rules are given, it is important to follow them.
Moreover, concept labels like "stress" and "aggressions are shorthand
designations for an otherwise long story that cannot be told in a definitional
format. The quandary over whether stress can be positive as well as negative
results from several conceptual errors: (l) failure to differentiate the
concepts of stress and arousal, (2) mixing referents that are categorically
different (job demands may be positive, but heart disease is not), and (3)
taking a static perspective instead of a transactional one, which would
recognize that coping skills can be learned during stressful life experiences.
The stress literature is, of course, enormous in volume, and there is an
abundance of research in elements of the physical, psychological, and social
environment that operate as stressors. Those elements that have direct
relevance to military settings will be discussed in the next section. As part
of this introductory overview, however, it will be useful to give a brief
account of key stress responses that are often studied in stress research.
Stress Responses
Four main classes of reaction were identified by Lazarus (1966) as stress
indexes, these being physiological arousal, emotional distress, motor
behaviors, and cognitive functioning, although the emphasis of his work was on
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cognitive processes. In the time since his landmark book, these general
categories still hold true.
A central component of stress reactions is physiological arousal. While
it is not always the case that arousal is assessed in stress research, it is
routinely assumed that patterns of physiological activation underlie illness
process. Selye's (1956) formulation of the stress response as a tri-component
cluster of bodily reactions and his concept of the general adaptation syndrome'
are cornerstones of stress research. His conceptualization of stress is that
it constitutes the "non-specific response of the body to any demand,. a
physiological common denominator if as.. mile
, __ , 1, representing a condition of
Swear and tear" in the body. Importantly, he identified adrenocortical
enlargement, shrinkage of lymphatic structures, and gastrointestinal
disturbances as the triparte response cluster that constitute the stress
response. His non-specificity thesis has been strongly criticized by psycho-
endocrinologists, especially Mason (1975~.
However, Selye's research directed investigators to activation in the
autonomic nervous system and to impairments in immunological function.
Classic research in the area of psychosomatic medicine by Ax (1954), Schachter
(1957), Funkenstein, King, and Drolette (1957), and Wolf and Wolff (1952)
directed attention to physiological processes in the study of stress and its
mastery. Frankenhauser (1975) was also instrumental in turning attention to
catecholamines in particular. Interest in physiology is routine among stress
researchers, and military populations have often been studied because they are
exposed to extreme environments. For example, an entire volume' has been
written on physiological processes associated with parachute jumping (Ursin,
Basde, & Levine, 1978).
Scientific interest in the physiology of stress was sparked by Cannon
(1929), who called attention to bodily states associated with emotional arousal
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and also to conditions relevant to military environments, such as cold, lack
of oxygen, and blood loss . S ince the time of Cannon, the autonomic nervous
system (ANS) is generally recognized as central to stress responses. This
system regulates the heart and smooth muscles of the body, the digestive
system, sweat glands, and certain endocrine functions. While the sympathetic
system component of the ANS is activated to mobilize the body's resources in
response to threat, the parasympathetic component is also important because of
its relevance to digestion, recuperation, and relaxation. Cannon's work on
ANS functions and its activation in conjunction with physical and
psychological conditions was extended by Seyle, who proposed a general
adaptation syndrome (GAS) for stress responses. His non-specificity thesis
regarding its activation has not been generally accepted, but he directed
attention to sympathetic-adrenocortical activity. Interest in sympathetic-
-adrenomedullary functions that Cannon had pioneered soon followed.
Research on catecholamine excretion has been studied with regard to many
stressful situations, and a leading researcher in this area is Frankenhauser
(1975~. In her laboratory in Stockholm, epinephrine and norepinephrine
output has been linked to physical work, mental strain, and emotional
states. Among those doing psychoendocrine research has been Mason (1975) at
the Walter Reed Army Institute, whose work in basic training and combat
environments will be discussed later. However, here it can be noted that his
laboratory-based research demonstrates that Selye's non-specificity concept
does not hold when psychological states (e.g., novelty, apprehension,
appraisal) are controlled during stressor exposure. He argued strongly
against the view of an indiscriminate action of the pituitary-adrenal cortical
system in response to nonpsychological stimuli or stressors as Selye had
proposed. Across a large set of laboratory studies, he has found no uniform
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pattern for psychoendocrine responses (epinephrine, norepinephrine, 17-OHCS)
to a range of stimulus conditions (Mason, 1975~.
The significance of physiological arousal as a stress response is
threefold. First, pronounced physiological activation constitutes a
disturbance of homeostatic balance. The continued onset of arousal, and its
prolongation is thought to be related to disease processes that affect the
heart, gastro-intestinal system, kidneys, and pancreas, as well as pain and
discomfort in the skeletal musculature. For example, acute psychophysiologic
reactivity has been linked to cardiovascular disease risk (Krantz & Hanuck,
1984).
Second, heightened arousal has been found to impair performance. The
empirical generalization that the relationship between arousal and performance
is an inverted U function often appears in stress literature and related
fields (e.g., sports psychology). This concept originated with Duffy (1932 &
1957) and has been associated with Hebb (1955), as well as being adopted by
Spence and his co-workers in their anxiety-drive research. While Duffy
focused on muscle tension-performance relationship, Hebb discussed the arousal
function in terms of information processing. Importantly, Easterbrook (1959)
explained the arousal-caused impairment of performance in terms of cue
utilization. Arousal acts to narrow the range of cues that can be used.
Hence, for complex tasks, arousal will have a disorganizing effect on
performance. Regarding the empirical generalization of an inverted U
function, the problems are that "arousal" is not a unitary phenomenon (various
indices have low intercorrelation) and that strong arguments have been made
for dissociations of electrocortical, autonomic, and behavioral arousal
(Lacey, 1967). Moreover, the way in which a particular level of arousal will
affect performance will very much depend on the nature of the task and the
individual's skill level.
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Stress R educe on 12
A third aspect of the significance of physiological arousal as a stress
response component is its involvement in disruptive emotion and its
maladaptive consequences. Fear (anxiety) and anger constitute emotional
states, defined in part by physiological activation. While these emotional
states themselves are unpleasant, they are linked to maladaptive behavior
patterns, such as recurrent avoidance and disorganization in the case of
anxiety and aggression in the case of anger. Because we are architects as
well as victims of our stress experiences (transactionality postulate), these
disruptive emotions potentiate continued stress and weigh against adaptive
recovery from bans itory s tress experiences .
Emotional states that constitute functional disturbances are indeed a
major category of stress reactions. In addition to fear/anxiety and anger,
guilt, shame, and sadness are relevant stress responses. Conditions of
depression and grief are frequently studied by stress researchers in
association with processes of coping. Anxiety is of course strongly involved
in combat stress, and depression is a prominent feature of wartime
-bereavement.
Motoric functioning in the sense of behavioral performance, as well as
flight and attack responses, are important aspects of stress responses,
although attention to overt behavior has been less than to physiology,
emotion, or cognitive functioning. Concerns about matters of productivity,
work performance on complex tasks, ant behavioral components of problem
solving must give attention to motoric dimensions.
The adequacy of cognitive functioning is strongly entailed in human
performance concerns. There is an abundance of work pertaining to effects of
stress on perception, information processing, social judgment, and cognitive
elements of coping. Tests of reasoning' signal detection, puzzle-solving)
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perceptual-motor skills, and memory have long been part of human performance
research, and personality-oriented studies have made ample use of measures of
expectation, intentions, appraisals, and attributions.
With this overview and theoretical framework, the determinants of stress
relevant to military contexts will be discussed. Attention will be given to
environmental factors, cognitive processes, behavioral performance and coping
styles, and social conditions that shape the experience of stress. Among the
relevant issues pertaining to the general topic of stress vis-a-vis the
military are themes of military socialization.
Stress as a Concern for the Militarv
The purpose of the military is obviously to fight wars, and the business
of war is the destruction of the enemy and of their will to fight. At times,
it is naively thought that soldiers are simply taught to follow orders and to
be mechanically brutal. Oddly enough, such ideas do seem to underlie Soviet
military training philosophy (Gabriel, 1986). But all wars involve being
immersed in a hostile atmosphere, where the soldier is enveloped by the
sounds, sights, and smells of destruction. Combat environments entail
multiple sources of stress that have cumulative effects. As developed in
Novaco, Cook, & Sarason (1983), warfare stressors can be thought to fall into
two principal classes: (1) harsh physical circumstances that affect tissue
needs, and (2) the threatening psychological ambiance of combat. The ability
of combat personnel to cope with these powerful stressors has an important
bearing on their performance effectiveness.
The stress associated with exposure to the extreme environments of
warfare has been studied extensively. Among the most notable works are those
of Grinker and Spiegel (1945) on air combat units, Kardiner and Spiegel (1947)
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regarding traumatic neuroses, Bourne (1969 & 1970) on psychological and
physiological stress reactions in Vietnam, ant Figley (1978) on combat-related
stress disorders among Vietnam veterans. The adverse consequences of stress
and the psychiatric casualties that may eventuate are a concern for United
States military organizations not only because of the humanistic values at the
foundation of our society but because the effectiveness of combat units is
seriously impaired. This was a salient lesson of World War II, as reflected
in a highly regarded analysis of military behavior by Marshall (1947), who
found that less than one-fourth of the men in combat fired their weapons.
Going back to the American Civil War Battle of Gettysburg, over 18,000 muskets
were found on the battle field that unmistakably had not been fired. The
evidence for this conclusion was that 12,000 had two charges, both
undischarged, rammed down the barrel; and another 6,000 had three to ten
packed charges. The men had panicked and were loading their weapons
purposelessly, or they deliberately wanted to appear as though they were
firing (Karsten, 1978).
Considering such observations, it-must be kept in mind that for World War
II the Army rejected about three of every ten men it screened for induction--5
1/4 million out of 18 million. Ginzburg (1959a; l959b) provided a critical
review of this ambitious screening operation and the factors associated with
the discharge of 470,000 men between 1942 and 1945 for performance
ineffectiveness. To be sure, it was not simply a matter of poor initial
screening, because ....many educated and strongly motivated men who were
properly trained and properly assigned also broke down. The cause of their
failure can be found neither within themselves nor within the military
organization; but it lies rather, in the excessive stresses to which they were
exposed as a result of the exigences of war" (Ginzburg, 1959b, p. 7). Despite
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induction screening of unstable individuals, the Army came to recognize that
even emotionally stable men could become ineffective. Problems at home,
casualties in the combat unit, and the strain of protracted battle, such as
the Normandy invasion or the push through Italy, could precipitate breakdown
(Ginzburg' 1959b, 1959c).
Looking at contemporary conflict, Israel is a natural laboratory for the
study of warfare-related stress (Milgram, 1982). Since its formal existence
nearly 40 years ago, as well as the 75 years of settlement that preceded the
establishment of the state, the Israelies have monitored and treated
psychological disabilities induced by warfare. Their concerns were made
salient by the Yom Kippur par (1973), which in contrast to the Six Day War
(1967) had much higher casualties and an unsatisfactory conclusion. The
initial success of the Egyptian and Syrian armies was shocking and brought
about the realization that the shadow of war and terrorist attack would be
perpetual (Milgram, 1982). Coping with war-related psychological distress
became a matter for the national consciousness. Moreover, general concern
about the disabling effects of combat stress have risen with observations
about the recent Lebanon war, as the Israeli army lost nearly twice as many
soldiers to "battle shock" as were killed by the enemy (Gabriel, 1986).
Despite the nuclear era, conventional warfare continues, and the Soviet's
themselves are concerned with how to improve the soldier's ability to
withstand stress and trauma. Gabriel's (1986) states that, since the Brezhnev
years, the Soviets have believed that conventional operations could be
conducted in a nuclear environment and that when nuclear arsenals were
exhausted, the conventional forces would be decisive. Soviet behavior in
World War II showed a proclivity to continue attacks until the units were
nearly decimated -- a willingness to accept staggering numbers of
casualties. Gabriel reports that units often fought down to 30% strength.
1-
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Stress R educiLon ; 5
Major causes of stress are the harsh physical circumstances of warfare
that affect tissue needs, such as conditions of deprivation (food, sleep, or
oxygen), extreme stimulation (temperature and noise), disease-engendering
conditions, ant trauma-intucing wounds. But it is the threatening
psychological ambiance of combat that is so pervasive. Every soldier must
cope with the fear of teeth. Fear has been fount to be greatest before going
into action ant to be reported by 7 of 10 men (Dollars ~ Horton, 1944;
Stouffer, Lumstaine, Lumsdaine, Williams, Smith, Janis, Star, & Cottrell,
1949). In the Vietnam War, the clandestine nature of the fighting exacerbated
the psychological strain, as American troops developed "a sense of
helplessness at not being able to confront the enemy in set piece battles.
The spectra of being shot at and having friends killed ant maimed by virtually
unseen forces generated considerable rage which came to be displaced on anyone
or anything available" (DeFazio, 1978, p. 30). The psychological ambiance of
combat associated with the Vietnam War hat a particularly negative effect on
veterans, who in large numbers manifested "delayed stress responses" (Horowitz
& Solomon, 197S).
MILITARY SOCIALIZATION AND THE ETHOS OF TRAINING
Despite variations across branches of the armed services, military
recruit training has a relatively homogeneous process. Basic training is a
period of rapid resocialization ant enculturation, occurring under conditions
of relative isolation ant confinement (Novaco et al., 1983). Ranging from
seven to eleven weeks across service branches, young men are expected to
develop new behavior confined to a narrow range of acceptability as shapes by
heavy doses of reward ant punishment. In a certain sense, boot camp can be
thought to habituate recruits to the unpredictable stresses likely to be
encountered in combat. According to Gabriel (1986), Soviet military training
Representative terms from entire chapter:
stress reduction
