was T This is to certify that the thesis entitled EFFECTS OF OPEN FOCUS RELAXATION TRAINING ON FRONTALIS EMG, SUBJECTIVE REPORTS OF STRESS, STATE-TRAIT ANXIETY AND ACADEMIC PERFORMANCE presented by Brenda J. White has been accepted towards fulfillment of the requirements for Ph.D. degreein Counseling 1912 N. m m professor 0 Date gl‘.’ [YO 0-7639 1.x“ . ' :44 n.3,. mill”. OVERDUE FIRES: 25¢ per day per item RETURNING LIBRARY MTERIALS: Place in book return to remove charge from circulatton record: EFFECTS OF OPEN FOCUS RELAXATION TRAINING ON FRONTALIS EMG, SUBJECTIVE REPORTS OF‘ STRESS, STATE-TRAIT ANXIETY AND ACADEMIC PERFORMANCE By Brenda J. White A DISSERTATION Submitted to Michigan State University in partial fulfillment of the requirements for the degree of DOCTOR OF PHILOSOPHY Department of Counseling and Personnel Services 1980 A. M ‘. if ‘IVU .. _ !.;R\. ‘hu‘ ABSTRACT EFFECT OF OPEN FOCUS RELAXATION TRAINING ON FRONTALIS EMG, SUBJECTIVE REPORTS OF STRESS, STATE-TRAIT ANXIETY AND ACADEMIC PERFORMANCE By Brenda J. White This study investigated the effects of relaxation training on stress reduction and academic performance of highly stressed gradu- ate students in a counseling course and in a statistics course. It was hypothesized that Open Focus relaxation training would reduce frontalis EMG, subjective reports of stress, state-trait anxiety and improve academic performance. The subjects chosen for the study were seven volunteer graduate students enrolled in the College of Education at Michigan State Uni- versity. Criteria for sample selection were (1) Score above the fifthieth percentile on the State-Trait Anxiety Inventory based on norms for college students, (2) Score a minimum of l50 on the Social Readjustement Rating Scale which indicated the chance of health change or illness due to stress, (3) No participation in any other relaxation program during the duration of the study, (4) Sign a consent form, and (5) Availability for participation in the study Spring Term, 1978. The Open Focus relaxation training was taught in two phases. One phase was three weeks in length and the other was two weeks. . yo i ‘u I'V. ‘ ‘T-J Brenda J. White Other experimental sessions included a baseline phase implemented prior to the relaxation training sessions and two placebo phases occurred between the relaxation training phases. During the base- line phase, frontalis muscle EMG observations were made for each subject. Subjects also reported subjective levels of stress during this phase of the study and each subsequent phase. In the second phase or the placebo phase each subject was presented a revolving disc and asked to focus on the disc. It was explained that the disc was a mechanism utilized to facilitate relaxation. Subjects listened to Open Focus recordings during the third phase which was a treat- ment phase. The fourth phase was a return to the placebo phase where they watched the revolving disc. In the fifth phase subjects again listened to the Open Focus relaxation tapes. Electromyographic responses and subjective self-report data for each subject were collected during each phase of the study. In addition, the subjects practiced relaxation at home using tape recordings of Open Focus during the treatment phases. A log was kept by each student of their home practice sessions. The criteria measures utilized in this study to evaluate the effects of Open Focus were frontalis EMG to measure continuous frontalis muscle tension; State-Trait Anxiety Inventory for pre- and post-testing of state and trait anxiety; stress scale for measuring subjective reports of stress; mid-term and final examinations to determine academic performance; and the number of home practice sessions. fut - . . S » p\.v . P. m . .a . . , ps: .9». r P. Pu :- :- QI :— .. . :— a . a u an. . a o A... 3- r b .9» .4 a .\a o . ..\. (a A n l‘ P us“ aw» AH. . v AM- P s f i 9 . o .1" .N. .\. .\.. .u- . - ani- .\- P I I I.u 0.5 Q h J cl D In. .I. .I . 1 r .0 a: U "1 a .I Flt pr I?! !\- nah e\l R ”we :0 I I’D to“ I\,I hi... thud it bi “h.“ 3. Brenda J. White Primarily, two analyses were performed on the data. The first was the median slope trend and was called for by the intensive design used in this study. The median slope trend evaluated the effects of Open Focus on frontalis EMG and subjective reports of stress. The second analysis was a non-parametric signed rank test which compared pre- and post-test observations of the State-Trait Anxiety Inventory. A comparison was made between the percentage of correct items ans- wered on the mid-term examination taken by each subject and the percentage of correct items answered on the final examination of the same course to determine the effects of the treatment procedure on academic performance. Another analysis was made of home practice sessions. The analysis focused on the number of times the subjects listened to Open Focus recordings. Mean ratings of home practice sessions were computed for each subject during the two-treatment phases. The results of the study indicate that the treatment procedure produced significant decreases in frontalis EMG microvoltage data, as well as subjective reports of stress. The subjects also exhibited significant change as measured by differences in the pre- and post- test scores on the State-Trait Anxiety Inventory. The performance by subjects on the final examination was found to be enhanced when comparison of the percentage of correct items answered on a mid- term examination with the percentage of correct items answered on a final examination were made. Based on the results of the number of home practice sessions for each subject, there appeared to be no definitive effect between number of practices of Open Focus, DEDICATION To Mother, Daddy and Mama ii :5 EIDT‘ES aster a li't‘w V' jun rerever 1152?“th :55." 36'; arts, 3 ACKNOWLEDGMENTS In the preparation and completion of this dissertation, I wish to express my respect and gratefulness to Dr. Bob Winborn, my advisor and committee chairperson, for his continual assistance and expertise on my topic of study. Sincere appreciation is extended to Dr. Robert Green, Dean of the College of Urban Development at Michigan State University,who sedulously guided and encouraged me whenever it was necessary. Both Dr. Winborn and Dr. Green were instrumental in my successful completion of this dissertation. I would also like to express my appreciation and thanks to other members of my committee for their advisement: Dr. Herbert Burks, Dr. Thomas Gunnings and Dr. John Schweitzer. To the graduate students at Michigan State University who volunteered to participate, I give a special thank you. Without their cooperation and interest, the study would have been impossible. In addition, I want to thank Miss Gloria Simmons and Dr. Cassandra Simmons whose friendship and encouragement was unrelenting. To my family, especially my mother and father, for their direc- tion through another challenge, I am grateful. To my husband, Clark, and daughters, Kenya Ife and Tsigie N'kolo for their patience and most of all their love, I give a very special thank you. on. lull 1". tail I'D. . \ Lev: _r\) TABLE OF CONTENTS LIST OF TABLES . LIST OF FIGURES LIST OF APPENDICES Chapter I. INTRODUCTION AND REVIEW OF THE LITERATURE The Stress Concept Stressors . . . Model of Stress . Stress and Anxiety Stress Reactions . Psychological and Physiological Effects of Stress on Learning and Performance . . . Value of Relaxation Autogenic Training Rationale for the Present Research 2. DESIGN AND PROCEDURES Subjects . Description . . . . Experimental Manipulations . Measures . . State-Trait Anxiety Inventory Description and Function . Social Readjustment Rating Scale Description and Function . . . . Stress Scale Performance Experimental Design Summary of the Design Hypotheses . Data Analysis Summary iv Page vi vii viii 1-:"Er '4'." SA) E...- Chapter Page 3. ANALYSIS OF RESULTS . . . . . . . . . . . 52 Individual Cases . . . . . . . . . . . . 53 Case l 53 Case 2 54 Case 3 57 Case 4 59 Case 5 63 Case 6 . . . . . . . . . . . . . . 65 Case 7 . . . . . . . . . . . . . . 66 Individual Case Hypotheses . . . . . . . . 68 Hypothesis l . . . . . . 7O Hypothesis 2 7O Hypothesis 3 7O Hypothesis 4 72 Hypothesis 5 72 Hypothesis 6 73 Hypothesis 7 74 Hypothesis 8 76 Hypothesis 9 . . . . . . . . . . . . 78 Summary . . . . . . . . . . . . . . . 78 4. SUMMARY . . . . . . . . . . . . . . . Bl Discussion . . . . . . . . . . . . . . 84 Open Focus Effects on Frontalis EMG . . . . 85 Open Focus Effects on State-Trait Anxiety . . . 87 Effects of Open Focus as Measured by a Stress Scale . . . . . . . . . . . . . . 88 Effects of Open Focus on Academic Performance . 89 Home Practice Sessions . . . . . . . . . 90 Individual Variables . . . . . . . . . . 91 Conclusions and Implications . . . . . . . . 92 Suggestions for Future Research . . . . . . . 93 APPENDICES . . . . . . . . . . . . . . . . . 94 REFERENCES FFUEEE p-‘IAt ‘U PE ‘1‘]. Table (ANN DON 3.8 LIST OF TABLES Personal and Demographic Characteristics . Research Schedule . Intensive Case Study A-A1-B-A1-B Design Median Slope Trend Analysis of Statistical Proba- bilities of Difference in Muscle Tension Reduction Between Baseline and Treatment Phases (81 and B2) and Baseline and Placebo Phases (A11 and A12) based on EMG . . . . . . Probabilities of Differences in EMG Microvoltage Between Consecutive Phases for Each Subject Using Median Slope Trend Analysis . . . . Analysis of Statistical Probabilities of Differences in EMG Microvoltage Between Second Treatment Phase and All Other Phases using Median Trend Statistics . Pre- and Posttest State Trait Anxiety Inventory Score . . . . . . . . . . . . . . Analysis of Statistical Probabilities of Differences in Stress Level Between Baseline (A) and all Other Phases (A l, B , A12, and 32) While in Class as Measured By the Stress Scale . . . . Analysis of Statistical Probabilities of Differences in Stress Lgvel Between Baseline A and all Other Phases A11, Bl, A1 , and 32 While Out of Class as Measured by the Stress Scale . . Percentage of Total Correct Items on Mid-term and Final Examination for Each Subject . . . Mean Ratings for Each Subject's Home Practice of Tape Recordings in Treatment Phases vi Page 27 28 47 7O 72 74 75 77 77 79 79 2.1 .III n/. 3 45 :J pull» . Riv o o u 0 Mid Div 3 Ali HIV 3.? Figure 2.1 3.1 3.2 3.3 3.4 3.5 3.6 3.7 LIST OF FIGURES Layout of the experimental room during each Representation of the rate of physiological based on the electromyograph for case 1 Representation of the rate of physiological based on the electromyograph for case 2 Representation of the rate of physiological based on the electromyograph for case 3 Representation of the rate of physiological based on the electromyograph for case 4 Representation of the rate of physiological based on the electromyograph for case 5 Representation of the rate of physiological based on the electromyograph for case 6 Representation of the rate of physiological based on the electromyograph for case 7 vii phase . responding responding responding responding responding responding responding Page 29 55 58 60 62 64 67 69 I i (‘1 tr, <‘J . C1") :1: (L LIST OF APPENDICES Appendix A. NCO 'l'l Presentation to ED 869 and ED 8l68 . State-Trait Anxiety Inventory Social Readjustment Rating Scale Consent Form Data Collection Sheet (EMG Readings) Stress Scale Open Focus Instruction . Transcript of Tapes . Home Practice Logs Life History Questionnaire Specifications of EMG Specifications of Score Keeper viii Page 96 lOO 103 105 lO7 109 ll] ll3 ll9 l2l 133 I35 95 1h” Q.l F. ,r‘ 0' b (O 5‘ y C A In “I sire E F‘ . if, 3" ul.v .5! l \ his .15 0' 1‘5: CHAPTER I INTRODUCTION AND REVIEW OF THE LITERATURE The effects of stress and its role in human health and emotional well being have become increasingly evident as the western world has experienced accelerated change during the twentieth century. Studies have been and are being conducted into the possible role of stress in precipitating various life-threatening illnesses, the intensity of stressful forces in different occupations, and the effects of stress on individuals in executive or decision-making positions. Since stress apparently influences human beings in these areas, correct management of stress should lead to less stressful and more productive lives. Of particular interest and a worthy topic of investigation is Open Focus Relaxation training in the management of stress. It is the focus of this study to investigate the effects of relaxation on the stressful lives of university students. This chapter will (I) investigate the concept of stress and anxiety, (2) examine the effects of stress reactions on university students, (3) review the psychological and physiological effects of stress on learning and performance, (4) evaluate the value of relaxa- tion training on performance, (5) review the research on autogenic training, and (6) propose a rationale for the research based upon the review of the literature. 5 J'Ill‘s 6.. The Stress Concept Stress has received a considerable amount of systematic investi- gation within the framework of its effect on psychological and physiological activation and its subsequent effect on learning and performance. Since the first identification of the problem (Selye, 1976), a growing interest has emerged as evidenced in the literature. During the last decade major research has concentrated on the allevia- tion of stress (Davidson, 1978; Zenmore, 1975; Monat & Lazarus, 1977; Brown, 1978, Pelletier, 1977). There can be little argument that humans are exposed to stressful life events. Modern society has become so industrialized and complex that many individuals are unable to adjust to the stress brought on by rapid social change and the mechanization of life. The effects of stress are potentially lethal. In fact, Pelletier (1977) states that the major stress-induced dis- orders are cardiovascular disorders, cancer, arthritis, and respira- tory diseases (including bronchitis and emphysema). Blythe (1973) points to the fact that up to 70% of patients being treated by general practitioners are suffering from conditions related to unrelieved stress. Other empirical studies are punctuated with information to support the assertion that stress leads to episodes of physical ill- ness (Solomon, Amkraut & Kasper, 1974; Holmes & Masuda, 1974; Rahe, 1974; Hinkle, 1974) and psychiatric symptomatology (Markush & Favero, 1974; Meyers, Lindenthal & Pepper, 1974). The problem of stress occupies a significant position in the theory of psychophysiology and social psychology. The development of stress theories and psychosomatic models of illness have progressed at a remarkable pace. Since Selye wrote his first article on stress around 1938, there have been over 110,000 scientific publications related to stress (Morse 8. Furst, 1979). Despite the research, the meaning of stress is still elusive. Stress has been defined in a number of ways in the history of stress research. For example, stress is thought to be the threat to the fulfillment of basic needs, to the maintenance of regulated (homeostatic) functioning, and to growth and development (Basowitz, Persky, Korchin 81 Grinker, 1955). A similar view of stress was sug- gested by Lazarus, Deese, and Osler (1952) and Cofer and Appley (1964). They speculated that stress exists when the well-being or integrity of an individual is intimidated or the attainment of a goal is threatened and he must devote all of his energies to its protection. Sel ye (1976), an early pioneer in stress research, hypothesized that stress is a cormnon element in all adaptive reactions in the body. He developed what he called a more precise definition stating that stress 1'5 " the state manifested by aspecific syndrome which consist of all the nonspecifically induced changes within a biological system" (Sel ye, 1956, p. 54). Selye's work has recently initiated a rapid expansion in the area of stress research and theoretical development. In view of Selye's work, change became a central issue in the COOcept of stress in the research of Holmes and Rahe (1967); D0hrenwend and Dohrenwend (1970); Fr’dberg, Karlson, Levi and Lieberg “971); Pelletier (1977); and Sylvester (1977). In other words, for :cnr 1" ~rgit1‘11 Ft. 1- 1 Un- ‘air a ‘5 an event to be classified as stressful, change and adaptation must occur in an individual's life regardless of whether the occurrence is positive or negative. To summarize, stress is a broad term defined in a variety of ways. Generally, stress is an individual's physiological and psy- chological response to environmental demands that can be continual and cumulative. For the purpose of this study, stress will be defined as the discomforting responses of persons in a particular situation. Stressors Investigators who have worked in the field suggest that stressors are any set of circumstances that create change and adaptation in an individual's ongoing life (Selye, 1976; Holmes & Rahe, 1967; Rabkin & Struenig, 1976; Pelletier, 1977). When an individual must adapt or make frequent alterations in his/her life events, stress and tension result. Stress, in this context, refers to any discomforting responses of persons in particular situations. It is a physiological reaction that may occur when a person experiences a threatening or u"familiar situation. In Western society with its ever-increasing technological ad\Iancements, stress has become a dangerous phenomenon (McQuade, 1972). P'=?.yc:hiatric literature is filled with abundant documentation dealing “1 th the stressfulness of common experiences. Rapid social change, e“\I‘ironmental change, present economic conditions, and job demands have been cited as general stressors. Olson (1959) suggest that stress OY‘i ginates from various experiences when he states that: €33" ‘ Irv-3| and. k-:1 U h The circumstances under which many persons live and work . . . sensory bombardment, frustration, conflicts of interest, and excessive demands for quality and quantity of input. tend to produce tension and increase blood pressure (p.24). Likewise, positive events are stress inducing. Included in these are achievements, promotions, vacations, recreational activities, marriage, and pregnancy (Holmes & Rache, 1967). All of these events siggnify or trigger physiological and psychological adaptation. Model of Stress The idea of stress as a precipitating element in the onset of psychosomatic illness has gained tremendous acceptance among the healing professions. Many researchers even postulate that stress car1 be a major factor in any disease, not just those classified psy- chosomatic. Dodge and Martin (1970) suspect that many of the chronic diseases, are etiologically linked with excessive stress which is a Product of specific socially structured situations inherent in the Organization of advanced societies. What is needed then is a formu- lat ion of a model to explain the relationship between environmental stress, induced situations, and illness onset. Generally, the model follows this pattern of conditions: 1. Presentation of social stressor 2. Mediating factors which affect individual's perception of stressful conditions 3. Stress 4. Onset of illness ”—7! ' ....".!a at: r ‘st1cs scarce, :gpg'flu: iéiyubdl a: 4111.51 5113738 First in the formulation of the model is the social stressor which refers to stressful environmental conditions. The character- istics of social stressors which affect the coping process include source, nature, duration, timing, intensity, frequency, rarity, and ambiguity (Lumsden, 1975). The social stressor, itself, does not cause disease but serves as a precipitating factor. Mediating factors are those characteristics that affect the perception of the stressor by the person. Rabkin and Struening (1976) suggest there are two categories of mediating factors: personal or internal (biological and psychological threshold sensitivities, intelligence, verbal skills, past experience, sense of mastery of one's fate, psychological defenses, and other similar variables) and interpersonal or external, (for example, social isolation, marginal social status and status inconsistency). Stress signaled by anxiety refers to a person's response to the social stressor. The response consists of psychophysiological reac- tions which are both imnediate and delayed, while the onset of ill- ness refers to the clinical diagnosis of the disease. Fehmi (1975) in a discussion on the etiology of functional ten- SIOH seems to suggest that this illness onset is similar to what he cal 'l s a "symptom of stress" and that the illness actually reflects a disease of attention, habitual rigidity of scope or field attention. 1“ the development of this rigidity or narrow focus, he suggests that 3'5 humans are initiated into social activities, they are encouraged or eXhorted to "pay attention," to "try to focus," to "be careful " and 11.. 1511's. . + :51". SL 1 " fig. Lna to “watch out." Such phrases corrmunicate an effort to focus on cer- tain stimuli while excluding other existing stimuli. Fehmi points curt that as a result, a repression or resistance occurs for certain atrtractive or distractive stimulation in favor of focusing upon environmental stimulations which are consistent with those valued by family or society. Consequently, this narrowing of focus becomes reinforced by many social factors and facilitates the learning of how to narrow and direct attention. Narrow focus represents the inhibition or repression of most modalities of sensation in favor of attention to and amplifi- cation of a limited number of elements in one modality. When one habitually functions in the mode of narrow focus, this repression, which is physiologically represented as tension, accumulates as a result of this increasing chronic tension, one gradually loses his facility to include a wider scope of his sensory environment (Fehmi, 1975, p. 9). Stress and Anxiety Much of the preceding discussion implies that stress involves change, either psychological or physiological. It is interesting to note that anxiety is the usual result of any change (Brier, 1951; Levri, 1972; Basowitz, 1955). In fact, Gersten, Langner, Eisenberg a"d Orzeck (1974) point out that anxiety is the basic or initial Preparation response to environmental changes. In this context, a"Xiety and stress are linked together by definition, such that s‘l'-‘r"£.=.ss refers to stimulus-arrangement which to some degree raises the anxiety level of individuals. The most important role of anxiety is that it serves as a Slgnal of danger to the organism which sets into operation human .— ”- 1 ‘ ‘Z .A :' .1 Von-:5 I Paco; Miro), resources at all levels of functioning. Briefly defined, anxiety is the conscious awareness of intense dread which is conceptualized as internally derived and not related to external threat (Basowtiz, 1955). To illustrate, when a person perceives a situation as stressful (regardless of any real danger) he/she will experience an increase in the intensity of his/her emotional state and the autonomic nervous system accelerates. Clinical and research literature (Cattell 8 Scheier, 1961; Cattell, 1966) has consistently reported two distinct anxiety con- cepts, "state" or "trait." State anxiety (A-state) is characterized by unpleasant, consciously perceived feelings of tension and appre- hension with corresponding activation of the autonomic nervous system. State anxiety, then, refers to "complex emotional reactions that are evoked in individuals who interpret specific situations as Personally threatening"(Spielberger, 1972, p. 30). On the other hand, trait anxiety (A-trait) refers to "relatively stable individual differences in anxiety proneness, that is, to differences in the disloosition to perceive a wide range of stimulus situations as danger- OUS or threatening, especially to those involving failure or threat ‘10 self-esteem and in the tendency to respond to such threats with A“state reactions" (Spielberger, 1972, p. 39). Furthermore, A-trait "e‘F‘l ects individual differences in the duration, intensity, and fr‘equency of A-state reactions. . 0... Stress Reactions In studying reactions to stress, an event or situation deemed stressful for one person may not affect another's psychological or physiological systems. McQuade (1972) maintains that different men have different hereditary capacities to withstand stress. There is a wide range of individual differences in response to such situations. To a great extent, an individual's appraisal of threatening elements depends on whether he/she feels control over the situation which is influenced by a succession of past environments, especially the family, and dispositions that have become internalized (Hamburg & Adams, 1967). Psychophysiological reactions to stress can be reduced if a person can maintain a level of "tolerable non-pathogenic stress," which actually contributes to heightened functioning and performance (Pelletier, 1977) by predicting the stressors. Many of the stressors cited-~those favorable and unfavorable-- have been identified as psychophysical stressors in the campus com- munity. Students experience high levels of stress and tension in their interactions with the university setting (Bloom, 1975). Snyder 311d Kahne (1969) report that of 893 students in the Massachusetts I"Stitute of Technology's class of 1965, 209 students were seen in Psychiatric service at least once during the four years. Knox (1970) reports that less than 50% of those entering graduate school to pursue a doctorate degree actually persist long enough to graduate. Recently, l‘ESearchers (Kierulff & Wiggins, 1976; Janissee 81 Palyse, 1976) have Identified various stressful situations encountered by these students. .J- ‘8‘- ’fl 10 Graduate students must meet the demands of intensive academic activity, ccunpetition, establishing inter-personal relationships, frequent tilne deadlines and establishing new living conditions. Janisse and Palys (1976) examined the frequency and intensity of’ anxiety in university students. They found that many situations exist that are stress-inducing for students, with some situations more stressful than others; for example, situations involving ego threats, ccnnpetition, school, dating. In Kjerulff and Wiggins' (1976) study, grwaduate students identified two categories of stressful situations. ‘Trwey were situations dealing with inter-personal problems and fate- failure situations defined as those situations clearly not anyone's fault. In examining the effects of anxiety on learning, empirical evidence points to the fact that the performance of high anxious sturdents is inferior to that of low anxious students on complex or di'Fficult tasks (Spence, 1958; Taylor, 1956). Alper and Haber (1960), ir1 a study on anxiety in an academic situation, imply that measurable a"X'iety responses, when present, are debilitating to performance. O'Neil, Spielberger and Hansen (1969) investigated performance on a comupter-assisted learning task and changes in state anxiety (A-state) for college students. They found that students with high A‘St:ate scores made fewer errors on easy materials and more errors on d1ii'f‘icult materials than low A-state subjects. Other negative effects 9" anxiety on academic performance have been documented (Paul & Eri ksen, 1964; Spielberger, 1966; Wine, 1971). F95 - I ln state ar ?e ant: 11 In light of this, research evidence supports the notion that state anxiety (feelings of apprehension and corresponding arousal of the autonomic nervous system) is more significantly related to learn- ing and performance than trait anxiety (Speilberger, 1966). For example, Meyers and Martin (1974) examined two hypotheses: (a) A-state would have a stronger debilitating effect on concept-learning performance than A-trait and (b) task conditions would affect A-state. Their results were consistent with the hypotheses. Psychological and Physiological Effects of Stress on Learning and Performance To determine the extent to which anxiety affects learning and pcarformance, the examination situation should be investigated since it: is a common area of academic activity and is a cumulatively taxing source of stress (Mechanic, 1962). The stress lies in the desire to avoid failure. University students and professors report that stu- dents experience stress due to test anxiety which alone may lower their performance on tests, and consequently their grade point aver- ages In the examination situation, high anxious persons spend ta sk time doing things that are task irrelevant and show a decrement 1?! complicated learning situations. Sarason (1960) in a review of tile literature on paper and pencil anxiety scales, identified several Studies indicating that high anxious subjects are "more self- OEprecatory, more self-preoccupied, and generally less content with themselves than subjects lower in the distribution of anxiety scales" (9. 404). They worry about performance, how well others might excel, , 1.1M :OOA'”‘S I r' .1 ~- 1 't-EUVEI f: k: inn Sin“. 3511' C fiXlEf 4“ r'abec ii'flicts 12 ruminate over choices open to them, and are repetitive in their attempts to solve the task (Marlett & Watson, 1968; Rapelson, 1957; Morris 8: Liebert, 1970; Mandler 81 Sarason, 1970; Mandler & Watson, 1966). Mechanic (1962) states that examinations can also threaten one's self-esteem. Montague (1953) reported that highly anxious subjects per- formed better than low-anxious subjects in serial learning of a relatively easy list of nonsense syllables, but performed more poorly than subjects on a more difficult list. Davidson (1959) in a project concerned with the development of anxiety in children predicted that low anxious children would be described more favorably and with less severe stresses, emotional conflicts and anxieties than highly anxious children. His findings were consistent with his predictions. Lundberg and Ekman (1970) in an attempt to follow the emo- ti onal reactions of a group of subjects in a real-life situation, asked 51 students to report their feelings over a period of time while anticipating in an important examination. The results indicate that as subjective time before the examination decreased, emotional involvement increased. In an analysis of 110 female undergraduates, Bond (1977) examined academic test performance by test day anxiety, nontest day anxiety, and change in anxiety from a nontest day. An analysis of Change in anxiety scores revealed that subjects who exhibited a high increase in anxiety on the test day performed more poorly on the test l3 tflian subjects who had either a low increase or a high decrease in anxiety. These data support the theory of drive states suggested by! Mandler and Sarason (1952) stating that an increase in anxiety exerts an intervening effect on test performance. The study also suggests that attempts be made to minimize increases and to decrease anxiety level of students on test day. -Only one study was found related directly to graduate-level students. Griffore (1977) studied the relationship between debilitat- irrg anxiety and performance on examinations. For the 68 subjects in his research, he found significant correlations to support the notion tirat debilitating anxiety as measured also operates among professional educators attending graduate school. Several studies discuSsed in the literature indicate that high anxiety leads to a breakdown or decline in achievement. Con- tJeary to these clinical observations, however, Schultz and Calvin (1955) report that level of anxiety has no demonstrable effect on academic performance. Barrell (1971) found a weak negative relation- 5111;) between anxiety and performance on complex tasks. Marton et a1. (1973) investigated the effects of stress- lnduced instructions on anxiety, learning and test performance. The induced stress had a positive effect on learning, and was signifi- Carrtly related to the level of anxiety in the learning phase. It was. further reported that during the performance phase the induced stress had a significant positive effect on anxiety but none on Performance. 14 Additionally the examination situation, representing the stress-eliciting stimulus results in certain physiological stress rwesponses. Syvalahti, Lammintausta and Pekkarinen (1976) studied 1:31 healthy medical students to determine if the psychic stress of an examination could affect the release of serum growth hormone, serum irisulin, and plasma renin activity. For each hormone the level rose significantly by at least 43%. Montgomery (1977) evaluated the effects of performance evaluation anxiety on cardiac response in 48 nmile undergraduate students. The analysis revealed accelerated ctianges in cardiac rate sensitive to both anxiety and failure within ttie evaluation-stress condition. Similarly, Suggs and Splinter (1966) found that initial rises ir1 heart rate occur prior to activity as a result of reflex activity ir1 the cortex caused by anxiety. Dill (1959) also found an acceler- ated heart rate in teenage males before testing in a laboratory situation. Dreyfuss and Czaczkes (1959) clearly demonstrated the stress reSponse to examination situations. Of the 21 students investigated, Seruum cholesterol levels were higher in 20 students during the examina- tltbri than they were in a control test taken two days later. There was alSo evidence of decrease in blood clotting time and a decrease in blood eosinophils. It was suggested that such a combined response r' example, he suggested that somatically based techniques resulted 1'1 *reductions primarily in measures of somatic activation, while coQnitively oriented procedures elicit reductions in skin conductance IEVel of subjects. Obrist, Webb, and Sutterer (1969) reported reduc- titons primarily in measures of somatic activation (heart-rate and Electromyography). Similarly, Benson, et a1. (1974) reported decreased respiratory rate, and pupil constriction. It was suggested that daily l7 [aractice of relaxation is of value in situations where chronic stress is present. Reinking and Kohl (1975) examined the effectiveness of ft>ur different types of relaxation training including electromographic ftzedback, Jacobson-Wolpe's progressive relaxation instruction, mone- tary reward and instruction plus reward. They found that all groups r1eported increased relaxation. The findings of Schwartz (1974) with rwegard to the comparability of effects achieved with biofeedback procedures are in agreement with previous studies of Budzynski and Steyva (1969) and Green, Green and Walters (1970) who reported reduc- trion in muscle tension, heart rate and blood pressure. While much of the research focuses on the effects of relaxation <3r1 physiological changes, few studies have been conducted on the effect of relaxation on learning efficiency. There is some evidence, aflthough limited, to support the hypothesis that relaxation can be expected to increase the efficiency of learning and performance by trigh anxious subjects under stressful conditions. Steinhaus and Norris (1964) conducted a survey utilizing personal arud subjective responses from 166 subjects. These subjects have received instructions in relaxation concerning the value of the train- lllsy. Respondents reporting improvements in mental concentration were 54%. The investigators suggested that improved relaxation may be more closely related to efficient use of the mind. Pascal (1949) demonstrated that muscle relaxation improved recall of paired-associates in subjects unselected for anxiety level. SUinn and Richardson (1971) trained clients to react to anxiety with 18 rwalaxation. Subjects were treated for mathematics anxiety and com- pared with untreated, nonanxious control subjects. Their results showed significant reductions, when compared with the control group, ir1 subjective anxiety and higher posttherapy scores on a performance "Measure involving mathematical computations. Johnson and Spielberger (1968) studied the effects of a muscle rmelaxation training program and the passage of time on empirical "measures of A-state and A-trait anxiety. They hypothesized that nweasures of A-state anxiety would decrease following relaxation 'ticaining and fluctuate over time, while A-trait anxiety would remain stable and unaffected by relaxation. The results indicate that s<:ores on three measures of A-state anxiety declined significantly ir1 response to the training procedures, but relaxation had not influ- ence On A-trait anxiety. To summarize, the function of relaxation training is to (1) ir1hibit physiological responses to stress; (2) control subjective reports of dysperia; and (3) reduce physical and mental fatigue, thus Permitting greater efficiency. In looking specifically at the effect of relaxation on academic Permformance, one can be pessimistic or optimistic in terms of the l‘esearch. Spielberger, Anton and Bedell (1976) state that behavioral treatment approaches (using some form of relaxation) have consistently fai'led to bring about improvement in academic achievement and perform- ance on cognitive intellectual tasks. Finger and Galassi (1977) concur on the basis of research literature reviewed that actual improvement in test performance is miniscule. 19 Contrary to these speculations, Cautela (1969) and Goldfried (1971) argue that relaxation training could be utilized effectively as an active coping skill if clients were taught when and how to relax. This position has been supported by Russell, Miller and June (1975), Suinn and Ricardson (1971), and Zenmore (1975) in the treatment anxiety associated with intellectual performance. Autogenic Training Therapeutic applications of deep relaxation procedures have been in existence for some time for the alleviation of stress. Autogenic training, however, has received little attention in this country. It is a comprehensive and successful therapeutic method which involves both the functions of the mind and the body. Because autogenic (self- generating) training involves a self-induced psychophysiological shift to a state which facilitates brain-directed, self-generating and self-regulatory processes of a self-normalizing nature, its effects can be considered as being diametrically opposed to changes brought about by stress (Schultz & Luthe, 1969). In fact, Oscar Vogt first Observed from his research on hypnosis as early as 1890 that when Patients performed a series of autohypnotic exercises during the day, Stressor effects such as tension and anxiety were reduced (Luthe, 1962). From a technical point of view, autogenic training is "a method 0f rational physiologic exercises designed to produce a general psy- Chobiologic reorganization in the subject which enables him to mani- fest all the phenomena otherwise obtainable through hypnosis (Gorton, 1959, p. 31). 20 The autogenic trainee makes mental contact with various body parts by responding to verbal cues which are called formulas (Morst & Furst, 1979). These include the following: "My right arm is heavy;" "My right arm is warm;" "My heart is beating calmly and regularly;" "My breathing is calm and regular;" My abdomen is warm;" and "My forehead is cool." Generally, the purpose of autogenic training is to improve functioning and performance by a series of self-directed mental exer- cises which leads to "increased self-direction of the organism with a strengthening of healthy biologic potentials and a reduction or elimination of malfunction or disease"(Gorton, 1959, p. 31). Gorton (1959) cites eight goals of autogenic training, three of which are directly pertinent to this study: 1. The ability to relax by dissolving psychophysiologic tensions 2. The ability to control physiologic functions that are usually involuntary 3. An increased capacity for voluntary physical and mental performance The research on autogenic training has followed two trends: research related to theoretical foundations and research related to Clir1ica1 applications. The research on theory has focused on specific PSYchophysiologic changes which occur during the practice of autogenic exercises, autogenic methods and specific problems associated with various components of the theory. 21 Many findings have been reported in the area of clinical applica- tion of autogenic training. Luthe (1962) reviewed the research and summarized forty years of clinical experience with autogenic train- ing: 5. Of patients suffering from various psychosomatic illnesses, 60% have been either markedly improved or cured by periods of standard training Behavior and motor disturbances have been treated effec- tively, for example, in cases of stuttering, phobias and certain states of anxiety in a matter of a few months. The emotional and physiologic tolerance of individuals was increased It was suggested that after autogenic training unconscious material was more readily surfaceable It was reported that intellectual capacity was increased as a result of training Group training is both possible and feasible Only one study (Snider & Oetting, 1966) employing autogenic training in the treatment of test-anxious subjects was found in the literature. Analysis of repeated measures showed that the treatment decreased test anxiety scores and 78% of the subjects reported high relaxation was achieved along with improved performance. Their results suggest that the majority of their subjects felt more relaxed, less stress prone, and more disciplined in their studies. It should also be noted that the average grade of the group went from C+ at the beQinning of training to a 8+ at the end of the term. 22 A type of autogenic training was used as a treatment method in this investigation. It is known as "Open Focus Exercises" and was developed by Fehmi (1975) as a highly specialized relaxation procedure for training people in stress management as well as for personal and transpersonal growth. The procedure enhances attentional flexibility as well as mental and emotional integration. It is suggested that in the development of the use of integrational status of attention as evidenced in Open Focus there is a natural tendency to release repressed energy and material into consciousness and there is a decrease of tension which was a result of habitually functioning in narrow focus (Fehmi, 1975). Although similar to Autogenic training that concentrates on formuli that instructs the subject to mentally suggest conditions to himself, Open Focus exercises concentrate on objectless stimuli such as space. The exercises consist of a number of questions designed to stimulate imagination of objectless experiences. The subject has to imagine these experiences. For example, the beginning of the series asks, "Can you imagine the space between your eyes?" These questions may be asked by the practitioner or they may be prerecorded. Rationale for the Present Research The study has three main elements. The first is based on the Idea that stress signals psychophysiological reactions manifested in 1Ntense emotional arousal and acceleration of the autonomic nervous System and increased frontalis muscle tension. The second is based on the concept that stress leads to decrements in performance, 23 particularly in the examination situation. And finally, deep relaxa- tion induced in individuals by an autogenic-type technique reduces stress and increases performance.particularly in the examination situation. Since stress has been shown to influence performance (i.e., Mandler & Sarason, 1952; Spence & Taylor, 1952; Spielberger, 1966) in numerous situations, it is reasonable that there would be interest in extending the research in this area to graduate-level students. Thus, the primary purpose of this study is to ascertain some of the possible effects of a nine-week relaxation training program utilizing autogenic methods upon the performance of graduate students expe- riencing stress in a statistics course and in a counseling course. Specifically, the study is designed and was implemented with the expectation that autogenic training would reduce stress and thereby improve academic performance on achievement tests given in the course and course grades of students. It is also expected that autogenic training will decrease certain physiological responses of students. To summarize, this research is important because precise identi- fication of the outcomes of Open Focus exercises will be presented and the effects of stress reactions on academic performance investi- gated. CHAPTER 2 DESIGN AND PROCEDURES This study has two main purposes. The first was to investigate whether highly stressed graduate-level students could lower their stress level (physiological-arousal) through Open Focus relaxation training as measured by Electromographic (EMG) biofeedback, the State-Trait Anxiety Inventory and the Stress Scale. The second was to determine if the lowering of stress levels significantly increased performance of these students on examinations. Subjects The subjects were selected Spring Term, 1978, from graduate courses in the College of Education at Michigan State University. A statistics class and a counseling class were visited in seeking student volunteers. A brief explanation of the nature of the investigation was given. Appendix A provides an illustration of the presentation. E1even people responded to the presentation and acknowledged an inter- ESt in participating. Selection of the subjects for the study was based on the following screening criteria: 24 25 1. Subjects had to score above the fiftieth percentile on the State-Trait Anxiety Inventory (Appendix 8) based on the norms for college students. The STAI was used for pre- testing of anxiety levels 2. Subjects had to score a minimum of 150 on the Social Readjustment Rating Scale which would indicate the chance of health change or illness due to stress (Appendix C) 3. Subjects had to sign a consent form (see Appendix D) 4. Subjects had to be available for participation in the study Spring Term, 1978 5. Subjects could not be engaged in any other relaxation program during this time At the beginning of the baseline phase of the investigation, seven subjects met all of the above criteria. Description The seven subjects included four females and three males enrolled in graduate degree programs with ages ranging from 28 to 49. The subjects described themselves as being highly anxious and tense. Three 01"the seven subjects reported having tried other forms of relaxation in (order to feel less stressed. These methods included tranquilizers Provided by physicians, yoga and physical exercise. All seven subjects exPressed that they had wanted to be involved in a relaxation program for at least a year. 26 Since the subjects were not drawn at random from a defined popu- lation, a summarization of the demographic and personal data is included in Table 2.1. Experimental Manipulations The seven subjects selected for treatment were notified and were scheduled for 19 individual training sessions extended over a nine- weekperiod. A schedule outlining the baseline, placebo and treat- ment phases of the study is provided in Table 2.2. Training time ranged from between 20 and 40 minutes for each session. A small counseling-consultation room in the 250 complex of Erickson Hall, Michigan State University served as the experimental setting where the treatment was administered (see Figure 2.1). After reporting to the experimental area for the initial base- line, each subject was introduced to the electromyography instrument and an electronic data counter. It was explained to each subject that the function of the equipment was to show how much muscle tension was present. The electromyography and the counter were turned away from the subject to prevent the subject from viewing the monitor. In addition, the investigator scheduled the remaining 18 sessions 1For each subject and explained the procedure for the following Sessions. Experimental sessions for each subject were conducted as fOllows: 27 wows: wows: mums: muwcz xumpm mops: xompm comm .<.z .<.z .o.;a .<.z .o.:a .o.;a .o.;a smummmm . . mow .nm . mom .vm mow .cm mom .um mmpm om mmpm am .puum mm_m cm .umpm .umum .pmum mmczou mew cowummcomm smoFoom new co_umo:vm canoe: mew mew town: so mmc< -Pmmczou owuamamcmge cuss: -Pmmesou a :oFumsumwcPEu< 1pmmcaou -mecaou cowuwuwpmmomam mpmcwm m_mcwm cmuco>wo newccmz umwccmz mpmcwm newccmz magnum Pmpwcmz 8 mm 8 cm mm on 3 e2 ope: mpmemm opmemm ope: ope: apogee mpwemu xmm m m m e m N F momuMVLmuomsmcu muumnnsm movemecmuumcwcu o_cqmgmoema new _m=omcmm ._.N m_nme 28 Asmae-emoav HocuWe m2m ncoumm .m genome can mpmom mmmcum mumpaeou .m mmcwccoomg muummmmo amp; .N mmowuumca ~_m N— so: mm_omze mwpmucoct mcwvsoomc apps: ago: an moan» o» swamp; .N acmEpmwc» new op mmuocpuwpm cumua< .F mmcwucoooc mauou zone on seamen .P pmcwa Feca< mmcwcmmc upo>ocowe o2m usoomm .N cmucmewcmaxm mm—uwae mFFmpcoLt op sesame ecu m—wum mmmcum uzo ppwm .N onwumpa lemp o» monocuumpm cuouu< ._ omwu mcw>Fo>mc a co wagon .p emcee Feca< mcwmccowpmmzo acopmw: mew; cmzmc< .m mmuzcwe om toe mac? assume ecu mopmom mmmcum use pre .N unmet u~o>ocuwe w2m ccoumm .N .mmwu some see xmmz can macaw mmpumse mwpmu -mmm emcee .uzm :o comma mcwucoammc Fmo «Flop icon» on monocuompm numpu< .F -wmopommzca mmmmmm on omega mcwpmmmn ccmuu< .F m:w_ommm Feca< newcmmcu so» mucwEHceoaam mmcmcc< .m muumnnam mo cowoowpmm .N mmczou mc_mec:ou new mmcaou muwpmwumpm mom cw maoo op 30: ecu accessoe meson ucmmcou mumpaeou .m -cma owemcmum can meowuocsw flammpnmcav cope _mowmopommsza co mmmsum scoucm>c~ ummcelmuMpm wumPQEou .N -mupum—om ~1e to uomeem co cowumucommca .F mmmm mum_aeou ._ pumnnzm peca< cowoucsu cmpcmewcmaxm copuoczm uumwaam manna mama o_:um:um zucmmmomuu.m.~ mum90 on On 0' 9. on On nu ON n. o. n o l l l w I O 9 T‘n‘l l I. W .I'Illn. L O.m .. 2m 2: v55 2:5. ...|.H I'l’h 2.33.. 326.3.- oo-..u>< .1 0-1 m wort! “01 C hood not non- SO”€ gard 68 worthless, inadequate, agitated, unassertive, unattractive, depressed, full of regrets, guilty and sympathetic. Medically, he reported that he had a relatively healthy child- hood, adolescence and adult life. He was not on medication and had not seen a physician since December of 1977. Considering family data, he described his father as closed and non-communicative and his mother as ambivalent--sometimes friendly, sometimes hostile. His interests and hobbies were swimming, cycling, jogging, and gardening. He expressed enthusiasm and interest in the program, but was frequently late in attending the sessions. His weekly high and low EMG recrodings throughout the phases is demonstrated in Figure 3.7. The trend lines are accelerating for Phases I and II and declerating for the subsequent phases. The electrical activity in the frontalis muscles for Phases III and IV was more reduced than in Phase IV. Individual Case Hypotheses For the purpose of data anlaysis in this study, the following hypotheses will be considered along with research data to either support or reject the hypothesis. The data for supporting or reject- ing the following three hypotheses are presented in Table 3.1. 69 £233 53 95.59 2:93.. £9.95... 96 $88; 9:. 32.3: 05 .o 830». 05 .0 833.5330: .o 33 so» €32.69;qu 05 co v33 959.83; .3320?an .0 3a.. 05 .o.n 33: £60 an On nv ov on on 0.0. ON n. O. n O I‘l‘l‘l I l O. l V. IIIIII.‘\ I. 2:30... ”Muffinuhuhwu H“ .I. O- «In am ..< SL'IOAOHOM 9W3 [\‘I re; ll‘lI 1"e in I A- r: iI 70 Table 3.1. Median Slope Trend Analysis of Statistical Probabilities of Differences in Muscle Tension Reduction Between Baseline and Treatment Phases $81 and B?) and Baseline and Placebo Phases (A11 and A1 ) based on EMG Subjects . Phases A-Al A-Bl A-A§ A-B2 1 .0175a .0000005a .0175a .0003a 2 .0702 .0000005a .0175a .00033 3 .0175a .0000005a .0003a .0003a 4 .l638 .0000005a .0003a .0003a 5 .0117 .0000075a .1400 .0003a 6 .0175a .0000005a .0003a .0003a 7 .01756 .0000005a .0003a .0003a aDenotes statistical significance between phases (p < .05). Hypothesis 1 During the first placebo phase (A1) muscle tension will be reduced or decreased below the baseline observation level (A) as indicated by the median slope trend. Hypothesis 2 During the first treatment phase (B) muscle tension will be reduced or decreased below the baseline observation level (A) as indicated by the median slope trend. Hypothesis 3 During the second treatment phase (B) muscle tension will be reduced or decreased below the baseline (A) observation level, as indicated by the median slope trend. 71 The data presented in column I of Table 3.1 indicates the statistically significant difference between the baseline (A) phase and the first placebo phase (A11). Hypothesis 1 was accepted for five out of seven subjects as denoted by the letter "a." The data suggest that for these five subjects EMG microvoltage was signifi- cantly reduced during the placebo (A11) phase than during the base- line (A) phase. Column 2 of Table 3.1 is representative of a comparison of tension levels between the baseline (A) phase and the first treatment phase (B‘). For each subject, EMG microvolts significantly lowered (p < .05). Therefore, Hypothesis 2 was accepted for all seven sub- jects. As demonstrated in column 4, the data present the significant difference between each subject's tension level in the baseline (A) phase and the second treatment (82) phase. Each subject's EMG microvolt readings were decreased significantly. Hypothesis 3 was accepted for each of the seven subjects. Similarly, a comparison was made between Phases A and A]2 in which statistical difference was determined in six of the seven cases. The data analyse the comparison in EMG microvoltage between the baseline (A) phase and the return to the second placebo (A12) phase. The statistical analysis of this table utilized White's (1972) split middle method of trend estimation. The scores cited in Table 3.1 represent probabilities of difference across baseline and all othEI IhES£ fl: fix. 0 72 other treatment phases. The data for accepting or rejecting Hypo- theses 4 and 5 are presented in Table 3.2. Table 3.2. Probabilities of Differences in EMG Microvoltage between Consecutive Phases for each Subject using Median Slope Trend Analysis Phases Subjects 1-11 II-III III-IV IV-V (A-A}) (A}-B]) (Bl-A?) (Afi-BZ) 1 .0175a .0000685a .0003a .0162a 2 .0702a .00000005a .017sa .0003a 3 .0175a .0000007a .0175a .0003a 4 .1638 .0000005a .0175a .0003a 5 .0117a .0000005a .0175a .19 6 .01753 .0000005a .0175a .0003a 7 .0175a .0000005a .01753 .0003a aDenotes statistical significance between phases (p < .05). Hypothesis 4 During the first treatment (Bl) phase, muscle tension will be reduced or decreased below the first placebo (A11) phase, as indi- cated by the median slope trend. Hypothesis 5 During the second treatment (82) phase muscle tension will be reduced or decreased below the second placebo (A12) phase, as indi- cated by the median slope trend. 73 According to Table 3.2, there was a statistically significant (p < .05) reduction in EMG microvoltage as demonstrated between the (All) and (8‘) phases for all individuals. Therefore, Hypothesis 4, stating that muscle tension during the first treatment phase would be decreased below the first placebo phase, was accepted for all seven subjects. As shown in the fourth column of Table 3.2, the reduction in EMG microvoltage was statistically significant in all but one case between phases (A12) and (82). Hypothesis 5, comparing the second treatment phase to the second placebo phase,was accepted for six out of seven cases. In summary, Hypothesis 4 was accepted for seven statistically significant outcomes while Hypothesis 5 was accepted for six out of seven statistically significant outcomes. The analysis of this table used the split middle method of trend estimation. Hypothesis 6 During the second treatment (82) phase muscle tension will be 1 1 and A12. To evaluate Hypothesis 6, Table 3.3 contains the data necessary reduced or decreased below all other phases A, A1 , B to determine the statistical difference between the second return to the treatment phase (82) and phases A, A1], 81 and A12. According 2, there was statistical significance for all seven individual cases. For the A]1 and 82 to the table, for comparison between A and B comparison, six out of the seven were significant. In comparing 1 2 B and B , three out of the seven cases were significant, which TablI ind' the rep con Cdll' 74 Table 3.3. Analysis of Statistical Probabilities of Differences in EMG Microvoltage Between Second Treatment Phase and All Other Phases using Median Trend Statistics Phases Subjects I-V II-V III-V IV-V (A-Bz) (A]‘-Bz) (3‘-32) (412-32) 1 .0003a .0003a .054 .0152a 2 .0003a .053 .22175 .0003a 3 .00036 .016a .053 .0003a 4 .0003a .0003a .0002a .0003a 5 .0003a .0003a .0002a .19 5 .00036 .0003a .192 .0003a 7 .0003a .0003a .0002a .0003a aDenoted statistical significance between phases (p < .05). indicated that out of the seven cases three individuals reduced their tension level in the second treatment phase below the level reported in the first treatment phase. Finally, in the A]2 and B2 comparison, six out of the seven cases were statistically signifi- cant. Significance between B2 and all other phases for each case is denoted by the letter "a." Hypothesis 7 As a result of relaxation training, post-state and post-trait anxiety scores will be less than pre-state and pre-trait anxiety inventory scores. 75 For the comparison between pre-state and post-state anxiety as measured by the State form of the State-Trait Anxiety Inventory, the null hypothesis was rejected since T = 0 is less than 4, p = .05 in favor of the alternative. It was, therefore, determined that as a result of relaxation training, post-state anxiety scores were statistically different from pre-state anxiety scores. In evaluating the pre-trait anxiety and the postetrait anxiety scores, the null hypothesis was accepted since T = 4 is greater than 3, p = .05. It was concluded that trait anxiety was not affected by relaxation training. The scores in Table 3.4 present pre- and post-test scores on the State Trait Anxiety Inventory. Table 3.4. Pre- and Post-Test State Trait Anxiety Inventory Scores Subject Pre-State Post-State Pre-Trait Post-Trait l 28 22 36 35 2 50 43 5l 45 3 56 32 42 40 4 40 37 3] 3l 5 49 41 6l 62 6 50 42 55 51 7 68 48 64 53 Hyooth Scale cated niiice other 65 me. colun betwe 0f tt diffs C086! betv TheI bOtI 76 Hypothesis 8 There will be a reduction in tension as measured by the Stress Scale both in class and out of class. This reduction will be indi- cated by the median slope trend. The data in Tables 3.5 and 3.6 present the statistically sig- nificant (p < .05) difference between the baseline Phase A and all other phases--A]], B1, A12, and 82 while in class and out of class as measured by the Stress Scale. Column 1 of Table 3.5 (in class report of stress level) and column 1 of Table 3.6 (out of class comparison of stress levels between phases) assesses the baseline phase to the first presentation of the placebo. It was determined that there was no statistical difference between A and A]1 in class or out of class for all seven cases. As demonstrated in column 2 of both Tables, a comparison is made between the baseline phase (A) and the first treatment phase (8]). It was found that statistical significance existed for six out of seven cases in class and five out of seven cases out of class. It was concluded that as a result of relaxation training these sub- jects reported feeling less stressed both in and out of class during the first treatment phase. Presented in column 3 of Table 3.5 and 3.6 are comparisons between the baseline (A) and the second return to the placebo (A12). There was no statistical difference found between these phases for both in or out of class reports. Tab 500 lat Sut 77 Table 3.5. Analysis of Statistical Probabilities of Differences in Str ss Level Between Baseline (A) and all Other Phases (A , B], A 2, and 62) While in Class as Measured by the Stress Scale. Phases 5”bjeCtS 1-11 I-III I-IV I-V (A-A,‘) (A-B‘) (A-A]2) (A-Bz) 1 .25 .0078a .125 .03125a 2 .25 .0078a .125 .03125a 3 .25 .052 .125 .03125a 4 .25 .0078a .125 .03125a 5 .25 .0078a .125 .156 6 .25 .0078a .125 .03125a 7 .25 .0078a .125 .03125a aDenotes statistical significance between phases (p < .05). Table 3.6. Analysis of Statistical Probabilities of Differences in Stress Level Between Baseline A and all Other Phases A 1, 8‘, A12, and 82 while Out of Class as Measured by the Stress Scale Phases Subjects I-II I-III I-IV I-V 1 .5 .0078a .125 .03125a 2 .25 .0078a .75 .03125a 3 2.0 .0078a .125 .3125 4 .25 .273 .375 .208 5 .25 .1638 .375 .3125 6 .25 .0078a .125 .03125a 7 .25 .0078a .125 .03125a aDenotes statistical significance between phases (p < .05). SEE tic ans 8X& ('88 its Dre SEV fO I‘I hen Eacl Sub- tree ct.) T Q: "C" 78 Column 4 provides an analysis of the baseline phase and the second return to the treatment (82). It was determined that statis- tical significance occurred for six out of the seven subjects for in class levels of stress and four out of seven subjects for out of class levels of stress. Hypothesis 9 There will be an increase in the number of correct items answered on the final examination as compared to the mid-term examination for each individual. The question posed here is whether or not the subjects, as a result of relaxation training, would improve the number of correct items on final examinations versus mid-term examinations in their respective courses. The percentages to assess that question are presented in Table 3.7. The information provided confirms that seven out of the seven individual cases made improvements. There- fore, Hypothesis 9 was accepted. In order to assess how well home practice sessions were imple- mented, self-reports of practices (a record of the number of times each subject listened to the relaxation tapes) were used. The subjects recorded how often they listened to Open Focus tapes during treatments B1 and 82. The mean ratings of these home practice reports for each subject are presented in Table 3.8. M A summary description of each case was presented, along with graphic representations of the subject's physiological response to Ti SL Fir Pha Sec Pha Bra 00:1 79 Table 3.7. Percentage of Total Correct Items on Mid-term and Final Examination for Each Subject Subject 9636::tmliems 662:;ci Items §tggrgfigfige 2 82 39 O7 3 79 96 ‘7 4 64 83 ‘9 5 92 98 06 5 86 92 05 7 89 94 05 Table 3.8. Mean Ratings for Each Subject's Home Practice of Tape Recordings in Treatment Phases Subjects l 2 3 4 5 6 7 First Treatment Phase 1.17 2.0 1.43 1.05 1.14 .76 1.24 Second Treatment Phase .64 1.07 1.29 1.00 .50 O 1.43 Grand Mean .91 1.54 1.36 1.03 .82 .38 1.34 Note. It was suggested that each subject listen to tapes once per day during the treatment phases. 80 the treatment program. Individual subject hypotheses were consid- ered and a group analysis was made on the pre- and post-test scores of the State-Trait Anxiety Inventory. The analysis indicated that EMG microvoltage was reduced from the baseline when compared with either the first treatment phase or the second treatment phase. Additionally, it was revealed that performance on academic tests was enhanced. Individual differences, however, did exist. The mean ratings of home practice sessions were totalled for 1 and 82. The each individual case for the two treatment Phases B mean scores were used to draw conclusions about the effect of home practice (listening to relaxation tapes) sessions on stress reduc- tion. Implications of these findings for the treatment of stress and anxiety about performance are discussed in Chapter 4. CHAPTER 4 SUMMARY 1 The purpose of this study was to investigate the effects of relaxation training hireducing stress and to increase the academic performance of graduate students. The relaxation program employed in this study was an autogenic training type of treatment called Open Focus that is commercially available. Open Focus is a program where subjects listen to a series of cassette recordings that ask interrogatory questions designed to stimulate objectless experiences and to broaden attentional focus. The treatment, to some extent, is similar to the Autogenic Training methods discussed by Schultz and Luthe (1969). It was hypothesized that if the relaxation procedure was powerful enough, physiologic parameters of tension as measured by an electromyographic (EMG) instrument and subjective feeling of anxiety as measured by the State Trait Anxiety Inventory scores should be reduced for each subject. It was also hypothesized that subjective reports of stress in and out of class should be reduced and that academic improvement would be achieved. The hypotheses presented were consistent with the recent theorizing of Fehmi (1975). The study was conducted over an eight-week period at Michigan State University in East Lansing, Michigan. Seven graduate students enrolled in the College of Education were included in the study. The 81 82 study used an extension of the basic A-B-A-B format (Mersen & Barlow, 1976) intensive design procedure. The Open Focus relaxation training was taught in two phases. One phase was three weeks in length and the other was two weeks. Other experimental sessions included a baseline phase implemented prior to the relaxation training sessions,and two placebo phases occurred between the relaxation training phases. During the base- line phase, frontalis muscle EMG observations were made for each subject. Subjects also reported subjective levels of stress during this phase of the study and each subsequent phase. In the second phase or the placebo phase each subject was presented a revolving disc and asked to focus on the disc. It was explained that the disc was a mechanism utilized to facilitate relaxation. Subjects listened to Open Focus recordings during the third phase,which was a treat- ment phase. The fourth phase was a return to the placebo phase where they watched the revolving disc. In the fifth phase subjects again listened to the Open Focus relaxation tapes. Electromyographic responses and subjective self-report data for each subject were collected during each phase of the study. The criteria measures used in the study to evaluate the effects of Open Focus relaxation training on stress were: a. Electromyography b. The State-Trait Anxiety Inventory c. The Stress Scale d. Mid-term and Final Examinations e. Log of Home Practice Sessions 83 Primarily, two analyses were performed on these data. The first was the median slope trend and was called for by the intensive design used in the study. In carrying out this analysis, specific hypotheses were stated for each individual case. These hypotheses were: H]: 1 During the first placebo phase (Al). muscle tension will be reduced or decreased below the baseline observation level (A) as indicated by the median slope trend. During the first treatment phase (B1), muscle tension will be reduced or decreased below the baseline obser- vation level (A) as indicated by the median slope trend. During the second treatment phase (B2) muscle tension will be decreased or reduced below the baseline (A) observation level, as indicated by the median slope trend. During the first treatment phase (B ), muscle tension will be reduced or decreased below the first placebo (A11) phase, as indicated by the median slope trend. During the second treatment phase (82) muscle tension will be reduced or decreased below the second placebo phase (A 2). During the second treatment phase (B2 ), muscle tension will be reduced or decreased below all other phases A, A6,, B1 and A12, as indicated by the median slope tren There will be a reduction in tension as measured by the Stress Scale. This reduction will be indicated by the median slope trend. The second analysis was a non-parametric signed rank test that addressed the following hypothesis: H8: As a result of relaxation training, post-state and post-trait will be less than pre-state and pre-trait anxiety inventory scores, as indicated by the Wilcoxon Signed Rank Test. 84 The analysis compared pre- and post-test observations of the State- Trait Anxiety Inventory. To study the effects of the treatment procedure on academic performance, a comparison was made between the percentage of correct items answered on Unemid-term examination taken by each subject and the percentage of correct items answered on the final examination of the same course. These differences were computed. The hypothesis was: H9: There will be an increase in the percent of correct items answered on the final exam1nat1on as compared to the mid-term. Another analysis was made of home practice sessions carried out by the subjects of this study. The analysis focused on the number of times the subjects listened to the Open Focus tapes. Mean ratings of home practice sessions were computed for each subject during the two treatment phases. Discussion It was hypothesized that Open Focus relaxation training would inhibit tension levels and increase academic performance. Direct assessments were made of physiological parameters and subjective responses to stress. The results of the study indicate that the treatment procedure produced significant decreases in frontalis EMG microvoltage data, as well as subjective reports of stress. The subjects also exhibited significant change as measured by differences in the pre- and post-test scores on the State-Trait Anxiety Inventory. The performance by subjects on the final examination was found to be enha on i wen tha' 993' -r1 .1 IO fro eac lin ran bef frc ide 50 lm; ea: I‘EI wiI ei 1 to M Vo' 85 enhanced when comparison of the percentage of correct items answered on a mid-term examination with the percentage of correct items ans- wered on a final examination was made. It would appear, therefore, that Open Focus may be useful for relatively well-functioning gradu- ate students for coping with graduate courses and examinations. Open Focus Effects on Frontalis EMG In considering the frontalis EMG data, the results are examined from the graphic representation of the physiological changes for each subject found in Chapter 3. Of interest was Phase I, the base- line session, where six out of the seven students' EMG readings ranged from fourteen to sixteen microvolts. This indicates that before presentation of any treatment, the graduate students' frontalis EMG was high. These findings are consistent with those identified by Griffore (1977), who found that older graduate-level students experienced a high degree of tension triggered by the impact of personal, social, environmental, and academic stressors. Assessment of the frontalis EMG changes which occurred during each consecutive phase revealed that five out of the seven subjects reduced EMG microvoltage during those phases. This was congruent with the hypotheses. The trend lines of subjects changed from either a horizontal position or an upward slope in the baseline phase to a continual downward slope in the remaining consecutive phases. Two subjects, however, did not show these reductions in EMG mirco- voltage output. During the first placebo phase, subject 4 was not 86 successful in reducing EMG microvoltage and subject 5 was not success- ful in decreasing EMG microvolts during the second treatment phase. A number of reasons may account for this. For student 4, lack of concentration was cited as one of his major complaints. Since the placebo phase required concentration on a revolving disc, this phase could have elicited a certain amount of anxiety. The student may have found it more difficult under the conditions of the placebo phase to decrease EMG microvolts, especially since this was the first experimental session. Student 5 indicated that she was experiencing high levels of anxiety during both the second placebo phase and second treatment phase. She was having a difficult time coping with personal stress- ors as well as academic ones. She was involved in a separation from her husband who had custody of the children,along with the academic pressures of projects and final exams. These factors seemed to prohibit her from listening to the tape recordings at home. It should be noted that this student's mean rating for home practice was the second lowest. However, as the end of the second treatment approached, her tension level decreased. It appears that the vari— ability in the frontalis EMG during consecutive phases could be attributed to the difficulty of the task during the phase, the current personal-life situations, academic stressors and the number of home practice sessions. Also of interest is the comparison between the two treatment phases B1 and 82. Only three of the students showed significant |m|© 87 differences between Phases III and IV. This seems to indicate that the effects of relaxation tended to peak early for some students and that as time passed, no differences occurred between the two phases. This suggests that there are individual differences in responding to the relaxation training phases. Open Focus Effects on State-Trait Anxiety Based on the pre- and post-testing with the State-Trait Anxiety Inventory, there appeared to be a definite effect between the Qpep_ Eggp§_training and the state anxiety scores of the subjects. A-state measures for subjects decreased significantly in response to the relaxation training. There was, however, no significant differential relationship between Open Focus training and decreased trait anxiety scores. This evidence seems to suggest that A-state is more likely to be reduced by Open Focus than A-trait. The results lend addi- tional support to the findings of Johnson and Spielberger (1968), showing that measures of A-state declined significantly in response to relaxation training procedures, while A-trait measures were impervious to relaxation training. An important implication of these findings is that Open Focus can be effectively utilized with graduate students in combating high levels of state anxiety. This means that academic performance can be enhanced since analyses of trait anxiety data generally shows that A-trait has no direct effect on perform- ance (King et al., 1976). The results of these findings that state anxiety was decreased and trait anxiety remained relatively stable are consistent with other 88 reports in the literature,as state-anxiety has been conceptualized as a transitory condition that varies in intensity from situation to situation, while trait anxiety refers to relatively more stable differences in anxiety proneness (Barsch & Nesselroade, 1973). Further, it was reported (Hodges, 1968) that since A-trait does measure the predisposition to respond, A-state anxiety is heightened in situations involving threats of loss of self-esteem or failure. This study then implies that when graduate students report feelings of stress, they are usually identifying anxiety associated with situations involving social or academic failures or ego-threatening situations. Effects of Open Focus as Measured By a Stress Scale 2, subjects involved in During the treatment Phases 81 and 8 this study reported their levels of stress during class and outside of class on the Stress Scale. Mixed differences were found in the reduction of subjective feelings of stress. The largest reduction in reported levels of stress was found in B1 for both in class and out of class time periods. In view of this finding it is possible to examine the effects of home practice sessions on the data. The subjects were required to listen to Open Focus tapes at least once per day during B1 and B2 phases. It seems that the application of the Open Focus relaxation tapes and the number of home practice sessions provided the subjects with a self-induced method of either alleviating or reducing anxiety in Phase III. Inspection of 89 Table 3.8 points to the diligence of subjects listening to tapes during the first treatment. The subjects listened to the tapes fewer times during the second treatment. It appears that when the subjects were capable of self-inducing relaxation then they could also relax in academic situations as well as in other stressful situations. A point should be made regarding the placebo phase. Stress levels were reported as being high during the two placebo phases 1 2 A1 and A1 . Since the subjects were not required to listen to the Open Focus tapes during these phases, it is likely that their expectations were not as high as they were during the treatment phases. The importance of this, however, does not appear to be very significant as students reduced frontalis EMG and decreased state-anxiety scores on the State-Trait Anxiety Inventory during placebo phases. Effects of Open Focus on Academic Performance The effects of the treatment procedure upon academic perform- ance were assessed by comparing the percentage of items passed by subjects on a mid-term examination with the percentage of items passed on a final examination in the same course. The percentage of change was then computed. The results show that an increase in correct responses from the mid-term examination to the final exam- ination did occur for each subject. Thus,the results indicate that Open Focus seemed to be a viable factor in improving examination performance for these subjects. 90 Many variables such as intelligence, amount of time spent in preparation for examinations, motivation, instructor grading pro- cedures and bias, and difficulty of examinations could not be controlled for in this investigation. However, the findings are consistent with much of the literature that indicates the ability to relax is correlated positively with improved academic performance. Home Practice Sessions The last set of data in Chapter 3 contains information regard- ing each student's mean ratings of home practice sessions. Four of the seven subjects practiced listening to tape recordings at least once per day. From inspection of the data, only subject five, whose practice grand mean was .82,had trouble reducing physiological tension as measured by the EMG and subjective feelings of anxiety. Subject 6,whose grand mean rating was .38,significantly reduced physiological tension and also reported decreased feelings of anxiety. Based on the results of the number of home practice ses- sions for this study, there appeared to be no definitive effect between number of practices of Open Focus, reduction of tension, and academic performance. It is possible that practicing Opep_ fppp§_each week in the laboratory was sufficient for some subjects to reduce their stress and they didn't need home practice as much as other subjects. Apparently, the effect of home practice varies with each subject. 116 SL 91 Individual Variables There are many personality types and genetic and environmental factors that influence a particular individual. It has been sug- gested that individual makeup and the length and type of a relaxa- tion program determine the program's effectiveness. From observing the seven students over the five phases of the study several vari- ables were considered. They include age, sex, race, marital status, degree program and specialization area. Motivation and length of the study were also considered. With these variables in mind a number of researchers (Morse & Furst, 1979) propose that different relaxers work for different people. Contrary to their research, the age, sex, race, marital status, degree program and specialization differences seemed not to affect the relaxation response as measured in this investigation. As discussed in Chapter 1, people have different mediating factors which affect perceptions of stressful conditions (individual makeup) and individuals vary in their physiological responses to stressors, but the relaxation method employed seemed to be not affected by these variables. In other words, Open Focus technique seems to be effec- tive in initiating and maintaining relaxation in different types of subjects. Two other factors which influence the effectiveness of a relaxa- tion program are motivation and length of training phases. Moti- vation is an important variable in a self-directed relaxation program such as this one. All subjects seem to maintain high levels of 92 motivation as evidenced by their attendance at the experimental sessions, their home practice sessions, and their record keeping. Their motivation seemed to stem from commonly reported feelings of decreased tension and increased sensations of warmth, numbness, floating, tingling, euphoria and various mental images. They also reported better study habits and improvements in interpersonal rela- tionships. These characteristics seemed to have a positive effect on motivation. The length of the training phases seemed appropriate for all subjects except one. Since people appear to vary in the length of the time needed for learning the relaxation response, this factor should be considered before a relaxation program is implemented. It is also possible that different relaxation training programs would influence individuals differently in terms of the amount of time required to learn how to relax. Conclusions and Implications Though these results need replication, Open Focus training as a relaxation technique appears to offer several advantages. The procedure appears to be effective and efficient in the remission of general anxiety and test anxiety as reported by the graduate students in this study. Thus, students can practice Open Focus and increase their sense of well-being, reduce tension and anxiety, and improve academic performance. Open Focus seems to work well with highly anxious students who are confronted with academic problems. It can become an established strategy in their repertoire of responses for 93 reacting to stressors and may broaden the individual's capacity for problem solving. This study not only speaks to the use of Open Focus as a pro- cedure for reducing tension, but it also highlights the importance of an automated technique. A relatively large population having experienced similar stress could be treated in a short time, through the use of the relaxation tapes, even where no therapist is physi- cally available. An intensive design was used in this study. The utilization of such a design lends itself to an investigation of a wide range of individual responses to relaxation training. It is possible through this design to study the ways in which people can use Open Focus to cope with stressful transitory experiences. Suggestions for Future Research The benefits derived from Open Focus, as discussed in this study, tended to be in the area of the physiological relaxation response, although significant differences were reported in the subjective areas of individuals coping with stressful situations. The treatment seemed to positively affect cognitive functioning as the students achieved positive gains on their final examinations. Future research will, of course, be needed to determine the degree to which the findings of this study can be generalized. In addi- tion, future research could expand our knowledge in this area by considering the following suggestions for investigating: 94 l. Replication of this study using a larger number of subjects. 2. A study investigating the effects of Open Focus on other dependent measures such as heart rate, blood pressure, and galvanic skin response. 3. A study using other forms of relaxation meditative therapy, in addition to the Open Focus and comparing the phases in terms of physiological response and academic performance. 4. A study investigating the academic performance of graduate students trained in Open Focus from the beginning of graduate training to completion of their program. 5. A study investigating the effects of Open Focus on subjects enrolled in other academic courses. APPENDICES 95 APPENDIX A PRESENTATION TO ED 869 AND ED 8168 96 APPENDIX A PRESENTATION T0 ED 869 AND ED 816B 1. Introduction 2. Studying effects of stress in academic environments-- a. Stress is becoming recognized as one of the major determinants for poor performance, unhappiness, illness, and disease. It is estimated that 60-80% of visits to general practitioners of medicine have problems that are stress related. All of us are faced with stress from a multitude of sources each day. Yet, few of us are adequately prepared to deal with it. b. The purpose of this research is to investigate the effects of a stress reduction program on individuals who are experiencing stress in a demanding academic course. 1. The reason for this presentation tonight is to offer some of you the opportunity to participate in this stress reduction program. The program offers the possibility for you not only to be able to perform at a higher level in your class, but a possible means for reducing stress in other situations 2. I am looking for volunteers who feel very anxious about their classes and who are willing to participate in an intensive stress reduction program. a. Those who are willing, after getting more informa- tion, to commit themselves to three sessions per week for about 30 minutes each session for eight weeks should see me for these individual sessions. b. Those who are willing to devote 30-45 minutes per day at home practicing the procedures you will be taught and will keep records of daily progress (5 minutes). 97 98 c. Those who are also willing for the researcher to collect data about their progress, personal history, tests, so as to measure the effectiveness of treat- ment. d. In no way will the treatment be abusive or belittl- ing. Much of the treatment will consist of listen- ing to cassette tapes and following directions given on tape in the privacy of your own home. No identi- fication of you as subjects will be revealed in any report or publication. e. If desired, your participation may serve as an independent study. Advantages for you. a. Personal benefits--learn to reduce your stress in many situations, especially academic stress. b. Those of you who plan to be teachers or plan to be college professors, this is an opportunity to learn a procedure that can be taught to others--your students, family, etc. c. At the end of the nine weeks, you will have for your own personal use a set of cassette tapes that contains the procedure. For those who are considering to volunteer, please remain after class. Please leave name, address, and telephone number. Male Female Under Medical Treatment? Yes No Cassette Type Tape Recorder? Yes No Explain Individual Design. a. Open Focus training was developed by Dr. Lester Fehmi of Princeton Medical Center. b. Learn to reduce effort and tension by focusing on certain internal and external events to the exclusion of other events; to reach a certain state of mental awareness that promotes relaxation at a very deep level--a sense of well- being. Use of visual imagery. The use of a natural process that people can easily learn--through practice. Homostatic response, physical illness, immune system usually works to combat disease. Open Focus lets mind's immunity system 99 combat stress. Passive mind--no responses going to body that creates internal stress to muscles and organs. Open Focus produces a pleasant state--get acquainted with your bodies--interesting. Those of you under current medical treatment should consult with physician using insulin, thyroxin, or anti-hypertension medicine. Relaxation--mental and physical stress reduction changes dosage requirements Requirements--Commitment. I am not able to provide opportunity to all, but for the most stressed or anxious. 1. Come to Erickson Hall three times per week for instruction and monitoring--30 minutes each session. Practice at home with cassettes at least 30 minutes each day. Monitor with EMG instrument which measures muscle relaxation and is applied to the forehead. First two weeks gather base- line data where you are now--take about 15-20 minutes (three times a week). Next seven weeks--3O minute sessions three times a week. Practice 30 minutes a day at home. Take some tests tonight so we can assess your level of stress or anxiety. Fill out a schedule. APPENDIX B STATE-TRAIT ANXIETY INVENTORY lOO lOl 8w-EVALUATION QUESTIONNAIRE Developedby C.D.Spielberger,R.LGoumd1andR.hnhene an: some n NAME DATE DIRECTIONS: A number of statement: which people have need to deacribe theirs-elven are given below. Read each afou- ment and then blacken in the appropriate circle to the right 0! the atabement to indioaee how you feel right now, that in, at this moment. There are no right or wrong anemn. Do not wend toomuch timeon anyoneataumentbutgivemeenawer whichaeernatoducribeyourpreaentfeelinpbut. ”8'80. 1. Malcolm .Ilaelaeoure . Iantenee 2 8 4. Iamrepetful 6. IIeelateaee O 7 8 9 699999 . Ifeelupaet . I am preaently worrying over poaaible mialortun- ..... . I feel rented ....... . I feel anxious 10. I he] mom» II. I feel elf-confident - 96996 12. Heelnervoue .. 13. I am jittery ......... 16. I an relaxed 9 16. I feel content ...... 17. I are worried 18. IHmadhdandratfled 19.1mm 20. Iloalpleaaant 6999996 CONSULTING PSYCROLOGISTS mess on colon Arm. Pale Alto. Cameron: 0430. oe mum am 99969696699966669666 66999999996699696669 99999699999999696999 102 IELF-IVALUA‘IION WNW! STAI FOR“ :4 N AME DATE DIRECTIONS: A number of statements which people have used to describe themselves are given below. Read each state- ment and then blacken in the appropriate circle to the right of the statement to indicate how you generally feel. There are no right or wrong answers Do not spend too much time on any one statement but give the answer thch accrue to describe how you generally feel. 21. 22. 23. 24. 25. 26. 27. 28. 29. 30. 31. 32. 33. 34. 35. 36. 38. 39. 40. I feel pleasant I tire quickly . . . ., ....... I feel like crying . . . .......... .. .................................. , I wish I could be as happy as other: aeem to be .. I am losing out on things hecauae I can't make up my mind aoon enough lfecl rested . ................ I am “calm. cool. and collected" , . I feel that difficulties one piling up ao that I cannot overcome them I worry too much over something that really doean't matter , I am happy ..., . I am inclined to take things hard ..................... . .......... . ..................... I lack self-confidence . I feel secure . I try to avoid facing a crisis or difficulty I feel blue I am content . Some unimportant thought rune through my mind and bothers me ........ I take disappointments ao keenly that I can’t put them out of my mind .. I am a ateady poreon ................................................................... I become tense and upeet when I think about my present concerns. ( “,1"th . 1961': h\ ('harh-s I) Npu'lhrrurr, Ifrprmfurfmn "I "II- Ira! or arm purmm M. n “I h\ mu prm ms IrIthnul u nth-n pc-IIIIIumn o] "u- Publrahrr u prnhrhIII-II MN 180’?" 6666666666999666 I99 (9 E) 6 ”KLEIN“ 9 6969966 6399999996 999 9 9 9999999999999 63‘ Q ’9 G SAVM‘IV .LSOK'IV ,9 @6369 (9‘) APPENDIX C SOCIAL READJUSTMENT RATING SCALE 103 APPENDIX C SOCIAL READJUSTMENT RATING SCALE Instructions: Please check off events which have happened to you within the last year and then total up the score by adding up the assigned values of these events. Events Value Death of a spouse 100 Divorce 73 Marital separation 65 Jail term 63 Death of close family member 63 Personal injury or illness 53 Marriage 50 Fired from work 47 Marital Reconciliation 45 Retirement 45 Change in family member's health 44 Pregnancy 40 Sex difficulties 39 Addition to family 39 Business readjustment 39 Change in financial status 38 Death of a close friend 37 Change to different line of work 36 Change in number of marital arguments 35 Mortgage or loan over $10,000 31 Foreclosure on mortgage or loan 30 Change in work responsi- bilities 29 Son or daughter leaving home 29 Trouble with in-laws 29 Subtotal 104 Events Value Outstanding personal achievement 28 Spouse begins or stops work 26 Start or finish school 26 Change in living condi- tions 25 Revisions of personal habits 24 Trouble with boss 23 Change in work hours, conditions 20 Change in residence 20 Change in schools 20 Change in recreational habits 19 Change in church activi- ties 19 Change in social activi- ties 18 Mortgage or loan under $10,000 17 Change in sleeping habits 16 Change in number of family gatherings 15 Change in eating habits 15 Vacation 13 Christmas season 12 Minor violation of the law 11 Total APPENDIX 0 CONSENT FORM 105 9) ur th DU to CEC APPENDIX 0 CONSENT FORM I, have had the research project entitled “A Study of Academic Stress" conducted by Bob Winborn and Brenda White explained to me to my satisfaction. I understand the experimental design and the requirements of the project. I also understand that any other explanation I desire will be provided me by the researchers and my name will not be mentioned in any way in any publication that might result from the research. I volunarily agree to participate in the project and understand that no research pro- cedures will be abusive to me as a person. Name Date 106 APPENDIX E DATA COLLECTION SHEET (EMG READINGS) 107 al.— n/L 2 _A_A_A_1I.A_n.mi_.nani_.mmu~ulb..M.DTM-W .Mb l8\.n.MI\A11\tmlnb/eb AMano «HDTV APPENDIX E RECORD OF EMG OBSERVATIONS Name Date EMG EMG EMG Note special feelings before and after observation period 108 APPENDIX F STRESS SCALE 109 APPENDIX F STRESS SCALE Most people agree that the following five words represent stress of increasing intensity. There are: 0 20% 40% 60% 80% 100% NONE MILD DISCOMFORTING ALARMING DISTRESSING ACUTE To get a better understanding of the effectiveness of the treatment on reducing stress, I will need to know how your stress (anxiety) varies in intensity during class and examination periods. How intense is your stress during these times? To measure your stress, darken in appropriate stress level. ACUTE . . . . . 100% l DISTRESSING . . . 80% ( ALARMING . . . . 60% DISCOMFORTING . . 40% MILD . . . . . 20% NONE . . . . . 9 4F- dl— '11- a} VI UI >~IE E >5 .. S 86 6 39 t6 ‘0- °PQI 03 'r- r— 0 '0‘- C US- U 00 'F' mm 4) E“- S— EH C 3 OJ 3 ‘4- 9—. o 0-4.0 D HID 110 APPENDIX G OPEN FOCUS INSTRUCTIONS 111 APPENDIX G OPEN FOCUS INSTRUCTIONS This is the date that you start on the Open Focus Training. It rnay take you some time to achieve the results indicated in the relaxa- ‘tion program (the amount of time varies with each person). DON'T [BECOME DISCOURAGED. . . . Keep practicing each day at least once more often if you have the time. Follow the directions on the tape and let the experience happen. [Don't work at following the directions. Take a lazy attitude toward listening and just let the experience happen. Just let go. This may seem to be a strange procedure to some of you for the reduction of stress. The idea is that when your mind is in Open Focus ‘the mind and body are in an optimum condition to work together in a holistic fashion to reduce stress. Eventually, with practice, Open Focus can become a natural part of your life. The exercises on the tapes will help you to attain Open Focus. Try to listen to the tapes in a quiet environment that is free of as many distractions as possible. Posture is also important. Sit or lie in a relaxed, comfortable position with legs outstretched and slightly parted, the feet fallingloosely outwards, arms loose beside the body or in your lap. If seated, let your head fall in a relaxed position on your chest. Make sure you can breathe easily and freely. Make sure no part of your body distracts you. One of the most important things about listening to the tapes is .your attitude. Just let other things be unimportant and let your entire Being get into the exercises given on the tapes. Remember that Open Focus can only be learned through practice. Practice but don't become impatient. 112 APPENDIX H OPEN FOCUS EXERCISE 113 OPEN FOCUS EXERCISE IS IT POSSIBLE FOR YOU TO IMAGINE --- or CAN YOU IMAGINE --- --- the space between your eyes --- the Space between your ears --- the space inside your throat --- that the space inside your throat eXpands to fill your whole neck as you inhale --- the space between your shoulders --- the space between your hips --- the space between your thumb and first finger on each hand --- the space between your first and middle finger on each hand --- the space between your middle and fourth finger on each hand --- the space between your fourth and little finger on each hand --- the space between all your fingers simultaneously --- that your thumbs are filled with space --- that your first fingers are filled with space --- that your middle fingers are filled with space --- that your fourth fingers are filled with space --- that your little fingers are filled with Space --- that your hands and fingers are filled with space --- the region between the tips of your fingers and your wrists is filled with space --- the region between your wrists and your elbows is filled with space 114 115 the region between your elbows and shoulders is filled with Space the region between your shoulders is filled with space that the s ace inside your throat is coextensive with the space etween your shoulders and in your shoulders and arms, hands, and fingers that the regions inside your shoulders, and the regions between your shoulders, and fingertips are simultane- ously filled with space the space between your toes that your toes are filled with space that your feet and toes are filled with space the region between your arches and your ankles is filled with space the region between your ankles and your knees is filled with space the region between your knees and your hips is filled with space that the region between your hips is filled with space your lower abdomen is filled with space your lower back is filled with space your body from the diaphragm down to your feet and toes is filled with space the region between your navel and your backbone is filled with space your stomach is filled with space the region inside your rib cage is filled with space that the region between your ribs is filled with space that the region between your shoulder blades is filled with space that the region between your shoulder blades and your ribs is filled with space 116 the region between your breast bone and your back bone is filled with space the region between your shoulders and your ribs is filled with space your neck is filled with space the region between your shoulder blades and your chin is filled with Space the Space inside your lungs as you inhale and exhale the space inside your bronchial tubes as you inhale and exhale your whole body, from the chin down, to your feet and toes is filled with space the space inside your throat as you inhale and exhale the Space inside your nose as you inhale and exhale the space between the tip of your chin and inside of your throat ‘ the distance between the space inside your throat and the space inside your ears the distance between the space inside your throat and the top of your head the distance between the space inside your throat and the Space behind your eyes that your jaw is filled with space the space between the tip of your chin and your lower 11> that your cheeks and mouth are filled with space that your tongue is filled with space that your teeth and gums are filled with space, that your lips are filled with space that space between your upper lip and the base of your nose 117 that the region around your eyes and behind your eyes is filled with Space ' that your eyes are filled with Space that your eyelids are filled with space that your nose and sinuses are filled with space the bridge of your nose is filled with Space that the region between your eyes and the back of your neck is filled with space M the region between the bridge of your nose and the back 0 your head is filled with space the region between your temples is filled with space - that your forehead is filled with space that your brain is filled with Space that your spine is filled with space that your whole head is simultaneously filled with space that your whole head and your face are simultaneously filled with space that your whole head, face, and neck are simultaneously filled with Space ' that your whole head, face and neck and your whole body including your hands and feet are Simultaneously filled with Space that your whole being fills with air when you inhale and your whole being is left filled with space when you exhale At the same time that you are imagining the space inside your whole body, is it possible for you to imagine the space around your body: the space between your fingers and toes, behind your neck and back, the space above your head and beneath your chair, the Space in front of you and to your sides that the boundaries between the space inside and the space outside are dissolving and that the space inside and the space outside become one continuous and unified Space 118 that this unified space, which is coextensive inside and outside, proceeds in three dimensions, front to back, right to left, and up and down that at the same time you imagine this unified space that you can Simultaneously let yourself attend equally to all the sounds that are available to you, the sound of my voice, the sounds issuing from you, and any other sounds that you may be able to ear that these sounds are issuing from and pervaded by unified space that at the same time you are attending the space and the sounds that you can also attend simultaneously to any emotions, tensions, feeling or pains that might also be present that these sensations and perceptions are permeated by Space that at the same time that you are aware of the Space, the sounds, emotions and other body feelings that you can also be simultaneously aware of any tastes, smells, thoughts and imagery that might be present that all your experience is permeated and pervaded by space that as you continue to practice the 0 en Focus exercise that you will increase your a ility to enter into Open Focus more quickly and more completely and more effortlessly ‘ that as you continue to practice this Open Focus exer- cise your imagery of Space will become more vivid and more pervasive that as you continue to practice this Open Focus exer- cise your ability to imagine space permeating all of your experience will continue to become more vivid and ever-present that as you continue to practice this Open Focus meditation exercise you will relax your mind and body and increase alpha brain waves that as you increase your alpha brain waves your ability to read and take tests will improve APPENDIX I HOME PRACTICE LOGS 119 Record of Home Practice Sessions Name Week Please bring with you one week from today. This is very important information for the research project. Please remember to practice each day. Practice at least once a dav. Rate 0 - 10 with 10 as hioh # of practices Tension level Tension level For each day report any each before after signs of ill health such day practice practice as headache, cold, etc. ficndav Tuesday Wednesday Thursday Friday Saturday Sunday Please elaborate here on any special feelings you had before, during, or after practice: Please elaborate here on any signs of ill health such (for example: morning headache over entire head that lasted for an hour, menstral period beoan and bad cramps all day, stomachache one hour after supper that lasted three hours etc 120 APPENDIX J LIFE HISTORY QUESTIONNAIRE 121 LIFE HISTORY QUESTIONNAIRE‘ Purpose of this questionnaire: The purpose of this questionnaire is to obtain a comprehensive picture of your background. In scientific work, records are necessary, since they permit a more thorough dealing with one's problems. By completing these questions as fully and as accurately as you can, you will facili- tate your therapeutic program. You are requested to answer these routine questions in your own time instead of using up your actual consulting time. It is understandable that you might be concerned about what happens to the information about you because much or all of this information is highly personal. Case records are strictly confidential. No outsider is permitted to see your case record without your writtengpermission. If you do not desire to answer any questions, merely write "Do not care to answer." PLEASE WRITE IN INK ONLY. Date 1. General Name: Address: Telephone numbers: (home) (work) Age: Occupation: By whom were you referred? With whom are you now living? (list people) Do you live in a house, hotel, room, apartment, etc.? Marital status (circle answer): single; engaged; married; remarried; separated; divorced; widowed; living with intimate partner If married, husband's (or wife's) name, age, occupation? ."Adapted from Arnold Lazarus, Ph.D. , 122 123 Religion and Activity: a) In childhood b) As an adult Clinical a) State in your own words the nature of your main problems and their duration: .4. b) Give a brief account of the history and development of your com- fl plaints (from onset to present): 1 c) On the scale below please estimate the severity of your problem(s): mildly upsetting moderately severe very severe extremely severe totally incapacitating d) Whom have you previously consulted about your present problem(s)? e) Name(s) of physician(s) and phone number(s) f) When did you last see a physician? Date Reason 124 8) Are you taking any medication? If "yes," what, how much, and with what results? What? How much? For what? What results? Personal Data a) Date of birth: Place of birth: Time of birth: b) Mother's condition during pregnancy (as far as you know): c) Check any of the following that applied during your childhood: ___Night terrors ___Bedwetting ___Sleepwalking ___ThUmb sucking ___Nail biting ___Stammering “___Fears ___Happy childhood ___Unhappy childhood ___Any others: d) Health during childhood? List illnesses: e) Health during adolescence? List illnesses: f) What is your height? Your weight? g) Any surgical operations? (Please list them and give age at the time h) Any accidents? 125 1) List your five main fears: J) 1K) 1. lbw” Check any of the following that apply to you: headaches palpitations bowel disturbances anger nightmares feel tense depressed unable to relax don't like week- ends and vacations can't make friends can't keep a Job financial problems excessive sweating concentration difficulties Others: dizziness stomach trouble fatigue take sedatives feel panicky conflict suicidal ideas sexual problems overambitious inferiority feelings ___pemnry problems ___lonely ' often use aspirin or painkillers ___hypoglycemia (low sugar) fainting Spells anxiety no appetite insomnia alcoholism tremors take drugs allergies shy with people can't make deci- sions home conditions had unable to have a good time Please list additional problems or difficulties here. Underline any of the following words which apply to you. Worthless, useless, a "nobody," "life is empty" Inadequate, stupid, incompetent, naive, "can't do anything right" Guilty, evil, morally wrong, horrible thoughts, hostile, full of hate Anxious, agitated, cowardly, unassertive, panicky, aggressive Ugly, deformed, unattractive, repulsive Depressed, lonely, unloved, misunderstood, bored, restless Confused, unconfident, in conflict, full of regrets Worthwhile, sympathetic, intelligent, attractive, confident considerate Others: 126 1) Present interests, hobbies, and activities: m) How is most of your free time occupied? n) What is the last grade of school that you completed? 0) Scholastic abilities; strengths and weaknesses: p) Were you ever bullied or severely teased? q) Do you made friends easily? Do you keep them? Occupational Data a) What sort of work are you doing now? b) Kinds of jobs held in the past? c) Does your present work satisfy you? (If not, in what ways are you dissatisfied?) d) What do you earn? How much does it cost you to live? e) Ambitions Past: Present: Sex Information a) Parental attitudes toward sex (e.g., was there sex instruction or discussion in the home?) b} d) 8) h) b) c) d) e) f) 8) h) i) 127 When and how did you derive your first knowledge of sex? When did you first become aware of your own sexual impulses? Were you ever sexually molested as a child? Did you ever experience any anxieties or guilt feelings arising out of sex or masturbation? If "yes" please explain: Any relevant details regarding your first or subsequent sexual experience: Is your present sex life satisfactory? (If not, please explain.) Provide information about any significant heterosexual (and/or homo- sexual) reactions: Are you sexually inhibited in any way? Menstrual History Age at first period? Were you informed or did it come as a shock? Are you regular? Duration: Do you have pain? Date of last period: Do your periods affect your moods? Marital History How long did you know your marriage partner before engagement? 128 How long have you been married? Husband's/Wife's age Occupation of husband or wife: a) Personality of husband or wife (in your own words): b) In what areas is there compatibility? c) In what areas is there incompatibility? d) How do you get along with your in-laws? (This includes brothers and sisters-in-law) How many children have you? Please list their sex and age(s): e) Do any of your children present special problems? f) Any relevant details regarding miscarriages or abortions? g) Comments about any previous marriage(s) and brief details. h) Give sex and ages of children by your previous marriage. 1) Give sex and ages of your partner's children by previous marriage: 129 8. 'Family Data a) Father: Living or deceased? If deceased, your age at the time of his death? Cause of death? If alive, father's present age? Occupation: Health: b) Mother: Living or deceased? If deceased, your age at the time of her death? Cause of death? If alive, mother's present age? Occupation: Health: c) Siblings: Number of brothers: Brothers' ages: Number of sisters: Sisters' ages: d) Give a description of your father’s personality and his attitude toward you (past and present): e) Give a description of your mother's personality and her attitude toward you (past and present): f) 8) h) 1) J') k) 1) m) n) 130 In what ways were you punished as a child? by your father? by your mother? Give an impression of your home atmosphere (i.e., the home in which you grew up. Mention state of compatibility between parents and between parents and children). Were you able to confide in one or both your parents? Did one or both your parents understand you? Basically, did you feel loved and respected by your parents? If you have a step-parent, give your age when_parent remarried: If you were not brought up by your parents, who did bring you up, and between what years? Has anyone (parents, relatives, friends) ever interfered in your marriage, occupation, etc.? - Who are the most important people in your life? 131 0) Does any mes-vr of your family suffer from alcoholism, epilepsy, or anything which can be considered a "mental disorder"? p) Have you ever lost control (e.g., temper or crying or aggression by hitting)? If so, please describe. 'Self-Description (Please complete the following) a. I am a person who D. All my life 0. Eversince I was a child d. One of the things I feel proud of is e. It's hard for me to admit f. One of the things I can't forgive is g. One of the things I feel guilty about is h. If I didn't have to worry about my image i. One of the ways people hurt me is j. Mother was always k. What I wanted from mother and didn't get was 1. Father was always m. What I wanted from my father and didn't get was n. ly mother wanted me to be more 0. My father wanted me to be more p. If I weren't afraid to be myself, I might q. One of the things I'm angry about is r. What I want and have never received from a woman/man is s. The bad thing about growing up is t. One of the ways I could help myself but don't is 10. b) C) 132 What is there about your present behavior that you would like to change? What feelings do you wish to alter (e.g., increase or decrease)? APPENDIX K SPECIFICATIONS OF EMG 133 APPENDIX K SPECIFICATIONS OF EMG Technical Specifications of the J & J EMG Model M-55 Amplifer Differential type, fully protected Input noise: 0.2 uV RMS maximum Common mode rejection greater than 100 db 60 H2 notch filter, 40 db notch depth 60 H2 normal mode rejection, 60 dg Four bandpasses Ten ranges: l-1000 uV full scale Input impedance: 10 megohms Feedback Meter: direct reading, uV RMS calibration better than 3% Outputs: raw EMG, selected band EMG, rectified EMG, audio, meter signal Controls Range: 1, 2, 5, l0, 20, 50, 100, 200 500, 1000 uV full scale Threshold: 0 to full meter scale Inputs Electrode test, electrode operate Electrodes: (3) silver/silver chloride fully shielded, screw-on type Power Clinical: (4) size "0" flashlight cells 134 APPENDIX L SPECIFICATIONS OF SCORE KEEPER 135 APPENDIX L SPECIFICATIONS OF SCORE KEEPER Technical Specifications of the J & J LGS-lEO DigitET’Intggrating Score-Keeper Display 3 ll? digit LED display, 0.5% accuracy Count indicator: lights when integrating Controls Time 358: .2559 25, 45, 85, 15, 305, 1m: 2m: 4m, 8m: 16m, 32m Range and function: Temperature, threshold, microvolts: l, 2, 5, 10, 20, 50, 100, 200, 500, l000. 136 REFERENCES 137 REFERENCES Alpert, R., & Haber, R. 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