Chapter 1

INTRODUCTION

In the present 'era of anxiety' and 'century of stress', civilized human beings are paying
the price of their civilization, on different counts - being victimized by the known and the
unknown predators emerging from the hideouts of their bio-psycho-social life space.
Experienced stress in life is the host; it is also the process that mediates, makes and mars
health and illness, peace and happiness, and propels the individual towards skepticism and
skewed interaction with 'self and 'others'. Escapism from the acids of life through
'denial' paves the way to disaster. Beliefs prompt, 'perceptions' get colored, needs soar,
responses become unrealistic and conflicting mind gets into 'dissonance', disturbing the
homeostasis of life. Imbalance in psychosomatic axis worsens and contributes to the
genesis of pathology or aggravation of the same (Mishra, 1998).

Different periods in history have been associated with different kinds of stress. In times
gone by, people were concerned primarily with survival - avoiding death by starvation,
disease or violence. Though, this is still the case today in some beleaguered parts of world,
the word 'stress' is commonly associated with western civilization, in which the majorities
do not have to face severe hardship or the stark struggle merely to survive. Still their life-
style largely involves emotional factors such as uncertainty, insecurity, relationship
problems, time pressure, fears of inadequacy and role conflicts.

The term 'Stress'

The word 'stress' entered the American consciousness in 1956, with the publication of
'The Stress of Life" by Dr. Hans Selye. Selye borrowed the term from physics and applied
it to his 'stress syndrome', the body's response to any external demand. "When I made the
choice, I did not know English well enough to know the difference between stress and
strain," he wrote in his autobiography. 'Strain', he realized several years later, was the
proper term for changes in the body caused by an outside force; 'stress' was the force
itself. But it was too late, so Selye coined the term 'stressor'. Selye soon discovered that
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there was no direct equivalent for 'stress' in any other language, and thus '/e stress', 'der
stress', 'lo stress', 'el stress' and 'o stress' were born. Colloquially, however, 'stress*
means so much more. It has the privilege of being a noun, a verb and also an adjective. It
can mean anxiety, fear, uncertainty, anger and excitement. Stressor is an external pressure,
which is broxight to bear upon the individual. These stressors might bring about a variety of
signs and symptoms that invariably include anxiety. Being anxious is often roughly
equated to being 'in a state of stress'. Anxiety is the commonest human response to stress.
It may be regarded as a disorder when it occurs in the absence of an appreciable degree, or
kind, of threat or danger. Although its original purpose was, still is, to enhance survival
and learning of adaptive behaviour, excessive anxiety impairs physical and cognitive
performance of the individual.

The definition of stress is not simply a question of semantics, and it is important that there
would be agreement, at least in broad terms, on its nature. A lack of such agreement would
seriously hamper research into stress and subsequent development of effective stress
management strategies. The simple equating of demand witli stress has been associated
with the belief that a certain amount of stress is linked to maximal performance and
possibly good health. Belief in optimal levels of stress has been used, on occasions, to
justify poor management practices. Given this, it is an unfortunate but popular
misconception that there is little consensus on the definition of stress as a scientific
concept or, worse, that stress is in some way indefinable and un-measurable. This belief
belies a lack of knowledge of the relevant scientific literature. For the purpose of the
present study, the definition of stress put forward by Jvsncevich and Matteson (1986) is
taken in to account. They treat stress as some characteristics, event, or situation in the
environment that in some way results in a potentially disruptive consequence.

Effect of stress is felt in all walks of human life. Occupational (work) stress is one major
area in which research is gaining considerable momentum. Various studies have shown
that chronic work stress is a high predictor of psychological symptoms, in addition to life
events. While each incident by itself may be of little consequence, a chronically high
frequency may have a cumulative impact on health outcomes. The domain in which the
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stress occurs may determine the degree of distress experienced and how it is dealt with. In
addition there may be the spreading of stress from work to family and vice versa (Crouter,
1984).

It has been concluded in several different reviews of the stress literature that there are
essentially three different, but overlapping, approaches to the definition and study of stress
in work settings- The first approach conceptualizes occupational stress as an aversive or
noxious characteristic of the work environment, and, in related studies, treats it as an
independent variable - the environmental cause of ill health. This has been termed the
'engineering approach'. The second approach, on the other hand, defines stress in terms of
the common physiological effects of a wide range of aversive or noxious stimuli. It treats
stress as a dependent variable - as a particular physiological response to a threatening or
damaging environment. This has been termed the 'physiological approach*. The third
approach conceptualizes work stress in terms of the dynamic interaction between persons
and their work environment. This final approach has been termed the 'psychological
approach*,

Two specific criticisms have been offered of the first two approaches: the first empirical,
and the second conceptual. First, both engineering and physiological models do not
adequately account for the existing data. For instance, both ignore the mediation of strong
cognitive as well as situational (context) factors in the overall stress process. The second
criticism is that the engineering and the physiological models of stress are conceptually
dated in that they are set within a relatively simple stimulus-response paradigm, and
largely ignore individual differences of a psychological nature and the perceptual and
cognitive processes that might underpin. These two approaches, therefore, treat the person
as a passive vehicle for translating the stimulus characteristics of the environment into
psychological and physiological response parameters. They largely ignore the interactions
between the person and their various environments, whicTTare an essential part of systems-
based approaches to biology, behaviour and psychology. However, the third approach to
the definition and study of stress pays special attention to environmental factors and, in
particular, to the psychosocial and organizational contexts to work stress. Stress is either
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inferred from the existence of problematic person-environment interactions or measured in

terms of the cognitive processes and emotional reactions that underpin those interactions.
This has been termed the 'psychological approach'. The development of psychological
models has been, to some extent, an attempt to overcome the criticisms leveled at the
earlier approaches. There is now a consensus developing around this approach to the
definition of stress. For example, psychological approaches to the definition of stress are
largely consistent with the International Labour Organization's definition of psychosocial
hazards (International Labour Organization, 1986) and with the definition of wellbeing
recommended by the World Health Organization (1986).

Valiants of the psychological approach dominate contemporary stress theory, and among
them two distinct types can be identified: the interactional, and the transactional. The
former focuses on the structural features of the persons' interaction with their work
enviromnent, while the latter is more concerned with the psychological mechanisms
underpinning that interaction. Transactional models are primarily concerned with cognitive
appraisal and coping. In a sense they represent a development of the interactional models,
and are largely consistent with them. There is a growing consensus on the definition of
stress as a negative psychological state with cognitive and emotional components, and on
its effects on the health of both individual employees and their organizations. Furthermore,
now there are theories of stress that can be used to relate the experience and effects of
work stress, to exposure to work hazards and to the harmful effects on health that such
exposure might cause. Applying such theories to the understanding of stress at work allows
an approach to the management of work stress.

Stress and Health

Stress is ubiquitous in the present society and this is reflected in the popular discourse
surrounding the term. Stresses thought to be 'on the increase*. It has been suggested by
many scientists that stress at least partly form the increasingly fast pace of modem life, as
manifested in both the escalating degree of time pressure and increasingly becoming less
able to keep apace with rapidly changing social attitudes, work practices and
methodological advances. Stress is bad for health has become a modern cultural truism.
 G\ 3s$ss
However, there is also a significant body of research evidence that lends support to this
idea. The evaluation of this evidence is difficult task for several reasons. Firstly, the sheer
volume of research in terms of the number of published research findings is astonishing.
For instance, during 1981, 451 new articles appeared in the Social Sciences Citation Index
with the word 'stress* appearing as a keyword in the title or abstract; by 1991, this had
risen to over 1600 articles per year and during 1997 over 3000 such articles were
published. And lately, internet search by the present researcher, using various search
engines including Google, Yahoo, AltaVista, Medline etc. gave a formidable number of
55,000 plus web pages containing stress research articles,

A growing body of scientific literature documents the ill effects of stress in the etiology
and development of a variety of psychological and physical disorders. Stress-related
maladies are a major cause for concern in terms of the impact of stress on both individuals'
lives and productivity of organizations and countries. An individual under the impact of
stress may present with one or more of a variety of symptoms in the somatic, emotional,
cognitive or behavioral domain. In the somatic domain, the frequently reported stress
responses are disturbances in sleep and appetite, difficulty in digestion, loss of weight,
palpitations, easy fatigability, and aches and pain. In the emotional domain, irritability,
anger, apprehension, fear and sadness are commonly reported. In the cognitive domain
stress responses include lack of concentration, indecisiveness, and unproductive ruminative
patterns of thinking. In the behavioral domain^ the frequently reported stress responses are
decreased performance, impaired motivation, avoidance of certain situations, absenteeism,
increase or decrease in activity level and increase in the use of caffeine, smoking, alcohol
and other drugs. Forman and Myers (1981) have identified five stages of job stress. In the
first stage people suffer from anxiety, anger, tension and the general feeling of being
uptight. In stage two the responses are mostly psychological, ranging from constant
depression to feelings of fatigue. The third stage is when actual physiological changes start
to take place. Blood pressure rises, hormone levels and nutrients in the blood become
unbalanced and stomach muscles stay constantly tightened. By the fourth stage, physical
health starts deteriorating. Typical symptoms include gastro-intestinal disorders, coronary
heart disease, asthma and other psychosomatic problems. In the fi$b<~$taget work
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performance is degraded, productivity falls drastically and errors creep into all phases of
work.

A variety of psychosocial factors, which have been implicated in the development of an

organizational stress response, include personality characteristics like Type-A behavior
pattern, maladaptive coping, and life style factors such as diet, exercise etc. (Pestonjee,
1999), Occupational stress has been studied extensively and researchers have found that
job stress can severely damage one's health if it persists. The better functioning of an
organization essentially depends on its employees. The topic stress along with its
relationship to worker behaviour is a major factor of concern for any organization.
Occupational stress is being recognized increasingly across a range of jobs. While
comparing the different occupations, Dharmangadan (1988) found that police officers
experienced highest degree of stress and teachers the lowest. At the same time, the three
other occupations he studied (the administrative officers, the bank managers, and the
supervisors/foremen) did not show any consistent tendency to differ from one another.

Over the past three decades, there has been a growing belief in all sectors of employment
and in government that the experience of stress at work has undesirable consequences for
the health and safety of individuals and for the health of their organizations. This belief has
been reflected both in public and media interest and in increasing concern voiced by trade
unions, and professional and scientific bodies. The research summarized in the pages that
follow reveals that, even within a life perspective, work-related stress is a significant
problem and represents a major challenge to occupational health. The European
Foundation's (1996) Working Conditions in the European Union revealed that 29% of the
workers questioned believed that their work affected their health. The work-related health
problems mentioned most frequently are musculoskeletal complaints (30%) and stress
(28%); 23% of respondents said they had been absent from work for work-related health
reasons during the previous 12 months. The average number of days* absence per worker
was 4 days per year, which represents around 600 million working days lost per year
across the European Union.
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Executives as .well as professionals have received considerable attention as groups prone to

i' -I.
a number of stress related health problems. Higher levels of physical illness (such as
'>—
coronary heart disease, peptic ulcer, and hypertension) and psychological disturbance (such
as depression, exhaustion, and burnout) have been documented in this group (Karasek and
Theorell, 1990). According to Asian Health Care Services study report in 2001,
approximately 30% of IT (Information Technology) professionals suffer from depression
and the last eight years have seen a dramatic rise in the number of such cases reported from
IT industry. According to this report, patients above 30 years of age have weaker coping
strategies and as a result they seek quick symptomatic relief in tranquilizers and
antidepressants. There is a clear trend pointing to a possibility of drug dependence among
those in the IT industry in India, which may come to light in the next 5 to 10 years. An
important source of stress among IT professionals lies in their motive for choosing this
industry as a career option. Those who are in it only for money or the chance to go abroad
are most likely to feel the pressure of working in developed countries. The cultural and
social hurdles of being in a foreign country may compound the stress effect. Subsequently
this may result in coming back of many aspiring IT professionals to India. Most of them
will have unresolved psychological issues related to their unrealistic ambitions. Lack of
professional counseling before going abroad also has a snowballing effect when combined
with a general reluctance to seek psychological help even if available at foreign locations.

Stress and health outcomes are topics of concern to organizations, their members and
mental health professionals. In the last decade, there has been a considerable increase in
stress related disorders, leading to a number of studies highlighting the need for clinically
effective and cost effective stress management programmes (Ivancevich, Matteson,
Freedman and Phillips, 1990), However, stress management is not one specific technique,
but a generic term used to define any systematic and structured attempt at (i) reducing
excessive debilitating stress, once it has begun, thus decreasing the problem of stress
related illness and (ii) implementing strategies that can be used to prevent excessive stress
or to harness and direct the stress response into a positive motivational force thus
improving health and performance. Hence focusing on the fact that prevention is better
than cure (Everly and Feldman, 1985).
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Numerous theoretical and exploratory studies done in the West as well as in the Indian
context have established the important role of cognitive appraisal in determining coping
stress (Lazarus, 1993; Mehta, 1989). Yet its application within a stress management
programme has been negligible (Lazarus, 1991). For this reason, the present study will be
carried out to examine the effectiveness of Cognitive Appraisal Model within a Meditation
based Stress Management Paradigm in individuals facing high levels of stress. As IT
professionals have been documented to be a high-risk group and to be prone to a variety of
stress-related health problems, this group will be selected for the study.

There are three common purposes for evaluations of stress management programmes (Cox
et. al., 2000a). The first is to ask whether the programme is effective; specifically whether
the programme objectives are being met. A second purpose is to determine the efficiency
or comparative effectiveness of two or more programmes or methods within a programme.
The third purpose is to assess the cost-benefit or the cost-effectiveness of the programme.
Evaluation data on stress management programmes are relatively rare. There are relatively
fewer cost-benefit and cost-effectiveness studies compared to studies on the overall
effectiveness of programmes or the relative effectiveness of their component parts. What
there is suggests that stress management programmes are effective in improving the quality
of working life of workers and their immediate psychological health, albeit self-reported.

Statement of the Problem

With the proliferation of IT industry, work related stress has caught the attention of IT
workers, their employers and academic communities. Psychological understanding of the
problem and need for intervention based on it became a social concern. IT sector became
the exemplar of work related stress by nineteen nineties, although even during the nineteen
eighties it was considered to be the ideal ground for 'descent work*. This initial
expectation has been attracting the creamy layer of the educated mass. This inversion in
the realization stimulated thoughts directed at the management of stress. In India, IT sector
is growing over time and it has been accompanied by increasing number of workers under
distress. There are several studies that highlight this fact; however, there is hardly any
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study which examined the results of intervention programmes aimed at ameliorating stress
among the employees of this new and growing sector. The aim and objectives of the
present investigation is pitched on this research gap.

Aim
The present study is aimed to design, implement, and assess the efficacy of a stress
management intervention among IT professionals.

Objectives

1. To assess the extent of experienced distress and consequent quality of life among
IT professionals.

2. To design and implement a stress management intervention among the IT

professionals.

3. To examine the efficacy of the proposed stress management intervention, named

Organizational Skills Enhancement Training (OrgSET).

4. To follow-up the IT professionals for subsequent three months and evaluate their
progress.

Hypotheses
in accordance with the objectives of the present study, the following null hypotheses are
formulated. These hypotheses are tested on the basis of data collected from Information
Technology professionals in pre, post and follow-up periods in the case of study group,
With control group, Stress and Quality of Life are assessed between 3-month period .
intervals for comparison purpose.

Hen: There will not be any significant difference in the study variables between the study
subjects and the control subjects at the initial phase of the study.
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H02: There will not be any significant differences between the study subjects and the
control subjects in the study variables after the stress management intervention to
the former,

H03: There will be no significant difference in stress and quality of life among the
subjects during the pre-intervention, post-intervention and follow-up phases of the
stress management intervention concerned.

Scope of the Study

Stress is associated with impairment of health; although it can be good to the extent the
psychological and physiological responses to stress are within one's homeostatic limits. At
the same time, the negative emotional experiences are detrimental to 'quality of life and
sense of wellbeing'. Stress and health can form a 'positive feedback loop or a vicious
circle'. The complex nature of the concepts of stress and health invites the use of a
sophisticated meta-theoretical framework, such as the bio-psycho-social paradigm adopted
and developed by health psychology. Health Psychology is concerned with the application
of psychological theories and models in the promotion and maintenance of health, and the
individual and interpersonal aspects of adaptive behavior in illness and disability. Health
psychology has a wide remit and a potentially important role to play in the future.

Better functioning of any organization essentially depends on its employees. The topic
stress and its relationship to worker behavior is a major factor of concern in any
organization. Occupational stress is being recognized increasingly across a range of jobs.
Long hours, fear of redundancy, lack of confidence, changing work-place practices, greater
use of information technology, and perceptual re-organization are certain factors
contributing to the likelihood of work stress continuing (Cambridge and District Chamber
of Commerce News Letter, 1995). Society's sensitivity to stress issues has also sharpened;
primarily because, people started realizing that trauma and stress can be ameliorated with
stress management and counseling and also that, job stress has become a subject of
litigation. Two facts about stress cannot be ignored: first, people get sick from stress at
work; second, the costs associated with stress are significant to every employer. The only
natural conclusion one can draw is that organizations cannot ignore the stress issue, and
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must actively seek to do something about it. It is in management's self-interest to take an

active stance because, if for no other reason, it provides a basis for defending the
organization against claims that its jobs and working conditions are stress creating and the
primary cause for emotional problems.

Despite the general agreement that stress plays an adverse role in every day life, there
continues to be substantial controversy about how stress can be managed at the worksite.
During last decade, knowledge of stress management procedures has increased
substantially (Ivancevich et al., 1990). Stress management programmes employed in
worksite studies have included Muscle Relaxation, Biofeedback, Cognitive restructuring,
Stress Inoculation Techniques, Rational Emotive Therapy, Behaviour Skills Training
including Social Skills Training, Assertiveness Training etc. and a combination of these
methods. Yoga and meditation appears to be one of the most frequently studied techniques
in the Indian context. Datey (1977), and Singh and Udupa (1977) threw light on the
positive effects of yogic-meditative practices on experienced stress. Various studies report
that, meditative state are consistent with relaxation and lowered stress, and this relaxation
seems to persist in experienced meditators even when they are not meditating. In addition
to this, stress reduction has been achieved by the use of behavioral techniques such as
systematic desensitization, relaxation-response techniques and problem-solving methods.

The role of relaxation, especially in reducing the physiological symptoms of stress has
been well established. The efficacy of cognitive techniques in coping has also been widely
researched. However, few studies have explored the effectiveness of a combined
meditative-relaxation and cognitive techniques in stress management intervention
paradigm. Thus, studies are required to determine the value of such an intervention
modality that it would be both time and cost effective for the Indian IT professionals, in the
working situation. The present study is a concrete step towards managing stress at
workplace, incorporating eastern and western techniques - combining cognitive behavioral
techniques with meditation relaxation for successful stress management and better living.
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Structure of the Study

The present thesis is comprised of seven chapters followed by appendices on the module of
stress management intervention employed, psychological assessment tools used and the
consent form. Chapter 1, introduction, outlines context of the study, the concept of stress in
relation to health, statement of the problem focused in the study, aim, objectives and
hypotheses, and scope of the study. The theoretical frameworks on stress and health on a
broader context along with literature on stress among IT professionals are dealt with in
Chapter 2, Chapter 3 presents a detailed review of relevant literature on organizational
stress and stress management intervention studies. The methodological frame work dealing
with sample selection, inclusion exclusion criteria, psychometric properties of the tools
used, the procedure of the study and analyses is given in Chapter 4. Analyses of the
observations, findings and their contextual significance, and a detailed discussion of the
results are illustrated in the following Chapters 5 and 6 respectively. Chapter 7 gives
summary and conclusions of the present thesis, which also includes limitations and new
scopes for further research.