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Stress is a broad term that describes a wide range of problems over a range of time periods. The experience of stress has been associated with a variety of health-related problems and behaviours. Once stress is defined, the Theory of Planned Behaviour will be explained, used to link health-risk behaviour with behavioural responses to stress using the examples of alcoholism and procrastination and will provide a theoretical framework for stress impact reduction. The theory will then be critiqued.
Stress has multiple definitions and is associated with unwanted feelings and reactions, both physical and psychological, in response to a situation which one finds daunting or dangerous, such as a demanding life event, a chronic situation, a catastrophic event or every day troubles (Govender, Petersen, & Pillay, 2016). Understanding stress involves the way people in which people consider it in its context. How the individual and environment interrelate and is termed the transactional model. When the person is initially alarmed and assesses whether the situation is stressful is the primary appraisal. Thereafter, the situation is deemed harmful, threatening or challenging. The latter two are undergo secondary appraisal: the subjective assessment of the individual’s personal coping capacity. Different people will appraise a situation differently and according to their personality type (type A, anxious, optimistic), thus emphasising the individual’s cognitive processing and the influence of the context (the personal impact of the stress, the environment) (Govender, Petersen, & Pillay, 2016).
Acute, intermittent or chronic (ranging from short to long term respectively) stress can be induced by a life changing event or an imbalance of daily troubles and uplifts known as stressors (American Psychological Association, n.d. in Govender, Petersen, & Pillay, 2016). Frustration (caused by being kept from obtaining one’s goals, conflict (in terms of choice anxiety) and societal and self-inflicted pressure are also stressors (Govender, Petersen, ; Pillay, 2016).
Stressors give rise to physical, psychological and behavioural symptoms and responses (Govender, Petersen, ; Pillay, 2016). Physical stress is associated illnesses like cardiovascular diseases, arrythmia, blood clots, compromised immune system, gastrointestinal issues, pain, muscular tension, sexual and reproductive health concerns and skin flareups. Psychologically, stress may induce insomnia, paranoia, exhaustion, depression and anxiety (Dimsdale, 2008). The general adaptation syndrome graphically illustrates the steep decline of the individual into exhaustion once their resistance to stress peaks resulting in a burnout or breakdown characterised by frequent illnesses and an attitude of apathy, irritation, anxiety and self-destruction. Behavioural responses to stress can be adaptive reactions which can positively and cathartically, or negatively address stress (Govender, Petersen, ; Pillay, 2016). Responses are categorised as being “problem-focussed” by addressing stress head-on and planning a management method, “emotion-focused” by avoiding negative emotions and “avoidance-withdrawal coping” where the individual isolates themselves socially or psychologically (Govender, Petersen, ; Pillay, 2016, 436).These responses to stress are linked to behavioural responses such as indulgence (of foods and alcohol) and are strongly associated with health-risk behaviours (addiction, lack of sleep, unsafe sexual practices and infrequent exercise) (Govender, Petersen, ; Pillay, 2016).
Because health risk behaviours, behaviours which increase one’s susceptibility to diseases (vulnerabilities), are a response to stress, stress itself is a risk factor, a combination of behaviours or conditions which increase the susceptibility of disease. Stress is thus perpetuated by and an inducer of health risk behaviours. For this reason, an analysis of the Theory of Planned Behaviour can be used to account for stress and its associated health risk behaviours and an application of the theory to reduce the impact of stress through identifying areas for intervention. However, stress impact reduction solutions are limited for reasons discussed in the critique.
The Theory of Planned Behaviour, an extension of the Theory of Reasoned Action, explains how behaviour arises from an intention to act which is influenced by one’s attitudes, the subjective norms and one’s perceived behavioural control (Govender, Petersen, & Pillay, 2016). Both theories account for the individual’s attitudes: their own beliefs about a behaviour’s possible outcome and an assessment of that outcome. The subjective norms regard what the individual thinks that other respected people believe about the behaviour and its outcome. The individual’s desire to observe those beliefs is also considered. The Theory of Planned Behaviour makes a further advancement to the Theory of Reasoned action. It incorporates the influence of the community and society on an individual’s intention to behave and their behaviour by including the contribution of how the individual perceives their own influence over a behaviour to control. This important addition reinforces society’s influence on one’s behaviour and how the individual views their abilities, freedoms and choices within a societal context (Govender, Petersen, & Pillay, 2016).
One can account for the overconsumption of alcohol as a common stress response behaviour using the Theory of Planned Behaviour (Anthenelli & Grandison, 2012). The physiological, mental, personal and social consequences being associated with liver and brain damage, violence, unlawfulness, depression, suicidal attempts, unsafe sexual behaviours and addiction as some examples makes the response behaviour a health risk behaviour (Chaveepojnkamjorn & Pichainarong, 2011). A study on a group of university students revealed that those with a lack of social support structure increased their alcohol consumption by 18.5% during times of their exam period (Steptoe, Wardle, Pollard, Canaan & Davies, 1996). The attitude that drinking alcohol reduces stress and anxiety is well known and documented (Anthenelli & Grandison, 2012). Thus, following a stressful situation, an individual may be inclined to resort to drinking alcohol believing it is effect in reducing tension and that tension reduction is needed to be calmer and more focussed in a stressful situation. Several contextual factors determine why the individual chooses alcohol over a positive behaviour such as exercise namely their genetic predisposition to alcoholism and their exposure to alcohol drinking especially in times of stress (Anthenelli & Grandison, 2012). They may not consider or realise their addictive behaviour pattern of drinking when stressed. Intervention by means of promoting positive and more beneficial stress outlets like exercise and emphasizing the risks associated with alcohol consumption would be valuable in preventing the intention and therefore the behaviour of overconsuming alcohol.
The subjective norm normalising consuming large volumes of alcohol for pleasure, especially in a young adult environment, serves as confirmation of this personal attitude contributing to the intention to drink. Steptoe, et al.’s study (1996) revealed that those with low social support increased their alcohol consumption. In the case of an individual with low social support, those who’s opinion they value are not present to reprimand their health risk behaviour despite knowing that heavy drinking is unpalatable for the family and those whose opinions they value. Thus, there is a low desire to abide by those people’s opinions and more of an inclination to drink, compounded by the pressure to comply to the social environment and drink with companions. On the other hand, those with a high social support system had a 17,5% reduction in alcohol consumption. This confirms that the opinions of their social support system are considered. Building a present, strong and encouraging social support system and an environment that values health behaviours rather than risk behaviours are therefore valuable in stress and health risk behaviour reduction.
The element of perceived behaviour control is evident in that those with an addiction often use the defence mechanism of denial: refusing to confront that they may be unable to stop drinking and are heavily reliant on it to cope (Brenton, 2009). This is especially problematic in high-functioning alcoholics. They believe they are in control of their drinking. The depressant effect of the alcohol, perceived to be positively calming, and the lack of losses that lower functioning alcoholics encounter provides a false sense of control over one’s stress (Brenton, 2009). It is thus important to bring attention to the varying types of alcoholics and the mechanisms used to rationalise control and their addiction. This should actively be pointed out to and discussed with the alcoholic by those close to the alcoholic or a psychologist.
Procrastination is another stress response behaviour and involves purposefully avoiding or delaying something (Cambridge Dictionary, 2018). Research by Baumeister and Tice (1997) revealed that students who procrastinate tend to report higher levels of stress and report over all worse sickness than their non-procrastinating counterparts making it a health risk behaviour. Procrastination is thus seen to be self-destructive (Baumeister & Tice, 1997). Procrastination occurs when faced with an unpleasant, stressful or difficult task and is therefore a stress response behaviour (Pychyl, Lee, Thibodeau and Blunt, & 2000). Additionally, procrastination increases the risk for more stress and thus further health implications (Sirois, 2007).
Research shows that students knew their procrastination negatively impacted their academics and learning ability as well as their quality of life (Solomon & Rothblum, 1984, in Pychyl et al., 2000). However, fear, stress or apathy outweighed this knowledge of the negative effects and procrastination is rationalised (making plausible excuses for doing other activities). The attitude towards procrastination is short-sighted favouring the short-term benefits over the long-term detriments. This attitude could result from an individual’s poor self-esteem, mental health, fear of the task, being deemed incompetent or low appraisal of coping abilities. Sirois (2014) explains that self-compassion mediates stress and procrastination and thus can be encouraged. The theory indicates deeper rooted issues give rise to a procrastination attitude (Beheshtifar, Hoseinifar ; Modhadam, 2011). Individuals should be encouraged to seek counselling to realise and rectify their personal issues to boost their confidence. Positive thought patterns enhance self-esteem.
Procrastination also has an organisational and societal (peers) aspect (Beheshtifar, Hoseinifar ; Modhadam, 2011). These reflect the subjective norms. One may see their employers, colleagues or peers averting a task at hand which reflects a common attitude towards procrastinating. These people are role models and thus motivation to comply with these people is high, especially because their ways confirm the individual’s attitudes and thus intention to procrastinate (Beheshtifar, Hoseinifar & Modhadam, 2011). Employers should be aware of their influence and should model the organisation and enthusiasm they wish to see in their employees. Individuals can encourage one another and collectively reshape the subjective norms and culture of their environment thereby reducing the inclination to procrastinate and therefore the impact of stress.
Different kinds of procrastinators have varying perceptions of control over the behaviour. Some confident kinds of procrastinators, “optimistic procrastinators,” (Lay, 1987 in Beheshtifar, Hoseinifar & Modhadam, 2011, p. 61) perceive their control to be sufficient as reflected in unconcerned comments like “I work best under pressure”; “the day is still young” and “there is still more time to do the job” (Beheshtifar, Hoseinifar & Modhadam, 2011, p. 62). These statements are used to justify their procrastination but rather reflect their inability to focus and need to delay the task for various reasons. On the other hand, “passive procrastinators,” being so overwhelmed (stressed) by the task at hand, procrastinate and fail to make decisions and perform the task timeously (Chu & Choi, 2005, in Beheshtifar, Hoseinifar & Modhadam, 2011, p. 61). They have a low perception of control over their procrastinating but do not know what they can do to stop procrastinating or being extremely stressed. Adequate stress management techniques suited to the type of procrastinator and their associated perceived control are thus important in providing sufficient control over stress and improving their coping abilities and trust therein.
It is challenging to practically and extensively apply the theory to stress impact reduction and so general solutions are limited. While the Theory of Planned Behaviour breaks down behaviour as caused by the intention thereof into three categories where one could intervene to reduce stress and allows for the societal influence, it does not provide practical ways of intervening. The theory merely broadly acknowledges possible considerations of an individual before executing a behaviour. Intervention at one aspect is not as powerful as in all three, thus requiring a detailed and thorough approach to intercept the intention. Additionally, the aspects are assessed by the individual in their own subjective evaluation thus intervention needs to be personalised.
Ultimately, stress, which is multifaceted, results in and from health risk behaviours. As seen with alcoholism and procrastination, the Theory of Planned Behaviour is useful in identifying areas to intercept one’s intention to perform health risk behaviours, thereby intercepting one’s behaviour before its execution which would increase one’s susceptibility to harm and ultimately reducing the impact of stress. However, the theory requires an extension of practical ways to mediate stress and health risk behaviours on a braod scale but is a valuable tool for personal intervention.

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