Understanding Stress and Its Effects
Understanding Stress and Its Effects
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An Introduction to Stress
Stress is commonly de ned as the body’s responses to the demands placed upon it. Perception
plays a very large role in the degree of stress su ered and this is discussed in detail later in
this chapter (The Stress Model). Anything that causes stress is known as a stress factor or
stressor.
It is hard to measure stress in biological terms, though the strain produced by many physical
and mental stressors can be measured in terms of alteration in blood pressure, pulse rate,
weight, change in e ciency and so on.
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varying external conditions and it contains numerous mechanisms to keep the status quo. For
Stress
example, as body heat increases, sweat is produced which, by the cooling e ect of evaporation,
cools the body in an attempt to return it to its normal temperature. As soon as outside
conditions either put strain upon these homeostatic mechanisms or are so extreme as to
nullify them, physical stress takes place.
Mental stress, however, is much harder to measure, except in special laboratory experiments.
Whereas stress is a natural requirement of life, too much stress is harmful. Animals are
designed to cope with their environment and if all forms of external stimulation are removed
they tend to pine away and even die. Experiments on volunteers kept for a considerable period
of time in a stimulus-free environment have shown that they tend to regress to an infantile
stage and may not return to normal for a considerable time. Thus it can be said that a certain
amount of stress is of fundamental importance in keeping us aware and vigilant, whereas too
much stress will degrade the performance of both body and mind.
We are all di erent and the stress level caused by a particular stressor will di er from
one individual to another. The level will largely depend on the person’s inborn and learnt
characteristics.
Stress is cumulative. If a pilot is experiencing a minor irritation or stress, his/her stress level will
increase disproportionately if another stressor is added, even though the original situation may
have been resolved. Thus if a pilot, having had an argument with a colleague on the ground,
then ies and encounters a problem on the ight deck, his/her stress level will rise to a higher
level than that if the argument had not taken place.
Experience helps ward o stress. The successful completion of a stressful task will reduce the
amount of stress experienced when a similar situation arises in the future.
In everyday life too little stimulation may lead to mental unrest. The active man, who retires
from work, frequently becomes bored and irritable; in some cases he may fail to adjust and so
develop a chronic illness.
A reasonable level of stress in our life is bene cial but a high stress level is associated with
unpleasant psychological and physiological responses such as:
• Sweating.
• Dry mouth.
• Di culty in breathing.
• Increased heart rate.
• Anxiety/apprehension.
• Fatigue.
• Fear.
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From Figure 7.1 it will be appreciated that the feedback mechanism is of great importance
in determining the amount of stress experienced on subsequent performances of the task.
Successful completion of a perceived di cult task will both reduce the perceived demand and
increase the perceived ability thus changing the original evaluation and reducing the stress and
vice versa.
One of the features of stress is that an event which causes high stress in one individual may
not have the same e ect on another. It is also a fact that something which is stressful for an
individual on one occasion may not be stressful at another time. Stress is subjective.
At low arousal levels, such as just a er waking or during extreme fatigue, the attentional
mechanism is not very active, processing of sensory information is slow and the nervous system
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is not fully functioning. The individual will have a slow environmental scan and may miss
information. Thus performance is low.
At the optimal arousal level we are at our most e cient - we have enough demands to keep
our attention and the capability to deal with complex tasks.
At high arousal levels our performance starts to deteriorate, errors are made and information
may be missed. We will su er from a narrowing of attention as we tend to focus on a limited
source of data. At very high arousal levels we experience overload as we reach a limit of
processing capacity and/or our ability to complete all the tasks. This funnels our attention to
events which we perceive as being relevant to the perceived primary task. Thus information
may be missed from important, but more peripheral and non-attended sources.
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Stress
At these high levels the attention mechanism can reject vital information solely due to overload.
OPTIMAL
LOW AROUSAL HIGH
AROUSAL AROUSAL
AROUSAL
(STRESS)
Figure 7.2 The relationship between arousal and performance (Yerkes Dodson)
These control systems are neurohormonal in their makeup and are highly self-regulated under
normal circumstances.
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Sympathetic Branch
This provides the body with the resources to cope with a new and sudden source of stress,
known as the FIGHT OR FLIGHT RESPONSE and its purpose is to prepare the body and mind
for immediate physical activity.
Parasympathetic Branch
This prolongs the body’s mobilisation, to give it time to nd a solution to the stressful situation,
and restores the body to normal functioning when the perceived danger has passed.
• Resistance.
• Exhaustion.
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This causes a massive release of sugar reserves from the liver and also brings about the following
bodily reactions:
Adrenaline causes all of the above to increase the body’s resources by increasing the energy
available. This initial defence mechanism, common to all animals, is relatively primitive - it allows
one to react physically and has only indirect e ects on the brain. These are:
Phase 2 - Resistance
This is when the parasympathetic system takes over and attempts to prolong the mobilization
of the body’s resources to give time to nd a solution. A di erent stress hormone cortisol
(cortisone) is released which assists the body to quickly convert fats to sugar to maintain the
supply of energy to the muscles.
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This hormone also acts on the brain to improve the memory of stress situations, which is why
we remember these events particularly intensely. If, however, an individual is exposed to stress
for too long, his/her energy resources become depleted.
Phase 3 - Exhaustion
Occurs over a variable period and will normally a ect only speci c parts of the body. With rest,
this exhaustion stage is temporary but, if allowed to continue without respite, it can result in
death as the defence mechanism completely shuts down.
The stress hormones, adrenaline and cortisol generate waste matter which must be eliminated.
This is not an easy process and some secondary e ects may occur. If the stress situation is coped
with successfully or the stressors are removed, the body will gradually return to its normal
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(homeostatic) state.
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It is of note that stress may be “good” or “bad” and that most stressors increase the arousal
level.
DOMESTIC
COLD PROBLEMS EMERGENCY
WORKLOAD
SEXUAL
PROBLEMS
LACK OF
TRAINING HEALTH
NOISE HEAT
MOVING
HOUSE VIBRATION
BEREAVEMENT
LOW HUMIDITY
PROMOTION MONEY LACK OF
WORRIES EXPERIENCE
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• Physiological.
• Cognitive.
• Non-professional.
• Imaginary.
• Organizational.
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Below 15°C the individual becomes uncomfortable and may lose feeling and some control in
the hands, especially for ne muscle movement.
Noise
When bored or fatigued, some noise can raise arousal levels and increase performance.
Excessive noise (above about 90 dB) will disrupt performance and cause:
• Disrupted concentration.
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in workload.
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• An increased number of crew errors.
In designing aircra warnings for system failures, care must be taken to ensure that the
aural warnings should attract attention but not startle the crew.
Vibration
Vibration may a ect the whole body, or speci c parts thereof. Any vibration will cause fatigue
and can a ect both visual and motor performance, leading to uncomfortable symptoms.
The frequency of the vibration will determine which parts are a ected and the magnitude of
the vibration will determine the severity of the symptoms.
Frequency E ects/Symptoms
8 to 12 Hz Backache.
Resonances of 30 - 40 Hz applied to the whole body will interfere with the human responses. If
applied to the head, although no physical damage is done to the eye, there is a possibility that
visual acuity may be degraded.
Resonance of the skull itself occurs at a frequency of approximately 1 - 4 Hz. This may also
a ect vision.
Helicopters can vibrate in all three axes at frequencies related mainly to rotor, gearbox and
engine speeds. Helicopter pilots will, therefore, be particularly susceptible to this stress factor.
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Low Humidity
The air conditioning system of a modern aircra draws air from outside the aircra via the
engine’s compressor. At airline operating altitudes the temperature may be as low as -30°C
to -55°C. At these temperatures the air is very dry, with a relative humidity as low as 5%.
For comfort man requires a relative humidity of 40% to 60%. At low humidity the individual
becomes uncomfortable due to drying out of the mucous membranes of the nose and throat.
Eyes become sore as the tears evaporate rapidly and the tear ducts dry. Water vapour is added
to the cabin environment during respiration, but as the air is continually replaced this will have
a limited e ect in increasing the cabin humidity. It would be possible to add water to the cabin
air but the weight penalty of extra water to be carried is not considered commercially viable.
It is not advisable to take on a lot of extra uids in these circumstances but drink only enough
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to maintain comfort.
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Note: Humidity in the cockpit typically varies between 5% and 15%. Thus ight crew should
drink su cient uids in ight to avoid dehydration. During ight, the relative humidity in the
cabin is similar to a dry summer climate or to being indoors in the wintertime.
Dry air may cause irritation of the eyes especially if contact lenses are worn and these may have
to be removed.
The humidity control system within some aircra may alleviate this problem.
• This dehydration leads to a further rise in body temperature, thus exacerbating the situation.
Typical symptoms are: muscle cramps, giddiness, and fatigue.
• Rapid increase of the heart rate and an associated need for more oxygen.
• Thirst.
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• Cell damage - especially within the brain.
• Heat stroke.
• Coma.
• The body loses water through the skin, lungs and kidneys.
Should the blood temperature rise to approximately 43°C (110°F), death will result.
Note: Generally speaking the mind and body need an average of 2 weeks to acclimatise to a hot
and humid environment.
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Stress
Extreme Cold Stress
If the core temperature drops to approximately 35°C shivering declines and eventually ceases.
• Uncontrollable shivering and an associated need for more oxygen. Around 34.5°C, the
shivering that will have started earlier will tend to cease.
• Coma.
• Death.
It is important to stress that the e ects of exposure to extreme temperatures are not restricted
to the more dramatic conditions described above. Smaller temperature variations within these
limits can have a detrimental e ect on a person’s ability to perform a task.
• Hunger.
• Thirst.
• Fatigue.
• Lack of sleep.
• Pain.
With the exception of pain, these factors are normally within the control of aircrew. It is of
fundamental importance that crews ensure they never start a period of duty with any of these
internal physiological stressors.
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• When the situation facing the pilot is unexpected and no procedure exists to resolve it.
• When the solution to the unexpected problem is realized but the pilot has insu cient time,
or is unable to apply the solution. This can occur when the pilot is “overloaded”.
• When the solution is applied but the results are not as expected and the problem remains
unsolved.
• The individual’s inborn and learnt characteristics. A pilot may be easily stressed in such
a situation either because of his personal character traits and sensitivity to stress or the
realisation that he/she possess insu cient knowledge to solve the new problem.
• The time available to solve the problem. In a dynamic situation, a lack of time is, in itself, an
additional source of stress and will o en lead to risk taking.
Bereavement
The loss of a spouse, partner or child has been found to lead to higher levels of stress than
any other event. Some airlines will ensure that a pilot su ering such a loss is removed from
ying duties for a time as they are aware that the pilot’s stress level will be so high that his/her
performance and reactions could be severely degraded.
Domestic Stress
Stress at home can a ect the pilot at work and equally stress at work can a ect the pilot’s
home life. Pilots su ering from domestic stress should be aware that this can a ect their
concentration and performance when at the controls of an aircra . Aircrew must try and use
all available facilities to ensure that they are not being a ected by this form of stress.
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Non-professional Personal Factors/Stressor Table
Evidence indicates there is a relationship between stress and health and some evidence for a
correlation between non-professional stress and the risk of an accident.
Although the stress level caused by a particular stressor will di er from one individual to
another, it is possible to make a general assessment of stress levels.
The table below gives a suggested weighting for various incidents in an average westerner’s
life. When applying such weighting to other cultures there will be some marked di erences.
Aircrew must remain sensitive to these cultural di erences.
As stress is cumulative, all of the events experienced should be added to give an indication of
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the total stress acting on any one person.
Stress
Stress Table
Death of a spouse, partner, or child 100
Divorce 73
Marital separation 65
Death of a close family member 63
Personal injury or illness 53
Marriage 50
Loss of job 47
Retirement 45
Pregnancy 40
Sexual problems 40
Birth 39
Change of nancial situation 38
Son or daughter leaving home 29
Change of eating habits 25
Change of residence 20
Taking on a bank loan or HP debt 17
Vacations 13
Minor violations of the law 11
This list is not a complete catalogue of all events which may cause stress and the weighting
given will vary according to the personal background and cultural system in which the individual
was raised. As a guide only, to indicate your own stress level, add together the marks for each
event occurring in your life in the last six months.
Scoring:
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Unpleasant events in life may be apparently completely forgotten but the anxiety associated
with them can be brought to the surface by one of the senses (a scene, noise, smell) and distort
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perception. This anxious apprehension can be strong enough so as to trigger the GAS response.
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Organizational Stress
The Organization
In the aviation industry today, nancial pressures on companies can cause pilots to work under
considerable pressure. Small unserviceabilities may be carried, duty hours stretched to the limit,
checks rushed to make a slot time, and there are many other examples. As an extreme example
of stress generated by poor management, the president of an airline which was in nancial
di culties, instructed pilots to y below the legal minima in bad weather. They were also
instructed to ignore maximum take-o weights and reduce minimum fuel reserves. As a direct
result of these decisions the airline su ered three serious accidents in a short period.
If management continually exerts pressure on its employees to operate in ways that are more
consistent with short-term monetary concerns than with safety and good practice, then the
whole company will develop ‘organizational stress’.
Stress may also arise from a long-term high work load. Airlines operate in a competitive world
and must make maximum use of sta and equipment. An aircra and crew standing idle
are not producing revenue. Even with the advances of modern ATC there will be times when
airspace and airports become overcrowded. Add to this technical delays and additional stress
is created.
Rostering of crews can also lead to stress problems. A particular pilot may have to perform an
excessive number of night ights and su er undue disruption to his home life. This, in turn,
leads to further cumulative stress.
Poor relationships and/or communications with management and colleagues, both on and o
the ight deck, leads to stress. Some cockpit voice recordings, listened to a er accidents, have
detected crew members arguing on the ight deck just prior to the accident.
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Organizational Stress Sources in Pilots
A survey of commercial pilots showed some of the main sources of stress to be:
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Of signi cance in the above list is insu cient ying. The modern airliner is most e ciently and
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economically operated by automatic control, indeed it is the policy of many airlines that the
ight management system should operate the aircra for more than 96% of its ight time.
Whilst modern systems and their back-ups are undoubtedly extremely reliable, many pilots
are worried that the systems may fail and are unsure of their ability to manage the aircra
themselves. A pilot ying the maximum allowable duty hours may have very little actual hands-
on time per month.
Stress Effects
Stress has e ects on the body, the mind, and the health and thus the performance of the
individual. The short-term e ects of a sudden source of stress will be caused by the ‘ ght or
ight’ response.
Performance
Figure 7.5 shows the relationship between stress and performance. Like the arousal/
performance graph it is an inverted U curve, however, there is a “break point”.
When there is little or no stress, there is a drop in vigilance and performance is poor. As stress
increases performance increases up to the optimum - the “break point”- a er which, if stress
continues to rise, performance is degraded.
PERFORMANCE BREAKPOINT
STRESS LEVEL
NO MEDIUM INTENSE
STRESS STRESS STRESS
MOTIVATION
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Health Effects
The long-term e ects of chronic stress damage a person’s health. The e ects are usually seen
earliest in the gastrointestinal system, and symptoms include nausea, indigestion, diarrhoea
and, a er an extended period of time, ulcers. There is evidence of a connection between stress
and coronary heart disease and high blood pressure. Those who su er stress have a higher
than normal risk of getting of asthma, headaches, sleep disorders and neuroses. They also
are much more likely to have allergies, skin diseases and tend to su er more from colds and
in uenza.
Behavioural Effects
When under stress the individual will exhibit restlessness, trembling, or may have a nervous
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laugh. There will be a tendency to take longer over tasks and there may well be excessive
changes in appetite and an increase in smoking or drinking.
Stress
Moods swings are also a common symptom of stress. Some individuals become aggressive in
the cockpit towards other members of the crew and/or outside agencies (ATC). On the other
hand, others submit to the situation with an air of resentfulness and frustration. Either way
there is a loss of exibility. Alternatively, there are some individuals who react to stress by a
tendency to rush into decisions. Fewer parameters are taken into account and, therefore, the
risk of errors is increased.
Cognitive Effects
Stress has a major e ect on the thought process with forgetfulness being an early symptom.
The ability to think and to concentrate is reduced and there is an inability to determine
priorities or make decisions. Correct actions are forgotten and procedures learnt in the past
are substituted. This is known as regression.
Fixation or “mental block,” is another symptom, where it becomes impossible to review what
has been done and consider other solutions.
A further cognitive e ect is con rmation bias, which is discussed further in Chapter 8. This is a
compulsive and repeated search for information to con rm a decision reached.
Stress causes the mind to limit its attention to only those factors it feels it can cope with and
to ignore additional inputs which may be vital in assessing a situation accurately. This loss of
situational awareness and “not being able to see the wood for the trees” has been the root
cause of many accidents.
In one case, when debriefed a er escaping successfully from a burning aircra , passengers
reported how quiet everything around them seemed to be. It was stress that caused them to
concentrate only on their escape, the screams around them were never registered.
It is commonly accepted that auditory information is the rst to be discarded under extreme
stress.
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Among any population there is a wide variation in how stress is perceived. At one extreme,
individuals suppress knowledge of problems and thereby appear not to perceive them or
require stress coping strategies. At the other extreme are those who are highly sensitive to
problems and will anticipate di culties not perceived by others and employ coping strategies
to avoid the stress experience.
• Action Coping.
• Cognitive Coping.
• Symptom Directed Coping.
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Action Coping
Stress
In action coping the individual attempts to reduce stress by taking some action. He reduces the
level of demand by either removing the problem or changes the situation so that it becomes
less demanding. For example a pilot asked to y in marginal conditions could refuse, thus
removing the immediate stressor. However, this action could lead to another stressor - loss of
employment.
The demand could be changed, however, by delaying take-o for a few hours when the weather
is forecast to improve. In this case, reducing the perceived demand of the original task, without
substituting another stressor. The individual may also hand over some tasks, either to other
crew members, or to Air Tra c Control by asking for, as an example, assistance in navigation.
The individual may remove himself from the stress situation by changing his job, or in the case
of domestic stress, by divorce. These methods may, however, only substitute one source of
stress for another. Clearly in many cases it is impossible to undertake this kind of solution.
Cognitive Coping
As action coping cannot change some situations, cognitive coping involves reducing the impact
of stress on the individual. Our brain can employ ‘defence mechanisms’ which operate outside
our conscious awareness; a system of repression or denial to prevent the conscious brain from
even becoming aware of the stressor.
Other strategies involve rationalization or detachment which may change the perceived
magnitude of the problem. “Pretend it’s a simulator detail the same as the one you did last
week” will enable the conscious mind to perceive the problem as having a solution.
It must be emphasized that only the symptoms are treated by this form of coping and that the
stressor(s) will remain until addressed separately.
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Individually one must learn and acquire experience to develop automatic responses which cost
little in energy and strongly resist stress:
• A thoroughly professional approach to training will increase the range of responses available
to the individual and will reduce the chances of meeting unknown situations. Hence the
emphasis on regular simulator ights when any emergency can be practised in a safe
environment.
• One should learn from the past, including the experience of others.
• Thorough pre ight brie ng and preparation will allow the individual to anticipate events.
The pilot must be prepared for all incidents which could, plausibly, arise during the ight.
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Stress
Crew Resource Management (CRM) will teach techniques for sharing and allocating tasks
to prevent any one individual becoming overloaded and will highlight the e ective use of all
members’ knowledge to increase the range of possible responses. It should improve everyone’s
awareness of the situation, and, by combined e orts, allow for the creation of new ideas.
A good atmosphere on the ight deck is a great help in a stressful situation and humour can
be an e ective antidote to stress.
and
• Relaxation Techniques
Meditation, self-hypnosis, yoga, and biofeedback can all help to reduce tension by mental
and physical (muscle) relaxation or control of heart rate and blood pressure.
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• Religious Practice
For many people some form of religious practice will help to cope with stress, particularly if
it is a major life event such as bereavement, accident or chronic illness. There are, however,
some possible dangers if the particular belief is of a fatalistic nature. “It is in the hands of
God” may prevent some individuals from trying to resolve their own problems.
• Counselling Techniques
Many individuals will bene t not only from professional counselling but also from just
talking to their friends or colleagues. It will help to reduce feelings of inadequacy if they
know that others nd a particular task di cult.
The basic principle behind counselling is that, since stress is caused by an individual’s perception
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of a situation, the stress will be reduced if the individual can be made to change the way he/
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she perceives or reacts to the situation by changing or modifying his/her beliefs or assumptions
about the event (cognitive coping). Counselling may also assist an individual to see that some
behavioural change may be necessary (action coping), and help bring about that change.
An individual, such as a pilot, who must demonstrate authority and control in his work may
show some reluctance to ‘admit’ that he is experiencing problems with stress. He may fear that
the admission of being under stress might be interpreted as weakness or a lack of competence.
All pilots should be aware that stress can in uence performance on the ight deck, particularly
in an emergency, and take positive steps to deal with the stress if they feel they are a ected
by it.
Note: Evidence that people under stress o en smoke more, overeat or increase alcohol/ca eine
consumption has led to the theory that apparent self-abusive behaviours may actually be forms
of stress management.
Stress Summary
Stress is simply a fact of life. We all require some stress to activate our nervous system, to
stimulate us and allow us to adapt. It is only when the stress is high or sudden that it can
become destructive and may exceed our abilities to adapt. Stress encountered in our daily lives
is cumulative and depletes our reserves. However, a lack of stimuli may be just as bad since this
encourages anxiety.
Although it is extremely di cult to eliminate stress, we can, through training and other
techniques, increase our resistance to it. Stress coping can be either short-term (action coping)
or long-term Stress Management (a change of lifestyle or counselling) depending on the
situation. The rst step is, however, to recognize and admit to oneself that the condition exists.
Although the stress mechanism is mainly physiological and triggered as a defence mechanism
to help us survive, coping strategies to deal with stress are mainly psychological.
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