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Table of Contents
ORIGINAL ARTICLE
Year : 2019  |  Volume : 51  |  Issue : 3  |  Page : 102-106

To investigate the relationship between psychological factors and stress in two different developmental stages in adults: A cross sectional study


Occupational Therapy Training School and Centre, L.T.M.M.C and GH, Sion, Mumbai, Maharashtra, India

Date of Submission31-Mar-2019
Date of Acceptance06-Jun-2019
Date of Web Publication20-Sep-2019

Correspondence Address:
Dr. Sushant Deepak Sarang
566, Sector New 50, Soham Plot 66, Sector New 50, Nerul, Navi Mumbai - 400 706, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijoth.ijoth_8_19

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  Abstract 


Background: Stress can cause significant impact on social and occupational participation. This study aimed to investigate association between psychological factors (six factors of psychological well-being [PSW] and self-reported mindfulness) and perceived stress. Further, the study aimed to compare the relationship of psychological factors and stress between Erick Erickson's two adult developmental stages, i.e., intimacy versus isolation (19–40 years) and generativity versus stagnation (40–65 years). Objectives: To measure PSW (six factors), mindfulness, and perceived stress in people from the two developmental stages, to study the correlation between psychological factors (the six factors of PSW and mindfulness) and stress in each group, and to compare the relation between psychological factors and stress in these two developmental stages. Study Design: A cross-sectional study design was chosen for the research. Methods: Males and females belonging to intimacy versus isolation (19–40 years) and generativity versus stagnation (40–65 years) stages of Erick Erikson's classification of development were included in the study. Written informed consent was taken from all the participants. Paper-based version of Perceived Stress Scale (PSS), mindful attention awareness scale (MAAS), and Ryff's PSW scale were administered. The scores obtained on PSS, MAAS, and Ryff's PSW were compared. Results: Individuals belonging to the intimacy vs. isolation stage (19-40 years) and generativity vs. stagnation (40-65 years) stage of development showed a significant correlation between psychological factors and stress, with a significant correlation (P = 0.010, 95% CI: 187.600-169.080) in the intimacy vs. isolation stage and (P = 0.005, 95% CI: 165.004-155.136) in the generativity vs. stagnation stage. Conclusions: Individuals in the generativity versus stagnation (40–65 years) stage are more stressful than those in intimacy versus isolation stage (19–40 years) stage. Thus, practicing mindfulness and being mindful helps us to deal with stress better.

Keywords: Erick Erickson's Developmental Stages, Mindfulness, Perceived Stress, Psychological Well-Being


How to cite this article:
Sarang SD, Karnam AG, Shitole RB. To investigate the relationship between psychological factors and stress in two different developmental stages in adults: A cross sectional study. Indian J Occup Ther 2019;51:102-6

How to cite this URL:
Sarang SD, Karnam AG, Shitole RB. To investigate the relationship between psychological factors and stress in two different developmental stages in adults: A cross sectional study. Indian J Occup Ther [serial online] 2019 [cited 2019 Oct 22];51:102-6. Available from: http://www.ijotonweb.org/text.asp?2019/51/3/102/267482




  Introduction Top


Stress is defined as “a state of psychological and physiological imbalance resulting from the disparity between situational demand and the individual's ability and motivation to meet those needs.”1 Different age groups experience stress at some point of time in their lifetime.[2]

Erikson's model of psychosocial development is a very significant, highly regarded, and meaningful concept. Life is a series of lessons and challenges which help us to grow. Erikson's theory helps to tell us why.3 Psychological well-being (PSW) is the dynamic and active process that gives a sense of knowledge to the people about how their lives are enduring the interaction between their circumstances, activities, and psychological resources or mental capital.4 Carol Ryff developed the six-factor model of PSW which determines six factors which contribute to an individual's PSW.5

Mindfulness involves the self-regulation of attention to the experience of the present moment and nonjudgmental awareness having its roots in Buddhist philosophy whose construct goes beyond religious concepts.[6],[7] Mindfulness can be improved by attention training and meditation.[7],[8] Mindfulness has proved to be a protective characteristic, showing negative correlations with stress and positive correlations with well-being.9

Individuals in the two adult developmental stages (i.e., isolation vs. intimacy and generativity vs. stagnation) differ in that they both try to resolve conflicts that arise in their respective developmental stages. The success or failure to resolve those conflicts structures the basic personality of that individual which in turn determines the PSW of that individual and how they perceive stress. This study was thus aimed to help us acquire any such relationship between the psychological factors (the six factors of PSW and mindfulness) and stress.


  Methods Top


Study Design

A cross-sectional study design was chosen for the research. Adults (n = 60) comprised of males and females belonging to the isolation versus intimacy stage (n = 30: 3 males and 27 females) and generativity versus stagnation stage (n = 30: 5 males and 25 females) of Erick Erickson's developmental stages.[10]

Inclusion and Exclusion Criteria

Adults in their productive age group, i.e., males and females falling in intimacy versus isolation (19–40 years) and generativity versus stagnation (40–65 years) stages of Erick Erickson's classification of developmental stages were included in the study. Adults diagnosed with any physical or mental illness and currently receiving treatment for the same were excluded from the study. Also, adults hospitalized due to any physical or mental illnesses were excluded from the study.

Procedure and Ethics

Approval for the study was taken from Institutional Ethics Committee. Data were collected between September 2018 and October 2018 at a tertiary care municipal corporation hospital. All the participants were explained about the study and were asked to sign an informed consent form. After the informed consent was taken from all the participants, they were asked to fill up the three questionnaires, i.e., the mindful attention awareness scale (MAAS), Perceived Stress Scale (PSS), and Ryff's PSW scale. A convenience sampling method was used for data collection. The majority of adults from the intimacy versus isolation stage who participated in the study were undergraduate, graduate, and postgraduate students pursuing bachelors and masters in occupational therapy and the adults in the generativity versus stagnation stage were working women, therapists, and clerks at a tertiary care municipal corporation hospital.

Outcome Measures

The MAAS is a unidimensional, 15-item instrument, rated on a 6-point Likert scale (almost always to almost never). Higher scores indicate increased mindfulness, related to the level of awareness and attention to present events.[11]

PSS is a 14-item instrument rated on a 4-point Likert scale (almost never to always), which evaluates the perception of stressful events. An example item is, “in the last month, how often have you felt nervous and stressed?” We added the scores of all questions to calculate total scores, inversely calculating items with positive connotation against the stress (0 = 4, 1 = 3, 2 = 2, 3 = 1, and 4 = 0). The PSS has adequate internal consistency (α = 0.82).[10]

The Ryff's PSW scale of measurement is a psychometric inventory consisting of 42 items in which respondent's rate statements on a scale of 1–6, where 1 indicates strong disagreement and 6 indicates strong agreement. The Ryff Scale is based on six factors, specifically, PSW autonomy (PSWa), PSW environmental mastery (PSWe), PSW personal growth (PSWpg), PSW positive relations with others (PSWpr), PSW purpose in life (PSWpr), and PSW self-acceptance (PSWs). Higher total scores indicate higher PSW.[12]

Data Analysis

Data analysis was done using windows-based R Programming created by Ross Ihaka and Robert Gentleman at University of Aukland, New Zealand and developed by R Development Core team. The mean and standard deviation (SD) of the participant's age were calculated. A mean and SD of the PSS scores, MAAS, and Ryff's PSW scale for the two groups were calculated. A Pearson's correlation test was used to determine the correlation between perceived stress and the psychological factors (mindfulness and the six factors of PSW) in the two groups. A Wilcoxon rank test was used to evaluate the relation between stress and age. Stress levels of two independent age groups, i.e., 19–40 years (isolation vs. intimacy stage) and 40–65 years (generativity vs. stagnation stage) were tested using Mann–Whitney U-test to evaluate the variation in stress level between the two groups. The level of significance set at the outset of the study was P < 0.05, and 95% confidence interval (CI) values were computed.


  Results Top


Of the adults who participated in the study and who belonged to isolation versus intimacy stage of Erick Erickson's stage of development (n = 30), 3 (10%) were males and 27 (90%) females with a mean age of 25.73 years and a SD of 6.522. The generativiy versus stagnaton stage (n = 30) consisted of 5 (16.66%) males and 25 (83.34%) females with a mean age of 47.89 years and SD of 4.482 [Table 1].
Table 1: Characteristics of Participants

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Associations between Mindfulness, Stress, and Psychological Well-being

As per [Table 2], the results display a strong correlation between stress (PSS) and mindfulness (MAAS) (P = 0.001, 95% CI: 4.723–3.543). Also, PSWpg (P = 0.002, 95% CI: 34.858–31.142), PSWpr (P = 0.034, 95% CI: 32.610–27.590), PSWp (P = 0.041, 95% CI: 33.574–29.826), and PSWs (P = 0.002, 95% CI: 32.455–28.065) were correlated with stress. The test concluded a strong correlation between the psychological factors and stress. On the other hand, PSWa and PSWe were not found to be significant with stress in this group.
Table 2: Correlation of Stress with Psychological Factors (the Six Dimensions of Psychological Well-being and Mindfulness) in Isolation versus Intimacy Stage

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When perceived stress and psychological factors were compared in the generativity versus stagnation stage, the results displayed a strong correlation between stress and MAAS (P = 0.000, 95% CI: 4.382–3.602). Also, PSWa (P = 0.000, 95% CI: 29.486–27.252), PSWe (P = 0.000, 95% CI: 29.482–28.058), PSWpg (P = 0.000, 95% CI: 28.454–26.856), PSWpr (P = 0.002, 95% CI: 28.918–27.358), and PSWs (P = 0.000, 95% CI: 32.082–29.504) were correlated with stress. The test concluded a strong correlation between the psychological factors and stress. On the other hand, PSWp was not found to be significant with stress in this group [Table 3].
Table 3: The Correlation between Stress and Psychological Factors (The Six Dimensions of Psychological Well-Being and Mindfulness) in Generativity versus Stagnation Stage

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  Discussion Top


This study aimed at comparing the relationship between perceived stress and psychological factors (six dimensions of PSW and mindfulness) in Erick Erickson's two adult developmental stages, i.e., intimacy versus isolation and generativity versus stagnation stages.

Perceived stress is the feeling or thoughts that an individual has about how much stress they are under at a given point in time or over a given time period.[13] Mindfulness is the quality or state of being conscious or aware. Isolation versus intimacy stage (19–40 years) is one of Erick Erickson's adult developmental stage wherein people strive to develop close, committed relationships with others and also to maintain good emotional and physical health.[13] On the other hand, in the generativity versus stagnation stage (40–65 years), adults strive to create or nurture things that will outlast them; often by parenting children or contributing to positive changes that benefit other people.[14]

When focused on perceived stress and mindfulness in the two adult developmental stages, the results showed that perceived stress had a negative effect on mindfulness in both the groups. The majority of population in the isolation versus intimacy stage comprised of students and young professionals, which might be the reason for increased perceived stress. Students have to undergo various challenges in academics; worrying about future goals and building strong relationships with others. A cross-sectional study conducted on medical students in Saudi Arabia to determine the prevalence, sources, and predictors of high stress levels and burnout among medical students, concluded that the most common reason of stressor in students were concern about the future, defective clinical practice skills, fear of harming patients, and high parental expectations.[14] On the other hand, majority of adults in the generativity versus isolation stage were working females. Work is known to add stress. Furthermore, in this stage, looking after family is an added responsibility which in turn adds to stress. A study conducted in India on occupational stress at workplaces, concluded that 87% of the respondent felt stressed due to work-related issues.[15]The correlation between perceived stress and mindfulness in these two adult developmental stages in the current study can be supported by the study conducted on Chinese adults (18–66 years) that associated dispositional mindfulness, emotional intelligence, and perceived stress and concluded that mindfulness was negatively associated with perceived stress.[16]

When focused on relationship between perceived stress and the six factors of PSW in the intimacy versus isolation stage (19–40 years), the results showed a significant correlation between perceived stress on positive relations in life, personal growth, purpose in life, and self-acceptance while there was no significant correlation with autonomy and environmental mastery. As mentioned earlier, majority of adults in this group consisted of students. During this phase, individuals seek to form strong relations with others which can be long lasting. Hence an individual looks for positive relations with others, developing and executing new skills that are required to excel in academics and at work resulting in personal growth. Inability to maintain positive relations and develop skills may lead to increased perceived stress or vice-a-versa. An individual in this phase is prone to think about future goals and might be looking for a purpose in life related to work, academics, or career, which influences the levels of perceived stress. Thus, people who can set goals for their future and work toward them might experience less levels of perceived stress.[17]

A study conducted by Brough states that college students may be at greater risk for stress and consequentially, at risk for decreased mental and physical health.[18] Stress is not only the most frequently cited barrier to academic performance but it has also been shown to be associated with depression, eating disorders and obesity in student populations.[19],[20],[21],[22],[23],[24]

On the other hand, when perceived stress and the six factors of PSW were compared in the generativity versus stagnation stage (40–65 years), there was a significant co-relation between perceived stress and positive relations in life, personal growth, and self-acceptance, autonomy, and environmental mastery. There was no significant correlation between perceived stress and purpose in life. The mean age in this group was found to be around 47 years and majority of adults comprised of working females. In this stage people experience a need to create or nurture things that will outlast them, often having mentees or creating positive changes that will benefit other people. They want to give back to society through raising children, being productive at work, and becoming involved in community activities and organizations. The majority of participants of the current study comprised of adults who were working and married females. They might need to maintain a good relationship with their children or with colleagues at workplace to maintain positive relations. Failure to do so leads to increased levels of perceived stress. Also, as a parent, colleague, or employee, one needs to have a sense of mastery and competence in managing the environment, control complex array of external activities, and make effective use of surrounding opportunities to give oneself a sense of control over the environment. Perceived stress thus increases when one is unable to effectively control the environment. Work and family care offers an opportunity for personal growth in this stage. Individuals gain growth through promotions, nurturing their children and going a step beyond their capacities. Lack of personal growth leads to higher perceived stress.[25]

A study conducted by Vemuri stated that the conflict of women will be all the more intense if her employer, as well as her family members held unreasonable expectations from her. Women's involvement in multiple role had a deleterious effect on their mental as well as their physical health. Due to this, a woman is constantly under stress either at home or at workplace.[26]

Limitations

A small sample size and uneven distribution of gender are the limitations of the study.

Future Suggestions

The results can be used to develop specific intervention programs in the two adult developmental stages.


  Conclusions Top


The study highlights the dynamics involving the association between psychological factors (mindfulness and six actors of PSW) and perceived stress across two developmental stages in adults. It can be thus concluded that psychological factors (mindfulness and six factors of PSW) and stress are inversely correlated to each other in the two adult stages of isolation versus intimacy and generativity versus stagnation. In the isolation versus intimacy stage, the PSW factors of environmental mastery and autonomy have no significant correlation with stress. In generativity versus stagnation stage, the PSW factors of purpose in life have no significant correlation with stress. Since mindfulness and stress were inversely correlated; we can thus conclude that practicing mindfulness will help respond to stress better.

Acknowledgments

We sincerely thank Dr. Mrs. Mondkar, Dean LTMMC and LTMGH for granting permission to conduct this study. We would like to express sincere gratitude to Dr. Rashmi Yeradkar, Associate Professor and Incharge for her kind support and allowing us to conduct the study.

Financial Support and Sponsorship

Nil.

Conflicts of Interest

There are no conflicts of interest.



 
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