FIRST PAGES. Comprehensive Stress Management

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1 FIRST PAGES Comprehensive Stress Management gre29621_fm_i-xviii.indd i 07/15/06 00:16:38

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3 FIRST PAGES Comprehensive Stress Management TENTH EDITION Jerrold S. Greenberg University of Maryland Boston Burr Ridge, IL Dubuque, IA Madison, WI New York San Francisco St. Louis Bangkok Bogotá Caracas Kuala Lumpur Lisbon London Madrid Mexico City Milan Montreal New Delhi Santiago Seoul Singapore Sydney Taipei Toronto gre29621_fm_i-xviii.indd iii 07/15/06 00:16:40

4 COMPREHENSIVE STRESS MANAGEMENT Published by McGraw-Hill, a business unit of The McGraw-Hill Companies, Inc., 1221 Avenue of the Americas, New York, NY Copyright 2008, 2006, 2004, 2002, 1999, 1996, 1993, 1990, 1987, 1983 by The McGraw-Hill Companies, Inc. All rights reserved. No part of this publication may be reproduced or distributed in any form or by any means, or stored in a database or retrieval system, without the prior written consent of The McGraw-Hill Companies, Inc., including, but not limited to, in any network or other electronic storage or transmission, or broadcast for distance learning. Some ancillaries, including electronic and print components, may not be available to customers outside the United States. This book is printed on acid-free paper CCI/CCI ISBN-13: ISBN-10: Vice President and Editor-in-Chief: Emily Barrosse Senior Sponsoring Editor: Christopher C. Johnson Freelance Development Editor: Kelly Wagner Editorial Assistant: Sarah B. Hill Executive Marketing Manager: Pamela S. Cooper Managing Editor: Jean Dal Porto Project Manager: Ruth Smith Art Editor: Katherine McNab Designer: Srdjan Savanovic Cover: TBD Photo Research Coordinator: Natalia C. Peschiera Media Producer: Michele Borrelli Production Supervisor: Janean A. Utley Composition: 10.5/12 Minion, by Techbooks Printing: 45 # Pub Matt, e Courier Credits: The credits section for this book begins on page and is considered an extension of the copyright page. INSERT CIP The Internet addresses listed in the text were accurate at the time of publication. The inclusion of a website does not indicate an endorsement by the authors or McGraw-Hill, and McGraw-Hill does not guarantee the accuracy of the information presented at these sites. gre29621_fm_i-xviii.indd iv 07/15/06 00:16:42

5 If I were asked to choose the best way to manage stress, I would probably choose communicating with other people and obtaining social support from them. For this to occur, though, people have to make themselves available to provide that support, meaning they have to sacrifice a good deal of their own time, effort, and energy. That is why this book is dedicated to my wife, Karen. Karen is social support incarnate. She is caring, concerned, considerate, loving, and available to friends, family, and even acquaintances. That is why she is sought out by people in her world who encounter problems and need a sympathetic ear to listen. To recognize this extraordinary person, whom I am fortunate to have in my life, and to acknowledge that sympathetic ear, that loving person, that stressbuster, I dedicate this book with love. gre29621_fm_i-xviii.indd v 07/15/06 00:16:42

6 brief table of contents brief table of contents part 1 Scientific Foundations Chapter 1 What is Stress? Chapter 10 Autogenic Training and Imagery Chapter 11 Progressive Relaxation Chapter 2 Stress Psychophysiology Chapter 3 Stress and Illness/Disease part 2 General Applications: Life-Situation and Perception Interventions Chapter 4 Intervention Chapter 5 Life-Situation Interventions: Intrapersonal Chapter 6 Life-Situation Interventions: Interpersonal Chapter 7 Perception Interventions Chapter 8 Spirituality and Stress part 3 General Applications: Relaxation Techniques Chapter 9 Meditation Chapter 12 Other Relaxation Techniques part 4 General Applications: Physiological Arousal and Behavior Change Interventions Chapter 13 Physiological Arousal Interventions: Exercise Chapter 14 Strategies for Decreasing Stressful Behaviors Chapter 15 Diversity and Stress part 5 Specific Applications Chapter 16 Occupational Stress Chapter 17 Stress and the College Student Chapter 18 Family Stress Chapter 19 Stress and Older Adults gre29621_fm_i-xviii.indd vi 07/15/06 00:16:42

7 Preface xiv part 1 Scientific Foundations CHAPTER 1 WHAT IS STRESS? The Pioneers Stress Theory Life-Events Theory Hardiness Theory Social Support Theory The Stressor Stress Reactivity Gender Differences in Reactivity A Definition of Stress Stress Management Goals The Way to Use This Book Your Personal Stress Profile and Activity Workbook The Stress Portfolio Getting Involved in Your Community Boxes SUMMARY NOTES INTERNET RESOURCES COPING IN TODAY S WORLD LAB ASSESSMENT 1.1: WHY DO SOME OF YOUR STRESSORS RESULT IN A STRESS RESPONSE? CHAPTER 2 STRESS PSYCHOPHYSIOLOGY The Brain The Endocrine System The Autonomic Nervous System The Cardiovascular System The Gastrointestinal System The Muscles The Skin Symptoms, Stress, and You SUMMARY NOTES INTERNET RESOURCES COPING IN TODAY S WORLD LAB ASSESSMENT 2.1 HOW MUCH DO YOU KNOW ABOUT STRESS PSYCHOPHYSIOLOGY? table of contents table of contents LAB ASSESSMENT 2.2 WHAT ARE YOUR PHYSIOLOGICAL REACTIONS TO STRESS? CHAPTER 3 STRESS AND ILLNESS/DISEASE Hot Reactors Psychosomatic Disease Stress and the Immunological System Stress and Serum Cholesterol Specific Conditions Hypertension Stroke Coronary Heart Disease Ulcers Migraine Headaches Tension Headaches Cancer Allergies, Asthma, and Hay Fever Rheumatoid Arthritis Backache TMJ Syndrome Posttraumatic Stress Disorder Stress and Other Conditions SUMMARY NOTES INTERNET RESOURCES COPING IN TODAY S WORLD LAB ASSESSMENT 3.1: DO YOU KNOW WHAT TO DO FOR POSTTRAUMATIC STRESS DISORDER? part 2 General Applications: Life-Situation and Perception Interventions CHAPTER 4 INTERVENTION A Model of Stress Feedback Loops in the Stress Model Setting Up Roadblocks Comprehensive Stress Management Eustress and the Model gre29621_fm_i-xviii.indd vii 07/15/06 00:16:42

8 Taking Control Making a Commitment SUMMARY INTERNET RESOURCES COPING IN TODAY S WORLD LAB ASSESSMENT 4.1: WHAT EUSTRESSORS HAVE YOU EXPERIENCED? CHAPTER 5 LIFE-SITUATION INTERVENTIONS: INTRAPERSONAL Eliminating Unnecessary Stressors Nutrition and Stress Noise and Stress Life Events and Stress Hassles and Chronic Stress Success Analysis SUMMARY NOTES INTERNET RESOURCES COPING IN TODAY S WORLD LAB ASSESSMENT 5.1 WHAT IS YOUR RESTING METABOLIC RATE (RMR)? LAB ASSESSMENT 5.2 WHAT STRESSFUL EVENTS DO YOU EXPERIENCE? LAB ASSESSMENT 5.3 ARE YOUR LIFE EVENTS UNHEALTHY? LAB ASSESSMENT 5.4 WHAT HASSLES DO YOU ENCOUNTER? CHAPTER 6 LIFE-SITUATION INTERVENTIONS: INTERPERSONAL Asserting Yourself Nonverbal Assertiveness Verbal Assertiveness Conflict Resolution Communication Nonverbal Communication Verbal Communication Time Management Assessing How You Spend Time Setting Goals Prioritizing Scheduling Maximizing Your Rewards Saying No Delegating Evaluating Tasks Once Using the Circular File Limiting Interruptions Investing Time Social Support Networking SUMMARY NOTES INTERNET RESOURCES COPING IN TODAY S WORLD LAB ASSESSMENT 6.1 HOW ASSERTIVE ARE YOU? LAB ASSESSMENT 6.2 HOW DO YOU RESOLVE CONFLICTS? LAB ASSESSMENT 6.3 HOW IS YOUR SOCIAL SUPPORT? CHAPTER 7 PERCEPTION INTERVENTIONS Selective Awareness Stop to Smell the Roses Perspective and Selective Awareness An Attitude of Gratitude Humor and Stress Type A Behavior Pattern Self-Esteem Locus of Control Anxiety Management Test Anxiety Trait and State Anxiety Panic Disorder Social Phobia (Social Anxiety Disorder) Specific Phobias Coping Techniques Hardiness SUMMARY NOTES INTERNET RESOURCES COPING IN TODAY S WORLD LAB ASSESSMENT 7.1 ARE YOU A TYPE A? LAB ASSESSMENT 7.2 HOW IS YOUR SELF-ESTEEM? LAB ASSESSMENT 7.3 HOW IS YOUR PHYSICAL SELF-ESTEEM? LAB ASSESSMENT 7.4 WHAT IS YOUR LOCUS OF CONTROL? LAB ASSESSMENT 7.5 WHAT IS YOUR LEVEL OF ANXIETY? LAB ASSESSMENT 7.6 WHAT IS YOUR LEVEL OF TEST ANXIETY? LAB ASSESSMENT 7.7 WHAT IS YOUR LEVEL OF SOCIAL PHYSIQUE ANXIETY? LAB ASSESSMENT 7.8 DO YOU HAVE IRRATIONAL BELIEFS? viii Table of Contents gre29621_fm_i-xviii.indd viii 07/15/06 00:16:43

9 CHAPTER 8 SPIRITUALITY AND STRESS Spiritual Health Religion and Spirituality Spirituality and Health How Spirituality and Religion Affect Health Control Theory Social Support Theory Spirituality, Social Support, and Terrorism Placebo Theory Forgiveness and Health Volunteerism as a Spiritual and Healthy Activity Service-Learning: A Spiritual and Academic Activity Closing Thoughts on Spirituality, Health, and Managing Stress SUMMARY NOTES INTERNET RESOURCES COPING IN TODAY S WORLD LAB ASSESSMENT 8.1: HOW SPIRITUAL ARE YOU? part 3 General Applications: Relxation Techniques CHAPTER 9 MEDITATION What Is Meditation? Types of Meditation Benefits of Meditation Physiological Effects Psychological Effects How to Meditate Making Time for Meditation SUMMARY NOTES INTERNET RESOURCES COPING IN TODAY S WORLD LAB ASSESSMENT 9.1 IS MEDITATION FOR YOU? CHAPTER 10 AUTOGENIC TRAINING AND IMAGERY What Is Autogenic Training? Benefits of Autogenic Training Physiological Effects Psychological Effects How to Do Autogenic Training Prerequisites Body Position Six Initial Stages of Autogenic Training Imagery An Autogenic Training Experience SUMMARY NOTES INTERNET RESOURCES COPING IN TODAY S WORLD LAB ASSESSMENT 10.1 IS AUTOGENIC TRAINING FOR YOU? CHAPTER 11 PROGRESSIVE RELAXATION Bracing What Is Progressive Relaxation? Benefits of Progressive Relaxation Physiological Effects Psychological Effects How to Do Progressive Relaxation Cues Identifying Tension Prerequisites Body Position Exercises Other Short Exercises SUMMARY NOTES INTERNET RESOURCES COPING IN TODAY S WORLD LAB ASSESSMENT 11.1 IS PROGRESSIVE RELAXATION FOR YOU? CHAPTER 12 OTHER RELAXATION TECHNIQUES Biofeedback Benefits of Biofeedback How to Relax Using Biofeedback How to Arrange for Biofeedback Training Diaphragmatic Breathing Body Scanning Massage and Acupressure Yoga and Stretching Repetitive Prayer Quieting Reflex Instant Calming Sequence Mindfulness Music and Relaxation Tai Chi Pets and Stress Table of Contents ix gre29621_fm_i-xviii.indd ix 07/15/06 00:16:43

10 SUMMARY NOTES INTERNET RESOURCES COPING IN TODAY S WORLD LAB ASSESSMENT 12.1: HOW DO YOU CAUSE STRESS, AND WHAT WILL YOU DO ABOUT IT? LAB ASSESSMENT 12.2: PETS: TRESS BUSTERS IN SPITE OF IT ALL? part 4 General Applications: Physiological Arousal and Behavior Change Intervention CHAPTER 13 PHYSIOLOGICAL AROUSAL INTERVENTIONS: EXERCISE Exercise and Health Aerobic and Anaerobic Exercise Physical Health Psychological Health Can Physical Fitness and Exercise Make You Smarter? The Healthy Way to Exercise Principles of Exercise Intensity, Frequency, and Duration Assessing Your Cardiorespiratory Fitness Starting an Exercise Program How to Exercise Do s and Don ts Competition and Enjoyment Choosing an Exercise Program Swimming Rope Jumping Bicycling Walking Jogging Aerobic Dance Low-Impact Aerobic Dance Stretching Weight Training Exercise and the Elderly Where to Get More Information Exercise Keeping It Going SUMMARY NOTES INTERNET RESOURCES COPING IN TODAY S WORLD LAB ASSESSMENT 13.1: CAN YOU OVERCOME ROADBLOCKS TO EXERCISE? LAB ASSESSMENT 13.2: CAN YOU DIFFERENTIATE BETWEEN EXERCISE MYTHS AND FACTS? CHAPTER 14 STRATEGIES FOR DECREASING STRESSFUL BEHAVIORS Health and Lifestyle Behaviors Health-Behavior Assessment Selected Lifestyle Behaviors Barriers to Action Locus of Control Methods for Decreasing Stressful Behaviors Self-Monitoring Tailoring Material Reinforcement Social Reinforcement Social Support Self-Contracting Contracting with a Significant Other Shaping Reminders Self-Help Groups Professional Help Application of Behavior Change Techniques Example: Exercise Behavior Change Theories and Stress Stages of Change Theory Self-Efficacy Theory The Theory of Reasoned Action and the Theory of Planned Behavior SUMMARY NOTES INTERNET RESOURCES COPING IN TODAY S WORLD LAB ASSESSMENT 14.1 ARE YOUR BEHAVIORS HEALTHY? LAB ASSESSMENT 14.2 ARE YOUR LIFESTYLE BEHAVIORS HEALTHY? LAB ASSESSMENT 14.3 WHAT ARE YOUR BARRIERS TO BEHAVING HEALTHFULLY? LAB ASSESSMENT 14.4 HOW MUCH CONTROL DO YOU HAVE? CHAPTER 15 DIVERSITY AND STRESS Minority Defined Positive Aspects of Minority Status An Introduction to the Descriptions of Problems Faced by Minorities Stressors Challenging Minorities x Table of Contents gre29621_fm_i-xviii.indd x 07/15/06 00:16:43

11 Health Status National Health Objectives and Diversity Infant Mortality Life Expectancy Years of Potential Life Lost High Blood Pressure Acquired Immune Deficiency Syndrome (AIDS) Cancer Mental Health Poverty and Educational Level Family Life Homelessness Family Structure Age and Physical Disability Elders People with Disabilities SUMMARY NOTES INTERNET RESOURCES COPING IN TODAY S WORLD LAB ASSESSMENT 15.1: HOW HAS PREJUDICE AFFECTED YOUR LEVEL OF STRESS? LAB ASSESSMENT 15.2: WHAT BIASES DO YOU POSSESS? part 5 Specific Applications CHAPTER 16 OCCUPATIONAL STRESS Occupational Stress Cycle What Is Occupational Stress? Why Is Occupational Stress of Concern? Gender and Occupational Stress Disease and Occupational Stress Physiological Effects Disease States Psychological Effects Occupational Stressors Lack of Participation Role Problems Job Dissatisfaction The Work Environment The Workaholic Burnout Women and Work Outside the Home Sexual Harassment at Work Working in the Home Interventions Life-Situation Interventions Perception Interventions Emotional Arousal Interventions Physiological Arousal Interventions Managing Occupational Stress SUMMARY NOTES INTERNET RESOURCES COPING IN TODAY S WORLD LAB ASSESSMENT 16.1 DO YOU HAVE OCCUPATIONAL STRESS? LAB ASSESSMENT 16.2 ARE YOU A WORKAHOLIC? LAB ASSESSMENT 16.3 DO YOU HAVE BURNOUT OR BROWNOUT? CHAPTER 17 STRESS AND THE COLLEGE STUDENT The Younger College Student Lifestyle Change Grades Course Overload Finances Friendship Love Sex HIV/AIDS Other Sexually Transmitted Infections Date Rape Shyness Jealousy Breakups The Older College Student Career and School Family and School Self-Doubt The Minority College Student Interventions Life-Situation Interventions Perception Interventions Emotional Arousal Interventions Physiological Arousal Interventions SUMMARY NOTES INTERNET RESOURCES COPING IN TODAY S WORLD LAB ASSESSMENT 17.1 HOW INTIMATE ARE YOUR FRIENDSHIPS? LAB ASSESSMENT 17.2 WHAT TYPE OF LOVER ARE YOU? Table of Contents xi gre29621_fm_i-xviii.indd xi 07/15/06 00:16:43

12 CHAPTER 18 FAMILY STRESS The Family Needs Satisfied by the Family The Effective Family The Changing Family Marriage Cohabitation Divorce Single-Parent Families Gay and Lesbian Families Family Stressors The Dual-Career Family Children Family Planning Adoption Mobility Violence: A Family Matter Financial Stressors Other Stressors A Model of Family Stress Interventions Life-Situation Interventions Financial Stress Interventions Perception Interventions Emotional Arousal Interventions Physiological Arousal Interventions SUMMARY NOTES INTERNET RESOURCES COPING IN TODAY S WORLD LAB ASSESSMENT 18.1 ARE YOU READY FOR MARRIAGE? LAB ASSESSMENT 18.2 HOW DO YOU VIEW ABORTION? Adjustment in the Later Years Erik Erikson: Life Crises Robert Havighurst: Developmental Tasks Positive Change Exercise and the Elderly Retirement Caregiving Death and Dying Death Dying Grief Interventions Life-Situation Interventions Perception Interventions Emotional Arousal Interventions Physiological Arousal Interventions SUMMARY NOTES INTERNET RESOURCES COPING IN TODAY S WORLD LAB ASSESSMENT 19.1 WHAT ARE YOUR ATTITUDES TOWARD DEATH? LAB ASSESSMENT 19.2 WHAT ARE YOUR FEELINGS ABOUT DEATH? Epilogue Appendix A- Stress Information Resources Glossary G- Selected Bibliography Credits C- Index I- B- CHAPTER 19 STRESS AND OLDER ADULTS The Elderly: A Description Test of Knowledge About the Elderly xii Table of Contents gre29621_fm_i-xviii.indd xii 07/15/06 00:16:43

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14 preface The first edition of this book evolved out of two needs. The first pertained to my discussions with students, colleagues, friends, and relatives who, as I listened more carefully, seemed to be crying out for help in dealing with the stress of life. Upon closer scrutiny, I realized that the only cries I was deaf to were my own. I, too, needed help managing stress. The second need related to the nature of texts on this subject. I thought they were informative or interesting but seldom both. Furthermore, I didn t think stress management was presented as the complex subject I envision it to be. I thought books on this subject explored parts of stress management but omitted several key components. Both of these needs continue to exist and cry out for this, the tenth edition of Comprehensive Stress Management. This book, then, is written in a more personal, informal manner than most and is organized to consider stress as a function of situations in life that, when perceived as distressing, result in emotional and physiological arousal. There is an abundance of scientific and statistical information in this book, but it hangs on to anecdote, humor, and personal experience to breathe life into its content. In addition, numerous means of self-evaluation are provided in the form of Laboratory Assessments at the end of all chapters so that content takes on personal meaning for each reader. New to This Edition We all learn from our experiences, and I am no exception. Consequently, this tenth edition of Comprehensive Stress Management incorporates changes recommended by readers of the first nine editions while maintaining the elements valued by those readers. Revisions include the following: Boxed content has been added at the end of the chapters. Entitled Coping in Today s World, these boxes present current and interesting additional material related to the chapter s content for the student to consider. Among the Coping in Today s World boxes are discussions of environmental noise and stress, life satisfaction, effects of brain neuroplasticity and stress, laughter clubs to cope with stress, complementary and alternative medicine, new technology and stress, hospital clowns to help patients cope with their illnesses, the Health Belief Model, health disparities, American workers vacation days and lunch times compared with those of other countries workers, ethical violations by college students, and marriage and stress. Ten new Lab Assessments have been added at the end of the chapters. Now, each chapter has at least one Lab Assessment. The new USDA MyPyramid replaces the previous Food Guide Pyramid in Chapter 5. The Web site address for the new pyramid is provided. Maintained, though, are the discussions and references to ethnic food guide pyramids. The discussion of women and social support appearing in Chapter 6 has been replaced with updated content and references from studies published in A new scale has been added that helps students identify how satisfied they are with their lives. This scale appears in Chapter 6 and is entitled the Satisfaction with Life Scale. By completing this scale, students are challenged to take action to improve their lives so they are more satisfied. The result will be less stress. Current research findings related to locus of control have been added in Chapter 7. These studies demonstrate the relationship between locus of gre29621_fm_i-xviii.indd xiv 07/15/06 00:16:44

15 control and breast cancer, chronic fatigue syndrome, sick leave from work, and response to a diagnosis of human papillomavirus. A new scale, the Spirituality Assessment Scale has been added to Chapter 8. This scale allows students to measure their perceptions of their purpose and meaning in life, innerness (or inner resources) unifying interconnectedness, and transcendence. Current research findings related to autogenics and cancer, multiple sclerosis, coronary angioplasty, anxiety, drug abuse, menstrual discomfort, scoliosis, and dyspnea (painful breathing) have been added in Chapter 10. Updated statistics and an expanded discussion regarding caregiving and stress are presented in Chapter 19. Statistics have been revised to present the latest available data. These data have been acquired through credible sources, mostly U.S. governmental data repositories. References have been updated throughout the book. More than 120 current references most from the year 2000 and later have been added, and outdated references omitted. Web sites presented at the end of each chapter allow students to explore the chapter s content in more detail. All of these references have been checked, and those no longer operational have been replaced with current Web sites. New color photographs replace less relevant and outdated images throughout the book. A new full-color format and design provide a fresh look to the text. The sum of these changes assures the student of the most current and accurate content, presented in an interesting and educational format. Pedagogial Features The workbook icon appears alongside content that relates to sections in the accompanying online workbook, Your Personal Stress Profile and Activity Workbook, giving instructors the option of integrating coursework with workbook content. The stress portfolio icon appears with related content in the text to better enable students to organize their materials into one source and to develop their own stress portfolio. Lab Assessments are included at the end of each chapter, enabling students to specifically relate the chapter content to their personal lives. The boxed feature Getting Involved in Your Community, appearing in selected chapters, challenges students to apply the chapter content to a related community project to assist in decreasing stress levels in their communities. Bulleted chapter summaries are provided at the end of every chapter to reinforce the content and assist students with test preparation. The extensive bibliography is updated and included at the back of the book so students can delve further into the topics discussed. Organization Part 1 of this book contains a complete discussion of the stress reaction and its relationship to specific illnesses and diseases. Parts 2, 3, and 4 teach you how to intervene to step between the stressor and physiological arousal. Consequently, you should be able to limit the harmful effects of the stressors you encounter. In brief, you will learn how to adjust your life situations, perceive events differently, react less emotionally, and use the products of stress to limit their duration. In addition, you should be able to recognize the relationship between spirituality and stress. Part 5 discusses Preface xv gre29621_fm_i-xviii.indd xv 07/15/06 00:16:44

16 the particular stress needs of homemakers, workers outside the home, children and youths, college students, and older adults. The stress management procedures presented in Parts 2, 3, and 4 are applied to each of these specific populations to demonstrate their use in alleviating the harmful effects of stress. The major theme of this book is that people usually have greater control over their lives and their environments than they realize. Unfortunately, many of us do not exercise this control and become rudderless in a rapidly changing and stressful society. Stress management is learning to recapture control of ourselves, and this book describes how to do that. Supplements Available with the tenth edition of Comprehensive Stress Management is a comprehensive package of supplementary materials designed to enhance teaching and learning. Instructor s Resource CD-ROM The Instructors Resource CD-ROM provides teaching tools in an easy-to-use format. The Course Integrator Guide includes learning objectives, suggested lecture outlines, classroom activities, media resources, and Web links. It also describes how to integrate other supplementary materials into lectures and assignments for each chapter. The test bank includes multiple choice, true-false, and fill-in-the-blank questions for each chapter. The test bank is available as Word files and with EZ Test computerized testing software. EZ Test provides a powerful, easy-touse test maker to create printed quizzes and exams. For secure online testing, exams created in EZ Test can be exported to WebCT, Blackboard, PageOut, and EZ Test Online. EZ Test comes with a Quick Start Guide, and once the program is installed, users have access to a User s Manual and Flash tutorials. Additional help is available online at The PowerPoint slides provide a lecture tool that you can add to or change to meet the needs of your course. The slides include key lecture points, ensuring that your students can follow your lectures point by point. Online Learning Center for Comprehensive Stress Management ( The Online Learning Center for Comprehensive Stress Management offers resources for both instructors and students. For the instructor: Course Integrator Guide PowerPoint slide presentation Web links For the student: Chapter reviews Interactive quizzes Glossary flashcards PowerPoint slide presentation Also available on the Online Learning Center is Your Personal Stress Profile and Activity Workbook, 4 th edition, by Jerrold Greenberg. Referenced at appropriate places in the text with a special icon, the workbook shows students how to evaluate their current level of stress, develop a personal stress profile, and use the tools and xvi Preface gre29621_fm_i-xviii.indd xvi 07/15/06 00:16:44

17 activities to become active participants in managing their own stress. The workbook can be accessed by students using the registration code found on the card bound into the front of new copies of the textbook. Acknowledgments There are many people who have helped bring this project to completion. They can never be adequately thanked, but perhaps a mention here will let them know that their help has been appreciated. First are my students, who have taught me as much about stress management as I have ever taught them. Not only do I learn from their term papers and other assignments, but the way in which they live their lives teaches me much about managing stress. Then there are my professional colleagues, who encourage, stimulate, and provoke me to be as competent and as qualified as I can if for no other reason than to keep pace with them. In particular, I wish to thank Robert Feldman, the author of Chapter 14, whose contribution to this book is obvious, albeit immeasurable. And, of course, there are the academic reviewers, whose comments sometimes exasperated, bewildered, or angered me but who also encouraged me and provided important guidance for revision. Because of them, this book is better than it otherwise would have been. These reviewers include Dr. Edward Baker Chesapeake College Guy E. Cunningham Grand View College Danna Ethan Borough of Manhattan Community College, CUNY Rebecca A. Glass Austin Peay State University Gary Guyot Regis University Loeen M. Irons Baylor University Dr. Mary L. Jones Glendale Community College Martin J. Loy University of Wisconsin Stevens Point Joanne Marrow California State University Sacramento Steven J. Radlo Western Illinois University Mary Ellen Rose American University Janet L. Sholes Frederick Community College Gayle Lynn Westberg University of Utah I would be remiss not to acknowledge the support of Kelly Wagner, my developmental editor for the tenth edition of Comprehensive Stress Management, for helping to guide this edition through the sometimes confusing production process. Her support, competence, and encouragement are very much appreciated. Most important, there is my family. They not only respected my need for quiet time to write but also provided much of the inspiration I needed. Karen, Keri, and Todd I don t tell you often enough how much you contribute to my work and productivity, but you do, and I recognize your support and value it. Preface xvii gre29621_fm_i-xviii.indd xvii 07/15/06 00:16:44

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