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Stress and Coping 1 Table of Contents List of Tables and Figures........................................................................................3 Chapter 1 - Background to the Study.......................................................................4 Introduction..........................................................................................................

4 Statement of the Problem.....................................................................................4 Justification for the Study....................................................................................6 Purpose of the Study............................................................................................7 Significance of the Study.....................................................................................9 Objectives of the Study........................................................................................9 Research Hypotheses.........................................................................................10 Operationalization of Terms..............................................................................10 Chapter 2 Literature Review...............................................................................12 Perceived Stress.................................................................................................12 Coping................................................................................................................15 Dispositional and Situational Coping............................................................21 Gender and Coping........................................................................................21 Adaptive and Maladaptive Coping................................................................23 Substance Use - An Emotion-Focused Coping Mechanism..............................24 Cannabis.........................................................................................................24 Cigarettes. .....................................................................................................27 Alcohol..........................................................................................................28 Students at the Mona Campus of the UWI........................................................31 Chapter 3 - Methodology.......................................................................................36 Sample................................................................................................................37 Research Design.................................................................................................38 Instrumentation..................................................................................................39 Procedures for Collecting Data..........................................................................40 Data Analysis.....................................................................................................41 Chapter 4 - Results.................................................................................................42 Perceived Stress Levels Among Respondents...................................................46 Perceived Stress and Gender..........................................................................47 Objective1. Frequency of Substance Use as a Coping Mechanism...................48 Substance Use Coping and Gender, Residential Status and Faculty.............48 Hypothesis One .............................................................................................49 Objective 2. The Substance Most Frequently Used as Coping Mechanism.....50 Objective3. Coping Styles Most Frequently Used by Students........................51 Objective 4. Analysis of the Impact of Expectation of Substance Effect on the Relationship between Level of Perceived Stress and Substance Use Coping . .52 Hypothesis 2. .................................................................................................53 Students Perceptions of Substances..............................................................54 Chapter 5 - Discussion...........................................................................................55 Objective1. Frequency of Substance Use as a Coping Mechanism...................55 Objective 2. The Substance Most Frequently Used as a Coping Mechanism. .56 Objective3. Coping Styles Most Frequently Used by Students........................58 Gender and Coping........................................................................................59

Stress and Coping 2 Objective 4. Analysis of the Impact of Expectation of Substance Effect on the Relationship between Level of Perceived Stress and Substance Use Coping . .59 Limitations.........................................................................................................60 Recommendations..............................................................................................61 Suggestions for Future Research.......................................................................62 Conclusion.........................................................................................................62 References..............................................................................................................64 Appendix A............................................................................................................70 Appendix B............................................................................................................75

Stress and Coping 3 List of Tables and Figures Figure 1.1 Folkman and Lazarus Transactional Stress and Coping Model..17 Figure 1.1 Gender Distribution at the University of the West Indies, Mona Campus......30 Table 1.1 Population Distribution at the University of the West Indies, Mona Campus.......................31

Figure 3.1 Research Design Diagram35 Table 3.2 Sample Selection ...37 Figure 4.2 Gender Distribution..38 Figure 4.1 Faculty Distribution..39 Table 4.1 Age Distribution....40 Figure 4.3 Perceived Stress Frequency Distribution..... 42 Table 4.2 Stress Category Distribution by Gender....43 Figure 4.4 Substance Use Coping Distribution.................... .43 Table 4.3 Distribution of Substance Use Coping Scores by Gender.44 Figure 4.5 Relationship between Perceived Stress and Substance Use Coping...45 Table 4.4 Frequency of CCA Use.46 Figure 4.6 Means Plot of Expectation of Substance Use and Substance Use Coping Mean Scores......48

Stress and Coping 4 Chapter 1 - Background to the Study Introduction Levels of perceived stress among students of the Mona campus of the University of the West Indies and the coping styles in which they engage are the areas of interest for this research. How students cope with daily hassles or life events has consistently been an area of interest for researchers (Matheny, Ashby & Cupp, 2005; OHare & Sherrer, 1997; Dyson & Park, 2006; Robotham & Julian, 2006; Shang & Zhang, 2007; Gencoz, Gencoz, & Bozo, 2006; Herrington et. al, 2005; Sasaki & Yamasaki, 2007; Struthers, Perry & Menec, 2000). However, this researcher is particularly interested in students choice of coping style and more so whether they use substances as part of their approach to coping with stress. This issue will be examined in this study, along with associated topics inclusive of trends in their coping behaviours. Statement of the Problem Perceived stress and coping are areas which have been thoroughly researched in the United States, Europe, Japan and in some developing nations (Matheny & Cupp, 2005; Matheny, Ashby, & Cupp, 2005; Gencoz, Gencoz & Bozo, 2006, & Yamasaki, 2007; Struthers, Perry & Menec, 2000). However, research in this field has been limited in the Caribbean. Furthermore, examining the use of psychoactive substances as coping techniques for perceived stress is an even less studied area in the Jamaican setting. Most of the research conducted in Jamaica has been focused on life events or physiological aspects of stress and not on perceptions of stress (Lindo, 2003; Duncan, 2000; Scott-Fisher, 1999). In

Stress and Coping 5 addition, several of the studies were focused on specific groups such as adolescents, primary school students or vocational groups such as teachers, doctors, and police officers (Oo, 2002; Williams, 1993; Edwards, 1988; Freckleton, 1984; Andrews, 1980). Understanding the relationship between perceived stress and coping, particularly the use of substances as an effort to cope is crucial for the development of appropriate health education programmes. Carver (1997) discusses the categorization of coping styles into emotion-focused and problem/solution-focused. He describes the former as approaches which do not result in any change in the stressful situation but in the feelings aroused by it and the latter as attempts to solve the problem. Carvers categories will be employed in this study. Substance use as a coping technique will be classified as an emotion-focused technique. It is arguable that some substances such as depressants have calming effects on an organism (Coomber, Oliver, & Morris, 2003) and as such may be useful in addressing the actual problem. However, in this study, this and other beneficial effects of substances are seen as methods of managing the emotions evoked by the stressful situation. Studies have been conducted which demonstrate an association between the use of alcohol as a tension reducer and problem drinking among college students (OHare & Sherrer, 1997). Problem drinking was defined in OHare and Sherrers study as the consumption of alcoholic beverages significantly correlated with arrests and incidents reported to campus security. This finding is significant for the current study although the focus is not on problem drinking or other problematic substance use. Its significance lies in the recognition of the potential for the

Stress and Coping 6 development of problem drinking behaviours out of the use of drinking as a tension reducer. Graduates of the University of the West Indies become leaders in Caribbean society and as such are predisposed to experiencing high demands placed on their coping resources. Developing healthy coping skills will be an invaluable accomplishment for students, future leaders in commerce, government, medicine, and other areas. As such, the undertakings of the present study can be appreciated in light of its potential for contributing to the development of the students at the Mona campus of the University of the West Indies. Given the relationship between stress-coping and health, Sarafino and Ewing (1999) noted that "being able to assess and reduce student stress is an important concern for college counseling and health centers because of students' many adjustment and physical health problems" (cited in Matheny, Ashby & Cupp, 2005). Justification for the Study The use and abuse of substances by University students is a perennial and pervasive problem internationally (OHare & Sherrer, 1997; Baer et. al, 2001). Several studies have shown that binge drinking, cannabis and tobacco misuse are prevalent on University campuses in the United States of America and in Europe (Baer et. al, 2001; Wallenstein, Pigeon, Kopans, Jacobs, Aseltine, 2007). An association has also been found between the use of alcohol as a tension reducer and problem drinking (OHare & Sherrer, 1997). Studies have repeatedly shown that individuals use drinking in an attempt to cope with stress (P.E. Baer, Garmezy, McLaughlin, Pokorny, & Wernick, 1987; M. Seeman, Seeman, & Budros, 1988 as cited in Taylor, 2003). Perceived stress varies from person to

Stress and Coping 7 person, making the transition into university life an experience rated more or less stressful by different individuals. Arguably, perceived stress may influence ones ability to cope and also the methods employed in the coping process. It is therefore, crucial to understand the relationship between perception of stress and the use of substances as coping techniques among students of the University of the West Indies, Mona Campus. The lack of data on the prevalence of substance use among students of the Mona campus makes reliance on national data and overseas data for college campuses mandatory for this study. However, local trends indicate first use of cigarettes and alcohol to occur at ages 15 and 13 respectively for males (Douglas, 2000). Studies have not yet been conducted which seek to identify whether substance users in Jamaica engage in the use of substances for their tension reducing effects or more so as a social practice. The current research focuses on the use of substances as a coping mechanism for stress and will identify students perceptions of the potentially harmful and beneficial effects of substances. Purpose of the Study Substance use has been studied as a subset of problematic behaviours. The use of substances is seen as contributing to health problems by some and as a means of enjoyment or entertainment by others. This study examines the use of substances by university students as a coping mechanism for stress. The students perception of the substances as having harmful, beneficial, or mixed effects upon them is the value placed upon the use of the substances. The substances which

Stress and Coping 8 will be focused on in this study are Cannabis Sativa (Ganja), Nicotine (Cigarettes), and Alcohol (CCA). The study seeks to identify the drug of choice among students of the University of the West Indies when experiencing feelings of stress. It is also designed to determine whether these students perception of the drugs effect on them will impact upon whether they engage in the use of substances as a coping mechanism for stress. The study provides information regarding the following: i. Levels of perceived stress ii. Most frequently used coping styles iii. Students perceptions of the effects of substances (CCA) iv. Frequency of students use of CCA as a coping mechanism If significant relationships and patterns are identified in the research, the information will be passed on to the Universitys Health Centre. The aim of this is to inform their development of substance awareness programmes. For instance, posters on health issues are regularly displayed at the Health Centre. Given the information generated by this research, staff at the facility may be able to develop posters or other campaigns to educate students about the effects of substances. The necessity of passing on the data will depend on students responses to items on the Stress and Coping Style Questionnaire. One such item asks respondents to identify which of six drugs are addictive. Of the six drugs, it is a well documented fact that all but cannabis and ecstasy are agreed upon to be chemically addictive (Taylor, 2003). Health centre staff and administrators may find it a worthwhile task to provide more information on drugs of addiction if a

Stress and Coping 9 large percentage of students are currently misinformed about substances such as heroine and crack/ cocaine. Significance of the Study There is currently no literature available on the topic of stress, coping, and substance use as a coping mechanism of students at the Mona Campus of the University of the West Indies. The current work is the first of its kind in this setting. Additionally, it will contribute to the literature on stress and coping in Jamaica a topic which has not been adequately examined in this country. The research which has been conducted has focused primarily on stress responses, indicators and the implications of high stress levels for certain vocations (Duncan, 2000; Henriques-Piper, 1998). Furthermore, the distinctive aspect of this research is that it is looking at substance use as a coping mechanism which has not yet been examined locally. This feature allows for contribution to be made to the literature on substance use among Jamaicans, and particularly university students in Jamaica. Objectives of the Study The major objectives of the study are as follows: 1. To provide reliable data on the frequency of substance use as a coping technique among students at the Mona campus. 2. To discover the substance most frequently used as a coping technique by students at the Mona campus. 3. To discover the coping style most frequently used by students at the Mona Campus.

Stress and Coping 10 4. To analyze the impact of expectations of the substance as a mediating factor between the level of perceived stress and the use of substances as a coping mechanism. Research Hypotheses The hypotheses which will be tested in this research are: 1. There will be a positive relationship between the level of perceived stress and the use of substances as a coping technique. 2. The likelihood of the use of substances as a coping technique will increase if the substances are considered to have positive effects. Operationalization of Terms The following key concepts discussed in this study are delineated as follows: i. Perceived stress will refer to the individuals appraisal of stressful situation(s) in his/ her life. ii. Coping will refer to the resources, both internal and external, which the individual possesses and employs to manage the stress. Coping will be categorized into two types: a. Solution-focused coping - incorporates methods which seek to address the problem. b. Emotion-focused coping incorporates methods which seek to reduce the emotional distress being experienced as a result of the problem.

Stress and Coping 11 iii. Substance Use is being delineated as the use of any psychoactive substance, including but not limited to cannabis, cigarettes, and alcohol. iv. Substance use- An emotion-focused coping mechanism refers to the use of psychoactive substances in efforts to reduce the emotional distress experienced as a result of levels of perceived stress. In light of the relationship between perceived stress and coping which has been demonstrated in previous research (Matheny & Ashby, 2005; Herrington et. Al, 2005) the current study will examine the dynamics of that relationship as it pertains to students at the Mona campus of the University of the West Indies. Extant literature in this field will be reviewed highlighting the findings related to gender (Matheny, Ashby, & Cupp, 2005) and the various dimensions of coping such as situational and dispositional coping (Sasaki & Yamasaki, 2002); maladaptive and adaptive coping styles (Gan, Shang, & Zhang, 2007). Findings related to the use of substances as a coping mechanism (OHare & Sherrer, 1997) and the potential harmful (Baer et. al, 2001; Abel, 2003) and beneficial effects (Coomber, Oliver, & Morris, 2003) of substance use will also be discussed. Prevalence data for Jamaica will also be presented (Douglas, 2000). The discussion of the research methodology will present the details of sample distribution, research design and data analysis used in the study. The findings and discussion will present the trends in the sample and demonstrate significant relationships between variables. Limitations, recommendations and suggestions for future study arising from the work will also be presented.

Stress and Coping 12 Chapter 2 Literature Review Perceived Stress Stress has been studied in different ways by different researchers. According to Hans Selye, an organism responds to external threats with set physiological patterns of reaction (as cited in Taylor, 2003). Selye further posits that after repeated stimulation, the system naturally becomes worn and the resources exhausted, laying the groundwork for disease. Selyes theory continues to inform research falling under the disease model of stress, which is most often the utilized in medical research (Taylor, 2003). The study of stress has often been undertaken from a physiological or neuropsychological point of view. Taylor et. al (2004) point out that stressful experiences can be noted as areas in the amygdala are activated whenever there is something new or unexpected in the environment, particularly when there are signs of danger. Matheny and Ashby (2005) point out that stress was originally a physics term referring to the pressure applied to materials to investigate their resilience, and when the pressure exceeded the tolerance of the material, its molecules were unable to spring back and maintain the integrity of the material. They further illustrate that when used in relation to the human condition it is suggested that excessive environmental stressors may challenge the homeostatic capacity of the organism to maintain physical and psychological balance. Stress, as it is currently used, is an umbrella term including stressors, the stress response, and stress symptoms (Matheny & Ashby, 2005).

Stress and Coping 13 Stressors have been defined as events and/or conditions that are external to the individual which place demands upon the individuals resources (Brunswick, Lewis, & Messeri, 1992). Lazarus and Folkman (1987) conceptualized stress as daily hassles which they describe as uncontrollable aspects of everyday life which tend to evoke irritation in individuals; an example is traffic on the way home from work. It has also been operationalized by Holmes and Rahe (1967) as life events (as cited in Taylor, 2003). Holmes and Rahe defined stressful life events as those which cause high levels of emotional distress. Some examples they provide are death of a loved one, divorce, and moving. Lazarus and Folkman (1987) found that daily hassles are better predictors of current and subsequent psychological symptoms than life events. They argue that this is because ordinary stressful experiences of daily living, inclusive of those which are the products of life events and those which arise out of other merely adventitious encounters contribute to a persons experience of stress. Furthermore, research has shown that ones interpretation of the difficult experience is what determines how stressful it is on that individual. Appraisal is the construct which captures the idea of perceived stress. It concerns the implications of the event (stressor) for ones personal well-being. In other words What does this mean for me personally? (Lazarus & Folkman, 1987). Herrington et al (2005) support Lazarus and Folkmans position and argue that the prevailing stress model is a transaction model that views stress as resulting from an imbalance between perceived demands and perceived resources. It has also become widely accepted that the impact of stressful experiences is to

Stress and Coping 14 some degree determined by ones perception of its demand upon their coping resources (Cohen, Kamarck & Mermelstein, 1983). The extent to which a harmful or potentially harmful encounter between the person and the environment is stressful depends on the meaning or significance of that encounter, which in turn is based on the personal agendas and coping resources the person brings to the situation (Gruen, Lazarus & Folkman, 1988). The measurement of stress has also been an area which has sparked much debate. However, as perceived stress is the focus of the present study, an instrument which measures individuals perception of stress rather than actual exposure to stressful experiences has been selected for use in data collection. The Perceived Stress Scale developed by Cohen, Kamarck and Mermelstein (1983) was incorporated into the Stress and Coping Style Questionnaire used in this study. The authors discuss the benefit of using objective measures of stress which focus on elements of actual external factors and ask respondents to state whether they have experienced any of the stated events. An example would be living in an extremely noisy environment and having respondents rate how many nights per week they were exposed to the noise. On the other hand, Cohen, Kamarck and Mermelstein (1983) put forward the superiority of measures which take into consideration the reality that individuals actively interact with their environment, appraising potentially challenging or threatening events in the light of available coping resources (p.386). The Perceived Stress Scale (PSS) was designed to measure the degree to which situations in ones life are appraised as stressful. This made it an appropriate instrument to suit the objectives of this study. The

Stress and Coping 15 psychometric properties of the PSS will be discussed in further detail in the methodology section of this research report. Coping Dressler (1991) defines coping as cognitive and behavioral attempts to alter events or circumstances that are threatening (as cited in Dyson & Renk, 2006). Matheny and Ashby (2005) have delineated the concept as coping resources, coping styles, and coping behaviors. Herrington et. al (2005) define coping as those personal characteristics and possessions drawn upon when managing stressful events. For the purposes of this study, coping will be discussed primarily as it relates to coping mechanisms. Lazarus and Folkmans transactional stress coping model provide the conceptual framework for much of the research in this area. The current usage of the term coping mechanism is best summarized in DeLongis and Holtzmans (2005) work. They define coping as adaptively changing cognitive and behavioral efforts to manage psychological stress. However, it must be noted here that the discussion of coping mechanisms incorporates the understanding that individuals present with both internal and external coping resources, both of which are subsumed within the concept of coping mechanisms. The dynamic interaction between the demands placed upon the individual by the experience appraised as stressful and the responses manufactured in an effort to either reduce the distress or solve the problem is at the crux of the current study. Sutton and Lachman (1996) postulate that the study of coping is rooted in individual differences in reaction to stress, with the assumption that how

Stress and Coping 16 individuals cope is largely a function of personality characteristics, which result in global coping styles. They argue that the literature shows that stress and coping processes are widely understood to be affected by both personality and environmental factors. Some studies have demonstrated that personality traits such as neuroticism and hardiness affect both the individuals appraisal of the stressful experience and the use of coping strategies or mechanisms (Bolger, 1990; Florian, Mikulincer & Taubman, 1995 as cited in Sutton and Lachman, 1996). Measuring personality traits and extensive environmental factors are beyond the scope of this research. However, some environmental factors were examined, namely school, home, and relationship. Struthers, Perry and Menec (2000) argue that academic stress poses a significant challenge for students and when appraised negatively, can have adverse effects on students motivation and performance. Evidently, several models for understanding the relationship between stress and coping have been postulated. However, Lazarus and Folkmans (1987) transactional stress and coping model serve as the theoretical framework for the present study. They argue that adaptation to a stressor is influenced by the coping processes in which people engage following that stressor (Lazarus & Folkman, 1984 as cited in Park, 2005). Park (2005) explicates Lazarus and Folkmans theory in a forthright manner: This model focuses on cognitive appraisals of the situation and the coping strategies that follow from this appraisal. Cognitive appraisal involves making initial attributions about why the event occurred; determining the extent to which the event is threatening, controllable, and predictable (primary appraisal); and deciding

Stress and Coping 17 what can be done (secondary appraisal). These appraisals, in turn, influence the coping efforts put forth by the individual. Lazarus and Folkmans transactional stress and coping model is illustrated diagrammatically in figure 2.1.

Stressful experience

Primary Appraisal Is the situation controllable, challenging, irrelevant?

Stress and Coping 18

Secondary Appraisal What are the resources available to cope with the situation?

Stress and Coping 19

Coping Efforts Solution Focused: Directed at changing the problem Emotion Focused: Directed at adjusting emotional distress

Figure 2.1 Folkman and Lazarus Transactional Stress and Coping Model

Stress and Coping 20 According to Lazarus and Folkmans theory, the coping process begins with the individuals perception of the stressful situation. A judgment must be made about the severity of the threat to the individuals sense of equilibrium. That judgment is made within the context of the individuals abilities to address the situation. And ultimately, these cognitive evaluations impact upon the coping mechanisms engaged in by the individual to address the stressful experience. Some coping researchers distinguish between problem-focused coping strategies (attempts to directly change the problem) and emotion-focused coping strategies (attempts to regulate the distress) (Park, 2005). Lazarus and Folkman (1987) describe these two functions of coping as: (1) to change the actual terms of the troubled person-environment relationship - problem-focused coping; (2) to regulate emotional distress, categorized as emotion-focused or cognitive coping. Other researchers have categorized coping styles as adaptive or maladaptive. DeLongis and Holtzman (2005) argue that there is a lack of consistency across studies regarding which coping strategies are adaptive and maladaptive for dealing with stressful events. The reasons they provide include methodological differences across studies and lack of fit between methods and conceptual models of coping. Various research findings indicate that some types of emotion-focused coping, particularly talking with others about the stressful experience, are helpful in coping (Nolen-Hoeksema & Larson, 1999 as cited in Park, 2005). On the other hand, other emotion-focused strategies, such as avoidance, tend to be related to continued distress, while problem-focused coping tends to be more consistently

Stress and Coping 21 related to better adjustment outcomes (Aldwin, in press as cited in Park, 2005). These findings would seem to support DeLongis and Holtzmans view that the findings are sometimes contradictory. Dispositional and Situational Coping. Some researchers discuss coping in terms of dispositional versus situational coping. Sasaki and Yamasaki (2002) delineate dispositional coping as a trait approach to coping a long term, personality based approach to dealing with stress. They outline situational coping as a state or transient method of coping the individual may engage in depending on the situation. They argue that dispositional coping can impact upon situational coping but that this is not always the case. Sasaki and Yamasaki (2002) also found that an increase in dispositional emotion expression, cognitive reinterpretation, and problem solving predicts reductions in mental distress. These findings challenge the notion that emotionfocused coping consistently leads to continued emotional distress or fewer measured adjustment outcomes than problem-focused coping. Gender and Coping. As it relates to gender differences in coping, some studies suggest that men are more likely to use problem-focused coping strategies and women are more likely to use emotion-focused strategies (La France & Banaji, 1992; Larson & Pleck, 1998 as cited in Matheny, Ashby & Cupp, 2005). Matheny, Ashby and Cupp (2005) argue that it is unclear whether women actually experience emotional reactions more frequently than men but that they seem to express their

Stress and Coping 22 emotions more frequently and more intensely (Grossman & Wood, 1993; Brody & Hall, 1993; Sprecher & Sedikides, 1993; Fujita, Diener, & Sandvik, 1991 as cited in Matheny, Ashby & Cupp, 2005). The authors further postulate that such gender differences likely result from the combined effects of biology, prenatal and perinatal factors, culture, and family influences. In a meta-analytic review of 50 studies of sex differences in coping, Tamres et al. (2002) found women to be significantly more likely than men to use social support, to ruminate longer over stressors, and to engage in positive self-talk (cited in Matheny, Ashby & Cupp, 2005). Taylor, Klein, Lewis, Gruenewald, Gurung, and Updegraff (2000) speculated that the greater use of social support by women has a biological basis (cited in Matheny, Ashby & Cupp, 2005). When women are faced with a threat they are more likely to engage in a "tend-and-befriend" response while men are more likely to engage in a "fight-or-flight" response. The greater likelihood of a woman's making a tend-or-befriend response may be attributed to the larger production of the bonding hormone, oxytocin (Taylor, Dickerson, & Klein, 2001). However, the differential reinforcement of the use of social support by one's reference group may account for its greater use by women. A study among southern African Americans revealed that active coping was a buffer for the effects of stress for black women. Whereas for black men, it exacerbated the effects of stress (Dressier, 1985 as cited in Matheny, Ashby, & Cupp, 2005). Evidently, gender differences in coping have been well established in the literature.

Stress and Coping 23 Adaptive and Maladaptive Coping. Gan, Shang and Zhang (2007) provide a different perspective on the issue of adaptive and maladaptive coping styles. They termed their conceptual framework the situation-strategy fit. This is described as the goodness of fit between appraisal of control and coping strategies. When situations are perceived as controllable, and problem-focused strategies are utilized, this may be referred to as situation strategy fit. Likewise, when a situation is perceived as uncontrollable and emotion-focused strategies are used, this may also be seen as situation-strategy fit. Gan, Shang and Zhang (2007) suggest that emotion-focused coping methods may be the most suitable in cases where the situation is appraised as uncontrollable. This is logical as if there is nothing or very little the individual can do to adjust the situation, it would be advisable to adjust ones response to it and also to seek ways of altering the emotions related to the stressful situation. On the other hand, applying emotion-focused coping methods to situations over which the individual has greater levels of control may produce fewer results than applying solution focused methods. However, it may be argued that emotionfocused methods may be applied first to alter the individuals emotional response, allowing for a more rational approach to the solution-focused methods. The use of mood-altering substances as a coping mechanism is arguably one such emotion-focused method which positively alters the emotional state of the individual and allows for greater focus when using problem-focused methods. This hypothesis will be discussed in greater detail in the next section.

Stress and Coping 24 Substance Use - An Emotion-Focused Coping Mechanism As previously discussed, emotion-focused coping mechanisms are those which seek to reduce the emotional distress experienced as a result of the dynamic interplay of internal and external phenomena during experiences perceived as stressful. Carver (1997) includes substance use in the category of emotionfocused coping mechanisms. He also includes the use of substances on the Brief COPE. Cannabis sativa, cigarettes, and alcohol (CCA) will be the substances under examination in this study. This decision was based upon prevalence data for Jamaica which indicates that these are the dominant drugs of choice (Abel, 2003). Cannabis. The Cannabis plant has three varieties: cannabis sativa, cannabis indica, and cannabis ruredalis (Canadian Senate Special Committee on Illegal Drugs, 2002). The most common form of the substance is cannabis sativa which produces the substance that is smoked. Cannabis sativa is a psychoactive substance also known as marijuana, pot, weed, ganja, among other names. It is classified as a psychoactive substance because of its effects on the central and periphery nervous systems. The use of Cannabis Sativa has sparked much international debate. Some countries have passed laws allowing the substance to be used therapeutically, others have passed laws allowing its use for any reason, while others still have outlawed use of the psychoactive substance. Nations such as the United States and Jamaica continue to have laws that make cannabis use illegal. This may be contrasted with the prevailing high illegal use rates in these

Stress and Coping 25 two countries (Canadian Senate Special Committee on Illegal Drugs, 2002; Abel, 2003). On the other hand, nations such as Spain allow free personal use of the substance and report relatively low usage rates. One of the reasons that cannabis use remains controversial is the debate over whether it is to be considered a gateway drug. Gateway drugs, which consist of cannabis, alcohol, and tobacco, are those which are thought to lead to the use of other illicit substances or hard drugs. The Canadian Senate Special Committee on Illegal Drugs (2002) operationalized the term as the theory suggesting a sequential pattern in involvement in drug use from nicotine to alcohol, to cannabis and then to hard drugs. Furthermore, in regard to cannabis, they offered that the theory rests on a statistical association between the use of hard drugs and the fact that these users have generally used cannabis as their first illicit drug. Fergusson and Horwood (2000) present the arguments for and against Cannabis Sativa being described as a gateway drug. In the argument supporting this description, it is held that cannabis is a "gateway" drug whose usage encourages other forms of more serious illicit drug use (Kandel & Faust, 1975 as cited in Fergusson & Horwood, 2000). The stage theory of substance use holds that the development of substance use and abuse follows a generally lawful progression in which the individual makes transitions from using legitimate drugs including alcohol and tobacco to various forms of illicit drug use (MacCoun, 1998 as cited in Fergusson & Horwood, 2000). The authors outline the assumptions of the stage theory of substance use and abuse as follows: (a) those using illicit drugs will invariably have used licit drugs but (b) not all of those using licit drugs will move to using illicit

Stress and Coping 26 drugs. In this sequence, the use of cannabis can be seen as the first step in a process in which individuals make a transition to the use of illicit drugs. It has been suggested that this transition, in turn, increases the likelihood that cannabis users will progress to taking other illicit, and potentially more harmful, drugs (Fergusson & Horwood, 2000, p.506). Challengers of stage theory argue that the overlap between users of more harmful drugs and those who use cannabis may be explained by other common factors such as similar life choices and other personality or environmental factors (Huba, Wingard & Bentler, 1981; Hays et al, 1987 as cited in Fergusson & Horwood, 2000). Hence, the argument against the categorization of cannabis as a gateway drug lies in the fact that there are other predisposing factors which predict hard drug usage and studies have not yet conclusively shown that cannabis is the cause of the transition. Cannabis Sativa is a well known substance in the Jamaican context. It is expected that a large number of the sample in this study, perhaps as much as 15%, will report using this substance. 1997 prevalence data indicates that 27 per cent of the secondary school population had used cannabis at some point in their lives (Abel, 2003). However, the use of this substance remains an issue of national debate. This is the case as findings continue to emerge which support both the position that cannabis use has negative effects and that there are some beneficial effects to its use, often times, depending on the mode of delivery. As it relates to smoking the substance, there have been findings which suggest an association between smoking cannabis and increased violent behaviour (Howard & Menkes, 2007). Wendel Abel (2003), then consultant psychiatrist at the University of the

Stress and Coping 27 West Indies, reported that studies have shown that cannabis use is associated with short term memory impairment and psychomotor retardation and may affect the performance of persons carrying out demanding jobs such as pilots and operators of heavy vehicles. He further reported that long term use of cannabis via inhalation increases the risk of lung diseases such as chronic bronchitis and lung cancer. On the other side of this argument are those who contend that cannabis use has mostly beneficial outcomes. In one study, Coomber, Oliver and Morris (2003) reported that persons using cannabis for its therapeutic properties perceived it to be highly effective in treating their symptoms, in complementing existing medication, and in producing fewer unwanted effects of their medication. This is a crucial factor in nations determining whether to legalize personal use of the substance. In Canada, this was one of the reasons for the Special Committee on Illegal Drugs making the recommendation for the Government to amend the Controlled Drugs and Substances Act to create a criminal exemption scheme, under which the production and sale of cannabis would be licensed (2002). Another popular argument for legalizing the use of Cannabis in Jamaica is for religious purposes. Rastafarians have long lobbied for the legalization of cannabis for use in their religious rituals. Nevertheless, the use of cannabis in Jamaica, even for therapeutic consumption remains illegal. Cigarettes. The World Health Organization describes Tobacco use (including smoking) as being causally linked to a number of chronic diseases including

Stress and Coping 28 several cancers, Chronic Obstructive Pulmonary Disease (COPD), and cardiovascular diseases. On a global level, the organization reports that a recent study suggests that 4.83 million deaths were attributable to smoking in 2000 (Ezzati and Lopez, 2004 as cited in WHO Global Infobase). The organization further reports that over half of these (2.69 million deaths) were among people aged 30 to 69 years, resulting in a large number of premature deaths. As it relates to comparisons between developing and developed countries, there were equal numbers of deaths due to tobacco. However, findings revealed that there were greater numbers of diseases associated with smoking in developing countries. The organization attributes this to the fact that smoking related deaths occur at younger ages in developing countries, accounting for a larger loss of life from premature mortality in developing countries relative to developed countries. Prevalence data for Jamaica revealed that in 2006, 37% of 13-15 year old males and females from a sample of 1854 rural and urban students had smoked a cigarette at some time in their lives. The health concerns associated with cigarette use for smokers and those inhaling the second hand smoke have been well documented. As a result, smoking cigarettes as a coping mechanism for stress among UWI Mona students has more scientific support for concern than does the use of cannabis. The prevalence of smoking as a coping mechanism in the present sample is expected to be higher than that of cannabis use, at perhaps 20%. Alcohol. Alcohol use has also had a long and colourful history globally. Nations have come full circle from having alcohol consumption outlawed to allowing its

Stress and Coping 29 use, to regulating its use, and in some instances, discouraging its use. The Jamaican experience with alcohol has been closely linked to the nations experience with slavery and the slave trade, as alcohol was one of the primary derivatives from the sugar cane industry. Prevalence data from Professor Kolawole Soyibos study (1995) indicates that 54.4 % of 16-17 year olds in the sample of 1,345 rural and urban Jamaican youths had consumed alcohol in their lifetime (WHO). The use of CCAs is being classified as an emotion-focused way of coping as it does not directly address the problematic situation. It is arguable that CCA use indirectly addresses the situation as the reduction of tension may allow the individual the mental composure to engage in problem solving. However, a more suitable example of a mixed coping approach, incorporating aspects of both emotion-focused and problem-focused coping is the use of social support as presented by Gencoz, Gencoz, and Bozo (2006). Their findings were as follows: Social support was viewed as a mixed coping style since it might encompass different types of resources such as emotional support being convinced that one is loved and cared for, tangible support attaining the required instrument for the solution of the problem, and informational support - attaining the required information for the solution of the problem. Thus, this type of coping may include features of both problem-focused and emotion-focused coping. Some research indicates that coping styles vary between cultures identified as being collectivistic and those identified as being individualistic (Gan, Shang, & Zhang, 2007; Gencoz, Gencoz, & Bozo, 2006). Jamaica may be considered a nation in transition from a more collectivistic way of being among individuals and groups to a more individualistic way of being among members of

Stress and Coping 30 the society. Gencoz, Gencoz, and Bozo (2006) propose that Turkey is one such nation, and as such may engage in more social support seeking methods of coping, and examine this style as separate from emotion-focused and problemfocused. As aforementioned, they outline how social-support may or may not incorporate aspects of both emotion and problem focused approaches to coping. Like Turkey, Jamaica is a developing nation experiencing the transition into higher levels of traditionally Western individualism. However, this author postulates that rather than pursuing social support coping styles, individuals may tend towards substance use as a coping mechanism to deal with increasing levels of stress in their increasingly complicated and socially distant lifestyles. This pattern may obtain for UWI students in the Jamaican context, who though somewhat insulated from the society, are nevertheless impacted upon by the prevailing cultural norms. The underlying implication of the current research is that higher levels of perceived stress will be linked to more frequent use of emotion-focused coping styles. With substance use being a subset of emotion-focused coping mechanisms, this style is expected to have a higher frequency among those scoring higher levels of perceived stress. It is arguable that individuals who appraise various situations negatively and experience them as extremely stressful and perhaps even uncontrollable are more likely to engage in distress-reducing emotion-focused coping mechanisms. Gan, Shang and Zhang (2007) posit that situations perceived as uncontrollable are well dealt with by engaging in emotionfocused coping styles. It is the postulation of this researcher that substance use as

Stress and Coping 31 one such emotion focused coping mechanism will be engaged in by persons experiencing higher levels of stress perceived as uncontrollable. Studies have shown that individuals consistently report feeling a reduction in tension after the use of alcohol (OHare & Sherrer, 1997). It is this researchers position that this is an emotion-focused means of coping. It is the individuals attempt to reduce the distress (s)he is experiencing as a result of a stressful event or perception of something as stressful. Studies demonstrate that the onset of tobacco and alcohol use occurs primarily in early adolescence (Douglas, 2000). One may therefore question the importance of conducting a study among a young adult population, since the likelihood of them already beginning substance use is increased. The necessity rests in the increased chance of first use or increased use under high levels of perceived stress (Brady & Sonne, 1999). Students at the Mona Campus of the UWI The Mona Campus of the University of the West Indies has been consistently registering a significantly higher proportion of female relative to male students. The current gender distribution of the total student body is approximately 71% female to 29% male. Chart 1.1 illustrates the gender distribution trends in the university over the past three years.

Stress and Coping 32

80 70 60 50 40 30 20 10 0 2004/2005 2005/2006 2006/2007 Male Female

Figure 1.1 Gender Distribution at the University of the West Indies, Mona Campus (Data Source: http://www.mona.uwi.edu/opair/profile/student-demographics.pdf) Jamaicans constitute the majority of the student body with 91% of the student body being citizens of Jamaica. 52% of the student population is under 24 years old; 27% are between 25 and 34; and 8% are above 45 years. 72% of the student population currently resides off campus. 2,364 students are presently enrolled in the Faculty of Social Sciences. This constitutes 36.4% of total enrollment. The ratio of students enrolled in the Faculties is Social Sciences (36): Humanities and Education (26): Medical Sciences (18): Pure and Applied Sciences (19): Law (1). Faculty enrollment according to gender is displayed in Table 1.1.

Stress and Coping 33 Table 1.1 Population Distribution at the University of the West Indies, Mona Campus Faculty Humanities and Education Law Medical Sciences Pure and Applied Sciences Social Sciences Total Males 351 7 268 545 590 1761 Females 1330 39 870 721 1774 4734 Total 1681 46 1138 1266 2364 6495

The impact of stress is a reality for university students. There are also unique aspects of that status which bring additional challenges to the student. However, as previously noted, the degree to which one is affected is determined more by their perception or appraisal of the stressor than the actual objective reality of the experience. Abouserie (1994) suggests that approximately one in ten students may need professional support to reduce their levels of stress (as cited in Robotham & Julian, 2006). Though these statistics are based on U.S. populations, it may be argued that the situation at Mona may be similar, since many of the experiences of University students are similar. However, research is necessary to support such a postulate as there are also a multitude of differences between students at the UWI and students in the U.S.A. Coping mechanisms of students may be similar to those in the general population. It is of interest to note, however, that university students have high expectations of substances such as alcohol to function as agents of relaxation and tension reduction (Rauch & Bryant, 2000). This is an important relationship to the study of coping mechanisms employed by university students. Research has

Stress and Coping 34 shown that university campus life provides students many opportunities for growth, however, it is also often associated with serious psychological distress (Aspinwall & Taylor,1992; Leong, Bonz, & Zachar, 1997 as cited in Gan, Shang & Zhang, 2007). In attempts to help students cope with this stress, preventive programs have been administered to university students in both Western and Eastern countries (e.g., Fontana, Hyra, Godfrey, & Cermak, 1999; Hirokawa, Yagi, & Miyata, 2002; Nicholson, Belcastro, & Duncan, 1989 as cited in Gan, Shang & Zhang, 2007). The main component of these preventive programs has been cognitive-behavioral stress management training, particularly relaxation training and coping skills training. The authors argue that understanding the process by which university students experience and cope with psychological distress is crucial for the success of these programs. This will also be the case at the University of the West Indies, making the current research a beginning step in the process of understanding coping among its students. Wallenstein et. al (2007) found that 80.7% of the students surveyed on college campuses in the U.S.A. had consumed alcohol at some time in the past year. Furthermore, more than 44% reported having at least one heavy-drinking episode (5 or more drinks in a single session for men, 4 or more drinks per session for women). Although these statistics relate to what obtains in the U.S.A., the paucity of literature available in this area locally forces reliance upon such data. However, prevalence data for Jamaican 13th graders in 1997 suggests 28% of that segment of the population had consumed alcohol in the past 30 days.

Stress and Coping 35 Studies of substance use behaviours might be considered more robust if individual personality factors are considered. One important factor is locus of control. Gan, Shang and Zhang (2007) describe Rotters locus of control concept as one of the most important personality variables affecting mental health. The perceived stress scale on the Stress and Coping Style Questionnaire examines the level of control the individual feels (s)he has over events in his or her life. Hence, locus of control as it relates to perception of stress is an element which will be incorporated in this study. The literature on stress and coping is vast. However, the primary areas of focus of this research include the relationship between perceived stress and coping styles, particularly substance use as a coping mechanism, the impact of substance expectation on the use of substances as a coping mechanism, and the effect of variables such as controllability of experienced stress on perceived stress scores. These variables will all be examined by factors such as gender, faculty and ethnicity.

Stress and Coping 36 Chapter 3 - Methodology The Perceived Stress and Coping study employs quantitative research methodology to test the following hypotheses: 1. There will be a positive relationship between the level of perceived stress and the use of substances as a coping technique. 2. The likelihood of the use of substances as a coping technique will increase if the substance is considered to have a positive effect. This section will describe the sample distribution and sample selection. The psychometric properties of the Stress and Coping Style Questionnaire as well as the two scales used in its construction, the Perceived Stress Scale (PSS) and the Brief COPE, will be discussed. In addition, data collection procedures and analysis will be outlined. Figure 3.1 illustrates the research design and informs the discussion which follows.

Stress and Coping 37

1. 2.

Hypotheses There will be a positive relationship between the level of perceived stress and the use of substances as a coping technique. The likelihood of the use of substances as a coping technique will increase if the substance is perceived to have a positive effect.

(A) Independent Variable: Perceived Stress

(B) Dependent Variable: Substance Use as a Coping Technique Data Presentation: (E) Tables, Bar Charts, SPSS, Frequency Distributions, Pearsons r, ANOVA Quantitative Data Analysis:Histograms, and Frequency Distribution Graphs. Moderator Variable: Expectation of Substance Impact Figure 3.1 Research Design Diagram Sample The sample was taken from the population of students at the Mona Campus of the University of the West Indies. The stated hypotheses were looked at by gender, faculty, and residential status, using the respective ratios for each category. The anticipated strength of the association is a correlational coefficient (r = .35) with 90% power, (alpha = .05). To demonstrate statistical significance amongst the identified subgroups a minimum sample size of 240 respondents was required. 40 extra

Stress and Coping 38 respondents were included to allow for discards. The sample size calculating software SamplePower v.2.0 was used (developed by SPSS inc., Chicago, IL, USA). Stratified Random sampling was used to administer the instrument. Table 3.1 shows the distribution of the sample according to the stated categories. Table 3.1 Sample Distribution Humanities & Gender On Campus Off Campus Gender Total Faculty Total Total Research Design Survey methodology was used to collect the data on the association between perceived stress and coping in the sample. It is a correlational study which seeks to establish the association between the stated variables on the Mona campus of the University of the West Indies. Additionally, the effect of a moderator variable, expectation of substance impact will be analyzed. Baron and Kenny (1986) describe a moderator variable as a qualitative (e.g. sex, race, class) or quantitative variable that affects the direction and/ or strength of a relation between an independent or predictor variable and a dependent or criterion variable a basic moderator effect can be represented as an interaction between a focal independent variable and a factor (the moderator) that specifies the appropriate conditions for its operationModerator variables are typically education M F 4 16 11 40 15 71 56 Law M 0 1 1 3 F 1 1 2 Medical sciences M F 9 10 3 26 12 48 36 55 103 n = 280 Pure & applied M F 7 8 18 22 25 30 Social sciences M F 8 21 20 54 28 75

Stress and Coping 39 introduced when there is an unexpectedly weak or inconsistent relationship between a predictor and a criterion (cited in Holmbeck, 1997). The moderators effect was examined by including an item on the questionnaire which determines the expectations respondents have of various substances. Instrumentation The questionnaire is a 30 item instrument consisting of a demographic section, two pre-constructed scales, and items constructed by the

researcher. The perceived stress scale constructed by, Cohen, Kamarck, and Mermelstein (1983) consists of 10 items. Internal reliability of r = .86 was achieved on a sample of University of Oregon students. Test-re-test reliability for this scale was also found to be r = .85 (Cohen, Kamarck & Mermelstein, 1983). The psychometric properties of the 14-item PSS were determined from data collected from three samples, two groups of college students, and one group of respondents in a community smoking-cessation program. Coefficient alpha reliability for the PSS was .84, .85, and .86 in each of the three samples. Therefore it may be said that the PSS has a reasonably high level of internal reliability. According to George and Mallory (2003) Cronbachs alpha may be interpreted as follows alpha > .90 excellent; alpha > .80 good; alpha > .70 acceptable; alpha > .60 questionable; alpha > .50 poor; alpha < .50 unacceptable. The shortened COPE was adapted from Charles Carvers Brief COPE (1997) for use in this study. The Brief COPE includes 28 items, which measure 14 conceptually differentiable coping reactions (Carver, 1997). However, after

Stress and Coping 40 receiving feedback from respondents in the piloting of the Stress and Coping Style Questionnaire the researcher shortened the Brief COPE and included only one of the two items on each of the fourteen scales. Exception was made for the scale related to substance use to allow for scale analysis with the perceived stress scale score. As a result, reliability can only be calculated for the Substance Use scale of the Brief COPE. Reliability for this scale is alpha = 0.882, which is good reliability. The instrument, which is a compilation of the two previously mentioned scales, demographic items and the 6 items constructed by the researcher was piloted at the University of the West Indies engaging 28 students (10 % of the sample size). This led to the adaptation of the instrument. As mentioned the Brief COPE was shortened to allow for faster completion of the instrument. A copy of the instrument is provided in Appendix A. Procedures for Collecting Data Lecturers of core courses in each faculty were asked to allow the researcher to address students after class was dismissed to solicit their participation. Students who were willing to participate completed the instrument in approximately 10 minutes. The places, courses and dates on which data were collected are presented in Table 2.2 Sample Selection. The questionnaire was distributed by the researcher to all students in the class who were willing to participate and collected as persons indicated that they were finished. Table 3.2 Sample Selection

Stress and Coping 41 Number of students 36 35 3 55 46 37 20 48 280

Faculty

Course/ Location PH10A Introduction to Logic PH10B Ethics and Applied Ethics

Humanities & Education

Law Pure & Applied Sciences

Outside the Faculty of Law main entrance M08B Pre-Calculus EC 16A Introductory Statistics GT23F Issues in Contemporary Politics SW 24D Drug and Society Medical Library

Social Sciences

Medical Sciences Total Data Analysis

Descriptive statistics were computed for all variables of interest and reported. Tests that were run are Chi-Square test of independence; Spearmans correlation was conducted to analyze the association between perceived stress and coping style. Cronbachs alpha was used to analyze the reliability of the Perceived Stress Scale on the Stress and Coping Style Questionnaire. Analysis of Variance (ANOVA) was used to determine whether a significant difference exists between students enrolled in the various faculties. ANOVA was also used to determine the difference between groups of persons expecting no effect from the use of CCAs, beneficial effect, harmful effect, and mixed effects in actual reporting of CCA use as a coping mechanism.

Stress and Coping 42

Chapter 4 - Results The findings of this study are indicative of patterns and trends among students of the Mona campus of the University of the West Indies. 268 was the final number of respondents included in the study after removing incomplete questionnaires. The sample distribution by gender was not identical to the

Stress and Coping 43 stratification in the population. On the Mona campus, 71% of students are female and 29% are male. In the sample, 69.8% of respondents were female and 30.2% were male. There was a .8% difference from what was suggested by the population. Overall, the sample was representative of the UWI Mona population as it relates to gender. The breakdown is depicted in Figure 4.1.

Male - 30.2% Female - 69.8%

Figure 4.1 Gender Distribution

Stratified random sampling methodology was used to ensure that the sample distribution represented the population of the University of the West Indies Mona campus according to Faculty. As a result, the actual sample distribution is representative of the enrollment levels across Faculties on the

Stress and Coping 44 campus. The distribution in the sample according to Faculty is represented in Figure 4.2.

40%

30%

20%
Percent

10 %

0%
Humanities & Education Law

Medical Sciences

Pure & Applied Social Sciences Sciences

Faculty

Figure 4.2 Sample Distribution by Faculty

Respondents were asked to provide the researcher with their age range. Most of the respondents, 53.7%, fell between 18 and 21 years. One subject reported being under 18 and 11.2% of respondents were above age 30. The age

Stress and Coping 45 distribution in the sample is not representative of the Universitys population as only 50% of undergraduate students on the Mona Campus are under 25 years of age. Over 80% of the respondents in the sample were below 25 years. Age distribution of the respondents is illustrated in Table 4.1.
Table 4.1 Age Range

Age range

Frequency

Percent

Under 18 1 .4 18-21 144 53.7 22-25 75 28.0 26-29 18 6.7 30 & up 30 11.2 Total 268 100.0 ________________________________________________ Of the 268 respondents, 85.4% had full-time enrollment status, with the remaining 14.6% being part-time students. As it relates to residency status, 77.2% of participants resided on-campus and the remaining 22.8% resided off-campus. Approximately 30% of respondents were affiliated with Taylor Hall, 17.9% with Preston Hall, 17.2% with Rex Nettleford Hall, 15.7% with Irvine Hall, 8.6% with Mary Seacole Hall, and 6.3% with Chancellor Hall. Ten respondents did not provide information on their Hall of attachment. Persons describing themselves as Black constituted the greater portion of the sample totaling 84.7% of respondents. Three percent of respondents were of Indian descent. Respondents of mixed descent accounted for 11.9% of the sample. One participant was of Caucasian descent. Jamaicans made up 92.5% of the sample. The second largest group consisted of Trinidadians with 1.9%. Other

Stress and Coping 46 countries represented were Antigua, Bahamas, Barbados, Belize, British Virgin Islands, Guyana, Monsterrat, St.Lucia, St. Vincent, and the United Kingdom. Perceived Stress Levels Among Respondents The Perceived Stress Scale of the Stress and Coping Style Questionnaire measures the level of stress individuals perceive themselves as experiencing over the past 30 days. The lowest possible score on the scale is 0 and the highest possible score is 40. The closer an individuals score is to 40, the higher their level of perceived stress. The opposite also holds true, that is, the closer the score is to 0, the lower is the individuals level of perceived stress. The median point, 20, can be interpreted as showing that the individual is experiencing moderate levels of stress. The five point Likert-type scale was used to calculate respondents scores. PSS scores were derived by summing the responses to the ten items on the scale. The distribution of scores on the PSS among the entire sample fell along the normal curve, with a mean PSS score of 20.9 and standard deviation of 6.42. This sample mean is comparable to that of the normative sample of 332 students from the University of Oregon whose average PSS Score was 23.18. There were a few outliers in the present sample. Nevertheless, most scores clustered around the mean. The normal distribution of the PSS score indicates that the respondents in the sample were reporting moderate levels of stress. According to George and Mallory (2003), good reliability is alpha > .80. By these standards, internal reliability for the Perceived Stress Scale was good as evidenced by

Stress and Coping 47 Cronbachs alpha = 0.849. The distribution of the PSS in the sample is highlighted in Figure 4.3. Perceived Stress Score
50

40

% of Subjects
30

Frequency

20

10

0 0 10 20 30 40

Mean = 20.9 Std. Dev. = 6.418 N = 268

Perceived Stress Score Figure 4.3 Perceived Stress Frequency Distribution Perceived Stress and Gender. Respondents reported that School Related stress was the most difficult type of stress for them to cope with. This pattern was noted among both males and females. However, females also reported more than one as being most difficult. This is reflected in Table 4.2. In addition, females were twice as likely as males to report relationship related stress as the most difficult for them to cope with. The distribution of types of stress and how difficult each type is perceived, according to gender, is outlined in Table 4.2. Table 4.2 Stress Category Distribution by Gender

Stress and Coping 48 Relationship related stress 15.0% 30.5% Home related stress 17.5% 25.1%

Gender Males Females

School related stress 67.5% 72.7%

Objective1. Frequency of Substance Use as a Coping Mechanism One of the objectives of this study was to provide data on the frequency of the use of substances as a coping mechanism for stress among students of the University of the West Indies, Mona campus. The two item subscale related to substance use coping was used to calculate substance use coping scores. On this scale, 11.2% of respondents reported that they used alcohol, cigarettes or cannabis to make themselves feel better when experiencing stress. This is reflected in Figure 4.4.
250 200

No. of subjects
150

100
Frequency

50
0

Mean = 0.31 Std. Dev. = 0.989

N = 268 6 4 0 2 Substance and Gender, Residential Substance Use CopingUse Coping Scale Score Status and Faculty.

Figure 4.4 Substance Use Coping Frequency Substance Use Coping Scale Scores indicate that there was no significant difference in substance use coping behaviours between males and females. This was demonstrated by the Chi-square test of significance, .273. Table 4.3 demonstrates the scores obtained by males and females in the study. There was

Stress and Coping 49 also no statistically significant difference between substance use coping scores by residential status or faculty. Table 4.3 Distribution of Substance Use Coping Scores by Gender Gender Males Females 0 84.0% 89.8% 1 4.9% .5% Substance use coping scale scores 2 3 4 5 8.6% 1.2% 0% 0% 5.3% 2.1% 0% .5% 6 1.2% 1.6%

Hypothesis One The first hypothesis of this study is that there will be a positive relationship between the level of perceived stress and the use of substances as a coping mechanism. In other words, as the level of perceived stress increases, so should the use of substances as a coping mechanism. Calculation of Pearsons r coefficient indicated a positive correlation between levels of perceived stress and substance use coping, r = 0.191; alpha=.01. However, the correlation is not statistically significant. Furthermore, the relationship between the two variables may be better described as curvilinear. This is depicted in Figure 4.5.

Stress and Coping 50

35

30

25

o s t S d v i c r P n a e M
20 0 1 2 3 5 6

Substance Use Coping Scale

Figure 4.5 Relationship between Perceived Stress and Substance Use Coping Given this curvilinear nature of the association between the two variables, the null hypothesis that there will be no positive relationship between levels of perceived stress and substance use coping must be accepted.

Objective 2. The Substance Most Frequently Used as Coping Mechanism Among respondents reporting the use of substances as a coping mechanism, the majority reported alcohol as their drug of choice. The second most frequently used substance was cannabis, followed by alcohol. Some respondents reported that they did not use substances as a coping mechanism, but

Stress and Coping 51 went on to endorse alcohol as the substance they would use when feeling stressed. This pattern led to higher frequencies being reported for the use of alcohol as a coping mechanism for stress than those reported on the substance use coping scale. This latter scale had combined the three substances (CCA) on the two items. Table 4.4 depicts the frequency of the use of alcohol, cannabis, and cigarettes in the sample. Table 4.4 Frequency of CCA Use Substance Percentage of sample reporting substance use Alcohol 21.6% Cigarettes 4.5% Cannabis 4.1%

Objective3. Coping Styles Most Frequently Used by Students The third objective of this research was to discover the coping style most frequently used by students at the Mona Campus. The results indicate that planning as titled by Cohen (1995) on the Brief COPE was the most frequently used coping style with 38.1% of respondents reporting that they were coming up with a strategy about what to do a lot of the time. The related concept of active coping, also outlined by Cohen (1995) was the second most frequently used coping mechanism, with 31.3% of students endorsing it as their most frequently used approach to coping with stress. It must also be noted that there were no statistically significant gender differences in the use of planning and active coping. The least frequently used coping mechanism used by students was denial

Stress and Coping 52 with 3.9% of students reporting that they have been saying this isnt real a lot of the time. Objective 4. Analysis of the Impact of Expectation of Substance Effect on the Relationship between Level of Perceived Stress and Substance Use Coping The fourth and final objective of this study was to analyze the impact of expectations of the substances effect as a mediating factor between the level of perceived stress and the use of substances as a coping mechanism. Students expectations of the effect of the use of CCAs was linked to a statistically significant amount of the variation in the level of substance use as a coping mechanism, F (5, 262) = 6.688, p<0.001). Respondents expecting substances to have harmful effects on them reported significantly lower use of substances as a coping mechanism than those expecting the use of CCAs to have either a beneficial or a mixed effect. Those expecting beneficial effects reported significantly higher levels of substance use as a coping mechanism than those with mixed expectations. The difference in the expectations of the use of substances as a coping mechanism was greatest between those who expected CCAs to have a harmful effect and those who expected CCAs to have beneficial effects, with the former group having a statistically significantly higher score on the substance use as a coping scale than the latter group. Figure 4.7 depicts the distribution of mean substance use scores among the four groups.

Harmful Harmful

Stress and Coping 53

0.8

0.6

Mean Sub. Use Scale Score


0.4

Mean of substanceuse

0.2

None

Beneficial

Harmful

Mixed (Beneficial & Harmful)

What effect would you expect the use of CCA to have on you?

Figure 4.6 Means Plot of Expectation of Substance Use and Substance Use Coping Mean Scores Hypothesis 2. The statistically significant differences between the means of substance use coping scale scores of respondents with different expectations of substances effect indicates a statistically significant relationship between those two variables. Accordingly, the second hypothesis of this study that the likelihood of the use of substances as a coping technique will increase if the substances are considered to have positive effects was supported by this finding. The statistically significant

Stress and Coping 54 relationship between the variables indicates that the null hypothesis must be rejected. Students Perceptions of Substances Responses to the item enquiring about which substances are considered addictive indicate that 33.7% of respondents are of the opinion that heroine is not an addictive substance. Findings further indicate that 19.8% of respondents reported that they did not consider crack/cocaine to be an addictive substance. Approximately 70% of the respondents indicated that they think cigarettes are addictive. As it relates to cannabis and alcohol, 67.5% of respondents and 71.6% of respondents respectively indicated that these substances were addictive.

Stress and Coping 55 Chapter 5 - Discussion The findings of the study indicate that there is an association between perceived stress and coping, though it is a weak one. The findings also demonstrate that there is a statistically significant relationship between the expectation of the substances effect and the actual use of the substance as a coping mechanism for stress which finds support in OHare and Sherrers study (1997). These findings and other patterns identified in the data along with the implications of these findings will be discussed in this section. Additionally, limitations, recommendations, and suggestions for future research arising from the findings will also be presented. Objective1. Frequency of Substance Use as a Coping Mechanism The first objective of this study was to provide data on the frequency of the use of substances as a coping mechanism among UWI Mona students. As reported, 11.2% of respondents reported that they engaged in the use of alcohol, cigarettes or cannabis in efforts to cope with their experiences of stress. It is significant to note that almost 90% of the respondents indicated that they did not engage in the use of substances as a coping mechanism for stress. Findings indicate that the levels of perceived stress among respondents were moderate, with a mean stress score of 20.9. This indicates that students were reporting levels of stress comparative to the students in the normative sample of University of Oregon students. This may be construed as a positive indicator of the students emotional well-being as they were not reporting extreme levels of perceived stress. It is arguable that the moderate levels of stress being experienced by

Stress and Coping 56 respondents accounted for the low use of substances as a coping mechanism. However, that conclusion would be hasty since the relationship between perceived stress and substance use coping was weak, r=0.191. The hypothesis that higher levels of perceived stress would be associated with higher levels of substance use as a coping mechanism was supported by the data, though moderately so. There was an association between the two variables which was weak, r = 0.191; alpha=.01. The curvilinear relationship was depicted in Figure 4.5. Given that the relationship between the two variables was not significant as stated in the hypothesis, the null hypothesis was accepted. Objective 2. The Substance Most Frequently Used as a Coping Mechanism The second objective of the study was to establish the drug of choice for students at the Mona campus of the University of the West Indies when they are feeling stressed. As the results indicate, alcohol was the drug of choice among respondents, with 21.6% of participants reporting use when feeling stressed. Cigarettes were the second most prevalent, followed by cannabis, with 4.5% and 4.1% respectively reporting use of these substances. This finding is supported by the extant literature which indicates that alcohol is a prevalent drug of choice on university and college campuses in the United States (Baer et.al, 2001). The lack of literature available for Jamaican universities and colleges makes comparison impossible. However, prevalence data for the nation indicates that alcohol is the most frequently used substance among youths between the ages of 15 to 17 (WHO).

Stress and Coping 57 The prevalence of the use of alcohol as a coping mechanism among respondents bears significance for students at the University of the West Indies since the use of alcohol as a tension reducer has been found to lead to problematic drinking (OHare & Sherrer, 1997). Problematic drinking was outlined as any consumption of alcohol associated with legal problems or disruptive behaviours. Further research on the Mona campus can elucidate whether problem drinking is a cause for concern in this setting and if so, it can set the stage for the necessary education programmes warranted to address the situation. This has been the approach in other universities where problem drinking has been identified as disrupting student and campus life (Lang & Marlatt, 1982, as cited in Taylor, 2003). Regarding the prevalence of cannabis use among the respondents, the stated projection of 15% of the sample was not met. Rather, 4.1% of respondents reported using cannabis as a coping mechanism. This rate appears to be lower than prevalence data for the Jamaican population. It is possible that this low rating was due to the effect respondents expected substances inclusive of cannabis to have on them. Most respondents expected the use of CCAs to have a harmful effect upon them. The ANOVA indicates that respondents expectations were significantly related to the use of CCAs as a coping mechanism and accounted for much of the variance in use. Low rates of cigarette use in coping were also reported among the respondents (4.5%). This is also lower than prevalence rates for Jamaica.

Stress and Coping 58 Objective3. Coping Styles Most Frequently Used by Students The coping style reported as the most frequently used by students in dealing with their levels of perceived stress was planning, with 38.1% of participants endorsing this option. Active coping was the second most frequently used coping style with 31.3% of respondents indicating that choice. It is apparent that solution-focused coping is the dominant approach among students in the sample. According to Gan, Shang, and Zhang (2007) this is an adaptive approach to coping for university students who are faced with the many challenges of balancing academic work with other aspects of life. This finding is potentially a positive indicator for the psychological well-being of students at the Mona campus of the University of the West Indies. Consideration must be given to the fact that the study employed self-report measures. Moreover, the data collection was done in the school environment. It is not far-fetched to propose that social psychological factors may have impacted students responses to items on the questionnaire. It would be an interesting endeavor to administer perceived stress and coping instruments in different settings and compare the results. This would be one way of assessing whether Sasaki and Yamasakis (2007) concept of situational coping was being represented in the present study. It is possible that the high reporting of planning and active coping as approaches to dealing with stress was influenced by the situation in which the research was conducted. This could have been the case as students may have been reflecting primarily on the coping mechanisms they engage in as it relates to school related stress. The finding that most participants

Stress and Coping 59 reported that school related stress was the most difficult type of stress to deal with may be an indication that respondents attentions were grounded in their setting while completing the instruments. However, this is an assumption which can serve to inform future research into the area of situational and dispositional coping as outlined by Sasaki and Yamasaki (2007). Gender and Coping. It is also of interest to note that there were no statistically significant gender differences in coping styles identified in this study. However, there were statistically significant differences in the perceptions of stressful experiences among male and female respondents. Males were two times less likely than females to report that relationship related stress was the most difficult for them. On the other hand, males and females both reported that school related stress was the most difficult type of stress for them to cope with. Objective 4. Analysis of the Impact of Expectation of Substance Effect on the Relationship between Level of Perceived Stress and Substance Use Coping As previously mentioned, the ANOVA indicates statistically significant differences between students substance use behaviour as a function of their expectations of the substances impact. Whether this mediates the relationship between level of perceived stress and substance use as a coping mechanism has not been clearly established. Limitations related to the type of measurement employed in the examination of substance effects restricted the possibilities for statistical analysis. Although a relationship exists between expectations and

Stress and Coping 60 substance use coping scores, it cannot be stated conclusively that this relationship impacted upon the association between substance use coping and perceived stress. Limitations One of the major weaknesses of this study was how the Brief COPE was administered. Prior to the pilot study, the scale was abbreviated and one item from each of the two-item scales of the Brief COPE was omitted. This made the data limited in the statistical analysis which could be applied to it such as the exclusion of regression analyses from the study. The original two-item scales would have allowed for greater statistical analysis of each coping style. Comparisons between coping styles and correlations between each coping style and the Perceived Stress Scale were rendered impossible by the alteration. This challenge could have been circumvented by removing sub-scales which were not of immediate importance to the current research. The other major weakness of this study is also related to measurement. The researcher developed an item to assess respondents expectations of the effects of cannabis, alcohol and cigarette use. However, the item was structured in a manner which clustered all three substances together and did not allow for two important things. First, the item failed to allow respondents to rate the effects of each substance independently. Secondly, the item did not allow respondents to indicate the extent to which each substance could have a positive, negative, or mixed effect. For example, it would have been useful to know whether respondents rated cannabis as having more or less calming effects than alcohol or

Stress and Coping 61 cigarettes. This type of rating scale can be developed using a five point likerttype scale for each substance. Recommendations Findings of this study indicate that students of the Mona campus of the UWI are experiencing moderate levels of stress comparable to the normative sample of 332 students at the University of Oregon. However, universities around the world are investing in their student body by developing programmes targeted at educating them about stress reduction (Taylor, 2003). As such, it is the recommendation of this researcher that the University of the West Indies administrators and leaders give thought to the establishment of health awareness courses. This would be to the benefit of students, particularly freshmen making the transition into university life. Studies have shown that freshmen benefit from programmes geared towards preparing them to handle the challenges of academia (Gan, Shang, & Zhang, 2007). Another recommendation arising from the study is the need for more substance abuse awareness among students of the University of the West Indies. Respondents indicated some misinformation concerning the chemically addictive nature of some substances including heroine and crack/cocaine. Approximately 33% and 20% of respondents identified heroine and crack/cocaine respectively as not being addictive substances. This demonstrates a lack of knowledge among students or it could demonstrate a defiance of established facts. Nevertheless, the recommendation of this researcher is to develop additional substance awareness

Stress and Coping 62 programmes to educate students about the properties of hard drugs such as heroine and crack/cocaine. Suggestions for Future Research As it relates to future research in this field, it would be of interest to discover whether Jamaicans and Caribbean people have different approaches to coping. One particular aspect of interest would be to determine in what domains the people of this region are more likely to engage in situational versus dispositional coping. Also, it would be useful to examine which conditions are more likely to elicit maladaptive and adaptive coping approaches. Furthermore, it would be helpful to determine whether approaches labeled as maladaptive and adaptive are perceived in the same way and produce the same results as their use in other societies. Conclusion The measure of perceived stress reflected a normal distribution among respondents in this study. The most dominant coping mechanism reported was planning. Some might argue that these are positive indicators of the psychological well-being of the respondents. Furthermore, actual substance use coping behaviours were far less than what was projected based on international trends. Compared to the prevalence data for Jamaica, this study shows significantly lower use of cannabis and cigarettes. The hypothesis that perceived stress and substance use coping would be positively related was moderately supported. The secondary hypothesis which postulated that the relationship between perceived stress and substance use coping would be mediated by

Stress and Coping 63 expectations was not adequately explored. However, there is reliable evidence that expectations of substance impact accounted for much of the variance in substance use coping scores. This finding is significant as it could indicate that expectations mediate the relationship between the independent and dependent variables. However, this cannot be stated conclusively from the data gathered in this study. One of the most important findings of this study is the low prevalence of substance use as a coping mechanism among students of the Mona Campus of the University of the West Indies. The high use of planning and active coping strategies potentially make a case for assessing the student body as having at least one indicator of positive psychological functioning. Further research is necessary to examine the nature of the use of alcohol among UWI Mona students to determine whether the substance is being misused. The findings of this research indicate that students are making decisions based on their assumptions about substances.

Stress and Coping 64 References Abel, Wendel. (2003). Ganja-the facts. An article published in The Jamaica Gleaner. Wednesday, November 5, 2003. Aldwin, C.M., Sutton, K.J., & Lachman, M. (1996). The development of coping resources in adulthood. Journal of Personality, 64. Andrews, T. V. (1980). Sources and symptoms of stress among a sample of Jamaican secondary school teachers (Doctoral Dissertation, University of the West-Indies). Baer, J.S., Kivlahan, D.R., Blume, A.W., McKnight, P., & Marlatt, G.A. (2001). Brief intervention for heavy-drinking college students: 4-Year follow-up and natural history. American Journal of Public Health, 91, 1310 1316. Brady, K.T. & Sonne, S.C. (2000). The role of stress in alcohol use, alcoholism treatment, and relapse. Alcohol Research & Health, 23, 263-271. Brunswick, A.F., Lewis, C.S., & Messeri, P.A. (1992). Drug use and stress: Testing a coping model in an urban African-american sample. Journal of Community Psychology, 20. Canadian Senate Special Committee on Illegal Drugs. Cannabis: Our position for a Canadian public policy http://www.parl.gc.ca/37/1/parlbus/commbus/senate/com-e/ille-e/repe/summary-e.pdf Carver, C.S. (1997). You want to measure coping but your protocols too long:

Stress and Coping 65 Consider the Brief COPE. International Journal of Behavioural Medicine, 4, 92 100. Cohen, S., Kamarck, T. & Mermelstein, R. (1983). A global measure of perceived stress. Journal of Health and Social Behavior, 24, 385 396. Coomber, R., Oliver, M. & Morris, C. (2003). Using cannabis therapeutically in the uk: A qualitative analysis. Journal of Drug Issues. DeLongis, A. & Holtzman, S. (2005). Coping in context: The role of stress, social support and personality in coping. Journal of Personality, 73. Douglas, Ken-Garfield. (2000). Patterns of substance use and abuse among post primary students. Prepared for Planning Institute of Jamaica Policy Development Unit. Pear Tree Press: Kingston. Duncan, R. (2000).Prevalance of upper extremity musculo-skeletal disorders, eyestrain and stress related illness a(Doctoral Dissertation, University of the West-Indies). Dyson, R. & Renk, K. (2006). Freshmen adaptation to university life: Depressive symptoms, stress, and coping. Journal of Clinical Psychology, 62, 12311244. Edwards, A. A. (1988). Correlates of stress experienced by Common Entrance candidates. (Doctoral Dissertation, University of the West-Indies). Fergusson, D.M. & Horwood, L.J. (2000). Research report on cannabis: Does cannabis use encourage other forms of illicit drug use? Addiction, 95, 505-520.

Stress and Coping 66 Freckleton, V. P. (1984). A study of the relationship between stress and hypertension among factory workers in Jamaica (Doctoral Dissertation, University of the West-Indies). Gan, Y., Shang, J., & Zhang, Y. (2007). Coping flexibility and locus of control as predictors of burnout among Chinese college students. Social Behavior and Personality, 35, 1087-1098. Gencoz, F., Gencoz, T., & Bozo, O. (2006). Hierarchical dimensions of coping styles: A study conducted with Turkish university students. Social Behavior and Personality, 34, 525-534. George, D. & Mallory, P. (2003). SPSS for windows step by step: A simple guide and reference. Allyn and Bacon: Boston. Gruen, R.J., Folkman, S. & Lazarus, R.S. (1988). Centrality and individual differences in the meaning of daily hassles. Journal of Personality. 56, No. 4. Herrington, A.N., Matheny, K.B., Curlette, W.L., McCarthy, C.J., & Penick, J. (2005). Lifestyles, coping resources, and negative life events as predictors of emotional distress in university women. The Journal of Individual Psychology, Vol. 61, No. 4. Howard, R.C. & Menkes, D.B. (2007). Changes in brain function during acute cannabis intoxication: Preliminary findings suggest a mechanism for cannabis-induced violence. Criminal Behavior and Mental Health, 17, 113-117. Lazarus, R.S. & Folkman, S. (1987). Transactional theory and research on

Stress and Coping 67 emotions and coping. European Journal of Personality.1, 141 169. Lindo, J. L. (2003). General mental well being among medical personnel in two urban hospitals in Kingston, Jamaica (Doctoral Dissertation, University of the West-Indies). Matheny, K. B. & Ashby, J.S. (2005). Stress and coping and individual psychology. The Journal of Individual Psychology, 61, No. 4 Matheny, K.B., Ashby, J.S., & Cupp, P. (2005). Gender differences in stress, coping, and illness among college students. The Journal of Individual Psychology, 61. Mulligan Rauch, S.A. & Becker Bryant, J. (2000). Gender and Context differences in alcohol expectancies. Journal of Social Psychology, 140, 240 253. OHare, T. & Sherrer, M.V. (1997). Drinking problems, alcohol expectancies, and drinking contexts in college first offenders. Journal of Alcohol and Drug Education,.43, 31 46. Oo, M. K. (2002). A study of postraumatic stress disorder among Jamaica Constabulary Force personnel (Doctoral Dissertation, University of the West-Indies). Robotham, D. & Julian, C. (2006). Stress and the higher education student: a critical review of the literature. Journal of Further and Higher Education, 30, 107117. Sasaki, M. & Yamasaki, K. (2007). Stress coping and the adjustment process among university freshmen. Counselling psychology quarterly, 20, 51-67.

Stress and Coping 68 Scott-Fisher, K. (1999). Relationship between stressful life events and pain in young adults age 20-34 (Doctoral Dissertation, University of the WestIndies). Struthers, C.W., Perry, R.P., & Menec, V.H. (2000). An examination of the relationship among academic stress, coping, motivation, and performance in college. Research in Higher Education, 41. Taylor, Shelley E. (2003). Health Psychology. McGraw Hill: Boston. Taylor, S.E., Lerner, J.S., Sage, R.M., Lehman, B.J., &. Seeman, T.E. (2004). Early environment, emotions, responses to stress, and health. Journal of Personality 72, 1365 - 1394. Wallenstein, G.V., Pigeon, S., Kopans, B., Jacobs, D.B., Aseltine, R. (2007). Results of national alcohol screening day: College demographics, clinical characteristics and comparison with online screening. Journal of American College Health, 55, 341- 350. Williams, B.E. (1993).Self esteem and stress in public primary and private preparatory schools(Doctoral Dissertation, University of the West-Indies). UWI student demographics. (n.d.). Retrieved September 10, 2007, from http://www.mona.uwi.edu/opair/profile/student-demographics.pdf UWI student demographics. (n.d.). Retrieved October 1, 2007, from http://www. mona.uwi.edu/opair/research/ WHOs infobase. (n.d.) Retrieved April 3, 2008, from http://www.who.int/infobase/mddetails.aspx?surveycode=102588a1

Stress and Coping 69 WHOs infobase. (n.d.). Retreived April 3, 2008, from http://www.who.int /infobase/reportviewer.aspx? rptcode=ALL&uncode=388&dm=15&surveycode=101530c2

Stress and Coping 70 Appendix A


This is a survey of your style of coping with stress. Your most accurate response is greatly appreciated. Thank you for your participation. Please place a tick in the appropriate box. A. Age Range: Under 18 30 & up B. C. Sex: Male Faculty: Law Female Medical Sciences Social Sciences Humanities & Education 18 21 22 25 26- 29

Pure & Applied Sciences D. E. Major:

___________________________________ Masters Doctoral

Degree: Bachelors

Diploma/ Other (Specify)______________ F. G. H. Status: Full-Time Reside: On-Campus Part-Time Off-Campus Irvine

Hall of Attachment: Aston Preston Chancellor Mary Seacole Rex Nettleford Taylor Relationship Status: Single Committed Number of Children: None 12

I.

Recently Separated

Widowed J. K. 3-4 5 or more Indian/

Race/ Ethnicity: Black Caucasian/ Caucasian Descent Chinese/ Chinese Descent Indian Descent Mixed (Specify)______________ Other (Specify) _______________________________________

L.

Nationality: Jamaican

Other (Specify) ____________________

Stress and Coping 71


The next section asks you about your feelings and thoughts during the last month. In each case, please indicate with a check how often you felt or thought a certain way.

1. In the last month, how often have you been upset because of something that happened unexpectedly? 2. In the last month, how often have you felt that you were unable to control the important things in your life? 3. In the last month, how often have you felt nervous and "stressed"? 4. In the last month, how often have you felt confident about your ability to handle your personal problems? 5. In the last month, how often have you felt that things were going your way? 6. In the last month, how often have you found that you could not cope with all the things that you had to do? 7. In the last month, how often have you been able to control irritations in your life? 8. In the last month, how often have you felt that you were on top of things? 9. . In the last month, how often have you been angered because of things that were outside of your control? 10. In the last month, how often have you felt difficulties were piling up so high that you could not overcome them?

Almos Never t Never

Sometime s

Fairly Often

Very Often

Stress and Coping 72

These items deal with ways you've been coping with the stress in your life in the past 30 days. Each item describes a particular way of coping. I want to know to what extent you've been doing what the item says - how much or how frequently. Don't answer on the basis of whether it seems to be working or notjust whether or not you're doing it. Try to rate each item separately in your mind from the others. Make your answers as true FOR YOU as you can. Please place a tick in the box with the response that best describes you. I haven't been doing this at all I've been doing this a little bit I've been doing this a medium amount I've been doing this a lot

Your way of coping 11. I've been saying to myself this isn't real. 12. I've been using alcohol, ganja, cigarettes or other drugs to make myself feel better. 13. I've been getting emotional support like comfort and understanding from others. 14. I've been giving up trying to deal with it. 15. I've been taking action to try to make the situation better. 16. I've been saying things to let my unpleasant feelings escape. 17. Ive been getting help and advice from other people. 18. I've been using alcohol, ganja, cigarettes or other drugs to help me get through it. 19. I've been trying to see it in a different light, to make it seem more positive.

Stress and Coping 73


I've been doing this a medium amount

Your way of coping 20. I've been trying to come up with a strategy about what to do. 21. I've been doing something to think about it less, such as going to movies, watching TV, reading, daydreaming, sleeping, or shopping. 22. I've been trying to find comfort in my religion or spiritual beliefs. (Prayer/ Meditation) 23. I've been learning to live with the stressors. 24. Ive been blaming myself for things that happened. 25. I've been making fun/ jokes about the situation.

I haven't been doing this at all

I've been doing this a little bit

I've been doing this a lot

26. Which type of stress is the most difficult for you to deal with:

___ School Related (e.g. papers, exams, registration, etc.) ___ Relationship Related (e.g. break up, argument, etc.) ___ Home Related (e.g. parents argue, family dispute, etc.) ___ Other (Specify)_______________

Stress and Coping 74 27. For which type of stress are you
most likely to drink alcohol, smoke a cigarette, or use ganja (seasoned spliff, chillum pipe, etc.) to cope? ___ School Related (e.g. papers, exams, registration, etc.) ___ Relationship Related (e.g. break up, argument, etc.) ___ Home Related (e.g. parents argue, family dispute, etc.) ___ Other (Specify)_______________ ___ None

28. Which of the following substances


are you most likely to use when feeling stressed:

___ Alcohol ___ Ganja

___ Cigarette ___ None

___ Other (Specify) ______________

29. Which of the following substances are drugs that people can be addicted to?

___ Crack/ Cocaine ___ Ganja ___ Heroine

___ Alcohol ___ Cigarettes ___ Ecstasy

30. If you were to use alcohol,


cigarettes, or ganja, which of these effects would you expect it to have on you?

___Reduce Tension ___Enhance Sexual Performance ___Improve Health ___Increase Concentration

___Reduce Nervousness ___Damage Brain Cells ___None ___Damage Other Organs

Thank You!

Stress and Coping 75

Appendix B Informed Consent Stress and Coping Among Students of the University of the West Indies, Mona Campus You are being asked to participate in a research study. Before you give your consent to volunteer, it is important that you read the following information and ask as many questions as necessary to be sure you understand what you will be asked to do. Investigators Principal Investigator: and Karen Carpenter, PhD, Department of Language, Linguistics, Philosophy University of the West Indies, Mona Campus. karen.carpenter@uwimona.edu.jm Co-Investigator: Mona. Email: blestshelly@hotmail.com Telephone: (876) 881-4853. Purpose of the Research This research study is designed to measure the level of stress being experienced by students on the Mona Campus of the University of the West Indies and to ascertain the coping styles being employed by students. The results of this study will contribute to the research project as part of the requirements of the degree Master in Clinical Psychology. Procedures If you volunteer to participate in this study, you will be asked to complete a questionnaire during class time and submit it to the Co-Investigator. Your participation will take approximately 10 minutes. Potential Risks or Discomforts Risks associated with this study are minimal. Inconveniences have also been minimized. Risks and inconveniences to you may include: 1. Time taken from lecture 2. Potential for unpleasant thoughts or feelings aroused by items on the questionnaire Shelly-Ann James, M.Sc. Clinical Psychology (Candidate), Department of Sociology, Psychology and Social Work, UWI,

Stress and Coping 76 If at any time you feel that participation in the study is too burdensome you are free to withdraw by discontinuing the questionnaire. Potential Benefits of the Research By participating in this project you may be exposed to material which may assist you in thinking of different ways of coping with stress. This research may also benefit the student body as results will be submitted to the universitys Health Centre for consideration when planning Health Education Promotions. Confidentiality and Data Storage Your identity will be protected as your name will not be taken by the researcher. A number will be assigned to all questionnaires and there will be no way of identifying you in the study. All questionnaires will be processed by number only and will be kept in private offices at all times. Only the Principal Investigator, Co-Investigator, and Statistician will have access to the questionnaires. They will be shredded after the University has collected the research paper. Participation and Withdrawal Your participation in this research study is voluntary. As a participant you may refuse to participate at anytime. If you decide to participate, you are free to withdraw at anytime. To withdraw from the study you simply have to discontinue the questionnaire. Please destroy the questionnaire and throw it in the nearest bin. However, as the data is anonymous, please note that you will be unable to withdraw after you have submitted your questionnaire as there will be no way of determining which questionnaire was completed by you. If You Need to Talk With Someone As you complete this questionnaire, you may discover that you are uncomfortable with your approach to handling stress. If this applies to you, you may make contact with the Counselling Centre at the Universitys Health Centre to make an appointment at Tel. 927-2520 or 970-1992, Monday Friday, 8:30 am 4:30 pm. Questions about the Research If you have any questions about the research, please speak with Shelly-Ann James, Co-Investigator: researchshelly@hotmail.com, (876) 886-5405; or Dr. Karen Carpenter, Principal Investigator, Dept. of Language, Linguistics, and Philosophy UWI Mona. If you have questions later, you may contact either of the above mentioned persons. This project has been reviewed and approved by the Ethics Committee of the University Hospital of the West Indies/ University of the West Indies Faculty of Medical Sciences. If you believe there is any infringement upon your rights as a research participant, you may contact the Chair, Professor Archibald McDonald at (876) 927-2556.

Stress and Coping 77 If you agree to participate a copy of this form will be given to you. My signature below indicates that I have read and understood this document and that I agree to participate in this research study. ___________________________ Participants Name (Please Print) ____________ Date _______________________ ___________ Participants Signature

___________________________ Co-Investigators Name ___________________________ Signature of Witness

____________ Date _______________________ ___________ Co-Investigators Signature

_____________ Date

Please sign and tear off the section below this line and return to the co-investigator.

-------------------------------------------------------------------------------------------------My signature below indicates that I have read and understood this document and that I agree to participate in the research study Perceived Stress and Coping. ___________________________ Participants Name (Please Print) ___________________________ Co-Investigators Name ___________ Date ___________ Date _______________________ Co-Investigators Signature _______________________ Participants Signature