TA 73 TA 1 7.6 TF 78 7.10 TAL TAZ 713 TAG TAS 716 BAT CHAPTER SEVEN - STRESS Contents AN INTRODUCTION TO STRESS........ THE STRESS MODEL. AROUSAL AND PERFORMANCE. STRESS REACTION AND THE GENERAL ADAPTION SYNDROME (GAS)........ STRESS FACTORS (STRESSORS: PHYSIOLOGICAL STRESS FACTORS. EXTERNAL PHYSIOLOGICAL FACTORS. INTERNAL PHYSIOLOGICAL FACTORS........ COGNITIVE STRESS FACTORS/STRESSORS.........sereccecsssrsvrsseesrecssssnseerenressssnne 21D. NON-PROFESSIONAL PERSONAL FACTORS/STRESSORS....sssssesssssssesseseseT = 12, IMAGINARY STRESS (ANXIETY) ORGANISATIONAL STRESS. STRESS EFFECTS... 7-16 COPING WITH STRESS... 7-18 COPING WITH STRESS ON THE FLIGHT DECK...0...cccccscseeeersseinneeenenind = 19) STRESS MANAGEMENT AWAY FROM THE FLIGHT DECK. 7 = 20. STRESS SUMMARY... 7-21 CHAPTER 7 - REVISION QUESTIONS...HUMAN PERFORMANCE STRESS 7 AN INTRODUCTION TO STRESS Stress is commonly defined as the body's responses to the demands placed upon it. Perception plays a very large role in the degree of stress suffered and this is discussed in detail in paragraph 7.1 of this Chapter (The Stress Model). Anything that causes stress is known as a Stress Factor or Stressor. Icis hard to measure stress in biological terms, though the strain produced by many physical and mental stressors can be measured in terms of alteration in blood pressure, pulse rate, weight, change in efficiency and so on. ‘The body constantly strives to maintain physiological equilibrium (Homeostatis) in spite of varying external conditions and it contains numerous mechanisms to keep the status quo. For example, as body heat increases, sweat is produced which, by the cooling effect of evaporation, cools the body attempting to return it to its normal temperature. As soon as outside conditions either put strain upon these Homeostatic mechanisms or are so extreme as to nullify them, physical stress takes place. Mental stresses, however, are much harder to. measure, except in special laboratory experiments. Whereas stress is a normal human reaction, too much stress is harmful, but a degree of stress is a natural requirement of life. Animals are designed to cope with their environment and if all forms of external stimulation are removed they tend to pine away and even die, Experiments on volunteers kept for a considerable period of time in a stimulus-free environment have shown that they tend to regress to an infantile stage and may not return to normal for a considerable time, Thus it ean be said that @ certain amount of stress is of fundamental importance in keeping us aware and vigilant. However, too much stress will degrade both body and mind, We are all different and the stress level caused by a particular stressor will differ from one individual to another, The level will largely depend on the person’s inborn and learnt characteristics. Experience helps ward off stress. A successful completion of a stressful task will reduce the amount of stress experienced when a similar situation arises in the future. In everyday life too little stimulation may lead to mental unrest. ‘The active man, who retires from work, frequently becomes bored and irritable; in some cases he may fail to adjust and develop a chronic illness A reasonable stress level is beneficial to our life but a high stress level is associated with unpleasant psychological and physiological responses a) Sweating b) Dry mouth ©) Difficulty in breathing @)—_Tncreased heart rate ) —_Anxiety/apprehension f) Fatigue 2) Fear 7-1 © Oxford Aviation Services LimitedHUMAN PERFORMANCE STRESS 12 THE STRESS MODEL Stress arises from the evaluation individuals make of the demands which they perceive to be placed upon them and the ability they perceive they have to cope with the demand. It is the person's evaluation of the demands imposed rather than the actual demands which will be used in his evaluation of the difficulty of the task. Equally it is the pereeption of abilities rather than actual abilities that determine the amount of stress. CHS) | Figure 7.1 A model of Stress and Coping From Figure 7.1 it will be appreciated that the feedback mechanism is of great importance in determining the amount of stress experienced on subsequent performances of the task. Successful completion of a perceived difficult task will bath reduce the perceived demand and increase the perceived ability thus changing the original evaluation and reducing the stress and. viee versa. One of the features of stress is that an event which causes high stress in one individual may not have the same effect on another. It is also a fact that something which is stressful for an individual on one occasion may not be stressful at another time. 2 © Oxford Aviation Services LimitedHUMAN PERFORMANCE STRESS 73 AROUSAL AND PERFORMANCE Arousal can be defined as: “The measure of the Human Being’s readiness to respond”. The relationship between Arousal and Performance is shown in Figure 7.2. Atlow arousal levels, such as just after awakening or during extreme fatigue, the Attentional Mechanism is not very active, processing of sensory information is slow and the nervous system is not fully fimetioning, The individual will have a slow environment scan and may miss information. Thus performance is low At the optimal arousal level we are at our most efficient - we have enough demands to keep ‘our attention and the capability to deal with complex tasks. At high arousal levels our performance starts to deteriorate, errors are made and information may be missed, We will suffer from a narrowing of attention as we tend to focus on a limited source of data, At very high arousal levels we expetience overload as we reach a limit of processing capacity and/or our ability to complete all the tasks. This funnels our attention to events which we perceive as being relevant to the perceived primary task. Thus information may be missed from important, but more peripheral and non-attended sources. Indeed at these levels the Attention Mechanism can reject vital information solely due to overload. OPTIMAL AROUSAL Low AROUSAL HIGH AROUSAL ——— PERFORMANCE —>> Figure 7.2 The Relationship Between Arousal and Performance. 7-3 © Oxford Aviation Services LimitedHUMAN PERFORMANCE STRESS 7A ‘TRESS REACTION AND THE GENERAL ADAPTION SYNDROME (GAS) ‘The General Adaptation Syndrome (GAS) is the term used to describe the mechanism by which the individual reacts to an outside real, perceived or anticipated threat. ‘The ANS and the GAS Trigger. ‘The syndrome is triggered by the arousal mechanism which operates through the Autonomic Nervous System (ANS). As has been discussed, this controls many of the body's essential functions : respiration, circulation, digestion, etc. over which we have normally no conscious control. The Homeostasis is mainly defended by this system, The ANS system is divided into two systems = a) Sympathetic system b) —_Parasympathetie system, ‘These control systems are neuro-hormonal in their make-up and are highly self-regulated under normal circumstances, Sympathetic System. The sympathetic system provides the body with the resources to cope with a new and sudden source of stress. This is known as the FIGHT OR FLIGHT RESPONSE and its purpose is to prepare the body and mind for physical activity. Parasympathic System. This prolongs the body's mobilisation to give it time to find a solution and restores the body to normal functioning when the perceived danger has passed or abated. ‘The Phases of G a The mechanism occurs in three phases: a) Alarm Reaction, b) Resistance. ©) Exhaustion. Phase | - Alarm Reaction. In this, the alarm phase, the brain will start a reaction - depending on past experience - to the stimulus. The brain will adapt and colour (pleasure or displeasure) the perceived event, ‘The sympathetic nervous system is triggered to mobilize the body and allow it to react. The suprarenal (adrenal) glands play an important part in the process as they secrete the stress hormone - Adrenaline. This causes a massive release of sug following body reactions reserves from the liver and also brings about the a) The pupils of the eye will dilate. b) The flow of saliva will be inhibited. ©) The heart beat rate will increase. d) The breathing rate and depth will be increased. e) ‘The bronchi will be dilated to allow a greater volume of air (oxygen) to the alveoli TA © Oxford Aviation Services LimitedHUMAN PERFORMANCE STRESS 1) Peristalsis (the movement of food along the digestive system) will be inhibited. £) Bladder contraction will be inhibited. h) Increased blood pressure. i) Greater flow of blood to the muscles. j) Muscles are tensed. k) The senses are sharpened. Adrenaline causes all of the above to increase the body's resources by increasing the energy available to the muscles. This initial defence mechanism, common to all animals, is relatively primitive - it allows one to react physically and has only indirect effects on the brain ‘These physical changes indirectly effect the brain's readiness and causes : 2) Acceleration of the activities of the brain b) Improved quality of immediate decisions. ©) A speeding up of the decision-making process. d) Memory improvement. ©) Improved alertness. Phase 2 - Resistance. Phase 2 of the GAS is Resistance and this is when the parasympathetic system takes over and altempts to prolong the mobilization of the body's resources to give time to find a solution, This phase uses a different stress hormone cortisol (cortisone) which assists the body to quickly convert fats to sugar to maintain the supply to the muscles. ‘This hormone also acts on the brain to improve the memory of stress situations, which is why ‘we remember these events particularly intensely, If an individual is exposed to stress for too long a period, his/her energy resources are exhausted - the individual becomes tired and increasingly vulnerable. 7-5 © Oxford Aviation Services Limited4UMAN PERFORMANCE STRESS Phase 3 - Exhaustion. Phase 3, Exhaustion will occur over a variable period and will normally affect only specific parts of the body. For example, marathon runners will experience severe stress in their muscles and cardiovascular system leading to exhaustion. With rest, this exhaustion stage is, temporary but, if allowed to continue without respite, it can result in death as the individual completely ‘shuts down’ his/her defence mechanism, Importantly, the stress hormones, adrenaline and cortisol, generate waste matter which must be eliminated. However this is not easy and, in consequence, secondary effects can occur. If the stress situation is coped with successfully or the stressors are removed then the body will gradually retum to its normal state of functioning once the stress hormones cease to be secreted. It is of note that stress sometimes is referred to as “good stress”, which stimulates and adapts, the body to make the effort needed to face the danger/problem (FIGHT) and “bad stress’ tress”) which occurs when the body cannot cope (FLIGHT). Broadly speaking the GAS reaction syndrome can be said to be divided into a cl distinct types of reaction a) Psychological React n: where the brain registers fear, alarm or erisis. b) Psychosomatic Reaction : during which the brain triggers the release of hormones, adrenaline and sugars into the blood, ° ion : the responses of the various organs of the body to the hormonal and chemical releases, 7-6 (Oxford Aviation Services LimitedHUMAN PERFORMANCE 15 STRESS FACTORS (STRESSORS) STRESS Figure 7.3. illustrates, in general terms, some of the various stress factors (Stressors) to which we may be exposed, ‘The Cumulative effect of Stress Factors. An important fact to remember about stressors is that they are cumulative. If a pilot is experiencing a minor irritant or stressor his/her stress level will increase disproportionally if another small stressor is added even though the situation may have changed. Thus if a t, having had an argument with a colleague on the ground, then flies and encounters another small problem on the flight deck, his/her stress level will rise toa higher level than had the argument not taken place. Categor DOMESTIC COLD PROBLEMS EMERGENCY WORKLOAD NOISE MOVING. HOUSE BEREAVEMENT LOw HumioiTy PROMOTION MONEY LACK OF WORRIES EXPERIENCE Figure 7.3 Stress of Stress Factors. ‘The stressors above can be can be broadly sub-divided into : a) b) ¢) co) e) Physiological. Cognitive. Non-professional. Imaginary stress. Organisational stress. rt © Oxiord Aviation Services LimitedHUMAN PERFORMANCE STRESS 16 1d PHYSIOLOGICAL STRESS FACTORS This category can be broken down into two parts : a) External Physiological Factors (noise, temperature, vibrations etc). This is sometimes known as Environmental Stress. b) _ Internal Physiological Fa tors (hunger, fatigue, lack of sleep etc). EXTERNAL PHYSIOLOGICAL FACTORS: Discussion will be limited to those stressors associated with aviation (see Figure 7.4). DOMESTIC ear PROBLEMS HEALTH EMERGENCY BEREAVEMENT ROSTERING INSUFFICIENT FLYING. NOISE VIBRATION are: FATIGUE ANAIETY OVER Low COURSESICHECKS! HUMOTTY MEDICALS CAREER Lack oF LAGK OF TRAINING EXPERIENCE Figure 7.4 Some Flight Deck Stress Factors/Stressors Flight Deck External Physiological Factors On the flight deck there are a number of possible physical sources of stress; heat, vibration, noise etc. As we have seen, the effects of stress are cumulative and the negative consequences of one source are likely to lower an individual's resistance to other forms of stress. Heat. A comfortable temperature for most people in normal clothing is around 20°C. Above 30°C heart rate, blood pressure and sweating increases. Below 15°C the individual becomes uncomfortable and may lose feeling and some control in the hands, especially for fine muscle ‘movement. The body's reaction to extreme heat is discussed later in this Chapter, 7-8 © Oxford Aviation Services LimitedHUMAN PERFORMANCE, STRESS Noise, In low arousal states, some noise can increase performance and maintain arousal levels, during boredom and fatigue. Excessive noise (above about 90 dbs) will always disrupt performance and will cause : a) Annoyance or irritability. b) Fatigue. ©) Loss or tunnelling of attention, @) Disrupted concentration. ©) Degradation of information being received in the working memory and therefore an increase of workload. 1) Increasing number of crew errors. In designing aircraft warnings for system failures, care must be taken to ensure that the aural warnings selected to alert the pilot are sufficient to attract attention but not so loud as to startle. Vibration, Vibrations may effect a pilot’s whole body, specific body parts that contact a vibrating structure of the aireraft and visual acuity. Any vibration will cause fatigue and ean affect both visual and motor performance leading to uncomfortable symptoms, ‘The frequency of the vibration will determine those functions affected and the strength of vibration will determine the severity. Frequency | Effects/Symptoms 110 4Hz. | Interferes with breathing. F410 10Hz. | Chest and abdominal pains. 8t012Hz, | Backache. 10 to 20 Hz. | Headache, eyestrain, pains in the throat, speech difficulties and muscular tensions plus degradation of visual acuity A body resonance of 30 - 40 Hz will interfere with the human responses mainly due to the eyeball itself resonating. Although no physical damage is done to the eye, extreme and violent vibrations will cause eyeball resonance increasing to such an extent that focussed vision becomes impossible. Resonance of the skull itself happens at a low vibration level of approximately 1 - 4 Hz which may also affect vision. Relief can be given to the pilot by isolation from some vibrations. This can mostly be achieved by using a properly designed seat. 7-3 © Oxford Aviation Services LimitedHUMAN PERFORMANCE STRESS It is worthy of note that helicopters. vibrate in all three axes at frequencies related mainly to rotor speeds, gearboxes and engines. Thus helicopter pilots will be particularly vulnerable to this stress factor Low Humidity. ‘The air conditioning system of a modern aircraft draws in air from outside the aircraft. At airline operating altitudes the temperature may be as low as -30°C to -55°C. At these temperatures the air is very dry, with a relative humidity as low as For comfort man requires a relative humidity of 40% to 60%. At low humidity the individual becomes uncomfortable due to drying out of the mucous membranes of the nose and throat. Eyes become sore as the tears evaporate rapidly and the tear ducts dry. Water vapour is added to the cabin environment during respiration, but as the air is continually replaced this will have a limited effect in increasing the cabin humidity. It would be possible to add water to the cabin air but the weight penalty of extra water to be carried is not considered commercially viable, Itis not advisable to take on a lot of extra fluids in these circumstances but drink only enough to maintain comfort. Note: At high altitudes humidity in the cockpit typically varies between 5% and 15%. Thus Flight Crew need to be careful to drink sufficient fluids in flight to avoid dehydration In general, human performance is poor in an environment which is humid regardless of the ambient temperature. Surroundings which are both dry and warm are most conducive to high performance. Extreme Temperatures Stress Factors. ‘The human body is extremely sensitive to heat and cold and functions efficiently only over a remarkably small temperature range, The normal oral temperature is considered to be between 36.1°C (97°F) and 37.2° (99°F). Physical and mental performance start to be significantly impaired at an internal body temperature of about 38°C. Apart from the skin and fat, which both act as insulators, the body has mechanisms which are controlled by the brain and which endeavour to cope with change of body temperature and to maintain an equilibrium (sweating and shivering for example), However when the body is exposed to extreme temperatures with which these internal homeostatic mechanisms cannot cope, it reacts violently. Extreme Heat Stress. Once the blood temperature rises to approximately 41°C (106°) the self-regulatory systems of the body can no longer cope and the effects of extreme heat are a) Excessive sweating leading, to fast depletion of body fluids and electrolytes. This dehydration leads internally to a further rising of the body temperature thus exacerbat- ing the situation. This is associated with muscle cramps, giddiness, and fatigue. b) Rapid increase of the heart rate and an associated need for more oxygen. ©) Thirst. 4) Cell damage - especially within the brain. ©) Heat stroke. f Coma. g) Should the blood temperature rise to approximately 43°C (110°F) death will result. Note: Generally speaking the mind and body need an average of 2 weeks to acclimatise 10 a hot and humid environment. 7-10 © Oxford Aviation Services LimitedHUMAN PERFORMANCE. STRESS 18 Extreme Cold Stress. If the blood temperature decreases to approximately 34.5°C (94°F) the self-regulatory systems of the body are seriously impaired and if there is a further drop to approximately 29.5°C (85°F) they are completely lost. The effects of extreme cold are a) Uncontrollable shivering and an associated need for more oxygen, Around 34.5°C. the shivering that will have started earlier will tend to cease b) Cell damage - especially of the brain, ©) Sleepiness associated with a feeling of contentment or apathy. @) Circulatory impairment and degradation of the sensory nerves. e) Severe damage to the skin and tissues (frostbite). f) Coma. g) Death. It is important to stress that the effects of exposure to extreme temperatures are not restricted to the more dramatic conditions described above. Temperature variation within these limits can have a detrimental effect on a person's ability to perform a skilled task INTERNAL PHYSIOLOGICAL STRESS FACTORS. ‘The most important of these factors are : a) Hunger b) Thirst. ©) Fatigue. 4) Lack of sleep. ©) Pain, With the exception of pain, these factors are normally within the control of aircrew. In any case it is of fundamental importance that they ensure that they never start duty with any of these internal physiological stressors. ‘The Brain’s Ability to Adapt to Physiological Stressors. Repeated exposure to moderate levels of stress from the environment will cause the body to adapt to the stress in order to reduce its impact. For example if an individual lives close to a busy airport the noise may not be noticed after a time but a visitor will certainly suffer from the high sound levels. This ability is limited and varies from person to person. 7-11 © Oxford Aviation Services LimitedHUMAN PERFORMANCE STRESS 79 7.10 COGNITIVE STRESS FACTORS/STRESSORS, ‘These differ from physiological stressors knowledge, experience and skill. ince they depend on the operator's professional ‘They can occur in the cockpit under the following conditions: a) The situation facing the pilot is unexpected and no procedure exists to resolve it b) The solution to the unexpected problem is realised but the pilot has insufficient time, or is unable to apply the solution. This happens when the pilot is “over-loaded”. c) The sol unsolved, n is applied but the results are not as expected and the problem remains Levels of Cognitive Stress Factors/Stressors. ‘These will depend on a) The individual's inborn and learnt characteristics. A pilot may be easily stressed in such a situation either because of his personal character traits and sensitivity to stress or the realisation that he/she possess insufficient knowledge to solve the new problem, b) The time available to solve the problem. In a dynamic situation, a lack of an additional source of stress and will often lead to taking risks. ie is, in PROFESSIONAL PERSONAL FACTORS/STRESSORS: In our modern complicated lives we can, unless we are very careful, bring a whole baggageful of stress with us to work. Probably the most common form is Domestic Stress. Bereavement. The loss of a spouse, partner or child has been found to lead to higher levels of stress than any other event, Some airlines will ensure that a pilot suffering such a loss is removed from flying duties for a few months as they are aware that the pilot's stress level will be at such a high level that his/her performance and reactions could be severely degraded. Domestic Stress. Stress at home can affect the pilot at work and equally stress at work can affeet the pilot's home life. Pilots suffering from domestic stress should be aware that this can affect their concentration and performance when at the controls of an aircraft. Help is always at hand whether through counselling, friends, or one’s employer. Aircrew must try and use every facility available to them to ensure that they are not being affected by this form of stress. Non-professional Personal Factors/Stressor Table, There is good evidence for a relationship between stress and health and some evidence for a relationship between non-professional stress and accident involvement. 7-12 © Oxford Aviation Services LimitedHUMAN PERFORMANCE STRESS ‘Whereas stress is subjective (the stress level caused by a particular stressor will differ from one individual to another) it is possible to assess stress levels in general. The table below gives a suggested weighting for various incidents in an average Westerners life. When applying such weightings to other cultures there will be some marked differences. Airerew must remain sensitive to these cultural differences, As stress is cumulative, all of the events should be totalled to give an indication of the stress acting on any one person. STRESS TABLE Death of a spouse partner, or child 100 Divorce 73 Marital separation 65 Death of a close family member 63 Personal injury or illness 53 Marriage 50 Loss of job 47 Retirement 45 Pregnancy 40 Sexual problems. 40 Birth 39 Change of financial situation 38 Son or daughter leaving home 29 Change of eating habits 25 Change of residence 20 king on a bank loan or HP debt i Vacations: 13 Minor violations of the law W 7-13 © Oxford Aviation Services LimitedHUMAN PERFORMANCE, STRESS 7A This list is not a complete catalogue of all events which may cause stress and the weighting ven will vary according to the personal background and cultural system in which the individual was raised. As a guide only, to indicate your own stress level, add together the marks for each event occurring in your life in the last six months. Scoring Below 60 marks: a life unusually free of stress. 60 - 80 marks: normal amount of stre 80 - 100 marks: stress in life is rather high, 100+ marks under serious amount of stress IMAGINARY STRESS (ANXIETY) Both human beings and animals can suffer from stress without there being a stressor present, Itis the anxiety that a future risk exists together with the feeling of an inability to cope or lack of self-confidence. A good example of this natural response in animals is when a dog is taken to the vet having undergone pain in a previous visit. The animal shows signs of anxiety even though no stressor exists. The same can be said about a child’s visit to the dentist, Inevitably anxiety will reduce performance. A more complex version exists in adults, Unpleasant events in life may be apparently completely forgotten but the anxiety associated with them can be brought to the surface by one of the senses (a scene, noise, smell) and distort perception. This anxious apprehension can be strong enough as to trigger the ANS system within the body. Psychologists may be able to help in the expressing of these anxieties and their rationalisation. ORGANISATIONAL STRESS ‘The Organisation In the aviation industry today, financial pressures on companies can cause pilots to work under considerable pressure. Small unserviceabilities may be carried, duty hours stretched to the limit, checks rushed to make a slot time, and there are many other examples. As an extreme example of stress generated by poor management, the president of an airline which was in financial difficulties, instructed pilots to fly below the legal minima in bad weather. They were also instructed to ignore maximum take-off weights and reduce minimum fuel reserves. As a direct result of these decisions the airline suffered three serious accidents in a short period. If management continually exerts pressure on its employees to operate in ways that are more consistent with short term monetary concerns than with safety and good practice, then the whole company will develop ‘organisational stress’ as they wait for an accident to happen. 7-14 ‘© Oxford Aviation Services LimitedHUMAN PERFORMANCE STRESS ‘The symptoms will manifest themselves as: a) Poor industrial relations. b) Absenteeism. ©) Ahigh accident rate. ‘crew and the Organisation. Work stress may be caused by a sudden high work load such as an emergency, The stress experienced will be increased if the pilot is unsure how to react or feels inadequately trained situation. Realistic simulator training is essential to reduce the impact of any for the speci emerg Stress ma arise from a long term quantitative work load. Airlines operate in a competitive world and must make maximum use of staff and equipment. An aircraft and crew standing idle are not producing revenue, Even with the advances of modern ATC there will be times when airspace and airports become overcrowded. Technical delays lead to time pressure and these cause additional stress Rostering of crews can lead to stress problems. It can happen that a particular pilot may have to perform an excessive number of night flights and suffer undue disruption to his home life ous circle. This, in turn, leads to more stress thus developing a vi Poor relationships with management and colleagues, both on and off the flight deck, leads to stress. Poor communicatio either between crew members or in the management system, can also be a source of stress, Some cockpit voice recorders listened to after accidents have detected crew members arguing on the flight deck just prior to the accident. A European flight Which crashed off the Canadian coast in September 1998 killing all 229 on board is a classi ‘example of this problem Organisational Stress Sources in Pilots. A study conducted among pilots showed some of the main identified sources of stress to be: a) A lack of contro! or disruption of events in their lives. b) Scheduling and rostering. ©) Insufficient hands-on flying, d) Anxiety over courses/ehecks. e) Home to work interface. f) Career prospects and achievements. 2) Lack of responsibility and decision making. h) Fatigue and flying patterns, 7-15 © Oxford Aviation Services LimitedHUMAN PERFORMANCE STRESS Of significance in the above list is insufficient flying. ‘The modern airliner is most efficiently and economically operated by automatic control, indeed it is the policy of many airlines that the flight management system should operate the aiteraft for more than 96% of its flight time, ‘Whilst modern systems and their back-ups are undoubtedly extremely reliable, many pilots are worried that the systems may fail and are unsure of their ability to manage the aircraft themselves. pilot flying the maximum allowable duty hours may obtain as little as one hour actual hands-on control per month: Stress has effects on the body, the mind, and the health and thus the performance of the individual. ‘The short term effects of a sudden source of stress will be those caused by the ‘fight or flight’ response, Performance. Figure 7.5 shows the relationship between stress and performance. Like the arousal/ performance graph it is an inverted U-curve however there is a “break point”. When there is litle or no stress, there is a drop in vigilance and thus performance is low. As stress increases performance increases up to the optimum - the “break point”- after which, if stress continues to rise, performance is degraded. PERFORMANCE BREAKPOINT STRESS LEVEL NO MEDIUM INTENSE STRESS: STRESS STRESS MOTIVATION Figure 7.5 Comparison of Performance and Stress Levels 7-16 © Oxford Aviation Services LimitedHUMAN PERFORMANCE STRESS Health Effects. ‘The long term effects of chronic stress damage a person's health, The effects are usually seen earliest in the gastro-intestinal system, nausea, indigestion, diarrhoea and, after an extended period, time ulcers. ‘There is evidence of a connection between stress and coronary heart disease and permanently high blood pressure. Those who suffer stress have a higher than normal incidence of asthma, headaches, sleep disorders and neuroses. They also much more likely to have allergies, skin diseases and tend to suffer more from colds and influenza. Behavioural Effects. When under stress the inclividual will exhibit restlessness, perhaps a trembling, and may have a nervous laugh. There will be a tendency to take a longer time over tasks and there may well be excessive changes in appetite and an increase in smoking or drinki Moods swings are also a common symptom of stress. Some individuals become aggressive in the cockpit towards the other members of the crew and/or outside agencies (ATC). On the other hand, others submit to the situation with an air of resentfulness and frustration. Either way there is a loss of flexibility. However, alternatively, there are some individuals who react to stress by a tendency rush into decisions. Thereby less parameters are taken into account which can only lead to errors. Cognitive Effect Stress has a major effect on the thought process with forgetfulness as an early symptom. The ability (o think and to concentrate is reduced and there is an inability to determine priorities or make decisions. Correct actions are forgotten and substituted for procedures learnt in the past and this is known as Regression. Fixation or a “mental block”, is another and even to consider other solutions. ymptom, where it becomes impossible to review A further cognitive effect is Confirmation Bias, which is discussed further in Chapter 8. This is a compulsive and repeated search for the same information to confirm a decision reached. Most critically, stress encourages the mind to limit its attention only to those factors it feels it can cope with and to ignore additional inputs which may be vital 10 assess a situation accurately, This loss of Situational Awareness and “not being able 10 see the wood for the trees” has been the root cause of many accidents. It is often the case, when de-briefed after escaping successfully from a burning aircraft, passengers report that it was notable how quiet everything was around them, In fact stress caused them only to be able to concentrate on their escape and the screams around them were never registered. It is commonly accepted that the auditory attention is the first to get discarded under extreme stress, 7-17 © Oxtord Aviation Services LimitedHUMAN PERFORMANCE STRESS 714 COPING WITH STRESS Stress Awareness In order to cope with stress itis fundamental that there is an awareness that the problem exists. An individual who recognises the fuct that he/she is suffering from stress is a long way along the road to identifying the source(s) and overcoming the problem, Having recognised the sttess fuctor, the object is to either change our attitudes or our environment in order to re- establish harmony between the two. Among any population there is a wide range of perceptions of stress. At one extreme, individuals suppress knowledge of problems and thereby appear not to perceive them or require stress coping strategies. At the other extreme, are those who are highly sensitive to problems in that they will anticipate difficulties not perceived by others and employ coping strategies to avoid the stress experience. ‘The strategies that a person may adopt to cope with stress may be classified into three categories: a) Action Coping, b) Cognitive Coping. cc) Symptom Directed Coping. Action Coping. In action coping the individual attempts to reduce stress by taking some action. He reduces the level of demand by either removing the problem or changes the situation so t less demanding. For example a pilot asked to fly in marginal conditions could refuse, thus removing the immediate stressor. However, this action could lead to another stressor - loss of ‘employment. it becomes ‘The demand could be changed, however, by delaying take off for a few hours when the weather is forecast to improve. In this case, reducing the perceived demand of the original task, without substituting another stressor. The individual may also hand over some tasks, cither to other crew members, or to Air Traffic Control by asking for, as an example, assistance in navigation. The individual may remove himself from the stress situation by changing his job, or in the case of domestic stress, by divorce. These methods may, however, only substitute one sour of stress for another, Clearly in many cases it is impossible to undertake these kinds of solutions. 7-18 © Ontord Aviation Services LimitedHUMAN PERFORMANCE STRESS. Cognitive Coping, As action coping cannot change some situations, cognitive coping involves reducing the impact of stress on the individual. Our brain can employ ‘defence mechanisms’ which operate outside our conscious awareness; @ system of repression or denial to prevent the conscious brain from even becoming aware of the stressor Other strategies involve rationalisation or detachment which may change the perceived magnitude of the problem, "Pretend it’s a simulator detail the same as the one you did last week" will enable the conscious mind to perceive the problem as having a solution. Symptom Directed Coping. Some of the symptoms of stress may be relieved by the use of drugs. In this context the drugs may be relatively simple such as coffee or tea. Other cases may be eased by the use of alcohol or tobacco, After a traumatic experience in the air, some relief may be obtained by a few stiff drinks in the bar. In some individuals relief from stress may be achieved by meditation. It mast be emphasised that only the symptoms are treated by this form of coping and that the stressor(s) will remain until addressed separately. COPING WITH STRESS ON THE FLIGHT DECK Coping is the process whereby the individual either adjusts to the perceived demand of the situation or changes the situation itself. Some coping changes appear to be carried out unconsciously; it is only if they are unsuccessful that we consciously take note of the stressor. To reduce the effect of stress in flight involves mainly psychological mechanisms and includes behavioural patterns which can be learned, Individually one must lear and acquire experience to develop automatic responses which cost little in energy and strongly resist stress : A thoroughly professional approach to training will increase the range of responses available to the individual and will reduce the chances of meeting unknown situations, Hence the emphasis on regular simulator flights when any emergency can be practised in a safe environment, b) One should learn from the past, including the experience of others ©} Thorough pre-flight briefing and preparation will allow the individual to anticipate events, The pilot must be prepared for all incidents which could, plausibly, arise during the flight, 7-19 © Oxford Aviation Services LimitedHUMAN PERFORMANCE STRESS 716 Collectively a course in Crew Resource Management (CRM) will teach techniques for shating and allocating tasks to prevent any one individual becoming overloaded. It will ‘emphasise making effective use of all member's knowledge to increase the range of responses available. It will greatly improve everyone's awareness of the situation, and, by combined efforts, allow for the creation of new ideas. A good atmosphere on the flight deck is a great help in a stressful situation and humour ean be an effective antidote to stress. ‘There are five major guidelines to prevent stress affecting safety: a) Keep it simple and basic - ‘ly the aircraft. b) Accept the situation - do not attempt to conceal the facts or danger. c) __Usealll crew resources (group support). 4) The Captain (unless incapacitated) must decide and ‘set the tone’. ©) Never give up: there is always a suitable response. STRESS MANAGEMENT AWAY FROM THE FLIGHT DECK ‘This is the process whereby individuals adopt systems to assist coping strategies. The success of any stress management will be determined by the individual's willingness to recognize the source of his/her stress and the determination to do something about it, The main difference between stress management and stress coping is that, whereas coping is dealing day-to-day with stressors, stress management is a lifestyle change and addresses the whole situation. Helpful techniques can include a) Health and Fitness Programmes. Regular physical exercise reduces tension and anxiety and makes it much easier to withstand fatigue, Physical fitness also improves cognitive function and improves reaction times. b) Relaxation Techniques. Meditation, self-hypnosis, yoga, and bio-feedbuck can all assist in release of tension. ‘These techniques usually involve muscle relaxation. Bio- feedback and some yoga disciplines allow the individual to control their heart rate and blood pressure, ©) Religious Practice. For many people some form of religious practice will help to cope with stress, particularly some major life events such as bereavement or accident toachild. There are, however, some possible dangers if the particular belief is of a fatalistic nature. "I is in the hands of God" may prevent some individuals from trying {o resolve their own problems. 7-20 © Oxford Aviation Services LimitedHUMAN PERFORMANCE STRESS d) Counselling Techniques. Many individuals will benefit not only from professional counselling but from just talking to their friends or colleagues. Tt will reduce thei feelings of inability if they find that everyone else finds a particular task difficult. ‘The basic principle behind counselling is that, since stress is caused by an individual's perception of a situation, the stress will be reduced if the individual can be made to change the way he/she perceives or reacts to the situation by changing or modifying his/her belie's or assumptions about the event (Cognitive Coping). Counselling may also, however, assist an individual to see that some behavioural change may be necessary (Action Coping), and help bring about that change. An individual, such as a pilot, who must demonstrate authority and control in his work may show some reluctance to ‘admit’ that they are experiencing problems with stress. ‘They fear that the admission might be interpreted as a lack of competence or weakness, All pilots should be aware that stress can influence performance on the flight deck, particularly in an emergency, and take positive steps to deal with the stress if they feel themselves to be affected by it. Note: Evidence that people under stress often smoke more, over-eat or increase alcohol! eine consumption has led to the theory that apparent self-abusive behaviours may actually be forms of Stress Management. RES S SUMMARY Stress is simply a fact of life. We all require some stress to activate our nervous system, to stimulate us and allow us to adapt. It is only when the stress is high or sudden that it can become destructive and may exceed our abilities to adapt. Stress encountered in our daily lives is additive and depletes our reserves. However, a lack of stimuli may be just as bad since this encourages anxiet Although it is extremely difficult to eliminate stress, we can, through training and other techniques, increase our resistance to it. Stress Coping can be cither short-term (Action Coping) or long-term Stress Management (a change of life-style or counselling) depending on the situation, however the first step is to recognise and admit to oneself that the condition exists Although the stress mechanism is mainly physiological and triggered as a defence mechanism to help us survive, coping strategies to deal with stress are mainly psychological To increase stress tolerance the hie weapons in your armoury are : 2) Experience (lewer unexpected situations). b) Learning (reflex responses are performed correctly, even under stress) ©) CRM (using all resources available). 7-21 © Oxford Aviation Services LimitedHUMAN PERFORMANCE STRESS 5 CHAPTER7 - REVISION QUESTIONS Naving successfully overcome a stressful situation once, how will the person react if placed in the same or similar situation a second time 7 a) There will be little difference b) He/she willl know what is ahead and be already in a stressful condition thus stress will increase ¢) He/she will feel more confident and therefore stress will reduce d) It will depend on the individual How is performance effected by over and under arousal? a) Ibis improved b) There is little difference ©) Itis degraded 4) It will depend on the individual ‘What is the purpose of the “sympathetic” nervous system’? a) Tocontrol the emotional response under stressful conditions b) —_Tocontrol the effects of adrenalin ©) Toreturn the body after the “fight or flee” syndrome 4) To prepare the body to “fight or flight” What is the purpose of the “parasympathetic” nervous system ? a) To prolong the bodies mobilisation and return the body to normal after the “fight or flight” syndrome. b) —_Toprepare the body to “fight or flee” ©) Todirect the adrenalin to the correct organs of the body @)—Toretum the body to normal alter an emotional response under stressful conditions ‘What part of the body is effected with the vibration in the 4 to 10 Hz frequency range? a) The brain plus there will be a headache b) The chest plus there will be an abdominal pain ©) The respiration plus pains in the chest d) The pulse rate 7-23 © Oxford Aviation Services LimitedHUMAN PERFORMANCE STRESS 6. 10, Which shaped graph shows the relationship between arousal and stress ? a) AU shaped graph b) —Aninverted U shaped graph cc) Astraight 45°line @) An M shaped graph ‘The three phases of the GAS Syndrome are : a) Alarm, Fear, Resistance b) Alarm, Resistance, Exhaustion c) Alarm, Pear, Exhaustion d) Fear, Resistance, Exhaustion Which stressor will cause the most stress ? a) Home/work interface b) Divorce ©) Death of a family member d) Death of a spouse, partner or child suis released to During the Resistance phase of the GAS Syndrome convert fats to sugar. sist the body to a) Adrenaline b) Glucose c) White blood cells d) Cortisol Broadly speaking the GAS Syndrome consists of three categories of reactions. These are a) Somatic, Psychosomatic, Physiological b) Physiological, Psychosomantic, Psychologice ©) Somatic, Physiological, Psychological d) Somatic, Psychosomatic, Psychological Stress factors are : a) Non-cumulative b) Cumulative ©) Stress reactions d) Stress co-actions 7-24 © Orford Aviation Services LimitedHUMAN PERFORMANCE STRESS 12, 16, A comfortable temperature for most people in normal clothing is : a) 25°C by 15°C ©) 20°C a 30°C The Autonomic Nervous system comprises of : 8) Sympathetic, Neo-sympathetic and Parasympathetic systems b) Sympathetic and Parasympathetic systems ©) Neo-sympathetic and Parasympathetic systems d) None of the above Define three methods of coping with stress a) _ Action coping, Forced Coping, Symptom Directed Coping by Action coping, Cognitive Coping, Symptom Directed coping ©) Slip coping, Cognitive Coping, Symptom Directed coping d) Slip Coping, Action Coping, Symptom Directed coping Among the five major g idelines to avoid stress in the cockpit and affecting safety are : 2) Planned sleep patterns and use all crew resources b) Planned sleep patterns and Keep It Simple ©) Usealll crew resources and keep a good flight deck atmosphere d) Never give up - there is always a suitable response Most successful weapons against high stress levels are : 2) Planning, experience and self-control (fewer unexpected situation) b) Learning, experience and Anticipation ©) Learning, experience and CRM 4) Planning, experience and CRM Once the blood temperature rises above ....-seeen the Homeostatic mechanisms within the body can no longer cope. a) 40°C by) 35°C 50°C d 418 7-25 © Oxford on Services Limited4UMAN PERFORMANCE STRESS 0 A comfortable humidity for most people in normal clothing is a) 40% - 50% b) 30% - 40% ©) 20% - 50% a) 40% - 60% An additional stress factor (stressor) can be : a) A lack of time b) —_ Homeostatis ) Sympathetic system d) —_Parasympathetic system The “Break- point” is when a) The pilot “over-loads” due to stress b) The point in time when the pilot is unable to think positively ¢) The point in time when the pilot is unable to think rationally 4) The point of optimum performance 7-26 © Oxford Aviation Services Limited