Stress Management Professional An International Journal

Vol.2, No.2, JULY - DECEMBER 2014

15

p s y c h o l o g i c a l i n s t r u m e n t t o a d m i n i s t e r,

a written consent was also taken from those who

comprehend, and score (Cohen, Kamarck,

accepted the invitation and eventually included. Data

Mermelstein, 1983). It measures the degree to which

collection for the study was done between the

situations in one's life over the past month are

periods of December 2008 to January 2010. Following

appraised as stressful. Items were designed to detect

this, information on socio-demographic datasheet

how unpredictable, uncontrollable, and overloaded

was taken and pre-assessment was done. Following

respondents find their lives. Respondents report the

the assessment, the patients were randomly allotted

prevalence of an item on a five-point scale, ranging

to experimental group and one control group, thus

from never to very often. Higher scores indicate more

there were 25 patients in each group. There were no

stress.

significant age or diagnosis differences among

groups. In addition, with all the CHD groups, one

3. Hospital Anxiety Depression Scale (HADS):

session of coronary counseling with patients and one

H A D S was developed by Zigmond & Snaith

session of behavioral counseling to significant others

(Zigmond&Snaith, 1983) in 1983 and consists of a

were carried out after the pre-assessment. No other

series of 14 questions, 7 of which are related to anxiety

sessions were held with this group till post-

(HAD-Anxiety subscale) while the other 7 questions

assessment. Post-assessment was carried out for TAU

are related to depression (HAD-Depression subscale).

group, 10-17 weeks after the pre-assessment and

It is worth noting that items referring to depression

education session, at completion of interventions. All

symptoms that describe somatic aspects of

the patient groups were taking their medical

depression (e.g. insomnia and weight loss) are not

treatment during the study period as usual.

included in the scale.

Therapeutic Procedure
4. Jenkins Activity Survey (Form C) JAS-C:
The JAS-C is a 52-item multiple-choice questionnaire

Stress inoculation training (SIT), a kind of CBT with

that measures the Type-A behavior pattern and three

a multi-component coping-skillsapproach, was

other related factors: Speed and impatience, Job

developed by Meichenbaum (1985).It is based on the

involvement, and Competitiveness (Jenkins,

theoretical premise that in learning to deal with mild

Zyzanski, Rosenman, 1979).Of the four scores derived

levels of stress, clients essentially become inoculated

from this test, the Type-A score is an overall estimate

against uncontrollable levels of stress (Knapp & Beck,

of the behavior pattern that is characterized by

2008). CBT can be applied to the assessment and

extremes or competitiveness, aggressiveness,

treatment of almost every chronic medical problem

impatience, and time pressure (Jenkins, Zyzanski,

(White, 2000). Enright (1997) has suggested that it is

Rosenman, 1979). The subscale (A- scale) used in

logical to assert that there is no psychological or

present study consists of 21 items.

physical problem that cannot potentially be assisted

by a cognitive behavioral approach . The stress

Procedure :

inoculation procedure consists of developing the

Protocol of the study was presented to and approved

person's cognitive, affective and behavioral coping

by Research Committees of Maharshi Dayan and

skills and then provides for the practice of these skills

University, Rohtak (Haryana). All patients fulfilling the

with exposure to everyday stressors as well as

inclusion criteria were informed about the study and

anticipated future stressors. The procedure comprises