Stress debate is just about nicely balanced?

Ordinary, everyday conversation suggests that there is a critical difference between being “stressed” and being “stressed out”. One is part and parcel of hard work, the other a sign that things are unraveling.

The complex physiology behind the distinction is becoming better understood. At The Rockefeller University in New York, for example, the eminent neuroendocrinologist Bruce McEwen [1] is developing an interdisciplinary approach to the mechanisms behind stress and hormone actions on the brain.

His laboratory is investigating behavioral, neurochemical and cellular factors, and, as the findings get more detailed, so they are attracting the attention of specialists in education and child development.

At a simple level, McEwen explains, stress is associated with a surge of hormones preparing the body for action: you are energized, your decision making is focused and your memory sharpened. Being stressed can give you that little push you need to overcome challenges or to succeed. Being stressed out is bad news: it indicates that the burst of hormones has become an overwhelming torrent. Your mind becomes a whirl and your body gets worn down. The ability to make clear or good decisions is compromised.

Other aspects of current research suggest that stress responses are learned from earlier experiences. The body becomes habitualized in its reaction to threat, and the mind runs the same good or bad routines of coping (avoiding the problem or over-analyzing it, for example). Hence the hypothesis among educators that teaching children at an early stage how to deal more effectively with threats or challenges may better prepare them for slings and arrows to come.

This is precisely what the proliferation of intervention programs for children has been designed to do and the idea of “coping power” or “coping skills” features prominently among them.

In such situations it quicky becomes difficult to see the scientific wood for the trees. So, step forward Gerda Kraag at Maastricht University in The Netherlands, who, with colleagues from the same university and collaborators from the UK and Lebanon has been assessing the impact of 19 programs designed to help children to cope with stress.

At first glance, the picture from their meta-analysis looks promising. The average effect size was 1.5, indicating a large positive effect (but the authors caution that this is probably an overestimation due to “publication bias”). More fine-grained analysis showed that programs focusing on reducing the physiological symptoms of stress accounted for a large proportion of this positive finding (an effect size of 0.9).

But, taking the Rockefeller University research into account, how far is it right to go in seeking to eradicate stress in children’s lives? We know that some stress is a good thing; we have no basis for saying how much. Indeed, while a number of programs in the Maastricht study reduced the symptoms of stress, few had any impact on behavioral, social or emotional outcomes. So, even if some such programs alleviate the immediate anxiety, they may not have much impact on the longer-term negative consequences.

Helping children to embrace and use stress to their advantage looks like being a more promising avenue. Kraag’s meta-analysis showed that while symptom-reducing programs accounted for a large amount of the effect, those helping children to cope with stress came out on top (a massive effect size of 3.5 in relation to improving coping strategies). This suggests that it may be possible to change the way children think about stressful experiences, and that in doing so this may help children learn more adaptive strategies.

As for how or why some children deal well with stress while others do not – here, more research is needed. For example, whilst being stressed out is often associated with a range of negative outcomes, not all children succumb [See The puzzle is why even more young lives aren't destroyed [2]].

Bruce McEwen suggests that the explanation lies in interaction between the way children appraise stress (the way they think) and their physiological thresholds for stress, their bio-reactivity and their ability to damped down such responses (the way their body is built).

So the challenge for researchers and program developers is to better elucidate the mechanisms linking particular facets of stress to good or poor outcomes. Only then will interventions truly have the potential to help children deal effectively with what life throws at them.

• John Bruer, president of the James McDonnell foundation, which awards $18 million annually to biomedical science, education, and international projects argues that prematurely connecting the classroom and the laboratory is hindering educational reform. In an "Education and Neuroscience: A Bridge Too Far?" he argues that despite the progress of brain research, neuroscientists can as yet only speak about relatively mechanical aspects of the mind, such as vision, hearing, and speech. They have nothing very useful to say about creativity, intelligence, and emotion, and little to offer teachers in terms of informing classroom practice, he claims. [See: Educational Researcher, Vol. 26, No. 8 pp 4-16]