AQA A-level Psychology (7182): Paper 3 – Stress – Study Guide

This guide covers the Stress option of AQA A-level Psychology (7182), as set out in the AQA AS and A-level Psychology (7181, 7182) specification, Version 1.4 (1 September 2025), for teaching from September 2025. Stress is section 4.3.7 of the specification and is topic 14, one of the three topics in Option 2. It is assessed in Paper 3: Issues and Options in Psychology, in Section C.

Use it with the Stress revision notes and Stress practice questions. See also the AQA A-level Psychology hub and the AQA A-level Psychology checklist.

How Paper 3 works

The specification prints these rules for Paper 3:

• What’s assessed: compulsory content 8 (Issues and debates in Psychology) and optional content, “one from option 1, 9–11, one from option 2, 12–14, one from option 3, 15–17”.
• Option 2 is Schizophrenia (12), Eating behaviour (13) and Stress (14).
• Written exam: 2 hours, 96 marks in total, 33.3% of A-level.
• Section A: “multiple choice, short answer and extended writing, 24 marks”. Sections B to D are the options, so your teacher will confirm that Section A covers Issues and debates.
• Section C: “one topic from option 2, 12–14 above, multiple choice, short answer and extended writing, 24 marks”.

The specification says sections B, C and D contain extended response questions, and that you should “evaluate therapies and treatments including in terms of their appropriateness and effectiveness”. How the 24 marks are split is not printed; your teacher will confirm typical tariffs.

Coverage table

Syllabus reference	What you must know or be able to do (from the document)	Where assessed
4.3.7	The physiology of stress: general adaptation syndrome, the hypothalamic pituitary-adrenal system, the sympathomedullary pathway, the role of cortisol	Paper 3, Section C
4.3.7	The role of stress in illness, with reference to immunosuppression and cardiovascular disorders	Paper 3, Section C
4.3.7	Sources of stress: life changes and daily hassles; workplace stress, including workload and control	Paper 3, Section C
4.3.7	Measuring stress: Social Readjustment Ratings Scale, Hassles and Uplifts Scale, physiological measures including skin conductance response	Paper 3, Section C
4.3.7	Individual differences: personality types A, B and C and associated behaviours; hardiness (commitment, challenge, control)	Paper 3, Section C
4.3.7	Managing and coping: drug therapy, stress inoculation therapy, biofeedback; gender differences in coping; social support (instrumental, emotional, esteem)	Paper 3, Section C

1. The physiology of stress

Sympathomedullary pathway (SAM). This is the fast, acute response. The hypothalamus activates the sympathetic branch of the autonomic nervous system. Sympathetic nerves stimulate the adrenal medulla, which releases adrenaline and noradrenaline into the blood. Heart rate, blood pressure and breathing rise, and glucose is released for energy. This is the fight-or-flight response.

Hypothalamic pituitary-adrenal system (HPA). This is the slower response to an ongoing stressor. The hypothalamus releases corticotropin-releasing hormone (CRH). CRH makes the anterior pituitary gland release adrenocorticotropic hormone (ACTH). ACTH travels in the blood to the adrenal cortex, which releases cortisol.

The role of cortisol. Cortisol raises blood glucose so energy stays available over hours or days, and lowers sensitivity to pain. The cost is that it suppresses the immune system. High cortisol feeds back to the hypothalamus and pituitary to reduce CRH and ACTH, which normally switches the response off.

General adaptation syndrome (GAS). Selye (1936) exposed rats to different harmful stimuli, such as cold and injury, and saw the same pattern each time. He proposed three stages:

• Alarm reaction: the stressor is detected and the body mobilises (SAM activity, adrenaline).
• Resistance: the body tries to adapt; stress hormones stay raised and the person appears to cope.
• Exhaustion: with prolonged stress, the body can no longer adapt, and illness becomes more likely.

Evaluation. GAS was one of the first models to link long-term stress to illness. However, it came from rats, and rats do not appraise stressors the way people do. Lazarus argued that stress depends on whether we judge a situation as beyond our coping resources, and GAS leaves this cognitive appraisal out.

Worked paragraph (application and evaluation). A student has revised for weeks and now catches every cold going. In GAS terms, she may have moved from resistance into exhaustion, as weeks of raised cortisol suppress immune function. However, GAS came from rats, so it cannot explain why her friend sees the same exams as a challenge and stays well.

2. The role of stress in illness

Immunosuppression means a weakened immune system. Cortisol reduces the activity of white blood cells such as natural killer (NK) cells, which fight viruses and tumours.

• Kiecolt-Glaser et al. (1984) took blood samples from medical students a month before exams and during the exams. NK cell activity was lower during the exam period. Students who reported more loneliness also showed lower immune function.
• Kiecolt-Glaser et al. (1995) found that small wounds took significantly longer to heal in people caring for a relative with dementia than in matched controls.
• Cohen et al. (1991) gave volunteers nasal drops containing a cold virus. Those with higher stress scores were more likely to develop a cold.

Cardiovascular disorders include hypertension and coronary heart disease (CHD). Repeated SAM activation raises heart rate and blood pressure, which can damage blood vessels over time.

Evaluation. The exam studies use real stressors. But the link is not simple. Segerstrom and Miller (2004), in a meta-analysis of more than 300 studies, concluded that short-term stressors can boost some immune functions, while chronic stress suppresses them. Much of the research is correlational, and stressed people may sleep less or smoke more, so behaviour may explain some of the link.

Worked paragraph. One strength of the immunosuppression explanation is Kiecolt-Glaser et al. (1984), who found lower NK cell activity in medical students during exams than a month before. Testing the same students twice controlled participant variables. However, students under exam stress may also sleep and eat badly, so the drop could be partly behavioural, which limits how firmly we can say stress itself caused it.

3. Sources of stress

Life changes are major events, such as bereavement, divorce or moving house, that require psychological readjustment. Holmes and Rahe (1967) gave each event a life change unit (LCU) value. Rahe et al. (1970) recorded US Navy sailors’ life change scores for the previous six months, then tracked their health over the next six months. They found a weak positive correlation (about +0.12) between life change scores and illness.

Daily hassles are frequent minor irritations, such as traffic, losing keys or arguments. Uplifts are small positive events that may offset them. Kanner et al. (1981) gave middle-aged adults hassles and uplifts scales once a month for ten months and found that hassles predicted psychological symptoms better than major life events. One explanation is the amplification hypothesis: a life change can create many new hassles (bereavement brings paperwork and new chores), and the hassles do the damage.

Workplace stress. The specification names workload and control. Johansson et al. (1978) studied a Swedish sawmill. “Finishers” did repetitive, machine-paced work with high responsibility and little control. They had higher stress hormone levels, more illness and more absence than cleaners, who had more control over their pace. Marmot et al. (1997) analysed over 7,000 London civil servants in the Whitehall II study. Lower-grade staff had more new CHD, and low job control made the largest contribution to that difference. A companion paper from the same study (Bosma et al., 1997) found that job demands (workload) were not related to CHD risk.

Evaluation. Life change research is mostly correlational and relies on recall. The Whitehall II findings challenge the simple idea that heavy workload alone causes illness. The researchers adjusted for risk factors such as smoking, but the study is correlational and low control goes with lower pay and different lifestyles, so confounding cannot be fully ruled out.

Worked paragraph. A teacher with a heavy marking load but freedom over when and how she marks may cope better than one with a lighter load set by others. This fits the Whitehall II study (Marmot et al., 1997), where low control, not high workload, was linked to heart disease. However, this was correlational: low control goes together with lower pay and different lifestyles, so control may not be the only cause.

4. Measuring stress

Social Readjustment Ratings Scale (SRRS). Holmes and Rahe (1967) listed 43 life events, rated against marriage (set at 50). Death of a spouse scored highest at 100. A person ticks the events they have experienced in a set period, and the LCUs are summed.

Hassles and Uplifts Scale. Respondents go through a list of everyday hassles and uplifts and rate how much each one has affected them over a set period. Kanner et al. (1981) produced separate hassles and uplifts scales; DeLongis and colleagues later combined them.

Physiological measures. The skin conductance response (SCR) measures sweating on the skin, usually the fingers. Sympathetic arousal increases sweat, so the skin conducts electricity better. Cortisol in saliva or blood can also be measured.

Evaluation. Self-report scales are quick and cheap, but the SRRS treats every event as equally stressful for everyone, and some items (marriage, holidays) can be positive. Answers depend on memory and honesty. Physiological measures are objective and avoid social desirability bias. However, excitement also raises SCR, and baselines differ between people, so you need a comparison condition.

Worked paragraph. A researcher compares SCR on an ordinary day and on the morning of a driving test. Because SCR is measured by a sensor, it avoids the social desirability bias of a self-report scale. However, a higher reading could reflect excitement rather than stress, so the researcher should add a self-report measure to interpret what the arousal means.

5. Individual differences in stress

Type A behaviour includes competitiveness, time urgency, impatience and hostility. Type B people are relaxed and patient. Type C people suppress negative emotions, especially anger, and are cooperative and unassertive.

• Friedman and Rosenman began the Western Collaborative Group Study with over 3,000 men in California. After about eight and a half years, Type A men were roughly twice as likely to have developed CHD as Type B men.
• Ragland and Brand (1988) followed up the men in this study who had developed CHD. Type A men were actually less likely to die from CHD than Type B men, which weakens the claim. Many researchers now argue that hostility is the active ingredient.
• Type C and cancer. Greer and Morris (1975) found that women diagnosed with breast cancer were more likely to report suppressing emotions, especially anger. However, a large Japanese cohort study (Nakaya et al., 2003) found no link between personality and cancer risk.

Hardiness. Kobasa (1979) studied business executives and proposed that hardy people show:

• Commitment: involvement in work and relationships.
• Challenge: seeing change as an opportunity, not a threat.
• Control: believing you can influence events.

Kobasa found that highly stressed executives who stayed healthy scored higher on hardiness. Maddi and colleagues followed managers at Illinois Bell Telephone through the upheaval of the US telephone industry’s deregulation. About two-thirds showed declines in health or performance, and those who stayed well were higher in hardiness. A criticism is that hardiness overlaps with low negative affectivity (low anxiety), so it may not be a separate trait. Early samples were mostly male executives, which limits generalisation.

Worked paragraph. Ravi is always rushing, interrupts colleagues and gets angry in traffic, which shows Type A time urgency and hostility. Friedman and Rosenman found Type A men were about twice as likely to develop CHD. However, a follow-up found Type A men with CHD were less likely to die from it, and hostility seems to matter more than the whole profile, so Ravi’s anger, not his rushing, may be the real risk.

6. Managing and coping with stress

Drug therapy. Benzodiazepines (BZs) enhance the effect of GABA, the brain’s main inhibitory neurotransmitter, which reduces anxiety. Beta-blockers block adrenaline and noradrenaline at beta-adrenergic receptors in the heart and blood vessels, which lowers heart rate and blood pressure. Drugs act quickly and need little effort, but BZs can cause dependence and drugs treat symptoms, not causes.

Stress inoculation therapy (SIT). Meichenbaum (1985) described a cognitive-behavioural therapy in three phases: conceptualisation (understanding stress and how you appraise it), skills acquisition and rehearsal (relaxation, positive self-talk, problem-solving) and application and follow-through (practising skills in increasingly stressful situations). Saunders et al. (1996), in a meta-analysis of 37 studies, found SIT reduced anxiety and improved performance under stress. SIT prepares people for future stressors, but it takes time, money and motivation.

Biofeedback. A person sees or hears real-time information about a body response, such as muscle tension or heart rate, while learning to relax. Lowering the reading is rewarding (operant reinforcement), and the skill is then transferred to everyday life. Lemaire et al. (2011) found that doctors using a biofeedback-based tool for 28 days showed a significantly greater fall in stress scores than controls. Biofeedback has no drug side effects, but it needs equipment and training, and relaxation alone may explain the benefit.

Gender differences in coping. A traditional view is that men use more problem-focused coping and women more emotion-focused coping. Taylor et al. (2000) proposed tend-and-befriend: women respond to stress by protecting offspring and seeking social contact, possibly linked to oxytocin. Tamres et al. (2002), in a meta-analysis, found women were more likely than men to use most coping strategies, not only emotion-focused ones. Some differences depended on the type of stressor. Differences may reflect social roles, not biology alone.

Social support. The specification names three types:

• Instrumental: practical help (lending money, giving a lift).
• Emotional: listening, warmth, reassurance.
• Esteem: boosting someone’s belief in their own ability.

Cohen et al. (2015) exposed adults to a cold virus. Those who reported more social support and more frequent hugs were better protected: support buffered the extra infection risk linked to interpersonal conflict, and infected people with more support had milder symptoms.

Worked paragraph (evaluating therapies). For a surgeon with stage fright before presenting, a beta-blocker acts quickly by blocking adrenaline, so it is appropriate for a one-off event. However, it does nothing about her fear of being judged. SIT would take weeks, but its conceptualisation phase would target this appraisal, so it may be more effective long term.

Common errors

• Mixing up the pathways: the SAM uses the adrenal medulla (adrenaline); the HPA uses the adrenal cortex (cortisol).
• Writing that ACTH comes from the hypothalamus. It comes from the anterior pituitary.
• Treating Type C as a cause of cancer. The evidence is mixed.
• Saying workplace stress is caused by workload alone. The specification asks for workload and control.
• Describing SCR as a direct measure of stress rather than of sympathetic arousal.

Where to go next

For the nervous and endocrine systems, revisit Approaches in Psychology. For Paper 1 content, see Introductory Topics.

Official syllabus

AQA AS and A-level Psychology (7181, 7182) specification, Version 1.4 (1 September 2025), for teaching from September 2025, section 4.3.7.