An Exploration of the Correlation Between Intimacy And

Home , Significant other

AN EXPLORATION OF THE CORRELATION BETWEEN INTIMACY AND

GRADUATE STUDENT STRESS

A Project

Presented to the faculty of the Division of Social Work

California State University, Sacramento

Submitted in partial satisfaction of the requirements for the degree of

MASTER OF SOCIAL WORK

by Morgan Chandler

Shellyatta Johnson

SPRING 2016

AN EXPLORATION OF THE CORRELATION BETWEEN INTIMACY AND

GRADUATE STUDENT STRESS

A Project

Morgan Chandler

Shellyatta Johnson

Approved by:

______, Committee Chair Teiahsha Bankhead, Ph.D., LCSW

______Date

xii

Student: Morgan Chandler Shellyatta Johnson

I certify that these students have met the requirements for format contained in the

University format manual, and that this project is suitable for shelving in the Library and

credit is to be awarded for the project.

______, Graduate Program Director ______Dr. S. Torres, Jr. Date

Division of Social Work

Abstract

xiii

AN EXPLORATION OF THE CORRELATION BETWEEN INTIMACY AND

GRADUATE STUDENT STRESS

Morgan Chandler

Shellyatta Johnson

Emotional support is widely known as a protective factor while experiencing stress

(Killian, 2008; Chao, 2011; Arria et. al, 2009). Intimacy or the culture of “hooking up” is a concept that has been less recognized or studied as a buffer for stress (Armstrong et. al.,

2012). The purpose of this study was to explore the relationship between intimacy and graduate student stress. This quantitative research examined graduate level social work students at California State University, Sacramento using five scales to assess stress level, intimacy level, beliefs about hooking up, social support and self-care utilization. The students’ scores were used to assess their stress level in correlation to other variables such as intimacy and social support. Most students reported having high levels of social support with a mean score of 49.9 out of 60 during their graduate careers. There was no significant correlation between their beliefs about hooking up and intimacy and stress

level (r=.187) (p=.170). There was a weak to moderate correlation (r=.417) and statistical

significance (p=.001) between the student’s age and acceptance of “hooking up”. As

students age increased their acceptance of “hooking up” decreased. This research study is

xiv

one of the few that has explored alternative coping methods of intimacy for stress. The implications for social work practice and recommendations for future research are also discussed.

______, Committee Chair Teiahsha Bankhead, Ph.D., LCSW

______Date

TABLE OF CONTENTS Page

List of Tables……………………………………………………………………………..ix

List of Figures………………………………………………………………………..……x

Chapter 1. INTRODUCTION……………………………………………………………….....…1

Background of Problem………………………………………………………..……...2

Study Purpose……………………………………………………………………..…..4

Theoretical Framework…………………………………………………………..……5

Justification……………………………………………………………………..……..8

Limitations…………………………………………………………………..………...9

Assumptions……………………………………………………………………..…...9

Definition of Key Terms……………………………………………………..………10

Statement of Collaboration…………………………………………………..……....11

2. LITERATURE REVIEW…..……………………………………………..…...…….12

Stress…………………………….………………………………..………………….14

Stress and Social Work Graduate Students………………………..…………………19

Coping Strategies and Stress………………………………………..………………..25

Self-Care………………………………………………………..……………………26

Social Support………………………………………………………..…..…………..28

Evolution of Primary Love Relationships and Effects on Mental Health………...... 31

Diverse Intimate Relationships…………………………………………………..…..32

Gaps in Literature……………………………………………………………..……..39

xvi

3. METHODOLOGY……………………………………………………………..……38

Study Design…………………………………………………………………..……..38

Sampling Procedures………………………………………………………..……….39

Data Collection Procedures…………………………………………………..……....40

Instruments……………………………………………………………...………...... 40

Protection of Human Subjects…………….…………………………………..……..41

Data Analysis………………………………...………………………………..……..42

4. RESULTS AND FINDINGS………………………………………..…………...…..43

Demographics…………………………………………………..……………………43

Significant Findings on Various Scales………………………………..…………….45

Correlation between Intimacy Scale and Stress Scale……………………..…...……55

Correlation between Age and Intimacy…………………………..………………….58

Correlation between Stress Scale and Length of Relationship……………..……..…59

Correlation between Stress Scale and Social Support…………………………...…..61

Summary…………………………………………………………..…………………62

5. SUMMARY AND RECOMMENDATIONS……………………..……….………..63

Implications for Social Work Practice…….…………………………………..……..66

Recommendations for Future Research…………………………………………...…66

Limitations……………..…………………………………………………………….68

Conclusion………………………………………………………………..………….68

Appendix A. Survey Instrument……………………………………………...………..70

xvii

Appendix B. Informed Consent Letter……………………………………...…….……80

Appendix C. Human Subjects Approval………………….……………………………82

References………………………………………………………………………………..85

xviii

LIST OF TABLES Tables Page

1. Participants’ Ethnicity By Percentage………………………………………..….44

2. Participants’ Employment Status By Percentage…………………………....…..45

3. Participants’ Responses for Social Support, Family Support, Friend Support...... 47

4. Participants’ Responses for Perception of Sex Scale…………………………….50

5. Participants’ Responses in Relationship to the Statement I would participate

in an intimate relationship or “hooking up” outside of a committed

relationship…………………………………………………………………..…...51

6. Participants’ Responses in Relationship to the Statement I think it is okay

to have friends with benefits…………………………………..………………....52

7. Participants’ Responses in Relationship to the Statement I think that friends

with benefits is a natural step to develop a committed relationship……….……53

8. Participants’ Responses in Relationship to the Statement I am comfortable

discussing significant problems with my partner……………………………..….54

9. Participants’ Responses in Relationship to the Statement I hide my emotions

from my intimate partner………………….…………………………………….55

10. The Correlation between Final Sex Scale, Intimacy Scale and Stress Scale….....57

11. The Correlation between Age and Final Sex Scale………………………..…….59

12. The Correlation between Length of Relationship and Stress Scale……..……….60

13. The Correlation between Stress Scale and Social Support Scale………..………62

xix 1

Chapter 1

INTRODUCTION

Stress is a concept almost everyone has experienced once in their lives. Stress is a commonly known experience but effective ways of managing stress are less apparent. Social work students in particular are more susceptible to stress due to the nature of their work and educational demands (Garcia & Mendieta, 2013). Negative physical and mental health outcomes are direct results of ongoing stress among graduate students. The adverse effects, such as depression, alcoholism and burnout are typical consequences of graduate students who are not effectively managing their stress (Myers et al., 2012; Eastwood & Ecklund, 2008; Killian, 2008).

The way in which graduate educational programs promote and support mental well-being and positive management of stress is a significant part of developing an effective graduate program.

Social work students are thought to have unique experiences due to continuous exposure to complex and emotionally draining conflicts, balancing professional development and demanding school work (Napoli & Bonifas, 2011; Pottag & Huxley, 1996). Commonly known stress relievers among social workers are exercising (Fleshner, 2005), social support (Lazarus,

1984; Wilks & Spivey, 2010), mediating (Turner et. al., 2005), mindfulness (Brown & Ryan,

2003) and engaging in a hobby (Norcoss, 2000). Despite large amounts of literature promoting healthy ways of managing stress, students are still burning out, becoming emotionally exhausted and having negative health outcomes (Bober & Regeher, 2006; Killian, 2008; Norcoss, 2000).

Social workers who are typically compassionate and altruistic by nature seek the need to help others but at the stake of their own well-being. Social workers, both students and professionals,

have one of the highest burnout rates among professional careers (Observer, 2008; Grant &

Kinman, 2012). The broader problem is not how to avoid stress but how to reflect and manage

distress in more healthy ways. Understanding factors the promote positive, resilient, healthy

social workers is more necessary now than previous research that focused more on what happens

after someone experiences high levels of stress. This particular research will begin to explore

how specific intimate relationships correlate with the positive well-being and stress levels of graduate students.

Background of Problem

Social work is one of the most rewarding jobs, yet one of the most challenging. The

profession has become highly recognized as a demanding and emotionally straining career.

Despite high satisfaction in the social work profession, high levels of stress have also been

reported among social workers (Neely et. al, 2009; Coffey et. al, 2014). Studies have examined

the high turnover rate and burnout experienced by social workers globally (Grant & Kinman,

2012; Lee, Foster & Rehner, 2011). Even during early training of a social worker’s career,

students are presenting negative psychological and emotional consequences that persist as they

graduate and move into independent professional careers (Garcia & Mendieta, 2013; Myers et. al,

2012). Social work students must be proactive in their ability to recognize distress and challenges

in order to maintain a healthy boundary and lifestyle for themselves.

The long-term consequences of chronic stress became widely noticed during the mid

1900’s. Exposure to stress for long periods of times can result in the manifestation of physical

illness, PTSD symptoms and neurological damage (Quick & Speilberger, 1994; Park et. al, 2012).

The correlation between stress and students was less recognized but more heavily researched

within the context of the working population. Goldberg & Williams (1988) reported 34% of their

students showed signs of psychological disturbances; Wilks and Spivey (2010) also found that

graduate students showed moderate levels of stress associated with academic responsibilities.

Research began to shift from only solely recognizing social work professionals as targets of

emotional distress to recognizing graduate students as equally susceptible to stress when more

empirical data discovered high depression (Arria et. al, 2009 ), poor sleep quality (Mezick et al.,

2009) and high levels of alcohol consumption (Chao, 2012) among students. Continuous research

is being explored to help provide Graduate Social Work students with the successful tools to help

manage stress and cope with the strenuous responsibilities of the social work profession

(Dziegielewski, Marti, & Turnage, 2004; Napoli & Bonifas, 2011).

There is a huge body of research beginning in the early 1920’s that began to identify what

stressors are and the mental and physical affects it has on individuals (Carson and Kuipers, 1998).

Professionals began to recognize that research must not only focus on what a stressor is but how

to cope with these stressors effectively. Lazarus began to explore the importance of social

support, in its efforts to create a protective shield against stress in response to unhealthy

psychological states and underutilization of effective coping strategies (Lazarus, 1984). Social

support, which could be family, friends, loved ones or peers, was looked at as positive factors that

enhance personal efficacy, resilience and positivity (Zajacova et. al., 2005; Wilks & Spivey,

2010; Lazarus, 1996). Current studies are continuing Lazarus’ research on social support and the

effects positive relationships have on people’s health and well-being. Studies such as Wilks &

Spivey’s (2010) conclude that social support accounts for 48% of the variation in resiliency and a

higher ability to adapt to challenges and stress. Garcia & Mendieta (2013) studied 613 students

and professionals, finding that burnout and the ability to overcome adversity was largely

attributed to higher levels of perceived social support and positive interactions with supervisors

and peers.

Addressing student stress through a positive framework researching how students can become successful and manage stress needs to be prominent in literature. Social work students are still becoming increasingly overwhelmed with the demands of school and internship practice.

Social support, which has been identified as an essential to combating stress, is a concept that can still be greatly scrutinized. Social support can be a vaguely interpreted term, further research focusing on specific relationships such as intimate relationships, supervisors or coworkers needs to be distinguished. The progressive nature of relationships is shifting, therefore the meaning and exchange of relationships is evolving as well. Understanding the nature of various dynamic relationships and how it contributes to the positive well-being of students and professionals is a unique contribution to the discussion of engaging in social support among students.

Study Purpose

The purpose of this study is to explore whether hooking up or the concept of friends with benefits among graduate students can have an impact on their stress levels. Students juggle these various roles within a program that at times can make it difficult to manage any one of these roles. Being able to have a healthy social life can be beneficial to one’s stress levels. The secondary focus of this study is to view how romantic relationships can promote self-care and reduce stress. Although self-care is encouraged in the social work Master’s program, graduate students may continue to find it strenuous to practice self-care techniques. Therefore, having an intimate relationship can promote healthier lifestyles and help improve one’s well-being.

This study will first provide an overview of current literature to illustrate how graduate students have a heavy workload that can cause emotional exhaustion as well as psychological and physical stress. This paper will then evaluate how graduate students cope with stress and if having an imitate relationship helps decrease stress. The meaning of an intimate relationship has evolved over the years. Being in committed relationships is not necessarily the only way to achieve intimacy, but intimacy can be shared among several individuals who share a common goal or interest. This research will also examine how romantic status impacts stress levels. Social support, such as having a romantic partner, spouse, friend, co-worker, or supervisor can provide emotional support. Finally, this paper will explore the idea that romantic relationships do not just consist of committed relationships, but also can occur in non-committed relationship among friends.

Theoretical Framework

The content of this research study is to understand how intimacy correlates with student’s stress levels. The current theoretical frameworks most appropriate for understanding the correlation between stress and intimacy would be Erik Erikson’s Developmental Theory and

Hans Seyle Stress Theory. Erik Erikson’s theory gives a descriptive background on the stages of intimacy and how intimacy interacts with the development of personal identity. Hans Seyle Stress

Theory gives a conceptual framework on how individuals cope with stress and how it impacts their lives.

Erik Erikson’s developmental theory: intimacy vs. isolation

Erikson theorized eight stages of psychosocial human development in 1959 (Simply

Psychology, 2015), believing that humans continue to develop over the years through certain age

periods. His theory hypothesized about the identity conflict and subsequent ego development

human’s encounter during different developmental ages. Erikson’s sixth stage, Intimacy vs

Isolation, is the most relevant developmental identity conflict pertaining to this particular research

study. Erikson’s theory of the stages of development provides a theoretical basis for this paper

because we focus on how intimacy can reduce or increase stress levels among graduate students.

Erikson’s sixth stage, Intimacy vs. Isolation, occurs often in young-mid adulthood, from

the ages 18-40. One of the concepts of stage six is in order to be able to share intimacy with

others one must fully exit the prior stage of identity vs. identity confusion. Intimacy vs. isolation

is the developmental stage that signifies willingness to compromise in favor for interpersonal

connection and the individual’s expansion of self-concept in relation to others (Gold & Rogers,

1996). The successful development of the ego is hypothesized to develop the individual’s

empathy and ability to create significant bonds and relationships (Gold & Rogers, 1996).

Many individuals tend to link intimacy with sexual encounters, and while this may be true for some, intimacy contributes to the need for attachment, that bond that is established in the beginning of one’s infant years with a care giver. This bond of attachment plays a significant role in the way intimacy is formed throughout childhood into adulthood. Intimacy requires a closeness and/or bond between two individuals that can involve warmth and affection (Sperry, 2003).

James and Ruthellen (2013) explore Erikson’s Stages of Development theory in terms of intimacy versus isolation. Their study focuses on the various stages of intimacy that include

intimate, pre-intimate, pseudo intimate, stereotyped, and isolated. These five stages of intimacy link well with our particular research study because of its focus on how levels of intimacy can provide social support. The authors state that, intimacy focuses on oneself knowing their identity.

In order for one to be comfortable with another individual they must have a clear understanding of their own identity, whereas stereotyped individuals tend to conform to social expectations of dating such as the “male” or “female” role. This concept is important to our current study due to the fact that graduate students have to manage several roles and their identity can sometimes be at risk.

When individuals practice stereotyped relationships their expectations follow traditional dating guidelines, whereas pseudo-intimate relationships are relationships that are intimate, but may not be as emotional or have the psychological connections that a committed relationship would (James and Ruthellen, 2013). Research has suggested pseudo-intimate relationships could allow individuals from getting hurt by others because they are not psychologically invested in the relationship (James and Ruthellen, 2013).

This study will explore the new term “hooking up” and other types of pseudo-intimate

relationships. The reason being is because in today’s social climates on campus pseudo-intimate

relationships offer overwhelmed and exhausted grad students a glimpse of the benefits of

intimacy, rather than relegating them to isolation due to their lack of free time.

Isolated relationships are viewed as emotionally disconnected or non-existing. James and

Ruthellen (2013) point out people involved in isolated relationships could have had difficulties in younger years with trust and autonomy. They state that within intimate experiences there are

different roles that are played. Overall, this theory supports our study in how having a committed

or non-committed relationship can continue to provide social support for graduate students.

Stress Theory

Hans Selye developed the concept of the stress theory in 1935 (Viner, 1999). Stress is conflict linked between human beings and their living environments. Hans Seyle viewed stress as an expected human experience because all humans will experience some sort of hardship in their lifetime (Viner, 1999). Lazarus and Cohen define stress as an internal or external balance of emotions that can affect physical and psychological well-being due to life demands. The stress theory supports our research due to the fact that many graduate students experience stress because of the high demands that are placed on them.

Lazarus and Cohen’s transactional model of stress and coping is a framework that divides coping with stress into a primary appraisal and secondary appraisal approach. This model focuses on how humans cope with stressful events. The primary appraisal is the way someone views the emotional reaction of the threatening events, while the secondary appraisal focuses on how that person views the way they can respond to the event. This is important and applies to our research because at some point in time graduate students will experience a stressful event and, how they handle it could be a way of coping with the issue. In many cases having social support can help reduce the pressure of stress.

Justification

The social work population has students who come from different demographics and backgrounds. Some students may be in committed relationships, have families or participate in casual dating. While managing these personal relationships, graduate students have to maintain

school requirements. Being in the graduate program in itself can cause stress and anxiety.

Therefore, having such responsibilities in one’s personal life and professional life can become

stressful and overwhelming.

There have been several studies done on measuring social workers stress levels and how

important self-care can be. However, there are limited studies on measuring graduate students stress levels regarding intimacy. The goal of this research is to see if having intimacy either in committed or non-committed relationships has impacted ones stress level. The objective of this

research will help to identify whether being in committed relationships or “hooking up” can

increase or decrease ones perception of stress.

Limitations

There are a few limitations to this study that should be noted. First, researchers are only focusing on the Social Work Division at California State University, Sacramento. Therefore, this study will have results that may not be applicable to other Social Work Divisions. Second, this research study is particularly evaluating only graduate students. Lastly, only certain demographics will be explored in this study and that particular demographic is that they must be

18 or older to participate in this study.

Assumptions

The assumptions that need to be considered for this study include: 1) Graduate students

consume a high of stress; 2) As graduate students it is important to have self care; 3) Intimacy can

help reduce or increase the level of stress; 4) Having an intimate relationship whether committed,

“hooking up,” or friends with benefits can have an impact on ones well being; 5) Having a

romantic partner, spouse, friend, co-worker, or supervisor can provide social and emotional support.

Definitions of Key Terms

Friends with benefits relationships-(FWBRs) - are defined as relationships

between cross-sex friends in which the friends engage in sexual activity but do not define

their relationship as romantic (Hughes, Morrison, and Asada, 2005).

Hooking up- Can consist of any sexual contact between two individuals whether

opposite sex or same sex (Lovejoy, 2015)

Intimacy- Requires a closeness and/or bond between two individuals that can involve warmth and affection (Sperry, 2003).

Marriage/ Monogamous- Commitment between one individual is theorized to be the living force necessary for physical, mental and moral health (Bartels & Zeki, 2004).

Self-care.-Is the term researchers use to refer to as the awareness of one’s own emotional experiences in response to stressors (Salloum et. al, 2014).

Social Work student- Graduate student enrolled in a Master of Social Work

program (Sacramento State Division of Social Work, n.d.)

Stress- An internal or external balance of emotions that can affect physical and

psychological well-being due to life demands (Viner, 1999).

Social support-As commonly defined with three primary

components: support schemata (or mental maps of supportive social network individuals), supportive relationships (or those actual individuals who provide support), and supportive communicative encounters (Boren, 2013) (Pierce, Sarason, & Sarason, 1996).

Statement of Collaboration

Both researchers equally distributed work amongst each other. The first chapter was equally broken up into four parts, each researcher writing and completing two sections. The

Literature Review was also broken up into various topics and subtopics so both researchers can write on a particular topic. The remaining chapters were similar to the first chapters, researchers divided each section into equal parts to write and complete by a designated date and time.

We both equally contributed to the data collection and data input process of the thesis project. Both researchers went to two separate classrooms to distribute questionnaires and collect data. Data was stored and secured with one researcher in a secured lock box. Both researchers took 30 questionnaires and entered the data separately. Final data and SPSS findings were computed and combined on one SPSS file so we could have equal access to data.

Chapter 2

LITERATURE REVIEW

Social work is one of the most rewarding jobs, yet one of the most challenging. Despite high satisfaction in the social work profession, high levels of stress have also been reported among social workers (Neely et. al, 2009; Coffey et. al, 2014). Goldberg & Williams (1988) reported 34% of their students showed signs of psychological disturbances; Wilks and Spivey

(2010) also found that graduate students showed moderate levels of stress associated with academic responsibilities. As awareness and research broadens to understand stress and graduate students’ wellbeing, social work education is being modified to promote and develop the well- being and quality of life for students (Grant & Kinman, 2012). Continuous research is being explored to help provide Graduate Social Work students with the successful tools to help manage stress and cope with the strenuous responsibilities of the social work profession (Dziegielewski,

Marti, & Turnage, 2004; Napoli & Bonifas, 2011).

Student life can be extremely difficult. Student’s demands increase drastically during their graduate studies; students must fill numerous roles within school, family, work-place and other roles simultaneously. Students can begin to experience academic stress, emotional exhaustion and compassion fatigue all contributing to their quality of life and psychological health. High-levels of stress have been linked to physical distress (Bledsoe et. al, 2011; Ying,

2009; Wilks & Spivey, 2010) as well as psychological distress (Ying, 2009). Students identify academic demands, financial pressures and training for social work as primary stressors (Moore et. al, 2011; Turner et. al., 2005). It is important for educators as well as students to understand positive coping mechanisms during increasingly stressful times. Educators have coined the term

“self-care” as a form of coping strategy that develops the student’s ability to tolerate high levels of stress and maintain a healthy life. Self-care can be defined as “engagement in behaviors that maintain and promote physical and emotional well-being” (Myers et. al., 2012, p. 56). Self-care can be engaging in significant social relationships, exercising, religious/spiritual rituals, volunteering or even traveling. Engaging in self-care has been studied as one of the moderating factor linking the psychological wellbeing of social work students and their ability to be resilient, or tolerate high-levels of stress (Grant & Kinman, 2012; Garcia & Mendieta, 2014).

Researchers have found the significant impact of social supports as a protective buffer for student’s stress tolerance and resiliency (Gianakos, 2002; Lee, Koeske, & Sales, 2004).

Resiliency is a defining characteristic social workers develop to help them shape their effectiveness of practice, empathy and overall ability to withstand immense adversity (Luthar &

Cicchetti,1995; Garcia & Mendieta, 2014). Social support can consist of any significant relationship in a person’s life. Most studies show the significance of social supports and its relationship to managing stress but have not specifically researched the impact of primary love or significant love relationships as a protective buffer for students. Numerous studies have linked how important social supports are, serving the purpose of providing emotional support, empathy and a positive outlet (Dziegielewski, Marti, & Turnage, 2004; Gianakos, 2002) but insignificant research on the specific outcomes of romantic love or relationships has been reported.

The operational definition of primary love and relationships is evolving. Adulthood relationships are becoming more and more non-traditional, marked not just by monogamous marital status but casual relationships, multiple intimate relationships and cohabitating. As the traditional primary love and marriage concept is changing, research needs to evolve and progress

as well. Identifying and including various significant relationships is needed to then understand how these relationships impact students, specifically social workers. Understanding the evolutionary trends of relationships and romantic love can help identify these entities as stress buffers or additives among graduate students. Understanding how significant romantic relationships, as well as casual intimate relationships can help analyze the implications of the evolving concept of relationships and intimate love; does it help reduce or increase students’ stress?

Examining these factors can help identify the complex factors that develop a more resilient social worker. Identifying specific influences among stress is essential in promoting a healthier life for those professionals who are faced with the demands of improving the lives of others.

Stress

Stress is unique and an individual experience for everyone. Stress is such an individualized condition because the primary source and manifestation can be vastly different for everyone and is primarily dependent on the individuals’ perception of stress (Pederson, 2012).

Physiologically, health is determined by the stable balance of parts in the body that function in harmony (Smith & Selye, 1979). An unhealthy body, or body undergoing immense stress, is characterized as a demand either internal or external, which produces in emotional arousal that creates a change of behavior (Ragheb & McKinney, 1993). In the early 1900’s, the concept of stress and its physiological effects on the body became widely researched after the biologist

Walter Cannon began to research the physical and emotional threat of stress (Quick &

Speilberger, 1994 ).

Cannon described the physical response of stress as “fight or flight” instinct, where the body responds to a perceived threat in the Sympathetic Nervous System (SNS) (Quick &

Speilberger, 1994). Cannons initial research continued to influence the medical and psychology field throughout the 20th century. Carson and Kuipers (1998) furthered Cannons research by

developing a stress model that consists of three main factors; stressors, stress process and stress

outcomes (Pederson, 2012). Their findings contributed to the broader knowledge of stress by

creating a model that looked deeper into the process of stress, rather than focusing on the physical

manifestations of stress.

Physical and Mental Implications of Stress

Challenging situations causes the individual to not only respond to the adversity psychologically but physically. Stressors can vary, from physical, social, psychological and can take form in a life event or chronic strain (Pederson, 2012; Hudd et. al., 2000; Chao, 2011). When stressors become excessive and negatively perceived by the individual, psychological and physical impairments can occur (Misra & McKean, 2000; Gianakos, 2002) causing the body to respond altering neurological and hormonal systems, as well as cognitive functions (Adams et. al., 2006).

Hans Selye is considered to be the pioneer of stress research and it’s correlation to physical health. Current research is based off of Han Seyle’s original hypothesis on the physical adaptation of distress. Seyle (1979) spent multiple decades researching the physiological response of stress and how the body adapts and reacts overtime. Seyle developed a three-stage model describing the body’s reaction to chronic (long-term stress) within the brain and rest of the body.

Within his three-stage adaptation model-Alarm reaction, Resistance, and Exhaustion-he analyses

the relationship between the weakening of body systems and individuals susceptibility to disease and illness. Some medical researchers consider 50-80% of specific illnesses-Ulcers, hypertension, cancer- are a result of distress and stress to the body (Smith & Selye, 1979). Later studies also find that individuals that experience higher levels of stress can develop chronic inflammatory disorders, depression, chronic pain and immune deficiencies (Raja et. al, 2008; Dutton et. al.,

2006)

Physical health outcomes of stress are less commonly studied among graduate students but an enormous amount of research has been done on the physical effects of stress on other trauma exposed professions such as police officers, veterans and firefighters. Since less research has been done to specifically estimate the physical effects of ongoing stress within the graduate student population, research pulled from other related professional fields that are chronically exposed to stress can help the field of social work analyze the implications of stress more broadly. A study examining the physical effects of violence and traumatic stress among African

American, female veterans, looks deeper into the correlation of the physiological response of stress and long-term health complications (Raja et. al., 2008). A total of 268 female, veterans completed a questionnaire including questions that examined Post-Traumatic Stress Disorder

(PTSD) symptomatology as well as physical health symptomatology. Their findings show that

PTSD mediated the relationship between stress, violence and physical health symptoms (Raja et. al., 2008). The participants that reported higher levels of violence and PTSD symptomatology also reported higher levels of pain-related conditions. Particular studies like that of Raja et al,

2008, show a significant relationship between psychological distress and the physical body.

Professionals undergoing immense stress can potentially have a higher risk of physical conditions.

Another significant study estimated the effects of work stressors among police officers to determine the impact of physical health and coping techniques (Gershon, 2009). Police officers who surprisingly endure similar stressors to social workers are exposed to traumatic/emotional

incidents just as frequently. Gershon et. al, (2009) administered a 132-item survey to 1,072 police

officers at the Baltimore Police Department. The survey measured 4 particular themes, coping

strategies, perceived stress, police stressors and adverse outcomes. A total of 35% of the police

officers reported lower back pain, followed by chronic insomnia, migraines and foot problems

(Gershon, et. al, 2009). These findings support Seyle’s original theory that a body enduring

chronic stress depletes in strength and its ability to fight disease and infections.

More specific physical outcomes of stress include sleep disturbances, unhealthy diets, and stress related illness. Sleep is a significant factor that can be heavily affected by stress and impact physical health (Pallos et. al., 2007; Mezick et. al., 2009; Myers. et. al,) In a survey of 219 graduate students, 25.6% of the students were poor sleepers, reporting short durations of sleep every night (Pallos, et,al,). Students reporting reduced hours of sleep and deprivation reported more serious injuries and poor health (Pallos, et. al., 2009)

High levels of stress in students has also been linked to depression and suicidal ideation (Hudd et. al., 2000; Myers et. al., 2012). A recent study (Arria et. al, 2009) researched the prevalence of suicidal ideation among students and the prevalence of stress. Arria et. al (2009), included 1,249 college students, 48% male and 52%, whom completed a questionnaire based on The Beck

Depression Inventory. Out of 1,249, 75 students presented suicidal ideations and 55 met the criteria for possessing high depressive symptoms. On-going stressors identified as academic stress, role changes and family stressors (Arria et. al, 2009). This particular research illuminates

the great amount of pressure students endure during their educational experiences. Adapting to

new challenges and academic pressures can be so significant students are unable to effectively

cope. Literature also reveals alcohol/drug consumption (El-Ghoroury et. al., 2012; Chao, 2011) is also associated with high levels of stress among graduate students specifically.

Another study (Chao, 2011), 459 graduate psychology students completed a survey on stress and coping mechanisms. The study’s intent was to explore graduates students stress level, using a Perceived Stress Scale, and specific coping mechanisms; particularly hypothesizing that the well-being of the student would be the lowest when social support was low and dysfunctional coping was high. Chao (2011), examined the well-being of students, dysfunctional coping and perceived stress to analyze the relationship and integration between all three variables. Around

15% of the 459 students reported significant and above average alcohol/drug use specifically.

Findings also highlight that even with higher perceived social support, dysfunctional coping can still continue to lower well-being and increase susceptibility to stress. (Chao, 2011). With the rise of dysfunctional coping techniques such as suicide and alcohol use, collective data on students particular stressors help professionals evaluate how they can best help support students during their educational careers.

Stress and Social Work Graduate Students

Social work students carry a heavy burden of responsibilities. Social work students have to effectively manage their time while juggling not only academic stressors but financial, internship experience and personal life. Along with the academic pressure of graduate studies, professional training and emotional exhaustion are unique to Social work students. Social work students are faced with emotional intensity, professional education and social work development

that can stimulate more distress in comparison to more traditional graduate programs

(Dziegielewski et. al, 2004; Coffey et. al, 2014). Grant (2002), analyzed stress and coping mechanisms among 200 graduate level students at a university to add broader knowledge to social work education and professional educators. Participants completed a survey and in-depth interview on their coping strategies and primary source of stressors. Grant (2002) found that the primary sources of stressors for graduate students in particular were their abilities to cope with their studies, deadlines, grades, finances and future careers. These particular stressors are unique specifically to graduate students because of their dual responsibilities as a student and professional.

Vast amount of research has been completed to specifically recognize the implications of the work environment and its overall effects on professional’s wellbeing (Spielberger & Reheiser,

1995; Gianakos, 2002). A UK publication estimated that of the 76,000 social workers in the country, 20% of those workers missed 20 consecutive days of work due to stress or anxiety

(Observer, 2008). With social workers burning out and becoming exhausted at such an alarming rate, the research topic of burnout and compassion fatigue is increasing. Burnout and compassion fatigue are terms heavily associated with the profession of social work (Killian, 2008; Adams,

Boscarino, & Figley, 2006). Burnout is the general term to describe professional’s prolonged exposure to demands, stress and interpersonal situations; it can result in emotional exhaustion and depersonalization (Adams, Boscarino & Figley, 2006).

Burnout is frequently attributed to the working class social worker and less associated with the role of a student. Research on compassion fatigue and burnout are more heavily targeted toward the professional population and less within the graduate student population. One unique

study intended to bridge the gap in understanding the difference between professional and student

resiliency and stress factors. Garcia & Mendieta (2013) included 613 participants, 175 social

work students and 304 social workers, in their longitudinal study evaluating their resiliency,

coping mechanisms and adversity at work. Resiliency was measured using Grortbergs resilience

scale, using personal competence statements “I am, I can, I have”. Garcia & Mendieta (2013)

found that resiliency and the ability to manage stress among professionals already in the social

work field was associated with years of experience, acceptance and coping techniques at work.

Factors associated with social work students were different than that of professionals, graduate

students acceptance of life, personal competence and social support created a larger buffer for a

more resilient and healthy individual. Garcia & Mendieta’s (2013) findings are similar to Kim &

Stoner’s (2008) findings which reflect professionals experience overtime has a larger impact on

overall satisfaction and resilience in comparison to graduate students that are largely impacted by

social support and self-acceptance. Although Garcia & Mendieta’s work is based in the

University of Spain, the global implications are powerful. Social Work students and social work

professionals conceptualize their work experience and personal achievement differently. Students

tend to seek social support and own personal competence as a buffer while professionals believe

work experience overtime helps them be a more resilient social worker.

Within the last decade the phenomenon of stress and undergraduate student life has been explored, minimal research has been done to examine graduate level social work students in particular (Munson, 1984). Despite Garcia & Mendieta’s (2013) unique studies, large gaps still remain specifically including social work graduate students in the discussion of burnout and stress tolerance. The idea of burnout and compassion fatigue within the professional environment is heavily accepted, while less within the graduate student context.

The combination of intense social work training, academic stress and overall stressors during a person’s life can induce the student’s stress. A study by Munson, opened the discussion for researchers to begin to recognize high-levels of stress among social workers and their experiences as a student and professional. Munson’s exploratory study was conducted with graduate level students at an urban university. 82 students completed a 75-question questionnaire concerning their demographics, physical/psychological symptoms, field experience (including supervision) and sense of accomplishment or failure (Munson, 1984). 71% of the participants experienced physical stress in the class, while the other 29% experience physical stress during field placement. In addition, 57% of the participants experience psychological distress in the class setting verses 42% experiencing psychological distress during their field placement experience

(Munson, 1984). Munson’s methodology was particularly imperative for future research because it began to look at the vast sources of stressors for students both academic and professionally.

Munson’s findings suggested that not only do students experience physical and psychological stress within the academic setting, the field placement experience in which students begin to apply social work practice is another factor influencing student social workers distress.

Some studies suggest that students do in fact experience higher levels of stress compared to professionals already in the social work field (Dziegielewski, Marti, & Turnage, 2004; Tobin

& Carson, 1994; Mayer & Rosenblatt, 1974). A second study, Mayer and Rosenblatt (1974) supports that exact idea. Mayer and Rosenblatt presented a more thorough view on the student’s field placement experience and the cognitive/emotional distress associated with the stringent training of social work practice.

In hopes to create a framework for supervisors, students and educators about the field placement experience in conjunction to the pressures of being a student 39 second-year graduate students from Columbia University were asked to write (as well as discuss during an interview) 3 particular situations that caused them the most stress. Each was told to explain why it caused them stress, who was involved and how they attempted to cope with the situation. Within these personal narratives and interviews researchers were able to pull out common themes and notice patterns throughout the graduate students that could possibly help identify specific sources of stress. During field placement, Mayer and Rosenblatt (1974) suggest that students have exceedingly high expectations of themselves in the field, role ambiguities, supervision concerns, emotional immaturity and blaming themselves for failure or client behavior. The apprehensiveness of becoming too involved or too emotionally connected to their clients was specifically reported among these students. Mayer and Rosenblatt suggest the unique and particular role social supports, such as supervisors play in the development of students. Their study also holds significant implications about the daunting fear of “failing” or not being a competent social worker during field placement experiences-which is much more prevalent in student interns than seasoned social workers.

More recent studies support Mayer and Rosenblatt’s findings (Lemieux et. al, 2010;

Tobin & Carson, 1994; Ngai & Chueng, 2009). Graduate students are exposed to emotionally difficult situations, academic standards and haunting altruism. Researchers are closing the gap by researching graduate student social workers process stress and the primary sources of those stressors. More research recognizing the various roles of social work students and the emotional implications of social work training can provide educators with more education on the importance of recognizing burnout and stress.

Recent studies like Ngai & Cheung (2009) and Lemieux et. al. (2005) analyze students stress and coping mechanisms and effects on the effectiveness of their professional practice. Ngai and Cheung (2009) administered a study to explore social work student’s altruism and emotional exhaustion among 165 students. This study was unique in its form because it looked at social workers idealist perspective and its manifestations into psychological distress. The results from the questionnaire determined there was a link between student’s idealism, altruism and emotional exhaustion (Ngai and Cheung, 2009). Social work students have an ideal perspective on what their field placement experience will be like and when confronted with different experiences than expected emotional exhaustion is more likely to occur. Social workers have unique experiences that are developed and conjoined by altruism, field experience and emotional intensity. Various research that explore numerous factors of social work students experience create a platform for future researchers to begin to investigate social work student’s unique experiences and psychological well-being.

Coping Strategies and Stress

Stress is an individualized experience unique to each person; the way in which individuals respond to particular stressors is an individualized phenomenon as well. Coping strategies is the dynamic process in which individuals respond to a particular stressor, being an internal or external condition (Lee, Forster, Rehner, 2011). Literature suggests coping strategies are developed by the influence of internal/external conditions (Lee, Forster, Rehner, 2011), personality traits (Gianakos, 2002; Armstrong-Stassen, 1994), locus of control (Gianakos, 2002;

Speilberger & Reheiser, 1995; Lazarus, DeLongnis, Folkman, 1988) and gender (Gianakos, 2002;

Turner et. al., 2005). Lazarus (1984) identified three constituents of coping strategies-

problem/emotion focused, control/escape, and approach/avoidance. More recent studies have

been done to determine the significance of locus of control and the development and utilization of

coping mechanisms (Gianakos, 2002; Gianakos, 1995; Mann-Feder & Savicki, 2003).

Mann-Feder & Savicki (2003) surveyed 116 social workers employed with child welfare services for the purpose of exploring how individual’s perceived control- if a person believes control is determined internally or by external events and its effects on their level of stress and emotional exhaustion. Participants were given a questionnaire addressing topics that adhere to locus of control, work satisfaction and emotional exhaustion-including physical health. Mann-

Feder & Savicki (2003), findings present that locus of control was associated with emotional exhaustion and burnout; internal control coping was inversely related to emotional exhaustion while escape coping was positively related to emotional exhaustion. Those social workers who see problems as external to them, having no control of the events that happen, are more likely to experience emotional exhaustion. Mann-Feder & Savicki literature on locus of control can help educators shape and develop the way students perceive stress and challenges in their lives. Mann-

Feder & Savicki findings were also constant with Gianakos (2002) and Riolli & Savicki (2006) that concluded locus of control is a significant variable in the use of specific coping mechanisms.

Gianakos (2002) found out of 208 employed adult students, escape related coping was associated with external locus of control- resulting in increase stress, increase compensating behaviors and poor health. Gianakos’ research on locus of control expands knowledge on the development of particular coping strategies among different personalities and personal characteristics.

Parallel to the abundance of research on the variables contributing to coping strategies, researchers have also identified the difference between functional and dysfunctional coping

mechanisms (Lazarus, 1984; Armstong-Stassen, 1994; Chao 2011; Buote et. al, 2007).

Researchers are becoming more interested in dysfunctional coping because it is becoming more

prevalent among universities (Chao, 2011). The recognition and awareness of dysfunctional

functioning and well-being is urgent in the efforts to support and care for students. Inadequate coping skills can result in the person being unable to attempt to solve the problem (Lazarus,

1994) and result in having little to no effectiveness (Carver et. al., 1989). Avoiding such stressors

can be detrimental to one’s health. Being able to notice stress physically and psychologically is a

protective factor created to avoid utilizing dysfunctional or inadequate coping mechanisms.

Inadequate coping mechanisms consist of excess consumption of alcohol/drugs,

avoidance/escaping stress, isolation, focusing/complaining of emotions (Carver et. al, 1989). In

Gianakos (2002) research employees engaging in avoidance coping consumed more alcohol and

stayed at their jobs much longer than their counterparts. In another study Riolli & Savicki (2006)

determined that out of 160 service workers, escape coping was positively related to high turnover

rates, depression and isolation.

Self-Care

What can students and educators do to try to combat the stressors of school and work?

Recognizing stressors as they occur and being proactive in one’s health is critical in the social

work field. Siegel (2010), once said “If we don’t care for ourselves we’ll become limited in how

we can care for others”. Self-care is the term researchers use to refer to as the awareness of one’s

own emotional experiences in response to stressors (Salloum et. al, 2014). Self-care is becoming more prevalent in social work education in hopes to provide proper education on the importance of taking care of oneself. In result providing the most effective and objective practice. Self-care is

an ambiguous term and can be perceived as almost anything. The most common forms of self-

care that have been collected from researchers over the last few decades have been,

praying/meditating, exercising, sleeping, traveling and engaging in social support (Lazarus,

Delongis, Folkman, 1988; Turner et. al., 2005; Mckenzie et. al., 2006; Myers et. al., 2012).

Social workers are constantly exposed to complex situations and challenging decisions.

Not effectively utilizing self-care techniques can have not only a detrimental effect of the

professional but also the relationship between the professional and client. One of social works

core values is integrating an objective, compassionate and appropriate relationship with

individuals (Seigel, 2007). Integrative health is the idea that the social worker and client are

“partners” in the healing process (Napoli & Bonifas, 2011; Siegel, 2007). The relationship

between underutilization of self-care and negative outcomes on social work practice has been

significantly researched. Salloum et. al (2014) interviewed 104 child welfare social workers,

analyzing compassion fatigue, client relationship and job satisfaction. Their study determined

compassion fatigue and the role of self-care affect the social workers potential quality of care,

decision-making and job satisfaction (Salloum et. al, 2014) . In constant communication and

exposure to complex individuals it is hard to maintain a certain level of objectivity and awareness

of one’s own personal emotions. Siegel is a major researcher on the concept of mindfulness and

the role of self-care on the fragile yet unique relationship between social worker and client. Siegel

(2007) suggested clinicians create more coherent expression of thought, objectivity and empathy when engaging in self-care activities and practicing mindfulness.

Napoli & Bonifas (2011) designed a pretest-posttest experiment using Kentucky

Inventory of Mindfulness Scale, to further explore Siegel’s concept of mindfulness and its effects

on clinician/client relationship, as well as student’s self-awareness and professional development.

48 students enrolled in the 16-week mindful/self-care course; significant improvements were made with an overall .84 gain in mean scores in relation to observing/recognizing one’s own emotions. Other researchers support the concept of self-care and mindfulness in its importance on client-clinician relationship. It protects the clinician from feeling vulnerable and overwhelmed/over-involved, making the ability to set appropriate boundaries much easier (Salloum et. al., 2014; Eastwood & Ecklund, 2008; Siegel, 2010). Other implications of engaging in self- care is reducing potential countertransference, burdening client with own personal emotions/bias and blaming client (Figley, 2002; Eastwood & Ecklund, 2008; Napoli & Bonifas, 2011; Salloum et. al., 2014).

Social Support

In the 1980’s Lazarus created a measure to study the coping process called Ways of

Coping (Carver, Weintraub & Scheier, 1989). Within his measurement tool him and his colleagues recognized the significance of social supports as a problem and emotion focused coping mechanism. Carver et. al (1989) challenged Lazarus certainty of the importance of social supports by recognizing that social supports can also have negative connotations. Seeking out social supports as a form of coping can result in the ventilation or complaining of one’s feelings which is not always adaptive or an adequate form of coping (Carver et. al., 1989; Chao, 2011).

Bober, Regehr, & Zhou (2006) found no association between the perception of self-care strategies such as seeking social support and decrease of stress level after evaluating 330 trauma counselors.

Killian (2008) suggests that maybe the perception of seeking social support and the actual action

of seeking social support is what accounts for the discrepancies between Bober et. Al (2006)

findings and Lazarus initial hypothesis on social support.

Despite some findings that are reluctant to find associations between social support and overall stress level (Bober, Regehr, & Zhou, 2006) more findings have been in favor of the significance of social support. In an attempt to correlate job autonomy, role stress and social support, Kim & Stoner (2008) explored social workers high burnout rate and turnover intention.

A total of 346 California registered social workers were randomly selected and given a questionnaire examining role stress, job autonomy, social support and burnout. Results suggest that job stress and turnover intention is stronger when social support is low. Job autonomy and social support negatively affected turnover rate, hypothesizing that social support increases turnover among social workers. Kim & Stoner’s findings were synonymous with Grotberg’s belief that resilience and ability to withstand stress is built through the sources of support a person requires over life experiences.

Killian (2008) surveyed 104 therapists nationwide researching the relationship between social supports, locus of control and stress level. The purpose of the study was to provide a more thorough understanding of therapists stress and factors contributing to resiliency and burnout.

After administering 104, 28-item questionnaires and 20 in-depth interviews Killian (2008) discovered that engaging in proactive positive self-care such as engaging in social support, socializing with colleagues and seeking supervision support buffers stress tolerance. Social support and internal locus of control accounted for 41% difference within the sample population, although women were more likely to seek social support or report higher levels of stress (Killian,

2008).

Extensive research has been done to extend Lazarus’ initial hypothesis about the importance of social support in not just graduate students’ lives but everyone’s. Humans are particularly social beings; the need to communicate, connect and share emotions with one another is part of human existence. The exclusion of social support can result in excessive dysfunctional coping mechanisms (Chao, 2011; Arria et. al, 2009), higher levels of stress (Killian, 2008; Kim &

Toner, 2008) and could increase physical health concerns (Mann-Feder & Savicki, 2003; Pallos et. al, 2011). Humans are complex, therefore acquire various ways of receiving self-gratification and maintaining the wellness of the psyche, social work research must be continuous to help explain and predict how students best manage their educational career and live a healthy life within the connection of others.

Evolution of Primary Love Relationships and Effects on Mental Health

The idea of monogamous relationships is evolving, especially among younger adults, making unmarried cohabitation, premarital sex and long-term uncommitted relationships more prevalent (D. Currier, 2013; Armstrong et al., 2012). Particular research on the ambiguity of relationships has focused on the micro aspects of this phenomenon; examining gender roles (D.

Currier; Waite & Joyner, 2001; Messner, 2002) increase dating violence (Kahn et. al., 2000), alcohol use (Whitton et. al., 2013) and religious morality (D. Currier, 2013). Minimal findings are focused on the positive effects or mental health outcomes of diverse intimate relationships, such as casual “hook-ups” or relationships outside of marriage. The large body of research done on the mental health outcomes of romantic relationships or primary love is done within the framework

of marriage or monogamous/committed relationships (Whitton et. al., 2013, Mackey et. al., 2014;

Aron et. al, 2005; Fisher, 1998). A particular amount of research on committed relationships only

entails the benefits of being “in love” or in a monogamous relationship but minimal findings on

participating in a less monogamous or traditional relationships.

Research entails that participating in an intimate relationship exerts protective factors that potentially reduce stress (Mackey et. al, 2014, Esch & Stefano, 2005) but intimate relationships could vary in time and dynamic, which research does not reflect.

In the 1980’s, Sternberg first coined the Triangular Theory of Love to constitute the meaning of intimate relationships that partners experience over a lifetime (Sternberg, 1986). He hypothesized that love is a complete integration of intimacy, passion and commitment, which is not only

genetically instinctive but also socially learned. Love can also be described as the focused

attention, increased energy and euphoric feeling activated by hormonal changes in the brain

(Aron et. al., 2005; Wlodarski & Dunbar, 2014). Researchers have found a significant interest in

the effects of love on the human brain and cognitive functioning due to its close connection to

positive psychology, the theory behind human’s motivation to seek pleasurable experiences and

rewards (Esch & Stefano, 2005; Eshan et. al, 2011). Humans innately seek social contact and

emotional connect from others both biologically and socially. Neurological researchers have done

neurological testing on subjects to determine the underlining brain stimulation and hormonal

functioning affected by the social perception of love and intimacy (Mackey et. al, 2014; Young &

Wang, 2004).

Despite research and even political reforms to promote the sacredness of marriage and

committed relationships, individuals are opting out of fully committing to monogamous

relationships. With the meaning of intimate relationships widening, the implications of stress and

psychological outcomes are also affected. Exploring how different individuals understand

intimate relationships and the purpose of those intimate relationships can seek to understand how

stress and emotional well-being manifests within different forms of relationships.

Committed Relationships

Differentiating and comparing the meaning and implications of various intimate

relationships is necessary in developing a clear picture of how each relationship affects

psychological well-being and stress management. First, the analysis of marriage or a committed

monogamous relationship is examined. Marriage is typically a monogamous lifetime commitment

to another person. Marriage or the monogamous commitment between one individual is theorized

to be the living force necessary for physical, mental and moral health (Bartels & Zeki, 2004). The

linkage between psychological health and love came from the inverse concept of “broken heart

syndrome” (Nakhaie & Arnold, 2010; Mackey et. al, 2014). Researchers began to notice not only

the psychological distress that accompanied a break-up but the physical distress as well. The intense feeling of love and Euphoria, is rooted in the chemical hormone of Dopamine and

Serotonin (Wlodarski & Dunbar, 2014; Young & Wang, 2004; Mackey et. al, 2014) Researchers determined couples in the early intense stages of love, produce more dopamine-which contributes to the addictive perception of love and high levels of oxytocin (Wlodaski & Dunbar, 2014;

Mackey et. al, 2014), when the relationship is no longer present those chemical hormones drastically drop.

Oxytocin has been widely studied as one of the main biological driving force behind human’s innate desire toward intimacy. Dr. Sean Mackey and his colleagues out of Stanford

University, conducted a study to examine the hormonal changes created during early-romantic

stages and the physical relief of pain. The purpose of the study was to explore the intense

biological power of love and attachment and its implications on physical health. Multiple couples

were initially screened to participate in the study but only 27 couples were chosen using a 15-tem

Passionate Love Scale, who identified as monogamous, committed and in their first year in their

relationship. These participants were shown pictures of their partner; researchers determined the

sight of their partner activated oxytocin and regions of their brain that are strongly associated

with pain relief (Mackey et. al., 2014). The attachment enhanced hormones that activate reward

system motivation and limbic system, which is also controlled in the same region of the brain as

pain. Mackey research on love as a metaphorical painkiller correlates with other research that

examines the biological aspects of love that reduce stress (Fisher, 1998; Young & Wang, 2004;

Dunbar & Schultz, 2010). The reward system and limbic system is researched to deactivate the

amygdala, which reduces fearful and stress responses normally alert when amygdala is activated

(Esposito et al., 1984; Liebowitz, 1983; Aron et. al, 2005). Biological research on love links the

psychological and mental outcomes of participating in an intimate relationship. Mackey’s

research in particular alludes to the hypothesis that Romantic Love could potentially be a

beneficial investment for individuals experiencing severe pain, both physically and emotionally.

Monogamous relationships are more socially accepted and many studies have researched advantages of being in a more monogamous or married relationship rather than the disadvantages.

Romantic relationships are associated with emotional dependency, security/comfort and commitment that often reduces stress and anxiety in particular individuals (Fisher, 1998; Dunbar

& Schultz, 2010; Nakhaie & Arnold, 2010). Infinite amount of research details the social benefits of being in a monogamous relationship, like receiving emotional support (Sternberg, 1986; Esch

& Stefano, 2005), stress management (Esch & Stefano, 2005) and also financial benefits

(Nakhaie & Arnold, 2010). A 4-year analysis on how loving relationships impacts mental health

was completed using 9,442 participants throughout Canada, to examine how structural support of

loving relationships tend to effect emotional support and in return influence health status

(Nakhaie & Arnold, 2010). The longitudinal study researched by Nakahir & Arnold,

hypothesized that the intimacy and closeness of a loving relationship is connected to the well-

being and health of individuals. Participants completed a phone interview, as well as

questionnaire to examine perceived love, social engagements (religion/community involvement),

demographics, income status and health. Their findings show that perceived love constitutes the

largest coefficient moderating change in mental and physical health, followed by food security,

then income security. Participants that rated higher levels of perceived love, including marriage,

participated less in risky health behaviors like smoking and had more positive mental health.

(Nakhaie & Arnold, 2010).

Non-Committed Relationships

In our modern times being in a committed relationship is not mandatory, as having

intimate relationships with friends, known colloquially as friends with benefits, which is

becoming more common (Hughes, Morrison, & Asada, 2015). Specific research studies have

explored this particular population to understand the importance and potential outcomes of

participating in a non-committed relationship. Hughes, Morrison and Asada (2015), studied the importance of friends with benefits relationships (FWBRs) amongst college students. FWBRs are defined as a relationship between cross-sex friends who participate in sexual activities; however

the participants do not consider it to be a romantic relationship. This study examined the FWBRs

in college and how they can contribute to a positive love attitude, network communicating, and

support. A survey was distributed and completed by 143 respondents who had enrolled in a

course called introductory communication at Midwestern University. The 143 participants gave

their insight on same-sex network communication, support and their current states of their

FWBRs and also completed a short form of the love attitude scale. This study showed that

women tend to link love with sex, while men learned the boundaries between the two.

The overall results of this study showed that college students seemed to equally compare

their attachment to their FWBRs to their non-sexual relationships inferring that their FWBRs didn’t account for more or less emotional social support than their platonic friendships (Hughes,

Morrison, & Asada, 2015).

Friends with Benefits are also known as ‘Hooking up’ within specific cultures. “Hooking

Up” is a newer concept that many college students practice (Lovejoy, 2015). Hooking up can consist of any sexual contact between two individuals whether opposite sex or same sex

(Lovejoy, 2015). This practice is not usually participated in by those who are in a committed relationship, but rather those who prefer a sexual encounter. In a research study conducted by

Lovejoy (2015), she explores the positive and negative outcomes of college women’s experiences of hooking up. Her research shows that the positive benefits of hooking up could range from self- growth, autonomy, and self-gratification. However, her research also explores the negative outcomes of hooking up that can possibly lead to being a victim of sexual assault, sexual stigma,

Sexual Transmitted Infections (STIs), regrets, and shame and, self-blame. Lovejoy (2015) conducted 30 in-depth interviews with college women aged 18 to 22 from different schools ranging from private colleges to public universities. There were 10 women selected to participate

from each school from different races, social classes and religious backgrounds. Thirteen of the

30 students were currently in a relationship at the time and 20 of them had experience with at least one sexual encounter either manual sex or oral sex. Of the 30, only 5 women had engaged in non-genital hook ups and the other 5 had never hooked up before. The results of this study showed the Individualistic Normative Structure of hooking up, which means that these women were given a more liberated feeling about hooking up and it helped them obtain the sensation of sexual and emotional benefits. They were not obligated to have a committed relationship, which made it easier for them to focus on their academics and careers. They were freed from discussing a imitate relationship because they had an understanding of their roles, whereas, being in committed relationship there is a higher level of expectation and roles are established (Lovejoy,

2015).

Allison and Risman (2014) explored how many college students view hooking up as a salient cultural scenario for their lives. Qualitative in-depth interviews were conducted with 87 college students at the University of Illinois and each student’s environmental factors, race and class were all taking into account. Findings of this study show that “race, class, and the social structural organization of campus impacts student ability to perform a hooking-up script for non- relational sexuality” (Allison & Risman, 2014, p 118). Overall, this research showed that the location of where students influences how likely they were to hook up, and most college students who lived on campus or partied were more likely to hook up more often. In contrast, Manthos,

Owen and Fincham (2013) examined hooking up among two distinct groups ranging from ages

18-25. There were 339 participants that were given a questionnaire to complete. Of the participants, 30% of them accounted for 74% of those who reported that they have had relationships based off only hooking up in the entire sample size. These students reported a

higher level of alcohol use and depressive symptoms compared to other participants. The results

showed that many college students use hooking up as a way of coping with stress or to meet

attachment needs. Overall, the findings reported that the reason for hooking up varies among

college students (Manthos, et al., 2013).

Currier (2013) defines the concept of hooking up as strategic ambiguity, which is another term for hooking up. Strategic ambiguity is when individuals use the term hooking up to describe their sexual activities, while also protecting their sexual and social identities. Currier (2013) looks at how men are able have a more liberal satisfaction to hooking up due to their musicality, while women are more conform to preserve components of emphasized femininity. This study focuses on the social sexual interaction and it shows how hooking up can affect or be affected by traditional historic patterns of intimate partnering (Currier, 2013). In this study, there were 78 full-time heterosexual students that participated in in-depth interviews. Each participant was able to define what they considered hooking up to be and explain if they ever hooked up before, as well as gave their opinions of how they felt about hooking up. The finding showed that 84.6 participants reported that they have hookup at one point in their lifetime and that hooking up is very common among college students.

The findings also showed that there is a double standard between male and female

“hooking up”. For this reason, Currier analyzed that there is a heterosexist bias in the definition of the term hooking up because hooking up is glamorized in the male population, while it can leave a negative stigma on the female population (Currier, 2013). This research is trying to imply that the culture of hooking up is normalize amongst college students, however it can also have a negative impact on individuals emotionally, mainly younger adult women. Hooking up can cause

some emotional distress because there is no expected solid commitment and committed

relationship can be equivalent when compared to the higher level of expectations.

Gaps in Literature

Researchers have made significant contributions to help understand the importance of managing stress and utilizing healthy coping skills to maintain a self-gratifying and over-all healthy life. Countless research has reported the significant outcomes of not engaging in social outlets or being mindful of over exposure to stressful situations (Brown & Ryan, 2003; Myers et. al., 2012). Despite the well-known reports of the adverse outcomes of stress, a more strengths based body of literature needs to be present exploring how specific students can be successful and resilient despite difficult challenges, an addition to existing literature that focuses on factors that create burnout and stress amongst students. Diversifying the context of social support by including the various spectrum of intimate relationships broadens social work knowledge by exploring how less common or accepted forms of relationships impacts student’s psychological well-being. Research involving the impact of romantic or intimate relationships has on stress management has a strong emphasis on marriage and committed/monogamous relationships

(Armstrong et. al, 2012; Currier, 2013) while excluding less committed or casual relationships.

More research needs to reflect the diversity and uniqueness of all individuals, so educational systems and institutions can promote the well-being and mental health of all students. This study can help fill the gap in literature by extending the boundaries of relationships and exploring how non-traditional or casual intimate relationships can play a role in students.

Chapter 3

METHODOLOGY

This chapter presents a description of the methods used in this study. This section includes the study design, sampling procedures, data collection procedures, instruments,

Protection of Human Subjects and data analysis. The overall purpose of this study is to a) examine and compare various forms of intimate relationships and their differences between perceived stress and b) compare degree of intimacy and utilization of other co-existing self-care mechanisms to examine the similarities and differences among identified groups.

Study Design

In order to examine how diverse intimate relationships correlate with graduate student stress, an exploratory quantitative design was chosen. Generally, exploratory studies are analyzed and utilized within a qualitative research framework (McGill, 2015) for the flexibility provided in understanding a phenomenon or analyzing human behaviors but for this research study quantitative analysis was most applicable. The data collection tools used in this study consist of paper-based questionnaires that include various scales to find concise, quantitative conclusions.

The statistical results will then represent the subjects’ perceived stress and intimacy levels. The purpose of this study will entail analyzing the relationship between intimacy and stress, which in return can predict how emotional/intimated support relates to mental health across a generalized population.

There are both advantages and disadvantages of using a quantitative research design.

Some oppose quantitative methodology because it reduces human subjects and capacity to mere numeric data and create categorical constraints to individual behaviors and capacities (Covell,

Sidani & Ritchie, 2012). Qualitative data collection in opposition investigates small, targeted

populations using interviews and observations to develop hypothesis about human behavior that

cannot be measured in a mathematical or numerical way (McGill, 2015) The purpose of this

research study is not to understand intimacy or perceived stress, but rather to analyze the

relationship between the two particular variables. Quantitative methodology is verification

orientated and comparison driven; qualitative research that aims to interpret and discover is less

valuable within this study. Positive rationale for using quantitative research in academia is to

reduce biased conclusions and enhance validity within the research design (Covell, Sidani, &

Ritchie, 2012). Quantitative methodology that is geared toward objectivity (Abusabha & Woelfel,

2003) is most logical in its purpose to examine the correlation between intimacy and stress.

Sampling Procedures

A non-probability procedure was used to generate participants. Kelle (2006) suggests before selecting the most appropriate sampling procedure researchers must 1. Determine the feasibility of the sampling procedure and 2. Make sure the sampling procedure is stemmed logically from the research question being addressed. The research question examines graduate students only, generating specific criterion for participation, so conducting a purposive sampling procedure is most logical. Members of the researchers’ masters level social work classes at

California State University, Sacramento were selected and recruited from social work classrooms.

Researchers were granted permission to administer questionnaires during social work courses to increase feasibility and direct selection of participants.

Data Collection Procedures

The authors of this paper contacted social work professors at Sacramento State via email in October of 2015, to allow permission for the survey’s to be distributed to their students in their classrooms. Investigators will give surveys to students in certain social work graduate courses and collect them after completion in mid-November of 2015. Participants will have approximately 10 to 15 minutes to complete the survey, before the distribution of the survey students will receive an informed consent form to agree to voluntary participation in the research study. The researchers will briefly explain the study to the participants in the classroom and ask them if they have any questions. After completion of the surveys, the researchers will have students place their consent forms and surveys in two separate envelopes. The purpose of the envelopes is to ensure the surveys remain anonymous and to protect the human subjects.

Instruments

In this study, researchers will be administering a 55 question survey relating to the

research topic. Participants will be selected from some of the graduate classes at California State

University, Sacramento, Social Work Division. The researchers will give each individual a

consent form to sign that shows they agree to participate in this study (Appendix A). The survey

will be based on of a Likert-type scale where participants choose which answer best fits. The

instruments used will measure participants’ level of stress, while also measuring the participants’

level of intimacy. The demographic information collected by the survey will include age, gender,

ethnicity, and marital status. The survey will include six scales that are based on participants’

stress level, social support, self-care, sex, love attitude, and intimacy. Researchers’ chose a

questionnaire as the data collection instrument to maintain confidentiality and less bias responses

from participants, opposed to in depth interviews.

Protection of Human Subjects

Definite measures were taken to protect the human subjects participating in this research study. The Human Subjects Protocol was completed and submitted to the IRB at California State

University, Sacramento. This committee thoroughly examined the research study to uphold the protection, safety and ethical boundaries of all human subjects participating in the study. This research study was under the “exempt” category of study because it had minimal risk factors pertaining to human subjects.

An informed consent and detailed explanation of voluntary participation is required by all

“exempt” research studies. The informed consent is a written document that details the confidentiality and voluntary participation of all informants that partake in the study. The informed consent is explained in full detailed to all participants, then distributed for the participants to sign and return in a marked envelope.

To protect and minimize psychological effects of the human subjects, investigators excused themselves from the classroom to give the participants privacy while completing the survey. In the classroom, envelopes were provided for the collection of tools while the investigators remained outside to ensure all surveys remained anonymous to investigators. The two envelopes provided, one for the signed consent forms and one for the completed surveys, remained in the classroom until investigators returned to complete participation. The surveys contained indirect identifiers- age, ethnicity, and gender. To maintain the confidentiality of the human subjects all completed surveys will be stored in a locked file box at the investigators’

home. There was no use of names or other direct identifying information during data collection.

The two investigators and the thesis advisor were the only people that had access to the data. All

data will be destroyed one year after successful completion of the MSW project and graduation

from the program.

Data Analysis

Upon completion of the survey, participants will be rewarded with candy as an appreciation

of their participation. All surveys we will collect and stored in a safety box at one of the researcher’s homes. Investigators will use SPSS to analyze the data and conduct a content analysis to compare common responses. The survey will be organized under the following themes: perceived stress scale, perceived social support, and self-care scale, perception of sex scale, love attitude scale, and intimacy scale. Analyzing the data within these themes will be useful to help us to gain a greater understanding of how stress is experienced, ways that self-care helps, and how intimate support plays a role in the self-care process. The analysis will help to understand the variables of this study.

Chapter 4

RESULTS AND FINDINGS

The study examined a total of 59 California State University, Sacramento social work graduate students. The data was analyzed to help investigate two factors: 1) whether intimacy has an impact on graduate students’ level of stress, and 2) whether the level of intimacy impacts stress among students differently to explore how they cope with various stressors. The research study aims to explore how graduate students cope with various stressors. The literature suggests emotional and social support is a protective factor for students across various professions (Killian,

2008; Lazarus 1984; Wilks & Spivey, 2010) but little research explores the impact of intimacy and sexual relationships on students’ ability to manage stress.

Demographics

A total of 59 California State University, Sacramento, graduate students participated in the study. Of the total participants a large majority, 86.4%, were female (n =51) while males were only 13.6% (n =8) of the sample (see Figure 1). Participants’ ages ranged from 24 to 40. Most participants were in the 21 to 30 year age range at 81.4%, while 6.8% (n =7) ranged from 31 to 40 years old. The 41 to 50 age group was the least frequent age identified, at 5.1% (n =4).

Results of the racial demographics are presented in Table 1. Caucasians were the largest

identified racial group among the study participants at 32.2% (n =19). Hispanic/Latin participants

comprised 30.5% (n =18) of the sample. Of other groups, 20.3% (n =12) identified as

Asian/Pacific Islander, 8.5% (n =5) African-American, 3.4% (n =2) Native American, and 5.1%

(n =3) identified as other.

Table 1

Participants’ Ethnicity by Percentage (N =59)

Frequency Percentage Ethnicity

White/Caucasian 19 32.2

Black/African American 5 8.5

Hispanic/Latino 18 30.5

Asian/Pacific Islander 12 20.3

Native American 2 3.4

Other 3 5.1

Total 59 100

Data on employment status was also collected in the questionnaire. Participants were

instructed to select full-time, part-time and not employed as possible answers. A majority of the participants were working part-time at 47.5% (n =28), 37.3% (n =22) identified as not employed and 15.3% (n =9) identified as being employed full-time (see Table 2).

Table 2

Participants’ Employment Status by Percent (N =59)

Employment Frequency Percent

Full-time 9 15.3

Part-time 28 47.5

Not Employed 22 37.3

Participants were instructed to write down the approximate length of their current intimate relationship in years and months. For statistical and data purposes, all results were converted into months for calculation. A total of 45 participants responded to the provided question, while 14 participants failed to write down a numeric value for length of relationship.

The average length of relationship is 55 months or approximately 4 and a half years. The longest identified relationship in the study was 14 years, while the shortest intimate relationship reported was 0 months, meaning they were not in an intimate relationship.

Significant Findings on Various Scales

In order to fully understand the research questions, a total of five scales were analyzed in this study: Perceived Social Support Scale, Stress Scale, Self-Care Scale, Perception of Sex Scale and Intimacy Scale. This section will explore all five scales and present significant findings on each.

Perceived Social Support Scale

The Perceived Social Support Scale was developed by Zimet et. al., (1988) to measure

the perception of support from three specific sources, consisting of significant other’s support,

family support and friend support. The scoring key (Zimet et. al, 1988) indicated the total number of possible points ranged from 12 to 60; 12 indicating low levels of social support and 60 indicating high levels of social support. Participants ( N =59) scored an average of 49.7 on the

Social Support scale, suggesting students reported having moderate to high levels of social support during their graduate studies.

We then analyzed how participants scored on each individual subscale of social support: significant other support, family support, and friend support. Students showed the highest levels of significant other support in comparison to the two other subsources of social support. The subcategories of social support that were calculated had a sum of 20 possible points. As shown in

Table 3, the participants’ mean scores of significant other support totaled 17.8. The scoring key from Zimet et. al. (1988) indicates that participants who have a score between 16 to 20 have a high level of those specific categories of support; where as those participants who score between the ranges of 4 to 7 report having significantly low levels of social support.

Overall findings showed that there were little to no differences among the various sources of social support. Support from a significant other had the highest scores among the three sources of social support, indicated by the mean score of 17.8, but all subscales are very high. Results from the subcategory family support are not significantly different. Participants also scored fairly well on family support with a mean of 16.2 (refer to Table 3). Finally, data displays that

participants scored the lowest on friend support, with a mean score of 15.7. However, the

difference is minimal in comparison to the other sources of social support.

Table 3

Participants’ Responses for Social Support, Family Support and Friend Support

Responses Social support Family support Friend support

Valid 59 59 59

Mean 17.7627 16.2203 15.7627

Median 20.0000 17.0000 16.0000

Mode 20.00 20.00 20.00

Stress Scale

The stress scale developed by Cohen (1994) measures the perception of stress that one

might appraise during a stressful life situation. Participants’ responses showed they experienced

some stress during their graduate program, but not high concerning levels. There were a total of

54 participants who completed the stress scale. The stress scale was scored out of 50 possible

points; a high score of 50 correlates to high levels of stress while the score of 10 correlates to low

stress levels. The participants’ average stress score was 32.5 (SD= 3.42). After interpreting the

data we found that students fall within moderate to average levels of stress, neither approaching

low levels of 10 nor scoring high levels approaching 50. Due to the results of the scores, it can be

assumed that most students felt some levels of stress during graduate school.

Self-Care Scale

The Mindfulness Self-Care Scale developed by Cook-Cottone, C.P. (2014) measures individuals’ level of self-care based on their emotional and physical well-being. This scale was designed to help identify areas of strengths and weaknesses in self-care behaviors. A total of 59 participants completed this scale. The scoring key indicated the total number of points possible was 60 and the lowest number of points possible was 12. Students scoring between the ranges 12 to 23 were classified as having low utilization of self-care, while students that scored 48 to 60 were classified as having high levels of self-care. Data results showed participants had a mean score of 38 (SD= 7.3). This data reflects that students are moderately to frequently utilizing self- care techniques and methods to help manage or reduce stress.

Perception of Sex Scale Findings

The Love and Sex Scale was designed to measure perceptions of sex and ones’ beliefs about the relationship between love and sex (Neto, 2012). For this study, we refer to this scale as

“Perception of Sex Scale”. The complete Perception of Sex Scale includes questions that relate to four identified beliefs or subcategories. The subcategories consist of “hooking up,” “sex,” “love and sex” and “love first”; each of these reflects beliefs and ideas of the interaction and connection between sex and love. Specific questions help the researchers determine how students feel about hooking up and different forms of intimacy.

For the purpose of data analysis, we grouped together specific questions to create subcategories reflecting the participants’ beliefs. Questions specifically concerning beliefs about hooking up were scored in a “hooking-up” subscale. If participants scored between 4 to 7 on the hooking up subscale this indicates that they were less accepting of “hooking up”. If participants

scored between 8 to 11 their results were neutral about their beliefs about “hooking up”. If

participants scored between 12 to 16 they were classified as moderately accepting and if they

scored 17 to 20 this indicated that they have high levels of acceptance toward participation in

“hooking up”.

A total of 57 participants out of 59 students fully answered questions concerning beliefs about hooking up. Table 4 shows that students scored a mean of 6.8. These findings show that participants are less accepting of “hooking up”. Results show that students are not particularly open or accepting to the hooking up culture, or sexual relationships outside commitment.

The subscale titled “Sex” reflects students’ beliefs that sex demonstrates love.

Participants scored a mean of 5.1, a median of 5 and a mode of 2 (see Table 4). In order to correctly analyze the data and calculate valid results, particular questions in this subcategory were inversely scored, meaning when students answered ‘1’ it now indicated strongly agreeing that sex is a separate entity than love and ‘5’ meaning students strongly disagreed that sex and love are separate. The data reflects a low mean score of 5.1 out of 20 on the Sex subscale, suggesting that students overall disagree with the belief that sex demonstrates love.

The “love and sex” subscale offers questions that indicate stronger beliefs or acceptance about the unity between love and sex. Results showed a mean of 14.4, a median of 14 and a mode of 16. These findings indicate that students fell between the moderate to high ranges on the love and sex subcategory, suggesting students are more likely to believe that love and sex cannot be separated.

Lastly, the subscale titled “Love First Scale” includes statements about the belief that love is more important than sex. A total of 59 participants answered and results showed that most

participants strongly agreed that love should be first. As shown in Table 4 students scored a mean of 5.7, a median of 6 and a mode of 2. Therefore, overall findings suggest that student’s value love and sex as a union during an intimate relationship, however those who are not in an intimate relationship do not believe love has to be present before sexual activity occurs.

Table 4

Participants’ Responses for Perception of Sex Scale

Hooking up Love & sex Response Scale Sex scale scale Love first scale

Valid 57 59 58 59

Missing 2 0 1 0

Mean 6.9 5.1 14.4 5.8

Median 6.0000 5.0000 14.0000 6.0000

Mode 4.00 2.00 16.00 2.00

Perception of sex scale questions. We chose to analyze specific questions within the

Perception of Sex Scale to grasp a more in-depth understanding of students’ perceptions about non-committed sexual relationships. The specific statements that were analyzed were: “Love and sex cannot be separated,” “I would participate in an intimate relationship or hooking up outside a committed relationship,” and “I think that friends with benefits are a natural step to develop a committed relationship”.

As shown in Table 5, for the students who responded to the first statement “I would participate in an intimate relationship,” 61% of respondents did not agree with hooking up, while

13% were neutral and 14% completely agree that they would participate in a casual intimate

relationship or “hooking up”. As stated above, most students did not agree with their own

personal involvement in hooking up, having low acceptance of participating in non-committed

relationships or polygamous relationships.

Table 5

Participants’ Responses in Relationship to the Statement I would participate in intimate

relationships or “hooking up” outside committed relationships

Responses Frequency Percentage

Do Not Agree 36 61.0

Sometimes 7 11.9

Neutral 8 13.6

Agree 8 13.6

Total 59 100

As shown in Table 6, there were a total of 29 participants who responded to the statement

“I think that it is okay to have friends with benefits”. Results showed 42% of participants did not agree, 15% said ‘sometimes’ and 20% completely agreed. Almost half of the statements disagree with participating or thinking it is acceptable to have friends with sexual benefits. This data supports the above results that students particularly are not open to the idea of hooking up.

Table 6

Participants’ Responses in Relationship to the Statement I think it is okay to have friends with benefits

Response Frequency Percent

Do Not Agree 25 42.4

Sometimes 9 15.3

Neutral 5 8.5

Agree 12 20.3

Very Often 7 11.9

Total 58 98.3

Intimacy Scale

For the participants who responded to the statement, “I think that friends with benefits are a natural step to develop a committed relationship,” results showed that 51% of participants did not agree. However, 20% of students indicated that sometimes friends with benefits could be a natural step to a committed relationship, 18% were neutral and only 3% said very often (see

Table 7)

Table 7

Participants’ Responses in Relationship to the Statement I think that friends with benefits is a natural step to develop a committed relationship (N =58)

Response Frequency Percent

Do Not Agree 30 50.8

Sometimes 12 20.3

Neutral 11 18.6

Agree 2 3.4

Very Often 2 3.4

Total 58 98.3

The intimacy scale was created by Hendricks and Hendricks (1986) to measure attitudes toward intimacy. In this section, researchers choose to focus on two statements and students responses. The statements are: “I am comfortable discussing significant problems with my partner” and “I hide my emotions from my partner”.

As shown in Table 8, all 59 participants who responded to the statement “I am comfortable discussing significant problems with my partner”. Of these, 5% reported that they were almost always comfortable discussing their problems with their significant other, 11% indicated sometimes, 15% indicated fairly often, and 62% very often share with their partner.

Results showed that participants felt very comfortable discussing their personal problems with their partners.

Table 8

Participants’ Responses in Relationship to the Statement I am comfortable disusing significant problems with my partner(N =56)

Responses Frequency Percentage

Almost 3 5.1

Sometimes 7 11.9

Fairly 9 15.3

Very Often 37 62.7

Total 56 94.9

Finally, as shown in Table 9, for the statement “I hide my emotions from my partner,” 32% of

participants said “never”, 32% said “almost never” and 27% stated they would “sometimes”

hide their emotions from their partner (refer to Table 9). From these findings it is clear that

most participants are comfortable sharing their concerns with their partner.

Table 9

Participants’ Responses in Relationship to the Statement I hide my emotions from my intimate partner(N =56)

Responses Frequency Percentage

Never 19 32.2

Almost 19 32.2

Sometime 16 27.1

Fairly 2 3.4

Total 56 94.9

Correlation between Intimacy Scale and Stress Scale

The intent of the study was to examine whether stress had any correlation with the intensity of intimacy. These researchers first had to analyze students’ responses to the specific scales to be able to calculate the correlation between the various scales and other variables. After analyzing and finding results for the specific variables and scales, we used a Pearson’s

Correlation and a 2-tailed significance test to calculate the correlation and significance between the variables.

The relationship between intimacy and stress was the first correlation to be analyzed because of its importance and implications on the research study. Table 10 provides statistical data concerning the relationship between intimacy and stress. Pearson’s Correlation shows r =-

.083 (n = 52), indicating a weak correlation between the two variables. There is a negative correlation between the variables, and almost a zero correlation. A 2-tailed significance test was used to calculate the statistical significance between intimacy and stress: there was no statistical significance found, with the p = .557 much higher than the p =.05 threshold for significance.

Although there was no statistical significance between intimacy and stress, the negative correlation amongst the variables may be of importance for further discussion. Negative correlation, even a very weak correlation, could suggest that those students who in fact do score low on the intimacy scale tend to also score high on the stress scale.

Students’ perception and beliefs about hooking up and the relationship between love and sex was captured by 12 questions in the Perception of Sex Scale. Examining the correlation between students beliefs about hooking up and their perspective intimacy levels, could help researchers understand whether their current level of intimacy has an influential effect on their beliefs about hooking up. Data shows that there essentially is no relationship between intimacy and the students’ beliefs about hooking up. Table 10 shows there was a weak correlation between the two variables (r =.187). There was also no statistical significance indicated by p =.170 (n

=53).

There was no statistical evidence to infer that students who have a higher level of intimacy are more or less accepting of hooking up. The level of intimacy seems to have no correlation with a students’ beliefs about participating in casual intimate relationships. The

findings could show that intimacy could be derived from different interpersonal relationships, outside of intimate or sexual relationships.

Table 10

The Correlation between Final Sex Scale, Intimacy Scale and Stress Scale

Final Sex Scale Intimacy Scale Stress Scale

Final Sex Scale Pearson Correlation 1 .187 -.152

Sig. (2-tailed) .179 .283

N 56 53 52

Final Intimacy Scale Pearson Correlation .187 1 -.083

Sig. (2-tailed) .179 .557

N 53 56 52

Stress Scale Pearson Correlation -.152 -.083 1

Sig. (2-tailed) .283 557

N 52 52 54

Correlation between Age and Intimacy

Analyzing the relationship between age and perception of sex is important in understanding the generational influence that could potentially impact graduate students. The overall Perception of Sex Scale was inversely scored, indicating a higher score on the Perception of Sex Scale signifies a lower acceptance or participation in “hooking up”. As shown in Table 11, there is a moderate statistical significance between the student’s age and their beliefs about

“hooking up”. As indicated, the significance is p =.001, when the p-value is significant at p<.01.

Pearson’s Correlation indicates there is weak to moderate correlation between the perspective variables (r =.417**); moderate correlation implies that there is a positive relationship between students’ increasing age and their increasing absence of acceptance of “hooking up”.

The mean score for age was 26 years old amongst the participants. With data that determines a moderate correlation, yet significant relationship, older age seems to be correlating with more less openness to more committed intimate relationships. As age increases acceptance of “hooking up” decreases. Discussion and further implications on the relationship between age and the students’ perceptions of sex are discussed in Chapter five.

Table 11

The Correlation between Age and Final Sex Scale

Gender Age Final Sex Scale

Gender Pearson Correlation 1 -.062 -.056

Sig. (2-tailed) .641 .683

N 59 59 56

Age Pearson Correlation -.062 1 .417**

Sig. (2-tailed) .641 .001

N 59 59 56

Final Sex Scale Pearson Correlation -.056 .417** 1

Sig. (2-tailed) .683 .001

N 56 56 56

**. Correlation is significant at the 0.01 level (2-tailed).

Correlation between Stress Scale and Length of Relationship

Table 12 illustrates the correlation between participant’s level of stress and length of relationship. Before analyzing the data understanding how the question, “length of relationship” was recorded is important. The question was asked on the survey as “How long have you been with your intimate partner?” Some individuals who were not involved with a significant intimate partner chose to leave that answer blank, instead of entering the value of 0. Those participants who did not enter a numeric value have been excluded from statistical findings. Only 45

participants gave numeric values (recorded in months and years) for data to be analyzed. Stress

Scale and length of relationship have no correlation (r =. 003) and show no statistical significance

(p =.984).

Surprisingly, there is not statistical significance supporting that being in a relationship for a longer period of time is associated with stress levels. Almost 69% of the participants have been involved in an intimate relationship for 5 years or less, yet findings show that as the length of involvement with an intimate partner increases stress is neither negatively nor positively impacted. The data could suggest that the length of relationship is not associated with one’s ability to cope with stress.

Table 12

The Correlation between Length of Relationship and Stress Scale

Length of Relationship Stress Scale

Length of Relationship Pearson Correlation 1 .003

Sig. (2-tailed) .984

N 45 42

Stress Scale Pearson Correlation .003 1

Sig. (2-tailed) .984

N 42 54

Correlation between Stress Scale and Social Support

Statistical findings indicate the insignificant relationship between how long students have been in an intimate relationship and stress levels. If the length of relationship has no significant correlation, other variables must be analyzed to understand how students cope with stress or whom they connect with in hopes for emotional support. Data analysis indicates that graduate students at Sacramento State University have significantly high levels of support, particularly from their significant others. Yet, the length of the relationship has no particular significance in its association with levels of stress.

Social support has a weak negative correlation to student’s stress levels (r = -.247). The negative correlation does show the inverse relationship between the two variables, as stress increases social support decreases. The 2-tailed significance tests shows p =.071, suggesting near statistically significance. Students who in fact do score high on stress simultaneously score low on social support. These findings denote that social support does have an impact on positive stress management.

Table 13

The Correlation between Stress Scale and Social Support Scale

Stress Scale Social Support

Stress Scale Pearson Correlation 1 -.247

Sig. (2-tailed) .071

N 54 54

Social Support Pearson Correlation -.247 1

Sig. (2-tailed) .071

N 54 59

Summary

This chapter focuses on specific research findings and an in-depth analysis of the correlation between intimacy and stress. This chapter also explored demographics and other variables, such as age and length of relationship, that impact intimacy and stress. Various correlations of scales were also explored. This study did not show any specific correlation between intimacy and the Sex Scale however, there was a strong significance between the student’s age and acceptance of “hooking up” with older people accepting “hooking up” more than younger people. Data analysis also found that students are strongly impacted by their social supports, specifically their significant others. The next chapter will further discuss these findings and present recommendations, limitations and social work implications.

Chapter 5

SUMMARY AND RECOMMENDATIONS

The purpose of this research was to examine: (1) whether participating in intimacy/hooking up has any impact on graduate students’ stress level, and (2) if intimacy has an impact on stress level, does it reduce stress and play a significant factor in students’ ability to cope with stress. Our research findings do not support either research question. There were no significant correlations between student’s level of intimacy and their stress level. Many students in the study scored moderate to high on the intimacy spectrum during the completion of the study, meaning a majority of the students were involved in some type of intimate relationship. Yet, there was no significant correlation to their intimacy and their ability to cope with stress.

Social support was a moderating factor in the research study. Findings showed a weak negative correlation (r =-.247) between social support and student’s stress but was statistically close to significant at p=.071. The negative correlation between social support and stress indicates that students who experience low levels of social support also experience higher levels of stress.

These findings support existing findings that suggest the influential impact of having social support as a protective factor for stress (Killian, 2008; Bartels and Zeki, 2004; Esch & Stefano,

2005).

Our research shows that many graduate students in the CSUS social work program are not accepting of “hooking up”. As discussed in Chapter 4, many students believed that sex is a separate entity than love and sex but despite that belief many students were less accepting of hooking up for themselves. Many factors could influence students’ answer choices and provide reasons why students were not open to hooking up or having non-committed sexual relationships.

The participants’ answers could be strongly influenced by their present relationship. Many of the students (almost 69%) were either in a committed relationship or married. The average length of relationship was 55 months (4 ½ years), and it is likely that the idea of hooking up or participating in non committed sexual relationships is a concept that does not reflect their values at the present time.

Although the existing literature examines the importance of age in the culture of hooking up, we hypothesized that in a more progressive time and among a seemingly progressive subgroup, hooking up culture would be more present within this population. The study sample was on average 27 years old. With a younger population, we theorized that there would be a higher rate of acceptance for “hooking up” or involvement in non-committed relationships. Our research findings reject our original hypothesis. Although on average the target population was youth in their mid 20s they were not open to hooking up. , Research suggests that hooking up is more significant in the even younger undergraduate population (Hughes, Morrison, & Asada,

2015).

Existing literature that examines the relationship between “hooking up” and mental health focuses narrowly on the undergraduate population. Currier (2013) and Manthos et. al.

(2013) agreed that hooking up culture is something more strongly prevalent in undergraduate and younger individuals. Currier (2013) discussed how many individuals succumbed to the pressure of participating in hooking up because of the culture of the group but as participants got older the concept was less glamorized. Our research aligns with existing literature that suggests as students age their acceptance of “hooking up” decreases.

Our research also supports existing literature that discusses how graduate students experience a moderate to high level of stress during graduate school (Mann-Feder & Savicki,

2003; Dziegielewski et. al, 2004; Grant 2002). Participants scored moderate levels of stress, according to the Stress Scale created by Cohen (1994). Students did display some levels of stress, although not extreme, which some studies describe can exist (Garcia & Mendieta, 2013; Killian,

2008; Norcoss, 2000). Due to study limitations, there was not in depth analysis on the causation of stress. We were unable to study what particular factors caused stress among the participants.

Rather we primarily focused on understanding intimacy as a protective factor.

One important finding our research discovered was that graduate students do rely heavily on their intimate partners for support. Our social support scale categorized sources of social support in groups of significant other support, friend support, and family support. Though the statistical difference between the significant other support and the two other sources of support were minimal, data does show the importance of having an intimate partner for emotional support. Existing literature does point to the importance of a significant or romantic relationship during stressful times in life such as graduate school because it allows the individual to feel emotionally supported and share personal intimate feelings, such as worries, failures and hopes

(Bartels & Zeki, 2004; Fisher, 1998). Our research indicates that graduate students do value their intimate relationships and romantic partners during stressful times. Research might not be able to narrow in on the sexual aspect of intimacy but our findings do support the notion that emotional and other sources of intimacy play a heavy role in student’s ability to manage stress.

Implications for Social Work Practice

Social work programs could use this data to promote healthier lifestyles amongst graduate students. Essentially, this research was conducted to understand how intimacy and

“hooking up” culture has an impact on stress management. This research study could impact the profession of social work by providing more empirical evidence of the importance of social support. Social work education, including both the academic and internship portions, could require students to attend yearly self-care workshops and trainings. Integrative practices, such as mindfulness or journaling could be included in the graduate student process, alongside academic rigor and internship completion.

Social work programs are recommended to promote more self-care practices among students. Social work departments could also implement more social events in divisions or cohorts to promote a more intimate cohesion of students. Since emotional support was such a significant variable in our research, the implications of emotional and intimate supports are relevant. Developing a curriculum that supports one on one reflection in class, and building more intimate and safe relationships could give students the feeling of emotional support from their classmates and other peers.

Recommendations for Future Research

As discussed in Chapter Two (Literature Review) there is an extensive amount of research

that investigates various types of coping strategies and mechanisms that have been proven

effective in stress management. Research done on stress management for social workers is vital to

the world of social work. Due to so many cases of compassion fatigue and burnout, any research

that demonstrates a positive impact on social work students and the social work professionals

living healthy and stable lives is essential. Although this study did not show a significant correlation on how sexual intimacy impacts stress, if a more extensive research study did find significant correlations between the two variables, it could impact the teaching and practice of social work.

Recommendations can be made not only for social work programs but for social work research as well. Future research needs to broaden its spectrum of analysis to include nonconforming relationship ideologies and less accepted lifestyles, such as hooking up or

“friends with benefits”, to maximize the social work profession’s understanding of how individuals perceive stress and effectively manage it. Researchers recommend looking more in depth at other management tools that have been less researched, to include activities and relationships not commonly accepted or analyzed. More inclusive research could lead to a more empathetic and less judgmental culture. Examining all facets of intimacy, not just marriage, with research-proven facts could lessen the judgment of those individuals who do not solely conform to committed relationships.

We also recommend that future researchers use different methodologies, such as mixed methods or qualitative research for data collection purposes. Qualitative research including personal interviews could be used to help gain a more in-depth understanding of the correlation between stress and intimacy. Future research could include sampling multiple schools to have a larger and more diverse sample size. Collecting data from a larger sample size and other social work programs would create a broader and more accurate understanding of the topic.

Limitations

There were several limitations to this research study. One limitations of this study included the number of participants (N=59), with the majority of participants being women and

Caucasian in their early-to mid-20s and-30s. The participants of this study only included MSW graduate students at California State University, Sacramento. This means that the results we obtained would not be applicable for all social work graduate students.

Another limitation to this study is that it was a quantitative study. A qualitative study could have provided more meaningful and significant responses. Interviewing respondents could have provided more insight to participant’s perception of intimacy and the correlation to stress.

Researchers could have done online surveys to ensure more privacy and allotted longer time for participants to complete the survey. Online surveys could offer more diversity and also increase the sample size.

Lastly, the researcher’s interest in this study topic could have caused biases in the data collection, and analysis of findings. Bias caused in this study could have also impacted the way survey questions were presented. .

Conclusion

The overall purpose of this study was to explore the relationship between stress levels and intimate relationships. The study design also aimed to view how ones’ intimate relationship status as committed or non-committed could help increase or decrease graduate students ability to cope with or manage stress. The findings from this study did not provide evidence regarding whether graduate students who participated in intimate relationships showed higher or lower levels of stress, but there was statistically significant correlation between the student’s age and

acceptance to hooking up outside of a committed relationship. In-depth studies of a larger and more diverse sample could be explored to show possible correlations between relationship status and stress levels and provide guidance on managing stress for social work students and professionals.

Appendix A

Survey Instrument

QUESTIONNAIRE An exploration of the correlation between intimacy and graduate student stress

Demographics 1. Gender- 1. Male 2. Female 3. Other

2. Age _____

3. Ethnicity 1. White/Caucasian 2. Black/African-American 3. Hispanic/Latino 4. Asian/Pacific Islander 5. Native American or American Indian 6. Other

4. Employment Status 1. Full-time 2. Part-time 3. Not employed

5.Relationship status 1. Married 2. Committed Relationship 3. Non-committed Relationship with 1 partner 4. Non-committed relationship with more than 1 partner

5. No intimate partner

6. How long have you been involved with your partner or in a committed relationship?

____Years _____Months

1 = 2=Almost Never 3= 4= 5= Often Perceived stress scale Never Sometimes Fairly Often 1. In the last month, how often have you been upset because of something that happened unexpectedly 1 2 3 4 5

2. In the last month, how often have you felt that you were unable to control the important things in your life 1 2 3 4 5

3. In the last month, how often have you felt nervous and “stressed” 1 2 3 4 5

4. In the last month, how often have you felt confident about your ability to handle your personal problems 1 2 3 4 5

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 1 2 3 4 5 not cope with all the things that you had to do

7. In the last month, how often have you 1 2 3 4 5 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 1 2 3 4 5 9. In the last month, how often have you been angered because of things that were outside of your 1 2 3 4 5 control

10. In the last month, how often have you felt difficulties were piling up so high 1 2 3 4 5 that you could not overcome them

1 2 3 4 5

Perceived Social 1 = 2=Almost 3= 4= 5 = Often Support Never Never Sometimes Fairly Often

1. There is a special person who is around when I am in need

2. There is a special 1 2 3 4 5 person with whom I can share joys and sorrows

3. My family really 1 2 3 4 5 tries to help me

4. I get the emotional help & support I need 1 2 3 4 5 from my family

1 2 3 4 5 5. I have a special person who is a real source of comfort to me

6. My friends really try to help me 1 2 3 4 5

7. I can count on my friends when things go wrong

8. I can talk about my problems with my 1 2 3 4 5 family

9. I have friends with whom I can share my 1 2 3 4 5 joys and sorrows with

10. There is a special 1 2 3 4 5 person in my life who cares about my feelings

1 2 3 4 5 11. My family is willing to help me make decisions

1 2 3 4 5 12. I can talk about my problems with my friends

1 2 3 4 5

Self-Care Scale 1 = 2=Almost Never 3= 4= 5= Often Never Sometimes Fairly Often 1. I use deep breathing to relax 1 2 3 4 5 2. I do not know how to relax 1 2 3 4 5

1 2 3 3 5

3. I think about calming things (e.g., nature, happy 1 2 3 4 5 memories)

4. When I get stressed, I stay stress for hours (i.e., I 1 2 3 4 5 couldn’t calm down)

5. I do something physical to help me relax (e.g., taking a bath, 1 2 3 4 5 yoga, going for a walk)

6. I do 1 2 3 4 5 something intellectual (using my mind) to help me relax (e.g., read a book, write) 4 5 1 2 3

7. I do something interpersonal to relax (e.g., connect with friends)

8. I do something creative to relax (e.g., drew, play instrument, 1 2 3 4 5 write creatively, sing, organize)

9. I listen to relax (e.g., to music, a podcast, radio show, rainforest sounds) 1 2 3 4 5

10. I look at images to relax (e.g., art, film, window shopping, nature) 1 2 3 4 5

I use smells to relax (lotions, nature, candles/incense, smells of baking) 1 2 3 4 5

I use tactile or touch- based experiences to relax (e.g., petting an animal, cuddling a soft blanket, floated in a pool, put on comfy clothes)

5 = Perception of Sex 1 = Do 2=Sometimes 3= Neutral 4= Completely Scale Not Agree Agree Agree

1. Love and sex cannot be separated 1 2 3 4 5 2. My partner and I wouldn’t have had sex if we didn’t love each other

3. When I am 1 2 3 4 5 intimate with someone, it proves I love my partner

4. I have to love someone before I engage in intimacy 1 2 3 4 5

5. For me, intimacy is secondary to the friendship aspects a relationship 1 2 3 4 5

6. Intimacy is not necessary but it can

make love or a relationship stronger

7. Communication is 1 2 3 4 5 more important than physical affection

8. For me, the physical aspect is a small part of the 1 2 3 4 5 whole relationship

9. I would participate in intimate relationships or “hooking up” outside 1 2 3 4 5 of a committed relationship

10. I think it is okay to have friends with benefits 1 2 3 4 5 11. I feel more comfortable “hooking up” with someone than talking about my feelings with them

12. I feel that friends with benefits is a natural step to 1 2 3 4 5 develop a committed relationship

Intimacy Scale 1 = 2=Almost Never 3= 4= Fairly 5 = Very Never Sometimes Often Often

1. I am comfortable discussing significant problems with my intimate partner 1 2 3 4 5

2. I feel comfortable telling this person things I do not tell other people 1 2 3 4 5

3. I reveal to my intimate partner what I feel are my 1 2 3 4 5 shortcomings

4. I keep very personal 1 2 3 4 5 information to myself and do not tell it to my intimate partner 1 2 3 4 5

5. There are times when I hold back information from 1 2 3 4 5 my intimate partner

6. I hide my 1 2 3 4 5 emotions from my intimate partner

Appendix B

Informed Consent Letter

INFORMED CONSENT An exploration of intimacy and its effects on graduate student stress

You are invited to participate in an IRB approved research study which will include collecting data (survey’s) from human subjects from students at the graduate student level. Our names are Morgan Chandler and Shellyatta Johnson and we are MSW II graduate students at California State University, Sacramento, Social Work Department

Your participation in this project is voluntary. Even after you agree to participate, you may decide to leave the study at any time.

The purpose of this research is to explore how romantic/intimate relationships impact graduate student stress and how different levels of committed or non-commited relationships relate to student stress and over all well-being. If you decide to participate, you will be asked to complete a 55 question survey. Your participation in this study will last approx. 15 mins. Risks associated with this study are not anticipated to be greater than those risks encountered in daily life. If you have any questions about your rights as a participant in a research project please call the Office of Research Affairs, California State University, Sacramento, (916) 278-5674, or email [email protected].

Any information that is obtained in connection with this study and that can be identified with you will remain confidential and will be disclosed only with your permission. Measures to insure your confidentiality are made by securely locking all surveys and consent forms in a locked box in researchers home. The data obtained will be maintained in a safe, locked location and will be destroyed after a period of three years after the study is completed.

Your signature below/ Your participation in this study indicates that you have read and understand the information provided above.

Signature Date

______

Appendix C

Human Subjects Approval Letter

CALIFORNIA STATE UNIVERSITY, SACRAMENTO DIVISION OF SOCIAL WORK

To: Morgan Chandler & Shellyatta Johnson Date: November 30, 2015 From: Research Review Committee

RE: HUMAN SUBJECTS APPLICATION

Your Human Subjects application for your proposed study, “An exploration of the

correlation between intimacy and graduate student stress”, is Approved as Exempt.

Discuss your next steps with your thesis/project Advisor.

Your human subjects Protocol # is: 15-16-026. Please use this number in all official correspondence and written materials relative to your study. Your approval expires one year from this date. Approval carries with it that you will inform the Committee promptly should an adverse reaction occur, and that you will make no modification in the protocol without prior approval of the Committee.

The committee wishes you the best in your research.

Research Review Committee members Professors Teiahsha Bankhead, Maria Dinis, Kisun Nam,

Francis Yuen

Cc: Bankhead

Your Human Subjects application Protocol # is: 15-16-026. Please use this number in all official correspondence and written materials relative to your study.

Required Modification:

Required F-I-a): Indicate whether the scales in the survey instrument are created by

Modification 1 the researchers themselves or adopted by other published scales.

Required F-I-a): As it proposes to use implied consent, which the researchers do not

Modification 2 need to collect, consider removing/revising “Two specific envelopes titled

… “Completed Consent Forms” …” clause.

Recommendation

Recommendation 1 Several survey questions are normal sentences but have the question

marks at the end; recommend removing the question marks to avoid

confusion

Recommendation 2 “Perception of Sex Scale” question #1 to 8 & #10 are not relevant

with the choices of never through very often.

Thesis Advisor signature:______

Review Committee Members: Professors Teiahsha Bankhead, Maria Dinis, Kisun Nam, Francis

Yuen

Cc: Bankhead

References

Abusabha, R & Woelfel, M (2003) Qualitative vs quantitative methods: Two opposites

that make a perfect match. Journal of American Dietetic Association, 103(5), 566-

569.

Adams. E. R., Boscarino, A. J., & Figlyer, R. C. (2006) Compassion fatigue and

psychological distress among social workers: a validation study. Journal of

Orthopsychiatry, 76(1), 103-108.

Allison, R., & Risman, B. J. (2014). "It goes hand in hand with the parties": Race, class,

and residence in college student negotiations of hooking up. Sociological

Perspectives, 57(1), 102-123.

Aron, A., Fisher, H., Mashek, J. D., Strong, G., Li, H., & Brown, L.L. (2005) Reward,

motivation, and emotion systems associated with early-stage intense romantic

love. Journal of Nuerophysiology, 94, 327-337.

Arria, M. A., O-Grady, E. K., Caldeira, M. K., Vincent, B. K., Wilcox, C. H., & Wish, D.

E (2009) Suicide ideation among college students: a multivariate analysis.

Archives of Suicide Research, 13, 230-246.

Bartels, A. & Zeki, S. (2003) The neural correlates of maternal and romantic love.

NeuroImage, 21, 1155-1166.

Bober, T., Regehr, C., & Zhou, R. Y. (2006) Development of the coping strategies

inventory for trauma counselors. Journal of Loss and Trauma, 11, 71-83.

Campbell, R., Greeson, R. M., Bybee, D., & Raja, S. (2008) The co-occurrence of

childhood sexual abuse, adult sexual assault, intimate partner violence, and sexual

harassment: a meditational model of posttraumatic stress disorder and physical

health outcomes. Journal of Consulting and Clinical Psychology, 76(2), 194-207.

Carver, S. C., Scheier, F. M., & Weintraub, K. J. (1989) Assessing coping strategies: a

theoretically based approach. Journal of Personality and Social Psychology,

56(2), 267-283.

Chao, R. (2012) Managing perceived stress among college students: the roles of social

support and dysfunctional coping. Journal of College Counseling, 15, 5-21.

Coffey, M., Samuel, U., Collins, S., & Morris, L. (2014) A comparative study of social

work students in India and the UK: Stress, support and well being. British Journal

of Social Work, 44, 163-180.

Cohen, S., Kamarack, T., & Mermelstein, R.(1983) A global measure of perceived stress.

Journal of Health and Social Behavior, 24, 386-396.

Cook-Cottone, C.P. (2014) The mindful self-care scale: self-care as a tool to promote

physical, emotional and cognitive well-being Retrieved from:

http://gsc.buffalo.edu/about/directory/faculty/cook-cottone.

Covell, C, Sidani, S, & Ritchie, J. (2012) Does the sequence of data collection influence

participants’ responses to closed and open-ended questions? A methodological

study. International Journal of Nursing Studies, 49(6), 664-671.

Coyle, D., Edwards, D., Hannigan, B., Fothergill, A., & Burnard, P (2005) A systematic

review of stress among mental health social workers. International Social Work,

48(2), 201-211.

Currier, D. M. (2013). Strategic ambiguity: Protecting emphasized femininity and

hegemonic masculinity in the hookup culture. Gender & Society, 27(5), 704-727.

Dziegielewski, F. S., Turnage, B., & Roest-Marti, S. (2004) Addressing stress with social

work students: A controlled evaluation. Journal of Social Work Education, 40(1),

105-119.

Eastwood, D. C. & Ecklund, K. (2008) Compassion fatigue risk and self-care practices

among residential treatments center childcare workers. Residential Treatment for

Children & Youth, 25(2), 103-122.

El-Ghoroury, H. N., Galper, I. D., Sawaqdeh, A., & Bufka, F. L. (2012) Stress, coping,

and barriers to wellness among psychology graduate students. Training and

Education in Professional Psychology, 6(2), 122-134.

Esch, T., & Stefano, B. G. (2005) Love promotes health. Neuroendocrinology Letters, 26

(3), 264-267.

Figley, R. C. (2002) Compassion Fatigue: Psychotherapists’ chronic lack of self-care.

Journal of Clinical Psychology, 58 (11), 1433-1441.

Gershon, M. R., Barocas, B., Canton, N. A., Li, X. & Vlahov, D. (2009) Mental,

physical, and behavioral outcomes associated with perceived work stress in police

officers. Criminal Justice and Behavior, 36(3) 275-289.

Gianakos, I. (2002) Predictors of coping with work stress: The influences of sex, gender

role, social desirability, and locus of control. Sex Roles, 46(5/6), 149-158.

Gold, M. J & Rogers, D. J. (1996) Intimacy and isolation: A validation study of Erikson’s

theory. Journal of Humanistic Psychology, 3(1), 78-86.

Gold, M. Rogers, H. (1996). Transactional model of stress and coping. American

Psychologist, 51(8), 763-765. Doi:1037/0003-066X.51.8.763.

Grant, L. & Kinman, G. (2012) Enhancing wellbeing in social work students: Building

resilience in the next generation. Social Work Education, 31(5), 605-621.

Haggins, L. K. (2005) Intern self-care: An exploratory study into strategy use and

effectiveness. Professional Psychology: Research and Practice, 36 (6), 674-680.

Hook, M., Gerstein, L. H., Defferich, L., & Gridley, B. (2003). How close are we?

Measuring intimacy and examining gender differences. Journal Of Counseling &

Development, 81(4), 462-474.

James, M, & Ruthellen, J, R. (2013). Eriksonian personality research and its implications

for psychotherapy. J Pers Journal of Personality, 81(6), 617-629.

Doi.111/jopy.12014.

Jones, H. S. (2005) A self-care plan for hospice workers. American Journal of Hospice &

Palliative Medicine, 22(2), 125-128.

Killian, D. K. (2008) Helping till it hurts? A multimethod study of compassion fatigue,

burnout, and self-care in clinicians working with trauma survivors. Tramautology,

14 (2), 32-44.

Kim, H. & Stoner, M. (2008) Burnout and turnover intention among social workers:

effects of role strong job autonomy and social support. Administration in Social

Work, 32 (3), 5-25.

Lee, J., Forster, M., & Rehner, T (2011) The retention of public child welfare workers:

the roles of professional organizational culture and coping strategies. Children

and Youth Services Review, 33, 102-109.

Lee, J., Koeske, F. G., & Sales, E. (2004) Social support buffering of acculturative stress:

a study of mental health symptoms among Korean International students.

International Journal of Intercultural Relations, 28, 399-414.

Lovejoy, M.(2015). Hooking up as an individualistic practice: A double-edged sword for

college women. Sexuality & Culture. 19(3), 464-492.doi:10. 1007/s 12119-015-

9270-9.

Mann-Feder, V. & Savicki, V. (2003) Burnout in Anglophone and francophone child and

youth workers in Canada: a cross-cultural comparison. Child & Youth Care

Forum, 32(6), 337-354.

Manthos, M., Owen, J., & Fincham, F. (2014). A new perspective on hooking up among

college students. Social and Personal Relationships. 31(6), 815-829.

Mayer, E. J. & Rosenblatt, A. (1974) Sources of Stress among student practitioners in

social work: a sociological view. Journal of Education for Social Work, 10 (3),

56-66.

McGill Qualitative Health Research Group (2016) Qualitative or quantitative research?.

Retrieved from https://www.mcgill.ca/mqhrg/resources/what-difference-between-

qualitative-and-quantitative-research.

Myers, B. S., Sweeney, C. A., Popick, V, Wesley, K., Bordfeld, A., & Fingerhut, R.

(2012) Self-care practices and perceived stress levels among psychology graduate

students. Training and Education in Professional Psychology, 6(1), 55-66.

Nakhaie, R. & Arnold, R. (2010) A four-year (1996-2000) analysis of social capital and

health status of Canadians: the difference that love makes. Social Science &

Medicine, 71, 1037-1044.

Napoli, M. & Bonifas, R. (2011) From theory toward empathetic self-care: Creating a

mindful classroom for social work students. Social Work Education, 30 (6), 635-649.

Nilakantan, A., Younger, J., Aron, A., & Mackey, S. (2014) Preoccupation in an early-

romantic relationship predicts experimental pain relief. Pain Medicine, 15, 947-

953.

Palma-Garcia, M., & Hombrados-Mendieta, I. (2014) The development of resilience in

social work students and professionals. Journal of Social Work, 14(4), 380-397.

Pederson, E. D. (2012) Stress carry-over and college student health outcomes. College

Student Journal, 620-627.

Quick, C. J. & Spielberger, D. C. (1994) Walter Bradford Cannon: Pioneer of stress

research. International Journal of Stress Management, 1(2), 141-143.

Salloum, A., Kondrat, C. D., Johnco, C., & Olson, R. K. (2015) The role of self-care on

compassion satisfaction, burnout, and secondary trauma among child welfare

workers. Children and Youth Services Review, 49, 54-61.

Sharkey, W. (1997, May 1). Erik Erikson. Psychosocial stages simply psychology.

Retrieved From http://www.simplypsychology.org/Erik-Erikson.html

Soderfeldt, M., Soderfeldt, B., & Warg, L. (1995) Burnout in social work. Journal of

Social Work, 40(5), 638-646.

Sternberg, J. R. (1986) A triangular theory of love. Psychological Review, 93(2), 119-

135.

Traupmann, J. & Hatfield, E. (1981) Love and its effect on mental and physical health.

Turner, A. J., Eicken. M. I., Castro, R. J., Edwards, M. L., Yokoyama, K, Tran, T. A., &

Turner, K (2009) Mindfulness: the present moment in clinical social work. Clinical

Social Work Journal, 37, 95-10.

Viner, R. (1999). Putting stress in life: Hans Selye and the making of stress theory. Social

Studies of Science, 29(3), 391-410.

Weinberg, M. (2014) The ideological dilemma of subordination of self versus self-care:

identity construction of the “ethical social worker”. Discourse & Society, 25 (1), 84-99.

Williams, J., & Jovanovic, J. (2015). Third wave feminism and emerging adult sexuality:

friend with benefits relationship. Sexuality & Culture, 19(1), 157-171. Doi:10. 1007/s

12119-014-9252-3

Wilks, E. S., & Spivey, A. C. (2010) Resilience in undergraduate social work students:

Social support and adjustment to academic stress. Social Work Education, 29 (3),

276-288.

Wlodarski, R. & Dunbar, M. R. (2014) The effects of romantic love on mentalizing

abilities. Review of General Psychology, 18(4), 313-32.

Zajacova, A., Lynch, M. S., & Espenshade, J. T. (2005) Self-efficacy, stress, and

academic success in college. Research in Higher Education, 46 (6), 677-706.

Zimet, G.D., Dahlem, N. W., Zimet, S.G. & Farley, G.K. (1998) The multidimensional

scale of perceived social support. Journal of Personality Assessment, 52, 30-41.