Stress Booklet

STRESS
Revision Booklet

Name ____________________ Form ___________

1

Specification:

The physiology of stress including the GAS*, the hypothalamic-pituitary-adrenal
system, the sympathomedullary pathway and the role of cortisol.
The role of stress in illness including reference to immunosuppression and
cardiovascular disorders
Sources of stress: Life changes, Daily Hassles and Workplace stress including
the effects of workload and control
*Measuring stress: self-report measures (SRRS and Hassles and Uplifts Scale)
and physiological measures including skin conductance response
Individual differences in stress: personality types A, B and *C and associated
behaviours, and hardiness including commitment, challenge and control
Managing and coping with stress: drug therapy (BZs and beta blockers), stress
inoculation therapy and biofeedback
*Gender differences in coping with stress
*The role of social support in coping with stress: types of social support
including instrumental, emotional and esteem support

The old textbooks contain a huge amount of material which is relevant to the
new syllabus. You will therefore be able to use all the old textbooks for
everything EXCEPT that which is marked with a * in the table above.

Exam Hint:
You will be examined on this section in Paper 3 in June 2018. The exam will be
two hours long and will consist of four separate sections: Issues and Debates,
Gender, Stress and Addiction. There may also be a couple of research methods
questions which will be contextualised within other questions. You should ensure
that you revise Research Methods in addition to the other topics for this exam.

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Stress Documentary: Portrait of a Killer
Merapolis Topic 1 You tube link……

1. What does the documentary suggest that stress is?

2. What did Robert Sapolsky discover about the biological effects of stress
on baboons?

3. Professor Sir Michael Marmot tracked the health of over 28,000 people
over the course of 40 years in his Whitehall study. Outline his findings
into workplace stress (workload and control) and illness.

4. What effect does stress have on the body?

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5. How can stress lead to a reduction in immune system functioning and what
effect does this have on the body?

6. f
6. How does stress affect the brain? (e.g. hippocampus)

7. What effect do high stress hormones have on body over a period of
time? (e.g. heart disease, weight gain etc)

8. Describe the effects of stress on the foetus and how these effect the
child as it grows up.

9. According to the documentary, what is the best way to reduce our stress
and lead healthy lives?

4

The body’s response to stress:

You need to be able to:
• Describe the hypothalamic-pituitary-adrenal system (HPA) and the
sympathomedullary stress pathway (SAM).

What is stress?
How does your body

respond to it?

Stress is a very useful adaptive response: it has evolved from the EEA as it
gives us the ability to cope in situations which may be quite dangerous or even
life threatening. This is known as the fight or flight response. Our bodies
identify when something is a threat and react physically with an increased heart
rate, deeper breathing and an increase in glucose – all in preparation for having
to run away or fight for our lives.

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Acute stressors are dealt with by the sympathomedullary pathway which is
controlled by the autonomic (automatic) nervous system (ANS).

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Chronic stressors are dealt with by the pituitary-adrenal system. It works like
this…

ACTH Cortisol

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Assessment Task 1:

Complete the following diagram using the phrases below to show how the
hypothalamus responds to chronic and acute stress.

(6 marks)
• Gets body ready for ‘fight or flight’
• Stimulates the adrenal medulla
• Stimulates the adrenal cortex
• Releases adrenalin
• Releases corticosteroids
• Stimulates the pituitary gland to release ACTH.

Hypothalamus

Physiological reactions e.g. Liver releases energy and
increased heart rate. immune system is
suppressed.

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Stress related illness and the immune system:

You need to be able to:
• Describe the structure and functions of the immune system
• Describe and evaluate research into the relationship between stress,
immune functioning and illness.
• Draw conclusions about the link between stress and illness.

The immune system has three key functions:
•
•
•

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One of the most important parts of the immune system are the w________
b______ c_______ (also known as lymphocytes).
Produced in the bone marrow, these lymphocytes give us n___________
i____________ to everyday bacteria and viruses.
They act within minutes and are our first line of defence.
Our immune systems also provide us with s___________ i_____________.
This occurs when our l______________ produce antibodies designed to target
and eliminate specific antigens.
This form of immunity develops over a period of days and mobilises the systems
needed to fight the specific antigen.
When s_________ reduces the functioning of our immune systems, the natural
and specific immunities cannot work properly and this leads to i___________.

Kiecolt-Glaser et al. (1984) conducted a key study into the relationship between
stress and immune system functioning. Outline her study below.
Aim(s):

Procedure:

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Findings:
Conclusions:
This research was both supported and contradicted by Evans et al. (1994).
Outline their research around the box provided, to explain their findings.

Evans et al. (1994)

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Read about the role of stress in illness and answer the following questions:
1. What physiological changes that occur in the body as a result of long-
term stress lead to immunosuppression?
2. What type of stressors lead to an increase in immune system functioning?
3. What physiological changes that occur in the body as a result of acute
(short-term) stress lead to cardiovascular symptoms?
4. Explain why stress has both direct and indirect effects on health.
5. Much of the research into the effect of stress on illness is either
correlational or natural experiments. Why is this problematic in terms of
drawing conclusions?

Evaluating research
into stress and the

immune system

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Stress and the Immune System Crossword

Complete the crossword puzzle below to demonstrate your knowledge of stress
and the effect it has on the immune system.

6
2

3
8
5
1
4
7

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Across: Down:

1. The type of immunity produced by 2. The name of the researcher
white blood cells. who studied the effect of exam
stress.
3. Furring up of arteries.
5. Increase in immune system
4. Reduction in immune system functioning.
functioning.
6. The type of cells used to
7. White blood cells. produce specific immunity.

8. The researchers who conducted a
meta-review of 293 stress-based
studies.

Exam hint: There is enough AO1 and AO3 material for this to be a 16 mark
question. Make sure you can outline both Kiecolt-Glaser et al’s and Evans’
research and provide four well-elaborated evaluation points to discuss them.
You should also be able to draw an overall conclusion about the relationship
between stress-related illness and the immune system. Then you need to do the
same for research into stress and cardiovascular disorders…

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Life Changes and Daily Hassles

You need to be able to:

• Describe and evaluate research using Holmes and Rahe’s SRRS.

• Evaluate the role of life changes and daily hassles as sources of stress-
related illness.

What are life changes?

___________________________________________________________
___________________________________________________________
___________________________________________________________

A key study into the effects of life changes and stress was conducted by
Holmes and Rahe in 1967. Both researchers worked in the medical profession
and noticed that individuals who had reported several life changes suffered
significantly more with heart disease.

Holmes and Rahe asked 394 people to rate 43 different life changes and score
them. They averaged out all responses and came up with the social readjustment
rating scale – a scale which measures the degree of adjustment needed every
time a life event happened.

Part of the scale looks a little like this…

Life event: Stress value:

Death of a spouse

Marriage

Pregnancy

Starting/ending school

Christmas

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The scale works very simply. All you need to do is add up the total life change
units (LCUs) accumulated in the past year and (much like a magazine quiz)
identify what this means. For example, if you scored…
0-149

150 - 299

300+

A score of over 150 is classified as a l______ c_________ which (according to
Holmes and Rahe) means that you have an increased chance of _____%
developing stress related illness.
A score aver 300 indicates a m________ crisis and increases the illness risk by
a whopping ______%.
Research into this scale was conducted by Rahe et al. (1970). They studied
______ US Navy personnel over a period of several months. Each participant
filled in the S__________ for the previous six months and was then followed
up over a s__________ month tour of duty. All stress-related illness over this
period of time was r_________ and rated for severity, producing an overall
i________ score.

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Rahe et al. (1970) found that there was a ______________ correlation of
+___________ between LCU scores and illness scores.
This is a relatively s_______ correlation but is still considered to be
s_____________ s_____________ because the l_______ number of
participants mean that anomalies are less influential. Therefore we can be
confident in the conclusions that:
___________________________________________________________
___________________________________________________________
___________________________________________________________

Evaluating Rahe et
al’s (1970) research

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Daily Hassles:

Other researchers had a slightly different view to Holmes and Rahe. They
believed that life changes were quite rare and that much smaller daily hassles
were responsible for the onset of stress-related illness.
What are daily hassles?
___________________________________________________________
___________________________________________________________
___________________________________________________________
Which pictures represent life changes and which pictures represent daily
hassles?

Just like previous research, Delongis et al. (1982) measured the effects of daily
hassles on a scale called the Hassles and Uplifts Scale (HSUP). The scale
contains _____ items which are worded so that the participant can indicate
whether a given event is a h_______, an uplift or b______. Participants
indicate that the event is a hassle by circling a number on the r______, an
uplift by circling a number on the l_______, or both…by doing both!

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Try it yourself… Possible Daily Occurrence Daily Uplift
Daily Hassle

0 1 2 3 4 5 Having a bad hair day 012345

0 1 2 3 4 5 Bumping into an old friend 0 1 2 3 4 5

0 1 2 3 4 5 Missing the bus 012345

0 1 2 3 4 5 The car won’t start 012345

0 1 2 3 4 5 Finding £20 in the street 0 1 2 3 4 5

0 1 2 3 4 5 Scoring an A on an exam 012345

012345 Spilling a fizzy drink over 0 1 2 3 4 5
your i-pod/android phone.

What research tells us
about the role of daily
hassles as a source of
stress-related illness...

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Assessment Task 2:

1. What is the difference between life changes and daily hassles? (2 marks)

_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________

2. Amanda is finding it very difficult to deal with her busy life and has
started to feel ill. She is currently going through a divorce, is planning a
holiday and it will soon be Christmas. Based on these events, explain why
Amanda is starting to feel ill. (4 marks)

_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________

3. Outline the findings of one piece of research into daily hassles and
stress. (2 marks)

_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________

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Workplace Stress

You need to be able to:
• Explain how workload and control affect workplace stress.
• Describe and evaluate research into sources of workplace stress.

What are some of
the sources of

workplace stress?

There are two key factors you most need to know about – workload and control.
In 1979, Karasek created a model which showed the relationship between
workload and control. It looks a little like this…

High workload + low control = High control + low workload =

_______________________ _______________________
_______ _______
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In order to test the relationship between workload and control, Marmot et al.
(1997) set up a longitudinal study. Complete the table below to identify the key
parts of this research.

Marmot studied a total of…

They all worked for the government as…

Ppts were followed up over…

Ppts were asked to complete…

Additional measurements taken
included…

Marmot’s key findings were as follows:

___________________________________________________________
___________________________________________________________
___________________________________________________________

What is the key conclusion that we can draw from this research?

___________________________________________________________
___________________________________________________________

Strengths and Weaknesses of the research

+ All Ppts were free of heart - The study was largely based on
disease before the study began questionnaires which could have
which increases the reliability and resulted in biased responses.
validity of the results.

+-

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Assessment Task 3:

1. Outline one study into the effects of job control and workload on stress-
related illness. [4 marks]

_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________

2. Explain one strength and one weakness of research into workplace stress.
[4 marks]

_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________

3. Explain how the weakness described above could be overcome. [2 marks]

_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________

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The influence of personality on stress:

You need to be able to:
• Describe personality factors, including Type A, Type B and Type C
behaviour, hardiness, and how they each relate to stress.
• Outline and evaluate research studies on the relationship between
personality factors and stress.

It is thought that we can characterise people into different personality types.
The three main personality types which have generated the most interest in
stress research are:
➢ Type A/B
➢ Type C
➢ Hardy
Label the below people with their appropriate characteristics.

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Type A & Type B Personality Quiz

For each statement, circle the response that most applies to you.

I am never late for appointments
3 strongly agree 2 agree 1 disagree 0 strongly disagree

I am not a competitive person

0 strongly agree 1 agree 2 disagree 3 strongly disagree

I listen to what people say without interrupting

0 strongly agree 1 agree 2 disagree 3 strongly disagree

I always feel rushed, especially under pressure
3 strongly agree 2 agree 1 disagree 0 strongly disagree

I can wait patiently for things

0 strongly agree 1 agree 2 disagree 3 strongly disagree

When I do a good job, I want others to recognise it
3 strongly agree 2 agree 1 disagree 0 strongly disagree

I walk and eat very fast 1 disagree 0 strongly disagree
3 strongly agree 2 agree

I rarely talk about my feelings
3 strongly agree 2 agree 1 disagree 0 strongly disagree

I am an ambitious person 1 disagree 0 strongly disagree
3 strongly agree 2 agree

I am an easy-going person 2 disagree 3 strongly disagree
0 strongly agree 1 agree

Now add up the scores for each response you selected, to give you an
overall Type A/Type B score.

My score is: _____ (0 = very type B, 30 = very type A)

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Friedman and Rosenman (1959) believed that the characteristics of a Type A
personality would lead to:

•
•
•

The researchers decided to test their hypothesis that Type A personality was
associated with CHD. Fill in the gaps to identify the key elements of their
research.

➢ Friedman and Rosenman (1959) enrolled _____ Californian men aged
between ___ and ______ into their study.

➢ The participants were examined for any signs of _____ and then took
part in a s___________ i_____________ to identify their personality
type.

➢ Participants who were already i_____ were removed from the study in
order to improve v__________.

➢ The interview contained q____________ about how each individual
responded to everyday p___________ e.g. having to wait in a long queue.

➢ Interviewers took note of the answers and of any b___________ signs
relevant to the personality type.

➢ E.g. finger tapping or restlessness as a sign of Type ____.

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Participants were followed up for a total of 8 and-a-half years.
The table below shows the alarming findings of the study…

Type A Type B
Heart Attacks
Recurring Heart Attacks
Fatal Heart Attacks

➢ After 8-and-a-half years, twice as many Type A participants had died of
cardiovascular problems.

➢ Over 12% of the Type A personality participants had experienced a heart
attack in comparison to 6% of the Type B’s.

➢ Type A’s were also more likely to smoke and have a family history of CHD.

What do these findings suggest about the effects of personality on illness?
___________________________________________________________
___________________________________________________________
___________________________________________________________

Evaluating Friedman
and Rosenman’s
(1959) research

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The Hardy Personality:
Kobasa and Maddi (1977) suggested that not all
individuals can be fitted into personality types A or B.
They believed that some individuals were more
psychologically hardy than others and despite suiffering
from stress did not succumb to illness due to their
“hardy personality”

The researchers came to this conclusion after studying _______ American
business executives. They assessed their stress levels using Holmes and Rahe’s
S________ and drew up a stress score for each participant. Around ____ of
the ______ participants were classified as having high stress levels.

However, out of those 150, only a s_______ number of the ppts had a high
stress-related i__________ record. This suggested that there was something
m____________ the effect of stress felt by different individuals.

All participants also completed a hardy personality questionnaire, the results of
which found that individuals who belonged to the high-stress/low-illness
category scored highly on all three C-characteristics of…

C
C
C

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The Hardy Personality Quiz:

For each statement, circle the response that most applies to you.

I enjoy school and find it interesting and satisfying
3 strongly agree 2 agree 1 disagree 0 strongly disagree

I take an active interest in the people around me
3 strongly agree 2 agree 1 disagree 0 strongly disagree

I use my leisure time creatively
3 strongly agree 2 agree 1 disagree 0 strongly disagree

I enjoy involvement with my family
3 strongly agree 2 agree 1 disagree 0 strongly disagree

I welcome change and see it as an opportunity
3 strongly agree 2 agree 1 disagree 0 strongly disagree

I take decisive action to deal with challenges
3 strongly agree 2 agree 1 disagree 0 strongly disagree

I take care of my health 1 disagree 0 strongly disagree
3 strongly agree 2 agree

I believe I have control over my life
3 strongly agree 2 agree 1 disagree 0 strongly disagree

I can easily find solutions to personal problems
3 strongly agree 2 agree 1 disagree 0 strongly disagree

My life has meaning and a purpose
3 strongly agree 2 agree 1 disagree 0 strongly disagree

My score is: _______.

Score Analysis:

0 - 9 LOW hardiness.
10 - 20 MODERATE hardiness.
21 - 30 HIGH hardiness.

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Assessment Task 4:

1. What is meant by a Type A personality? [2 marks]
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________

2. How are people with a Type B personality most likely to act when
confronted with a stressful situation? [2 marks]

_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________

3. Outline one piece of research into the effects of personality on stress
and illness. [4 marks]

___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________

4. Explain one weakness of research into the effects of personality on
stress and illness. [2 marks]

___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________

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Psychological methods of stress management:

You need to be able to:

• Describe and evaluate stress-inoculation therapy (SIT) as a method of
stress management.

Meichenbaum (1985) created Stress Inoculation Therapy (SIT) because he
believed that we have the power to change the way we think about stressful
situations, even if we have no control over the situation itself. He claimed that
negative thinking (e.g. I failed to meet my target so everyone in the office must
think I’m worthless) is likely to lead to additional stress/anxiety whereas
positive thinking will lead to more positive attitudes and feelings. Positive
feelings help us to feel better, and it is that which SIT most focuses on.

Stress Inoculation Training (SIT) has three main phases:
➢ Conceptualisation Phase

➢ Skills Acquisition Phase

➢ Application Phase

• Conceptualisation Phase

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We can help!!

Why not consider Meichenbaum’s Stress Inoculation
Training??

We can teach you how to:

Stress Inoculation Training is a form of CBT and includes
these easy stages:
C
S
A

This training really works because:

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(or create your own advertisement here)
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Now is the time to put your knowledge into action. In small groups, create a
case study of a client who needs help dealing with stress. Outline their main
problems in the space provided below and clearly explain what you will do to help
them at each stage and why.

Client Case Study:
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
__________________________________________________________

I would take the client through the following SIT process:
Conceptualisation Phase

•
•
•
•

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I have chosen to do this because…
___________________________________________________________
___________________________________________________________
___________________________________________________________
Skills Acquisition Phase

•
•
•
•

I have chosen to do this because…

___________________________________________________________
___________________________________________________________
___________________________________________________________

Application Phase
•
•

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•
•
•

I have chosen to do this because…
___________________________________________________________
___________________________________________________________
___________________________________________________________
I think that the above SIT process would help my client through their
problem because:
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________

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Evaluating Stress Inoculation
Therapy (SIT)

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Assessment Task 5:

Outline and evaluate one psychological therapy used in the treatment of stress.
[8 marks]

___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
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___________________________________________________________

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Extra Space:

___________________________________________________________
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Biological Methods of stress management (drug therapy):

You need to be able to:
• Describe and evaluate drugs (BZs and BBs) as a method of stress
management.
Biological (physiological) methods of stress management are usually drug-
based because they are considered to be fast-acting and effective.
The two most popular forms of drug therapies used in the management of
stress are:
➢ Benzodiazepines (BZs)
➢ Beta-blockers (BBs)
BZ’s include drugs such as Librium and Valium, and work well to reduce
feelings of anxiety associated with stress. They work like this:

40

BBs include drugs such as Atenolol and Propranolol. Their key role is to
reduce activation of the cardiovascular system. BBs work by:

41

Design task planning space:
42

Potential essay questions:

• Discuss research which explores the link between the immune
system and stress related illness.

• Outline and evaluate biological methods of stress management.
• Discuss psychological methods of stress management.
• Outline and evaluate one psychological and one biological method of

stress management.
• Outline and evaluate research into the effects of life changes and

daily hassles on stress-related illness.
• Discuss the use of stress inoculation training as a treatment for

stress-related illness.
• Discuss research into workplace stress.

In addition to completing this booklet for revision, you could do any of the
following:

✓ Interactive Quiz on each double page of PHG Stress section
✓ Apply it questions in PHG – many of these have suggested answers
✓ Multiple choice questions at end of chapter in PHG book
✓ Look at the example answers (both short and essay) at the end of

the chapter; these include examiner comments as feedback
✓ Go back through the topics on Merapolis and try any of the ‘COULD:’

prep activities you haven’t already done
✓ Complete some of the Practice Questions on Merapolis
✓ Make essay plans for one essay on every topic (double page in PHG)

NOTE; all these activities are digital/online so you can do them anywhere!
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