Stress and panic are two factors which cause diving accidents. The techniques on how divers can deal with pressure and prevent panic attacks during dives are included.

Divers learn about the effects of pressure and how to deal with them but do not learn nearly as much about stress and panic, which are factors in nearly all dive accidents. Find out if you know as much as you should about these important topics.

1. Stress is

A. A psychological and physiological state that evokes effort to maintain or restore equilibrium
B. Fear or apprehension you experience in the face of real or imagined danger
C. An imbalance between perceived demand and perceived capacity to respond to a situation
D. A or C but not B

2. Select the most correct statement:

A. Some individuals enter rapidly into a stress state
B. Some individuals show increased alertness and improved performance when stressed
C. Some individuals are immune to the stress producing qualities of environmental conditions
D. All the above statements are correct

3. The number one factor causing diving stress is:

A. Cold
B. Workload
C. Fitness
D. Fluid balance

4. Which of the following items is not a sign of stress:

A. Irritability
B. Repetitive behavior
C. Increased respiration rate
D. All the above are signs of stress

5. Psychological effects of stress include:

A. Impaired analysis
B. Decreased perception and awareness
C. Dependence on most recently acquired skills
D. A and B but not C are correct

6. Optimum performance for complex tasks usually occurs when stress is:

A. Low
B. Extremely low
C. Neither extremely high nor extremely low
D. High

7. Arrange into proper sequence the following physiological effects of stress:

A. Increased pulse and respiration rates
B. Adrenaline secretion
C. Repetitive behavior
D. Trembling or jerky movements

8. When a problem occurs while diving, a three event cycle can ultimately cause panic. Select the three events and arrange them in sequence.

A. Mental narrowing and physiological changes
B. Stress
C. Uncontrolled respiration
D. Single thought fixation

9. Arrange the following stress control procedures into the correct sequence:

A. Establish controlled, deep breathing (if air is available)
B. Correct the problem causing the difficulty
C. Identify the problem
D. Analyze the problem

10. Panic is:

A. Sudden, extreme, unreasoning fear
B. Total loss of logic and mental control
C. The ultimate effect of unmanaged stress
D. Any of the above

11. Select the two answers that are most likely to minimize stress and panic:

A. Good, well maintained equipment
B. Awareness and analytical thinking
C. Controlled activity and respiration
D. Favorable environmental conditions

12. True or false. Panic can result from real or imagined dangers and can lead to either active (struggling) or passive (frozen) behavior, either gradually or instantaneously.

A. True
B. False

13. Select the false statement:

A. An unexpected problem is more likely to cause stress or panic than one a diver expects
B. A lone diver experiences more stress than a diver with a buddy
C. Advanced problem solving using mental visualization is an ineffective method of problem management
D. Fear caused by the consequences of a problem may be eliminated by concentrating on the solution to the problem

14. Task Relevant Instructional Self Talk (TRIST) can help prevent panic. Select all items that are TRIST components

A. Relax and think
B. Encourage yourself and others
C. Monitor and counteract distorted thinking
D. Use skill and task relevant statements
E. Phrase instructions positively

15. The leading factor contributing to scuba diving fatalities is:

A. Insufficient air
B. Buoyancy problems
C. Entrapment
D. Panic

Answers: Stress and Panic

1. D. A or C but not B. People confuse anxiety with stress. Anxiety is the fear or apprehension you experience when confronted with either real or imagined danger. Stress requires effort to control an anxious reaction to fight or flee the stressor.

2. D. All the above statements are correct. All the statements are correct. Some people stress easily, while others experience improved performance. Some individuals, such as the astronaut whose heart rate increased only six beats per minute during a launch, are immune to stress.

3. A. Cold. Cold exposure is so routine for divers they accept it and ignore its potential for harm. Cold affects mental and physical ability and distracts divers. Mental and physical errors create problems that may be avoided and easily corrected by a diver who is not hypothermic. Minor problems and the inability to manage them leads to stress and, ultimately, panic.

4. D. All the above are signs of stress. Increased respiration and heart rates are initial reactions to stress. Mood extremes are common tension symptoms. Repetitive behavior, especially incorrect behavior, signals serious mental narrowing and a significant performance capability degradation.

5. D. A and B but not C are correct. As stress builds, mental narrowing occurs. As perceptual narrowing occurs, analysis narrows, response narrows and control weakens. Mental narrowing can initiate a degenerative cycle that can lead to panic. The need to think, analyze and retain control when in difficulty is paramount to diving safety.

6. C. Neither extremely high nor extremely low. A moderate amount of stress may enhance performance. Professional athletic performance benefits frequently from moderate stress. Extreme stress rarely enhances performance, it is detrimental and undesirable.

7. B, A, C, D or B, A, D, C. The main point to note is that fear or concern causes adrenaline secretion, which causes increased heart and respiration rates. Rapid breathing is detrimental to divers. You need to control respiration to control stress. Any erratic behavior by a diver should arouse a suspicion of stress.

8. B, C, A. Fear causes the physiological changes described in the previous answer. The changes lead to a respiration control loss, which increases anxiety and compounds the problem. Loss of control establishes a cycle a diver must interrupt or it will repeat itself until the mental process reduces to a single thought, e.g., getting to the surface. Panic will result. The cycle need not occur and may be arrested.

9. C, D, A, E, B. Control stress by stopping all activity, thinking about the situation and concentrating on breathing. Mind over matter applies literally in the presence of stress. After you confirm a problem and have your breathing under control, think of possible options to overcome your difficulty, select the best possible option and take action. Divers often compound difficulties by acting before thinking.

10. D. All the above. Panic is one of your worst enemies. Panic displaces analysis, perception and control. Panic limits response to instinctive reactions. A panicked person is convinced doom is immediate and loses all mental and physical control. Panic is not self-curable; you must prevent it.

11. B. Awareness and analytical thinking and C. Controlled activity and respiration. The key to preventing stress and panic is control of mind and body. The advice to “get hold of yourself” when tension mounts is a sound recommendation. Recognizing what is happening and taking charge of both mental and physical functions should be the goal of anyone facing as stressful situation.

12. A. True. A person can reach a state of panic gradually from the stress cycle or instantly if the individual experiences sudden and extreme fear. Avoid visualizing dangers mentally because your body reacts the way it would if the event were real. Passive panic, although rare, can occur. Consider passive panic if a diver freezes in one position and is unresponsive.

13. C. Advanced problem solving using mental visualization is an ineffective method of problem management. The foregoing statement is incorrect. Positive mental visualization can be effective. Just as envisioning dangers and their consequences is detrimental, anticipating problems and visualizing correct response is beneficial. Pre-visualization allows extended time for analysis and produces confidence. Mental rehearsals reduce stress when a previously anticipated problem arises.

14. All the listed items are TRIST components. Ellis (1962), Maultsby (1968), Beck (1976) and Asken (1993) address “self talk” and its benefits. It is important to understand that your reaction to stress depends much more on your self talk than the situation. Divers learn to identify stress and take physical actions to manage difficulties but they also need to learn the critical self talk skills.

15. A. Insufficient air. It’s a widespread belief that panic is the diver’s number one enemy. While an uncontrolled reaction to a problem is extremely serious, running out of air, a lack of ability to control buoyancy and entrapment are the primary factors affecting diving fatalities. No matter how well you manage stress and prevent panic, it is much better to minimize its causes. To maximize diving safety, avoid and be prepared for no air emergencies, develop a high degree of buoyancy control and avoid entrapment.

Were you afraid you would not select the correct answers as you read the questions? Did your heart and breathing rates increase? Did you feel the effects of stress? If you understand stress, recognize its symptoms, anticipate problems and prepare to manage them and maintain control during difficulties, you can avoid accidents. The quiz addresses only a few aspects of a comprehensive topic. I encourage further study of these important subjects.

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