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Map Of Alton for Ogden and Mtandabari , and stress arising from both educational factors and family factors predicted smoking among adolescent girls only Byrne and Mazanov This association between stress and behaviour is an indirect route by which stress can be considered to influence illness status. Exam stress has also been found to affect bodily responses, such as blood pressure, which was found to increase among medical students on the day of their exams Sausen et al This kind of study is required to continuously assess physical indices of stress reactivity such as blood pressure in order to achieve multiple baselines against which to assess increases and decreases in blood pressure over time and during different activities. To obtain such data, Sausen and colleagues employed ambulatory monitoring techniques whereby stress reactivity the physiological arousal, such as increased heart rate or blood pressure, experienced during a potentially stressful encounter. devices attached to individual participants activated at set and regular intervals to read blood pressure. A link between acute stressors such as exams and actual illness rather than focusing on physiological reactivity, which is generally short-lived and poses no danger to the individual has been proposed following findings that students exhibit increased prevalence of infections at exam periods compared with during non-assessment periods. These studies often include blood sampling and have examined immunological markers that have led to the conclusion that for many individuals, exams appear to be sufficiently stressful to increase susceptibility to illness, via immunosuppressant effects e.g. Map Of Alton 2016.