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07-SEPTEMBER-2008 03:17:44 - Stress biological Redirected from Stress medicine Stress is the consequence of the failure to adapt to change. It is, in medical terms, the consequence of the disruption of homeostasis through physical or psychological stimuli. Less simply: it is the condition that results when person-environment interaction leads someone to perceive a painful discrepancy, real or imagined, between the demands of a situation on the one hand and their social, biological, or psychological resources on the other. Stressful stimuli may be mental, physiological, anatomical or physical1. The term stress in this sense was first used by the endocrinologist Hans Selye in the 1930s specifically in relation to the physiological responses of laboratory animals. Selye later broadened and popularized the concept to include the perceptions and responses of ordinary people trying to adapt to the challenges of everyday life. Stress in certain circumstances may be seen as a positive phenomenon: an evolved adaptive response prompting activation of internal resources to meet such challenges and achieve realistic goals, etc. Contents 1 Models of Stress 1.1 General Adaptation Syndrome 1.2 Lazarus 1.3 Zajonc 2 Neurochemistry and physiology 3 Common sources of stress 4 Adaptation to stress 5 History and usage 6 See also 7 References 8 External links Models of Stress General Adaptation Syndrome Hans Selye researched the effects of stress2 on rats and other animals by exposing them to unpleasant or harmful stimuli. He found that all animals presented a very similar series of reactions, broken into three stages. He describes this universal response to the stressors as the General Adaptation Syndrome, or GAS, in 1936.34 Alarm This is the 1st stage. When the threat or stressor is identified or realized, the body's stress response is a state of alarm. During this stage adrenaline will be produced in order to bring about the fight-or-flight response. There is also some activation of the HPA axis, producing cortisol. Resistance This is the 2nd stage. If the stressor persists, it becomes necessary to attempt some means of coping with the stress. Although the body begins to try to adapt to the strains or demands of the environment, the body cannot keep this up indefinitely, so its resources are gradually depleted. Exhaustion This is the 3rd stage. In the final stage in the GAS model, all the body's resources are eventually depleted and the body is unable to maintain normal function. At this point the initial autonomic nervous system symptoms may reappear sweating, raised heart rate etc.. If stage three is extended, long term damage may result as the capacity of glands, especially the adrenal gland, and the immune system is exhausted and function is impaired resulting in decompensation. The result can manifest itself in obvious illnesses such as ulcers, depression, trouble with the digestive system or even cardiovascular problems, along with other mental illnesses. Lazarus Richard Lazarus published in 1974 a model dividing stress into eustress and distress.5 Where stress enhances function physical or mental, such as through strength training or challenging work it may be considered eustress. Persistent stress that is not resolved through coping or adaptation, deemed distress, may lead to anxiety or withdrawal depression behavior. The difference between experiences which result in eustress or distress is determined by the disparity between an experience real or imagined, personal expectations, and resources to cope with the stress. Alarming experiences, either real or imagined, can trigger a stress response.6 Therefore, Lazarus's model argues that cognitive processes of appraisal are central in determining whether a situation is potentially threatening or harmful.7 Zajonc Robert B. Zajonc 1984, somewhat in opposition to the Lazarus model of stress, argued that emotional reactions occur before cognitive reactions, and in fact, may be at odds with cognitive responses. This belief was consonant with the previous James-Lange hypothesis 1890, 1922, which held that the body's emotional reaction to stress occurred prior to and resulted in conscious responses. The debate has underscored the existence of two modes of reactivity, one conscious and under volitional control, and the other automatic and uncontrollable. Scholars such as Aldwin have argued for a simultaneous, parallel processing approach rather than a sequential neurological processing model where emotions come first followed by cognition, or vice versa.7 Neurochemistry and physiology The neurochemistry of the stress response is now believed to be well understood, although much remains to be discovered about how the components of this system interact with one another, in the brain and throughout in the body. In response to a stressor, corticotropin-releasing hormone CRH and arginine-vasopressin AVP are secreted into the hypophyseal portal system and activate neurons of the paraventricular nuclei PVN of the hypothalamus. The locus ceruleus and other noradrenergic cell groups of the adrenal medulla and pons, collectively known as the LC/NE system, also become active and use brain epinephrine to execute autonomic and neuroendocrine responses, serving as a global alarm system.8 The autonomic nervous system provides the rapid response to stress commonly known as the fight-or-flight response, engaging the sympathetic nervous system and withdrawing the parasympathetic nervous system, thereby enacting cardiovascular, respiratory, gastrointestinal, renal, and endocrine changes.8 The so-called hypothalamic-pituitary-adrenal axis HPA, a major part of the neuroendocrine system involving the interactions of the hypothalamus, the pituitary gland, and the adrenal glands, is also activated by release of CRH and AVP. This results in release of adrenocorticotropic hormone ACTH from the pituitary into the general bloodstream, which results in secretion of cortisol and other glucocorticoids from the adrenal cortex. These corticoids involve the whole body in the organism's response to stress and ultimately contribute to the termination of the response via inhibitory feedback.8 Stress can significantly affect many of the body's immune systems, as can an individual's perceptions of, and reactions to, stress. The term psychoneuroimmunology is used to describe the interactions between the mental state, nervous and immune systems, as well as research on the interconnections of these systems. Chronic stress has also been shown to impair developmental growth in children by lowering the pituitary gland's production of growth hormone, as in children associated with a home environment involving serious marital discord, alcoholism, or child abuse.9 Common sources of stress Both negative and positive stressors can lead to stress. Some common categories and examples of stressors include: Sensory: pain, bright light Life events: birth and deaths, marriage, and divorce Responsibilities: lack of money, unemployment Illness: depression, obsessive compulsive disorder Work/study: exams, project deadlines, and group projects Personal relationships: conflict, deception, Break up Lifestyle: heavy drinking, insufficient sleep Environmental: Lack of control over environmental circumstances, such as food, housing, health, freedom, or mobility Social: Struggles with conspecific individuals and social defeat can be potent sources of chronic stresses Adverse experiences during development e.g. prenatal exposure to maternal stress,1011 poor attachment histories,12 sexual abuse13 are thought to contribute to deficits in the maturity of an individual's stress response systems. One evaluation of the different stresses in people's lives is the Holmes and Rahe stress scale. Adaptation to stress Main article: Stress management Responses to stress include adaptation, psychological coping such as stress management, anxiety, and depression. Over the long term, distress can lead to diminished health or illness; to avoid this, stress must be managed. History and usage The term stress had none of its current general senses before the 1950s. As a semi-psychological term referring to hardship or coercion, it dated from the 14th century. It is a form of the Middle English destresse, derived via Old French from the Latin stringere - to draw tight.14 It had long been in use in physics to refer to the internal distribution of a force exerted on a material body, resulting in strain. In the 1920s and 30s, the term was occasionally being used in psychological circles to refer to a mental strain or unwelcome happening, and by advocates of holistic medicine to refer to a harmful environmental agent that could cause illness. Walter Cannon used it in 1934 to refer to external factors that disrupted what he called homeostasis. But a new scientific usage developed out of Hans Seyle's reports of his laboratory experiments in the 1930s. Selye started to use the term to refer not just to the agent but to the state of the organism as it responded and adapted to the environment. His theories of a universal non-specific stress response attracted great interest and contention in academic physiology and he undertook extensive research programmes and publication efforts.15 However, while the work attracted continued support from advocates of psychosomatic medicine, many in experimental physiology concluded that his concepts were too vague and unmeasurable. During the 1950s Selye turned away from the laboratory to promote his concept through popular books and lectures tours. The US military became a key center of stress research, attempting to understand and reduce combat neurosis and psychiatric casualties. Seyle wrote for both non-academic physicians and, in an international bestseller titled Stress of Life, for the general public. A broad biopsychosocial concept of stress and adaptation offered the promise of helping everyone achieve health and happiness by successfully responding to changing global challenges and the problems of modern civilisation. He coined the term eustress for positive stress, by contrast to distress. He argued that all people have a natural urge and need to work for their own benefit, a message that found favor with industrialists and governments.15 He also coined the term stressor to refer to the causative event or stimulus, as opposed to the resulting state of stress. From the late 1960s, Selye's concept started to be taken up by academic psychologists, who sought to quantify life stress by scoring significant life events, and a large amount of research was undertaken to examine links between stress and disease of all kinds. By the late 1970s stress had become the medical area of greatest concern to the general population, and more basic research was called for to better address the issue. There was renewed laboratory research into the neuroendocrine, molecular and immunological bases of stress, conceived as a useful heuristic not necessarily tied to Selye's original hypotheses. By the 1990s, stress had become an integral part of modern scientific understanding in all areas of physiology and human functioning, and one of the great metaphors of Western life.15 Focus grew on stress in certain settings, such as workplace stress. Stress management techniques were developed. Its psychological uses are frequently metaphorical rather than literal, used as a catch-all for perceived difficulties in life. It also became a euphemism, a way of referring to problems and eliciting sympathy without being explicitly confessional, just stressed out. It covers a huge range of phenomena from mild irritation to the kind of severe problems that might result in a real breakdown of health. In popular usage almost any event or situation between these extremes could be described as stressful.14 The most extreme events and reactions may elicit the diagnosis of Posttraumatic stress disorder. See also Jon Kabat-Zinn Burnout psychology Hypothalamic-pituitary-adrenal axis Oxidative stress Compassion fatigue References September 2007 ^ Rippetoe-Kilgore, Mark and Lon. 2006. Practical Programming for Strength Training. ISBN 0-9768-0540-5 ^ Selye, Hans 1950. Diseases of adaptation. Wisconsin medical journal 49 6: 515-6. ^ Seyle, Hans 1936. A syndrome produced by diverse nocuous agents. Nature 138: 32. doi:10.1038/138032a0. ^ Selye Biologic Reaction to Stress chart, Chronic Fatigue Unmasked, by Dr. Gerald E. Poesnecker, February 1999 ISBN 0916285618 ^ Lazarus RS 1993. From psychological stress to the emotions: a history of changing outlooks. Annual Review of Psychology 44: 1-22. doi:10.1146/annurev.ps.44.020193.000245. PMID 8434890. ^ Ron de Kloet, E; Joels M. Holsboer F. 2005. Stress and the brain: from adaptation to disease. Nature Reviews Neuroscience 6 6: 463-475. doi:10.1038/nrn1683. PMID 15891777. ^ a b Aldwin, Carolyn 2007. Stress, Coping, and Development, Second ion. New York: The Guilford Press. ISBN 1572308400. ^ a b c Tsigos, C. Chrousos, G.P. 2002. Hypothalamic-pituitary-adrenal axis, neuroendocrine factors, and stress. Journal of Psychosomatic Research, 53, 865-871. ^ Powell, Brasel, Blizzard, 1967. ^ Davis et al. June 2007. Prenatal Exposure to Maternal Depression and Cortisol Influences Infant Temperament. Journal of the American Academy of Child Adolescent Psychiatry, v46 n6 p737. ^ O'connor, Heron, Golding, Beveridge Glover. June 2002. Maternal antenatal anxiety and children's behavioural/emotional problems at 4 years. Br J Psychiatry. 180:478-9. ^ Schore, Allan 2003. Affect Regulation the Repair of the Self. New York: W.W. Norton. ISBN 0393704076. ^ Michael D. DeBellis, George P. Chrousos, Lorah D. Dorn, Lillian Burke, Karin Helmers, Mitchel A. Kling, Penelope K. Trickett, and Frank W. Putnam. Hypothalamic-Pituitary-Adrenal Axis Dysregulation in Sexually Abused Girls ^ a b Keil, R.M.K. 2004 Coping and stress: a conceptual analysis Journal of Advanced Nursing, 456, 659-665 ^ a b c Viner, R. 1999 Putting Stress in Life: Hans Selye and the Making of Stress Theory Social Studies of Science, Vol. 29, No. 3 Jun., 1999, pp. 391-410 Petersen, C., Maier, S.F., Seligman, M.E.P. 1995. Learned Helplessness: A Theory for the Age of Personal Control. New York: Oxford University Press. ISBN 0-19-504467-3 Seligman, M.E.P. 1975. Helplessness: On Depression, Development, and Death. San Francisco: W.H. Freeman. ISBN 0-7167-2328-X Seligman, M.E.P. 1990. Learned Optimism. New York: Knopf. Reissue ion, 1998, Free Press, ISBN 0-671-01911-2. Holmes, T.H. and Rahe, R.H. 1967. The social readjustments rating scales. Journal of Psychosomatic Research 11:213-218. External links The American Institute of Stress University of Massachusetts Medical School Stress Reduction Program Research on Work-Related Stress, European Agency for Safety and Health at Work EU-OSHA Working on Stress, European Agency for Safety and Health at Work EU-OSHA Taming Stress, Scientific American, September 2003 Retrieved from http://en..org/wiki/Stress_biological Categories: StressHidden category: Articles needing additional references from September 2007 Views Article Discussion this page History Personal tools Log in / create account Navigation Main page Contents Featured content Current events Random article Search Go Search Interaction Community portal Recent changes Contact Donate to Help Toolbox What links here Related changes Upload file Special pages Printable version Permanent link Cite this page Languages العربية БългарÑ?ки Català Česky Dansk Deutsch Español Esperanto Euskara Ù?ارسی Français Bahasa Indonesia Italiano עברית Lietuvių Lingála Magyar МакедонÑ?ки मराठी Nederlands 日本語 ‪Norsk bokmÃ¥l‬ Polski Português Română РуÑ?Ñ?кий Simple English SlovenÄ?ina СрпÑ?ки / Srpski Suomi Svenska தமிழà¯? Türkçe ä¸æ–‡ This page was last modified on 28 August 2008, at 13:14
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