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Transcript
Stress and Disease
Chapter 10
1
Stress

A person experiences stress when a demand
exceeds a person’s coping abilities, resulting
in reactions such as disturbances of cognition,
emotion, and behavior that can adversely
affect well-being
2
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Dr. Hans Selye



Worked to discover a new sex hormone
Injected ovarian extracts into rats
Witnessed:




Enlargement of the adrenal cortex
Thymic atrophy
Development of bleeding ulcers in the stomach and
duodenal lining
Dr. Selye witnessed these changes with many agents.
He called these stimuli “stressors.”
3
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General Adaptation Syndrome
(GAS)


Dr. Selye termed this general response, the
general adaptation syndrome (GAS)
Three stages

Alarm stage


Stage of resistance or adaptation


Arousal of body defenses
Mobilization contributes to fight or flight
Stage of exhaustion

Progressive breakdown of compensatory mechanisms
4
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GAS Activation

Alarm stage

Stressor triggers the hypothalamic-pituitaryadrenal (HPA) axis


Resistance stage


Activates sympathetic nervous system
Begins with the actions of adrenal hormones
Exhaustion stage

Occurs only if stress continues and adaptation is
not successful
5
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Psychological Mediators



Reactive response
Anticipatory response
Conditional response
6
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Psychoneuroimmunologic
Mediators




Interactions of consciousness, the brain and spinal
cord, and the body’s defense mechanisms
Corticotropin-releasing hormone (CRH) is released
from the hypothalamus
CRH is also released peripherally at inflammatory
sites
Immune modulation by psychosocial stressors leads
directly to health outcomes
7
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Central Stress Response

Catecholamines

Released from chromaffin cells of the adrenal
medulla


α-adrenergic receptors


α1 and α2
β-adrenergic receptors


Large amounts of epinephrine; small amounts of
norepinephrine
β1 and β2
Mimic direct sympathetic stimulation
8
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Central Stress Response

Cortisol (hydrocortisone)






Activated by adrenocorticotropic hormone (ACTH)
Stimulates gluconeogenesis
Elevates the blood glucose level
Protein anabolic effect in the liver; catabolic effect
in other tissues
Lipolytic in some areas of the body, lipogenic in
others
Powerful anti-inflammatory/immunosuppressive
agent
9
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Central Stress Response
10
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Central Stress Response
11
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Stress-Induced Hormone
Alterations

Female reproductive system



Cortisol exerts inhibiting effects by suppressing
the release of luteinizing hormone, estradiol, and
progesterone
Stress suppresses hypothalamic gonadotropinreleasing hormone
Estrogen stimulates the HPA axis
12
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Stress-Induced Hormone
Alterations

Endorphins and enkephalins


Proteins found in the brain that have painrelieving capabilities
In a number of conditions, individuals not only
experience insensitivity to pain but also increased
feelings of excitement, positive well-being, and
euphoria
13
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Stress-Induced Hormone
Alterations

Growth hormone (somatotropin)



Produced by the anterior pituitary and by
lymphocytes and mononuclear phagocytic cells
Affects protein, lipid, and carbohydrate
metabolism and counters the effects of insulin
Enhances immune function
14
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Stress-Induced Hormone
Alterations

Prolactin




Released from the anterior pituitary
Necessary for lactation and breast development
Prolactin levels in the plasma increase as a result
of stressful stimuli
Oxytocin



Produced by the hypothalamus
Produced during orgasm in both sexes
May promote reduced anxiety
15
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Stress-Induced Hormone
Alterations

Testosterone



Secreted by Leydig cells
Regulates male secondary sex characteristics and
libido
Testosterone levels decrease due to stressful
stimuli
16
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Stress, Personality, Coping, and
Illness


A stressor for one person may not be a stressor for
another
Psychologic distress


General state of unpleasant arousal after life events that
manifests as physiologic, emotional, cognitive, and
behavior changes
Coping

Managing stressful demands and challenges that are
appraised as taxing or exceeding the resources of the
person
17
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Stress, Personality, Coping, and
Illness
18
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Aging and Stress

Stress-age syndrome








Excitability changes in the limbic system and
hypothalamus
Increased catecholamines, ADH, ACTH, and cortisol
Decreased testosterone, thyroxine, and other hormones
Alterations of opioid peptides
Immunodepression
Alterations in lipoproteins
Hypercoagulation of the blood
Free radical damage of cells
19
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