Stress and DiseaseStressGAS ActivationPsychoneuroimmunologic MediatorsCentral Stress ResponseSlide 6Slide 7Slide 8Stress-Induced Hormone AlterationsSlide 10Slide 11Slide 12Slide 13Stress, Personality, Coping, and IllnessSlide 15Aging and Stress1Stress and DiseaseChapter 10Mosby items and derived items © 2006 by Mosby, Inc.2Stress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General Adaptation Syndrome (GAS)-response to stressorsThree stagesAlarm stageArousal of body defensesStage of resistance or adaptationMobilization contributes to fight or flightStage of exhaustionProgressive breakdown of compensatory mechanismsMosby items and derived items © 2006 by Mosby, Inc.3GAS ActivationAlarm stageStressor triggers the hypothalamic-pituitary-adrenal (HPA) axisActivates sympathetic nervous systemResistance stageBegins with the actions of adrenal hormonesExhaustion stageOccurs only if stress continues and adaptation is not successfulMosby items and derived items © 2006 by Mosby, Inc.4Psychoneuroimmunologic 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 outcomesMosby items and derived items © 2006 by Mosby, Inc.5Central Stress ResponseCatecholaminesReleased from chromaffin cells of the adrenal medullaLarge amounts of epinephrine; small amounts of norepinephrineα-adrenergic receptorsα1 and α2β-adrenergic receptorsβ1 and β2Mimic direct sympathetic stimulationMosby items and derived items © 2006 by Mosby, Inc.6Central 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 agentMosby items and derived items © 2006 by Mosby, Inc.7Central Stress ResponseMosby items and derived items © 2006 by Mosby, Inc.8Central Stress ResponseMosby items and derived items © 2006 by Mosby, Inc.9Stress-Induced Hormone AlterationsFemale reproductive systemCortisol exerts inhibiting effects by suppressing the release of luteinizing hormone, estradiol, and progesteroneStress suppresses hypothalamic gonadotropin-releasing hormoneEstrogen stimulates the HPA axisMosby items and derived items © 2006 by Mosby, Inc.10Stress-Induced Hormone AlterationsEndorphins and enkephalinsProteins found in the brain that have pain-relieving capabilitiesIn a number of conditions, individuals not only experience insensitivity to pain but also increased feelings of excitement, positive well-being, and euphoriaMosby items and derived items © 2006 by Mosby, Inc.11Stress-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 functionMosby items and derived items © 2006 by Mosby, Inc.12Stress-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 anxietyMosby items and derived items © 2006 by Mosby, Inc.13Stress-Induced Hormone AlterationsTestosteroneSecreted by Leydig cellsRegulates male secondary sex characteristics and libidoTestosterone levels decrease due to stressful stimuliMosby items and derived items © 2006 by Mosby, Inc.14Stress, 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 personMosby items and derived items © 2006 by Mosby, Inc.15Stress, Personality, Coping, and IllnessMosby items and derived items © 2006 by Mosby, Inc.16Aging 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