The document discusses stress and its effects on the body. It describes the general adaptation syndrome (GAS) which has three stages: alarm, resistance, and exhaustion. In the alarm stage, the body's defenses are aroused. The resistance stage involves mobilizing body resources to fight or flee. Exhaustion occurs if stress continues without successful adaptation. Stress activates the hypothalamic-pituitary-adrenal axis and sympathetic nervous system. Hormonal changes induced by stress include increased cortisol, catecholamines, and prolactin, and decreased testosterone. Personality and coping abilities influence how stress impacts health.

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Stress and Disease
Chapter 10

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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
 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 mechanisms

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GAS 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 successful

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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

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Central 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 stimulation

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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

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Central Stress Response

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Central Stress Response

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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 gonadotropin-
releasing hormone
 Estrogen stimulates the HPA axis

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Stress-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
euphoria

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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

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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

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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

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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

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Stress, Personality, Coping, and
Illness

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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