Physiological and Emotional Response to Psychological Stressors in Psychiatric and Psychosomatic Disorders

Abstract

Deviations from emotional and physiological homeostasis in humans occur under episodic, chronic, or traumatic stress experiences. These dysregulations can provoke emotional and physical disturbances that may result in stress-related psychiatric or psychosomatic disorders. This brief review discusses a variety of both naturally occurring and experimental stressors and the complexity of intervening variables on cardiovascular and hormonal dysregulations of the hypothalamic-pituitary-adrenal (HPA) axis. In addition to the type, intensity, and duration of the stressor, subject variables such as dispositional factors (e.g., age and sex), personality traits, and coping styles are considered. Finally, emotional and physiological stress responses to naturally occurring stressors and psychological challenge tests in depressed patients and anxiety disorder patients are presented and discussed. Stressors in humans induce emotional arousal, which leads to physiological activation of the central nervous system, an increase of hormones of the HPA axis, and coping reactions on the psychological and behavioral level. Depending on the type, intensity, and duration of the stressor, on personal and psychosocial resources of the individual, stressful situations may provoke emotional and physical disturbances. These dysfunctions may result in psychosomatic or psychiatric disorders. The following brief review intends to discuss a variety of stressors that have been examined in humans in order to gain insight into the complex relationship between physiological and behavioral stress reactions and the occurrence or maintenance of stress related psychosomatic and psychiatric disorders.

Salivary Secretion of Highly Concentrated Chromogranin a in Response to Noradrenaline and Acetylcholine in Isolated and Perfused Rat Submandibular Glands

“…The sympathetic-adrenomedullary systems in the brain and at the periphery are the fastest systems activated to induce the 'flightÏfright' response during the stage of alarm reaction. The magnitude of the effect of the systems has been evaluated by monitoring the sympathetic-adrenomedullary systems directly (adrenaline and NAd release) or studying psychophysiological measures (heart rate, blood pressure, and skin conductance responses) or physical and emotional well-being (Ehlert & Straub, 1998). In the chain of reactions by which the brain co-ordinates the stress response, the sympathetic-adrenomedullary systems constitute key components, with a dominant role for catecholamines as primary messengers in the flightÏfright response.…”

Exposure to Repeated, Intermittent d-amphetamine Induces Sensitization of HPA Axis to a Subsequent Stressor

“…3 D -amphetamine Induces Sensitization of HPA Axis 287 tant factor in the development of many forms of human disease (McEwen 2000;Koob and Le Moal 2001). A wealth of evidence suggests that an increased reactivity to stressors and/or the inability to respond effectively and appropriately to stressors plays an important role in the development and expression of many forms of mental illness (Ehlert and Straub 1998;Kreek and Koob 1998;Dohrenwend 2000;Heim et al 2000). Clearly, a better understanding of the underlying neurobiology of this sensitivity to stressors may help in the prophylaxis and treatment of these disorders.…”

Neuroendocrine Responses to Psychological Stress in Adolescents with Anxiety Disorder

“…In particular, responses of the hypothalamus-pituitaryadrenal (HPA) axis to stress have been widely investigated with contrasting results in healthy subjects and psychiatric patients: larger cortisol (CORT) responses to psychological stress were evidenced in male subjects than in females by Kirschbaum et al [6], while in another experimental evaluation, CORT was not increased by a psychological stressor, but was stimulated by physical stress in normal subjects [7]. Among adults, HPA axis dysregulation in coping reactions seems to be associated with psychosomatic disorders [8] and with posttraumatic stress disorder [9,10]. It has been suggested that hypersecretion of corticotropin-releasing factor (CRF) and HPA axis hyperactivity contribute to the symptomatology of anxiety-related disorders [11].…”