Stress in Health and Disease

Rolf Ekman gained his BSc and MD from Uppsala University, and his PhD from Lund University. In 1991, he was appointed Professor of Neurochemistry at G?org University, a post he holds today. Professor Ekman is a member of the International Society of Neurochemistry, the Society for Neuroscience, The New York Academy of Sciences, ISPNE and ECNP, and has been on the advisory board of Peptides since 1991. He has won both the Smith, Klein & French Research Award as well as the Boehinger Ingelheim Research Award, and has well over 300 publications to his name. Bengt B. Arnetz received his BSc, MD, and PhD from the Karolinska Institute, Stockholm, Sweden, where he became associate professor of psychophysiology in 1986. He has also worked as a postgraduate fellow at Harvard School of Public Health, Boston, USA, and as senior occupational health advisor to the Boston Police Department, before joining Exxon Biomedical Sciences as section head of occupational health research. He was then made associate professor/unit head of the occupational health section at the National Institute for Psychosocial Factors and Health, Stockholm before joining Uppsala Academic Hospital, where he is currently professor and head of social medicine. Professor Arnetz is a member of several societies, including the Swedish Medical Association, the American Public Health Association, and the American College of Occupational and Environmental Medicine.

Foreword. Preface. List of Contributors. A Multifaceted View of Stress. 1 Modern Fatigue: A Historical Perspective (Karin Johannisson). 1.1 Introduction. 1.2 Overstrain and Modern Society in 1900. 1.3 The "Fatigue Problem". 1.4 Neurasthenia. 1.5 Between Nervous Fatigue and Chronic Fatigue: Stress. 1.6 Chronic Fatigue Syndrome. 1.7 Burnout and Modern Society in 2000. 1.8 Conclusion. References. 2 Evolutionary Aspects of Stress (Bjorn Folkow). 2.1 Introduction. 2.2 Man's Situation in a Phylogenetic Perspective. 2.3 From Intuitive Insight to Experimental Documentation. 2.4 Organization of Stress Induced Response Patterns. 2.5 Implications Concerning Man in Modern Society. 2.6 Concluding Remarks. References. 3 Stress It Is All in the Brain (Hege Randi Eriksen and Holger Ursin). 3.1 Background. 3.2 Introduction. 3.3 The Starting Point: Consensus Statements. 3.4 The Alarm: When and Why Does this Alarm Occur? 3.5 CATS: From Words to Formal Logics and Theory. 3.6 Expectancies: What Do Brains Really Do? 3.7 Expectancies: Priorities, Probabilities, and Values. 3.8 Variance in Stress Responses: Stimulus Expectancy. 3.9 Variance in the Stress Responses. Coping: Positive Response Outcome Expectancies. 3.10 Variance in the Stress Responses. Lacking or Negative Response Outcome Expectancies: Helplessness and Hopelessness. 3.11 The Variance in Coping Concepts. 3.12 Covert Coping. 3.13 Outcome Evaluations, Fear, Anxiety and Alarm. 3.14 Access to the Alarm System. 3.15 Stress as an Alarm System: Adaptive or Maladaptive? 3.16 Allostatic Load Repeated Strong Arousals Training or Straining? 3.17 Sustained Activation. 3.18 Stress and Disease: Coping and Health. 3.19 Sustained Activation, Sustained Attention and Sensitization. 3.20 Rumination and Sustained Activation. 3.21 Too Much Coping Being Too Good: the Dangers of Narcissism. 3.22 Social Inequality in Health and in Response Outcome Expectancies. 3.23 Brain Mechanisms. 3.24 Conclusions. References. Stress at the Societal and Organizational Level. 4 Collective Traumatic Stress: Crisis and Catastrophes (Lars Weisath). 4.1 Introduction: The Individual as a Citizen. 4.2 Society's Denial of Psychic Trauma and its Consequences to Health. 4.3 Central Concepts and Models. References. 5 Stress Why Managers Should Care (Bengt B. Arnetz). 5.1 Introduction. 5.2 Stress An Organizational Perspective. 5.3 Organization A Biological Entity. 5.4 Drivers of Constant Needs of Organizational Changes. 5.5 Organizational Stressors' Impact on the Bottom Line. 5.6 Optimal Organizational Stress and Slack. 5.7 Organizational Stress Models Concepts and De.nitions. 5.8 Organizational Ine.ciency and Organizational Stress. 5.9 Ingredients for Healthy and Productive Work Environments. 5.10 Work, Stress and Productivity. 5.11 Organizational Effectiveness and Perceived Stress. 5.12 Stress Intervention and Implications for Organizational Health and Productivity. 5.13 QWC Theory, Model and Applicability. 5.14 Multiorganizational Assessments of Organizational and Employee Well Being. 5.15 Leadership and Employee Job Satisfaction and Organizational Performance. 5.16 Implementation of Productive and Healthy Work Practices. References. 6 The Empowered Organization and Personnel Health (Tores Theorell). 6.1 Introduction. 6.2 A Historical Perspective. 6.3 Concepts Related to Work Control. 6.4 How to Evaluate Decision Latitude? 6.5 Questionnaires. 6.6 Relationship Between Decision Latitude and Health. 6.7 Decision Latitude and Physiological Reactions. 6.8 What Can Be Done for the Improvement of Decision Latitude? References. 7 Can Health be Subject to Management Control? Suggestions and Experiences (Ulf Johanson and Andreas Backlund). 7.1 Introduction. 7.2 Health and Pro.tability. 7.3 Health in the Balance Sheet. 7.4 Health in the Pro.t and Loss Account. 7.5 HR Costings. 7.6 Recent Management Control Methods. 7.7 Health Statements. 7.8 Health and Management Control in the Swedbank: A Case Study. 7.9 Conclusion and Dilemmas. References. Stress and Brain Plasticity. 8 The Neonatal and Pubertal Ontogeny of the Stress Response: Implications for Adult Physiology and Behavior (Russell D. Romeo and Bruce S. McEwen). 8.1 Introduction. 8.2 Stress, Homeostasis, Allostasis, and Allostatic Load. 8.3 The Hypothalamic Pituitary Adrenal Axis. 8.4 Neonatal Development of the HPA Axis. 8.5 Early Life Events and the Shaping of the HPA Axis. 8.6 Pubertal Development of the HPA Axis. 8.7 Puberty as a Period of Intervention. 8.8 Implications for Human Health and Development. 8.9 Conclusions and Future Directions. References. 9 Neurobiological and Behavioral Consequences of Exposure to Childhood Traumatic Stress (Martin H. Teicher, Jacqueline A. Samson, Akemi Tomoda, Majed Ashy, and Susan L. Andersen). 9.1 Introduction. 9.2 Exposure to Stress in Early Life and Stress Response Systems. 9.3 Gene Expression, Myelination, Neural Morphology, Neurogenesis and Synaptogenesis. 9.4 Differential Sensitivity to the Effects of Stress in Various Brain Regions. 9.5 Neuropsychiatric Consequences and Psychopathology. 9.6 Perspectives. Acknowledgements. References. 10 The Brain in Stress In.uence of Environment and Lifestyle on Stress Related Disorders (Rolf Ekman and Bengt B. Arnetz). 10.1 Background. 10.2 Introduction. 10.3 Relationship Between Chronic Stress and Stress Related Disorders. 10.4 The HPA Axis Out of Balance a Link to Depression? 10.5 Stress Related Mental Disorders and Neurodegenerative Diseases. 10.6 Unhealthy Environments; a Link to PTSD? 10.7 Conclusions and Future Prospects. References. 11 The Healthy Cortisol Response (Tommy Olsson and Robert Sapolsky). 11.1 Introduction. 11.2 The Hippocampus as a GC Target. 11.3 Glucocorticoids, Stress and Synaptic Plasticity in the Hippocampus. 11.4 Glucocorticoids, Stress and Hippocampal Dependent Cognition. 11.5 Glucocorticoids, Stress and Neurogenesis. 11.6 Glucocorticoids, Stress and Atrophy of Dendritic Processes. 11.7 Glucocorticoids, Stress and Neurotoxicity. 11.8 Glucocorticoids, Stress and the Endangerment of Hippocampal Neurons. 11.9 Clinical Implications. 11.10 Main Points. 11.11 Future. References. 12 Antistress, Well Being, Empathy and Social Support (Kerstin Uvnas Moberg and Maria Petersson). 12.1 Introduction. 12.2 Brief Overview of the Fight Flight or Stress and Defense Mechanisms. 12.3 Deduction of Physiology of the Antistress Pattern from the Physiology of Breastfeeding. 12.4 The Chemistry of Oxytocin. 12.5 Effects of Oxytocin. 12.6 Release of Oxytocin in Response to Touch. 12.7 Health and Social Interaction. References. 13 Stress, Sleep and Restitution (Torbjorn Akerstedt). 13.1 Introduction. 13.2 The Physiological Description of Sleep. 13.3 The Effects of Stress on Sleep. 13.3.1 Human Studies. 13.3.2 Animal Studies on Stress. 13.4 Physiological Processes During Sleep. 13.5 Sleep and Stress Markers. 13.6 Sleep Loss. 13.7 Sleep Loss and Disease. 13.8 Sleep Regulation. 13.9 Final Comment. References. Stress and the Individual. 14 Brain Mechanisms In Stress and Negative Affect (Mats Fredrikson and Tomas Furmark). 14.1 Introduction. 14.2 Brain Imaging Techniques and Paradigms. 14.3 Theories of Emotion and Neuroimaging Applications. 14.4 Dismantling Fear from Disgust: a Theory Test. 14.5 Emotional Activation versus Emotional Control: Activating, Controlling and Modulating Brain Circuits. 14.6 Imaging Stress. 14.7 Relieving Stress: Treatment Studies. 14.8 Genetic In.uences on Stress and Brain Activity. 14.9 Psychosomatic Stress and Emotional Brain Circuits. References. 15 Is It Dangerous To Be Afraid? (Markus Heilig). 15.1 Introduction. 15.2 Animal Models of Fear's Behavioral Component. 15.3 Do You Run Because You Are Scared or Are You Scared Because You Run? 15.4 A Sketch of the Organization of Fear. 15.5 The Price of Being Conscious. 15.6 Mediators of Emotions. 15.7 To Stop in Time. 15.8 A Sea Horse that Bolts. 15.9 Can a Vicious Circle Be Broken? References. 16 Fatigue and Recovery (Bengt B. Arnetz and Rolf Ekman). 16.1 Introduction. 16.2 Fatigue a Distinct Entity or Part of a Syndrome?. 16.3 Fatigue Dominating Syndromes. 16.4 Fatigue Among the General Population. 16.5 Fatigue, Chronic Fatigue and Chronic Semantic Confusion. 16.6 Assessing Fatigue. 16.7 Stress Related Fatigue. 16.8 Fatigue Scale Versus Other Scales Assessing Fatigue Related Conditions. 16.9 Fatigue Development Over Time Risk Factors and Protective Factors. References. 17 The Role of Stress in the Etiology of Medically Unexplained Syndromes (James Rubin and Simon Wessely). 17.1 Medically Unexplained Syndromes. 17.2 Evidence for an Association with Psychosocial Stress. 17.3 Possible Mechanisms. 17.4 Implications for Diagnosis. 17.5 Implications for Treatment. References. 18 Oxidative Inflammatory Stress in Obesity and Diabetes (Paresh Dandona, Ahmad Aljada, Ajay Chaudhuri, and Husam Ghanim). 18.1 Introduction. 18.2 Oxidative Stress. 18.3 Inflammatory Stress. 18.4 Oxidative Stress in Obesity and Diabetes. 18.5 Antioxidant and Antiinflammatory Effect of Insulin. 18.6 Mental Stress and Inflammation. 18.7 Atherogenesis and Insulin. 18.8 The New Paradigm. 18.9 Future Horizons. References. 19 The Metabolic Syndrome (Christian Berne and Per Bjorntorp). 19.1 Introduction. 19.2 History. 19.3 Metabolic Syndrome. 19.4 Hormones in Metabolic Syndrome. 19.5 Hypertension. 19.6 Stress Axes. 19.7 Other Conditions. 19.8 Prevention and Therapy. 19.9 Summary. References. 20 Chronic Pain: the Diathesis Stress Model (Yuan Bo Peng, Perry N. Fuchs, and Robert J. Gatchel). 20.1 Introduction. 20.2 A Conceptual Model of the Transition from Acute to Chronic Pain and Emotional Distress. 20.3 The Diathesis Stress Model. 20.4 Summary and Conclusions. Acknowledgements. References. 21 Emotional Stress, Positive Emotions, and Psychophysiological Coherence (Rollin McCraty and Dana Tomasino). 21.1 Introduction. 21.2 The Emotional Basis of Stress. 21.3 Breaking the Stress Cycle: The Power of Positive Emotions. 21.4 Positive Emotion Focused Tools and Techniques. 21.5 The Scienti.c Basis of the HeartMath Techniques. 21.6 Revisiting the HeartMath Techniques: A Repatterning Process. 21.7 Heart Rhythm Coherence Feedback Training: Facilitating Coherence. 21.8 Conclusions and Implications. Acknowledgements. Note. References. 22 Stress Systems in Aging Cognitions and Dementia (Nicole C. Schommer and Isabella Heuser). 22.1 Introduction and Overview. 22.2 Endocrine Systems in the Healthy Elderly. 22.3 Cognitive Function in the Healthy Elderly and Impact of Endocrine Stress Reactivity. 22.4 Stress Systems and Dementia. 22.5 Summary and Conclusion. References. 23 Stress and Addiction (Bo Soderpalm and Anna Soderpalm). 23.1 Introduction. 23.2 Stress, Alcohol and Nicotine. 23.3 What Are the Biological Underpinnings? 23.4 Stress and Inhibitory Control. 23.5 Stress Sensitivity and Risk for Excessive Drug Self Administration. 23.6 Human Studies. 23.7 Summary. References. Index.