Health and Behavior The Interplay of Biological, Behavioral, and Societal Influences (2001) / Chapter Skim
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Pages 39-86
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From page 39... ...
Real~time imaging of the living human brain cluring different behavioral states has promoted our unclerstancling of the links between human behavior anc3 basic neurochemical processes or specific neuroanatomic pathways. Common availability of monoclonal antiboc3' ies, routine production of genetically altered animals, anc3 new unclerstanc3' ing of the genetic code have contributed to exploration of how genetics interacts with development anc3 early experiences to influence both vul' nerability to disease anc3 resistance to age-relatec3 Decline.
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From page 40... ...
The stress response consists of many coaclaptecl and simultaneous shifts in the physiological functioning of the carcliovascular, respiratory, muscular, metabolic, immune, and central nervous systems. Physiological changes can be accompanied by altered emotional responses, enhanced vigilance, heightened appraisal of risk, enhancec3 memory storage anc3 retrieval, anc3 changes in motivation.
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From page 41... ...
An increasing body of evidence indicates that stress is a potent contributor to illness (Cohen and Herbert, 1996; Cohen et al., 1991; Hermann et al., 1995; Kiecolt-Glaser et al., 1996; McEwen, 1998~. The continued and unproductive activation of the stress response, includ' ing the failure to shut off this response when it is not needed, called allostatic load, is discussed below.
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From page 42... ...
And it also includes contributions of lifestyle factors, such as diet, alcohol anc3 tobacco use, physical activity, anc3 sleep, through their influences on the production of stress hormones. Protective and Damaging Effects of Stress Mediators A behavioral response to challenge or stress can be protective or clam' aging.
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From page 44... ...
For example, even a brief period of exercise can enhance glucose uptake by reducing the insulin resistance of muscle tissue (Perseghin et al.,1996~. The mediators of protective anc3 damaging effects of allostatic responses are mainly adrenal steroids anc3 catecholamines.
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From page 45... ...
by an increase in circulating catecholamines from the autonomic nervous system and glucocorticoids from the adrenal cortex. This sets into motion adaptive processes that alter the structure and function of a variety of cellls and tissues.
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The third pattern entails the failure to terminate the hormonal stress response or the lack of appearance of the normal trough in the daily cortisol release pattern. Examples are increased blood pressure caused by work-relatec3 stress (Gerin anc3 Pickering, 1995)
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~ 1999) , who report that death from coronary heart disease (CHD)
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From page 48... ...
Neurotransmitters, Experience, and Behavior Changes in balance among neurotransmitters in the brain can influence behavioral responses to potentially stressful situations, can alter the interpretation of stimuli, and might be associated with anxiety and depression. Research that has accelerated rapidly over the past few decades reveals that the human brain has multiple neurotransmitters and neuromodulators.
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From page 49... ...
anc3 in primates (Johnson et al., 1996b; Shively et al., 19971. Social status affects the response of the HPA axis, such that hypothalamic CRH release is deficient in subordinate rats, which also show reclucec3 testosterone con' centrations uncler these conditions (Blancharc3 et al., 1993; Albeck et al., 1997~.
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From page 50... ...
Some important advances in animal model studies related to emotional experiences have recently been carried over to human brain func' tion. Human brain~imaging studies have shown that emotionally arousing information (pleasant or unpleasant)
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From page 51... ...
Those laboratory findings have been carried over to the human brain by magnetic resonance imaging. Hippocampal atrophy and cognitive impairment have been reported in conditions as adverse as Cushing's syn' urome, post~traumatic stress disorder, and recurrent major depression (for reviews, see McEwen et al., 1997; Sapolsky, 19961.
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From page 52... ...
Bidirectional interaction of common chemical mes' sengers anc3 cellular receptors connects the immune system with the ner' vous system anc3 the endocrine system. In this interactive communication between systems, sensory stimuli to the central nervous system that acti' vases the HPA axis result in the peripheral release of adrenal steroids anc3 catecholamines, both of which can have immunoregulatory effects.
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From page 53... ...
The recep' tars provide a mechanism for other physiologic systems to modulate immune responses. Activation of the HPA axis, which leads to systemic release of potent antiinflammatory substances, such as cortisol and other glucocorticoids, regulates inflammatory and immune responses (Berczi, 19981.
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From page 54... ...
This signal is transduced at the cellular and molecular levels leading to activation, trafficking and expression of effecter functions in the immune system. Products of the immune system, including cytokines, chemokines and growth factors can stimulate the nervous system resulting in the release of steroid hormones, catecholamines, opioids.
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From page 55... ...
Proinflammatory cytokines released in periph' eral tissues function as hormones, anc3 biologically are associated with the development anc3 expression of behaviors associated with illness (Dantzer et al., 1998; Maier et al., 1998) anc3 can induce chronic stress responses (Shanks et al., 1998~.
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From page 56... ...
Studies of experimental viral infections in mice demonstrate that both the HPA axis anc3 the sympathetic system alter virus-inclucec3 pathophysiology uncler conditions of imposec3 experimental stress (Hermann et al., 19931. The stress response also can suppress specific components of natural resistance anc3 adaptive immune responses to viral infection, both acute (Dobbs et al., 1993; Sheridan et al., 1991)
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From page 57... ...
The effects of disaster- related stress responses on the immune system have been stucliec3 (Ironson et al., 1997; Solomon et al., 19971. Major effects of distress of natural disasters include alterations in natural anc3 adaptive immunity, as inclicatec3 by lower natural killer- cell cytotoxicity (NKCC)
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From page 58... ...
Although the role of neurotrophin regulation in exercise is not known, it has been reported that voluntary exercise increases procluction of new neurons in the dentate gyrus of the hippocampus, the brain region that is important in spatial anc3 declarative memory (van Praag et al., 19991. The study of factors that promote resilience, still poorly clefinec3, is important as a complement to the more traditional approach of studying the damaging effects of stress mecliators.
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From page 59... ...
Patients who are more prone to poor coping have histories of social isolation, recent losses, or multiple obligations (Rowland, 1990~. Breast cancer patients who learn to use more direct anc3 confrontational coping strategies are less clistressec3 than are those who use avoic3ance anc3 denial (Holland anc3 Rowland, 19901.
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From page 60... ...
, anc3 in health-compromising responses to stress that include increased autonomic arousal anc3 elevated blood pressure (Baum anc3 Posluszny, 1999~. Extensive research documents that expression of emotions has beneficial effects on both emotional anc3 physical well-being (Esterling et al., 1999; Pennebaker, 19971.
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From page 61... ...
There is general agreement that acute stress can trigger acute cardiovascular events (Muller anc3 Toiler, 1990) , but the more subtle influences of chronic stress anc3 allostatic loac3 are not well unclerstooc3.
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From page 62... ...
There is experimental evidence that increased heart rate (Beere et al., 1984) anc3 increased blood pressure variability are both risk factors for atherosclerosis (Sasaki et al., 1994~.
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From page 63... ...
Although anticipation or experience of acute stress activates the HPA axis (Smyth et al., 1998) , the degree of activation with repeated exposure to stress is greatly variable (Kirschbaum et al., 1995~.
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From page 64... ...
' gators to examine inconsistencies and identify variables within the multi' faceted type A behavior patterns that were most predictive of CHD (Chesney et al., 1988; Matthews et al., 19771. These analyses revealed that hostility was the best variable for distinguishing men who clevelopec3 heart disease from men who clic3 not (Hecker et al., 1988; Matthews et al., 1977~.
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From page 65... ...
Vital E~austiorl One common premonitory symptom of myocarclial infarction is vital exhaustion, a state of excessive fatigue, increased irritability, and clemoralization (Appels et al., 19871. A prospective study of 3877 city employees in Rotterciam, The Netherlands, compared the risk of coronary heart clisease among those scoring in the highest third on a measurement scale of exhaustion to those with lower scores.
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From page 66... ...
Depression predicts significantly poorer outcome with heart disease (Denollet et al., 1996; Denollet anc3 Brutsaert, 1998; King, 1997) anc3 roughly doubles the risk of recurrent cardiovascular events (Barefoot et al., 1996; Barefoot anc3 Schroll, 1996; Frasure-Smith et al., 19951.
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From page 67... ...
Thus, cle' pression floes not seem to predict cancer incidence, but it is elevated among those who have cancer. Anxiety, Worry, arid Hope Anxiety anc3 worry have recently rece ivecl renewed attention as risk factors for cardiovascular disease.
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From page 68... ...
, including a genetic component that is heavily influenced by experience (van cler Boom, 1994~. The mi' nority of infants who have difficult temperaments can experience attachment problems anc3 high levels of stress, with consequences for their stress responses as aclults.
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From page 69... ...
Activation of specific neuroenclocrine systems, such as the HPA axis, also has been found in conditions of normative, acute stress, such as that which accompanies the transition to primary school (Boyce et al., 1995) , anc3 prolonged extreme neglect anc3 sensory deprivation, such as adverse rearing in a Romanian orphanage (Gunner, 1998~.
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From page 70... ...
(1993~. Depressed affect, hopelessness, and the risk of ischemic heart disease in a cohort of U.S.
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From page 71... ...
The association between 'vital exhaustion' and past, present and future coronary heart disease. Journal of Psychosomatic Research, 33, 727-738.
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From page 72... ...
American Journal of Psychiatry, 139, 741746. Bulloch, K
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( 1995~. Depression as a risk factor for cardiac events in established coronary heart disease: a review of possible mechanisms.
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(1996) Personality as independent predictor of long-term mortality in patients with coronary heart disease.
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(1999~. Catch-up growth in childhood and death from coronary heart disease: Longitudinal study.
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Psychosomatic Medicine, 54, 22-29. Glaser, R., Kiecolt-Glaser, J.K., Malarkey, W., and Sheridan, J.F.
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(1989~. Hostility, coronary heart disease, and total mortality: A 33-year follow-up study of university students.
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(1998~. Relationship of social support to stress responses and immune function in healthy and asthmatic adolescents.
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(1997~. Social capital, income inequality, and mortality.
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. Workplace conditions, socioeconomic status, and the risk of mortality and acute myocardial infarction: The kuopio ischemic heart disease risk factor study.
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(1986~. Hostility, coronary heart disease (CHD)
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From page 82... ...
American Journal of Cardiology, 66, 1-70.
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(1981~. Coronary-prone behavior and coronary heart disease: A critical review.
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From page 84... ...
and risk of recurrent coronary heart disease in the Aspirin Myocardial Infarction Study. AmericarlJourrlal of Cardiology, 56, 221-225.
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From page 85... ...
(1999~. Cardiac autonomic control buffers blood pressure variability responses to challenge: A psychophysiologic model of coronary artery disease.
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From page 86... ...
Washington, DC: Centers for Disease Control and Prevention National Center for Chronic Disease Prevention and Health Promotion. The President's Council on Physical Fitness and Sports.
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