Biological basis of the stress response.

Chronic, as well as acute emotional arousal, is a consequence of various types of social interaction, i.e., those between mother and infant and between controlling dominant and less effective subordinate. The neurohumoral accompaniments of this social stress include the sympathetic adrenal medullary and hypothalamic pituitary adrenal responses. A common ensuing pathophysiological state involves a chronic increase of blood pressure. Although Selye's General Adaptation Syndrome presupposed the same response to a variety of stimuli; recent work shows that specific perceptions of control result in different patterns of neuroendocrine activation. A challenge perceived as easy to handle will elicit an active coping response and release of the neurosympathetic system's norepinephrine. Testosterone will rise as the subject savors success. With increasing anxiety this active coping shifts to a more passive mode and the behavior becomes less assured as the animal loses control. The norepinephrine/epinephrine ratio decreases as epinephrine, prolactin, renin and fatty acids rise. As the outcome becomes still less certain and distress grows, adrenocorticotropic hormone and cortisol levels arise. Thus, the effort required on the one hand and the degree of frustration conflict and uncertainty on the other, determine the ratio of catecholamines to corticoids. With severe emotional trauma, brain dysfunction may occur. These effects can be lasting, and corticoids paradoxically return to normal as the behavior changes to that of post-traumatic stress disorder. Repression and denial set in and the organism responds with decreased concern of impaired attachment and increased irritability.