1,720,989 research outputs found
Resiliencing in the face of adversity: Causes and consequences of psychoemotional stress, appraisal and coping from a neurobiological perspective
No full textin gynecological practice, psychoemotional irritation, fear, anxiety and feelings of helplessness are much more often seen and play a much greater role than in may other somatic medical disciplines. Whether or not a certain diagnosis or treatment will trigger a psychoemotional stress response is primarily dependent on the subjective judgment and the appraisal of the situation by the individual patient. This response can only partly be influenced by the medical practitioners. It is governed by the previous experiences made by the individual patient in the course of her life. This contribution describes how such subjective experiences of failure and of success in mastering difficult situations are anchored in the brain. Alternating experiences of the controllability and the uncontrollability of stressors are required for the facilitation and stabilization of neuronal networks and synaptic connections. Based on the current knowledge about the use- and experience-dependent adaptive modification and reorganization of neuronal connectivity, the reasons are discussed which will make certain patients either more vulnerable or more resistant to stressful life events. it is described why the internalized attitudes and views of the individual patient are of uttermost importance for her appraisal. The prerequisites and conditions for the acquisition of resource-strengthening attitudes and views are discussed
Anxiety and stress-induced disorders. Towards a neurobiologically based psychotherapy
No full textAnxiety and stress-induced disorders are used in this contribution as an example to demonstrate how effectively neurobiological research findings can be used to improve psychotherapeutical interventions. The acquisition and facilitation of maladaptive coping strategies is the result of the activation of a cascade of emergency reactions which cannot be halted by the activation of available pro-adaptive coping strategies. Such experiences of uncontrollability and helplessness undermine the most essential resources to deal with stress and pave the way to the manifestation of disturbances at the level of secure attachment, self-efficacy, trust, affect control, self-regulation etc. Psychotherapeutic interventions will be most effective if they focus on the restoration of the resources at the level at which the maladaptive coping pattern became primarily stabilized (relational, emotional, cognitive approaches)
Physiological and psychological stress responses in adult patients with Attention-Deficit/Hyperactivity Disorder (ADHD)
No full textPhysiological and psychological stress responses in adults with attention-deficit/hyperactivity disorder (ADHD)
No full textAccording to self-report and unsystematic observational data adult patients with attention-deficit/hyperactivity disorder suffer from increased vulnerability to daily life stressors. The present study examined psychological and physiological stress responses in adult AND subjects in comparison to healthy controls under laboratory conditions. Thirty-six subjects (18 patients with DSM-IV ADHD diagnosis, 18 sex- and age-matched healthy controls) underwent the Trier Social Stress Test (TSST; Kirschbaum, C., Pirke, K.-M., Hellhammer, D.H., 1993. The "Trier Social Stress Test" -a tool. for investigating psychobiological stress responses in a laboratory setting. Neuropsychobiology 28, 76-81), a standardized psychosocial stress protocol which contains a stress anticipation phase and a stress phase with a free speech assignment and subsequent performance of a mental arithmetic. Physiological stress measures were salivary cortisol as an indicator of the HPA axis, heart rate (HR), and time- and frequency-domain heart rate variability (HRV) parameters. Subjective stress experience was measured via self-report repeatedly throughout the experimental session. In line with previous theoretical and empirical work in the field of childhood ADHD, it was hypothesized that the AND and control group would exhibit comparable baseline levels in all dependent variables. For AND subjects, we expected attenuated responses of the physiological parameters during anticipation and presence of the standardized stressor, but elevated subjective stress ratings. Hypotheses were confirmed for the baseline condition. Consistent with our assumptions in regard to the psychological stress response, the ADHD group experienced significantly greater subjective stress. The results for the physiological variables were mixed
Altered circadian melatonin secretion patterns in relation to sleep in patients with chronic sleep-wake rhythm disorders
No full textInteractions between evening and nocturnal cortisol secretion and sleep parameters in patients with severe chronic primary insomnia
No full textRecent research provides evidence for an interaction between sleep and the activation of the hypothalamic-pituitary-adrenal (HPA)-axis, but detailed studies in patients are still missing. We investigated hourly evening and nocturnal plasma cortisol secretion and sleep in seven male patients with severe chronic primary insomnia and age- and gender-matched controls. Evening and nocturnal cortisol levels were significantly increased in patients. Evening cortisol correlated with the number of nocturnal awakenings in patients and controls. Additionally, patients showed significant correlations between sleep parameters and the first 4 h of nocturnal cortisol secretion. These results are indicative of changes in the HPA system in insomnia and may reflect a path of physiological mechanism of chronic insomnia resulting in a vicious cycle of both disturbed HPA functions and chronic insomnia according to the arousal hypothesis of insomnia. (C) 2002 Elsevier Science Ireland Ltd. All rights reserved
Presence of melatonin in the human hepatobiliary-gastrointestinal tract
No full textA variety of speculations about the possible origin and physiological role of the neurohormone melatonin in the gastrointestinal tract exist. However, the experimental evidence supporting any of these theories is not substantial and are missing for humans. We studied the distribution of melatonin which was measured with radioimmunoassay in the following compartments and organs of the human hepatobiliary-gastrointestinal tract: bile (obtained by endoscopic retrograde cholangiopancreaticography), peripheral venous and portal venous blood (obtained from patients undergoing liver transplantation), endoscopically derived biopsies (mainly consisting of mucosa and submucosa) of stomach, duodenum, large intestine as well as in resected liver tissue. Melatonin concentrations in gastrointestinal mucosa were between 136 +/- 27 pg/100mg (stomach) and 243 +/- 37 pg/100mg (descending colon, each n = 5). Biliary melatonin concentrations (85 +/- 45 pg/ml) correlated well with plasma concentrations (55 +/- 38 pg/ml, each n = 14) and a considerable amount of melatonin (about 51 ng/24 hours) appears to be excreted into the gut via the bile duct. Melatonin concentrations were slightly higher in portal than in peripheral venous blood and also the liver contained higher concentrations of melatonin than the blood. In conclusion the presence and distribution of melatonin in human gut, bile, liver and portal blood and the various reports on modulatory actions of melatonin on gut and liver functions suggest that melatonin may act as a mediator of inter-organ communication between gut and liver. (C) 2001 Elsevier Science Inc. All rights reserved
Cortisol in night-urine: Introduction of a research method in psychoneuroendocrinology
No full textCortisol is one of the major parameters investigated in psychoneuroendocrinological research, but the methods employed for sample collecting are often unsatisfactory, A suitable method of sample collection should allow for the integrative assessment of long-term changes of the HPA-system, should be non-invasive, and should not exceed the subject's compliance. The assessment of cortisol in night-urine fulfils these demands; although this method has been occasionally employed, it has not yet been described systematically, For the first time a detailed description is given here that allows for a standardized replication. In ten previous studies and three investigations of our own this method has been successfully applied to detect changes in the cortisol excretion of patients with endocrinological and psychiatric disorders as well as in subjects under conditions of psychosocial stress. The determination of cortisol in night-urine represents an ideal method for the assessment of changes in the basal HPA-activity in numerous areas of psychoneuroendocrinological research, e.g. field and screening studies in natural environment, clinical studies in psychiatry and especially follow-up studies in psychotherapy research
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