It includes a state of alarm and adrenaline Epinephrine is a hormone and neurotransmitter that participates in the "fight or flight" response of the sympathetic nervous system. It is a catecholamine, a sympathomimetic monoamine produced by the adrenal glands from the amino acids phenylalanine and tyrosine production, short-term resistance as a coping mechanism, and exhaustion. Common stress symptoms include irritability, muscular tension, inability to concentrate and a variety of physical reactions, such as headaches and elevated heart rate.^[2]

Origin and terminology

The term "stress" was first used by the endocrinologist Endocrinology is a branch of medicine dealing with disorder of the endocrine system and its specific secretions called hormones, the integration of developmental events such as proliferation, growth, and differentiation (including histogenesis and organogenesis) and the coordination of metabolism, respiration, excretion, movement, reproduction, Hans Selye Hans Hugo Bruno Selye, CC (January 26, 1907 — October 16, 1982) was a Canadian endocrinologist of Austro-Hungarian origin and Hungarian ethnicity. Selye did much important factual work on the hypothetical non-specific response of the organism to stressors. While he did not recognize all of the many aspects of glucocorticoids, Selye was aware of in the 1930s to identify physiological responses in laboratory animals. He later broadened and popularized the concept to include the perceptions and responses of humans trying to adapt to the challenges of everyday life. In Selye's terminology, "stress" refers to the reaction of the organism, and "stressor" to the perceived threat.

Stress in certain circumstances may be experienced positively. Eustress Eustress is a term coined by endocrinologist Hans Selye, which is defined, in the model of Richard Lazarus , as stress that is healthy, or gives one a feeling of fulfillment or other positive feelings. Eustress is a process of exploring potential gains, for example, can be an adaptive response prompting the activation of internal resources to meet challenges and achieve goals.

The term is commonly used by laypersons in a metaphorical rather than literal or biological sense, as a catch-all for any perceived difficulties in life. It also became a euphemism, a way of referring to problems and eliciting sympathy without being explicitly confessional, just "stressed out".

It covers a huge range of phenomena from mild irritation to the kind of severe problems that might result in a real breakdown of health. In popular usage almost any event or situation between these extremes could be described as stressful.

Signs of stress may be cognitive, emotional, physical or behavioral and include (but are not limited to) symptoms such as: poor judgment, a general negative outlook, excessive worrying, moodiness, irritability, agitation, inability to relax, feeling overwhelmed, feeling lonely or isolated, depressed, aches and pains, diarrhea or constipation, nausea, dizziness, chest pain, rapid heartbeat, eating too much or not enough, sleeping too much or not enough, withdrawing from others, procrastinating or neglecting responsibilities, using alcohol, cigarettes, or drugs to relax, and nervous habits (e.g. nail biting, pacing).

Models

General Adaptation Syndrome

Hans Selye Hans Hugo Bruno Selye, CC (January 26, 1907 — October 16, 1982) was a Canadian endocrinologist of Austro-Hungarian origin and Hungarian ethnicity. Selye did much important factual work on the hypothetical non-specific response of the organism to stressors. While he did not recognize all of the many aspects of glucocorticoids, Selye was aware of researched the effects of stress^[3] on rats and other animals by exposing them to unpleasant or harmful stimuli. He found that all animals presented a very similar series of reactions, broken into three stages. In 1936, he described this universal response to the stressors as the general adaptation syndrome, or GAS.^[4][5]

Alarm is the first stage. When the threat or stressor is identified or realized, the body's stress response is a state of alarm. During this stage adrenaline will be produced in order to bring about the fight-or-flight response The "fight-or-flight response", also called the "fight-or-flight-or-freeze response", the "fright, fight or flight response", "hyperarousal" or the "acute stress response", was first described by Walter Cannon in 1915. His theory states that animals react to threats with a general discharge of the. There is also some activation of the HPA axis The hypothalamic-pituitary-adrenal axis , also known as the limbic-hypothalamic-pituitary-adrenal axis (LHPA axis), is a complex set of direct influences and feedback interactions among the hypothalamus (a hollow, funnel-shaped part of the brain), the pituitary gland (a pea-shaped structure located below the hypothalamus), and the adrenal (or, producing cortisol Cortisol is a corticosteroid hormone or glucocorticoid produced by the adrenal cortex, that is part of the adrenal gland . It is usually referred to as the "stress hormone" as it is involved in response to stress and anxiety, controlled by CRH. It increases blood pressure and blood sugar, and reduces immune responses. Various synthetic.

Resistance is the second stage. If the stressor persists, it becomes necessary to attempt some means of coping with the stress. Although the body begins to try to adapt to the strains or demands of the environment, the body cannot keep this up indefinitely, so its resources are gradually depleted.

Exhaustion is the third and final stage in the GAS model. At this point, all of the body's resources are eventually depleted and the body is unable to maintain normal function. At this point the initial autonomic nervous system The autonomic nervous system is the part of the central nervous system that acts as a control system functioning largely below the level of consciousness, and controls visceral functions. The ANS affects heart rate, digestion, respiration rate, salivation, perspiration, diameter of the pupils, micturition (urination), and sexual arousal. Whereas symptoms may reappear (sweating, raised heart rate etc.). If stage three is extended, long term damage may result as the capacity of glands, especially the adrenal gland, and the immune system is exhausted and function is impaired resulting in decompensation Decompensation is the functional deterioration of a previously working structure or system. Decompensation may occur due to fatigue, stress, illness, or old age. When a system is "compensated", it is able to function despite stressors or defects. Decompensation describes an inability to compensate for these deficiencies. It is a general.

The result can manifest itself in obvious illnesses such as ulcers A peptic ulcer, also known as ulcus pepticum, PUD or peptic ulcer disease, is an ulcer of an area of the gastrointestinal tract that is usually acidic and thus extremely painful. As many as 80% of ulcers are associated with Helicobacter pylori, a spiral-shaped bacterium that lives in the acidic environment of the stomach, however only 20% of those, depression Major depressive disorder is a mental disorder characterized by an all-encompassing low mood accompanied by low self-esteem, and loss of interest or pleasure in normally enjoyable activities. The term "major depressive disorder" was selected by the American Psychiatric Association to designate this symptom cluster as a mood disorder in, diabetes Diabetes mellitus —often referred to simply as diabetes—is a disease in which the body does not produce or properly use insulin. Insulin is a hormone produced in the pancreas, an organ near the stomach. Insulin is needed to turn sugar and other food into energy. In diabetes, the body either doesn't make enough insulin or can't use its own, trouble with the digestive system The digestive tract is the system of organs within multicellular animals that takes in food, digests it to extract energy and nutrients, and expels the remaining waste. The major function of the GI tract are ingestion, digestion, absorption, and defecation. The GI tract differs substantially from animal to animal. Some animals have multi-chambered or even cardiovascular The circulatory system is an organ system that transports nutrients , gases, hormones, blood cells, nitrogen waste products, etc. to and from cells in the body to help fight diseases and help stabilize body temperature and pH to maintain homeostasis. This system may be seen strictly as a blood distribution network, but some consider the problems, along with other mental illnesses.

Selye: eustress and distress

Hans Selye Hans Hugo Bruno Selye, CC (January 26, 1907 — October 16, 1982) was a Canadian endocrinologist of Austro-Hungarian origin and Hungarian ethnicity. Selye did much important factual work on the hypothetical non-specific response of the organism to stressors. While he did not recognize all of the many aspects of glucocorticoids, Selye was aware of published in 1975 a model dividing stress into eustress Eustress is a term coined by endocrinologist Hans Selye, which is defined, in the model of Richard Lazarus , as stress that is healthy, or gives one a feeling of fulfillment or other positive feelings. Eustress is a process of exploring potential gains and distress.^[6] Where stress enhances function (physical or mental, such as through strength training Strength training is the use of resistance to muscular contraction to build the strength, anaerobic endurance and size of skeletal muscles. There are many different methods of strength training, the most common being the use of gravity or elastic/hydraulic forces to oppose muscle contraction. See the resistance training article for information or challenging work) it may be considered eustress Eustress is a term coined by endocrinologist Hans Selye, which is defined, in the model of Richard Lazarus , as stress that is healthy, or gives one a feeling of fulfillment or other positive feelings. Eustress is a process of exploring potential gains. Persistent stress that is not resolved through coping or adaptation, deemed distress, may lead to anxiety Anxiety is a psychological and physiological state characterized by cognitive, somatic, emotional, and behavioral components. These components combine to create an unpleasant feeling that is typically associated with uneasiness, fear, or worry or withdrawal (depression Major depressive disorder is a mental disorder characterized by an all-encompassing low mood accompanied by low self-esteem, and loss of interest or pleasure in normally enjoyable activities. The term "major depressive disorder" was selected by the American Psychiatric Association to designate this symptom cluster as a mood disorder in) behavior.

The difference between experiences which result in eustress or distress is determined by the disparity between an experience (real or imagined), personal expectations, and resources to cope with the stress. Alarming experiences, either real or imagined, can trigger a stress response.^[7]

Lazarus: cognitive appraisal model

Lazarus ^[8]argued that in order for a psychosocial situation to be stressful, it must be appraised as such. He argued that cognitive processes of appraisal are central in determining whether a situation is potentially threatening, constitutes a harm/loss, a challenge, or is benign.

This primary appraisal is influenced by both person and environmental factors, and triggers the selection of coping processes. Problem-focused coping is directed at managing the problem, while emotion-focused coping processes are directed at managing the negative emotions. Secondary appraisal refers to the evaluation of the resources available to cope with the problem, and may alter the primary appraisal.

In other words, primary appraisal also includes the perception of how stressful the problem is; realizing that one has more than or less than adequate resources to deal with the problem affects the appraisal of stressfulness. Further, coping is flexible in that the individual generally examines the effectiveness of the coping on the situation; if it is not having the desired effect, s/he will generally try different strategies. ^[9]

Neurochemistry and physiology

The neurochemistry of the stress response is now believed to be well understood, although much remains to be discovered about how the components of this system interact with one another, in the brain and throughout in the body. In response to a stressor, corticotropin-releasing hormone Corticotropin-releasing hormone , originally named corticotropin-releasing factor (CRF), and also called corticoliberin, is a polypeptide hormone and neurotransmitter involved in the stress response (CRH) and arginine-vasopressin Arginine vasopressin , also known as vasopressin, argipressin or antidiuretic hormone (ADH), is a hormone found in most mammals, including humans. Vasopressin is a peptide hormone. It is derived from a preprohormone precursor that is synthesized in the hypothalamus and stored in vesicles at the posterior pituitary. Most of it is stored in the (AVP) are secreted into the hypophyseal portal system The hypophyseal portal system is the system of blood vessels that link the hypothalamus and the anterior pituitary in the brain and activate neurons of the paraventricular nuclei The paraventricular nucleus is a neuronal nucleus in the hypothalamus. It contains multiple subpopulations of neurons that are activated by a variety of stressful and/or physiological changes. Many PVH neurons project directly to the posterior pituitary where they release oxytocin or vasopressin into the general circulation. Other PVN neurons (PVN) of the hypothalamus The hypothalamus is a portion of the brain that contains a number of small nuclei with a variety of functions. One of the most important functions of the hypothalamus is to link the nervous system to the endocrine system via the pituitary gland . The hypothalamus, (from Greek ὑποθαλαμος = under the thalamus) is located below the.

The locus ceruleus The Locus coeruleus, also spelled locus caeruleus, is a nucleus in the brain stem involved with physiological responses to stress and panic. It was discovered in the 1700s by Félix Vicq-d'Azyr and other noradrenergic As a stress hormone, norepinephrine affects parts of the brain where attention and responding actions are controlled. Along with epinephrine, norepinephrine also underlies the fight-or-flight response, directly increasing heart rate, triggering the release of glucose from energy stores, and increasing blood flow to skeletal muscle cell groups of the adrenal medulla The adrenal medulla is part of the adrenal gland. It is located at the center of the gland, being surrounded by the adrenal cortex and pons The pons is a structure located on the brain stem. It is cranial to the medulla oblongata, caudal to the midbrain, and ventral to the cerebellum. In humans and other bipeds this means it is above the medulla, below the midbrain, and anterior to the cerebellum, collectively known as the LC/NE system As a stress hormone, norepinephrine affects parts of the brain where attention and responding actions are controlled. Along with epinephrine, norepinephrine also underlies the fight-or-flight response, directly increasing heart rate, triggering the release of glucose from energy stores, and increasing blood flow to skeletal muscle, also become active and use brain epinephrine Epinephrine is a hormone and neurotransmitter that participates in the "fight or flight" response of the sympathetic nervous system. It is a catecholamine, a sympathomimetic monoamine produced by the adrenal glands from the amino acids phenylalanine and tyrosine to execute autonomic and neuroendocrine Neuroendocrine [IPA nʊəroʊˈɛndəkrɪn] cells are cells that release a hormone into the circulating blood in response to a neural stimulus. These hormones may be amines, neuropeptides, or specialized amino acids. They package the hormones in vesicles and send these packages via long processes to blood vessels. When stimulated (by hormones from responses, serving as a global alarm system.^[10]

The autonomic nervous system The autonomic nervous system is the part of the central nervous system that acts as a control system functioning largely below the level of consciousness, and controls visceral functions. The ANS affects heart rate, digestion, respiration rate, salivation, perspiration, diameter of the pupils, micturition (urination), and sexual arousal. Whereas provides the rapid response to stress commonly known as the fight-or-flight response The "fight-or-flight response", also called the "fight-or-flight-or-freeze response", the "fright, fight or flight response", "hyperarousal" or the "acute stress response", was first described by Walter Cannon in 1915. His theory states that animals react to threats with a general discharge of the, engaging the sympathetic nervous system The Sympathetic Nervous System is a branch of the autonomic nervous system along with the enteric nervous system and parasympathetic nervous system. It is always active at a basal level (called sympathetic tone) and becomes more active during times of stress. Its actions during the stress response comprise the fight-or-flight response and withdrawing the parasympathetic nervous system The parasympathetic nervous system is a division of the autonomic nervous system (ANS), along with the sympathetic nervous system (SNS) and enteric nervous system (ENS or "bowels NS"). The ANS is a subdivision of the peripheral nervous system (PNS). ANS sends fibers to three tissues: cardiac muscle, smooth muscle, or glandular tissue, thereby enacting cardiovascular, respiratory, gastrointestinal, renal, and endocrine changes.^[10] The hypothalamic-pituitary-adrenal axis The hypothalamic-pituitary-adrenal axis , also known as the limbic-hypothalamic-pituitary-adrenal axis (LHPA axis), is a complex set of direct influences and feedback interactions among the hypothalamus (a hollow, funnel-shaped part of the brain), the pituitary gland (a pea-shaped structure located below the hypothalamus), and the adrenal (or (HPA), a major part of the neuroendocrine system Neuroendocrinology is the study of the interactions between the nervous system and the endocrine system. The concept arose from the recognition that the secretion of hormones from the pituitary gland is closely controlled by the brain, especially by the hypothalamus involving the interactions of the hypothalamus The hypothalamus is a portion of the brain that contains a number of small nuclei with a variety of functions. One of the most important functions of the hypothalamus is to link the nervous system to the endocrine system via the pituitary gland . The hypothalamus, (from Greek ὑποθαλαμος = under the thalamus) is located below the, the pituitary gland The pituitary gland, or hypophysis, is an endocrine gland about the size of a pea and weighing 0.5 g . It is a protrusion off the bottom of the hypothalamus at the base of the brain, and rests in a small, bony cavity (sella turcica) covered by a dural fold (diaphragma sellae). The pituitary fossa, in which the pituitary gland sits, is situated in, and the adrenal glands In mammals, the adrenal glands are the star-shaped endocrine glands that sit on top of the kidneys; their name indicates that position (ad-, "near" or "at" + renes, "kidneys"; and as concerns supra-, meaning "above"). They are chiefly responsible for regulating the stress response through the synthesis of, is also activated by release of CRH and AVP.

This results in release of adrenocorticotropic hormone Adrenocorticotropic hormone is a polypeptide tropic hormone produced and secreted by the anterior pituitary gland. It is an important component of the hypothalamic-pituitary-adrenal axis and is often produced in response to biological stress (along with corticotropin-releasing hormone from the hypothalamus). Its principal effects are increased (ACTH) from the pituitary into the general bloodstream, which results in secretion of cortisol Cortisol is a corticosteroid hormone or glucocorticoid produced by the adrenal cortex, that is part of the adrenal gland . It is usually referred to as the "stress hormone" as it is involved in response to stress and anxiety, controlled by CRH. It increases blood pressure and blood sugar, and reduces immune responses. Various synthetic and other glucocorticoids Glucocorticoids are a class of steroid hormones that bind to the glucocorticoid receptor (GR), which is present in almost every vertebrate animal cell. The name glucocorticoid (glucose + cortex + steroid) derives from from their role in the regulation the metabolsim of glucose, their synthesis in the adrenal cortex, and their steroidal structure ( from the adrenal cortex Situated along the perimeter of the adrenal gland, the adrenal cortex mediates the stress response through the production of mineralocorticoids and glucocorticoids, including aldosterone and cortisol respectively. It is also a secondary site of androgen synthesis. These corticoids involve the whole body in the organism's response to stress and ultimately contribute to the termination of the response via inhibitory feedback.^[10]

Stress can significantly affect many of the body's immune systems, as can an individual's perceptions of, and reactions to, stress. The term psychoneuroimmunology Psychoneuroimmunology is the study of the interaction between psychological processes and the nervous and immune systems of the human body. PNI takes an interdisciplinary approach, incorporating psychology, neuroscience, immunology, physiology, pharmacology, molecular biology, psychiatry, behavioral medicine, infectious diseases, endocrinology, is used to describe the interactions between the mental state, nervous and immune systems, as well as research on the interconnections of these systems.

Chronic stress has also been shown to impair developmental growth 'Developmental psychology', also known as human development, is the scientific study of systematic psychological changes that occur in human beings over the course of the life span. Originally concerned with infants and children, the field has expanded to include adolescence and adult development, aging, and the entire life span. This field in children by lowering the pituitary gland The pituitary gland, or hypophysis, is an endocrine gland about the size of a pea and weighing 0.5 g . It is a protrusion off the bottom of the hypothalamus at the base of the brain, and rests in a small, bony cavity (sella turcica) covered by a dural fold (diaphragma sellae). The pituitary fossa, in which the pituitary gland sits, is situated in's production of growth hormone, as in children associated with a home environment involving serious marital discord, alcoholism Alcoholism is a term with multiple and sometimes conflicting definitions to refer to the consumption of alcoholic beverages. In common and historic usage, alcoholism refers to any condition that results in the continued consumption of alcoholic beverages, despite health problems and negative social consequences. Modern medical definitions describe, or child abuse.^[11]

Common sources

Both negative and positive stressors can lead to stress. Some common categories and examples of stressors include: sensory input such as pain, bright light, or environmental issues such as a lack of control over environmental circumstances, such as food, housing, health, freedom, or mobility.

Social issues can also cause stress, such as struggles with conspecific or difficult individuals and social defeat, or relationship conflict, deception, or break ups, and major events such as birth and deaths, marriage, and divorce.

Life experiences such as poverty, unemployment, depression, obsessive compulsive disorder, heavy drinking ^[12], or insufficient sleep can also cause stress. Students and workers may face stress from exams, project deadlines, and group projects.

Adverse experiences during development (e.g. prenatal exposure to maternal stress,^[13][14] poor attachment histories,^[15] sexual abuse)^[16] are thought to contribute to deficits in the maturity of an individual's stress response systems. One evaluation of the different stresses in people's lives is the Holmes and Rahe stress scale.

Adaptation

Responses to stress include adaptation, psychological coping such as stress management, anxiety, and depression. Over the long term, distress can lead to diminished health and/or increased propensity to illness; to avoid this, stress must be managed.

Stress management encompasses techniques intended to equip a person with effective coping mechanisms for dealing with psychological stress, with stress defined as a person's physiological response to an internal or external stimulus that triggers the fight-or-flight response. Stress management is effective when a person utilizes strategies to cope with or alter stressful situations.

There are several ways of coping with stress, such as controlling the source of stress or learning to set limits and to say "No" to some demands that bosses or family members may make.

History and usage

The term "stress" had none of its current general senses before the 1950s. As a semi-psychological term referring to hardship or coercion, it dated from the 14th century. It is a form of the Middle English destresse, derived via Old French from the Latin stringere – to draw tight.^[17]

It had long been in use in physics to refer to the internal distribution of a force exerted on a material body, resulting in strain. In the 1920s and 1930s, the term was occasionally being used in psychological circles to refer to a mental strain or unwelcome happening, and by advocates of holistic medicine to refer to a harmful environmental agent that could cause illness. Walter Cannon used it in 1934 to refer to external factors that disrupted what he called "homeostasis".

A new scientific usage developed out of Hans Seyle's reports of his laboratory experiments in the 1930s. Selye started to use the term to refer not just to the agent but to the state of the organism as it responded and adapted to the environment. His theories of a universal non-specific stress response attracted great interest and contention in academic physiology and he undertook extensive research programmes and publication efforts.^[18]

However, while the work attracted continued support from advocates of psychosomatic medicine, many in experimental physiology concluded that his concepts were too vague and unmeasurable. During the 1950s Selye turned away from the laboratory to promote his concept through popular books and lectures tours.

The US military became a key center of stress research, attempting to understand and reduce combat neurosis and psychiatric casualties. Seyle wrote for both non-academic physicians and, in an international bestseller titled "Stress of Life", for the general public.

A broad biopsychosocial concept of stress and adaptation offered the promise of helping everyone achieve health and happiness by successfully responding to changing global challenges and the problems of modern civilization. He coined the term "eustress" for positive stress, by contrast to distress.

He argued that all people have a natural urge and need to work for their own benefit, a message that found favor with industrialists and governments.^[18] He also coined the term "stressor" to refer to the causative event or stimulus, as opposed to the resulting state of stress.

From the late 1960s, Selye's concept started to be taken up by academic psychologists, who sought to quantify "life stress" by scoring "significant life events", and a large amount of research was undertaken to examine links between stress and disease of all kinds. By the late 1970s stress had become the medical area of greatest concern to the general population, and more basic research was called for to better address the issue.

There was renewed laboratory research into the neuroendocrine, molecular and immunological bases of stress, conceived as a useful heuristic not necessarily tied to Selye's original hypotheses. By the 1990s, "stress" had become an integral part of modern scientific understanding in all areas of physiology and human functioning, and one of the great metaphors of Western life.^[18] Focus grew on stress in certain settings, such as workplace stress. Stress management techniques were developed.

Its psychological uses are frequently metaphorical rather than literal, used as a catch-all for perceived difficulties in life. It also became a euphemism, a way of referring to problems and eliciting sympathy without being explicitly confessional, just "stressed out".

It covers a huge range of phenomena from mild irritation to the kind of severe problems that might result in a real breakdown of health. In popular usage almost any event or situation between these extremes could be described as stressful.^[17]

The most extreme events and reactions may elicit the diagnosis of Posttraumatic stress disorder (PTSD), an anxiety disorder that can develop after exposure to one or more terrifying events that threatened or caused grave physical harm. PTSD is a severe and ongoing emotional reaction to an extreme psychological trauma; as such, it is often associated with soldiers, police officers, and other emergency personnel.

This stressor may involve viewing someone's actual death, a threat to the patient's or someone else's life, serious physical injury, or threat to physical or psychological integrity, overwhelming usual psychological defenses coping. In some cases it can also be from profound psychological and emotional trauma, apart from any actual physical harm. Often, however, the two are combined.

See also

• Stress management
• Jon Kabat-Zinn
• Burnout (psychology)
• Defense Physiology
• Hypothalamic-pituitary-adrenal axis
• Oxidative stress
• Compassion fatigue
• Self-medication
• Work-life balance

References

1. ^ The Stress of Life, Hans Selye, New York: McGraw-Hill, 1956.
2. ^ Stress can occur in a variety of methods, including anxiety. Anxiety is a form of stress but may have different symptoms, and diffent bodily reactions.EHealthMD: What is stress Retrieved September 3, 2008.
3. ^ Selye, Hans (1950). "Diseases of adaptation". Wisconsin medical journal 49 (6): 515–6.
4. ^ Selye, Hans (1936). "A syndrome produced by diverse nocuous agents". Nature 138: 32. doi:10.1038/138032a0.
5. ^ "Selye Biologic Reaction to Stress chart", Chronic Fatigue Unmasked, by Dr. Gerald E. Poesnecker, February 1999 (ISBN 0916285618)
6. ^ Selye (197). Confusion and controversy in the stress field. 1. pp. 37–44.
7. ^ Ron de Kloet, E; Joels M. & Holsboer F. (2005). "Stress and the brain: from adaptation to disease". Nature Reviews Neuroscience 6 (6): 463–475. doi:10.1038/nrn1683. PMID 15891777.
8. ^ name = "Lazarus">((cite book |last = Lazarus | first = RS |date = 1966 | title = Psychological Stress and the Coping Process | publisher = McGraw-Hill | location = New York
9. ^ Aldwin, Carolyn (2007). Stress, Coping, and Development, Second Edition. New York: The Guilford Press. ISBN 1572308400.
10. ^ ^{a b c} Tsigos, C. & Chrousos, G.P. (2002). Hypothalamic-pituitary-adrenal axis, neuroendocrine factors, and stress. Journal of Psychosomatic Research, 53, 865-871.
11. ^ Powell, Brasel, & Blizzard, 1967.
12. ^ Glavas MM, Weinberg J (2006). "Stress, Alcohol Consumption, and the Hypothalamic-Pituitary-Adrenal Axis". in Yehuda S, Mostofsky DI. Nutrients, Stress, and Medical Disorders. Totowa, NJ: Humana Press. pp. 165–183. ISBN 978-1-58829-432-6.
13. ^ Davis et al. (June 2007). Prenatal Exposure to Maternal Depression and Cortisol Influences Infant Temperament. Journal of the American Academy of Child & Adolescent Psychiatry, v46 n6 p737.
14. ^ O'connor, Heron, Golding, Beveridge & Glover. (June 2002). Maternal antenatal anxiety and children's behavioural/emotional problems at 4 years. Br J Psychiatry. 180:478-9.
15. ^ Schore, Allan (2003). Affect Regulation & the Repair of the Self. New York: W.W. Norton. ISBN 0393704076.
16. ^ Michael D. DeBellis, George P. Chrousos, Lorah D. Dorn, Lillian Burke, Karin Helmers, Mitchel A. Kling, Penelope K. Trickett, and Frank W. Putnam. Hypothalamic—Pituitary—Adrenal Axis Dysregulation in Sexually Abused Girls
17. ^ ^{a b} Keil, R.M.K. (2004) Coping and stress: a conceptual analysis Journal of Advanced Nursing, 45(6), 659–665
18. ^ ^{a b c} Viner, R. (1999) Putting Stress in Life: Hans Selye and the Making of Stress Theory Social Studies of Science, Vol. 29, No. 3 (Jun., 1999), pp. 391-410

• Petersen, C., Maier, S.F., Seligman, M.E.P. (1995). Learned Helplessness: A Theory for the Age of Personal Control. New York: Oxford University Press. ISBN 0-19-504467-3
• Seligman, M.E.P. (1975). Helplessness: On Depression, Development, and Death. San Francisco: W.H. Freeman. ISBN 0-7167-2328-X
• Seligman, M.E.P. (1990). Learned Optimism. New York: Knopf. (Reissue edition, 1998, Free Press, ISBN 0-671-01911-2).
• Holmes, T.H. and Rahe, R.H. (1967). The social readjustments rating scales. Journal of Psychosomatic Research 11:213-218.

External links

• The American Institute of Stress
• University of Massachusetts Medical School Stress Reduction Program
• "Research on Work-Related Stress", European Agency for Safety and Health at Work (EU-OSHA)
• "Working on Stress", European Agency for Safety and Health at Work (EU-OSHA)
• "Taming Stress", Scientific American, September 2003
• Self help guide (NHS Direct)

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