Preface xiii Acknowledgments xvi 1 Stressors, Stress, and Distress 1 What this book is about 1 What do we mean when we talk about stressors? 3 The characteristics of stressors: comparing apples, oranges, and lemons 5 Chronic stressors and allostatic overload 10 Before you go 11 2 Individual Differences in Relation to Stressors and Stress Responses 12 Vulnerability and resilience 13 Genetic influences 13 Age 17 Sex 18 Personality differences in relation to stress responses 18 Previous stressor experiences 19 Stress generation 19 Before you go 20 3 Appraising Stressful Events 21 Appraising stressors 22 Guidance through primary and secondary appraisals 22 Thinking fast and slow 22 Guideposts and anchors 25 Appraisals based on what others think 27 Appraisals in relation to learning, memory, automaticity, expectation, and habit 28 Positive and negative emotions 30 Gauging stressors 31 Before you go 33 4 Coping with Stressors 35 First responses to stressors 36 Coping methods 36 Personal growth and finding meaning 38 Social support 40 Loneliness 40 Unsupportive interactions 42 Social rejection 44 Forgiveness and trust 46 Empathy 48 Before you go 48 5 Hormones and What They Do 50 What s a hormone? 51 Linking hormones and behaviors 51 The hormonal stress response 54 Hormones of the autonomic nervous system 54 The hypothalamic ]pituitary ]adrenal (HPA) axis and glucocorticoids 55 What cortisol (corticosterone) does for us 55 The cortisol/corticosterone response to an acute stressor 55 Cortisol variations in humans 56 Yesterday s stressors influence today s responses 59 A cacophony of hormones associated with stress, eating and energy regulation: leptin, ghrelin, CRH, and neuropeptide Y 60 Oxytocin and positive responses 62 Estrogen and testosterone 64 Before you go 67 6 Neurotransmitter Processes and Growth Factors 69 Neuronal and glial processes in relation to challenges 70 Stressors influence neurotransmitter functioning 72 Acetylcholine (ACh) 72 Serotonin, norepinephrine and dopamine 75 Corticotropin releasing hormone (CRH): beyond the HPA system 76 Glutamate 78 Gamma ]aminobutyric acid (GABA) 79 Cannabinoids 79 Neurotrophic factors 80 The past influences the future 82 Before you go 83 7 Immunological Effects of Stressors 84 A brief look at how the immune system works 85 Cells of the immune system 86 Immune memories 87 Cytokines: messenger molecules of the immune system 88 Immune hormone interactions 88 Stress, brain processes, and immunological changes 91 Cytokine changes in response to stressors 93 Before you go . 93 8 Stress across the Life Span 95 Connections over time 96 Prenatal experiences 96 Biological correlates of prenatal stress in humans 98 Consequences of prenatal infection in animals and humans 99 Stress experienced early in life 101 Transitional periods 104 Older age 106 Before you go 107 9 Cardiovascular Disease 108 Coronary artery disease (CAD) 109 The heart s response to a challenge 109 Psychosocial factors associated with heart disease 110 The influence of stressors on heart disease 110 Job strain 112 Depressive illness and heart disease 113 Socioeconomic status (SES) 114 Sex ]dependent trajectories for heart disease 114 Personality factors and heart disease 115 Type A personality 115 Type D personality 116 Physiological stress responses associated with heart disease 116 Sympathetic nervous system reactivity 116 Inflammatory processes in heart disease 117 Stress, pathogen burden, and heart disease 118 Obesity, cytokines, and heart disease 119 Before you go 120 10 Diabetes 121 Type 1 diabetes 122 Type 2 diabetes 122 Stressor influences in relation to the development of Type 2 diabetes 123 Immune factors in Type 2 diabetes 126 Genetic contributions 127 Before you go 127 11 Stress, Immunity, and Disease 128 Immunity and illness 128 Allergies 129 Infectious illness 130 Stressors influence vulnerability and the course of infectious illness 133 Autoimmune disorders 134 Exacerbation of autoimmune disorders by stressful experiences 137 Before you go 137 12 Stress and Cancer: Cancer and Stress 138 The cancer process 139 The stress cancer link 141 Implication for cancer treatment 144 Stress stemming from cancer 145 Treating cancer ]related distress 147 Before you go 148 13 Depressive Illnesses and Cognitive Mistakes 149 What is depression? 150 Depressive subtypes 152 Cognitive theories of depressive disorders 153 Helplessness 153 Hopelessness 154 Depression from an evolutionary perspective 156 Depression from a neurochemical vantage 158 Neurobiological explanations of depressive disorders 158 Serotonin, norepinephrine and dopamine in relation to depressive disorders 159 Gene and environmental interactions 160 Reward processes in depression: dopamine and anhedonia 161 Depression and anxiety: corticotropin releasing hormone (CRH) as a player in depression 162 Coordination and discoordination of neuronal process: gamma ]aminobutyric acid (GABA) 163 Growth factors and depression 164 Inflammatory processes and depressive disorders 165 Before you go 169 14 Fretting over Anxiety Disorders 171 A plague of anxiety disorders 172 Generalized anxiety disorder (GAD) 172 Panic disorder 173 Obsessive ]compulsive disorder (OCD) 174 Phobias and social anxiety 177 Before you go 178 15 Acute Stress Disorder and Posttraumatic Stress Disorder 179 Acute stress disorder 180 Posttraumatic stress disorder 180 Vulnerability and resilience 181 Neuroanatomical underpinnings of PTSD 182 Biochemical determinants of PTSD 184 CRH and corticoids in relation to PTSD ]related memories 185 Norepinephrine and serotonin and PTSD ]related memories 187 GABA and the extinction of fear responses in PTSD 187 Neuropeptide Y (NPY) and resilience 188 Before you go 188 16 Addictions and Forbidden Fruits 190 What s an addiction 190 Stress as a provocateur in the addiction process 191 Reward and aversion in relation to addiction: a multistep process 191 Dopamine in relation to stress and reward 192 Corticotropin hormone in relation to stress and addiction 193 Can eating become an addiction? 195 An integrated perspective 195 Treatment for addictions 196 Before you go 197 17 Coping with Illness, Caregiving, and Loss 199 How might illness come to affect health? 200 Major physical illnesses 201 What patients know and what they need to know 201 Appraising and coping with illness 202 Personal control, decision ]making, and trust 203 Social support and unsupportive interactions in the face of illness 204 Mood changes associated with illness 205 Adjustment to chronic illnesses: psychological resilience in the face of illness 206 Stress associated with caregiving 207 Loss and grief 208 Before you go 209 18 The Workplace for Better or Worse 211 Job ]related distress 212 Status and job strain 212 Burnout 212 Absenteeism and presenteeism 212 Bullying in the workplace 213 Social support in the workplace 215 Trust in the workplace 216 Unemployment 216 Time management and juggling 217 Before you go 218 19 Transmission of Trauma across Generations 220 Traveling across generations 221 Parental stress influences on children 221 Intergenerational effects of trauma: beyond poor parenting 222 Environments modify gene actions 223 The case of epigenetic effects 223 Collective and historic trauma 226 Before you go 229 20 Stress Reduction through Cognitive and Behavioral Strategies 231 Prelude to dealing with stress 232 Relaxation training 233 Exposure therapy 233 Cognitive behavioral therapy (CBT) 234 Interpersonal psychotherapy (IPT) 237 Meditation 237 Mindfulness 238 The default mode network 240 Positive psychotherapy (PPT) 241 Giving and receiving 242 The social cure 243 Before you go 244 21 Drug Remedies to Attenuate Stress and Stress ]Related Disorders 246 Something about drug treatments 247 Placebo and nocebo responses 247 Selecting the right treatment and related caveats 249 Treating depression 250 Selective serotonin reuptake inhibitors (SSRIs) 250 A cocktail of acronyms: SNRI, NDRI, NaSSA, MAOI 253 Ketamine 256 Deep brain stimulation 257 Anti ]inflammatory agents 258 Treating anxiety disorders 259 Treating PTSD 259 Herbal (naturopathic) treatments 262 Before you go 266 22 Epilogue 267 It s OK to go now 267 References 269 Index 272
