Stress and Health

William R. Lovallo (PhD, biological psychology, University of Oklahoma, 1978) conducts research on relationships between stress, biological responses, and their implications for health. His current projects address cardiovascular and endocrine responses during mental stress and effects on persons at risk for alcoholism and other addictions. He has served as director of the Behavioral Sciences Laboratories and as senior research career scientist at the VA Medical Center and is professor of psychiatry and behavioral sciences at the University of Oklahoma Health Sciences Center in Oklahoma City. Lovallo has also served as associate director of the John D. and Catherine T. MacArthur Foundation′s Research Network on Mind-Body Interactions. He is on advisory committees for the National Institutes of Health and the Veterans Administration.

• Chapter 1: Psychosocial Models of Health and DiseaseThe Standard Biomedical Model and New Approaches to MedicineA Biobehavioral Model of Disease and TreatmentPlacebo EffectsPsychoneuroimmunologyCultural, Intrapersonal, and Physiological Influences in Coronary Heart DiseasePsychosocial Theories of Disease and TreatmentThe Foundation of Behavioral MedicineChapter 2: History of the Concept of StressThe Age of Enlightenment and the Emergence of Scientific ThoughtDescartes and the Mechanical Model of Living ThingsThe Worldview and Premises of Modern ScienceThe Mind-Body problemClaude Bernard and the Modern Biomedical ModelClaude Bernard and the VitalistsWalter CannonDefinition of StressHans SelyeThe Concept of AllostasisAdditional Considerations on the Stress ConceptChapter 3: Homeostatic Regulation: Normal Function and Stress ResponsesA Hierarchy of Homeostatic ControlsIntrinsic Control MechanismsAutonomic Controls Over HomeostasisThree Autonomic DivisionsCoordinated Actions of the Autonomic BranchesHigher Controls Over HomeostasisThe Hypothalamus and Emotional ExpressionEndocrine Responses During StressAdrenomedullary ResponseAdrenocortical ResponseNegative Feedback by CortisolCortisol During StressBeta-endorphinChapter 4: Physical and Psychological StressClasses of Stress ResponsesThe Exercise ResponseExercise and Adaptation to StressThe Fight-or-Flight ResponseDifferent Emotions and Motivations Accompany Exercise and the Fight–Flight ResponseWhy Is Exercise Considered Good If It Is a Stressor?Psychological StressThe Responses to Aversive and Nonaversive ChallengesExposure to Noise and ShockActivation and DistressChapter 5: Central Nervous System Integration of the Psychological Stress ResponseAppraisals, Psychological Stress, and Negative EmotionsPrimary and Secondary AppraisalsOutcomes of Coping Efforts and Physiological ResponsesCentral Integration of the Response to Psychological StressThe Limbic System and Associated Parts of the BrainPrimary Appraisals: Sensory Intake and Interpretation of the EnvironmentWhat Is It? And Where Is It?Cognition and Emotion: Generating Emotions Based on Appraisal ProcessesPrefrontal-Limbic Interactions and Thoughts and FeelingsSecondary Appraisals: How Well Did Our Coping Attempt Work?Physiological Correlates of Primary and Secondary Appraisal ProcessesInternal Sources of Amygdaloid Activity and Internally Generated Emotional ResponsesInitiation of Behavioral, Autonomic, and Neuroendocrine Responses to Psychological StressorsFeedback to the Cortex and Limbic System: The Central Feedback SubsystemAutonomic and Endocrine Outflow: The Emotional Response SubsystemChapter 6: Stress and the Endocrine SystemOverview of Stress Endocrine RegulationActivation of Stress Endocrine Secretion and the Central Corticotropin-Releasing Factor SystemCortisol’s Feedback Actions in the Central Nervous SystemCortisol Effects on Frontal-Limbic ActivityAmygdala Responses to Cortisol and Altered Responsivity of the Central Nervous SystemAmygdala Sensitization and Potential Implications for HealthThe Hypothalamic-Sympatho-Adrenomedullary AxisStress Endocrine Secretion and Regulation of Long-Term Stress ReactivityHierarchy of Autonomic and Endocrine Controls Over Homeostasis Leading to Long-Term Memory FormationRecap: How Ideas Come to Have Power Over Our BodiesChapter 7: The Immune System Stress and BehaviorOverview of the Immune SystemStructural Components of the Immune SystemImmune System CellsImmune System MessengersInnate ResistanceAcquired Immunity and Establishment of Immune System MemoryThe Behavior-Immune InterfaceBehavior-Immune Interactions and Health IndicatorsStress Buffers, Positive Emotions, and Physical HealthChapter 8: Helplessness Coping and HealthDeath Due to Uncontrollable StressHelplessness and Exposure to Uncontrollable StressStudies of Ulceration in Rats“Learned Helplessness” and the Consequences of Lack of ControlLazarus’s Model of Psychological Stress and HelplessnessCentral Neurotransmitters and Severe StressUncontrollable Shock, Norepinephrine, and DepressionSerotonin MechanismsEmotions and HealthChapter 9: Genes, Stress, and BehaviorEarly Life Experience, Epigenetic Programming of Gene Expression, and Stress ReactivityA Rat Model of Early Experience, Development, and Responses to StressMaternal Separation and NeglectNurturing by Rat Mothers is Increased by Brief SeparationGenotype, Genetic Vulnerability to Early Life Adversity, and Psychobehavioral Outcomes in HumansChapter 10: Individual Differences in Reactivity to StressA Proposed Classification of Individual Differences in ReactivityPersons May Differ in Stress Reactivity Because of Inborn Factors or ExperienceIndividual Differences in Stress Responses May be Conditioned by Functional Alterations at Three Levels in the SystemIndividual Differences in Evaluative and Emotional Processes—Level IIndividual Differences in Hypothalamic and Brainstem Responses to Stress—Level IIIndividual Differences in Peripheral Responses to Stress—Level IIIChapter 11: Health Implications of Exaggerated and Blunted Stress ReactivityReactivity Tests in MedicineHealth Outcomes Related to Exaggerated Cardiovascular and Endocrine ReactivityIndividual Differences in Level I Reactivity and Health ImplicationsIndividual Differences in Level II Reactivity: Cardiovascular Reactivity as a Mediator of Disease RiskIndividual Differences in Level III Reactivity and DiseaseBlunted Stress Reactivity and HealthEarly Life Adversity and Blunted Stress ReactivityEarly Life Adversity, Psychological Characteristics, Cognition, and Behavioral RegulationEarly Life Adversity and Low Versus High Stress Reactivity: Unanswered QuestionsBlunted Stress Reactivity, Social Adversity, and HealthDiscussionExaggerated Reactivity and DiseaseBlunted Reactivity and DiseaseFamily Dysfunction, Socioeconomic Status, Neighborhood Characteristics, and Health OutcomesChapter 12: Behavior, Stress, and HealthThe Historical Dilemma of Mind-Body DualismMatter and BehaviorBehavioral Medicine in Relation to Traditional MedicineSystems Organization and StressPsychological Stress and Its ConsequencesStress and Behavioral MedicineStress, Stress Reduction, and Improved health