Stress (redirected from Tensile stress)

Stress 

Definition

Stress is defined as an organism's total response to environmental demands or pressures. When stress was first studied in the 1950s, the term was used to denote both the causes and the experienced effects of these pressures. More recently, however, the word stressor has been used for the stimulus that provokes a stress response. One recurrent disagreement among researchers concerns the definition of stress in humans. Is it primarily an external response that can be measured by changes in glandular secretions, skin reactions, and other physical functions, or is it an internal interpretation of, or reaction to, a stressor; or is it both?

Description

Stress in humans results from interactions between persons and their environment that are perceived as straining or exceeding their adaptive capacities and threatening their well-being. The element of perception indicates that human stress responses reflect differences in personality, as well as differences in physical strength or general health.

Risk factors for stress-related illnesses are a mix of personal, interpersonal, and social variables. These factors include lack or loss of control over one's physical environment, and lack or loss of social support networks. People who are dependent on others (e.g., children or the elderly) or who are socially disadvantaged (because of race, gender, educational level, or similar factors) are at greater risk of developing stress-related illnesses. Other risk factors include feelings of helplessness, hopelessness, extreme fear or anger, and cynicism or distrust of others.

Causes and symptoms

Causes

The causes of stress can include any event or occurrence that a person considers a threat to his or her coping strategies or resources. Researchers generally agree that a certain degree of stress is a normal part of a living organism's response to the inevitable changes in its physical or social environment, and that positive, as well as negative, events can generate stress as well as negative occurrences. Stress-related disease, however, results from excessive and prolonged demands on an organism's coping resources. It is now believed that 80-90% of all disease is stress-related.

Recent research indicates that some vulnerability to stress is genetic. Scientists at the University of Wisconsin and King's College London discovered that people who inherited a short, or stress-sensitive, version of the serotonin transporter gene were almost three times as likely to experience depression following a stressful event as people with the long version of the gene. Further research is likely to identify other genes that affect susceptibility to stress.

One cause of stress that has affected large sectors of the general population around the world since 2001 is terrorism. The events of September 11, 2001, the sniper shootings in Virginia and Maryland and the Bali nightclub bombing in 2002, the suicide bombings in the Middle East in 2003, have all been shown to cause short-term symptoms of stress in people who read about them or watch television news reports as well as those who witnessed the actual events. Stress related to terrorist attacks also appears to affect people in countries far from the location of the attack as well as those in the immediate vicinity. It is too soon to tell how stress related to episodes of terrorism will affect human health over long periods of time, but researchers are already beginning to investigate this question. In 2004 the Centers for Disease Control and Prevention (CDC) released a report on the aftereffects of the World Trade Center attacks on rescue and recovery workers and volunteers. The researchers found that over half the 11,700 people who were interviewed met threshold criteria for a mental health evaluation. A longer-term evaluation of these workers is underway.

A new condition that has been identified since 9/11 is childhood traumatic grief, or CTG. CTG refers to an intense stress reaction that may develop in children following the loss of a parent, sibling, or other loved one during a traumatic event. As defined by the National Child Traumatic Stress Network (NCTSN), "Children with childhood traumatic grief experience the cause of [the loved one's] death as horrifying or terrifying, whether the death was sudden and unexpected (for example, due to homicide, suicide, motor vehicle accident, drug overdose, natural disaster, war, terrorism, and so on) or due to natural causes (cancer, heart attack, and so forth). Even if the manner of death does not appear to others to be sudden, shocking, or frightening, children who perceive the death in this way may develop childhood traumatic grief. In this condition, even happy thoughts and memories of the deceased person remind children of the traumatic way in which the deceased died." More information on the identification and treatment of childhood traumatic grief can be obtained from the NCTSN web site, 〈http://www.nctsnet.org/nccts/nav.do?pid=hom_main〉.

Symptoms

The symptoms of stress can be either physical or psychological. Stress-related physical illnesses, such as irritable bowel syndrome, heart attacks, arthritis, and chronic headaches, result from long-term overstimulation of a part of the nervous system that regulates the heart rate, blood pressure, and digestive system. Stress-related emotional illness results from inadequate or inappropriate responses to major changes in one's life situation, such as marriage, completing one's education, becoming a parent, losing a job, or retirement. Psychiatrists sometimes use the term adjustment disorder to describe this type of illness. In the workplace, stress-related illness often takes the form of burnout—a loss of interest in or ability to perform one's job due to long-term high stress levels. For example, palliative care nurses are at high risk of burnout due to their inability to prevent their patients from dying or even to relieve their physical suffering in some circumstances.

Diagnosis

When the doctor suspects that a patient's illness is connected to stress, he or she will take a careful history that includes stressors in the patient's life (family or employment problems, other illnesses, etc.). Many physicians will evaluate the patient's personality as well, in order to assess his or her coping resources and emotional response patterns. There are a number of personality inventories and psychological tests that doctors can use to help diagnose the amount of stress that the patient experiences and the coping strategies that he or she uses to deal with them. A variation on this theme is to identify what the patient perceives as threatening as well as stressful. Stress-related illness can be diagnosed by primary care doctors, as well as by those who specialize in psychiatry. The doctor will need to distinguish between adjustment disorders and anxiety or mood disorders, and between psychiatric disorders and physical illnesses (e.g., thyroid activity) that have psychological side effects.

Treatment

Recent advances in the understanding of the many complex connections between the human mind and body have produced a variety of mainstream approaches to stress-related illness. Present treatment regimens may include one or more of the following:

Alternative treatment

Treatment of stress is one area in which the boundaries between traditional and alternative therapies have changed in recent years, in part because some forms of physical exercise (yoga, tai chi, aikido) that were once associated with the counterculture have become widely accepted as useful parts of mainstream stress reduction programs. Other alternative therapies for stress that are occasionally recommended by mainstream medicine include aromatherapy, dance therapy, biofeedback, nutrition-based treatments (including dietary guidelines and nutritional supplements), acupuncture, homeopathy, and herbal medicine.

Prognosis

The prognosis for recovery from a stress-related illness is related to a wide variety of factors in a person's life, many of which are genetically determined (race, sex, illnesses that run in families) or beyond the individual's control (economic trends, cultural stereotypes and prejudices). It is possible, however, for humans to learn new responses to stress and, thus, change their experiences of it. A person's ability to remain healthy in stressful situations is sometimes referred to as stress hardiness. Stress-hardy people have a cluster of personality traits that strengthen their ability to cope. These traits include believing in the importance of what they are doing; believing that they have some power to influence their situation; and viewing life's changes as positive opportunities rather than as threats.

Prevention

Complete prevention of stress is neither possible nor desirable, because stress is an important stimulus of human growth and creativity, as well as an inevitable part of life. In addition, specific strategies for stress prevention vary widely from person to person, depending on the nature and number of the stressors in an individual's life, and the amount of control he or she has over these factors. In general, however, a combination of attitudinal and behavioral changes works well for most patients. The best form of prevention appears to be parental modeling of healthy attitudes and behaviors within the family.

Resources

Books

Beers, Mark H., MD, and Robert Berkow, MD., editors. "Psychiatry in Medicine." In The Merck Manual of Diagnosis and Therapy. Whitehouse Station, NJ: Merck Research Laboratories, 2004.

Pelletier, Kenneth R., MD. The Best Alternative Medicine, Part I, "Spirituality and Healing." New York: Simon & Schuster, 2002.

Periodicals

Blumenthal, J. A., M. Babyak, J. Wei, et al. "Usefulness of Psychosocial Treatment of Mental Stress-Induced Myocardial Ischemia in Men." American Journal of Cardiology 89 (January 15, 2002): 164-168.

Cardenas, J., K. Williams, J. P. Wilson, et al. "PSTD, Major Depressive Symptoms, and Substance Abuse Following September 11, 2001, in a Midwestern University Population" International Journal of Emergency Mental Health 5 (Winter 2003): 15-28.

Centers for Disease Control and Prevention. "Mental Health Status of World Trade Center Rescue and Recovery Workers and Volunteers—New York City, July 2002–August 2004." Morbidity and Mortality Weekly Report 53 (September 10, 2004): 812-815.

Gallo, L. C., and K. A. Matthews. "Understanding the Association Between Socioeconomic Status and Physical Health: Do Negative Emotions Play a Role?" Psychological Bulletin 129 (January 2003): 10-51.

Goodman, R. F., A. V. Morgan, S. Juriga, and E. J. Brown. "Letting the Story Unfold: A Case Study of Client-Centered Therapy for Childhood Traumatic Grief." Harvard Review of Psychiatry 12 (July-August 2004): 199-212.

Hawkley, L. C., and J. T. Cacioppo. "Loneliness and Pathways to Disease." Brain, Behavior, and Immunity 17, Supplement 1 (February 2003): S98-S105.

Latkin, C. A., and A. D. Curry. "Stressful Neighborhoods and Depression: A Prospective Study of the Impact of Neighborhood Disorder." Journal of Health and Social Behavior 44 (March 2003): 34-44.

Ottenstein, R. J. "Coping with Threats of Terrorism: A Protocol for Group Intervention." International Journal of Emergency Mental Health 5 (Winter 2003): 39-42.

Ritchie, L. J. "Threat: A Concept Analysis for a New Era." Nursing Forum 39 (July-September 2004): 13-22.

Surwit, R. S., M. A. van Tilburg, N. Zucker, et al. "Stress Management Improves Long-Term Glycemic Control in Type 2 Diabetes." Diabetes Care 25 (January 2002): 30-34.

West, P., and H. Sweeting. "Fifteen, Female and Stressed: Changing Patterns of Psychological Distress Over Time." Journal of Child Psychology and Psychiatry 44 (March 2003): 399-411.

White, K., L. Wilkes, K. Cooper, and M. Barbato. "The Impact of Unrelieved Patient Suffering on Palliative Care Nurses." International Journal of Palliative Nursing 10 (September 2004): 438-444.

Organizations

The American Institute of Stress. 124 Park Avenue, Yonkers, NY 10703 (914) 963-1200. Fax: (914) 965-6267. http://www.stress.org.

Centers for Disease Control and Prevention. 1600 Clifton Rd., NE, Atlanta, GA 30333. (800) 311-3435, (404) 639-3311. http://www.cdc.gov.

National Child Traumatic Stress Initiative. Center for Mental Health Services, Substance Abuse and Mental Health Services Administration, Department of Health and Human Services, 5600 Fishers Lane, Parklawn Building, Room 17C-26, Rockville, MD 20857. (301) 443-2940. http://www.nctsnet.org/nccts/nav.do?pid=hom_main.

National Institute of Mental Health (NIMH). 6001 Executive Boulevard, Room 8184, MSC 9663, Bethesda, MD 20892-9663. (301) 443-4513. http://www.nimh.nih.gov.

Other

National Center for Post-Traumatic Stress Disorder, Department of Veterans Affairs. Fact Sheet: Survivors of Human-Caused and Natural Disasters. http://www.ncptsd.org/facts/disasters/fs_survivors_disaster.html.

National Institute of Mental Health (NIMH) news release, July 17, 2003. "Gene More Than Doubles Risk of Depression Following Life Stresses." 〈http://www.nimh.nih.gov/events/prgenestress.cfm〉.

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stress (stres)

1. forcibly exerted influence; pressure.

2. force per unit area.

3. in dentistry, the pressure of the upper teeth against the lower in mastication.

4. a state of physiological or psychological strain caused by adverse stimuli, physical, mental, or emotional, internal or external, that tend to disturb the functioning of an organism and which the organism naturally desires to avoid; see also stress reaction, under reaction.

5. the stimuli that elicit such a state or stress reactions.

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stress (strs)

n.

1. An applied force or system of forces that tends to strain or deform a body.

2. The resisting force set up in a body as a result of an externally applied force.

3. A physical or psychological stimulus that can produce mental tension or physiological reactions that may lead to illness.

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stress,

n any factor (environmental, chemical, physical, or emotional) that contributes to the “stress response” (physiologic reactions to tension). Has been implicated in a number of diseases—including asthma, autoimmune disease, cancer, cardiovascular disease, diabetes, depression, irritable bowel syndrome, premenstrual tension syndrome, rheumatoid arthritis, and ulcers.

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stress,

n 1. a force induced by or resisting an external force; measured in terms of force per unit area.
2. the force of energy directed against a tissue structure or against the function of tissue as the result of injury and trauma associated with fracture, burn, infection, surgical procedure, pharmacologic action, or anxiety states. The response to stress involves local metabolic function, the hormonal activity of the endocrine system regulated by the pituitary gland, and the autonomic and central nervous systems. The stress phenomenon is often associated with the general adaptation syndrome.
3. in prosthetic dentistry, forcibly exerted pressure (e.g., the pressure of the maxillary teeth against the mandibular teeth or the pressure contact of a distorted removable partial denture on the supporting teeth or ridge structures).

stress, axial,

n excessive force applied vertically to the teeth and their periodontium.

stress, bone in,

n the responses of bony structures to applied force. With application of excessive pressure stimuli to bone, adaptation may occur by the formation of thicker and more numerous trabeculae. If tissue components cannot compensate for excessive stress, bone resorption will occur.

stress, buccolingual,

n an excessive pressure exerted against teeth and their attachment apparatus from a buccal or lingual aspect.

stress, compressive,

n the internal induced force that opposes shortening of the material in a direction parallel to the direction of the stress.

stress control,

n See control, stress.

stress, damage to restorations by,

n a mechanical property that pertains to the capacity of substances used for restorative and preventive applications to loosen in response to continual pressure over time. See also strain.

stress response,

n the physiologic changes that occur as a result of threatening situations, including rapid breathing, increased heart rate, and increased perspiration. Also known as the “fight or flight” response.

stress, shearing,

n the internal induced force that opposes the sliding of one plane of the material on the adjacent plane in a direction parallel to the stress.

stress, tensile,

n the internal induced force that opposes elongation of a material in a direction parallel to the direction of stress.

stress-bearing area,

n See area, basal seat.

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stress

1. forcibly exerted influence; pressure, e.g. compression, tension.

2. the sum of the biological reactions to any adverse stimulus, physical, mental, or emotional, internal or external, that tends to disturb the homeostasis of an organism. Should these reactions be inappropriate, they may lead to disease states. The term is also used to refer to the stimuli that elicit the reactions, e.g. heat, nutritional, lactational, confinement, transportation. See also psychosomatic disease.

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stress induced diarrhea of the horse

see acute undifferentiated and chronic undifferentiated diarrhea of the horse.

porcine stress syndrome

see porcine stress syndrome.

stress reaction

see alarm reaction.

stress-starvation syndrome

said of sheep. See pregnancy toxemia.

stress testing

a test for evaluating circulatory response to physical stress produced by exercise. See also exercise testing.