Cognitive Therapy

By Alex Vernocci

✓ Do you know how stress can impact your health?
✓ Which are main disorders and illness stress can cause you?
✓ Do you know maternal stress can have effects on the child's development?
✓ How to recognize symptoms to anticipate the possibility of the disease getting worse?

Everyone perceives and reacts differently to daily situations and their emotional reaction will be positive (joy) or negative (fear) or even of total indifference in the case in which perception of the event is neutral.
People's reaction to stress can vary from subject to subject, depending on the circumstances.
The meaning given to a potentially-stressful factor influences the way the event is perceived and the way to face it.
Everyone, at least once in their own life, has experienced stress. It is not surprising that the exposition to stress is associated with a wide range of negative outcomes, such as a reduction of well-being, higher incidence of diseases, post-traumatic stress disorder, generalized anxiety disorder, and major depression.
Exposure to extreme stressors determine a strong emotional involvement and a feeling of helplessness can result in serious long-term effects inducing conditions of recurrent memories of trauma, sleep disturbances, physiological hyper-activation and intense psychological distress.
Somatization can generally be defined as the expression of psychological discomfort through physical symptoms, so anything that refers to a constant and inseparable interaction of the psyche (mind) and soma (body).
Furthermore, intense and prolonged stress can have significant effects between the pregnant woman and her fetus: numerous speculations have been made about its nature, however, recent scientific and technological advances have opened up new scenarios allowing to evaluate intrauterine life and better characterize this relationship.
Psychosomatic symptoms involve different body systems, such as:
★ Cardiovascular system
★ Respiratory system
★ Gastrointestinal system
★ Skin system
★ Endocrine system
★ Immune system
★ Urogenital system
★ Musculoskeletal system
... and others...

However, not all individuals develop similar diseases, as some resort to resilience, commonly referred as "the ability to maintain or improve mental health in stressful situations.”
The concepts of emotional regulation is explored in this book, as well as the mentalization, and emotional processing of anger experiences.

If you want to discover more, buy with confidence and start your journey!

• Language: English
• Publisher: Lulu.com
• Release date: Jan 4, 2021
• ISBN: 9781716260513

Book preview

Conclusions

Preface

According to a study conducted by the European Association against Stress and Cellular Aging, 70% of deaths are said to be due to illness caused by stress. Also, recent research conducted testify how stressful the condition is dependent on cultural enjoyment. These data give the idea of the severity and, at the same time, the complexity of the stress phenomenon.

Overseas the importance of stress is also attested by the fact that the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, one of the nosography systems for mental or psychopathological disorders most used by psychiatrists, psychologists, and doctors from all over the world, both in clinical practice and in research), it is giving a wide space to somatization disorders and stress.

The major theoretical-clinical knowledge on the condition of stress has increased awareness of the phenomenon and made it possible to detect the real incidence. European epidemiological data show how stress is a high impact condition: Sweden 35%, Norway 31%, Germany and France 28%, Italy 26%, Spain 19%, Netherlands 16%. The economic costs associated with the stress condition have a significant impact on national budgets. In France, work stress had an estimated incidence between € 2-3 billion on the national budget. In Germany it was quantified that 11 million working days are lost due to work stress, with an increase of 70% of absences in the last ten years. In Austria, it has been calculated that stress weighs 0.73% on national GDP due to medical treatment, lost productivity, and absenteeism.

Even in the United States, the phenomenon is taking on significant dimensions: 32% of men and 25% of women are affected by stress. In the US, there has been an increase in the past 12 years of 700% at the expense of antidepressants, of which 60% due to the condition of stress. From a comparison between Europe and the United States of the annual costs having stress as a driver, it emerges that there is an expenditure of 300 billion dollars in the USA, with a cost of 967 dollars per person, while in Europe, the total expenditure it is about 200 billion euros with a cost per person of only 404 euros.

This book analyzes the psychophysiological bases of the stress reaction, describing the forms of chronic and acute stress and the somatization and elaboration processes of the emotions underlying the phenomenon. A specific section will explore the theme of female stress variations, being a woman and a mother, describing both the relationships between maternal stress during pregnancy and the effects on the child's development, and the emblematic case of acute stress heart syndrome that mainly affects women.

Chapter 1 - The neuro-psychophysiological bases of the reaction from stress and somatization

1.1 Historical background

The term stress refers to a physical notion and denotes the force that, acting on an organism, modifies its characteristics. Already in 1600, experts were noting that any stimulation of the mind experienced as pain or pleasure, as expectation or fear, it is the cause of psychosomatic imbalance whose influence extends to the heart.

Also, Charles Darwin, in The expression of the emotions in man and animals, spoke of somatic manifestations of emotional states such as sweating, tachycardia, hairs erection, pupillary dilation. But it is some years later that stress becomes a studied topic, especially from a physiological point of view: he introduced the concept of stress to indicate the physiological changes caused by the perception of adverse situations, calling them alarm reaction.

For this new approach, as soon as a warning signal is received, the individual takes a response escape or attack, but once the threat has ceased, it returns to the state of internal equilibrium which it had been altered. In this regard, the author speaks of homeostasis to indicate a process regulation of the internal environment in response to external stimuli, which serves to guarantee optimal bodily functioning, an important concept that is still recognized valid today.

Therefore, the stress response is useful in the short term to cope with aversive stimuli but can be harmful if prolonged over time. Going through the origins of the studies on stress, we come to the discovery made in a way completely random by a physiologist in the 30s, who made some isolation attempts of a new sex hormone, he observed that laboratory guinea pigs were reacting in the same way to different harmful stimuli (extreme temperatures, intoxication by chemical substances, trauma, etc.), in a nonspecific way (decrease of the volume of thymus and lymph nodes, gastroduodenal ulcerations, increased glands adrenals).

Therefore, the physiologist defined stress as a non-specific body response at each request made to it, definition that leads to consider stress as the set of physiological variations caused by the perception of an adverse or threatening situation; the reaction can activate starting from specific stressors, or stressors that can be both physical and psychological.

Specifically, the General Adaptation Syndrome (GAS) was proposed, representing it in a three-stage model:

In this way, it was established a continuum between physiology and pathology, putting in evidence that the body responds with a general reaction, non-specific to heterogeneous stressors.

The short-term stress responses correspond to adaptive variations that help the subject to respond to stressor (for example, resistance to infections and inhibition of inflammatory processes), while long-term stress responses produce anti-adaptive variations (for example, the increase in sensitivity to infections, gastric ulcer).

Adaptation to environmental stressors it is the principle of life, so stress is not always negative as sometimes even acts as a motivating effect as an action mechanism is needed to react to achieve a certain purpose, and this positive and functional stress on the organism is defined eustress or acute stress; when, on the other hand, acute stress becomes chronic, it damages individual adaptation skills, and we speak of distress or dysfunctional stress.

Starting from this work, it was highlighted that the basis of various types of pathology could be a common pathogenic mechanism consisting of chronic activation of the hypothalamic-pituitary-adrenal axis, as well as immune-suppression defenses.

1.2 Neurophysiological aspects of the stress response

Stressful stimuli, whether internal or external, are picked up by our perceptive system based on sense organs and brought to the level of the thalamus; here the thalamic nuclei receive, process, and select sensory stimuli and transmit them to the amygdala, a structure located at the base of the brain that is part of the limbic system, which represents the nerve center that plays a key role in registering memories related to unpleasant events and circumstances and destined to activate emotions of fear and behavior related to this type of emotion.

The amygdala communicates with the hypothalamus, both with direct pathways and mediated by the locus coeruleus. The hypothalamic paraventricular nucleus free CRH (Corticotrophin Releasing Hormone), hormone release of corticotrophin, which acts as an alarm signal, activating two different routes: the endocrine route, known as the Hypothalamic-Pituitary-Adrenal (HPA) axis (long route), and the nervous system (NS) of the neuro-vegetative system (NVS) (short way).

In the endocrine pathway of stress, the CRH, released by the hypothalamus, arrives in the front part of the pituitary (adenohypophysis) called the pituitary gland, located at the base of the skull, which releases the Adrenocorticotropic hormone (ACTH) in the blood. ACTH, through the bloodstream, acts on another gland, the adrenal cortex, located in the upper area of the kidneys, and determines the release of glucocorticoids, among which the most important is cortisol, considered the stress hormone par excellence.

The neuroendocrine system is self-regulating (negative feedback), i.e., the circulating levels of cortisol are read by the hypothalamus and from the pituitary through specific receptors, which allow activation or inhibition of the system, depending on the circulating cortisol levels. The neuro-vegetative system, also called autonomous and which constitutes the other way, is divided into sympathetic and parasympathetic systems, whose activities compensate each other.

The sympathetic system acts through two neurotransmitters (adrenaline and noradrenaline), placing the body in a state of alert and preparing it for action, increasing cardiac and respiratory activities, inhibiting digestive function, dilating bronchi and pupils.

The parasympathetic system acts through an additional neurotransmitter (acetylcholine) and