Episodes Of Acute Stress Research Articles

A neuronal coping mechanism linking stress-induced anxiety to motivation for reward.

Stress coping involves innate and active motivational behaviors that reduce anxiety under stressful situations. However, the neuronal bases directly linking stress, anxiety, and motivation are largely unknown. Here, we show that acute stressors activate mouse GABAergic neurons in the interpeduncular nucleus (IPN). Stress-coping behavior including self-grooming and reward behavior including sucrose consumption inherently reduced IPN GABAergic neuron activity. Optogenetic silencing of IPN GABAergic neuron activation during acute stress episodes mimicked coping strategies and alleviated anxiety-like behavior. In a mouse model of stress-enhanced motivation for sucrose seeking, photoinhibition of IPN GABAergic neurons reduced stress-induced motivation for sucrose, whereas photoactivation of IPN GABAergic neurons or excitatory inputs from medial habenula potentiated sucrose seeking. Single-cell sequencing, fiber photometry, and optogenetic experiments revealed that stress-activated IPN GABAergic neurons that drive motivated sucrose seeking express somatostatin. Together, these data suggest that stress induces innate behaviors and motivates reward seeking to oppose IPN neuronal activation as an anxiolytic stress-coping mechanism.

A case of outpatient treatment in a 58-year-old woman with hoarding disorder and hallucinations.

IntroductionIn hoarding disorder the patient has a strong tendency to collect and accumulate objects with or without value and great difficulty in destroying them.In this case, a 58-year-old woman diagnosed with a hoarding disorder 5 years ago, came to a psychiatry clinic due to frequent auditory hallucinations related to episodes of acute stress. She received treatment in an outpatient mental health unit which consisted of psychopharmaceuticals and cognitive behavioural therapy. The patient achieved a partial remission of the hallucinations and a clinical improvement of the accumulation symptoms.ObjectivesThe main objective of this study is to describe the psychiatric and psychological treatment of this patient. We also performed a review of the available literature on comorbidity of the symptoms of Diogenes syndrome and psychotic symptoms.MethodsA close follow-up of the psychopathology of this patient was carried out and we did a database search in PubMed to document the case, with the keywords: “hoarding disorder”, “psychotic disorder”, “comorbidity”, “hallucination”, with the inclusion criteria: In the last ten years, Spanish and English language.ResultsThe patient, who was being treated with sertraline 100 mg, started treatment with olanzapine 10 mg and with a psychotherapeutic plan with different objectives: stabilization of symptoms, reduction of hoarding behaviours, letting go of objects, as well as coping with stressful situations. Cognitive behavioural techniques such as psychoeducation, exposure with response prevention and cognitive therapy were included in the psychological treatment. After one year of treatment the hallucinatory symptoms have remitted and the patient’s daily functioning has improved. The most resistant symptoms are those of accumulation that are slowly decreasing but the patient has stopped collecting objects from the street.ConclusionsMore studies of the treatment of hoarding disorder and more investigation of its possible comorbidities are needed.Disclosure of InterestNone Declared

Altered Cav1.2 trafficking contributes to β-adrenergic receptor hypo-responsivity in the aging myocardium

Progressive, age-associated CaV1.2 hypo-responsivity to β-adrenergic receptor (βAR)-stimulation occurs in both human and animal hearts, reducing inotropic reserve and diminishing their capacity to manage episodes of acute stress. Disruption of this crucial regulatory mechanism lowers the threshold for heart failure, yet the causal links between aging and βAR hypo-responsivity remain unclear. We have previously reported that a pre-synthesized pool of sub-sarcolemmal CaV1.2-containing vesicles/endosomes resides in cardiomyocytes and can be mobilized to the sarcolemma in response to βAR stimulation to tune EC-coupling.

The aftermath of the Covid-19 crisis in the field of intimacy: How to bounce back and rethink our values?

Human relationships and bonding reconfigure and reinvent themselves over time. For several decades, it has been interesting to note that both the digital dimension and the development of artificial intelligence have played a great evolutionary role in our relational society. There is an accessibility and intensification of social exchanges between internet users (published writings, photos, conversations, conferences… ). Although we access this interplanetary sharing of connection, despite everything the distancing and physical emotional social deprivation between several individuals belonging to a different household can bring significantly high suffering. Moreover, with the Covid-19 crisis, there has also been that fragility of our own personal doubt that will settle psychically in us: the uncertainty will be more intimate, more present and more distressing. If there is exposure to a potentially threatening stimulus as is the case with COVID-19, the exploration of positive or negative resources of survival and that of creativity (psychological capital) will emerge during this first increasedmajor confinement in order to bring non-negligible and bearable psychic responses to possible traumas and episodes of acute stress. However, the goal of this article is to propose a possible understanding of a resilience, thought and mobilized from a systemic approach: The relationship between the individual and his different systems of social, relational and existential belonging.

Morphologic Markers of Acute and Chronic Stress in Child Abuse.

ObjectivesTo elucidate pathologic markers of acute and chronic stress found but rarely reported in chronic child abuse.MethodsAutopsies of 3 cases of fatal child abuse with well-documented chronic maltreatment are reported, with an emphasis on the nontraumatic findings of acute and chronic stress.ResultsBesides the overwhelming physical injuries, all 3 children and 1 additional case obtained for consultation had telogen effluvium, a form of alopecia well known to be associated with stress in adults and some children but never reported in chronic abuse. All 3 had the microscopic findings of markedly involuted thymus, a well-known marker of physiologic stress in children but only occasionally referred to in child abuse. All 3 also had microscopic findings of myocardial necrosis associated with supraphysiologic levels of catecholamine, a well-documented finding associated with stress but rarely reported in fatalities associated with child abuse. Two of the 3 children also had Anitschkow-like nuclear changes in cardiac tissue, markers associated with prior, nonischemic myocardial pathologies that may be associated with prior episodes of acute stress.ConclusionsPathologists are urged to explore these markers as supportive evidence in their own investigations of possible child abuse fatalities, especially when associated with stress.

Gender roles are related to cortisol habituation to repeated social evaluative stressors in adults: secondary analyses from a randomized controlled trial

Masculine and feminine gender roles influence stressor appraisals and coping in everyday life, but their effect on stress response systems like the hypothalamic-pituitary-adrenocortical axis is unclear. Accordingly, the present study tested the association between gender roles and cortisol responses to repeated stress as part of secondary analyses of data from a randomized controlled trial examining the effects of stress management interventions on cortisol habituation. Participants (Nfinal = 86; 72% female) completed a baseline survey assessing gender role endorsement using the Bem Sex Role Inventory, from which 4 groups were derived: masculine (n = 20), feminine (n = 20), androgynous (high masculinity, high femininity; n = 22), and undifferentiated (low masculinity, low femininity; n = 24). Following the stress management intervention (mindfulness-based stress reduction or cognitive-behavioral skills training) or waitlist period control, participants completed the Trier Social Stress Test on two laboratory visits (48 h apart). Salivary cortisol was assessed 0, 25, 35, and 60 min post-stressor during both laboratory visits. Androgynous and undifferentiated individuals both exhibited a significant decrease in total cortisol from visit 1 to visit 2 (i.e. habituation) whereas feminine and masculine individuals did not. Undifferentiated individuals exhibited greater habituation than feminine and masculine individuals, whereas androgynous individuals only exhibited greater habituation than the feminine group. Controlling for study condition assignment did not alter these results. Results imply that gender roles may be implicated in stress-related disease because of their association with HPA axis functioning during episodes of acute stress.

Machine Learning Based Solutions for Real-Time Stress Monitoring

Stress may be defined as the reaction of the body to regulate itself to changes within the environment through mental, physical, or emotional responses. Recurrent episodes of acute stress can disturb the physical and mental stability of a person. This subsequently can have a negative effect on work performance and in the long term can increase the risk of physiological disorders like hypertension and psychological illness such as anxiety disorder. Psychological stress is a growing concern for the worldwide population across all age groups. A reliable, cost-efficient, acute stress detection system could enable its users to better monitor and manage their stress to mitigate its long-term negative effects. In this article, we will review and discuss the literature that has used machine learning based approaches for stress detection. We will also review the existing solutions in the literature that have leveraged the concept of edge computing in providing a potential solution in real-time monitoring of stress.

Acute Psychological Stress is a Trigger for Stroke: A Case-Crossover Study

BackgroundConventional risk factors for stroke that have been identified are mostly chronic diseases that explain much of the variation as to who develops stroke. However, these risk factors do not equip us with the means to predict when an event like stroke will occur. It has been observed that acute events like stroke and coronary heart disease are preceded by episodes of acute stress. The present study was undertaken to determine whether acute psychological stress is a potential triggering factor for the occurrence of stroke. MethodsIn accordance with the case-crossover study design, patients or Legally Authorized Representative (LAR) were asked to report psychological stress during the two-hour hazard period before the event and during the control period, which was the same 2-hour time period the day before the event. Conditional logistic regression was used to compare each person's exposure during the hazard period to their exposure during the control period. ResultsA total of 151 stroke patients were interviewed. Acute psychological stress was associated with transient increased odds of stroke in the subsequent 2 hours that was 3.4 times higher than the odds during periods with no exposure to these triggers (95% confidence interval 1.55-7.50). ConclusionsAcute psychological stress is a potential independent triggering factor for the occurrence of stroke. Further confirmatory studies are required to help corroborate these findings and elucidate the mechanisms underlying this short-term increase in risk.

In This Issue

In This Issue

Interventions after acute stress prevent its delayed effects on the amygdala

Stress is known to elicit contrasting patterns of plasticity in the amygdala and hippocampus. While chronic stress leads to neuronal atrophy in the rodent hippocampus, it has the opposite effect in the basolateral amygdala (BLA). Further, even a single episode of acute stress is known to elicit delayed effects in the amygdala. For example, 2 h of immobilisation stress has been shown to cause a delayed increase in dendritic spine density on BLA principal neurons 10 days later in young rats. This is paralleled by higher anxiety-like behaviour at the same delayed time point. This temporal build-up of morphological and behavioural effects 10 days later, in turn, provides a stress-free time window of intervention after exposure to acute stress. Here, we explore this possibility by specifically testing the efficacy of an anxiolytic drug in reversing the delayed effects of acute immobilisation stress. Oral gavage of diazepam 1 h after immobilisation stress prevented the increase in anxiety-like behaviour on the elevated plus-maze 10 days later. The same post-stress intervention also prevented delayed spinogenesis in the BLA 10 days after acute stress. Surprisingly, gavage of only the vehicle also had a protective effect on both the behavioural and synaptic effects of stress 10 days later. Vehicle gavage was found to trigger a significant rise in corticosterone levels that was comparable to that elicited by acute stress. This suggests that a surge in corticosterone levels, caused by the vehicle gavage 1 h after acute stress, was capable of reversing the delayed enhancing effects of stress on anxiety-like behaviour and BLA synaptic connectivity. These findings are consistent with clinical reports on the protective effects of glucocorticoids against the development of symptoms of post-traumatic stress disorder. Taken together, these results reveal strategies, targeted 1 h after stress, which can prevent the delayed effects of a brief exposure to a severe physical stressor.

Influences of photic stress on postsubicular head-directional processing.

The stress response serves vital adaptive functions. However, acute stress episodes often negatively impact cognitive processing. Here, we aimed to elucidate whether stress detrimentally affects the head‐direction cells of the postsubiculum, which may in turn impair downstream spatial information processing. We recorded neurons in the rats’ postsubiculum during a pellet‐chasing task during baseline non‐stress conditions and after a 30‐min acute photic stress exposure. Based on their baseline firing rate, we identified a subpopulation of head‐direction cells that drastically decreased its firing rate as a response to stress while preserving their head directionality. The remaining population of head‐direction cells as well as other neurons recorded in the postsubiculum were unaffected. The observed altered activity in the subpopulation might be the basis for spatial processing deficits observed following acute stress episodes.

Measurement of physiological responses to acute stress in multiple occupations: A systematic review and implications for front line healthcare providers.

Optimizing performance of individuals in acutely stressful work-related situations requires a deeper understanding of the interaction between the demands of the stimuli and an individual's associated physiological response. Identifying these responses is particularly germane for healthcare professionals, who experience episodes of acute stress on a regular basis. The purpose of this review was to examine and synthesize empirical literature to identify studies assessing physiological responses to acute stress, determine common methods for measuring acute stress in near real-time, and identify common research designs employed across industries. A modified PRISMA approach was followed. Systematic searches were conducted of four databases (PsycINFO, Medline, PubMed, and Turning Research into Practice [TRIP]) to access eligibility. Reference list searches and a hand search were also conducted to identify other articles suitable for inclusion. Studies selected examined an acute physiological response while participants were engaged in a stress-inducing task. Twenty-two articles were included. Fifteen (68.2%) were centered on the human service industry while only three (13.6%) focused on healthcare professionals. Half of the studies incorporated a simulation into the research design while only two (9.1%) articles looked at physiological responses in real-world settings. Heart rate and cortisol emerged as the most common physiological measures collected. This review demonstrates that acute stress is primarily assessed retrospectively, and that there is a pragmatic gap in methodological approach, with many data collection methods inappropriate for the healthcare environment. Future research should capitalize on advancements in sensor technology to passively examine acute stress in healthcare professionals.

Trait mindfulness predicts the presence but not the magnitude of cortisol responses to acute stress

BackgroundMindfulness, or the practice of observing present moment experiences with acceptance, is thought to improve health at least partially by limiting hypothalamic-pituitary-adrenal (HPA) axis over-responsiveness during episodes of acute stress. However, models of allostatic load suggest that HPA axis under-responsiveness can also be detrimental to health, and the relationship between mindfulness and cortisol under-responsiveness has yet to be examined. The present study therefore aimed to address this knowledge gap, and to revisit the relationship between mindfulness and acute cortisol response magnitude while excluding (or statistically controlling for) individuals displaying HPA axis under-responsiveness. MethodsParticipants (124 healthy undergraduate students) were subjected to a stressful speech task, and completed a trait mindfulness questionnaire. Salivary cortisol was collected 0, +15, +25, +40, and +55 min post-stressor onset. ResultsGreater trait mindfulness was associated with greater odds of displaying a cortisol response relative to none, but was unrelated to the magnitude of cortisol responses among those who displayed an acute response. ConclusionsIn the present sample, trait mindfulness was associated with cortisol responses, but this was driven by the fact that subjects low in mindfulness were more likely to be non-responders. Contrasting the effects of mindfulness on the presence (i.e., present vs. absent) and the degree (i.e., magnitude) of acute stress responses may therefore be warranted in future research.

Stress in chelonians (tortoises, terrapins and turtles)

Chelonians are not commonly seen in general veterinary practice. Stress, distress and pain can be very difficult to observe or measure in this group of reptiles. As ectotherms they are totally reliant on the captive environment for provision of suitable conditions to maintain good health and wellbeing. This is essential to avoid environmental stress in chelonians. Stress in captivity is likely to be chronic, and is often due to poor husbandry or environmental conditions. Transportation, treatment and handling could also lead to acute stress episodes. Any treatment, extended stay or handling at the veterinary practice requires provision of suitable accommodation, which is often not available.

Antioxidant Enzymes in Brain Cortex of Rats Exposed to Acute, Chronic and Combined Stress

The study deals with manganese superoxide dismutase, copper, zinc superoxide dismutase, and catalase activities in brain cortex of Wistar rats exposed to acute stress (immobilization or cold for 2 h), chronic stress (long-term isolation or long-term forced swimming for 21 days), or to combined chronic/acute stress. We observed that i) single episodes of acute stress by immobilization increased activity of both superoxide dismutases; ii) both types of chronic stresses significantly elevated activities of all examined enzymes; iii) chronic social isolation was a much stronger stressor than physical stress by swimming; iv) in animals pre-exposed to chronic isolation, additional stress by immobilization or cold significantly decreased previously elevated activities of all enzymes, while after chronic swimming, acute immobilization lowered only catalase activity. The obtained results indicate that stress conditions most probably altered the cell redox equilibrium, thus influencing the antioxidant response in brain cortex. Further investigation of neuronal prooxidant/antioxidant cellular conditions is needed to improve the prevention and treatment of various stress induced diseases.

Loss of sex difference in high-density lipoprotein cholesterol in diabetic women during acute stress.

The gender gap in high-density lipoprotein cholesterol (HDL-C) is well documented in health and also maintained in diverse chronic conditions, including menopause and diabetes. The mechanism for this difference in HDL-C and its regulation is not well understood. We evaluated whether this gender gap is maintained during acute stress. Diabetic patients with metabolic decompensation (n=179) were studied in the fasting state within 24 hours of admission to hospital, and again at outpatient follow-up. Fasting lipids and measures of glycemic control were evaluated on both occasions. The population was predominately minority, 78% Hispanic or African American. During admission, fasting lipid concentrations were not different in women (W) (n = 88) and men (M) (n = 91); serum total cholesterol (total-C), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), and HDL-C were similar. Glycemic control was also similar; hemoglobin A1c (A1C) and serum glucose at presentation to hospital were not different in men and women. Compared with a subset of patients with pre-admission data (W, 35; M, 24), a decline of HDL-C was observed, greater in women (P = .005). At outpatient follow-up after admission, median duration approximately 4 months in each group (P = .39), changes in TG, LDL-C, and total-C from baseline admission were not different in men and women. In contrast, whereas HDL-C increased in both groups, the increase (median [interquartile range]) was significantly greater in women, 11 (4, 23) vs 6 (-1, 15) mg/dL (P < .003). This larger increase restored the gender gap in fasting HDL-C, 48 (39, 61) and 41 (36, 49) mg/dL in women and men at follow-up (P < .002). A1C improved similarly in each group. The sex difference in HDL-C levels is lost at time of admission to hospital in patients with diabetes, and returns when acute stress has resolved. These results raise the possibility that recurrent episodes of acute stress may lead to cumulative loss of the HDL-C advantage in women.

Acute stress causes rapid synaptic insertion of Ca2+-permeable AMPA receptors to facilitate long-term potentiation in the hippocampus

The neuroendocrine response to episodes of acute stress is crucial for survival whereas the prolonged response to chronic stress can be detrimental. Learning and memory are particularly susceptible to stress with cognitive deficits being well characterized consequences of chronic stress. Although there is good evidence that acute stress can enhance cognitive performance, the mechanism(s) for this are unclear. We find that hippocampal slices, either prepared from rats following 30 min restraint stress or directly exposed to glucocorticoids, exhibit an N-methyl-d-aspartic acid receptor-independent form of long-term potentiation. We demonstrate that the mechanism involves an NMDA receptor and PKA-dependent insertion of Ca2+-permeable AMPA receptors into synapses. These then trigger the additional NMDA receptor-independent form of LTP during high frequency stimulation.

Homer1 Mediates Acute Stress-Induced Cognitive Deficits in the Dorsal Hippocampus

In recent years, the glutamatergic system has been implicated in the development and treatment of psychiatric disorders. Glutamate signaling is processed by different receptors, including metabotropic glutamate receptors (mGluRs), which in turn interact with the scaffolding protein Homer1 to modulate downstream Ca(2+) signaling. Stress is a major risk factor for the incidence of psychiatric diseases, yet acute stress episodes may have diverging effects on individuals. Cognitive impairments have often been shown to occur after episodes of stress, however the specific role of mGluR5/Homer1 signaling in the interaction of stress and cognition has not yet been elucidated. In this study we show that a single episode of social defeat stress is sufficient to specifically induce cognitive impairments in mice 8 h after the stressor without affecting the animals' locomotion or anxiety levels. We also demonstrate that Homer1b/c levels as well as mGluR5/Homer1b/c interactions in the dorsal hippocampus are reduced up to 8 h after stress. Blockade of mGluR5 during the occurrence of social stress was able to rescue the cognitive impairments. In addition, a specific overexpression of Homer1b/c in the dorsal hippocampus also reversed the behavioral phenotype, indicating that both mGluR5 and Homer1b/c play a crucial role in the mediation of the stress effects. In summary, we could demonstrate that stress induces a cognitive deficit that is likely mediated by mGluR5/Homer1 signaling in the hippocampus. These findings help to reveal the underlying effects of cognitive impairments in patients suffering from stress-related psychiatric disorders.

Syndrome de takotsubo: à propos d’un cas

Takotsubo syndrome is a recent heart syndrome that may mimic acute coronary syndrome without significant coronary artery disease. It is usually observed in elderly women and often triggered by an episode of acute stress, especially emotional stress. The pathophysiology of this syndrome remains unclear and its treatment is empiric. Prognosis seems to be favorable, excluding acute and unpredictable complications.

Short-term spatial memory responses in aged Japanese quail selected for divergent adrenocortical stress responsiveness

Stress-induced glucocorticoids can dampen learning and spatial memory via neuronal damage to the hippocampus. Cognition losses can be transient (associated with acute stress episodes) or permanent as in aged individuals who show chronic glucocorticoid-induced accelerated brain aging and neurodegeneration (dementia). Thus, chronic versus acute stress effects on spatial memory responses of quail selected for reduced (low stress, LS) or exaggerated (high stress, HS) plasma corticosterone (B) response to brief restraint were assessed. Aged food-motivated male LS and HS quail were tested for 10 min in a feed-baited 8-arm radial arm maze (RAM) 1) at 255 d of age (quail who had experienced lifelong management stressors but who were otherwise never intentionally stressed; that is, chronically stressed birds), 2) on the next day post-acute stressor treatment (5 min of restraint), and 3) on the next day without treatment (acute stress recovery). The RAM tests used the win-shift procedure in which visited arms were not rebaited. Radial arm maze performance was measured by determination of the total number of arm choices made, the number of correct entries made into baited arms out of the first 8 choices, the time required to make a choice, and the number of pellets eaten. Line effects (P < 0.001 in all cases) were detected for total number of arm choices made (HS < LS), number of correct entries made into baited arms out of the first 8 choices (HS < LS), time required to make a choice (HS > LS), and number of pellets eaten (HS < LS). However, neither the effects of day of RAM testing nor its interaction with line further influenced these variables. Thus, although selection for divergent plasma B responsiveness to an acute stressor was found to be associated with severe impairment of spatial memory in aged male HS compared with LS quail, the observed spatial memory impairments (HS > LS) could not be further altered by acute stressor treatment. Line differences in cognition may reflect lifelong management-induced stress episodes that periodically produce higher plasma B responses in HS than LS quail, which underlie HS quail memory deficits, or other etiologies, or both.