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Stress and Health

Stress and Health
Biological and Psychological Interactions

Third Edition
  • William R. Lovallo - University of Oklahoma Health Sciences Center, Veterans Affairs Medical Center, Oklahoma City, University of Oklahoma, USA

February 2015 | 352 pages | SAGE Publications, Inc

Stress and Health: Biological and Psychological Interactions is a brief and accessible examination of psychological stress and its psychophysiological relationships with cognition, emotions, brain functions, and the peripheral mechanisms by which the body is regulated. Updated throughout, the Third Edition covers two new and significant areas of emerging research: how our early life experiences alter key stress responsive systems at the level of gene expression; and what large, normal, and small stress responses may mean for our overall health and well-being.

Chapter 1: Psychosocial Models of Health and Disease
The Standard Biomedical Model and New Approaches to Medicine

A Biobehavioral Model of Disease and Treatment

Placebo Effects


Cultural, Intrapersonal, and Physiological Influences in Coronary Heart Disease

Psychosocial Theories of Disease and Treatment

The Foundation of Behavioral Medicine

Chapter 2: History of the Concept of Stress
The Age of Enlightenment and the Emergence of Scientific Thought

Descartes and the Mechanical Model of Living Things

The Worldview and Premises of Modern Science

The Mind-Body problem

Claude Bernard and the Modern Biomedical Model

Claude Bernard and the Vitalists

Walter Cannon

Definition of Stress

Hans Selye

The Concept of Allostasis

Additional Considerations on the Stress Concept

Chapter 3: Homeostatic Regulation: Normal Function and Stress Responses
A Hierarchy of Homeostatic Controls

Intrinsic Control Mechanisms

Autonomic Controls Over Homeostasis

Three Autonomic Divisions

Coordinated Actions of the Autonomic Branches

Higher Controls Over Homeostasis

The Hypothalamus and Emotional Expression

Endocrine Responses During Stress

Adrenomedullary Response

Adrenocortical Response

Negative Feedback by Cortisol

Cortisol During Stress


Chapter 4: Physical and Psychological Stress
Classes of Stress Responses

The Exercise Response

Exercise and Adaptation to Stress

The Fight-or-Flight Response

Different Emotions and Motivations Accompany Exercise and the Fight–Flight Response

Why Is Exercise Considered Good If It Is a Stressor?

Psychological Stress

The Responses to Aversive and Nonaversive Challenges

Exposure to Noise and Shock

Activation and Distress

Chapter 5: Central Nervous System Integration of the Psychological Stress Response
Appraisals, Psychological Stress, and Negative Emotions

Primary and Secondary Appraisals

Outcomes of Coping Efforts and Physiological Responses

Central Integration of the Response to Psychological Stress

The Limbic System and Associated Parts of the Brain

Primary Appraisals: Sensory Intake and Interpretation of the Environment

What Is It? And Where Is It?

Cognition and Emotion: Generating Emotions Based on Appraisal Processes

Prefrontal-Limbic Interactions and Thoughts and Feelings

Secondary Appraisals: How Well Did Our Coping Attempt Work?

Physiological Correlates of Primary and Secondary Appraisal Processes

Internal Sources of Amygdaloid Activity and Internally Generated Emotional Responses

Initiation of Behavioral, Autonomic, and Neuroendocrine Responses to Psychological Stressors

Feedback to the Cortex and Limbic System: The Central Feedback Subsystem

Autonomic and Endocrine Outflow: The Emotional Response Subsystem

Chapter 6: Stress and the Endocrine System
Overview of Stress Endocrine Regulation

Activation of Stress Endocrine Secretion and the Central Corticotropin-Releasing Factor System

Cortisol’s Feedback Actions in the Central Nervous System

Cortisol Effects on Frontal-Limbic Activity

Amygdala Responses to Cortisol and Altered Responsivity of the Central Nervous System

Amygdala Sensitization and Potential Implications for Health

The Hypothalamic-Sympatho-Adrenomedullary Axis

Stress Endocrine Secretion and Regulation of Long-Term Stress Reactivity

Hierarchy of Autonomic and Endocrine Controls Over Homeostasis Leading to Long-Term Memory Formation

Recap: How Ideas Come to Have Power Over Our Bodies

Chapter 7: The Immune System Stress and Behavior
Overview of the Immune System

Structural Components of the Immune System

Immune System Cells

Immune System Messengers

Innate Resistance

Acquired Immunity and Establishment of Immune System Memory

The Behavior-Immune Interface

Behavior-Immune Interactions and Health Indicators

Stress Buffers, Positive Emotions, and Physical Health

Chapter 8: Helplessness Coping and Health
Death Due to Uncontrollable Stress

Helplessness and Exposure to Uncontrollable Stress

Studies of Ulceration in Rats

“Learned Helplessness” and the Consequences of Lack of Control

Lazarus’s Model of Psychological Stress and Helplessness

Central Neurotransmitters and Severe Stress

Uncontrollable Shock, Norepinephrine, and Depression

Serotonin Mechanisms

Emotions and Health

Chapter 9: Genes, Stress, and Behavior
Early Life Experience, Epigenetic Programming of Gene Expression, and Stress Reactivity

A Rat Model of Early Experience, Development, and Responses to Stress

Maternal Separation and Neglect

Nurturing by Rat Mothers is Increased by Brief Separation

Genotype, Genetic Vulnerability to Early Life Adversity, and Psychobehavioral Outcomes in Humans

Chapter 10: Individual Differences in Reactivity to Stress
A Proposed Classification of Individual Differences in Reactivity

Persons May Differ in Stress Reactivity Because of Inborn Factors or Experience

Individual Differences in Stress Responses May be Conditioned by Functional Alterations at Three Levels in the System

Individual Differences in Evaluative and Emotional Processes—Level I

Individual Differences in Hypothalamic and Brainstem Responses to Stress—Level II

Individual Differences in Peripheral Responses to Stress—Level III

Chapter 11: Health Implications of Exaggerated and Blunted Stress Reactivity
Reactivity Tests in Medicine

Health Outcomes Related to Exaggerated Cardiovascular and Endocrine Reactivity

Individual Differences in Level I Reactivity and Health Implications

Individual Differences in Level II Reactivity: Cardiovascular Reactivity as a Mediator of Disease Risk

Individual Differences in Level III Reactivity and Disease

Blunted Stress Reactivity and Health

Early Life Adversity and Blunted Stress Reactivity

Early Life Adversity, Psychological Characteristics, Cognition, and Behavioral Regulation

Early Life Adversity and Low Versus High Stress Reactivity: Unanswered Questions

Blunted Stress Reactivity, Social Adversity, and Health


Exaggerated Reactivity and Disease

Blunted Reactivity and Disease

Family Dysfunction, Socioeconomic Status, Neighborhood Characteristics, and Health Outcomes

Chapter 12: Behavior, Stress, and Health
The Historical Dilemma of Mind-Body Dualism

Matter and Behavior

Behavioral Medicine in Relation to Traditional Medicine

Systems Organization and Stress

Psychological Stress and Its Consequences

Stress and Behavioral Medicine

Stress, Stress Reduction, and Improved health


A recommended reading for the student that has a keen interest in occupational health psychology and stress in particular. The mutual influence between biological and psychological components is key for a deeper understanding of the phenomenon and its prevention.

Dr Teresa C. D'Oliveira
School of Psychology, University of East London
May 23, 2016

very interesting chapters covering the most important topics related to stress.
Technical language very well explained making the book very accessible

Dr Florbela Soares Teixeira
Education , Coventry University
June 2, 2016

excellent coverage of bioloical topics in stress

Dr Susan Wilbraham
Psychology , University of Cumbria
February 15, 2016

Very informative book clearly explaining the finner detail of the effects of stress. We incorporated some of this finner detail into the professional regulatory unit of the course

Miss Kelly McGrath
Animal Management and veterinary nursing, Sparsholt College Hampshire
October 28, 2015

was not appropriate to level of knowledge

Miss Kathryn Bould
Dental Institute, King's College London
July 2, 2015

A very informative text but a bit too physiological for our purposes. But I sure will recommend it to students interested in the physiological aspects of stress (and health).

Mr Peter Karlsson
Sch of Health & Social Sciences - HOS, Halmstad University
May 3, 2015

This is a really detailed and research-evidenced journey through the psychobiology of stress, and is one of the texts at the forefront of reporting on psychoneuroimmunology at an accessible level. It explicates what is know, identifies what may be inferred and demonstrates that some research may be interesting but inconclusive. By resisting the broad, but unsupported, sweep of the relationships between stress and physiology, and between "types" and stress reactions, this text explores individual differences and how they interact with stress to affect health outcomes. An invaluable text from foundation year to doctoral level, for all those interested in the psychological and physiological aspects of stress.

Mrs Hazel Chapman
Faculty of Health and Social Care, Chester University
March 31, 2015
Key features


  • This new edition features thoroughly updated chapters and illustrations with increased coverage of emerging areas of research.  
  • Chapter 1 now presents a biopsychosocial model of health and disease that frames the rest of the book.
  • A new Chapter 10 covers individual differences in stress reactivity with discussions of exaggerated stress reactions in terms of health consequences along with emerging research on severely blunted stress reactivity and its effects on risk for alcoholism and other addictive disorders.
  • A new Chapter 11 discusses the experience of early life stress and its long-term impact on behavior and health, with an emphasis on genetic vulnerabilities to adverse early experience.
  • Chapter 12 integrates new studies of gene-environment interactions and the correlation with classic mind-body issues.


  • The integration of stress biology with its psychological causes helps readers with minimal backgrounds in biology and physiology understand of the impacts of stress on health.
  • Pedagogical features such as chapter-opening introductions and learning objectives, figures and tables, Points for Discussion, chapter summaries, and recommendations for further reading support students in mastering the material.

Sample Materials & Chapters

Chapter 5

Chapter 10

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