Over the course of the past century, exposure to stressful life events has emerged as one of the most ubiquitous determinants of ultimate health outcomes for the individual. Stress is pervasive in human life, and it plays a prominent role in moderating both the onset and severity of many major psychiatric syndromes. Indeed, one of the primary issues that has driven stress research is the question of how a general construct such as "stress" can produce such a wide array of psychiatric and physiological ailments. This puzzle is further complicated by the observation that comparable life stressors produce widely discrepant effects across different individuals. It is clearly of interest for clinicians and researchers alike to develop a fundamental understanding of stress as a mitigating factor in disease susceptibility and progression. This chapter will provide an overview of the major stress responsive systems against a historical backdrop,

Textbook of Biological Psychiatry. Edited by Jaak Panksepp Copyright © 2004 by Wiley-Liss, Inc. ISBN: 0-471-43478-7

delineate several important new areas of inquiry in the field of stress research, and demonstrate how these stress responsive systems can both propagate and exacerbate major psychiatric illnesses.

In addition to a coverage of stress, brief discussions of work on sleep and sexuality are included at the end. These may seem like odd bedfellows. Partly, this juxtaposition is a matter of expediency since those important topics could not be given separate chapters with the space constraints of this book. However, there are also good reasons to consider these foundational issues together. Individuals who have been exposed to stressors exhibit difficulty sleeping and are less likely to indulge in pleasurable activities such as sex, presumably because more pressing emotional and motivational concerns are monopolizing neuromental resources. However, even as we highlight such interrelations, we will treat these topics in series.

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