Stress ( English for 'pressure, tension'; Latin for more stringent 'tense') describes on the one hand psychological and physical reactions in living beings caused by specific external stimuli ( stressors ) , which enable them to cope with special demands, and on the other hand the resulting physical reactions and mental stress.
According to the current allostasis concept, stress is of central importance for adapting physically and mentally to changing environmental conditions. Stress can also have an evolutionary effect, with the result that stress can be endured better or ultimately neutralized by an appropriate stress tolerance . Thus, through the selective advantages of individual individuals, stress can cause adaptation and ultimately species formation. Through the genetic fixation of traits that bring about selection advantages, certain hereditary traits can evolve to assert themselves. Examples of such properties are succulence in plants in arid areas or sickle cell anemia in humans in malaria areas.
The term stress was first used by Walter Cannon (1914, quoted from Lazarus & Folkman, 1984) in relation to alarm situations ( fight-or-flight ). Based on this work, Hans Selye (1936, quoted from Lazarus & Folkman, 1984) formulated stress as a physical state under stress, which is characterized by tension and resistance to external stimuli (stressors) - the general adaptation syndrome (GAS). Hans Selye had borrowed the term from physics to name the “unspecific reaction of the body to any requirement”. In materials science, stress refers to the change in a material due to external forces: this is followed by tension, distortion and bending. With the cognitive turnaround , appraisal and coping of psychological stress were assigned a central role (Lazarus and Folkman, 1984). To date there has been no agreement on a definition and a conceptual operationalization of stress (Kahn and Byosiere, 1992). Depending on how the term stress is conceptualized, there are a number of attempts at definition (Väänänen et al., In press).
The occurrence of stress requires a sensual perception of the stress-inducing stimulus as well as a nervous transmission of such a stimulus to a stimulus- processing region of the body. A side effect at the biochemical level is usually the release of stress hormones and other secretions from glands .
The starting point was the confrontation of an animal with an acute dangerous situation , for example an encounter with a predator or an intravenous aggressor or a physical danger such as forest fire or just an alarming noise etc. The animal must then be more ready to act, which is also the readiness of its muscles and the circulatory system as well as its central nervous attention and willingness to make decisions. Therefore z. B. the release of the adrenal hormone adrenaline creates a vegetative chain of effects, which ultimately increases blood pressure and blood sugar as well as general muscle tone .
In the brain, the influence of the relatively slow processing of the cerebrum is suppressed, and schematic decision-making patterns of the brain stem are used with priority. This happens through altered distribution patterns of suppressing serotonin and stimulating norepinephrine in the relevant parts of the brain. The animal can then react more quickly, albeit with a higher error rate.
With a precise assessment of the situation by the cerebrum, an appropriate reaction in the acute dangerous situation would often come about slowly and dangerously.
For this reason, a dangerous situation is often not initially identified via the cerebrum , but rather via schematized triggering patterns to which evolutionary old brain stem mechanisms react: sudden sound or sudden change in brightness, high-pitched sounds (screams), etc. Such triggering patterns occur in modern times Everyday life for many people. They are then called unspecific stressors and each time they occur, they generate a physical reaction to the supposed danger ( fight-or-flight ). In the case of long-term stress , further stress hormones are released . In addition to the classic stress hormones, the body's own neuropeptides, such as substance P, opioid peptides, etc. also play a role in the stress reaction. If a person is permanently under stress, physical reactions can damage their health ( general adaptation syndrome ).
Stress in humans
Definition: Stress is understood to mean the strain (effect of the loads) on people through internal and external stimuli or loads (objective factors affecting people as well as their sizes and periods of time). These can be artificial as well as natural, both biotic and abiotic , affect both the body and the psyche of humans and ultimately be perceived as positive or negative or have an effect. Coping with the stress depends on the personal (including health) characteristics and cognitive abilities of the individual person; dealing with a threat is also called coping . Usable behaviors are e.g. B. aggression , flight, behavior alternatives, acceptance, changing the condition or denying the situation.
"Positive stress" or eustress (the Greek prefix εὖ (eu) means "well, well, right, easy") are those stressors that stress the organism but have a positive effect. Positive stress increases alertness and promotes maximum performance of the body without harming it. Eustress occurs, for example, when a person is motivated to perform certain tasks, has the time and opportunities to prepare for them, or when a (possibly longer or severe) crisis or illness is nevertheless positively addressed, coped with (see coping strategy ) and overcome can be. As a result, moments of happiness can even be felt. Eustress has a positive effect on the psychological or physical functionality of an organism, even if it occurs frequently over a long period of time.
Stress is only perceived negatively if it occurs frequently or permanently and can not be compensated physically and / or psychologically and is therefore rated as unpleasant, threatening or overwhelming. In particular, negative effects can occur if the individual person (also through their interpretation of the stimuli) does not see or has no opportunity to cope with the situation. Examples of this are exams without time or the ability to learn, a disease that is unclear or not recognized despite a doctor's visit (see Semmelweis reflex ), an apartment that is unbearable due to noise and without the possibility of moving, etc. In this case, permanent negative stress (also Disstress or dysstress, English distress; the Greek prefix δύς (dys) means "bad, bad") can be prevented by appropriate help or stress management strategies.
Abiotic stress factors would be e.g. B. physical nature , such as cold, heat , noise , exhaust gases and natural and artificial radiation . The latter include, for example, strong and excessively long exposure to sunlight or other such as high-frequency or radioactive or electromagnetic radiation . Furthermore toxic substances such. B. Plasticizers such as diethylhexyl phthalate (DEHP) in PVC floor coverings or children's toys; (Cigarette) smoke and the substances it contains; Pollution of drinking water; excessive and regular consumption of alcohol; nutrient-poor diet or increasingly in a variety of products and application methods of agriculture (. eg " weed control " by glyphosate applied) - and thus taken into the human body - pesticides .
Biotic factors would be, for example, exposure to pathogens or tumors , also chronic and autoimmune inflammatory processes , which in turn are influenced by the abiotic factors mentioned above (stressors with effects on cell metabolism and the immune system ). On an emotional level, psychological stress such as bullying , certain personal attitudes and expectations of a person or z. B. his parents, and fears continue to be stressors (see psychosocial stressors ).
So first of all, stress is the strain on the body from such stressors . This is followed by a reaction and, if necessary, adaptation of the body to and to these factors, possibly with external help. Distress leads to a greatly increased tension in the body (release of certain neurotransmitters and hormones, e.g. adrenaline and noradrenaline, activation of the sympathetic nervous system) and, in the long term, to a decrease in alertness and performance. Stress and / or distress only have a damaging effect on the human organism , if stress exceeds the range of possible adaptation and repair functions (e.g. DNA repair ) of the individual person or his organism according to his individual physique and psyche or health condition , beyond (chronic stress / duration of exposure; excess; possibly multiple factors).
In this case, the above Factors affecting the metabolism (see metabolic stress ; oxidative stress ) and thus generalized impairment of healing processes or (immune) reactions to infections and all kinds of effects and / or in this way also to cell mutations , i.e. cancer , unhindered by the immune system , lead (see medical aspects ).
Stimulus concept (stimulus based model)
The stimulus concept focuses on specific conditions and events. Within this operationalization, certain stimuli are called stressors. For example, time pressure, interpersonal conflicts and accidents are referred to as stressors (Sonnentag and Frese, 2003). The problem with this approach is that almost every event or almost every stimulus can be described by an individual as a stressor (Lehmann, 2012).
Response concept (response based model)
The reaction concept focuses on the physiological stress reaction within an individual or on specific physiological reaction patterns (Lehmann, 2012). This conceptualization has the disadvantage that different situations can cause the same physiological reactions, which can also be changed by the coping (counter-reactions of the individual with the aim of homeostasis) of the individual.
The two previous approaches are integrated into this approach. The nature of the situation and the individual's reaction also influence the definition of stress. According to this approach, stress results from an interaction between the environment and the individual, whereby the expectations, interpretations and coping of the individual are also taken into account. This approach was used in stress research, but at the same time verbal statements or the measurement of physiological data were used when measuring stress, whereby this would actually be based on a conception of stress as a reaction. Lazarus and Folkmann define stress as the relation between humans and the environment, which the individual considers to be important for his or her well-being and in which, however, his resources are insufficient to react adequately to a stressor.
The concept of discrepancy tries to operationalize stress as an imbalance between the demands of the environment and the resources or demands of the individual. Carver defines stress as the discrepancy between the environment and the stressors and resources of the individual. Semmer defines stress as a subjectively perceived physiological malaise (state) due to tension, which stems from the fact that the individual fears not being able to adequately meet the aversive stimuli. This definition emphasizes the negative qualities of stress (Lehmann, 2012).
From concepts of stress to models for research
Conceptions and the associated definitions of stress can be transferred to more concrete models in a further step (Lehmann, 2012). Models try to explain the stress process, the stress reactions and the connections between the stressors and the strain and thus represent the basis for empirical research (Lehmann, 2012).
There are a number of models (Kahn & Byosiere, 1992, quoted from Sonnentag and Frese, 2003), which either focus on the process of the development of stress as such, or the relationship between a configuration of different stressors and the associated loads try to explain.
see main article stress theory
Psychosocial Stress Factors
- chronic conflicts in the couple relationship
- Lack of time, tight deadlines
- Lack of money, poverty , debts , over-indebtedness
- lack of design options , lack of interest in work and in leisure time
- great responsibility
- Bullying in the workplace, bullying at school , bullying in everyday life
- Shift work (causes disruption of the sleep-wake cycle and health problems)
- Constant concentration on the work (for example on assembly line work)
- Fear of not being enough ( fear of failure)
- Perfectionism (excessive demands on yourself and on others)
- Social isolation , contempt, and neglect
- sleep deprivation
- Illnesses and pain, own and those of relatives
- Emotional problems, subliminal conflicts
- Serious events (for example, a break-in, an operation, an exam)
- also (unbalanced) underload, boredom and lethargy
- Overstrained by new technical developments ( technical stress , technostress )
- Overstrained by social interaction
- Stress from threats to the self (failure of oneself or the disrespect of others)
see main article Stress Response
Typical stress / panic / crisis reactions in:
- Brain : reduction of brain mass, restriction of the emotional level, circulatory disorders in the brain,
- Feelings: sadness, fear of loss, anger, guilt, reproaches, fear, abandonment, tiredness, helplessness, " shock ", whining, numbness, emptiness, hopelessness, deprivation , humiliation, increased aggressive behavior, urge to move, irritability, emotionless thinking,
- Cognition : disbelief, confusion, prejudice, concentration, hallucinations , depersonalization , forgetfulness,
- physical: sweating , nausea, tightness in the throat and chest , over-sensitivity to noise, breathlessness, muscle weakness, tension in muscles, lack of energy, dry mouth, stomach and intestinal problems, temporary impotence , hair loss , poor skin, reddish eyes, reduced facial expressions, Heart attack , sudden hearing loss , joint pain, skin rash, weakened immune system, magnesium and calcium deficiency , long-term disruption of the digestive process as well as increased risk of high blood pressure , stroke and heart attack (see also section Medical Aspects ),
- Behavior: Decreased creativity, insomnia, loss of appetite, absent-mindedness, social withdrawal, dreams about the event, avoidance of proximity to the crime scene or similar situations, sighing, activism, crying, guarding "treasures".
- Children and adolescents in
- Age from 1 to 5:
- Age from 5 to 11:
- Being irritated, whining, clinging, aggressiveness, sibling rivalry, nightmares, fear of darkness, fear of school, biting fingernails, social withdrawal from peers, lack of interest, lack of concentration, sweating.
- Age from 11 to 14:
- Sleep disorders, eating disorders, rebellion at home, lack of interest in activities of the same age, school problems (e.g. tendency to violence, withdrawal, lack of interest, striving for focus), physical problems (e.g. headache, indefinable pain, skin problems, digestive problems, other psychosomatic complaints ), sweating .
- Age from 14 to 18:
Influences such as fear or stress can lead to sensitization to stress. After sensitization, a stressor triggers a stronger stress reaction than before. A stress sensitization arises, for example, in the event of trauma , for example in the case of a post-traumatic stress disorder .
Pregnancy and Prenatal Stress
If a pregnant woman experiences stress, it also affects the unborn child and influences its development. Prenatal stress is a risk factor for excessive crying in the 3rd to 6th month of life and for a later tendency of the child to fearful reactions. The cause is assumed to be increased stress hormone concentrations. More generally speaking, depression, anxiety, and stress during pregnancy are considered risk factors for developing emotional and cognitive symptoms in the child. Conversely, positive life experiences during pregnancy correlate with a reduced concentration of the stress hormone cortisol in the third trimester of pregnancy.
Dynamics of stress and recovery
Recreation research regards recovery as an "intentionally controlled process that includes a person's active engagement with their environment as well as the fundamental controllability of the recovery process" (Almer, 1996). At its center is the complex interaction between stress and recovery.
Eichhorn (2006) outlines the most important relationships:
- The type and duration of the stress phase radiate into the recovery phase. The longer and harder the stress phase lasts, the longer it takes to recover from it and be fit again for the next stress phase.
- After a stressful day at work you feel on the one hand overworked and tense inside, on the other hand without energy and power. In extreme cases, you don't feel like doing anything anymore. Experts speak of low-effort activities, i.e. activities that do not require great effort. The disadvantage of them is that they are hardly relaxing.
- The load adds up. If you're still relatively relaxed at eight o'clock in the morning, things will look completely different again at eleven or three o'clock. This can even lead to the next phase of stress not being optimally recovered if, for example, stress even affects the quality and quantity of sleep. Then you are overloaded again faster and consequently need an even longer recovery phase. This can create a dangerous cycle.
An established method for analyzing the state of stress and recovery is the recovery-stress questionnaire (EBF; Kallus, 1995). The EBF is now also available in a sport-specific (EBF-Sport; Kallus & Kellmann, 2000) and a work-specific (EBF-work; Kallus & Jimenez, 2008) version. The EBF-work is often used in company health management or in company health promotion projects.
Prior to coping with stress, there is active avoidance of pathogenic stress with professional problem solving. In addition to individual approaches related to the individual employee, there are collective approaches that are intended to eliminate structural stress generation in companies.
In the area of work stress, works councils increasingly had to build up competence, which is used in assessing the resources available for projects and the organization of work. Trade unions , professional associations and advisory institutions also provide support . The legal basis for the protection of employees against work-related illnesses is, in particular, the Occupational Safety and Health Act in conjunction with the Works Constitution Act .
The recording of illness-causing or fatal stress automatically raises questions of liability. This makes measurement and avoidance difficult. Health insurance companies and employers' liability insurance associations are particularly motivated in problem-solving stress research , since mental illnesses triggered by stress cause considerable costs.
The design of the working and learning environment offers further starting points, since psychophysiological effects are also known here : a comparative study by the Joanneum Institute at an Austrian school revealed a clear, u. a. the heart rate lowering effect on those students who were taught in wood-paneled classrooms . Likewise, the social stress felt by the students by the students decreased.
Stress at work and subsequent psychological stress are also reflected in the early retirement statistics. According to a calculation by the DRV Bund (2008), the number of early retirement due to mental disorders and mainly anxiety, depression and other consequences of stress rose continuously between 1993 and 2006. With a share of over 30%, these early retirements have now climbed to the top position among the declared causes of early retirement. In 2007, two thirds of the employed in the regular Swiss health survey complained about stress and time pressure at work. 41% agreed with strong nervous tension. The follow-up costs are estimated at 4.2 billion francs annually. In the USA, according to “Brain Facts 2003”, 60% of the adults surveyed stated that they were under a pronounced stress load at least once a week. 60% of the health problems that adult US Americans see a doctor about are caused or associated with stress. The economic damage caused by stress - stress-related loss of work and production as well as expenditure in the health system - is estimated at US $ 300 billion annually. Another study by Grebner, Berlowitz, Alvaro and Cassina (2010) found that 34.4 percent of Swiss employees state that they are frequently or very often exposed to stress at work. This corresponds to an increase of 30 percent compared to the year 2000.
Measurement of stress using questionnaires
So far, only individual facets can be recorded using psychological questionnaires, such as stressful life events, subjective stress or coping with stress. There are accordingly different psychological questionnaires:
- TICS - Trier inventory on chronic stress
- EBF - Recovery-Stress-Questionnaire
- PSQ - Perceived Stress Questionnaire
- SVF 120/84/78/42 - Stress processing questionnaires
- TBB - diary for recording everyday stresses and coping with them
- ABF - everyday stress questionnaire
- ATE - questionnaire for recording emotionally relevant everyday events
Coping with stress, therapy
The starting point for stress management techniques are the transactional stress model and the theory of resource conservation. A distinction is made between problem-related and emotion-related coping strategies .
Stress due to unresolved conflicts shows up in cognitive, emotional, muscular, vegetative-hormonal and social reactions. Corresponding stress management techniques dampen the stress reactions or try not to let them arise in the first place. Examples: autogenic training , biofeedback , neurofeedback and Mind Machine , Feldenkrais Method , progressive muscle relaxation (PMR), Focusing or mindfulness-based stress reduction , internalization of problem- and emotion-oriented coping strategies as in the perception of steering or positive self-instruction , group-focused coping strategies such as seeking support, team building , considerate behavior or aggressive-antisocial coping , depicted in the multiaxial coping model . Western adapted methods from India, China or Japan, such as B. Qigong , Yoga or Reiki can be used. Through physical exercise as in sports (especially endurance sports, cycling, jogging, like swimming ...), stress can be quickly degraded by the body.
Just five minutes of exercise in a green environment improves mood and self-esteem remarkably well and relieves stress. This was the result of a meta-analysis of ten studies with 1,250 subjects.
Stress affects the psyche as well as the state of mind of the body. Mild and serious illnesses can occur. The effect of emotional stress on the onset of colds , AIDS , herpes labialis and problems with the gastrointestinal tract such as eg. B. Indigestion.
Numerous studies have proven the disease-causing effects of so-called stress hormones . Stress increases the concentration of adrenaline , noradrenaline or cortisol in the blood (see also psychophysiological activation, reactivity and reaction patterns ). This leads to long-term damage to the blood vessels . By a protective body's response to stress can cause an unnatural muscular tension come ( Dysponesis ), which by a chronic z. B. can also lead to back pain . Stress can cause teeth grinding ( bruxism ), which can damage the teeth .
Stress is a possible (co-) cause of obesity . The Selfish Brain Theory even ascribes a central role to stress in the development of obesity; According to this theory, chronic stress and the resulting permanently increased cortisol level in humans typically leads to one of the following two symptom groups, depending on the type: if the stress system remains highly reactive and the brain continues to get the energy it needs, an allostatic load arises and this increases Long-term damage to health as well as fat accumulation in visceral (abdominal) fat tissue due to the mobilization of ketones ; If, on the other hand, the stress system is dampened and thus less reactive, the brain gets the energy it needs from additional food if possible, which leads to an oversupply of food in the body and thus long-term obesity.
Stress increases the risk of vision loss and, conversely, vision loss contributes to stress. Stress also increases the risk of retinopathia centralis serosa , which is caused by the retina . Stress may lead to increased prolactin mirror ( hyperprolactinemia lead) and an associated increased risk of mastitis .
Various studies suggest that psychosocial stress is arguably a risk factor for heart disease. A special kind of stress, the " stage fright ", can - depending on the strength - have a positive or negative effect.
In mice that have to face social, mental and physical challenges, tumors grow much more slowly or even shrink. Scientists have demonstrated this effect for colorectal cancer and malignant melanoma in animal models . The tumors in mice that lived together in groups of 20 conspecifics and had toys, exercise bikes and hiding places were significantly smaller than the tumors of animals that were only five housed and received fewer stimuli. In almost every fifth mouse in the first group, the tumor had even regressed after six weeks. Physical activity alone was not able to inhibit cancer growth: the activities had to be proven to cause mild stress. This throttled the release of leptin from the adipose tissue. The hormone, which actually acts as a kind of appetite suppressant in the body, apparently also promotes cancer growth. For example, when the researchers gave them leptin, the lumps in mice enlarged. In contrast, animals whose leptin production was artificially blocked had significantly smaller tumors than their conspecifics. Perhaps it is also not advisable for people with cancer - according to the authors - to avoid all stress.
Stress from the threat to the self
A number of stress factors are already recognized and established in organizational stress research; however, this list cannot be considered complete. In scientific studies of stress, self-esteem has so far been examined primarily as a resource or as a lost variable. The theoretical framework “Stress as Offence to Self” (SOS concept), which was created by Semmer and his working group at the University of Bern, puts the threat to the self as the cause of stress at the center of the stress process. The central elements of the SOS concept are either stress from a threat to the self due to one's own failure (SIN) or from the disrespect of other people (SAD). The threat of self through respect turn unemployment includes threats of self by illegitimate social actions, illegitimate tasks or illegitimate stressors.
- Stress model by Lazarus (1974) - by Arnold A. Lazarus , the founder of multimodal behavioral therapy
- Theory of resource conservation according to Stevan Hobfoll
- Burnout syndrome
- Psychological stress
- Simple living
- Stress response
- Petra Buchwald, Christine Schwarzer, Stevan E. Hobfoll: Coping with stress together. Resource management and multiaxial coping. Hogrefe, Göttingen 2004, ISBN 3-8017-1679-1 .
- Christine F. Doyle: A Study of Stress. In: Work and Organizational Psychology. 2003, ISBN 0-415-20872-6 , pp. 111-158.
- Christoph Eichhorn: Relax well - live better. The practical book for your everyday life. Klett-Cotta, Stuttgart 2006, ISBN 3-608-94413-3 .
- August Wilhelm von Eiff Ed .: Stress - Phenomenology, Diagnosis and Therapy in the Different Stages of Life , Thieme Verlag, Stuttgart / New York 1980, ISBN 3-13-584501-X .
- Lotte Habermann-Horstmeier: "Stress" as a risk factor. Hogrefe, Bern 2017, ISBN 978-3-456-85708-4 .
- Stevan E. Hobfoll: Stress, culture, and community. Plenary, New York 1998.
- Richard Lazarus , Susan Folkman: Stress, appraisal, and coping. Springer, New York 1984
- Klaus Peter Müller: No time to live. Philosophical essays on the experience of time in modern times. Tectum, Marburg 2012, ISBN 978-3-8288-2956-5 .
- C. Palentien: Youth and Stress. Causes, development and coping. Luchterhand, Berlin 1997.
- Patrick Kury : The overwhelmed person. A story of knowledge from stress to burnout. Campus, Frankfurt / New York 2012, ISBN 978-3-593-39739-9 .
- Ludger Rensing, Michael Koch, Bernhard Rippe, Volkhard Rippe: People in stress. Psyche, body, molecules. Spectrum Academic Publishing House, Heidelberg 2005, ISBN 3-8274-1556-X .
- Klaus Scheuch, Gert Schreinicke: Stress - thoughts, theories, problems. People and Health, Berlin 1986.
- Ralf Schwarzer: Stress, fear and regulation of action. Kohlhammer, Stuttgart 2000.
- Hans Selye : Stress. Coping and life gain. From the English by Hans Th. Asbeck. Piper, Munich / Zurich 1974, ISBN 3-492-02086-0 .
- Frederic Vester : Stress as a Phenomenon. 19th edition. Deutscher Taschenbuch Verlag, Munich 2008, ISBN 978-3-423-33044-2 .
- S. Grebner, I. Berlowitz, V. Alvaro, M. Cassina: Stress among Swiss workers. Relationships between working conditions, personal characteristics, well-being and health. 2010. Accessed online June 24, 2016.
- J. Lehmann: The threat to the self as a cause of stress - an experimental operationalization of the SOS concept. Institute for Psychology, University of Bern, 2012.
- Philippe Zawieja , Franck Guarnieri (ed.): Dictionnaire des risques psychosociaux . Éditions du Seuil , Paris 2014, ISBN 978-2-02-110922-1 . (in French).
- Lea Haller, Sabine Höhler, Heiko Stoff (eds.): Stress! In: Zeithistorische Forschungen / Studies in Contemporary History. 11, issue 3, 2014.
- Federal Institute for Occupational Safety and Health: Stress Report Germany 2012
- John Carpi: Stress: It's Worse Than You Think. 1996/2010.
- Erich Latniak, Anja Gerlmaier: Between innovation and daily guerrilla warfare. (PDF; 302 kB)
- Video: Manfred Spitzer : Stress ( Memento from April 12, 2005 in the Internet Archive ) . RealVideo from the BR-alpha series "Mind and Brain" (approx. 15 minutes)
- Friedrich Kluge: Etymological dictionary of the German language . Walter de Gruyter, 1989, ISBN 3-11-084503-2 , p. 708 ( limited preview in Google Book search).
- G. Hüther: Biology of fear - how feelings become from stress. Vandenhoeck & Ruprecht, Göttingen 1997, ISBN 3-525-01439-2 .
- P. Sterling, J. Eyer: Allostasis: a new paradigm to explain arousal pathology. In: S. Fisher, J. Reason (Eds.): Handbook of life stress, cognition and health. Wiley & Sons, New York 1988, pp. 631-651.
- BS McEwen: Stress, sex, and neural adaptation to a changing environment: mechanisms of neuronal remodeling. In: Ann NY Acad Sci. 1204 Suppl, 2010, pp. E38-E59. NYAS5568 doi: 10.1111 / j.1749-6632.2010.05568.x
- Jürgen Beckmann: Understanding the causes of stress and pain: Health psychology and sociology in prevention and rehabilitation . Georg Thieme Verlag, 2009, ISBN 978-3-13-152831-5 , p. 105 ( limited preview in Google Book search).
- Peter Oehme , Karl Hecht : Reflections on substance P research; Reflections on Substance P Research (with 50 references). Leibniz Society of Sciences in Berlin, 2017. https://leibnizsozietaet.de/ergaenzende-wissenschaftliche-mitteilung-zur-substanz-p-forschung-von-peter-oehme-mls-und-karl-hecht/
- Dirk Brändli, Sandra Reinacher: Herbicides in urine. ithaka-journal.net, January 7, 2012.
- I. Cernak, V. Savic, J. Kotur, V. Prokic, B. Kuljic, D. Grbovic, M. Veljovic: Alterations in magnesium and oxidative status during chronic emotional stress. In: Magnesium Research. Official Organ of the International Society for the Development of Research on Magnesium, 13 (1), 2000, pp. 29-36. PMID 10761188
- MF van der Wal et al .: Stress and emotional problems during pregnancy and excessive infant crying. In: J Dev Behav Pediatr. 28 (6), Dec 2007, pp. 431-437. PMID 18091087
- H. Wurmser et al .: Association between life stress during pregnancy and infant crying in the first six months postpartum: a prospective longitudinal study. In: Early Hum Dev. 82 (5), May 2006, pp. 341-349. PMID 18091087
- EP Davis, CA Sandman: Prenatal psychobiological predictors of anxiety risk in preadolescent children. In: Psychoneuroendocrinology . 37 (8), Aug 2012, pp. 1224-1233. PMID 22265195
- Brigitta vom Lehm: Baby cribs are typically German. May 6, 2007, accessed July 25, 2016 .
- Vivette Glover: Maternal depression, anxiety and stress during pregnancy and child outcome; what needs to be done. In: Best Practice & Research. Clinical Obstetrics & Gynecology. Vol. 28, No. 1, 2014, pp. 25-35. PMID 24090740 , doi: 10.1016 / j.bpobgyn.2013.08.017
- M. Pluess et al .: Positive life events predict salivary cortisol in pregnant women. In: Psychoneuroendocrinology. Vol. 37, No. 8, 2012, pp. 1336-1340. PMID 22309824 , doi: 10.1016 / j.psyneuen.2012.01.006
- EBF: Recovery-Stress-Questionnaire. 1995, accessed September 23, 2011 .
- IG Metall: Health and Work ( Memento from February 7, 2010 in the Internet Archive )
- z. B. Social Network Hessen
Jens Gäbert, Brigitte Maschmann-Schulz: Codetermination in health protection. 2008, ISBN 978-3-7663-3498-5
Michael Kittner, Ralf Pieper: Occupational Safety and Health Act. 2007, ISBN 978-3-7663-3201-1 .
- see also Karōshi
- Learning in the "wood class" makes you healthy , ORF , December 21, 2009.
- School without stress. ( Memento from January 14, 2013 in the web archive archive.today ) at: www.humanresearch.at , accessed on August 14, 2012.
- Stress is a common ailment in our work environment. In: Doctors newspaper. January 18, 2010, p. 6.
- Markus Heinrichs, Tobias Stächele, Gregor Domes: Stress and coping with stress . Hogrefe, 2015, ISBN 978-3-8409-2252-7 , pp. 39–47 ( limited preview in Google Book search).
- Jürgen Bengel, Markus Wirtz, Christian Zwingmann: Diagnostic procedures in rehabilitation . Hogrefe, 2008, ISBN 978-3-8409-2095-0 , pp. 139–143 ( limited preview in Google Book search).
- Jürgen Bengel, Markus Wirtz, Christian Zwingmann: Diagnostic procedures in rehabilitation . Hogrefe Verlag, 2008, ISBN 978-3-8409-2095-0 , pp. 130–134 ( limited preview in Google Book search).
- Jürgen Bengel, Markus Wirtz, Christian Zwingmann: Diagnostic procedures in rehabilitation . Hogrefe, 2008, ISBN 978-3-8409-2095-0 , pp. 135–138 ( limited preview in Google Book search).
- see online resource 46532, Deutscher Bildungsserver ( Memento from September 25, 2011 in the Internet Archive )
- Tips for relaxation (pharmacy review). Retrieved March 27, 2018 .
- Environmental Science & Technology, online
- See e.g. B. Bruce McEwen, Eliot Stellar: Stress and the Individual: Mechanisms Leading to Disease. In: Archive of Internal Medicine. Volume 153, September 27, 1993.
- Sheldon Cohen et al: Psychological Stress and Susceptibility to the Common Cold. In: New England Journal of Medicine . Volume 325, August 1991, pp. 606-612, doi: 10.1056 / NEJM199108293250903
- Arthur A. Stone, Donald S. Cox, Heiddis Valdimarsdottir, John M. Neale: Secretory IgA as a Measure of Immunocompetence. In: Journal of Human Stress. 13, 1987, pp. 136-140, doi: 10.1080 / 0097840X.1987.9936806 .
- RD Clover et al .: Family Functioning and Stress as Predictors of Influenza B Infection. In: Journal of Family Practice. Volume 28, May 1989, ( online ( memento from July 10, 2012 in the web archive archive.today ))
- Ronald Glaser, Janice Kiecolt-Glaser: Psychological influences on immunity: Implications for AIDS. In: American Psychologist . Vol 43, Iss. Nov 11, 1988, pp. 892-898, doi: 10.1037 / 0003-066X.43.11.892
- HE Schmidt et al: Stress as a Precipitating Factor in Subjects With Recurrent Herpes Labialis. In: Journal of Family Practice. Vol 20, Iss. 4, April 1985, pp. 359-366.
- Dirk Förger: Beware of stress: the intestine “feels”. In: The world . June 14, 1997, accessed December 2, 2014 .
- Markus Köller: Even children feel stressed on their stomachs. In: childhood today . November 27, 2014, accessed December 2, 2014 .
- Flatulence, air in the abdomen. Apotheken Umschau , November 27, 2014, accessed on December 2, 2014 .
- Dysponesis, chronic unnatural muscle tension. springerlink.com
- J. Ahlberg et al.: Reported bruxism and stress experience. In: Community Dentistry and Oral Epidemiology. Volume 30, No. 6, December 2002, pp. 405-408. doi: 10.1034 / j.1600-0528.2002.00007.x
- L. Sominsky, SJ Spencer: Eating behavior and stress: a pathway to obesity. In: Front Psychol. 5, May 13, 2014, p. 434. doi: 10.3389 / fpsyg.2014.00434 .
- Achim Peters , Sebastian Junge: Myth overweight. Why fat people live longer. C. Bertelsmann Verlag, 2013, ISBN 978-3-570-10149-0 . Section type A or B? - Why some people stay slim despite stress and why that is not an advantage…. P. 24 ff.
- BA Sabel, J. Wang, L. Cárdenas-Morales, M. Faiq, C. Heim: Mental stress as consequence and cause of vision loss: the dawn of psychosomatic ophthalmology for preventive and personalized medicine. In: The EPMA Journal. Volume 9, No. 2, June 2018, pp. 133-160. PMID 29896314 , doi: 10.1007 / s13167-018-0136-8
- R. Conrad, I. Bodeewes, G. Schilling, F. Geiser, K. Imbierowicz, R. Liedtke: Chorioretinopathia centralis serosa and psychological stress. In: The ophthalmologist. Vol. 97, No. 8, August 2000, pp. 527-531. doi: 10.1007 / s003470070059
- Claudia Pedain, Julio Herrero Garcia: Case book gynecology and obstetrics. Thieme, 2011, ISBN 978-3-13-152082-1 , p. 173. (books.google.com)
- Alan Rozanski, James A. Blumenthal, Jay Kaplan: Impact of Psychological Factors on the Pathogenesis of Cardiovascular Disease and Implications for Therapy. In: Circulation. 99, 1979.
- L. Cao et al .: Environmental and Genetic Activation of a Brain-Adipocyte BDNF / Leptin Axis Causes Cancer Remission and Inhibition. In: Cell. 142, 2010, pp. 52-64. doi: 10.1016 / j.cell.2010.05.029 PMID 20603014 (quoted from SZ, July 9, 2010, p. 16.)
- Urs Willmann: Beautiful stress. In: The time. April 21, 2016. Retrieved May 21, 2016 .