Stress and Addiction: When a Robust Stress Response Indicates Resiliency

Area of Science:

• Neuroscience
• Psychology
• Physiology

Background:

• Traditionally, stress reactivity research focused on exaggerated stress responses and their health impacts.
• Emerging evidence indicates that attenuated (blunted) stress responses and delayed recovery also pose significant health risks.

Purpose of the Study:

• To review the role of the hypothalamic-pituitary-adrenocortical axis, endogenous opioid system, and cardiovascular system in hypertension, pain perception, and addictive behaviors.
• To integrate findings on stress response alterations and their implications for health and disease.

Main Methods:

• Review of research integrating laboratory findings over two decades with external studies and theories.
• Focus on assessment methods and stress paradigms relevant to hypertension, pain, and addiction.

Main Results:

• Exaggerated stress responses and blunted pain perception are linked to hypertension and cardiovascular disease risk.
• Blunted stress responses correlate with increased pain sensitivity, withdrawal symptom exacerbation, and relapse in nicotine addiction.
• Sex, personality, and early life adversity are key moderators of stress response alterations.

Conclusions:

• A blunted stress response may signify long-term physiological dysregulation with potential consequences for cardiovascular health, pain, and addiction.
• Individual and situational factors critically influence the clinical significance of stress response dysregulation.