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Psihijatrija danas
2000, vol. 32, br. 2-3, str. 73-93
jezik rada: srpski
vrsta rada: neklasifikovan
Psihobiološke osnove akutnog stresnog poremećaja i posttraumatskog stresnog poremećaja
Univerzitet u Beogradu, Medicinski fakultet, Institut za neurologiju i psihijatriju za decu i omladinu

Sažetak

Stres je uvek isti odgovor organizma na stresne faktore, stresni faktor je svaki onaj dejstveni agens koji taj organizam ugrožava. Kod čoveka kao stresni faktori osim fizičkih, deluju i psihički stresni faktori. Akutni stresni poremećaj i posttraumatski stresni poremećaj su označeni kao poremećaji koji su neposredno izazvani stresom. Polazeći od postavke bio-psiho-socijalnog jednistva čoveka, neophodno je sagledati neke psihološke i biološke teorije nastanka ovih poremećaja. Psihotraumatizovani ljudi razvijaju svoje odbrambene mehanizme da bi se odbranili od intruzivnih elemenata vezanih za traumu i povećane su razdražljivosti. Ukoliko do ovoga ne dođe onda ovaj događaj počinje svoj nezavisni 'svugde i stalno lebdeći život' (traumatske memorije-paraziti uma). Kada se razvije PTSP, naknadne intruzije više nemaju adaptivnu funkciju, već naprotiv postaju toksične i vode ka senzitizaciji. Svako naknadno prisećanje dovodi do daljeg distresa. Vremenom ove negativne posledice počinju da dobijaju i svoje biološke korelate. Autonomni nervni sistem se slabije habituira na nove nadražaje pri kojima je registrovan i povećan skok adrenalina i noradrenalina. Registrovane su promene u nivou adrenalina, noradrenalina i serotonina, ali nema međusobnog preklapanja ovih promena, što ukazuje na multi neurotransmitersku etiologiju ovih poremećaja. Psihoendokrine studije o PTSP-u su dale podatke o niskom nivou kortizola, visokom noradrenalinu i adrenalinu, visokom testosteronu, visokom slobodnom i totalnom trijod tironinu i totalnom tetrajod tironinu. Registrovane su i neuroanatomske promene među kojima je najznačajnije smanjenje volumena hipokampusa, a studije pozitron emisione tomografije ukazuju na povećanje aktivnosti pojedinih zona tokom podsećanja na trumatsko iskustvo. Takođe su registrovane i značajne psiho-neuro-imunološke promene.

Ključne reči

stres; anksioznost; akutni stresni poremćaj; posttraumatski stresni poremećaj; paraziti uma; podsvesne fiksirane ideje; neuroendokrine promene; neuroimidžing; psihoneuroimunologija

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