Book Review

Stress: The Brain-Body Connection

Hellhammer, D.H. (Trier), Hellhammer, J. (Trier) (Eds) Karger, Basel (2008) (VII + 108 pp., 3 fig,CHF 42.00, Hard cover, ISBN: 978-3-8055-8295-7).

"Psychoneuroendocrinology has grown at the interface between the psychological aspects of stress, as exemplified by coping theories, and the neuroendocrine consequences of stress, including the hypothalamic-pituitary-adrenal axis and autonomic nervous system. Concordance, as well as discordance, has been observed between these two facets of the stress response, and the late Seymour Levine spent a sizeable portion of his life trying to making sense of this paradox. In contrast to earlier claims on the monotonous reactivity of the HPA axis to stress, clinical studies have emphasized the bi-directionality of this HPA response. As just one example, the classical increase in plasma cortisol level that is observed during stress is actually replaced by decreases  in certain stress-related conditions. This type of research has generated many new ideas and concepts about the nature of stress. However, the problem is that all the knowledge that has accumulated on the psychoneuroendocrinology of stress has never resulted in the emergence of any valuable diagnostic tool, despite the efforts of many generations of scientists. There is nothing like a stressometer. In the same manner, there is still no therapy guided by the principles of psychoneuroendocrinology, even if some researchers are betting on the use of antagonists of cortisol and the development of specific CRH receptor antagonists. This situation does not ultimately favor the type of translational research that needs to be carried out for the benefit of patients afflicted with stress-related disorders.

In the 174th volume of the series "Key issues in mental health" currently edited by A. Riecher-Rössler and M. Steiner, Dirk and Juliane Hellhammer, aim at introducing a new paradigmatic tool for remedying the unfortunate situation of the missing covariance between psychological and physiological aspects of the stress response. – This new toolbox is presented as the key factor for the success of a new approach to neurobehavioral medicine that would overcome its current limitations (and probably those of health psychology) so that it would permit one to "understand the language of the brain in the processing of psychological and behavioral events in stress-related disorders" Put in simpler terms, Neuropattern is nothing other than an exhaustive description of the various psychobiological elements of the stress response. This descriptive tool allows a full consideration of the diversity of the psychobiological patterns that are observed in patients. This is done with the ultimate objective of being able to discriminate different psychobiological patterns or profiles in individual patients suffering from the same category of stress-related disorders. – The book edited by Dirk and Juliane Hellhammer is very much consumer-oriented. It begins with a description of the necessity of neurobehavioral medicine for the prevention and treatment of stress-related disorders. From there, it moves to the description of the Neuropattern toolbox. Then it presents what this toolbox can be used for. This is done not just by enumerating the infinite variety of stress-related disorders, but by very ingeniously reformulating these disorders in the form of deviations from normality in the glandotropic, ergotropic and trophotropic modes of reaction. An index at the end of the book allows the disease-oriented reader to find out how his/her particular disorder of interest (e.g., chronic fatigue, post-traumatic stress disorder, metabolic syndrome, irritable bowel disorder), fits within this new framework."

Prof. Dr. Robert Dantzer
University of Illinois at Urbana-Champaign