The fight-or-flight or the fight-flight-freeze-or-fawn [1] (also called hyperarousal or the acute stress response) is a physiological reaction that occurs in response to a perceived harmful event, attack, or threat to survival. [2] It was first described by Walter Bradford Cannon in 1915. [a] [3] His theory states that animals react to threats with a general discharge of the sympathetic nervous system, preparing the animal for fighting or fleeing. [4] More specifically, the adrenal medulla produces a hormonal cascade that results in the secretion of catecholamines, especially norepinephrine and epinephrine. [5] The hormones estrogen, testosterone, and cortisol, as well as the neurotransmitters dopamine and serotonin, also affect how organisms react to stress. [6] The hormone osteocalcin might also play a part. [7] [8]
This response is recognised as the first stage of the general adaptation syndrome that regulates stress responses among vertebrates and other organisms. [9]
Originally understood as the "fight-or-flight" response in Cannon's research, [3] the state of hyperarousal results in several responses beyond fighting or fleeing. This has led people to calling it the "fight, flight, freeze" response, "fight-flight-freeze-fawn" [1] [ citation needed ] or "fight-flight-faint-or-freeze", among other variants. [10]
The wider array of responses, such as freezing, flop, faint, flee and fright, [11] has led researchers to use more neutral or accommodating terminology such as "hyperarousal" or the "acute stress response".
The autonomic nervous system is a control system that acts largely unconsciously and regulates heart rate, digestion, respiratory rate, pupillary response, urination, and sexual arousal. This system is the primary mechanism in control of the fight-or-flight response and its role is mediated by two different components: the sympathetic nervous system and the parasympathetic nervous system. [12]
The sympathetic nervous system originates in the spinal cord and its main function is to activate the arousal responses that occur during the fight-or-flight response. [13] The sympathetic nervous system transfers signals from the dorsal hypothalamus, which activates the heart, increases vascular resistance, and increases blood flow, especially to the muscle, heart, and brain tissues. [14] It activates the adrenal medulla, releasing catecholamines that amplify the sympathetic response. Additionally, this component of the autonomic nervous system utilizes and activates the release of norepinephrine by the adrenal glands in the reaction. [15]
The parasympathetic nervous system originates in the sacral spinal cord and medulla, physically surrounding the sympathetic origin, and works in concert with the sympathetic nervous system. It is known as the calming portion of the autonomic nervous system. [16] While the sympathetic nervous system is activated, the parasympathetic nervous system decreases its response. Efferent vagal fibers originating from the nucleus ambiguous fire in parallel to the respiratory system, decreasing the vagal cardiac parasympathetic tone. [17] After the fight or flight response, the parasympathetic system's main function is to activate the "rest and digest" response and return the body to homeostasis. This system utilizes and activates the release of the neurotransmitter acetylcholine. [18]
The reaction begins in the amygdala, which triggers a neural response in the hypothalamus. The initial reaction is followed by activation of the pituitary gland and secretion of the hormone ACTH. [19] The adrenal gland is activated almost simultaneously, via the sympathetic nervous system, and releases the hormone epinephrine. The release of chemical messengers results in the production of the hormone cortisol, which increases blood pressure, blood sugar, and suppresses the immune system. [20]
The initial response and subsequent reactions are triggered in an effort to create a boost of energy. This boost of energy is activated by epinephrine binding to liver cells and the subsequent production of glucose. [21] Additionally, the circulation of cortisol functions to turn fatty acids into available energy, which prepares muscles throughout the body for response. [22]
Catecholamine hormones, such as adrenaline (epinephrine) or noradrenaline (norepinephrine), facilitate immediate physical reactions associated with a preparation for violent muscular action. [23]
The physiological changes that occur during the fight or flight response are activated in order to give the body increased strength and speed in anticipation of fighting or running. Some of the specific physiological changes and their functions include: [24] [25] [26]
In the context of the fight or flight response, emotional regulation is used proactively to avoid threats of stress or to control the level of emotional arousal. Emotional socialization can develop someone's ability to successfully regulate their emotions. Faced with a perceived threat (in the context of a fight or flight situation) those raised with supportive parental behaviors are far more likely to easily self-regulate their emotions. [27] [28]
During the reaction, the intensity of emotion that is brought on by the stimulus will also determine the nature and intensity of the behavioral response. [29] In a experiment conducted by Clayton, Lang, Leshner and Quick (2019), they viewed the responses of 49 participants to antitobacco messages. [30] Participants reacted in two orders of fashion after seeing the message with the individual smoker and their affects on those surrounding them. [31] The first reaction was participants who had higher defense mechanisms, who decided to ignore the messages, while the other participants who had lower defense mechanisms, ended up arguing and becoming frustrated after viewing the antitobacco messages. [32] [33] Individuals with higher levels of emotional reactivity (Such as an anxiety disorder) may be prone to anxiety and aggression, which illustrates the implications of appropriate emotional reaction in the fight or flight response. [34] [35]
The specific components of cognitions in the fight or flight response seem to be largely negative. These negative cognitions may be characterised by: attention to negative stimuli, the perception of ambiguous situations as negative, and the recurrence of recalling negative words. [36] There also may be specific negative thoughts associated with emotions commonly seen in the reaction. [37]
Perceived control relates to an individual's thoughts about control over situations and events. [38] Perceived control should be differentiated from actual control because an individual's beliefs about their abilities may not reflect their actual abilities. Therefore, overestimation or underestimation of perceived control can lead to anxiety and aggression. [39]
The social information processing model proposes a variety of factors that determine behavior in the context of social situations and preexisting thoughts. [40] The attribution of hostility, especially in ambiguous situations, seems to be one of the most important cognitive factors associated with the fight or flight response because of its implications towards aggression. [41]
An evolutionary psychology explanation is that early animals had to react to threatening stimuli quickly and did not have time to psychologically and physically prepare themselves. [42] The fight or flight response provided them with the mechanisms to rapidly respond to threats against survival. [43] [44]
A typical example of the stress response is a grazing zebra. If the zebra sees a lion closing in for the kill, the stress response is activated as a means to escape its predator. The escape requires intense muscular effort, supported by all of the body's systems. The sympathetic nervous system's activation provides for these needs. A similar example involving fight is of a cat about to be attacked by a dog. The cat shows accelerated heartbeat, piloerection (hair standing on end), and pupil dilation, all signs of sympathetic arousal. [23] Note that the zebra and cat still maintain homeostasis in all states.
In July 1992, Behavioral Ecology published experimental research conducted by biologist Lee A. Dugatkin where guppies were sorted into "bold", "ordinary", and "timid" groups based upon their reactions when confronted by a smallmouth bass (i.e. inspecting the predator, hiding, or swimming away) after which the guppies were left in a tank with the bass. After 60 hours, 40 percent of the timid guppies and 15 percent of the ordinary guppies survived while none of the bold guppies did. [45] [46]
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Animals respond to threats in many complex ways. Rats, for instance, try to escape when threatened but will fight when cornered. Some animals stand perfectly still so that predators will not see them. Many animals freeze or play dead when touched in the hope that the predator will lose interest. [47]
Other animals have alternative self-protection methods. Some species of cold-blooded animals change color swiftly to camouflage themselves. [48] These responses are triggered by the sympathetic nervous system, but, in order to fit the model of fight or flight, the idea of flight must be broadened to include escaping capture either in a physical or sensory way. Thus, flight can be disappearing to another location or just disappearing in place, and fight and flight are often combined in a given situation. [49]
The fight or flight actions also have polarity – the individual can either fight against or flee from something that is threatening, such as a hungry lion, or fight for or fly towards something that is needed, such as the safety of the shore from a raging river.
A threat from another animal does not always result in immediate fight or flight. There may be a period of heightened awareness, during which each animal interprets behavioral signals from the other. Signs such as paling, piloerection, immobility, sounds, and body language communicate the status and intentions of each animal. There may be a sort of negotiation, after which fight or flight may ensue, but which might also result in playing, mating, or nothing at all. An example of this is kittens playing: each kitten shows the signs of sympathetic arousal, but they never inflict real damage.
Acute stress response is a common issue in self-defense criminal cases. Expert opinions are usually required if the defender's fault becomes the focus of the case. [50]
Fear is an intensely unpleasant emotion in response to perceiving or recognizing a danger or threat. Fear causes psychological changes that may produce behavioral reactions such as mounting an aggressive response or fleeing the threat. Fear in human beings may occur in response to a certain stimulus occurring in the present, or in anticipation or expectation of a future threat perceived as a risk to oneself. The fear response arises from the perception of danger leading to confrontation with or escape from/avoiding the threat, which in extreme cases of fear can be a freeze response. The fear response is also implicated in a number of mental disorders, particularly anxiety disorders.
Stress, whether physiological, biological or psychological, is an organism's response to a stressor such as an environmental condition. When stressed by stimuli that alter an organism's environment, multiple systems respond across the body. In humans and most mammals, the autonomic nervous system and hypothalamic-pituitary-adrenal (HPA) axis are the two major systems that respond to stress. Two well-known hormones that humans produce during stressful situations are adrenaline and cortisol.
The autonomic nervous system (ANS), sometimes called the visceral nervous system and formerly the vegetative nervous system, is a division of the nervous system that operates internal organs, smooth muscle and glands. The autonomic nervous system is a control system that acts largely unconsciously and regulates bodily functions, such as the heart rate, its force of contraction, digestion, respiratory rate, pupillary response, urination, and sexual arousal. The fight-or-flight response, also known as the acute stress response, is set into action by the autonomic nervous system.
The hypothalamic–pituitary–adrenal axis is a complex set of direct influences and feedback interactions among three components: the hypothalamus, the pituitary gland, and the adrenal glands. These organs and their interactions constitute the HPS axis.
The sympathetic nervous system is one of the three divisions of the autonomic nervous system, the others being the parasympathetic nervous system and the enteric nervous system. The enteric nervous system is sometimes considered part of the autonomic nervous system, and sometimes considered an independent system.
Physiological psychology is a subdivision of behavioral neuroscience that studies the neural mechanisms of perception and behavior through direct manipulation of the brains of nonhuman animal subjects in controlled experiments. This field of psychology takes an empirical and practical approach when studying the brain and human behavior. Most scientists in this field believe that the mind is a phenomenon that stems from the nervous system. By studying and gaining knowledge about the mechanisms of the nervous system, physiological psychologists can uncover many truths about human behavior. Unlike other subdivisions within biological psychology, the main focus of psychological research is the development of theories that describe brain-behavior relationships.
Arousal is the physiological and psychological state of being awoken or of sense organs stimulated to a point of perception. It involves activation of the ascending reticular activating system (ARAS) in the brain, which mediates wakefulness, the autonomic nervous system, and the endocrine system, leading to increased heart rate and blood pressure and a condition of sensory alertness, desire, mobility, and reactivity.
Psychoneuroimmunology (PNI), also referred to as psychoendoneuroimmunology (PENI) or psychoneuroendocrinoimmunology (PNEI), is the study of the interaction between psychological processes and the nervous and immune systems of the human body. It is a subfield of psychosomatic medicine. PNI takes an interdisciplinary approach, incorporating psychology, neuroscience, immunology, physiology, genetics, pharmacology, molecular biology, psychiatry, behavioral medicine, infectious diseases, endocrinology, and rheumatology.
The baroreflex or baroreceptor reflex is one of the body's homeostatic mechanisms that helps to maintain blood pressure at nearly constant levels. The baroreflex provides a rapid negative feedback loop in which an elevated blood pressure causes the heart rate to decrease. Decreased blood pressure decreases baroreflex activation and causes heart rate to increase and to restore blood pressure levels. Their function is to sense pressure changes by responding to change in the tension of the arterial wall. The baroreflex can begin to act in less than the duration of a cardiac cycle and thus baroreflex adjustments are key factors in dealing with postural hypotension, the tendency for blood pressure to decrease on standing due to gravity.
Acute stress reaction (ASR), also known as psychological shock, mental shock, or simply shock, and acute stress disorder (ASD), is a psychological response to a terrifying, traumatic, or surprising experience. Combat stress reaction (CSR) is a similar response to the trauma of war. The reactions may include but are not limited to intrusive or dissociative symptoms, and reactivity symptoms such as avoidance or arousal. It may be exhibited for days or weeks after the traumatic event. If the condition is not correctly addressed, it may develop into post-traumatic stress disorder (PTSD).
Norepinephrine (NE), also called noradrenaline (NA) or noradrenalin, is an organic chemical in the catecholamine family that functions in the brain and body as a hormone, neurotransmitter and neuromodulator. The name "noradrenaline" is more commonly used in the United Kingdom, whereas "norepinephrine" is usually preferred in the United States. "Norepinephrine" is also the international nonproprietary name given to the drug. Regardless of which name is used for the substance itself, parts of the body that produce or are affected by it are referred to as noradrenergic.
Chronic stress is the physiological or psychological response induced by a long-term internal or external stressor. The stressor, either physically present or recollected, will produce the same effect and trigger a chronic stress response. There is a wide range of chronic stressors, but most entail relatively prolonged problems, conflicts and threats that people encounter on a daily basis. Several chronic stressors have been identified as associated with disease and mortality including "neighbourhood environment, financial strain, interpersonal stress, work stress and caregiving."
Polyvagal theory (PVT) is a collection of proposed evolutionary, neuroscientific, and psychological constructs pertaining to the role of the vagus nerve in emotion regulation, social connection and fear response. The theory was introduced in 1994 by Stephen Porges. There is consensus among experts that the assumptions of the polyvagal theory are untenable. PVT is popular among some clinical practitioners and patients, but it is not endorsed by current social neuroscience.
Adrenaline, also known as epinephrine, is a hormone and medication which is involved in regulating visceral functions. It appears as a white microcrystalline granule. Adrenaline is normally produced by the adrenal glands and by a small number of neurons in the medulla oblongata. It plays an essential role in the fight-or-flight response by increasing blood flow to muscles, heart output by acting on the SA node, pupil dilation response, and blood sugar level. It does this by binding to alpha and beta receptors. It is found in many animals, including humans, and some single-celled organisms. It has also been isolated from the plant Scoparia dulcis found in Northern Vietnam.
Voodoo death, a term coined by Walter Cannon in 1942 also known as psychogenic death or psychosomatic death, is the phenomenon of sudden death as brought about by a strong emotional shock, such as fear. The anomaly is recognized as "psychosomatic" in that death is caused by an emotional response—often fear—to some suggested outside force. Voodoo death is observed in native societies, and concentration camps or prisoner of war camps, but the condition is not specific to any particular culture.
Neural top–down control of physiology concerns the direct regulation by the brain of physiological functions. Cellular functions include the immune system’s production of T-lymphocytes and antibodies, and nonimmune related homeostatic functions such as liver gluconeogenesis, sodium reabsorption, osmoregulation, and brown adipose tissue nonshivering thermogenesis. This regulation occurs through the sympathetic and parasympathetic system, and their direct innervation of body organs and tissues that starts in the brainstem. There is also a noninnervation hormonal control through the hypothalamus and pituitary (HPA). These lower brain areas are under control of cerebral cortex ones. Such cortical regulation differs between its left and right sides. Pavlovian conditioning shows that brain control over basic cell level physiological function can be learned.
The effects of stress on memory include interference with a person's capacity to encode memory and the ability to retrieve information. Stimuli, like stress, improved memory when it was related to learning the subject. During times of stress, the body reacts by secreting stress hormones into the bloodstream. Stress can cause acute and chronic changes in certain brain areas which can cause long-term damage. Over-secretion of stress hormones most frequently impairs long-term delayed recall memory, but can enhance short-term, immediate recall memory. This enhancement is particularly relative in emotional memory. In particular, the hippocampus, prefrontal cortex and the amygdala are affected. One class of stress hormone responsible for negatively affecting long-term, delayed recall memory is the glucocorticoids (GCs), the most notable of which is cortisol. Glucocorticoids facilitate and impair the actions of stress in the brain memory process. Cortisol is a known biomarker for stress. Under normal circumstances, the hippocampus regulates the production of cortisol through negative feedback because it has many receptors that are sensitive to these stress hormones. However, an excess of cortisol can impair the ability of the hippocampus to both encode and recall memories. These stress hormones are also hindering the hippocampus from receiving enough energy by diverting glucose levels to surrounding muscles.
The sympathoadrenal system is a physiological connection between the sympathetic nervous system and the adrenal medulla and is crucial in an organism's physiological response to outside stimuli. When the body receives sensory information, the sympathetic nervous system sends a signal to preganglionic nerve fibers, which activate the adrenal medulla through acetylcholine. Once activated, norepinephrine and epinephrine are released directly into the blood by adrenomedullary cells where they act as the bodily mechanism for "fight-or-flight" responses. Because of this, the sympathoadrenal system plays a large role in maintaining glucose levels, sodium levels, blood pressure, and various other metabolic pathways that couple with bodily responses to the environment. During numerous diseased states, such as hypoglycemia or even stress, the body's metabolic processes are skewed. The sympathoadrenal system works to return the body to homeostasis through the activation or inactivation of the adrenal gland. However, more severe disorders of the sympathoadrenal system such as pheochromocytoma can affect the body's ability to maintain a homeostatic state. In these cases, curative agents such as adrenergic agonists and antagonists are used to modify epinephrine and norepinephrine levels released by the adrenal medulla.
Neurocardiology is the study of the neurophysiological, neurological and neuroanatomical aspects of cardiology, including especially the neurological origins of cardiac disorders. The effects of stress on the heart are studied in terms of the heart's interactions with both the peripheral nervous system and the central nervous system.
The shift-and-persist model has emerged in order to account for unintuitive, positive health outcomes in some individuals of low socioeconomic status. A large body of research has previously linked low socioeconomic status to poor physical and mental health outcomes, including early mortality. Low socioeconomic status is hypothesized to get "under the skin" by producing chronic activation of the sympathetic nervous system and hypothalamic–pituitary–adrenal axis, which increases allostatic load, leading to the pathogenesis of chronic disease. However, some individuals of low socioeconomic status do not appear to experience the expected, negative health effects associated with growing up in poverty. To account for this, the shift-and-persist model proposes that, as children, some individuals of low socioeconomic status learn adaptive strategies for regulating their emotions ("shifting") and focusing on their goals ("persisting") in the face of chronic adversity. According to this model, the use of shift-and-persist strategies diminishes the typical negative effects of adversity on health by leading to more adaptive biological, cognitive, and behavioral responses to daily stressors.