The central adaptation syndrome: Psychosocial stress as a trigger for adaptive modifications of brain structure and brain function

This review makes an attempt to combine data from biological and psychosocial stress literature and to suggest an alternative interpretation of the relationship between stress and disease. It rearranges the presently available knowledge on the short- and long-term effects of stress on many different aspects of brain structure and brain function in the form of a new conceptualization of the biological role of the stress response. The higher associative brain structures are not only the sites in which environmental and psychosocial demands are recognized and from which a less or more systemic, i.e. controllable or uncontrollable, stress response is initiated. They are also the sites which are primarily affected in the course of the stress response: the stress response acts as a trigger for the adaptive modification of the structure and the function of the brain of higher vertebrates and serves thus to adjust, in a self-optimizing manner, the behavior of an individual to the ever-changing requirements of its external world. This novel concept summarizes a large amount of information into a framework that lends itself to testable strategies for future research.