Differing mechanisms for proactive effects of intermittent and single shock on gastric ulceration

Restoring psychology's role in peptic ulcer

This paper reviews the history of the transition from the belief that gastrointestinal ulcers are caused primarily by psychological factors to the current state of belief that they are caused primarily by infection and argues that neither is fully accurate. We argue that psychological factors play a significant role as predisposing to vulnerability, modulating of precipitation, and sustaining of gastric ulceration. We review data that challenge the assumption of a simple infectious disease model and adduce recent preclinical data that confirm the predisposing, modulatory, and sustaining roles for psychological factors. We note that others, too, are now challenging the adequacy of the contemporary simple bacterial infection model. We hope to replace the competition between psychology and medicine with cooperation in understanding and treating patients suffering gastric ulceration and ulcer.

PTSD and stress sensitisation: a tale of brain and body Part 2: animal models

Animal models that are characterised by long-lasting conditioned fear responses as well as generalised behavioural sensitisation to novel stimuli following short-lasting but intense stress have a phenomenology that resembles that of PTSD in humans. These models include brief sessions of shocks, social confrontations, and a short sequence of different stressors. Subgroups of animals with different behavioural traits or coping styles during stress exposure show a different degree or pattern of long-term sensitisation. Weeks to months after the trauma, treated animals on average also show a sensitisation to novel stressful stimuli of neuroendocrine, cardiovascular and gastrointestinal motility responses as well as altered pain sensitivity and immune function. Functional neuroanatomical and pharmacological studies in these animal models have provided evidence for involvement of amygdala and medial prefrontal cortex, and of brain stem areas regulating neuroendocrine and autonomic function and pain processing. They have also generated a number of neurotransmitter and neuropeptide targets that could provide novel avenues for treatment in PTSD.

Sensitization and conditioning as contributors to gastrointestinal vulnerability

Electric shocks are stressful and if signalled can result in Pavlovian conditioning of the stress response. Stress arising from such shocks or conditioned psychological "threat" influences vulnerability to gastrointestinal disorders. Reviewed are our studies with rats showing that unconditioned stress experiences sensitize the glandular portion of the stomach to later restraint-in-water induced erosions, as an animal model of ulcer disease. These stress effects are not attributable to corticoids but may be opioid/endorphin dependent. The unconditioned stress-induced sensitization is reduced by allowing the rat either control over or prediction of the shocks even though the direct experience with shocks is identical. Elicitation of the conditioned stress response by a signal during the ulcer induction or even shortly afterwards increases gastric vulnerability to erosions. We are now finding parallel unconditioned stress effects on colonic erosions and increases in intestinal permeability induced by dextran sulphate sodium, as an animal model of inflammatory bowel disease. We conclude that psychological context of past trauma and/or current threat increases vulnerability to gastrointestinal disorders.

Anxiety and helplessness in the face of stress predisposes, precipitates, and sustains gastric ulceration

When an organism is subjected to stress, gastric ulcers or ulcerations commonly develop but the vulnerability to and amount of pathology induced varies considerably between individuals. The role of psychological factors in determining the occurrence and severity of these ulcerations is amply demonstrated in the studies reviewed here. The present paper (a) gives a brief history of the search for the causes of gastric ulcer, (b) provides a review of our own research which reveals that vulnerability to gastric ulceration is modulated by psychologically meaningful experiences, and (c) offers a multifactorial perspective on the causes of gastric ulceration and the future of research on it.

Amino Acid Effects on Post-Stress Ulcers: Relationship to Brain Serotonin, 5-HIAA and Norepinephrine

To replicate and extend results of earlier studies on amino acid effects on post-stress ulcers, rats were subjected to i.p. injections of (a) saline, (b) tryptophan, (c) tyrosine + valine or(d) tryptophan + tyrosine + valine, either 30 minutes before or immediately after one hour of water restraint stress. Gastric lesions, brain norepinephrine, serotonin and 5-hydroxyindoleacetic acid (5-HIAA) were examined after one hour of poststress rest. We hypothesised that post-stress lesions could be aggravated by central noradrenergic hypoactivity and serotonergic hyperactivity during the post-stress period. Other studies have indicated that tyrosine + valine reduces central serotonergic activity, while additional tryptophan blocks this effect. We therefore expected post-stress lesions to be reduced in tyrosine + valine but not in tryptophan + tyrosine + valine treated animals. Although these expectations were met tentatively in animals injected prior to stress, thus replicating tyrosine + valine effects we had observed earlier, opposite results were found in animals treated post-stress. The brain analyses indicate that the data cannot be explained by a norepinephrine/serotonin imbalance hypothesis. The time dependency of the effects underlines the need for caution in clinical applications of these amino acid treatments.

Prediction of individual vulnerability to stress-induced gastric ulcerations in rats: a factor analysis of selected behavioral and biological indices

Fifty rats were subjected seriatim to 6 different test tasks (open-field, startle, drug-induced sterotypy, oral finickiness, defensive burying, and memory for aversive event). This yielded 12 test-specific plus 2 general biobehavioral measures (growth and defecation). These 14 measures were subjected to factor analysis to determine if these measured tapped a common construct of "emotionality." The data yielded a 4-factor structure of Finickiness, Defensiveness, Startle-Sensitivity, and Dopaminergic-Sensitivity that accounted for 62% of the variance. Then, all rats were subjected to restraint-in-water stress to induce gastric ulcerations. Multivariate techniques tested if there was a factor or factor-structure that could predict individual differences in vulnerability to the stress-induced gastric ulcerations. Only the Dopaminergic-Sensitivity factor predicted ulcerogenic vulnerability, and its predictive power resided substantially in the latency to initiate stereotypic gnawing induced by apomorphine. This single test score correlated with amount of ulcer (r = +0.52), accounting for 25% of the variance in ulcer, suggesting that 1. prescreening rats on this variable could be a tool for reducing intrastrain experimental variance in future studies of treatments that modulate ulcerogenicity, and 2. the dopaminergic system may be intimately involved in the causal path of ulcerogenicity.

Endogenous opiates: 1994

This article is the 17th installment of our annual review of research concerning the opiate system. It includes papers published during 1994 involving the behavioral, nonanalgesic, effects of the endogenous opiate peptides. The specific topics covered this year include stress; tolerance and dependence; eating; drinking; gastrointestinal, renal, and hepatic function; mental illness and mood; learning, memory, and reward; cardiovascular responses; respiration and thermoregulation; seizures and other neurological disorders; electrical-related activity; general activity and locomotion; sex, pregnancy, and development; immunological responses; and other behaviors.