
saamoohika sammarda parisodhana

manushya gaveshana pankaalikalil vishwasaneeyamaayi sammarddam srishtikkaan upayogikkunna oru laborattari prakriyayaan trier soshyal stress testt (tii. ezz. ezz. tii). munbu sammarddathinu kaaranamaakumenn ariyappettirunna nadapadikramangalude samyojanamaanithu, ennaal muun nadapadikramangal vishwasaneeyamaayi cheythilla. 1993ll trier sarvakalashaalayil clemens kirshbam sahapravarthakarum chernnaanu ithu srishtichathu.
charithram.
umineer, rakthathile serem courtisol, prolaaktin, human groth hormon (echjiechu), adrenocorticotropic hormon (aakt), hridayamidippu thudangi vividha biomarkerukalumaayi psychosocial stress bandhappettirikkunnu. 1993 nuu munbu, colled presher testt, strope testt, public speaking thudangi niravadhi laborattari jolikal gaveshanathinaayi eee stress markerukal kandethunnathinu upayogichirunnu.
eee padanangal rund prasnangal nerittu onnamathaayi, sammarddathodulla shaareerika prathikaranatthil valia vyakthigatha vyathiyaanamundaayirunnu, randaamathaayi, munbu upayogichirunna reethikal vishwasaneeyamaayi alakkaan kazhiyaathathra cheruthaayirunna phalangal srishtikkaan pravanatha kaanichu. thathfalamaayi, eee padanangalil ninnulla phalangal asthiravum vishwasaneeyamallaathathumaanu.
clemens kirshbam trier sarvakalaashaalayile sahapravarthakarum eee parimithikale marikadakkaan shramichath, sammarddam srishtikkunna vividha jolikal uyarnna nilavaaramulla formaattil samyojippichukondu, athil pothu samsaram, maanasika kanakk, prathekshakal ennivayude gadakangal ulppedunnu. mikka manushya vishaya samrakshana kammittikalum amgeekarikkaavunnathra soumyamaaya oru chumatala roopakalppana cheyyendathum avarkk aavashyamaayirunnu. avar trier soshyal stress testt ennu peritta avarude dauthyam, avarude pankaalikalil bhooribhaagathilum sthiramaayi valare valia physiological efakttukal srishtichu, angane muun gaveshanathinte parimithikale marikadannu. 1993ll neuro psychobiology jenalilaanu avar aadyamaayi eee parisodhana report cheythath.
stress gaveshanathil stress maathrkayaayi tii. ezz. ezz. tii vyaapakamaayi upayogikkunnu. udaaharanathinu, 2020-ll prasidheekaricha oru chittayaya avalokanathil tii. ezz. ezz. tii upayogicha 1099 vyathirikthamaya yadhaartha padanangal kandethi. koodaathe, kuttikalodoppam upayogikkunnathinulla oru pathipp (tii. ezz. ezz. tii-sii), sammarddamillaatha placibo pathipp, maanasikarogikalaya pankaalikalkoppam upayogikkunnathinulla oru pathipp ennivayulppede parisodhanayude niravadhi vakabhedangal vikasippicheduthittundu. tsstyumaayulla mikka gaveshanangalum sammarddathodulla shaareerika prathikaranangalil shradha kendreekarichittundu, ennaal chila gaveshakar tsst sammarddathodulla maanasika prathikaranangale engane badhikkunnu, aaa prathikaranangal shaareerika prathikaranangalumayi engane bandhappettirikkunnu ennathinekkurichu sookshumamaaya parishodhanaykkaayi vaadikkunnu.
nadapadikramam.
saamoohika moolyanirnnaya saahacharyangalodulla sammarda prathikaranatthinte durbalata chooshanam cheiyunnathinaanu tii. ezz. ezz. tii roopakalppana cheythirikkunnathu. tsst-yude vyathyastha pathippukal undengilum (udaaharanathinu, yadhaartha pathipp kurachu dairkhyameriyathaayirunnu), nilavile nadappaakkalukalil bhooribhaagavum inipparayunnavaykku samanamaaya oru paatten pinthudarunnu
induced stressinte kaalayalav ekadesham 15 minitt neendunilkkukayum 5 minitt gadakangalaayi vibhajikkukayum cheiyunnu. parisodhana aarambhikkunnathin munbu, pankedukkunnayaalkku raktham shekharikkunnathinaayi IV umm hridayamidippu monittarum gadippichirikkunnu. oru viidiyoo camera audiyo recorder sahitam moonnu jadjimaarude oru paanal kaathirikkunna oru muriyilekku pankedukkunnayaale kondupokunnathiloodeyaanu stress induction aarambhikkunnath.
aadya 5 minitt ghadakam munkoor sammarda gattamaanu, eee samayat jadjimar pankedukkunnavarodu 5 minitt avatharanam thayyarakkan aavashyappedunnu. mikka padanangalilum eee avatharanam oru thozhil abhimukhathinte bhagamaayaanu roopappeduthunnathu. koodaathe, testtiludaneelam nishpakshamaaya aavishkaarangal nilanirthaan jadjimark pariseelanam nalkiyittundu. pankedukkunnayaalkku avarude avatharanam samghadippikkaan kadalas penayum upayogikkaan anuvaadamundu, ennaal avatharanam aarambhikkaanulla samayamaakumbol eee paper apratheekshithamaayi avaril ninnu eduthukalayunnu.
5 minitt avatharana gadakathil, jadjimar abhipraayamillaathe pankedukkunnayaale nireekshikkunnu. pankedukkunnayaal muzhuvan 5 minittum upayogikkunnillenkil, avar avanodu allengil avalodu thudaraan aavasyappedum. 5 minitt muzhuvan upayogikkunnathuvare ithu thudarunnu.
avatharanathe udan thanne maanasika ganitha ghadakam pinthudarunnu, eee samayat pankedukkunnavarodu 13-nte ghattangalil 1,022-ll ninnu pinnilekku kanakkakkaan aavashyappedunnu. oru thettu sambhavichaal, avar thudakkam muthal veendum aarambikkanam. eee ghadakam 5 minitt neendunilkkukayum thudarnnu veendedukkal kaalayalav undaakukayum cheiyunnu.
parishodhanaykk thottupinnaale oru debriefing undu, athil pankedukkunnavarodu parisodhanayude uddeshyam sammarddam srishtikkukayaanennum phalangal oru tharatthilum avarude vyakthiparamaaya kazhivukalude prathifalanamallennum parayunnu. stress induction kaalayalav avasaanichathinusesham umineerinteyum rakthathinteyum saambilukal shekharikkunnathu thudarunnu.
nadapadikrama gattangal (udha.jii.1993ll prasidheekarichathinushesha tii. ezz. ezz. tii. yude courtisol nadapadikal sweekarikkunnathinulla prathyeka samayam maari. oru koottam gaveshakar varshangaliludaneelamulla reethishaasthraparamaaya mattangalekkurichu aadyathe chittayaya avalokanam nadathukayum niravadhi poruthakkedukal kandethukayum cheythu. padanangaliludaneelam tii. ezz. ezz. tii. yude upayogam maanadandamaakkuka enna uddeshyathode tii. ezz. ezz. tii. upayogikkunnathinu avar niravadhi maargganirddeshangal nirddeshichu. udaaharanathinu, ozhivakkal maanadandangal enthokke pariganikkanam, jadjimaarude paanalinte ghadana, eppol, ethra shaareerika nadapadikal sweekarikkanam (athaayath.iii. courtisol, hridayamidippu, raktham), koodaathe tii. ezz. ezz. tii reethishaasthrathinte mattu pala vashangalum.
soochakangal.
shareera sammarddathinte pradhana chaalakashakthiyaaya hypothalamic-pityoottari-adrenal axis (hpaa) sajeevamakkunnathaayi soochippikkunna niravadhi padaarthangalude alavu tsst vardhippikkunnu. prolaaktin, echu. jii. echu, aakt, courtisol (umineerilum rakthathilum) enniva ithil ulppedunnu.
niyanthranavumayi thaarathamyappeduthumbol, tii. ezz. ezz. tii anubhavathinu vidheyaraakunna saadhaarana aarogyamulla vyakthikal 30 sathamaanam (prolaaktin) muthal <aii. dii. 1> (echu. jii. echu) vare adisthaanarekhayil vardhikkunnu. eee maattangalude samayavum padaarthatthinanusarichu vyathyaasappedunnu. stress induction avasaanichathinu thottupinnaale serem courtisol, prolaaktin, aakt ennivayude alavu uyarunnu, ennaal 10 minittinusesham umineer courtisol uyarukayum 40 minittinusesham echjiechu uyarukayum cheiyunnu. pankedutthavaril 70 sathamaanathiladhikam aalukalil eee phalangal kandethi.
hridayamidippu sammarddathinte soochakam koodiyaanu. saadhaarana vyakthikalil, hridayamidippu parishodhanaykk munbu sharashari 70.5 bpmil ninnu sammarddakaramaaya joliyil paramavadhi sharashari 96.5 bpmilake pookunnu. stress induction avasaanichathinu sesham hridayamidippu vegathil saadhaarana nilayilekku madangunnu.
parasparabandhangal.
tsstyodulla prathikaranatthinte alavum dishasoochana vividha gadakangalumaayi bandhappettirikkunnave kandethiyittundu. laingikabandham, nicottin upayogam, janithakashasthram, maanasikarogam enniva ithil ulppedunnu.
purushanmaar tsstod valia courtisol prathikaranangal prakadippikkunnathaayi ariyappedunnu. sthreekal kaanikkunna sammarddathodulla courtisol prathikaranatthinte eratti purushanmaar saadhaaranayaayi kaanikkunnu. ennirunnaalum, sthreekalude courtisol prathikaranangal avarude aarthavachakrathinte eathu ghattathilaanu ennathine aasrayichirikkunnu. aarthavachakrathinte lutyal ghattathilulla sthreekalkku purushanmarumaayi thaarathamyappeduthaavunna courtisol prathikaranangalund, ennaal avarude follicular ghattatthile sthreekalude courtisol prathikaranam garbhanirodhana marggangal kazhikkunna sthreekalumaayi thaarathamyappeduthaavunnatha.
nicottin upayogavumaayi bandhappett, vittumaaraatha nicottin upabhogam pukavalikkaathavarekkaal tsstyodulla kuranja courtisol prathikaranangalumayi bandhappettirikkunnu. nicottin hypothalaamasile sii. aarr. echu adangiya neuronukalude vittumaaraatha uthejanavumaayi ithu bandhappettirikkamenn abhipraayappettittund.
courtisol prathikaranatthile vyathiyaanathinum janithaka gadakangal kaaranamaakunnu ennathinu thelivukalundu. maanasika saamoohika sammarddathodulla courtisol prathikaranam mithamaayatho uyarnnatho aanu. udaaharanathinu, bcll polymorphysatthinte vaahakam tsstyodulla umineer courtisol prathikaranam kurachittundu, athesamayam enn363ezz polymorphysatthinte vaahakam prathikaranam mechappeduthiyittundu.
maanasikarogam tii. ezz. ezz. tii prathikaranatthil, soochakatheyum rogatheyum aashrayich, palatharatthilulla phalangal undaakkunnu. laingikaathikramam, paribhranthi, aadyakaala jeevita sammarddathinte amithamaya anubhavam enniva moolamundaakunna pariharikkappedaatha aaghaatham ulppedeyulla mikka klinikkal manashaasthraparamaaya avasthakalum tsstyodulla mangiya prathikaranavumayi bandhappettirikkunnu, ennirunnaalum sathamaanam maattangalude kuranja theevratha uyarnna sharashari dainamdina sammarddam moolamundaakunna adisthaana panapperuppatthinu kaaranamakaam, eee avasthakalulla vyakthikalkk dainamdina jeevitam baadhikkappedaatha vyakthikale apekshichu parisodhanaa avasthakalodu kooduthal aduthathaayi anubhavappedunnu. tsstyodulla uyarnna prathikaranavumayi bandhapetta churukkam chila avasthakalil onnaanu mejar depression.
bhaavi dishakal.
tsstumaayulla mikka pravartthanangalum falamaayi physiological nadapadikalil shradha kendreekarichu. 2012-ll, janaa campbell alrick ehlert vaikaarika sammarddavum shaareerika soochakangalum thammilulla saadhyamaaya bandhangal parishodhikkunnathinaayi nilavilulla 358 tii. ezz. ezz. tii padanangalude avalokanam nadatthi. atharam padanangal upayogikkunna aathmanishtamaaya nadapadikalil uyarnna alavilulla poruthakkedukal avar kandethi (vividha vishwal analog skeyilukal upayogichu), athinaal avarude vishakalanathinte phalangal anishchithathvathilaayirunnu. bhaviyil eee bandham kooduthal poornnamaayi paryavekshanam cheyyaan kazhiyunnathinayi tsstcoppam upayogikkunna aathmanishtamaaya nadapadikalil kooduthal nilavaaramulla maanadandavalkkaranathinaayi avar vaadikkunnu.
tii. ezz. ezz. tii nadakkunna niyantritha saahacharyangalil, labhikkuna vaikaarika prathikaranam valare durbalav shaareerika prathikaranangalumayi sthiramaayi bandhappettirikkunnathi valare vyathyaasappettirikkum chilar abhipraayappettittund.
tii. ezz. ezz. tii oru "active" stress task aanenna kaaryam sradhikkendathaanu, mattu gaveshanangal "passive" stress taaskkukal upayogikkunnu.

