Neuroanatomy and Control of the Uncertainty and Stress Process Triggered by Disasters

Öz

Uncertainty is characterized by the feeling of anxiety experienced in danger. It is an important factor that causes stress. To maintain a state of complete well-being, people need to be confident that they can maintain their physical, mental, and social well-being. When a change occurs external or internal, it is considered which strategy to choose to maintain this well-being. Uncertainty occurs and stress is triggered when hesitant to choose the appropriate strategy. With the hierarchical structure in brain, sensory and interoceptive inputs from the sensorimotor and visceral sensory cortex are transmitted to the lateral prefrontal cortex. Estimation errors between the current situation and what needs to be done are detected. The larger difference, the greater uncertainty about which strategy to choose and the stronger the activation of the amygdala. The indecisiveness of the anterior cingulate cortex in choosing the appropriate strategy increases amygdala activation. To clear uncertainty, the brain goes on alert. The anterior cingulate cortex-amygdala complex activates three systems: attention, learning, and habit. Neuroendocrine responses activated by arousal contribute to learning and synapse formation. Making stress responses a habit is important to create a faster response when faced with similar situations later. In the case of chronic stress, effects on metabolic, cardiovascular, immune systems, cognitive functions, and post-traumatic stress disorders can be seen. Post-traumatic stress disorders are common in disasters where people feel helpless and lose their sense of control. Making contingency plans, and habit processes in mind through exercises and trainings will speed process of choosing appropriate strategy and minimize uncertainty and stress it causes. The aim of this review is to reveal coping methods by addressing the neuroanatomy and control mechanism of the stress process, which is likely to be triggered by disaster-related uncertainties.

Anahtar Kelimeler

• Uncertainty
• stress
• trauma
• natural disaster
• earthquake.

Afetlerle Tetiklenen Belirsizlik ve Stres Sürecinin Nöroanatomisi ve Kontrolü

Öz

Belirsizlik, tehlike altında yaşanan endişe duygusuyla karakterizedir. Strese yol açan önemli bir faktördür. İnsanların tam iyilik halini sürdürebilmesi için fiziksel, zihinsel ve sosyal açılardan iyilik halini koruyabileceklerinden emin olmaları gerekir. Dışsal ya da içsel bir değişiklik meydana geldiğinde bu iyilik halini korumak için hangi stratejinin seçilmesi gerektiği düşünülür. Uygun stratejiyi seçmek konusunda kararsız kalındığında belirsizlik oluşur ve stres duygusu tetiklenir. Beyindeki hiyerarşik yapılanma ile, sensorimotor ve visserosensori kortekse gelen duyusal ve interoseptif girdiler, lateral prefrontal kortekse iletilir. Bu yapılar arasındaki bilgi akışı ile mevcut durum ile yapılması gerekenler arasındaki tahmin hataları tespit edilir. Farklılıklar veya risk ne kadar büyük olursa, hangi stratejinin seçileceğine dair belirsizlik o kadar artar ve amigdalanın aktivasyonu o kadar güçlü olur. Anterior singulat korteksin uygun stratejiyi seçmede kararsız kalması amigdala aktivasyonunu artırır. Belirsizliği gidermek için beyin alarm durumuna geçer ve anterior singulat korteks-amigdala kompleksi üç sistemi aktive eder. Bu sistemler, dikkat, öğrenme ve alışkanlıktır. Uyarılma ile aktive olan nöroendokrin yanıtlar öğrenmeye ve sinaps oluşumuna katkıda bulunur. Bu stres yanıtlarının alışkanlık haline getirilmesi daha sonra benzer durumlarla karşılaşıldığında daha hızlı yanıt oluşturabilmek için önemlidir. Kronik stres durumunda metabolik hastalıklar, kardiyovasküler etkilenimler, immün sistemde zayıflama, bilişsel fonksiyonlarda etkilenimler ve travma sonrası stres bozuklukları görülebilir. Travma sonrası stres bozuklukları, insanların kendini çaresiz hissettikleri ve kontrol hissini kaybettikleri doğal afetlerde sık görülür. Acil durum planlarının yapılması, tatbikatlar ve eğitimlerle, öğrenme ve alışkanlık süreçlerinin önceden hafızada yer etmesi uygun stratejiyi seçme sürecini hızlandırarak belirsizliği ve neden olduğu stresi en aza indirecektir. Bu derlemenin amacı, afet nedenli belirsizliklerle tetiklenme olasılığı olan stres sürecinin nöroanatomisini ve kontrol mekanizmasını ele alarak başa çıkma yöntemlerini ortaya koymaktır.

Anahtar Kelimeler

• Belirsizlik
• stres
• travma
• afet
• deprem.

Kaynakça

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