The DOI matches its Crossref record; 214 of the 216 references it cites were found in a registry or an index.
Uncertainty and stress: Why it causes diseases and how it is mastered by the brain
Open accessAbstract
The term 'stress' - coined in 1936 - has many definitions, but until now has lacked a theoretical foundation. Here we present an information-theoretic approach - based on the 'free energy principle' - defining the essence of stress; namely, uncertainty. We address three questions: What is uncertainty? What does it do to us? What are our resources to master it? Mathematically speaking, uncertainty is entropy or 'expected surprise'. The 'free energy principle' rests upon the fact that self-organizing biological agents resist a tendency to disorder and must therefore minimize the entropy of their sensory states. Applied to our everyday life, this means that we feel uncertain, when we anticipate that outcomes will turn out to be something other than expected - and that we are unable to avoid surprise. As all cognitive systems strive to reduce their uncertainty about future outcomes, they face a critical constraint: Reducing uncertainty requires cerebral energy. The characteristic of the vertebrate brain to prioritize its own high energy is captured by the notion of the 'selfish brain'. Accordingly, in times of uncertainty, the selfish brain demands extra energy from the body. If, despite all this, the brain cannot reduce uncertainty, a persistent cerebral energy crisis may develop, burdening the individual by 'allostatic load' that contributes to systemic and brain malfunction (impaired memory, atherogenesis, diabetes and subsequent cardio- and cerebrovascular events). Based on the basic tenet that stress originates from uncertainty, we discuss the strategies our brain uses to avoid surprise and thereby resolve uncertainty.
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“Psychological and neural mechanisms through which uncertainty-inducing stressors elicit negative mental states, particularly anxiety, and may lead to psychopathology have been extensively described in the literature [31,35,36,57,119,120], and these models are broadly relevant in the present context.”
From Impact of Media-Induced Uncertainty on Mental Health: Narrative-Based Perspective. (2025) · cites this paper as [120]
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“While sustained vigilance represents the initial adaptive response under conditions of uncertainty [35,120], it can develop into hypervigilance, that is, increased attention to threatening or potentially threatening stimuli.”
From Impact of Media-Induced Uncertainty on Mental Health: Narrative-Based Perspective. (2025) · cites this paper as [120]
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Items 201–214 of 214
The brain's supply and demand in obesity
Kubera, B., Hubold, C., Zug, S., Wischnath, H., Wilhelm, I., Hallschmid, M., Entringer, S., Langemann, D., & Peters, A. (2012) · Frontiers in Neuroenergetics · doi:10.3389/fnene.2012.00004 · Cited by 31
Self-citationKubera, B., Hubold, C., Otte, S., Lindenberg, A.-S., Zeiß, I., Krause, R., Steinkamp, M., Klement, J., Entringer, S., Pellerin, L., et al. (2012) · Obesity Facts · doi:10.1159/000339958 · Cited by 31
Self-citationWhy Doesn’t the Brain Lose Weight, When Obese People Diet?
Peters, A., Bosy‐Westphal, A., Kubera, B., Langemann, D., Goele, K., Later, W., Heller, M., Hubold, C., & Müller, M. J. (2011) · Obesity Facts · doi:10.1159/000327676 · Cited by 29
Self-citationReassessing VMPFC: full of confidence?
Barron, H. C., Garvert, M. M., & Behrens, T. E. J. (2015) · Nature Neuroscience · doi:10.1038/nn.4076 · Cited by 29 · cited 4×
“The ‘states that agents believe they should occupy’ are represented in regions like the ventromedial prefrontal cortex prefrontal cortex (vmPFC) and the orbitofrontal cortex (OFC) (Barron et al., 2015; Bechara et al., 2000; Gottfried et al., 2003; O'Doherty et al., 2003; Roesch and Olson, 2004).”
InfluentialMaldonato, M. N., & Dell’Orco, S. (2012) · World Futures · doi:10.1080/02604027.2012.693846 · Cited by 28 · cited 2×
“This represents a problem of causal inference for the brain, analogous in many respects to our everyday reasoning about cause and effect, and to scientific methods of causal inference (Hohwy, 2013).”
Rise of ketone bodies with psychosocial stress in normal weight men
Kubera, B., Hubold, C., Wischnath, H., Zug, S., & Peters, A. (2014) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2014.03.008 · Cited by 25
Self-citationPreserving neuroplasticity: Role of glucocorticoids and neurotrophins via phosphorylation
McEwen, B. S. (2015) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.1521416112 · Cited by 21 · cited 4×
“In many people – but not in habituators (see below) – the brain demands supplementary cerebral energy from the body stores (Peters and McEwen, 2015).”
InfluentialSelf-citationLyons, D. M., & Levine, S. D. (1994) · Psychoneuroendocrinology · doi:10.1016/0306-4530(94)90066-3 · Cited by 19 · cited 1×
“Over the past forty years, many researchers have defined stressful situations – from a bio-psychological perspective – as characterized by ‘no information, no control, uncertainty with a sense of threat’ (Koolhaas et al., 2011; Lyons and Levine, 1994; Monat et al., 1972).”
Comparison of the inhibitory effect of insulin and hypoglycemia on insulin secretion in humans
Fruehwald‐Schultes, B., Kern, W., Jan Born, A., Fehm, H. L., & Peters, A. (2000) · Metabolism · doi:10.1053/meta.2000.6757 · Cited by 14
Self-citationDexamethasone Induces TrkA and p75NTR Immunoreactivity in the Cerebral Cortex and Hippocampus
Shi, B., & Mocchetti, I. (2000) · Experimental Neurology · doi:10.1006/exnr.2000.7360 · Cited by 14 · cited 2×
“, 1999; Zhang and Poo, 2002), and that TrkB receptor production rate displays a bellshaped-dose-response dependency on glucocorticoids (Schaaf et al., 1997; Shi and Mocchetti, 2000).”
Making sense of AMPA receptor trafficking by modeling molecular mechanisms of synaptic plasticity
Langemann, D., Pellerin, L., & Peters, A. (2008) · Brain Research · doi:10.1016/j.brainres.2008.01.097 · Cited by 14
Self-citationOrtega, P. A., & Braun, D. A. (2015) · Cognitive Neuroscience · doi:10.1080/17588928.2015.1051525 · Cited by 5
Differences in fairness and trust between lean and corpulent men
Kubera, B., Klement, J., Wagner, C., Rädel, C., Eggeling, J., Füllbrunn, S., Kaczmarek, M. C., Levı́nský, R., & Peters, A. (2016) · International Journal of Obesity · doi:10.1038/ijo.2016.134 · Cited by 4
Self-citationRichmond, B. J., & Wiener, M. C. (2006) · The MIT Press eBooks · doi:10.7551/mitpress/9780262042383.003.0004 · Cited by 2 · cited 1×
“If the brain is in the business of inferring what its body should do next, it has to encode – at some level – probability distributions (Richmond and Wiener, 2007).”
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REBUS and the anarchic brain: Toward a unified model of the brain action of psychedelics
Carhart-Harris, R. L., & Friston, K. J. (2019) · Pharmacological Reviews · doi:10.1124/pr.118.017160 · Cited by 1,180
“…(Carhart-Harris, 2018a), exemplified by findings of increased brain complexity/entropy (Schartner et al., 2017) and decreased modular differentiation (Petri et al., 2014), provides an iconic image of dysregulated global brain function under psychedelics, with the 5-HT2AR as the trigger point.”
BackgroundEarly life stress and development: potential mechanisms for adverse outcomes
Smith, K. E., & Pollak, S. D. (2020) · Journal of Neurodevelopmental Disorders · doi:10.1186/s11689-020-09337-y · Cited by 500
“There is now a wealth of research in adults demonstrating that individual variability in neurobiological responses to stress is informed through the assessment of factors that shape perceptions and interpretations of stress [10, 179, 180].”
BackgroundSmith, K. E., & Pollak, S. D. (2020) · Perspectives on Psychological Science · doi:10.1177/1745691620920725 · Cited by 379
“This extended activation alters brain architecture in regions such as the PFC, amygdala, and hippocampus, which undermines adaptive regulation and coping (Peters et al., 2017).”
BackgroundAn Active Inference Approach to Interoceptive Psychopathology
Paulus, M. P., Feinstein, J. S., & Khalsa, S. S. (2019) · Annual Review of Clinical Psychology · doi:10.1146/annurev-clinpsy-050718-095617 · Cited by 394
“…attentional bias toward threat (Hakamata et al. 2010), increased worry and self-related cognitions, dysfunctional learning about bodily states over time (Van den Bergh et al. 2017), and increased allostatic load leading to increased stress and mental illness (Peters et al. 2017, Sterling 2014).”
BackgroundLevin, M. G. (2019) · Frontiers in Psychology · doi:10.3389/fpsyg.2019.02688 · Cited by 334
“…Castelfranchi, 2009; Stepp, 2009; Shemesh et al., 2010; Stepp and Turvey, 2010; Mossbridge et al., 2012; Dhar et al., 2013; Goel and Mehta, 2013; Bohm et al., 2016; De Berker et al., 2016; Katz and Springer, 2016; Peters et al., 2017; Wilson et al., 2017; Gagliano et al., 2018; Katz et al., 2018).”
Background
Metadata
- Authors
- Peters, A., McEwen, B. S., & Friston, K.
- Affiliations
- University of Lübeck (DE)
- Rockefeller University (US)
- Wellcome Centre for Human Neuroimaging (GB)
- Corresponding author
- Peters, Achim
- Venue
- Progress in Neurobiology
- Publisher
- Elsevier BV
- Published
- 2017-09
- Volume
- 156
- Pages
- 164-188
- ISSN
- 0301-0082 (ISSN-L)
- OpenAlex
- W2618517468
- Cited by
- 652
- References
- 216
- Citations by year
- 2026: 53 · 2025: 65 · 2024: 82 · 2023: 90 · 2022: 97 · 2021: 103 · 2020: 74 · 2019: 48 · 2018: 32 · 2017: 8
- FWCI
- 4.96
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Progress in Neurobiology (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Embodied and Extended Cognition
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Life Sciences › Neuroscience › Cognitive Neuroscience › Memory and Neural Mechanisms
- Keywords
- uncertainty, stress, free energy principle, information theory, entropy (information theory), surprise, brain energy metabolism, allostasis, allostatic load
- MeSH terms
- Animals, Brain, Diabetes Mellitus, Humans, Memory Disorders, Stress, Psychological, Uncertainty, Atherosclerosis
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