Efferent pathway

The functional response, that is the degree to which the stimulus is recognised as a stress, is determined by the individual perceptions of the magnitude and importance of the challenge. The degree of the effector response is determined by factors, which may suppress or magnify this reaction. Thus patient reactions to a bee sting can be demonstrably different. In the truly venom-allergic patient this may lead to an immediate dramatic immune-mediated anaphylaxis. Secondly, in the bee-phobic individual, fear and pain lead to autonomic vaso-vagal collapse because of a highly psychologically reactive drive. For most people who are stung there is recognition of the pain and a local inflammatory and immune reaction in the skin but no threat to general well-being. The bee-keeper may pay no attention at all to yet another sting because it is perceived as normal or suppressed possibly by an anergic mechanism and therefore not perceived as a threat.

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