Psychoneuroimmunology and specific
pathological disorders (i.e. PTSD,
ADD, Depression, Anxiety, etc.)
Psychoneuroimmunology
1. The term psychoneuroimmunology was first
introduced by Robert Ader during his presidential
lecture to the American Psychosomatic Society in 1980.
2. It is essentially an integrative discipline. It seeks to
shed light on how mental evens and process modulate
the function of the immune system.
Immune System Basics
1. The ability of immune cells to circulate, enter extravascular spaces, and
recirculate permits their function of detecting pathogens and localizing
reactions to them (i.e. causing inflammation).
2. It must detect invaders and abnormal cells to accomplish the task of
protecting the individual from microscopic invaders or abnormal cells
within the individual.
3. The major cell types of the immune system derive from the
hematopoietic stem cells located in the bone marrow.
4. They differentiate into two broad cell types; megakaryocytes and
leukocytes (which can differentiate into polymorphonuclear leukocytes
(granulocytes and mononuclear leukocytes. These give rise to subtypes
including neutrophils, eosinophils, and basophils. The mononuclear
leukocytes include the monocytes and the lymphocytes. The latter
including; B lymphocytes, and NK or Natural Killer cells.
Early Studies:
David Spiegel, M.D.’s work at Stanford with 4 stage metastatic breast cancer
patients was an initial study that was a booster rocket for the field (though
some have called it into question:
The psycho/social efficacy was as expected, but the physiological changes
shocked all the investigators.
A field still in its infancy, but we are learning more each day. An example
being that every time you get angry (regardless of the justification or lack
thereof) your immune system will be suppressed for up to 6 hours.
Physiological Components to
psychological disoders:
1. Is sleep deprivation (or hypo somnia…about 5% of pts) a symptom of
depression or is depression a symptom of insomnia?????
2. Is low lPFC activity and high RPFC activity a symptom of depression or is
depression a symptom of the above??????
3. Is lack of communication between vmPFC and limbic system a symptom
of depression or is depression a symptom of the dysregulation?????
4. The same could be said for obesity, addictive behaviors, impulsive
behaviors, etc…..????
PNI
An emerging field of study with many
implications for psychiatric and
spiritual health.
Treatment Approaches
1. Implications of chronic stress
(Zebras Don’t Get Ulcers)?
(Cortisol and DHEA levels)
2. Limbic kindling and couples
counseling (cf. Steven Stosny, Ph.D.
Improving Your Marriage Without
Talking About It (w. Patricia Love).
The Red Dragon- Anger
Andy Newberg, M.D. makes a profound statement:
“Anger is, perhaps, the most dangerous emotion,
because it forces us to think, unknowingly, in narrow,
superficial ways.”
“We do not communicate with clarity or depth of
understanding, yet, we feel self-righteous and
justified in maintaining our negative beliefs.”
What do you think? Have we turned a corner on
1980’s CPE? Are there positive and negative
emotions? We, absolutely, know this to be true from
an immunological and physiological position.
Mindfulness Approaches to TX
ACT (Acceptance and Commitment Therapy).
MBSR (Mindfulness-Based Stress Reduction)
MBCT (Mindfulness-Based Cognitive Therapy)
DBT (Dialectical-Behavior Therapy)
MAP’s (Mindfulness Awareness Practice) Brain Kamp.
Buddhist Psychology (What is it? A philosophy, religion, or psychology?)
In fact, what is mindfulness?