Linking Social & Behavioral
Sciences with Biology
Jessica Kitchen
EPI 6181
Wednesday, April 2, 2008
Overview
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Description of Psychosomatics
History & Background Information
Theoretical Approaches
Introduction to Mind-Body
The Mind
The Limbic System
The Mind-Body Pathway
Hypothalamic-Pituitary-Adrenal Axis (HPA)
Sympathetic-Adrenal-Medulla Axis (SAM)
Link between Social Status & Physiological
Responses
Psychosomatics
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Psychosomatics = A branch of
psychiatry that looks at the
relationship between emotional and
physical health: can feelings &
emotions influence physical health?
Psychosomatic: ‘psyche’ = soul and
‘soma’ = body
Background Information
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Hysteria
• Seen as an “imaginary disease”
• In Greek "hysteria" = uterus
• Believed the uterus could detach and
move throughout the body and
hysterical symptoms would emanate
from wherever the uterus was lodged
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By the 17th & 18th centuries the
disorder was recognized as being
associated with emotional causation
History
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Johann Christian August Heinroth introduced the
term ‘psychosomatic’ in 1818 to describe the
notion of the mind being capable of enticing both
mental and physical illness
Sigmund Freud believed that hysterical
symptoms resulted from undischarged
“memories” connected to “physical and
psychological” trauma
Franz Alexander tried to establish a link between
physiology and Freudian theory (early 20th
century)
• Emotion leads to physical illness as a result of prolonged
overarousal of the autonomic nervous system
• Identified that unconscious wishes and infantile desires
in the “psychic stimuli” precipitate specific physiological
responses
History
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Adolf Meyer introduced psychobiology;
emphasized that biological, psychological
and social factors all contribute to disease
(early 20th century)
Cannon (1927) mapped the anatomic and
chemical pathways showing how different
emotions produced patterns of
physiological alterations
Pavlov’s dogs demonstrated how visceral
somatic organs could respond to mental
signals
Theoretical approaches
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Psychophysiology – focuses on how
emotion, thoughts etc. modify the
physiological response to a stimulus
• Selye noted that the stress response is
dependent on the nature, the intensity and the
individual’s previous experience with that
stimulus
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Psychoanalytical Approaches – noted that
stress produces a general effect;
attempted to explain why a particular
organ was affected in under certain
circumstances
Theoretical approaches
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Cognitive Theories – evaluated the links
between stress, personality and coping
• Martin (1985) identified the alexithymic
personality:
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Inability to identify stressful situations and express
emotions, leading to inability to modify and cope
Oriental Theories – oriental medicine
attempts to restore balance of the “ki”
energy, which regulates somatic and
psychosocial aspects
Other approaches include Sociological,
Family Systems theory etc.
Introduction
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Stimulus → Interpretation →
Emotional response → Biological
response
Our physiological reaction to an
event is dependent on our perception
and interpretation of it
• i.e. its predictability, controllability,
implications
The Mind
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Three levels:
• Awareness - the ability to perceive and
respond to stimuli
• Conscious mind - our emotional reactions to
those stimuli and our intelligent behaviour
• Self-conscious mind - knowing that one knows
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Philosophical problem: the mind has no
direct access to the body, mediated
through the brain
The Limbic System
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Part of the brain that translates ideas and
affects into feelings and emotions
Structurally it is composed of an upper
and lower circuit, which bridge the
neocortex (thinking brain) to parts of the
endocrine system
Upper circuit appears to be involved in
feeling states, while the lower circuit is
involved in emotional states specific to
survival (flight or fight response)
The Limbic System
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Functions of the limbic system include:
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Olfaction
Arousal, motivation, etc.
Coding in laying down new memories
Emotional responses, learning and higher
control over exchanges between the body and
the external world through emotions
• Regulation of homeostasis through the
autonomic and endocrine systems
Body-Mind Pathway
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Stimuli are recognized and processed in
the neocortex (thinking brain)
The limbic system interprets and perceives
these stimuli as stressful or not (emotional
response)
• Suggestion that emotions are stored in body
as peptides or receptors, and resulting
emotions are due to binding
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Results in a physiological response
through the endocrine system
Body-Mind Pathway
HPA Axis
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Hypothalamic-pituitary-adrenal (HPA) axis part of
neuroendocrine system, controls reactions to
stress and regulates various body processes
Amygdala, hippocampus and hypothalamus
(lower circuit of limbic system) facilitate
activation of HPA axis, which leads to the release
of cortisol
Prolonged high levels of cortisol have been
associated with suppressed immune function,
depression and may facilitate central adiposity, a
risk factor for coronary heart disease and
diabetes (Cohen S. et al. 2006)
HPA Axis
SAM Axis
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Sympathetic-adrenal-medulla (SAM) axis
part of the sympathetic nervous system,
responsible for initiating fight or flight
response
Stress stimulates nerves that directly
innervate the adrenal medulla, releasing
norephinephrine and epinephrine
Results in increased heart rate, increased
blood flow to muscles and diverted blood
flow from digestive system, inhibited
salivary flow, dilated pupils etc.
SAM Axis
Link between Social Status &
Physiological Responses
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Sapolsky et al. (1997) showed baboons of higher
rank had greater cortisol suppression, suggesting
more effective glucocorticoid negative feedback
Steptoe & Marmot noted that cardiovascular
reactivity is generally greater in lower SES
individuals (confounding by stressor
characteristics, or hostility, etc.?)
Lupien, et al. (2000) showed lower SES children
had higher salivary cortisol levels than higher
SES children
Cohen et al. (2006) found higher SES was
associated with lower levels of cortisol and
epinephrine, independent of race, age, gender
and body mass
Link to Disease
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Chronic stress → chronic HPA & SAM
activation:
• May increase other risk factors (abdominal
obesity, immune functioning, insulin
resistance)
• May disrupt normal homeostatic processes
resulting in abnormal physiological functioning
• May have long-term effects on the immune
and cardiovascular systems, increasing risk of
disease and leading to more rapid progression
once established (Adler, N. & Ostrove, J, 1999)