Abstract
The objective of the present article is to offer a reflection on the relationship between emotion and falling ill and to present two ongoing research projects on this relationship from a psychobiological perspective. The projects are part of the lecturing and assisting activities we carry out.

Introduction

The research we undertake is based on a psychosomatic approach to the disease. Factors of psychobiological vulnerability are identified and worked upon, either in the sense of reducing that vulnerability, or in the sense of reducing emotional pain associated to experiencing a chronic disease and its impact on the life of the patient. It is equally anchored on models of understanding emotional, cognitive, behavioural, and social factors that determine the patient’s self-regulation, in accordance with Health Psychology perspectives.

At a psychological level, we have attempted to research the relationship between emotion, stress, and illness, taking into account factors of development and individual strategies when establishing the existence of a vulnerability that can be perceived at a clinical level.

The importance of emotional disturbance in the mortality and morbidly associated with several pathologies has fostered interest in the role of emotion in the processes of adapting to the disease. On the other hand, it has been demonstrated that the experience of negative emotions, which are frequent and long lasting, or its opposite, their suppression, are aggravating factors in the evolution of some diseases, and have a negative impact on the body’s balance as far as psycho-physiological and cognitive-behavioural aspects are concerned.

In the same fashion, chronic stress, considered to be a threat to homeostasis, generates a state of alertness in the body, and activates a set of adaptive responses of a biological and behavioural nature. This adaptive response, which has the purpose of balancing the homeostatic level, triggers a set of regulating mechanisms globally known as the stress system, which is basically represented by the Hypothalamus-Hypophysis-Supra Renal axis and the Autonomic Nervous System, coordinated at the level of the Central Nervous System. By assuming the importance of activating these structures, and in order to explain the relationship between stress and distinct pathologies, new paradigms arise, which place the core of research in the immunological, neuroendocrine and inflammation mechanisms (pro-inflammatory cytokines and system inflammation markers), in the role of other neuropeptids and corresponding receptors, as well in as in the study on the interaction between genetic factors and the environment.

With regard factors associated with development, the research has sustained that attachment styles, relatively stable throughout life, appear to influence the way individuals respond to stress situations. In what concerns factors associated to development, research has sustained that attachment styles, relatively secure throughout life, appear to influence the way individuals respond to stress situations. The attachment schemes reflect learning that also shapes neural networks, which depend on genetic, as well as learning factors, and which connect the orbitofrontal cortex, the amygdale and the alertness, emotion and affection regulatory circuits. It is within the context of these networks that early interactions connect to feelings of comfort and safety, or anxiety or fear. The schemes of secure attachment, connected to positive emotions, foster the creation of a neurochemical environment that leads to growth, self-regulation, and autonomy. On the contrary, schemes of insecure attachment associated with negative emotions appear to be frequently associated with physical or mental diseases.

Ongoing projects
The field of psychobiological processes associated with illness, stress, and adaptation to chronic disease has been our investment area, be it in clinical terms or in terms of study and search. In an attempt to continue the research done so far, the unit has carried out projects that bring together the clinical and the research components in dealing with a psychosomatic approach to the disease.

Accordingly, efforts have been made to research vulnerability to stress, starting with its determining factors throughout its development, as well as the relations between stress factors, life experience, and emotional expressiveness in adapting to, and in the evolution of chronic diseases.

Depression, obesity, and diabetes are priority fields in mental and physical health, and they represent privileged areas for a preventive intervention. Research on the role of risk factors in the etiology of any of these disturbances has followed multiple paths, ranging from the biological to the psychosocial.

It is within this context that we have been developing research that aims to evaluate the importance of psychological factors associated with personality/character, expressing emotions, and vulnerability to stress, in the genesis/evolution of diabetes, the metabolic syndrome and its complications. This project is called ‘Psychological Factors and Vulnerability to Stress in Diabetes, Obesity, and Metabolic Syndrome’

Research has shown that maladaptive interactions in childhood are connected with insufficient self-regulation competences, namely regarding the production of adequate levels of cortisol, compared to stressors. Such disorders are frequently associated with psychiatric pathologies or physical disease.

The present research, stemming from a model of development of self-regulating systems in the interaction with early experiences, aims to understand the importance of reactivity to stress and adaptation strategies in breast cancer and HIV/AIDS infection. Accordingly, we aim to characterize and relate vulnerability to stress and physical adapting to disease according to attachment type, and explore the interactions between psychophysiological, emotional, and behavioural dimensions and a control sample. The project is titled “Psychophysiological Indicators of Reactivity to Stress and Adaptation to Illness: Attachment Styles, Coping, and Emotional Regulation”.

These projects have been delineated through teamwork and with the collaboration of other researchers from our Unit, other Research Centres, and students from Master and Doctoral programmes.

“Para lá da dor” (‘Beyond pain’).
Author: Francisco Simões

Sílvia Ouakinin
Medical Psychology Unit, Psychiatry and Mental Health University Clinic, FMUL / CHLN
souakinin@fm.ul.pt
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