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Emotion and falling ill –Ongoing Research Projects

By etavares On 30 September, 2010 Open Space | 2010 Comments Off on Emotion and falling ill –Ongoing Research Projects No tags

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
______________________
Bibliography

Coe CL, Laudenslager ML. Psychosocial influences on immunity, including effects on immune maturation and senescence. Brain Behav Immun 2007; 21:1000–1008

Cole S W and Kemeny M E. Psychosocial Influences on the progression of HIV Infection. In: Psychoneuroimmunology , 3rd Ed. Edited by R. Ader, D. Felten and N. Cohen. Academic Press, New York, 2001. pp 583-612

Cozolino, L J. The Neuroscience of Human Relationships: Attachment and the Developing Social Brain. WW Norton & Company, 2006. New York.

Gunnar, M., Quevedo, K. The neurobiology of stress and development. Annual Review of Psychology, 2007. Vol 58, pp. 145-173

Keller SE, Schleifer SJ, Bartlet JA, Shiflett SC, Rameshwar P. Stress, Depression, Immunity and Health. In: Psychoneuroimmunology. Edited by Karl Goodkin and Adriaan Visser, American Psychiatric Press, 2000. Washington, DC

Kyrou I, Chrousos GP. (2006). Stress, Visceral Obesity, and Metabolic Complications. In: Chrousos GP, Tsigos C. (Ed) Stress, Obesity, and Metabolic Syndrome. The New York Academy of Sciences, Blackwell Publishing, Boston, pp.77-110.

Mayne T.J. Emotions and Health. In: Mayne T.J. and Bonanno G.A. (Ed.) Emotions: Current Issues and Future Directions. The Guilford Press, New York, 2001; 361-397

Miller G, Chen E, and Cole S W. Health Psychology: Developing Biologically Plausible Models Linking the Social World and Physical Health. Annu. Rev. Psychol. 2009, 60:501–24

Rosmond R. Stress Induced disturbances of the HPA axis: a pathway to Type 2 diabetes? Med Sci Monit 2003;9(2):RA35-39.

Schore A.N. Affect regulation and the Origin of the Self. The Neurobiology of Emotional Development. Lawrence Erlbaum Associates, Inc. Publishers, Hiisdale, 1994. New Jersey.

Taylor G., Bagby R., and Parker J. (Ed.). Disorders of affect regulation. Cambridge University Press, 1997. Cambridge

Turner-Cobb J M Sephton S E and Spiegel D. Psychosocial Effects on Immune Function and Disease Progression in Cancer: Human Studies. In: R. Ader, D. Felten and N. Cohen (Ed.) Psychoneuroimmunology, 3ª Ed., Academic Press, 2001. New York.

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Index - News # 16 | ago/set. 2010
 Editorial Note
 Cultural Soirée Commemorative of the 100th Anniversary of the Faculty of Medicine of the University
 Launch of the Electronic Staff Attendance Register at the Faculty of Medicine UL
 New members in the Editorial Team
 Molecular Medicine Institute (IMM) Researchers identify a new cell population of the immune system with therapeutic potential 
 Welcome II Programme
 FMUL welcomes new students
 Characterization – Psychiatry University Clinic from the Faculty of Medicine of Lisbon
 III Forum of Obesity Prevention Projects
 Medical Research in Portugal: Opportunities and Constraints
 Launching of the Book “”O meu amigo, o sono” (sleep, my friend)
 Book of the Month
 Master Degree in Diagnostic Technology and Cardiovascular Intervention – 2nd Edition
 Scientific Research Projects for Students
 Academic Examinations at the Faculty Of Medicine of The University Of Lisbon
 Publications FMUL/HSM/IMM
 Lecturers’ Participation in Academic Examinations Panels in other institutions
 Ongoing Training Courses at the Faculty of Medicine of the University of Lisbon
 Instituto de Medicina Molecular Seminars
 PhD Students 2010
 Consultation-Liaison Psychiatry and Bioethics
 Propensity towards Victimization: is it possible to diminish it?
 Exhibition of a Future Essay – Transformation, Creativity, and Art
 Parenthood in Multi-Problem Families
 Current Indications of Clinical Hypnosis
 The Issue on Rabdomyolisis
 Self-injury, self-mutilation, and self-aggression. The same definition?
 Day Hospital of the Psychiatry and Mental Health Unit of the Neuroscience Department of CHLN
 Bipolar Disease and Attention Deficit Hyperactivity Disorder in childhood
 Emotion and falling ill –Ongoing Research Projects
 Researching Science and Health
 Hospital, Scientific and Pedagogical Indicators of the Psychiatry and Mental Health Unity
 7th AstraZeneca Foundation / Faculty of Medicine of the University of Lisbon Research Grant
 Research: Instructions Handbook – 6 October
 European Depression Day (Portugal) October 2010
 JIMBA – Lower Alentejo Medical Internship Encounters – 8- 9 October 2010
 1st PAM (Porto’s Autoimmune Meeting) – 8 and 9 November
 Scientific and Technological Cooperation Competition – 15 October
 Cycle of Conferences on Health Technologies for Primary Health Care – 19 October 2010
 From Cardiac Insufficiency to Pulmonary Thromboembolism – 22 October
 28th Brazilian Congress in Psychiatry (CBP) – 27-30 October
 6th Psychiatry National Congress – 6-8 December 2010
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100 AnosPropriedade e Edição: Faculdade de Medicina da Universidade de Lisboa NIPC: 502662875  Periodicidade: Mensal  Diretor: Prof. Doutor Fausto J. Pinto Conselho Editorial: Prof. Doutor Fausto J. Pinto, Profª. Doutora Ana Sebastião, Prof. Doutor Mamede de Carvalho, Prof. Doutor António Vaz Carneiro, Prof. Doutor Miguel Castanho, Dr. Luís Pereira  Equipa Editorial:  Ana Raquel Moreira, Cristina Bastos, Isabel Varela, Joana Sousa, Maria de Lurdes Barata, Rui Gomes, Sónia Teixeira  Colaboração:  Gabinete de Relações Públicas, Internacionais e Comunicação  Versão Inglesa: AP|PORTUGAL- Language Services  Conceção: Metatexto, Lda. e-mail: news@medicina.ulisboa.pt  Sede do Editor e Sede da Redação: Avenida Prof. Egas Moniz, 1649-028 Lisboa Estatuto Editorial Anotado na ERC 

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