About this Research Topic
The principal goal of psychosomatic medicine is the integration of biological, psychological, and social systems that may influence health or pathology, namely in chronic diseases and co-morbid physical and psychiatric disorders. The consensual biopsychosocial model still lacks specificity and falls short of the demonstration of possible causal mechanisms involved in this research field. Recognizing the dynamic association between negative emotions and health-disease processes, morbidity and mortality in several diseases has increased attention to the mediating role of psychophysiological dimensions. Emotional suppression has been associated to disease through increased physiological arousal, less efficient coping and impaired health promoting and preventive behaviours, with a negative impact in general wellbeing.
In this perspective emotional regulation has a central role, considering emotion not only as physiological arousal, cognition or behaviour but as the coordination of these systems facing triggering events operating within specific levels. Physiological arousal and its direct impact in body can represent an overloading factor, promoting biological systems dysfunction. Chronic stress, from a psychological or biological nature and adaptation processes intensify the organism exposure to the response mediators that can disrupt homeostatic balance.
There are several pathways linking mind and body reflecting different levels of function: psychological states and traits; the brain; connecting systems (autonomic nervous system, immune, endocrine) and the body itself (organ function/dysfunction). The complexity involved in these relations is still undercover, regardless of the integrative efforts in different domains, including affective neurosciences or psychoneuroimmunology.
Recent studies support these interactions exploring communication pathways between the immune and central nervous systems and identifying the large set of neurotransmitters or ligands they share. Cytokines are mediators that may explain a number of observed interactions in the immune-neuro-endocrine network. The hypothalamic-pituitary-adrenal axis has been investigated as a component of the regulatory circuits that interacts with the autonomic regulation, to expose immunologic processes associated to stress or depression and also to several diseases. Immune dysregulation and psychological distress have been linked to each other in somatic diseases, depression, chronic stress and major life events.
Thus, new paradigms emerge such as the immunologic, neuroendocrine and inflammatory ones, through the investigation of proinflammatory cytokines, systemic inflammation, the role of neuropeptides and receptors, as well as their interface with genetic and environmental factors. Numerous studies support the hypothesis that maladjusted interactions in childhood are associated with poor self-regulatory skills, especially in the production of adequate cortisol levels in face of stressors, arising from physiological or functional deficits in limbic structures and in the right hemisphere. Such dysfunctions are often associated with psychiatric or physical disorders.
Innovative methodologies in different fields, such as molecular biology, genetics, imagiology and interdisciplinary research brought new challenges and changed the clinical understanding and management of distress or emotional disorders associated to physical illness.
Further knowledge in 'Psychobiological research in psychosomatic medicine' offers a forum for upgrading information and developments in integrative research concerning the biological mechanisms that connect psychosocial factors and the body, overcoming a dualistic approach.
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