Linking Social & Behavioral

Sciences with Biology
Jessica Kitchen
EPI 6181
Wednesday, April 2, 2008
 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
 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
 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
 By the 17th & 18th centuries the
disorder was recognized as being
associated with emotional causation
 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 20

• 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
 Adolf Meyer introduced psychobiology;
emphasized that biological, psychological
and social factors all contribute to disease
(early 20
 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

Theoretical approaches
 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
 Psychoanalytical Approaches – noted that
stress produces a general effect;
attempted to explain why a particular
organ was affected in under certain
Theoretical approaches
 Cognitive Theories – evaluated the links
between stress, personality and coping
• Martin (1985) identified the alexithymic
 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.
 Stimulus → Interpretation →
Emotional response → Biological
 Our physiological reaction to an
event is dependent on our perception
and interpretation of it
• i.e. its predictability, controllability,
The Mind
 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
 Philosophical problem: the mind has no
direct access to the body, mediated
through the brain
The Limbic System
 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
 Functions of the limbic system include:
• 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
 Stimuli are recognized and processed in
the neocortex (thinking brain)
 The limbic system interprets and perceives
these stimuli as stressful or not (emotional
• Suggestion that emotions are stored in body
as peptides or receptors, and resulting
emotions are due to binding
 Results in a physiological response
through the endocrine system
Body-Mind Pathway
HPA Axis
 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
 Sympathetic-adrenal-medulla (SAM) axis
part of the sympathetic nervous system,
responsible for initiating fight or flight
 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
 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
 Chronic stress → chronic HPA & SAM
• May increase other risk factors (abdominal
obesity, immune functioning, insulin
• 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)