心理社会应激的免疫反应规律与机制

心理社会应激会引起免疫系统发生免疫防御、免疫自稳和免疫监视方面的功能变化, 并随着应激刺激的时间和强度的变化而发生着异常与正常之间的动态转变。其机制与遗传、神经内分泌、自由基代谢和肠道菌群变化等生物学因素相关, 且小胶质细胞可能在其中起着重要的中介作用。诸多的生物学因素与年龄、性别和经济地位等人口学因素共同决定着心理社会应激的免疫反应发生发展。在其干预中, 运动疗法中的体育锻炼是极为值得重视的一种手段。     

活体肝移植供者心理社会方面问题的研究进展

活体肝移植供者心理社会方面问题的主要研究进展为：多数供者与受者之间有血缘关系,或者有亲密的情感联系;供者有利他主义动机;供者术后有短期健康相关生存质量下降,但术后1年之内可恢复正常。     

急性心理性应激诱发的神经内分泌反应及其影响因素

急性心理性应激源分别通过下丘脑-脑垂体-肾上腺轴(hypothalamus–pituitary–adrenal axis,HPAA)和交感神经-肾上腺髓质轴(sympathetic-adrenal medulla axis)诱发神经内分泌反应。唾液皮质醇被认为是检测急性心理性应激所诱发的HPA轴反应的稳定指标。以特里尔社会应激测试(Trier Social Stress Test,TSST)及其变式作为应激源, 以HPA轴的反应作为应激指标, 影响个体在急性心理性应激情境中发生特异性神经内分泌反应的因素主要包括人口统计学、环境和应激频率三大方面, 未来应加强急性心理性应激所诱发的神经内分泌反应的纵向研究。     

The role of psychosocial processes in explaining the gradient between socioeconomic status and health

The gradient between socioeconomic status (SES) and health is well established: Many measures of health show that health increases as SES increases. However, the mechanisms underlying this association are not well understood. Behavioral, cognitive, and affective tendencies that develop in response to the greater psychosocial stress encountered in low-SES environments may partially mediate the impact of SES on health. Although these tendencies might be helpful for coping in the short term, over time they may contribute to the development of allostatic load, which increases vulnerability to disease. Debate remains regarding the direction of causation between SES and health, the impact of income inequality, the interaction of SES with race-ethnicity and gender, and the effects of SES over the life course.     

What Makes Crohn's Disease Patients Difficult to Manage? The Role of Psychosocial Factors

Most GI clinicians face the problem of a small group Crohn's Disease (CD) patients who function poorly and consume inordinate amounts of service with poor outcome. This study examines the hypothesis that psychosocial factors differentiate the CD patients who function poorly from the typical CD patient. A prototypal sample of CD patients with problems functioning, more typical CD patients (not selected for having problems in functioning), and healthy controls each completed a battery of validated psychosocial measures of disease-specific quality of life, coping skills, social support and life stress, perceived medical symptoms and life history factors. Chart data on hospital admissions, ER, GI, Surgeon, and GP visits were also collected. The CD patients with problems functioning reported more symptoms (GI and non-GI) and had many more ER, GI, and GP visits than the typical group. Psychologically, those with problems functioning had poorer quality of life and were more likely to cope using emotional discharge and support seeking. They experienced significantly more stress and reported a more chaotic family history. No differences on an experimental method of information processing biases were found between the CD groups, however. These results indicated that patients with problems functioning, selected by GI staff because they were best-case examples of functional difficulties, shared little with a matched group of typical CD patients. These patients likely require psychological as well as medical intervention to best manage their illness.     

The Role of Formal Mentoring on Business Success and Self-Esteem in Participants of a New Business Start-Up Program

The current study investigated the relationship between career-related mentoring, psychosocial mentoring, business success, and self-esteem in participants of a program that was designed to assist in the establishment of a new business. Seventy-seven protégés and their matched mentors were included in the study. A comparison of mentor and protégé perceptions revealed that mentors considered themselves to provide higher levels of psychosocial support than did the protégés. Protégé perceptions of business success were predicted by the frequency of mentor contact and the level of career-related support provided by their mentor.     

Quality of Life in Heart Transplant Candidates

Research on quality of life with heart transplant patients is complicated by the physical and psychological variables associated with heart failure. This study examined quality of life with several instruments in order to sample more general and more idiosyncratic aspects of quality of life in this particular patient population. We also examined the relationship between various aspects of quality of life and several psychosocial variables, including sensitivity to social desirability effects. The quality of life measures used in this study were found to be significantly correlated with each other and with measures of psychological distress. Implications of these findings are discussed.     

Current Status of Psychosocial Intervention Research for Pediatric Outpatient Surgery

We reviewed 20 published studies of psychosocial interventions (i.e., preoperative preparation, parental presence) for children undergoing outpatient surgical procedures. The effectiveness of different intervention strategies on child and parent outcomes is summarized. Few positive effects were found for any of the psychosocial interventions. However, only a small number of randomized controlled trials were conducted and many of the studies using quasi-experimental designs had significant methodological problems that limited the interpretation of their findings. Research recommendations are described such as strengthening methodological rigor, making intervention strategies relevant to outpatient surgery, and using developmentally appropriate intervention strategies.     

Psychosocial Issues That Face Patients With Charcot-Marie-Tooth Disease: The Role of Genetic Counseling

Charcot-Marie-Tooth (CMT) disease is a hereditary debilitating progressive muscular atrophy and sensory neuropathy of the distal extremities. CMT is usually nonlife threatening. Signs of the disease usually present in childhood or in young adulthood and the level of disability can be variable within and between families. Research addressing specific psychosocial and emotional issues faced by individuals with CMT is limited. Fourteen adults with a clinical and/or molecular diagnosis of CMT (ages 32–74 years) consented to an audio taped interview. The format of the interview was based around an informal questionnaire to prompt and guide the interviewee to describe their experiences of living with a disabling genetic disorder. The interviews focused on their experiences of first symptoms and diagnosis, their life experience with CMT, their limitations due to disability and the role of genetic counseling. This study identifies and explores life issues that individuals with CMT may face, specifically grief over the loss of independence, emotional pain and stress such as embarrassment and guilt of passing on a gene mutation, impact on quality of life, the impact of wearing orthopedic devices, and fear of progressive disability. Our findings suggest that that there are emotional and psychosocial issues specific to affected individuals at different life stages and genetic counselors need to be aware of these issues in order to provide age appropriate support and advice to individuals affected by CMT.     

Neighborhood Violence and Psychosocial Adjustment in Low-Income Urban African American Children: Physical Symptoms as a Marker of Child Adjustment

We examined the association between neighborhood violence and three domains of psychosocial adjustment in low-income, urban African American children: internalizing, externalizing, and physical symptoms. Based on anecdotal and empirical evidence, it was hypothesized that, relative to internalizing and externalizing problems, a stronger association would emerge between physical symptoms and neighborhood violence. Mother-reported neighborhood violence was associated with child-reported physical symptoms, but not internalizing or externalizing symptoms. Child-reported neighborhood violence was associated with child-reported internalizing, externalizing, and physical symptoms; however, neighborhood violence accounted for a greater percentage of variance in physical symptoms than the other two symptom domains. Our findings were not moderated by the age or gender of the child. We discuss the importance of physical symptoms as a marker of child adjustment in low-income, urban, African American children, as well directions for future research.