What We Know and What We Don’t: The Influence of Psychological Factors on Medical Illness
Early psychoanalytic researchers attempted, with varying degrees of success, to prove that psychological conflicts are complicit in medical illness. Ironically, current medical research indicates that psychological issues do in fact, play a role in the development or exacerbation of illness. The relationship between psychology and illness exists not because of the nature or symbolism of neurotic conflicts per se, though it's certainly possible that someone with a number of unconscious conflicts might be more vulnerable to the psychological states that are linked with disease. Current research suggests that it is actual physiological consequences of psychological disorders that explains the findings that some emotional factors are associated with disease.
Although many questions remain about these associations, there are at least two pathways thought to partially explain the influence of emotional functioning on the body. The first is that certain psychological disorders and personality traits affect the likelihood of engaging in high-risk health behaviors. Second, certain psychological states, when they persist over time, cause physical changes that increase the risk of disease.
KeywordsHeart Attack Psychological Factor Mental Health Clinician Borderline Personality Disorder Adverse Childhood Experience
- Amabile, N., Susini, G., Pettenati-Soubayroux, I., Bonello, L., Gil, J. M., Argues, S., et al.. (2008). Severity of periodontal disease correlates to inflammatory systemic status and independently predicts the presence and angiographic extent of stable coronary artery disease. Journal of Internal Medicine, January 16, 2008. E-pub ahead of print, doi:10.1111/j.1365–2796.2007.01916.x.Google Scholar
- Falagas, M. E., Zarkadoulia, E. A., N loannidou, E., Peppas, G., Christodoulou, C., & Rafaildis, P. I. (2007). The effect of psychological variables on breast cancer outcome: A systematic review. Breast Cancer Research 9 (R44), retreived on-line on February 10, 2008 at http://breast-cancer-research.com/content/9/4/R44.Google Scholar
- Friedman, M., & Rosenman, R. H. (1972). Type A behavior and your heart. New York: Knopf.Google Scholar
- Heppner, P. F., Crawford, E. F., Haji, U. A., Afari, N., Hauger, R. L., Dashevsky, B. et al. (2009). The association of posttraumatic stress disorder and metabolic syndrome: A study of increased health risk in veterans. BMC Medicine, Online January 8, 2009.Google Scholar
- Iribarren, C., Sidney, S., Bild, D. E., Liu, K., Markovitz, J. H., Roseman, J. M., et al. (2000). Association of hostility with coronary artery calcification in young adults: The CARDIA study. Coronary artery risk development in young adults.Journal of the American Medical Association, 283(19), 2546–2551.PubMedCrossRefGoogle Scholar
- Jackson, B., Kubzansky, L. D., Cohen, S., Jacobs, D. R., & Wright, R. W. (2007). Does harboring hostility hurt? Associations between hostility and pulmonary function in the coronary artery risk development in (young) adults (CARDIA) study. Health Psychology, 26(3), 333–340.PubMedCrossRefGoogle Scholar
- Kahl, K. G., Rudolf, S., Stoeckelhuber, B. M., Dibbelt, L., Gehl, H. B., Markof, K., et al.. (2005). Bone mineral density, markers of bone turnover, and cytokines in young women with borderline personality disorder with and without comorbid major depressive disorder. American Journal of Psychiatry 162(1), 168–174.PubMedCrossRefGoogle Scholar
- Rutledge, T., Reis, S. E., Olson, M., Owens, J., Kelsey, S. E., Pepine, C. J., et al. ( 2006) Depression is associated with cardiac symptoms and hospitalization among women with suspected coronary heart disease: The NHLBI-sponsored WISE study. Psychosomatic Medicine, 68, 217–223.PubMedCrossRefGoogle Scholar
- Shen, B. J., Avivi, Y. E., Todaro, J. F., Spiro, A., Laurenceau, J. P., Ward, K. D., et al. (2008). Anxiety characteristics independently and prospectively predict myocardial infarction in men: The unique contribution of anxiety among psychologic factors. Journal of the American College of Cardiology, 51(2), 113–119.PubMedCrossRefGoogle Scholar