A new Special Series, “Clinical Applications in Psychosomatic Medicine,” is launched in this issue of the journal. The Guest Editors of the series discuss the rationale and goals of this Special Series in an introductory editorial. Psychosomatic Medicine is now taking new submissions for this new Special Series at the journal’s manuscript website.
Pages 112–113; http://dx.doi.org/10.1097/PSY.0000000000000657
The first article in the new Special Series on Clinical Applications in Psychosomatic Medicine is on the topic of chronic pain, a significant health problem which is increasing in prevalence. Dr. Mark A. Lumley and Dr. Howard Schubiner examine leading evidence-based psychological therapies for chronic pain. The authors propose an integrative treatment approach consisting of a progression of interventions to achieve pain reduction: tailored pain neuroscience education, cognitive and mindfulness skills to decrease the pain danger-alarm mechanism, behavioral engagement in avoided painful and other feared activities, emotional awareness and expression to reverse avoidance and overcome trauma or psychological conflict, and adaptive communication to decrease interpersonal stress.
Pages 114–124; http://dx.doi.org/10.1097/PSY.0000000000000654
The biopsychosocial model is foundational in current psychosomatic medicine, and the biological mechanisms accounting for psychological and social factors in health and disease require a solid theoretical framework. Smith et al. draw upon recent advances in computational neuroscience and embodied cognition to propose an evidence-based and theoretically sophisticated mechanistic model that is capable of organically integrating biopsychosocial processes.
Pages 125–145; http://dx.doi.org/10.1097/PSY.0000000000000661
Imaging studies in adults with irritable bowel syndrome (IBS) have shown both morphological and resting state functional connectivity alterations related to cortical modulation of sensory processing. Bhatt et al. investigated analogous differences in children, comparing gray matter volume and resting state functional connectivity between girls with IBS and healthy controls, and testing the correlation between brain metrics and laboratory-based pain thresholds. Girls with IBS had lower gray matter volume in the prefrontal cortex, basal ganglia, and anterior mid-cingulate, as well as altered functional connectivity between multiple brain networks, suggesting that structural changes related to IBS occur early in brain development.
Pages 146–154; http://dx.doi.org/10.1097/PSY.0000000000000655
Recognizing facial emotion expressions is a fundamental socio-cognitive process, influencing interpersonal functioning, and growing evidence suggests impairments in facial emotion recognition are present in various disorders. Wyssen et al. used a computer-based emotion recognition test to study the ability of adults to distinguish six basic emotions. Detection of fear, anger, disgust, happiness, sadness, and surprise was assessed in patients with eating disorders, patients with mental disorders, and healthy controls. Contrary to expectations, basic emotion recognition abilities were similar across the three groups. Basic facial emotion recognition processes may therefore be intact in patients with eating and mental disorders, but misinterpretation of emotional cues at higher levels of cognitive processing might contribute to problems with emotion regulation.
Pages 155–164; http://dx.doi.org/10.1097/PSY.0000000000000664
In patients with non-metastatic breast cancer, psychoeducational interventions may reduce distress and modulate the immune system. In a pilot randomized trial in patients who had undergone surgery for breast cancer, Stanzer et al. showed that the “Learning to Live with Cancer” program significantly reduced anxiety scores and was associated with a decline in the number of initially elevated number of T-regulatory cells. The reduction in anxiety was correlated with the decline of T-regulatory cells, which is relevant to the biology of cancer progression.
Pages 165–175; http://dx.doi.org/10.1097/PSY.0000000000000656
Depressive symptoms and major depression predict cardiovascular disease (CVD) and CVD risk factors in adulthood. Evidence regarding the role of depression in the early development of CVD risk in youth is minimal. Matthews et al. evaluated the prospective relationship between depressive symptoms in childhood and adolescence and cardiovascular risk factors in men in their thirties. Early life depressive symptoms predicted health behaviors in adulthood but not the metabolic syndrome or biological markers of inflammation. Future research is needed to examine prospective associations at later life stages.
Pages 176–183; http://dx.doi.org/10.1097/PSY.0000000000000652
Saleem et al. assessed the reactive hyperemia index (RHI), a novel measurement of microvascular endothelial function, as a predictor of cognition in patients with coronary artery disease who were in a cardiac rehabilitation program. Lower RHI was associated with poorer memory at baseline, and an increase in RHI was associated with improvements in overall cognition and processing speed over the course of cardiac rehabilitation. RHI may be a clinically useful predictor of cognitive change in patients with coronary artery disease.
Pages 184–191; http://dx.doi.org/10.1097/PSY.0000000000000651
Left ventricular assist devices (LVAD) for circulatory support until heart transplant or as destination therapy for patients with end-stage heart failure are increasingly used. However, LVADs result in substantial patient burden and mortality rates in patients with LVADs are high. Modica et al. assessed coping styles, quality of life, and mood in rehabilitation patients after LVAD implant. Results indicate that after discharge from cardiac rehabilitation, one third showed a profile characterized by worse perceived quality of life, mood disorders, and dysfunctional coping that is associated with long-term mortality. These factors are potential targets for intensive post-LVAD support.
Pages 192–199; http://dx.doi.org/10.1097/PSY.0000000000000658
Chen et al. investigated the diurnal cortisol profiles of children who use shift-and-persist coping strategies. The shift-and-persist strategy involves accommodation to stressors by shifting cognitive and emotional coping styles depending on the situational demands and persisting through adversity via orientation to the future. Higher levels of shift-and-persist were associated with higher cortisol at awakening and a steeper daily cortisol decline. The findings demonstrate that shift-and-persist, considered as one variable, is associated with healthier diurnal cortisol profiles among socioeconomically disadvantaged children.
Pages 200–208; http://dx.doi.org/10.1097/PSY.0000000000000659
With data from a long-running birth cohort study in a rural community, Tindula et al. examined the relationship of home environment and obesity. They uncovered significant associations in protective social and home factors and maternal depressive symptoms with the fat-cell hormone adiponectin in children at ages 5, 9, and 14. The findings suggest that better home environment and maternal mental health scores are related to more favorable profiles of biological factors relevant to obesity.
Pages 209–219; http://dx.doi.org/10.1097/PSY.0000000000000663