Mind Body Medicine
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VIII Biological Underpinnings Of Mind-Body Therapies

1. Ader, R. & Cohen, N. (1975). Behaviorally Conditioned Immunosuppression. Psychosomatic Medicine, 37(4),279-286.
This landmark study was designed to examine the possibility that behavioral conditioning techniques could be used to modify immune processes. The hypothesis was that the pairing of a neutral stimulus (saccharin) with cyclophosphamide, an immunosuppresive agent, would result in the conditioning of immunosuppression. Immunosuppression was determined by measuring antibody titers in rats following the administration of antigen. Animals were divided into three groups: conditioned, nonconditioned and placebo. Conditioned animals (paired administration of saccharin in drinking water and injection of cyclophosphamide) exposed to additional saccharin when injected with antigen were significantly immunosuppressed compared with nonconditioned animals. The results ftom additional experiments using lithium chloride, a nonimmunosuppresive agent, instead of cyclophosphamide further supported the hypothesis that the immunosuppression was behaviorally conditioned and was not mediated by a non-specific elevation in adrenocortical steroids.

2. Ader, R., Cohen, N., & Felten, D. (1995). Psychoneuroimmunology: Interactions Between the Nervous System and the Immune System. Lancet, 345,99-103.
This review article discusses the interactions between behavioural, neural, endocrine, and immune processes. They set forth observations which provide the basis for behaviorally induced alterations in immune function and immunologically based changes in behaviour. The influence on psychosocial factors and emotional states on the development and progression of infectious, autoimmune and neoplastic disease is also presented.

3. Besedovsky, H.O., Herberman, R.B., Temoshok, L.R., & Sendo, Fujiro. (1996) Psychoneuroimmunology and Cancer: Fifteenth Sapporo Cancer Seminar. Cancer Research, 56(18), 4278-4281.
This meeting report contains short summaries of many reports related to cancer and psychoneuroimmunology. Several of these reports address the relationship between emotions, especially anger, and cancer. One group reported the results of a study that suggested a lack of expression of anger may be related to melanoma progression. Another group reported on a study where expression of anger was associated with a longer disease free interval and survival in breast and colon cancer patients.

4. Blalock, J.E. (1994). The Syntax of Immune-Neuroendocrine Communication, Immunology Today, 15(11), 504-511.
This review summarizes evidence that the immune and neuroendocrine systems represent a totally integrated information circuit that results from a sharing of ligands and their receptors. A clearer understanding of this circuitry is dramatically altering our understanding of physiology and may profoundly affect the treatment of human disease.

5. Bone, R.C. Immunologic dissonance: a continuing evolution in our understanding of the systemic inflammatory response syndrome (SIRS) and the multiple organ dysfunction syndrome (MODS). Ann Intern Med 1996; 125: 680-687.

6. Cacioppo, J.T., Berntson, G., Gary G., Malarkey W.B., Kiecolt-Glaser, J.K., Sheridan, Jlfl, Poehlmann, K.M., Burleson, M.H., Ernst, J.M., Hawkley, L.C., Glaser, R. Autonomic, neuroendocrine and immune responses to psychological stress: the stress reactivity hypothesis, Ann N Y Acad Sci 8400: 664-673.1998.

7. Chrousos, G.P. (1995) The hypothalamic-pituitary-adrenal axis and immune-mediated inflammation. New Engl. J. Med. 332: 1351-1362.

8. Chrousos, G.P., Gold, P.W. The concepts of stress and stress system disorders. Overview of physical and behavioural homeostasis. JAMA 267: 1244-1252, 1992.

9. Cohen, N., Moynihan, J.A., Ader, R. (1994). Pavlovian Conditioning of the Immune System. International Archives of Allergy and Immunolology, 105(2), 101-106.
This mini-review article highlights selective aspects or the intriguing relationships between conditioning and immunity (including the landmark study cited above). These experiments have revealed an intimate relationship between the central nervous system and the immune system. The authors discuss how conditioned immunopharmacological effects may prove clinically important in therapeutic settings where it is beneficial to reduce the amount of actual drug administered to and autoimmune patients or to a transplant recipient.

10. Dhabhar, F.S. Stress-induced enhancement of cell-mediated immunity. Ann N Y Acad Sci 8400: 359-372, 1998.

11. Fricchione, G.L. and Stefano, G.B. (1994). The stress response and autoimmunoregulation. Adv. Neuroimmunol. 4: 13-27.

12. Fricchione, G. Bilfinger TV. Jandorf L. Smith EM. Stefano GB. Surgical anticipatory stress manifests itself in immunocyte desensitization: evidence for autoimmunoregulatory involvement. International Journal of Cardiology, 53 Suppl:S65-73, 1996 Apr 26.

13. Gordon, LS. (199'0). What is Stress? Chapter 1 in Stress Management. New York: Chelsea House Publishers, 13-20.
This chapter discusses the concept of stress, pioneering research in stress, and the psychosocial aspects of stress.

14. Gordon, J.S. (1990). The Biology of Stress. Chapter 2 in Stress Management. New York: Chelsea House Publishers, 25-40.
This chapter discusses stress and its effects on the central nervous system, the endocrine system, and the immune system.

15. Harrington, L., Affleck, G., Urrows, S., Tennen, H., Higgins, P., Zautra, A. and Hoffman, S. Temporal covariation of soluble interleukin-2 receptor levels, daily stress, and disease activity in rheumatoid arthritis. Arthritis and Rheumatism, 36: 199-203, 1993.

16. Ingvar, D.H. Memory of the future: An essay on the temporal organisation of conscious awareness. Human Neurobiol 1985; 4: 127-136.

17. Kemeney, M.E., Solomon, G.F., Morley, J.E. & Herbert, T. L. (1993). Psychoneuroimmunology , In Nemeroff CB (Ed. ), Neuroendocrinology , Boca Raton, FL: CRC Press, 563-592.
This chapter presents two forms of evidence that support a nervous-immune system interaction: {I) direct anatomical and physiological evidence indicating linkages between the nervous and immune systems and (2) indirect evidence indicating that during psychological disturbance, the immune system is alerted, as are the likelihood and course of immunologically mediated or resisted diseases. Topics covered include communication between the nervous system to the immune system; experiential effects on immune processes in animals; experiential effects on immune processes in humans; and clinical implications of psychological factors and immune processes.

18. Maier, S.F., Watkins, L.R., & Fleshner M. (1994). Psychoneuroimmunology: The Interface Between Behavior, Brain, and Immunity. American Psychologist, 49(12),1004-1007.
This article provides an overview of psychoneuroimmunology for the general psychologist. The existence of bidirectional communication pathways between the brain and the immune system and the implications of this network for behavior are emphasized. These implications are that behavioral-psychological processes ought to be capable of altering immune function and that events that occur as part of immune responses should modulate behavior. Evidence for influences in both of these directions is reviewed. The discussion of psychological modulation of immunity focuses on classical conditioning and stress, whereas that of immune modification of behavior highlights behavioral effects produced by substances released by the immune system.

19. McEwen, B.S., Protective and damaging effects of stress meditation. NEJM 1998; 338: 171-179.

20. Reichlin, S. (1993) Neuroendocrine-Immune Interactions. New England Journal of Medicine, 329(17), 1246-1253.
This review summarizes the implications of neuroendocrinimmunology for clinical medicine from the more important insights gained from research in this field.

21. Savino, W. (1995). Immune-Neuroendocrine Interactions. Immunology Today 16(7), 318322.
This review article gives a brief overview of neuroendocrinology research including a molecular basis for immune-neuroendocrine crosstalk and immune-neuroendocrine interactions in pathology.

22. Weigent, D.A. & Blalock, J.E. (1995). Associations between the Neuroendocrine and Immune Systems. Journal of Leukocyte Biology 58(2), 137-150.
This review article gives detailed information on the production of neuroendocrine hormones by the immune system and the production of cytokines by the neuroendocrine system. Each hormone and cytokine is listed individually and a review of the research supporting its production and its role is presented