Bonet José
Centro de Estrés, Fundación Favaloro. Universidad Favaloro, Argentina.
Vertex. 2019 May-Jun;XXX(145):185-194.
The notion that "psychological factors " and the psychosocial environment influence the body function and the health maintenance or disease onset has been maintained over the years, and from different approaches to science, medicine, and psychology. Psychosomatic Medicine traditionally deals with this issue, but the "psychosomatic" name is now being criticized because of some implicit ambiguity, probably derived from the identification with the different theoretical frameworks and/or specific research methods that have been used in its evolution. This has given rise to misunderstandings about its definition, objectives, and a delay in the search for pathways of mediatizing these effects. Since then, there has been an increasing interest in the research of mechanisms, or mediatizing pathways through which the mind, the brain, and the environment could produce an impact on the somatic functioning. This brief review focuses on early stress, epigenetics and polymorphisms, such as the mechanism of penetration of the psychosocial environment; alostasis and alostatic load such as the accumulated wear and tear produced by the continuous adaptation to a variable psicosocial context; activation of the neuroimmune pathways as the physiological basis of somatizations; and interoception as a the pathway that the body introduces into the brain, mind and consciousness.
多年来,“心理因素”和社会心理环境会影响身体功能、健康维持或疾病发生这一观念一直存在,且来自科学、医学和心理学等不同领域。心身医学传统上处理这一问题,但“心身”这个名称如今正因一些隐含的歧义而受到批评,这种歧义可能源于其在发展过程中与不同理论框架和/或特定研究方法的关联。这导致了对其定义、目标的误解,以及在寻找介导这些影响的途径方面的延迟。从那时起,人们对机制的研究兴趣日益浓厚,即心理、大脑和环境对身体功能产生影响的介导途径。这篇简短的综述聚焦于早期应激、表观遗传学和多态性,如社会心理环境的渗透机制;稳态应变和稳态应变负荷,如持续适应变化的社会心理环境所产生的累积损耗;神经免疫途径的激活作为躯体化的生理基础;以及内感受作为身体引入大脑、心理和意识的途径。