No description available.

Historically the trend in health care has been the domain of health care professionals such as doctors, nurses and other professionals from the medical fraternity. This created the separation between the mind and body, due to the diagnostic and treatment origins being segregated. This thesis addresses the idea that psychological processes have significant impacts on our physical health {and visa versa). It establishes the notion that health care needs to be understood holistically, from a broader systemic perspective, expanding the working model of health. The second chapter of this thesis addresses the power of the mind and the connection between the mind and body. It establishes the importance of beliefs and perceptions and the huge effect this has on people and their lives. How we choose to perceive a situation will give that situation meaning. The meanings that we give to events usually depict how we will see and respond to that event, sometimes more than the actual event itself. It explains the importance of the mind (psychological issues) as well as the body (physiological issues) when understanding and dealing with health and wellbeing. The following chapter discusses the historical developments of physical and mental health; from Hippocrates and Descartes to a modern holistic approach and attitude. Behaviour Medicine6, explicitly recognises that mind and body are intimately interconnected and that an appreciation of these interconnections and their scientific study is an interdisciplinary field, uniting the behavioural sciences with the biomedical sciences; in the hope that the cross fertilization will yield a more comprehensive picture of health and illness. The 'biopsychosocial model'7 provides a theoretical framework, explaining how an awareness of biological, psychological and social process are all important in understanding disease and recovery, supported by systemic principles. The scientific research and practical implications of psychoneuroimmunology8 (PNI) takes this biopsychosocial model one-step further. It describes how thoughts, perceptions and emotions have interchangeable influences with brain chemistry, which in turn influences the body and neurological systems1 particularly immune system functioning. The concept that we all have an inner ability /intelligence to heal ourselves is also detailed. Miller (1997: 350) discusses this notion, stating that we all have "a healer within." He states that this inner healer can be awakened in order to participate in "our deep healing.11 He claims, "This vital essence has been with us since birth ... Its function is to maintain homeostasis (internal balance). As humans, we can1 through our ability to change our images and beliefs, enhance, or inhibit the power of this inner healer." The concepts discussed thus far in the thesis are then demonstrated practically. The relationship between stress and health is examined and practical ways to maintain a healthier lifestyle is detailed. The researcher then introduces a South African company that is currently working in the field with the concepts of mindbody medicine and psychoneuroimmunology. This led the researcher to find a philosophical container in which to hold the holistic mind body theories and concepts. Anderson & Carter (2003: 222) states, "Social work distinguishes itself by exploring the 'person-environment fit'. This is an area in social work where constructivism may prove supportive. Such an emphasis increases the likelihood that diverse voices and points of view are integrated in social work theory and practice." Therefore/ a constructive epistemology/ philosophy in which meaning is intimately connected with experience, is expanded upon. The mind/body theory and concepts are then linked to Constructivism and Personal Construct Theory (by George Kelly). Constructivism postulates that we all create and interpret our own meaning systems, which become our subjective realities. The link to mind body medicine is pertinent in that both constructivism and mind body medicine share similar ideologies about how realities are construed, and how this in turn effects treatment of disease and maintenance of wellbeing. Cybernetic complementarities then expand our understanding of the mind and body connection in a monolistic framework, where mind and body are recursive partial arcs of a holistic health care system. Constructivism therefore integrates eastern and western concepts, cementing all the concepts used in this thesis, in a holistic manner. It also helps us to understand how some of the mind body techniques may be working within the mind body realm. Given the unique needs of a changing and developing society, as found in South Africa, there is a need to be creative and find alternative ways to cope with our societal stresses and daily occurrences. This is where the researcher feels that the social work profession needs to be involved in working and contributing to our health care services. The development of medical social work is detailed and the latest social work definition discussed. It is reveals how contents of the definition of social work are relevant and are a pertinent fit with mind-body approaches to health and wellbeing. The researcher debates the role of social workers in this field of health care. It is then proposed, in the detailed discussion, that social workers practising in this field should be known as Health Care Social Workers. This field of holistic health care has many proposed strengths and implication, for both Health Care Social Workers and other health care professionals. It will naturally also present challenges that need to be considered and contemplated. The final chapter of this thesis examine these strengths and challenges and their therapeutic implications. The researcher concludes by demonstrating that the literature study on holistic mind and body approaches matches her objectives from the first chapter. / Social work / M.A. (Social Science with specialisation in Mental Health)

As interações entre o sistema nervoso central e os sistemas imune e endócrino são o objeto de estudo da psiconeuroimunologia. Protocolos de indução de estresse têm sido amplamente utilizados como métodos confiáveis de investigação da relação entre transtornos psiquiátricos, aspectos psicológicos, traços de personalidade, ansiedade e a resposta imune. O procedimento de simulação de falar em público (SFP) é um protocolo experimental validado que reconhecidamente é capaz de ativar o eixo hipotálamo-hipófise-adrenal (HPA) e produzir respostas de estresse em sujeitos humanos. Esse método foi utilizado para: 1) Comparar a reatividade imunológica de indivíduos com diagnóstico de fobia social com a de indivíduos sem qualquer diagnóstico psiquiátrico; 2) Investigar se ocorrem alterações imunes subseqüentes à exposição a um estressor agudo induzido em laboratório e 3) identificar e correlacionar parâmetros imunológicos com traços de personalidade, humor, níveis de ansiedade e medidas fisiológicas. Os traços de personalidade foram investigados por meio dos seguintes instrumentos: Inventário de Temperamento e Caráter (TCI), Escala de Afeto Positivo e Negativo (PANAS), Inventário de Ansiedade Traço (IDATE-T), Inventário de Depressão de Beck (BDI), Inventário de Estratégias de ?Coping? de Folkman e Lazarus e Adaptação da Escala de Percepção de Estresse (PSS). Os sintomas de ansiedade foram avaliados por meio da Escala Analógica Visual de Humor (VAMS), da Escala de Sintomas Somáticos (ESS) e do IDATE-Estado. As variáveis psicofisiológicas avaliadas foram pressão arterial sistólica (PAS), diastólica (PAD), batimentos cardíacos (BPM), resposta galvânica da pele (GSR) e temperatura. Os níveis plasmáticos de catecolaminas (adrenalina, noradrenalina e dopamina) e hormônios do eixo HPA (cortisol e ACTH) também foram dosados. Realizou-se a contagem de células imunes polimorfonucleares e mononucleares no sangue periférico e mediu-se a atividade citotóxica de células NK e neutrófilos. Dosou-se proteínas de fase aguda e imunoglobulinas (A, D, G, M e E) a produção de citocinas no sangue por ELISA e RT-PCR. Os dados foram submetidos a análises de variância para dados com medidas repetidas testando efeitos de grupo, sexo, momento experimental e interações. As correlações entre as variáveis foram testadas por regressões múltiplas e coeficientes de correlação de Pearson. Os resultados apontam que o SFP foi eficiente para induzir estresse e produzir alterações detectáveis em diversos dos parâmetros investigados. As diferenças entre fóbicos sociais e controles são significativas para traços de personalidade e atuam ao longo do tempo para as medidas psicofisiológicas. Alterações imunes e hormonais estiveram mais frequentemente associadas ao gênero do que ao grupo experimental, e afetaram mais homens. Além disso, as alterações imunes foram de pequena magnitude afetando componentes inespecíficos da resposta imune. Conjuntamente, os resultados apontam uma relativa ativação do eixo HPA em fóbicos mas que não corresponde a alterações imunes de mesma magnitude. Mais estudos com uma amostra maior e a investigação de outros parâmetros são necessários para compreender melhor como a fobia social afeta o sistema imune de homens e mulheres e investigar se as alterações podem aumentar a susceptibilidade a doenças nesse grupo de sujeitos. Uma vez que essa interação seja melhor compreendida poderá subsidiar estratégias mais adequadas para abordar e elaborar estratégias de prevenção e intervenção capazes de promover comportamentos saudáveis. / Interactions among the nervous, immune and endocrine systems are the object of study of Psychoneuroimmunology. Stress protocols have been broadly used as reliable means to investigate the relationship among psychiatric disorders, psychological aspects, personality traits, anxiety and immune response has been studied using these interactions. The Simulated Public Speaking (SPS) is a validated experimental procedure known to activate the Hypothalamus-Pituitary-Adrenal (HPA) axis and produce stress responses in human subjects. This method was used to: 1) compare the immune reactions of individuals with a diagnosis of social phobia to that of individuals without any psychiatric diagnosis; 2) investigate if immune alterations occur subsequent to the exposure to an acute laboratory induced stressor; 3) identify and correlate immune parameters with personality traits, mood, anxiety levels and physiologic measures. Personality traits were investigated with Cloninger?s Temperament and Character?s Inventory (TCI), Positive and Negative Affects Scale (PANAS), State-Trait Anxiety Scale (STAI?T), Beck?s Depression Inventory (BDI), Lazarus?s Coping Strategies Inventory, Perceived Stress Scale (PSS). Anxiety symptoms were investigated along the procedure with the Bodily Symptoms Scale (ESS), STAI-E and the Visual Analogue Mood Scale (VAMS). Psychophysiologic variables assessed were Systolic (PAS) and Diastolic (PAD) Blood Pressure, Heart Rate (BPM), Galvanic Skin Response (GSR) and temperature. Plasmatic circulating levels of cathecolamines (Adrenaline, Noradrenaline and Dopamine) and HPA axis hormones (Cortisol, ACTH) were assessed. Peripheral blood cell population counts were obtained for polymorphonuclear (PMN) and mononuclear cells. Cytotoxic activity of neutrophils and NK cells was assessed, as well as cytokine production by ELISA and RT-PCR. Acute phase proteins and immunoglobulins (A, D, G, M, and E) were dosed on peripheral blood. Data was submitted to variance analysis for data with repeated measures testing effects of group, sex, experimental moment and interactions on variables. Correlations among variables were tested by multiple regressions and Pearson?s correlation deltas. The results show SPS was efficient in inducing stress and produce detectable alterations in several of the parameters investigated. Differences between social phobics and controls are significant for personality traits and, along time for psychophysiologic measures. Hormonal and immune alterations were more often associated to gender rather than to the group subjects belonged to, with men being more susceptible to the procedure. Also, immune changes were of small magnitude, usually affecting inespecific components of the response. Together, the results point to a relatively higher activation of the HPA-axis in social phobics, but one that does not correspond to immune responses of the same magnitude. Further studies with a larger sample and investigation of other parameters are necessary to better understand how social phobia affects the immune system of men and women and to investigate if the alterations can increase susceptibility to diseases in this group of individuals. Once this interaction is better understood it may provide the basis for an improved design to approach and elaborate prevention/intervention strategies and promote healthy behaviours.

Historically the trend in health care has been the domain of health care professionals such as doctors, nurses and other professionals from the medical fraternity. This created the separation between the mind and body, due to the diagnostic and treatment origins being segregated. This thesis addresses the idea that psychological processes have significant impacts on our physical health {and visa versa). It establishes the notion that health care needs to be understood holistically, from a broader systemic perspective, expanding the working model of health. The second chapter of this thesis addresses the power of the mind and the connection between the mind and body. It establishes the importance of beliefs and perceptions and the huge effect this has on people and their lives. How we choose to perceive a situation will give that situation meaning. The meanings that we give to events usually depict how we will see and respond to that event, sometimes more than the actual event itself. It explains the importance of the mind (psychological issues) as well as the body (physiological issues) when understanding and dealing with health and wellbeing. The following chapter discusses the historical developments of physical and mental health; from Hippocrates and Descartes to a modern holistic approach and attitude. Behaviour Medicine6, explicitly recognises that mind and body are intimately interconnected and that an appreciation of these interconnections and their scientific study is an interdisciplinary field, uniting the behavioural sciences with the biomedical sciences; in the hope that the cross fertilization will yield a more comprehensive picture of health and illness. The 'biopsychosocial model'7 provides a theoretical framework, explaining how an awareness of biological, psychological and social process are all important in understanding disease and recovery, supported by systemic principles. The scientific research and practical implications of psychoneuroimmunology8 (PNI) takes this biopsychosocial model one-step further. It describes how thoughts, perceptions and emotions have interchangeable influences with brain chemistry, which in turn influences the body and neurological systems1 particularly immune system functioning. The concept that we all have an inner ability /intelligence to heal ourselves is also detailed. Miller (1997: 350) discusses this notion, stating that we all have "a healer within." He states that this inner healer can be awakened in order to participate in "our deep healing.11 He claims, "This vital essence has been with us since birth ... Its function is to maintain homeostasis (internal balance). As humans, we can1 through our ability to change our images and beliefs, enhance, or inhibit the power of this inner healer." The concepts discussed thus far in the thesis are then demonstrated practically. The relationship between stress and health is examined and practical ways to maintain a healthier lifestyle is detailed. The researcher then introduces a South African company that is currently working in the field with the concepts of mindbody medicine and psychoneuroimmunology. This led the researcher to find a philosophical container in which to hold the holistic mind body theories and concepts. Anderson & Carter (2003: 222) states, "Social work distinguishes itself by exploring the 'person-environment fit'. This is an area in social work where constructivism may prove supportive. Such an emphasis increases the likelihood that diverse voices and points of view are integrated in social work theory and practice." Therefore/ a constructive epistemology/ philosophy in which meaning is intimately connected with experience, is expanded upon. The mind/body theory and concepts are then linked to Constructivism and Personal Construct Theory (by George Kelly). Constructivism postulates that we all create and interpret our own meaning systems, which become our subjective realities. The link to mind body medicine is pertinent in that both constructivism and mind body medicine share similar ideologies about how realities are construed, and how this in turn effects treatment of disease and maintenance of wellbeing. Cybernetic complementarities then expand our understanding of the mind and body connection in a monolistic framework, where mind and body are recursive partial arcs of a holistic health care system. Constructivism therefore integrates eastern and western concepts, cementing all the concepts used in this thesis, in a holistic manner. It also helps us to understand how some of the mind body techniques may be working within the mind body realm. Given the unique needs of a changing and developing society, as found in South Africa, there is a need to be creative and find alternative ways to cope with our societal stresses and daily occurrences. This is where the researcher feels that the social work profession needs to be involved in working and contributing to our health care services. The development of medical social work is detailed and the latest social work definition discussed. It is reveals how contents of the definition of social work are relevant and are a pertinent fit with mind-body approaches to health and wellbeing. The researcher debates the role of social workers in this field of health care. It is then proposed, in the detailed discussion, that social workers practising in this field should be known as Health Care Social Workers. This field of holistic health care has many proposed strengths and implication, for both Health Care Social Workers and other health care professionals. It will naturally also present challenges that need to be considered and contemplated. The final chapter of this thesis examine these strengths and challenges and their therapeutic implications. The researcher concludes by demonstrating that the literature study on holistic mind and body approaches matches her objectives from the first chapter. / Social work / M.A. (Social Science with specialisation in Mental Health)

As interações entre o sistema nervoso central e os sistemas imune e endócrino são o objeto de estudo da psiconeuroimunologia. Protocolos de indução de estresse têm sido amplamente utilizados como métodos confiáveis de investigação da relação entre transtornos psiquiátricos, aspectos psicológicos, traços de personalidade, ansiedade e a resposta imune. O procedimento de simulação de falar em público (SFP) é um protocolo experimental validado que reconhecidamente é capaz de ativar o eixo hipotálamo-hipófise-adrenal (HPA) e produzir respostas de estresse em sujeitos humanos. Esse método foi utilizado para: 1) Comparar a reatividade imunológica de indivíduos com diagnóstico de fobia social com a de indivíduos sem qualquer diagnóstico psiquiátrico; 2) Investigar se ocorrem alterações imunes subseqüentes à exposição a um estressor agudo induzido em laboratório e 3) identificar e correlacionar parâmetros imunológicos com traços de personalidade, humor, níveis de ansiedade e medidas fisiológicas. Os traços de personalidade foram investigados por meio dos seguintes instrumentos: Inventário de Temperamento e Caráter (TCI), Escala de Afeto Positivo e Negativo (PANAS), Inventário de Ansiedade Traço (IDATE-T), Inventário de Depressão de Beck (BDI), Inventário de Estratégias de ?Coping? de Folkman e Lazarus e Adaptação da Escala de Percepção de Estresse (PSS). Os sintomas de ansiedade foram avaliados por meio da Escala Analógica Visual de Humor (VAMS), da Escala de Sintomas Somáticos (ESS) e do IDATE-Estado. As variáveis psicofisiológicas avaliadas foram pressão arterial sistólica (PAS), diastólica (PAD), batimentos cardíacos (BPM), resposta galvânica da pele (GSR) e temperatura. Os níveis plasmáticos de catecolaminas (adrenalina, noradrenalina e dopamina) e hormônios do eixo HPA (cortisol e ACTH) também foram dosados. Realizou-se a contagem de células imunes polimorfonucleares e mononucleares no sangue periférico e mediu-se a atividade citotóxica de células NK e neutrófilos. Dosou-se proteínas de fase aguda e imunoglobulinas (A, D, G, M e E) a produção de citocinas no sangue por ELISA e RT-PCR. Os dados foram submetidos a análises de variância para dados com medidas repetidas testando efeitos de grupo, sexo, momento experimental e interações. As correlações entre as variáveis foram testadas por regressões múltiplas e coeficientes de correlação de Pearson. Os resultados apontam que o SFP foi eficiente para induzir estresse e produzir alterações detectáveis em diversos dos parâmetros investigados. As diferenças entre fóbicos sociais e controles são significativas para traços de personalidade e atuam ao longo do tempo para as medidas psicofisiológicas. Alterações imunes e hormonais estiveram mais frequentemente associadas ao gênero do que ao grupo experimental, e afetaram mais homens. Além disso, as alterações imunes foram de pequena magnitude afetando componentes inespecíficos da resposta imune. Conjuntamente, os resultados apontam uma relativa ativação do eixo HPA em fóbicos mas que não corresponde a alterações imunes de mesma magnitude. Mais estudos com uma amostra maior e a investigação de outros parâmetros são necessários para compreender melhor como a fobia social afeta o sistema imune de homens e mulheres e investigar se as alterações podem aumentar a susceptibilidade a doenças nesse grupo de sujeitos. Uma vez que essa interação seja melhor compreendida poderá subsidiar estratégias mais adequadas para abordar e elaborar estratégias de prevenção e intervenção capazes de promover comportamentos saudáveis. / Interactions among the nervous, immune and endocrine systems are the object of study of Psychoneuroimmunology. Stress protocols have been broadly used as reliable means to investigate the relationship among psychiatric disorders, psychological aspects, personality traits, anxiety and immune response has been studied using these interactions. The Simulated Public Speaking (SPS) is a validated experimental procedure known to activate the Hypothalamus-Pituitary-Adrenal (HPA) axis and produce stress responses in human subjects. This method was used to: 1) compare the immune reactions of individuals with a diagnosis of social phobia to that of individuals without any psychiatric diagnosis; 2) investigate if immune alterations occur subsequent to the exposure to an acute laboratory induced stressor; 3) identify and correlate immune parameters with personality traits, mood, anxiety levels and physiologic measures. Personality traits were investigated with Cloninger?s Temperament and Character?s Inventory (TCI), Positive and Negative Affects Scale (PANAS), State-Trait Anxiety Scale (STAI?T), Beck?s Depression Inventory (BDI), Lazarus?s Coping Strategies Inventory, Perceived Stress Scale (PSS). Anxiety symptoms were investigated along the procedure with the Bodily Symptoms Scale (ESS), STAI-E and the Visual Analogue Mood Scale (VAMS). Psychophysiologic variables assessed were Systolic (PAS) and Diastolic (PAD) Blood Pressure, Heart Rate (BPM), Galvanic Skin Response (GSR) and temperature. Plasmatic circulating levels of cathecolamines (Adrenaline, Noradrenaline and Dopamine) and HPA axis hormones (Cortisol, ACTH) were assessed. Peripheral blood cell population counts were obtained for polymorphonuclear (PMN) and mononuclear cells. Cytotoxic activity of neutrophils and NK cells was assessed, as well as cytokine production by ELISA and RT-PCR. Acute phase proteins and immunoglobulins (A, D, G, M, and E) were dosed on peripheral blood. Data was submitted to variance analysis for data with repeated measures testing effects of group, sex, experimental moment and interactions on variables. Correlations among variables were tested by multiple regressions and Pearson?s correlation deltas. The results show SPS was efficient in inducing stress and produce detectable alterations in several of the parameters investigated. Differences between social phobics and controls are significant for personality traits and, along time for psychophysiologic measures. Hormonal and immune alterations were more often associated to gender rather than to the group subjects belonged to, with men being more susceptible to the procedure. Also, immune changes were of small magnitude, usually affecting inespecific components of the response. Together, the results point to a relatively higher activation of the HPA-axis in social phobics, but one that does not correspond to immune responses of the same magnitude. Further studies with a larger sample and investigation of other parameters are necessary to better understand how social phobia affects the immune system of men and women and to investigate if the alterations can increase susceptibility to diseases in this group of individuals. Once this interaction is better understood it may provide the basis for an improved design to approach and elaborate prevention/intervention strategies and promote healthy behaviours.

No description available.

No description available.

No description available.