Chinese Medicine considers preventative care as important as treating the disease itself. If we cultivate our health we can prevent illness and injury from occurring and minimize their consequences when 'disease evils' do attack us. Join Kath Bartlett, MS, LAc as she shares thoughts, news articles, recipes & tips derived from a wide variety of source material, as it relates to Chinese medicine and cultivating optimal health for the body, mind and spirit.


Thursday, July 16, 2009

Studies Show Childhood Stress & Trauma Increase Risk For Auto Immune Diseases & Asthma

There have been some interesting studies published recently showing a positive correlation between childhood stress & trauma and auto immune diseases and asthma. Deepak Chopra has been discussing the findings of one of these studies on auto immune diseases on various news channels lately. I have pasted abstracts from a few of these studies published in Psychosomatic Medicine below for your perusal.

As an acupuncturist, this information has peaked my interest.

There are a couple of reasons I wanted to learn more about these findings. First, as a holistic medicine (meaning one that treats the whole: mind/body/spirit, and considers the organism to be inseparable or part of its surrounding environment) Traditional Chinese Medical (TCM) theory has long recognized the relationship between emotions and diseases. In fact, TCM considers the 7 emotions (joy, grief, sorrow, anger, worry, fright, fear) to be a direct cause of disease and pathology in the body. Trauma (coming from the exterior environment) would involve fright, fear, anger, sorrow, grief and worry all of which bind qi (prevent energy in the body from circulating smoothly) causing disease processes to set in: when qi, and hence blood & fluids (it takes qi or energy to move blood & fluids) do not flow smoothly, pain arises, growths (tumours) develop, phlegm accumulates (causing allergy & asthma symptoms) and so on. So a top priority in TCM treatment of any disease is to keep the qi (and hence blood and fluids) flowing smoothly.

The 7 emotions cause qi (blood & fluids) to stagnate (slow down or stop moving). I'll demonstrate this idea with anger: when we get angry we get tense and tighten up. This tightening prevents qi from moving smoothly. Likewise grief and sorrow result in emotional and physical depression, meaning qi slows down or stops moving. With fear & fright we stop, or freeze. Animals demonstrate this physically when they realize there is a predator near. When worrying, we get stuck in a feedback loop, going over and over the same thoughts: like an eddy in a river. The river of qi swirls around itself rather than moving forward with the current.

The studies mentioned here have focused on pediatric factors, but the implications are not limited to childhood trauma. The results can be extrapolated to include adult traumas & stresses as well, according to TCM theory of the 7 emotional causes of disease.

Secondly, I find it interesting that the recent study showed a high correlation between autoimmune diseases and stress & traumas. Let's explore this idea for a moment.

With autoimmune diseases, the immune system is attacking itself. It misidentifies it's own tissues, marking them as foreign bodies (pathogens) that must be attacked and neutralized. Deepak Chopra's interpretation of the study's results is that in the case of abuse or trauma, esp. for a child, one's boundaries begin to blur regarding who is friend and foe: most often the abuser is a family member. The confusion is registered in the body's immune system.

I would postulate that when under stress, this effect is amplified. We feel we are under attack by the outside force who's interaction with us becomes stressful, and due to that stress, we begin an inner dialogue which may in someways be self-abusive. We ruminate, are fearful, depressed and in perpetuating and nurturing these adverse emotions we are attacking ourselves, impeding our own inner peace and harmony. Thus our immune system identifies ourselves (physically) as a pathogen, or a disease causing agent. In a way, in the case of those who have a positive correlation between compromised immunity and high stress or trauma, the immune system can be seen as doing it's job by diagnosing/identifying ourselves (emotions & thoughts) as the disease pathogen, and it then goes on with its mission to attack and destroy the offending agent.

Maybe the lesson here with immune disorders (or any disease process for that matter) is to see if there is something we are doing in mind or lifestyle that is detrimental to the homeostasis of our well being and if so address it.

I realize that I am going out on a limb here with this extrapolation of the study findings. I am not suggesting that all autoimmune diseases can be cured merely by correcting poor life habits and state of mind. Or even that all autoimmune disease are correlated with stress & trauma in every case. What I am saying is that in TCM we know that lifestyle and emotions are a causative factor in the formation of diseases, and that an important component of any treatment plan is to address the role of these adverse factors in the disease process. KB


Psychosomatic Medicine 71:243-250 (2009)
© 2009 American Psychosomatic Society


ORIGINAL ARTICLES

Cumulative Childhood Stress and Autoimmune Diseases in Adults

Shanta R. Dube, PhD, MPH, DeLisa Fairweather, PhD, William S. Pearson, PhD, MHA, Vincent J. Felitti, MD, Robert F. Anda, MD, MS and Janet B. Croft, PhD

From National Center for Chronic Disease Prevention and Health Promotion (S.R.D., W.S.P. R.F.A., J.B.C.), Centers for Disease Control and Prevention, Division of Adult and Community Health, Atlanta, Georgia; Department of Environmental Health Sciences (D.F.), Bloomberg School of Public Health and Department of Pathology, School of Medicine, Johns Hopkins University, Baltimore, Maryland; and the Department of Preventive Medicine (V.J.F.), Southern California Permanente Medical Group (Kaiser Permanente), San Diego, California.

Address correspondence and reprint requests to Shanta R. Dube, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Division of Adult and Community Health, 4770 Buford Highway, N.E., MS K-50, Atlanta, GA 30341-3717. E-mail: skd7@cdc.gov

Objective:

To examine whether childhood traumatic stress increased the risk of developing autoimmune diseases as an adult.

Methods:

Retrospective cohort study of 15,357 adult health maintenance organization members enrolled in the Adverse Childhood Experiences (ACEs) Study from 1995 to 1997 in San Diego, California, and eligible for follow-up through 2005.

ACEs included

  • childhood physical
  • emotional
  • or sexual abuse
  • witnessing domestic violence
  • growing up with household substance abuse
  • mental illness
  • parental divorce
  • and/or an incarcerated household member.

The total number of ACEs (ACE Score range = 0-8) was used as a measure of cumulative childhood stress.

The outcome was hospitalizations for any of 21 selected autoimmune diseases and 4 immunopathology groupings:

  • T- helper 1 (Th1) (e.g., idiopathic myocarditis)
  • T-helper 2 (Th2) (e.g., myasthenia gravis)
  • Th2 rheumatic (e.g., rheumatoid arthritis)
  • and mixed Th1/Th2 (e.g., autoimmune hemolytic anemia).

Results:

Sixty-four percent reported at least one ACE.

The event rate (per 10,000 person-years) for a first hospitalization with any autoimmune disease was 31.4 in women and 34.4 in men.

First hospitalizations for any autoimmune disease increased with increasing number of ACEs (p < .05).

Compared with persons with no ACEs, persons with ≥2 ACEs were at a

  • 70% increased risk for hospitalizations with Th1,
  • 80% increased risk for Th2,
  • and 100% increased risk for rheumatic diseases (p < .05).

Conclusions:

Childhood traumatic stress increased the likelihood of hospitalization with a diagnosed autoimmune disease decades into adulthood.

These findings are consistent with recent biological studies on the impact of early life stress on subsequent inflammatory responses.

Key Words: childhood abuse • traumatic stress • autoimmune diseases • stress • inflammatory response

Abbreviations: ACE = adverse childhood experience; AD = autoimmune disease; Th1 = T-helper 1; Th2 = T-helper 2; CRP = C-reactive protein; CRH = corticoid releasing hormone


Psychosomatic Medicine 71:243-250 (2009)
© 2009
American Psychosomatic Society

Cumulative Childhood Stress and Autoimmune Diseases in Adults

Shanta R. Dube, PhD, MPH, DeLisa Fairweather, PhD, William S. Pearson, PhD, MHA, Vincent J. Felitti, MD, Robert F. Anda, MD, MS and Janet B. Croft, PhD

From National Center for Chronic Disease Prevention and Health Promotion (S.R.D., W.S.P. R.F.A., J.B.C.), Centers for Disease Control and Prevention, Division of Adult and Community Health, Atlanta, Georgia; Department of Environmental Health Sciences (D.F.), Bloomberg School of Public Health and Department of Pathology, School of Medicine, Johns Hopkins University, Baltimore, Maryland; and the Department of Preventive Medicine (V.J.F.), Southern California Permanente Medical Group (Kaiser Permanente), San Diego, California.

Address correspondence and reprint requests to Shanta R. Dube, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Division of Adult and Community Health, 4770 Buford Highway, N.E., MS K-50, Atlanta, GA 30341-3717. E-mail: kd7@cdc.gov

http://www.psychosomaticmedicine.org/cgi/content/abstract/71/2/243



Psychosomatic Medicine 71:243-250 (2009)
© 2009 American Psychosomatic Society


ORIGINAL ARTICLES

Received August 5, 2008
Returned for revision November 20, 2008

Double-Exposure to Acute Stress and Chronic Family Stress is Associated With Immune Changes in Children With Asthma

Teresa J. Marin , MA, Edith Chen , PhD, Jennifer A. Munch , BA, Gregory E. Miller , PhD


Address correspondence and reprint requests to: Teresa J. Marin, MA, E-mail: teresamarin@psych.ubc.ca.

 Abstract

Objective: To understand how psychological stress heightens risk for asthma flare-ups, we examined the relationship between acute stress, chronic family stress, and the production of asthma-related cytokines. Methods: Seventy-one children with asthma and 76 medically healthy children completed interviews regarding life stress, and peripheral blood samples were collected. After mononuclear cells had been mitogenically stimulated, production of the cytokines interleukin (IL)-4, IL-5, IL-13, and IFN-{gamma} was measured. All measurements were repeated every 6 months for 2 years. Children reported on their asthma symptoms for 14 days after each study visit. Results: Children with asthma who had higher levels of chronic family stress showed increased production of IL-4, IL-5, and IFN-{gamma} at times when they had experienced an acute event compared with times when they had not. These stress-related changes did not occur in asthmatic children with lower levels of chronic family stress, or in healthy controls. The combination of acute and chronic stress was also associated with increased asthma symptoms. Conclusion: These findings suggest that acute negative life events have a particularly strong impact among a subgroup of children with asthma who are under high chronic family stress. The heightened inflammatory profile in this group suggests an explanation for why children experiencing life stressors are at greater risk for asthma exacerbations.

Psychosom Med 2009, doi:10.1097/PSY.0b013e318199dbc3


























































© 2009 by American Psychosomatic Society


Psychosomatic Medicine 70:1035-1043 (2008)
© 2008 American Psychosomatic Society


ORIGINAL ARTICLES

Childhood Adversity, Early-Onset Depressive/Anxiety Disorders, and Adult-Onset Asthma

Kate M. Scott, PhD, Michael Von Korff, ScD, Jordi Alonso, MD, PhD, Matthias C. Angermeyer, MD, Corina Benjet, PhD, Ronny Bruffaerts, PhD, Giovanni de Girolamo, MD, Josep Maria Haro, MD, PhD, Ronald C. Kessler, PhD, Viviane Kovess, MD, PhD, Yutaka Ono, MD, Johan Ormel, PhD and José Posada-Villa, MD

From the Department of Psychological Medicine (K.M.S.), School of Medicine and Health Sciences, Otago University, Wellington, New Zealand; Center for Health Studies (M.V.K.), Group Health Cooperative of Puget Sound, Seattle, Washington; Health Services Research Unit (J.A.), Institut Municipal d'Investigacio Medica (IMIM) and CIBER en Epidemiologia y Salud Publica (CIBERESP), Barcelona, Spain; Center for Public Mental Health (M.C.A.), Gösing am Wagram, Austria; National Institute of Psychiatry (C.B.), Calzada Mexico Xochimilco, Mexico City, Mexico; Department of Neurosciences and Psychiatry (R.B.), University Hospital, Gasthuisberg, Leuven, Belgium; Regional Health Care Agency (G.G.), Emilia-Romagna Region, Bologna, Italy; Sant Joan de Deu-SSM (J.M.H.), RETICS RD06/0011 REM-TAP, Barcelona, Spain; Department of Health Care Policy (R.K.), Harvard Medical School, Boston, Massachusetts; Fondation MGEN pour la Santé Publique (V.K.), Université Paris 5, Paris, France; Health Center (Y.O.), Keio University, Tokyo, Japan; Department of Psychiatry (J.O.), University Medical Center, Groningen, Netherlands; and Colegio Mayor de Cundinamarca University (J.P.-V.), Bogota, Colombia.

Address correspondence and reprint requests to Kate M. Scott, Department of Psychological Medicine, School of Medicine and Health Sciences, Otago University, Wellington, PO Box 7343, Wellington South, New Zealand. E-mail: kate.scott@otago.ac.nz

Objectives: To investigate a) whether childhood adversity predicts adult-onset asthma; b) whether early-onset depressive/anxiety disorders predict adult-onset asthma; and c) whether childhood adversity and early-onset depressive/anxiety disorders predict adult-onset asthma independently of each other. Previous research has suggested, but not established, that childhood adversity may predict adult-onset asthma and, moreover, that the association between mental disorders and asthma may be a function of shared risk factors, such as childhood adversity.

Methods: Ten cross-sectional population surveys of household-residing adults (>18 years, n = 18,303) assessed mental disorders with the Composite International Diagnostic Interview (CIDI 3.0) as part of the World Mental Health surveys. Assessment of a range of childhood family adversities was included. Asthma was ascertained by self-report of lifetime diagnosis and age of diagnosis. Survival analyses calculated hazard ratios (HRs) for risk of adult-onset (>age 20 years) asthma as a function of number and type of childhood adversities and early-onset ( for current age, sex, country, education, and current smoking.

Results: Childhood adversities predicted adult-onset asthma with risk increasing with the number of adversities experienced (HRs = 1.49–1.71). Early-onset depressive and anxiety disorders also predicted adult-onset asthma (HRs = 1.67–2.11). Childhood adversities and early-onset depressive and anxiety disorders both predicted adult-onset asthma after mutual adjustment (HRs = 1.43–1.91).

Conclusions: Childhood adversities and early-onset depressive/anxiety disorders independently predict adult-onset asthma, suggesting that the mental disorder-asthma relationship is not a function of a shared background of childhood adversity.

Key Words: asthma • childhood adversity • comorbidity • depressive disorders • anxiety disorders

Abbreviations: CIDI = Composite International Diagnostic Interview; HR = hazard ratio; WMH = World Mental Health; HPA = hypothalamic-pituitary-adrenal; CI = Confidence Interval.


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