Inhoudsopgave
Homeostatic regulation................................................................................................................................. 4
Introduction..........................................................................................................................................................4
Hierarchy of homeostatic controls.......................................................................................................................4
Intrinsic control mechanisms – organ level......................................................................................................5
Autonomic control mechanism........................................................................................................................5
Endocrine control mechanisms and hypothalamus.........................................................................................7
Higher brain centers.........................................................................................................................................8
Central integration of the stress response...................................................................................................... 9
Appraisal model of psychological stress (Richard Lazarus & Susan Folkman, 1984)...........................................9
Brain structures underlying appraisals.................................................................................................................9
Overview of some key brain structures and functions..................................................................................10
Generation of psychological responses..........................................................................................................11
Endocrine stress responses.......................................................................................................................... 15
Overview of Stress Endocrine Regulation...........................................................................................................15
Activation of Stress Endocrine Secretion and the Central Corticotropin-Releasing Factor System....................15
Cortisol Regulation.........................................................................................................................................15
Stress Effects and the Central CRF System.....................................................................................................15
Cortisol’s Feedback Actions in the CNS...............................................................................................................16
Cortisol Receptors..........................................................................................................................................16
Cortisol Effects on Frontal-Limbic Activity..........................................................................................................16
Amygdala responses to cortisol and altered responsivity of the CNS................................................................16
Amygdala sensitization and potential implications for health...........................................................................17
The hypothalamic-sympatho-adrenomedullary axis..........................................................................................17
Stress hormone epinephrine..........................................................................................................................17
Amygdala and hippocampal responses to stress hormone feedback...........................................................17
Stress endocrine secretion and regulation of long-term stress reactivity..........................................................18
Hierarchy of autonomic and endocrine controls over homeostasis...................................................................18
Psychoneuroimmunology............................................................................................................................. 19
Immune system...................................................................................................................................................19
Cells of the immune system...........................................................................................................................19
Cytokines: communication in IS.....................................................................................................................19
Psychoneuroimmunology...................................................................................................................................21
IS and depression...........................................................................................................................................22
Stress and the immune system...........................................................................................................................22
Implications for health and disease....................................................................................................................23
Conditioning of the immune system...................................................................................................................25
Clinical applications............................................................................................................................................25
Summary.............................................................................................................................................................26
Physical Activity........................................................................................................................................... 26
1
, Physical Activity..................................................................................................................................................26
Definitions.......................................................................................................................................................26
Evolution in physical activity/health..............................................................................................................26
Physical health benefits of physical activity...................................................................................................27
Mental health benefits of physical activity....................................................................................................27
Mediating factors between physical activity and (mental) health.................................................................28
General thoughts on physical activity............................................................................................................31
Sedentary Behaviour...........................................................................................................................................31
Definition........................................................................................................................................................31
Sedentary insufficiently physically active......................................................................................................32
Mediating factors between sedentary behaviour and (mental) health.........................................................33
Summary.........................................................................................................................................................33
Positve psychology....................................................................................................................................... 34
Theory and concepts...........................................................................................................................................34
Well-being......................................................................................................................................................34
Flow................................................................................................................................................................35
Broaden-and-build theory..............................................................................................................................35
Positive affectivity (PA) and health.....................................................................................................................36
Measurement considerations........................................................................................................................36
Evidence for positive affect and health..........................................................................................................37
Practice...............................................................................................................................................................39
Happiness.......................................................................................................................................................39
Positive psychology interventions..................................................................................................................40
Summary.............................................................................................................................................................41
Biopsychosocial Aspects in Asthma.............................................................................................................. 41
Pathophysiology.................................................................................................................................................41
Psychological burden..........................................................................................................................................43
Psychological stress........................................................................................................................................43
How do biopsychosocial aspects influence asthma?.....................................................................................43
Acute emotions and stress..................................................................................................................................43
Chronic emotions and stress in human and animal studies...............................................................................45
Social aspects......................................................................................................................................................45
Neural aspects....................................................................................................................................................46
Biopsychosocial Aspects in COPD................................................................................................................. 46
Pathophysiology.................................................................................................................................................46
Physchological burden........................................................................................................................................48
Effects of negative emotions in COPD................................................................................................................48
Social aspects......................................................................................................................................................48
Potential cause-effect relationships...................................................................................................................49
Emotional and cognitive modulation of pain................................................................................................50
Pain.....................................................................................................................................................................50
Biological base of pain....................................................................................................................................50
Experimental pain paradigms.........................................................................................................................51
Pain in the brain..................................................................................................................................................52
2
, Attentional modulation of pain......................................................................................................................52
Emotional modulation of pain........................................................................................................................52
Cognitive modulation of pain.............................................................................................................................53
Expectation.....................................................................................................................................................53
Application in treatment of pain....................................................................................................................55
Cognitive regulation.......................................................................................................................................55
Social factors.......................................................................................................................................................55
Empathy..........................................................................................................................................................55
Social pain.......................................................................................................................................................56
Summary.............................................................................................................................................................56
Gastrointestinal disorders............................................................................................................................ 56
Anatomy and physiology of the gut-brain axis...................................................................................................56
Gastrointestinal tract......................................................................................................................................56
(Microbiota) Gut-Brain Axis............................................................................................................................57
Microbiotica impact on psychobiology...............................................................................................................57
The microbiota-gut-brain axis........................................................................................................................57
Rodent studies................................................................................................................................................57
Healthy humans..............................................................................................................................................57
Treatment.......................................................................................................................................................58
Current pitfalls and future perspectives.........................................................................................................58
Short chain fatty acids....................................................................................................................................58
Summary.........................................................................................................................................................59
Microbiota-gut-brain axis in inflammatory bowel disease................................................................................59
Signaling mechanisms: SCFA and inflammation.............................................................................................59
Biopsychosocial Aspects in Dyspnea............................................................................................................. 59
Dyspnea..............................................................................................................................................................59
Psychological and social aspects........................................................................................................................61
Impact on the perception of dyspnea.................................................................................................................61
Impact on neural processing of breathlessness..................................................................................................62
Correlation neural processing and dyspnea...................................................................................................62
Summary.............................................................................................................................................................62
3
, Homeostatic regulation
Introduction
Homeostatic regulation is the organism’s ability to keep its internal environment stable, despite
changes in the external environment
f.e.: temperature, blood ph, oxygen pressure, blood glucose
Central nervous system = interface for interaction with external environment
‘Stress’ = threat to homeostasis
o Stressor
Physical (e.g. cold): bottom-up homeostatic threat
Psychological (e.g. anticipation of pain, exam): top-down homeostatic threat
both need same system to come up with a compensatory response
o Compensatory stress response
Two mechanisms to retain homeostasis
1. Feedback control: reacts when a perturbation (verstoring) of the homeostasis occurs
reaction systems (brain stem and hypothalamus) sends info about peripheric condition
o Temperature
Setpoint of 37°C in hypothalamus, signals from nerves system
Too hot: widen bloodvessels, produce sweat giving heat to environment,
temperature drops
Too cold: constrict bloodvessels, stop sweating conserve heat, temperature back
to normal
long time in cold: shivering because muscles contract to produce warmth
o Blood pressure
Baroreceptors detect high bloodpressure
Information to brain stem/medulla which sends it to nerves system to react
Heart adjusts strokevolume and rate of heartbeats
Results: regulated and normal bloodpressure
o Blood pH levels/Arterial carbon dioxide pressure (PaCO2)
Peripheral chemoreceptors detects pH level decrease (and CO 2 increase)
Information to brain stem which sends it to nerves system to react
Activate respiratory center and more signals to breathing muscles
Results: more breathing decrease CO2 normal pH level
2. Feedforward control: reacts before a perturbation (verstoring) of the homeostasis occurs
o Anticipating or correcting perturbations before occurring
o Classical conditioning as a viable mechanism
E.g. ‘exercise hyperpnea’: increases in ventilation and heart rate occur at the onset
of physical exercise, even before an increase in PaCO 2
Hierarchy of homeostatic controls
Structure (from low to high)
1. Vital organs and local reflexes (e.g. heart)
2. Automatic and endocrine messages
3. Brainstem and endocrine controls
4. Hypothalamus
5. Higher brain centers
4
Homeostatic regulation................................................................................................................................. 4
Introduction..........................................................................................................................................................4
Hierarchy of homeostatic controls.......................................................................................................................4
Intrinsic control mechanisms – organ level......................................................................................................5
Autonomic control mechanism........................................................................................................................5
Endocrine control mechanisms and hypothalamus.........................................................................................7
Higher brain centers.........................................................................................................................................8
Central integration of the stress response...................................................................................................... 9
Appraisal model of psychological stress (Richard Lazarus & Susan Folkman, 1984)...........................................9
Brain structures underlying appraisals.................................................................................................................9
Overview of some key brain structures and functions..................................................................................10
Generation of psychological responses..........................................................................................................11
Endocrine stress responses.......................................................................................................................... 15
Overview of Stress Endocrine Regulation...........................................................................................................15
Activation of Stress Endocrine Secretion and the Central Corticotropin-Releasing Factor System....................15
Cortisol Regulation.........................................................................................................................................15
Stress Effects and the Central CRF System.....................................................................................................15
Cortisol’s Feedback Actions in the CNS...............................................................................................................16
Cortisol Receptors..........................................................................................................................................16
Cortisol Effects on Frontal-Limbic Activity..........................................................................................................16
Amygdala responses to cortisol and altered responsivity of the CNS................................................................16
Amygdala sensitization and potential implications for health...........................................................................17
The hypothalamic-sympatho-adrenomedullary axis..........................................................................................17
Stress hormone epinephrine..........................................................................................................................17
Amygdala and hippocampal responses to stress hormone feedback...........................................................17
Stress endocrine secretion and regulation of long-term stress reactivity..........................................................18
Hierarchy of autonomic and endocrine controls over homeostasis...................................................................18
Psychoneuroimmunology............................................................................................................................. 19
Immune system...................................................................................................................................................19
Cells of the immune system...........................................................................................................................19
Cytokines: communication in IS.....................................................................................................................19
Psychoneuroimmunology...................................................................................................................................21
IS and depression...........................................................................................................................................22
Stress and the immune system...........................................................................................................................22
Implications for health and disease....................................................................................................................23
Conditioning of the immune system...................................................................................................................25
Clinical applications............................................................................................................................................25
Summary.............................................................................................................................................................26
Physical Activity........................................................................................................................................... 26
1
, Physical Activity..................................................................................................................................................26
Definitions.......................................................................................................................................................26
Evolution in physical activity/health..............................................................................................................26
Physical health benefits of physical activity...................................................................................................27
Mental health benefits of physical activity....................................................................................................27
Mediating factors between physical activity and (mental) health.................................................................28
General thoughts on physical activity............................................................................................................31
Sedentary Behaviour...........................................................................................................................................31
Definition........................................................................................................................................................31
Sedentary insufficiently physically active......................................................................................................32
Mediating factors between sedentary behaviour and (mental) health.........................................................33
Summary.........................................................................................................................................................33
Positve psychology....................................................................................................................................... 34
Theory and concepts...........................................................................................................................................34
Well-being......................................................................................................................................................34
Flow................................................................................................................................................................35
Broaden-and-build theory..............................................................................................................................35
Positive affectivity (PA) and health.....................................................................................................................36
Measurement considerations........................................................................................................................36
Evidence for positive affect and health..........................................................................................................37
Practice...............................................................................................................................................................39
Happiness.......................................................................................................................................................39
Positive psychology interventions..................................................................................................................40
Summary.............................................................................................................................................................41
Biopsychosocial Aspects in Asthma.............................................................................................................. 41
Pathophysiology.................................................................................................................................................41
Psychological burden..........................................................................................................................................43
Psychological stress........................................................................................................................................43
How do biopsychosocial aspects influence asthma?.....................................................................................43
Acute emotions and stress..................................................................................................................................43
Chronic emotions and stress in human and animal studies...............................................................................45
Social aspects......................................................................................................................................................45
Neural aspects....................................................................................................................................................46
Biopsychosocial Aspects in COPD................................................................................................................. 46
Pathophysiology.................................................................................................................................................46
Physchological burden........................................................................................................................................48
Effects of negative emotions in COPD................................................................................................................48
Social aspects......................................................................................................................................................48
Potential cause-effect relationships...................................................................................................................49
Emotional and cognitive modulation of pain................................................................................................50
Pain.....................................................................................................................................................................50
Biological base of pain....................................................................................................................................50
Experimental pain paradigms.........................................................................................................................51
Pain in the brain..................................................................................................................................................52
2
, Attentional modulation of pain......................................................................................................................52
Emotional modulation of pain........................................................................................................................52
Cognitive modulation of pain.............................................................................................................................53
Expectation.....................................................................................................................................................53
Application in treatment of pain....................................................................................................................55
Cognitive regulation.......................................................................................................................................55
Social factors.......................................................................................................................................................55
Empathy..........................................................................................................................................................55
Social pain.......................................................................................................................................................56
Summary.............................................................................................................................................................56
Gastrointestinal disorders............................................................................................................................ 56
Anatomy and physiology of the gut-brain axis...................................................................................................56
Gastrointestinal tract......................................................................................................................................56
(Microbiota) Gut-Brain Axis............................................................................................................................57
Microbiotica impact on psychobiology...............................................................................................................57
The microbiota-gut-brain axis........................................................................................................................57
Rodent studies................................................................................................................................................57
Healthy humans..............................................................................................................................................57
Treatment.......................................................................................................................................................58
Current pitfalls and future perspectives.........................................................................................................58
Short chain fatty acids....................................................................................................................................58
Summary.........................................................................................................................................................59
Microbiota-gut-brain axis in inflammatory bowel disease................................................................................59
Signaling mechanisms: SCFA and inflammation.............................................................................................59
Biopsychosocial Aspects in Dyspnea............................................................................................................. 59
Dyspnea..............................................................................................................................................................59
Psychological and social aspects........................................................................................................................61
Impact on the perception of dyspnea.................................................................................................................61
Impact on neural processing of breathlessness..................................................................................................62
Correlation neural processing and dyspnea...................................................................................................62
Summary.............................................................................................................................................................62
3
, Homeostatic regulation
Introduction
Homeostatic regulation is the organism’s ability to keep its internal environment stable, despite
changes in the external environment
f.e.: temperature, blood ph, oxygen pressure, blood glucose
Central nervous system = interface for interaction with external environment
‘Stress’ = threat to homeostasis
o Stressor
Physical (e.g. cold): bottom-up homeostatic threat
Psychological (e.g. anticipation of pain, exam): top-down homeostatic threat
both need same system to come up with a compensatory response
o Compensatory stress response
Two mechanisms to retain homeostasis
1. Feedback control: reacts when a perturbation (verstoring) of the homeostasis occurs
reaction systems (brain stem and hypothalamus) sends info about peripheric condition
o Temperature
Setpoint of 37°C in hypothalamus, signals from nerves system
Too hot: widen bloodvessels, produce sweat giving heat to environment,
temperature drops
Too cold: constrict bloodvessels, stop sweating conserve heat, temperature back
to normal
long time in cold: shivering because muscles contract to produce warmth
o Blood pressure
Baroreceptors detect high bloodpressure
Information to brain stem/medulla which sends it to nerves system to react
Heart adjusts strokevolume and rate of heartbeats
Results: regulated and normal bloodpressure
o Blood pH levels/Arterial carbon dioxide pressure (PaCO2)
Peripheral chemoreceptors detects pH level decrease (and CO 2 increase)
Information to brain stem which sends it to nerves system to react
Activate respiratory center and more signals to breathing muscles
Results: more breathing decrease CO2 normal pH level
2. Feedforward control: reacts before a perturbation (verstoring) of the homeostasis occurs
o Anticipating or correcting perturbations before occurring
o Classical conditioning as a viable mechanism
E.g. ‘exercise hyperpnea’: increases in ventilation and heart rate occur at the onset
of physical exercise, even before an increase in PaCO 2
Hierarchy of homeostatic controls
Structure (from low to high)
1. Vital organs and local reflexes (e.g. heart)
2. Automatic and endocrine messages
3. Brainstem and endocrine controls
4. Hypothalamus
5. Higher brain centers
4
