Skip to main content
SpringerLink
Log in

Mind, Body, and Spirit in Chronic Illness

  • Chapter
  • First Online:
Integrative Pathways

  • 921 Accesses

Abstract

This chapter provides an introduction to chronic illness as conceptualized in the Pathways Model. Health care expenditures and the major conditions requiring costly medical care are discussed. The importance of environment, socioeconomic status, and developmental factors are highlighted. Several patient cases are utilized to demonstrate multiple risk factors, both biological and psychosocial, that increase the probability of developing a chronic illness. Patients describe in their own words the aspects of their background with which they have struggled. Adversity during the critical developmental period of childhood has ramifications for morbidity well into the adult years. Individuals who have experienced emotional, physical, or sexual abuse are at great risk for chronic illness, particularly pain conditions, depressive disorders, and cardiovascular disease. At similar risk are minimally educated, low-income patients who reside in a high stress neighborhood. The influence of lifestyle, particularly inactivity and high fat, high sugar diets is explored within the context of personal decisions and choices made by individuals. Isolated patients without social support who do not have a stable home suffer the effects of their environment both emotionally and physically. Chronic stress, due also to the illness itself, is associated with damaging effects mediated through the nervous system and the immune complex. First, the mind, body, and spiritual aspects of chronic illness are explored, and then they are correlated with the levels of intervention in the Pathways Model.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 69.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 99.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Ajzen, I. (2002). Perceived behavioral control, self-efficacy, locus of control, and the theory of planned behavior. Journal of Applied Social Psychology, 32(4), 665–683.

    Article  Google Scholar 

  • Blix, A. S. (2016). Adaptations to polar life in mammals and birds. Journal of Experimental Biology, 219, 1093–1105.

    Article  Google Scholar 

  • Block, J. P., & Subramanian, S. V. (2015). Moving beyond “food deserts:” Reorienting United States policies to reduce disparities in diet quality. PLoS Medicine, 12(12), e1001914.

    Article  Google Scholar 

  • Bourne, E. (1998). Healing fear: New approaches to overcoming anxiety. Oakland, CA: New Harbinger.

    Google Scholar 

  • Brennan, I. (2011). Anger antidotes. New York, NY: W.W. Norton.

    Google Scholar 

  • Center for Disease Control. (2013). Adverse childhood experiences study pyramid. Atlanta, GA: Centers for Disease Control and Prevention. Retrieved January 18, 2013, from https://www.cdc.gov/violenceprevention/acestudy/about.html

  • Cohen, S., & Rodriguez, M. S. (1995). Pathways linking affective disturbances and physical disorders. Health Psychology, 14(5), 374–380.

    Article  Google Scholar 

  • D’Zurilla, T. J., & Nezu, A. M. (2007). Problem-solving therapy: A positive approach to clinical intervention (3rd ed.). New York, NY: Springer.

    Google Scholar 

  • de Quervain, D. J., Aerni, A., Schelling, G., & Roozendaal, B. (2009). Glucocorticoids and the regulation of memory in health and disease. Frontiers in Neuroendocrinolology, 30, 358–370.

    Article  Google Scholar 

  • Dieleman, J. L., Baral, R., Birger, M., Bui, A. L., Bulchis, A., Chapin, A., & Murray, C. J. (2016). U.S. spending on personal health care and public health, 1996-2013. Journal of the American Medical Association, 316(24), 2627–2646.

    Article  Google Scholar 

  • Dinan, T. G., Stilling, R. M., Stanton, C., & Cryan, J. F. (2015). Collective unconscious: How gut microbes shape human behavior. Journal of Psychiatric Research, 63, 1–9.

    Article  Google Scholar 

  • Dorahy, M. J., Corry, M., Shannon, M., MacSherry, A., Hamilton, G., McRobert, G., et al. (2009). Complex PTSD, interpersonal trauma, and relational consequences: Findings from a treatment-receiving Northern Irish sample. Journal of Affective Disorders, 112, 71–80.

    Article  Google Scholar 

  • Dweck, C. S. (2006). Mindset: The new psychology of success. New York, NY: Random House.

    Google Scholar 

  • Edwards, L. (2013). A social history of chronic illness in America: In the kingdom of the sick. New York, NY: Walker Publishing Company, Inc.

    Google Scholar 

  • Endless house: Intersections of art and architecture (Exhibit). (2015). New York, NY: Museum of Modern Art.

    Google Scholar 

  • Fabbi-Destro, M., & Rizzolatti, G. (2008). Mirror neurons and mirror systems in monkeys and humans. Physiology, 23, 171–179.

    Article  Google Scholar 

  • Gardner, D. (2008). The science of fear: Why we fear the things we shouldn’t—And put ourselves in greater danger (1st ed.). Strand, London, UK: Penguin Books Ltd..

    Google Scholar 

  • Gibson, B., Marcus, R. L., Staggers, N., Jones, J., Samore, M., & Weir, C. (2012). Efficacy of a computerized simulation in promoting walking in individuals with diabetes. Journal of Medical Internet Research, 14(3), e71.

    Article  Google Scholar 

  • Global Burden of Disease Study 2013 Collaborators. (2015). Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990-2013: A systematic analysis for the Global Burden of Disease Study 2013. Lancet, 386, 743–800.

    Article  Google Scholar 

  • Grossoehme, D. H., VanDyke, R., & Seid, M. (2008). Spirituality’s role in chronic disease self-management: Sanctification of the body in families dealing with cystic fibrosis. Journal of Health Care Chaplaincy, 15(2), 149–158.

    Article  Google Scholar 

  • Heim, C., Shugart, M., Graighead, W. E., & Nemeroff, C. B. (2010). Neurobiological and psychiatric consequences of child abuse and neglect. Developmental Psychobiology, 52, 671–690.

    Article  Google Scholar 

  • Hermans, E. J., Henckens, M. J., Roelofs, K., & Fernandez, G. (2013). Fear bradycardia and activation of the human periaqueductal grey. Neuroimage, 66, 278–287.

    Article  Google Scholar 

  • Hobson, C. J., Kamen, J., Szostek, J., Nethercut, C. M., Tiedman, J. W., & Wojnarowicz, S. (1998). Stressful life events: A revision and update of the social readjustment rating scale. International Journal of Stress Management, 5(1), 1–23.

    Article  Google Scholar 

  • Holmes, T., & Rahe, R. (1967). The social readjustment rating scale. Journal of Psychosomatic Research, 11, 213–218.

    Article  Google Scholar 

  • Homan, K. J., & Boyatzis, C. J. (2010). Religiosity, sense of meaning, and health behavior in older adults. International Journal for the Psychology of Religion, 20(3), 173–186.

    Article  Google Scholar 

  • Hostinar, C. E., Ross, K. M., Chen, E., & Miller, G. E. (2015). Modeling the association between lifecourse socioeconomic disadvantage and systemic inflammation in healthy adults: The role of self-control. Health Psychology, 34(6), 580–590.

    Article  Google Scholar 

  • Hudson, C. (2005). Socioeconomic status and mental illness: Tests of the social causation and selection hypotheses. American Journal of Orthopsychiatry, 75(1), 3–18.

    Article  Google Scholar 

  • Izzard, C. E. (2009). Emotion theory and research: Highlights, unanswered questions and emerging issues. Annual Review of Psychology, 60, 1–25.

    Article  Google Scholar 

  • Johnson, L., Afari, N., & Zautra, A. (2009). The illness uncertainty concept: A review. Current Pain and Headache Reports, 13(2), 133–138.

    Article  Google Scholar 

  • Johnson, L. M., Zautra, A. J., & Davis, M. C. (2006). The role of illness uncertainty on coping with fibromyalgia symptoms. Health Psychology, 25(6), 696–703. https://doi.org/10.1037/0278-6133.25.6.696

    Article  PubMed  PubMed Central  Google Scholar 

  • Junger, A. (2013). Clean gut. New York, NY: Harper One.

    Google Scholar 

  • Juster, R. P., McEwen, B. S., & Lupien, S. J. (2010). Allostatic load biomarkers of chronic stress and impact on health and cognition. Neuroscience and Biobehavioral Reviews, 35, 2–16.

    Article  Google Scholar 

  • Kiecolt-Glaser, J. K., Fagundes, C. P., Andridge, R., Peng, J., Malarkey, W. B., Habash, D., & Belury, M. A. (2016). Depression, daily stressors, and inflammatory responses to high-fat meals: When stress overrides healthier food choices. Molecular Psychiatry, 22(3), 476–482. https://doi.org/10.1038/mp.2016.149

    Article  PubMed  PubMed Central  Google Scholar 

  • Kiviruusu, O., Huure, T., Haukala, A., & Aro, H. (2013). Changes in psychological resources moderate the effect of socioeconomic status on distress symptoms: A 10-year follow-up among young adults. Health Psychology, 32(5), 627–636.

    Article  Google Scholar 

  • Knez, I. (2005). Attachment and identity as related to a place and its perceived climate. Journal of Environmental Psychology, 25(2), 207–218.

    Article  Google Scholar 

  • Konturek, P. C., Brzozowski, T., & Konturek, S. J. (2011). Stress and the gut: Pathophysiology, clinical consequences, diagnostic approach and treatment options. Journal of Physiology and Pharmacology, 62(6), 591–599.

    PubMed  Google Scholar 

  • Krueger, P. M., & Reither, E. M. (2015). Mind the gap: Race/ethnic and socioeconomic disparities in obesity. Current Diabetes Reports, 15(11), 95.

    Article  Google Scholar 

  • Lackner, J. M., Quigley, B. M., & Blanchard, E. B. (2004). Depression and abdominal pain in IBS patients: The mediating role of catastrophizing. Psychosomatic Medicine, 66, 435–441.

    PubMed  Google Scholar 

  • Loehr, J., & Schwartz, T. (2003). The power of full engagement. New York, NY: Free Press.

    Google Scholar 

  • Low, A., Weymar, M., & Hamm, A. O. (2015). When threat is near, get out of here: Dynamics of defensive behavior during freezing and active avoidance. Psychological Science, 26(11), 1706–1716.

    Article  Google Scholar 

  • Lyubomirsky, S., King, L., & Diener, E. (2005). The benefits of frequent positive affect: Does happiness lead to success? Psychological Bulletin, 131(6), 803–855.

    Article  Google Scholar 

  • Mahoney, A., Pargament, K. I., Cole, B., Jewell, T., Magyar, G. M., Tarakeshwar, N., et al. (2005). A higher purpose: The sanctification of strivings in a community sample. International Journal for the Psychology of Religion, 15(3), 239–262. https://doi.org/10.1207/s15327582ijpr1503_4

    Article  Google Scholar 

  • Manseau, M. W. (2014). Economic inequality and poverty as social determinants of mental health. Psychiatric Annals, 44(1), 32–37.

    Article  Google Scholar 

  • Martos, T., Kezdy, A., & Horvath-Szabo, K. (2011). Religious motivations for everyday goals: Their religious context and potential consequences. Motivation and Emotion, 35, 75–88.

    Article  Google Scholar 

  • Mattavelli, G., Sormaz, M., Flack, T., Asghar, A. U., Fan, S., Manssuer, L., et al. (2014). Neutral responses to facial expressions support the role of the amygdala in processing threat. Social Cognitive and Affective Neuroscience, 9(11), 1684–1689. https://doi.org/10.1093/scan/nst162. Epub 2013 Oct 4.

    Article  PubMed  Google Scholar 

  • McGrady, A., & Moss, D. (2013). Pathways to illness, pathways to health. New York, NY: Springer.

    Book  Google Scholar 

  • Meara, E. R., Richards, S., & Dutler, D. M. (2008). The gap gets bigger: Changes in mortality and life expectancy, by education, 1981-2000. Health Affairs, 27(2), 350–360.

    Article  Google Scholar 

  • Michigan State University. (2001). Michigan forests forever teachers’ guide. Michigan State University Extension. Retrieved from http://mff.dsisd.net/Environment/WinterAnimals.htm

  • Morozink, J. A., Friedman, E. M., Coe, C. L., & Ryff, C. D. (2010). Socioeconomic and psychosocial predictors of interleukin-6 in the MIDUS national sample. Health Psychology, 29(6), 626–635.

    Article  Google Scholar 

  • Nouwen, H. (2009). Home tonight: Further reflections on the parable of the prodigal son. New York, NY: Doubleday.

    Google Scholar 

  • Orr, M. G., Kaplan, G. A., & Galea, S. (2016). Neighbourhood food, physical activity, and educational environments and black/white disparities in obesity: A complex systems simulation analysis. Journal of Epidemiology and Community Health, 70, 862–867.

    Article  Google Scholar 

  • Papagni, S. A., Benetti, S., Arulanantham, S., McCrory, E., McGuire, P., & Mechelli, A. (2011). Effects of stressful life events on human brain structure: A longitudinal voxel-based morphometry study. Stress, 14(2), 227–232.

    Article  Google Scholar 

  • Parr, L. A., Waller, B. M., & Fugate, J. (2005). Emotional communication in primates: Implications for neurobiology. Current Opinion in Neurobiology, 15, 716–720.

    Article  Google Scholar 

  • Pearce, P. Z. (2008). Exercise is medicine™. Current Sports Medicine Reports, 7(3), 171–175.

    Article  Google Scholar 

  • Phillips, M. L., Drevets, W. C., Rauch, S. L., & Lane, R. (2003). Neurobiology of emotion perception II: Implications for major psychiatric disorders. Biological Psychiatry, 54, 515–528.

    Article  Google Scholar 

  • Purves, D., Augustine, G. V., Fitzpatrick, D., Hall, W. C., LaMantia, A. S., White, L. E., & McNamara, J. O. (2012). Neurosciences (5th ed.). Sunderland, MA: Sinauer Associates.

    Google Scholar 

  • Rahko, J., Paakki, J. J., Starck, T., Nikkinen, J., Remes, J., Hurtig, T., & Kiviniemi, V. (2010). Functional mapping of dynamic happy and fearful facial expression processing in adolescents. Brain Imaging and Behavior, 4(2), 164–176.

    Article  Google Scholar 

  • Reuben, D. B., & Tinetti, M. E. (2012). Goal-oriented patient care—An alternative health outcomes paradigm. The New England Journal of Medicine, 366(9), 777–779.

    Article  Google Scholar 

  • Rippe, J. M., & Angelopoulos, T. J. (2011). Lifestyle medicine: Continuing to grow and mature. American Journal of Lifestyle Medicine, 5(1), 4–6.

    Article  Google Scholar 

  • Roy-Byrne, P. P., Davidson, K. W., Kessler, R. C., Asmundson, G. J. G., & Goodwin, R. D. (2008). Anxiety disorders and comorbid medical illness. Focus, 6, 467–485.

    Article  Google Scholar 

  • Sacks, O. (2010). The mind’s eye. New York, NY: Alfred A. Knopf.

    Google Scholar 

  • Schildkrout, B. (2011). Unmasking psychological symptoms. New York, NY: Wiley.

    Book  Google Scholar 

  • Segerstrom, S. (2010). Resources, stress, and immunity: An ecological perspective on human psychoneuroimmunology. Annals of Behavioral Medicine, 40, 114–125.

    Article  Google Scholar 

  • Slopen, N., Loucks, E. B., Appleton, A. A., Kawachi, I., Kubzansky, L. D., Non, A. L., et al. (2015). Early origins of inflammation: An examination of prenatal and childhood social adversity in a prospective cohort study. Psychneuroendocrinology, 51, 403–413.

    Article  Google Scholar 

  • Smith, M. T., Edwards, R. R., McCann, U. D., & Haythornthwaite, J. A. (2007). The effects of sleep deprivation on pain inhibition and spontaneous pain in women. Sleep, 30(4), 494–505.

    Article  Google Scholar 

  • Sowder, E., Gevirtz, R., Shapiro, W., & Ebert, C. (2010). Restoration of vagal tone: A possible mechanism for functional abdominal pain. Applied Psychophysiology and Biofeedback, 35(3), 199–206.

    Article  Google Scholar 

  • Stoeber, J., & Janssen, D. (2011). Perfectionism and coping with daily failures: Positive reframing helps achieve satisfaction at the end of the day. Anxiety, Stress, & Coping, 24(5), 477–497.

    Article  Google Scholar 

  • Suarez, K., Mayer, C., Ehlert, U., & Nater, U. M. (2010). Psychological stress and self-reported functional gastrointestinal disorders. The Journal of Nervous and Mental Disease, 198(3), 226–229.

    Article  Google Scholar 

  • Thoits, P. A. (2010). Stress and health: Major findings and policy implications. Journal of Health and Social Behavior, 51(S), 541–553.

    Google Scholar 

  • Todman, L. C., & Diaz, A. (2014). A public health approach to narrowing mental health disparities. Psychiatric Annals, 44, 27–31.

    Article  Google Scholar 

  • Todman, L. C., & Holliday, C. S. (2015). Adverse features of the built environment. In M. T. Compton & R. S. Shim (Eds.), The social determinants of mental health (pp. 193–212). Arlington, VA: American Psychiatric Association.

    Google Scholar 

  • Uher, R., Tansey, K. E., Dew, T., Maier, W., Mors, O., Hauser, J., & McGuffin, P. (2014). An inflammatory biomarker as a differential predictor of outcome of depression treatment with escitalopram and nortriptyline. American Journal of Psychiatry, 171, 1278–1286.

    Article  Google Scholar 

  • Wang, X., Xie, H., Cotton, A. S., Duval, E. R., Tamburrino, M. B., Brickman, K. R., et al. (2016). Preliminary study of acute changes in emotion processing in trauma survivors with PTSD symptoms. PLoS One, 11(7), e0159065. https://doi.org/10.1371/journal.pone.0159065

    Article  PubMed  PubMed Central  Google Scholar 

  • Wang, D. D., Li, Y., Chiuve, S. E., Hu, F. B., & Willett, W. C. (2015). Improvements in US diet helped reduce disease burden and lower premature deaths, 1999-2012; overall diet remains poor. Health Affairs, 34(11), 1916–1922. https://doi.org/10.1377/hlthaff.2015.0640

    Article  PubMed  Google Scholar 

  • Yeh, B. I., & Kong, I. D. (2013). The advent of lifestyle medicine. Journal of Lifestyle Medicine, 3(1), 1–8.

    PubMed  PubMed Central  Google Scholar 

  • Yu, D. S. F. (2008). Heart failure: The manifestations and impact of negative emotions. In L. Sher (Ed.), Psychological factors and cardiovascular disorders: The role of psychiatric pathology and maladaptive personality features (pp. 135–151). New York, NY: Nova Biomedical Books.

    Google Scholar 

  • Yuen, E. Y., Liu, W., Karatsoreos, I. N., Ren, Y., Feng, J., McEwen, B. S., & Yan, Z. (2010). Mechanisms for acute stress-induced enhancement of glutamatergic transmission and working memory. Molecular Psychiatry, 16(2), 156–170.

    Article  Google Scholar 

  • Zenk, S. N., Schulz, A. J., Lachance, L. L., Mentz, G., Kannan, S., Ridella, W., & Galea, S. (2009). Multilevel correlates of satisfaction with neighborhood availability of fresh fruits and vegetables. Annals of Behavioral Medicine, 38, 48–59.

    Article  Google Scholar 

  • Zhang, D., Giabbanelli, P. J., Arah, O. A., & Zimmerman, F. J. (2014). Impact of different policies on unhealthy dietary behaviors in an urban adult population: An agent-based simulation model. American Journal of Public Health, 104(7), 1217–1222.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Psychiatry, University of Toledo, Toledo, OH, USA

    Angele McGrady PhD

  2. College of Integrative Medicine and Health Sciences, Saybrook University, Oakland, CA, USA

    Donald Moss PhD Dean

Authors
  1. Angele McGrady PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Donald Moss PhD Dean
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG, part of Springer Nature

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

McGrady, A., Moss, D. (2018). Mind, Body, and Spirit in Chronic Illness. In: Integrative Pathways. Springer, Cham. https://doi.org/10.1007/978-3-319-89313-6_1

Download citation

Publish with us

Policies and ethics

Search

Navigation