|Professor Alex Brown
South Australian Health and Medical Research Institute
Title: Hearts and Minds: Understanding the Psychosocial Contributors to Chronic Disease Inequalities in Aboriginal Australians
Professor Alex Brown is currently the Theme Leader Aboriginal Health Research in the newly established South Australian Health and Medical Research Institute. His previous research positions include Executive Director of BakerIDI Central Australia (2007-2012), and establishing the Central Australian unit of Menzies School of Health Research (2003-2007). Over the last 15 years, Professor Brown has made significant contributions to national policy and research in Aboriginal health. His research focuses on overcoming disparities in health outcomes for Aboriginal people, with a particular emphasis on chronic disease as the primary contributor to life expectancy differentials. Prof Brown has been instrumental in exploring the links between heart disease, depression and chronic stress in disadvantaged communities and building health system responses to chronic disease (particularly in primary care). He has been involved in advocacy and advisory roles in policy since 1996. He leads a large group of Indigenous and non-Indigenous researchers focused on health systems research, chronic disease disparities, and psychosocial contributors to inequalities in health. He is active on ministerial advisory councils, lead committees for national NGOs, research
Much has been discussed in recent years about the size and contributors to the significant health inequalities experienced by Aboriginal and Torres Strait Islander Australians. On every marker of health and social status, Indigenous Australians fare worse than any other population group within contemporary society. Increasingly, the role of chronic disease such as cardiovascular disease, diabetes and chronic kidney disease have been recognised as the primary contributors to the 12 year life expectancy gap. The potential role of psychosocial factors in driving or modifying these conditions have received little attention. Whilst social disadvantage, chronic stress and marginalisation are considered important causes of illness in Indigenous Australians, the study of such factors faces many conceptual, logistical and methodological challenges. This session will outline these issues to explore the nexus of disadvantage, social inequality, health disparities and chronic diseases among Indigenous Australians.
|Steven Cole is a Professor of Medicine in the Division of Hematology-Oncology at the David Geffen School of Medicine at UCLA. His research utilizes molecular genetics and computational bioinformatics to analyze the pathways by which social and environmental factors influence the activity of the human genome, as well as viral and tumor genomes. He pioneered the field of human social genomics, and serves as Director of the UCLA Social Genomics Core Laboratory. He is also a member of the Jonsson Comprehensive Cancer Center, the Norman Cousins Center, the UCLA AIDS Institute, and the UCLA Molecular Biology Institute.
Social regulation of human gene expression
Relationships between genes and social behavior have historically been viewed as a one-way street, with genes in control. Research in social genomics has begun to challenge this view by discovering broad alterations in the expression of genes across differing socio-environmental conditions. This talk will summarize the emerging field of social genomics and its efforts to identify the types of genes subject to social regulation, the psychological and biological signaling pathways mediating such effects, and the genetic polymorphisms that modify their impact on individuals. Humans appear to have evolved distinct gene regulation regimes to capitalize on the changing threats and affordances associated with sociality. Regardless of how well these adaptations may have served us under ancestral conditions, they now create a deep molecular connection between the social world around us and the internal biological processes that shape our future health and behavioral trajectories.
|Professor Judith Prins
Radboud University Nijmegen
Prof. dr. Judith Prins is professor and chair of the department of Medical Psychology in the Radboud University Medical Centre, Nijmegen, the Netherlands. She is a licensed clinical psychologist and licensed cognitive behavior therapist in the department of Medical Psychology and the Radboud University Centre of Oncology. Judith Prins is president of the Netherlands Behavioural Medicine Federation (NBMF) and member of the ISBM Governing Council. She is chair of the scientific psychosocial oncology board of the Dutch Cancer Society (KWF) and member of the psychosocial advisory board of Pink Ribbon, the Netherlands. In het Dutch Association for Psycho-Oncology (NVPO) she is a member of the Educational Committee. Judith Prins received the 2003 Netherlands ME Foundation Award and the 2015 NVPO Award of the Dutch Association for Psycho-Oncology. In her research program on psychosocial oncology she aims to develop new methods for screening and psychological interventions for cancer patients and survivors, in close collaboration with clinical departments. Her educational activities in the medical school focus on behavioural medicine and psychosocial oncology. Her patient care activities are centred around psychosocial oncology and palliative care. As a clinical psychologist she has face-to-face consultations with cancer patients and survivors, (bereaved) caregivers and family members. In close cooperation with the Radboud University Centre for Oncology she has been developing new psychosocial oncology services, psychological screening of patients and caregivers in palliative care, services for adolescents and young adults with cancer, implementation of distress screening for cancer patients and a self management website for breast cancer patients and multidisciplinary psychosocial meetings.
Web-based self-management interventions and blended therapy for distress reduction in cancer survivors.
The survival rate of cancer has increased enormously. It is anticipated that in the next decades many people will be living with a diagnosis of cancer. Emotional distress is a common problem in the transition from cancer patient to survivor. Research shows that about one third of cancer survivors are severely distressed up to 5 years after cancer treatment and may benefit from evidence-based psychological interventions. Although the majority of cancer survivors have moderate levels of distress, they report high unmet needs for information and support. One of the unaddressed needs is how to cope with the psychological impact of cancer after primary treatment.
Web-based self-management (e-health) interventions are an effective way to meet the needs of those who cannot access professional psychosocial care. Psycho-education about survivorship topics and techniques based on cognitive behaviour therapy can make survivors familiar with effective coping strategies. A benefit of an e-health approach is that it can be offered to all patients early in the treatment trajectory and therefore may prevent some people from developing disabling levels of distress.
Systematic reviews showed that online therapies are more effective when guidance from a care provider is included. E-health can be integrated in face-to-face psychological interventions. This so called blended therapy may be more efficacious and cost-effective, and increase access of cancer survivors to psychosocial care.
The development and efficacy testing of web-based self management interventions (BREATH) and blended therapies (SWORD, CORRECT) for breast, colorectal and prostate cancer survivors will be presented.
|Professor Winfried Rief
Professor of Clinical Psychology and Psychotherapy, Philipps University of Marburg, Germany. Head of the Clinic for Psychological Interventions. License for psychotherapy and supervision. Dr. Rief worked for many years in hospital settings (e.g., Roseneck Hospital for Psychosomatic Medicine, Prien a. Ch.). He is specialized in placebo- and nocebo effects, perception and coping with somatic symptoms, optimization of clinical studies and interventions. He was guest professor at Harvard Medical School, Boston (2004/2005), University of Auckland Medical School (2002), and University of California San Diego (2009/2010). Additionally, he was nominated for the expert committee of WHO/APA for the revision of the classification of mental disorders according to DSM-5, and he is co-chairing the ICD-11 working group on “Chronic Pain Diagnoses”. Dr. Rief is elected coordinator for grant applications to the German Research Foundation and he is spokesperson of the DFG-research unit on placebo and nocebo mechanisms. His publication record summarizes more than 300 articles, and he is a world-leading expert in the field of behavioral medicine and somatoform disorders.
What can we learn from placebo and nocebo responses?
In clinical trials and clinical practice, many patients respond positively to placebo interventions. Vice versa, many patients report side effects, although they are in placebo groups or receive a treatment that is not supposed to induce the reported symptoms (“nocebo effects”). During the last decade, psychological and neurobiological mechanisms that are involved in the development of placebo and nocebo responses have been identified. While clinical trials used to reduce placebo mechanisms, clinical practice should try to make use of them for the benefit of the patient. Expectation and learning mechanisms are the major psychological factors contributing to placebo and nocebo effects. If patients’ expectations play a crucial role for the outcome of clinical interventions, it should be a goal of every treatment to optimize them. I will report examples how optimizing patients’ expectations in heart surgery patients leads to improved outcome 6 months later, and how similar approaches can be applied for other clinical conditions. Finally, implications for optimizing psychological interventions will be presented.