Structured Psychosocial Stress and Therapeutic Failure

Wallace, Rodrick; Wallace, Deborah

doi:10.1142/s0218339004001129

“…Regarding therapeutic intervention, as Wallace and Wallace (2004) argue at some length, imposed real stress may seriously interfere with any treatment strategies, affecting patient-provider interaction, patient compliance, and the actual effectiveness of drug or other interventions. Conversely, appropriate counterperturbation to stress, probably at the human keystone level of neighborhood/social network, can act to improve treatment effectiveness.…”

Section: Interventionmentioning

confidence: 99%

“…That is, serious comorbidity -perturbations can resonate across the full set of bioregulatory systems -are not only inevitable, but may often be an unfortunate consequence of therapeutic intervention as well. Thus, synergistic pairing of medical with appropriate neighborhood/social network interventionsfor humans, a keystone level of organization in Holling's (1992) sense -would be expected to (Wallace and Wallace, 2004):…”

Section: Peerj Preprintsmentioning

confidence: 99%

Magic Strategies: the basic biology of multilevel, multiscale, health promotion

Wallace

¹

,

Wallace

²

2013

Preprint

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A survey of the cultural psychology and related literatures suggests that Western biomedicine's fascination with atomistic, individual-oriented, interventions is a cultural artifact that may have little consonance with complex, subtle, multiscale, multilevel, social, ecological, or biological realities. Other cultural traditions may, in fact, view atomistic strategies as inherently unreal. A contrary perspective -similar to that of health promotion -implies that the most effective medical or public health interventions must be analogously patterned across scale and level of organization: 'magic strategies' will almost always be synergistically, and often emergently, more effective than 'magic bullets'. The result can be formally derived in a relatively straightforward manner using an adaptation of the Black-Scholes econometric model applied to the metabolic cost of bioregulation under uncertainty. Multifactorial interventions focused at the human 'keystone' ecosystem level of mesoscale social and geographic groupings may be particularly effective.The analysis indicates that there is unlikely to be much in the way of 'simple' chronic disease. That is, serious comorbidity is usually inevitable, and may often be a consequence of therapeutic intervention itself. Study suggests that pairing of medical and prevention strategies with appropriate mesoscale neighborhood/social network interventions would:(1) Damp down unwanted treatment side effects.(2) Make the therapeutic alliance between practitioner and patient more effective. (3) Improve patient compliance. (4) Enhance placebo effect.(5) In the context of real stress reduction, synergistically improve the actual biological impacts of medical interventions or prevention strategies.Much of this is well-known and has been repeatedly described across a vast array of public health and health policy literatures, but the results will be developed here from first principles, involving the interaction of cognitive and environmental phenomena across both scale and levels of organization, echoing something of the pioneering insights of Maturana and Varela. With some added complexity, the analysis can be extended to developmental trajectories, in a large sense, through a kind v PeerJ PrePrints | https://peerj.com/preprints/8v2/ | v2 received: 21

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“…As Wallace and Wallace (2004) argue at some length, imposed stress may seriously interfere with therapeutic strategies, affecting patient-provider interaction, patient compliance, and the actual effectiveness of drug or other interventions. Conversely, appropriate therapeutic stress, probably at the human keystone level of neighborhood/social network, can act to improve the effectiveness of therapeutic counterperturbations.…”

Section: Interventionmentioning

confidence: 99%

Magic Strategies: the basic biology of multilevel, multiscale, health intervention

Wallace

¹

,

Wallace

²

2013

Preprint

Self Cite

0

View full text Add to dashboard Cite

A survey of the cultural psychology and related literatures suggests that Western biomedicine's fascination with atomistic, individual-oriented, interventions is a cultural artifact that may have little consonance with complex, subtle, multiscale, multilevel, social, ecological, or biological realities. Other cultural traditions may, in fact, view atomistic strategies as inherently unreal. A contrary perspective suggests that the most effective medical or public health interventions must be analogously patterned across scale and level of organization: 'magic strategies' will almost always be synergistically - and often emergently - more effective than 'magic bullets'. The result can be formally derived in a relatively straightforward manner using an adaptation of the Black-Scholes economietric model, applied here to the metabolic cost of bioregulation under uncertainty. Multifactorial interventions focused at the human 'keystone' ecosystem level of mesoscale social and geographic groupings may be particularly effective.

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“…From a theoretical standpoint, emotions may represent preferred state space configurations in moods and reactions while mental disorders may exist when individuals either cannot select an appropriate response or cannot inhibit an inappropriate response [18]. This raises the question of what pattern over time should we see in normal and pathological states.…”

Section: Introductionmentioning

confidence: 99%

“…On the other hand, if the difference is a matter of change in dynamics, then a continuum should be observed and no clear‐cut classification is possible [8]. Such non‐linear dynamics and relationships should result in characteristic patterns of interaction among patients, stressors and treatment [18].…”

Section: Introductionmentioning

confidence: 99%

Power laws in covariability of anxiety and depression among newly diagnosed patients with major depressive episode, panic disorder and controls

Katerndahl

¹

2009

Evaluation Clinical Practice

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First, power laws suggest a scale-free relationship; the differences seen in transition from symptom level to change level may reflect that complex events at the level of mood assessment affect change in mood. Second, this covariation may be due to external factors acting on the patient or multiple internal interrelated factors. Third, different factors and populations can yield different slopes. Future research is needed to confirm these preliminary findings and to understand the origin of these dynamics.

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Structured Psychosocial Stress and Therapeutic Failure

Cited by 13 publications

References 71 publications

Magic Strategies: the basic biology of multilevel, multiscale, health promotion

Magic Strategies: the basic biology of multilevel, multiscale, health promotion

Magic Strategies: the basic biology of multilevel, multiscale, health intervention

Power laws in covariability of anxiety and depression among newly diagnosed patients with major depressive episode, panic disorder and controls

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