A Psychoneuroimmunologic Perspective on AIDS Research: Questions, Preliminary Findings, and Suggestions
George F. Solomon Department of Psychiatry University of California, Los Angeles
Lydia Temoshok Department of Psychiatry University of California, San Francisco
Acquired immunodeficiency syndrome (AIDS) and AIDS-spectrum disorders have emerged as perhaps the most critical public health problem of the 1980s. While a great deal of effort has been devoted to biomedical research on AIDS etiology and treatment, there is, to date, no known cure and no known vaccine for AIDS. This situation has led to a search for "co-factors" in AIDS onset and progression.
The complexity of interacting variables in the pathogenesis of immune deficiency and consequent vulnerability to a variety of infections and to cancer led the distinguished immunologist Norman Talal ( 1983) to state, "AIDS teaches us that immunoregulatory diseases are truly multifactorial" (p. 183). The biopsychosocial model of disease, credited to Engel ( 1960), is multifactoral, taking into account the interaction of genetic, biological (specific and nonspecific), emotional (state and trait), behavioral, situational ("stress"), and cultural factors in the pathogenesis of all disease, not just those classically considered "psychosomatic" (cf. e.g., Temoshok, Van Dyke, & Zegans, 1983). Given a particular genetic composition and/or physical exposure to a disease