Last week I posted the first of my two review posts for the American Psychosomatic Society Annual Meeting. Today I am rounding up (and reminiscing) on the last two days and teasing out the main themes I noticed and my main take home points. Whilst there are some upcoming posts based on some of the amazing insights I had whilst at the conference, this is the last of my conference/APS specific posts for now. I will resume normal functioning soon – but I was just too excited about this conference to not share! 🙂
Friday began bright and early again with a data blitz session which highlighted some of the posters that would be presented that evening – which just so happened to be alongside mine!
The talks kicked off with the Patricia Barchas Award winner, Edith Chen discussing health disparities in children and young people. Here I heard the term ‘skin-deep resilience’ for the second time after I first heard it in the plenary panel session on day two. I noted it down as something to look into a bit more! Chen also covered a huge amount of her findings in this talk, in an engaging way which illustrated her argument that it is incredibly important to continue this research. An interesting finding was that teenagers with lower but not higher SES who have more self-control in the context of adversity demonstrated better mental health but worse physical health 8 years later. Also, a follow-up study 19 years after an intervention found reduced inflammation in youth who received a parenting intervention as a child – which was an amazing thing to witness and hear about.
Next came the presidential address from Suzanne Segerstrom on the topic of personality and health. Key points of this presentation for me was the idea that personality has both stable and unstable components and also that it is important to reduce ‘noise’ when measuring personality and biomarkers of stress. We were hit with the fact that to reduce noise around data, at least 10 days of cortisol samples are required – something that many were shocked to hear but undoubtedly understood. Segerstrom presented further data, including a meta-analysis indicating noise in cortisol measurement and highlighted that small samples with small effects usually result in high variability. There were some great anecdotes within this lecture and after being asked about what APS meant to her, Segerstrom told us reminded that if you don’t leave the APS meeting with at least three ideas for studies – you’re doing it wrong!
The presidential address was followed by a plenary address from Mary Dozier, focussing on Resilience to Early Life Adversity, a topic that was right up my street! Dozier began by highlighting that infants are born to depend on their caregiver and as such, this can set up some very tough environments to grow and develop. Interestingly, children who experience adversity can make it difficult to receive nurturance and this was something that really caught my attention – how can we deliver interventions to give nurturance if young people make it difficult to do so? Despite this, Dozier has done it, with a fantastic parenting intervention called ‘ABC’. We were led through the elements and the incredible impact of this intervention. Everyone in the audience left certain that Dozier’s work with parenting interventions was having a massive impact on those who need it most, and the presentation was enhanced with photos and videos from parenting sessions, that both shocked and made us smile.
The early life adversity theme continued with a lunchtime round table chaired by Daryl O’Connor and Gerry Giesbrecht who had both organised the roundtable alongside Julie Turner-Cobb. We had a whistle-stop discussion of resilience in early life and the time restraints meant that comments were focussed and exceptionally critical. Again, we talked about the definition of resilience which ranged from it being a developmental process, bending not breaking and a potential energy with a possible genetic component also involved. We established that resilience is not something an individual is either born with or without and that only some types of adaptation are resilience, and this depends on the environmental circumstances. The importance of relationships were highlighted as was the need for self-reflection and evaluation. Contributors argued that for resilience to exist there must be an exposure to risk, somewhat contradicting earlier comments in the conference programme that suggested that a preventative approach might be beneficial. We then engaged in a topical discussion after O’Connor played devil’s advocate and asked whether there are people who just don’t want help and thus cannot be supported to develop resilience. Contributors were adamant that nobody is un-helpable and though there might be challenges within interventions, they can be useful. Finally, we concluded that it is important to operationalise our terms in a precise way, we don’t neccessarily need to agree on our definition of resilience, but it is important to be clear what we mean when we say it – without doing so, there is a risk that resilience will simply become an empty term.
The rest of the day was filled with interesting seminars and paper sessions, which ranged from further discussion of childhood adversity, to cultural factors that influence resilience. An afternoon symposium was dedicated to informal family caregivers that had me very excited indeed – this was my topic! Talks included those on sleep/wake cycles, pain catastrophizing, dementia caregiving and inflammation and finally an interesting talk on telomere length in caregivers. All of these talks were fascinating, however one thing I noticed was that none of the talks, research or answers to questions considered a young carer population at all. This was a bit disappointing, given I know how important this population is – maybe next year I’ll be able to present my own findings on this topic area
As it was though, I was able to fly the flag for young carers in the poster session, presenting the protocol for my current study. I was intrigued that many people felt the focus on young carers was unique and niche, which to some extent it is, however much less so in the UK. Research is being done on this topic, but there seems to be less awareness in the USA, something I thought was interesting! Despite this, I had lots of really excellent questions, people were really enthusiastic about my research plans and made some great comments and suggestions that will no doubt be helpful for my thesis.
The last day of the conference brought with it two more award presentations. The Paul D. McLean Award winner, Peter Strick spoke about ‘The Mind-Body Problem: Circuits that Link the Cerebral Cortex to the Adrenal Medulla’. Though a lot of this talk went over my head (!), there were some really fascinating elements presented particularly a point surrounding using the rabies virus to detect the area of the brain associated with mindfulness! Further research was presented which included Strick’s findings on mindfulness, whereby the effects of mindfulness meditation on areas of the brain linked to stress were noted. The closing summary was particularly attention grabbing, and the term ‘psychosomatic’ was broken down – concluded that mind-body (i.e. psychosomatic) conditions are not irrational or imaginary. They are real, but they are ‘all in your head’ – because that is where the brain resides!
The second award lecture was delivered by Herbert E Weiner Early Career Award winner Aric Prather and began with an amusing tale of Prather’s first journey to APS. He also took the time to acknowledge and thank mentors and colleagues, whilst emphasising the importance of APS – science, mentorship, community, celebration – the only thing missing for him was – sleep! And so the presentation of findings surrounding sleep and immune function began. Experimentally, Prather found that those who sleep less than 5 hours a night are 4 times more likely to contract a common cold and also found that the link between stress and sleep predicts greater biological ageing. Social rejection was also considered in relation to sleep, finding that those who ruminate after being rejected have more sleep disturbances and as such less overall sleep.
The end of the last day wound down with further paper sessions, highlights included emotion regulation and its association with cortisol and DHEA and a great session on stress and emotion. The last port of call was the last poster session which also featured a tasting of Bourbon – I discovered it wasn’t for me!
Overall, this conference was energising and motivating in ways I hadn’t imagined. I enjoyed last years programme, but this year was fantastic, perhaps due to the overwhelming relevance of the conference theme to my own work and specifically my thesis.
Key take home points for me included the idea that resilience is multifaceted, as was mentioned by a number of speakers, and that there are many small factors involved. As such, we should be designing interventions that target as many areas as possible, and not focussing our efforts on finding the ‘single predictor’ of resilience – which Bonanno argued is incredibly unlikely. Another take home point was that we must be optimistic and persistent in our attempts to build resilience, and that though doing so might be challenging at times, it is important to have faith and trust that everyone can benefit from building resilience and experience positive change, no matter how big or small that change is.
The final clear over-arching theme was that defining resilience is inherently difficult, or perhaps more so, agreeing on a definition of resilience is difficult. It means different things to different people, academics and research participants alike. There are a huge number of ways to capture and conceptualise the phenomenon that is resilience and because of this it is vital that when we talk about the concept or research it, we are exceptionally clear about what we mean by the term. Without this, we are at risk of resilience becoming a meaningless and empty term, that means too many things to too many people.
I want to take the opportunity to thank all those who were involved with arranging the APS meeting this year, for developing such an incredibly programme and delivering an interesting and engaging conference. I can’t wait for next year (funding permitting!).
Until next time 🙂