Prevention and intervention for inflammation-associated transdiagnostic psychopathology: A role for clinical psychologists

Difficult-to-treat cases of psychopathology and medically unexplained symptoms highlight the limitations of the U.S.’s divided approach to mental and physical healthcare. Decades of research demonstrate that inflammation, the body’s immune response to challenge, contributes to a range of psychological or “sickness” symptoms – such as anhedonia, fatigue, sleep and appetite changes — that cross diagnostic boundaries and necessitate integrated treatment strategies. Psychiatry dominates the existing literature concerning how to address inflammation-associated psychopathology, but here we highlight the potential for clinical psychologists to intervene – not solely via mind-body interventions, but also via mainstream psychotherapies – to promote better neuro-immune communication over time. We first briefly summarize psychoneuroimmunology research establishing bidirectional neuro-immune, and review inflammation’s leading causes and psychological consequences. We then shift to the article’s primary focus: providing clinicians with a practical guide for identifying inflammation-related symptoms, conceptualizing cases from a psychoneuroimmunology framework, and applying evidence-based psychotherapeutic techniques that may help to regulate neuro-immune activity. We describe a multipronged approach: (1) exposure to reduce threat sensitivity; (2) mindfulness meditation, diaphragmatic breathing, and social connection to promote embodied safety in the present moment; (3) motivational interviewing and behavioral activation to foster health behavior change; (4) exercise and other hormetic stressors to build neuroimmune resilience; and (5) positive affect regulation strategies to restore reward system functioning. We also detail how these strategies can integrate with psychiatric approaches. Overall, this article positions clinical psychology at the frontline of medicine, encouraging clinicians to consider their impact on both mental and physical health outcomes.