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Kirstin Aschbacher, PhD

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Home Institution: University of California, San Francisco

Field: Clinical Psychology/Psychoneuroimmunology

Current Positions:

My Driving Question

What are the best strategies for reducing stress—and physiological stress-arousal—in order to improve health?

Fellow Project 

The overarching goal of Dr. Aschbacher’s research is to illuminate the psychobiological mechanisms by which chronic and traumatic stress contribute to cardiometabolic disease, in order to develop integrative interventions to restore health.  

While many stress-reduction methods are effective in improving mental health symptoms, in general, they have less consistent and reliable effects on biomarkers of disease. When a “black box” approach is taken – where stress leads to “biomarker disturbances” which lead to disease – this insufficient understanding of the whole system can lead to inconsistent results, which do not progress to new and better treatments for patients in need.

Dr. Aschbacher has employed a novel systems biology-based approach, “Applied Dynamic Systems Analysis,” which uses personalized dynamic systems models to understand the activity of each individual’s system. Several of her studies now find that this approach is more effective than traditional measurements in identifying links between altered stress-system activation and disease symptoms or phenotypes. Her most recent work in this area contributes to understanding how stress may increase risk for obesity and metabolic syndrome.

In 2013, Dr. Aschbacher focused on launching her K23 Career Development Award, gathering data for several pilot studies, completing several papers linking stress and metabolic disease, and raising her new baby. Dr. Aschbacher has helped lead data collection for the K23, which includes flow cytometry and in vitro assays to better understand links between mental health and purported early endothelial progenitor cells (EPCs), or circulating angiogenic cells. These cells play an important role in maintaining and repairing the vasculature, thereby contributing to cardiovascular health, wound-healing and well-being. As part of these efforts, she has led a pilot study focusing on an African American sample, in order to better explore the potential role of social experiences of discrimination as a stressor, which contributes to racial disparities in cardiovascular health.

Dr. Aschbacher published two papers in the journal Psychoneuroendocrinology entitled, “Good stress, bad stress and oxidative stress” (2013) and “Chronic stress increases vulnerability to diet-related abdominal fat, oxidative stress, and metabolic risk” (2014). The first paper, which was highlighted by The New Scientist, the San Francisco Chronicle and The Huffington Post, used her theoretical orientation and knowledge gained from her work in dynamic systems to address the question of when stress builds resilience versus when it undermines health, with a focus on oxidative stress biomarkers linked with chronic disease and cellular aging. The second paper extends this work to help understand whether chronic psychological stress is associated with enhanced vulnerability to diet-related metabolic risk.

In a third paper, now under review, she brings together diverse literature from the fields of neuroscience, control systems engineering, psychology and medicine to address a question of critical importance to public health: how do key stress-arousal systems (e.g., the Hypothalamic-Pituitary-Adrenal axis) contribute to vulnerability (and resilience) to metabolic disease and obesity?

At the May 2014, International Research Congress for Integrative Medicine and Health, she will present the preliminary results of a Mindfulness Based Stress Reduction (MBSR) intervention in a study led by Dr. Elissa Epel, on which Dr. Aschbacher is a collaborator. These results, while still preliminary, explore the extent to which early adversity and stress-susceptibility impact MBSR treatment outcomes. She hopes this body of work will begin to raise awareness that stress-management has a valuable role to play in standard medical health care for prevention and management of chronic disease.

Biography 

Kirstin Aschbacher, PhD, joined the faculty of the Department of Psychiatry at the University of California, San Francisco, School of Medicine as an Assistant Professor in the Spring 2012. 

A Fellow at the Nova Institute for Health since 2011, she is the recipient of a Patient-Oriented Career Development Award through the National Institutes of Health’s National Heart, Lung, and Blood Institute.

Dr. Aschbacher holds a PhD, in Clinical Psychology from the Joint Doctoral Program of the University of California, San Diego, Department of Psychiatry and the San Diego State University Department of Psychology, where she specialized in behavioral medicine and psychoneuroimmunology. She completed a clinical internship at University of Washington-Harborview Hospital and a postdoctoral fellowship in psychology, medicine and complex systems at University of California San Francisco.

Curriculum Vitae

See Dr. Aschbacher’s CV
Education and Training
  • Post-doctoral training: Complex Systems Analysis in Psychobiology; Psychology and Medicine, University of California,
    San Francisco
  • PhD, Clinical Psychology & Behavioral Medicine, Joint Doctoral Program of San Diego State University/University of California,
    San Diego
  • BA,Music Composition, Theory & Technology, Brown University
Selected Honors
  • UCSF Program for Breakthrough Biomedical Research Award
  • Patient-Oriented Career Development Award (K23) from the National Heart, Lung, and Blood Institute / National Institutes of Health
  • Society for the Psychological Study of Social Issues (SPSSI) Award
  • RAND Summer Institute Scholarship Recipient
  • Best Paper Prize, International Conference on Modeling, Identification and Control
  • Systems Dynamics Track Scholarship, Institute on Systems Science and Health
  • Meritorious Student Poster Award, Annual Society of Behavioral Medicine
  • American Psychological Association Dissertation Research Award
Selected Publications

Healing is facilitated through safety, persistence, and trust.

  • Persistence: “People did not simply progress through this sequence and experience healing. The healing journey was a recursive, back and forth process. They found helpers, used the skills/resources that those helpers provided, found other helpers that provided more resources and used those skills and resources. As this process continued, people experienced a gradual amelioration of their suffering. Although many despaired at times, all demonstrated the quality of persistence—they refused to give up.”
  • Safety & Trust: “To connect to helpers, it was essential for people to feel safe in those relationships and able to trust that the person would be a helper and not a barrier to healing. Persons whose wounds included a violation of trust were especially careful about testing the safety of new relationships.”

Resources support us as we heal. They include reframing, responsibility, and positivity. “Making connections enabled participants to acquire and refine resources and skills that were essential in their healing journey. People also brought their own personal strengths to the journey.”

  • Reframing: “A particularly important skill was the ability to reframe—that is to look at suffering through a different lens.” This does NOT mean minimizing trauma or pain, but rather it often means the opposite: understanding what happened was wrong, unfair, or uncontrollable and that we are not to blame for it.
  • Responsibility: While we don’t have control over what happened to us, we are the only ones who can help ourselves heal. “A third essential resource that people acquired or refined was the ability to take an appropriate amount of responsibility for their healing journeys. They participated actively in the process of healing. Once again, some participants already had developed this skill, and some acquired or refined it from their helpers.”
  • Positivity: “Another resource that people acquired or refined during their healing journey was choose to be positive—that is to have some optimism about their situation.” People have varying predispositions to positivity. In the study, positivity was important in helping people heal. This doesn’t mean a toxic positivity, but rather simply finding some good in life and feeling hopeful about our situations.

“Connection to others was an essential part of all the healing journeys.” Humans are social creatures, and even the most introverted of us need close relationships. Friends and family add meaning and value to life and help support us, in good times and bad. 

When we experience relational trauma, relationships can feel scary, but reestablishing safety and trust in relationships is where the healing happens. (To be clear, we do not mean reestablishing safety and trust with abusers, but rather finding other healing relationships.) 

“When safety and trust had been established, people were able to connect with helpers. The nature of the behaviours of helpers that fostered healing ranged from small acts of kindness to unconditional love.”

  • “Moving from being wounded, through suffering to healing, is possible. It is facilitated by developing safe, trusting relationships and by positive reframing that moves through the weight of responsibility to the ability to respond.”
  • “Relationships with health professionals were among these but were not necessarily any more important to the healing journey than other kinds of helpers, which included family members, friends, spirituality and their God, pets, support groups, administrators, case workers and supervisors.”

Healing probably means different things to different people, but one definition that emerged from the study is: “The re-establishment of a sense of integrity and wholeness.” 

Healing was an emergent property that resulted from each individuals’ complex healing journey, a result of bridged connections between resources and relationships. “…they gradually found relief from suffering and began to exhibit emergent characteristics: a sense of hope, self-acceptance, and a desire to help others—the immediate precursors to healing.”

 In varying degrees, “they were able to transcend their suffering and in some sense to flourish.” 

  • Helping Others: We find meaning in helping others. “Understanding that suffering gives the strength and experience to help others in similar situations.”
  • Hope: We begin to have hope that we will not always feel this bad. A Crohn’s patient said, “I think gradually I realized that I was going to feel better. I did have days when I actually didn’t vomit, when I did feel better. And I think gradually I came to believe that maybe I could have a normal life again.”
  • Self-Acceptance: We see our inherent value and understand that we are not to blame for our suffering. A participant living with HIV said, “I’m really proud of myself. I think that now I still want to live. I don’t want to die, and I really love myself a lot. I have a lot of comfort in myself.”

Suffering is the ongoing pain from wounding. 

There is debate about whether or not one actually needs to experience suffering on the path to healing.

Wounding happens when we experience physical or emotional harm. It can stem from chronic illness or by physical or psychological trauma for which we do not have the tools to cope, or a combination of those factors. 

“The degree and quality of suffering experienced by each individual is framed by contextual factors that include personal characteristics, timing of their initial or ongoing wounding in the developmental life cycle and prior and current relationships.”

Characteristics: How predisposed someone may be to wounding/how many tools and resources someone may have to deal with trauma/illness.

Lifestages: Developmental timing plays an important role in the impact of trauma — young children often do not have the same resources as older adults.

Relationships: Relationships can provide solace and support for those suffering, while lack of healthy relationships can prolong suffering.