Neural mechanisms of emotion regulation and their role in endocrine and immune functioning: A review with implications for treatment of affective disorders.

In the past century, medical progress has helped increase life expectancy and improve health outcomes more generally. Despite this progress, psychiatric disorders-especially affective disorders including depressive and anxiety disorders-are quite common and have been linked to dysfunction in endocrine and immune systems. In this review, we discuss neurobiological correlates of emotion regulation strategies and their effects on mental and physical health. Some of these correlates, namely sub-regions of prefrontal cortex, also play a key regulatory role in autonomic, endocrine, and immunological processes. Given this functional overlap, we propose a novel neuro-immuno-affective framework that targets improving emotion regulation, in order to: (1) reduce negative affect associated with depressive and/or anxiety disorders; and (2) alter endocrine and immune system functioning (e.g., reduce inflammation)-via changes in activity within (and connectivity between) brain systems that support (successful) emotion regulation. We conclude by arguing that such a framework can be adapted for psychiatric treatment protocols that holistically incorporate neural and immunological biomarkers to promote mental and physical health.