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. Author manuscript; available in PMC: 2017 Apr 1.
Published in final edited form as: Psychosom Med. 2016 Apr;78(3):281–289. doi: 10.1097/PSY.0000000000000294

Figure 2.

Figure 2

Reciprocal Effects of Biopsychosocial Factors of Single Disease and Multi-Morbidity Etiology

(left panel) includes the same factors, such as shared genes, autonomic arousal, neurohormones, immune system-related activity, negative and positive affective dispositions, shared behavioral risk factors, etc., as in Figure 1. In one scenario, two or more diseases emerge more or less simultaneously because of a shared subset of the factors, listed in the left panel. The right panel depicts the staggered emergence of other conditions as a function of downstream biological effects of the initial disease, acute/chronic stress induced by diagnosis and treatment of the initial disease and/or the side-effects of medical treatment.