Systemic lupus erythematosus in African-American women: immune cognitive modules, autoimmune disease, and pathogenic social hierarchy

Abstract

Examining elevated rates of systemic lupus erythematosus in African-American women from the perspective of the emerging theory of immune cognition suggests the disease constitutes an internalized physiological image of external patterns of psychosocial stress, a 'pathogenic social hierarchy' involving the synergism of racism and gender discrimination. The disorder represents the punctuated resetting of 'normal' immune self-image to a self-attacking 'excited' state, a process formally analogous to models of punctuated equilibrium in evolutionary theory. We speculate that this punctuated onset takes place in the context of an immunological 'cognitive module' similar to what has been proposed by evolutionary psychologists for the human mind. We discuss the broader implications of a high rate of this disorder within a marginalized population, finding it to be a leading indicator for phenomena likely to entrain powerful subgroups into a larger pattern of embedding pathology