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Psychoneuroimmunology Flashcards

1
Q

Stress and Immune Function

  • Biopsychosocial model
  • What factors can come into play?
A
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2
Q

What is PNI? (psyconeuroimmunology)

  • links between … and … were part of pre-modern thought
    • – e.g. humoural medicine
  • classic early study found decreased phagocyte activity in response to stress (…, 1919)
  • substantial empirical evidence to demonstrate and explain links between psychological states and … function
  • links between immunity (PNI) and … (PNE)
  • increasing evidence of pathogenic involvement in diseases not always thought to involve infection and inflammatory processes
A
  • links between emotions and health were part of pre-modern thought
    • – e.g. humoural medicine
  • classic early study found decreased phagocyte activity in response to stress (Ishigami, 1919)
  • substantial empirical evidence to demonstrate and explain links between psychological states and immune function
  • links between immunity (PNI) and endocrinology (PNE)
  • increasing evidence of pathogenic involvement in diseases not always thought to involve infection and inflammatory processes
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3
Q
  • links between … and health were part of pre-modern thought
    • – e.g. humoural medicine
A
  • links between emotions and health were part of pre-modern thought
    • – e.g. humoural medicine
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4
Q

classic early study found decreased phagocyte activity in response to … (Ishigami, 1919)

A

classic early study found decreased phagocyte activity in response to stress (Ishigami, 1919)

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5
Q

substantial empirical evidence to demonstrate and explain links between psychological states and … function

A

substantial empirical evidence to demonstrate and explain links between psychological states and immune function

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6
Q

links between immunity (…) and endocrinology (PNE)

A

links between immunity (PNI) and endocrinology (PNE)

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7
Q

1919 Ishigami study found decreased … activity in response to stress

A

1919 Ishigami study found decreased phagocyte activity in response to stress

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8
Q

increasing evidence of pathogenic involvement in diseases not always thought to involve … and … processes

A

increasing evidence of pathogenic involvement in diseases not always thought to involve infection and inflammatory processes

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9
Q

Stress and immunity

  • when threatened, body is rapidly aroused and motivated by … nervous system (SNS) and …-…-… axis (HPA)
    • … and HPA affect immune function
    • … increases some immune activity (e.g. NK cells)
    • … suppresses some immune activity via cortisol (anti-inflammatory)
  • brief stress produces beneficial acute immune response
    • = immediate defence from injuries and broad risk of infection
      • rapid return to baseline levels when stress is removed
  • this is adaptive as it enables quick responses to threat … but …
    • Prolonged stress can be harmful because it disrupts psychological and physiological functioning
A
  • when threatened, body is rapidly aroused and motivated by sympathetic nervous system (SNS) and Hypothalamic-Pituitary-Aderenal axis (HPA)
  • SNS and HPA affect immune function
    • SNS increases some immune activity (e.g. NK cells)
    • HPA suppresses some immune activity via cortisol (anti-inflammatory)
  • brief stress produces beneficial acute immune response
    • = immediate defence from injuries and broad risk of infection
      • rapid return to baseline levels when stress is removed
  • this is adaptive as it enables quick responses to threat … but …
    • Prolonged stress can be harmful because it disrupts psychological and physiological functioning
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10
Q

Stress and immunity

  • when threatened, body is rapidly aroused and motivated by sympathetic nervous system (SNS) and Hypothalamic-Pituitary-Aderenal axis (HPA)
  • SNS and HPA affect immune function
    • SNS increases some immune activity (e.g. NK cells)
    • HPA suppresses some immune activity via … (anti-inflammatory)
  • brief stress produces … acute immune response
    • = immediate … from injuries and broad risk of infection
      • rapid return to baseline levels when stress is …
  • this is adaptive as it enables quick responses to threat … but …
    • Prolonged stress can be harmful because it disrupts … and physiological functioning
A
  • when threatened, body is rapidly aroused and motivated by sympathetic nervous system (SNS) and Hypothalamic-Pituitary-Aderenal axis (HPA)
  • SNS and HPA affect immune function
    • SNS increases some immune activity (e.g. NK cells)
    • HPA suppresses some immune activity via cortisol (anti-inflammatory)
  • brief stress produces beneficial acute immune response
    • = immediate defence from injuries and broad risk of infection
      • rapid return to baseline levels when stress is removed
  • this is adaptive as it enables quick responses to threat … but …
    • Prolonged stress can be harmful because it disrupts psychological and physiological functioning
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11
Q

When threatened, body is rapidly aroused and motivated by … (SNS) and … (HPA)

A

when threatened, body is rapidly aroused and motivated by sympathetic nervous system (SNS) and Hypothalamic-Pituitary-Aderenal axis (HPA)

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12
Q
  • SNS and HPA affect … function
  • SNS increases some … activity (e.g. NK cells)
  • HPA suppresses some … activity via … (anti-…)
A
  • SNS and HPA affect immune function
  • SNS increases some immune activity (e.g. NK cells)
  • HPA suppresses some immune activity via cortisol (anti-inflammatory)
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13
Q
  • brief stress produces … acute immune response
    • = … … from injuries and broad risk of infection
      • rapid return to … levels when stress is …
A
  • brief stress produces beneficial acute immune response
    • = immediate defence from injuries and broad risk of infection
      • rapid return to baseline levels when stress is removed
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14
Q

prolonged stress can be harmful because it disrupts … and … functioning

A

prolonged stress can be harmful because it disrupts psychological and physiological functioning

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15
Q

General adaptation syndrome (Selye, 1956)

  • General Adaptation Syndrome consists of 3 phases:
    • …
    • resistance
    • …
A
  • General Adaptation Syndrome consists of 3 phases:
    • alarm
    • resistance
    • exhaustion
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16
Q

Stress - affect on SNS and Pituitary

A
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17
Q

Stress

A
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18
Q

Stress

A
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19
Q

Stress

A
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20
Q

… increases some immune activity (e.g. NK cells)

A

SNS (Sympathetic nervous system) increases some immune activity (e.g. NK cells)

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21
Q

… suppresses some immune activity via cortisol (anti-inflammatory)

A

HPA (hypothalamic-pituitary-adrenal-axis) suppresses some immune activity via cortisol (anti-inflammatory)

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22
Q

General adaptation syndrome (Selye, 1956)

  • General Adaptation Syndrome consists of 3 phases:
    • …
    • …
    • exhaustion
A
  • General Adaptation Syndrome consists of 3 phases:
    • alarm
    • resistance
    • exhaustion
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23
Q

General adaptation syndrome (Selye, 1956)

  • General Adaptation Syndrome consists of 3 phases:
    • …
    • …
    • …
A
  • General Adaptation Syndrome consists of 3 phases:
    • alarm
    • resistance
    • exhaustion
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24
Q

general adaptation syndrome (Selye, 1956)

  • What is missing?
A
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25
* ... ... ... consists of 3 phases: * alarm * resistance * exhaustion
* **General Adaptation Syndrome** consists of 3 phases: * alarm * resistance * exhaustion
26
is stress good or bad for the immune system ?
yes - both (short term good, long term not so good)
27
why is prolonged stress harmful?
* **allostatic load** (McEwen & Stellar, 1993) * allostasis = body actively copes with stress by trying to find a new balance * if stress is prolonged, allostatic load accumulates * allostatic load is the physiological costs of prolonged fluctuation or elevated of SNS or HPA axis responses * measures of allostatic load include * decreased cell-mediated immunity * inability to shut off cortisol in response to stress
28
_why is prolonged stress harmful?_ * **... load** (McEwen & Stellar, 1993) * ... = body actively copes with stress by trying to find a new balance * if stress is prolonged, ... load accumulates * ... load is the physiological costs of prolonged fluctuation or elevated of SNS or HPA axis responses * measures of allostatic load include * decreased cell-mediated immunity * inability to shut off cortisol in response to stress
* **allostatic load** (McEwen & Stellar, 1993) * **allostasis** = body actively copes with stress by trying to find a new balance * if stress is prolonged, **allostatic** load accumulates * **allostatic** load is the physiological costs of prolonged fluctuation or elevated of SNS or HPA axis responses * measures of allostatic load include * decreased cell-mediated immunity * inability to shut off cortisol in response to stress
29
allostasis = body actively copes with ... by trying to find a new ...
allostasis = body actively copes with **stress** by trying to find a new **balance**
30
if stress is prolonged, ... load accumulates
if stress is prolonged, **allostatic** load accumulates
31
allostatic load is the physiological costs of prolonged fluctuation or elevated of ... or ... axis responses
allostatic load is the physiological costs of prolonged fluctuation or elevated of **SNS** or **HPA** axis responses
32
measures of allostatic load include (2)
* measures of allostatic load include * - decreased cell-mediated immunity * - inability to shut off cortisol in response to stress
33
* measures of allostatic load include * - decreased ...-... immunity * - inability to shut off ... in response to stress
* measures of allostatic load include * - decreased **cell-mediated** immunity * - inability to shut off **cortisol** in response to stress
34
Physiological response to stress can protect in the ... term (...) and harm in the ... term (...)
Physiological response to stress can protect in the **short** term (**acute**) and harm in the **long** term (**chronic**)
35
_What is stress?_ * Stress is a ... experience accompanied by ... changes aimed at ... the stressful event and/or ... its effects : * biochemical * physiological * cognitive * behavioural * stress is a response to a ... * appraisal of the stressor is important (Lazarus + Folkman, 1984) * is stress the same in animals and humans?
* Stress is a **negative** experience accompanied by **predictable** changes aimed at **altering** the stressful event and/or **accommodating** its effects : * biochemical * physiological * cognitive * behavioural * stress is a response to a **stressor** * appraisal of the stressor is important (Lazarus + Folkman, 1984) * is stress the same in animals and humans?
36
_What is stress?_ * Stress is a negative experience accompanied by predictable changes aimed at altering the stressful event and/or accommodating its effects : * biochemical * ... * ... * behavioural * stress is a response to a stressor * ... of the stressor is important (Lazarus + Folkman, 1984) * is stress the same in animals and humans?
* Stress is a negative experience accompanied by predictable changes aimed at altering the stressful event and/or accommodating its effects : * biochemical * **physiological** * **cognitive** * behavioural * stress is a response to a stressor * **appraisal** of the stressor is important (Lazarus + Folkman, 1984) * is stress the same in animals and humans?
37
_What is stress?_ * Stress is a negative experience accompanied by predictable changes aimed at altering the stressful event and/or accommodating its effects : * biochemical * physiological * cognitive * behavioural * stress is a response to a ... * appraisal of the ... is important (Lazarus + Folkman, 1984) * is stress the same in animals and humans?
* Stress is a negative experience accompanied by predictable changes aimed at altering the stressful event and/or accommodating its effects : * biochemical * physiological * cognitive * behavioural * stress is a response to a **stressor** * appraisal of the **stressor** is important (Lazarus + Folkman, 1984) * is stress the same in animals and humans?
38
_What is stress?_
* **Stress is a negative experience accompanied by predictable changes aimed at altering the stressful event and/or accommodating its effects :** * biochemical * physiological * cognitive * behavioural * stress is a response to a stressor * appraisal of the stressor is important (Lazarus + Folkman, 1984) * is stress the same in animals and humans?
39
_Transactional model (Lazarus + Folkman, 1984)_
40
_Transactional model (Lazarus + Folkman, 1984)_
41
_Transactional model (Lazarus + Folkman, 1984)_
42
_... model (Lazarus + Folkman, 1984)_
43
_Transactional model (Lazarus + Folkman, 1984)_
44
_Reactivity to stress_ * people ... in their reactivity to stress * reactivity refers to the magnitude of ... and HPA axis responses to stress * higher physiological reactivity is related to worse health outcomes in response to prolonged stress (Boyce et al., 1995) * allostatic load * reactivity may vary depending on the nature of the stressor/stress (Smith et al., 1998) * sex differences in reactivity and reactivity to different stressors
* people **vary** in their reactivity to stress * reactivity refers to the magnitude of **SNS** and HPA axis responses to stress * higher physiological reactivity is related to worse health outcomes in response to prolonged stress (Boyce et al., 1995) * allostatic load * reactivity may vary depending on the nature of the stressor/stress (Smith et al., 1998) * sex differences in reactivity and reactivity to different stressors
45
_Reactivity to stress_ * people vary in their reactivity to stress * reactivity refers to the magnitude of SNS and HPA axis responses to stress * ... physiological reactivity is related to worse health outcomes in response to ... stress (Boyce et al., 1995) * allostatic load * reactivity may vary depending on the nature of the stressor/stress (Smith et al., 1998) * ... differences in reactivity and reactivity to different stressors
* people vary in their reactivity to stress * reactivity refers to the magnitude of SNS and HPA axis responses to stress * **higher** physiological reactivity is related to worse health outcomes in response to **prolonged** stress (Boyce et al., 1995) * allostatic load * reactivity may vary depending on the nature of the stressor/stress (Smith et al., 1998) * **sex** differences in reactivity and reactivity to different stressors
46
_Reactivity to stress_ * people vary in their reactivity to stress * reactivity refers to the magnitude of SNS and HPA axis responses to stress * higher physiological reactivity is related to worse health outcomes in response to prolonged stress (Boyce et al., 1995) * ... load * reactivity may vary depending on the ... of the stressor/stress (Smith et al., 1998) * sex differences in reactivity and reactivity to different stressors
* people vary in their reactivity to stress * reactivity refers to the magnitude of SNS and HPA axis responses to stress * higher physiological reactivity is related to worse health outcomes in response to prolonged stress (Boyce et al., 1995) * **allostatic** load * reactivity may vary depending on the **nature** of the stressor/stress (Smith et al., 1998) * sex differences in reactivity and reactivity to different stressors
47
_Reactivity to stress_ * people vary in their reactivity to stress * reactivity refers to the magnitude of ... and ... axis responses to stress * higher physiological reactivity is related to ... health outcomes in response to prolonged stress (Boyce et al., 1995) * allostatic load * reactivity may vary depending on the nature of the stressor/stress (Smith et al., 1998) * sex differences in reactivity and reactivity to different stressors
* people vary in their reactivity to stress * reactivity refers to the magnitude of **SNS** and **HPA** axis responses to stress * higher physiological reactivity is related to **worse** health outcomes in response to prolonged stress (Boyce et al., 1995) * allostatic load * reactivity may vary depending on the nature of the stressor/stress (Smith et al., 1998) * sex differences in reactivity and reactivity to different stressors
48
_Coping_ * When are these actions taken?
* = actions people take to reduce stress. * = processes used to manage perceived discrepancies between the demands of a situation and perceived resources * not all coping responses are directed toward solving a problem
49
_Coping_ * = actions people take to reduce .... * = processes used to manage perceived discrepancies between the demands of a situation and perceived resources * not all coping responses are directed toward ...
* = actions people take to reduce **stress**. * = processes used to manage perceived discrepancies between the demands of a situation and perceived resources * not all coping responses are directed toward **solving a problem**
50
_Coping_ * = actions people take to reduce stress. * = processes used to manage perceived discrepancies between the ... of a situation and perceived ... * not all coping responses are directed toward solving a problem
* = actions people take to reduce stress. * = processes used to manage perceived discrepancies between the **demands** of a situation and perceived **resources** * not all coping responses are directed toward solving a problem
51
_2 major modes of coping (Lazarus & Folkman, 1984)_ * What are they?
* **emotion-focused aimed at improving emotional state** * behavioural * cognitive * **problem-focused** aimed at * reducing demands of situation and/or * increasing resources to deal with stressful situation * different strategies are better suited to different stressors
52
_2 major modes of coping (Lazarus & Folkman, 1984)_ * **...-focused aimed at improving ... state** * behavioural * cognitive * **...-focused** aimed at * reducing demands of situation and/or * increasing resources to deal with stressful situation * different strategies are better suited to different stressors
* **emotion-focused aimed at improving emotional state** * behavioural * cognitive * **problem-focused** aimed at * reducing demands of situation and/or * increasing resources to deal with stressful situation * different strategies are better suited to different stressors
53
_2 major modes of coping (Lazarus & Folkman, 1984)_ * emotion-focused aimed at improving ... state * behavioural * cognitive * problem-focused aimed at * reducing ... of situation and/or * increasing ... to deal with stressful situation * different strategies are better suited to different ...
* emotion-focused aimed at improving **emotional** state * behavioural * cognitive * problem-focused aimed at * reducing **demands** of situation and/or * increasing **resources** to deal with stressful situation * different strategies are better suited to different **stressors**
54
What are the 2 major modes of coping? (Lazarus & Folkman, 1984)
* Emotion-focused aimed at improving emotional state * behavioural * cognitive * Problem-focused aimed at * Reducing demands of situation and/or * Increasing resources to deal with stressful situation
55
_Responses to stress can lessen its effects on immune function_ * different coping interventions: * .../ ... * enhances mood, immune function, and health (Baikie & Wilhelm, 2005; Pennebaker et al., 1988) * relaxation / self-hypnosis / guided imagery * reduces effect of stress on immune system (Gruzelier, 2002; Kiecolt-Glaser et al., 1986) * problem solving and stress management * reduces effect of stress on immune function (de Brouwer et al., 2011; Fawzy et al., 1993) * physical activity * enhances mood, reduces effect of stress on cortisol (Pauly et al., 2019)
* different coping interventions: * **expressive writing /emotional disclosure** * enhances mood, immune function, and health (Baikie & Wilhelm, 2005; Pennebaker et al., 1988) * relaxation / self-hypnosis / guided imagery * reduces effect of stress on immune system (Gruzelier, 2002; Kiecolt-Glaser et al., 1986) * problem solving and stress management * reduces effect of stress on immune function (de Brouwer et al., 2011; Fawzy et al., 1993) * physical activity * enhances mood, reduces effect of stress on cortisol (Pauly et al., 2019)
56
_Responses to stress can lessen its effects on immune function_ * different coping interventions: * expressive writing /emotional disclosure * enhances mood, immune function, and health (Baikie & Wilhelm, 2005; Pennebaker et al., 1988) * r... / self-... / ... imagery * reduces effect of stress on immune system (Gruzelier, 2002; Kiecolt-Glaser et al., 1986) * problem solving and stress management * reduces effect of stress on immune function (de Brouwer et al., 2011; Fawzy et al., 1993) * physical activity * enhances mood, reduces effect of stress on cortisol (Pauly et al., 2019)
* different coping interventions: * expressive writing /emotional disclosure * enhances mood, immune function, and health (Baikie & Wilhelm, 2005; Pennebaker et al., 1988) * **relaxation / self-hypnosis / guided imagery** * reduces effect of stress on immune system (Gruzelier, 2002; Kiecolt-Glaser et al., 1986) * problem solving and stress management * reduces effect of stress on immune function (de Brouwer et al., 2011; Fawzy et al., 1993) * physical activity * enhances mood, reduces effect of stress on cortisol (Pauly et al., 2019)
57
_Responses to stress can lessen its effects on immune function_ * different coping interventions: * expressive writing /emotional disclosure * enhances mood, immune function, and health (Baikie & Wilhelm, 2005; Pennebaker et al., 1988) - emotion focused * relaxation / self-hypnosis / guided imagery * reduces effect of stress on immune system (Gruzelier, 2002; Kiecolt-Glaser et al., 1986) - emotion focused * ... solving and ... management * reduces effect of stress on immune function (de Brouwer et al., 2011; Fawzy et al., 1993) - problem + emotion focused * physical activity * enhances mood, reduces effect of stress on cortisol (Pauly et al., 2019) - emotion focused
* different coping interventions: * expressive writing /emotional disclosure * enhances mood, immune function, and health (Baikie & Wilhelm, 2005; Pennebaker et al., 1988) * relaxation / self-hypnosis / guided imagery * reduces effect of stress on immune system (Gruzelier, 2002; Kiecolt-Glaser et al., 1986) * **problem** solving and **stress** management * reduces effect of stress on immune function (de Brouwer et al., 2011; Fawzy et al., 1993) * physical activity * enhances mood, reduces effect of stress on cortisol (Pauly et al., 2019)
58
_Responses to stress can lessen its effects on immune function_ * different coping interventions: * expressive writing /emotional disclosure * enhances mood, immune function, and health (Baikie & Wilhelm, 2005; Pennebaker et al., 1988) - emotion focused * relaxation / self-hypnosis / guided imagery * reduces effect of stress on immune system (Gruzelier, 2002; Kiecolt-Glaser et al., 1986) - emotion focused * problem solving and stress management * reduces effect of stress on immune function (de Brouwer et al., 2011; Fawzy et al., 1993) - problem + emotion focused * ... activity * enhances mood, reduces effect of stress on cortisol (Pauly et al., 2019) - emotion focused
* different coping interventions: * expressive writing /emotional disclosure * enhances mood, immune function, and health (Baikie & Wilhelm, 2005; Pennebaker et al., 1988) * relaxation / self-hypnosis / guided imagery * reduces effect of stress on immune system (Gruzelier, 2002; Kiecolt-Glaser et al., 1986) * problem solving and stress management * reduces effect of stress on immune function (de Brouwer et al., 2011; Fawzy et al., 1993) * **physical** activity * enhances mood, reduces effect of stress on cortisol (Pauly et al., 2019)
59
What are the 4 different coping interventions?
* expressive writing /emotional disclosure * relaxation / self-hypnosis / guided imagery * problem solving and stress management * physical activity
60
* expressive writing /emotional disclosure * relaxation / self-hypnosis / guided imagery * problem solving and stress management * physical activity * All of these are examples of what interventions?
* expressive writing /emotional disclosure * relaxation / self-hypnosis / guided imagery * problem solving and stress management * physical activity * **coping interventions**
61
_\>\> social support_ * secondary appraisal of resources includes evaluating social support * review of 81 studies showed social support has beneficial effects on stress-related responses in, immune, neuroendocrine and cardiovascular systems (Uchino et al., 1996) * e.g. increased sociability associated in a linear fashion with a decreased risk of developing cold (Cohen et al., 2003) * high levels of loneliness and small social networks result in lowest antibody response to a flu vaccination (Pressman et al., 2005)
* secondary appraisal of resources includes evaluating social support * review of 81 studies showed social support has beneficial effects on stress-related responses in, immune, neuroendocrine and cardiovascular systems (Uchino et al., 1996) * e.g -\> increased sociability associated in a linear fashion with a decreased risk of developing cold (Cohen et al., 2003) * high levels of loneliness and small social networks result in lowest antibody response to a flu vaccination (Pressman et al., 2005)
62
_\>\> social support_ * secondary ... of resources includes evaluating social support * review of 81 studies showed social support has beneficial effects on stress-related responses in, ..., neuroendocrine and cardiovascular systems (Uchino et al., 1996) * e.g. increased sociability associated in a linear fashion with a decreased risk of developing cold (Cohen et al., 2003) * high levels of loneliness and small social networks result in lowest antibody response to a flu vaccination (Pressman et al., 2005)
* secondary **appraisal** of resources includes evaluating social support * review of 81 studies showed social support has beneficial effects on stress-related responses in, **immune**, neuroendocrine and cardiovascular systems (Uchino et al., 1996) * e.g. increased sociability associated in a linear fashion with a decreased risk of developing cold (Cohen et al., 2003) * high levels of loneliness and small social networks result in lowest antibody response to a flu vaccination (Pressman et al., 2005)
63
_\>\> social support_ * secondary appraisal of resources includes evaluating social support * review of 81 studies showed social support has beneficial effects on stress-related responses in, immune, neuroendocrine and cardiovascular systems (Uchino et al., 1996) * e.g. increased sociability associated in a linear fashion with a decreased risk of developing ... (Cohen et al., 2003) * high levels of loneliness and small social networks result in ... antibody response to a flu vaccination (Pressman et al., 2005)
* secondary appraisal of resources includes evaluating social support * review of 81 studies showed social support has beneficial effects on stress-related responses in, immune, neuroendocrine and cardiovascular systems (Uchino et al., 1996) * e.g. increased sociability associated in a linear fashion with a decreased risk of developing **cold** (Cohen et al., 2003) * high levels of loneliness and small social networks result in **lowest** antibody response to a flu vaccination (Pressman et al., 2005)
64
What are the 2 pathways of influence of social support?
* direct effects * via psychosocial influences on endocrine and immune function * i.e. people feel less stressed if they feel supported * indirect effects * people who provide social support can encourage better coping * more likely to adhere to medication * more likely to use health services * = better health outcomes
65
_2 Pathways of influence of social support_ * direct effects * via ... influences on endocrine and immune function * i.e. people feel ... stressed if they feel ... * indirect effects * people who provide social support can encourage better coping * more likely to adhere to medication * more likely to use health services * = better health outcomes
* direct effects * via **psychosocial** influences on endocrine and immune function * i.e. people feel **less** stressed if they feel **supported** * indirect effects * people who provide social support can encourage better coping * more likely to adhere to medication * more likely to use health services * = better health outcomes
66
_2 Pathways of influence of social support_ * ... effects * via psychosocial influences on endocrine and immune function * i.e. people feel less stressed if they feel supported * indirect effects * people who provide social support can encourage better ... * more likely to adhere to medication * more likely to use health services * = better health outcomes
* **direct** effects * via psychosocial influences on endocrine and immune function * i.e. people feel less stressed if they feel supported * indirect effects * people who provide social support can encourage better **coping** * more likely to adhere to medication * more likely to use health services * = better health outcomes
67
_2 Pathways of influence of social support_ * direct effects * via psychosocial influences on endocrine and immune function * i.e. people feel less stressed if they feel supported * indirect effects * people who provide social support can encourage better coping * more likely to adhere to ... * more likely to use ... services * = better health outcomes
* direct effects * via psychosocial influences on endocrine and immune function * i.e. people feel less stressed if they feel supported * indirect effects * people who provide social support can encourage better coping * more likely to adhere to **medication** * more likely to use **health** services * = better health outcomes
68
_2 Pathways of influence of social support_ * ... effects * via psychosocial influences on endocrine and immune function * i.e. people feel less stressed if they feel supported * ... effects * people who provide social support can encourage better coping * more likely to adhere to medication * more likely to use health services * = better health outcomes
* **direct** effects * via psychosocial influences on endocrine and immune function * i.e. people feel less stressed if they feel supported * **indirect** effects * people who provide social support can encourage better coping * more likely to adhere to medication * more likely to use health services * = better health outcomes
69
_Depression and immunity_ * negative emotions - loneliness, pessimism, depression - impair immune function (Herbert & Cohen, 1993; Kiecolt-Glaser & Glaser, 2002) * = greater susceptibility to infections * = slower wound healing * = altered immune function * reduced number and function of lymphocytes * reduced number and function of NK cells * changes in pro-inflammatory cytokines * increases in interleukin-6 (mediator of fever + inflammation) * ‘dose-response’ effect - more severe / prolonged depression has worse immune effects
* negative emotions - loneliness, pessimism, depression - impair immune function (Herbert & Cohen, 1993; Kiecolt-Glaser & Glaser, 2002) * = greater susceptibility to infections * = slower wound healing * = altered immune function * reduced number and function of lymphocytes * reduced number and function of NK cells * changes in pro-inflammatory cytokines * increases in interleukin-6 (mediator of fever + inflammation) * ‘dose-response’ effect - more severe / prolonged depression has worse immune effects
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_Depression and immunity_ * negative emotions - loneliness, pessimism, depression - **...** immune function (Herbert & Cohen, 1993; Kiecolt-Glaser & Glaser, 2002)
* negative emotions - loneliness, pessimism, depression - **impair** immune function (Herbert & Cohen, 1993; Kiecolt-Glaser & Glaser, 2002) * = greater susceptibility to infections * = slower wound healing * = altered immune function * reduced number and function of lymphocytes * reduced number and function of NK cells * changes in pro-inflammatory cytokines * increases in interleukin-6 (mediator of fever + inflammation) * ‘dose-response’ effect - more severe / prolonged depression has worse immune effects
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_Depression and immunity_ * negative emotions - loneliness, pessimism, depression - impair immune function (Herbert & Cohen, 1993; Kiecolt-Glaser & Glaser, 2002) * = greater susceptibility to ... * = slower wound ... * = altered immune ... * reduced number and function of lymphocytes * reduced number and function of NK cells * changes in pro-inflammatory cytokines * increases in interleukin-6 (mediator of fever + inflammation) * ‘dose-response’ effect - more severe / prolonged depression has worse immune effects
* negative emotions - loneliness, pessimism, depression - impair immune function (Herbert & Cohen, 1993; Kiecolt-Glaser & Glaser, 2002) * = greater susceptibility to **infections** * = slower wound **healing** * = altered immune **function** * reduced number and function of lymphocytes * reduced number and function of NK cells * changes in pro-inflammatory cytokines * increases in interleukin-6 (mediator of fever + inflammation) * ‘dose-response’ effect - more severe / prolonged depression has worse immune effects
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_Depression and immunity_ * negative emotions - loneliness, pessimism, depression - impair immune function (Herbert & Cohen, 1993; Kiecolt-Glaser & Glaser, 2002) * = greater susceptibility to infections * = slower wound healing * = altered immune function * reduced number and function of ... * reduced number and function of ... cells * changes in pro-inflammatory cytokines * increases in interleukin-6 (mediator of fever + inflammation) * ‘dose-response’ effect - more severe / prolonged depression has worse immune effects
* negative emotions - loneliness, pessimism, depression - impair immune function (Herbert & Cohen, 1993; Kiecolt-Glaser & Glaser, 2002) * = greater susceptibility to infections * = slower wound healing * = altered immune function * reduced number and function of **lymphocytes** * reduced number and function of **NK** cells * changes in pro-inflammatory cytokines * increases in interleukin-6 (mediator of fever + inflammation) * ‘dose-response’ effect - more severe / prolonged depression has worse immune effects
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_Depression and immunity_ * negative emotions - loneliness, pessimism, depression - impair immune function (Herbert & Cohen, 1993; Kiecolt-Glaser & Glaser, 2002) * = greater ... to infections * = slower wound healing * = altered immune function * reduced number and function of lymphocytes * reduced number and function of NK cells * changes in ...-... cytokines * increases in interleukin-6 (mediator of fever + inflammation) * ‘dose-response’ effect - more severe / prolonged depression has worse immune effects
* negative emotions - loneliness, pessimism, depression - impair immune function (Herbert & Cohen, 1993; Kiecolt-Glaser & Glaser, 2002) * = greater **susceptibility** to infections * = slower wound healing * = altered immune function * reduced number and function of lymphocytes * reduced number and function of NK cells * changes in **pro-inflammatory** cytokines * increases in interleukin-6 (mediator of fever + inflammation) * ‘dose-response’ effect - more severe / prolonged depression has worse immune effects
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_Depression and immunity_ * negative emotions - loneliness, pessimism, depression - impair immune function (Herbert & Cohen, 1993; Kiecolt-Glaser & Glaser, 2002) * = greater susceptibility to infections * = slower wound healing * = altered immune function * reduced number and function of lymphocytes * reduced number and function of NK cells * changes in pro-inflammatory ... * increases in interleukin-... (mediator of fever + inflammation) * ‘dose-response’ effect - more severe / prolonged depression has worse immune effects
* negative emotions - loneliness, pessimism, depression - impair immune function (Herbert & Cohen, 1993; Kiecolt-Glaser & Glaser, 2002) * = greater susceptibility to infections * = slower wound healing * = altered immune function * reduced number and function of lymphocytes * reduced number and function of NK cells * changes in pro-inflammatory **cytokines** * increases in interleukin-**6** (mediator of fever + inflammation) * ‘dose-response’ effect - more severe / prolonged depression has worse immune effects
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_Depression and immunity_ * negative emotions - loneliness, pessimism, depression - impair immune function (Herbert & Cohen, 1993; Kiecolt-Glaser & Glaser, 2002) * = greater susceptibility to infections * = slower wound healing * = altered immune function * reduced number and function of lymphocytes * reduced number and function of NK cells * changes in pro-inflammatory cytokines * increases in interleukin-6 (mediator of fever + inflammation) * ‘...-...’ effect - more severe / prolonged depression has worse immune effects
* negative emotions - loneliness, pessimism, depression - impair immune function (Herbert & Cohen, 1993; Kiecolt-Glaser & Glaser, 2002) * = greater susceptibility to infections * = slower wound healing * = altered immune function * reduced number and function of lymphocytes * reduced number and function of NK cells * changes in pro-inflammatory cytokines * increases in interleukin-6 (mediator of fever + inflammation) * **‘dose-response’** effect - more severe / prolonged depression has worse immune effects
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‘dose-response’ effect - more severe / prolonged ... has worse immune effects
‘dose-response’ effect - more severe / prolonged **depression** has worse immune effects
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* depression linked to more rapid progression of ...
* depression linked to more rapid progression of **disease** * - HIV/AIDS (Leserman, 2008) * - cancer (Speigel & Geise-Davis, 2003)
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* depression linked to more rapid progression of disease e. g... and ...
* depression linked to more rapid progression of disease * **- HIV/AIDS (Leserman, 2008)** * **- cancer (Speigel & Geise-Davis, 2003)**
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effects of depression may be ... or ....
* **direct**: effect on immune function * **indirect**: poor sleep, unhealthy behaviour, lower adherence (DiMatteo et al., 2000)
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effects of ... may be direct (effect on immune function) or indirect (poor sleep, unhealthy behaviour, lower adherence)
effects of **depression** may be direct (effect on immune function) or indirect (poor sleep, unhealthy behaviour, lower adherence) (DiMatteo et al., 2000)
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effects of depression may be direct (effect on ... ...) or indirect (poor ..., ... behaviour, lower ...) (DiMatteo et al., 2000)
effects of depression may be direct (effect on **immune** **function**) or indirect (poor **sleep**, **unhealthy** behaviour, lower **adherence**) (DiMatteo et al., 2000)
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* psychological ... to treat depression can affect the course of immune disorders * .... that improve psychological well-being also improve immune function (Carrico & Antoni, 2008)
* psychological **interventions** to treat depression can affect the course of immune disorders * **interventions** that improve psychological well-being also improve * immune function (Carrico & Antoni, 2008)
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Do psychological interventions to treat depression can affect the course of immune disorders?
* psychological interventions to treat depression can affect the course of immune disorders * interventions that improve psychological well-being also improve * immune function (Carrico & Antoni, 2008)
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Can interventions that improve psychological well-being also improve immune function ?
Yes - **interventions that improve psychological well-being also improve immune function (Carrico & Antoni, 2008)**
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_positive mood and immunity_ * Is there evidence that positive moods and personalities are related to enhanced immune function?
* **Increasing** evidence that positive moods and personalities are related to enhanced immune function (Dockray & Steptoe, 2010) * personality * optimism, emotional expressiveness, extraversion associated with: NK cell cytotoxicity; proliferation of helper T lymphocytes (Segerstrom et al., 1998 * [hard to modify] * mood * laughter / watching comedy videos leads to increases in immune function (Bennett et al., 2003; Berk et al., 2001; Toda & Ichikawa, 2012) * [modifiable]
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_positive mood and immunity_ * Increasing evidence that positive ... and ... are related to enhanced immune function (Dockray & Steptoe, 2010) * ... * optimism, emotional expressiveness, extraversion associated with: NK cell cytotoxicity; proliferation of helper T lymphocytes (Segerstrom et al., 1998 * [hard to modify] * ... * laughter / watching comedy videos leads to increases in immune function (Bennett et al., 2003; Berk et al., 2001; Toda & Ichikawa, 2012) * [modifiable]
* Increasing evidence that positive **moods** and **personalities** are related to enhanced immune function (Dockray & Steptoe, 2010) * **personality** * optimism, emotional expressiveness, extraversion associated with: NK cell cytotoxicity; proliferation of helper T lymphocytes (Segerstrom et al., 1998 * [hard to modify] * **mood** * laughter / watching comedy videos leads to increases in immune function (Bennett et al., 2003; Berk et al., 2001; Toda & Ichikawa, 2012) * [modifiable]
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_positive mood and immunity_ * Increasing evidence that positive moods and personalities are related to enhanced immune function (Dockray & Steptoe, 2010) * personality * optimism, emotional expressiveness, extraversion associated with: NK cell cytotoxicity; proliferation of helper T lymphocytes (Segerstrom et al., 1998 * [hard to ...] * mood * laughter / watching comedy videos leads to increases in immune function (Bennett et al., 2003; Berk et al., 2001; Toda & Ichikawa, 2012) * [...]
* Increasing evidence that positive moods and personalities are related to enhanced immune function (Dockray & Steptoe, 2010) * personality * optimism, emotional expressiveness, extraversion associated with: NK cell cytotoxicity; proliferation of helper T lymphocytes (Segerstrom et al., 1998 * [hard to **modify**] * mood * laughter / watching comedy videos leads to increases in immune function (Bennett et al., 2003; Berk et al., 2001; Toda & Ichikawa, 2012) * [**modifiable**]
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_positive mood and immunity_ * Increasing evidence that positive moods and personalities are related to ... immune function (Dockray & Steptoe, 2010) * personality * optimism, emotional expressiveness, extraversion associated with: NK cell cytotoxicity; proliferation of helper T lymphocytes (Segerstrom et al., 1998 * [hard to modify] * mood * laughter / watching comedy videos leads to ... in immune function (Bennett et al., 2003; Berk et al., 2001; Toda & Ichikawa, 2012) * [modifiable]
* Increasing evidence that positive moods and personalities are related to **enhanced** immune function (Dockray & Steptoe, 2010) * personality * optimism, emotional expressiveness, extraversion associated with: NK cell cytotoxicity; proliferation of helper T lymphocytes (Segerstrom et al., 1998 * [hard to modify] * mood * laughter / watching comedy videos leads to **increases** in immune function (Bennett et al., 2003; Berk et al., 2001; Toda & Ichikawa, 2012) * [modifiable]
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positive events and moods may have ...-lasting effects on immune function than negative events (e.g. Stone et al., 1994)
positive events and moods may have **longer**-lasting effects on immune function than negative events (e.g. Stone et al., 1994)
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... events and moods may have longer-lasting effects on immune function than ... events (e.g. Stone et al., 1994)
**positive** events and moods may have longer-lasting effects on immune function than **negative** events (e.g. Stone et al., 1994)
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* positive affect can have positive effects on disease ... in immune disorders * - e.g., linked to better viral control in HIV+ people (Wilson et al. 2017) * note: ... studies of positive emotions than negative emotions * so less robust evidence * implications for interventions
* positive affect can have positive effects on disease **progression** in immune disorders * - e.g., linked to better viral control in HIV+ people (Wilson et al. 2017) * note: **fewer** studies of positive emotions than negative emotions * so less robust evidence * implications for interventions
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* positive affect can have positive effects on disease progression in immune disorders * - e.g., linked to better ... control in ...+ people (Wilson et al. 2017) * note: fewer studies of positive emotions than negative emotions * so less ... evidence * implications for interventions
* positive affect can have positive effects on disease progression in immune disorders * - e.g., linked to better **viral** control in **HIV**+ people (Wilson et al. 2017) * note: fewer studies of positive emotions than negative emotions * so less **robust** evidence * implications for interventions
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what are the pathways by which social support may reduce the immune effects of stress and depression?
direct and indirect

Year 2 Medicine (162 decks)

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