Psychosocial influences on human immunity

Infant mortality rate in India: mediating causes

PURPOSE

The purpose of this paper is to develop a new approach to health service quality assurance.

DESIGN/METHODOLOGY/APPROACH

Data were collected using a structured, eight-section questionnaire. Stratified random samples were drawn from four villages based in four Indian regions.

FINDINGS

Psychological discomfort is an infant mortality rate (IMR) mediating factor. The root mean square error of approximation fit statistic for the model was 0.08, which was considered the best fit.

PRACTICAL IMPLICATIONS

Addressing mediating causes can reduce IMR in developing countries.

ORIGINALITY/VALUE

The model that the authors described helps health institution managers to map quality assurance health management and economics.

Inhibitory effect of pregnancy on stress-induced immunosuppression through corticotropin releasing hormone (CRH) and dopaminergic systems

To clarify the involvement of pregnancy in the response of the neuroendocrine-immune system to stress, we examined splenic natural killer-cell-activity-(NKCA) and its relevant central and blood parameters in female virgin and pregnant rats (10 to 11 days gestation) exposed to forced water-immersion stress with durations of 90 min and 180 min. Decreases in splenic NKCA, corticotropin releasing hormone (CRH) in the hypothalamus, and increases in progesterone (P), beta-endorphin (beta EP), and dopamine (DA) metabolic ratios in the frontal cortex and nucleus accumbens produced by stress were recognized in the virgin rats, but not in the pregnant rats. Pregnancy reduced splenic NKCA in rats without stress, but elevated it in the rats exposed to stress with a duration of 180 min. These findings suggest inhibitory effects of pregnancy on stress-induced immunosuppression and neuroendocrine changes, thereby promoting homeostasis in the neuroendocrine-immune system against stress. Such enhanced homeostasis associated with pregnancy seemed to be mediated by the activation of placental P and placental or pituitary beta EP in cooperation with mesocortical and mesolimbic DA systems and hypothalamic CRH.

Fostering children's resilience

Resilience is relevant to nurses because of its implications for health. Research on the resilience of children and adolescents has proliferated over the past five years. However, the specific processes underlying resilience and outcome variables require further study. Furthermore, few intervention studies have been conducted. This article describes resilience and factors that influence resilience of children, examines the relationship between resilience and health, identifies interventions that foster children's resilience and health, reviews research focusing on children's resilience, and suggests the relevance of resilience to nursing of children.

Social economics of childhood glucocorticoid stress response and health

This study examines socioeconomic conditions, psychosocial stress, and health among 264 infants, children, adolescents, and young adults aged 2 months to 18 years residing in a rural Caribbean village. Fieldwork was conducted over a 9 year period (1988-1996). Research methods and techniques include salivary cortisol radioimmunoassay (N = 22,438), systematic behavioral observations, psychological questionnaires, health evaluations, medical records, informal interviews, and participant observation. Analyses of data indicate complex relations among socioeconomic conditions, stress, and health. Household income, land ownership, parental education, and other socioeconomic measures are weakly associated with child illness. There is no evidence that apparent material benefits of high socioeconomic status--such as improved housing, diet, work loads, and access to private healthcare--have important direct effects on child health in this population. However, social relationships, especially family environment, may have important effects on childhood psychosocial stress and illness. Abnormal glucocorticoid response profiles, diminished immunity, and frequent illness are associated with unstable mating relationships for parents/caretakers and household composition. We suggest that family relationships and concomitant stress and immunosuppression are important intermediary links between socioeconomic conditions and child health.

Studies in psychoneuroimmunology: psychological, immunological, and neuroendocrinological parameters in Israeli civilians during and after a period of Scud missile attacks

Twenty-two male volunteers in Jerusalem were subjected to a battery of psychological tests at the height of the Iraqi Scud missile attacks on Israeli cities during the 1991 Persian Gulf War and again after the cessation of hostilities. Venous blood samples were taken at each time point. The separated mononuclear cells and plasma were cryopreserved, and a spectrum of immunological and neuroendocrine assays were performed on the preserved samples. Psychological testing indicated levels of anxiety were higher during the war than they were after the war ended, and both anxiety and anger during the hostilities were significantly elevated in comparison with prewar data. During the war, specific war-related pressures were greater than everyday pressures, and problem-focused coping was more evident than emotion-focused coping. Natural-killer cell activity and cell-mediated lympholysis were significantly elevated during the war, as were plasma levels of adrenocorticotrophic hormone, neurotensin, and substance P. The only biological test parameter found to be reduced during the war period was mononuclear cell thymidine incorporated in nonstimulated cultures.

Immune function in cigarette smokers who quit smoking for 31 days

A group of 28 healthy, white, male, light-to-moderate smokers, 21 to 35 years of age, were offered a financial inducement to abstain from smoking for 31 days. A matched control group of 11 smokers were paid to continue smoking during the same period. Nonspecific parameters of immune system function were monitored before and at various times after smoking abstinence. Abstinence increased natural killer cell cytotoxic activity but did not alter mitogen-induced T-lymphocyte proliferation as measured by responses to concanavalin A or phytohemagglutinin. Serum cortisol concentrations also decreased after smoking cessation; however, changes in immune function were not correlated with serum cortisol change, nor with indices of smoking such as plasma nicotine and cotinine levels. Responses to concanavalin A and phytohemagglutinin were positively correlated with change in self-reported alcohol ingestion during smoking abstinence. Results indicate that elevation in natural kill cell cytotoxic activity is detectable within 1 month of smoking cessation, even in light-to-moderate smokers. However, elevation in natural killer cell cytotoxic activity appears not to be directly related to cessation-induced reductions in plasma nicotine, cotinine, or circulating cortisol levels.

Stress, distress, and immunity

Since psychoimmunology is now 10 to 20 years of age, it seems appropriate to expect a certain maturity in the field. It seems reasonably well established that there really is neuroimmunomodulation. The biological and medical importance of this is the possible influence of psychological factors on immune competence. Inasmuch as it is reasonably well established that psychological factors do have such an influence, the field must now endeavor to establish how important this influence is. It no longer suffices to show that some sort of stressor has some sort of action on some part of the immune cascade of responses. "Stressors" do not act indiscriminately; they are filtered and interpreted by the brain following psychological principles that again are reasonably well known. The distinction between "stress" and "distress" is important for the health consequences of how and with what success an individual is handling a stressful situation. Concepts such as coping, control, helplessness, and hopelessness are required to understand how immune responses are influenced by the brain and to establish the extent to which these mechanisms have clinical validity in man and animals.

[Psychoimmunology and AIDS: a review of the literature]

In recent years, several studies have been carried out concerning the effect of psychosocial factors on the course of infection due to the human immunodeficiency virus (HIV). After summarizing the current status of general knowledge in the field of psychoimmunology, this article reviews the results of studies conducted in regard to HIV. Two conclusions are reached. The first is that current research has not shown psychosocial factors to have any impact on either the immunity status of seropositive patients or the medical complications inherent to AIDS. The second conclusion is that several types of intervention, in particular psychoeducational approaches, stress management programs, and the strengthening of social and family support, give good results where the psychosocial well-being of patients is concerned and should motivate various health professionals to improve the focus of their interventions. Furthermore, significant methodological weaknesses in several indexed studies are noted, and these should be rectified to enable future studies to confirm or correct the present observations.

Reliability of the Turkish version of the Perceived Social Support from Friends and Family scales, Scale for Interpersonal Behavior, and Suicide Probability Scale

This study investigated the reliability of the Turkish version of the Perceived Social Support (PSS) from Friends (PSS-Fr) and Family (PSS-Fa) scales, the Scale for Interpersonal Behavior (SIB), and the Suicide Probability Scale (SPS). Both test-retest and internal consistency reliability estimates were computed. Highly adequate reliability coefficients are recorded for the subscales and the total scales of the PSS, SIB, and SPS. The results of the present study clearly support the use of Turkish versions of the PSS-Fr, PSS-Fa, SIB, and SPS as reliable methods for assessing perceived social support from friends and family, assertiveness, and suicide risk.

Pediatric HIV infection: a neuropsychological and educational challenge

Pediatric acquired immunodeficiency syndrome (AIDS) and human immunodeficiency virus (HIV) infection will soon be the primary infectious cause of perinatally acquired developmental disabilities in the United States. HIV encephalopathy and a variety of opportunistic infections, neoplasms, and vascular changes associated with pediatric HIV infection create a high probability of neuropsychological impairment among preschool and school-age children infected perinatally. Although the use of antiretrovirals may moderate some of the functional difficulties faced by these children, specific neuropathological and neuropsychological deficits are likely to remain. Treatments that prevent the central nervous system (CNS) effects of HIV have yet to be identified. As the epidemic progresses among women of child-bearing age, well-controlled developmental studies are needed to further clarify the relationship between HIV and child development, and to aid professionals in developing appropriate, school-based educational plans.

The physiological and psychological effects of the expression and inhibition of emotion

Previous work has indicated that humor enhances immunity, but the immunological effects of overt crying have not been studied. Thirty-nine women viewed sad and humorous videotapes and either inhibited or expressed overt expressions of laughter and weeping; these were observed and timed. Moods and immunity (S-IgA) were repeatedly measured. The humorous stimulus resulted in improved immunity, regardless of the overt laughter expressed; overt crying was immunosuppressive, whereas the inhibition of weeping in the context of the same sad stimulus was not. Moods were more negative following the sad stimulus and in the expression condition. The results with respect to humor are consistent with previous research; the immunosuppressive effect of overt crying is discussed in the context of various types of crying that may have different effects.