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Svensson R, Malon M, Stensballe LG, Thorsen SU, Svensson J. The effect of stress on the antibody response after vaccination in children aged 0-18 years: A systematic review. Scand J Immunol 2024:e13394. [PMID: 38924129 DOI: 10.1111/sji.13394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Revised: 05/17/2024] [Accepted: 06/09/2024] [Indexed: 06/28/2024]
Abstract
Stress has been associated with less effective vaccine responses in adults. This review aims to investigate the evidence for a similar association in children. A systematic review search was conducted in January 2021 in three databases: Medline, Embase and PsycInfo. An updated search of the Medline database was systematically conducted until the most recent update on September 25th, 2023, to ensure the inclusion of the most current research available. Keywords related to stress, vaccines and children were used, and a total of 7263 (+1528) studies were screened by two independent investigators. Six studies met the inclusion criteria for data extraction and analysis. For quality assessment of the studies, the risk of bias in non-randomized studies-of interventions (ROBINS-I) tool was applied. Most of the studies suggest a negative role of stress on vaccine responses. However, the scarcity of studies, lack of confirmatory studies, risk of bias and heterogeneity according to age, type of vaccine, measures of stress and vaccine responses prevent a clear conclusion. Future studies should emphasize the use of as strict study designs as possible, including well-defined stress metrics and thorough examination of both pre- and post-vaccination responses. Systematic review registration: Prospero CRD42021230490.
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Affiliation(s)
- Rikke Svensson
- The Child and Adolescent Clinic 4072, The Danish National University Hospital, Copenhagen, Denmark
| | - Michelle Malon
- The Child and Adolescent Clinic 4072, The Danish National University Hospital, Copenhagen, Denmark
| | - Lone G Stensballe
- The Child and Adolescent Clinic 4072, The Danish National University Hospital, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Steffen U Thorsen
- Department of Clinical Immunology, The Danish National University Hospital, Copenhagen, Denmark
| | - Jannet Svensson
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Steno Diabetes Center Copenhagen, Copenhagen, Denmark
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Corallo KL, Lyle SM, Carlock MA, Ross TM, Ehrlich KB. Emotional Distress, Targeted Rejection, and Antibody Production After Influenza Vaccination in Adolescence. Psychosom Med 2022; 84:429-436. [PMID: 35100185 PMCID: PMC9064924 DOI: 10.1097/psy.0000000000001054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The purpose of this study was to explore how both ongoing emotional distress and the experience of a targeted rejection over the past 6 months are associated with adolescents' antibody response to influenza virus vaccination. We predicted that experiencing a targeted rejection would amplify the hypothesized negative association between emotional distress and antibody response after vaccination. METHODS Adolescent participants (N = 148) completed two study visits (mean [standard deviation] days between visits = 27.4 [1.8]). At the first visit, they provided blood samples, were administered the seasonal (2018-2019) quadrivalent influenza vaccine (Fluzone, Sanofi Pasteur), completed questionnaires, and participated in a semistructured interview. At the second visit, they provided another blood sample. Hemagglutination-inhibition assays were conducted to determine prevaccination and postvaccination antibody titers. Targeted rejection experiences were coded from adolescents' interviews. RESULTS The emotional distress by targeted rejection interaction predicted antibody response to the two A strains and the composite of all vaccine strains (b values = -0.451 to -0.843, p values < .05), but not the two B strains. Results suggested that, among adolescents who experienced a targeted rejection over the past 6 months, emotional distress was negatively associated with vaccine response (however, this finding did not reach statistical significance). Conversely, among adolescents who did not experience a targeted rejection, emotional distress was positively associated with vaccine response (b = 0.173, p = .032). CONCLUSIONS The current study highlights the importance of evaluating both acute life events and ongoing distress as they relate to adaptive immune functioning in adolescence.
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Affiliation(s)
| | | | | | - Ted M. Ross
- Center for Vaccines and Immunology and Department of Infectious Diseases, University of Georgia
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Chen MA, LeRoy AS, Majd M, Chen JY, Brown RL, Christian LM, Fagundes CP. Immune and Epigenetic Pathways Linking Childhood Adversity and Health Across the Lifespan. Front Psychol 2021; 12:788351. [PMID: 34899540 PMCID: PMC8662704 DOI: 10.3389/fpsyg.2021.788351] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Accepted: 11/04/2021] [Indexed: 12/17/2022] Open
Abstract
Childhood adversity is associated with a host of mental and physical health problems across the lifespan. Individuals who have experienced childhood adversity (e.g., child abuse and neglect, family conflict, poor parent/child relationships, low socioeconomic status or extreme poverty) are at a greater risk for morbidity and premature mortality than those not exposed to childhood adversity. Several mechanisms likely contribute to the relationship between childhood adversity and health across the lifespan (e.g., health behaviors, cardiovascular reactivity). In this paper, we review a large body of research within the field of psychoneuroimmunology, demonstrating the relationship between early life stress and alterations of the immune system. We first review the literature demonstrating that childhood adversity is associated with immune dysregulation across different indices, including proinflammatory cytokine production (and its impact on telomere length), illness and infection susceptibility, latent herpesvirus reactivation, and immune response to a tumor. We then summarize the growing literature on how childhood adversity may alter epigenetic processes. Finally, we propose future directions related to this work that have basic and applied implications.
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Affiliation(s)
- Michelle A Chen
- Department of Psychological Sciences, Rice University, Houston, TX, United States
| | - Angie S LeRoy
- Department of Psychological Sciences, Rice University, Houston, TX, United States
| | - Marzieh Majd
- Department of Psychological Sciences, Rice University, Houston, TX, United States
| | - Jonathan Y Chen
- McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Ryan L Brown
- Department of Psychological Sciences, Rice University, Houston, TX, United States
| | - Lisa M Christian
- Department of Psychiatry & Behavioral Health and the Institute for Behavioral Medicine Research, The Ohio State University Wexner Medical Center, Columbus, OH, United States
| | - Christopher P Fagundes
- Department of Psychological Sciences, Rice University, Houston, TX, United States.,Department of Behavioral Sciences, The University of Texas MD Anderson Cancer Center, Houston, TX, United States.,Department of Psychiatry & Behavioral Sciences, Baylor College of Medicine, Houston, TX, United States
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Shakiba N, Gao MM, Conradt E, Terrell S, Lester BM. Parent-child relationship quality and adolescent health: Testing the differential susceptibility and diathesis-stress hypotheses in African American youths. Child Dev 2021; 93:269-287. [PMID: 34473345 DOI: 10.1111/cdev.13667] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
This study tested two competing models of differential susceptibility and diathesis-stress in a prospective longitudinal study of African American youths (N = 935). It examined whether individual variations in the functioning of the hypothalamic-pituitary-adrenocortical axis at age 11 interact with middle childhood parent-child relationship quality to predict mental and physical health problems in adolescence (ages 11-15 years old). Adolescent boys with lower levels of cortisol reactivity to laboratory challenges had the highest levels of internalizing problems if they experienced a high conflictual relationship with their parents. Equally low-reactive boys, however, reported the lowest number of physical illnesses if their relationship with their parents was characterized by high levels of intimacy and support.
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Affiliation(s)
- Nila Shakiba
- Department of Psychological and Brain Sciences, Boston University, 64 Cummington Mall, Boston, Massachusetts, 02215, USA
| | | | - Elisabeth Conradt
- Department of Psychology, University of Utah, Salt Lake City, Utah, USA.,Department of Pediatrics, University of Utah, Salt Lake City, Utah, USA.,Department of OB/GYN, University of Utah, Salt Lake City, Utah, USA
| | - Sarah Terrell
- Department of Human Development and Family Studies, Pennsylvania State University, University Park, Pennsylvania, USA
| | - Barry M Lester
- Department of Psychiatry, Brown University, Providence, Rhode Island, USA.,Department of Pediatrics, Brown University, Providence, Rhode Island, USA
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Ehrlich KB. How does the social world shape health across the lifespan? Insights and new directions. ACTA ACUST UNITED AC 2021; 75:1231-1241. [PMID: 33382288 DOI: 10.1037/amp0000757] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Decades of research highlight the connections between stressful life experiences-particularly those experienced in childhood-and physical health across the lifespan. In recent years, studies at the intersection of social and biomedical science have provided intriguing insights into the biological mechanisms that might explain how chronic and acute stressors give rise to health problems, sometimes decades later in life. To date, efforts to understand these connections have relied on a handful of study designs, and these studies have revealed important observations about how stressful experiences are thought to shape health. At the same time, these study designs have some drawbacks that limit the conclusions that can be drawn about the role of the social world for health. This article provides an overview of research on social determinants of health and includes a discussion of conceptual and methodological directions for the field to consider. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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PCIT-Health: Preventing Childhood Obesity by Strengthening the Parent–Child Relationship. COGNITIVE AND BEHAVIORAL PRACTICE 2020. [DOI: 10.1016/j.cbpra.2020.07.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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O’Connor TG, Willoughby MT, Moynihan JA, Messing S, Vallejo Sefair A, Carnahan J, Yin X, Caserta MT. Early childhood risk exposures and inflammation in early adolescence. Brain Behav Immun 2020; 86:22-29. [PMID: 31059804 PMCID: PMC6825880 DOI: 10.1016/j.bbi.2019.05.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 04/26/2019] [Accepted: 05/02/2019] [Indexed: 02/06/2023] Open
Abstract
There is now reliable evidence that early psychosocial stress exposures are associated with behavioral health in children; the degree to which these same kinds of stress exposures predict physical health outcomes is not yet clear. We investigated the links between economic adversity, family and caregiving stress in early childhood and several markers of immune function in early adolescence. The sample is derived from the Family Life Project, a prospective longitudinal study of at-risk families. Socio-demographic and psychosocial risks have been assessed at regular intervals since the children were first assessed at 2 months of age. When the children were early adolescents, we conducted an in-depth health assessment of a subsample of families; blood samples were collected from venipuncture for interleukin(IL)-6, Tumor Necrosis Factor (TNF)-alpha, and C-reactive protein (CRP), as well as glucocorticoid resistance. Results indicated limited but reliable evidence of an association between early risk exposure and inflammation in adolescence. Specifically, caregiver depressive symptoms in early childhood predicted elevated CRP almost a decade later, and the prediction was significant after accounting for multiple covariates such as socio-economic adversity, health behaviors and body mass index. Our findings provide strong but limited evidence that early stress exposures may be associated with inflammation, suggesting one mechanism linking early stress exposure to compromised behavioral and somatic health.
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Affiliation(s)
| | | | - Jan A Moynihan
- Department of Psychiatry, University of Rochester Medical Center
| | - Susan Messing
- Department of Statistics and Bioinformatics, University of Rochester Medical Center
| | | | | | - Xiajuan Yin
- Frank Porter Graham Child Development Institute, University of North Carolina at Chapel Hill
| | - Mary T Caserta
- Department of Pediatrics, University of Rochester Medical Center
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O'Connor TG, Woolgar M, Humayun S, Briskman JA, Scott S. Early caregiving predicts attachment representations in adolescence: findings from two longitudinal studies. J Child Psychol Psychiatry 2019; 60:944-952. [PMID: 29904928 DOI: 10.1111/jcpp.12936] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/02/2018] [Indexed: 12/13/2022]
Abstract
BACKGROUND A growing research base demonstrates that adolescents' construction of secure attachment relationships may underlie successful social and personal relationships and healthy behavioral adjustment. Little is known about the early caregiving origins of adolescent attachment security; this study provides some of the first data on this topic. METHOD The relative contribution of early and current caregiving quality to attachment security in adolescence was assessed in two longitudinal studies of a clinic-referred and an at-risk community sample using identical measures (n = 209). Quality of early parent-child relationships at age 3-7 years of age and parent-adolescent relationship quality at approximately 12 years were assessed using observational methods; psychosocial risk was derived from extensive interview and questionnaire assessments; adolescent attachment quality was assessed using a standard attachment interview. RESULTS Analyses indicated moderate stability in observed parent-child interaction quality from early childhood to adolescence. Observational ratings of both early childhood and current caregiving quality were significantly associated with adolescent attachment security; however, early caregiver sensitivity was more strongly associated with adolescent attachment security and predicted later attachment security independently from current caregiving quality. Follow-up analyses indicated that this longitudinal prediction was significantly weaker in the clinic than in the at-risk community sample. CONCLUSIONS Parental sensitive responding in childhood has enduring effects on attachment representation in adolescence, independent of current parenting relationship quality. These findings provide important new evidence supporting early parenting interventions for promoting youth well-being and adjustment.
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Affiliation(s)
| | | | - Sajid Humayun
- King's College London, London, UK.,University of Greenwich, London, UK
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The Consequences of Foster Care Versus Institutional Care in Early Childhood on Adolescent Cardiometabolic and Immune Markers: Results From a Randomized Controlled Trial. Psychosom Med 2019; 81:449-457. [PMID: 31008902 PMCID: PMC6544473 DOI: 10.1097/psy.0000000000000696] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Children exposed to institutional rearing often exhibit problems across a broad array of developmental domains. We compared the consequences of long-term, high-quality foster care versus standard institution-based care, which began in early childhood on cardiometabolic and immune markers assessed at the time of adolescence. METHODS The Bucharest Early Intervention Project is a longitudinal investigation of children institutionalized during early childhood (ages 6 to 30 months at baseline) who were subsequently randomized to either high-quality foster care or continued institutional care. At the age of 16 years, 127 respondents participated in a biomarker collection protocol, including 44 institutionalized children randomly assigned to receive care as usual, 41 institutionalized children randomized to be removed from institutional care and placed in high-quality foster care in infancy, and a control group of 42 demographically matched children raised in biological families. Outcomes included body mass index (BMI), systolic and diastolic blood pressure, C-reactive protein, interleukin (IL)-6, IL-8, IL-10, tumor necrosis factor α, glycosylated hemoglobin A1c, and Epstein-Barr virus antibody titers. RESULTS Early institutional rearing was not associated with differences in cardiometabolic or immune markers. Randomization to foster care and age of placement into foster care were also unrelated to these markers, with the exception of BMI z-score, where children assigned to care as usual had lower BMI z-scores relative to children assigned to foster care (-0.23 versus 0.08, p = .06), and older age at placement was associated with lower BMI (β = -0.07, p = .03). CONCLUSIONS The impact of institutional rearing on measures of cardiometabolic health and immune system functioning is either absent or not evident until later in development. These findings provide new insights into the biological embedding of adversity and how it varies developmentally and across regulatory systems and adversity type. CLINICAL TRIAL REGISTRATION NCT00747396.
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Abstract
There is substantial variation between individuals in the immune response to vaccination. In this review, we provide an overview of the plethora of studies that have investigated factors that influence humoral and cellular vaccine responses in humans. These include intrinsic host factors (such as age, sex, genetics, and comorbidities), perinatal factors (such as gestational age, birth weight, feeding method, and maternal factors), and extrinsic factors (such as preexisting immunity, microbiota, infections, and antibiotics). Further, environmental factors (such as geographic location, season, family size, and toxins), behavioral factors (such as smoking, alcohol consumption, exercise, and sleep), and nutritional factors (such as body mass index, micronutrients, and enteropathy) also influence how individuals respond to vaccines. Moreover, vaccine factors (such as vaccine type, product, adjuvant, and dose) and administration factors (schedule, site, route, time of vaccination, and coadministered vaccines and other drugs) are also important. An understanding of all these factors and their impacts in the design of vaccine studies and decisions on vaccination schedules offers ways to improve vaccine immunogenicity and efficacy.
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Duration of Breastfeeding and Subsequent Adolescent Obesity: Effects of Maternal Behavior and Socioeconomic Status. J Adolesc Health 2018; 62:471-479. [PMID: 29426579 DOI: 10.1016/j.jadohealth.2017.10.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Revised: 08/26/2017] [Accepted: 10/30/2017] [Indexed: 02/01/2023]
Abstract
PURPOSE Previous research has shown that longer duration of breastfeeding is associated with less risk of obesity in childhood and adolescence. However, although putative physiological mechanisms have been proposed, less work has focused on psychosocial or environmental factors, including socioeconomic status (SES) and stressful family environments. METHODS The current study examined the role of observed maternal emotional behavior and SES (parental education) in the association between duration of breastfeeding and adolescent body mass index (BMI). One hundred fifteen mothers and adolescents participated in interaction tasks when adolescents were approximately 12 years of age. We measured adolescent BMI at approximately 15 years of age and, at one point over the course of the study, mothers retrospectively reported on duration of breastfeeding. RESULTS Controlling for adolescent gender, age, physical activity, number of perinatal complications, SES, birth weight, and mother's depressive symptoms, longer duration of breastfeeding was associated with lower adolescent BMI (p = .019), and this association was moderated by the mother's observed behavior during interactions with her adolescent, such that greater frequency of dysphoric behavior was associated with a stronger association between breastfeeding and adolescent BMI (p = .002). Longer duration of breastfeeding mediated the association between higher family SES and lower adolescent BMI. CONCLUSIONS This study is the first to show that observed parental behavior during adolescence may be an important moderator of the association between breastfeeding and obesity. The findings provide justification for future intervention research examining family environment factors in improving adolescent health.
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Abstract
This chapter explores the reasoning behind using the vaccination model to examine the influence of psychosocial factors on immunity. It then briefly discusses the mechanics of the vaccination response and the protocols used in psychoneuroimmunology vaccine research, before giving examples from the research literature of the studies examining relationships such as the association between stress and vaccination response. It also explores the ways the vaccination model can be used to answer key questions in psychoneuroimmunology, such as the following: "Does it matter when stressful life events occur relative to when the vaccine is received?" "What are the effects of prior exposure to the antigen?" "Do other psychosocial factors influence vaccine response besides stress?" Finally, it briefly considers the mechanisms underlying psychosocial factors and vaccination response associations and the future research needed to understand these better, and indeed to use current and future knowledge to improve and enhance vaccine responses in key at-risk populations.
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Affiliation(s)
- Anna C Whittaker
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK.
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