Stress and Disease Processes

Arthur A. Stone State University of New York at Stony Brook

There is little doubt that the field of psychoneuroimmunology (PNI) has made tremendous strides since the 1980s. Reports of PNI research have been frequent in topnotch journals, funding for PNI research has increased greatly, and there is a new journal devoted exclusively to the topic. Despite these achievements, many reasonable criticisms have been leveled at research conducted in this area. The identified problems include, but are not limited to, absence of the measurement of disease outcomes in studies, the meaning of immune measures and their relationship to disease processes, issues concerning the generalizability of laboratory studies, and the potential confounding of stress-immune system relationships by health-related behaviors, sleep, and so forth. My goal in this chapter is not to examine these potential problems, as that has been done in published reviews of the literature and in articles and chapters (including some in this volume) specifically addressing issues facing PNI researchers. Rather, the aim of this chapter is to describe methods of possibly improving PNI research by employing concepts from the psychological literature that may have thus far been overlooked by the field. I present this information not to criticize the field, but in the spirit of making the most of what psychology can offer PNI.

I suggest that there is much psychology has to offer to the PNI field. Already, PNI has incorporated psychological concepts such as stress, moderators of the stress response (such as social supports or loneliness), and ways of measuring mental health, but these are only a few of the potential contributions that psychology can make to the field. In this chapter I focus on four concepts from psychology that may be revelant for

-55-