Academic journal article Psychologische Beiträge

Autonomic, Neuroendocrine, and Immune Responses to Psychological Stress

Academic journal article Psychologische Beiträge

Autonomic, Neuroendocrine, and Immune Responses to Psychological Stress

Article excerpt

Summary

Although stress may be necessary for survival, it can also alter susceptibility to disease. Stress, particularly if prolonged or repeated, can produce cardiovascular changes that can contribute to a narrowing of blood vessels and to heart attacks or strokes and reduce the strength of immunological activities in the body. Stress may alter cardiovascular function, immune function, and health through various pathway. Stress may obscure symptoms, increase appraisal and patient delays and reduce medical compliance. Stress can activate maladaptive behaviors that reflect attempts to cope with negative emotional responses. Persons experiencing psychological stress may engage in unhealthy practices such as smoking, not eating or sleeping properly, and not exercising, and these behaviors may foster accidents, cardiovascular disease, and suppressed immune function. Nerve fibers connecting the central nervous system and immune tissue provide another path by which stress may influence immunity.

Stress also evokes a variety of adaptational somatic responses, including stimulation of the hypothalamic-pituitary-adrenal axis (HPA) and the sympathetic adrenal medullary (SAM) system. The pituitary and adrenal hormones and other neuropeptides play an important role in the modulation of the immune system. Hormones such as epinephrine, norepinephrine, and cortisol circulate in the blood and can act on visceral as well as cellular immune receptors. These neuroendocrines, therefore, are an important gateway through which psychological stressors affect the cellular immune response.

The association between stress and immune function has received considerable attention in recent years. This review focus on the association between autonomic, neuroendocrine, and immune responses to psychological stress.

Key words: stress, immune response, cardiovascular system.

As we approach the 21st century the world is increasingly burdened by preventable illness, injury, and disability. Heart disease, for instance, accounts for approximately three quarters of a million deaths annually in the U.S., cancer more than another half million; and respiratory and viral infections remain a major cause of morbidity and mortality among older adults (Baum, Cacioppo, Melamed, Gallant, & Travis, 1995; McGlone & Arden, 1987). In 1960, 5% of the Gross National Product (GNP) went to medical services; in 1990 this share had grown to 12% (U.S. Public Health Service, 1990). Injury now costs more than $100 billion annually, cardiovascular disease about $135 billion, and cancer over $70 billion.

Many of these health problems, and the consequent human, societal, and economic costs, have affective bases ranging from anxiety, anger, and depression to unrealistic or druginduced feelings of euphoria and invulnerability. According to the US Public Health Service, of the 10 leading causes of death, at least seven could be reduced substantially if people at risk would change just five behaviors: compliance (e.g., use of antihypertensive medication), diet, smoking, exercise, and alcohol and drug abuse. For instance, approximately 65% of instances of cancer are thought to be caused by smoking, diet, and exposure to sun; workplace carcinogens, chemical interactions among compounds like tobacco and asbestos or alcohol, and viruses such as hepatitis B are thought to account for another 20-30%. Epidemological studies have established a relationship between such social factors as social isolation and health. In a recent review of prospective studies, for instance, House, Landis, and Umberson (1988) found social isolation to be a major risk factor for morbidity and mortality from widely varying causes, even after statistically controlling for known biological risk factors, social status, and baseline measures of health. The strength of social isolation as a risk factor is comparable to health risk factors such as smoking, blood pressure, obesity, and physical activity (House et al. …

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