Acute and Chronic Stress and the Immune System
Laura Schneiderman Andrew Baum Uniformed Services University of the Health Sciences
The relationship between stress and health has long been one block in the foundation of behavioral medicine research and intervention. The contribution of stress to a wide variety of physical illnesses and to mental health are widely believed to be important, and research has addressed stress as a factor in heart disease, hypertension, stroke, cancer, and many other illnesses. Hormonal changes, hemodynamic responses, and other bodily reactions during stress have been considered to be risk factors for illness. Of some interest is the relationship between stress and immunity and whether the changes that have been observed are meaningful. Yet, we still know relatively little about how stress affects immune function, why such effects occur, and whether these changes have any real clinical significance.
One problem has been the relative dearth of research on human subjects, at least until recently. Most work through the 1970s was concerned with animal populations and, although extremely important in revealing links between behavioral factors and immune response ( Ader & Cohen, 1981), it provided an imperfect model of stress and immune function in humans. Related to this is the fact that most work with humans considered subjects who had been victimized or exposed to stressful conditions, be they bereaved, caregivers for seriously ill people, medical students facing examinations, or divorced and/or separated spouses. Relatively little research has addressed acute stress in humans and has examined the effects of experimentally applied stress on normal volunteers. The generalizability of the results of studies of intermediate or long-term stress on immunity to short-term events and the meaning of good or poor correspondence across stress durations remains undetermined. This chapter selectively reviews