overview of pni
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An Overview of An Overview of
Psychoneuroimmunology (PNI)Psychoneuroimmunology (PNI)
Psychosocial factors that weakenPsychosocial factors that weaken& strengthen the immune system& strengthen the immune system
Frank McDonalFrank McDonal
!onsultation & "iaison Psychologist!onsultation & "iaison Psychologist
##$##$
%etem'er %etem'er
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OverviewOverview
*+*+ ,hat is sychoneuroimmunology-,hat is sychoneuroimmunology-
++ ,hat has it taught us-,hat has it taught us-
.+.+ ,hich sychosocial factors weaken or,hich sychosocial factors weaken orstrengthen immunity- ,ho are more &strengthen immunity- ,ho are more &less vulnera'le-less vulnera'le-
/+/+ !an we 'oost immune system to healthier!an we 'oost immune system to healthierlevels 'y alying counteractinglevels 'y alying counteractingsychosocial resources-sychosocial resources-
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+ ,hat has PNI taught us-+ ,hat has PNI taught us-
*+*+ !ommonlace ersonal e4eriences of 5!ommonlace ersonal e4eriences of 5
immune6relate illness followingimmune6relate illness following
stress7emotional trauma0 now e4lica'le atstress7emotional trauma0 now e4lica'le at
'iomolecular level+ (neural6immune links3'iomolecular level+ (neural6immune links3
Felten et al+0 *189: enocrine;immuneFelten et al+0 *189: enocrine;immune
links3
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+ ,hat has PNI taught us-+ ,hat has PNI taught us-
$els to e4lain clinical e4eriences like3$els to e4lain clinical e4eriences like3
I see a lot of people with so-called problems relating toI see a lot of people with so-called problems relating to
dysfunctional immune systems. Things like recurrent coldsores,dysfunctional immune systems. Things like recurrent coldsores,recurrent infections, even hayfever, other allergies. Theserecurrent infections, even hayfever, other allergies. Thesenearly always occur on a background of stress.nearly always occur on a background of stress.
Dr. David Isaacs, Sydney suburban GP, 2000
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+ ,hat has PNI taught us-+ ,hat has PNI taught us-
++ Neuroenocrinological system research oints toNeuroenocrinological system research oints to
chronic stress as imortant contri'utor in rangechronic stress as imortant contri'utor in range
of immune6relate conitions+of immune6relate conitions+
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Variable impact of stress on immuneVariable impact of stress on immune
systemsystem(Adapted from obert Sapols!y in "erson, 200#$
+ ,hat has PNI taught us-+ ,hat has PNI taught us-
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+ ,hat has PNI taught us-+ ,hat has PNI taught us-
.+.+ !ertainly no e4erimental evience0 as!ertainly no e4erimental evience0 as
yet0 that min can cure immune systemyet0 that min can cure immune system
iseases (@elman & Angell0 )iseases (@elman & Angell0 )
/+/+ =vience suggests sychosocial varia'les=vience suggests sychosocial varia'les
may alter susceti'ility0 rogress &may alter susceti'ility0 rogress &
recurrence of these (#aylor0 *111) as wellrecurrence of these (#aylor0 *111) as well
as how well ts coe7O"as how well ts coe7O"
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.+ Psychosocial factors moulating immunity.+ Psychosocial factors moulating immunity
Pro'lemsPro'lems that can 'esetthat can 'eset immune systemimmune system Age Age
?enetic isorers?enetic isorers Infectious iseasesInfectious iseases NutritionNutrition !hemotheray!hemotheray
IrraiationIrraiation Allergies Allergies %%tresstress B focus of PNIB focus of PNI
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.+ Psychosocial factors moulating immunity.+ Psychosocial factors moulating immunity
a+ ,eakening influencesa+ ,eakening influences !hanges in immune system foun to accomany!hanges in immune system foun to accomany
stressful or conflictual social relationshis+ #hesestressful or conflictual social relationshis+ #hese
inclue3inclue36 "oss of an intimate relationshi from eath or"oss of an intimate relationshi from eath orivorce (
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.+ Psychosocial factors moulating immunity.+ Psychosocial factors moulating immunity
6 "oneliness+ "onely eole have oorer health+"oneliness+ "onely eole have oorer health+ Amongst e4am stuents they ha more e4treme Amongst e4am stuents they ha more e4treme
immuno6comromise (>iecolt6?laser et al+0 *18/)immuno6comromise (>iecolt6?laser et al+0 *18/)
6 Poorer marital Cuality for marrie coules 6Poorer marital Cuality for marrie coules 6associate with latent virus anti'oy resonseassociate with latent virus anti'oy resonse(>enney et al+0 *188)(>enney et al+0 *188)
6 !aring for a terminally6ill atient (=sterling et al+0!aring for a terminally6ill atient (=sterling et al+0
*112)*112)
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.+ Psychosocial factors moulating immunity.+ Psychosocial factors moulating immunity
Acaemic stress can lea to immunological Acaemic stress can lea to immunological
changes an illness+ ?laser et al+ (*18)changes an illness+ ?laser et al+ (*18)
assesse / assesse / nn year meical stuents 2year meical stuents 2
wks 'efore an uring final e4ams+wks 'efore an uring final e4ams+
"ymhocytes0 N> cells an N> cytoto4ic"ymhocytes0 N> cells an N> cytoto4ic
activity an interferon levels were lower activity an interferon levels were lower
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.+ Psychosocial factors moulating immunity.+ Psychosocial factors moulating immunity
%tarting kinergarten can raise cortisol levels an%tarting kinergarten can raise cortisol levels an
negatively alter immune measures (
num'ers ($er'ert & !ohen0 *11.)num'ers ($er'ert & !ohen0 *11.)
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.+ Psychosocial factors moulating immunity.+ Psychosocial factors moulating immunity
Perceive severe aily hasslesJ reictPerceive severe aily hasslesJ reict
lower N> cell activity ("evy et al+0 *181)lower N> cell activity ("evy et al+0 *181)
Across stuies it aears that more severe Across stuies it aears that more severe& long6term were stressors0 more& long6term were stressors0 more
vulnera'le iniviuals were to health6relatevulnera'le iniviuals were to health6relate
ro'lemsro'lems
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.+ Psychosocial factors moulating immunity.+ Psychosocial factors moulating immunity
'+ %trengthening influences'+ %trengthening influences
Positive social relationshis aear to actPositive social relationshis aear to act
as a 'uffer against stress inuce immuneas a 'uffer against stress inuce immunechanges+ (#aylor0 *111)changes+ (#aylor0 *111)
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.+ Psychosocial factors moulating immunity.+ Psychosocial factors moulating immunity
%ense of control social connectenessJ 'rings0%ense of control social connectenessJ 'rings0
shoul iniviual 'e face with ifficult lifeshoul iniviual 'e face with ifficult life
challenge0 aears more influential on generalchallenge0 aears more influential on general
health than any other single hysiological0 lifestylehealth than any other single hysiological0 lifestyleor sychological factor e+g+ serum cholesterol0or sychological factor e+g+ serum cholesterol0
'loo ressure0 alcohol intake0 smoking0 e4ercise0'loo ressure0 alcohol intake0 smoking0 e4ercise0
o'esity0o'esity0 %=%7income7goo Ko'%=%7income7goo Ko' & active ositive& active ositive
coing methos ($ouse et al *188: %yme0 *118)coing methos ($ouse et al *188: %yme0 *118)
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.+ Psychosocial factors moulating immunity.+ Psychosocial factors moulating immunity
%ocial connectenessJ measure3%ocial connectenessJ measure3
; LL!an you count on anyone to rovie you!an you count on anyone to rovie youwith emotional suort- (i+e+ talk overwith emotional suort- (i+e+ talk over
ro'lems or hel make ifficult ecisions)ro'lems or hel make ifficult ecisions)
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.+ Psychosocial factors moulating immunity.+ Psychosocial factors moulating immunity
Other factors that aear to moerate relationOther factors that aear to moerate relation
'etween stress & immune functioning3'etween stress & immune functioning3
6 Otimism a'out oneJs situation & engaging inOtimism a'out oneJs situation & engaging in
active coing 'uffers against acaemic stress+ Inactive coing 'uffers against acaemic stress+ Instuies of meical & law stuents (%egerstromstuies of meical & law stuents (%egerstrom
cite in #aylor0*111) essimistic0 avoiance coingcite in #aylor0*111) essimistic0 avoiance coing
stuents evience less N> cell cytoto4icity &stuents evience less N> cell cytoto4icity &
fewer # cellsfewer # cells
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.+ Psychosocial factors moulating immunity.+ Psychosocial factors moulating immunity
%elf6isclosure7ventilation (>iecolt6?laser et%elf6isclosure7ventilation (>iecolt6?laser et
al+0 *11)+ me stuents writing 72al+0 *11)+ me stuents writing 72
aily for *7+ $alf e4resse strongaily for *7+ $alf e4resse strong
feelings0 others3 meaningless toics+ At .7*feelings0 others3 meaningless toics+ At .7*
the e4ressive grou ha fewer octorJsthe e4ressive grou ha fewer octorJs
visits & 'etter immune function rofile thanvisits & 'etter immune function rofile than
controlscontrols
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.+ Psychosocial factors moulating immunity.+ Psychosocial factors moulating immunity
In resonse to stress of meical trainingIn resonse to stress of meical training
stuents using self6hynosis as coing skillstuents using self6hynosis as coing skill
show moest effects in N> cell num'ers N>show moest effects in N> cell num'ers N>
cell activity (,hitehouse et al+0 *112)cell activity (,hitehouse et al+0 *112)
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6 Other coing strategies that may relate toOther coing strategies that may relate to
the stress6immune functioning relationshi3the stress6immune functioning relationshi3
6 e4ercise activates 'eta6enorhins which maye4ercise activates 'eta6enorhins which may
stimulate N> cell activity an so 'uffer againststimulate N> cell activity an so 'uffer against
stress6relate immune changesstress6relate immune changes