STRESS AND DISEASE

A. The Immune System
1. Lymphatic system and lymphocytes (e.g., T-cells)
2. Non-specific immune system responses
  a. Phagocytosis
  b. Inflammation
3. Specific immune system response
  a. Cell-mediated immunity (inner defenses-cellular)
  b. Antigens and antibodies (outer defenses-bloodstream)
  c. Acquired immunity (e.g., measles)
  d. Induced immunity (e.g., vaccinations)
4. Immune disorders
  a. Immune deficiency (e.g., chemotherapy, AIDS)
  b. Allergies and asthma
  c. Autoimmune diseases (e.g., lupus, rheumatoid arthritis, possibly multiple sclerosis)
  d. Cancer (negative vs. positive feedback loops)

B. Psychoneuroimmunology
1. Connecting the immune system to psychology
  a. Traditional view: the immune system as separate
  b. Modern view: interaction of systems and behavior
    (1) Immunosuppression as a CR
    (2) Stress, immunocompetence and disease
2. Immunosuppression
  a. Physiology of immune system interaction (Rice, Figure 5-3)
  b. Reciprocal interaction
    (1) The stress-nervous system-immune system link
    (2) The immune system-nervous system-behavior link
  c. Therapeutic significance: boosting immunocompetence
    (1) Pennebaker et al.’s study of college students
    (2) Applications to HIV-positive individuals
    (3) Classical conditioning to enhance effects of medicinal drugs

C. Stress and Disease
1. Mechanisms
  a. Direct physiological pathways: interaction of HPA and SAM with immune system
  b. Indirect behavioral pathways: stress to behavior change to increased health risks
2. Specific conditions
  a. Headaches
  b. Infectious disease: studies of the ‘common cold’
  c. Cardiovascular disease (MI, hypertension, atherosclerosis)
    (1) Direct links
    (2) Indirect links (reactivity, risky behaviors)
  d. Diabetes mellitus
  e. Asthma
  f. Rheumatoid arthritis
  g. Ulcers

D. Stress and Maladjustment
1. The visceral brain
  a. Limbic system
  b. Hypothalamus
  c. Autonomic nervous system
  d. Neurohormones
2. Stress and negative mood
  a. Negative affectivity
  b. Depression
    (1) Direct effects of stressful life events
    (2) Mediated effects: Appraisal, vulnerability and coping
    (3) Mediated effects: Attribution theory (learned helplessness, pessimism)
3. Stress and anxiety
  a. Generalized anxiety and phobias
  b. PTSD and ASD
  c. Hyperventilation and panic attacks
4. Other psychological problems
  a. Suicide
  b. Substance use disorders
  c. Somatoform disorders
  d. Dissociative disorders

E. Individual Differences
1. Diathesis-stress
  a. Genetic and biochemical predispositions
  b. Acquired vulnerability (e.g., early trauma)
  c. Personality-based vulnerability
  d. Organ vulnerability and the ‘weak link’ theory
2. Hardiness
  a. Distinguishing risk factors and protective factors
  b. Kobasa: commitment, control and challenge
  c. Tests of the hardy personality model
3. Physiological toughness

Copyright ©1998 Beverly J. Volicer and Steven F. Tello, UMass Lowell.  You may freely edit these pages  for use in a non-profit, educational setting.  Please include this copyright notice on all pages.