Associations of Trauma and Posttraumatic Stress Disorder With Inflammation and Endothelial Function: On Timing, Specificity, and Mechanisms

Psychosocial Interventions and Immune System Function

“…In conclusion, recent research has shown that the immune system plays an integral role in many serious disease conditions and that psychosocial factors can modulate immune system function. [3][4][5][6]8,[107][108][109][110][111][112][113] The present meta-analysis extends this work by identifying for the first time the types of psychosocial interventions that have the most robust associations with immune system function, the immune system outcomes that are most consistently associated with these interventions, and the various factors that moderate these associations. Specifically, we found that psychosocial interventions were associated with improvements in immune system function over time-in particular, with decreased proinflammatory cytokines or markers and increased immune cell counts-and that these associations were most consistent for interventions that incorporate CBT or multiple interventions.…”

“…One of the most important recent discoveries in the health sciences involves the realization that the immune system is involved in the pathophysiology of not just a few disorders but several major health problems that cause substantial disease burden and mortality. 1,2 Given growing evidence showing that psychosocial factors play a role in shaping immunity, [3][4][5][6]8,[12][13][14][15][16][17][18][19][20]100,101 we conducted what we believe is the first systematic review and meta-analysis of RCTs examining how 8 different psychosocial interventions affect 7 common immune outcomes that have broad clinical relevance. This comprehensive review of 56 RCTs revealed that psychosocial interventions were significantly associated with enhanced immune system function, as indexed most consistently by intervention-related decreases in levels of proinflammator y c y tokines or markers (eg, interleukin-6, C-reactive protein) and, secondarily, by increases in immune cell counts (eg, CD56, CD4) over time.…”

“…Finally, although these data indicate that psychosocial interventions are associated with enhanced immune system function, they do not elucidate the mechanisms underlying these associations. It has been suggested that reductions in stressrelated neural or psychological processes may help explain such associations, [3][4][5][6]106 but psychosocial interventions can have wideranging effects on human cognition and behavior, and addi-tional research is needed to identify exactly how such interventions influence immune system activity and health.…”

Psychoneuroimmunology of Stress and Mental Health

“…The second largest literature on inflammation and mental health involves PTSD. There are several reasons for this, including the fact that (a) life stress exposure, which is known to increase inflammation, is the main psychosocial precipitant of the disorder; (b) cytokines are known to induce hypervigilance, which is a cardinal symptom of PTSD; (c) and many individuals with PTSD develop somatic health problems that have an inflammatory basis, including chronic pain, heart disease, diabetes, and neurodegeneration (O'Donovan & Neylan, 2017). Overall, studies examining associations between inflammation and PTSD have yielded mixed findings.…”

Chronic stress and endothelial dysfunction: mechanisms, experimental challenges, and the way ahead

“…As such, the exact mechanisms of endothelial dysfunction for each stress type (acute, chronic) and various mental disorders such as PTSD and depression remain relatively unclear. The evidence suggests that systemic inflammation and hypercortisolemia are prominent factors in the development of endothelial dysfunction in PTSD and depression/chronic stress, respectively (144,206). However, the effects of oxidative stress, inflammation, and cortisol are all interconnected, and hence, minor intracellular differences in the stress response likely contribute to different mental disorders and related endothelial dysfunction.…”