Optimism, distress, and immunologic status in HIV-infected gay men following hurricane andrew

Cruess, Stacy; Antoni, Michael H.; Kilbourn, Kristin; Ironson, Gail; Klimas, Nancy G.; Fletcher, Mary A; Baum, Andy; Schneiderman, Neil

doi:10.1207/s15327558ijbm0702_5

Cited by 22 publications

(21 citation statements)

References 62 publications

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“…As a consequence, measures of subjective experience were not significantly associated with immune parameters in healthy research participants, with the exception of a modest (r = −.10) relationship between intrusive thoughts and natural killer cell cytotoxicity. Psychological variables such as personality and emotion can give rise to individual differences in psychological and concomitant immunological Barger et al, 2000;Bosch et al, 2001;Cruess et al, 2000;Segerstrom, 2001;Stowell, Kiecolt-Glaser, & Glaser, 2001). …”

Section: Individual Differences and Immune Change Under Stressmentioning

confidence: 99%

Psychological Stress and the Human Immune System: A Meta-Analytic Study of 30 Years of Inquiry.

Segerstrom

Miller

2004

Psychological Bulletin

2,517

1,845

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The present report meta-analyzes more than 300 empirical articles describing a relationship between psychological stress and parameters of the immune system in human participants. Acute stressors (lasting minutes) were associated with potentially adaptive upregulation of some parameters of natural immunity and downregulation of some functions of specific immunity. Brief naturalistic stressors (such as exams) tended to suppress cellular immunity while preserving humoral immunity. Chronic stressors were associated with suppression of both cellular and humoral measures. Effects of event sequences varied according to the kind of event (trauma vs. loss). Subjective reports of stress generally did not associate with immune change. In some cases, physical vulnerability as a function of age or disease also increased vulnerability to immune change during stressors.Since the dawn of time, organisms have been subject to evolutionary pressure from the environment. The ability to respond to environmental threats or stressors such as predation or natural disaster enhanced survival and therefore reproductive capacity, and physiological responses that supported such responses could be selected for. In mammals, these responses include changes that increase the delivery of oxygen and glucose to the heart and the large skeletal muscles. The result is physiological support for adaptive behaviors such as "fight or flight." Immune responses to stressful situations may be part of these adaptive responses because, in addition to the risk inherent in the situation (e.g., a predator), fighting and fleeing carries the risk of injury and subsequent entry of infectious agents into the bloodstream or skin. Any wound in the skin is likely to contain pathogens that could multiply and cause infection (Williams & Leaper, 1998). Stress-induced changes in the immune system that could accelerate wound repair and help prevent infections from taking hold would therefore be adaptive and selected along with other physiological changes that increased evolutionary fitness.Modern humans rarely encounter many of the stimuli that commonly evoked fight-or-flight responses for their ancestors, such as predation or inclement weather without protection. However, human physiological response continues to reflect the demands of earlier environments. Threats that do not require a physical response (e.g., academic exams) may therefore have physical consequences, including changes in the immune system. Indeed, over the past 30 years, more than 300 studies have been done on stress and immunity in humans, and together they have shown that psychological challenges are capable of modifying various features of the immune response. In this article we attempt to consolidate empirical knowledge about psychological stress and the human immune system through meta-analysis. Both the construct of stress and the human immune system are complex, and both could consume bookCorrespondence concerning this article should be addressed to Suzanne C. Segerstrom, Department of Ps...

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Section: Individual Differences and Immune Change Under Stressmentioning

confidence: 99%

Psychological Stress and the Human Immune System: A Meta-Analytic Study of 30 Years of Inquiry.

Segerstrom

Miller

2004

Psychological Bulletin

2,517

1,845

View full text Add to dashboard Cite

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“…In contrast, optimistic outlook, including anticipating future activities, was related to lower mortality during follow-up in a group of hemophiliacs with HIV (Blomkvist et al, 1994). Dispositional optimism was related to less distress and better cellular immunologic control over EpsteinBarr virus and human herpes virus-6 in the months following Hurricane Andrew in people with HIV (Cruess et al, 2000). An inversely related construct, HIV-specific negative expectancy has been related to earlier symptom onset in bereaved men with HIV (Reed, Kemeny, Taylor, & Visscher, 1999).…”

Section: Introductionmentioning

confidence: 99%

Dispositional optimism and the mechanisms by which it predicts slower disease progression in HIV: proactive behavior, avoidant coping, and depression

Ironson

Balbin

Stuetzle

et al. 2005

Int. J. Behav. Med.

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121

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The issue of whether optimism may prospectively protect against disease progression is one that has generated much interest, with mixed results in the literature. The purpose of this study was to determine whether dispositional optimism predicts slower disease progression in HIV. Two indicators of disease progression, CD4 counts and viral load, were assessed over 2 years in a diverse group (men, women, White, African American, Hispanic) of 177 people with HIV in the midrange of disease at entry to the study. Optimism predicted slower disease progression (less decrease in CD4 and less increase in viral load) controlling for baseline CD4 and viral load, antiretroviral treatment, gender, race, education, and drug use. Those low on optimism (25th percentile) lost CD4 cells at a rate 1.55 times faster than those high on optimism (75th percentile). Optimists had higher proactive behavior, less avoidant coping, and less depression: These variables mediated the linear optimism-disease progression relationship. Thus, optimists may reap health benefits partly through behavioral (proactive behavior), cognitive (avoidant coping), and affective (depression) pathways. Implications, limitations, and interpretations are discussed. Taylor et al., 2000). One of the most intriguing of these is optimism. There is the popular belief that maintaining hope or optimism may influence survival. Many doctors encourage their patients to develop a positive attitude believing it may be helpful to patients (Schofield et al., 2004). However, there have only been a few studies scientifically examining this.One study gaining widespread attention (Schofield et al., 2004) recently found that dispositional optimism did not predict progression-free survival in patients with lung cancer and concluded that "encouraging patients to 'be positive' may only add to the burden of having cancer while providing little benefit" (p. 1276). Schulz, Bookwala, Knapp, Scheier, and Williamson (1996) found that, although dispositional optimism did not predict survival in patients with recurrent or metastasized cancer receiving palliative radiation treatment, pessimistic life orientation was a risk factor for mortality but only in younger (age < 59) patients. In contrast, dispositional optimism predicted survival over 1 year in head and neck cancer patients (Allison, Guichard, Fung, & Gilain, 2003). Several studies not restricted to cancer patients found that dispositional optimism is related to better health outcomes including better recovery and less rehospitalization from coronary bypass surgery Scheier et al., 1999) and lower all cause and cardiovascular mortality (Giltay, Geleijnse, Zitman, Hoeskstra, & Evert, 2004). In addition, one study found that a "cognitive adaptation index," which included dispositional optimism, situational-specific optimism, self-esteem, and mastery, predicted fewer new coronary events after Percutaneous Transluminal Coronary Angioplasty (PTCA) (Helgeson & Fritz, 1999).Although most of the studies noted previously focused on dis...

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“…To date, only a handful of studies have examined the potential link between CD4 count and self-reported physical health and findings are equivocal. Cruess et al (2000) reported a link between lower levels of T-suppressor/cytotoxic cells and higher severity of physical health symptoms. Lee et al (2001) found evidence for a link between CD4 count and certain physical health symptoms (e.g., increased daytime sleepiness) among a sample characterized by low income and high rates of unemployment that included a relatively large percentage of African American women (58%).…”

Section: Discussionmentioning

confidence: 99%

“…Higher levels of optimism have been linked to improved functioning across a variety of variables, from coping with stress (Carver et al, 1993) to lower morbidity and mortality (see Peterson, 2000, for a review). Among HIV infected gay men/men who have sex with men, optimism has also been linked to improved functioning and resiliency (e.g., Cruess et al, 2000); however, the role of optimism among infected women, particularly African American mothers, has received less attention (e.g., Jones, O'Connell, Gound, Heller, & Forehand, 2004).…”

mentioning

confidence: 99%

CD4 Count and Physical Symptoms Among Urban African American Mothers with HIV: An Examination of the Role of Optimism and Depressive Symptoms

O’Connell-Edwards

Jones

Forehand

et al. 2008

J Clin Psychol Med Settings

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The current study examined the link between immune functioning (CD4 count) and physical symptoms, as well as the moderating role of optimism and depressive symptoms, in a sample of 99 low income, inner city African American women with HIV. Although there was no main effect of CD4 count on physical symptoms, depressive symptoms moderated the association between CD4 count and physical symptoms. More compromised immune functioning (lower CD4 count) was associated with more physical symptoms under conditions of higher levels of depressive symptoms, but not lower levels of depressive symptoms. This finding was observed using both a self-report measure and a clinician-rating of women's depressive symptoms. There were no main or interactive effects for optimism. Clinical implications and future research directions are presented.

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Optimism, distress, and immunologic status in HIV-infected gay men following hurricane andrew

Cited by 22 publications

References 62 publications

Psychological Stress and the Human Immune System: A Meta-Analytic Study of 30 Years of Inquiry.

Psychological Stress and the Human Immune System: A Meta-Analytic Study of 30 Years of Inquiry.

Dispositional optimism and the mechanisms by which it predicts slower disease progression in HIV: proactive behavior, avoidant coping, and depression

CD4 Count and Physical Symptoms Among Urban African American Mothers with HIV: An Examination of the Role of Optimism and Depressive Symptoms

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