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Biomedical subjects

R C MacCallum

Publications and source records attributed to R C MacCallum.

16 recordsLinked to original sources

Long-term caregiving: what happens when it ends?

Data from a longitudinal study were used to examine what happens to caregivers in the years after their cognitively impaired spouse dies. Comparisons of 42 current caregivers, 49 former caregivers, and 52 noncaregivers over a 4-year period showed that former caregivers did not improve on several measures of psychological well-being. Although former caregivers experienced decreases in stress and negative affect, their scores on depression, loneliness, and positive affect did not rebound to levels comparable to noncaregivers and, in fact, remained similar to those of current caregivers up to 3 years after caregiving had ceased. The most consistent predictors of postcaregiving outcomes were social support and intrusive-avoidant thinking about caregiving. The data suggest that some consequences of long-term caregiving may be long-term as well. The needs of former spousal caregivers warrant greater attention both in research and in practice.

Aged↗

Evidence for a shift in the Th-1 to Th-2 cytokine response associated with chronic stress and aging.

BACKGROUND: A number of studies have shown that the chronic stress of caring for persons with dementia can have significant immunological consequences as demonstrated by the down-regulation/dysregulation of the cellular immune response. METHODS: Utilizing flow cytometry to measure the percentages and absolute numbers of CD-4(+) and CD-8(+) T lymphocytes producing the cytokines indicative of Th-1, Tc1 and Th-2, and Tc2 cells, we compared spousal caregivers and control subjects. The expression of interleukin-2 (IL-2), interferon gamma (IFN-gamma), and interleukin-10 (IL-10) in the cytoplasm of CD-4(+) and CD-8(+) lymphocytes was assessed. RESULTS: Neither stress nor age was significantly related to the percentage or number of IFNgamma(+)/CD-8(+), IL-2(+)/CD-8(+) cells, or IFNgamma(+), IL-2(+), CD-4(+) cells. However, the percentage of IL-10(+) cells was higher in lymphocytes obtained from caregivers than control subjects. In addition, the significant interaction between stress and aging for IL-10(+)/CD-4(+) and IL-10(+)/CD-8(+) cells demonstrated that the difference between caregivers and control subjects was age dependent; the difference between caregivers and control subjects was substantially larger in younger individuals than in older individuals. CONCLUSIONS: The data are consistent with previous reports on acute stress and suggest that there may also be a shift from a Th-1 to a Th-2 response associated with a chronic stressor such as caregiving. This shift could have implications for an individual's responses to pathogens.

Aged↗

Androstenediol-induced restoration of responsiveness to influenza vaccination in mice.

Androstenediol (AED), a metabolite of dehydroepiandrosterone (DHEA) regulates innate and adaptive immune responses. To examine whether AED could effectively reverse the age-associated decline of antiviral immunity, 3-, 10-, and 22-month-old mice were treated with AED-sulfate (AED-S) for 45 days beginning 10 days prior to vaccination. Subsequently, mice were primed and boosted with suboptimal doses of a commercially-available trivalent influenza vaccine. Treatment of 10-month-old animals with AED-S during vaccination increased the titer of circulating antiviral immunoglobulin G to levels comparable with those in 3-month-old mice. Furthermore, AED-S treatment protected 10-month-old animals from intranasal challenge with a lethal dose of influenza virus 21 days after secondary vaccination. Although AED-S treatment of 22-month-old mice did not enhance vaccine responses and failed to protect against lethal challenge, the data from the 10-month-old animals suggest that treatment with AED-S will prevent the early manifestations of immunosenescence.

Age Factors↗

Applications of structural equation modeling in psychological research.

This chapter presents a review of applications of structural equation modeling (SEM) published in psychological research journals in recent years. We focus first on the variety of research designs and substantive issues to which SEM can be applied productively. We then discuss a number of methodological problems and issues of concern that characterize some of this literature. Although it is clear that SEM is a powerful tool that is being used to great benefit in psychological research, it is also clear that the applied SEM literature is characterized by some chronic problems and that this literature can be considerably improved by greater attention to these issues.

Humans↗

Stress-related changes in proinflammatory cytokine production in wounds.

BACKGROUND: Several recent studies have shown that stress markedly delays wound healing. This study assessed the relationship between psychological stress and the secretion of proinflammatory cytokines at an actual wound site, providing in vivo data on the development of local immune responses that are central in the early stages of wound repair. METHODS: To study the dynamics of inflammation, skin blisters were induced on the forearm of 36 women (mean age, 57 years) by suction. After the blister roofs were removed, a plastic template was taped to the arm, and wells were filled with 70% autologous serum in buffer. Specimens were aspirated from blister chamber wells 5 and 24 hours after wounding. RESULTS: Women with higher perceived stress scores demonstrated significantly lower levels of 2 key cytokines--interleukin 1alpha and interleukin 8--at wound sites. In addition, subjects who had low levels of both cytokines after 24 hours reported more stress and negative affect, and they had higher levels of salivary cortisol than those who had high cytokine levels. CONCLUSION: Consistent with the evidence that stress delays wound healing, these data suggest a possible mechanism: psychological stress has measurable effects on proinflammatory cytokine production in the local wound environment.

Blood Pressure↗

Psychological influences on surgical recovery. Perspectives from psychoneuroimmunology.

Greater fear or distress prior to surgery is associated with a slower and more complicated postoperative recovery. Although anxiety presumably interferes with recuperation through both behavioral and physiological mechanisms, the pathways have been unclear. Recent work in psychoneuroimmunology (PNI) has demonstrated that stress delays wound healing. In addition, a second line of research has illustrated the adverse effects of pain on endocrine and immune function. A biobehavioral model is described that is based on these and other data; it suggests a number of routes through which psychological and behavioral responses can influence surgery and post-surgical outcomes. Clinical and research implications are highlighted.

General Surgery↗

Stress exacerbates age-related decrements in the immune response to an experimental influenza viral infection.

To test the hypothesis that stress exacerbates immune decrements associated with aging, the impact of restraint stress on immunosenescence was assessed using an experimental model of influenza A/Puerto Rico/8/34 viral infection. Beginning one day prior to infection, male C57BL/6 mice, 3 and 22 months of age, were subjected nightly to 12 hours of restraint stress. In both age groups, restraint induced a comparable increase in serum corticosterone levels. However, in contrast to the 3-month-old controls, serum corticosterone levels in 22-month-old mice returned to baseline slower after removal of the stressor. The characteristic influenza-driven increase in cellularity of the lung and draining lymph node was decreased by age and further suppressed by stress. Natural killer cell activity and virus-specific T helper cell function were also blunted by age and almost completely abrogated by stress. Furthermore, due to the weak immune response to viral infection, aged animals subjected to stress had a lower survival rate than age-matched controls.

Aging↗

Distinguishing optimism from pessimism in older adults: is it more important to be optimistic or not to be pessimistic?

Confirmatory factor analysis revealed that the Life Orientation Test (LOT) consisted of separate Optimism and Pessimism factors among middle-aged and older adults. Although the two factors were significantly negatively correlated among individuals facing a profound life challenge (i.e., caregiving), they were only weakly correlated among noncaregivers. Caregivers also expressed less optimism than noncaregivers and showed a trend toward greater pessimism, suggesting that life stress may affect these dispositions. Pessimism, not optimism, uniquely predicted subsequent psychological and physical health; however, optimism and pessimism were equally predictive for stressed and nonstressed samples. By exploring optimism and pessimism separately, researchers may better determine whether the beneficial effects of optimism result from thinking optimistically, avoiding pessimistic thinking, or a combination of the two.

Adaptation, Psychological↗

Marital conflict and endocrine function: are men really more physiologically affected than women?

This study assessed marital conflict behavior and endocrine function in 90 newlywed couples. Blood samples acquired hourly from 8:00 a.m. through 10:00 p.m. were combined to provide composite daytime values for 3 stress hormones -- epinephrine (EPI), norepinephrine (NEPI), and cortisol -- and 3 related hormones (ACTH, growth hormone, and prolactin). These pooled data provided a window on endocrine function in couples for whom the day included a conflict. For wives, higher probabilities of husband's withdrawal in response to wife's negative behavior were associated with higher NEPI and cortisol levels. In addition, higher frequencies of positive behaviors were associated with lower EPI and higher prolactin levels among wives. Husbands' endocrine data were not associated with behavioral data. These findings are discussed in the context of gender models of marital conflict.

Adrenocorticotropic Hormone↗

Recurrent syndromal depression in caregivers.

The authors investigated recurrent syndromal depression in 103 caregivers using a structured clinical interview. Participants who cared for a family member with a progressive dementia were assessed annually for 3 years and divided into 3 groups: never depressed (47%), episodically depressed (33%), and chronically depressed (20%). Compared with the other 2 groups, the chronically depressed caregivers reported greater levels of stress, upsetting social support, depressive symptomatology, along with higher frequencies of negative life events and more negative reactions to disruptive patient behavior. Precaregiving depression predicted depression during caregiving but did not sufficiently explain recurrent depression in caregivers. Lower levels of positive social support and higher number of life events were related to chronically elevated depressive symptoms and stress.

Caregivers↗

Hormonal modulation of Epstein-Barr virus replication.

Among the various factors thought to be associated with the reactivation of latent herpesviruses is psychological stress. An increase in levels of 'stress hormones' such as glucocorticoids occurs in individuals who are stressed and previous studies have shown that glucocorticoid hormones can reactivate latent Epstein-Barr virus (EBV) in vitro. In this study, we confirm that the EBV genome in latently infected lymphoblastoid cells can be reactivated with two glucocorticoid hormones, hydrocortisone and dexamethasone. In addition to hydrocortisone and dexamethasone, we also found that other hormones of the hypothalamic-pituitary-axis (corticotropin-releasing factor and adrenocorticotropin hormone but not epinephrine and norepinephrine) as well as somatostatin can enhance the lytic replication of the HR-1 strain of EBV in superinfected cells. These results suggest that multiple endocrine interactions may be involved in stress-induced reactivation/replication of latent EBV.

Adrenocorticotropic Hormone↗

The problem of equivalent models in applications of covariance structure analysis.

For any given covariance structure model, there will often be alternative models that are indistinguishable from the original model in terms of goodness of fit to data. The existence of such equivalent models is almost universally ignored in empirical studies. A study of 53 published applications showed that equivalent models exist routinely, often in large numbers. Detailed study of three applications showed that equivalent models may often offer substantively meaningful alternative explanations of data. The importance of the equivalent model phenomenon and recommendations for managing and confronting the problem in practice are discussed.

Analysis of Variance↗

The use of causal indicators in covariance structure models: some practical issues.

In conventional representations of covariance structure models, indicators are defined as linear functions of latent variables, plus error. In an alternative representation, constructs can be defined as linear functions of their indicators, called causal indicators, plus an error term. Such constructs are not latent variables but composite variables, and they have no indicators in the conventional sense. The presence of composite variables in a model can, in some situations, result in problems with identification of model parameters. Also, the use of causal indicators can produce models that imply zero correlation among many measured variables, a problem resolved only by the inclusion of a potentially large number of additional parameters. These phenomena are demonstrated with an example, and general principles underlying them are discussed. Remedies are described so as to allow for the evaluation of models that contain causal indicators.

Analysis of Variance↗

Model modifications in covariance structure analysis: the problem of capitalization on chance.

In applications of covariance structure modeling in which an initial model does not fit sample data well, it has become common practice to modify that model to improve its fit. Because this process is data driven, it is inherently susceptible to capitalization on chance characteristics of the data, thus raising the question of whether model modifications generalize to other samples or to the population. This issue is discussed in detail and is explored empirically through sampling studies using 2 large sets of data. Results demonstrate that over repeated samples, model modifications may be very inconsistent and cross-validation results may behave erratically. These findings lead to skepticism about generalizability of models resulting from data-driven modifications of an initial model. The use of alternative a priori models is recommended as a preferred strategy.

Adolescent↗

Marital conflict in older adults: endocrinological and immunological correlates.

OBJECTIVE: To assess endocrinological and immunological correlates of marital conflict and marital satisfaction, 31 older couples (mean age 67 years) who had been married an average of 42 years were studied. METHOD: Couples were admitted to the Clinical Research Center and a catheter was placed in each subject's arm. Blood was drawn on entry for immunological assays; for hormone analyses, five blood samples were drawn during a 30-minute conflict discussion and a 15-minute recovery session. The conflict session was recorded on videotapes that were later coded for problem-solving behaviors using the Marital Interaction Coding System (MICS). RESULTS: Among wives, escalation of negative behavior during conflict and marital satisfaction showed strong relationships to endocrine changes, accounting for 16% to 21% of the variance in the rates of change of cortisol, adrenocorticotropic hormone (ACTH), and norepinephrine (but not epinephrine). In contrast, husbands' endocrine data did not show significant relationships with negative behavior or marital quality. Both men and women who showed relatively poorer immunological responses across three functional assays (the blastogenic response to two T-cell mitogens and antibody titers to latent Epstein-Barr virus) displayed more negative behavior during conflict; they also characterized their usual marital disagreements as more negative than individuals who showed better immune responses across assays. CONCLUSION: Abrasive marital interactions may have physiological consequences even among older adults in long-term marriages.

Adrenocorticotropic Hormone↗

Chronic stress modulates the immune response to a pneumococcal pneumonia vaccine.

OBJECTIVE: Influenza and pneumonia account for significant morbidity and mortality, particularly in older individuals. Previous studies have shown that spousal caregivers of patients with dementia have poorer antibody and virus specific T cell responses to an influenza virus vaccine relative to noncaregiving control subjects. This study tested the hypothesis that stress can also significantly inhibit the IgG antibody response to a pneumococcal bacterial vaccine. METHOD: We measured antibody titers of current caregivers, former caregivers, and control subjects after vaccination with a pneumococcal bacterial vaccine. RESULTS: Caregivers showed deficits relative to controls and former caregivers in their antibody responses to vaccination. Although the groups did not differ before vaccination or in the rise in antibody 2 weeks or 1 month after vaccination, current caregivers had lower antibody titers 3 and 6 months after vaccination than either former caregivers or controls. CONCLUSIONS: These data, the first evidence that chronic stress can inhibit the stability of the IgG antibody response to a bacterial vaccine for pneumonia, provide additional evidence of health risks associated with dementia caregiving.

Alzheimer Disease↗