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Biomedical subjects

Sheldon Cohen

Publications and source records attributed to Sheldon Cohen.

32 records · Page 2Linked to original sources
PubMed2002

Parental stress as a predictor of wheezing in infancy: a prospective birth-cohort study.

The role of stress in the pathogenesis of childhood wheeze remains controversial. Caretaker stress might influence wheeze through stress-induced behavioral changes in caregivers (e.g., smoking, breast-feeding) or biologic processes impacting infant development (e.g., immune response, susceptibility to lower respiratory infections). The influence of caregiver stress on wheeze in infancy was studied in a genetically predisposed prospective birth-cohort (n = 496). Caregiver-perceived stress and wheeze in the children were ascertained bimonthly from the first 2 to 3 mo of life. Greater levels of caregiver-perceived stress at 2 to 3 mo was associated with increased risk of subsequent repeated wheeze among the children during the first 14 mo of life (RR, 1.6; 95% CI, 1.3 to 1.9). Caregiver-perceived stress remained significant (RR, 1.4; 95% CI, 1.1 to 1.9) when controlling for factors potentially associated with both stress and wheeze (parental asthma, socioeconomic status, birth weight, and race/ethnicity) as well as mediators through which stress might influence wheeze (maternal smoking, breast-feeding, indoor allergen exposures, and lower respiratory infections). Furthermore, caregiver stress prospectively predicted wheeze in the infants, whereas wheeze in the children did not predict subsequent caregiver stress. The effect of caregiver stress on early childhood wheeze was independent of caregiver smoking and breast-feeding behaviors, as well as allergen exposure, birth weight, and lower respiratory infections. These findings suggest a more direct mechanism may be operating between stress and wheeze in early childhood. Stress may contribute significantly to the population burden of preventable childhood respiratory illness.

Adolescent↗
PubMed2002

Stress, immune reactivity and susceptibility to infectious disease.

Psychological stress is known to affect immune function and to predict infectious disease susceptibility. However, not all individuals who are stressed develop disease. In the present article, we report on a series of studies from our laboratory describing interindividual variability of immune responses to psychological stress. In our initial series of experimental investigations, we demonstrated that acute laboratory stress alters both quantitative and functional components of cellular immunity. An examination of response variability revealed that individuals differ substantially in the magnitude of these immune responses. These differences were found to parallel (and be predicted by) interindividual variability in stress-induced sympathetic nervous system activation. Further investigation revealed that individuals vary consistently in the magnitude of their immune responses to stress, making it conceivable that individual differences in immune reactivity provide a vulnerability factor mediating relationships between stress and disease. In support of this possibility, we have recently reported initial evidence that individual differences in the magnitude of stress-induced reduction of immune function may be of clinical significance, being related to an immune response relevant for protection against infection, antibody response to hepatitis B vaccination.

Animals↗
PubMed2002

Chronic psychological stress and the regulation of pro-inflammatory cytokines: a glucocorticoid-resistance model.

This study examined whether chronic stress impairs the immune system's capacity to respond to hormonal signals that terminate inflammation. Fifty healthy adults were studied; half were parents of cancer patients, and half were parents of healthy children. Parents of cancer patients reported more psychological distress than parents of healthy children. They also had flatter diurnal slopes of cortisol secretion, primarily because of reduced output during the morning hours. There was also evidence that chronic stress impaired the immune system's response to anti-inflammatory signals: The capacity of a synthetic glucocorticoid hormone to suppress in vitro production of the pro-inflammatory cytokine interleukin-6 was diminished among parents of cancer patients. Findings suggest a novel pathway by which chronic stress might alter the course of inflammatory disease.

Adult↗
PubMed2002

Breathing easy: a prospective study of optimism and pulmonary function in the normative aging study.

Although there is good evidence that emotions are associated with chronic airways obstruction, evidence for the influence of psychological factors on the level and decline of pulmonary function is sparse. Optimism has been linked to enhanced well-being, whereas pessimism has been identified as a risk factor for poor physical health. This investigation examines prospectively the effects of optimism versus pessimism on pulmonary function. Data are from the Veterans Administration Normative Aging Study, an ongoing cohort of older men. In 1986, 670 men completed the revised Minnesota Multiphasic Personality Inventory from which we derived the bipolar Revised Optimism-Pessimism Scale. During an average of 8 years of follow-up, an average of 3 pulmonary function exams were obtained. Men with a more optimistic explanatory style had significantly higher levels of forced expiratory volume in 1 sec (FEV1) and forced vital capacity (both p < .01). Interactions between time and optimism suggested that rate of decline in FEV1 over time was slower in men with a more optimistic explanatory style relative to men who were more pessimistic. These data are the first to link optimism with higher levels of pulmonary function and slower rate of pulmonary function decline in older men, a protective effect that is independent of smoking.

Adult↗
PubMed2002

The pattern of alveolar crest height change in healthy postmenopausal women after 3 years of hormone/estrogen replacement therapy.

BACKGROUND: The loss of ovarian function at menopause is associated with loss of postcranial and oral bone. Hormone/estrogen replacement therapy (HRT/ERT) has a positive effect on both postcranial and oral bone. The objective of the study was to determine if the positive effect of HRT/ERT on alveolar crest height (ACH) is generalized or site specific. METHODS: The sample consisted of 49 women who completed a 3-year, HRT/ERT prospective study. Cemento-enamel junction distances (ACH) were measured on digitized images of bitewing radiographs. Lumbar spine and proximal femur bone mineral densities (BMDs) were determined with dual-energy x-ray absorptiometric scans. Measurements were made at baseline and at the end of year 3. For the 3-year study period, mean change in ACH was determined for each patient. In addition, the sites with the greatest, second and third greatest ACH changes were determined for each patient. Correlations between changes in ACH (as determined by the various methods) and postcranial BMD were determined. RESULTS: Mean ACH changes had an average correlation (r) of -0.24 with femoral and lumbar spine BMDs. Although the largest site-specific change in ACH resulted in a mean correlation of -0.21, the correlations for the second and third largest changes in ACH dropped to -0.15 and -0.12. Overall, the correlations for site-specific changes were substantively smaller than those for generalized change. CONCLUSIONS: The data of this study indicate that ACH change attributable to HRT/ERT is generalized rather than site specific. Studies of the effect of HRT/ERT on ACH should employ multiple measurements to minimize measurement errors associated with site-specific measurements.

Absorptiometry, Photon↗
PubMed2002

Being popular can be healthy or unhealthy: stress, social network diversity, and incidence of upper respiratory infection.

Diverse social contacts are generally associated with better health. However, diverse contacts can increase exposure to infectious agents. This should increase risk for disease, particularly among those whose host resistance is otherwise compromised (e.g., stressed individuals). In this prospective study, healthy college students who completed questionnaires assessing social network diversity and stressful life events were subsequently interviewed weekly for 12 weeks to track incidence of upper respiratory infections (URIs). URI episodes were defined by a symptom criterion and by clinically verified self-reported illness. Stress and diversity of social contacts interacted; diversity was associated with more illnesses among those with more stressful life events and slightly fewer illnesses among those with fewer stressful life events. Associations remained after controlling for neuroticism.

Adolescent↗
PubMedDate not supplied

Reactivity and vulnerability to stress-associated risk for upper respiratory illness.

OBJECTIVE: We tested the hypothesis that the greater a person's laboratory stress-elicited elevation in cortisol, the greater the life stress-related risk for upper respiratory infection (URI). We also tested the prediction that the greater the laboratory stress-elicited rise in natural killer cell (NK) cytotoxicity, the smaller the life stress-related URI risk. Finally, we explored whether sympathetic nervous system (SNS) and enumerative immune reactivities to laboratory stress moderate the relation between life stress and URI. METHODS: At baseline, 115 healthy subjects were administered a negative stressful life events checklist and were tested to assess their SNS (blood pressure, heart rate, and catecholamines), HPA (cortisol), and immune (NK cell cytotoxicity and lymphocyte subsets) reactivities to laboratory speech tasks administered 2 weeks apart. Responses were averaged across the two laboratory assessments to create reactivity scores. After these assessments were completed, participants were followed weekly for 12 consecutive weeks. At each follow-up they completed a measure of perceived stress experienced over the last week. They were also instructed to contact the study coordinator if they had a cold or flu at any time during follow-up. A health care worker verified reported illnesses. RESULTS: In a traditional prospective analysis, high cortisol reactors with high levels of life events had a greater incidence of verified URI than did high reactors with low levels of life events and low reactors irrespective of their life event scores. Using hierarchical linear modeling, CD8(+) number, Natural Killer (NK) cell number, and NK cell cytotoxicity, each interacted with weekly perceived stress levels in predicting concurrent occurrences of self-reported URIs. For these outcomes, low immune reactors were more likely to experience an URI during high stress than low stress weeks. High immune reactors did not exhibit differences in weekly URIs as a function of weekly stress level. The SNS reactivity markers did not moderate the association of stress and URI incidence in either analysis. CONCLUSIONS: Acute HPA and immune responses to laboratory stressors are markers of how vulnerable people are to the increased risk for URI associated with stressors in the natural environment.

Adolescent↗
PubMedDate not supplied

Emotional style and susceptibility to the common cold.

OBJECTIVE: It has been hypothesized that people who typically report experiencing negative emotions are at greater risk for disease and those who typically report positive emotions are at less risk. We tested these hypotheses for host resistance to the common cold. METHODS: Three hundred thirty-four healthy volunteers aged 18 to 54 years were assessed for their tendency to experience positive emotions such as happy, pleased, and relaxed; and for negative emotions such as anxious, hostile, and depressed. Subsequently, they were given nasal drops containing one of two rhinoviruses and monitored in quarantine for the development of a common cold (illness in the presence of verified infection). RESULTS: For both viruses, increased positive emotional style (PES) was associated (in a dose-response manner) with lower risk of developing a cold. This relationship was maintained after controlling for prechallenge virus-specific antibody, virus-type, age, sex, education, race, body mass, and season (adjusted relative risk comparing lowest-to-highest tertile = 2.9). Negative emotional style (NES) was not associated with colds and the association of positive style and colds was independent of negative style. Although PES was associated with lower levels of endocrine hormones and better health practices, these differences could not account for different risks for illness. In separate analyses, NES was associated with reporting more unfounded (independent of objective markers of disease) symptoms, and PES with reporting fewer. CONCLUSIONS: The tendency to experience positive emotions was associated with greater resistance to objectively verifiable colds. PES was also associated with reporting fewer unfounded symptoms and NES with reporting more.

Administration, Intranasal↗
PubMedDate not supplied

Psychological stress and antibody response to influenza vaccination: when is the critical period for stress, and how does it get inside the body?

OBJECTIVES: This study attempted to determine whether stress of moderate intensity could modulate the antibody response to an influenza vaccination in healthy young adults, identify critical periods during which stress could influence antibody response, and delineate behavioral and biological pathways that might explain relations between stress and antibody. METHODS: A cohort of 83 healthy young adults underwent 13 days of ambulatory monitoring before, during, and after vaccination. Four times daily, subjects reported the extent to which they felt stressed and overwhelmed and collected a saliva sample that was later used to measure cortisol. A battery of health practices (cigarette smoking, alcohol use, physical activity, sleep hygiene) was assessed daily. Antibody titers to the vaccine components were measured at baseline and at 1-month and 4-month follow-up assessments. RESULTS AND CONCLUSIONS: To the extent that they reported higher levels of stress across the monitoring period, subjects exhibited poorer antibody responses to the New Caledonia strain of the vaccine. Stress ratings on the 2 days before the vaccine and the day it was given were not associated with antibody response. However, the 10 days afterward appeared to be a window of opportunity during which stress could shape the long-term antibody response to varying degrees. With respect to potential mediating pathways, little evidence emerged in favor of cortisol secretion, alcohol consumption, physical activity, or cigarette smoking. However, analyses were consistent with a pattern in which feelings of stress and loss of sleep become locked into a feed-forward circuit that ultimately diminishes the humoral immune response. These findings may shed light on the mechanisms through which stress increase vulnerability to infectious disease.

Adolescent↗
PubMedDate not supplied

Childhood socioeconomic status and host resistance to infectious illness in adulthood.

OBJECTIVE: Low childhood socioeconomic status (SES) is a risk factor for adult morbidity and mortality primarily attributable to cardiovascular disease. Here, we examine whether childhood SES is associated with adult host resistance to infectious illness, and whether the effect is limited to a critical period of low SES exposure, can be undone by changes in childhood SES, and is explained by adult SES. METHODS: Three hundred thirty-four healthy volunteers reported their own and their parents' level of education and the ages during their childhood when their parents owned their homes. Volunteers' current home ownership was recorded from real estate records. Subsequently, they were given nasal drops containing 1 of 2 rhinoviruses and were monitored in quarantine for infection and signs/symptoms of a common cold. RESULTS: For both viruses, susceptibility to colds decreased with the number of childhood years during which their parents owned their home (odds ratios by tertiles adjusted for demographics, body mass, season, and prechallenge viral-specific immunity were 3.7 for fewest years, 2.6 and 1). This decreased risk was attributable to both lower risk of infection and lower risk of illness in infected subjects. Moreover, those whose parents did not own their home during their early life but did during adolescence were at the same increased risk as those whose parents never owned their home. These associations were independent of parent education level, adult education and home ownership, and personality characteristics. CONCLUSIONS: A marker of low income and wealth during early childhood is associated with decreased resistance to upper respiratory infections in adulthood. Higher risk is not ameliorated by higher SES during adolescence and is independent of adult SES.

Adolescent↗
PubMedDate not supplied

Socioeconomic status, race, and diurnal cortisol decline in the Coronary Artery Risk Development in Young Adults (CARDIA) Study.

OBJECTIVES: The objectives of this study were to assess whether socioeconomic status (SES) is associated with dysregulation of the cortisol diurnal rhythm and whether this association is independent of race and occurs equally in whites and blacks; and to determine if an association between SES and cortisol can be explained (is mediated) by behavioral, social, and emotional differences across the SES gradient. METHODS: Seven hundred eighty-one subjects from a multisite sample representing both whites and blacks provided six saliva cortisol samples over the course of the day: at awakening, 45 minutes, 2.5 hours, 8 hours, and 12 hours after awakening, and at bedtime. RESULTS: Both lower SES (education and income) and being black were associated with higher evening levels of cortisol. These relationships were independent of one another and SES associations with cortisol were similar across racial categories. The evidence was consistent with poorer health practices (primarily smoking), higher levels of depressive symptoms, poorer social networks and supports, and feelings of helplessness (low mastery) mediating the link between SES and cortisol. However, we found no evidence for psychosocial or behavioral mediation of the association between race and cortisol response. CONCLUSIONS: Lower SES was associated in a graded fashion with flatter diurnal rhythms as a result of less of a decline during the evening. This association occurred independent of race and the data were consistent with mediation by health practices, emotional and social factors. Blacks also showed a flatter rhythm at the end of the day. This association was independent of SES and could not be explained by behavioral, social, or emotional mediators.

Adolescent↗
PubMedDate not supplied

Socioeconomic status is associated with stress hormones.

OBJECTIVE: We assess whether socioeconomic status (SES) is associated with basal levels of cortisol and catecholamines and determine if any association between SES and these hormones can be explained (is mediated) by behavioral, social, and emotional differences across the SES gradient. METHODS: One hundred ninety-three adult subjects, including men and women and whites and African-Americans, provided 24-hour urine catecholamine samples on each of 2 days and seven saliva cortisol samples on each of 3 days beginning 1 hour after wake-up and ending 14 to 16 hours later. Values for both hormones were averaged across days to obtain basal levels. RESULTS: Lower SES (income and education) was associated with higher levels of cortisol and epinephrine and marginally higher levels of norepinephrine. These associations were independent of race, age, gender, and body mass. Low SES was also associated with a greater likelihood of smoking, of not eating breakfast, and with less diverse social networks. Further analyses provided evidence consistent with the hypothesis that these behavioral and social variables mediate the link between SES and the three stress hormones. CONCLUSIONS: Lower SES was associated in a graded fashion with higher basal levels of cortisol and catecholamines. These associations occurred independent of race, and the data were consistent with mediation by health practices and social factors.

Adult↗
PubMedDate not supplied

Diurnal cortisol decline is related to coronary calcification: CARDIA study.

OBJECTIVE: Chronic stress may be a risk factor for coronary heart disease and is associated with dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis. We tested the hypotheses that two markers of HPA axis dysregulation, elevated average level (area under the curve, adjusted for time awake) and diurnal decline of salivary cortisol, were associated with presence of coronary calcification (CaC). METHOD: Seven hundred eighteen black and white middle-aged adults enrolled in an ancillary study of Coronary Artery Risk Development in Young Adults provided six salivary cortisol samples throughout one full day and had measurements of CaC. RESULTS: The prevalence of any calcification was low, 8.1% in the participants of the ancillary study, with white men having the highest proportion. Average cortisol did not differentiate groups, means = 2.15 and 2.08. Those with any CaC declined approximately 6% per hour in cortisol over the course of the day, whereas those with no CaC declined more than 8% per hour (p < .003). Those persons with slope scores in the flattest quartile had a greater likelihood of any CaC than did those in the remaining quartiles adjusted for sex-race group, age, smoking, treatment for diabetes, systolic blood pressure, logged triglycerides, average cortisol, and educational attainment (odds ratio = 2.58; 95% confidence interval = 1.26-5.30). CONCLUSIONS: Our results are consistent with the hypothesis that HPA axis dysregulation may affect risk for atherosclerosis.

Adult↗