Affect, cognition, the immune system and health.
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Biomedical subjects
Publications and source records attributed to T L Gruenewald.
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Psychological beliefs such as optimism, personal control, and a sense of meaning are known to be protective of mental health. Are they protective of physical health as well? The authors present a program of research that has tested the implications of cognitive adaptation theory and research on positive illusions for the relation of positive beliefs to disease progression among men infected with HIV. The investigations have revealed that even unrealistically optimistic beliefs about the future may be health protective. The ability to find meaning in the experience is also associated with a less rapid course of illness. Taken together, the research suggests that psychological beliefs such as meaning, control, and optimism act as resources, which may not only preserve mental health in the context of traumatic or life-threatening events but be protective of physical health as well.
The human stress response has been characterized, both physiologically and behaviorally, as "fight-or-flight." Although fight-or-flight may characterize the primary physiological responses to stress for both males and females, we propose that, behaviorally, females' responses are more marked by a pattern of "tend-and-befriend." Tending involves nurturant activities designed to protect the self and offspring that promote safety and reduce distress; befriending is the creation and maintenance of social networks that may aid in this process. The biobehavioral mechanism that underlies the tend-and-befriend pattern appears to draw on the attachment-caregiving system, and neuroendocrine evidence from animal and human studies suggests that oxytocin, in conjunction with female reproductive hormones and endogenous opioid peptide mechanisms, may be at its core. This previously unexplored stress regulatory system has manifold implications for the study of stress.
Psychoneuroimmunology is the scientific field that investigates linkages between the brain, behavior, and the immune system and the implications of these linkages for physical health and disease. Recent evidence suggests that both naturalistic and laboratory stressors can alter enumerative and functional aspects of the human immune system. Chronic stress may increase vulnerability to infectious disease; however, the role of stress in the course of inflammatory bowel disease remains unclear. Because there are large individual differences in psychological response to stress, it is important to consider the role of cognitive and affective responses to stress. Depression has been associated with functional immune decrements and immune overactivation. Cognitive states such as perceived control, views of the self, and views of the future have been associated with immune parameters and health in some studies. Very few controlled clinical trials have been conducted to determine if psychosocial interventions can impact the immune system and the progression of medical conditions. There is suggestive evidence for the health benefits of relaxation training, cognitive-behavioral stress management, and support groups; but, there is little research on many other psychosocial interventions in widespread use for medical conditions. An evidence-based discussion of this research literature with interested patients may help them make informed decisions regarding adjunctive treatments.