Overview of PNI

8/20/2019 Overview of PNI

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An Overview of An Overview of

Psychoneuroimmunology (PNI)Psychoneuroimmunology (PNI)

Psychosocial factors that weakenPsychosocial factors that weaken& strengthen the immune system& strengthen the immune system

Frank McDonalFrank McDonal

!onsultation & "iaison Psychologist!onsultation & "iaison Psychologist

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%etem'er %etem'er


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OverviewOverview

*+*+ ,hat is sychoneuroimmunology-,hat is sychoneuroimmunology-

++ ,hat has it taught us-,hat has it taught us-

.+.+ ,hich sychosocial factors weaken or,hich sychosocial factors weaken orstrengthen immunity- ,ho are more &strengthen immunity- ,ho are more &less vulnera'le-less vulnera'le-

/+/+ !an we 'oost immune system to healthier!an we 'oost immune system to healthierlevels 'y alying counteractinglevels 'y alying counteractingsychosocial resources-sychosocial resources-


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+ ,hat has PNI taught us-+ ,hat has PNI taught us-

*+*+ !ommonlace ersonal e4eriences of 5!ommonlace ersonal e4eriences of 5

immune6relate illness followingimmune6relate illness following

stress7emotional trauma0 now e4lica'le atstress7emotional trauma0 now e4lica'le at

'iomolecular level+ (neural6immune links3'iomolecular level+ (neural6immune links3

Felten et al+0 *189: enocrine;immuneFelten et al+0 *189: enocrine;immune

links3


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$els to e4lain clinical e4eriences like3$els to e4lain clinical e4eriences like3

I see a lot of people with so-called problems relating toI see a lot of people with so-called problems relating to

dysfunctional immune systems. Things like recurrent coldsores,dysfunctional immune systems. Things like recurrent coldsores,recurrent infections, even hayfever, other allergies. Theserecurrent infections, even hayfever, other allergies. Thesenearly always occur on a background of stress.nearly always occur on a background of stress.

Dr. David Isaacs, Sydney suburban GP, 2000


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++ Neuroenocrinological system research oints toNeuroenocrinological system research oints to

chronic stress as imortant contri'utor in rangechronic stress as imortant contri'utor in range

of immune6relate conitions+of immune6relate conitions+


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Variable impact of stress on immuneVariable impact of stress on immune

systemsystem(Adapted from obert Sapols!y in "erson, 200#$



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.+.+ !ertainly no e4erimental evience0 as!ertainly no e4erimental evience0 as

yet0 that min can cure immune systemyet0 that min can cure immune system

iseases (@elman & Angell0 )iseases (@elman & Angell0 )

/+/+ =vience suggests sychosocial varia'les=vience suggests sychosocial varia'les

may alter susceti'ility0 rogress &may alter susceti'ility0 rogress &

recurrence of these (#aylor0 *111) as wellrecurrence of these (#aylor0 *111) as well

as how well ts coe7O"as how well ts coe7O"


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.+ Psychosocial factors moulating immunity.+ Psychosocial factors moulating immunity

Pro'lemsPro'lems that can 'esetthat can 'eset immune systemimmune system Age Age

?enetic isorers?enetic isorers Infectious iseasesInfectious iseases NutritionNutrition !hemotheray!hemotheray

IrraiationIrraiation Allergies Allergies %%tresstress B focus of PNIB focus of PNI


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a+ ,eakening influencesa+ ,eakening influences !hanges in immune system foun to accomany!hanges in immune system foun to accomany

stressful or conflictual social relationshis+ #hesestressful or conflictual social relationshis+ #hese

inclue3inclue36 "oss of an intimate relationshi from eath or"oss of an intimate relationshi from eath orivorce (


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6 "oneliness+ "onely eole have oorer health+"oneliness+ "onely eole have oorer health+ Amongst e4am stuents they ha more e4treme Amongst e4am stuents they ha more e4treme

immuno6comromise (>iecolt6?laser et al+0 *18/)immuno6comromise (>iecolt6?laser et al+0 *18/)

6 Poorer marital Cuality for marrie coules 6Poorer marital Cuality for marrie coules 6associate with latent virus anti'oy resonseassociate with latent virus anti'oy resonse(>enney et al+0 *188)(>enney et al+0 *188)

6 !aring for a terminally6ill atient (=sterling et al+0!aring for a terminally6ill atient (=sterling et al+0

*112)*112)


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Acaemic stress can lea to immunological Acaemic stress can lea to immunological

changes an illness+ ?laser et al+ (*18)changes an illness+ ?laser et al+ (*18)

assesse / assesse / nn year meical stuents 2year meical stuents 2

wks 'efore an uring final e4ams+wks 'efore an uring final e4ams+

"ymhocytes0 N> cells an N> cytoto4ic"ymhocytes0 N> cells an N> cytoto4ic

activity an interferon levels were lower activity an interferon levels were lower


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%tarting kinergarten can raise cortisol levels an%tarting kinergarten can raise cortisol levels an

negatively alter immune measures (

num'ers ($er'ert & !ohen0 *11.)num'ers ($er'ert & !ohen0 *11.)


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Perceive severe aily hasslesJ reictPerceive severe aily hasslesJ reict

lower N> cell activity ("evy et al+0 *181)lower N> cell activity ("evy et al+0 *181)

Across stuies it aears that more severe Across stuies it aears that more severe& long6term were stressors0 more& long6term were stressors0 more

vulnera'le iniviuals were to health6relatevulnera'le iniviuals were to health6relate

ro'lemsro'lems


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'+ %trengthening influences'+ %trengthening influences

Positive social relationshis aear to actPositive social relationshis aear to act

as a 'uffer against stress inuce immuneas a 'uffer against stress inuce immunechanges+ (#aylor0 *111)changes+ (#aylor0 *111)


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%ense of control social connectenessJ 'rings0%ense of control social connectenessJ 'rings0

shoul iniviual 'e face with ifficult lifeshoul iniviual 'e face with ifficult life

challenge0 aears more influential on generalchallenge0 aears more influential on general

health than any other single hysiological0 lifestylehealth than any other single hysiological0 lifestyleor sychological factor e+g+ serum cholesterol0or sychological factor e+g+ serum cholesterol0

'loo ressure0 alcohol intake0 smoking0 e4ercise0'loo ressure0 alcohol intake0 smoking0 e4ercise0

o'esity0o'esity0 %=%7income7goo Ko'%=%7income7goo Ko' & active ositive& active ositive

coing methos ($ouse et al *188: %yme0 *118)coing methos ($ouse et al *188: %yme0 *118)


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%ocial connectenessJ measure3%ocial connectenessJ measure3

; LL!an you count on anyone to rovie you!an you count on anyone to rovie youwith emotional suort- (i+e+ talk overwith emotional suort- (i+e+ talk over

ro'lems or hel make ifficult ecisions)ro'lems or hel make ifficult ecisions)


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Other factors that aear to moerate relationOther factors that aear to moerate relation

'etween stress & immune functioning3'etween stress & immune functioning3

6 Otimism a'out oneJs situation & engaging inOtimism a'out oneJs situation & engaging in

active coing 'uffers against acaemic stress+ Inactive coing 'uffers against acaemic stress+ Instuies of meical & law stuents (%egerstromstuies of meical & law stuents (%egerstrom

cite in #aylor0*111) essimistic0 avoiance coingcite in #aylor0*111) essimistic0 avoiance coing

stuents evience less N> cell cytoto4icity &stuents evience less N> cell cytoto4icity &

fewer # cellsfewer # cells


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%elf6isclosure7ventilation (>iecolt6?laser et%elf6isclosure7ventilation (>iecolt6?laser et

al+0 *11)+ me stuents writing 72al+0 *11)+ me stuents writing 72

aily for *7+ $alf e4resse strongaily for *7+ $alf e4resse strong

feelings0 others3 meaningless toics+ At .7*feelings0 others3 meaningless toics+ At .7*

the e4ressive grou ha fewer octorJsthe e4ressive grou ha fewer octorJs

visits & 'etter immune function rofile thanvisits & 'etter immune function rofile than

controlscontrols


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In resonse to stress of meical trainingIn resonse to stress of meical training

stuents using self6hynosis as coing skillstuents using self6hynosis as coing skill

show moest effects in N> cell num'ers N>show moest effects in N> cell num'ers N>

cell activity (,hitehouse et al+0 *112)cell activity (,hitehouse et al+0 *112)


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6 Other coing strategies that may relate toOther coing strategies that may relate to

the stress6immune functioning relationshi3the stress6immune functioning relationshi3

6 e4ercise activates 'eta6enorhins which maye4ercise activates 'eta6enorhins which may

stimulate N> cell activity an so 'uffer againststimulate N> cell activity an so 'uffer against

stress6relate immune changesstress6relate immune changes

Documents

Overview of PNI