Class 9
Stress II, Continued
and
Psychoneuroimmunology
Checking In and Updates
Daily Diaries: Complete this start of class
Quiz 1—on Thursday:
1. ONLY covers what we covered in class.
2. Quiz format: Multiple Choice
3. How to study:
a. Power Point Slides
b. Use slides to structure readings/studying
Class Project:
Emotions, Stress, and Health Tracking
Purpose: To observe changes in emotions, stress, and health, and see
how they interact.
Method: Complete Daily Events Diary at the start of each class,
beginning today (9/21) and ending on Nov. 2. Make 14 copies
of Daily Events Diary, staple into a booklet, and bring to class.
Analysis: You will sum up your scores, and also chart them. I'll show
how this is done.
Write up: You will write a 3-page summary based on your Diary data
AND class readings. You will have 2 weeks to do so.
Daily Events Diary
Date:_________________
Event
None
Very Little
Moderate
Amount
A
Lot
A
Great
Degree
Happy Mood
Sad Mood
Anxious Mood
Angry / Irritable Mood
Relationship Stress
Work/school/financial Stress
Very Sick
(Flu, severe
cold)
How would you rate your current health,
compared to normal?
Sick
(mild cold)
Fair
(sympts, but
not very sick)
Good
(few sympts,
mainly well)
Excellent
(no
symptoms)
Daily Events Diary
Date:_________________
Note and observations about significant events or experiences
going on in your life. Write only the facts of what is happening
to you, DO NOT write about your feelings or opinions.
__________________________________________________
__________________________________________________
__________________________________________________
__________________________________________________
__________________________________________________
__________________________________________________
__________________________________________________
__________________________________________________
Social Readjustment Scale
Holmes & Rahe, 1967
In the past year, have you experienced:
1. __ Death of a spouse/partner 100
26. __ Wife starting/ending work 26
2. __ Divorce 73
29. __ Change in personal habits 24
3. __ Marital separation 65
32. __ Change in residence 20
7. __ Marriage 50
33. __ Change to a new school 20
8. __ Being fired 47
35. __ Change in church activities 19
17.__ Death of a close friend 37
36. __ Change in social activities 18
18.__ Changing to different work 36
38. __ Change in sleeping habits 16
19.__ Change in # spouse arguments 35
41. __ Vacation 13
20.__ Taking a loan on house 31
43. __ Minor law issue (ticket, etc.) 11
CRITIQUE OF
SOCIAL READJUSTMENT RATING SCALE
(Holmes & Rahe, 1967)
1. Vague terms
2. Numeric values
3. Relevance across populations
4. Doesn’t distinguish between pos and neg events
5. Doesn't consider how well event was resolved
6. Individual diffs. in propensity to mark events
7. Memory lapses
SUBJECTIVE STRESS MEASURE
Cohen, Kamarck, & Mermelstein, (1983)
For each question, choose from the following alternatives:
0
Never
1
Almost never
2
Sometimes
3
Fairly often
4
Very often
1. In the past month, how often have you been upset because of something
that happened unexpectedly?
2. In the last month, how often have you felt nervous and “stressed”?
3. In the last month, how often have you found that you could not cope with
all the things that you had to do?
4. In the last month, how often have you been angered because of things that
were out of your control?
Hassles
The Measurement of Hassles
Kanner, et al. 1981
Severity
1. somewhat severe
2. moderately severe
3. extremely severe
1.
2.
3.
4.
Misplacing or losing things.
Troublesome neighbors.
Social obligations.
Inconsiderate smokers.
1
1
1
1
2
2
2
2
3
3
3
3
5. Thoughts about death.
6. Health of a family member.
1
1
2
2
3
3
“Unspoken” Danger of Hassles?
Joey, did Gramps tell you
about the Great Flood of
1954?
Joey, did Gramps tell you
about the day the cable
guy never came?
Disclosing major events is a health benefit—but
normal “hassles” often don’t merit disclosing.
Workplace Stress
Workplace stress is most common,
most preventable, chronic stressor
What are elements of workplace stress?
Overload: perception more important than total hours.
Time pressure: Time pressed 3X more likely to die early
Role conflict /ambiguity: Japanese baseball interpreters
Social isolation: Higher catecholamines, higher BP
Lack of control: Person/environment fit. Leads to coronary heart disease
Class 9
Psychoneuroimmunology
Psychoneuroimmunology
The relationship between psychological processes and the
activities of the nervous, endocrine, and immune systems.
Immune System Review
Primary function: Distinguish self from non-self, attack foreign elements.
Main components:
Humoral response – anti-bacterial, prevent viral re-infection
Cell-mediated response – T cells from Thymus gland, Tc respond to
specific antigens, produce anti-antigen toxins.
Other blood components
Mitogen Test: Introducing chemical that stimulates cell production.
Serves to test how “energetic” is immune system—e.g. how many
white blood cells produced after mitogen introduced.
Mitogen benign version of Antigen, which is foreign substance that
attacks body (e.g., bacteria, virus), causing antibody production.
Immunocompetence and Immunocompromise
Immunocompetence: How well immune system is working
Assessment:
a. Quantities of immune agents (T cells, white blood cells)
b. Functioning of immune agents
1. Activity
2. Proliferation
3. Transformation
4. Cytotoxicity
Immunocompromise: When immune system is impaired
Key Point: Stress can lead to immunocompromise
Stress and Immune Functioning
Stress and immunocompetence shown in:
Animal studies: stressed rats display immune dysfunction
Observations: TB white blood cells less robust after stress
Accumulated Research: 38 studies show more stress 
immunocompromise
The bigger the stressor, the worse the compromise.
Hurricane Andrew (1992), NK cell cytotoxicity
decreases. Tied to lack of sleep.
NOTE: This outcome fits which with measure
X
____Holmes
& Rahe ___ Cohen et al.
Chopin
Chronic Stress and Acute Stress
Chronic
Acute
On-going illness
Natural disaster
Family responsibilities
Childhood sexual abuse
Workload
Auto accident
Environmental noise
Job loss
Financial worries
Loss of loved one
Immunocompetence
STRESSOR
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
Days Exposed to Stressor
Stress-Induced Immunocompromise and Illness
Stress  Immunocompromise  colds, flu, herpes flare-ups
Daily hassles  reduced NK activity
Anticipatory stress  less robust TH cells. Mt. St. Helens/Pennebaker
School stress: 5 yr olds show increased cortisol, immunocompromise,
upon starting kindergarten. Esp. if earthquake co-occurs!
Social Relations, Stress, and Illness
Personal relationships are key moderators of stress/illness connection.
(More on this when we discuss Social Support)
Rat pups separated from mothers show
immunocompromise
Social Conditions linked to illness?
Bereavement
(but mainly if linked to depression)
Loneliness
Marital separation
Spitz Foundling Home Studies
René Spitz
Orphaned babies, in foundling homes, all material needs met
Do not have an emotional care-giver
Tragically high levels of grief
Highly susceptible to disease
High mortality rate
https://www.youtub
e.com/watch?v=bF
3j5UVCSCA
DEPRIVATION DWARFISM
Social Connections as a Health Risk
Newlyweds Study
90 newlywed couples, discuss marital problems
Style of discussion coded as:
a. Negative/hostile
b. Positive/collaborative
Assessed immune functioning after discussions.
Which group shows immunocompromise?
X Neg/hostile ___ Pos/collaborative
____
Caregivers of chronically ill
Produce fewer immune agents, wounds heal slowly,
weaker reaction to flu vaccine. Why?
Relation Between Stress and Health Not Perfect