Abstract
This article provides a selected overview of 20 years of research on the role of psychosocial factors in susceptibility to upper respiratory infections. We present evidence from our laboratory that psychological stress is associated with increased risk for developing respiratory illness for persons intentionally exposed to a common cold virus, that the longer the duration of the stressor the greater the risk, and that stress association with susceptibility may be mediated by stress-induced disruption of the regulation of proinflammatory cytokines. We further provide evidence that social relationships (social integration and social support) are also associated with risk for respiratory illness: Social integration is associated with reduced risk irrespective of stress level and social support protects persons from the pathogenic influences of stress. Finally, we report recent evidence that lower levels of early childhood socio-economic status (SES) are associated with greater risk of viral-induced illness during adulthood, independent of adult SES.
Article PDF
Similar content being viewed by others
References
Aber, J. L., Bennett, N. G., Conley, D. C., & Li, J. (1997). The effects of poverty on child health and development. Annual Review of Public Health, 18, 463–483.
Avitsur, R., Stark, J. L., & Sheridan, J. F. (2001). Social stress induces glucocorticoid resistance in animals. Hormones and Behavior, 39, 247–257.
Berkman, L. F. The role of social relations in health promotion. (1995). Psychosomatic Medicine, 57, 245–254.
Butel, J. (2000). Viral carcinogenesis: Revelation of molecular mechanisms and etiology of human disease. Carcinogenesis, 21, 405–426.
Cohen, S. (1988). Psychosocial models of social support in the etiology of physical disease. Health Psychology, 7, 269–297.
Cohen, S. (1991). Social supports and physical health: Symptoms, health behaviors and infectious disease. In A. L. Greene, M. Cummings, & K. H. Karraker ({dEds.}), Life-span developmental psychology: Perspectives on stress and coping (pp. 213–234). Hillsdale, NJ: Lawrence Erlbaum Associates, Inc.
Cohen, S. (1999). Social status and susceptibility to respiratory infections. Annals of the New York Academy of Sciences, 898, 246–253.
Cohen, S. (2004). Social relationships and health. American Psychologist, 59, 676–684.
Cohen, S., Doyle, W. J., Skoner, D. P., Rabin, B. S., & Gwaltney, J. M., Jr. (1997). Social ties and susceptibility to the common cold. Journal of the American Medical Association, 277, 1940–1944.
Cohen, S., Doyle, W. J., & Skoner, D. P. (1999). Psychological stress, cytokine production, and severity of upper respiratory illness. Psychosomatic Medicine, 61, 175–180.
Cohen, S., Doyle, W. J., Turner, R. B., Alper, C. M., & Skoner, D. P. (2003a). Sociability and susceptibility to the common cold. Psychological Science, 14, 389–395.
Cohen, S., Doyle, W. J., Turner, R. B., Alper, C. M., & Skoner, D. P. (2003b). Emotional style and susceptibility to the common cold. Psychosomatic Medicine, 65, 652–657.
Cohen, S., Doyle, W. J., Turner, R. B., Alper, C. M., & Skoner, D. P. (2004). Childhood socioeconomic status and host resistance to infectious illness in adulthood. Psychosomatic Medicine, 66, 553–558.
Cohen, S., Frank, E., Doyle, W. J., Skoner, D. P., Rabin, B. S., & Gwaltney, J. M., Jr. (1998). Types of stressors that increase susceptibility to the common cold in adults. Health Psychology, 17, 214–223.
Cohen, S., Gottlieb, B., & Underwood, L. (2000). Social relationships and health. In S. Cohen, L. Underwood, & B. Gottlieb (Eds.), Measuring and intervening in social support (pp. 3–25). New York: Oxford University Press.
Cohen, S., Kaplan, J. R., Cunnick, J. E., Manuck, S. B., & Rabin, B. S. (1992). Chronic social stress, affiliation and cellular immune response in nonhuman primates. Psychological Science, 3, 301–304.
Cohen, S., Line, S., Manuck, S. B., Rabin, B. S., Heise, E., & Kaplan, J. R. (1997). Chronic social stress, social status and susceptibility to upper respiratory infections in nonhuman primates. Psychosomatic Medicine, 59, 213–221.
Cohen, S., Tyrrell, D. A. J., Russell, M. A. H., Jarvis, M. J., & Smith, A. P. (1993). Smoking, alcohol consumption and susceptibility to the common cold. American Journal of Public Health, 83, 1277–1283.
Cohen, S., Tyrrell, D. A. J., & Smith, A. P. (1991). Psychological stress and susceptibility to the common cold. New England Journal of Medicine, 325, 606–612.
Cohen, S., Tyrrell, D. A. J., & Smith, A. P. (1993). Life events, perceived stress, negative affect and susceptibility to the common cold. Journal of Personality and Social Psychology, 64, 131–140.
Cohen, S., & Williamson, G. (1991). Stress and infectious disease in humans. Psychological Bulletin, 109, 5–24.
Cohen, S., & Wills, T. A. (1985). Stress, social support, and the buffering hypothesis. Psychological Bulletin, 98, 310–357.
Davey-Smith, G., Hart, C., Blane, D., Gillis, C., & Hawthorne, V. (1997). Lifetime socioeconomic position and mortality: Prospective observational study. British Medical Journal 314, 547–552.
Davey-Smith, G., Hart, C., Blane, D., & Hole, D. (1998). Adverse socioeconomic conditions in childhood and cause specific adult mortality: Prospective observational study. British Medical Journal, 316, 1631–1635.
Davey-Smith, G., McCarron, P., Okasha, M., & McEwen, J. (2001). Social circumstances in childhood and cardiovascular disease mortality: Prospective observational study of Glasgow University students. Journal of Epidemiology and Community Health, 55, 340–341.
Feldman, P., Cohen, S., Doyle, W. J., Skoner, D. P., & Gwaltney, J. M. (1999). The impact of personality on the reporting of un founded symptoms and illness. Journal of Personality and Social Psychology, 77, 370–378.
Frankel, S., Davey-Smith, G., & Gunnell, D. (1999). Childhood socioeconomic position and adult cardiovascular mortality: The Boyd Orr cohort. American Journal of Epidemiology, 150, 1081–1084.
Gissler, M., Rahkonen, O., Jarvelin, M. R., & Hemminki, E. (1998). Social class differences in health until the age of seven years among the Finnish 1987 birth cohort. Social Science & Medicine, 46, 1543–1552.
Gupta, S., & Camm, A. J. (1998). Chlamydia pneumoniae, antimicrobial therapy and coronary heart disease: A critical overview. Coronary Artery Disease, 9, 339–343.
Helgeson, V. S., Cohen, S., & Fritz, H. L. (1998). Social ties and cancer. In J. C. Holland & W. Breitbart (Eds.), Psycho-oncology (pp. 99–109). New York: Oxford University Press.
Herbert, T.B., & Cohen, S. (1993). Stress and immunityinhumans: A meta-analytic review. Psychosomatic Medicine, 55, 364–379.
Heslop, P., Davey-Smith, G., Macleod, J., & Hart, C. (2001). The socioeconomic position of employed women, risk factors and mortality. Social Science & Medicine, 53, 477–485.
Kraft, M., Cassell, G., Pak, J., & Martin, R. (2002). Mycoplasma pneumoniae and Chlamydia pneumoniae in asthma: Effect of clarithromycin. Chest, 121, 1782–1788.
Laudenslager, M. L. (1987). Psychosocial stress and susceptibility to infectious disease. In E. Kurstak, Z. J. Lipowski, & P. V. Morozov (Eds.), Viruses, immunity and mental disorders (pp. 391–402). New York: Plenum.
Marmot, M., Shipley, M., Brunner, E., & Hemingway, H. (2001). Relative contribution of early life and adult socioeconomic factors to adult morbidity in the Whitehall II Study. Journal of Epidemiology and Community Health, 55, 301–307.
Miller, G. E., Cohen, S., & Ritchey, A. K. (2002). Chronic psychological stress and the regulation of pro-inflammatory cytokines: A glucocorticoid resistance model. Health Psychology, 21, 531–541.
Nelson, M., Jr. (1992). Socioeconomic status and childhood mortality in North Carolina. American Journal of Public Health, 82, 1131–1133.
Nystrom, P. M. (1994). The importance of childhood socio-economic group for adult health. Social Science & Medicine, 39, 553–562.
O’Leary, A. (1990). Stress, emotion, and human immune function. Psychological Bulletin, 108, 363–382.
Poulton, R., Caspi, A., Milne, B. J., Thomson, W. M., Taylor, A., Sears, M. R., et al. (2002). Association between children’s experience of socioeconomic disadvantage and adult health: A life-course study. Lancet, 360, 1640–1645.
Roberts, I., & Power, C. (1996). Does the decline in child injury mortality vary by social class? A comparison of class specific mortality in 1981 and 1991. British Medical Journal, 313, 784–786.
Rook, K. S. (1984). The negative side of social interaction: Impact on psychological well-being. Journal of Personality and Social Psychology, 46, 1097–1108.
Seeman, T. E. (1996). Social ties and health: The benefits of social integration. Annals of Epidemiology, 6, 442–451.
Stark, J. L., Avitsur, R., Padgett, D. A., Campbell, K. A., Beck, F. M., & Sheridan, J. F. (2001). Social stress induces glucocorticoid resistance in macrophages. American Journal of Physiology. Regulatory, Integrative and Comparative Physiology, 280, 1799–1805.
Vagero, D., & Leon, D. (1994). Effect of social class in childhood and adulthood on adult mortality. Lancet, 343, 1224–1225.
Wannamethee, G. S., Whincup, P. H., Shaper, G., & Walker, M. (1996). Influence of father’s social class on cardiovascular disease in middle-aged men. Lancet, 348, 1259–1263.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Cohen, S. Keynote presentation at the eight international congress of behavioral medicine Mainz, Germany August 25–28, 2004. Int. J. Behav. Med. 12, 123–131 (2005). https://doi.org/10.1207/s15327558ijbm1203_1
Issue Date:
DOI: https://doi.org/10.1207/s15327558ijbm1203_1