Stress and the immune system

In this chapter, we provide an overview of how stress affects immune functioning and examine evidence in the literature regarding various intrapersonal and interpersonal factors that may exacerbate or buffer the health effects of stress and its related immune manifestations. We first review some basic information concerning the immune system to provide the reader with necessary background. We then present the primary pathways by which stress impacts the immune system, including the sympathetic nervous system, the hypothalamic-pituitary-adrenal (HPA) axis, and vagal withdrawal. Next, we discuss how the immune response varies and even goes awry, depending on the nature of the stress (acute versus chronic). Additionally, we discuss how the immune response varies depending upon the individual within whom the stress is occurring; specifically, we focus on various intrapersonal and interpersonal factors associated with immune functioning. Intrapersonal factors reviewed include rumination, emotion regulation, alexithymia, psychological stress, optimism, and positive affect. Interpersonal factors reviewed include close relationship and family processes such as negative and positive behaviors, ambivalence towards a relationship partner, social rejection and social isolation, and early life adversity. To conclude, we highlight some substantive and methodological considerations relevant to future research on the effects of stress on immunity.