Additionally, exposure to high levels of stress early in life can cause health problems in adulthood.  Studies have noted a correlation between cardiac disease and early childhood stress and future studies are looking to understand the long term affect of early exposure to stress. Children whom have survived pediatric cancers also seem to be at greater risk for high cholesterol, diabetes and high blood pressure, all of which predispose them to heart disease in adulthood.

Many of these examples of stress in children may be beyond our control, but it leads me to think that we need to introduce stress management techniques and cognitive behavioral therapies to our young people sooner rather than later. 

Rheumatoid Arthritis is an example of the inflammatory response that results in negative effects such as joint swelling, stiffness, pain, and a decrease in mobility (Heijnen & Kavelaars, 2005). There is a cyclical pattern with regard to the relationship between the bone destruction and inflammation process in the arthritic joints with the patient’s symptoms of pain and immune response.

The pathogenesis of Rheumatoid Arthritis has been related to stressful events that cause inflammation in the joints resulting in pain; however, there is debate as to whether or not severe stressors or mild daily stressors are associated with the pathogenesis of this disease (Potter & Zautra, 1997).

Heijnen, C. J. & Kavelaars, A. (2005). Psychoneuroimmununology and chronic autoimmune diseases: Rheumatoid arthritis. In K. Vedhara & M. Irwin (Eds.). Human psychoneuroimmunology. NY: Oxford University Press.

Potter, P. T. & Zautra, A. J. (1997). Stressful life events’ effects on rheumatoid arthritis disease activity. Journal of Consulting and Clinical Psychology, 65(2), 319-323.

Barlow and Minns (2000) found that head injuries in children younger than one year old (in a Scotland based study) was 24.6 per 100,000 children and that acute encephalopathy, subdural hemorrhages, skull fractures, retinal hemorrhages, and cerebral edema were present in most of the cases. Sadly, the median age of injury was 2.2 months and 78% of those who did not die due to brain injury suffered long term neurological and developmental abnormalities.

Shaken baby syndrome in the United States is equally prevalent and sadly most cases are not reported so data is not well established (Hymel, Ritzen, Reinert, & Hay, 1999). However, medical professionals or parents that suspect shaken baby syndrome can look for bruises on the head or face of children, be alert for soft spots on the head, or look for previous signs of bleeding which may be found, after the fact, in spinal fluid (Hymel, Ritzen, Reinert, & Hay, 1999). The outcome for children who survive this, and other non-accidental head injury, was explained by Barlow, Thompson, Johnson, and Minns (2004) in which 64% of the children had speech and language disorders or autism, 25% had visual deficits, and 20% had cranial nerve abnormalities and over 50% were considered to be severely mentally retarded.

Most of these injuries result from parental frustration with infants who do not stop crying and the new parents have not been educated with how to handle the child without shaking them (Barr, 2007). Simply putting down a child in a safe play pen and walking away could stop the abuse. With this basic understanding of the tragedy associated with child brain injury from shaken baby syndrome I would hope the committee will approve funding for preventative measures so that these statistics can be reduced if not eliminated in the near future.

Barlow, K., Thompson, E., Johnson, D., & Minns, R. (2004). The neurological outcome of non-accidental head injury. Pediatric Rehabilitation, 7(3), 195-203.

Barlow, K. M. & Minns, R. A. (2000). Annual incidence of shaken impact syndrome in young children. Lancet, 356(9241), 1571-2.

Barr, M. (2007). What do you say to the parent of a crying baby? NENA Outlook, 30(2), 13.

Hymel, J. C., Ritzen, A., Reinert, SE, & Hay, TC. (1999). Abusive head trauma: An analysis of missed cases. Journal of the American Medical Association, 281, 621-626.

Monfore, D. (2005). Resource guide on traumatic brain injury. Preventing School Failure, 49(4), 58-62.

Walden University . (2008, April 29). Overview of brain injury in adults. Neuropsychology PSYC-8710-01. Retrieved from Walden University Classroom: http://sylvan.live.ecollege.com.

Psychological stressors, such as significant life changes or an inability to manage or cope with stress, can result in a feeling of perceived “helplessness or hopelessness” as first defined by Dr. Engel. He was a medical physician that noted the lack of incorporation of the mental and social models of behavior with the biological model of behavior.

Infections and clinical illnesses as well as health practice measures are also associated with the relationships between stressful experiences and acute infections. For example, infections often are a result in the decreased ability for the body’s immune system to fend off further attacks on the immune system. Individuals that are not experiencing stress or clinical illnesses may have a reduced inflammatory response. When there is exposure to a potentially acute infection acute inflammation occurs which is a positive defense (Miller & Cohen, 2005, p. 13-14). Additionally, health practice measures such as preventative health care, proper dietary support, and proper intervention from physicians assist in the reduction of acute infection as a physician can reduce the stress levels on the HPA axis (Sperner-Unterweger2005).

Engel, G. (1968). A life setting conducive to illness: The giving-up—given-up complex. Annals of Internal Medicine, 69(2).

Miller, G. E. & Cohen, S. (2005). Infectious disease and psychoneuroimmununology. In K. Vedhara & M. Irwin (Eds.). Human psychoneuroimmunology. NY: Oxford University Press.

The adrenal axis plays a role with depression and immunity in the sense that there is a relationship between secretions of increased levels of cortisol in conjunction with poor performing immune system responses which may result in the removal of necessary immune cells from the normal circulatory process.

The autonomic nervous system has a role with depression and immunity in that the system is altered in a variety of ways.  One example is the increase in white blood cell counts as well as an increase in lymphocytes and neutrophils (Vedhara & Irwin, 2005).  There is a variety of research currently being conducted to assess the relationships between depressed patients, the immune system, and the relationship between the production of B and T cells that will be of great interest to health psychologists forthcoming.

Reiche, V., Maria, E., Kaminami, M., Morimoto, V., & Nunes, S. (2005). Stress and depression-induced immune dysfunction: Implications for the development and progression of cancer. International Review of Psychiatry, 17(6), 515-527.

Vedhara, K., & Irwin, M.R. (2005). Human Psychoneuroimmunology.  New York, NY: Oxford University Press.

Patients and physicians are becoming more interested in understanding psychosocial factors that may impact immune mechanisms and result in biological malfunctions. For example, if severe stress occurs there is an impact on the immunological functions which may result in a decreased ability for the body to recognize and eliminate potential cancer cells in the body (Rieger, 2001).

There has long been evidence that cancers, such as breast cancer in women, may progress faster or slower based upon psychosocial factors. Stress (both perceived and real) as well as family support have an impact upon endocrine and immunological processes (Van der Pompe, Antoni, Mulder, Heijnen, Goodkin, de Graeff, Garssen, & de Vries, 1994). This is supported by research that demonstrates a relationship between specific endocrine receptors that are located on lymphoid cells that provide neuronal communications with lymphoid tissues. These endocrine receptors can influence changes in the mammary epithelium (membranous tissue) which can change the progression of breast cancer (Van der Pompe et al., 1994 ).

The body defends against cancer by assessing changes in previously cells that have mutated into cancerous cells. The immune system has natural killer cells, dendritic cells, antibodies, and T lymphocytes that all work to manage the response the body has from an immunological response (Walker et al., 2005). Further, the functionality of immune cells and their ability to fight the proliferation of cancer cells is affected by stress and depression, emotional and social demands that are a side-effect of many cancer treatments, as well as those who receive psychological support throughout their cancer treatment regime.

Rieger, P. T. (2001). Did stress cause my cancer? ONS News, 16(9), 14.

Van der Pompe, G., Antoni, M. H., Mulder, C. L., Heijnen, C., Goodkin, K, de Graeff, A., Garssen, B., & de Vries, M. J. (1994). Psychoneuroimmunology and the course of breast cancer: An overview. Psycho-Onchology, 3(4), 271-288.

Walker, L. G., Green, V. L., Greenman, J., Walker, A. A., & Sharp, D. M. (2005). Psychoneuroimmununology and chronic malignant disease:Cancer. In K. Vedhara & M. Irwin (Eds.). Human psychoneuroimmunology. NY: Oxford University Press.

Research in these areas has been forwarded by the work and research often represented in the American Psychological Association by those interested in psychology and aging.  Current topics of research include neuropsychological mediators of the links among age, chronic illness, and everyday problem solving skills as well as the understanding of how age and health are affected by psychosocial stressors (Thornton, Deria, Gelb, Shapiro, & Hill, 2007).  Age related changes, such as moving to a new location, can affect an elder’s mood and quality of life (Vedhara & Irwin, 2005).  Depression has been related to a suppression of the proliferation of lymphocytes and elders with intrusive thoughts also show higher levels of the stress hormone cortisol.  Very often these behaviors are associated with the level of social support a person receives in terms of how they manage immune responses to a variety of situations. 

Now, there is further understanding of the relationship between psychological stressors and the immune system.  Specifically, older adults experience stress differently than younger adults in areas such as mood and quality of life, bereavement, cognitions, coping, or personality (Vedhara & Irwin, 2005). 

Cohen, S., Kessler, R. C., & Gordon, L. U. (1997). Measuring Stress: A Guide for Health and Social Scientists. NY: Oxford University Press.

Lovallo, W. (2004). Stress & Health: Biological and Psychological Interactions. Thousand Oaks, CA: Sage Publications.

Thornton, W. L., Deria, S., Gelb, S., Shapiro, J., & Hill, A. (2007). Neurophychological mediators of the links of age, chronic illness, and everyday problem solving. Psychology and Aging, 22(3), 470-481.

Vedhara, K., & Irwin, M.R. (2005). Human Psychoneuroimmunology.  New York, NY: Oxford University Press.

Organ systems decline and immune functionalities may decrease so it is becoming common practice to try and prevent the onset of illness such as the “flu” in the elderly before the flu season which may be late fall throughout the winter depending on where you live. If a 70 year old patient would inquire whether or not he or she should get a “flu shot” that that age, I would tell them that I would recommend that they do receive the shot.  However, I would want to ensure that they are in good health and have not had reactions in the past to influenza inoculations. 

As patients age they experience what is call immunosenescence which is the aging of the immune system (Vedhara & Irwin, 2005).  During this process lymphocyte activities change resulting in decreased or impaired activity in the overall immune system.  Therefore, Vedhara & Irwin (2005) note that over 40% of elderly patients who receive the flu shot do not develop proficient antibodies to fight the illness so preventative steps, such as handwashing and proper nutrition, should be incorporated into a person’s lifestyle as well.

Thorton, W. L., Deria, S., Gelb, S., Shapiro, R. J., & Hill, A. (2007).    Neuropsychological mediators of the links among age, chronic illness and everyday problem solving. Psychology and Aging, 22(3), 470-481.

Vedhara, K., & Irwin, M.R. (2005). Human Psychoneuroimmunology.  New York, NY: Oxford University Press.

There are also limitations in the in vitro measurement system such as the fact that although the levels of cell count can be measured, they often can not be correlated with a disease or disorder. Additionally, it is difficult to take one measurement and consider it to be an accurate reading because cell counts vary based upon factors such as time of day or migration of cells. These variables cause too much noise in terms of measuring the effectiveness of the immune system (Vedhara & Irwin, 2005).

The in vivo measures include observing delayed hypersensitivity tests, which is when the body actually harms itself using its own immune system by having an excessive release of hypersensitive anti-bodies (Vedhara & Irwin, 2005). The advantage of measuring the reactions that occur within the human body is real time experimentation can occur in a real-life situation versus that of experimentation in a laboratory or with animals.

However, there are limitations and risks with this form of measurement such as how inducing this type of reaction in a human being may have significant ethical implications for the person conducting the experiment or measurement. Causing an immune response that results in the destruction of a microbe, which results in an inflammatory response, could cause a great deal of harm to the person (O’Neill, 2005). Additionally, it is very hard to have a control group and a treatment group when you are dealing with all of the variability associated with an individual human being (Vedhara & Irwin, 2005). Hypothetically, one person in the study may be stressed out, another person may have a poor diet, another person could be in top physical fitness, or socioeconomic status, age, race or gender could impact the response.

AIDS.Org (2007). Complete blood count (cbc). Information, Education, and Action. Retrieved September 19, 2007 from the World Wide Web: http://www.aids.org/Factsheets/121-Complete-Blood-Count-CBC.html

O’Neill, L. (2005). Immunity’s early-warning system. Scientific American, 292(1), 38-45.

Vedhara, K., & Irwin, M.R. (2005). Human Psychoneuroimmunology. New York, NY: Oxford University Press.

The first type of antibody classification is Immunoglobulin A (IgA) which protects mucsosal surfaces with a fluid like secretion (Vedhara & Irwin, 2005). IgA is found in serum, mucus, saliva, tears, sweat, and milk and has also been associated with being transferred to an unborn child (passive immunity) and can also protect the child after birth for several months. This time frame can be further increased when the mother breast-feeds ( Niers, Stasse-Wolthuis, Rombouts, & Rijkers, 2007).

A second type of antibody classification is Immunoglobulin E (IgE) which triggers the release of histamines by attaching to antigens, basophils, and mast cells ( Vedhara & Irwin, 2005). IgE does not make up a very large portion of antigens but it is responsible for reactions resulting in hives, asthma, and hayfever as examples (Paustian & Roberts, 2005).

A third type of antibody classification is Immunoglobulin M (IgM) which forms antibody-antigens processed by the liver and stimulates complement-mediated lysis (Vedhara & Irwin, 2005). IgM makes up about 10% of the total antibodies and it is very important in the initial phases of an illness to stop the spreading of the pathogen ( Paustian & Roberts, 2005).

A fourth type of antibody classification is Immunoglobulin G (IgG) which allows for the consumption of pathogens such as bacteria by coating them so that macrophages and neutrophils will be able to recognize them as pathogens (Vedhara & Irwin, 2005). IgG is the largest classification of circulating antibodies ( Paustian & Roberts, 2005).

The fifth type of antibody classification is Immunoglobulin D (IgD) which is lacking in enough research to clearly understand its functions (Vedhara & Irwin, 2005). This antibody located on the surface of B-lymphocytes (Paustian & Roberts, 2005). Currently there are research studies being conducted on immature IgD antibodies to transfer them to becoming mature B cells in an effort to try and gain further understanding of the actual function IgD antibodies (Koelsch et al., 2007).

Koelsch, K., Nai-Ying, Z., Quigzhao, Z., Duty, A., Helms, C., Mathias, M. D., Jared, M., Smith, K., Capra, J., & Wilson, P. C. (2007). Mature b cells class switched to igd are autoreactive in healthy individuals. Journal of Clinical Investigation, 117(6), 1558-1565.

Niers, L., Stasse-Wolthuis, M., Rombouts, F. M., & Rijkers, G. T. (2007). Nutritional support for the infant’s immune system. Nutritional Reviews, 65(8), 347-360.

Paustian, T. & Roberts, G. (2005). Antibodies come in five classes. Through The Microscope: A Look At All Things Small, 15-18. Retrieved September 20, 2007, from the Bacteriology Department Website from the University of Wisconsin-Madison: http://www.microbiologytext.com/index.php?module=Book&func=displayarticle&art_id=393

Vedhara, K., & Irwin, M.R. (2005). Human Psychoneuroimmunology. New York, NY: Oxford University Press.