The effect of an academic examination on salivary norepinephrine and immunoglobulin levels

A Review of Psychological Stress among Students and Its Assessment Using Salivary Biomarkers

Numerous psychoneuroimmune factors participate in complex bodily reactions to psychological stress, and some of them can be easily and non-invasively measured in saliva (cortisol, alpha-amylase, proinflammatory cytokines). Cortisol plays a crucial role in the stress response; thus, stressful events (academic examinations, cardiac surgery, dental procedures) are accompanied by an increase in cortisol levels. (A correlation between cortisol blood levels and salivary values has already been confirmed, particularly during stress). Academic stress is defined as everyday stress among students that has an impact on aspects of their psychological and physiological well-being. For example, exams are considered one of the most acute stressful experiences for students. The strength of the association between academic self-efficacy, psychological stress, and anxiety depends on a variety of factors: the type of academic challenge (e.g., oral exam), the presence of an audience, etc. Higher stress levels were predominantly recorded among younger students, primarily regarding their academic tasks and concerns (grades, exams, competing with peers for grades, fear of failing the academic year, etc.). The measurement of stress levels during academic stress can improve our understanding of the character and influence of stressful events in populations of students, preventing adverse reactions to long-term stress, such as a decreased immune response and increased anxiety.

The Relationship Between Multidimensional Motivation and Endocrine-Related Responses: A Systematic Review

Multidimensional motivational theories postulate that the type of motivation is as important as the quantity of motivation, with implications for human functioning and well-being. An extensive amount of research has explored how constructs contained within these theories relate to the activation of the endocrine system. However, research is fragmented across several theories, and determining the current state of the science is complicated. In line with contemporary trends for theoretical integration, this systematic review aims to evaluate the association between multidimensional motivational constructs and endocrine-related responses to determine which theories are commonly used and what inferences can be made. Forty-one studies were identified incorporating five distinct motivation theories and multiple endocrine-related responses. There was evidence across several theories that high-quality motivation attenuated the cortisol response in evaluative environments. There was also evidence that motivational needs for power and affiliation were associated with lower and higher levels of salivary immunoglobulin A, respectively. The need for power may play a role in increasing testosterone when winning a contest; however, this evidence was not conclusive. Overall, this review can shape the future integration of motivational theories by characterizing the nature of physiological responses to motivational processes and examining the implications for well-being.

Salivary Proteome Changes in Response to Acute Psychological Stress Due to an Oral Exam Simulation in University Students: Effect of an Olfactory Stimulus

The autonomic nervous system (ANS) plays a crucial role both in acute and chronic psychological stress eliciting changes in many local and systemic physiological and biochemical processes. Salivary secretion is also regulated by ANS. In this study, we explored salivary proteome changes produced in thirty-eight University students by a test stress, which simulated an oral exam. Students underwent a relaxation phase followed by the stress test during which an electrocardiogram was recorded. To evaluate the effect of an olfactory stimulus, half of the students were exposed to a pleasant odor diffused in the room throughout the whole session. Saliva samples were collected after the relaxation phase (T0) and the stress test (T1). State anxiety was also evaluated at T0 and T1. Salivary proteins were separated by two-dimensional electrophoresis, and patterns at different times were compared. Spots differentially expressed were trypsin digested and identified by mass spectrometry. Western blot analysis was used to validate proteomic results. Anxiety scores and heart rate changes indicated that the fake exam induced anxiety. Significant changes of α-amylase, polymeric immunoglobulin receptor (PIGR), and immunoglobulin α chain (IGHA) secretion were observed after the stress test was performed in the two conditions. Moreover, the presence of pleasant odor reduced the acute social stress affecting salivary proteome changes. Therefore, saliva proteomic analysis was a useful approach to evaluate the rapid responses associated to an acute stress test also highlighting known biomarkers.

Exhaled nitric oxide and vascular endothelial growth factor as predictors of cold symptoms after stress

OBJECTIVE

Prior research has demonstrated that psychosocial stress is associated with respiratory infections. Immunologic, endocrine, and cardiovascular predictors of such infections have been explored with varying success. We therefore sought to study the unexplored role of airway mucosal immunity factors, nitric oxide (NO) and vascular endothelial growth factor (VEGF). NO is secreted by airway epithelial cells as part of the first line of defense against bacteria, viruses, and fungi. VEGF is expressed by mast cells in respiratory infections and recruits immune cells to infected sites, but in excess lead to vulnerability of the airway epithelium.

METHODS

In this proof-of-concept study we measured exhaled NO, exhaled breath condensate (EBC) VEGF, salivary VEGF, and salivary cortisol in 36 students undergoing final academic examinations at three occasions: a low-stress baseline during the term, an early phase of finals, and a late phase of finals. Participants also reported on cold symptoms at these time points and approximately 5 and 10days after their last academic examination.

RESULTS

Higher baseline NO was associated with fewer cold symptoms after stress, whereas higher baseline VEGF in EBC and saliva were associated with more cold symptoms after stress. Perceived stress at baseline as well as salivary VEGF and cortisol late in the finals also contributed to the prediction of later cold symptoms.

CONCLUSION

Basal levels of NO and VEGF may inform about mucosal immunocompetence and add to preventative treatments against airway infections from periods of stress in daily life.

The Scientific Status of Projective Techniques

Although projective techniques continue to be widely used in clinical and forensic settings, their scientific status remains highly controversial. In this monograph, we review the current state of the literature concerning the psychometric properties (norms, reliability, validity, incremental validity, treatment utility) of three major projective instruments: Rorschach Inkblot Test, Thematic Apperception Test (TAT), and human figure drawings. We conclude that there is empirical support for the validity of a small number of indexes derived from the Rorschach and TAT. However, the substantial majority of Rorschach and TAT indexes are not empirically supported. The validity evidence for human figure drawings is even more limited. With a few exceptions, projective indexes have not consistently demonstrated incremental validity above and beyond other psychometric data. In addition, we summarize the results of a new meta-analysis intended to examine the capacity of these three instruments to detect child sexual abuse. Although some projective instruments were better than chance at detecting child sexual abuse, there were virtually no replicated findings across independent investigative teams. This meta-analysis also provides the first clear evidence of substantial file drawer effects in the projectives literature, as the effect sizes from published studies markedly exceeded those from unpublished studies. We conclude with recommendations regarding the (a) construction of projective techniques with adequate validity, (b) forensic and clinical use of projective techniques, and (c) education and training of future psychologists regarding projective techniques.

A novel biomarker associated with distress in humans: calcium-binding protein, spermatid-specific 1 (CABS1)

Calcium-binding protein spermatid-specific 1 (CABS1) is expressed in the human submandibular gland and has an anti-inflammatory motif similar to that in submandibular rat 1 in rats. Here, we investigate CABS1 in human saliva and its association with psychological and physiological distress and inflammation in humans. Volunteers participated across three studies: 1) weekly baseline measures; 2) a psychosocial speech and mental arithmetic stressor under evaluative threat; and 3) during academic exam stress. Salivary samples were analyzed for CABS1 and cortisol. Additional measures included questionnaires of perceived stress and negative affect; exhaled nitric oxide; respiration and cardiac activity; lung function; and salivary and nasal inflammatory markers. We identified a CABS1 immunoreactive band at 27 kDa in all participants and additional molecular mass forms in some participants. One week temporal stability of the 27-kDa band was satisfactory (test-retest reliability estimate = 0.62-0.86). Acute stress increased intensity of 18, 27, and 55 kDa bands; 27-kDa increases were associated with more negative affect and lower heart rate, sympathetic activity, respiration rate, and minute ventilation. In both acute and academic stress, changes in 27 kDa were positively associated with salivary cortisol. The 27-kDa band was also positively associated with VEGF and salivary leukotriene B4 levels. Participants with low molecular weight CABS1 bands showed reduced habitual stress and negative affect in response to acute stress. CABS1 is readily detected in human saliva and is associated with psychological and physiological indicators of stress. The role of CABS1 in inflammatory processes, stress, and stress resilience requires careful study.

Increased Salivary Nitric Oxide and G6PD Activity in Refugees with Anxiety and Stress

Anxiety and stress are related to physiological changes in humans. Accumulating evidence suggests a cross-talk between psychiatric disorders and oxidative stress. The objective of this study was to compare oxidative stress and defensive antioxidant biomarkers in a group of refugees with acute anxiety and stress with a group of local Jordanians. The Hamilton Anxiety Rating Scale (HAM-A) and the Perceived Stress Scale (PSS) Arabic version were used to assess anxiety and stress respectively. Salivary nitric oxide concentration, glucose-6-phosphate dehydrogenase (G6PD) activity and total salivary protein were compared. As expected, refugees showed higher anxiety and stress scores compared with Jordanians. Also, we report a significant increase in salivary nitric oxide and G6PD activity in the refugee group while total protein concentration did not vary between the two groups. This is the first study that demonstrates an increase in nitric oxide and G6PD activity in the saliva of refugees, thus highlighting their potential role as possible biomarkers in anxiety and stress disorders. Copyright © 2015 John Wiley & Sons, Ltd.

Linking Motives and Emotions: A Test of McClelland's Hypotheses

McClelland (1985) hypothesized that motives and emotions are linked in specific ways, with each primary emotion relevant to only one motive. Two studies were generally supportive of the specific links hypothesized by McClelland. In Study 1, participants visualized success at satisfying each of three motives (achievement, affiliation-intimacy, and power); after each visualization, they reported their emotional state. As predicted, levels of interest and surprise were high after the achievement visualization but levels of excitement and focus were also high. Happiness and love were high after the affiliation-intimacy visualization (as predicted) but happiness was also high after the achievement visualization. Levels of anger, disgust, and confusion were highest after the power visualization. In Study 2, participants recalled instances of happiness, sadness, anger, and feeling challenged. Anger stories were most likely to be about power, sadness stories about affiliation-intimacy, and challenge stories about achievement. The most frequent happiness stories were about either affiliation-intimacy or achievement.

Public speaking in front of an unreceptive audience increases implicit power motivation and its endocrine arousal signature

The present study explored the motivational characteristics of the Trier Social Stress Test (TSST; Kirschbaum, Pirke, & Hellhammer, 1993). Seventy-two participants either completed the public-speaking component of the TSST or, as a control condition, the friendly TSST (Wiemers, Schoofs, & Wolf, 2013) and wrote picture stories both before and after treatment. Stories were coded for motivational imagery related to power, achievement, and affiliation as well as for activity inhibition, a marker of functional brain lateralization during stress. The TSST had a specific arousing effect on power motivation, but not on other motivational needs, on activity inhibition, or on story length. TSST-elicited increases in power imagery, but not in achievement or affiliation imagery, were associated with a relatively greater salivary alpha-amylase response and with a relatively lesser salivary cortisol response. These findings suggest that the TSST specifically induces power-related stress.

Does stress predispose to periodontal disease?

The relationship of a sound mind to the maintenance of a healthy body has been recognized throughout most of recorded history. The term 'stress' is used to describe adverse emotions or reactions to unpleasant experiences. Individuals with high levels of stress and poor coping skills experience twice as much periodontal disease as compared to those with minimal stress and good coping skills. Although stress may predispose an individual to more destruction from periodontitis, the presence of periodontal pathogens remains the essential aetiologic factor. This review presents a summary of stress, discussing how it can predispose an individual to periodontal disease.

CLINICAL RELEVANCE

Stress, which is a universal phenomenon, is implicated to have various systemic effects besides being a risk factor for periodontal disease. This article elucidates the relationship between psycho-social stress and destructive periodontal disease.

The change in the amount of immunoglobulins as a response to stress experienced by soldiers on a peacekeeping mission

PURPOSE

Recent studies have demonstrated various changes in systemic and mucosal immunity in people undergoing psychological stress. This study was designated for an assay of associations between the stress experienced by Lithuanian soldiers as a response to changed job conditions (deployment to Afghanistan) and level of immunoglobulins. Salivary and sera immunoglobulin concentrations were assessed and compared before and after the military mission; the associations between the deployment-related stress and the immunoglobulin level were examined.

METHODS

Special questionnaires covering state of health and strain experienced were used. Quantitative detection of immunoglobulins was performed by sandwich ELISA.

RESULTS

Comparison of the medians at three time points (before, after the deployment and 1 year after the mission) showed an increased level of salivary secretory immunoglobulin A (S-IgA) in association with deployment. Chi-square test of independence indicated statistically significant relationship between the stress and S-IgA amount. Correlation analysis using different health control methods revealed masked fear of soldiers to be expelled from the military service.

CONCLUSIONS

The results indicated that salivary S-IgA is the most sensitive representative of mucosal immunity system to psychological stress related to changed job conditions in military service.

[Stress in surgeries]

INTRODUCTION

The purpose of this article was to provide the literature regarding the psychological stress in the peri-operative period of adult patients undergoing operations under general anesthesia.

METHODS

The articles were obtained by surveying the papers published and catalogued in the Medline Pubmed interface database, Lilacs and the Biblioteca Virtual de Saúde (BVS) since 1984, crossing the headings stress, surgery, general anesthesia, psychology. Over 800 articles related to stress and surgery were analyzed with regards to their relevance to the considered subject. Eighteen articles were related to psychological stress. Their results confirmed the presence of psychological and physical stress, during the peri-operative period as well as relation between stress and de clinical post-operative recovery. There is a gap regarding in the peri-operative period.

CONCLUSION

More studies on psychological influence on stress may benefit patients and help professionals during the surgical treatment.

Secretory IgA in saliva can be a useful stress marker

To evaluate secretory immunoglobulin A (slgA) in saliva as an immunological stress marker, we reviewed the literature on slgA and its variation caused by psychosocial factors. Among the studies on the effect of academic stress on slgA secretion, we could distinguish two kinds of stress effects: the immediate stress effect which increases slgA secretion immediately after stress, and the delayed stress effect which decreases slgA secretion several days after stress. On the basis of production and secretion mechanisms of slgA, we also speculated on possible mechanisms that underlie the variations of slgA caused by stress. Eventually, we concluded diat slgA in saliva can be a useful stress marker if we analyze the delayed stress effect on slgA separately from the immediate stress effect on slgA.

Are implicit motives the need to feel certain affect? Motive-affect congruence predicts relationship satisfaction

The authors test the assumption that the core of implicit motives is the desire for particular affective experiences and that motive satisfaction need not be tied to any particular domain. Using the context of romantic relationships, cross-sectional Study 1 and experimental Study 2 showed that people with a high affiliation motive were more satisfied when they experienced more affiliation-specific affect (calmness and relaxation). However, people with a higher power motive were more satisfied in their relationships when they experienced more power-specific affect (strength and excitement) in these relationships. The results support the idea that an implicit motive involves the desire for specific affective experiences and that frequent experiences of one's preferred affect can lead to enhanced satisfaction and well-being in a domain, even one that is not typically associated with that motive.

Adrenergic signaling in human oral keratinocytes and wound repair

Catecholamines are present in saliva, but their influence on oral epithelium is not understood. Because psychological stress increases salivary catecholamines and impairs oral mucosal wound healing, we sought to determine if epithelial adrenergic signaling could link these two findings. We found that cultured human oral keratinocytes (HOK) express the α(2B)- and β(2)-adrenergic receptors (ARs). Exposure of HOK to either epinephrine or the β-AR agonist, isoproterenol, reduced migratory speed and decreased in vitro scratch wound healing. Incubation with the β-AR antagonist timolol reversed the catecholamine-induced effects, indicating that the observed response is mediated by β-AR. Epinephrine treatment decreased phosphorylation of the mitogen-activated protein kinases (MAPK) ERK1/2 and p38; these decreases were also reversed with timolol. Cultured HOK express enzymes of the epinephrine synthetic pathway, and generate epinephrine. These findings demonstrate that stress-induced elevations of salivary catecholamines signal through MAPK pathways, and result in impaired oral keratinocyte migration required for healing.

Use of saliva for assessment of stress and its effect on the immune system prior to gross anatomy practical examinations

The objective of this study was to determine the longitudinal effects of a series of stressful gross anatomy tests on the immune system. Thirty-six freshman occupational therapy students completed a written stress evaluation survey, and saliva samples were obtained at baseline and prior to each of three timed-practical gross anatomy tests. Cortisol, secretory IgA (sIgA), and IL-12 concentrations were measured within the salivary samples by enzyme-linked immunosorbent assay. The total scores from the stress surveys were used as markers for environmental stress. Data were compiled for each student at baseline and prior to each examination and were compared by repeated-measures MANOVA and Pearson's correlation test. Following normalization for protein concentration and flow rate, the concentrations of IL-2, IL-6, IL-12, and sIgA progressively increased from baseline to the third test. Cortisol concentrations, following normalization for flow rate, were highest prior to the first test and became significantly reduced prior to second and third test. Prior to second and third test, salivary concentrations of IL-6, IL-2, IL-12, and sIgA were significantly correlated (P < 0.05). In contrast, prior to third test, there was a negative correlation between salivary concentrations of cortisol and IL-12 (P < 0.05). Progressive increases in salivary sIgA, IL-6, IL-2, and IL-12 concentrations from the first to the third test coincident to decreased salivary cortisol suggest that the initial examination stressors precede significant effects on the immune system. These data suggest that there may be latent effects of examination stress on the immune system and that saliva can be used to predict these effects.

The hormonal correlates of implicit power motivation

Attempts to link testosterone to dominance dispositions using self-report measures of dominance have yielded inconsistent findings. Similarly, attempts to link testosterone changes to a situational outcome like winning or losing a dominance contest have yielded inconsistent findings. However, research has consistently shown that an indirect measure of an individual's dominance disposition, implicit power motivation, is positively related to baseline testosterone levels and, in interaction with situational outcomes, predicts testosterone changes. We propose a hormonal model of implicit power motivation that describes how testosterone levels change as an interactive function of individuals' implicit power motivation and dominance situations. We also propose that estradiol, and not testosterone, plays a key role in dominance motivation in women.

Cortisol as a marker for improvement in mindfulness-based stress reduction

While much attention has been devoted to examining the beneficial effects of Mindfulness-Based Stress Reduction programs on patients' ability to cope with various chronic medical conditions, most studies have relied on self-report measures of improvement. Given that these measures may not accurately reflect physiological conditions, there is a need for an objective marker of improvement in research evaluating the beneficial effects of stress management programs. Cortisol is the major stress hormone in the human organism and as such is a promising candidate measure in the study of the effects of Mindfulness-Based Stress Reduction programs. In conjunction with other biological measures, the use of cortisol levels as a physiological marker of stress may be useful to validate self-reported benefits attributed to this program. In the current manuscript, we review the available literature on the role of cortisol as a physiological marker for improvement with regards to mindfulness practice, and make recommendations for future study designs.

Knowledge and use of music therapy among pediatric practitioners in Michigan

OBJECTIVE

Increasingly, music therapy is being used, in combination with conventional treatment modalities, as part of the health care treatment plan. The objective of our study was to determine the awareness, knowledge and use of music therapy by members of the Michigan chapter of the American Academy of Pediatrics (Michigan AAP) in their health care practice.

METHODS

Members of the Michigan AAP were asked to participate in a survey designed to assess their knowledge and use of music therapy in their health care practice.

RESULTS

Although the majority of respondents were aware of the use of music therapy in health care settings, very few had referred their own patients for music therapy services.

CONCLUSION

Music therapy is an inexpensive and noninvasive treatment modality being used increasingly, especially to alleviate pain, stress, and anxiety among patients in a variety of conditions. Pediatric practitioners in Michigan, who responded to our survey, expressed a strong interest in learning more about music therapy and learning about ways to incorporate music therapy into their health care practice.

Basal and dynamic relationships between implicit power motivation and estradiol in women

This study investigated basal and reciprocal relationships between implicit power motivation (n Power), a preference for having impact and dominance over others, and both salivary estradiol and testosterone in women. 49 participants completed the Picture Story Exercise, a measure of n Power. During a laboratory contest, participants competed in pairs on a cognitive task and contest outcome (win vs. loss) was experimentally varied. Estradiol and testosterone levels were determined in saliva samples collected at baseline and several times post-contest, including 1 day post-contest. n Power was positively associated with basal estradiol concentrations. The positive correlation between n Power and basal estradiol was stronger in single women, women not taking oral contraceptives, or in women with low-CV estradiol samples than in the overall sample of women. Women's estradiol responses to a dominance contest were influenced by the interaction of n Power and contest outcome: estradiol increased in power-motivated winners but decreased in power-motivated losers. For power-motivated winners, elevated levels of estradiol were still present the day after the contest. Lastly, n Power and estradiol did not correlate with self-reported dominance and correlated negatively with self-reported aggression. Self-reported dominance and aggression did not predict estradiol changes as a function of contest outcome. Overall, n Power did not predict basal testosterone levels or testosterone changes as a function of dominance contest outcome.

Music therapy in pediatrics

The soothing effects of music have been well described over the centuries and across cultures. In more recent times, studies have shown the beneficial effects of music in alleviating symptoms in a wide variety of clinical and psychologic conditions. Music therapy has been primarily used as an intervention to control emotional states, in pain management, cognitive processing, and stress management. Stress is associated with increased production of the stress hormone cortisol, which is known to suppress immune responses. Several studies in the past few decades have demonstrated a positive effect of music therapy on reducing stress or increasing immune responses, or both. Music therapy should therefore be considered as a valuable addition to standard pharmacologic therapeutic modalities in enhancing the immune response and lowering stress levels in such conditions. This article reviews the role of music as a therapeutic modality and the future for music therapy, particularly in pediatrics.

Effect of repeated restraint stress on the levels of intestinal IgA in mice

The effects of restraint stress on the intestinal humoral immune system, particularly those about intestinal IgA production, have not been explored in detail. Thus, the purpose of this study was to assess the effect of restraint stress on the production and secretion of intestinal IgA as well as on the number of IgA+ cells in the intestinal lamina propria. The involvement of glucocorticoids and catecholamines were also evaluated. Mice were exposed to 1 or 4 h restraint stress for 4 d. The intestinal IgA concentration was quantified by ELISA and the number of IgA containing cells in the lamina propria was determined by immunohistochemistry. The effects of restraint were also analyzed in mice submitted to different procedures: adrenalectomy, chemical sympathectomy, treatment with a glucocorticoid antagonist (RU486), dexamethasone and epinephrine. The main findings were that (1) chronic restraint-stress reduced the intestinal IgA concentration without changing the number of IgA+ cells in lamina propria; (2) adrenalectomy restored the production of IgA in stressed mice; (3) RU486 and chemical sympathectomy partially blocked the decrease in intestinal IgA in stressed mice; and (4) pharmacological doses of dexamethasone and epinephrine significantly reduced the intestinal IgA concentration and the number of IgA+ cells. The restraint stress probably reduced the intestinal IgA concentration through the effects of glucocorticoids and catecholamines.

Stressful life events are associated with low secretion rates of immunoglobulin A in saliva in the middle aged and elderly

Whether chronic stress experience is related to downregulation of secretory immunoglobulin A (S-IgA) was tested in two substantial cohorts, one middle aged (N = 640) and another elderly (N = 582), comprising similar numbers of men (N = 556) and women (N = 666) and manual (N = 606) and non-manual (N = 602) workers. Participants indicated from a list of major stressful life events, up to six, they had experienced in the past 2 years. They also rated how disruptive and stressful the events were, at the time and now, as well as their perceived seriousness; the products of these impact values and event frequency were adopted as measures of stress load. From unstimulated 2-min saliva samples, saliva volume and S-IgA concentration were measured, and S-IgA secretion rate determined as their product. There was a negative association between the stress load measures and the S-IgA secretion rate, still evident following adjustment for such variables as smoking and saliva volume. The associations also withstood adjustment for sex, cohort, and household occupational status. Although these associations are small in terms of the amount of variance explained, they nonetheless suggest that chronic stress experience either decreases IgA production by the local plasma cells or reduces the efficiency with which S-IgA is transported from the glandular interstitium into saliva. Given the importance of S-IgA in immune defence at mucosal surfaces and the frequency with which infections are initiated at these surfaces, S-IgA downregulation could be a means by which chronic stress increases susceptibility to upper respiratory tract infection.

Effects of implicit power motivation on men's and women's implicit learning and testosterone changes after social victory or defeat

Two studies examined interactions of implicit power motivation and experimentally varied victory or defeat in a contest on implicit learning of a visuomotor sequence associated with the contest outcome and changes in testosterone and self-reported affect. In men and women, power motivation predicted enhanced learning (sequence-execution accuracy) after a victory and impaired learning after a defeat. In men, power motivation predicted testosterone increases among winners and decreases among losers, and testosterone decreases mediated the negative effect of power motivation on learning in losers. In women, power motivation predicted postcontest testosterone increases, particularly among losers. In both men and women, self-reported affective states were influenced only by contest outcome and were unrelated to participants' testosterone changes or implicit learning.

Effect of petting a dog on immune system function

The present study assessed the effect of petting a dog on secretory immunoglobulin A (IgA) levels. 55 college students were randomly assigned to either an experimental group or one of two control groups. Group 1 (n= 19) petted a live dog; Group 2 (n = 17) petted a stuffed dog, while Group 3 (n = 19) simply sat comfortably on a couch. Each participant was exposed to one of the three conditions for 18 min. Pre- and posttreatment saliva samples yielded a significant increase in IgA for Group 1 only. Participants were also asked to complete the Pet Attitude Scale of Templer, Salter, Dickey, Baldwin and Veleber. Scores on this scale correlated with IgA increases only for participants in Group 2 (petting a stuffed animal). Results are discussed in terms of the beneficial effects of pets on health in general, and immunity in particular.

Stress and Mood: The Moderating Role of Activity Inhibition

The present research tested the hypothesis that activity inhibition (as measured by the picture story exercise) moderates the relationship between stress and mood. Based on prior research that shows that (a) individuals high in activity inhibition restrain emotional and motivational impulses and (b) inhibiting negative emotion may lead to further emotional impairments, we assumed that individuals high in activity inhibition show evidence of increased negative mood when they are confronted with stressful events. Study 1 found evidence of increased negative mood-relevant thought among individuals high in activity inhibition who were confronted with the threat of social rejection. Study 2 found high negative mood among individuals high in activity inhibition who experienced many daily hassles. Also, participants high in activity inhibition reported a disproportionally higher amount of daily hassles in the middle (but not at the beginning) of a university semester. We suggest that this pattern of results can be accounted for by Wegner's (1994) theory of ironic effects of the suppression of thought and emotion.

Sexual frequency and salivary immunoglobulin A (IgA)

112 college students reported the frequency of their sexual encounters and were divided into four categories: none, infrequent (less than once a week), frequent (one to two times per week), and very frequent (three or more times per week). Participants also described their overall sexual satisfaction. Saliva samples were collected and assayed for salivary immunoglobulin A (IgA). Individuals in the frequent group showed significantly higher levels of IgA than the other three groups, which were comparable. Data on length of relationship and sexual satisfaction were not related to the group differences.

Psychological stress and the human immune system: a meta-analytic study of 30 years of inquiry

The present report meta-analyzes more than 300 empirical articles describing a relationship between psychological stress and parameters of the immune system in human participants. Acute stressors (lasting minutes) were associated with potentially adaptive upregulation of some parameters of natural immunity and downregulation of some functions of specific immunity. Brief naturalistic stressors (such as exams) tended to suppress cellular immunity while preserving humoral immunity. Chronic stressors were associated with suppression of both cellular and humoral measures. Effects of event sequences varied according to the kind of event (trauma vs. loss). Subjective reports of stress generally did not associate with immune change. In some cases, physical vulnerability as a function of age or disease also increased vulnerability to immune change during stressors.

Two urinary catecholamine measurement indices for applied stress research: effects of time and temperature until freezing

Research on stress at work often involves the analysis of urinary adrenaline and noradrenaline. It is usually assumed that samples have to be cooled quickly and stored at refrigerator temperature before freezing. This is often difficult to achieve in field studies. This experimental study therefore tests the robustness of results when samples are not cooled immediately. Samples of 9 men and women, collected at 3 points in time, were immediately frozen, kept for a variable delay in a warm room, or stored in a refrigerator before freezing. Two indices were calculated: (a) the ratio of hormones to liquid volume, period of excretion, and body weight; and (b) the ratio of hormones to urinary creatinine. The reliability of high performance liquid chromatography analysis was satisfactory, as was the comparability of the 2 indices. Unfavorable storage up to 24 hr did not cause bacteria-driven decreases of catecholamines, regardless of storage temperature or sampling time. Results suggest high stability for at least 24 hr without cooling, provided the samples are immediately acidified. Cooling may therefore be handled less restrictively than has been assumed. The application of this research is to facilitate research in settings where samples are collected at different places, such as participants' homes or different workplaces.

Psychological stress and the human immune system: a meta-analytic study of 30 years of inquiry

The present report meta-analyzes more than 300 empirical articles describing a relationship between psychological stress and parameters of the immune system in human participants. Acute stressors (lasting minutes) were associated with potentially adaptive upregulation of some parameters of natural immunity and downregulation of some functions of specific immunity. Brief naturalistic stressors (such as exams) tended to suppress cellular immunity while preserving humoral immunity. Chronic stressors were associated with suppression of both cellular and humoral measures. Effects of event sequences varied according to the kind of event (trauma vs. loss). Subjective reports of stress generally did not associate with immune change. In some cases, physical vulnerability as a function of age or disease also increased vulnerability to immune change during stressors.

Use and abuse of academic examinations in stress research

Previous research suggests that certain types of academic examinations can have a significant impact on psychological and physical health. However, there has not been adequate discussion about the methodological and statistical issues associated with using academic examinations as a model for short-term stress in the context of psychoneuroimmunology research. Limitations of the model are presented with recommendations for appropriate use. Specific suggestions include use of subjective and objective measures of test difficulty, within-subjects designs including measurements during the examination itself, statistical models for testing interactions of continuous variables, and participants with clinical conditions.

Secretory immunoglobulin A reactions to prolonged mental arithmetic stress: inter-session and intra-session reliability

Although previous evidence suggests that mucosal immunity may be influenced by mental stress, the importance of the duration of stress exposure on secretory immunoglobulin A (sIgA) has yet to be fully elucidated. Salivary sIgA and cardiovascular activity were measured at rest, following 14 and 28 min of mental arithmetic, and after recovery in 24 men and women on two sessions 2-4 days apart. Mental arithmetic was, on both sessions and after both the early and late phases of the task, associated with increases in sIgA concentration and sIgA secretion rate compared to rest and recovery. Task levels of sIgA concentration and sIgA secretion rate showed moderate to high intra- and inter-session test-retest reliability, while test-retest reliability was lower for change scores. Blood pressure and pulse rate were also elevated by the mental stress task, although correlational analyses revealed that stress-induced changes in sIgA were not related to cardiovascular reactions.

The relationship of depression and stressors to immunological assays: a meta-analytic review

This is a broad meta-analysis of the relations of both depression and stressors to immunological assays. The number of study samples (greater than 180) and measures (greater than 40) is much more extensive than any so far. Analyses are done by both fixed and random effects. By a fixed-effects analysis, both major depression and naturally occurring acute stressors are associated with (1) an overall leukocytosis, (2) mild reductions in absolute NK-cell counts and relative T-cell proportions, (3) marginal increases in CD4/CD8 ratios, and (4) moderate decreases in T- and NK-cell function. However, the degree of heterogeneity of the studies' results raises questions about their robustness. Therefore, we also did the first random effects analysis to estimate what is likely to appear in future studies. For depression, the analysis showed the immunological correlates included (1) an overall leukocytosis, manifesting as a relative neutrophilia and lymphoenia; (2) increased CD4/CD8 ratios; (3) increased circulating haptoglobin, PGE(2), and IL-6 levels; (4) reduced NK-cell cytotoxicity; and (5) reduced lymphocyte proliferative response to mitogen. For stressors, the random effects analysis showed that future studies are likely to find the following effects: (1) an overall leukocytosis, manifesting as an absolute lymphocytosis; (2) alterations in cytotoxic lymphocyte levels, CD4/CD8 ratios, and natural killer cell cytotoxicity with the direction of change depending on the chronicity of the stressor; (3) a relative reduction of T-cell levels; (3) increased EBV antibody titers; (4) reduced lymphocyte proliferative response and proportion of IL-2r bearing cells following mitogenic stimulation; and (5) increased leukocyte adhesiveness. The random-effects analysis revealed that for both major depression and naturally occurring stressors the following effects are shared: leukocytosis, increased CD4/CD8 ratios, reduced proliferative response to mitogen, and reduced NK cell cytotoxicity. The implications for these findings for disease susceptibility and the pathophysiology of these conditions is discussed.

Psychological treatment for recurrent symptoms of colds and flu in children

The effect of stress management and relaxation with guided imagery on upper respiratory tract infections (URTIs) was investigated in 45 children with a history of 10 or more infections in the past year. To investigate the influence of psychological treatment on mucosal immunity, secretory immunoglobulin A (sIgA) was measured before and during treatment. The number of symptomatic episodes during 13 weeks of monitoring was similar in treatment and waitlist conditions; however, episodes were shorter in stress management and guided imagery conditions than in the waitlist condition. Levels of sIgA increased toward the end of treatment. These findings were confirmed in a replication study. In addition, symptom reduction and improvements in psychological state persisted at 1-year follow-up. The findings suggest that psychological treatment interrupts a chronic illness cycle in children with symptoms of recurrent URTI.

Academic stress and secretory immunoglobulin A

Immediately before and after giving an oral presentation and taking examinations 10 final-year students provided saliva samples for immunoglobulin A assay. Compared with 'baseline', levels of immunoglobulin A were lower surrounding the examination conditions and before the presentation.

Prolonged reduction of salivary immunoglobulin A (sIgA) after a major academic exam

OBJECTIVE

In a previous study we observed a continuous reduction of salivary IgA concentration ([sIgA]) during a period of academic stress. This reduction of sIgA concentration exceeded the stress period by at least 1 week. The present study aimed to replicate and extend our previous finding. In particular, we wanted to examine the time of recovery of [sIgA] alterations associated with academic stress.

METHOD

Twenty-seven participants in a major medical exam and 27 controls not participating in any exam during the study provided daily saliva samples (immediately after awakening), from the 6th day prior to their last exam until the 14th day afterwards, for analysis of salivary IgA. Data were averaged for the last weeks of exams and the first and second week after exams, respectively.

RESULTS

A prolonged reduction of sIgA in exam students as compared to controls was observed. Fourteen days post-stress sIgA concentrations of exam students were still significantly lower than control levels (P=0.004). No recovery was observable. At the same time exam students and controls did not differ in terms of self-reported stress and recovery.

CONCLUSIONS

Psychological and immunological stress effects may be dissociated, the latter considerably exceeding the stress period. A closer look at the temporal dynamics of stress-induced immune alterations might increase our understanding of psychoimmuno relationships.

Stress and immune system function in a newspaper's newsroom

Data were collected on 10 newswriters in a newspaper's newsroom. These included self-reported stress ratings and saliva samples for secretary immunoglobulin A (IgA) analysis. The stress ratings and saliva samples were taken initially and after three 30-min. periods. The first time period was a baseline measure and involved the workers engaging in their usual tasks. At Time 2 music was presented for 30 min. while workers engaged in their normal activities. At Time 3 workers resumed their normal duties. Findings showed an increase in IgA that was not statistically significant, a reduction in stress during the music period that was statistically significant, and a statistically significant negative correlation between stress and IgA.

Secretory immunoglobulin A and cardiovascular activity during mental arithmetic: effects of task difficulty and task order

Secretory immunoglobulin A (sIgA) in saliva and cardiovascular activity were measured at rest and during mental arithmetic. Task difficulty was manipulated by presenting easy, hard, and impossible versions of the mental arithmetic task in counterbalanced order, while task novelty was operationalised as order of presentation (i.e. first, second, third). Mental arithmetic elicited significant increases in sIgA concentration and sIgA secretion rate, as well as significant cardiovascular effects. Performance decreased and rated difficulty increased with increasing task difficulty. However, sIgA and cardiovascular activity, with the exception of diastolic blood pressure, were insensitive to variations in task difficulty. In contrast, sIgA concentration and a broad range of cardiovascular variables were influenced by task novelty, with more pronounced activity characterising the task version presented first, irrespective of its level of difficulty. Task novelty would seem to be a more important determinant of sIgA and cardiovascular activity than task difficulty.

Cardiovascular and secretory immunoglobulin A reactions to humorous, exciting, and didactic film presentations

Secretory immunoglobulin A (sIgA) in saliva and cardiovascular activity were measured at rest and in response to three film extracts varying in affective content. Subjective ratings of film impact confirmed a priori assumptions; the humorous film was rated as funnier than the other two films, the didactic film as more boring than the other two films, and the exciting film as more exciting and more stressful than the other two films. The films elicited distinct patterns of cardiovascular autonomic activity. The exciting film provoked changes characteristic of beta-adrenergic activation: increased systolic blood pressure (SBP); heart rate (HR); cardiac output (CO); and shortened pre-ejection period (PEP). The didactic film had little impact on cardiovascular activity. While an increase in total peripheral resistance (TPR) occurred, the humorous film was largely notable for a reduction in beta-adrenergic drive, as evidenced by reduced CO and a lengthening of PEP. In contrast to previous research reporting a rise in sIgA particular to humorous exposures, the sIgA secretion rate, although enhanced by exposure to the films, did not vary with film content.

The effects of high-intensity intermittent exercise on saliva IgA, total protein and alpha-amylase

The aim of this study was to assess the effect of an acute bout of high-intensity intermittent exercise on saliva IgA concentration and alpha-amylase activity, since this type of training is commonly incorporated into the training programmes of endurance athletes and games players. Eight well-trained male games players took part in the study. They reported to the laboratory after an overnight fast and performed a 60-min cycle exercise task consisting of twenty 1-min periods at 100% VO2max, each separated by 2 min recovery at 30% VO2max. Unstimulated whole saliva was collected over a 5-min period into pre-weighed tubes and analysed for total protein, saliva IgA and alpha-amylase. The saliva flow rate ranged from 0.08 to 1.40 ml x min(-1) at rest and was not significantly affected by the exercise. The performance of the intermittent exercise bout did not affect the saliva IgA concentration, but caused a five-fold increase in alpha-amylase activity (P<0.01 compared with pre-exercise) and a three-fold increase in total protein concentration (P<0.01). These returned to pre-exercise values within 2.5 h post-exercise. It has been suggested that IgA concentration should be expressed as the ratio to total protein concentration, to correct for any concentrating effect due to evaporative loss of saliva water when breathing through the mouth (as in strenuous exercise). The present study clearly demonstrates that this is not appropriate, since there is an increase in salivary protein secretion rate immediately after exercise (571+/-77 microg x min(-1) compared with 218+/-71 microg x min(-1) pre-exercise; P<0.05). The increased saliva alpha-amylase activity after exercise may improve the protective effect of saliva, since this enzyme is known to inhibit bacterial attachment to oral surfaces. The saliva alpha-amylase secretion rate was lower immediately pre-exercise than at any other instant, which may have been due to anticipatory psychological stress, although the subjects were all familiar with interval exercise. This emphasizes the need for true resting non-stressed control conditions in future studies of the effects of exercise on saliva constituents.