A prospective study of neuroendocrine and immune alterations associated with the stress of an oral academic examination among graduate students

Stressful experiences may influence neuroendocrine, immune and cytokine functioning, as well as physical and psychological well being. The present prospective investigation assessed physiological and behavioral variations in anticipation of a critical oral academic examination among graduate students (i.e. related to a dissertation or comprehensive defense). Relative to matched control subjects, plasma cortisol levels were elevated among graduate students, especially females, 1 h prior to the oral examination, but not 6-8 weeks earlier (at about the time of the submission of the written document). In contrast, mitogen-stimulated (Con-A) lymphocyte proliferation was only reduced 6-8 weeks before the examination. Neither adrenocorticotrophic hormone (ACTH), prolactin, serum interleukin-1beta (IL-1beta) nor mitogen stimulated IL-1beta production was influenced at any time. Although, graduate students did not differ from controls with respect to perceived stress and feelings of mastery, they reported more frequent malaise (e.g. headaches, sore throat, fatigue) than did controls. The present findings suggest that during the course of lengthy anticipatory periods preceding a scheduled stressor, different stress-sensitive, situation-dependent biological processes may be engendered. It is further suggested that cortisol release is most closely aligned with immediate threats, while the immune alterations are sensitive to more distal events, or are subject to adaptation in response to a protracted stressor.

[1]  H. Anisman,et al.  The Impact of Stressors on Immune and Central Neurotransmitter Activity: Bidirectional Communication , 1993, Reviews in the neurosciences.

[2]  M. Lieberman,et al.  The stress process. , 1981, Journal of health and social behavior.

[3]  E. Bosmans,et al.  Elevated serum interleukin-6 (IL-6) and IL-6 receptor concentrations in posttraumatic stress disorder following accidental man-made traumatic events , 1999, Biological Psychiatry.

[4]  E. Bosmans,et al.  The effects of psychological stress on humans: increased production of pro-inflammatory cytokines and a Th1-like response in stress-induced anxiety. , 1998, Cytokine.

[5]  N. Schneiderman,et al.  Posttraumatic Stress Symptoms, Intrusive Thoughts, Loss, and Immune Function after Hurricane Andrew , 1997, Psychosomatic medicine.

[6]  J. Cacioppo,et al.  Heterogeneity in Neuroendocrine and Immune Responses to Brief PsychologicalStressors as a Function of Autonomic Cardiac Activation , 1995, Psychosomatic medicine.

[7]  H. Anisman,et al.  Neuroendocrine measures and lymphocyte subsets in depressive illness: Influence of a clinical interview concerning life experiences , 1997, Psychoneuroendocrinology.

[8]  D. Kang,et al.  Academic Examinations Significantly Impact Immune Responses, but Not Lung Function, in Healthy and Well-Managed Asthmatic Adolescents , 1996, Brain, Behavior, and Immunity.

[9]  D. Pearl,et al.  Influence of academic stress and season on 24-hour mean concentrations of ACTH, cortisol, and β-endorphin , 1995, Psychoneuroendocrinology.

[10]  B. Rabin,et al.  Stressor-induced alterations of immune function: mechanisms and issues. , 1994, International archives of allergy and immunology.

[11]  S. Savastano,et al.  Interleukin-1 beta and beta-endorphin circadian rhythms are inversely related in normal and stress-altered sleep. , 1992, The International journal of neuroscience.

[12]  C E Speicher,et al.  Marital quality, marital disruption, and immune function. , 1987, Psychosomatic medicine.

[13]  Bruce S. McEwen,et al.  INDUCTION OF CORTICOTROPIN-RELEASING HORMONE GENE EXPRESSION BY GLUCOCORTICOIDS: IMPLICATION FOR UNDERSTANDING THE STATES OF FEAR AND ANXIETY AND ALLOSTATIC LOAD , 1998, Psychoneuroendocrinology.

[14]  H. Anisman,et al.  Influence of psychosocial, psychogenic and neurogenic stressors on several aspects of immune functioning in mice. , 1999, Stress.

[15]  E. Workman,et al.  T-lymphocyte polyclonal proliferation: effects of stress and stress response style on medical students taking national board examinations. , 1987, Clinical immunology and immunopathology.

[16]  M. Irwin,et al.  Partial night sleep deprivation reduces natural killer and celhdar immune responses in humans , 1996, FASEB journal : official publication of the Federation of American Societies for Experimental Biology.

[17]  Melinda Beck,et al.  Stress-related immune suppression: Health implications , 1987, Brain, Behavior, and Immunity.

[18]  R. Lazarus Coping theory and research: past, present, and future. , 1993, Psychosomatic medicine.

[19]  J. Kiecolt-Glaser,et al.  Stress and Immune Function in Humans , 1991 .

[20]  S. Manuck,et al.  Cardiovascular reactivity and the course of immune response to an acute psychological stressor. , 1994, Psychosomatic medicine.

[21]  L. V. van Doornen,et al.  Effects of beta-adrenergic blockade on immunologic and cardiovascular changes induced by mental stress. , 1994, Circulation.

[22]  H. Anisman,et al.  Primary dysthymia: a study of several psychosocial, endocrine and immune correlates. , 1996, Journal of affective disorders.

[23]  C. Kirschbaum,et al.  Consistent sex differences in cortisol responses to psychological stress. , 1992, Psychosomatic medicine.

[24]  A. Bamberger,et al.  Systemic interleukin‐1 α and interleukin‐2 secretion in response to acute stress and to corticotropin‐releasing hormone in humans * , 1994, European journal of clinical investigation.

[25]  H. Anisman,et al.  Influence of Psychogenic and Neurogenic Stressors on Endocrine and Immune Activity: Differential Effects in Fast and Slow Seizing Rat Strains , 1997, Brain, Behavior, and Immunity.

[26]  S. Paul,et al.  Differential effects of controllable and uncontrollable acute stress on lymphocyte proliferation and leukocyte percentages in humans , 1990, Brain, Behavior, and Immunity.

[27]  R. Gräsbeck,et al.  Effects of psychological stress on plasma interleukins-1 beta and 6, C-reactive protein, tumour necrosis factor alpha, anti-diuretic hormone and serum cortisol. , 1993, Scandinavian journal of clinical and laboratory investigation.

[28]  T. Kamarck,et al.  A global measure of perceived stress. , 1983, Journal of health and social behavior.

[29]  S. Schleifer,et al.  Suppression of lymphocyte stimulation following bereavement. , 1983, JAMA.

[30]  H. Anisman,et al.  Aversive and Appetitive Events Evoke the Release of Corticotropin-Releasing Hormone and Bombesin-Like Peptides at the Central Nucleus of the Amygdala , 1998, The Journal of Neuroscience.

[31]  B. McEwen,et al.  Stress-induced declarative memory impairment in healthy elderly subjects: relationship to cortisol reactivity. , 1997, The Journal of clinical endocrinology and metabolism.

[32]  M. Schedlowski,et al.  Acute psychological stress increases plasma levels of cortisol, prolactin and TSH. , 1992, Life sciences.

[33]  M. Fink,et al.  Neuroleptic malignant syndrome and catatonia: One entity or two? , 1996, Biological Psychiatry.

[34]  S. Cohen,et al.  Stress and infectious disease in humans. , 1991, Psychological bulletin.

[35]  H. Moldofsky,et al.  Sleep and the immune system. , 1995, International journal of immunopharmacology.

[36]  D. Pearl,et al.  Plasma cortisol levels and reactivation of latent Epstein-Barr virus in response to examination stress , 1994, Psychoneuroendocrinology.

[37]  R. DeRubeis,et al.  Reduced Cytokine Levels and T-Cell Function in Healthy Males: Relation to Individual Differences in Subclinical Anxiety , 1994, Brain, Behavior, and Immunity.

[38]  H. Anisman,et al.  Endocrine and cytokine correlates of major depression and dysthymia with typical or atypical features , 1999, Molecular Psychiatry.

[39]  C. Kirschbaum,et al.  Free cortisol levels after awakening: a reliable biological marker for the assessment of adrenocortical activity. , 1997, Life sciences.

[40]  S. Cohen,et al.  Stress and immunity in humans: a meta‐analytic review. , 1993, Psychosomatic medicine.

[41]  J. Kiecolt-Glaser,et al.  Psychosocial Modifiers of Immunocompetence in Medical Students , 1984, Psychosomatic medicine.

[42]  H. Anisman,et al.  Lymphocyte Subsets Associated With Major Depression and Dysthymia: Modification by Antidepressant Treatment , 1995, Psychosomatic medicine.

[43]  R. Glaser,et al.  Psychological stress-induced modulation of interleukin 2 receptor gene expression and interleukin 2 production in peripheral blood leukocytes. , 1990, Archives of general psychiatry.

[44]  D. Pearl,et al.  The influence of academic stress and season on 24-hour concentrations of growth hormone and prolactin. , 1991, The Journal of clinical endocrinology and metabolism.

[45]  S. Manuck,et al.  Stability of Individual Differences in Cellular Immune Responses to Acute Psychological Stress , 1995, Psychosomatic medicine.

[46]  H. Anisman,et al.  Treatment of primary dysthymia with group cognitive therapy and pharmacotherapy: clinical symptoms and functional impairments. , 1999, The American journal of psychiatry.

[47]  D. Lysle,et al.  Stressor-induced alteration of lymphocyte proliferation in mice: Evidence for enhancement of mitogenic responsiveness , 1990, Brain, Behavior, and Immunity.

[48]  R. Adams,et al.  Coping behavior in depression: report on a new scale. , 1984, Behaviour research and therapy.

[49]  D. Gladman,et al.  Aberrations in lymphocyte subpopulations and function during psychological stress. , 1982, Clinical and experimental immunology.

[50]  J. Sheridan,et al.  Chronic stress alters the immune response to influenza virus vaccine in older adults. , 1996, Proceedings of the National Academy of Sciences of the United States of America.

[51]  M. Jadoul,et al.  Novel method for the measurement of cytokine production by a one-stage procedure. , 1993, Journal of immunological methods.

[52]  S. Lightman,et al.  Stress and the hypothalamo-pituitary-adrenal axis: acute, chronic and immunological activation. , 1992, The Journal of endocrinology.

[53]  J. Smyth,et al.  STRESSORS AND MOOD MEASURED ON A MOMENTARY BASIS ARE ASSOCIATED WITH SALIVARY CORTISOL SECRETION , 1998, Psychoneuroendocrinology.

[54]  H. Neels,et al.  Effects of psychological stress on serum immunoglobulin, complement and acute phase protein concentrations in normal volunteers , 1997, Psychoneuroendocrinology.

[55]  D. Shapiro,et al.  Immunological and physiological changes associated with induced positive and negative mood. , 1994, Psychosomatic medicine.