Publications

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    Lord, J.M, Phillips, A.C, Arlt
    Handbook of immunosenescence., 01/2009; Springer.
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    Phillips, A.C, Carroll
    The Psychologist 01/2009; 22:122-125. · 0.41 Impact Factor
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    Phillips, A.C
    Psychology Health and Medicine 01/2009; 14:125-126. · 1.53 Impact Factor
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    Janet M. Lord, Anna C. Phillips, Wiebke Arlt
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    ABSTRACT: Although ageing is a complex process, we now know much of what happens with age at the cellular and tissue level. In contrast, our understanding of how the various age-related changes interact to result in frailty and pathology is incomplete. For example, ageing is accompanied by a loss of immune function (Immunesenescence), an increase in the level of circulating proinflammatory cytokines (Inflammaging), a decline in adrenal androgen production (Adrenopause) whilst concurrently peripheral glucocorticoid availability increases. In this article we propose that these changes in combination increase the susceptibility of older adults to the adverse effects of physical and emotional stress, exacerbating the age-related decline in immune competence and exposing the older individual to increased risk of infections. We have focused upon the effects of stress and ageing on neutrophil function, an element of the immune system that has received less attention from immunogerontologists, despite the primary role of neutrophils in fighting bacterial infections and the major contribution of such infections to agerelated morbidity and mortality. We propose that physical and emotional stressors elicit an exaggerated response in older adults that synergises with the age-related loss of neutrophil function, to compromise antibacterial mechanisms. Moreover, the molecular basis of this effect may lie with the significant changes in tissue concentrations of cortisol and dehydroepiandrosterone in peripheral target cells including the immune compartment.
    Handbook of immunosenescence, 12/2008: chapter Synergistic effects of Ageing and Stress on Neutrophil function: pages 475-495; Springer.
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    ABSTRACT: Variation in response to vaccination, particularly in vulnerable groups, provides a strong rationale for developing vaccine adjuvants. If there were consistent diurnal variation in immune response, this could inform a simple intervention for enhancing vaccine efficacy. Data from two studies are presented examining morning versus afternoon vaccine administration; in the first, hepatitis A vaccine was administered to young adults, and in the second, influenza vaccine to older community-based adults. Men, but not women, vaccinated in the morning mounted a better peak antibody response to both hepatitis A and the A/Panama influenza strain. These results indicate that it would be worthwhile testing this effect in a large randomized control trial with vaccination during time periods representing the extremes of hormonal and cytokine diurnal rhythms.
    Psychophysiology 08/2008; 45(4):663-6. DOI:10.1111/j.1469-8986.2008.00662.x · 3.18 Impact Factor
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    ABSTRACT: In older populations, caregiving for a spouse with dementia has been associated with a poor antibody response to vaccination. The present study examined whether younger caregivers, specifically the parents of children with developmental disabilities, would also show a diminished antibody response to vaccination. At baseline assessment, 30 parents of children with developmental disabilities and 29 parents of typically developing children completed standard measures of depression, perceived stress, social support, caregiver burden, and child problem behaviours. They also provided a blood sample and were then vaccinated with a pneumococcal polysaccharide vaccine. Further blood samples were taken at 1- and 6-month follow-ups. Caregivers mounted a poorer antibody response to vaccination than control parents at both follow-ups. This effect withstood adjustment for a number of possible confounders and appeared to be, at least in part, mediated by child problem behaviours. The negative impact of caregiving on antibody response to vaccination is not restricted to older spousal caregivers, but is also evident in younger parents caring for children with developmental disabilities. The behavioural characteristics of the care recipients may be a key consideration in whether or not immunity is compromised in this context.
    Brain Behavior and Immunity 07/2008; 23(3):338-46. DOI:10.1016/j.bbi.2008.05.006 · 5.61 Impact Factor
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    Douglas Carroll, Anna C Phillips, Geoff Der
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    ABSTRACT: To examine the association between adiposity and the magnitude of cardiovascular reactions to acute psychological stress cross-sectionally and prospectively in a large community sample. Blood pressure and heart rate (HR) were measured at rest and in response to a brief time-pressured mental arithmetic stress in 1647 adults. At the same session and 5 years later, height, weight, waist and hip circumference were measured and body mass index (BMI) and waist-hip ratio were computed. Obesity was defined as a body mass index of > or = 30 kg/m(2). Contrary to expectations, the most robust and consistent results to emerge from cross-sectional analyses were negative associations between all three measures of adiposity and HR reactivity; those with greater BMI and waist-hip ratios and those categorized as obese displayed smaller HR reactions to stress. In prospective analyses, high HR reactivity was associated with a reduced likelihood of becoming obese in the subsequent 5 years. Our analyses suggest that it is low, not high, HR reactivity that is related to adiposity. Low HR reactivity, probably by reflecting generally blunted sympathetic nervous system reactions to challenge, may be a risk marker for developing obesity.
    Psychosomatic Medicine 07/2008; 70(6):653-60. DOI:10.1097/PSY.0b013e31817b9382 · 4.09 Impact Factor
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    ABSTRACT: Although the chronic stress of caring for a sick/disabled relative has been associated with poorer immunity using a range of outcomes, its impact on secretory immunoglobulin A (S-IgA) in saliva has yet to be examined. Three hypotheses were tested in analyses of data from a large community sample: first, caregivers would have lower S-IgA secretion rates than non-caregivers; second, the impact of caregiving on S-IgA would be particularly apparent in older participants; third, for caregivers, caregiving burden would be negatively associated with S-IgA. The sample comprised three distinct age cohorts, one young (N=623), one middle aged (N=639), and the other elderly (N=582). Participants were classified as caregivers if they regularly cared for somebody other than routine childcare. Caregiving strain was measured and a caregiving burden index was then derived as the composite of the number of people being cared for, the type of care provided, and the residential status of the person being cared for. From 2-min saliva samples, S-IgA secretion rate was measured. There was a significant caregiver status by age cohort interaction; caregivers in the eldest cohort had lower S-IgA secretion rates than their non-caregiving counterparts. Caregiving strain and burden and S-IgA were related, such that caregivers who experienced greater strain and burden had lower S-IgA secretion rates. These findings resonate with those from other studies using different immune outcomes. Considered together, it is clear that that the chronic stress of caregiving has widespread effects on immunity.
    Brain Behavior and Immunity 06/2008; 22(4):565-72. DOI:10.1016/j.bbi.2007.11.007 · 5.61 Impact Factor
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    ABSTRACT: The present study examined the association between psychological stress, social support and antibody response to both thymus-dependent and thymus-independent vaccinations. Stressful life events in the previous year and customary social support were measured by standard questionnaires at baseline in 75 (41 females) healthy students. Antibody status was assessed at baseline, 4 and 18 weeks following vaccination with formaldehyde inactivated hepatitis A virus and pneumococcal polysaccharides, which induce thymus-dependent and -independent antibody responses respectively. Controlling for baseline antibody status, life event stress was negatively associated with antibody response to the hepatitis A vaccine at the 18-week follow-up; participants reporting a greater number of stressful life events had a poorer antibody response. There was no relationship between psychological stress and antibody response to pneumococcal vaccination. Social support was not associated with the antibody response to hepatitis A vaccination. However, there was a significant association between support and the antibody response to the thymus-independent pneumococcal vaccine at 4-week follow-up; participants with larger social networks mounted a better response. These relationships could not be accounted for by age and sex, or by variations in health behaviours. Psychosocial factors would appear to influence the response to both thymus-dependent and thymus-independent vaccines, but not in the same manner.
    Brain Behavior and Immunity 06/2008; 22(4):456-60. DOI:10.1016/j.bbi.2007.10.018 · 5.61 Impact Factor
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    ABSTRACT: Evidence shows that psychosocial factors are associated with immunoglobulin G response to medical vaccinations. As yet, there are no reports of whether the earlier immunoglobulin M response is similarly susceptible. This study examined the association between psychological stress, social support and the immunoglobulin M response to vaccination with pneumococcal capsular polysaccharides. Stressful life events in the previous year and customary social support were measured by standard questionnaires at baseline in 74 healthy students (41 females). The response to five common pneumococcal serotypes was assessed at baseline and 5 days following vaccination. Social support, particularly tangible social support, was positively associated with the antibody response to two of five serotypes, after controlling for baseline titre. These associations survived adjustment for demographics and health behaviours. There was no association between life events stress and immunoglobulin M response. It appears that psychosocial factors affect both the immunoglobulin M and immunoglobulin G responses to vaccination.
    Biological Psychology 06/2008; 78(2):211-5. DOI:10.1016/j.biopsycho.2008.01.001 · 3.47 Impact Factor
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    ABSTRACT: This study examined predictors of excess psychological morbidity in parents of children with intellectual disabilities. Thirty-two parents of children with intellectual disabilities and 29 parents of typically developing children completed the Hospital Depression and Anxiety Scale, and measures of social support, child problem behaviors, sleep quality, and perceived caregiver burden. Parents of children with intellectual disabilities registered high depression and anxiety scores, and the majority met the criteria for possible clinical depression and/or anxiety. The strongest predictor of psychological morbidity was caregiver burden. Analyses of its component dimensions indicated that feelings of guilt held the greatest consequence for depression and anxiety. Caregiver burden, in general, and its guilt component, in particular, predicted symptoms of depression and anxiety in parents of children with intellectual disabilities. Assisting such parents to resolve their feelings of guilt should benefit their psychological status.
    Journal of Pediatric Psychology 05/2008; 33(10):1129-36. DOI:10.1093/jpepsy/jsn040 · 2.91 Impact Factor
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    Anna C Phillips, Douglas Carroll, Naeem Khan, Paul Moss
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    ABSTRACT: Infection with cytomegalovirus (CMV), a beta-herpesvirus, is common within the population. Although asymptomatic, infection is associated with increased serum concentrations of cytokines such as TNFalpha and IL-6, which are also related to mood and wellbeing. The present study examined whether infection with CMV was associated with mood in a community-based sample of older adults. Blood samples and scores on the General Health Questionnaire were available for 137 participants. Serum was analysed for the presence of CMV-specific IgG and the antibody titre was used as an indirect measure of viral load. The majority of the participants (66%) were CMV-seropositive and seropositive status was not associated with psychological morbidity. However, within the CMV-positive group, individuals with higher CMV-specific antibody titres were more likely to be depressed, anxious, and suffer more overall psychological morbidity. This association could be mediated by the impact of affect-moderating cytokines secreted through the CMV-specific immune response.
    Brain Behavior and Immunity 02/2008; 22(1):52-5. DOI:10.1016/j.bbi.2007.06.012 · 5.61 Impact Factor
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    Phillips, A.C
    Lifestyle and health research progress., 01/2008; Nova Science Publishers..
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    Phillips, A.C, Burns, V.E
    The Psychologist 01/2008; 21:202-204. · 0.41 Impact Factor
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    Anna C Phillips, Geoff Der, Douglas Carroll
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    ABSTRACT: Despite the widely-held view that psychological stress is a major cause of poor health, few studies have examined the relationship between stressful life-events exposure and death. The present analyses examined the association between overall life-events stress load, health-related and health-unrelated stress, and subsequent all-cause mortality. This study employed a prospective longitudinal design incorporating time-varying covariates. Participants were 968 Scottish men and women who were 56 years old. Stressful life-events experience for the preceding 2 years was assessed at baseline, 8-9 years and 12-13 years later. Mortality was tracked for the subsequent 17 years during which time 266 participants had died. Cox's regression models with time-varying covariates were applied. We adjusted for sex, occupational status, smoking, BMI, and systolic blood pressure. Overall life-events numbers and their impact scores at the time of exposure and the time of assessment were associated with 17-year mortality. Health-related event numbers and impact scores were strongly predictive of mortality. This was not the case for health-unrelated events. The frequency of life-events and the stress load they imposed were associated with all-cause mortality. However, it was the experience and impact of health-related, not health-unrelated, events that proved predictive. This reinforces the need to disaggregate these two classes of exposures in studies of stress and health outcomes.
    British Journal of Health Psychology 12/2007; 13(Pt 4):647-57. DOI:10.1348/135910707X258886 · 2.70 Impact Factor
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    Douglas Carroll, Anna C Phillips, Kate Hunt, Geoff Der
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    ABSTRACT: Depression and exaggerated cardiovascular reactivity are considered risk factors for cardiovascular disease, possibly as a result of common antecedents, such as altered autonomic nervous system function. We examined the association between depressive symptomatology and cardiovascular reactions to psychological stress in 1608 adults (875 women) comprising 3 distinct age cohorts: 24-, 44-, and 63-year olds. Depression was assessed using the Hospital Anxiety and Depression Scale. Blood pressure and heart rate were measured at baseline and during the paced auditory serial arithmetic test. Depression scores were negatively associated with systolic blood pressure and heart rate reactions, after adjustment for likely confounders such as sex, cohort, occupational status, body mass index, stress task performance score, baseline cardiovascular activity, antidepressant, and antihypertensive medication. The direction of association was opposite to that which would be expected if excessive reactivity were to mediate the association between depression and cardiovascular disease outcomes or if they shared common antecedents.
    Biological Psychology 05/2007; 75(1):68-74. DOI:10.1016/j.biopsycho.2006.12.002 · 3.47 Impact Factor
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    Anna C Phillips, Victoria E Burns, Janet M Lord
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    ABSTRACT: Age-related immunological and endocrinological changes may have implications for resilience to stress in older adults. We hypothesize that the combination of adrenopause and immunosenescence may leave this population particularly vulnerable to the negative effects of stress on immunity. We propose that exercise may be an effective intervention to limit the impact of stress on immunity in chronically stressed older populations.
    Exercise and Sport Sciences Reviews 02/2007; 35(1):35-9. DOI:10.1097/jes.0b013e31802d7008 · 4.82 Impact Factor
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    Burns, V.E, Phillips, A.C, Edwards
    Encyclopedia of stress, 2 01/2007; Oxford Academic press.
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    Anna C Phillips, Douglas Carroll, Kate Hunt, Geoff Der
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    ABSTRACT: The presence of supportive others has been associated with attenuated cardiovascular reactivity in the laboratory. The effects of the presence of a spouse and others in a more naturalistic setting have received little attention. Blood pressure and heart rate reactions to mental stress were recorded at home in 1028 married/partnered individuals. For 112 participants, their spouse/partner was present; for 78, at least one other person was present. Women tested with a spouse/partner present showed lower magnitude systolic blood pressure and heart rate reactivity than those tested without. Individuals tested with at least one nonspousal other present also displayed attenuated reactivity. This extends the results of laboratory studies and indicates that the spontaneous presence of others is associated with a reduction in cardiovascular reactivity in an everyday environment; spouse/partner presence would appear to be especially effective for women.
    Psychophysiology 12/2006; 43(6):633-40. DOI:10.1111/j.1469-8986.2006.00462.x · 3.18 Impact Factor
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    Douglas Carroll, John Macleod, Anna C Phillips
    Journal of Psychosomatic Research 08/2006; 61(1):9-10. DOI:10.1016/j.jpsychores.2006.02.013 · 2.84 Impact Factor