Trait Positive Affect Buffers the Effects of Acute Stress on Skin Barrier Recovery

Department of Psychology, University of Califonia, Los Angeles, CA 90095-1563, USA.
Health Psychology (Impact Factor: 3.59). 06/2009; 28(3):373-8. DOI: 10.1037/a0014662
Source: PubMed


This study examines the role of self-reported trait positive affect (PA) on skin barrier recovery after skin disruption, and whether the role of trait PA in wound healing is consistent with the direct effects model or the stress-buffering model of PA and health.
Sixty healthy participants (mean age 22.7 +/- 3.9 years) completed a self-report measure of trait positive and negative affect, underwent a "tape-stripping" procedure that disrupts normal skin barrier function, and were randomly assigned to a Stress (Trier Social Stress Test) or No Stress (reading task) condition.
Skin barrier recovery was assessed by measuring transepidermal water loss up to 2 hr after skin disruption.
Multilevel modeling indicated that greater trait PA was related to faster skin barrier recovery (p < .05). The effects of PA on skin barrier recovery were independent of levels of trait NA.
These findings suggest that trait PA may influence skin barrier recovery following a brief stressor. In addition, these results provide additional evidence that trait PA can positively impact objective health outcomes.

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Available from: Sarah D Pressman, Oct 09, 2015
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    • "Given that psychological stress can impair wound healing [1], [11]–[13], and given the role of microbicidal active M1 macrophages in early wound healing phases [6], stress may exert at least parts of its wound healing impairment by inhibiting the microbicidal potential (i.e. ROS production) of these cells. "
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    ABSTRACT: Psychological stress delays wound healing but the precise underlying mechanisms are unclear. Macrophages play an important role in wound healing, in particular by killing microbes. We hypothesized that (a) acute psychological stress reduces wound-induced activation of microbicidal potential of human monocyte-derived macrophages (HMDM), and (b) that these reductions are modulated by stress hormone release. Fourty-one healthy men (mean age 35±13 years) were randomly assigned to either a stress or stress-control group. While the stress group underwent a standardized short-term psychological stress task after catheter-induced wound infliction, stress-controls did not. Catheter insertion was controlled. Assessing the microbicidal potential, we investigated PMA-activated superoxide anion production by HMDM immediately before and 1, 10 and 60 min after stress/rest. Moreover, plasma norepinephrine and epinephrine and salivary cortisol were repeatedly measured. In subsequent in vitro studies, whole blood was incubated with norepinephrine in the presence or absence of phentolamine (norepinephrine blocker) before assessing HMDM microbicidal potential. Compared with stress-controls, HMDM of the stressed subjects displayed decreased superoxide anion-responses after stress (p's <.05). Higher plasma norepinephrine levels statistically mediated lower amounts of superoxide anion-responses (indirect effect 95% CI: 4.14-44.72). Norepinephrine-treated HMDM showed reduced superoxide anion-production (p<.001). This effect was blocked by prior incubation with phentolamine. Our results suggest that acute psychological stress reduces wound-induced activation of microbicidal potential of HMDM and that this reduction is mediated by norepinephrine. This might have implications for stress-induced impairment in wound healing.
    PLoS ONE 02/2013; 8(2):e55875. DOI:10.1371/journal.pone.0055875 · 3.23 Impact Factor
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    • "Relaxation has been shown to increase positive mood states in a student sample (Jain et al., 2007). With regards studies of wound healing, positive affect was not associated with cytokine levels in blister wounds (Glaser et al., 1999), but trait positive affect has been shown to buffer the effects of stress on skin barrier recovery (Robles et al., 2009). Positive affect may also act as a moderator. "
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    ABSTRACT: Psychological stress has been shown to impair wound healing, but experimental research in surgical patients is lacking. This study investigated whether a brief psychological intervention could reduce stress and improve wound healing in surgical patients. This randomised controlled trial was conducted at a surgical centre. Inclusion criteria were English-speaking patients over 18 years booked to undergo elective laparoscopic cholecystectomy; exclusion criteria were cancellation of surgery, medical complications, and refusal of consent. Seventy five patients were randomised and 15 patients were excluded; 60 patients completed the study (15 male, 45 female). Participants were randomised to receive standard care or standard care plus a 45-min psychological intervention that included relaxation and guided imagery with take-home relaxation CDs for listening to for 3 days before and 7 days after surgery. In both groups ePTFE tubes were inserted during surgery and removed at 7 days after surgery and analysed for hydroxyproline as a measure of collagen deposition and wound healing. Change in perceived stress from before surgery to 7-day follow-up was assessed using questionnaires. Intervention group patients showed a reduction in perceived stress compared with the control group, controlling for age. Patients in the intervention group had higher hydroxyproline deposition in the wound than did control group patients (difference in means 0.35, 95% CI 0.66-0.03; t(43)=2.23, p=0.03). Changes in perceived stress were not associated with hydroxyproline deposition. A brief relaxation intervention prior to surgery can reduce stress and improve the wound healing response in surgical patients. The intervention may have particular clinical application for those at risk of poor healing following surgery.
    Brain Behavior and Immunity 06/2011; 26(2):212-7. DOI:10.1016/j.bbi.2011.06.014 · 5.89 Impact Factor
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    • "These earlier methods record levels only in the nM range; however, plasma levels of epinephrine can increase to the µM range with severe stress (Pacak et al., 1998), and salivary levels may likewise rise to this range. Both acute and chronic stress have been associated with delayed wound healing (Kiecolt- Glaser et al., 1995; Marucha et al., 1998; Christian et al., 2006; Robles et al., 2009), and both acute and chronic stress are accompanied by increases in circulating epinephrine levels (Schmidt and Kraft, 1996; Pike et al., 1997). Additionally, we show here that HOK themselves are a source of epinephrine and that nanomolar levels Figure 3. β-AR activation decreased ERK1/2 and p38 MAPK phosphorylation. "
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    ABSTRACT: 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.
    Journal of dental research 02/2011; 90(2):186-92. DOI:10.1177/0022034510388034 · 4.14 Impact Factor
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