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Associations between stress, trait negative affect, acute immune reactivity, and antibody response to hepatitis B injection in healthy young adults

DOI:10.1037//0278-6133.20.1.4
Authors:
Anna L Marsland at University of Pittsburgh
Anna L Marsland
Sheldon Cohen at Carnegie Mellon University
Sheldon Cohen
Bruce Rabin at University of Pittsburgh
Bruce Rabin
Stephen Manuck at University of Pittsburgh
Stephen Manuck
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Abstract

Eighty-four healthy graduate participants were administered the standard course of 3 hepatitis B vaccinations. Five months after the first dose (shortly after the second injection), each participant completed psychosocial measures, and a blood sample was drawn for determination of hepatitis B surface antibody titer. After completion of the vaccination series, participants performed an acute stress protocol, consisting of a 30-min adaptation period and a 5-min evaluative speech task. Blood was drawn at the end of the resting and task periods for assessment of cellular immune measures. Lower antibody response, as assessed after the second hepatitis B injection, was predicted independently by (a) high trait negative affect and (b) diminished T-cell proliferation in response to PHA. These data provide evidence that trait negative affect and the magnitude of stress-induced suppression of immune function may have clinical significance.
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Carnegie Mellon University
Research Showcase
Department of Psychology College of Humanities and Social Sciences
1-1-2001
Associations Between Stress, Trait Negative Affect,
Acute Immune Reactivity, and Antibody Response
to Hepatitis B Injection in Healthy Young Adults
Anna L. Marsland
Western Psychiatric Institute and Clinic
Sheldon Cohen
Carnegie Mellon University, scohen@cmu.edu
Bruce S. Rabin
University of Pittsburgh - Main Campus
Stephen B. Manuck
University of Pittsburgh - Main Campus
This Article is brought to you for free and open access by the College of Humanities and Social Sciences at Research Showcase. It has been accepted
for inclusion in Department of Psychology by an authorized administrator of Research Showcase. For more information, please contact
kbehrman@andrew.cmu.edu.
Recommended Citation
Marsland, Anna L.; Cohen, Sheldon; Rabin, Bruce S.; and Manuck, Stephen B., "Associations Between Stress, Trait Negative Affect,
Acute Immune Reactivity, and Antibody Response to Hepatitis B Injection in Healthy Young Adults" (2001). Department of
Psychology. Paper 257.
http://repository.cmu.edu/psychology/257
... Studies of influenza vaccine response and NA specifically are limited but do suggest an association between mood and various immune parameters. One study of healthy students given hepatitis B vaccines found that high trait NA predicted lower antibody response (Marsland, Cohen, Rabin, & Manuck, 2001). Similarly, in a study measuring state NA following salmonella typhi vaccination, Wright, Strike, Brydon, and Steptoe (2005) found that negative changes in mood were significantly associated with increases in IL-6 compared to the placebo group, suggesting that NA may impact on inflammatory responses to vaccination. ...
... Thus, NA may be either a cause, or a consequence of impaired immunity. Alternatively, the association between NA and vaccine response may be influenced by confounding factors, such as poor sleep, stress, and loneliness, all of which are associated with negative affect (Marsland et al., 2001;O'Brien et al., 2010;, as well as independently impacting immune response (some of which is discussed in previous sections). Finally, it is notable that many studies of NA fail to also measure positive affect (PA) which means that, given their overlap, it can be unclear whether the effects seen are caused by increased NA or an absence of PA, or both. ...
... Indeed, high perceived stress and trait NA have been associated with reduced vaccine effectiveness (e.g. Marsland et al., 2001;Pedersen et al., 2009), whilst trait PA is associated with increased effectiveness (e.g. Marsland et al., 2006). ...
Enhancing positive mood in older adults: implications for vaccine effectiveness
Poster
  • Aug 2022
The influenza vaccine is less effective in older adults compared to their younger counterparts. At the same time, this population is more susceptible to contracting influenza, with more severe consequences, including higher rates of complications, hospitalisations, and deaths. There is an abundance of evidence demonstrating how psychological factors, such as stress, can influence and modulate immune function, including response to vaccinations. Recent work has extended this to other psychological factors, suggesting that mood, or affect, may also be linked to vaccine response, however the evidence here is much more limited. This thesis presents three inter-related pieces of research, which sought to build on this evidence base and contribute to our current understanding of the influence of mood on vaccinations. The ultimate aim of this research was to develop an intervention to enhance positive mood, with a view to enhancing the effectiveness of the influenza vaccination in the older adult population. First, the evidence surrounding the effectiveness of using participant-driven choice in interventions compared to ‘no-choice’ interventions was systematically reviewed. This review sought to investigate whether the integration of participant choice within an existing, previously trialled, positive mood intervention would maximise mood enhancement and thus the potential to enhance vaccine-specific antibody levels. The review found that whilst choice-interventions led to less drop-out and greater adherence, evidence for mood-related outcomes was unclear and warranted further investigation. Second, a randomised controlled clinical study (n=654) was conducted to investigate the effectiveness of the previously trialled fixed-content positive mood intervention, a new choice-based intervention, and usual care, in terms of enhancing positive mood. Vaccine response at four-weeks post-vaccination was assessed as a secondary outcome. Results showed that both the fixed-content and choice-based interventions significantly improved mood compared to usual care, however there were no significant differences between the two interventions. There were no significant differences between groups in terms of antibody levels at four weeks post-vaccination. Finally, a qualitative study using a thematic-content hybrid analysis approach was carried out with a selection of participants from the randomised trial, to assess participants’ perceptions of how the intervention may or may not have worked, and to identify ways in which both the intervention and study experience as a whole could be improved for a future trial implementing the optimised intervention. Analysis revealed that both interventions, as well as the overall study experience, were liked by participants, indicating that further optimisation may not be necessary. Additionally, several potential mechanisms underlying the relationship between the interventions and mood were identified. The research presented in this thesis has several important implications. Firstly, that the use of choice should be considered where there is concern regarding drop-out or adherence, but may not be more effective than no-choice interventions in enhancing mood. Secondly, that brief positive mood interventions are effective in enhancing positive mood in older adults in a primary care setting. Future work is required to evaluate their impact on immune outcomes including mechanistic work to understand the relationship between mood and immunity, and a large scale trial, with immune response as the primary outcome.
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... For example, a person who is afraid of flying may consider going on a far-flung holiday to be extremely stressful, whereas a person who likes flying may consider the holiday travelling to be much less stressful. In addition, physiological responses to the same stressor (which may be either a physical or mental stressor) differ across individuals [34]. That is, the biological stress response itself reflects multiple dimensions of individual differences, at least some of which dimensions are closely related both to personality and cognitive appraisal mechanisms. ...
... A concurrent validity of 0.47 was obtained by Erinoso [34] and an alpha coefficient of 0.77 and a test retest reliability coefficient of 0.90 were obtained by Derogatis [39]. ...
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... For example, individuals with depressive symptoms have been reported to exhibit an attenuated post vaccine immune response (Gidron et al, 2005;Lasserre et al, 2012;Petry et al, 1991;Costanzo et al, 2004). Studies have also reported attenuated immune response to vaccines in subjects with higher stress levels (Marsland et al., 2001;Wong et al, 2013;Snyder et al, 1990;Burns et al, 2003;Smith et al, 2004) and poor quality or duration of sleep (Miller et al., 2004;Prather et al., 2012;Lange et al., 2003;Spiegel et al., 2002), which are both symptoms of common mental disorders. It is also well documented that individuals with mental disorders exhibit immune dysregulation as measured by natural killer cell activity, lymphocyte response to mitogen stimulation, and increased risk of infection (Kronfol, 2002;Andersson et al., 2015). ...
... Studies have also found that low self esteem and fatigue (Morag et al, 1998), neuroticism (Phillips et al, 2005a), and loneliness (Pressmen et al., 2005) were associated with attenuated postvaccination antibodies. Marsland et al. (2001) found that healthy subjects with negative trait affect, but not higher stress levels or Beck Depression Inventory scores, had lower antibodies following hepatitis B vaccination. Social support has also been positively correlated with immunoglobulin M response to vaccination with pneumococcal polysaccharides (Gallagher et al, 2008). ...
Immune Response to Vaccination in Adults with Mental Disorders: A Systematic Review
Article
Background : Mental disorders are associated with immune dysregulation as measured by serum levels of biological markers of immunity. Adults with mental disorders have also been reported to have attenuated post vaccine immune response. The COVID-19 pandemic has invited the need to determine whether individuals with mental disorders exhibit differential immune response following the administration of vaccines for other infections. Methods : A systematic search of MEDLINE, Embase, Cochrane, and PsycInfo was conducted from inception to May 2021 investigating vaccine response in persons with mental disorders, as measured by biological markers of immunity (i.e., antibodies, cytokines). Results : Thirteen articles were identified which evaluated vaccine efficacy in persons with mental disorders. Individuals with major depressive disorder (MDD) or schizophrenia revealed attenuated immune response to vaccination, or no statistical difference compared to control subjects. Individuals with anorexia nervosa or post-traumatic stress disorder (PTSD) displayed no attenuated post-vaccination antibody level. Individuals with insomnia displayed lower levels of antibodies after vaccination, whereas individuals with obstructive sleep apnea (OSA) displayed no difference in vaccine response compared to control subjects. Limitations : The limitations of this review include the relatively few articles included (n = 13) and small sample sizes (less than thirty subjects) in the majority of articles. Conclusion : Vaccine response in adults with a mental disorder remains inconclusive. Notwithstanding the heterogeneity and relatively small number of studies, available evidence does suggest attenuated immune response across disparate vaccinations. Future research is required to confirm vaccine efficacy in persons with mental disorders, especially regarding immune responses to COVID-19 vaccination.
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... (Florani et al., 2004). Many factors can affect seroconversion (drug addiction, aging, diseases etc) (Marsland et al., 2001). The immune response to the Hepatit B vaccine is complex and regulated by some genes (Milich et al., 2003). ...
... There are factors that affect seroconversion. These factors include immunosuppressive diseases, aging, etc (Marsland et al., 2001). JWH-018 is an addictive material that acts on the endogenous cannabinoid system (ECS). ...
Effect of synthetic cannabinoids (JWH-018) on antibody response to HBV vaccination
Article
Full-text available
  • Apr 2021
Synthetic cannabinoids can affect the immune system and can cause some changes in immune response. The immune response to the Hepatit B vaccine is complex. Studies on hepatitis B vaccine antibody response and JWH-018 are extremely limited. The main aim of this study was to investigate the effect of JWH-018 on anti-HBs Ag changes before or after Hepatitis B vaccination. The study was performed on C57BL6 mice (n=25). Mice were divided into 3 groups. Control Group; it was immunized Engerix B at 3 times 3-week intervals. Group 1; JWH-018 (1 mg/kg) was administered once a week for 4 weeks. At the end of this period, Engerix B was immunized 3 times at 3-week intervals. Group 2; it was immunized 3 times at 3-weeks intervals with Engerix B. At the end of this period JWH-018 (1 mg/kg) was treated once a week for 4 weeks. Blood samples (3 times with an interval of 2 weeks) were collected at the end of drug and vaccine administration. It was calculated that the means obtained from the control group were lower than the other groups. The final measurement of the within-group was higher than other measures and was statistically significant (p=0,017). Statistical difference was measured in the first (p=0,018) and third measurements (p=0,005) of the between groups. A total of 5 mice from the experimental groups died at different stages of the study. In this study, the use of JWH-018 has been shown to be effective on the anti-HBs parameter. We think that our study is very valuable in terms of proving the relationship between JWH-018 and Anti-Hbs parameter. However, more data are needed to understand causation.
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... Different researchers have reported the various results to establish the association between ROS status and immune response induced by active immunization. 143 In the animal study, it was observed that immunization with conjunctival Brucella melitensis vaccine reduced the total antioxidant capacity after 1 month of vaccination and increased the serum level of malondialdehyde and glutathione peroxidase activity by the 4th ...
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... Different researchers have reported the various results to establish the association between ROS status and immune response induced by active immunization. 143 In the animal study, it was observed that immunization with conjunctival Brucella melitensis vaccine reduced the total antioxidant capacity after 1 month of vaccination and increased the serum level of malondialdehyde and glutathione peroxidase activity by the 4th ...
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Pregnancy is a critical period associated with alterations in physiologic, biologic, and immunologic processes, which can affect maternal-fetal health through development of several infectious diseases. At birth, neonates have an immature immune system that makes them more susceptible to severe viral infections and diseases. For this reason, different maternal nutritional and immunization interventions have been used to improve the immune and health status of the mother and her neonate through passive immunity. Here, we reviewed the protective role of maternal immunization with different types of vaccines, especially genetic vaccines, during pregnancy in maternal-fetal health, immune response, colostrum quality, immune response, and anti-oxidative status. The evidence demonstrated that inactivated or killed vaccines produced significant immune protection in the mother and fetus. Furthermore, most recent studies have suggested that the use of genetic vaccines (mRNA and DNA) during pregnancy is efficient at triggering the immune response in the mother and neonate without the risk of undesired pregnancy outcomes. However, factors such as maternal redox balance, nutritional status, and the timing of immunization play essential roles in regulating immune response inflammatory status, antioxidant capacity, and the welfare of both the pregnant mother and her newborn.
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... Other psychological factors that predicted lower antibody responses to vaccination included high trait negative affect (Marsland et al., 2001), low trait positive affect (Marsland et al., 2006), high neuroticism (Morag et al., 1999;Phillips et al., 2005), and low self-esteem (Morag et al., 1999). Not surprisingly, these dispositional factors increase distress as well as risk for depression. ...
Psychological and Behavioral Predictors of Vaccine Efficacy: Considerations for COVID-19
Article
Full-text available
  • Jan 2021
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine candidates are being evaluated, with the goal of conferring immunity on the highest percentage of people who receive the vaccine as possible. It is noteworthy that vaccine efficacy depends not only on the vaccine but also on characteristics of the vaccinated. Over the past 30 years, a series of studies has documented the impact of psychological factors on the immune system’s vaccine response. Robust evidence has demonstrated that stress, depression, loneliness, and poor health behaviors can impair the immune system’s response to vaccines, and this effect may be greatest in vulnerable groups such as the elderly. Psychological factors are also implicated in the prevalence and severity of vaccine-related side effects. These findings have generalized across many vaccine types and therefore may be relevant to the SARS-CoV-2 vaccine. In this review, we discuss these psychological and behavioral risk factors for poor vaccine responses, their relevance to the COVID-19 pandemic, as well as targeted psychological and behavioral interventions to boost vaccine efficacy and reduce side effects. Recent data suggest these psychological and behavioral risk factors are highly prevalent during the COVID-19 pandemic, but intervention research suggests that psychological and behavioral interventions can increase vaccine efficacy.
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... Other psychological factors that predicted lower antibody responses to vaccination included high trait negative affect (Marsland et al., 2001), low trait positive affect (Marsland et al., 2006), high neuroticism (Morag et al., 1999;Phillips et al., 2005), and low self-esteem (Morag et al., 1999). Not surprisingly, these dispositional factors increase distress as well as risk for depression. ...
Psychological and Behavioral Predictors of Vaccine Efficacy: Considerations for COVID-19
Preprint
Full-text available
  • Jan 2021
This review highlights key psychological and behavioral factors that can influence the immune system's response to a vaccine. The results generalize across a wide variety of vaccines, and therefore will likely be relevant to the SARS-COV-2 vaccine. Although the SARS-COV-2 vaccine candidates are highly efficacious, these psychological and behavioral factors can impact how long it takes to develop protective immunity as well as how long the protective immunity lasts. Importantly, even short-term psychological and behavioral interventions can boost the immune system's response to vaccination.
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INVESTIGATING THE IMPACT OF E-LEARNING ASSESSMENT USING PORTFOLIO ON WRITING ENGAGEMENT: INDONESIAN ISLAMIC EFL HIGH SCHOOL STUDENTS’ PERCEPTION
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  • Aug 2022
This paper reports an analysis of students’ perception on the impact e-learning assessment using portfolios on writing engagement. This research employed a case study approach. Questionnaires were used as data collection instruments. The participant of this study was students of Islamic High School of grade 10 in Garut and the data collection was obtained from the questionnaire with EFL Students. The results showed that the use of e-learning assessment through portfolio was very influential on students in collecting assignments. The results also show that the student's perception of e-learning assessment through the portfolio is very influential on students ' writing engagement.Keywords: assessment; e-portfolio; EFL students; perception; writing
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Psychological stress in humans and susceptibility to the common cold.
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Full-text available
  • Sep 1991
It is not known whether psychological stress suppresses host resistance to infection. To investigate this issue, we prospectively studied the relation between psychological stress and the frequency of documented clinical colds among subjects intentionally exposed to respiratory viruses. After completing questionnaires assessing degrees of psychological stress, 394 healthy subjects were given nasal drops containing one of five respiratory viruses (rhinovirus type 2, 9, or 14, respiratory syncytial virus, or coronavirus type 229E), and an additional 26 were given saline nasal drops. The subjects were then quarantined and monitored for the development of evidence of infection and symptoms. Clinical colds were defined as clinical symptoms in the presence of an infection verified by the isolation of virus or by an increase in the virus-specific antibody titer. The rates of both respiratory infection (P less than 0.005) and clinical colds (P less than 0.02) increased in a dose-response manner with increases in the degree of psychological stress. Infection rates ranged from approximately 74 percent to approximately 90 percent, according to levels of psychological stress, and the incidence of clinical colds ranged from approximately 27 percent to 47 percent. These effects were not altered when we controlled for age, sex, education, allergic status, weight, the season, the number of subjects housed together, the infectious status of subjects sharing the same housing, and virus-specific antibody status at base line (before challenge). Moreover, the associations observed were similar for all five challenge viruses. Several potential stress-illness mediators, including smoking, alcohol consumption, exercise, diet, quality of sleep, white-cell counts, and total immunoglobulin levels, did not explain the association between stress and illness. Similarly, controls for personality variables (self-esteem, personal control, and introversion-extraversion) failed to alter our findings. Psychological stress was associated in a dose-response manner with an increased risk of acute infectious respiratory illness, and this risk was attributable to increased rates of infection rather than to an increased frequency of symptoms after infection.
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Health Complaints, Stress, and Distress: Exploring the Central Role of Negative Affectivity
Article
Full-text available
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Most current models in health psychology assume that stress adversely affects physical health. We re-examined this assumption by reviewing extensive data from the literature and from six samples of our own, in which we collected measures of personality, health and fitness, stress, and current emotional functioning. Results indicate that self-report health measures reflect a pervasive mood disposition of negative affectivity (NA); self-report stress scales also contain a substantial NA component. However, although NA is correlated with health compliant scales, it is not strongly or consistently related to actual, long-term health status, and thus will act as a general nuisance factor in health research. Because self-report measures of stress and health both contain a significant NA component, correlations between such measures likely overestimate the true association between stress and health. Results demonstrate the importance of including different types of health measures in health psychology research.
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Persistence of anti-HBs among health care personnel immunized with hepatitis B vaccine
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  • Jun 1990
Health care personnel who received the hepatitis B vaccine (Heptavax-BR, MSD) were followed for persistence of hepatitis B surface antibody (anti-HBs). Response occurred in 135/146 (92.5 percent) vaccinees. Loss of anti-HBs (less than 72 RIA units; 10 S/N) occurred in 35.9 percent during the 36-month surveillance. Stepwise discriminant analysis found age and magnitude of initial antibody level, but not weight-height index, to be predictive of antibody loss over the 36 months. Twenty-four of 27 employees (88.9 percent) who lost anti-HBs responded to a fourth vaccine dose. In contrast, three of eight initial non-responders (37.5 percent) developed antibody after a fourth vaccine dose.
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