Abstract
The traditional biomedical paradigm upon which contemporary Westem Medicine is based has been found to be increasingly inadequate to explain a wide range of research findings, both physiological and behavioural, which suggest that rather than being separate entities, ' Mind' and 'Body' are on a continuum and there are bi-directional links between the Central Nervous System and the Immune System. What is emerging is a new paradigm which emphasises the rather complex interactions between social, psychological and biological factors which has become known as "psychoneuroimmWiology (PNI)".
The present study reviewed the literature supp01ting the PNI pandigm and aimed to test empiiically the hypothesis that psychosocial vmiables can influence the workings of the immune system. The measure ofimmuue response used was the subjects' blood antibody titre response to a course ofHepatitis B vaccinations (dependent vatiable) and a comprehensive range of psychosocial variables were used as the independent variables.
The results indicated that 'hyper-reactivity' (the interaction of anxiety and somatic symptoms of stress) was associated, with raised blood antibody levels, whereas 'hypo-reactivity' (the interaction of depression and emotional exhaustion) was associated with lowered blood antibody levels. The results of a stepwise multiple regression analysis foWid that these two interactions together with 'perceived control' (manageability sub scale of the Sense of Coherence Questionnaii·e) jointly predi.cted 26% of the variance in blood antibody titre scores. Independently, ' hypo-reactivity accouuted for 11%, hyper-reactivity 8% and perceived control 7% of the vatiance accordingly (p<0.0005). Hypo-reactivity was also found to be predictive of sickness absence over a one year period, accoWiting for 6.5% of the variance ii1 sickness absence (p<0.05). TI1e results also suggest that Personality and Coping Style act as moderating vruiables between life events and emotional distress.
A 'two stage' model oftbe relationship between psychosocial stress and the immune response to Hepatitis B vaccine is proposed, which emphasises 'perceived controllability over life events' as a central factor in the type and severity of emotional distress experienced aud ultimately effects on the immune system.
