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NIH Record

Seminar Examines Social Support, Stress and the Common Cold

By Susan M. Persons

Friends are good medicine, especially during cold season. A study presented by Dr. Sheldon Cohen at a recent NIH Office of Behavioral and Social Sciences Research (OBSSR) seminar has found that diverse ties to friends, family, work and community help to reduce susceptibility to upper respiratory illness. Although chicken soup may provide soothing relief to cold symptoms, it is the friend who brings you the soup that is proving to be important in maintaining health.

Dr. Sheldon Cohen

"Psychological and social factors play an important role in determining our resistance to upper respiratory illness," reported Cohen. For the past 10 years, Cohen, professor of psychology at Carnegie Mellon University and adjunct professor of pathology and psychiatry at the University of Pittsburgh School of Medicine, has been studying the effects of psychological stress and social support on immunity and susceptibility to infectious disease. At the OBSSR seminar, Cohen described his study of 276 healthy volunteers ages 18 to 55, who were given nasal drops containing viruses that cause a common cold. "Only 40 percent of those exposed to a virus actually develop a clinical illness," Cohen said.

"Our work has shown that those having more types of social relationships including family but also neighbors, friends, work mates, and members of religious and social groups were less likely to develop a cold when exposed to a rhinovirus." Those who had 1-3 types of social relationships were over 4 times more likely to develop a cold than those with 6 or more types. "Not only were they less susceptible to developing colds, they produced less mucus, were more effective in mucocilliary clearance of the nasal passage, and shed less virus," Cohen stated. In addition, "network diversity was a more important determinant of susceptibility than the total number of people in one's social network," he said.

The association between social network diversity and colds occurred in both those who entered the study with and without antibody to the experimental viruses. Cohen also found that health practices including smoking, alcohol consumption, sleep quality, exercise and dietary intake of vitamin C were also associated with susceptibility to illness. However, differences in health practices were not responsible for the relationship between diverse social networks and susceptibility.

Cohen also discussed his work on the relationship of psychological stress and susceptibility to upper respiratory infections. Again, study participants who completed questionnaires assessing psychological stress were subsequently given nasal drops containing respiratory viruses. "In all three studies, we found that those reporting higher levels of stress before exposure to the virus were more likely to develop respiratory illness," Cohen said. "We have found stress is associated with increased susceptibility to illness induced by 7 different viruses, including 6 cold viruses and an influenza virus."

However, not every stressful event increases the risk of illness. "The longer the duration of the stressful event the greater the risk," according to Cohen. For example, an argument with your spouse that is resolved in a few days has little effect. However, if the marital discord lasts a month or longer, there is a substantial increase in the risk of illness. "The type of stress also plays an important role in disease susceptibility. Job loss and divorce produced the most serious threat to the individual, whereas other less significant life challenges may not have the same impact," Cohen said.

The association between psychological stress and illness could not be explained by differences in stressed and nonstressed people in their demographics, allergic status, weight or height. Nor did the season, viral specific antibody status before virus-exposure, nor their health behaviors provide an explanation. "The relation between stress and susceptibility is probably attributable to stress induced changes in the immune function," Cohen said. "Our most recent work is moving toward identifying the relevant components of immunity with stress-induced changes in the production of proinflammatory cytokines as the most likely culprit."

The next OBSSR seminar will provide an update on the National Longitudinal Study of Adolescent Health by Dr. J. Richard Udry from the University of North Carolina at Chapel Hill on Thursday, Jan. 29 in Wilson Hall, Bldg. 1, from 10 to 11 a.m. All are invited to attend.

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