Psyc 412 1st Edition Lecture 21Outline of Last Lecture I. The Reproductive SystemII. The Immune SystemOutline of Current Lecture I. PsychoneuroimmunologyII. AIDSCurrent Lecture- Psychoneuroimmunologyo The immune system the surveillance system of the body profile of the immune system:- natural: defense against a variety of pathogens- specific:o lymphocytes have receptor sites on their cell surfaces that fit with only one antigen and respond to only one kind of invadero humoral and cell-mediated immunityo Immunity: The body’s resistance to injury from invading organisms, acquired from the mother at birth, through disease, or through vaccinations and inoculationso Assessing immune functioning: indicators: - measuring numbers of different cells in the immune system by looking at blood sampleso example: counting T, B, NK cells in the blood- assessing the functioning of immune cells (assessing the activation, proliferation, transformation and cytotoxicity of cells) o Stress and immune functioning: commonplace stressors can adversely affect the immune systemo Negative affect and immune functioning: depression is a culprit in the stress-immune relationshipo Stress, immune functioning and interpersonal relationships: marital disruption and conflict care-giving protective effects of social supporto Coping and coping resources: optimism: active coping strategies are protective against stress self-efficacy/personal control:- 3 possibilities (Bandura, 1989):o perceived self-efficacy may reduce the experience of stresso it may reduce the tendency to develop depression in response to stressful eventso it may create some expectancy-based CNS modulation of immunologic reactivityo Interventions to enhance immune functioning:  relaxation:- mutes effects of stress on immune system- research shows higher NK cell activity after relaxation interventiono Stress and the developing immune system: may be vulnerable to stress, depression and grief these experiences may permanently affect the immune system in ways that persist into adulthoodo Moderators of the Stress Experience A considerable amount of research has examined disclosure of emotional experiences and its beneficial effects on health. For many years, researchers have suspected that, when people undergo traumatic events and cannot or do not talk about them, those events may fester inside them, producing obsessive thoughts for years and even decades. When people talked about traumatic events, their skin conductance, heart rate, and systolic and diastolic blood pressure all decreased. Similar studies have shown beneficial long-term effects on immune functioning following emotional disclosure.- AIDS: Acquired Immune Deficiency Syndrome (AIDS)o first appearance is unknowno began in Central Africa, 1970so spread rapidly through heterosexual population: high rate of extra-marital sex low rate of condom use high rate of gonorrhea medical clinics reused needles to promote vaccinationso AIDS and HIV infection in the United States: first diagnosed case: 1981 viral agent is a retrovirus:- human immunodeficiency virus (HIV)- attacks immune system, especially the helper T cells and macrophages- transmitted by exchange of cell-containing bodily fluids, such as semen and blood- highly variable time between contracting virus and developing AIDS symptoms Highly variable time between contracting virus and developing AIDS symptoms: “Thus, a person may test HIV seropositive (HIV+) but be free of AIDS and, during the asymptomatic period, pass on the virus to many other people.” o HIV is transmitted by:  Injection drug use: needle sharing exchanges fluids Sexual Behavior:- Gay and Bisexual men- Anal sex- Receptive partner more at risk Heterosexual men and women- Vaginal sex- Women more at risk than meno Mother-to-child (“Vertical transmission”) During Childbirth, late pregnancy Passed to infant through breast milko Vertical Transmission Untreated, an HIV-positive mother has a 25% chance of passing HIV during childbirth With a single dose of anti-retrovirals to mother during delivery and child after birth, chance drops to 10% ($10) With anti-retrovirals over several weeks, chance drops to 2% ($150-300) Cost of treating AIDS (lifetime, U.S.) = $200,000.00o How HIV infection progresses: mild early symptoms: swollen glands, flu-like symptoms 3 to 6 weeks:  infection abates, asymptomatic period amount of virus gradually rises:  immune system compromised opportunistic infections, such as Kaposi’s sarcoma, occur common symptom for women: gynecologic infectiono Antiretroviral therapy: highly active antiretroviral therapy (HAART) treatments are complex, adherence variableo Who is at risk for getting AIDS? early at-risk groups: homosexual men, IV drug users low-income minorities adolescents and young adults (multiple partners) child and adolescent runaways AIDS growing fastest among womeno Psychosocial impact of HIV infection: depression and thoughts of suicide stigma associated with AIDS people react negatively toward people with AIDS initial response produces positive changes in health interventions that reduce depression are valuableo Disclosure: major barrier to controlling spread of HIV: not disclosing HIV status those who don’t disclose: less likely to use condoms benefits of disclosure:- positive health consequences- more CD4 cells than non-disclosers o Women and HIV: lives are often chaotic and unstable getting food and shelter for families often more salient than HIV status depression likelyo Interventions to reduce the spread of AIDS: education: provide knowledge to target populations health beliefs and AIDS risk-related behavior: perceptions of self-efficacy are critical targeting sexual activity: interventions have focused on communicationo Health belief model A theory of health behaviors; the model predicts that whether a person practices a particular health habit can be understood by knowing the degree to which the person perceives a personal health threat and the perception that a particularhealth practice will be effective in reducing that threat.  The text notes the role of Education in reducing the spread of AIDS. World AIDS Day, in December 2003, led to many relevant reports on education. Among those that were posted on CBSNEWS.com was a story by Chiang