CENTER ON BEHAVIORAL MEDICINE

MIND-BODY CONNECTION

PSYCHOIMMUNOLOGY

Negative Emotions:  Research Article

Psychoimmunology Menu

Loneliness, Social Network Size, and Immune Response to Influenza Vaccination in College Freshmen

CITATION:  Pressman, S.D., Cohen, S., Miller, G. E., Barkin, A., Rabin, B. S., Treanor, J. J.  (2005) Loneliness, Social Network Size, and Immune Response to Influenza Vaccination in College Freshmen. Health Psychology Vol. 24, No. 3, 297-306.

ABSTRACT:  Antibody response to the influenza immunization was investigated in 83 1st-semester healthy university freshmen. Elevated levels of loneliness throughout the semester and small social networks were independently associated with poorer antibody response to 1 component of the vaccine. Those with both high levels of loneliness and a small social network had the lowest antibody response. Loneliness was also associated with greater psychological stress and negative affect, less positive affect, poorer sleep efficiency and quality, and elevations in circulating levels of cortisol. However, only the stress data were consistent with mediation of the loneliness-antibody response relation. None of these variables were associated with social network size, and hence none were potential mediators of the relation between network size and immunization response.

References

Andresen, E. M., Malmgren, J. A., Carter, W. B., & Patrick, D. L. (1994). Screening for depression in well older adults: Evaluation of a short form of the CES-D.  American Journal of Preventive Medicine, 10, 77-84. 

Antonucci, T. C., & Akiyama, H. (1987). Social networks in adult life and a preliminary examination of the convoy model.  Journal of Gerontology, 42, 519-527. 

Barefoot, J. C., Dodge, K. A., Peterson, B. L., Dahlstrom, W. G., & Williams, R. (1989). The Cook-Medley Hostility Scale: Item content and ability to predict survival.  Psychosomatic Medicine, 51, 46-57. 

Baron, R. M., & Kenny, D. A. (1986). The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations.  Journal of Personality and Social Psychology, 51, 1173-1182. 

Berg, S., Mellstrom, D., Persson, G., & Svanborg, A. (1981). Loneliness in the Swedish aged.  Journal of Gerontology, 36, 342-349. 

Berkman, L. F., & Syme, L. (1979). Social networks, host resistance, and mortality: A nine-year follow-up study of Alameda County residents.  American Journal of Epidemiology, 109, 186-203. 

Berkman, L. F., Vaccarino, V., & Seeman, T. (1993). Gender differences in cardiovascular morbidity and mortality: The contribution of social networks and support.  Annals of Behavioral Medicine, 15, 112-118. 

Bisschop, M. I., Kriegsman, D. M., van Tilburg, T. G., Penninx, B. W., van Eijk, J. T., & Deeg, D. J. (2003). The influence of differing social ties on decline in physical functioning among older people with and without chronic diseases: The Longitudinal Aging Study Amsterdam.  Aging Clinical and Experimental Research, 15, 164-173. 

Burns, V. E., Carroll, D., Drayson, M., Whitham, M., & Ring, C. (2003). Life events, perceived stress and antibody response to influenza vaccination in young, healthy adults.  Journal of Psychosomatic Research, 55, 569-572. 

Burns, V. E., Carroll, D., Ring, C., Harrison, L. K., & Drayson, M. (2002). Stress, coping, and hepatitis B antibody status.  Psychosomatic Medicine, 64, 287-293. 

Buysse, D. J., Reynolds, C. F., Monk, T. H., Berman, S. R., & Kupfer, D. J. (1989). The Pittsburgh Sleep Quality Index: A new instrument for psychiatric practice and research.  Psychiatry Research, 28, 193-213. 
Cacioppo, J. T., Ernst, J. M., Burleson, M. H., McClintock, M. K., Malarkey, W. B., Hawkley, L. C.  et al. (2000). Lonely traits and concomitant physiological processes: The MacArthur social neuroscience studies.  International Journal of Psychophysiology, 35, 143-154. 

Cacioppo, J. T., Hawkley, L. C., & Bernston, G. G. (2003). The anatomy of loneliness.  Current Directions in Psychological Science, 12, 71-74. 

Cacioppo, J. T., Hawkley, L. C., Berntson, G. G., Ernst, J. M., Gibbs, A. C., Stickgold, R., & Hobson, J. A. (2002). Do lonely days invade the nights? Potential social modulation of sleep efficiency.  Psychological Science, 13, 384-387. 

Cacioppo, J. T., Hawkley, L. C., Crawford, E., Ernst, J. M., Burleson, M. H., Kowalewski, R. B.  et al. (2002). Loneliness and health: Potential mechanisms.  Psychosomatic Medicine, 64, 407-417. 

Cohen, S. (1988). Psychosocial models of the role of social support in the etiology of physical disease.  Health Psychology, 7, 269-297. 

Cohen, S., Doyle, W. J., Skoner, D. P., Rabin, B. S., & Gwaltney, J. M. Jr. (1997). Social ties and susceptibility to the common cold.  JAMA, 277, 1940-1944. 

Cohen, S., Doyle, W. J., Turner, R. B., Alper, C. M., & Skoner, D. P. (2003). Emotional style and susceptibility to the common cold.  Psychosomatic Medicine, 65, 652-657. 

Cohen, S., Miller, G. E., & Rabin, B. S. (2001). Psychological stress and antibody response to immunization: A critical review of the human literature.  Psychosomatic Medicine, 63, 7-18. 

Cohen, S., Turner, R., Alper, C. M., & Skoner, D. P. (2003). Sociability and susceptibility to the common cold.  Psychological Science, 14, 389-395. 

Cox, J. H., deSouza, M., Ratto-Kim, S., Ferrari, G., Weinhold, K. J., & Birx, D. L. (2002). Cellular immune assays for evaluation of vaccine efficacy in developing countries.  In N. R. Rose, R. G. Hamilton, & B. Detrick (Eds.), Manual of clinical laboratory immunology (pp. 301-317). Washington, DC: ASM Press.

Cutrona, C. E. (1982). Transition to college: Loneliness and the process of social adjustment.  In L. A. Peplau & D. Perlman (Eds.), Loneliness: A sourcebook of current theory, research, and therapy (pp. 291-309). New York: Wiley.

Douglas, J. D. (1967).  The social meanings of suicide.  Princeton, NJ: Princeton University Press.
Fees, B. S., Martin, P., & Poon, L. W. (1999). A model of loneliness in older adults.  Journals of Gerontology: Series B: Psychological Sciences and Social Sciences, 54, P231-P239. 

Feldman, P. J., Cohen, S., Doyle, W. J., Skoner, D. P., & Gwaltney, J. M. Jr. (1999). The impact of personality on the reporting of unfounded symptoms and illness.  Journal of Personality and Social Psychology, 77, 370-378. 

Galle, O. R., & Gove, W. R. (1978). Overcrowding, isolation, and human behavior: Exploring the extremes in population distribution.  In K. Taeuber & J. Sweet (Eds.), Social demography (pp. 95-132). New York: Academic Press.

Glaser, R., Kiecolt-Glaser, J. K., Bonneau, R. H., Malarkey, W., Kennedy, S., & Hughes, J. (1992). Stress-induced modulation of the immune response to recombinant hepatitis B vaccine.  Psychosomatic Medicine, 54, 22-29. 

Glaser, R., Kiecolt-Glaser, J. K., Malarkey, W. B., & Sheridan, J. F. (1998). The influence of psychological stress on the immune response to vaccines.  In S. M. McCann (Ed.), Annals of the New York Academy of Sciences: Vol. 840. Neuroimmunomodulation: Molecular aspects, integrative systems, and clinical advances (pp. 649-655). New York: New York Academy of Sciences.

Glaser, R., Kiecolt-Glaser, J. K., Speicher, C. E., & Holliday, J. E. (1985). Stress, loneliness, and changes in herpesvirus latency.  Journal of Behavioral Medicine, 8, 249-260. 

Goldberg, L. R. (1992). The development of markers for the Big-Five factor structure.  Psychological Assessment, 4, 26-42. 

Hanson, B. S., & Oestergren, P. O. (1987). Different social network and social support characteristics, nervous problems and insomnia: Theoretical and methodological aspects on some results from the population study “men born in 1914,” Malmoe, Sweden.  Social Science & Medicine, 25, 849-859. 

Hawkley, L. C., & Cacioppo, J. T. (2003). Loneliness and pathways to disease.  Brain Behavior and Immunity, 17, 98-105.  (Suppl. 1)

Herlitz, J., Wiklund, I., Caidahl, K., Hartford, M., Haglid, M., Karlsson, B. W.  et al. (1998). The feeling of loneliness prior to coronary artery bypass grafting might be a predictor of short- and long-term postoperative mortality.  European Journal of Vascular and Endovascular Surgery, 16, 120-125. 

House, J. S., Landis, K. R., & Umberson, D. (1988, July 29). Social relationships and health.  Science, 241, 540-545. 

Jabaaij, L., Grosheide, P. M., Heijtink, R. A., Duivenvoorden, H. J., Ballieux, R. E., & Vingerhoets, A. J. (1993). Influence of perceived psychological stress and distress on antibody response to low dose rDNA hepatitis B vaccine.  Journal of Psychosomatic Research, 37, 361-369. 

Kiecolt-Glaser, J. K., Garner, W., Speicher, C. E., Penn, G. M., Holliday, J. E., & Glaser, R. (1984). Psychosocial modifiers of immunocompetence in medical students.  Psychosomatic Medicine, 46, 7-14. 

Kiecolt-Glaser, J. K., Ricker, D., George, J., Messick, G., Speicher, C. E., Garner, W., & Glaser, R. (1984). Urinary cortisol levels, cellular immunocompetency, and loneliness in psychiatric inpatients.  Psychosomatic Medicine, 46, 15-23. 

Levin, I., & Stokes, J. P. (1986). An examination of the relation of individual difference variables to loneliness.  Journal of Personality, 54, 717-733. 

Mahon, N. E., Yarcheski, A., & Yarcheski, T. J. (1993). Health consequences of loneliness in adolescents.  Research in Nursing & Health, 16, 23-31. 

Maier, S. F., & Watkins, L. R. (1998). Cytokines for psychologists: Implications of bidirectional immune-to-brain communication for understanding behavior, mood, and cognition.  Psychological Review, 105, 83-107. 

Marsland, A. L., Cohen, S., Rabin, B. S., & Manuck, S. B. (2001). Associations between stress, trait negative affect, acute immune reactivity, and antibody response to hepatitis B injection in healthy young adults.  Health Psychology, 20, 4-11. 

Mendes de Leon, C. F., Gold, D. T., Glass, T. A., Kaplan, L., & George, L. K. (2001). Disability as a function of social networks and support in elderly African Americans and Whites: The Duke EPESE 1986-1992.  Journals of Gerontology: Series B: Psychological Sciences and Social Sciences, 56, S179-S190. 

Miller, G. E., Cohen, S., Pressman, S., Barkin, A., Rabin, B. S., & Treanor, J. (2004). Psychological stress and antibody response to influenza vaccination: When is the critical period for stress, and how does it get inside the body?  Psychosomatic Medicine, 66, 215-223. 

Miller, G. E., Cohen, S., Rabin, B. S., Skoner, D. P., & Doyle, W. J. (1999). Personality and tonic cardiovascular, neuroendocrine, and immune parameters.  Brain, Behavior & Immunity, 13, 109-123. 

Miller, G. E., Kemeny, M. E., Taylor, S. E., Cole, S. W., & Visscher, B. R. (1997). Social relationships and immune processes in HIV seropositive gay and bisexual men.  Annals of Behavioral Medicine, 19, 139-151. 

Nerviano, V. J., & Gross, W. F. (1976). Loneliness and locus of control for alcoholic males: Validity against Murray need and Cattell trait dimensions.  Journal of Clinical Psychology, 32, 479-484. 

Nicholson, K. G., Webster, R. G., & Hay, A. J. (1998).  Textbook of influenza.  Oxford, England: Blackwell Science.

O'Reilly, P. A., & Thomas, H. E. (1989). Role of support networks in maintenance of improved cardiovascular health status.  Social Science & Medicine, 28, 249-260. 

Paffenbarger, R. S. Jr., Blair, S. N., Lee, I. M., & Hyde, R. T. (1993). Measurement of physical activity to assess health effects in free-living populations.  Medicine and Science in Sports and Exercise, 25, 60-70. 

Peplau, L. A., & Perlman, D. (1982). Perspectives on loneliness.  In L. A. Peplau & D. Perlman (Eds.), Loneliness: A sourcebook of current theory, research, and therapy (pp. 1-20). New York: Wiley.
Perlman, D., & Peplau, L. A. (1981). Toward a social psychology of loneliness.  In S. Duck & R. Gilmour (Eds.), Personal relationships: Vol. 3. Personal relationships in disorder (pp. 31-56). London: Academic Press.

Reynolds, P., & Kaplan, G. A. (1990). Social connections and risk for cancer: Prospective evidence from the Alameda County study.  Behavioral Medicine, 16, 101-110. 

Rook, K. S. (1984). Research on social support, loneliness, and social isolation: Toward an integration.  Review of Personality & Social Psychology, 5, 239-264. 

Rosenberg, M. (1965).  Society and the adolescent self-image.  Princeton, NJ: Princeton University Press.

Russell, D. (1996). UCLA Loneliness Scale (Version 3): Reliability, validity, and factor structure.  Journal of Personality Assessment, 66, 20-40. 

Russell, D., Peplau, L. A., & Cutrona, C. E. (1980). The revised UCLA Loneliness Scale: Concurrent and discriminant validity evidence.  Journal of Personality and Social Psychology, 39, 472-480. 

Sanchez-Martin, J. R., Cardas, J., Ahedo, L., Fano, E., Echebarria, A., & Azpiroz, A. (2001). Social behavior, cortisol, and sIgA levels in preschool children.  Journal of Psychosomatic Research, 50, 221-227. 

Sorkin, D., Rook, K. S., & Lu, J. L. (2002). Loneliness, lack of emotional support, lack of companionship, and the likelihood of having a heart condition in an elderly sample.  Annals of Behavioral Medicine, 24, 290-298. 

Stone, A. A., & Shiffman, S. (1994). Ecological momentary assessment (EMA) in behavioral medicine.  Annals of Behavioral Medicine, 16, 199-202. 

Townsend, P. (1968). Isolation, desolation and loneliness.  In E. Shanas, P. Townsend, D. Wedderburn, H. Frus, P. Milhaj, & J. Stehouwer (Eds.), Older people in three industrial societies (pp. 258-287). New York: Atherton.

Trout, D. L. (1980). The role of social isolation in suicide.  Suicide and Life Threatening Behavior, 10, 10-23. 

Vedhara, K., Cox, N. K., Wilcock, G. K., Perks, P., Hunt, M., Anderson, S.  et al. (1999). Chronic stress in elderly carers of dementia patients and antibody response to influenza vaccination.  Lancet, 353, 627-631. 
Weiss, R. S. (1973).  Loneliness: The experience of emotional and social isolation.  Cambridge, MA: MIT Press.