Review of the Literature: Integrating Psychoneuroimmunology into Pediatric Chronic Illness Interventions

Objective Provide an orientation to psychoneuroimmunology, a rationale for including assessments of immune function in intervention studies of pediatric chronic illness, review the current literature, and provide recommendations for future research. Methods Using electronic searches and previous reviews, selected and reviewed published studies in which immunological changes related to psychological interventions were assessed in pediatric samples. Results Eight studies were identified and included in the review. These utilized a range of interventions (e.g., disclosure and hypnosis) and included a variety of pediatric samples (e.g., those with asthma, HIV infection, or lupus). Conclusions Results suggest that psychological intervention can influence immune function in pediatric samples. Recommendations for advancing our knowledge by studying populations for whom the immune system plays an active role in disease pathophysiology, measuring disease-relevant immune mediators, studying pediatric patients under times of stress, and focusing on interventions aimed at altering the stress system are provided. Key words intervention; pediatric chronic illness; psychoneuroimmunology; review. The field of psychoneuroimmunology (PNI) has grown dramatically over the past three decades as researchers and the lay public have become increasingly interested in the bi-directional associations between psychological and biological processes, as well as in the intriguing hypothesis that psychological factors influence disease initiation and course (Lovallo, 2005; Rabin, 1999). Researchers have sought to determine associations between psychological factors (e.g., stress, depression, hostility, and optimism) and diseases (e.g., hypertension, cancer, asthma, and the common cold), as well as between psychological factors and specific biological processes (e.g., biological stress response and immune function) that underlie medical conditions and might mediate the association between psychological factors and disease (see reviews by Herbert & Cohen, 1993a,b