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Biological Research

For Nursing
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Nursing Research in Stress, Psychoneuroimmunology, and Allostasis


Maureen Wimberly Groer and Bruce S. McEwen
Biol Res Nurs 2012 14: 309
DOI: 10.1177/1099800412456731
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Editorial

Nursing Research in Stress,


Psychoneuroimmunology, and Allostasis

Biological Research for Nursing


14(4) 309-310
The Author(s) 2012
Reprints and permission:
sagepub.com/journalsPermissions.nav
DOI: 10.1177/1099800412456731
http://brn.sagepub.com

Maureen Wimberly Groer, RN, PhD, FAAN1, and


Bruce S. McEwen, PhD2

This issue of Biological Research for Nursing, Nursing


Research in Stress, Psychoneuroimmunology, and Allostasis,
reflects nursing science at the leading edge of a new paradigm
of human health and illnessone that illuminates many issues
that nurses have tried to understand for years. Why are there
such great disparities in health related to socioeconomic levels,
ethnicity, and environment? How can stress affect illness risk?
Why does an intervention work effectively for one patient and
not for another? How does ones history impact ones future
health? What can nurses do to prevent chronic illness? This
paradigm shows us that there are answers to these questions
and new ways of addressing these problems.
The allostasis theory seems to resonate with nursing science
due to its hypothesis-generating potential and its promise of
interventions that better use allostasis for promotion of health and
prevention, or at least minimization, of allostatic load and overload. Allostasis emphasizes the dynamic, nonlinear nature of a
host of biological mediators that are turned on by stressors in order
to maintain homeostasis and promote adaptation. The social environment in which we live is an enormous source of challenges that
require allostasis. Problems arise, however, if the allostatic
response to a stressor is not turned on when needed or not turned
off when the stressor is over. In these cases, the body and brain
experience negative consequences that, over time and repetition
of stressors, may accumulate and result in pathophysiology. This
is allostatic load or overload in the extreme.
A related approach is that of psychoneuroimmunology, a
maturing science that investigates connections among stress,
emotions, neurochemistry, and immunity at every level, from
molecular to ecosystem. The immune system is a very sensitive
index of successful or unsuccessful allostasis since acute stress
will enhance immune defenses, while chronic stress can
suppress those defenses. Moreover, inflammatory processes are
part of all the major disorders of modern lifefrom diabetes to
cancer to neurodegenerative brain diseasesand the regulation
of inflammation involves not only glucocorticoids but also
sympathetic/parasympathetic balance.
Both of these theoretical approaches to health acknowledge
the central role of stress in disease. Nurses have always been
cognizant of the importance of stress in health and illness.
Many of our most basic approaches are inculcated with ways
to address stress: the stress of hospitalization, the stress of

illness, the stress of living with chronic disease, family stress,


and stress in communities. But now these new frameworks are
providing us with tools for deepening our understanding and
intervening to minimize the negative effects of stress.
In this issue, you will read of theoretical approaches and
ideas, intervention with multiple populations, basic and clinical
research studies and critical reviews of literature in stress,
psychoneuroimmunology, and allostasis. Beckies comprehensive review and critique of studies that have used allostasis as a
framework or explanatory model introduces us to the strengths
of the model but also points out the areas that need further
investigation and clarification. Granger, Johnson, Szanton,
Out, and Schumann provide an in-depth review of the methodology for salivary cortisol measurement, an important stress
and allostasis biomarker. There are papers that examine gender
(Arroyo-Morales, Rodriguez, Rubio-Ruiz, and Olea), ethnicity
(DAlonzo, Johnson, and Fanfan), and prematurity (Weber,
Harrison, and Steward). Other papers in this issue describe
studies that have incorporated salivary cortisol measurement
in various populations: Woods and Yefimova study cortisol
patterns in nursing home patients with dementia, while Saban,
Mathews, Bryant, OBrien, and Janusek examine the
relationship between depression and salivary cortisol in female
caregivers. Two papers consider significant biobehavioral
markers of stress, psychoneuroimmunology, and allostasis:
Peace, Majors, Patel, Wang, Dell Valle-Pinero, Martino, and
Henderson explore genetic variations in relationship to stress
in individuals with chronic abdominal pain, while Lee and
Theus focus on heart rate variability in traumatized individuals.
Rounding out the perspectives provided by these outstanding
investigators are papers that examine caring (Zender and
Olshansky) and touch (Papathanassoglou and Mpouzika).
These papers remind us that, while nursing is certainly a

1
2

University of South Florida College of Nursing, Tampa, Florida, FL, USA


The Rockefeller University, New York, NY, USA

Corresponding Author:
Maureen Wimberly Groer, RN, PhD, FAAN, University of South Florida
College of Nursing, 12901 Bruce B. Downs Blvd., MDC 22, Tampa, FL 33612,
USA
Email: mgroer@health.usf.edu

310
science, it is also a deeply rooted art, and the holistic nature of
the paradigm described in this issue embraces these two
perspectives.
The articles in this issue address important nursing problems and emerging nursing science in these areas. We have
been inspired and motivated by the work that has been submitted. This work has reinforced our conviction that students need to understand these important theories, and
nursing science must continue to develop and test these

Biological Research for Nursing 14(4)


theories to find new interventions that directly impact
health. In order to incorporate the concepts of allostasis and
psychoneuroimmunology into their research and practice,
nurses today must have an excellent background education
in genetics, neuroscience, psychology, and immunology.
We are heartened to see that many nursing scholars are
committed to ensuring that training and research encompass
these fields to prepare the next generation of scientists and
practitioners.