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DOI: 10.1177/10998004124567312012 14: 309Biol Res Nurs

Maureen Wimberly Groer and Bruce S. McEwenNursing Research in Stress, Psychoneuroimmunology, and Allostasis

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Editorial

Nursing Research in Stress,Psychoneuroimmunology, and Allostasis

Maureen Wimberly Groer, RN, PhD, FAAN1

, andBruce 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 over-

load. Allostasis emphasizes the dynamic, nonlinear nature of a

hostof biological mediators that areturnedon by stressorsin order

to maintain homeostasisand promote adaptation. The social envi-

ronmentin which we live is an enormous source of challenges thatrequire 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 arepart 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 comprehen-

sive 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 metho-

dology 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 cortisolpatterns 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

1University of South Florida College of Nursing, Tampa, Florida, FL, USA2The 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

Biological Research for Nursing14(4) 309-310 The Author(s) 2012Reprints and permission:sagepub.com/journalsPermissions.nav

DOI: 10.1177/1099800412456731http://brn.sagepub.com

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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 prob-

lems and emerging nursing science in these areas. We have

been inspired and motivated by the work that has been sub-

mitted. This work has reinforced our conviction that stu-

dents need to understand these important theories, and

nursing science must continue to develop and test these

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.

310 Biological Research for Nursing 14(4)