ABSTRACT

Stress is associated with higher mortality, morbidity and generally worse outcomes for a range of diseases such as cancer and cardiovascular disease (Russ et al., 2012). Psychoneuroimmunology (PNI) attempts to understand the mechanisms behind these relationships by studying the complex interrelationships between the psyche, the neuroendocrine and immune systems (Glaser & Kiecolt-Glaser, 2005). Interest in the relationship between psychological stress and wound healing has developed, in part, out of a desire to move away from evidence that associates stress with immune incompetence alone (Segerstrom & Miller, 2004), to an examination of whether the effects of stress are clinically meaningful (Robinson, Mathews, & Witek-Janusek, 2002). In this context, wounds are discrete, time-limited events (apart from chronic wounds) that enable researchers to measure levels of stress before the event (i.e., wound onset) and eliminate the problem of reverse causality – disentangling whether the stress is a consequence of delayed healing or a determinant. As such, wound healing, alongside infectious diseases and vaccination responses, provides a paradigm whereby we can study PNI processes through to clinically meaningful endpoints (e.g., time to healing).