Health Psychology
1998, Vol. 17, No. 3, 214-223
Copyright 1998 by the American Psychological Association, Inc.
0278-6133/98/S3.00
Types of Stressors That Increase Susceptibility to the Common
Cold in Healthy Adults
Sheldon Cohen
Carnegie Mellon University
Ellen Frank
University of Pittsburgh School of Medicine
William J. Doyle and David P. Skoner
University of Pittsburgh School of Medicine and
Children's Hospital of Pittsburgh
Jack M. Gwaltney, Jr.
University of Virginia Health Sciences Center
Bruce S. Rabin
University of Pittsburgh School of Medicine
Two-hundred seventy-six volunteers completed a life stressor interview and psychological
questionnaires and provided blood and urine samples. They were then inoculated with
common cold viruses and monitored for the onset of disease. Although severe acute stressful
life events (less than 1 month long) were not associated with developing colds, severe chronic
stressors (1 month or longer) were associated with a substantial increase in risk of disease.
This relation was attributable primarily to under- or unemployment and to enduring
interpersonal difficulties with family or friends. The association between chronic stressors and
susceptibility to colds could not be fully explained by differences among stressed and
nonstressed persons in social network characteristics, personality, health practices, or
prechallenge endocrine or immune measures.
Key words: stress, colds, infection, immunity, endocrine
On exposure to an infectious agent, only a proportion of
people develop illness. The possibility that psychological
stress contributes to this variability in response has received
considerable attention (e.g., S. Cohen, Tyrrell, & Smith,
1991; Glaser et al., 1987; Stone et al., 1993; Turner Cobb &
Steptoe, 1996). Probably because of their very high inci-
dence, upper respiratory infections (URIs) have served as
the primary model in the study of stress and susceptibility to
infectious disease. Although there is a large literature on the
relation between stress and self-repor