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Immune Function Declines With Unemployment and Recovers After Stressor Termination

Cohen, Frances PhD; Kemeny, Margaret E. PhD; Zegans, Leonard S. MD; Johnson, Paul MPhil; Kearney, Kathleen A. PhD; Stites, Daniel P. MD

doi: 10.1097/PSY.0b013e31803139a6
Original Articles

Objective: To examine the effect of unemployment on natural killer cell cytotoxicity (NKCC) and, in a subsample of persons who become re-employed, to determine if, after termination of the stressor, immune values recover to levels similar to matched controls.

Methods: One hundred unemployed and 100 matched employed healthy men and women, aged 29 to 45 years, were followed for 4 months with monthly blood samples taken to measure NKCC, the ability of NK cells to kill target cells. Twenty-five participants obtained employment before the end of the study, leaving 75 unemployed (and 75 employed) participants in the main sample. For unemployed participants who obtained employment before the end of the study, subsample analyses compared NKCC levels before and after obtaining a new job.

Results: The persistently unemployed sample had significantly lower NKCC levels for all three effector:target ratios (100:1, p = .0004; 50:1, p = .002; and 25:1, p = .02) when compared with the matched employed sample. There were no significant gender effects. In the subsample analyses, NKCC was significantly higher after the participants became employed, compared with their unemployed period, with substantial “recovery” of immune function (44%–72%) compared with values from the steadily employed group.

Conclusions: Chronic stress is associated with persistent NKCC impairment. When the chronic stressor is terminated, however, the immune cell functional capacity quickly begins to recover. We believe this is the first study in humans to document immune function recovery after the definable end of a chronic stressor.

NK = natural killer; NKCC = natural killer cell cytotoxicity.

From the Health Psychology Program, Department of Psychiatry (F.C., M.E.K, P.J., K.K.), Department of Psychiatry (L.E.Z.), and Department of Laboratory Medicine (D.P.S.), University of California San Francisco School of Medicine, San Francisco, CA.

Address correspondence and reprint requests to Frances Cohen, Health Psychology Program, University of California San Francisco School of Medicine, 3333 California Street, Suite 465, San Francisco CA 94143-0848. E-mail:

Received for publication June 13, 2006; revision received September 19, 2006.

This study was supported by Grant MH46788 (F.C.) from the National Institute of Mental Health.

Copyright © 2007 by American Psychosomatic Society
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