SHAKING UP IMMUNITY - PSYCHOLOGICAL AND IMMUNOLOGICAL CHANGES AFTER ANATURAL DISASTER

Objective. The 1994 Northridge earthquake created life disruption and psychological distress for employees of the nearby Sepulveda VA Medica l Center. We were interested in the immunologic correlates of disrupti on and distress under these stressful circumstances. Method, Sixty-eig ht employees were examined beginning 11 days post-earthquake and were observed until about 4 months after the earthquake, during which time three psychological and immunologic assessments were done. Subjects ex perienced life disruption from the earthquake itself, damage to home a nd possessions, injury to self and others, and damage to and functiona l disruption of workplace. questionnaires assessed degree of life disr uption (personal and work-related), mood, earthquake-specific distress , and repression (alexithymia, coping style or ''Type C'', and ''immun osuppression-prone'' traits), immune measures included lymphocyte subs ets-total T (CD3+), helper T (CD4+), cytotoxic T (CD3+CD8+), B (CD19+) , and natural killer (NK; CD3-CD16+CD56+)-as well as lymphoid cell mit ogenesis (PHA and PWM), and NK cell cytotoxicity. Results, Along with a lessening degree of distress over time, a number of immunologic meas ures declined over the assessment period (CD3+, CD8+, CD16+56+ cells, T cell blastogenesis, and NK cell cytotoxicity). Furthermore, subjects reporting low distress had higher numbers of CD3+ and CD8+ cells and a higher proliferative response to PHA. Those with distress correspond ing to life disruption had highest levels of CD3+ and CD8+ cells. Meas ures of repression did not relate directly to immunity. Conclusion. Th ese results suggest that appropriateness of psychological reaction to the realistic degree of life stress was least disruptive of an aspect of immunity.