The DOI matches its Crossref record; 30 of the 32 references it cites were found in a registry or an index.
Psychological Stress and Susceptibility to the Common Cold
Abstract
BACKGROUND: It is not known whether psychological stress suppresses host resistance to infection. To investigate this issue, we prospectively studied the relation between psychological stress and the frequency of documented clinical colds among subjects intentionally exposed to respiratory viruses. METHODS: After completing questionnaires assessing degrees of psychological stress, 394 healthy subjects were given nasal drops containing one of five respiratory viruses (rhinovirus type 2, 9, or 14, respiratory syncytial virus, or coronavirus type 229E), and an additional 26 were given saline nasal drops. The subjects were then quarantined and monitored for the development of evidence of infection and symptoms. Clinical colds were defined as clinical symptoms in the presence of an infection verified by the isolation of virus or by an increase in the virus-specific antibody titer. RESULTS: The rates of both respiratory infection (P less than 0.005) and clinical colds (P less than 0.02) increased in a dose-response manner with increases in the degree of psychological stress. Infection rates ranged from approximately 74 percent to approximately 90 percent, according to levels of psychological stress, and the incidence of clinical colds ranged from approximately 27 percent to 47 percent. These effects were not altered when we controlled for age, sex, education, allergic status, weight, the season, the number of subjects housed together, the infectious status of subjects sharing the same housing, and virus-specific antibody status at base line (before challenge). Moreover, the associations observed were similar for all five challenge viruses. Several potential stress-illness mediators, including smoking, alcohol consumption, exercise, diet, quality of sleep, white-cell counts, and total immunoglobulin levels, did not explain the association between stress and illness. Similarly, controls for personality variables (self-esteem, personal control, and introversion-extraversion) failed to alter our findings. CONCLUSIONS: Psychological stress was associated in a dose-response manner with an increased risk of acute infectious respiratory illness, and this risk was attributable to increased rates of infection rather than to an increased frequency of symptoms after infection.
Overview
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“Although attempts to identify behavioral pathways linking stress to cold susceptibility have not been especially successful (14,15)”
From Chronic stress, glucocorticoid receptor resistance, inflammation, and disease risk (2012) · cites this paper as [14]
In the citing paper
“A series of studies have shown that chronic stress is associated with increased susceptibility to developing a common cold among persons experimentally exposed to an upper respiratory virus (e.g., refs.[14][15][16][17].”
From Chronic stress, glucocorticoid receptor resistance, inflammation, and disease risk (2012) · cites this paper as [14]
In the citing paper
“Of the 50 highest quality studies, 42 (84%) reported inverse relationships [333–343] and none found a positive one.”
From Religion, Spirituality, and Health: The Research and Clinical Implications (2012) · cites this paper as [341]
In the citing paper
“Stressed persons are prone to viral infections, more frequent and severe flare-ups of asthma, multiple sclerosis, and arthritis, and to developing premature coronary disease (2–7).”
From A Functional Genomic Fingerprint of Chronic Stress in Humans: Blunted Glucocorticoid and Increased NF-κB Signaling (2008) · cites this paper as [2]
In the citing paper
“Stressed persons are prone to viral infections, more frequent and severe flare-ups of asthma, multiple sclerosis, and arthritis, and to developing premature coronary disease (2–7).”
From A Functional Genomic Fingerprint of Chronic Stress in Humans: Blunted Glucocorticoid and Increased NF-κB Signaling (2008) · cites this paper as [2]
In the citing paper
“Stressed persons are prone to viral infections, more frequent and severe flare-ups of asthma, multiple sclerosis, and arthritis, and to developing premature coronary disease (2–7).”
From A Functional Genomic Fingerprint of Chronic Stress in Humans: Blunted Glucocorticoid and Increased NF-κB Signaling (2008) · cites this paper as [2]
In the citing paper
“The resulting cellular level changes support what has been observed for decades – that there is a strong association between chronic stress and the incidence and progression of infection, including sepsis (Cohen et al., 1991; NeSmith et al., 2020; Ojard et al., 2015; Song et al., 2019).”
From On race, human variation, and who gets and dies of sepsis (2022) · cites this paper as Cohen et al., 1991
In the citing paper
“Stress can undermine health in many ways, for example, by increasing the number and severity of somatic symptoms,31 the probability of infection and the severity of symptoms following exposure to a cold virus,32 and systemic inflammation.33”
From Social Media Use and Its Link to Physical Health Indicators (2022) · cites this paper as [32]
In the citing paper
“Common cold is also more likely in those suffering from psychological stress [59], while moderate physical exercise may decrease the risk [60].”
From Immune function and micronutrient requirements change over the life course (2018) · cites this paper as [59]
In the citing paper
“Psychological stress is associated with susceptibility to the common cold in a dose-dependent manner.26”
From The common cold (2003) · cites this paper as [26]
Citations
Cites
Coefficient Alpha and the Internal Structure of Tests
Cronbach, L. J. (1951) · Psychometrika · doi:10.1007/bf02310555 · Cited by 43,931
(1990) · Choice Reviews Online · doi:10.5860/choice.27-3338 · Cited by 35,305
“Stress: appraisal and coping,”
Folkman, S. (2013) · Encyclopedia of Behavioral Medicine · doi:10.1007/978-1-4419-1005-9_215 · Cited by 27,833
(1988) · Cited by 4,111
Self-citationComputer-Aided Multivariate Analysis
Afifi, A. A., & Clark, V. A. (1996) · Springer eBooks · doi:10.1007/978-1-4899-3342-3 · Cited by 1,358
Best Subsets Logistic Regression
Hosmer, D. W., Jovanovic, B. D., & Lemeshow, S. A. (1989) · Biometrics · doi:10.2307/2531779 · Cited by 1,175
Noradrenergic and peptidergic innervation of lymphoid tissue
Felten, D. L., Felten, S. Y., Carlson, S. L., Olschowka, J. A., & Livnat, S. (1985) · The Journal of Immunology · doi:10.4049/jimmunol.135.2.755 · Cited by 1,025
Comparison of tests used to distinguish smokers from nonsmokers
Jarvis, M. J., Tunstall-Pedoe, H., Feyerabend, C., Vesey, C., & Saloojee, Y. (1987) · American Journal of Public Health · doi:10.2105/ajph.77.11.1435 · Cited by 994
The structure of mood change: An idiographic/nomothetic analysis.
Zevon, M. A., & Tellegen, A. (1982) · Journal of Personality and Social Psychology · doi:10.1037/0022-3514.43.1.111 · Cited by 778
Stress and infectious disease in humans.
Cohen, S., & Williamson, G. M. (1991) · Psychological Bulletin · doi:10.1037/0033-2909.109.1.5 · Cited by 756
Self-citationNeurosis and the Social Environment
Henderson, S., Byrne, D. G., & Duncan‐Jones, P. (1982) · Cited by 741
Opioid Peptides Mediate the Suppressive Effect of Stress on Natural Killer Cell Cytotoxicity
Shavit, Y., Lewis, J. W., Terman, G. W., Gale, R. P., & Liebeskind, J. C. (1984) · Science · doi:10.1126/science.6691146 · Cited by 602
Sphere-specific measures of perceived control.
Paulhus, D. L. (1983) · Journal of Personality and Social Psychology · doi:10.1037/0022-3514.44.6.1253 · Cited by 540
Eysenck, H. J., & Eysenck, S. B. G. (1963) · PsycTESTS Dataset · doi:10.1037/t02711-000 · Cited by 501
Felten, S. Y., & Olschowka, J. A. (1987) · Journal of Neuroscience Research · doi:10.1002/jnr.490180108 · Cited by 329
Feyerabend, C., & Russell, M. A. (1990) · Journal of Pharmacy and Pharmacology · doi:10.1111/j.2042-7158.1990.tb06592.x · Cited by 309
STREPTOCOCCAL INFECTIONS IN FAMILIES
Meyer, R. J., & Haggerty, R. J. (1962) · PEDIATRICS · doi:10.1542/peds.29.4.539 · Cited by 302
Streptococcal infections in families. Factors altering individual susceptibility.
Meyer, R. J., & Haggerty, R. J. (1962) · PubMed · Cited by 257
Bidirectional interaction between the central nervous system and the immune system
Rabin, B. S., Cohen, S., Ganguli, R., Lysle, D. T., & Cunnick, J. E. (2018) · PubMed · doi:10.1184/r1/6613715 · Cited by 171
Self-citationInfluence of Life Events and Family Routines on Childhood Respiratory Tract Illness
Boyce, W. T., Jensen, E. W., Cassel, J. C., Collier, A. M., Smith, A. H., & Ramey, C. T. (1977) · PEDIATRICS · doi:10.1542/peds.60.4.609 · Cited by 166
Self-citationSTRESS AND ACUTE RESPIRATORY INFECTION
Graham, N. M. H., Douglas, R. M., & Ryan, P. (1986) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a114409 · Cited by 155
The dimensionality of self-esteem: Some results of a college sample.
Fleming, J. S., & Watts, W. A. (1980) · Journal of Personality and Social Psychology · doi:10.1037/0022-3514.39.5.921 · Cited by 131
Predicting experimental colds in volunteers from different measures of recent life stress
Totman, R., Kiff, J., Reed, S. E., & Craig, J. (1980) · Journal of Psychosomatic Research · doi:10.1016/0022-3999(80)90037-9 · Cited by 121
Callow, K. A. (1985) · Journal of Hygiene · doi:10.1017/s0022172400062410 · Cited by 119
Some further studies on the prediction of experimental colds in volunteers by psychological factors
Broadbent, D. E., Broadbent, M., PHILLPOTTS, R. J., & Wallace, J. G. (1984) · Journal of Psychosomatic Research · doi:10.1016/0022-3999(84)90085-0 · Cited by 98
Asian influenza. Infection, disease, and psychological factors
Cluff, L. E. (1966) · Archives of Internal Medicine · doi:10.1001/archinte.117.2.159 · Cited by 33
Methodological issues in behavioral immunology research with humans.
Kiecolt-Glaser, J., & Glaser, R. (1988) · Brain, behavior, and immunity · doi:10.1016/0889-1591(88)90007-4 · Cited by 31
An ELISA for the detection of rhinovirus specific antibody in serum and nasal secretion
Barclay, W., & Al‐Nakib, W. (1987) · Journal of Virological Methods · doi:10.1016/0166-0934(87)90048-6 · Cited by 25
Picornaviridae: Rhinoviruses—Common Cold Viruses
Al‐Nakib, W., & Tyrrell, D. A. J. (1988) · Springer eBooks · doi:10.1007/978-1-4612-3900-0_37 · Cited by 21
Self-citationPsychosocial Stress and Susceptibility to Infectious Disease
Laudenslager, M. L. (1987) · Springer eBooks · doi:10.1007/978-1-4613-1799-9_38 · Cited by 15
Research works printed but not linked: 7
- Rabin, 1989, Crit Rev Immunol, 9, 279
- Ader R, ed. Psychoneuroimmunology. New York: Academic Press, 1981.
- Caiabrese, 1987, Am J Psychiatry, 114, 1123
- Kiecolt-Glaser JK, Glaser R. Psychosocial factors, stress, disease, and immunity. In: Ader R, Feiten DL, Cohen N, eds. Psychoneuroimmunology. New York: Academic Press, 1991:849–67.
- Alexander, 1956, Student Med, 4, 61
- Beare AS, Reed SE. The study of antiviral compounds in volunteers. In: Oxford JS, ed. Chemoprophyiaxis and virus infections. Vol. 2. Cleveland: CRC Press, 1977:27–55.
- Morahan PS, Murasko DM. Viral infections. In: Nelson DS, ed. Natural immunity in disease processes. New York: Academic Press. 1989:557–86.
Cited by
Sorted by citations
Self-rated health and mortality: a review of twenty-seven community studies.
Idler, E. L., & Benyamini, Y. (1997) · Journal of Health and Social Behavior · doi:10.2307/2955359 · Cited by 8,598
Protective and Damaging Effects of Stress Mediators
McEwen, B. S. (1998) · New England Journal of Medicine · doi:10.1056/nejm199801153380307 · Cited by 6,733
Racism as a stressor for African Americans: A biopsychosocial model.
Clark, R., Anderson, N. B., Clark, V. R., & Williams, D. R. (1999) · American Psychologist · doi:10.1037/0003-066x.54.10.805 · Cited by 2,830
Social Conditions as Fundamental Causes of Disease
Link, B. G., & Phelan, J. C. (1995) · PubMed · doi:10.13016/rpln-eiwa · Cited by 2,684
Socioeconomic status and health: The challenge of the gradient
Adler, N. E., Boyce, T., Chesney, M. A., Cohen, S., Folkman, S., Kahn, R. L., & Syme, S. L. (1994) · American Psychologist · doi:10.1037/0003-066x.49.1.15 · Cited by 2,383
Self-citation
Metadata
- Authors
- Cohen, S., Tyrrell, D. A. J., & Smith, A. P.
- Affiliations
- Carnegie Mellon University (US)
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 1991-08-29
- Volume
- 325
- Issue
- 9
- Pages
- 606-612
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W2327530675
- Cited by
- 1,712
- References
- 32
- Citations by year
- 2026: 23 · 2025: 30 · 2024: 30 · 2023: 87 · 2022: 62 · 2021: 71 · 2020: 68 · 2019: 46 · 2018: 46 · 2017: 40 · 2016: 46 · 2015: 46 · 2014: 55 · 2013: 51 · 2012: 61
- FWCI
- 18.73
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- KiltHub Repository (submittedVersion)
- Bristol Research (University of Bristol) (submittedVersion)
- Funders
- National Institutes of Health (5r01ai023072-04)
- National Institute of Mental Health (MH00721)
- National Institute of Allergy and Infectious Diseases (AI 23072)
- Topics
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Health Sciences › Medicine › Epidemiology › Respiratory viral infections research
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cancer Research › Cancer, Stress, Anesthesia, and Immune Response
- Keywords
- psychological stress, common cold, respiratory infections, host resistance to infection, rhinovirus, respiratory syncytial virus, coronavirus, viral challenge, dose-response relationship, stress and disease
- MeSH terms
- Adolescent, Adult, Antibodies, Viral, Common Cold, Coronaviridae Infections, Disease Susceptibility, Female, gamma-Globulins, Humans, Leukocyte Count, Male, Middle Aged, Respirovirus Infections, Personality, Prospective Studies, Respiratory Syncytial Viruses, Rhinovirus, Stress, Psychological
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
