Multi-faceted effects of positive incidents on stress system functioning in a patient with systemic lupus erythematosus

Abstract

This study on a patient with systemic lupus erythematosus (SLE) investigated the impact of positive emotionally pleasing incidents on hypothalamus-pituitary-adrenal (HPA) axis and cellular immune system activity under complex everyday conditions. A 52 year-old woman collected her entire urine for 56 days in 12-h intervals for the determination of cortisol and neopterin, a cellular immune parameter. Psychological variables were based on daily questionnaires and weekly interviews. Time series analysis consisted of ARIMA modeling and cross-correlational analysis. Positive everyday incidents were associated with three distinct emotional reactions: short-term positive reactions, anticipatory negative reactions, and long-term negative reactions. Short-term positive reactions were associated with a decrease in urine cortisol after 36 h and an increase after a total of 48 h, while urine neopterin increased 24 h after the incidents and decreased after a total of 84 h. Anticipatory negative reactions were associated with an initial increase in urine cortisol 24 h before the incident occurred and with a subsequent decrease a total of 12 h following the incident. Long-term negative reactions were associated with an ultimate increase in urine neopterin 144 h after the incidents. These findings empirically demonstrate that one specific category of positive everyday incidents can be associated with multiple emotional reactions that differ in valence (positive/negative) and duration (short-term/long-term), and also depend on whether an incident was expected (anticipated/not anticipated). This calls for a careful categorization of positive incidents when testing stress system functioning under complex everyday life conditions. Copyright © 2006 John Wiley & Sons, Ltd.