We expect that more frequent conflict will be associated with increased susceptibility. Here we examine whether global perceptions of social support and the actual receipt of physical touch during daily life-i.e., being hugged, attenuate the association of an interpersonal stressor (social conflict) with subsequent risk for infection, cold signs, and clinical disease in response to an experimentally administered cold virus. This increased susceptibility under stress is attributable to stress associated risk of the virus replicating (infection) and/or stress associated production of signs (objective markers) of illness in infected persons (e.g., Cohen et al., 1991 Cohen, Doyle & Skoner, 1999). In our own work, interpersonal stressors have been associated with an increased risk of developing a cold when participants are experimentally exposed to a common cold virus ( Cohen et al., 1998 Cohen, Tyrrell & Smith, 1991). Touch itself may be an especially effective means of conveying support in that it is invisible-i.e., it is unlikely to provoke feelings of weakness or neediness on the part of the recipient ( Bolger & Amarel, 2007 Jukubiak & Feeney, 2014)-and it is easy to enact well. That is, social wounds may be best healed by intimate behaviors of others. At the same time, those experiencing interpersonal stressors may be particularly receptive to the stress-buffering effects of behaviors indicating care and intimacy such as physical touch. Interpersonal stressors, especially conflicts, have been found to have potent aversive effects on psychological well-being (e.g., Rook, 1984 1992 Bolger, DeLongis, Kessler & Schilling, 1989), and to activate stress physiology and dysregulate immune response ( Kiecolt-Glaser & Newton, 2001). However, evidence for whether such nonverbal gestures act to buffer stress effects on disease is lacking, as is evidence of touch buffering stress effects in natural settings (suggestive evidence in Ditzen, Hoppmann, & Klumb, 2008). In fact, laboratory studies have generally found that touch from a trusted other buffers the usual effects of stress on pain ( Masters, Eisenberger, Taylor, Naliboff, Hirinyan & Lieberman, 2009), and on activation of autonomic pathways ( Ditzen, Neumann, Bodenmann, von Dawans, Turner et al., 2007 Grewen, Anerson, Girdler, & Light, 2003), the hypothalamic-pituitary-adrenal axis ( Ditzen et al., 2007), and the brain ( Coan, Schaefer, Davidson, 2006). Several investigators have proposed nonsexual, caring physical touch such as hugging or hand-holding as an important means of conveying empathy, caring and reassurance (e.g., Holt-Lunstad, Birmingham & Light, 2008 Grewen, Anderson, Girdler & Light, 2003 Reis & Patrick, 1996). However, the aforementioned evidence for stress-buffering derives from studies assessing global perceptions of support, and we know little about the specific behaviors most effective in conveying the availability of these resources to others (cf. Offering support of any kind can be viewed as an expression of empathy, caring and reassurance, resources thought to be most beneficial in the face of stressful events ( Cobb, 1976). Perceived support may also protect against stress-elicited increases in risk for physical morbidity and mortality ( Rosengren, Orth-Gomer, Wedel, & Wilhelmsen, 1993 Falk, Hanson, Isacsson & Ostergren, 1992). The perceived availability of social support has been found to protect against the potential of stressful events to elicit psychological distress, depression and anxiety (reviews by Cohen & Wills, 1985 Kawachi & Berkman, 2001 Schwartzer & Leppin, 1989). Social support refers to a social network’s provision of psychological and material resources intended to benefit an individual’s ability to cope with stressful events (e.g., Cassel, 1976 Cobb, 1976 Cohen, 2004 Thoits, 1986). These data suggest that hugging may act as an effective means of conveying support. Among infected participants, greater perceived support and more frequent hugs each predicted less severe illness signs. A similar stress-buffering effect emerged for hugging, which explained 32% of the attenuating effect of support. Perceived support protected against the rise in infection risk associated with increasing frequency of conflict. Subsequently, participants were exposed to a virus that causes a common cold, and monitored in quarantine to assess infection and illness signs.
Perceived support was assessed by questionnaire, and daily interpersonal conflict and receipt of hugs by telephone interviews on 14 consecutive evenings. In 406 healthy adults, we examined the roles of perceived social support and received hugs in buffering against interpersonal stress-induced susceptibility to infectious disease. How such protection might be conferred, however, is not well understood. Perceived social support has been hypothesized to protect against the pathogenic effects of stress.
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