Psychosomatic Medicine: Looking Forward.

ABSTRACT: The new Editor-in-Chief of Psychosomatic Medicine thanks the outgoing editorial team, reflects on the longevity and impact of the journal, and looks forward to challenges and opportunities. Science-and scientific publications-must address and embrace reproducibility and replication, inclusivity and diversity, statistical advances, and more.

Physiometrics in Salivary Bioscience.

BACKGROUND: Accurate estimation in statistical models depends on sample size but also, critically, reliability of the measure. Physiometrics is the equivalent of psychometrics for measures such as sex hormones, catabolic hormones, and products of the immune system. METHOD: There are multiple ways to measure physiometrics, from simple correlation to complex generalizability theory designs. Depending on the design, these estimates can provide information about equivalency (e.g., the correlation between two measurements taken close together in time) or stability (e.g., the correlation between two measurements taken farther apart in time). RESULTS: The physiometrics of salivary measures including cortisol, α-amylase, testosterone, and cytokines range from highly stable, requiring only a single sample, to highly unstable, requiring multiple samples to achieve generalizability to longer periods of time. However, generalizability is relative to the study design, and only some designs call for stable and generalizable measures. CONCLUSION: Both dedicated physiometric studies and more reporting of physiometrics in psychoneuroendocrinology and psychoneuroimmunology will improve the quality of salivary bioscience study designs in the future.

Between the Error Bars: How Modern Theory, Design, and Methodology Enrich the Personality-Health Tradition.

The study of relationships between personality traits and health has a long history in psychosomatic research. However, personality science has evolved from an understanding of personality as fixed traits to one that acknowledges that personality is dynamic. Dynamic approaches to conceptualizing and measuring personality and individual differences can enrich personality-health research. In this Presidential Address (American Psychosomatic Society, 2018), I consider how different formulations of personality-stable traits, stable signals in a noisy or variable measure, within-person changes, and intraindividual variability-can be implemented to better understand how personality is related to health and particularly to immune function. These approaches recognize and, in some cases, capitalize on the fact that personality factors can display variability as well as stability over time. They also require repeated measurement and therefore greater methodological sophistication that considers reliability and generalizability, Simpson's paradox, and the difference between variability and flexibility. Dynamic qualities of personality and individual differences potentially influence health, and designs and methodology that incorporate them can illuminate the important processes that occur inside the error bars.

Self-Regulatory Deficits Associated with Unpracticed Mindfulness Strategies for Coping with Acute Pain.

Training in mindfulness is a well-supported therapeutic strategy for pain conditions, though short-term mindfulness training for acute pain is not always effective. To explore the possibility that initial attempts at mindfulness in people without previous training may drain self-regulatory resources, the current study used a student sample (N=63) to test the hypothesis that brief instruction in mindfulness would lead to reduced pain tolerance on a cold pressor task (CPT), compared to more familiar strategies for coping with acute pain. We also investigated whether high heart rate variability (HRV), a physiological indicator of self-regulatory capacity, would predict pain tolerance. Higher HRV predicted greater pain tolerance only in the control group, suggesting that applying unfamiliar mindfulness strategies while attempting to tolerate pain more rapidly sapped self-regulatory strength.

Resources, stress, and immunity: an ecological perspective on human psychoneuroimmunology.

Ecological immunology provides a broad theoretical perspective on phenotypic plasticity in immunity, that is, changes related to the value of immunity across different situations, including stressful situations. Costs of a maximally efficient immune response may at times outweigh benefits, and some aspects of immunity may be adaptively suppressed. This review provides a basic overview of the tenets of ecological immunology and the energetic costs of immunity and relates them to the literature on stress and immunity. Sickness behavior preserves energy for use by the immune system, acute stress mobilizes "first-line" immune defenders while suppressing more costly responses, and chronic stress may suppress costly responses in order to conserve energy to counteract the resource loss associated with stress. Unexpected relationships between stress "buffers" and immune functions demonstrate phenotypic plasticity related to resource pursuit or preservation. In conclusion, ecological models may aid in understanding the relationship between stress and immunity.

Identifying immune traits and biobehavioral correlates: generalizability and reliability of immune responses in rhesus macaques.

Variation in immune responses over time and in different contexts presents a methodological challenge for characterizing the typical immune status of an individual. Our analyses statistically evaluated sampling strategies for optimizing the determination of an "immune trait" in studies of individual differences with nonhuman primates. Lymphocyte proliferation and natural killer cell activity were assessed on multiple occasions at 3-week intervals in male rhesus macaques for up to 1 year while they lived in undisturbed conditions. Generalizability and Monte Carlo analyses were utilized to explore the benefits of multiple evaluations and the effects of reliability on replication. There were substantial gains in reliability and stability by obtaining 4 or more immune assessments of the same individual, and the benefits continued to accrue to an optimal assessment level of 10 or more evaluations for each individual. The value of determining "immune traits" was then exemplified by demonstrating the degree to which the monkeys' handedness correlated with reliable indices of proliferative and cytolytic responses averaged over 1 year of assessment.

Optimism and immunity: do positive thoughts always lead to positive effects?

The effects of dispositional optimism, as defined by generalized positive expectations for the future, on physical health are mixed, especially in diseases that can be immunologically mediated such as HIV and cancer. Both experimental and naturalistic studies show that optimism is negatively related to measures of cellular immunity when stressors are difficult (e.g., complex, persistent, and uncontrollable) but positively related when stressors are easy (e.g., straightforward, brief, and controllable). Although the negative relationship between optimism and immunity has been attributed to the violation of optimists' positive expectancies and subsequent disappointment, empirical evidence suggests that it is more likely to be a consequence of optimists' greater engagement during difficult stressors. For example, negative mood does not account for the effect, but conscientiousness, a personality facet related to engagement, does. The mixed immunological correlates of optimism may explain why it does not consistently predict better disease outcomes.