Abstract: Research in the field of psychoneuroimmunology has burgeoned over the past 25 years, with dramatic demonstrations of not only the role of psychosocial and behavioural factors on immune function, but also their impact on wound healing. The goal of this chapter is to review key established findings in the area, while simultaneously highlighting findings in related areas that are less well consolidated, such as interconnections between psychological factors, physical pain, immune function, and healing. We begin by reviewing the physiological aspects of wound repair that are related to psychological stress. Next, we review human studies documenting the impact of psychoneuroimmunological factors on wound healing, studies which have dealt with diverse aspects of stress, including perceived psychological stress, stressful events, depression, anxiety, and pain. Separate attention is paid to issues of tissue type (dermal verses mucosa) and wound type (acute versus chronic). Chronic wounds have received less empirical attention than acute wounds, yet represent a much larger financial burden on health care and are the focus of most intervention efforts. We also review promising and relatively recent research on the impact of individual differences (e.g. gender and age) and health behaviors (e.g. alcohol use and sleep) on the healing process. Finally, we conclude with a summary of findings in these areas and suggest avenues for future research and clinical efforts.
Citation: Engeland, C. G. & Graham, J. E. (2011). Psychoneuroimmunological aspects of wound healing and the role of pain. In D. Upton (Ed.). Psychological Impact of Pain in Patients with Wounds. Wounds UK Ltd., London, 87-114.