Development and Psychopathology


Associations among depression, perceived self-efficacy, and immune function and health in preadolescent children

Mary T. Casertaa1 c1, Peter A. Wymana1, Hongyue Wanga1, Jan Moynihana1 and Thomas G. O'Connora1

a1 University of Rochester School of Medicine and Dentistry


Experimental animal studies and adult research consistently show that stress exposure and/or psychological symptoms are associated with poorer health and immune functioning. The application to children is not yet clear, however, and we lack developmental models for studies in this area. The objective of this paper was to test the hypothesis that self-reported self-efficacy and depression, two markers of psychological well-being in children, would predict immunity and rate of illnesses. The data are based on a prospective study of 141 healthy, normally developing children aged 7–13 years who were recruited from an ambulatory pediatric setting. Children completed self-efficacy and depression measures and had blood obtained for IL-6 plasma levels and natural killer cell functional assays on three occasions, 6 months apart. Parents maintained weekly child illness diaries over 1 year using a thermometer to record fever. Parent psychiatric symptoms and income were used as covariates. Results indicated that, across the three occasions of measurement collected over the 1-year period, higher perceived self-efficacy was significantly associated with lower plasma interleukin 6 concentrations. There was no overall main effect of depressive symptoms on immune measures; however, for older girls, higher depression was associated with elevated natural killer cell cytotoxicity and an increased rate of total illnesses and febrile illnesses. The findings provide some of the first evidence that psychological processes are associated with immunity and health in a normally developing sample of preadolescents. Furthermore, the pattern of results suggests a modified model of a link between psychological well-being and immunological processes in children. These results build on and expand research on the notion of allostatic load and develop a groundwork for developmental studies in this area.

(Online publication October 21 2011)


c1 Address correspondence and reprint requests to: Mary Caserta, Department of Pediatrics, University of Rochester Medical Center, 601 Elmwood Avenue, Box 690, Rochester, NY 14642; E-mail:


This work was supported by Grant RO1 HD 38938 from the National Institute of Child Health and Development and in part by General Clinical Research Grant 5 MO1 RR00044 from the National Center for Research Resources, NIH.