Hostile marital interactions, proinflammatory cytokine production, and wound healing

Arch Gen Psychiatry. 2005 Dec;62(12):1377-84. doi: 10.1001/archpsyc.62.12.1377.


Context: A growing epidemiological literature has suggested that marital discord is a risk factor for morbidity and mortality. In addition, depression and stress are associated with enhanced production of proinflammatory cytokines that influence a spectrum of conditions associated with aging.

Objective: To assess how hostile marital behaviors modulate wound healing, as well as local and systemic proinflammatory cytokine production.

Design and setting: Couples were admitted twice to a hospital research unit for 24 hours in a crossover trial. Wound healing was assessed daily following research unit discharge.

Participants: Volunteer sample of 42 healthy married couples, aged 22 to 77 years (mean [SD], 37.04 [13.05]), married a mean (SD) of 12.55 (11.01) years.

Interventions: During the first research unit admission, couples had a structured social support interaction, and during the second admission, they discussed a marital disagreement.

Main outcome measures: Couples' interpersonal behavior, wound healing, and local and systemic changes in proinflammatory cytokine production were assessed during each research unit admission.

Results: Couples' blister wounds healed more slowly and local cytokine production (IL-6, tumor necrosis factor alpha, and IL-1beta) was lower at wound sites following marital conflicts than after social support interactions. Couples who demonstrated consistently higher levels of hostile behaviors across both their interactions healed at 60% of the rate of low-hostile couples. High-hostile couples also produced relatively larger increases in plasma IL-6 and tumor necrosis factor alpha values the morning after a conflict than after a social support interaction compared with low-hostile couples.

Conclusions: These data provide further mechanistic evidence of the sensitivity of wound healing to everyday stressors. Moreover, more frequent and amplified increases in proinflammatory cytokine levels could accelerate a range of age-related diseases. Thus, these data also provide a window on the pathways through which hostile or abrasive relationships affect physiological functioning and health.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Aged
  • Blister / etiology
  • Blister / immunology
  • Blister / physiopathology
  • Conflict, Psychological
  • Cross-Over Studies
  • Cytokines / biosynthesis*
  • Cytokines / immunology
  • Female
  • Hostility*
  • Humans
  • Interpersonal Relations
  • Male
  • Marital Status
  • Marriage / psychology*
  • Middle Aged
  • Risk Factors
  • Social Support
  • Stress, Psychological / immunology
  • Stress, Psychological / physiopathology
  • Suction / adverse effects
  • Time Factors
  • Wound Healing / immunology
  • Wound Healing / physiology*


  • Cytokines