Anxiety, not anger, induces inflammatory activity: An avoidance/approach model of immune system activation

Emotion. 2015 Aug;15(4):463-76. doi: 10.1037/emo0000055. Epub 2015 Jun 8.


Psychological stressors reliably trigger systemic inflammatory activity as indexed by levels of proinflammatory cytokines. This experiment demonstrates that one's specific emotional reaction to a stressor may be a significant determinant of whether an inflammatory reaction occurs in response to that stressor. Based on extant correlational evidence and theory, a causal approach was used to determine whether an avoidant emotion (anxiety) triggers more inflammatory activity than an approach emotion (anger). In an experimental design (N = 40), a 3-way Emotion Condition × Time × Analyte interaction revealed that a writing-based anxiety induction, but not a writing-based anger induction, increased mean levels of interferon-γ (IFN- γ) and interleukin-1β (IL-1β), but not interleukin-6 (IL-6) in oral mucous, F(2, 54) = 4.64, p = .01, ηp(²) = .15. Further, self-reported state anxiety predicted elevated levels of proinflammatory cytokines, all ΔR(²) >.06, ps <.04, but self-reported state anger did not. These results constitute the first evidence to our knowledge that specific negative emotions can differentially cause inflammatory activity and support a theoretical model explaining these effects based on the avoidance or approach motivations associated with emotions.

MeSH terms

  • Anger* / physiology
  • Anxiety / immunology
  • Anxiety / physiopathology*
  • Humans
  • Immune System / immunology*
  • Inflammation / physiopathology*
  • Interferon-gamma
  • Interleukin-1beta
  • Interleukin-6
  • Motivation
  • Self Report
  • Stress, Psychological / immunology*
  • Writing


  • IL6 protein, human
  • Interleukin-1beta
  • Interleukin-6
  • Interferon-gamma