School of Medical Sciences


Principal investigator



We are interested in areas relating to the dynamics of immune system behaviour and the maintenance of integrity. How does the immune system establishes and maintains its large portfolio of recognition structures and how the balance between self and non-self recognition is altered by such things as infection, illness or stress?

A second area draws on the extensive communication channels that exist between the immune system and the nervous system and the fact that, like the immune system, the nervous system is involved in the establishment and maintenance of a coherent self identity. This area of deals with the connection between self-defining immunological and psychological processes and the implications of the relationship for illness and health.

Research projects

Immune system coherence within living individuals

The relationship between immune and psychological processes can be approached from a number or perspectives. A common way is to explore the extensive pathways of biochemical connection between the immune system and the nervous system as evidence that psychological factors can influence immunity. We have developed a theoretical approach through which psycho-immune relationships might be better appreciated in humans. We see the immune system as a cognitive, self-defining system in which defence against the outside world arises as a consequence of self determination rather than as a primary reason for the immune system's existence. Briefly, our model is built around a principle which we call ' teleological coherence' which asserts that:

'The relationships between psychosocial and immunological domains arise as a consequence of their shared goal, which is to establish and continuously maintain a self-identity and an adequate relationship with an ever-changing context.'

'The nature of the relationships between these two domains is governed by the necessity for 'harmony of purpose' or coherence among all levels of the organism.'


Emotional disclosure, immune responsiveness and health

We are investigating whether such psychological processes as the disclosure or repression of emotionally upsetting events in people's lives can influence the development of immunity. For example, in assessing whether emotional expression of traumatic experiences affects the immune response to vaccination, we found that subjects assigned to write about personal traumatic events over four consecutive days developed significantly higher antibody levels against hepatitis B vaccine over the subsequent six months than did subjects assigned to write about trivial topics. In other work we have found differential effects on immune variables depending on whether people express or suppress their thoughts about upsetting issues.

The manner in which people handle emotional issues in their lives is known to affect their health. Our work suggests that emotional disclosure may influence immune responsiveness as well as having general health benefits. We are investigating the effects of emotional expression in women with breast cancer and in patients with psoriasis - a chronic immunologically-related skin condition.


Psychoimmune factors in wound healing

Early stages of wound healing involve a set of immunological hormones called pro-inflammatory cytokines. Laboratory-based studies have shown that the concentration of these cytokines in experimental wounds is affected by how stressful people feel their lives to be at the time of measurement. Our research extends this work into the clinical arena where we have found that in patients undergoing surgery for hernia repair, there is a correlation between their levels of perceived stress in the week prior to surgery and the concentration of pro-inflammatory cytokines and other wound healing factors in their wound fluid 24 hours after surgery.


Selected publications

  • Zargar-Shoshtari, K., Paddison, J. S., Booth, R. J., & Hill, A. G. (2009). A prospective study on the influence of a fast-track program on postoperative fatigue and functional recovery after major colonic surgery. J Surg Res, 154(2), 330-335.
  • Paddison, J. S., Booth, R. J., Cameron, L. D., Robinson, E., Frizelle, F. A., & Hill, A. G. (2009). Fatigue after colorectal surgery and its relationship to patient expectations. J Surg Res, 151(1), 145-152.
  • Paddison, J. S., Booth, R. J., Fuchs, D., & Hill, A. G. (2008). Peritoneal inflammation and fatigue experiences following colorectal surgery: a pilot study. Psychoneuroendocrinology, 33(4), 446-454.
  • Vedhara, K., Moss-Morris, R., Booth, R., Horgan, M., Lawrence, M., & Birchall, N. (2007). Changes in mood predict disease activity and quality of life in patients with psoriasis following emotional disclosure. Journal of Psychosomatic Research, 62(6), 611-619.
  • Tamagawa, R., Lobb, B., & Booth, R. (2007). Tolerance of shift work. Appl Ergon, 38(5), 635-642.
  • Loft, P., Thomas, M. G., Petrie, K. J., Booth, R. J., Miles, J., & Vedhara, K. (2007). Examination stress results in altered cardiovascular responses to acute challenge and lower cortisol. Psychoneuroendocrinology, 32(4), 367-375.
  • Cameron, L. D., Booth, R. J., Schlatter, M., Ziginskas, D., & Harman, J. E. (2007). Changes in emotion regulation and psychological adjustment following use of a group psychosocial support program for women recently diagnosed with breast cancer. Psychooncology, 16(3), 171-180.
  • Booth, R. J. (2007). Stress and antibody responses. In G. Fink (Ed.), Encyclopedia of Stress (Second Edition) (Vol. 1, pp. 199-205). London: Academic Press.
  • Booth, R. J. (2007). Are there meaningful relationships between psychosocial self and physiological self? Attachment: New directions in Psychotherapy and Relational Psychoanalysis, 1(2 (July)), 165-178.
  • Booth, R. J. (2007). Immunisation. In S. Ayers, Baum, A., McManus, C., Newman, S., Wallston, K., Weinman, J., West, R. (Ed.), Cambridge Handbook of Psychology, Health and Medicine (Second ed., pp. 751-754). Cambridge: Cambridge University Press.
  • Paddison, J. S., Booth, R. J., Hill, A. G., & Cameron, L. D. (2006). Comprehensive assessment of peri-operative fatigue: development of the Identity-Consequence Fatigue Scale. J Psychosom Res, 60(6), 615-622.
  • Chuang, D., Paddison, J. S., Booth, R. J., & Hill, A. G. (2006). Differential production of cytokines following colorectal surgery. ANZ J Surg, 76(9), 821-824.
  • Cameron, L. D., Booth, R. J., Schlatter, M., Ziginskas, D., Harman, J. E., & Benson, S. R. (2005). Cognitive and affective determinants of decisions to attend a group psychosocial support program for women with breast cancer. Psychosom Med, 67(4), 584-589.
  • Booth, R. J. (2005). Emotional disclosure and psychoneuroimmunology. In K. Vedhara & M. Irwin (Eds.), Human Psychoneuroimmunology (pp. 319 - 341). Oxford: Oxford University Press.
  • Whitesman, S., & Booth, R. (2004). Psychoneuroimmunology - mind-brain-immune interactions. S Afr Med J, 94(4), 259-261. Petrie, K. J., Fontanilla, I., Thomas, M. G., Booth, R. J., & Pennebaker, J. W. (2004).