is attributable to some endogenous opioid substance, although the specific molecule has not been identified. The influence of plasma betaendorphin on immune function is only beginning to be explored. Future research should provide more specific findings on behavioral and psychological interventions for enhancing immune system functioning. Identification of endogenous physical mediators of immune enhancement can be expected to guide future research. PSYCHOLOGICAL COPING ASSOCIATED WITH LESS DISTRESS Referring back to the model connecting environmental events with psychological states, which in turn influence the immune system, coping is the step in the model that determines whether environmental events will result in the development of a psychological state of negative mood or a state of efficacy or strength. Data collected from HIV-positive people identify coping styles that result in particular psychological states that, in turn, exert immune system consequences. Support for the benefits of active cognitive and behavioral coping in people with HIV has been reported (Goodkin et al., 1992). Seeking out information about the disease, seeking out social support, focusing on meaning in life, and arranging the environment to avoid becoming distressed are coping skills associated with lower levels of distress (Fleishman & Fogel, 1994; Goodkin et al., 1992; Namir, Wolcott, Fawzy, & Alumbaugh, 1987). In a longitudinal study, active coping at time 1 predicted less distress 11 months later (Fleishman & Fogel, 1994). Beyond relating to psychological states, active coping styles are also associated with stronger natural killer cell activity (Goodkin et al., 1992), as are greater self-nurturing, less preoccupation with the disease of AIDS, and regular exercise (Temoshok, cited in Goodkin et al., 1992). Some personality traits predispose people toward active coping strategies and are, in turn, related to less distress. Two global personality construc...
