A Grieving Heart: Does Feeling Burdensome to Others Impact Inflammatory Outcomes During Spousal Bereavement?

悲伤的心：在配偶丧亲期间，对他人感到负担是否会影响炎症结果？

• 批准号: 10541666
• 负责人: Angie S LeRoy
• 金额: $ 2.56万
• 依托单位: RICE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-01-30 至 2022-06-14
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10541666
• 关键词: Adult; Bereavement; Biological; Cardiovascular system; Caring; Cessation of life; Clinical; Data; Development; Disease; Distress; Emotional; Feeling; Feeling suicidal; Fibrinogen; Funding; Genetic Transcription; Goals; Grief reaction; Guilt; Health; Heart; Heart Diseases; Hematological Disease; Individual; Inflammation; Inflammatory; Intervention; Investigation; Link; Literature; Lung diseases; Mediating; Mental Health; Mission; Modeling; Morbidity - disease rate; NF-kappa B; National Heart, Lung, and Blood Institute; Outcome; Pathway interactions; Perception; Phase; Population; Prevention; Process; Production; Psyche structure; Psychosocial Factor; Public Health; Research; Research Design; Research Personnel; Risk; Risk Factors; Sampling; Spouses; Stressful Event; Support System; Symptoms; Time; clinically relevant; cytokine; disorder prevention; experience; heart damage; improved; modifiable risk; mortality; novel; psychosocial; psychosocial stressors; social; systemic inflammatory response

Project Summary/Abstract Grieving the death of a spouse is an extremely stressful life event. The grieving process may extend for a long period of time, taking a physical, mental, and emotional toll on the bereaved. Bereaved individuals are at an increased risk for morbidity and mortality, particularly within the first 6 months following the loss. Mortality rates are heavily imbalanced by cardiovascular-related deaths, which account for 20-53% of deaths following the loss of a spouse. However, researchers lack an understanding of the psychosocial aspects that may help explain why some bereaved individuals die of a “broken heart”, while others do not. Self-perceived burden, a psychosocial stressor, refers to a concern for the impact on others of one’s care needs resulting in guilt, distress, feelings of responsibility, and diminished sense of self. Psychosocial stressors promote transcription nuclear factor kappa B (NF-kB) activation, a prime pathway for upregulating proinflammatory cytokine production. Inflammation is central to all stages of CVD and our preliminary data identifies inflammation as a potential mechanism underlying CVD among the bereaved. Further, because self-perceived burden is a psychosocial stressor, it may impact bereaved individuals’ CVD risk by promoting systemic inflammation, thereby damaging the heart. Thus, it is important to understand when and if self-perceived burden develops during bereavement, and how it impacts CVD risk via inflammation. In the current study, we aim to investigate self-perceived burden, a novel psychosocial stressor, and its relationship to grief symptoms during the first year after losing a spouse. In addition, we will longitudinally investigate the relationship between self-perceived burden and inflammation, a marker of CVD risk. Last, we will explore which issues appear first in the time course during the grief trajectory; specifically, we will examine whether self-perceived burden partially mediates the relationship between earlier grief symptoms (2 months post-loss) and later inflammation (12 months post- loss). Concurrent with an R01 project funded by NHLBI, this project will examine grief symptoms, self- perceived burden, and inflammation among a sample of 160 bereaved individuals who recently lost their spouse. These associations will be examined longitudinally, with data collected at 2 months, 4 months, 6 months, and 12 months after the spouse’s passing. Investigation of the relationship between self- perceived burden and inflammation would further our understanding of who may be at risk for CVD. Importantly, self-perceived burden is a modifiable risk factor; results may yield important information related to the development or revision of existing clinical interventions for bereaved individuals targeting disease prevention.

项目总结/摘要 对配偶的死亡感到悲伤是一件非常有压力的生活事件。悲伤的过程可能会持续很长时间 一段时间后，采取的身体，精神和情感上的损失。失去亲人的人 发病率和死亡率的风险增加，特别是在损失后的前6个月内。死亡率 与心血管相关的死亡严重失衡，心血管相关死亡占术后死亡的20-53%。 失去配偶。然而，研究人员缺乏对心理社会方面的理解， 解释为什么有些失去亲人的人死于“心碎”，而另一些人则没有。自我感觉负担，a 社会心理压力，是指担心自己的护理需求对他人的影响，导致内疚， 痛苦、责任感和自我意识减弱。心理社会压力促进转录 核因子-κ B（NF-kB）激活是上调促炎细胞因子的主要途径 生产炎症是心血管疾病所有阶段的核心，我们的初步数据将炎症确定为心血管疾病的一个重要组成部分。 潜在的心血管疾病的发病机制。此外，由于自我感知的负担是一个 心理社会压力源，它可能会影响丧亲者的心血管疾病的风险，通过促进全身炎症， 从而损伤心脏。因此，了解自我感知的负担何时以及是否发展是很重要的 以及它如何通过炎症影响CVD风险。在当前的研究中，我们的目标是调查 自我感知负担，一种新的心理社会应激源，及其与第一次治疗期间悲伤症状的关系 失去配偶后的一年。此外，我们还将纵向考察自我知觉与 负担和炎症，CVD风险的标志物。最后，我们将探讨哪些问题在时间上首先出现 过程中的悲伤轨迹;具体来说，我们将研究是否自我感知的负担部分介导 早期悲伤症状（损失后2个月）和后期炎症（损失后12个月）之间的关系。 损失）。与NHLBI资助的R 01项目同时进行，该项目将检查悲伤症状，自我 在最近失去亲人的160个人的样本中， 配偶这些相关性将被纵向检查，在2个月、4个月、6个月收集数据。 12个月后，配偶去世。自我与社会关系的研究 感知的负担和炎症将进一步我们了解谁可能有CVD的风险。 重要的是，自我感知的负担是一个可改变的风险因素;结果可能会产生重要的信息 与为丧失亲人的个人制定或修订现有的临床干预措施有关 针对疾病预防。