Psychological and inflammatory biobehavioral mechanisms underlying the association between bereavement and cardiovascular disease

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Project Summary The loss of a spouse is one of most stressful experiences one can encounter. In the face of such loss, people are physiologically and emotionally dysregulated. As a result, bereaved individuals are at increased risk of cardiovascular disease (CVD), morbidity, and mortality. CVD accounts for an astounding 20-53% of deaths following loss of a spouse. Highly stressed individuals, such as bereaved spouses, exhibit heightened inflammatory responses in comparison to those who are less stressed. Importantly, inflammation is a predictor of all stages of CVD from initial lesion to end-stage thrombotic complications. Therefore, as bereaved individuals are highly stressed and at increased risk of CVD, inflammation may be a key mechanism underlying this CVD risk. Further, bereavement-related stress is often manifested in emotional and physical reactions such as despair, symptoms of depression, excessive grief rumination, insomnia, and decreased physical activity. In bereavement, the ability to successfully regulate emotion is a vital skill for healthy coping, predictive of health outcomes, and may represent a key psychological mechanism accounting for varying degrees of resilience. Psychological distancing is one promising adaptive emotion regulation strategy in which an individual appraises a negative situation by taking a step back, distancing oneself, and coolly, objectively evaluates what is happening. The objective of the present work is to investigate if psychological distancing, implemented implicitly via natural language use (i.e., linguistic distancing (LD)), is related to proinflammatory cytokine biomarkers of CVD risk and bereavement-related health indicators. 160 participants who experienced the loss of their spouse within the last two months will complete questionnaires that index bereavement-related health indices (i.e., risk for mortality, general health, symptoms of depression, perceived stress, grief rumination, sleep quality, and physical activity), and undergo a blood draw to assess proinflammatory cytokine biomarkers of CVD risk. Participants will be asked to discuss their relationship with the deceased spouse for six minutes while being recorded. To assess LD, lexical assays of each participant's oral transcripts will index the extent of his or her spontaneous psychological distancing using a well-established, standardized LD metric. Greater LD scores indicate greater psychological distancing and have been associated with more adaptive emotion regulation and health indices. Primary aims include assessing (1) if LD is negatively associated with CVD- related proinflammatory cytokine responses, (2) if LD is negatively related to deleterious bereavement-related health indicators, and (3) as an exploratory aim, examining and characterizing functional interrelationships among LD, proinflammatory cytokine responses, and bereavement-related health indices. This work may explain novel dependencies among language, emotion, and CVD risk, identify resilience factors, and probe the translational value of LD in this vulnerable population to inform the future design of scalable, effective treatments to reduce risk of CVD, morbidity, and mortality.