The role of emotion regulation and social support in grief, depression, and inflammation markers in breast cancer patients

项目摘要。对经历过损失的乳腺癌（BC）患者的悲伤知之甚少 与癌症诊断相关，哪些是可以预防悲伤的保护因素 严重抑郁症（MDD）。悲伤是一种心理现象，与MDD有关， 这是在亲人去世后经历的，一些文献认为， 在非死亡相关的损失之后。被诊断患有BC的妇女经历了几次由BC引起的损失 诊断可能是悲伤和抑郁的潜在预测因素。文献显示，在BC患者中， 社会支持会导致抑郁症状的发作和象征性的损失，如性功能障碍和头发 失落会导致情绪困扰。情感神经科学领域已经表明，悲伤是七种主要的 我们大脑中的情感，其主要功能是维持社会联系，因为它们传达安全感。根据 在动物模型中，PANIC/GRIEF的神经通路（系统）由社会分离触发， 绝望，持续激活PANIC/GRIEF导致抑制寻求奖励系统触发 抑郁症症状另一方面，抑郁症的社会信号传导理论假设， 人际逆境可以上调参与炎症过程的免疫系统成分， 引发与抑郁症状的发生相关的行为变化。文学作品表明，悲伤可以 激活HPA轴，导致与MDD和BC相关的炎症标志物表达增加 进展悲伤已被广泛研究的背景下死亡的亲人，但是，研究有关 非死亡相关的损失和悲伤已经进行了使用模型，显示出较差的一致性突出 需要一种经验主义的方法。无法科普不同类型的感知非死亡相关 损失可能意味着对BC患者的健康影响。理解了 损失，悲伤和抑郁，以及潜在的保护因素是改善BC生活质量的关键 患者，因为这些信息可以有助于有针对性的心理治疗。这个问题的核心假设是 情绪调节和社会支持是潜在的保护性应对方式 悲伤管理、抑郁症状和各种促炎因子上调的机制 在非死亡相关损失后的BC肿瘤进展。这项研究的总体目标是调查非死亡- 由于BC诊断与悲伤有关的相关损失，并确定情绪的潜在作用 调节和社会支持作为对抗全身性炎症上调和抑郁的保护因素 拉丁裔BC患者的症状。目标1将确定预期的非死亡相关损失 PANIC/GRIEF系统的表达、抑郁症状及严重程度与乳腺癌的诊断有关。 最后，目标2将定义情绪调节和社会支持在表型表达中的作用， 与BC肿瘤进展相关的PANIC/GRIEF系统、抑郁和循环炎症标志物

Project Summary. Little is known about grief in breast cancer (BC) patients that have experience losses associated to the cancer diagnosis, and which are the protective factors that could manage grief preventing complications such as Major Depression Disorder (MDD). Grief is a psychological phenomenon, related to MDD, which is experienced after the death of a loved one, and some literature argues that it could be also experienced after a non-death-related loss. Women diagnosed with BC experience several losses which stem from the BC diagnosis that could be potential predictors of grief and depression. Literature shows that in BC patients’ loss of social support leads to depression symptoms onset, and symbolic losses, such as sexual dysfunction, and hair loss leads to emotional distress. The affective neuroscience field has shown that grief is one of the seven primary emotions in our brain, which main function is to maintain social bonds as they convey security. According to animal models, the PANIC/GRIEF’s neurological pathway (system) is triggered by social separation, causing despair, and sustained activation of PANIC/GRIEF leads to inhibition of the seeking-reward system triggering depression symptoms. On the other hand, the social signal transduction theory of depression hypothesizes that interpersonal adversity can up-regulate components of the immune system involved in inflammation processes eliciting changes in behavior associate with initiation of depression symptoms. Literature shows that grief can activate the HPA axis resulting in increased expression of inflammation markers associated with MDD and BC progression. Grief has been widely studied in the context of death of a loved one, however, studies concerning non-death-related losses and grief have been conducted using models that show poor consistency highlighting the need for an empirical approach. The inability to cope with different types of perceived non-death-related losses could imply concerning health repercussions in BC patients. Understating the relationship between losses, grief, and depression, as well as potential protective factors is key for improving quality of life in BC patients as it this information can contribute to targeted psychological treatments. The central hypothesis of this administrative supplement is that emotion regulation and social support are potential protective coping mechanisms in grief management, depression symptoms, and upregulation of proinflammatory factors assorted to BC tumor progression after non-death-related losses. The overall goal of this study is to investigate non-death- related losses due to the BC diagnosis in relation to grief, and to determine the potential role of emotional regulation and social support as protective factors against systemic inflammation upregulation, and depression symptoms in Latina BC patients. Aim 1 will determine the relationship of perceived non-death-related losses due to breast cancer diagnosis with the expression of PANIC/GRIEF system, depression symptoms and severity. Lastly, aim 2 will define the role of emotion regulation and social support in the phenotypical expression of PANIC/GRIEF system, depression, and circulating inflammation markers associated to BC tumor progression.