35. Grief is associated with cortisol awakening response and TNF-alpha in female partners of veterans with traumatic brain injury

• Published in: Brain, behavior, and immunity Vol. 26; p. S10
• Main Authors: Saban, K.L, Mathews, H.L, Hogan, N.S, Griffin, J.M, Bryant, F.B, Pape, T.L, Collins, E.G, Janusek, L. Witek
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 01.09.2012
• Subjects: Allergy and Immunology; Psychiatry
• ISSN: 0889-1591; 1090-2139
• DOI: 10.1016/j.bbi.2012.07.059

Severe traumatic brain injury (TBI) produces permanent personality and cognitive changes. Grief, although traditionally conceptualized as a bereavement-related reaction, is also experienced by significant others in response to profound changes in their loved-one. Grief may be a key emotional process underlying neuroendocrine and inflammatory alterations among partners responding to changes in their loved-one following TBI. The purpose of this study was to determine whether grief is associated with alterations in cortisol awakening response (CAR) and levels of a proinflammatory cytokine (TNF-alpha) in partners of veterans with TBI. A cross-sectional sample of 40 women (mean age = 42 years) caring for a significant other who suffered a moderate or severe TBI from 6 months to 10 years ago were enrolled. Subjects completed the Perceived Stress Scale and Hogan Grief Reaction Checklist and provided saliva samples upon awakening and 30 min after awakening to measure CAR and TNF-alpha. Controlling for BMI and caregiving frequency and duration, CAR was inversely associated with perceived stress ( r = −.522, p = .007) and with the grief subscale of panic behavior ( r = −.489, p = .013). TNF-alpha was positively associated with grief subscales: detachment ( r = .436, p = .030) and blame/anger ( r = .480, p = .015). A blunted CAR may reflect “burnout” resulting from the chronic stress and grief experienced by caregivers. This may unleash proinflammatory cytokines and predispose caregivers to future inflammatory-related health risks.