The Man I Once Knew: Grief and Inflammation in Female Partners of Veterans With Traumatic Brain Injury

Biol Res Nurs. 2016 Jan;18(1):50-9. doi: 10.1177/1099800414568661. Epub 2015 Jan 30.

Abstract

Grief, although traditionally conceptualized as a bereavement-related reaction, is also experienced by significant others in response to the profound cognitive and personality changes associated with a traumatic brain injury (TBI) in a loved one. Grief associated with the death of a loved one is related to increases in proinflammatory cytokines, yet it is not clear whether this is the case for grief experienced by individuals caring for a significant other with TBI. The purpose of this cross-sectional, exploratory study was to examine grief and its association with a proinflammatory cytokine, tumor necrosis factor α (TNF-α), in wives/partners caring for veterans with TBI. Participants completed written measures of grief, perceived stress, and depressive symptoms and provided morning saliva samples for TNF-α analysis. Participants reported levels of grief comparable to those reported in studies evaluating individuals grieving the death of a loved one. Path analysis revealed that grief was not associated with TNF-α; however, participants reporting high levels of blame/anger, a subscale of the grief scale, had higher levels of TNF-α. In addition, both grief and blame/anger were related to increased perceived stress and depressive symptoms; however, path analysis demonstrated that perceived stress and depressive symptoms did not mediate the influence of blame/anger on TNF-α. These findings suggest that blame/anger associated with grief may be related to the elevations in TNF-α exhibited by individuals caring for a loved one with TBI.

Keywords: TNF-α; anger; blame; brain injury; caregivers; cytokines; grief.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adult
  • Biomarkers / blood*
  • Brain Injuries, Traumatic / nursing*
  • Caregivers / psychology*
  • Cross-Sectional Studies
  • Cytokines / blood
  • Depression / physiopathology*
  • Female
  • Grief*
  • Humans
  • Inflammation / physiopathology*
  • Male
  • Middle Aged
  • Spouses / psychology*
  • Tumor Necrosis Factor-alpha / blood
  • United States
  • Veterans

Substances

  • Biomarkers
  • Cytokines
  • Tumor Necrosis Factor-alpha