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Emotion regulation and immune functioning during grief: testing the role of expressive suppression and cognitive reappraisal in inflammation among recently bereaved spouses.

OBJECTIVE
Losing a spouse is a distressing life event that can negatively impact both mental and physical health. Stress-induced health consequences often include increased risk for cardiovascular disease (CVD) and altered immune system functioning marked by increased inflammation. Here, we sought to identify individual difference factors that co-vary with problematic inflammatory outcomes.


METHOD
We measured recently bereaved spouses' (N=99) propensity to use emotion regulation strategies and peripheral inflammation-as measured by levels of pro-inflammatory cytokines following ex vivo stimulation of peripheral leukocytes with T cell agonists. Specifically, we measured participants' use of cognitive reappraisal, an adaptive emotion regulation strategy in many contexts, and expressive suppression, a less adaptive emotion regulation strategy that involves actively inhibiting emotions after already experiencing them.


RESULTS
Bereaved spouses who self-reported frequently using expressive suppression as an emotion regulation strategy tended to have a more pronounced inflammatory response, as indexed by higher levels of a composite cytokine index consisting of interleukin (IL) 17A, IL-2, IL-6, TNF- α, and IFN- γ, b = .042, as well as tumor necrosis factor alpha (TNF-α), b = .083, and interferon gamma (IFN-γ), b = .098, when analyzed individually. Notably, these associations were observed in both unadjusted and adjusted models, with the latter including known covariates of inflammation and other potential confounding variables.


CONCLUSIONS
These findings suggest that bereaved spouses' use of emotion regulation strategies is associated with altered immune functioning, and such a link may be an important biological pathway by which interventions targeting affect may improve immune system related health outcomes.