Summary: Cortisol levels are altered in people experiencing bereavement, causing possible consequences for health.
Researchers have examined what’s currently known about the neuroendocrine effects of grief and whether biological factors can predict complicated or prolonged grief after the death of a loved one. The findings appear in the Journal of Neuroendocrinology.
The review of the 20 published studies that were deemed relevant found that most studies reported on levels of the stress hormone cortisol, finding higher blood urine, or saliva levels associated with bereavement. While most published studies on the topic were of fair statistical quality only, many found that cortisol levels were altered in bereaved individuals, with possible consequences for health.
The authors called for additional studies encompassing more potential markers of neuroendocrine activity associated with grief. Such efforts may point to new treatment strategies related to psychological and physical adaptations to loss.
“Anticipatory grief and grief after social loss are fundamental stressors and can have long-term health implications for those who lose a loved one. Identifying neuroendocrine factors that are associated with grief might help tailor interventions for the bereaved and help them cope with loss.” said senior author Beate Ditzen, PhD, of Heidelberg University Hospital, in Germany.
About this neuroscience research article
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Neuroendocrine mechanisms of grief and bereavement: A systematic review and implications for future interventions
Bereavement is associated with many negative behavioural, psychological and physiological consequences and leads to an increased risk of mortality and morbidity. However, studies specifically examining neuroendocrine mechanisms of grief and bereavement have yet to be reviewed. This systematic review is a synthesis of the latest evidence in this field and aims to draw conclusions about the implications of neurobiological findings on the development of new interventions. PRISMA guidelines for systematic reviews were used to search for articles assessing neuroendocrine correlates of grief. Findings were qualitatively summarised. The National Heart, Lung, and Blood Institute Study Assessment Tool was used to assess the quality of the included studies. Out of 460 papers, 20 met the inclusion criteria. However, most were of fair quality only. As a neuroendocrine marker, the majority of the studies reported cortisol as the outcome measure and found elevated mean cortisol levels, flattened diurnal cortisol slopes and higher morning cortisol in bereaved subjects. Cortisol alterations were moderated by individual differences such as emotional reaction to grief, depressive symptoms, grief severity, closeness to the deceased and age or gender. Research on neuroendocrine mechanisms of grief is still in its early stages regarding grief measures and the use and timing of neuroendocrine assessments. Most of the studies focus on cortisol as outcome, and only limited data exist on other biomarkers such as oxytocin. Future research might consider assessing a broader range of neuroendocrine markers and use longitudinal designs with a focus on the psychobiological reactions to loss. Based on this, individually tailored psychosocial interventions, possibly in the palliative care context, might be developed to prevent prolonged grief disorder.