title: The unique impact of late-life bereavement and prolonged grief on diurnal cortisol.
abstract: OBJECTIVE
  This study expands on previous research by examining the effects of prolonged grief disorder (PGD) symptoms and bereavement on diurnal cortisol patterns above and beyond depressive symptomatology.
  
  
  METHODS
  Drawing on information from 56 depressed older adults, 3 groups were compared: (1) a depressed nonbereaved group, (2) a depressed bereaved without elevated PGD symptoms group, and (3) a depressed bereaved with elevated PGD symptoms group. Multilevel modeling was used to examine differences in diurnal cortisol profiles between these 3 groups, controlling for demographic factors and depressive symptoms.
  
  
  RESULTS
  Results revealed that those who were bereaved had more dysregulated cortisol patterns, but PGD symptomatology seemed to have little effect. Subsidiary analysis with just the bereaved participants suggests that those who were recently widowed may have had greater cortisol dysregulation compared with other bereaved individuals in the sample.
  
  
  CONCLUSIONS
  These findings suggest that the circumstance of being bereaved may be associated with more dysregulated cortisol, regardless of PGD symptomatology. This pattern of results might reflect greater disturbance in daily routines among bereaved individuals and acute stress in the case of those experiencing the recent loss of a spouse, which leads to disruption in circadian rhythms and the diurnal cycle of cortisol.
authors.affiliation: Correspondence should be addressed to Jason M. Holland, Department of Psychology, University of Nevada, Las Vegas, 4505 South Maryland Parkway, Box 455030, Las Vegas, NV 89154-5030. E-mail: jason.holland@unlv.edu.
authors.forename: Jason M
authors.initials: JM
authors.lastname: Holland
authors.forename: Vincent
authors.initials: V
authors.lastname: Rozalski
authors.forename: Kara L
authors.initials: KL
authors.lastname: Thompson
authors.forename: Roanne Joy
authors.initials: RJ
authors.lastname: Tiongson
authors.forename: Alan F
authors.initials: AF
authors.lastname: Schatzberg
authors.forename: Ruth
authors.initials: R
authors.lastname: O'Hara
authors.forename: Dolores
authors.initials: D
authors.lastname: Gallagher-Thompson
mesh_terms: D000368:Aged; D001601:Bereavement; D002940:Circadian Rhythm / Q000502:physiology; D003863:Depression / Q000503:physiopathology / Q000523:psychology; D005260:Female; D006117:Grief; D006801:Humans; D006854:Hydrocortisone / Q000032:analysis / Q000502:physiology*; D008297:Male; D011569:Psychiatric Status Rating Scales; D012463:Saliva / Q000737:chemistry; D017805:Widowhood / Q000523:psychology
chemical_list: D006854:Hydrocortisone
keywords: Biomarkers; Complicated grief.; Death and dying; Salivary cortisol; Widowhood