title: How Does Bereavement Get Under the Skin? The Effects of Late-Life Spousal Loss on Cortisol Levels.
abstract: OBJECTIVE
  We used data from the Changing Lives of Older Couples, a prospective multiwave study of 1,532 married individuals aged 65 and older, to investigate the extent to which spousal loss and death-context characteristics are associated with the stress hormone cortisol at 6 (W1) and 18 (W2) months postbereavement.
  
  
  METHODS
  We used ordinary least squares regression models to estimate the effects of death-context characteristics (forewarning, caregiving, and postloss numbness, reported at W1) on cortisol levels (at W1 and W2). We included age and gender and evaluated a two-way interaction term between gender and death circumstances.
  
  
  RESULTS
  Bereaved spouses who reported prolonged forewarning of the death evidenced higher cortisol levels at W1 than those who did not experience prolonged forewarning. Bereaved women had higher cortisol levels than bereaved men at W1. A two-way interaction between gender and emotional numbness was statistically significant, where men (but not women) who experienced postloss numbness had elevated cortisol levels at W2.
  
  
  CONCLUSIONS
  Our findings reveal that stressful life events are associated with stress-related neuroendocrine reactions for longer durations than researchers have previously documented. The specific death-related stressor affecting cortisol varies by gender. Implications for research and practice are discussed.
authors.affiliation: College of Social Work, Ohio State University, Columbus. richardson.2@osu.edu.
authors.forename: Virginia E
authors.initials: VE
authors.lastname: Richardson
authors.affiliation: Department of Psychology, University of Liverpool, UK.
authors.forename: Kate M
authors.initials: KM
authors.lastname: Bennett
authors.affiliation: Institute for Health, Health Care Policy and Aging Research, Rutgers University, New Brunswick, New Jersey.
authors.forename: Deborah
authors.initials: D
authors.lastname: Carr
authors.affiliation: Centre for Social Issues Research, Department of Psychology, University of Limerick, Ireland.
authors.forename: Stephen
authors.initials: S
authors.lastname: Gallagher
authors.affiliation: Department of Social Welfare, Pusan National University, Korea.
authors.forename: Jinhyun
authors.initials: J
authors.lastname: Kim
authors.affiliation: School of Social Work, University of Texas at Arlington.
authors.forename: Noelle
authors.initials: N
authors.lastname: Fields
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001601:Bereavement; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006854:Hydrocortisone / Q000652:urine*; D008016:Life Change Events; D008297:Male; D008875:Middle Aged; D012737:Sex Factors; D013315:Stress, Psychological / Q000209:etiology / Q000652:urine*; D017805:Widowhood / Q000523:psychology*
chemical_list: D006854:Hydrocortisone
keywords: Bereavement; Caregiving; Cortisol; Stress; Widowhood.