title: The Man I Once Knew: Grief and Inflammation in Female Partners of Veterans With Traumatic Brain Injury.
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.
authors: Edward Hines Jr. VA Hospital, Center of Innovation for Complex Chronic Healthcare, Hines, IL, USA Marcella Niehoff School of Nursing, Loyola University Chicago, Chicago, IL, USA ksaban@luc.edu.
authors: Karen L
authors: KL
authors: Saban
authors: Loyola University Stritch School of Medicine, Maywood, IL, USA.
authors: Herbert L
authors: HL
authors: Mathews
authors: Edward Hines Jr. VA Hospital, Center of Innovation for Complex Chronic Healthcare, Hines, IL, USA College of Nursing, University of Illinois at Chicago, Chicago, IL, USA.
authors: Eileen G
authors: EG
authors: Collins
authors: Marcella Niehoff School of Nursing, Loyola University Chicago, Chicago, IL, USA.
authors: Nancy S
authors: NS
authors: Hogan
authors: Marcella Niehoff School of Nursing, Loyola University Chicago, Chicago, IL, USA.
authors: Dina
authors: D
authors: Tell
authors: Department of Psychology, Loyola University Chicago, Chicago, IL, USA.
authors: Fred B
authors: FB
authors: Bryant
authors: Edward Hines Jr. VA Hospital, Center of Innovation for Complex Chronic Healthcare, Hines, IL, USA Department of Physical Medicine & Rehabilitation, Northwestern Feinberg School of Medicine, Chicago, IL, USA.
authors: Theresa Louise Bender
authors: TL
authors: Pape
authors: Center for Chronic Disease Outcomes Research, Minneapolis VA Health Care System, Minneapolis, MN, USA.
authors: Joan M
authors: JM
authors: Griffin
authors: Marcella Niehoff School of Nursing, Loyola University Chicago, Chicago, IL, USA.
authors: Linda Witek
authors: LW
authors: Janusek
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood*; D000070642:Brain Injuries, Traumatic / Q000451:nursing*; D017028:Caregivers / Q000523:psychology*; D003430:Cross-Sectional Studies; D016207:Cytokines / Q000097:blood; D003863:Depression / Q000503:physiopathology*; D005260:Female; D006117:Grief; D006801:Humans; D007249:Inflammation / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D018454:Spouses / Q000523:psychology*; D014409:Tumor Necrosis Factor-alpha / Q000097:blood; D014481:United States; D014728:Veterans
chemical_list: D015415:Biomarkers; D016207:Cytokines; D014409:Tumor Necrosis Factor-alpha
keywords: TNF-α; anger; blame; brain injury; caregivers; cytokines; grief