Divergent gene expression responses to complicated grief and non-complicated grief

Predicting psychosocial intervention response from baseline gene expression

To address the challenge of predicting psychological response to a psychosocial intervention we tested the possibility that baseline gene expression profiles might provide information above and beyond baseline psychometric measures. The genomics strategy utilized individual level inferences of transcription factor activity to predict changes in loneliness and affect in response to two well-established meditation interventions. Initial algorithm development analyses focused on three a-priori defined stress-related gene regulation pathways (CREB, GR, and NF-ĸB) as inferred from TELiS promoter-based bioinformatic analysis of basal (pre-intervention) blood samples from a randomized-controlled trial comparing a compassion-based meditation (CM, n = 45) with mindfulness meditation (MM, n = 44). Greater baseline CREB activity (but not GR or NF-ĸB) predicted greater reductions from pre- to post-intervention in loneliness (b = -0.24, p = 0.016) and negative emotions (b = -0.23, p = 0.017) for CM, but not for MM. A second algorithm validation analysis applied the same approach to another randomized controlled trial comparing CM (n = 42) with MM (n = 38) and a health education control condition (n = 41). Similarly, greater baseline CREB activity predicted greater pre- to post-intervention decreases in loneliness (b = -0.24, p = 0.029) and greater increases in satisfaction with life (b = 0.21, p = 0.046) for the CM condition only. Baseline CREB activity was not associated with baseline psychometric measures in either study. Results raise the possibility that pre-intervention gene expression profiles may reflect non-conscious psychobiological states that affect psychological responses to distinct psychosocial interventions, and thereby help personalize intervention selection.

Cortical gradient perturbation in attention deficit hyperactivity disorder correlates with neurotransmitter-, cell type-specific and chromosome- transcriptomic signatures

AIMS

This study aimed to illuminate the neuropathological landscape of attention deficit hyperactivity disorder (ADHD) by a multiscale macro-micro-molecular perspective from in vivo neuroimaging data.

METHODS

The "ADHD-200 initiative" repository provided multi-site high-quality resting-state functional connectivity (rsfc-) neuroimaging for ADHD children and matched typically developing (TD) cohort. Diffusion mapping embedding model to derive the functional connectome gradient detecting biologically plausible neural pattern was built, and the multivariate partial least square method to uncover the enrichment of neurotransmitomic, cellular and chromosomal gradient-transcriptional signatures of AHBA enrichment and meta-analytic decoding.

RESULTS

Compared to TD, ADHD children presented connectopic cortical gradient perturbations in almost all the cognition-involved brain macroscale networks (all pBH <0.001), but not in the brain global topology. As an intermediate phenotypic variant, such gradient perturbation was spatially enriched into distributions of GABAA/BZ and 5-HT2A receptors (all pBH <0.01) and co-varied with genetic transcriptional expressions (e.g. DYDC2, ATOH7, all pBH <0.01), associated with phenotypic variants in episodic memory and emotional regulations. Enrichment models demonstrated such gradient-transcriptional variants indicated the risk of both cell-specific and chromosome- dysfunctions, especially in enriched expression of oligodendrocyte precursors and endothelial cells (all pperm <0.05) as well enrichment into chromosome 18, 19 and X (pperm <0.05).

CONCLUSIONS

Our findings bridged brain macroscale neuropathological patterns to microscale/cellular biological architectures for ADHD children, demonstrating the neurobiologically pathological mechanism of ADHD into the genetic and molecular variants in GABA and 5-HT systems as well brain-derived enrichment of specific cellular/chromosomal expressions.

Does losing family members in midlife matter for late-life mental and cognitive health? A longitudinal study of older Swedes spanning 30 years

OBJECTIVES

Mental and cognitive health is crucial to ensure well-being in older age. However, prolonged periods of stress, grief, and bereavement might compromise mental health balance, leading to profound changes. This study investigated the sex-stratified associations between midlife bereavement experiences (e.g. sibling loss, spousal loss, and multiple losses) and late-life depression (LLD) and cognitive impairment.

METHOD

Linked data from the Swedish Level-of-Living Survey and the Swedish Panel Study of Living Conditions of the Oldest Old (SWEOLD) were used. Multiple logistic regressions were performed to examine the associations between midlife bereavement and LLD (n = 1078) and cognitive impairment (n = 995), separately.

RESULTS

Sibling loss and multiple losses in midlife were associated with lower odds of LLD, especially among women. Among men, sibling loss in midlife was associated with lower odds of cognitive impairment, while the experience of two losses among women suggested an increased (but non-significant) risk of cognitive impairment. Interaction analyses did not show significant effects between bereavement and gender on LLD and cognitive impairment.

CONCLUSION

Midlife bereavement might have gendered implications on LLD and cognitive impairment, but associations need to be confirmed by well-powered studies. Further research is warranted to elucidate the association between multiple midlife losses and reduced LLD risk.

How does loneliness "get under the skin" to become biologically embedded?

Loneliness is linked to declining physical health across cardiovascular, inflammatory, metabolic, and cognitive domains. As a result, loneliness is increasingly being recognized as a public health threat, though the mechanisms that have been studied do not yet explain all loneliness-related health risk. Potential mechanisms include loneliness having 1.) direct, causal impacts on health, possibly maintained by epigenetic modification, 2.) indirect effects mediated through health-limiting behaviors, and 3.) artifactual associations perhaps related to genetic overlap and reverse causation. In this scoping review, we examine the evidence surrounding each of these pathways, with a particular emphasis on emerging research on epigenetic effects, in order to evaluate how loneliness becomes biologically embedded. We conclude that there are significant gaps in our knowledge of how psychosocial stress may lead to physiological changes, so more work is needed to understand if, how, and when loneliness has a direct influence on health. Hypothalamic-pituitary adrenocortical axis disruptions that lead to changes in gene expression through methylation and the activity of transcription factor proteins are one promising area of research but are confounded by a number of unmeasured factors. Therefore, wok is needed using causally informative designs, such as twin and family studies and intensively longitudinal diary studies.

Social network position and the Conserved Transcriptional Response to Adversity in older Koreans

BACKGROUND

Social connections are crucial to human health and well-being. Previous research on molecular mechanisms in health has focused primarily on the individual-level perception of social connections (e.g., loneliness). This study adopted socio-centric social network analysis that includes all social ties from the entire population of interest to examine the group-level social connections and their association with a molecular genomic measure of health.

METHODS

Using socio-centric (global) social network data from an entire village in Korea, we investigated how social network characteristics are related to immune cell gene expression among older adults. Blood samples were collected (N = 53, 65-79 years) and mixed effect linear model analyses were performed to examine the association between social network characteristics and Conserved Transcriptional Response to Adversity (CTRA) RNA expression patterns.

RESULTS

Social network positions measured by k-core score, the degree of cohesive core positions in an entire village, were significantly associated with CTRA downregulation. Such associations emerged above and beyond the effects of perceived social isolation (loneliness) and biobehavioral risk factors (smoking, alcohol, BMI, etc.). Social network size, defined as degree centrality, was also associated with reduced CTRA gene expression, but its association mimicked that of perceived social isolation (loneliness).

CONCLUSIONS

The current findings implicate community-level social network characteristics in the regulation of individual human genome function above and beyond individual-level perceptions of connectedness.

Spousal caregiving, widowhood, and cognition: A systematic review and a biopsychosocial framework for understanding the relationship between interpersonal losses and dementia risk in older adulthood

Accumulating research suggests that stressful life events, especially those that threaten close intimate bonds, are associated with an increased risk of dementia. Grieving the loss of a spouse, whether in the form of caregiving or after the death, ranks among 'life's most significant stressors', evoking intense psychological and physiological distress. Despite numerous studies reporting elevated dementia risk or poorer cognition among spousal caregivers and widow(er)s compared to controls, no review has summarized findings across cognitive outcomes (i.e., dementia incidence, cognitive impairment rates, cognitive performance) or proposed a theoretical model for understanding the links between partner loss and abnormal cognitive decline. The current systematic review summarizes findings across 64 empirical studies. Overall, both cross-sectional and longitudinal studies revealed an adverse association between partner loss and cognitive outcomes. In turn, we propose a biopsychosocial model of cognitive decline that explains how caregiving and bereavement may position some to develop cognitive impairment or Alzheimer's disease and related dementias. More longitudinal studies that focus on the biopsychosocial context of caregivers and widow(er)s are needed.

'Unprepared for the depth of my feelings' - Capturing grief in older people through research poetry

Background

Older people are more likely to experience bereavements than any other age group. However, in healthcare and society, their grief experiences and support needs receive limited attention. Through innovative, arts-based research poetry, this study aimed to capture older people’s bereavement stories and the effects of grief on their physical and mental health.

Method

Semi-structured in-depth interviews with 18 bereaved older adults were analysed using thematic and poetic narrative analysis, following a five-step approach of immersion, creation, critical reflection, ethics and engagement.

Results

Research poems were used to illustrate three themes of bereavement experiences among older adults: feeling unprepared, accumulation of losses and ripple effects of grief. While half of participants reported that the death of their family member was expected, many felt unprepared despite having experienced multiple bereavements throughout their life. Instead, the accumulation of losses had a compounding effect on their health and well-being. While these ripple effects of grief focussed on emotional and mental health consequences, many also reported physical health effects like the onset of a new condition or the worsening of an existing one. In its most extreme form, grief was connected with a perceived increased mortality risk.

Conclusions

By using poetry to draw attention to the intense and often long-lasting effects of grief on older people’s health and well-being, this article offers emotional, engaging and immersive insights into their unique bereavement experiences and thereby challenges the notion that grief has an expiry date.

Traumatic events and mental health: The amplifying effects of pre-trauma systemic inflammation

BACKGROUND

Traumatic experiences are strongly predictive of adverse mental health outcomes. Experimental studies have demonstrated that systemic inflammation can increase reactivity to threatening stimuli. It is not known whether naturally occurring inflammation amplifies the impact of traumatic experiences on mental health. Here we test whether incident traumatic events are more predictive of adverse mental health outcomes for individuals with greater pre-trauma systemic inflammation in a racially and ethnically diverse cohort study of youth assigned male at birth who identify as sexual or gender minorities (ages 16-29, n = 518), a group at high risk for trauma exposure.

METHODS

Measures of inflammation, depression symptom severity, and perceived stress were measured at baseline. One year later, depression symptom severity and perceived stress were measured again, and participants reported the traumatic events they had experienced in the intervening year.

RESULTS

In a model adjusted for baseline depression symptom severity and other key covariates, we found that higher baseline levels of interleukin-1β amplified the effect of incident trauma exposure on depression symptom severity at follow-up (β = 0.234, SE = 0.080, P = 0.004). In a model adjusted for baseline perceived stress and other key covariates, we found that higher baseline scores on a multi-marker inflammatory index amplified the effect of incident trauma exposure on perceived stress at follow-up (β = 0.243, SE = 0.083, P = 0.003).

CONCLUSIONS

These findings suggest that greater pre-trauma inflammation may predict poorer mental health following trauma exposure. Understanding how inflammation interacts with trauma to shape mental health may generate novel insights for preventing and treating the debilitating psychological consequences of trauma.

Glucocorticoid resistance and β2-adrenergic receptor signaling pathways promote peripheral pro-inflammatory conditions associated with chronic psychological stress: A systematic review across species

Activation of the HPA-axis and SNS are widely accepted to link chronic stress with elevated levels of peripheral pro-inflammatory markers in blood. Yet, empirical evidence showing that peripheral levels of glucocorticoids and/or catecholamines mediate this effect is equivocal. Recent attention has turned to the possibility that cellular sensitivity to these ligands may contribute to inflammatory mediators that accompany chronic stress. We review current evidence for the association of chronic stress with glucocorticoid receptor (GR) and β-adrenergic receptor (β-AR) signaling sensitivity. Across 15 mouse, 7 primate, and 19 human studies, we found that chronic stress reliably associates with downregulation in cellular GR sensitivity, alterations in intracellular β-AR signaling, and upregulation in pro-inflammatory biomarkers in peripheral blood. We also present evidence that alterations in GR and β-AR signaling may be specific to myeloid progenitor cells such that stress-related signaling promotes release of cells that are inherently less sensitive to glucocorticoids and differentially sensitive to catecholamines. Our findings have broad implications for understanding mechanisms by which chronic stress may contribute to pro-inflammatory phenotypes.

Beta-adrenergic blockade blunts inflammatory and antiviral/antibody gene expression responses to acute psychosocial stress

Dysregulation of the immune system is one potential mechanism by which acute stress may contribute to downstream disease etiology and psychopathology. Here, we tested the role of β-adrenergic signaling as a mediator of acute stress-induced changes in immune cell gene expression. In a randomized, double-blind, and placebo-controlled trial, 90 healthy young adults (44% female) received a single 40 mg dose of the β-blocker propranolol (n = 43) or a placebo (n = 47) and then completed the Trier Social Stress Test (TSST). Pre- and post-stress blood samples were assayed for prespecified sets of pro-inflammatory and antiviral/antibody gene transcripts. Analyses revealed increased expression of both inflammatory and antiviral/antibody-related genes in response to the TSST, and these effects were blocked by pre-treatment with propranolol. Bioinformatics identified natural killer cells and dendritic cells as the primary cellular context for transcriptional upregulation, and monocytes as the primary cellular carrier of genes downregulated by the TSST. These effects were in part explained by acute changes in circulating cell types. Results suggest that acute psychosocial stress can induce an "acute defense" molecular phenotype via β-adrenergic signaling that involves mobilization of natural killer cells and dendritic cells at the expense of monocytes. This may represent an adaptive response to the risk of acute injury. These findings offer some of the first evidence in humans that β-blockade attenuates psychosocial stress-induced increases in inflammatory gene expression, offering new insights into the molecular and immunologic pathways by which stress may confer risks to health and well-being.

Only the Lonely: Expression of Proinflammatory Genes Through Family Cancer Caregiving Experiences

OBJECTIVE

The experience of cancer elicits not only turmoil but also resilience in the family, which has been related to psychological adjustment and physical health of family caregivers. The biological pathways linking family cancer caregiving to health, however, remain poorly understood. This study examined the extent to which psychological risk and resilience factors related to a proinflammatory gene expression profile (conserved transcriptional response to adversity, or CTRA) among caregivers during the first-year postdiagnosis of a patient with colorectal cancer.

METHODS

A total of 41 caregivers (mean age = 54 years, 74% female, 40% Hispanic) provided psychological data and peripheral blood samples around 4 and 12 months after diagnosis. Mixed regression models controlling for demographic and biometric factors were used to test the associations of caregiver CTRA gene expression with caregiving stress, loneliness, and lack of social support (risk factors), as well as benefit finding and meaning (resilience factors).

RESULTS

When individually tested, all but benefit finding were significantly related to CTRA (R2 ≥ 0.112, p < .045). When adjusted for other factors in either the risk or resilience group, loneliness, social support, and meaning effects remained significant (R2 ≥ 0.120, p < .041). When all study factors were simultaneously adjusted (R2 = 0.139), only loneliness remained significant (p = .034).

CONCLUSIONS

Findings suggest that caregiving-related transcriptional effects seem to be most pronounced when caregivers experience low social support and loneliness, as well as little meaning or purpose in their caregiving. These findings suggest that the development of new intervention strategies that prioritize reductions in caregiver loneliness may favorably impact biological mechanisms related to caregiver health.

Social regulation of inflammation related gene expression in the multi-ethnic study of atherosclerosis

BACKGROUND

Exposure to adverse social factors has been associated with an altered inflammatory profile, a risk factor for several acute and chronic diseases. Differential gene expression may be a biological mediator in the relationship. In this study, associations between a range of social factors and expression of inflammation-related genes were investigated.

METHODS

Social factor and gene expression data were collected from 1,264 individuals in the Multi-Ethnic Study of Atherosclerosis (MESA). Inflammation-related genes were identified from the Gene Ontology database. The associations between social factors and gene expression were first assessed using the Global Analysis of Covariance (Global ANCOVA) gene set enrichment test. When the global test was significant, linear regression and elastic net penalized regression were employed to identify the individual gene transcripts within each gene set associated with the social factor.

RESULTS

Loneliness (p = 0.003), chronic burden (p = 0.002), and major or lifetime discrimination (p = 0.045) were significantly associated with global expression of the chronic inflammatory gene set. Of the 20 transcripts that comprise this gene set, elastic net selected 12 transcripts for loneliness, 8 for chronic burden, and 3 for major or lifetime discrimination. Major or lifetime discrimination was also associated with the inflammatory response (p = 0.029), regulation of the inflammatory response (p = 0.041), and immune response (p = 0.025) gene sets in global analyses, and 53, 136, and 26 transcripts were selected via elastic net for these gene sets respectively. There were no significant associations in linear regression analyses after adjustment for multiple testing.

CONCLUSIONS

This study highlights gene expression as a biological mechanism through which social factors may affect inflammation.

Isolation, social stress, low socioeconomic status and its relationship to immune response in Covid-19 pandemic context

The coronavirus disease 2019 (COVID-19) outbreak was first reported December 2019, in Wuhan, China, and has since spread worldwide. Social distancing or isolation measures were taken to mitigate the pandemic. Furthermore, stress and low socioeconomic status in humans confer increased vulnerability to morbidity and mortality, what can be biologically observed. This condition tends to remain during the Covid-19 pandemic. Social disruption stress (SDR) raises important questions regarding the functioning of the immune system, and the release of several stress hormones. A molecular pattern, conserved transcriptional response to adversity (CTRA), is thought to have evolved to defend against physical injury during periods of heightened risk. Chronic CTRA activation could leave an organism vulnerable to viral infections, leading to increased pro-inflammatory gene expression and a suppression of anti-viral gene expression. The activation of such transcriptional status is related to conditions of social stress through either hostile human contact, or increased predatory vulnerability due to separation from the social group and also low socioeconomic status. This review aims to point out questions for government officials, researchers and health professionals to better target their actions during a pandemic and encourage studies for a better understanding of these characteristics.

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The coronavirus disease 2019 (COVID-19) outbreak has spread worldwide.

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Community mitigation guidelines, such as social distancing were taken.

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Social disruption stress leads to immune response alterations, and stress hormones.

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CTRA activation may lead to vulnerable to viral infection and systemic inflammation.

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CTRA may be activated due to social isolation and socioeconomic status.

The Psychobiology of Bereavement and Health: A Conceptual Review From the Perspective of Social Signal Transduction Theory of Depression

Losing a spouse is considered one of the most stressful life events a person can experience. Particularly in the immediate weeks and months after the loss, bereavement is associated with a significantly increased risk of morbidity and mortality. Despite an abundance of research aimed at identifying risk factors for adverse health outcomes following marital death, the mechanisms through which mental and physical health problems emerge following bereavement remain poorly understood. To address this issue, the present review examines several pathways that may link bereavement and health, including inflammation and immune dysregulation, genetic and epigenetic changes, gut microbiota activity, and biological aging. We then describe how these processes may be viewed from the perspective of the Social Signal Transduction Theory of Depression to provide a novel framework for understanding individual differences in long-term trajectories of adjustment to interpersonal loss. Finally, we discuss several avenues for future research on psychobiological mechanisms linking bereavement with mental and physical health outcomes.

A Systematic Review of the Association Between Bereavement and Biomarkers of Immune Function

OBJECTIVE

Bereavement is associated with increased risk for morbidity and all-cause mortality across epidemiological, meta-analytic, and case-control studies. The body of research examining the association between bereavement and immune function, beginning in 1977, has yet to be reviewed. The current systematic review clarifies these findings, identifies limitations of the diverse literature, and suggests a model and directions for future research.

METHODS

The PRISMA guidelines for systematic reviews were used to synthesize 41 years of research. Compared with a meta-analysis, a systematic review is appropriate given the heterogeneous nature of the studies. We used the National Heart, Lung, and Blood Institute Study Quality Assessment Tool to assess the quality of select studies.

RESULTS

Thirty-three publications met inclusion criteria. Most studies support the association between bereavement and maladaptive changes in immune parameters in adults, with mixed findings on bereavement-related changes in cellular immunity. A handful of recent, good-quality studies show bereaved people demonstrate higher levels of systemic inflammation, maladaptive immune cell gene expression, and lower antibody response to vaccination compared with nonbereaved controls. Individual differences in psychological response to bereavement (e.g., depression, grief) seem to influence the association between bereavement and immune function.

CONCLUSIONS

Research examining the association between bereavement and biomarkers of immune function is heterogeneous in methods and quality. Despite these limitations, there is evidence supporting maladaptive changes in immune function after bereavement. The research area would benefit from longitudinal research with larger sample sizes, advanced immunological methods, and incorporating measures of psychological responses to bereavement. The field is poised to refine and scale up its investigation of this common and important phenomenon.

Expression of socially sensitive genes: The multi-ethnic study of atherosclerosis

BACKGROUND

Gene expression may be an important biological mediator in associations between social factors and health. However, previous studies were limited by small sample sizes and use of differing cell types with heterogeneous expression patterns. We use a large population-based cohort with gene expression measured solely in monocytes to investigate associations between seven social factors and expression of genes previously found to be sensitive to social factors.

METHODS

We employ three methodological approaches: 1) omnibus test for the entire gene set (Global ANCOVA), 2) assessment of each association individually (linear regression), and 3) machine learning method that performs variable selection with correlated predictors (elastic net).

RESULTS

In global analyses, significant associations with the a priori defined socially sensitive gene set were detected for major or lifetime discrimination and chronic burden (p = 0.019 and p = 0.047, respectively). Marginally significant associations were detected for loneliness and adult socioeconomic status (p = 0.066, p = 0.093, respectively). No associations were significant in linear regression analyses after accounting for multiple testing. However, a small percentage of gene expressions (up to 11%) were associated with at least one social factor using elastic net.

CONCLUSION

The Global ANCOVA and elastic net findings suggest that a small percentage of genes may be "socially sensitive," (i.e. demonstrate differential expression by social factor), yet single gene approaches such as linear regression may be ill powered to capture this relationship. Future research should further investigate the biological mechanisms through which social factors act to influence gene expression and how systemic changes in gene expression affect overall health.

The Conserved Transcriptional Response to Adversity

Gene expression profiling studies of people exposed to chronic threat have identified a Conserved Transcriptional Response to Adversity (CTRA) in circulating immune cells. This physiological pattern is characterized by up-regulated expression of genes involved in inflammation and down-regulated expression of genes involved in Type I interferon responses. The CTRA is mediated by beta-adrenergic signaling pathways that transduce sympathetic nervous system activity into changes in transcription factor activity and hematopoietic output of myeloid lineage immune cells (monocytes, neutrophils, and dendritic cells). Recent research has begun to identify the CNS processes that regulate peripheral CTRA activity, define its implications for disease, and explore the role of positive psychosocial factors in buffering such effects. The CTRA provides a genomic framework for understanding PNI relationships and connecting macro-level psychosocial processes to the micro-level biology of health and disease.

Optimism and the conserved transcriptional response to adversity

Dispositional optimism, a personality trait predisposing individuals to positive expectations, has been suggested to promote better health. However, little is known about the biological mechanism of the salubrious health effects of optimism. We hypothesized that by diminishing a sense of threat to the self, optimism will be associated with a healthier profile of gene expression in immune cells. Specifically, the "conserved transcriptional response to adversity" (CTRA) is activated by fight-or-flight stress responses and results in increased transcription of genes involved in inflammation and decreased transcription of genes involved in antiviral defense. In a sample of 114 male Japanese workers, we found that optimism was inversely linked to CTRA after controlling for demographic variables, health-risk factors, and indices of well-being. These results are consistent with the hypothesis that reduced activity of threat-related gene expression programs may contribute to the health effects associated with optimism. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Social genomics of healthy and disordered internet gaming

OBJECTIVES

To combine social genomics with cultural approaches to expand understandings of the somatic health dynamics of online gaming, including in the controversial nosological construct of internet gaming disorder (IGD).

METHODS

In blood samples from 56 U.S. gamers, we examined expression of the conserved transcriptional response to adversity (CTRA), a leukocyte gene expression profile activated by chronic stress. We compared positively engaged and problem gamers, as identified by an ethnographically developed measure, the Positive and Negative Gaming Experiences Scale (PNGE-42), and also by a clinically derived IGD scale (IGDS-SF9).

RESULTS

CTRA profiles showed a clear relationship with PNGE-42, with a substantial linkage to offline social support, but were not meaningfully associated with disordered play as measured by IGDS-SF9.

CONCLUSIONS

Our study advances understanding of the psychobiology of play, demonstrating via novel transcriptomic methods the association of negatively experienced internet play with biological measures of chronic threat, uncertainty, and distress. Our findings are consistent with the view that problematic patterns of online gaming are a proxy for broader patterns of biopsychosocial stress and distress such as loneliness, rather than a psychiatric disorder sui generis, which might exist apart from gamers' other life problems. By confirming the biological correlates of certain patterns of internet gaming, culturally-sensitive genomics approaches such as this can inform both evolutionary theorizing regarding the nature of play, as well as current psychiatric debates about the appropriateness of modeling distressful gaming on substance addiction and problem gambling.

Relationships and Health: The Critical Role of Affective Science

High-quality social relationships predict a range of positive health outcomes, but no broadly accepted theory can explain the mechanisms of action in this area. The central argument of this article is that affective science can provide keys for integrating the diverse array of theoretical models concerning relationships and health. From nine prominent theories, we cull four components of relational affect that link social resources to health-related outcomes. This component model holds promise for integrating research from the different theoretical perspectives and for generating new, mechanistic questions about the connection between relationships and health. The article closes by outlining three empirical study ideas that illustrate ways in which the different components can be studied together in the context of mechanism-focused research.

Differentially conserved transcriptomic response to adversity related to self-rated health in the multi-ethnic study of atherosclerosis

Self-rated health (SRH) is considered a strong indicator of well-being and clinical health status and has been linked to inflammatory markers. The objective of this work was to examine how self-rated physical health (SRPH) and mental health (SRMH) influence the immune system through the regulation of a stress-related gene expression profile known as the 'conserved transcriptional response to adversity' (CTRA), which involves the up-regulation of pro-inflammatory genes and down-regulation of genes involved in type I interferon (IFN) response and antibody synthesis. CTRA expression data were derived from genome-wide transcriptional data on purified monocytes in 1264 adult participants from the multi-ethnic study of atherosclerosis. SRPH and SRMH were assessed through the SF-12 questionnaire. Multiple linear regression models were used to determine the association between the composite score of the CTRA subsets and SRPH and SRMH. Higher scores of SRPH and SRMH were associated with an increased expression of the overall CTRA profile. The individual gene subsets analysis did not reveal an increased expression of pro-inflammatory genes in persons with lower scores of SRH. However, we observed that higher scores of SRPH positively modulate the immune response through the up-regulation of both type I interferon response and antibody synthesis-related genes, while better scores of SRMH were associated with a down-regulation of genes involved in antibody synthesis. The significant association between SRH and a gene expression profile related to type I IFN response and antibody synthesis suggests that SRH may be linked to the immunocompetence status. Impact statement In this work, we evaluated for the first time how self-rated mental (SRMH) and physical health (SRPH) influence the immune response at the molecular level in a large multi-ethnic cohort. We observed that both SRMH and SRPH are related to immunocompetence status. These findings indicated that the link between how we perceive our health and poorer health outcomes could be explained by alterations in the immune response by shifting the expression of genes related to the type I IFN response and antibody synthesis.

Effectiveness of bereavement counselling through a community-based organization: A naturalistic, controlled trial

This controlled, longitudinal investigation tested the effectiveness of a bereavement counselling model for adults on reducing complicated grief (CG) symptoms. Participants (N = 344; 79% female; mean age: 49.3 years) were adult residents of Scotland who were bereaved of a close relation or partner, experiencing elevated levels of CG, and/or risks of developing CG. It was hypothesized that participants who received intervention would experience a greater decline in CG levels immediately following the intervention compared to the control participants, but the difference would diminish at follow‐up (due to relapse). Data were collected via postal questionnaire at 3 time points: baseline (T), post‐intervention (T + 12 months), and follow‐up (T + 18 months). CG, post‐traumatic stress, and general psychological distress were assessed at all time points. Multilevel analyses controlling for relevant covariates were conducted to examine group differences in symptom levels over time. A stepwise, serial gatekeeping procedure was used to correct for multiple hypothesis testing. A main finding was that, contrary to expectations, counselling intervention and control group participants experienced a similar reduction in CG symptoms at postmeasure. However, intervention participants demonstrated a greater reduction in symptom levels at follow‐up (M = 53.64; d = .33) compared to the control group (M = 62.00). Results suggest community‐based bereavement counselling may have long‐term beneficial effects. Further longitudinal treatment effect investigations with extensive study intervals are needed.

What Is the Molecular Signature of Mind-Body Interventions? A Systematic Review of Gene Expression Changes Induced by Meditation and Related Practices

There is considerable evidence for the effectiveness of mind–body interventions (MBIs) in improving mental and physical health, but the molecular mechanisms of these benefits remain poorly understood. One hypothesis is that MBIs reverse expression of genes involved in inflammatory reactions that are induced by stress. This systematic review was conducted to examine changes in gene expression that occur after MBIs and to explore how these molecular changes are related to health. We searched PubMed throughout September 2016 to look for studies that have used gene expression analysis in MBIs (i.e., mindfulness, yoga, Tai Chi, Qigong, relaxation response, and breath regulation). Due to the limited quantity of studies, we included both clinical and non-clinical samples with any type of research design. Eighteen relevant studies were retrieved and analyzed. Overall, the studies indicate that these practices are associated with a downregulation of nuclear factor kappa B pathway; this is the opposite of the effects of chronic stress on gene expression and suggests that MBI practices may lead to a reduced risk of inflammation-related diseases. However, it is unclear how the effects of MBIs compare to other healthy interventions such as exercise or nutrition due to the small number of available studies. More research is required to be able to understand the effects of MBIs at the molecular level.

Family environments and leukocyte transcriptome indicators of a proinflammatory phenotype in children and parents

High conflict and low warmth in families may contribute to immune cells developing a tendency to respond to threats with exaggerated inflammation that is insensitive to inhibitory signaling. We tested associations between family environments and expression of genes bearing response elements for transcription factors that regulate inflammation: nuclear factor kappa B (NF-κB) and glucocorticoid receptor. The overall sample (47 families) completed interviews, questionnaires, and 8-week daily diary assessments of conflict and warmth, which were used to create composite family conflict and warmth scores. The diaries assessed upper respiratory infection (URI) symptoms, and URI episodes were clinically verified. Leukocyte RNA was extracted from whole blood samples provided by a subsample of 42 children (8-13 years of age) and 73 parents. In children, higher conflict and lower warmth were related to greater expression of genes bearing response elements for the proinflammatory transcription factor NF-κB, and more severe URI symptoms. In parents, higher conflict and lower warmth were also related to greater NF-κB-associated gene expression. Monocytes and dendritic cells were implicated as primary cellular sources of differential gene expression in the sample. Consistent with existing conceptual frameworks, stressful family environments were related to a proinflammatory phenotype at the level of the circulating leukocyte transcriptome.

Parents' Acute Illnesses, Hospitalizations, and Medication Changes During the Difficult First Year After Infant or Child NICU/PICU Death

BACKGROUND AND OBJECTIVES

Infant/child death is described as a most stressful life event; however, there are few reports of effects on parent physical health during the first year after the death. The study's purpose is to examine the patterns of parent acute illnesses, hospitalizations, and medication changes over 1 to 13 months after neonatal intensive care unit (NICU) or pediatric intensive care unit (PICU) infant/child death in 3 racial/ethnic groups.

METHODS

Secondary analyses were conducted with longitudinal data on parent health and functioning 1 to 13 months after infant/child NICU/PICU death. Parents (176 mothers, 73 fathers; 44% Hispanic, 35% black non-Hispanic, and 21% white non-Hispanic) of deceased infants/children were recruited from 4 children's hospitals and state death records. Inclusion criteria-parents understood English or Spanish and had a deceased neonate/child ≤ 18. Exclusion criteria -deceased newborn from multiple gestation pregnancy, child in foster care, child's injury due to suspected abuse, or parent death in illness/injury event. Parents reported numbers and types of acute illnesses, hospitalizations, and medication changes 1 to 13 months postdeath.

RESULTS

Parents' acute illnesses, hospitalizations, and medication changes were greatest between months 1 and 6, with relative quiescence in months 7 to 10, and an increase in months 11 to 13. Mothers (aged 32 ± 7.8 years) reported 300 acute illnesses (primarily colds/flu, headaches, anxiety/depression, and infections) and 89 hospitalizations (primarily infections, chest pain, and gastrointestinal problems). Fathers (aged 37 ± 8.8 years) reported 104 acute illnesses (colds/flu and headaches) and 9 hospitalizations.

CONCLUSION

After infant/child NICU/PICU death, mothers had greater morbidity than fathers, with no significant differences by race/ethnicity. Parents' health needs to be monitored in months 1 to 6 and months 11 to 13, and interventions targeted to parents in these months.

Bodily Contributions to Emotion: Schachter’s Legacy for a Psychological Constructionist View on Emotion

Although early emotion theorists posited that bodily changes contribute to emotion, the primary view in affective science over the last century has been that emotions produce bodily changes. Recent findings from physiology, neuroscience, and neuropsychology support the early intuition that body representations can help constitute emotion. These findings are consistent with the modern psychological constructionist hypothesis that emotions emerge when representations of bodily changes are conceptualized as an instance of emotion. We begin by introducing the psychological constructionist approach to emotion. With Schachter as inspiration, we next examine how embodied representations contribute to affective states, and ultimately emotion, with inflammation as a key example. We close by looking forward to future research on how body representations contribute to human experience.

Disrupted prefrontal activity during emotion processing in complicated grief: An fMRI investigation

Complicated Grief, marked by a persistent and intrusive grief lasting beyond the expected period of adaptation, is associated with a relative inability to disengage from idiographic loss-relevant stimuli (O'Connor and Arizmendi, 2014). In other populations, functional magnetic resonance imaging (fMRI) studies investigating the neural networks associated with this bias consistently implicate the anterior cingulate cortex (ACC) during emotion regulation. In the present study, twenty-eight older adults were categorized into three groups based on grief severity: Complicated Grief (n=8), Non-Complicated Grief (n=9), and Nonbereaved, married controls (n=11). Using a block design, all participants completed 8 blocks (20 stimuli per block) of the ecStroop task during fMRI data acquisition. Differences in neural activity during grief-related (as opposed to neutral) stimuli across groups were examined. Those with Complicated Grief showed an absence of increased rostral ACC (rACC) and fronto-cortical recruitment relative to Nonbereaved controls. Activity in the orbitofrontal cortex (x=6, y=54, z=-10) was significantly elevated in the Non-Complicated Grief group when compared to Nonbereaved controls. Post hoc analysis evidenced activity in the dorsal ACC in the Complicated Grief and Nonbereaved groups late in the task. These findings, supported by behavioral data, suggest a relative inability to recruit the regions necessary for successful completion of this emotional task in those with Complicated Grief. This deficit was not observed in recruitment of the orbitofrontal cortex and the rACC during processing of idiographic semantic stimuli in Non-Complicated Grief.

What is "normal" in grief?

Research conducted over the past two decades has revealed that grief, a common phenomenon experienced by many people following the loss of a loved one, is rarely experienced as a steady progression from high acuity (intensity) to eventual resolution. Instead of this single "traditional" path, four distinct trajectories are supported by empirical data: resilience, chronic grief, depressed-improved, and chronic depression. Furthermore, a small subset of individuals never fully integrate the loss into their life, and continue to experience severe disruption in daily life many years after the loss event, a phenomenon known as Complicated Grief (CG). Continued empirical research will help further our understanding of the normative grief process and CG as a disorder. This information is crucial for informing clinicians of best practices when attending to those suffering from loss.

Bereavement reduces neutrophil oxidative burst only in older adults: role of the HPA axis and immunesenescence

Background

The effect of the chronic stress of bereavement on immunity is poorly understood. Previous studies have demonstrated negative effects on immunity in older adults, and those who report higher depressive symptoms. The aim of the present study was to compare the effect of bereavement on neutrophil function in healthy young and old adults, also assessing serum levels of the stress hormones, cortisol and dehydroepiandrosterone sulphate (DHEAS). 41 young (mean age 32 years) and 52 older adults (mean age 72 years), bereaved and non-bereaved, took part in the study. They completed questionnaires on socio-demographic and health behaviour characteristics, as well as psychosocial variables, and provided a blood sample for analysis of neutrophil function (phagocytosis and reactive oxygen species (ROS) production) and stress hormone analysis.

Results

Bereaved participants in both age groups reported more symptoms of depression and anxiety than controls and scored moderately highly on bereavement-specific questionnaires for these symptoms. Despite this, young bereaved participants showed robust neutrophil function when compared to age-matched non-bereaved controls, and comparable stress hormone levels, while reduced neutrophil ROS production and raised stress hormone levels (cortisol:DHEAS ratio) were seen in the older bereaved group compared to their age-matched controls.

Conclusions

Reduced neutrophil function among older bereaved participants may be the result of the inability to maintain stress hormone balance, specifically the cortisol:DHEAS ratio.

Human social genomics

A growing literature in human social genomics has begun to analyze how everyday life circumstances influence human gene expression. Social-environmental conditions such as urbanity, low socioeconomic status, social isolation, social threat, and low or unstable social status have been found to associate with differential expression of hundreds of gene transcripts in leukocytes and diseased tissues such as metastatic cancers. In leukocytes, diverse types of social adversity evoke a common conserved transcriptional response to adversity (CTRA) characterized by increased expression of proinflammatory genes and decreased expression of genes involved in innate antiviral responses and antibody synthesis. Mechanistic analyses have mapped the neural "social signal transduction" pathways that stimulate CTRA gene expression in response to social threat and may contribute to social gradients in health. Research has also begun to analyze the functional genomics of optimal health and thriving. Two emerging opportunities now stand to revolutionize our understanding of the everyday life of the human genome: network genomics analyses examining how systems-level capabilities emerge from groups of individual socially sensitive genomes and near-real-time transcriptional biofeedback to empirically optimize individual well-being in the context of the unique genetic, geographic, historical, developmental, and social contexts that jointly shape the transcriptional realization of our innate human genomic potential for thriving.