Evidence map›Paper›PMID 30368120›Full record

ArticlePsychoneuroendocrinology2019

Grief, depressive symptoms, and inflammation in the spousally bereaved.

Christopher P Fagundes, Ryan L Brown, Michelle A Chen, Kyle W Murdock, Levi Saucedo, Angie LeRoy, E Lydia Wu, Luz M Garcini, Anoushka D Shahane, Faiza Baameur and 1 more

Registry-linked trialOpen access · greenAbstract read
In one paragraph

Article in Psychoneuroendocrinology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04822194 (Neural Mechanisms of Enhancing Emotion Regulation in Bereaved Spouses), which is not on this map. Cited by 47 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
47citing papers in PubMed, 5 pooled it
7.7field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04822194 nacompletednot on this mapstarted 2022, after this paper: background citation

Neural Mechanisms of Enhancing Emotion Regulation in Bereaved Spouses

TypeinterventionalSponsorBryan DennyRan2022 to 2024Enrolled75ConditionsAffect, Bereavement, Emotions, Depressive SymptomsArmsCognitive Emotion Regulation Training
3 · Its place in the literature

Who cites it

47 citing papers in PubMed, 5 syntheses or guidelines pooled it, 75 citations in OpenAlex.

  1. Pooled it
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  5. Pooled it
  6. Dyadic death-preparedness concordance states and bereaved caregivers' health-related quality of life and psychological outcomes: a longitudinal study.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2026
    Article
  7. Article
  8. Article
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  11. Stimulated cytokine production, attachment, and emotional well-being in dementia spousal caregivers.Health psychology : official journal of the Division of Health Psychology, American Psychological Association · 2026
    Article
  12. Prolonged grief disorder in later life: advancing our understanding of biopsychosocial mechanisms to guide future personalized interventions.Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2026
    Review
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  18. Accelerated Resolution Therapy for Early Maladaptive Grief Study Protocol.The American journal of hospice & palliative care · 2025
    Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 3 institutions in 1 country.

Christopher P FagundesRice University, Houston, TX, United States; The University of Texas MD Anderson Cancer Center, Houston, TX, United States; Baylor College of Medicine, Houston, TX, United States. Electronic address: christopher.fagundes@rice.edu.
Ryan L BrownRice University, Houston, TX, United States.
Michelle A ChenRice University, Houston, TX, United States.
Kyle W MurdockThe Pennsylvania State University, University Park, PA, United States.
Levi SaucedoRice University, Houston, TX, United States.
Angie LeRoyRice University, Houston, TX, United States.
E Lydia WuRice University, Houston, TX, United States.
Luz M GarciniRice University, Houston, TX, United States.
Anoushka D ShahaneRice University, Houston, TX, United States.
Faiza BaameurThe University of Texas MD Anderson Cancer Center, Houston, TX, United States.
Cobi HeijnenThe University of Texas MD Anderson Cancer Center, Houston, TX, United States; The Pennsylvania State University, University Park, PA, United States.
Rice University · USPennsylvania State University · USThe University of Texas MD Anderson Cancer Center · US

Funding

Project Heart: Biobehavioral Effects on Cardiovascular Risk for Bereaved SpousesR01HL127260 · NHLBI · RICE UNIVERSITY · PI FAGUNDES, CHRISTOPHER PAUL · 2015 to 2019
$4.1M
NHLBI NIH HHS R01 HL127260
6 · The paper itself

Abstract

Grief is conceptualized by strong negative emotions, which include longing, sadness, and preoccupations with thoughts, recollections, and images of the spouse. In the initial months after the loss of a spouse, those who are widowed are at risk for cardiovascular problems and premature mortality. In the general population, depression is characterized by chronic low-grade inflammation, a key predictor of cardiovascular problems, morbidity, and mortality. Although depression and grief share similarities, they are distinct constructs. We aimed to identify if grief was related to inflammation among those who had a spouse recently die. We also sought to determine if those who are widowed and already experience elevated levels of depressive symptoms compared with the general population had higher levels of inflammation compared with those who are widowed who report fewer depressive symptoms. Ninety-nine recently bereaved individuals (M = 84.74 days since passing, SD = 18.17) completed a blood draw and psychological assessments. Proinflammatory T cell-derived cytokines were assessed, which included interferon gamma (IFN-γ), interleukin (IL)-6, tumor necrosis factor alpha (TNF-α), IL17-A, and IL-2. Bereaved individuals with a higher grief severity (using an established cut-score) had higher levels of the proinflammatory cytokines IFN-γ, IL-6, and TNF-α than those with less grief severity. Those who experienced higher levels of depression exhibited elevated levels of proinflammatory cytokines compared with those who had lower levels of depression (using a continuous measure of depressive symptoms, as well as an established cut score). This is the first study to demonstrate that inflammatory markers can distinguish those who are widowed based on grief severity such that those who are higher on grief severity have higher levels of inflammation compared with those who are lower on grief severity. These findings also add to the broader literature on depression and inflammation by showing that even in a population with high levels of depressive symptoms, there is a positive relationship between depression and inflammation.

Indexed as

BereavementGriefAgedAged, 80 and overComorbidityCytokinesDepressionFemaleHumansInflammationInterleukin-6MaleMiddle AgedPsychoneuroimmunologySpousesTumor Necrosis Factor-alphaCytokinesInterleukin-6Tumor Necrosis Factor-alphaBereavementDepressionGriefInflammationPsychoneuroimmunologyWidow

Identifiers

PMID30368120
PMCPMC6889080
OpenAlexW2898049430

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.