Grief: A Brief History of Research on How Body, Mind, and Brain Adapt

Abstract

Objective: Using an integrative view of psychology, neuroscience, immunology and psychophysiology, the present review of literature curates the findings that have had an impact on the field of bereavement research, and shaped its development. Methods: Beginning with Lindemann’s systematic descriptions of medical and psychological responses to the death of a loved one, specific studies that investigate medical outcomes following loss, their psychological predictors, and biopsychosocial mechanisms are discussed. This selective review culminates in recommendations for the field for future research, including greater integration of these disparate fields of inquiry. Results: Morbidity and mortality following the death of a loved one has long been a topic of research. Early researchers characterized somatic and psychological symptoms and studied immune cell changes in bereaved samples. More recent research has repeatedly demonstrated increased rates of morbidity and mortality in bereaved samples, as compared to married controls, in large epidemiological studies. Recent developments also include the development of criteria for prolonged grief disorder (also termed complicated grief). Newer methods, including neuroimaging, have observed that the greatest impact of the death of a loved one is in those who have the most severe psychological grief reactions. Mechanisms tying bereavement to medical outcomes are scarce, but differences in rumination, in inflammation and in cortisol dysregulation between those who adapt well and those who do not, have been offered with some evidence. Conclusions: Recommendations to propel the field forward include longitudinal studies to understand differences between acute reactions and later adaptation, comparing samples with grief disorders from those with more typical responses, and integrating responses in brain, mind and body.

Grief: Aetiology, Symptoms and Management

“…But there is a subset of people who will be chronically disrupted and will need recovery support because of reduced systemic inflammation processes and other immunological problems. Many of them, as a consequence, will manifest some psychosomatic disorder related to the experienced prolonged or chronical stress [11,12,13].…”

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

“…As a highly stressful event, the death of a significant person is known to trigger biological responses via several autonomic, neuroendocrine, and inflammatory pathways (22). These responses, either directly or via interaction with the social environment, can cause alterations in biological functioning that include the onset of chronic low-grade inflammation, which can increase risk for sickness behaviors, infections, mental and physical health problems, and premature mortality in vulnerable individuals (26,(47)(48)(49).…”

“…Second, additional research is warranted to better understand the clinical significance, timing, duration, and trajectories of immune changes that occur following interpersonal loss ( 22 ). Large-scale longitudinal studies that systematically collect data on mental and physical health outcomes prior to and after spousal bereavement are needed.…”

“…In particular, the past decade has produced a substantial body of knowledge shedding light on how specific types of stressors can trigger increases in inflammation (15,(17)(18)(19)(20)(21), which has in turn been linked with the development of numerous disease conditions, including autoimmune disorders, CVD, and some cancers, as well as mortality (12). Consequently, bereavementrelated dysregulation in immune function may be one potential process that underlies the increased risk for morbidity and mortality seen in spousal bereaved individuals (22).…”

A Biopsychosocial Approach to Grief, Depression, and the Role of Emotional Regulation

“…Research and clinical practice have been changing directions in the conceptualization of grief, so as to accommodate research-informed models [ 27 ]. Likewise, some researchers have shifted their focus to a biopsychosocial approach for conceptualizing grief, in order to underline the importance of holistic approaches to studying grief, and its impact on psychopathologies [ 28 , 29 , 30 ].…”