Relationship Between Psychological Defenses and Mean Urinary 17-Hydroxycorticosteroid Excretion Rates

Loss and bereavement can be regarded as risk factors for the development of psychiatric and medical illness. Vulnerability to physical illness and mortality are increased during the first 2 years of bereavement, with men at higher risk than women. Symptoms of anxiety and a frank depressive syndrome are common during the first months of bereavement and, although depressive symptoms are usually transient and self-limited, bereaved individuals not rarely go on to develop major depression. In our perspective, loss perceived as irreparable, and persistence of perceived loss may favour the development of complicated grief and depression. Factors such as unexpectedness, absence of social support, concurrent loss or illness, and grief proneness may predict poor adjustment after bereavement. Complicated bereavement should be distinguished from uncomplicated bereavement, because patients with the latter need no treatment. In humans, there is evidence of increased adrenocortical activity and altered immune function following bereavement, whereas in non-human primates, biogenic amine systems appear to be involved in the response to maternal or social separation. According to a ‘psychosomatic view of the brain’, critical life events can both affect brain neurotransmitters and contribute to psychological and somatic symptoms of depression. Emotional events may be transduced into long-lasting brain changes, involving neurotransmitters, neuropeptides and receptors. Although only very limited evidence exists, long-term consequences could involve changes at the gene expression level.

Section: Biological Correlates O F the Process O F Griefmentioning

confidence: 99%

Clinical and Biological Aspects of Bereavement and Loss-Induced Depression: A Reappraisal

Biondi

Picardi²

1996

“…Especially in psychosomatic studies it has always been possible to establish a correlation between the degree of success in the functioning of defenses and somatic processes (10,16,(25)(26)(27). The term 'coping behavior' combines uncon scious defense processes with attempts to adapt which are closer to the con scious level.…”

Section: Discussionmentioning

confidence: 99%

Defense Mechanisms and Coping Behavior in Terminal Illness

Heim¹,

Moser²,

Adler³

1978

Psychosomatic medicine is increasingly concerned with illness behavior, a concept which includes defense mechanisms and coping styles. An attempt was made to compare defensive processes and social adaptation in a group of 31 patients suffering from a probable terminal illness of iatrogenic origin. The surprising degree of conformity between the defense profiles towards the illness and those towards general life stress was found. Reaction-formation and stoicism were the defense mechanisms most often associated with successful defense. Interdependence of several ego measures such as defense against general life stress, defense against illness and social adaptation could be shown in various evaluations. Surprisingly, however, aggravators of illness turned out to be psychologically more stable than minimizers, a result which is in contrast to behavior in nonterminal illness. Theoretical implications of the results are discussed.

“…It has been hypothesized that plasma prolactin levels increase particularly during episodes of passive coping during a crisis and may ac cordingly, both in women and in men. mirror a withdrawn passive giving-up attitude [21], Similarly, in studies of parents of children with cancer, it was shown that marked plasma cortisol elevation was only observed in par ents with ineffective coping patterns [ 17],…”

Section: Physiological Monitoringmentioning

confidence: 96%

“…studies have shown that plasma corti sol and prolactin increase during unemploy ment [14], Plasma prolactin increases during the weeks after a subway train driver has killed or seriously injured somebody under the train [15]. Plasma cortisol increases dur ing the terminal phase of the cancer illness of a close relative [16,17], Cellular immune function is affected by the death of a spouse [18] and by unemployment. In general, the accumulation of several life changes during a week [19] or a month [20] is associated with increasing urinary excretion of adrenaline although the amount of reaction and the strength of the association vary markedly be tween subjects.…”

Section: Physiological Monitoringmentioning

confidence: 99%

Critical Life Changes

Theorell

1992

This review of ideas presented in life event research presents a psychological and a sociological research tradition. Physiological recordings of endocrine factors have been utilized in studies of life events both in the study of natural course (bereavement and accidents, for instance) and in the laboratory during talk about critical life events. Recently, several programmes have been started for improving people’s life event tolerance. However, ‘eventlessness’ has also been observed to be a possible disease-provoking factor.