Examining the Mediating Effects of Symptoms of Depression, Anxiety, and Perceived Stress on the Association Between Bereavement and Inflammation

Bereavement is a stressor that impacts the psychological well-being of an individual and their physical health. This study aimed to develop a more nuanced understanding of the association between bereavement and its psychological and biological consequences, and the potential mediating role of symptoms of depression, anxiety, and stress within the relationship between bereavement and inflammation. Data was collected through Midlife in the United States (MIDUS) Refresher 1, a longitudinal study that examines social, psychological, and biological vulnerabilities associated with potential health outcomes (Weinstein et al., 2019). The study consisted of 863 participants (bereaved=373, non-bereaved=490) who completed an in-person study visit which involved answering self-report questionnaires and a venipuncture blood draw to examine inflammation. An independent samples t-test found no differences in psychological health (i.e., stress, depression, and anxiety) and no differences for inflammatory markers CRP and TNF-α between bereaved and non-bereaved individuals; however, an independent samples t-test found higher IL-6 among bereaved individuals. An ANCOVA found significantly higher levels of depression, anxiety, and perceived stress among bereaved individuals compared to non-bereaved individuals, while considering covariates. Further, an ANCOVA found higher levels of IL-6 and TNF-α in bereaved individuals than non-bereaved individuals, but no differences in CRP. Mediation analyses found that psychological symptoms did not have an indirect effect on the relationship between bereavement and inflammation. Overall, the findings inform clinicians and physicians of the unique needs of bereaved individuals, such as early psychological intervention in the bereavement experience, potential need to change health behaviors, and health education to stave off the negative consequences of bereavement.