Salivary alpha-amylase reactivity during discussion of the death of a spouse in recently bereaved elders
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In this study, bereavement-related biological and physiological stress reactivity during the discussion of a loss are evaluated by collecting saliva samples in patients aged 55 or more who have lost a spouse within the last 12 months. The concentration of salivary α-Amylase, a marker for stress, is measured. Grief symptoms are also examined in these individuals. BACKGROUND: Grief is a complex psychobiological phenomenon triggered by the loss of a loved one, and that comprises emotions (e.g., yearning, longing, intense feeling of sorrow/emotional pain), thoughts (e.g., thoughts or images about the deceased, difficulty accepting the death, guilt), and behaviors (e.g., avoidance of reminders, spending time with deceased belonging). Because bereavement is a major stressor, it has been suggested that the grief reaction is associated with increased sympathetic activity. Salivary α-Amylase levels have been proposed to be a reliable non invasive biomarker of sympathetic activity. The present study aims to examine salivary α-Amylase reactivity to discussion of the death of a spouse in older adults, and the relationship between this reactivity and grief symptom severity. METHODS: Participants were N=8 individuals who have lost a spouse within the last year (Mean(SD)age=72.8(7.5); 60% women); Mean(SD) time since death=10.6(2.5) months). Participants completed self-reported measures including the 19-item Inventory of Complicated Grief (ICG; total score ranges 0-76; Prigerson et al. 1995). The Mean(SD) ICG score was 30.5(11.5). Saliva samples were collected using cotton swabs and Salivettes at four time points during the screen: right before discussion of the loss (T1), right after discussion of the loss (T2), before screening for psychiatric disorders (T3), and at the end of the screening (T4). Salivary α-Amylase samples were frozen and assayed using a kinetic enzyme assay kit specifically designed and validated for the kinetic measurement of salivary α-Amylase activity. A repeated measure ANOVA, with α-Amylase as the dependent variable, and time as the within subject repeated factor were conducted to examine differences in α-Amylase activity across time points. Further, we examined the association between rise in α-Amylase activity (change between T1 and T2) and ICG scores. RESULTS: The ANOVA revealed a marginally significant main effect of time (F(3,20)=2.74, p=0.07), with α-Amylase activity being more elevated right after discussion of the loss (T2; Mean (SD)=194.9(79.4) µg/dL) compared to the other time points (T1: 140.00(77) µg/dL; T3: 140.5(56) µg/dL; T4: 143.0(70.3) µg/dL). Further, the rise in α-Amylase activity between T1 and T2, was marginally significantly associated with greater grief symptoms (r=0.69, p=0.08). CONCLUSION: Our preliminary findings suggest that discussion of the loss of a spouse may increase salivary α-Amylase activity, reflecting a potential increase in sympathetic activity. Targeting loss-related sympathetic reactivity might be an interesting avenue to decrease grief related distress and impairment. Limitations for this study include a small sample size and the absence of a real control condition. Future research examining sympathetic activity in grief and its relationship with persistent complex bereavement disorder pathophysiology is warranted.