The Man I Once Knew: Grief and Inflammation in Female Partners of Veterans With Traumatic Brain Injury

Karen L. Saban*, Herbert L. Mathews, Eileen G. Collins, Nancy S. Hogan, Dina Tell, Fred B. Bryant, Theresa Louise Bender Pape, Joan M. Griffin, Linda Witek Janusek

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

7 Scopus citations


Grief, although traditionally conceptualized as a bereavement-related reaction, is also experienced by significant others in response to the profound cognitive and personality changes associated with a traumatic brain injury (TBI) in a loved one. Grief associated with the death of a loved one is related to increases in proinflammatory cytokines, yet it is not clear whether this is the case for grief experienced by individuals caring for a significant other with TBI. The purpose of this cross-sectional, exploratory study was to examine grief and its association with a proinflammatory cytokine, tumor necrosis factor α (TNF-α), in wives/partners caring for veterans with TBI. Participants completed written measures of grief, perceived stress, and depressive symptoms and provided morning saliva samples for TNF-α analysis. Participants reported levels of grief comparable to those reported in studies evaluating individuals grieving the death of a loved one. Path analysis revealed that grief was not associated with TNF-α; however, participants reporting high levels of blame/anger, a subscale of the grief scale, had higher levels of TNF-α. In addition, both grief and blame/anger were related to increased perceived stress and depressive symptoms; however, path analysis demonstrated that perceived stress and depressive symptoms did not mediate the influence of blame/anger on TNF-α. These findings suggest that blame/anger associated with grief may be related to the elevations in TNF-α exhibited by individuals caring for a loved one with TBI.

Original languageEnglish (US)
Pages (from-to)50-59
Number of pages10
JournalBiological research for nursing
Issue number1
StatePublished - Jan 1 2016


  • TNF-α
  • anger
  • blame
  • brain injury
  • caregivers
  • cytokines
  • grief

ASJC Scopus subject areas

  • Research and Theory


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