A J Khan1, A O'Donovan2, T C Neylan3, J J Gross4, B E Cohen3. 1. San Francisco Veterans Affairs Health Care System, San Francisco, CA, United States; Department of Psychiatry, University of California, San Francisco, CA, United States. Electronic address: Amanda.Khan@va.gov. 2. San Francisco Veterans Affairs Health Care System, San Francisco, CA, United States; Department of Psychiatry, University of California, San Francisco, CA, United States. 3. San Francisco Veterans Affairs Health Care System, San Francisco, CA, United States; School of Medicine, University of California, San Francisco, CA, United States. 4. Department of Psychology, Stanford University, Stanford, CA, United States.
Abstract
BACKGROUND: Emotion dysregulation can elicit inflammatory activity. The current study examined whether specific maladaptive and adaptive emotion regulation strategies were associated with inflammatory markers in trauma-exposed veterans, above and beyond PTSD. METHODS: In a cohort study, 606 participants exposed to a Criterion A trauma and recruited from Veteran Health Administration facilities completed fasting blood draws, the Emotion Regulation Questionnaire, and the Clinician Administered PTSD Scale-IV. Inflammation was assessed with high sensitivity C-reactive protein (hsCRP), white blood cell count (WBC), and fibrinogen levels. An inflammation index was created by summing standardized log-transformed levels of the three biomarkers. Our primary linear regression models were adjusted for sex, age, race, education, income, creatinine, and PTSD. RESULTS: Suppression, but not cognitive reappraisal, was significantly associated with higher levels of the inflammatory index (β = 0.14, p = 0.001). Parallel analyses for the individual inflammatory markers also showed suppression, but not reappraisal, was significantly associated with higher hsCRP (β = 0.11, p = 0.01), WBC (β = 0.11, p = 0.01), and fibrinogen (β = 0.10, p = 0.02). CONCLUSIONS: Emotional suppression is related to elevated systemic inflammation independent of PTSD. Cognitive reappraisal is unrelated to inflammation. Findings suggest over-utilization of maladaptive, rather than under-utilization of adaptive, emotion regulation strategies may be associated with systemic inflammation in trauma-exposed veterans. Published by Elsevier Ltd.
BACKGROUND: Emotion dysregulation can elicit inflammatory activity. The current study examined whether specific maladaptive and adaptive emotion regulation strategies were associated with inflammatory markers in trauma-exposed veterans, above and beyond PTSD. METHODS: In a cohort study, 606 participants exposed to a Criterion A trauma and recruited from Veteran Health Administration facilities completed fasting blood draws, the Emotion Regulation Questionnaire, and the Clinician Administered PTSD Scale-IV. Inflammation was assessed with high sensitivity C-reactive protein (hsCRP), white blood cell count (WBC), and fibrinogen levels. An inflammation index was created by summing standardized log-transformed levels of the three biomarkers. Our primary linear regression models were adjusted for sex, age, race, education, income, creatinine, and PTSD. RESULTS: Suppression, but not cognitive reappraisal, was significantly associated with higher levels of the inflammatory index (β = 0.14, p = 0.001). Parallel analyses for the individual inflammatory markers also showed suppression, but not reappraisal, was significantly associated with higher hsCRP (β = 0.11, p = 0.01), WBC (β = 0.11, p = 0.01), and fibrinogen (β = 0.10, p = 0.02). CONCLUSIONS: Emotional suppression is related to elevated systemic inflammation independent of PTSD. Cognitive reappraisal is unrelated to inflammation. Findings suggest over-utilization of maladaptive, rather than under-utilization of adaptive, emotion regulation strategies may be associated with systemic inflammation in trauma-exposed veterans. Published by Elsevier Ltd.