Suppression, but not reappraisal, is associated with inflammation in trauma-exposed veterans. (December 2020)

• Record Type: Journal Article
• Authors: Khan, A.J.; O'Donovan, A.; Neylan, T.C.; Gross, J.J.; Cohen, B.E.
• Is Part Of: Psychoneuroendocrinology. Volume 122(2020)
• Publication Date: 2020-12
• Subjects: Emotion regulation -- Inflammation -- Trauma -- PTSD -- Veterans -- Immunology; Psychoneuroendocrinology -- Periodicals; Endocrinology -- Periodicals; Neurology -- Periodicals; Psychiatry -- Periodicals; Neuropsychoendocrinologie -- Périodiques; 616.8
• DOI: 10.1016/j.psyneuen.2020.104871
• Languages: English
• ISSNs: 0306-4530

Abstract

Highlights: Expressive suppression is associated with elevated inflammatory markers. Cognitive reappraisal is not significantly related to inflammation. Above and beyond PTSD, suppression is associated with elevated inflammation. 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.