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Finding positive meaning and its association with natural killer cell cytotoxicity among participants in a bereavement-related disclosure intervention

  • Published:
Annals of Behavioral Medicine

Abstract

This study tested the hypothesis that cognitive processing about a past bereavement would produce increases in goals and priorities indicative of finding positive meaning from the loss. It was further hypothesized that increases in meaning-related goals would be associated with changes in immune function, specifically increased natural killer cell cytotoxicity (NKCC). Cognitive processing was manipulated using written emotional disclosure. Forty-three women who had lost a close relative to breast cancer wrote about the death (cognitive processing/disclosure group) or about nonemotional topics weekly for 4 weeks. Contrary to predictions, written disclosure did not induce changes in meaning-related goals or NK cell parameters. However, women in both experimental groups who reported positive changes in meaning-related goals over the study period also showed increases in NKCC. Results suggest that prioritizing goals emphasizing relationships, personal growth, and striving for meaning in life may have positive biological correlates but that solitary written disclosure may not be sufficient to induce changes in these goals in response to a past bereavement.

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References

  1. Herbert TB, Cohen S: Stress and immunity in humans: A meta-analytic review. Psychosomatic Medicine. 1993, 55:364–379.

    Article  CAS  PubMed  Google Scholar 

  2. Janoff-Bulman R, Frantz CM: The impact of trauma on meaning: From meaningless world to meaningful life. In Power M, Brewin C (eds), The Transformation of Meaning in Psychological Therapies. London: Wiley, 1997.

    Google Scholar 

  3. Taylor SE: Adjustment to threatening events:Atheory of cognitive adaptation. American Psychologist. 1983, 41:1161–1173.

    Article  Google Scholar 

  4. Tedeschi RG, Calhoun LG: Trauma and Transformation: Growing in the Aftermath of Suffering. Thousand Oaks, CA: Sage, 1995.

    Book  Google Scholar 

  5. Park CL, Folkman S: Meaning in the context of stress and coping. Review of General Psychology. 1997, 1:115–144.

    Article  Google Scholar 

  6. Davis CG, Nolen-Hoeksema S, Larson J: Making sense of loss and benefiting from the experience: Two construals of meaning. Journal of Personality and Social Psychology. 1998, 75:561–574.

    Article  CAS  PubMed  Google Scholar 

  7. Bower JE, Kemeny ME, Taylor SE, Fahey JL: Cognitive processing, discovery of meaning, CD4 decline, and AIDS-related mortality among bereaved HIV seropositive gay men. Journal of Consulting and Clinical Psychology. 1998, 66:979–986.

    Article  CAS  PubMed  Google Scholar 

  8. Schwartzberg SS: Struggling for meaning: How HIV-positive gay men make sense of AIDS. Professional Psychology: Research and Practice. 1993, 24:483–490.

    Article  Google Scholar 

  9. Updegraff JA, Taylor SE, Kemeny ME, Wyatt GE: Positive and negative effects of HIV-infection in women with low socioeconomic resources. Personality and Social Psychology Bulletin. 2002, 28:382–394.

    Article  Google Scholar 

  10. Taylor SE, Lichtman RR, Wood JV: Attributions, beliefs about control, and adjustment to breast cancer. Journal of Personality and Social Psychology. 1984, 46:489–502.

    Article  CAS  PubMed  Google Scholar 

  11. Andrykowski MA, Brady MJ, Hunt JW: Positive psychological adjustment in potential bone marrowtransplant recipients: Cancer as a psychosocial transition. Psycho-Oncology. 1993, 2:261–276.

    Article  Google Scholar 

  12. Tennen H, Affleck G, Mendola R: Causal explanations for infertility: Their relationship to control appraisals and psychological adjustment. In Stanton A, Dunkel-Schetter C (eds), Infertility: Perspectives From Stress and Coping Research. New York: Plenum, 1991, 109–132.

    Chapter  Google Scholar 

  13. Affleck G, Tennen H, Croog S, Levine S: Causal attributions, perceived benefits, and morbidity after a heart attack: An 8-year study. Journal of Consulting and Clinical Psychology. 1987, 55:29–35.

    Article  CAS  PubMed  Google Scholar 

  14. Thompson SC: The search for meaning following a stroke. Basic and Applied Social Psychology. 1991, 12:81–96.

    Article  Google Scholar 

  15. Cruess DG, Antoni MH, McGregor BA, et al.: Cognitive-behavioral stress management reduces serum cortisol by enhancing benefit finding among women being treated for early stage breast cancer. Psychosomatic Medicine. 2000, 62:304–308.

    Article  CAS  PubMed  Google Scholar 

  16. Greenberg MA: Cognitive processing of trauma: The role of intrusive thoughts and reappraisals. Journal of Applied Social Psychology. 1995, 25:1262–1296.

    Article  Google Scholar 

  17. Horowitz MJ: Stress Response Syndromes (2nd ed.). New York: Aronson, 1986.

    Google Scholar 

  18. Calhoun LG, Cann A, Tedeschi RG, McMillan J: A correlational test of the relation between posttraumatic growth, religion, and cognitive processing. Journal of Traumatic Stress. 1999, 13:521–527.

    Article  Google Scholar 

  19. Pennebaker JW: Writing about emotional experience as a therapeutic process. Psychological Science. 1997, 8:162–166.

    Article  Google Scholar 

  20. Esterling BA, Antoni MH, Fletcher MA, Margulies S, Schneiderman N: Emotional disclosure through writing or speaking modulates latent Epstein-Barr virus antibody titers. Journal of Consulting and Clinical Psychology. 1994, 62:130–140.

    Article  CAS  PubMed  Google Scholar 

  21. Pennebaker JW, Kiecolt-Glaser JK, Glaser R: Disclosure of traumas and immune function: Health implications for psychotherapy. Journal of Consulting and Clinical Psychology. 1988, 56:239–245.

    Article  CAS  PubMed  Google Scholar 

  22. Petrie KJ, Booth RJ, Pennebaker JW, Davison KP, Thomas MG: Disclosure of trauma and immune response to a hepatitis B vaccination program. Journal of Consulting and Clinical Psychology. 1995, 63:787–792.

    Article  CAS  PubMed  Google Scholar 

  23. Pennebaker JW, Beall SK: Confronting a traumatic event: Toward an understanding of inhibition and disease. Journal of Abnormal Psychology. 1986, 95:274–281.

    Article  CAS  PubMed  Google Scholar 

  24. Kelley JE, Lumley MQ, Leisen JCC: Health effects of emotional disclosure in rheumatoid arthritis patients. Health Psychology. 1997, 16:331–340.

    Article  CAS  PubMed  Google Scholar 

  25. Smyth JM, Stone AA, Hurewitz A, Kaell A: Effects of writing about stressful experiences on symptom reduction in patients with asthma or rheumatoid arthritis. Journal of the American Medical Association. 1999, 281:1304–1309.

    Article  CAS  PubMed  Google Scholar 

  26. Pennebaker JW, Mayne TJ, Francis ME: Linguistic predictors of adaptive bereavement. Journal of Personality and Social Psychology. 1997, 72:863–871.

    Article  CAS  PubMed  Google Scholar 

  27. Zakowski SG, Valdimarsdottir HB, Bovbjerg DH, et al.: Predictors of intrusive thoughts and avoidance in women with family histories of breast cancer. Annals of Behavioral Medicine. 1997, 19:362–369.

    Article  CAS  PubMed  Google Scholar 

  28. Bovbjerg DH, Valdimarsdottir HB: Interventions for healthy individuals at familial risk for cancer: Biobehavioral mechanisms for health benefits. In Baum A, Anderson B (eds), Psychosocial Interventions for Cancer. Washington, DC: American Psychological Association, 2001.

    Google Scholar 

  29. Whiteside TL, Herberman RB: The role of natural killer cells in human disease. Clinical Immunology and Immunopathology. 1989, 53:1–23.

    Article  CAS  PubMed  Google Scholar 

  30. Strayer DR, Carter WA, Brodsky I: Familial occurrence of breast cancer is associated with reduced natural killer cytotoxicity. Breast Cancer Research and Treatment. 1986, 7:187–192.

    Article  CAS  PubMed  Google Scholar 

  31. Futterman AD, Kemeny ME, Shapiro D, Fahey JL: Immunological and physiological changes associated with induced positive and negative mood. Psychosomatic Medicine. 1994, 56:499–511.

    Article  CAS  PubMed  Google Scholar 

  32. Fawzy FI, Kemeny ME, Fawzy NW, et al.: A structured psychiatric intervention for cancer patients: Changes over time in immunological measures. Archives of General Psychiatry. 1990, 47:729–735.

    Article  CAS  PubMed  Google Scholar 

  33. Kiecolt-Glaser JK, Glaser R, Williger D, et al.: Psychosocial enhancement of immunocompetence in a geriatric population. Health Psychology. 1985, 4:25–41.

    Article  CAS  PubMed  Google Scholar 

  34. Carver CS, Scheier MF: On the Self-Regulation of Behavior. New York: Cambridge University Press, 1998.

    Book  Google Scholar 

  35. Kemeny ME, Gruenewald T: Affect, cognition, the immune system and health. In Mayer EA, Saper C (eds), The Biological Basis for Mind Body Interactions: Progress in Brain Research Series. Amsterdam: Elsevier Science B.V., 2000, 291–308.

    Google Scholar 

  36. Cole SW: Negative physical health effects of psychological inhibition in disclosure study control groups. Manuscript submitted for publication.

  37. Smyth JM: Written emotional expression: Effect sizes, outcome types, and moderating variables. Journal of Consulting and Clinical Psychology. 1998, 66:174–184.

    Article  CAS  PubMed  Google Scholar 

  38. Kemeny ME: The Life Goals Inventory. Unpublished manuscript.

  39. Kemeny ME, Reed G, Taylor SE, Visscher B, Fahey JL: Negative HIV-specific expectancies predict immunological evidence of HIV progression. Unpublished manuscript.

  40. Kemeny ME, Dickerson S, Gruenewald T, Bower J, Lu Q: Validation of a measure of life goals and priorities. Unpublished manuscript.

  41. Radloff LS: The CES-D scale: A self-report depression scale for research in the general population. Applied Psychological Measurement. 1977, 1:386–401.

    Article  Google Scholar 

  42. Faschingbauer TR, Zisook S, DeVaul R: The Texas Revised Inventory of Grief. In Zisook S (ed), Biopsychosocial Aspects of Bereavement. Washington, DC: American Psychiatric Press, 1987, 109–128.

    Google Scholar 

  43. Kiecolt-Glaser JK, Glaser R: Methodological issues in behavioral immunology research with humans. Brain, Behavior, and Immunity. 1988, 2:67–78.

    Article  CAS  PubMed  Google Scholar 

  44. Stanton AL, Danoff-Burg S, Sworowski LA, et al.: Randomized, controlled trial of written emotional expression and benefit finding in breast cancer patients. Journal of Clinical Oncology. 2002, 20:4160–4168.

    Article  PubMed  Google Scholar 

  45. Range LM, Kovac SH, Marion MS: Does writing about bereavement lessen grief following sudden, unintentional death? Death Studies}. 2000, 24:115–134.

    Article  CAS  PubMed  Google Scholar 

  46. Stroebe M, Stroebe W, Schut H, Zech E, van den Bout J: Does disclosure of emotions facilitate recovery from bereavement? Evidence from two prospective studies. Journal of Consulting and Clinical Psychology. 2002, 70:169–178.

    Article  PubMed  Google Scholar 

  47. Spiegel D, Classen C: Group Therapy for Cancer Patients: A Research-Based Handbook of Psychosocial Care. New York: Basic Books, 2000.

    Google Scholar 

  48. Antoni MH, Lehman JM, Kilbourn KM, et al.: Cognitive-behavioral stress management intervention decreases the prevalence of depression and enhances benefit finding among women under treatment for early stage breast cancer. Health Psychology. 2001, 20:20–32.

    Article  CAS  PubMed  Google Scholar 

  49. Friedman EM, Irwin MR: Modulation of immune cell function by the autonomic nervous system. Pharmacology and Therapeutics. 1997, 74:27–38.

    Article  CAS  PubMed  Google Scholar 

  50. McEwen BS, Biron CA, Brunson KW, et al.: The role of adrenocorticoids as modulators of immune function in health and disease: Neural, endocrine, and immune interactions. Brain Research Reviews. 1997, 23:79–133.

    Article  CAS  PubMed  Google Scholar 

  51. Epel ES, McEwen BS, Ickovics JR: Embodying psychological thriving: Physical thriving in response to stress. Journal of Social Issues. 1998, 54:301–322.

    Article  Google Scholar 

  52. Seligman MEP, Csikszentmihalyi M: Positive psychology [Special issue]. American Psychologist. 2000, 55(1).

    Google Scholar 

  53. Ryan RM, Sheldon KM, Kasser T, Deci EL: All goals are not created equal: An organismic perspective on the nature of goals and their regulation}. In Gollwitzer PM, Bargh JA (eds), The Psychology of Action: Linking Cognition and Motivation to Behavior. New York: Guilford, 1996, 7–26.

    Google Scholar 

  54. Schmale AH: Giving up as a final common pathway to changes in health. Advances in Psychosomatic Medicine. 1972, 8:20–40.

    Article  CAS  PubMed  Google Scholar 

  55. Fleshner M, Laudenslager ML, Simons L, Maier SL: Reduced serum antibodies associated with social defeat in rats. Physiology and Behavior. 1989, 45:1183–1187.

    Article  CAS  PubMed  Google Scholar 

  56. Stefanski V, Ben-Eliyahu S: Social confrontation and tumor metastasis in rats: Defeat and beta-adrenergic mechanisms. Physiology and Behavior. 1996, 60:277–282.

    Article  CAS  PubMed  Google Scholar 

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Author information

Author notes

  1. Julienne E. Bower Ph.D.

    Present address: , A2-125 CHS, Box 956900, Los Angeles, CA, 90095-6900, USA

Authors and Affiliations

  1. Cousins Center for Psychoneuroimmunology, Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, USA

    Julienne E. Bower Ph.D.

  2. Health Psychology Program, University of California, San Francisco, USA

    Margaret E. Kemeny Ph.D.

  3. Department of Psychology, University of California, Los Angeles, USA

    Shelley E. Taylor Ph.D

  4. Departments of Microbiology and Immunology, Immunology, and Molecular Genetics, University of California, Los Angeles, USA

    John L. Fahey M.D.

Authors
  1. Julienne E. Bower Ph.D.
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  2. Margaret E. Kemeny Ph.D.
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  3. Shelley E. Taylor Ph.D
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  4. John L. Fahey M.D.
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Corresponding author

Correspondence to Julienne E. Bower Ph.D..

Additional information

Preparation of this article was supported in part by the Norman Cousins Program in Psychoneuroimmunology at the University of California, Los Angeles; a National Institute of Mental Health (NIMH) Research Scientist Development Award (MH00820) Dr. Kemeny; and grants from the NIMH (MH056880) and National Science Foundation (SBR9905157) Dr. Taylor.

We would like to thank Drs. David Wellisch, Michelle Craske, and Steve Cole for their contributions to this project, and Dr. Annette Stanton for her assistance in reviewing an earlier draft of this article.

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Bower, J.E., Kemeny, M.E., Taylor, S.E. et al. Finding positive meaning and its association with natural killer cell cytotoxicity among participants in a bereavement-related disclosure intervention. ann. behav. med. 25, 146–155 (2003). https://doi.org/10.1207/S15324796ABM2502_11

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  • DOI: https://doi.org/10.1207/S15324796ABM2502_11

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