Catecholamine predictors of complicated grief treatment outcomes

Could sympathetic hyperarousal limit treatment success in complicated grief? The present study investigated persons with complicated grief, a chronic condition with distinct symptoms including persistent intense yearning and longing for the person who died, avoidance of reminders that the person is gone, deep relentless sadness, self-blame, bitterness, or anger in connection with the death, and an inability to gain satisfaction or joy through engaging in meaningful activities or relationships with significant others. Length of bereavement did not correlate with complicated grief scores. Catecholamines (i.e., epinephrine, norepinephrine, dopamine) in plasma were assessed pre- and post-psychotherapeutic treatment. Participants with the highest levels of epinephrine at pre-treatment had the highest levels of complicated grief symptoms at post-treatment, accounting for baseline levels of symptoms. This predictive relationship was not seen for depressive symptoms. The present study supports the hypothesis that catecholamine levels are affected by bereavement, and in turn, can affect the ability of those with complicated grief to benefit from psychotherapy.

► Higher epinephrine pre-therapy predicted complicated grief symptoms post-therapy.
► Norepinephrine and dopamine did not predict complicated grief treatment.
► The data supports the hypothesis that social stress affects autonomic functioning.