Suppression, but not reappraisal, is associated with inflammation in trauma-exposed veterans

Psychoneuroendocrinology. 2020 Dec:122:104871. doi: 10.1016/j.psyneuen.2020.104871. Epub 2020 Sep 16.

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.

Keywords: Emotion regulation; Immunology; Inflammation; PTSD; Trauma; Veterans.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Biomarkers / blood
  • C-Reactive Protein / analysis
  • Cognition / physiology*
  • Cohort Studies
  • Emotional Regulation / physiology*
  • Emotions / physiology
  • Female
  • Fibrinogen / analysis
  • Humans
  • Inflammation / metabolism
  • Inflammation / physiopathology
  • Leukocyte Count
  • Male
  • Middle Aged
  • Stress Disorders, Post-Traumatic / psychology
  • Veterans / psychology*
  • Wounds and Injuries / psychology

Substances

  • Biomarkers
  • Fibrinogen
  • C-Reactive Protein