Conclusion Why focus on the immunologic and neuroimaging biomarkers? One reason is precisely because these physiological variables may shed light on the similarities and differences between acute grief and CG. Along the same lines,

studying the underlying aspects of the body’s stress response to a death event may reveal distinctions between CG and post-traumatic stress disorder (PTSD), or CG and major depressive disorder. A second reason to focus on biomarkers is to generate theories as to how the death of a loved one Inhibitors,research,lifescience,medical can lead to the “broken-heart phenomenon,” or the unexpected death of a recently bereaved individual. Given that morbidity and mortality are necessarily physical events, some

interaction is occurring between Inhibitors,research,lifescience,medical the individual’s knowledge of the loss and their physical body, and although the mechanisms linking them are not well understood, the immune system is a likely suspect. A third reason to focus on biomarkers is that understanding the mechanisms of CG may lead to improved treatment for this disorder. Although GDC-0068 molecular weight pharmacological treatment seems the obvious way to use biomarkers, Inhibitors,research,lifescience,medical psychological treatment that takes advantage of biomarkers is also possible. To draw on an example from another disorder, psychotherapy

for PTSD has taken advantage Inhibitors,research,lifescience,medical of the discovery that when a patient’s heart rate is high at the beginning of the first exposure treatment, therapy outcomes are better.48 The study of the physiology and neurobiology of CG is only at the earliest beginning. Self -regulation, at the psychological as well as physiological levels, may be important in coping with pangs of grief and in acceptance of the death Inhibitors,research,lifescience,medical of a loved one. The assimilation of the reality of the death occurs in the brain for the working model of attachment to be revised. One hypothesis is that if the assimilation of the new information does not occur, either for psychological Cediranib (AZD2171) reasons (eg, extreme guilt or avoidance) and/or biological ones (eg, the effect of flattened diurnal Cortisol on hippocampal function), then the adaptation to the death may be prolonged and lead to CG. Some physiological markers of CG will correlate with a separation distress response and others will correlate with a general stress response. The physiological markers that correlate with a general stress response may occur with other stressful life events, but the physiological markers that correlate with the separation distress should be specific to the loss of an attachment figure.