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

• Published in: Psychoneuroendocrinology Vol. 122; p. 104871
• Main Authors: Khan, A.J., O’Donovan, A., Neylan, T.C., Gross, J.J., Cohen, B.E.
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01-12-2020
• Subjects: Emotion regulation; Immunology; Inflammation; PTSD; Trauma; Veterans; PTSD; Inflammation; Immunology; Veterans; Emotion regulation; Trauma
• ISSN: 0306-4530; 1873-3360
• DOI: 10.1016/j.psyneuen.2020.104871

•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.
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.
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.
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).
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.