The role of emotional regulation and interpersonal support in grief, depression, and markers of inflammation in Hispanic women with breast cancer

**Loss, grief, and emotion regulation in the context of the cancer experience: a proposed model to understand the link between depression and systemic inflammation: **The proposed supplement parts from wide literature in the affective neuroscience field, in which studies have identified seven primary emotion neurological pathways (SEEKING, LUST, CARE, PLAY, RAGE, FEAR, and PANIC/GRIEF). 53,54 When the PANIC/GRIEF system is activated, studies in animal models have shown that rats make a call after separation to seek help and thus, prevent danger. The PANIC/GRIEF system’s main function is to maintain social bonds as they convey security.53,54 As grief has been identified as the first reaction after an interpersonal loss (separation), the despair caused by the activation of the PANIC/GRIEF system has been linked to the reason why depression hurts.52 Panksepp and Watt conceptualize grief as the despair feeling caused after an interpersonal loss, and according to animal studies, prolonged sustained activity of the grief neurological pathway leads (by an unknown mechanism) to inhibition of the seeking-reward system.52 Inhibition of the seeking-reward systems in rat studies manifests as surrender and defeat in different tasks (used to measured depression phenotype), which Panksepp and Watt conceptualized as anhedonia, one of the primary symptoms of Major Depression Disorder (MDD).52 As interpersonal loss has been identified as a predictor of phenotypic expressions of depression symptomatology using animal models; likewise, Slavish and Irwin have stated a Social Signal Transduction Theory of Depression linking early trauma and chronic stress (including interpersonal loss and social rejection) as a high predictor of MDD.17 The authors conceptualize stressful events as triggers for MDD and associate them with the onset or exacerbation of other major inflammatory health conditions that involve inflammatory processes (rheumatoid arthritis, chronic pain, obesity, diabetes, and cardiovascular disease). This theory suggests that exposure to psychosocial trauma and thus, the inability to cope with loss could be linked to risk factors that are important in understanding the repercussions on health, both psychological and physical. However, there is a gap in literature regarding non-death-related losses and how they affect the context of the cancer diagnosis. The different types of losses a cancer patient faces after a diagnosis could imply loss of security. Different types of perceived non-death-related losses could imply concerning repercussions on health, therefore investigating the relationship between non-death-related losses, grief, and depression as well as potential protective factors that are key to improving quality of life for BC patients as this information can contribute to targeted psychological treatments. The study team hypothesizes that emotion regulation and social support are potential protective coping mechanisms in grief management, depression symptoms, and upregulation of proinflammatory factors associated with BC tumor progression after non-death-related losses.Files and variables· phq9: PHQ-9 which measures depression symptomatology and severity.· fssi: Frequency of Suicide Ideation Inventory which measures suicide ideation· mpss: Multidimensional Scale Of Perceived Social Support which measures perceived· social support. It is composed of three subscales.· anps: The PANIC/GRIEF system was measured using its respective subscale from the Affective Neuroscience Personality Scale.· bhi: the Beck Hopelessness Inventory was used to measure hopelessness· ders: the Dificulty with Emotion Regulation Scale was used to measure emotion regulation difficulties· ddpg:the Grief Diagnostic Instrument For General Practice was used to assess type of losses experienced related to the the breast cancer diagnosis.SoftwareIBM SPSS version 29