A Biopsychosocial Approach to Grief, Depression, and the Role of Emotional Regulation

prolonged and sustained activation of the grief neurological pathway can cause a cascade of neurotransmitters that inhibits the reward-seeking system, causing symptoms of depression.

• Biological Superiority of Women
• People with two X chromosomes turn out to have a special capacity for generating a diversity of cells in their bodies, especially brain cells (neurons). The diversity of the female brain may make it a kind of laboratory in which key aspects of human innovation have been conceived and tested out. The X chromosome carries more genes related to the brain than any of our other 22 chromosomes. With twice the diversity in X genes, new patterns of connectivity and neuronal response could emerge in the incubator of the female brain, and such innovations could find use in the right time and place.
• As anthropologist David Graeber and archaeologist David Wengrow write in their treatise on human innovation The Dawn of Everything, our ancestors’ breakthroughs in the development of agriculture and complex social organization, gained from experimentation with a host of animal, plant, and microbial species, were "accumulated over centuries, largely by women, in an endless series of apparently humble but in fact enormously significant discoveries.” These discoveries “had the cumulative effect of reshaping everyday life every bit as profoundly as the automatic loom or lightbulb." This accumulation of human wisdom could well be related to the genetic diversity of the female brain,
• Biological Differences in Male vs Female Brains
  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3030621/
  • On average, women use addictive drugs at lower levels than men, but women become addicted to drugs more rapidly than men.
  • male homosexuality was more often on the mother's side of the family versus the father's side
  • Each older brother increases the odds of male homosexuality by approximately 33%
    • The effect is only influenced by older brothers born via the same mother,
    • it is not influenced by the number of older sisters, and it only seems to be true for right-handed homosexual men
• Sex Differences in Empathy
  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5110041/
  • Females mammals are more likely to comfort
  • Other studies show that while female play more often involves caring for another individual (e.g., pretended baby), male play does not. However the proximate mechanisms underlying these different preferences remain largely unknown (how much is social vs biological)
  • Some sex differences in ToM tasks may be driven by the fact that males, compared to females, report that they less often adopt someone else’s perspective during everyday situations
    • Inconclusive
  • higher level of altruistic behavior in females
  • Disorders characterized by impaired empathy, including autism, are more common in males than females (Blair, 1995; Charman et al., 1997; Dodge, 1980; Baron-Cohen, 2002), and males also appear to be more susceptible to impairments in empathy. For example, one way in which male infants appear more susceptible to impairments in empathy is through their pacifier use. Specifically, infants’ pacifier use – which decreases facial mimicry – predicts, and is negatively associated with, later perspective taking and emotional intelligence in males, but not in females (Niedenthal et al., 2012). In other words, males may be more negatively impacted by interference with their facial mimicry early in development, which impacts their later emotion understanding (Niedenthal et al., 2012).
  • study of 5- to 13-year-old children’s reactions to an infant crying found that females were better than males at both guessing causes of the infant’s distress (indicating better perspective-taking) and thinking of ways to comfort the infant (Catherine and Schonert-Reichl, 2011). By 2 to 6 years of age, females outperform males in false belief tasks (Charman et al., 2002), a classical test of ToM. A study of preschool children’s theory-of-mind understanding and social competence reported that, after controlling for age, theory-of-mind understanding significantly predicted aggressive or disruptive behavior for boys and prosocial behavior for girls (Walker, 2005). Theory-of-mind understanding also was related to lower scores of shyness or withdrawn behavior for boys. This may suggest that ToM is devoted toward differing goals in males and females, with males tending to seek dominance and females tending to seek conciliation (Walker, 2005).
  • It must be noted that both male and female children appear more empathetic toward same-sex individuals
  • Male children may have more control over their empathy or may not empathize as automatically as female children.
  • Specifically, in students aged 13 to 16 years, females showed developmental increases in empathy toward both males and females, while males showed, with age, increases in empathy to females, but decreases in empathy to males (Olweus and Endresen, 1998). Similarly, another study found that in 7th graders, but not in 1st or 4th graders, males exhibited greater empathy for females than for males, but females exhibited equal levels of empathy for both sexes (Bryant, 1982). These differences in empathy as a function of target sex have been interpreted in terms of different evolutionary selective pressures on males and females, especially with regard to issues associated with mating (Olweus and Endresen, 1998).
  • Finally, though it has been explored little, it appears that the type of stimulus (e.g., sex of stimulus) has an important impact on male but not female empathy (Bryant, 1982; Olweus and Endresen, 1998). Although speculative, it is possible that this differential responding as a function of target sex may account for some of the sex differences reported across development. Specifically, it may be the case that males are not necessarily less empathetic than females, but that they direct varying levels of empathy at different types of social partners, with female targets eliciting equal levels of empathy from male and female viewers and male targets eliciting greater empathy in female viewers compared to male viewers. Of course, this would still render males, on average, less empathetic than females. In addition, males have more deliberate control over their production of expressions, and this control increases with age (e.g., Eisenberg et al., 1989), so many of these measures that rely on overt signals of empathy may find lower levels in males than females. Given that males have more control over their emotional expressions, they may likewise have more control over their empathy (Brehm et al., 1984). Though this hypothesis has not been directly tested in healthy populations – to our knowledge – it is consistent with data demonstrating associations between various disorders and empathetic control. Males, but not females, are less empathetic toward social partners who are perceived as behaving unfairly (Singer et al., 2006). In this way, males may be more sensitive to contextual influences on their empathy and their empathy may be more dependent on their motivational state
  • Empathetic behavior appears particularly strong in social species with prolonged parental care, such as mammals and some birds, in which there are reports of behaviors that are indicative not only of sensitivity to others’ emotional states, but also of the presence of some basic forms of empathy (Gonzalez-Liencres et al., 2013; de Waal, 2008; Edgar et al., 2011). In some species, the bond between individuals is expressed through sophisticated emotional channels that have been shaped through a long natural history. For example, capacities to cooperate, to support conspecifics during conflicts, and to provide comfort to social partners in distress have been widely described in primates and other animals (e.g., elephants: Plotnik and de Waal, 2014; chimpanzees: Romero et al., 2010).
  • Testosterone decreases the ability to empathize
• Testosterone in relationships
  • Both men's and women's testosterone was negatively correlated with their own and their partner's satisfaction and commitment. The couples were more satisfied and committed when they or their partner had low testosterone levels, the research indicated.
    • Married and non-married men in stable relationships had lower baseline levels of testosterone compared to single men. This fits with the interpretation that testosterone is adaptive and serves a purpose as a reaction to the environment especially in terms of mating ability and dominance.
  • People have a higher testosterone response when faced with a situation that challenges their social status or mating abilities (motivational cues of sex and power)
• Empathy / emotional regulation / depression
  • Individuals with good emotional regulation had low levels of depression overall and their depression symptoms were lowest when levels of affective empathy were average. Individuals with poor emotional regulation had high levels of depression overall, particularly when levels of empathy were moderate to high. Extremely high and low levels of cognitive empathy were associated with elevated depression, regardless of the test subject's emotional regulation.
  • https://scholarworks.gsu.edu/cgi/viewcontent.cgi?article=1142&context=psych_facpub
• Empathy and utilitarian decision making
  • Test subjects are posed a moral dilemma: Would they cause the death of 1 person to save 5 people?
    • Test subjects that scored higher in empathy justified their decisions based on personal values and emotional reactivity. Whereas reduced empathy leads to decisions based on egoistic concern and utilitarian choice (greatest overall positive outcome).
    • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6136766/
• Gender and Emotional Expression
  • Men and women differ in neural responses when experiencing negative emotions. "Compared with women, men showed lesser increases in prefrontal regions that are associated with reappraisal, greater decreases in the amygdala, which is associated with emotional responding, and lesser engagement of ventral striatal regions, which are associated with reward processing" (McRae, Ochsner, Mauss, Gabrieli, & Gross, 2008).[15] The way that male and female brains respond to emotions likely impacts the expression of those emotions.
  • although women may be more expressive of most emotions, at least in Western cultures, men show equal or greater levels of physiological arousal, for example with men showing greater blood pressure and cortisol responses to emotionally arousing stressors
  • https://en.wikipedia.org/wiki/Gender_and_emotional_expression
  • girls start off with biologically based lower arousal and better emotion vocabulary and they are socialized over time to enhance expression of emotion
  • Shame, sadness, fear are not as affected by socialization or unfolding of biological mechanisms over time, perhaps suggesting that gender differences in some internalizing emotions, including fear, are biologically based (or based on very early socialization, starting in infancy).
• Boundaries, Communication, and Rejection
  • Our theory postulates that targets and sources’ needs are better maintained if sources use clear, explicit verbal communication. We propose that sources have three options: explicit rejection (clearly stating no), ostracism (ignoring), and ambiguous rejection (being unclear). Drawing on psychology, sociology, communications, and business research, we propose that when sources use explicit rejection, targets’ feelings will be less hurt, their needs will be better protected, and sources will experience less backlash and emotional toil than if sources use ambiguous rejection or ostracism.
  • When targets are unable to restore their level of self-esteem, they show detriments in other areas of their life. People who fail to restore their self-esteem following an exclusion (i.e., those with vulnerable baseline levels of self-esteem) do not benefit from the usual buffering effects of companionship (Teng and Chen, 2012), show decreased ability to engage in self-control (vanDellen et al., 2012), engage in self-blame attributions, and show increased stress reactivity
  • With both control and meaningful existence restoration, it may seem paradoxical that targets would engage in aggressive or antisocial behaviors to restore their threatened needs as those behaviors may threaten their other two fundamental needs (belongingness and self-esteem). However, targets are unlikely to behave aggressively to restore threatened needs if they feel that belongingness is still possible (Maner et al., 2007). It is only when belongingness feels out of reach that targets will behave in antisocial ways to restore their other needs (Maner et al., 2007). Therefore, research indicates that social exclusion threatens targets’ sense of control, and targets will go to lengths to restore it.
  • Targets’ self-esteem, control, belongingness, and meaningful existence may fare better when they sense that, although the source is excluding them from the desired social request, sources are still going to lengths to include them in direct communication (i.e., providing a positive social cue) rather than ignoring or sending mixed messages. The target can also experience a sense of control over the outcome of the social exclusion when it is delivered as an explicit rejection. The target knows that the exclusion has taken place and can decide on the next step forward. In explicit rejection, the targets can respond and have an active role as the exclusion unfolds (e.g., communicate that it is not a big deal, argue back, etc.).
  • sources who engage in explicit rejection will be seen by the rejected party in a more positive light and will have to expend less emotional effort
  • Silent treatment (ostracism) may be the worst choice for exclusion if sources want to minimize hurt feelings and make future interactions possible. Specifically, ostracizing a romantic partner during conflict is highly damaging and is associated with high levels of distress
    • A lack of acknowledgment by others can make targets feel as though they are invisible or dead, as if their life has no meaning. In some societies it is used as the most severe form of punishment (Gruter and Masters, 1986; Case and Williams, 2004), and James (1890, p. 293) famously described being ignored as being “cut dead.”
    • Finally, ostracism is threatening to the target’s sense of control because targets are not able to respond to the exclusion. With explicit rejection, targets have the option of responding to the exclusion, but ostracism prevents that option. Therefore, the targets experience diminished control in an already negative situation.
    • In terms of sources’ reputations, targets state that the worst rejection is the one that is never conveyed (e.g., Brown, 1993).
    • Research involving instructed or recalled ostracism has indicated that ignoring someone or giving the silent treatment requires a sustained effort and depletes mental resources. Ostracism, though it seems passive on the surface, requires violating the highly ingrained social norms of attending, acknowledging, and responding to a person. It is possible that when sources want to hurt or punish a target that ostracism may be the preferred method
  • Ambiguous rejections
    • The sense that the source may have led the target on could elicit a sense of betrayal in the target. Betrayal is one of the main elicitors of hurt feelings (Leary et al., 1998), and therefore ambiguous rejection may be problematic for protecting targets’ feelings. In addition to hurt feelings arising from a sense of betrayal, ambiguous rejections may also increase targets’ hurt feelings and lower their self-esteem because targets may perceive that sources did not care enough to provide an explicit rejection.
    • Ambiguous rejections may be particularly hurtful because they can initially convey the message that the target has the possibility of being included, yet it is eventually revealed in the end that the target was in fact rejected from the start
    • If the rejection had been explicit, the target would at least know what kind of responses would help them restore their sense of control (e.g., coping strategies). In summary, with ambiguous rejections, targets are left uncertain about how to act and therefore experience diminished control over the interaction and over their own coping.
    • In a study of unrequited love (Baumeister et al., 1993), both parties viewed indirect messages as undesirable. Those seeking love thought most poorly of those spurning love when an ambiguous rejection was involved.
    • ambiguous rejections cause the source to appear capricious and inconsistent. Both of these traits are generally undesirable and associated with seeming dishonest (e.g., Zuckerman et al., 1982; Heinrich and Borkenau, 1998; Weisbuch et al., 2010). As a result, the target may view the source’s actions as malicious because they put the target in an uncertain and potentially hopeful situation before destroying those hopes.
    • The uncertainty of ambiguous rejection means that sources may have to continually reassert their positions until the target finally understands what is happening
    • Specifically, people with high levels of neuroticism feel an even greater sense of diminished control, compared to people with low levels of neuroticism, when they are unsure whether or not they have been rejected (Boyes and French, 2009).
  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5056179/
  • Ghosting, brain scans of pain w/ being ignored
• Making Sense and Moving On: The Potential for Individual and Interpersonal Growth Following Emerging Adult Breakups
  • Having control over initiating a breakup at age 22 predicted relative increases in peer-rated internalizing symptoms and autonomy-undermining interactions with a new partner at ages 23-25.
  • Having a greater understanding of the reasons for a breakup predicted lower self-reported internalizing symptoms and relative decreases in partner-reported romantic conflict as well as relative increases in self-reported relationship satisfaction and peer-rated intimate relationship competence at ages 23-25.
• Buzzfeed article on MRA A Voice for Men founder, Paul Elam
  • https://www.buzzfeed.com/adamserwer/how-mens-rights-leader-paul-elam-turned-being-a-deadbeat-dad#.gmrRkXB8bR