Spousal loss predicts alterations in diurnal cortisol activity through prospective changes in positive emotion.

OBJECTIVE The objective of this study was to examine the role of spousal bereavement and positive emotion in naturally occurring levels of daily cortisol. METHODS Analyses were conducted using data from the Midlife in the United States survey and the National Study of Daily Experiences. Baseline assessments of extraversion, neuroticism, trait positive emotion, and trait negative emotion were obtained, as were reports of demographic and health behavior covariates. Salivary cortisol levels were measured at wakeup, 30 min after awakening, before lunch, and at bedtime on each of 4 successive days. RESULTS Multilevel growth curve analyses indicated that independent of age, gender, education, extraversion, neuroticism, negative emotion, medication use, and smoking, spousal bereavement was associated with lower levels of cortisol at wakeup and a flattening of the diurnal cortisol rhythm. Mediation analyses revealed that prospective changes in positive emotion accounted for the impact of bereavement on diurnal cortisol slopes. CONCLUSION The current prospective study is among the first to provide evidence for a role for positive emotion as a mechanism by which bereavement influences hypothalamic-pituitary-adrenal axis dysregulation in older adults.