Mary-Frances O'Connor

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Scholarly Contributions

Books

• O'connor, M., & O'connor, M. F. (2013). Physiological mechanisms and the neurobiology of complicated grief. Taylor and Francis. doi:10.4324/9780203105115

Chapters

• Andrews-hanna, J. R., Andrews-hanna, J. R., Christoff, K., O'connor, M., & O'connor, M. F. (2020). Dynamic Regulation of Internal Experience: Mechanisms of Therapeutic Change. In The Neuroscience of Enduring Change: The Neural Basis of Talk Therapies.. Oxford University Press. doi:10.1093/OSO/9780190881511.003.0005
• O'connor, M., Mcconnell, M. H., Mcconnell, M. H., & O'connor, M. F. (2018). Grief Reactions: A Neurobiological Approach. In Handbook of Bereavement and Grief Reactions. Humana Press, Cham. doi:10.1007/978-3-319-65241-2_3
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  This chapter reviews the current state of neuroscience research suggesting that there may be neurobiological correlates of grief. This evidence comes from studies involving functional and structural neuroimaging techniques in bereaved individuals with a typical grief pattern as well as in those whose grief is more severe and prolonged. Understanding the neurological mechanisms contributing to various outcomes in grief may allow us to not only better understand and treat bereaved populations, but also to predict and prevent conditions such as complicated grief.

Journals/Publications

• Chandler, A. B., Wank, A., Vanuk, J. R., O'Connor, M., Dreifuss, B. A., Dreifuss, H. M., Ellingson, K., Khan, S. M., Friedman, S. E., & Athey, A. (2021). Adapting Psychological First Aid for Healthcare Workers During the COVID-19 Pandemic: A Feasibility Study of the HCW HOSTED ICARE Telehealth Model.. Journal of Community Health.
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  Abstract Maintaining the resilience of healthcare workers (HCWs) during the protracted COVID-19 pandemic is critical as chronic stress is associated with burnout, inability to provide high-quality care, and decreased attentiveness to infection prevention protocols that protect patients and HCWs. Between May 2020 and July 2020, we adapted and implemented ICARE, a psychological first aid (PFA) model, in a novel online (i.e., telehealth) format to address the psychological support needs of HCWs during the COVID-19 pandemic. In doing so, we had the following aims: (1) assess the mental health and psychological functioning of HCWs, (2) determine the feasibility and acceptability of an online PFA program for HCWs, and (3) identify the psychological support needs of HCWs. During the aforementioned period, the HCWs in this program reported low to moderate levels of stress, fair to good quality sleep, and minimal to mild depression and anxiety. We found implementation of the program to be feasible via use of a program website, an online survey system, and a videoconferencing platform. The HCWs in our program repeatedly expressed appreciation for the support we provided. Lastly, we found that HCWs needed psychological support related to obtaining clear information about pandemic policies and guidelines, navigating new rules and responsibilities, and processing overwhelming and conflicting emotions. Future directions include establishing asynchronous online discussion forums, increasing opportunities for individual support, and training HCWs to provide peer support using PFA. This program has far-reaching potential benefit to HCWs and to society at large in the context of a pandemic. Keywords: COVID-19, healthcare workers (HCWs), ICARE, psychological first aid (PFA), telehealth
• O'Connor, M., & Wilson, D. T. (2022). From Grief to Grievance: Combined Axes of Personal and Collective Grief Among Black Americans. Frontiers in Psychiatry. doi:10.3389/fpsyt.2022.850994
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  In the current article, we argue that the current conceptualization of grief as "the acute pain that accompanies the loss of a loved one" is too narrow in scope. Specifically, our current conceptualization of grief fails to account for the various ways in which grief is manifested amongst Black Americans. Throughout the article, we explore how the history of the racialization of Black people in America has resulted in a unique experience of loss, grief, and bereavement which previous research has largely failed to elucidate. Additionally, we explore how grief catalyzes political and social action. The article also proposes a novel theoretical conceptualization of personal and collective grief to deepen our conceptualization of grief amongst Black Americans. Finally, we posit that we must also consider how to further research on this collective grief to increase our understanding of it and to account for similar phenomena that may exist in communities who've had similar experiences (e.g., Indigenous peoples in the Americas and Dalits in India).
• O'connor, M. F., Luik, A. I., Ikram, M. A., Feijter, M. D., & Arizmendi, B. J. (2021). The longitudinal association of actigraphy-estimated sleep with grief in middle-aged and elderly persons.. Journal of psychiatric research, 137, 66-72. doi:10.1016/j.jpsychires.2021.02.042
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  Most people experience grief after a loss, about 10% develop complicated grief, often accompanied by sleep complaints. Yet, the role of objectively estimated poor sleep remains unclear. Therefore, we assessed the cross-sectional and longitudinal association of actigraphy-estimated sleep with grief. We included 1,776 participants (mean age: 61.8 ± 8.9 years, 55% women) of a prospective population-based cohort. Of 1,471 participants (83%) repeated measures of grief were available (median follow-up 6 years, inter quartile range 5.6-6.3). At baseline, sleep was objectively estimated using actigraphy (mean duration 6.0 ± 0.8days). At baseline and follow-up, participants were asked about significant losses and completed the Dutch Inventory of Complicated Grief (17 items, cut-off ≥22). At baseline 1,521 (86%) participants experienced no grief, 44 (2%) acute grief (
• Sbarra, D. A., O'connor, M., Mayer, C. M., Lawrence, E. E., Knowles, L. M., Kaszniak, A. W., Jovel, K. S., & Bottrill, K. C. (2021). A controlled trial of two mind-body interventions for grief in widows and widowers.. Journal of consulting and clinical psychology, 89(7), 640-654. doi:10.1037/ccp0000653
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  Objective: Following bereavement, yearning and grief rumination are repetitive cognitive processes that can lead to disordered grief. Mindfulness training (MT) has been shown to reduce maladaptive repetitive thought. The current quasi-randomized controlled trial examined the feasibility, acceptability, and preliminary efficacy of MT for bereavement-related grief. Method: Ninety-five widow(er)s (Mage = 67.5, 79% women, 98% White) between 6 months to 4 years post-loss were assigned to a 6-week MT intervention or a progressive muscle relaxation (PMR) intervention, or a wait-list condition. Outcome measures were grief severity (Revised Inventory of Complicated Grief), yearning (Yearning in Situations of Loss), rumination (Utrecht Grief Rumination Scale), and decentering (Experiences Questionnaire-Decentering) assessed at baseline, Weeks 2 and 4 of intervention, post-intervention, and 1-month post-intervention. Growth curve analysis examined group differences in rates of improvement in outcomes through follow-up and associations with improvement in grief severity. Results: The MT and PMR groups showed significant rates of decline in grief severity and yearning, though only the PMR group showed a greater rate of decline in grief severity than wait-list. All groups showed significant rates of decline in grief rumination. The PMR and wait-list groups showed significant rates of increase in decentering compared to the MT group. Conclusions: Results support the feasibility and acceptability of MT and PMR for widow(er)s as well as the preliminary efficacy of PMR for improving grief severity in widow(er)s compared to a wait-list control condition. With replication, PMR could be a standalone intervention for non-disordered grief or a component of treatment for disordered grief. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
• Seeley, S. H., & O'connor, M. (2022). Grieving as a form of learning: Insights from neuroscience applied to grief and loss.. Current opinion in psychology, 43, 317-322. doi:10.1016/j.copsyc.2021.08.019
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  Recent grief research suggests that the influential cognitive stress theory should be updated with evidence from cognitive neuroscience. Combining human and animal neuroscience with attachment theory, we propose that semantic knowledge of the everlasting nature of the attachment figure and episodic, autobiographical memories of the death are in conflict, perhaps explaining the duration of grieving and generating predictions about complications in prolonged grief disorder (PGD). Our gone-but-also-everlasting model emphasizes that grieving may be a form of learning, requiring time and experiential feedback. Difficulties before loss, such as spousal dependency or pre-existing hippocampal volume, can prolong learning and predict PGD. Complications such as avoidance, rumination, and stress-induced hippocampal atrophy may also develop after loss and create functional or structural mechanisms predicting PGD.
• Stelzer, E. M., Palitsky, R., Hernandez, E. N., Ramirez, E. G., & O'Connor, M. F. (2019). The role of personal and communal religiosity in the context of bereavement. Journal of prevention & intervention in the community, 48(1), 64-80.
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  Religion and spirituality often become relevant after the death of a loved one. In light of the multidimensionality of religion and spirituality, we investigate the role of communal religiosity in predicting associations between personal religiosity and bereavement outcomes. A mixed-methods analysis of interviews and questionnaires from 33 bereaved adults was conducted. Interview mentions of personal and communal religiosity, and their associations with self-reported religious coping and grief symptoms, were assessed. Personal ( = 0.55, < .01) and communal religiosity ( = 0.50, < .01) predicted positive religious coping, as well as negative religious coping and grief severity ( = 0.53, < .01). In addition, personal religiosity predicted more negative religious coping for participants who expressed low communal religiosity,  = 1.58, SE = .15, (28) = 4.08, < .001. After loss, personal religiosity by itself is not necessarily protective. The presence of personal and communal religiosity contributes to positive religious coping, and reduced negative religious coping. However, the absence of communal religiosity indicates vulnerability.
• Stelzer, E., & O'connor, M. F. (2021). Can Less Ever Be More? A Model of Emotion Regulation Repertoire of Social Support (ERROSS):. Emotion Review, 13(2), 125-138. doi:10.1177/1754073921992848
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  Do people really fare better if they can rely on many social ties? Research suggests that benefits of interpersonal emotion regulation (ER) can be derived from both large and small social networks....
• Eisma, M. C., Stelzer, E. M., Lenferink, L. I., Knowles, L. M., Gastmeier, S. K., Angelopoulou, M., Doering, B. K., & O'Connor, M. F. (2020). Wish you were here: The Dutch, German, and English Yearning in Situations of Loss Short Form. Journal of clinical psychology, 76(10), 1995-2014.
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  Yearning, a hallmark of grief disorders, relates to rumination and potentially to cognitive avoidance. We developed an 8-item short form of the only existing validated yearning measure, the Yearning in Situations of Loss Scale (YSL), to improve its validity and administration ease.
• Irgens, M. S., Doyle, C. Y., Chau, R. F., Shanholtz, C. E., Price, S. N., Shanholtz, C. E., Sbarra, D. A., Price, S. N., O'connor, M. F., Mckinney, A. L., Lawrence, A. V., Irgens, M. S., Hoeve, E. S., Etten, E. J., Doyle, C. Y., Chau, R. F., Chandler, A. B., Brener, S. A., Alkozei, A., & Acevedo-molina, M. C. (2020). Think Again: Adaptive Repetitive Thought as a Transdiagnostic Treatment for Individuals Predisposed to Repetitive Thinking Styles. Journal of Psychotherapy Integration, 31(2), 208-222. doi:10.1037/int0000209
• O'Connor, M. (2020). Lawrence, A. V., Alkozei, A., Irgens, M. S., Acevedo-Molina, M. C., Brener, S. A., Chandler, A. B., Chau, R. F., Doyle, C. Y., McKinney, A. L., Price, S. N., Shanholtz, C. E., Van Etten, E. J., Ver Hoeve, E. S., Sbarra, D. A., & O’Connor, M.-F. (2020). Think Again: Adaptive Repetitive Thought as a Transdiagnostic Treatment for Individuals Predisposed to Repetitive Thinking Styles. Journal of Psychotherapy Integration.
• Stelzer, E. M., Knowles, L. M., Wilson, D. T., & O'Connor, M. F. (2020). Recruitment and retention in clinical and experimental bereavement research: Lessons learned from creating a research registry. Death studies, 44(12), 771-777.
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  A small body of research investigates recruitment and retention of bereaved people in experimental and intervention research. The present study compares the effectiveness of different recruitment strategies implemented by a grief laboratory at a large state university in order to optimize recruitment efforts. The most effective method is letters sent to bereaved community members identified through online newspaper obituaries. Despite a small overall response rate, the large population from which to sample provides continuous accrual every month. Other methods include electronic/print media, community institution referrals, word of mouth and community outreach. Best practices for recruitment and retention are recommended.
• Stelzer, E., Stelzer, E., Ramirez, E. G., Palitsky, R., O'connor, M. F., & Hernandez, E. N. (2020). The role of personal and communal religiosity in the context of bereavement.. Journal of prevention & intervention in the community, 48(1), 64-80. doi:10.1080/10852352.2019.1617523
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  Religion and spirituality often become relevant after the death of a loved one. In light of the multidimensionality of religion and spirituality, we investigate the role of communal religiosity in predicting associations between personal religiosity and bereavement outcomes. A mixed-methods analysis of interviews and questionnaires from 33 bereaved adults was conducted. Interview mentions of personal and communal religiosity, and their associations with self-reported religious coping and grief symptoms, were assessed. Personal (β = 0.55, p < .01) and communal religiosity (β = 0.50, p < .01) predicted positive religious coping, as well as negative religious coping and grief severity (β = 0.53, p < .01). In addition, personal religiosity predicted more negative religious coping for participants who expressed low communal religiosity, β = 1.58, SE = .15, t(28) = 4.08, p < .001. After loss, personal religiosity by itself is not necessarily protective. The presence of personal and communal religiosity contributes to positive religious coping, and reduced negative religious coping. However, the absence of communal religiosity indicates vulnerability.
• Knowles, L. M., Ruiz, J. M., & OʼConnor, M. F. (2019). A Systematic Review of the Association Between Bereavement and Biomarkers of Immune Function. Psychosomatic medicine, 81(5), 415-433.
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  Bereavement is associated with increased risk for morbidity and all-cause mortality across epidemiological, meta-analytic, and case-control studies. The body of research examining the association between bereavement and immune function, beginning in 1977, has yet to be reviewed. The current systematic review clarifies these findings, identifies limitations of the diverse literature, and suggests a model and directions for future research.
• O'Connor, M. F. (2019). Grief: A Brief History of Research on How Body, Mind, and Brain Adapt. Psychosomatic medicine, 81(8), 731-738.
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  Using an integrative view of psychology, neuroscience, immunology, and psychophysiology, the present review of literature curates the findings that have had an impact on the field of bereavement research and shaped its development.
• Stelzer, E. M., Atkinson, C., O'Connor, M. F., & Croft, A. (2019). Gender differences in grief narrative construction: a myth or reality?. European journal of psychotraumatology, 10(1), 1688130.
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  : Narratives play a central role in the recovery process following death, and linguistic properties of grief narratives can serve as indicators of adjustment to loss. The present study examined whether bereaved men and women differ in how they discuss their loss, and how linguistic markers relate to psychological functioning. Positive associations were hypothesized between first-person singular pronoun use and psychological distress. Gender differences were expected for different emotion and social process words, and overall word use. Exploratory analyses were conducted to assess the relationship between linguistic markers and psychosocial outcomes for men and women separately. : 50 bereaved widow(er)s and parents (29 women, 21 men;  = 71.16 years,  = 9.95) completed psychosocial self-report questionnaires and individual in-depth interviews. Grief narratives were analysed using Linguistic Inquiry and Word Count (LIWC), a software program that quantifies words into linguistic and psychological categories. : Contrary to our hypothesis, first-person pronoun use was not related to psychological distress. Although gender differences emerged in self-reported psychosocial outcomes, we failed to find the predicted gender differences in linguistic markers (emotion and social process words, overall word count). Exploratory analyses revealed additional associations between linguistic markers and psychosocial outcomes, and gender differences in these relationships. Notably, first-person pronoun use was related to heightened grief avoidance. Furthermore, various linguistic markers were associated with increased depression levels in females, but not males. In contrast, nonfluencies were positively associated with indicators of psychological distress in men only. : In line with the gender similarities hypothesis, analyses suggest similarities between men and women's discussion of their grief experience. Associations between linguistic markers and psychological adjustment indicate that grief narratives contain meaningful indices of underlying health.
• Stelzer, E. M., Zhou, N., Maercker, A., O'Connor, M. F., & Killikelly, C. (2019). Prolonged Grief Disorder and the Cultural Crisis. Frontiers in psychology, 10, 2982.
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  Prolonged grief disorder (PGD) is included as a new mental health disorder in the 11th edition of the International Classification of Diseases (ICD-11). Understandably, this has boosted research efforts to investigate this newcomer to psychopathology. However, the use of different diagnostic algorithms has resulted in substantially different prevalence rates both within and across cultural groups. Furthermore, global applicability of the new criteria outside of the Global North has not been yet been established. This perspective presents key findings from Asian research groups and discusses the roadblocks to unified PGD research, including the heterogeneric use of diagnostic algorithms and the lack of cultural compatibility of ICD-11 items. The authors discuss the key issues and address implications for practice.
• van Zutphen, L., Maier, S., Siep, N., Jacob, G. A., Tüscher, O., van Elst, L. T., Zeeck, A., Arntz, A., O'Connor, M. F., Stamm, H., Hudek, M., & Joos, A. (2019). Intimate stimuli result in fronto-parietal activation changes in anorexia nervosa. Eating and weight disorders : EWD, 24(6), 1155-1164.
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  Intimacy is a key psychological problem in anorexia nervosa (AN). Empirical evidence, including neurobiological underpinnings, is however, scarce.
• Kaplan, D. M., Palitsky, R., Carey, A. L., Crane, T. E., Havens, C. M., Medrano, M. R., Reznik, S. J., Sbarra, D. A., & O'Connor, M. F. (2018). Maladaptive repetitive thought as a transdiagnostic phenomenon and treatment target: An integrative review. Journal of clinical psychology, 74(7), 1126-1136.
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  Maladaptive repetitive thought (RT), the frequent and repetitive revisiting of thoughts or internal experiences, is associated with a range of psychopathological processes and disorders. We present a synthesis of prior research on maladaptive RT and develop a framework for elucidating and distinguishing between five forms of maladaptive RT.
• Karl, S., Fallon, M., Palitsky, R., Martinez, J. A., Gündel, H., & O'Connor, M. F. (2018). Low-Dose Aspirin for Prevention of Cardiovascular Risk in Bereavement: Results from a Feasibility Study. Psychotherapy and psychosomatics, 87(2), 112-113.
• McConnell, M. H., Killgore, W. D., & O'Connor, M. F. (2018). Yearning predicts subgenual anterior cingulate activity in bereaved individuals. Heliyon, 4(10), e00852.
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  Complicated grief, or persistent complex bereavement disorder, is a condition that affects approximately 10% of bereaved individuals and is marked by intense longing and yearning for the deceased. Little is known about the neurocognitive mechanisms contributing to this syndrome, but previous research suggests that reward pathways in the brain may play a role. Twenty-five older adults were categorized based on grief severity into one of three groups: complicated grief (CG), non-complicated grief (NCG) and non-bereaved married controls (NB). Neural activation was examined using fMRI while participants viewed a countdown on the screen (anticipation) followed by a photo of their (living or deceased) spouse. There was no significantly differential activation between the three groups for the spouse v. stranger photo contrast, nor for anticipation period v. spouse photo. Post-hoc analyses were conducted using self-reported yearning scores as a regressor across all bereaved participants, which revealed that greater symptoms of yearning predicted greater activation in the subgenual anterior cingulate cortex (sgACC). Given the small sample size, the results should be considered preliminary and in need of replication, but may suggest a more nuanced, transdiagnostic role of the sgACC. This region of the brain has been previously linked to depression and suggests that symptoms of yearning may present an opportune place to intervene to improve outcomes in CG.
• Seeley, S. H., Chou, Y. H., & O'Connor, M. F. (2018). Intranasal oxytocin and OXTR genotype effects on resting state functional connectivity: A systematic review. Neuroscience and biobehavioral reviews, 95, 17-32.
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  Evaluate effects of intranasal oxytocin (IN-OT) and OXTR genotype on resting state functional connectivity in the human brain.
• Knowles, L. M., Stelzer, E., Jovel, K. S., & O'Connor, M. (2017). A pilot study of virtual support for grief: Feasibility, acceptability, and preliminary outcomes. COMPUTERS IN HUMAN BEHAVIOR, 73, 650-658.
• Reed, R. G., O'Connor, M. F., Pace, T. W., Raison, C. L., & Butler, E. A. (2017). Dyadic coping and salivary interleukin-6 responses to interpersonal stress. Journal of family psychology : JFP : journal of the Division of Family Psychology of the American Psychological Association (Division 43), 31(3), 367-373.
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  Dysregulated immune responses to stress are a potential pathway linking close relationship processes to health, and couples' abilities to cope with stress together (dyadic coping) likely impact such immune responses. Most stress research has focused on immune reactivity, whereas knowledge of immune recovery remains limited. The present study examined how acute interpersonal stress affects immune reactivity and recovery, as well as whether dyadic coping moderates these effects. Healthy couples (N = 24) completed the Dyadic Coping Inventory and provided saliva samples 4 times each day for 5 days, including 2 days before a laboratory dyadic stressor (discussing an area of disagreement), the day of, and 2 days after. Four additional saliva samples were taken throughout the laboratory stressor. Saliva samples were assayed for interleukin (IL)-6. Multilevel models that adjusted for demographic and health variables indicated that partners low in dyadic coping showed immune reactivity to the stressor whereas partners high in dyadic coping did not. Dyadic coping did not moderate immune recovery, which had occurred by 5 hr poststressor across all participants. Results suggest that partners low in dyadic coping show increased reactivity of immune responses to interpersonal stress. Enhancing dyadic coping in couples may impact not only their mental health and relationship quality, but also their risk of stress-related immune disorders. (PsycINFO Database Record
• Arizmendi, B., Kaszniak, A. W., & O'Connor, M. F. (2016). Disrupted prefrontal activity during emotion processing in complicated grief: An fMRI investigation. NeuroImage, 124(Pt A), 968-76.
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  Complicated Grief, marked by a persistent and intrusive grief lasting beyond the expected period of adaptation, is associated with a relative inability to disengage from idiographic loss-relevant stimuli (O'Connor and Arizmendi, 2014). In other populations, functional magnetic resonance imaging (fMRI) studies investigating the neural networks associated with this bias consistently implicate the anterior cingulate cortex (ACC) during emotion regulation. In the present study, twenty-eight older adults were categorized into three groups based on grief severity: Complicated Grief (n=8), Non-Complicated Grief (n=9), and Nonbereaved, married controls (n=11). Using a block design, all participants completed 8 blocks (20 stimuli per block) of the ecStroop task during fMRI data acquisition. Differences in neural activity during grief-related (as opposed to neutral) stimuli across groups were examined. Those with Complicated Grief showed an absence of increased rostral ACC (rACC) and fronto-cortical recruitment relative to Nonbereaved controls. Activity in the orbitofrontal cortex (x=6, y=54, z=-10) was significantly elevated in the Non-Complicated Grief group when compared to Nonbereaved controls. Post hoc analysis evidenced activity in the dorsal ACC in the Complicated Grief and Nonbereaved groups late in the task. These findings, supported by behavioral data, suggest a relative inability to recruit the regions necessary for successful completion of this emotional task in those with Complicated Grief. This deficit was not observed in recruitment of the orbitofrontal cortex and the rACC during processing of idiographic semantic stimuli in Non-Complicated Grief.
• Bourassa, K. J., Knowles, L. M., Sbarra, D. A., & O'Connor, M. F. (2016). Absent but Not Gone: Interdependence in Couples' Quality of Life Persists After a Partner's Death. Psychological science, 27(2), 270-81.
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  Spouses influence each other's psychological functioning and quality of life. To explore whether this interdependence continues after a person becomes widowed, we tested whether deceased spouses' characteristics were associated with their widowed partners' later quality of life using couples drawn from a multinational sample of aging adults. Independent subsamples (ns = 221 and 325) were assessed before and after a spouse's death. Regressions revealed that deceased partners' quality of life prior to their death positively predicted their spouses' quality of life after the partners' death, even when we controlled for spouses' prior quality of life to account for environmental factors shared within couples. Further, widowed participants' quality of life was lower than nonwidowed couples' 2 years before and after their partners' death, but was equivalent 4 years prior. Finally, the strength of the association between partners' earlier quality of life and participants' later quality of life did not differ between widowed and nonwidowed participants. These findings suggest that interdependence in quality of life continues after one's partner has passed away.
• Fallon, M. A., Careaga, J. S., Sbarra, D. A., & OʼConnor, M. F. (2016). Utility of a Virtual Trier Social Stress Test: Initial Findings and Benchmarking Comparisons. Psychosomatic medicine, 78(7), 835-40.
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  The Trier Social Stress Test (TSST) is one of the most widely used laboratory-based acute psychosocial stressors. However, there may be advantages to conducting the TSST through the virtual world, including reducing the cost and burden (i.e., no need for colocation between the evaluators and participants). The virtual TSST might also increase the standardization between studies and provide the capacity to bring psychology experiments to more settings (e.g., the home, the magnetic resonance imaging scanner).
• O'connor, M., & Sussman, T. J. (2016). Yearning in Situations of Loss Scale. Death Studies. doi:10.1037/T48606-000
• Robinaugh, D. J., Mauro, C., Bui, E., Stone, L., Shah, R., Wang, Y., Skritskaya, N. A., Reynolds, C. F., Zisook, S., O'Connor, M., Shear, M., & Simon, N. M. (2016). Yearning and its measurement in complicated grief.. Journal of Loss and Trauma, 21(5), 410-420. doi:10.1080/15325024.2015.1110447
• Ruiz, J. M., Hamann, H. A., Mehl, M. R., & O'Connor, M. (2016). The Hispanic health paradox: From epidemiological phenomenon to contribution opportunities for psychological science. GROUP PROCESSES & INTERGROUP RELATIONS, 19(4), 462-476.
• Ruiz, J., Hamann, H., O'Connor, M., & Mehl, M. R. (2016). The Hispanic Health Paradox: From Epidemiological Phenomenon to Contribution Opportunities for Psychological Science.. Group Processes & Intergroup Relations, 19, 462-476.
• Sicotte, N. L., O'connor, M. F., Yamakawa, C., Smith, K., Sicotte, N. L., Shi, Y., Renner, B., O'connor, M. F., Lopez, E., Gold, S. M., & Gahm, J. K. (2016). Hippocampal and Cognitive Impacts of Depression in Multiple Sclerosis (P4.178). Neurology, 86.
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  OBJECTIVE: To determine the imaging and cognitive consequences of comorbid depression in multiple sclerosis BACKGROUND: Depression is a common comorbidity in multiple sclerosis (MS) impacting quality of life, employment status and cognitive performance. Selective subregional hippocampal atrophy, alterations in diurnal cortisol secretion patterns and cognitive impairment have been reported in MS patients with depressive symptoms, similar to idiopathic major depressive disorder (MDD). However, the relationship of comorbid major depressive disorder in MS (MSD) to MDD has not been established. We performed structured interviews, detailed cognitive testing and high resolution structural MR imaging in 4 subject cohorts (MSD, MS without depression (MSN), MDD and healthy controls (HCC)) to contrast comorbid MDD in MS with idiopathic MDD. METHODS: A total of 105 subjects were enrolled at a single center. They underwent a full neuropsychological assessment including a structured interview for psychiatric disorders and detailed cognitive testing. High-resolution structural brain MR imaging was collected on a 3T scanner. Corrected brain volumes were obtained using an automated algorithm (FIRST). Analysis of cognitive testing results were performed with adjustment for age and sex (ANCOVA) using percentile test scores. Subregional hippocampal differences will be explored using surface based mapping validated with manually segmented subregional volumes. RESULTS: All patient groups (MSD, MSN, MDD) demonstrated impaired verbal learning as compared to the healthy controls (ANCOVA p=0.014) with idiopathic MDD the most impaired. Delayed verbal recall (p=0.05) and processing speed (p=0.005) were impaired in MSD versus HCC. Total hippocampal volumes were significantly reduced in the MS patient groups (p < 0.01) compared to healthy controls. CONCLUSIONS: MS related MDD is associated with significant cognitive impairment and hippocampal volume loss. These effects share features with, but are distinct from, idiopathic MDD suggesting that different pathophysiological underpinnings may exist between these forms of major depressive disorder. Study Supported by: NMSS Disclosure: Dr. Sicotte has nothing to disclose. Dr. Gold has received personal compensation for activities with Novartis for consulting. Dr. O9Connor has nothing to disclose. Dr. Lopez has nothing to disclose. Dr. Smith has nothing to disclose. Dr. Yamakawa has nothing to disclose. Dr. Renner has nothing to disclose. Dr. Gahm has nothing to disclose. Dr. Shi has nothing to disclose.
• Arizmendi, B. J., & O’Connor, M. (2015). What is “normal” in grief?. Australian Critical Care, 28, 58--62.
• Hasselmo, K., Sbarra, D. A., O'Connor, M., & Moreno, F. A. (2015). Psychological distress following marital separation interacts with a polymorphism in the serotonin transporter gene to predict cardiac vagal control in the laboratory. Psychophysiology, 52, 736--744.
• Kern, K. C., Gold, S. M., Lee, B., Montag, M., Horsfall, J., O'Connor, M., & Sicotte, N. L. (2015). Thalamic--hippocampal--prefrontal disruption in relapsing--remitting multiple sclerosis. NeuroImage: Clinical, 8, 440--447.
• Knowles, L. M., & O'Connor, M. (2015). Coping flexibility, forward focus and trauma focus in older widows and widowers. Bereavement Care, 34, 17--23.
• O'connor, M. F., & Arizmendi, B. J. (2015). Approach and avoidance in complicated grief: Neuroscience results and clinical implications. Journal of Psychosomatic Research, 78(6), 616-617. doi:10.1016/j.jpsychores.2015.03.100
• Serrano-careaga, J. A., Sbarra, D. A., O'connor, M. F., & Fallon, M. (2015). The Trier Social Stress Test 2.0: Using a virtual world to elicit an acute cortisol response. Journal of Psychosomatic Research, 78(6), 600. doi:10.1016/j.jpsychores.2015.03.049
• Soenke, M., O'Connor, M., & Greenberg, J. (2015). Broadening the definition of resilience and" reappraising" the use of appetitive motivation. Behavioral and Brain Sciences, 38.
• Gold, S. M., O'Connor, M., & Sicotte, N. L. (2014). Detection of altered hippocampal morphology in multiple sclerosis-associated depression using automated surface mesh modeling. Human Brain Mapping, 35, 30–37.
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  PMC3748203
• Grinberg, A. M., Serrano Careaga, J., Mehl, M. R., & O'Connor, M. (2014). Social engagement and user immersion in exploring a virtual world. Computers in Human Behavior, 36, 479–486.
• O'Connor, M., & Arizmendi, B. (2014). Neuropsychological correlates of complicated grief in older spousally bereaved adults. Journals of Gerontology: Psychological Sciences, 69B, 12-18.
• O'Connor, M., & Sussman, T. (2014). Developing the Yearning in Situations of Loss scale: Convergent and discriminant validity for bereavement, romantic breakup and homesickness. Death Studies, 38, 450-458.
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  DOI: 10.1080/07481187.2013.782928
• O'Connor, M., Arizmendi, B., & Kaszniak, A. W. (2014). Virtually supportive: a feasibility pilot study of an online support group for dementia caregivers in a 3D virtual environment. Journal of Aging Studies, 30, 87-93.
• O'Connor, M., Schultze-Florey, C. R., Irwin, M. R., & Cole, S. W. (2014). Divergent Gene Expression Responses to Complicated Grief and Non-complicated Grief. Brain, Behavior and Immunity, 37, 78–83.
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  NIHMSID 553078
• O'Connor, M., Shear, M. K., Fox, R., Skritskaya, N., Campbell, B., Ghesquiere, A., & Glickman, K. (2013). Catecholamine predictors of complicated grief treatment outcomes. International Journal of Psychophysiology, 88, 349-352.
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  NIHMS413016
• O'Connor, M., Gold, S. M., Gill, R., Kern, K. C., Shi, Y., Henry, R. G., Pelletier, D., Mohr, D. C., & Sicotte, N. L. (2012). Detection of altered hippocampal morphology in multiple sclerosis-associated depression using automated surface mesh modeling: Hippocampal Morphology and Depression in MS. Human Brain Mapping, 35(1), 30-37. doi:10.1002/hbm.22154
• O'connor, M. F., Sicotte, N. L., Sicotte, N. L., O'connor, M. F., Montag, M., Lee, B., Kern, K. C., Horsfall, J., & Gold, S. M. (2012). Hippocampal-Thalamic Disruption Predicts Cognitive Function in Relapsing-Remitting Multiple Sclerosis (S51.006). Neurology, 78(Meeting Abstracts 1), S51.006-S51.006. doi:10.1212/wnl.78.1_meetingabstracts.s51.006
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  Objective: To investigate hippocampal-thalamic disruption in relapsing-remitting multiple sclerosis (RRMS) and its contribution to cognition. Background Thalamic and hippocampal atrophy have been demonstrated in RRMS patients and are associated with cognitive dysfunction and episodic memory impairment. We hypothesized that hippocampal-thalamic pathways, primarily the fornix and the cingulum bundles, play a role in the cognitive decline. Damage to the uncinate fasciculus, a temporal-frontal pathway, has also been linked to memory function in MS. We used Diffusion Tensor Imaging (DTI) to identify and evaluate the integrity of these pathways in RRMS patients and controls and assessed their contributions to cognition. Design/Methods: A neuropsychological battery was administered to 27 RRMS patients and 20 age and gender matched healthy controls. Results, to Z-scores, were averaged across three cognitive domains: attention/executive function, verbal memory, and spatial memory. Two DTI averages were acquired at 3T with 30 non-collinear diffusion directions using a B-value of 1000 s/mm2. Tractography and white matter skeletonization were used to identify the centermost voxels of 3 bilateral white matter pathways: the fornix, the cingulum and the uncinate fasciculus. Mean FA for each pathway was contrasted across groups using mixed ANOVA. For each cognitive domain, step-wise linear regression considered mean FA of each pathway, age and Beck Depression Inventory (BDI) as predictors of cognitive function. Results: Mean FA was significantly reduced in RRMS patients in each of the 3 pathways (p=.003). In the RRMS group, cingulum FA was the only independent predictor of attention/executive function (beta=3.74, adjusted R-squared=0.16, p=0.021); fornix FA was the only independent predictor of verbal memory (beta=2.74, adjR-squared=0.114, p=0.048); and both uncinate FA and BDI were independent predictors of spatial memory (beta1=17.65, beta2=-0.048, adjR-square=0.382, p=0.001). Controls showed no significant associations. Conclusions: Hippocampal-thalamic-frontal lobe disruption may underlie cognitive dysfunction in RRMS. DTI biomarkers may identify RRMS patients that would benefit from cognitive therapies. Supported by: The Consortium of Multiple Sclerosis Centers Foundation medical student scholarship (KCK) and the National Multiple Sclerosis Society RG 3914 (NLS). Disclosure: Dr. Kern has nothing to disclose. Dr. Lee has nothing to disclose. Dr. Montag has nothing to disclose. Dr. Horsfall has nothing to disclose. Dr. Gold has received personal compensation for activities with Novartis as a consultant. Dr. O9Connor has nothing to disclose. Dr. Sicotte has nothing to disclose.
• O'Connor, M. (2012). Immunological and neuroimaging biomarkers of Complicated Grief. Dialogues in Clinical Neuroscience, 14, 141-148.
• Schultze-Florey, C. R., Martínez-Maza, O., Magpantay, L., Breen, E. C., Irwin, M. R., Gündel, H., & O'Connor, M. (2012). When grief makes you sick: Bereavement induced systemic inflammation is a question of genotype. Brain, Behavior, and Immunity, 26, 1066-71.
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  PMC3601554
• Stanton, A. L., Stanton, A. L., Irwin, M. R., Irwin, M. R., O'connor, M. F., Wellisch, D. K., Stanton, A. L., Olmstead, R. G., O'connor, M. F., & Irwin, M. R. (2012). Diurnal cortisol in Complicated and Non-Complicated Grief: slope differences across the day.. Psychoneuroendocrinology, 37(5), 725-8. doi:10.1016/j.psyneuen.2011.08.009
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  Although grief has been described primarily as a psychological phenomenon, empirical evidence reveals that grief also has physiological correlates that have consequences for health. The present study investigates the diurnal cortisol production patterns in women who have been bereaved in the past 18 months. Specifically, the study compares women with Complicated Grief (n=12) from those with Non-Complicated Grief (n=12), testing whether cortisol slope distinguishes the two groups. Results demonstrate that the two groups do not differ on demographic variables (except education), but as hypothesized, those with Complicated Grief have a flatter slope across the day, controlling for education and body mass index.
• Zisook, S., Meert, K. L., Zisook, S., Wall, M. M., Sung, S. C., Skritskaya, N., Simon, N. M., Shear, M. K., Schiff, M., Sareen, J., Reynolds, C. F., O'connor, M. F., Neimeyer, R. A., Nakajima, S., Melhem, N. M., Meert, K. L., Mancini, A. D., Lebowitz, B. D., Konishi, T., , Keshaviah, A., et al. (2011). Complicated grief and related bereavement issues for DSM-5.. Depression and anxiety, 28(2), 103-17. doi:10.1002/da.20780
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  Bereavement is a severe stressor that typically incites painful and debilitating symptoms of acute grief that commonly progresses to restoration of a satisfactory, if changed, life. Normally, grief does not need clinical intervention. However, sometimes acute grief can gain a foothold and become a chronic debilitating condition called complicated grief. Moreover, the stress caused by bereavement, like other stressors, can increase the likelihood of onset or worsening of other physical or mental disorders. Hence, some bereaved people need to be diagnosed and treated. A clinician evaluating a bereaved person is at risk for both over-and under-diagnosis, either pathologizing a normal condition or neglecting to treat an impairing disorder. The authors of DSM IV focused primarily on the problem of over-diagnosis, and omitted complicated grief because of insufficient evidence. We revisit bereavement considerations in light of new research findings. This article focuses primarily on a discussion of possible inclusion of a new diagnosis and dimensional assessment of complicated grief. We also discuss modifications in the bereavement V code and refinement of bereavement exclusions in major depression and other disorders.
• Sicotte, N. L., O'connor, M. F., Yoo, Y. S., Sicotte, N. L., O'connor, M. F., Montag, M. J., Kim, A., Kern, K. C., Gold, S. M., & Giesser, B. S. (2010). Smaller cornu ammonis 2-3/dentate gyrus volumes and elevated cortisol in multiple sclerosis patients with depressive symptoms.. Biological psychiatry, 68(6), 553-9. doi:10.1016/j.biopsych.2010.04.025
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  The hippocampus is likely involved in mood disorders, but in vivo evidence for the role of anatomically distinct hippocampal subregions is lacking. Multiple sclerosis, an inflammatory disease of the central nervous system, is linked to a high prevalence of depression as well as hippocampal damage and may thus provide important insight into the pathologic correlates of medical depression. We examined the role of subregional hippocampal volume for depression in relapsing-remitting multiple sclerosis..Anatomically defined hippocampal subregional volumes (cornu ammonis 1-3 [CA1-CA3] and the dentate gyrus [CA23DG], subiculum, entorhinal cortex) were measured using a high-resolution T2-weighted magnetic resonance imaging sequence in 29 relapsing-remitting multiple sclerosis patients and 20 matched healthy control subjects. Diurnal salivary cortisol was assessed at awakening, 4 pm, and 9 pm on 2 consecutive days. Subjects also completed the Beck Depression Inventory..Multiple sclerosis patients showed smaller hippocampal volumes compared with control subjects, particularly in the CA1 and subiculum subregions. In addition, multiple sclerosis patients with depressive symptoms (Beck Depression Inventory score >13) also showed smaller CA23DG volumes and higher cortisol levels. Within the multiple sclerosis group, CA23DG volume was correlated with depressive symptoms and cortisol levels. There were no associations with number of previous steroid treatments, global atrophy, or disease duration..This report provides in vivo evidence for selective association of smaller CA23DG subregional volumes in the hippocampus with cortisol hypersecretion and depressive symptoms in multiple sclerosis.
• Cho, H. J., Cho, H. J., Robles, T. F., Robles, T. F., Irwin, M. R., Irwin, M. R., O'connor, M. F., Thomas, K. S., Sloan, E. K., Robles, T. F., O'connor, M. F., Martin, J. L., Irwin, M. R., Hoyt, M. A., Hamby, M. E., Dimitrov, S., Creswell, J. D., Cho, H. J., & Bower, J. E. (2009). To assess, to control, to exclude: effects of biobehavioral factors on circulating inflammatory markers.. Brain, behavior, and immunity, 23(7), 887-97. doi:10.1016/j.bbi.2009.04.005
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  Behavioral scientists have increasingly included inflammatory biology as mechanisms in their investigation of psychosocial dynamics on the pathobiology of disease. However, a lack of standardization of inclusion and exclusion criteria and assessment of relevant control variables impacts the interpretation of these studies. The present paper reviews and discusses human biobehavioral factors that can affect the measurement of circulating markers of inflammation. Keywords relevant to inflammatory biology and biobehavioral factors were searched through PubMed. Age, sex, and hormonal status, socioeconomic status, ethnicity and race, body mass index, exercise, diet, caffeine, smoking, alcohol, sleep disruption, antidepressants, aspirin, and medications for cardiovascular disease are all reviewed. A tiered set of recommendations as to whether each variable should be assessed, controlled for, or used as an exclusion criteria is provided. These recommendations provide a framework for observational and intervention studies investigating linkages between psychosocial and behavioral factors and inflammation.
• Irwin, M. R., O'connor, M. F., Wellisch, D. K., O'connor, M. F., & Irwin, M. R. (2009). When grief heats up: pro-inflammatory cytokines predict regional brain activation.. NeuroImage, 47(3), 891-6. doi:10.1016/j.neuroimage.2009.05.049
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  Pro-inflammatory cytokines are associated with sickness behaviors, a set of behaviors including low mood, which are orchestrated by the brain and described as shift in motivational state. The present study investigated the hypothesis that local inflammation is associated with greater subgenual anterior cingulate cortex (sACC) activation in persons undergoing chronic stress..Women undergoing the emotional stress of bereavement had fMRI scans during a grief elicitation task. Local inflammation was measured by salivary concentrations of two markers of pro-inflammatory cytokine activity (e.g., interleukin-1beta and soluble tumor necrosis factor receptor II)..Analyses revealed that both inflammatory markers were positively associated with ventral prefrontal activation (e.g., sACC and orbitofrontal cortex) as well as other regions important in the emotional task such as noun retrieval (e.g., temporal cortex), and visual processing (e.g., cuneus and fusiform gyrus). In separate analyses, the ventral prefrontal activations correlated with free recall of grief-related word stimuli, but not neutral word stimuli..This is the first study to demonstrate the relationship between emotional processing, regional brain activation and localized inflammation in a chronically stressed population of adults.
• Pokorny, D., O'connor, M. F., Koops, E., Henningsen, P., Heinrichs, M., Gundel, H., George, C., & Buchheim, A. (2009). Oxytocin enhances the experience of attachment security.. Psychoneuroendocrinology, 34(9), 1417-22. doi:10.1016/j.psyneuen.2009.04.002
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  Repeated interactions between infant and caregiver result in either secure or insecure relationship attachment patterns, and insecure attachment may affect individual emotion-regulation and health. Given that oxytocin enhances social approach behavior in animals and humans, we hypothesized that oxytocin might also promote the subjective experience of attachment security in humans. Within a 3-week interval, 26 healthy male students classified with an insecure attachment pattern were invited twice to an experimental session. At the beginning of each experiment, a single dose of oxytocin or placebo was administered intranasally, using a double-blind, placebo-controlled within-subject design. In both conditions, subjects completed an attachment task based on the Adult Attachment Projective Picture System (AAP). Thirty-two AAP picture system presentations depicted attachment-related events (e.g. illness, solitude, separation, and loss), and were each accompanied by four prototypical phrases representing one secure and three insecure attachment categories. In the oxytocin condition, a significant proportion of these insecure subjects (N=18; 69%) increased in their rankings of the AAP prototypical "secure attachment" phrases and decreased in overall ranking of the "insecure attachment" phrases. In particular, there was a significant decrease in the number of subjects ranking the pictures with "insecure-preoccupied" phrases from the placebo to the oxytocin condition. We find that a single dose of intranasally administered oxytocin is sufficient to induce a significant increase in the experience of attachment security in insecurely attached adults.
• Stanton, A. L., Stanton, A. L., Eisenberger, N. I., Eisenberger, N. I., Irwin, M. R., Irwin, M. R., Lieberman, M. D., Lieberman, M. D., O'connor, M. F., Wellisch, D. K., Stanton, A. L., O'connor, M. F., Lieberman, M. D., Irwin, M. R., & Eisenberger, N. I. (2008). Craving love? Enduring grief activates brain's reward center.. NeuroImage, 42(2), 969-72. doi:10.1016/j.neuroimage.2008.04.256
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  Complicated Grief (CG) occurs when an individual experiences prolonged, unabated grief. The neural mechanisms distinguishing CG from Noncomplicated Grief (NCG) are unclear, but hypothesized mechanisms include both pain-related activity (related to the social pain of loss) and reward-related activity (related to attachment behavior). Bereaved women (11 CG, 12 NCG) participated in an event-related functional magnetic resonance imaging scan, during grief elicitation with idiographic stimuli. Analyses revealed that whereas both CG and NCG participants showed pain-related neural activity in response to reminders of the deceased, only those with CG showed reward-related activity in the nucleus accumbens (NA). This NA cluster was positively correlated with self-reported yearning, but not with time since death, participant age, or positive/negative affect. This study supports the hypothesis that attachment activates reward pathways. For those with CG, reminders of the deceased still activate neural reward activity, which may interfere with adapting to the loss in the present.
• Irwin, M. R., Irwin, M. R., Ganz, P. A., Ganz, P. A., O'connor, M. F., Seldon, J., O'connor, M. F., Kwan, L., Irwin, M. R., & Ganz, P. A. (2007). Pro-inflammatory cytokines and depression in a familial cancer registry.. Psycho-oncology, 16(5), 499-501. doi:10.1002/pon.1108
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  Patients undergoing cancer treatment (e.g., interferon or IL-2 treatment) develop depression, and there is a positive relationship between their depression and circulating levels of proinflammatory cytokines. Depressed patients who are medically healthy also show increases in circulating markers of inflammation. The present study characterized baseline levels of inflammatory cytokine activity in 18 pairs of depressed and non-depressed persons at high risk for cancer and matched for age, ethnicity and all unaffected by a personal history of cancer. Circulating levels of interleukin-6 (IL-6), soluble IL-6 receptor (sIL-6R), tumor necrosis factor-alpha-receptor (TNF-RII), and soluble intercellular adhesion molecule (sICAM) did not differ between those with and without depression. The present data are important for characterizing persons at high risk for cancer who may later acquire knowledge of further increased risk through genetic testing.
• Irwin, M. R., O'connor, M. F., Valladares, E. M., Olmstead, R. G., O'connor, M. F., Motivala, S. J., & Irwin, M. R. (2007). Sex differences in monocyte expression of IL-6: role of autonomic mechanisms.. American journal of physiology. Regulatory, integrative and comparative physiology, 293(1), R145-51. doi:10.1152/ajpregu.00752.2006
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  Sex differences in the prevalence of inflammatory disorders exist, perhaps due to sex differences in cellular mechanisms that contribute to proinflammatory cytokine activity. This study analyzed sex differences of monocyte intracellular expression of IL-6 and its associations with reproductive hormones and autonomic mechanisms in 14 matched pairs of men and women (n = 28). Monocyte intracellular IL-6 production was repeatedly assessed over two circadian periods. Sympathetic balance was estimated by heart rate variability and the ratio of power in the low-frequency (LF) to high-frequency (HF); vagal tone was indexed by the power of HF component. As compared to men, women showed greater monocyte expression of IL-6 across the circadian period. In addition, women showed lower sympathetic balance (LF/HF ratio), and greater levels of vagal tone (HF power). In women, but not men, sympathovagal balance was negatively associated with monocyte IL-6 expression, whereas vagal tone was positively associated with production of this cytokine. Levels of reproductive hormones were not related to monocyte IL-6 expression. The marked increase in monocyte expression of interleukin-6 in women has implications for understanding sex differences in risk of inflammatory disorders. Additionally, these data suggest that sex differences in sympathovagal balance or vagal tone may be a pathway to explain sex differences in IL-6 expression. Interventions that target autonomic mechanisms might constitute new strategies to constrain IL-6 production with impacts on inflammatory disease risk in women.
• Lane, R. D., O'connor, M. F., Mcrae, K., Lane, R. D., & Gundel, H. (2007). Baseline vagal tone predicts BOLD response during elicitation of grief.. Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology, 32(10), 2184-9. doi:10.1038/sj.npp.1301342
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  Previous studies of the relationship between autonomic and central nervous system activity using fMRI have primarily utilized cognitive, motor or conditioning tasks. The present study investigated the association between the regional brain activity during the evocation of grief and baseline parasympathetic activity. Eight right-handed women who had experienced the death of a loved one in the past 18 months were scanned during the presentation of personalized pictures and words that evoked grief and had a measure of baseline parasympathetic activity taken. Greater posterior cingulate cortex (PCC) activity was associated with lower parasympathetic activity (eg more arousal). Connectivity has been demonstrated between the ventral PCC (vPCC) and the subgenual ACC (sACC), which then projects to the autonomic nuclei. In the present study, functional connectivity analysis revealed a positive correlation between vPCC and sACC/orbitofrontal cortical activity. Additionally, bilateral cuneus and parahippocampus were associated with higher baseline parasympathetic tone, important to visual perception in emotional processing and episodic memory respectively. Future studies should compare differences between central and peripheral arousal in complicated and non-complicated grief.
• Kaszniak, A. W., O'connor, M. F., Kaszniak, A. W., & Allen, J. J. (2005). Emotional disclosure for whom? A study of vagal tone in bereavement.. Biological psychology, 68(2), 135-46. doi:10.1016/j.biopsycho.2004.04.003
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  Recent investigations have shown little evidence that written disclosure benefits bereaved individuals over a control condition. The present study hypothesized that the effectiveness of written disclosure for bereavement may be moderated by vagal tone, as indexed by respiratory sinus arrhythmia (RSA). Vagal tone has been identified as an important individual difference in depression. The present study investigated 35 bereaved participants in a longitudinal design, with participants writing each week for 3 weeks, and then participating in follow-up sessions 1 week and 1 month later. As with previous studies, bereaved participants showed improvement, although no differential improvement was seen in the emotional Disclosure group compared to a Control writing group. As hypothesized, however, those participants with the highest RSA benefited most from the written disclosure, while RSA level did not predict outcome in the control condition. Future research should investigate whether vagal tone moderates the impact of written disclosure for non-bereaved individuals.
• O'connor, M. F. (2005). Bereavement and the brain: invitation to a conversation between bereavement researchers and neuroscientists.. Death studies, 29(10), 905-22. doi:10.1080/07481180500299063
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  A recent development by neuroscience is neuroimaging, a method of looking into the "black box" of the brain while people are feeling, doing, and thinking in real time. The first fMRI study of bereavement has recently been published, and the present article summarizes it in non-specialist language, focusing on its theoretical and clinical applications. In an attempt to bridge the gap between bereavement researchers and neuroscientists, the author discusses how these two fields could assist each other in forwarding both fields. Three current debates in the field of bereavement research are outlined, including (a) adaptation in the normal grief process, (b) complicated grief vs. resilience, and (c) meaning-making vs. return-to-baseline models of bereavement. The potential contribution of neuroscientific data to these debates is discussed in several hypothetical examples. These examples stimulate thinking about the reciprocity between 2 questions: What can bereavement teach us about the brain? and What can the brain tell us about bereavement? This article is designed to provide enough background for investigators who are primarily concerned with the brain and those primarily concerned with bereavement to open a dialogue between both of these fields.
• O'connor, M. F. (2004). Finding boundaries inside prison walls: case study of a terminally ill inmate.. Death studies, 28(1), 63-76. doi:10.1080/07481180490249274
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  The number of terminally ill prison inmates rises each year. Mental health professionals are uniquely prepared to provide therapy during the end-of-life process with their assessment, training, empathy, and communication skills. This case study examines the six-month therapy of one terminally ill inmate, using a client-centered approach. Drawing from existential therapy, the review of meaningful life events in the client's life clarifies current goals and the value of the current final stage of life. Ethical issues that arose are discussed, including pain management and compassionate release. Creative solutions to these ethical dilemmas were implemented through consideration of the overt and underlying goals of the inmate, the necessary rules and protocols of the prison, and in conjunction with professional codes of ethics.
• Lane, R. D., O'connor, M. F., Littrell, L., Lane, R. D., Gundel, H., & Fort, C. (2003). Functional neuroanatomy of grief: an FMRI study.. The American journal of psychiatry, 160(11), 1946-53. doi:10.1176/appi.ajp.160.11.1946
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  In this study the authors examined the functional neuroanatomy of grief, which to their knowledge has not been studied previously in functional neuroimaging research..Grief was elicited in eight bereaved women through photographs of the deceased versus a stranger, combined with words specific to the death event versus neutral words. Use of both pictures and words resulted in a 2x2 factorial design..Three brain regions were independently activated by the picture and word factors: posterior cingulate cortex, medial/superior frontal gyrus, and cerebellum. The two factors also activated distinct regions: for the picture factor, they were the cuneus, superior lingual gyrus, insula, dorsal anterior cingulate cortex, inferior temporal gyrus, and fusiform gyrus; and for the word factor, they were the precuneus, precentral gyrus, midbrain, and vermis. The interaction of the two factors showed significant activation in the cerebellar vermis..Grief is mediated by a distributed neural network that subserves affect processing, mentalizing, episodic memory retrieval, processing of familiar faces, visual imagery, autonomic regulation, and modulation/coordination of these functions. This neural network may account for the unique, subjective quality of grief and provide new leads in understanding the health consequences of grief and the neurobiology of attachment.
• O'connor, M. F. (2003). Making Meaning of Life Events: Theory, Evidence, and Research Directions for an Alternative Model:. Omega-journal of Death and Dying, 46(1), 51-75. doi:10.2190/0ckd-pvq0-t260-ntxu
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  Utilizing cognition, emotion, and psychotherapy research, theoretical and empirical evidence on adjustment to negative life events is reviewed. Two models of adjustment to negative life events are ...
• Kaszniak, A. W., O'connor, M. F., Kaszniak, A. W., & Allen, J. J. (2002). Autonomic and emotion regulation in bereavement and depression.. Journal of psychosomatic research, 52(4), 183-5. doi:10.1016/s0022-3999(02)00292-1
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  Prior research suggests important differences between depression and the depressed feelings experienced in the context of bereavement, despite some overlap. Differences include an increase in restlessness, suggesting underlying physiological differences between the groups..This study examined the level of depressive symptoms, heart rate (HR), and heart rate variability (HRV), and coping style of 10 bereaved, 10 depressed, and 10 control participants..Bereaved participants showed significantly higher HR than either depressed or control participants, while there were no such differences in HRV. Level of depression in the bereaved group correlated negatively with HRV. Additional analyses showed that the use of passive coping had a marginally significant negative correlation with HRV in bereaved subjects..The present data suggest that differences in HR and HRV could be associated with increased cardiovascular fatalities in bereaved individuals, known as the "broken heart phenomenon." These physiological differences have potential implications for both the mental and physical health of the bereaved.
• Weber, J. T., Parker, K. K., O'connor, M. F., Kinzler, N., & Hayataka, K. (1998). A bioactive peptide from the transmembrane 5-intracellular loop 3 region of the human 5HT1a receptor.. Biochemistry and cell biology = Biochimie et biologie cellulaire, 76(4), 657-60. doi:10.1139/bcb-76-4-657
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  15 amino acid peptide from the transmembrane 5-intracellular loop 3 region of the human 5HT1a receptor produced concentration-dependent decreases in agonist binding. This result is consistent with a competitive interaction between peptide, receptor, and G protein at the receptor-G protein interface. Bombesin and a 13 amino acid peptide from the carboxyl terminus region of the receptor were inactive. Additionally, the peptide decreased forskolin-mediated cAMP elevation. Overall, these results suggest that amino acid residues from this region of the receptor are involved in receptor-G protein coupling and that G protein is activated by the receptor.
• Weber, J. T., Parker, K. K., O'connor, M. F., & Hayataka, K. (1997). Rabbit cerebral cortex 5HT1a receptors.. Comparative biochemistry and physiology. Part C, Pharmacology, toxicology & endocrinology, 117(1), 19-24. doi:10.1016/s0742-8413(97)00614-2
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  Selective 5HT1a agonist binding to membranes from rabbit cerebral cortex was concentration-dependent and saturable; the Kd was 1.1 nM and Bmax of 480 fmols/mg protein. Scatchard as well as Hill plots were linear; the Hill coefficient was 0.96, suggesting a single, non-interacting binding site. Agonist binding was inhibited in a concentration-dependent fashion by gamma S GTP, a result consistent with the coupling of this binding site to the G protein signal transduction system. In competition experiments involving agonist and a series of agents with known affinities and specificities at 5HT1a receptors, a rank order relationship was found consistent with this binding site being a 5HT1a binding site. Direct comparisons of agonist and antagonist binding at rat cerebral cortex 5HT1a receptors and cloned human 5HT1a receptors also suggested that the rabbit binding site belongs to the 5HT1a class. The only rank order anomalies were with methiothepin in rabbit cerebral cortex, where a comparatively high Ki was observed and with buspirone in cloned human 5HT1a receptor, where a low Ki was determined; these anomalies bear further study in light of the comparative pharmacology of 5HT1a receptors. Finally, the natural product parthenolide was tested for affinity in the rabbit, rat, and human systems, where it uniformly was unable to displace agonist, suggesting that the 5HT1a receptor is not a target for this compound. Overall, these results suggest that a functional 5HT1a receptor exists in rabbit cerebral cortex.
• Weber, J. T., Russo, E. B., Parker, K. K., O'connor, M. F., Medora, R. S., Hayataka, K., & Colson, N. (1997). Activity of Parthenolide at 5HT2A receptors.. Journal of natural products, 60(6), 651-3. doi:10.1021/np960644d
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  Parthenolide displaces [3H]ketanserin from 5HT2A receptors from rat and rabbit brain and cloned 5HT2A receptors. Ki's are in the 100-250 microM range. These results suggest that parthenolide may be a low-affinity antagonist at 5HT receptors; it is unlikely that the entire mechanism of action can be explained by its modest 5HT2A receptor affinity.

Presentations

• O'Connor, M. (2021, February). Neurobiological aspects of grief after perinatal loss. University of Zurich Perinatal Grief and Loss Winter Workshop.
• O'Connor, M. (2020, January). Grief: A Multi-Method Approach. Social Neuroscience of Grief Conference.
• O'Connor, M. (2020, June). Bereavement Stress and Gene Expression: Does It Go Both Ways?. NINR Invited Symposium: Genomic Response to the Social Environment: Implications for Health OutcomesNational Institute of Nursing Research (NINR).
• O'Connor, M. (2020, November). A Pull to Be Close: The Effect Of Oxytocin on Approach Behavior in Complicated Grief. International Society for the Study of Traumatic Stress.
• O'Connor, M. (2020, October). Complicated Grief. Betsy Cantwell Fireside Research Chat.
• O'Connor, M. (2017, April). When Grief is Complicated Webcast. Hospice of Foundation of America and Casa de la LuzHospice of Foundation of America and Casa de la Luz.
• O'Connor, M. (2016, August). Kindness on the Brain. Ben's Bells Science of Kindness Conference. Tucson: Ben's Bells.
• O'Connor, M. (2016, March). Low Dose Aspirin Reduces Cardiovascular Reactivity and Depressed Mood in Acutely Bereaved: A Pilot Study.. American Psychosomatic Society Annual Conference. Denver, CO: American Psychosomatic Society.
• O'Connor, M. (2016, March). What happens to health, when relationships end?. German Congress of Psychosomatic Medicine and Psychotherapy Annual Conference. Potsdam, Germany: German Congress of Psychosomatic Medicine and Psychotherapy.
• O'Connor, M. (2016, May). Complicated Grief: Clinical phenomenology and neural substrates.. Southwest Psychological Association Annual Conference. Dallas, TX: Southwest Psychological Association.
• O'Connor, M. (2016, May). Virtual Reality: The Real Effect on Mood, Behavior and Physiological Stress Response.. Association of Psychological Science Annual Convention. Chicago, IL: Association of Psychological Science.
• O'Connor, M. (2016, September). Bereavement, Health and Disease.. Arizona Psychological Association Annual Conference. Tucson, AZ: Arizona Psychological Association.
• O'Connor, M. (2015, July). Understanding the health effects of bereavement: Immune function, gene transcription and neuroimaging markers. Plenary talk at the European Association for Psychosomatic Medicine. Nuremberg, Germany.
• O'Connor, M. (2015, November). Compassion, the Caregiver and the Clinician. End of Life Community ConferenceTucson Medical Center Hospice, Carondolet Hospice, Casa de la Luz Hospice.
• O'Connor, M. (2014, April). Optimizing Resilience: What Can We Do?. Arizona Geriatrics Society. Tucson, Arizona.
• O'Connor, M. (2014, March). Complicated Grief and the widowhood effect: Inflammatory genotype, gene expression and circulating levels of IL-6. Anxiety and Depression Association of America Annual Conference. Chicago, IL.
• O'Connor, M. (2014, May). Empathic response to strangers based on interoceptive experience: an fMRI study.. Southern Arizona Psychological Association Research Day.
• O'Connor, M. (2014, November). Optimizing Resilience. End of Life Community Conference.
• O'Connor, M. (2014, October). The Other Wes Moore: Early adversity, grief and physiology.. University of Arizona Honors College SmartTalks.
• O'Connor, M. (2013). Getting your science into the media. Psychosomatic Medicine, 75, A18.
• O'Connor, M. (2013, April). Bereavement, grief, health, and illness. 12th Annual Women's Mental Health Symposium. Tucson, AZ.
• O'Connor, M. (2013, January). Stress: A Balance Between Too Little and Too Much!. Annual Conference on Successful Aging. Tucson, Arizona.
• O'Connor, M. (2013, March). Stress and Coping in Mid-life and Beyond. Osher Lifelong Learning Institute (OLLI). Green Valley, Arizona.
• O'Connor, M. (2013, May). Divergent gene expression responses to Complicated Grief and Non-complicated Grief. Paper presented at the Association for Psychological Science. Washington, D.C..
• O'Connor, M. (2013, November). Neural and physiological consequences of social loss: the model of bereavement. Society for Social Neuroscience. San Diego, CA.
• O'Connor, M. (2013, October). Bereavement and Health. Osher Lifelong Learning Institute (OLLI). Green Valley, Arizona.
• O'Connor, M. (2013, October). Stress: A Balance Between Too Little and Too Much!. Sun City Oro Valley Active Health Series. Oro Valley, Arizona.
• O'Connor, M. (2012, November). How grief affects our bodies, our minds. Holocaust Survivors Group, Jewish Family and Children Service. Tucson, Arizona.
• O'Connor, M. (2012, November). The effects of grief on physical health. Carondolet Hospice. Tucson, Arizona.
• O'Connor, M., Schultze-Florey, C. R., Irwin, M. R., & Martínez-Maza, O. (2012). A polymorphism in the oxytocin receptor gene is linked to avoidant attachment. Psychosomatic Medicine, 74, A6.
• O'Connor, M., Schultze-Florey, C. R., Irwin, M. R., & Martínez-Maza, O. (2012). Gene x environment: Bereavement influences on cellular inflammation. Psychosomatic Medicine, 74, A95.

Poster Presentations

• O'Connor, M., West, M., & Friedman, S. (2021, August). Bereavement in the COVID-19 Pandemic: The Grief Experience of African American & Latino Communities.. University of Arizona Undergraduate Research Opportunities Consortium: Summer Research Institute. Tucson, Arizona.: University of Arizona.
• O'Connor, M., West, M., & Friedman, S. (2021, October). Bereavement in the COVID-19 Pandemic: The Grief Experience of African American & Latino Communities.. Arizona Psychological Association Annual Meeting. Tucson, Arizon.
• O'Connor, M., & McConnell, M. (2017, March). Yearning predicts subgenual anterior cingulate activity in complicated grief.. American Psychosomatic Society Annual Conference. Seville, Spain: American Psychosomatic Society.
• Knowles, L. M., Stelzer, E. M., Jovel, K., & O'Connor, M. (2016, April). Online Support for Grief Improves Health Behaviors and Reduces Mental Health Problems in Widow/ers.. Annual Meeting of Society of Behavioral Medicine, Washington, DC.. Washington, DC..
• Fallon, M., Serrano-Careaga, J., & O'Connor, M. (2015, March). The Trier Social Stress Test 2.0: Using a virtual world to elicit an acute cortisol response. Poster presented at the American Psychosomatic Society. Savannah, GA.
• Karl, S., Fallon, M., Palitsky, R., Gündel, H., & O'Connor, M. (2015, July). Low dose aspirin reduces cardiovascular reactivity and depressed mood in acutely bereaved. Poster presented at the European Association for Psychosomatic Medicine. Nuremberg, Germany.
• Karl, S., Fallon, M., Palitsky, R., Gündel, H., & O'Connor, M. (2015, March). Low dose aspirin reduces cardiovascular reactivity and depressed mood in acutely bereaved. Poster presented at the American Psychosomatic Society. Savannah, GA.
• Knowles, L. M., Sbarra, D. A., & O'Connor, M. (2015, March). Coping flexibility following bereavement or divorce may not be predictive of physiological parameters. Poster presented at the American Psychosomatic Society. Savannah, GA.
• Arizmendi, B. J., O'Connor, M., & Kaszniak, A. W. (2014, June). Virtually supportive: A feasibility pilot study of an online support group for dementia caregivers in a 3D virtual environment. Poster presented at the 16th annual Arizona Alzheimer’s Consortium Scientific Conference. Mesa, AZ.
• Arizmendi, B., & O'Connor, M. (2014, March). The neuroanatomical correlates of bereavement and Complicated Grief in older adults. Poster presented at the Anxiety and Depression Association of America. Chicago, IL.
• Arizmendi, B., O'Connor, M., Kaszniak, A. W., Arizmendi, B., O'Connor, M., & Kaszniak, A. W. (2014, June). Virtually supportive: a feasibility pilot study of an online support group for dementia caregivers in a 3D virtual environment. 16th Annual Conference of the Arizona Alzheimer's Consortium. Mesa, AZ.
• Fallon, M., Carreaga Serrano, J., & O'Connor, M. (2014, March). Perceived stress and the Trier Social Stress Test in an online virtual reality. Poster presented at the American Psychosomatic Society. San Francisco, CA.
• Knowles, L. M., Schultze-Florey, C. R., Irwin, M. R., & O'Connor, M. (2014, March). The interaction between inflammatory genotype and Complicated Grief disorder is associated with elevated circulating levels of IL-6. Poster presented at the American Psychosomatic Society. San Francisco, CA.
• O'Connor, M. (2014, March). Empathic response to strangers based on interoceptive experience: an fMRI study. Poster presented at the American Psychosomatic Society. San Francisco, CA.
• Serrano Careaga, J., Fallon, M., & O'Connor, M. (2014, April). Self-focused attention in situations of acute stress. Poster presented at the 2014 Psychology Honors Research Forum. Tucson, AZ.
• Serrano Careaga, J., Fallon, M., & O'Connor, M. (2014, January). Yearning and the Trier Social Stress Test in a virtual world. Poster presented at the 25th Annual Undergraduate Biology Research Program (UBRP) conference. Tucson, AZ.
• Williams, C. M., Grinberg, A. M., & O'Connor, M. (2014, February). Can pixels make you jealous?. Poster presented at the 27th Annual Honors Research Expo. Tucson, AZ.
• Arizmendi, B., & O'Connor, M. (2013, May). Attentional Bias and Complicated Grief in Spousally Bereaved Older Adults. Poster presented at the Association for Psychological Science. Washington, D.C.
• Chavez, S., O'Connor, M., & Mehl, M. (2013, January). Stream of consciousness and the default network: Linguistic predictors of depression. Poster presented at the 24th annual Undergraduate Biology Research Program (UBRP) conference. Tucson, AZ.
• Grinberg, A. M., O'Connor, M., Serrano Careaga, J., & Noethen, E. (2013, March). Social Interactions in the Study of Second Life as a Social Support Tool. Poster presented at Society for Behavioral Medicine. San Francisco, CA.
• Schultze-Florey, C. R., O'Connor, M., Irwin, M. R., & Cole, S. W. (2013, June). Does gene regulation make it complicated?. Poster presented at the Psychoneuroimmunology Research Society. Stockholm, Sweden.
• Gupta, A., Gee, G. C., Leuchter, A. F., Cohen, M. S., Wyatt, G. E., & O'Connor, M. (2012). The Social Environment Impact: Brain Activation and Distress During Imagery of Racial Discrimination Experiences. Poster presented at the annual Society for Neuroscience meeting. New Orleans, LA.
• O'Connor, M., Schultze-Florey, C. R., Irwin, M. R., & Martínez-Maza, O. (2012). Gene x environment: Bereavement influences on cellular inflammation. Poster presented at the 24th Association for Psychological Science Annual Convention. Chicago, IL.