title: How much striving is too much? John Henryism active coping predicts worse daily cortisol responses for African American but not white female dementia family caregivers.
abstract: BACKGROUND
  The John Henryism active coping (JHAC) hypothesis suggests that striving with life challenges predicts increased risk for cardiovascular disease for those with scarce coping resources. This study examined the moderating role of JHAC in the associations of 1) caregiver status and 2) care recipient functional status with diurnal salivary cortisol patterns among 30 African Americans (AAs) and 24 white female dementia caregivers and 63 noncaregivers (48 AAs).
  
  
  METHODS
  Caregiver participants completed the JHAC-12 scale, Activities of Daily Living (ADL) scale, and Revised Memory and Behavior Problem checklist (RMBPC) and collected five saliva samples daily (at awakening, 9 A.M., 12 P.M., 5 P.M., and 9 P.M.) for 2 successive days.
  
  
  RESULTS
  Univariate analysis of variance tests with mean diurnal cortisol slope as the outcome illustrated that among AA caregivers, higher JHAC scores were related to flatter (or more dysregulated) cortisol slopes. The JHAC by ADL and JHAC by RMBPC interactions were each significant for AA caregivers. Among AA caregivers who reported higher ADL and RMBPC scores, higher JHAC scores were associated with flatter cortisol slopes.
  
  
  CONCLUSIONS
  These findings extend recent studies by showing that being AA, a caregiver, and high in JHAC may elevate the risk for chronic disease, especially for those with higher patient ADL and behavioral problems. Thus, it is imperative that interventions appreciate the pernicious role of high-effort coping style, especially for AA caregivers, to minimize the stressful side effects of patient ADL and memory and behavioral problems for the caregiver.
authors.affiliation: Department of Psychology and Center on Age and Community, University of Wisconsin Milwaukee, Milwaukee, WI 53201, USA. merrittm@uwm.edu
authors.forename: Marcellus M
authors.initials: MM
authors.lastname: Merritt
authors.forename: T J
authors.initials: TJ
authors.lastname: McCallum
authors.forename: Thomas
authors.initials: T
authors.lastname: Fritsch
mesh_terms: D000203:Activities of Daily Living; D000223:Adaptation, Psychological; D001741:Black or African American / Q000523:psychology* / Q000706:statistics & numerical data; D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers / Q000523:psychology* / Q000706:statistics & numerical data; D002940:Circadian Rhythm; D003704:Dementia / Q000451:nursing*; D003863:Depression / Q000208:ethnology / Q000378:metabolism / Q000503:physiopathology; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism*; D008603:Mental Health; D008875:Middle Aged; D009820:Ohio / Q000453:epidemiology; D011237:Predictive Value of Tests; D012463:Saliva / Q000737:chemistry; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000208:ethnology / Q000378:metabolism / Q000503:physiopathology; D011795:Surveys and Questionnaires; D044465:White People / Q000523:psychology* / Q000706:statistics & numerical data
chemical_list: D006854:Hydrocortisone
references.citation: J Psychiatr Res. 1975 Nov;12(3):189-98
references.pmid: 1202204
references.citation: Am J Geriatr Psychiatry. 2006 Apr;14(4):334-42
references.pmid: 16582042
references.citation: Am J Alzheimers Dis Other Demen. 2005 Sep-Oct;20(5):273-80
references.pmid: 16273992
references.citation: Am J Geriatr Psychiatry. 2009 Dec;17(12):1077-84
references.pmid: 20104064
references.citation: Biol Psychol. 2008 Oct;79(2):250-5
references.pmid: 18639608
references.citation: Am J Geriatr Psychiatry. 2009 Oct;17(10):899-906
references.pmid: 19910878
references.citation: Psychol Health Med. 2007 Jan;12(1):18-30
references.pmid: 17129930
references.citation: Psychosom Med. 1999 Mar-Apr;61(2):197-204
references.pmid: 10204973
references.citation: Am J Geriatr Psychiatry. 2006 Aug;14(8):684-93
references.pmid: 16861373
references.citation: JAMA. 1963 Sep 21;185:914-9
references.pmid: 14044222
references.citation: J Gerontol B Psychol Sci Soc Sci. 2000 May;55(3):P142-50
references.pmid: 11833976
references.citation: J Gerontol B Psychol Sci Soc Sci. 2004 May;59(3):S138-45
references.pmid: 15118019
references.citation: Am J Geriatr Psychiatry. 2010 Mar;18(3):193-203
references.pmid: 20224516
references.citation: Gerontologist. 1969 Autumn;9(3):179-86
references.pmid: 5349366
references.citation: Psychol Aging. 1995 Dec;10(4):540-52
references.pmid: 8749581
references.citation: J Health Soc Behav. 1983 Dec;24(4):385-96
references.pmid: 6668417
references.citation: Psychoneuroendocrinology. 2008 Jun;33(5):601-11
references.pmid: 18329182
references.citation: Am J Geriatr Psychiatry. 2009 Mar;17(3):246-54
references.pmid: 19454851
references.citation: Alzheimer Dis Assoc Disord. 2008 Apr-Jun;22(2):181-3
references.pmid: 18525292
references.citation: Psychosom Med. 2006 Jan-Feb;68(1):41-50
references.pmid: 16449410
references.citation: Am J Geriatr Psychiatry. 2006 Apr;14(4):299-306
references.pmid: 16582038
references.citation: J Psychosom Res. 2003 Apr;54(4):293-302
references.pmid: 12670605
references.citation: Ethn Dis. 2005 Winter;15(1):17-24
references.pmid: 15720045
references.citation: Aging Ment Health. 2002 Nov;6(4):325-42
references.pmid: 12425767
references.citation: JAMA. 1999 Dec 15;282(23):2215-9
references.pmid: 10605972
references.citation: J Gen Intern Med. 2004 Oct;19(10):1027-33
references.pmid: 15482555
references.citation: Psychol Bull. 2003 Nov;129(6):946-72
references.pmid: 14599289
references.citation: J Gerontol B Psychol Sci Soc Sci. 2005 Sep;60(5):S257-62
references.pmid: 16131626
references.citation: Psychol Aging. 1992 Dec;7(4):622-31
references.pmid: 1466831
references.citation: J Nerv Ment Dis. 2008 Nov;196(11):838-43
references.pmid: 19008735
references.citation: J Neuropsychiatry Clin Neurosci. 2005 Spring;17(2):201-7
references.pmid: 15939974
references.citation: Am J Public Health. 2008 Sep;98(9 Suppl):S29-37
references.pmid: 18687616
references.citation: J Gerontol B Psychol Sci Soc Sci. 2000 May;55(3):S163-72
references.pmid: 11833984
references.citation: Psychosom Med. 2004 Jan-Feb;66(1):49-55
references.pmid: 14747637
references.citation: Health Psychol. 2007 Sep;26(5):564-76
references.pmid: 17845108
references.citation: J Clin Psychol. 2000 Apr;56(4):519-43
references.pmid: 10775045
references.citation: Am J Geriatr Psychiatry. 2008 Apr;16(4):310-7
references.pmid: 18378556
references.citation: Psychol Aging. 2003 Dec;18(4):906-15
references.pmid: 14692875
references.citation: Psychosom Med. 2006 Sep-Oct;68(5):657-61
references.pmid: 17012518
references.citation: Psychoneuroendocrinology. 2006 Apr;31(3):299-311
references.pmid: 16183206
references.citation: Alzheimer Dis Assoc Disord. 2002 Oct-Dec;16(4):248-53
references.pmid: 12468899
references.citation: Br J Health Psychol. 2003 Feb;8(Pt 1):1-17
references.pmid: 12643813
references.citation: Gerontologist. 2004 Aug;44(4):508-19
references.pmid: 15331808
references.citation: Am J Geriatr Psychiatry. 2010 Feb;18(2):146-53
references.pmid: 20104070
references.citation: Am J Geriatr Psychiatry. 2010 Jun;18(6):531-43
references.pmid: 20220602
references.citation: Gerontologist. 2001 Jun;41(3):334-47
references.pmid: 11405431
references.citation: Am J Geriatr Psychiatry. 2009 Nov;17(11):925-33
references.pmid: 20104051
references.citation: Aging Ment Health. 2006 May;10(3):312-8
references.pmid: 16777660
references.citation: Health Psychol. 2008 May;27(3):358-68
references.pmid: 18624601