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.
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.
Merritt
Marcellus M
MM
Department of Psychology and Center on Age and Community, University of Wisconsin Milwaukee, Milwaukee, WI 53201, USA. merrittm@uwm.edu
McCallum
T J
TJ
Fritsch
Thomas
T
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
D006854:Hydrocortisone
J Psychiatr Res. 1975 Nov;12(3):189-98
1202204
Am J Geriatr Psychiatry. 2006 Apr;14(4):334-42
16582042
Am J Alzheimers Dis Other Demen. 2005 Sep-Oct;20(5):273-80
16273992
Am J Geriatr Psychiatry. 2009 Dec;17(12):1077-84
20104064
Biol Psychol. 2008 Oct;79(2):250-5
18639608
Am J Geriatr Psychiatry. 2009 Oct;17(10):899-906
19910878
Psychol Health Med. 2007 Jan;12(1):18-30
17129930
Psychosom Med. 1999 Mar-Apr;61(2):197-204
10204973
Am J Geriatr Psychiatry. 2006 Aug;14(8):684-93
16861373
JAMA. 1963 Sep 21;185:914-9
14044222
J Gerontol B Psychol Sci Soc Sci. 2000 May;55(3):P142-50
11833976
J Gerontol B Psychol Sci Soc Sci. 2004 May;59(3):S138-45
15118019
Am J Geriatr Psychiatry. 2010 Mar;18(3):193-203
20224516
Gerontologist. 1969 Autumn;9(3):179-86
5349366
Psychol Aging. 1995 Dec;10(4):540-52
8749581
J Health Soc Behav. 1983 Dec;24(4):385-96
6668417
Psychoneuroendocrinology. 2008 Jun;33(5):601-11
18329182
Am J Geriatr Psychiatry. 2009 Mar;17(3):246-54
19454851
Alzheimer Dis Assoc Disord. 2008 Apr-Jun;22(2):181-3
18525292
Psychosom Med. 2006 Jan-Feb;68(1):41-50
16449410
Am J Geriatr Psychiatry. 2006 Apr;14(4):299-306
16582038
J Psychosom Res. 2003 Apr;54(4):293-302
12670605
Ethn Dis. 2005 Winter;15(1):17-24
15720045
Aging Ment Health. 2002 Nov;6(4):325-42
12425767
JAMA. 1999 Dec 15;282(23):2215-9
10605972
J Gen Intern Med. 2004 Oct;19(10):1027-33
15482555
Psychol Bull. 2003 Nov;129(6):946-72
14599289
J Gerontol B Psychol Sci Soc Sci. 2005 Sep;60(5):S257-62
16131626
Psychol Aging. 1992 Dec;7(4):622-31
1466831
J Nerv Ment Dis. 2008 Nov;196(11):838-43
19008735
J Neuropsychiatry Clin Neurosci. 2005 Spring;17(2):201-7
15939974
Am J Public Health. 2008 Sep;98(9 Suppl):S29-37
18687616
J Gerontol B Psychol Sci Soc Sci. 2000 May;55(3):S163-72
11833984
Psychosom Med. 2004 Jan-Feb;66(1):49-55
14747637
Health Psychol. 2007 Sep;26(5):564-76
17845108
J Clin Psychol. 2000 Apr;56(4):519-43
10775045
Am J Geriatr Psychiatry. 2008 Apr;16(4):310-7
18378556
Psychol Aging. 2003 Dec;18(4):906-15
14692875
Psychosom Med. 2006 Sep-Oct;68(5):657-61
17012518
Psychoneuroendocrinology. 2006 Apr;31(3):299-311
16183206
Alzheimer Dis Assoc Disord. 2002 Oct-Dec;16(4):248-53
12468899
Br J Health Psychol. 2003 Feb;8(Pt 1):1-17
12643813
Gerontologist. 2004 Aug;44(4):508-19
15331808
Am J Geriatr Psychiatry. 2010 Feb;18(2):146-53
20104070
Am J Geriatr Psychiatry. 2010 Jun;18(6):531-43
20220602
Gerontologist. 2001 Jun;41(3):334-47
11405431
Am J Geriatr Psychiatry. 2009 Nov;17(11):925-33
20104051
Aging Ment Health. 2006 May;10(3):312-8
16777660
Health Psychol. 2008 May;27(3):358-68
18624601