title: Depressive Mood, Anger, and Daily Cortisol of Caregivers on High- and Low-Stress Days.
abstract: OBJECTIVE
  This study examines the association of daily cortisol with depressive mood and anger.
  
  
  METHODS
  Depressive mood, anger and 2 markers of cortisol, area under the curve (AUC), and cortisol awakening response (CAR) were examined for caregivers (N = 164) of individuals with dementia (IWDs) across 8 days, some of which IWDs attended an adult day service (ADS) program. Caregivers were primarily female (86.7%) with a mean age of 61.99. First, multilevel models were run with CAR and AUC each as separate covariates of anger and depressive mood. A second set of models examined contextual factors of caregivers (i.e., care-related stressors and amount of ADS use) were added to the models for anger and depressive mood (Model 2).
  
  
  RESULTS
  On days where caregivers had AUCs below their average they expressed higher anger scores. However in Model 2, anger was associated with more care-related stressors, but not ADS use or daily cortisol. Caregivers who on average had smaller CARs were more likely to be depressed. In Model 2, depressed mood was associated with more care-related stressors and a low average CAR.
  
  
  CONCLUSIONS
  We found that hypocortisol patterns, reflective of chronic stress experienced by caregivers, are associated with negative mood.
authors.affiliation: Department of Psychiatry, The University of Michigan, Ann Arbor. leggetta@med.umich.edu.
authors.forename: Amanda N
authors.initials: AN
authors.lastname: Leggett
authors.affiliation: Department of Human Development and Family Studies, The Pennsylvania State University, University Park.
authors.forename: Steven H
authors.initials: SH
authors.lastname: Zarit
authors.affiliation: Department of Human Development and Family Sciences, The University of Texas at Austin.
authors.forename: Kyungmin
authors.initials: K
authors.lastname: Kim
authors.affiliation: Department of Human Development and Family Studies, The Pennsylvania State University, University Park.
authors.forename: David M
authors.initials: DM
authors.lastname: Almeida
authors.affiliation: Department of Biobehavioral Health and Penn State Institute of the Neurosciences, The Pennsylvania State University, University Park.
authors.forename: Laura Cousino
authors.initials: LC
authors.lastname: Klein
mesh_terms: D000328:Adult; D000339:Affect; D000368:Aged; D000369:Aged, 80 and over; D000786:Anger; D017028:Caregivers / Q000523:psychology*; D002940:Circadian Rhythm; D003704:Dementia / Q000628:therapy; D003863:Depression; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000032:analysis*; D008297:Male; D008875:Middle Aged; D012463:Saliva / Q000737:chemistry*; D013315:Stress, Psychological / Q000175:diagnosis / Q000378:metabolism
chemical_list: D006854:Hydrocortisone
keywords: Adult day services; Anger; Care-related stress; Caregiving; Cortisol; Depression