Too Much of a Good Thing?: Positive Religious Coping Predicts Worse Diurnal Salivary Cortisol Patterns for Overwhelmed African American Female Dementia Family Caregivers

Abstract

Religious coping arguably prevents negative health outcomes for stressed persons. This study examined the moderating role of religious coping (positive, negative, and combined) in the connection of care recipient functional status with diurnal salivary cortisol patterns among dementia family caregivers. Thirty African American (AA) female dementia caregivers and 48 AA noncaregivers completed the Religious Coping (RCOPE) scale, the Activities of Daily Living scale, and the 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 straight days. Hierarchical regression tests with mean diurnal cortisol slope as the outcome illustrated surprisingly that higher combined and positive (but not negative) RCOPE scores were associated with increasingly flatter or worse cortisol slope scores for caregivers (but not noncaregivers). Of note, the RCOPE by RMBPC interaction was significant. Among caregivers who reported higher RMBPC scores, higher combined and positive (but not negative) RCOPE scores were unexpectedly associated with increasingly flatter cortisol slopes. These results extend current findings by showing that being AA, a caregiver, and high in positive religious coping may predict increased daily stress responses, mainly for those with higher patient behavioral problems. Because religious coping is a central coping strategy for AA caregivers, it is vital that epidemiologic assessments of religious coping in health and aging as well as tailored interventions focus on the unique reasons for this disparity.