This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Caregiving for a spouse with Alzheimer's disease is related to increased physical morbidity and early mortality (Schulz & Beach, 1999). Researchers have proposed that these health outcomes are a result of chronic exposure to stressors. Caregivers report high levels of stress (e.g., Pearlin, 1993) and show neuroendocrine dysregulation and decrements in cellular and humoral immune functioning relative to matched controls (e.g., Kiecolt-Glaser et al., 1996). The exposure to chronic stress places people at physical and psychological risk, yet perceptions of this strain predict physical and emotional health above the level of burden (e.g., Mittelman, Roth, Haley, & Zarit, 2004). The proposed study will examine how perception of risk, specifically the cognitive appraisals of perceived stress and controllability, relate to physiological reactivity among caregivers and non-caregiving matched controls in the laboratory and in daily life. We will focus on the proinflammatory cytokine and cortisol systems, as they can be activated under certain stressful situations (Dickerson & Kemeny, 2004; Segerstrom & Miller, 2004), and increased levels of these products have been linked with negative health outcomes (e.g., Connor & Leonard, 1998). We propose that the exposure of chronic stress from caregiving is linked with exaggerated proinflammatory and cortisol responses to acute stressors; repeated activation of these systems over time among caregivers may lead to detrimental health outcomes. In addition, we predict that chronic stress also influences appraisals of stressors, such that caregivers appraise stressors as less controllable and more stressful. These appraisals, in turn, are associated with greater physiological reactivity to stressors.
Specific aims and hypotheses are outlined below.
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