The role of familism in stress and coping processes among African American and White dementia caregivers: effects on mental and physical health.

OBJECTIVE: To explore how familism, burden, and coping styles mediate the relationships between ethnicity and the mental and physical health of caregivers. DESIGN: A probability sample of 65 White and 95 African Americans respondents caring for an older family member with dementia was used to test hypotheses from a sociocultural stress and coping model using path analysis. MAIN OUTCOME MEASURES: Measures of caregivers' health included subjective health, self-reported diseases, blood pressure, and heart rate. Mental health measures included self-reported depression and psychological symptoms. RESULTS: Contrary to the hypothesis, familism had an adverse effect on outcomes and was related to low education levels rather than to African American ethnicity. A buffering effect of active coping between being African American and diastolic blood pressure was found even after controlling for levels of education. CONCLUSIONS: Findings supported a core stress and coping model in which more behavior problems of care recipients were associated with poorer mental health of caregivers via greater burden and more use of avoidant coping. Results also demonstrate that this core model can be extended to physical health.