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J Natl Med Assoc. 2005 Feb;97(2):206-12.

Relationships between perceived stress, coping behavior and cortisol secretion in women with high and low levels of internalized racism.

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  • 1Minority International Research Training Program, University of Pittsburgh, PA, USA.



It is hypothesized that a chronic defeat response to social or environmental stressors increases the likelihood of dysfunction of the hypothalamic-pituitary-adrenal (HPA) axis with dysregulation of cortisol, accumulation of abdominal fat and development of glucose intolerance. Recent studies show that African-Caribbean women who have a high level of internalized racism (INR) are at increased risk for abdominal obesity and glucose intolerance. The aim of the current study was to determine if African-Caribbean women with high and low INR differ in their levels of perceived stress and defeat coping style, and in the relationship of these factors to cortisol secretion.


On the island of Dominica, information on perceived stress and coping style was collected from age- and body mass index-matched samples of nondiabetic women aged 25-60 with high (n = 27) and low (n = 26) INR. Cortisol levels for each participant were determined from saliva specimens collected at 8:30 am and 10:30 pm.


A higher mean perceived stress score (PSS) and greater tendency to use "restraint," "denial" and "behavioral disengagement" (defeated) coping (BDC) styles were found among women with high INR compared to those with low INR. In the combined sample, PSS and BDC were significantly correlated with an indicator of dysregulation of cortisol. However, in group-specific analyses, adjusting for age and education, these correlations remained significant only among women with high INR.


These findings support the view that high perceived stress and defeated coping style may be factors that link high INR to dysregulation of cortisol and, perhaps, also to greater risk of metabolic abnormalities.

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