Elevated C-reactive protein in adolescents: roles of stress and coping.

OBJECTIVE: Psychological stress can up-regulate inflammatory processes and increase disease risk. In the context of stress, differences in how individuals cope might have implications for health. The goal of this study was to evaluate associations among stress, coping, and inflammation in a sample of African American and white adolescents.
METHODS: Adolescents (n = 245) completed self-report measures of stressful life events and coping, provided daily diary reports of interpersonal conflict for 7 days, and provided fasting blood samples for assessment of C-reactive protein (CRP).
RESULTS: In regression analyses adjusted for age, sex, race, body mass index, smoking, and socioeconomic status, there were no significant associations between stress and CRP, but significant interactions between stress and coping emerged. For adolescents reporting more unpleasant stressful life events in the past 12 months, positive engagement coping was inversely associated with CRP (β= -.19, p < .05), whereas coping was not significantly associated with CRP for adolescents reporting fewer stressful life events. Positive engagement coping was significantly and inversely associated with CRP in the context of interpersonal stress, whether measured as stressful life events reflecting interpersonal conflict (e.g., arguments with parents or siblings, conflict between adults in the home, and friendship ended) or frequency of arguments with others reported in daily diaries. Disengagement coping was unrelated to CRP.
CONCLUSIONS: Findings suggest that positive engagement coping is associated with lower levels of inflammation, but only when adolescents are challenged by significant stress.