Religious coping and mental health outcomes among bereaved older women in the Nurses Health Study II

ABSTRACT Background Bereaved individuals face elevated risks of depression and anxiety and may benefit from religious coping. Older women, who are at heightened risk both for bereavement and for depressive and anxiety symptoms, may derive particular benefit. Methods The study utilizes data from 6,868 older females (mean age: 65.9 years [SD: 4.5]) who experienced death of a loved one and answered the religious coping question from the COVID-19 substudy of Nurses’ Health Study II. Baseline variables included sociodemographic, bereavement-related, behavioral, and psychological characteristics. The primary outcome was overall psychological distress (PHQ-4), comprised of anxiety (GAD-2) and depression (PHQ-2) symptom items. After multiple imputation for missing variables, inverse probability treatment weights were derived using logistic regression. Weighted linear regression models estimated associations between prospectively assessed religious coping and subsequent depression and anxiety symptoms measured 6 to 12 months after bereavement between January and October 2021. Results Among 6,868 people who experienced the death of a loved one between March 2020 and October 2020, 87.4% practiced religious coping. Conclusion Prospectively assessed religious coping was not associated with lower subsequent depression among bereaved older females. Among participants without baseline depression, religious coping was associated with higher subsequent psychological distress.