Older adults are at risk of mental illness overall and are at particular risk of experiencing mood disorders (Valiengo et al., 2016) and more than two-fifths report engaging in religious coping when experiencing distress (Koenig et al., 1988). Among acute older adult psychiatric patients with mood disorders, negative religious coping and aspects of positive religious coping are associated with symptom severity (Rosmarin et al., 2014). Indeed, among hospitalized elderly patients, religious coping is associated better longitudinal treatment outcomes (Koenig et al., 1992). On the other hand, negative religious coping is associated with significantly worse mood symptoms among older adults (Rosmarin et al., 2014). However, much less is known about neurobiological correlates of religious coping among older adults with and without mood disorders.

Several brain regions have been associated with spirituality/religion, including the frontal cortex, orbitofrontal cortex, precuneus, posterior cingulate cortex, default mode network (DMN), caudate, insula, and salience networks (SN, Rosmarin et al., 2022). The current study focuses on Menon's triple network model (TNM; Menon, 2011), which includes networks such as DMN, cingulo-opercular salience (cSN) and central executive network (CEN). Impairments within- and between-network connectivity of these networks are reported in many psychiatric disorders (Rosmarin et al., 2022) and are specifically implicated among individuals with mood disorders (Pastrnak et al., 2021), and may be relevant to religious coping among older adults.

Non-neurobiological research has identified cognitive aspects of religious coping that buffer against emotional dysregulation and emotional distress (Dolcos et al., 2021). Indeed, the fronto‐parietal network (FPN) has been identified as important for cognitive control and adaptive behavioral regulation, the DMN is implicated in self-referential mentation, and the SN is critical in the detection and mapping of salient external and internal inputs (Menon, 2011).

TNM framework specifically identifies dysfunction in the DMN, insula, and SN as well as changes in these symptoms when cognitive effort is put forth in tasks (Menon, 2011). Indeed, research also indicates that greater connectivity between the DMN and CEN may be associated with greater effortful coping (Menon, 2011). Neurobiological research has corroborated the applicability of the TNM among individuals with bipolar and major depressive disorder (Wang et al., 2020). Research is needed to explore how TNM may be applicable for understanding positive and negative religious coping in the context of mood disorders.

To our knowledge, no prior study has examined the neurobiological correlates of positive and negative aspects of mental health among older adults specifically. Given the known clinical relevance of religious coping to mood symptoms among older adults and coping, we conducted a preliminary examination to investigate influence of religious coping on TNM using resting-state fMRI among older adults with and without mood disorders. We specifically investigated both within- and between-network connectivity of cSN, DMN and CEN networks. Given the dearth of previous neuroimaging studies on spirituality within this specific population, no specific hypotheses were proposed.