Integrating Cognitive Behavioural and Islamic Principles in Psychology and Psychotherapy: A Narrative Review

Standardisation of knowledge has become a by-product of globalisation, and western-based models are often seen as the ultimate answer to expertise and development. In light of this, some professionals have debated the feasibility of employing cognitive behavioural therapy (CBT) with Muslim communities. Debates have focused on CBT's secular roots and its compatibility with a world where Islam permeates most aspects of life. This article highlights some of the theoretical dilemmas of integration and suggests ways to bridge the existing gap between secular and Islamic literature and avoid alienating those individuals who might feel uncomfortable with secular CBT teachings.

Palestinian Muslim College Students' Attitudes to Mental Health Treatment: A Comparative Study

This study examined the association between the degree of religiosity, combined with cultural beliefs, social stigmas, and attitudes towards mental-health treatment in two groups, who, despite having similar cultural and religious affiliation, have experienced different socio-political contexts: Palestinian Muslim college students living in the Occupied Palestinian Territory (OPT) and Israel. The study was guided by Tanhan and Young's (2021) conceptual framework. Methods: A snowball recruitment strategy was applied, using a cross-sectional survey. A total sample size was 214 students, 105 from the OPT and 109 from Israel. Results indicate that students from the OPT (n = 105) did not differ from those living in Israel (n = 109) on religiosity using the Islamic Belief scale, or Attitudes Towards Mental Health treatment (F(1, 189) = 1.07, p = 0.30). However, students from the OPT had higher confidence in mental-health professionals (M = 15.33) than their counterparts (M = 14.59), and women had higher confidence (M = 16.03) than men (M = 13.90). The reliance on traditions for Muslim students over Western mental-health approaches is a critical factor in predicting the attitudes towards students' mental problems and their chosen treatment. Sociopolitical context played a significant role in shaping attitudes toward mental-health providers.

Mental Health, Islam, Clinical Issues and COVID-19

In this fifth issue of the Journal of Religion and Health for 2022, four key themes are revisited: (1) mental health, (2) Islam, (3) various clinical issues relating to religiosity and/or spirituality and (4) the ongoing concerns of COVID-19.

Prayers and Mindfulness in Relation to Mental Health among First-Generation Immigrant and Refugee Muslim Women in the USA: An Exploratory Study

The goal of our study was to explore how first-generation immigrant/refugee Muslim women experience prayer and mindfulness in relation to their mental health. Participants were nine women from an urban city in the Midwestern USA. The women completed a structured demographic survey and a virtual semi-structured interview in a focus group. Using qualitative thematic analysis, we obtained four overarching themes from the data: (a) Prayer helps to build community, (b) Prayer promotes wellbeing, (c) Prayer increases faith, and (d) Prayer encourages intentional awareness. The findings demonstrate that prayer involves awareness and has a strong influence on the mental health of the women participants.

Arab Muslims' Perceptions of Perinatal Loss Care in the United States of America

One in four American women will experience a miscarriage, stillbirth or neonatal death each time she becomes pregnant. These perinatal losses occur even more frequently in women who are immigrants from developing countries. Care of Muslim families after perinatal loss is based primarily on expert opinion as opposed to research evidence, as few, if any, studies exist on this topic. It is critically important to know what parent's preferences for care actually are, since care that is incongruent with the desires of the bereaved parents may intensify their grief. The purpose of this study was to examine the perceptions and attitudes of immigrant Arab Muslims regarding psychosocial bereavement practices common in the United States after perinatal loss and to pilot test an investigator-developed instrument for collecting data regarding culturally relevant psychosocial bereavement practices of immigrant Arab Muslims after perinatal loss. The study employed a cross-sectional survey design using an investigator-developed instrument entitled the Arab Muslim Perceptions of Perinatal Loss Care (AMPPLC). The AMPPLC, available in both English and Arabic, was used to collect data on perinatal loss care from a convenience sample of 79 immigrant Arab Muslim adults (male n = 43 [54.4%]; female n = 36 [45.6%]). The study opened in June 2017 and closed in August 2019. The AMPPLC instrument demonstrated good reliability (α = 0.89) in measuring participants' responses. Responses by survey participants did not always agree with prior published literature on Muslim preferences after a loss. Optimal care for Arab Muslim immigrants involves offering all options that are typically part of Western bereavement care as well as options that may be more specifically associated with Islam. This information will enable healthcare providers to provide more culturally sensitive and compassionate care to Middle Eastern Muslim parents during this difficult and tragic experience.

Islamic law and investments in children: Evidence from the Sharia introduction in Nigeria

Islamic law lays down detailed rules regulating children's upbringing. This study examines the effect of such rules on investments in children by analysing the introduction of Sharia law in northern Nigeria. Triple-differences estimates using temporal, geographical and religious variation together with large, representative survey data show decreases in infant mortality. Official government statistics further confirm improvements in survival. Findings also show that Sharia increased vaccination rates, duration of breastfeeding and prenatal health care. Evidence suggests that Sharia improved survival by specifying strict child protection laws and by formalising children's duty to maintain their parents in old age or in sickness.

The Impact of Listening to, Reciting, or Memorizing the Quran on Physical and Mental Health of Muslims: Evidence From Systematic Review

Objectives: Listening to or memorizing the Quran has been suggested to affect the psychosocial health and well-being of Muslims. Muslims who memorized Quran have a higher quality of life (QoL) and lower anxiety and stress. Hence, this systematic review was conducted to evaluate the studies that assessed the effect of listening to, reciting, or memorizing the Quran on physical and mental health.

Methods: This review was performed on articles published from the inception and April 2021. Databases including ProQuest, PubMed and Web of Science were searched on 19 April 2021. Keywords such as “Quran”, “al- Quran,” “al- Kareem,” “Holy Quran,” “memori,” “Tahfiz,” “Huffaz,” “listening” and “reciting” were used for databases searching. The risk of bias was assessed using Cochrane risk of bias tool and Joanna Briggs Institute (JBI). Only 20 articles were included in data synthesis out of a total of 230.

Results: The findings revealed that listening to, reciting or memorizing the Quran had a favorable effect on depression, anxiety, physiologic parameters, quality of life, quality of sleep and intelligence quotient.

Conclusion: The current evidence suggests that, listening to, reciting or memorizing the Quran may be useful as an intervention to improve physical and mental health.

Playing God? Religious Perspectives on Manipulating the Genome

The Human Genome Project (HGP) is a remarkable medical science breakthrough that enables the understanding of genetics and the intervention of human health. An individual's health is influenced by physical, emotional, social, intellectual, and religious factors. Among these, religious beliefs shape our thinking on cloning, stem cells, and gene editing, affecting healthcare decisions and the motivation for seeking treatment. Is the human genome sacred? Does editing it violate the idea that we're made in God's image or allow us to "play God"? Understanding the perspectives behind the fundamental religious doctrines of Islam, Christian, Hindu, and Buddhist on gene editing/therapy in somatic and germline cells would ensure a right balance between geneticists and theologians in providing the best healthcare while catering to individual beliefs.

Ramadan Fasting as a Religious Obligation: A Qualitative Study on Opinions and Experiences of Muslim Pregnant Women about Fasting in Turkey

The aim of this study was to examine opinions and experiences of Muslim pregnant women about Ramadan fasting in Turkey. The study had a descriptive, phenomenological design and included 17 Muslim pregnant women living in Turkey. Content analysis and word cloud analysis were performed. The content analysis revealed two themes. The most frequent words in the word cloud analysis were fasting, pregnancy, Ramadan, fast, religious duty, health, observing a missed fast, relief, concern, baby, thirsty and hungry. The findings of the study showed that religious beliefs, experiences, family and society pressured the pregnant women to keep Ramadan fasts. However, due to feeling worried about their own physical and psychological health and their infants, some of the women did not go on a fast. It can be recommended that pregnant women wanting to keep their fasts should be offered information about possible risks of fasting.

Recruitment Process in Salafi-Jihadist Groups in the Middle East (A Qualitative Study)

Studies on the psychology of terrorism and fundamentalism place great importance on the role of groups, with a central concept of "us" versus "them." The present study examines how and why Salafi-jihadist groups in the Middle East have attracted typical citizens. The participants in this qualitative study were unremarkable Kurdish people living near the western borders of Iran with an allegiance toward Salafi-jihadist groups. We selected 12 people for the purposes of this study. Findings indicate that "group adaptation" and "rejection of the other" are the two overarching themes pointed out by the participants. Group adaptation included four sub-themes: (a) Idealization of, plus identification and assimilation with the leader, (b) developing strong group bonds, (c) direct and nonhierarchical agency of the individual in the group, and (d) group hypnotic suggestion. The "rejection of the other" included two sub-themes: (a) in-group rejection (reducing legitimate Islam to Salafism) and (b) out-group rejection (rejection of non-Muslims). The results of the study highlight the importance of a sense of belonging to the group in the process of recruitment and assimilation of individuals into jihadist groups. Findings also indicate that the concepts of adaptation and rejection play a pivotal role in the formation of fundamentalist Salafi-jihadist groups and resultant violence. We discuss the implications of group analysis for possible ways to counterterrorism.

Improving Recruitment for Mental Health Research in Muslim American Women : Research Recruitment in Muslim American Women

This study determines the methods for improving recruitment of Muslim American women in mental health research. Studying this minority population in more depth will reduce their suffering from mental illness. A 40-item survey, along with cover letter, was hosted on the Stanford University website and sent via email to organizations known to have large Muslim American women populations. Although approximately 200-300 responses were hoped for, an unexpected total of 1279 women completed the survey within days. The effectiveness of this survey was attributed to multiple factors: ease of an online survey, privacy afforded through an anonymous survey, trust in the PI, the survey being hosted by a reputable university and understanding the importance of mental health research. It is important to continue improving methods to recruit the minority Muslim American women population for studies.

'Mad', bad or Muslim? The UK's Vulnerability Support Hubs and the nexus of mental health, counterterrorism and racism

The UK government's 'Prevent' counter-extremism policy was placed on a statutory footing in 2015, requiring specified authorities including NHS providers by law to work to 'prevent people being drawn into terrorism', leading to calls for a boycott on ethical grounds. Since 2016, mental health professionals have been embedded within counterterrorism police units in 'Vulnerability Support Hubs', to assist in the management of individuals referred to Prevent perceived to have vulnerabilities related to mental health. Drawing on data obtained through Freedom of Information requests, this paper examines these hubs in the context of Prevent's racial politics. It examines the pseudo-scientific concept of radicalization through the lens of racialization theory and explores the whitewashing and colourblindness endemic to most research and practice at the nexus of counterterrorism and mental health. Four ethical issues arising from the hubs are highlighted: (a) the securitization of care, including the way counterterrorism concerns appear to influence medical treatment regimes; (b) harm, including potential criminalization; (c) the erosion of patient agency and confidentiality; and (d) the pathologization of political dissent. It is argued that due to the UK's status as a leading innovator in the field of counter-radicalization, all of these highly racialized phenomena hold wider relevance and augur a troubling direction of travel for counterterrorism's turn towards mental health.

Safety Assessment of Glucose-Lowering Drugs and Importance of Structured Education during Ramadan: A Systematic Review and Meta-Analysis

BACKGROUND

Ramadan is the sacred month of the Islamic Hijri (lunar) calendar, and during this entire month, healthy adult Muslims abstain from eating and drinking from dawn to sunset. Muslims with Type 2 Diabetes Mellitus (T2DM) who choose to fast during Ramadan encounter major risks such as hypoglycemia, hyperglycemia, diabetic ketoacidosis, dehydration, and thrombosis. Although patients with poor glycemic control and on multiple insulin injections are at high risk and exempt from fasting, many still insist on it. Thus, healthcare professionals play a pivotal role in managing diabetes-related complications in patients who fast during Ramadan. However, there is a lack of standard guidelines to be followed in association with structured education and administration of drugs and dosage. Therefore, we performed a systematic review and meta-analysis of the literature to determine the safety and efficacy of different classes of drugs and the importance of structured education during Ramadan.

METHODS

In this review, an extensive PubMed search was performed to obtain literature on T2DM patients who fast during the month of Ramadan until the year 2020. Preference was given to fully downloadable articles. The articles were extracted based on the eligibility criteria. The extracted data were analyzed using Review Manager software version 5.3.

RESULTS

A total of 32 articles were included for the review and 7 studies for meta-analysis. Majority of the studies demonstrated the importance of structured education either as a group session or as a one-on-one session with the healthcare professionals in preventing diabetes-related risks during Ramadan. As far as glucose-lowering drugs are concerned, DPP-4 inhibitor combined with metformin remains the drug of choice for T2DM patients who fast during Ramadan. The newer class of glucose-lowering agents appear to lower the risk of hypoglycemia in comparison with sulphonylureas, while among sulphonylureas gliclazide is relatively safe. The meta-analysis indicates that DPP-4 inhibitors would significantly reduce the risk of hypoglycemia as compared to sulphonylurea (odds ratio = 0.38, 95% CI: 0.26 to 0.55, p < 0.00001).

CONCLUSION

The results of our systematic review show that structured education and counselling by healthcare professionals can be an effective tool in preventing complications associated with fasting during Ramadan in people with T2DM. Additionally, the safest class of oral glucose-lowering drugs preferred during Ramadan fasting in T2DM patients is DPP-4 inhibitors.

Improving Healthcare Access by Teaching Intercultural Communication

Nonnative English speakers may hesitate or avoid accessing healthcare in the United States due to cultural and communication barriers. Role-play is effective as a method of reducing healthcare access due to inadequate communication skills. A role-play activity used with female Muslim immigrants to the United States enabled participants to develop communication skills and gain confidence for future interactions with a healthcare provider.

Ramadan Fasting Improves Body Composition without Exacerbating Depression in Males with Diagnosed Major Depressive Disorders

Background: Ramadan fasting (RF) is a form of intermittent fasting that generally improves body composition and related metabolic profiles. Whether RF exacerbates depressive symptomatology in individuals diagnosed with major depressive disorder (MDD) is undetermined. Methods: 100 men, who lived in Bahrain and were between the ages of 18 and 64 years with an established diagnosis of MDD, participated in this 4-week study. Based on preference, participants were assigned to a fasting group (FG, n = 50) and a non-fasting group (NFG, n = 50). The FG engaged in fasting from 03:40 to 18:10 (dawn and dusk timings). Changes in depressive symptoms, body mass, body composition, and components of metabolic syndrome were measured. Results: There were no significant changes in depressive symptoms within the FG vs. NFG after controlling for baseline covariates: mean difference 0.49 (SE = 0.63), p = 0.43. No adverse effects were reported in either group. The FG experienced significant reductions in body mass, 1.87 kg, p = 0.001; body mass index, 0.69 kg/m², p = 0.001; body fat, 0.87%, p = 0.001; body surface area, 0.03 m², p = 0.001; and lean mass, 0.77 kg, p = 0.001. Conclusions: RF did not negatively affect depressive symptoms and improved body composition, suggesting short-term intermittent fasting may be a safe dietary practice for adult males with MDD.

Do religious beliefs influence concerns for animal welfare? the role of religious orientation and ethical ideologies in attitudes toward animal protection amongst Muslim teachers and school staff in East Java, Indonesia

There is ample research supporting White's (1967) thesis, which postulates that religion and religious belief inhibit ecological concerns. This study thus seeks to explore the relationship between individuals' acceptability for harming animals as one representation of ecological concern (measured using Animal Issue scale (AIS)) and their religious belief (measured using Religious Orientation Scale (ROS)) and ethical ideology (measured using Ethical Position Questionnaire (EPQ)). The study surveyed 929 Muslim teachers and school staff in East Java, Indonesia. We found that ROS correlates with EPQ whereby intrinsic personal (IP) relates with idealism while extrinsic social religious orientation (ES)-where religion is perceived as an instrument for social gain, membership and support-relates with relativism. However, using multiple regression analysis to examine both EPQ and ROS relation to acceptability for harming animals suggests mixed results. We found that, idealism and IP relate to a lower acceptability for harming animals, while relativism and ES correlate to a higher acceptability for harming animals. In another model where we calculate all the main variables with all the demographical and other determinants, we found that only ROS consistently relates to acceptability for harming animals. Additionally, we identify, explain and discuss significant demographic determinants along with this study's limitations.

Religion as an influencing factor of right-wing, left-wing and Islamist extremism. Findings of a Swiss youth study

In criminological research the relationship between religion and delinquency has received great attention. Religiosity has been shown to be a protective factor for violent behaviour, drug use and other types of crime. In contrast, the relationship between religion and extremism was rarely investigated and then almost exclusively in relation to Islamist extremism. This paper presents results of a youth survey on extremism in Switzerland. A total of 8317 young people in ten cantons were interviewed about right-wing, left-wing and Islamist extremism. The study allows in a unique way to analyse religion, religiosity and religious attitudes in relation to three forms of extremist attitudes. The results show that religion is an important influencing factor of extremism, but religious affiliation and religiosity are less important than specific religious attitudes such as religious tolerance and religious exclusivity.

Intersectional experiences: A mixed methods experience sampling approach to studying an elusive phenomenon

Social scientists are increasingly interested in methodological advances that can illuminate the distinct experiences and health outcomes produced by various systems of inequality (e.g., race, gender, religion, sexual orientation). However, innovative methodological strategies are needed to (a) capture the breadth, complexity, and dynamic nature of moments co-constructed by multiple axes of power and oppression (i.e., intersectional experiences) and (b) keep pace with the increasing interest in testing links between such events and health among underresearched groups. Mixed methods designs may be particularly well suited for these needs, but are seldom adopted. In light of this, we describe a new mixed methods experience sampling approach that can aid researchers in detecting and understanding intersectional experiences, as well as testing their day-to-day associations with aspects of health. Drawn from two separate experience sampling studies examining day-to-day links between intersectional experiences and psychological health-one focusing on Black American LGBQ individuals and another on Muslim American LGBQ individuals-we provide quantitative and qualitative data examples to illustrate how mixed methods investigations can advance the assessment, interpretation, and analysis of everyday experiences constructed by multiple systems of power. Limitations, possible future adaptations, implications for research, and relevance to the clinical context are discussed. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Coming Home to One's Self: Butch Muslim Masculinities and Negotiations of Piety, Sex, and Parenthood in Singapore

In Singapore, discrimination toward LGBT citizens has been reinforced through a monolithic notion of the traditional Asian family. This ethnography focuses on the lived experiences of 7 ethnic minority Malay Muslim "butch" individuals and their journey to parenthood. Drawing upon frameworks of intersectionality and piety, I explore how butches negotiate and reconcile their queer practices and desires as Muslim daughters around "coming out," foster children with same-sex partners, being a biological parent and their perceptions of Assisted Reproductive Technologies (ART). Reproductive futures, enacted by Malay Muslim butches, disrupt yet reinforce the durability of "natural" life trajectories scripted through conventions of marriage, family and fatherhood that have, insofar, excluded them. Further, their experiences also offer alternatives to existing literature on same-sex families that tend to render other nonwhite and/or non-Western queer family practices invisible.

Spirituality and Religious Engagement, Community Involvement, Outness, and Family Support: Influence on LGBT+ Muslim Well-Being

The current study utilized data from the Social Justice Sexuality Project to investigate influences on psychological well-being of LGBT+ Muslims (N = 75) in the United States. Specifically, path analyses were used to examine the association between spiritual and religious engagement, LGBT community involvement, outness, and family support with psychological well-being. Control variables included lifespan Islam involvement, age, income, and the age at which the participant came out to themselves. Findings illustrate spiritual and religious engagement, outness, and income were all positively related to psychological well-being. Moreover, individuals who had converted to Islam but were not raised in the faith had significantly lower psychological well-being than those who had a consistent experience with Islam from their childhood until the time of the study. The present investigation provides critical contributions to the study of gender and sexual minorities in the United States and the experiences of currently practicing LGBT+ Muslims and those who were raised Muslim. Clinical implications and future research suggestions are discussed.

"I feel as if I'm lying to them": Exploring Lesbian Muslims' Experiences of Rejection, Support, and Depression

The current exploratory study utilized a mixed-methods design to study 18 lesbian Muslims' mental health in relation to familial and online social support (M Age = 24, Sd = 9). Due to the threat of familial rejection, the majority of participants (n = 11) selectively disclosed their sexual identity and four participants publicly disclosed. Half of participants scored as mildly to severely depressed on the Beck Depression Inventory (M = 15, Sd = 9). Participants reporting changes in their familial relationships due to their sexual orientation scored as the most highly depressed, F (2, 15) = 4.75, p = .025. Participants' depression scores varied significantly between those that belonged to online support groups addressing religion and sexuality (n = 8, M = 8.712, SD = 6.183) and those that did not (n = 10, M = 20.250, SD = 7.772), t(16) = 3.416, p = .004. Future research would benefit from exploring how therapeutic alliances and family of choice networks can help buffer lesbian Muslims' experiences of familial rejection.

Incorporating Transformative Intersectional Psychology (TIP) into Our Understanding of LGBTQ Muslims' Lived Experiences, Challenges, and Growth

This article serves as the first in a series of six articles providing a theoretically and empirically informed approach to understanding Muslim LGBTQ lives from an intersectional positive-growth framework, transformative intersectional psychology (TIP). Within this perspective, LGBTQ Muslims' religious, gender and sexual identities are mutually interactive and situated within the dynamic systems of power, privilege and oppression. This approach recognizes that LGBTQ individuals negotiate multiple minority identities as they navigate oppression and build pathways of resilience. In the present article, we provide an introduction to TIP and this theory's relevance to the distinct experiences of LGBTQ Muslims. We then conclude with an overview of the goals of this Special Issue, The LGBTQ Muslim Experience, and introduce the subsequent articles in the series. The articles in this Special Issue address the implications of transformative intersectional psychology for LGBTQ Muslim research, training and clinical practice.

Voices of Resistance and Agency: LBTQ Muslim Women Living Out Intersectional Lives in North America

This qualitative study critically examined, from an interpretive perspective, 14 life stories of LBTQ Muslim women across North America. This paper explored how LBTQ Muslim women navigated Muslim and LGBTQ hegemonic norms and exclusions as they negotiated and lived out identity intersections. Transnational and critical race feminisms, intersectionality, and critical Islamic liberationist approaches to gender and sexuality framed the project. The study findings suggested that LBTQ Muslim women resisted hegemonic norms by mapping out alternative paths grounded in Islam, and in living out lives in LGBTQ communities. Participants discussed their experiences of being "othered" within LGBTQ communities, how they challenged the notion of a monolithic Islam, how they expanded coming-out frameworks to include their own experiences, as well as how they asserted their own religious agency and resistance. Participants demonstrated that living out an intersectional identity was a complex task where constant negotiations of positionality were transpiring concurrently.

This Being is a Guest House: Embracing Humility, Liberation & Strengths in Therapy with Sexual and Gender Diverse Muslims

The complexity of the lives of sexual and gender diverse Muslims within the United States calls for mental health providers to own our power and privilege. Embracing cultural humility in service of aligning ourselves with liberation psychology, we call for an intersectionally informed, strengths-based approach to empowering/affirming clients whose diverse religious experiences intersect with their experiences of marginalization as sexual and gender diverse (SGD) Muslims. Drawing on extant personal narratives around mental health and therapy of this population, the authors offer critical reflections, processes and opportunities for clinicians to take responsibility in honoring the diverse journeys and experiences of SGD Muslims in serving them in journeys of healing.

Differences in the Factor Structure of the Eating Attitude Test-26 (EAT-26) in Different Cultures in Israel: Jews, Muslims, and Christians

BACKGROUND

In recent years, there has been a shift in the clinical presentation and, hence, diagnostic definitions of eating disorders (EDs), reflected in a dramatic change in the diagnostic criteria of EDs in the DSM-5. The Eating Attitudes Test-26 (EAT-26) is currently considered an accepted instrument for community studies of EDs, although it features an inconsistent factorial structure in different cultures. Therefore, it is essential to investigate whether the EAT-26 can still be considered an adequate instrument for identifying the risk of developing EDs in different cultures. The aim of the present study was to examine the construct validity and internal consistency of the EAT-26.

METHOD

The study used exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) among different cultural populations in Israel.

RESULTS

Findings indicated different factors in different ethnic groups, most of which do not correspond with the original EAT-26 three-factor structure.

RESULTS

The analysis yielded two main factors among Israeli Jews, four main factors among Israeli Muslim Arabs, and three main factors among Israeli Christian Arabs.

CONCLUSION

These findings shed light on cultural factors affecting perceptions of the EAT-26 items. This calls for a reconsideration of the generalization of the original three-factor structure of the questionnaire in different cultures.