Religious Coping and Substance Use: The Moderating Role of Sex

Crisis of Faith and Sleep Quality in the United States: A Literal Dark Night of the Soul?

A crisis of faith is an intrapersonal struggle with ultimate meaning that occurs when one's supramundane reality is called in question. We propose a theoretical model which suggests that a crisis of faith will contribute to poorer sleep quality by undermining a general sense of meaning and purpose in life, especially among women. We use national survey data from the Wave 5 of the Baylor Religion Survey United States (N = 1395). Ordinary least squares regression models with robust standard errors are utilized. Sobel-Goodman mediation techniques are used to test the proposed mediating pathway. Our results suggest that a crisis of faith is associated with lower sleep quality, and that this pathway is partially mediated by a lower sense of meaning and purpose in life. Finally, we found that the relationship between a crisis of faith and lower sleep quality was weaker for women. We discuss the implications of our results and suggest how future research may explore the relevance of a crisis of faith for well-being as well as other aspects of the human condition.

Perceived Stress, Religiosity, and Substance Use Among African American and Latinx College Students with Asthma in the USA

This study examined associations among perceived stress, religiosity, and substance use in African American and Latinx college students with asthma. Participants included 194 college students with asthma (18-20 years, 63.4% African American, 21.1% Latinx). Eligible students completed an online questionnaire that included measures of asthma control, perceived stress, religiosity, alcohol misuse, and last 30-day tobacco use and marijuana use. Over one-quarter (25.3%) of participants reported using tobacco and 31.9% reported using marijuana in the past 30 days. Perceived stress and religiosity were each independently associated with multiple indicators of substance use. Asthma control moderated associations between religiosity and tobacco use in the past 30 days (b =  - .014, p = .002), such that the association between religiosity and tobacco use was stronger among those with better asthma control. Participant gender significantly moderated the association between perceived stress and alcohol misuse (b =  - .099, p = .029); a stronger, positive association between stress and alcohol misuse was found among men. Students' perceived stress levels were associated with marijuana use in the past 30 days and high alcohol misuse. Religiosity was inversely linked to substance use. There is a need for healthcare providers to recognize and focus on substance use prevention specifically among African American and Latinx college students with asthma.

Reproducibility of the brief religious coping inventory with African athletes' sample using ordinal factor analytical approach

Background

Previous studies have revealed that religious coping strategy is common among athletes due to the stressful experiences before and during competitions as part of the mental preparations they go through, the uncertainty of sporting outcomes, and other organizational issues they encounter. This research assessed the reproducibility of the Brief Religious Coping (RCOPE) instrument in an African setting using athletes' samples from different countries. Particularly, the research sought to assess the (1) factor structure of Brief RCOPE with an African sample, (2) construct validity of the RCOPE measure, and (3) measurement invariance of the RCOPE instrument based on gender and nationality.

Methods

The study surveyed a convenient sample of 300 athletes, including 164 male and 136 female athletes, from 3 African countries (Benin, Ghana, and Nigeria) who participated in the 2018 West African University Games. The Brief RCOPE instrument was administered to the athletes for validation purposes before the competition. Exploratory and confirmatory factor analyses were conducted using the ordinal factor analytic approach.

Results

This validation study confirmed the two-factor dimension (positive and negative religious coping) of the Brief RCOPE measure. Further, all items for each of the dimensions of the inventory contributed significantly to the measure of the Brief RCOPE domains. The positive and negative religious coping dimensions contributed more than half of the variance of their respective indicators. Measurement invariance across gender and nationality was confirmed.

Conclusion

Sufficient evidence was gathered to support the interpretation and use of the Brief RCOPE measure. Coaches and sports psychologists could adopt the Brief RCOPE measure to understand the mental or thought patterns of religious athletes based on existential concerns or stress accrued from impending competitions to inform appropriate religious coping interventions. This notwithstanding, the Minimum Clinical Important Difference (MCID) of the Brief RCOPE should be further investigated to enhance the utility of the instrument for use in intervention-based studies.

Protective Behavioural Mechanisms Against Cannabis Use Among Adolescents in Cannabis-Growing Settings of South Africa: Insights Into Adolescent Cannabis Use Prevention

We aimed to explore the behavioural protective mechanisms against cannabis use among adolescents living in South African illicit cannabis-growing communities, based on the Self Determination Theory (SDT). Exploratory qualitative design techniques were followed in conducting the study. The snowball sampling technique was used to recruit thirty (30) non-cannabis smoking adolescents from 2 purposively selected communities and grouped into 4 focus groups and interviewed. A semi-structured focus group interview guide was used to moderate the discussions. Data were analysed inductively, using the ATLAS. ti software. Nine behavioural coping mechanisms, grouped under intrinsic and extrinsic protective behavioural mechanisms, protected participants from using cannabis. Intrinsically, participants' determination not to engage in bad behaviours, focus on their academic work during their free periods, their non-financial dependence on cannabis-using peers, self-preservation to ensure good marriages, and religious beliefs on substance abuse motivated them to not use cannabis. On the other hand, the concept of Ukuphoxa (preservation of family dignity), fear of arrest, fear of being tagged a social deviant, and the fear of contracting illnesses such as lung cancer served as protective behavioural mechanisms against cannabis use. Health promotion and education programmes for adolescents on non-cannabis use in communities where illicit cannabis abounds must identify and draw on contextual intrinsic and extrinsic motivations that ensure non-cannabis use.

Explaining Cannabis Use by Adolescents: A Comparative Assessment of Fuzzy Set Qualitative Comparative Analysis and Ordered Logistic Regression

Background: This study assesses the relevance of several factors that the literature on the substance use of adolescents considers relevant. The factors embed individual variables, such as gender or age; factors linked with parental style; and variables that are associated with the teenager’s social environment. Methods: The study applies complementarily ordered logistic regression (OLR) and fuzzy set qualitative comparative analysis (fsQCA) in a sample of 1935 teenagers of Tarragona (Spain). Results: The OLR showed that being female (OR = 0.383; p < 0.0001), parental monitoring (OR = 0.587; p = 0.0201), and religiousness (OR = 0.476; p = 0.006) are significant inhibitors of cannabis consumption. On the other hand, parental tolerance to substance use (OR = 42.01; p < 0.0001) and having close peers that consume substances (OR = 5.60; p < 0.0001) act as enablers. The FsQCA allowed for fitting the linkages between the factors from a complementary perspective. (1) The coverage (cov) and consistency (cons) attained by the explanatory solutions of use (cons = 0.808; cov = 0.357) are clearly lower than those obtained by the recipes for nonuse (cons = 0.952; cov = 0.869). (2) The interaction of being male, having a tolerant family to substance use, and peer attitudes toward substances are continuously present in the profiles that are linked to a risk of cannabis smoking. (3) The most important recipe that explains resistance to cannabis is simply parental disagreement with substance consumption. Conclusions: On the one hand, the results of the OLR allow for determining the strength of an evaluated risk or protective factors according to the value of the OR. On the other hand, the fsQCA allows for the identification not only of profiles where there is a high risk of cannabis use, but also profiles where there is a low risk.

Without Your Therapist: Contemplative Prayer During Treatment as a Religious Exposure Intervention to Reduce Religious Struggle and Anxious God Representation

This case study focuses on the treatment of a 44-year-old Dutch man presenting with an anxious God representation and religious struggles according to DSM-5 criteria. Having received prior treatment for a panic disorder and alcohol use disorder, the patient was given a 60-day treatment in which the Jesus Prayer intervention was used to address his religious and spiritual problems. To our knowledge, this is the first case study involving the Jesus Prayer in the treatment of a patient. The intervention had positive effects on the patient’s religious and spiritual problems concerning an anxious God representation, religious struggles, stress levels and surrender to God. The intervention may also play a supporting role in decreasing symptoms of depression and anxiety and in promoting global mental health, as reliable change index analyses revealed symptom reduction between baseline levels and at post-assessment levels for all measured symptoms, with a semi-gradual decrease over the course of treatment. These improvements were continued in a 3-month follow-up assessment, suggesting promise for the Jesus Prayer as an effective treatment method for religious and spiritual problems. Recommendations regarding the importance of assessing the religious life of patients and implementing spiritual interventions are discussed, as well as the relevance of the therapist’s own assumptions when treating a religious or spiritual problem.

The Impact of COVID-19 and Associated Interventions on Mental Health: A Cross-Sectional Study in a Sample of University Students

BACKGROUND

Mental health issues have continued to rise globally, including among university students. The COVID-19 pandemic has exacerbated the previously existing and concerning problem. Given that coping mechanisms have been proposed to mediate the relationship between stressors and mental health, the aim of our cross-sectional study was to investigate the mediation of coping mechanisms on the relationship between the impact of the COVID-19 pandemic and mental health.

METHODS

University students (≥18 years old; N = 676; 31% male, 69% female) were administered an anonymous survey addressing current demographics, COVID-19 pandemic-related demographics, personal experiences, sources of stress and perceived effect on mental health, politics, sources of news/information, and various pre-validated scales addressing mental health (DASS-21), the impact of the COVID-19 pandemic (IES-R) and coping strategies utilized (Brief COPE).

RESULTS

Our results indicate a substantial proportion of our sample reporting scores in the severe and extremely severe DASS-21 categories, in addition to ~50% reporting a perceived deterioration in mental health relative to pre-COVID-19 pandemic. Moreover, a substantial proportion of students reported IES-R scores at levels where PTSD is of clinical concern. Alarmingly, a significant proportion of females (~15%) reported scores reflecting potential long-term PTSD-related implications. Females tended to be more severely impacted in all mental health measures. Mediation analysis indicated that while dysfunctional coping mediated the relationship between the impact of the event (COVID-19 pandemic) and all three mental health outcomes, overall, this was not the case with the positive coping strategies.

CONCLUSION

Our study appears to indicate a reduced buffering influence on negative mental health outcomes by the positive coping mechanisms investigated in relation to the COVID-19 pandemic and secondary interventions implemented. While the findings of this study pertain specifically to university students, they corroborate the existing extensive body of research (from physiological to behavioral, preclinical to clinical) pertaining to the response associated with major stressful events at every level of society. In this regard, the findings imply the necessity for health and other authorities, tasked with safeguarding public well-being, to avoid reactive interventions that do not appropriately balance the risks and benefits, potentially exacerbating pre-existing psychopathologies and compromising social order.

Religiosity and substance use in U.S. adults: Findings from a large-scale national survey

BACKGROUND

In recent decades, the US religious landscape has undergone considerable change such as a decline in religious service attendance. These changes may indicate that religious social support structures have deteriorated, possibly leading to a decrease in strengths of associations with substance use. Considering this, and given limitations of past studies (e.g., limited control for potential confounders), large-scale general population studies are needed to reexamine associations between religiosity domains and substance use.

METHODS

This cross-sectional study used data from the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions-III (N = 36,309). In unadjusted and adjusted models, controlling for religiosity domains and other covariates, we examined associations between three religiosity domains (importance of religiosity/spirituality, service attendance, and religious affiliation) and DSM-5 SUD. Focusing on service attendance, we also examined associations with other substance use-related outcomes.

RESULTS

Among religiosity domains, only frequency of service attendance was associated with SUD across most substances. Frequent service attendees had lower odds of alcohol use disorder (adjusted OR [aOR] = 0.4, 95 % CI 0.33,0.51), tobacco use disorder (aOR = 0.3, 95 % CI 0.22,0.33) and cannabis use disorder (aOR = 0.4, 95 % CI 0.24,0.68), compared to non-service attendees. For alcohol and tobacco, the protective effect of frequent service attendance was more robust for SUD than for respective substance use.

CONCLUSIONS

Despite decreasing rates of religious belief and practice in the US, service attendance independently lowered the odds of substance use and SUD across multiple substances. Results may inform religious leaders and clinicians about the value of utilizing religious social support structures in the prevention and treatment of substance use and SUD.

The Relationship Between Spiritual Well-Being and Burnout in Collegiate Athletic Trainers

CONTEXT

Spiritual well-being is the expression of one's spirituality as measured in the dimensions of existential and religious well-being. The Smith Cognitive Affective Model of Athletic Burnout suggests that personality factors such as spiritual well-being and the use of religious coping methods may affect burnout as well as its causes and outcomes. This has not been examined in collegiate athletic trainers (ATs).

OBJECTIVE

To investigate the relationship between spiritual well-being and burnout in collegiate ATs.

DESIGN

Cross-sectional study.

SETTING

Web-based survey.

PATIENTS OR OTHER PARTICIPANTS

A total of 783 certified ATs employed full time in the collegiate setting participated. Part-time employees (eg, graduate assistants, interns) were excluded.

MAIN OUTCOME MEASURE(S)

A 100-item online questionnaire was created for this study. It used items from previously developed scales, including the Spiritual Well-Being Scale, the Brief RCOPE, the Maslach Burnout Inventory, and substance-use questions from the Monitoring the Future study. Participants were able to complete the survey in approximately 10-15 minutes. Multiple regression analyses were used to analyze survey data. We mapped all independent (existential well-being, religious well-being, positive and negative religious coping) and dependent variables (situational variables, Maslach Burnout Inventory burnout subscales, substance use, and intention to leave) onto the Smith Cognitive-Affective Model of Athletic Burnout to determine which variables altered burnout levels, substance use, and intention to leave. Tests of mediation or moderation were conducted when appropriate.

RESULTS

Existential well-being was a significant positive predictor of social support and a significant negative predictor of work-family conflict, decreased sense of personal accomplishment, emotional exhaustion, depersonalization, intention to leave the profession, and binge drinking. Existential well-being also served as a mediator or moderator in several components of the model.

CONCLUSIONS

Existential well-being was a protective factor against burnout as well as some of the causes and effects of burnout in collegiate ATs.

Religious Attendance in a Secular Country Protects Adolescents from Health-Risk Behavior Only in Combination with Participation in Church Activities

Religiosity and spirituality have been considered to be protective factors of adolescent health-risk behavior (HRB). The aim of this study was to assess the relationship between adolescents’ HRB and their religiosity, taking into account their parents’ faith and their own participation in church activities. A nationally representative sample (n = 13377, 13.5 ± 1.7 years, 49.1% boys) of Czech adolescents participated in the 2018 Health Behavior in School-aged Children cross-sectional study. We measured religious attendance (RA), faith importance (FI) (both of respondents and their parents), participation in church activities and adolescent HRB (tobacco, alcohol, and cannabis use and early sexual intercourse). We found that neither RA nor FI of participants or their parents had a significant effect on adolescents’ HRB. Compared to attending respondents who participate in church activities (AP), non-attending respondents who participate in church activities were more likely to report smoking and early sexual intercourse, with odds ratios (ORs) ranging from 3.14 (1.54–6.39) to 3.82 (1.99–7.35). Compared to AP, non-attending respondents who did not participate in church activities were more likely to report early sexual intercourse, with OR = 1.90 (1.14–3.17). Thus, our findings show that RA does not protect adolescents from HRB; they suggest that RA protects adolescents from HRB only in combination with participation in church activities.

Assessing the Associations between Religiosity and Alcohol Use Stages in a Representative U.S. Sample

Background: Problematic alcohol drinking has been a public health concern in the United States. Studies showed that religiosity serves as a protective factor, delaying the onset of alcohol use, and reducing the frequency of drinking. Few studies, however, have examined these associations with large, nationally representative samples, and even fewer have assessed the impact of religiosity on drinking behavior transitions/changes. Objectives: This study examined a national adult sample to investigate the associations between religiosity and alcohol use stages including initiation, reinitiation, and persistence of alcohol use. Methods: Data from the National Epidemiologic Survey of Alcohol and Related Conditions Waves 1-2 were used. Wave 1 sample included 6113 nondrinkers, 6189 prior drinkers, and 21,950 current drinkers who were at risk for initiation, reinitiation, and persistent use of alcohol, respectively. Religiosity constructs included importance of religious and frequency of practice. Three logistic regressions examined the aforementioned associations. Results: Compared to those not attending religious services, the most frequent attenders exhibited lower odds of initiating alcohol use, reinitiation after prior use, and persistent drinking (ORs = 0.23, 0.51, 0.55, respectively; ps < .01). Those identifying religious beliefs as very important exhibited lower odds of initiation and reinitiation of alcohol use (both ORs = 0.63, ps < .05). Conclusions: Religiosity plays an important role in preventing/delaying alcohol use initiation, reinitiation, and persistence. Incorporating religiosity aspects (e.g. meditation) into alcohol prevention and control programs may serve to increase protective effects. Future studies should seek to delineate what religiosity factors can be leveraged and embedded into secular prevention programs delivered to youth and adolescents.

The Role of Religion and Religiosity in Alcohol Consumption in Adolescents in Spain

This study explored the relationship between religion, religiosity and alcohol consumption in a sample of 2.890 adolescents (ages 12-18) in Madrid, Spain. Results showed that non-believers were the group that consume and abuse alcohol the most, as opposed to Catholics. Besides, religiosity was related to a lower alcohol use. Therefore, religion and religiosity in Spanish adolescents appear to be related to a low alcohol use. This contribution may help to clarify the risk and protection factors for alcohol consumption by adolescents and contribute to strengthening the preventive actions.

Positive and Negative Religious Coping Styles as Prospective Predictors of Well-Being in African Americans

Research on religious coping has proliferated in recent years, but many key questions remain, including the independent effects of positive and negative religious coping styles on well-being over time. Further, little research on religious coping styles has been conducted with African Americans in spite of their documented importance in this population. The present study examined the independent prospective effects on well-being of positive and negative religious coping styles over the subsequent 2.5 years in a national sample of African American community-dwelling adults. Well-being indicators included depressive symptoms and positive and negative affect as well as self-esteem and meaning in life. Results indicated that when considering positive and negative religious coping styles together, baseline positive religious coping consistently and positively predicted the well-being indicators 2.5 years later, while negative religious coping consistently and negatively predicted the well-being indicators 2.5 years later. These effects remained when examining change in well-being levels over time, although they attenuated in magnitude. Finally, negative religious coping more strongly predicted the negative aspects of well-being (e.g., depressive symptoms, negative affect) 2.5 years later than did positive religious coping, an effect that also remained but was attenuated when controlling for baseline levels of well-being. These results highlight the nuanced relationships between both positive and negative religious coping styles and positive and negative aspects of well-being over time among African Americans. Future research might usefully examine how to minimize negative effects and capitalize on the salutary effects of positive religious coping.

Patterns of cancer-related health behaviors among middle-aged and older adults: Individual- and area-level socioeconomic disparities

Multiple health behaviors could have greater impact on chronic diseases than single behaviors, but correlates of behavioral clusters are relatively understudied. Using data from NIH-AARP Diet and Health Study (initiated in 1995) for 324,522 participants from the U.S. (age 50-71), we conducted exploratory factor analysis to identify clusters of adherence to eight cancer prevention behaviors. Poisson regressions examined associations between cluster scores and neighborhood socioeconomic deprivation, measured with census block group (1) poverty and (2) low education. Four clusters emerged: Movement (adequate physical activity/less TV); Abstinence (never smoked/less alcohol); Weight control (healthy body mass index/high fruits and vegetables); and Other (adequate sleep/receiving cancer screenings). Scores on all clusters were lower for participants in neighborhoods with the highest poverty (most deprived quintile versus least deprived: relative risk [RR] = 0.95 (95% confidence interval [CI] = 0.94-0.96) for Movement, 0.98 (95% CI = 0.97-0.99) for Abstinence, 0.94 (95% CI = 0.92-0.95) for Weight control, and 0.94 (95% CI = 0.93-0.95) for Other; all p < 0.001). Scores on three clusters were lower for participants in neighborhoods with the lowest education (RR = 0.88 (95% CI = 0.87-0.89) for Movement, 0.89 (95% CI = 0.88-0.90) for Weight control, and 0.90 (95% CI = 0.89-0.91) for Other; all p < .001). Health behaviors among older adults demonstrated four clusters. Neighborhood deprivation was associated with lower scores on clusters, suggesting that interventions to reduce concentrated deprivation may be an efficient approach for improving multiple behaviors simultaneously.