Religiosity as a Moderator of Self-Efficacy and Social Support in Predicting Traumatic Stress Among Combat Soldiers

The Relationship Between Spirituality and Post-Traumatic Stress Symptoms in Syrian Adolescents in Jordan

The civil war in Syria began in 2011 and escalated over years resulting in one of the largest humanitarian crises since the Second World War. Injury, loss, poverty, and immigration trapped the Syrian population in a diversity of psychological disorders, including post-traumatic stress disorder (PTSD). Spirituality has, on the other hand, been consistently reported as a resilient factor against developing mental disorders. Hence, spirituality or religiosity have been incorporated in clinical and psychotherapeutic practice for several mental disorders. We explored the association between spirituality and the development of PTSD symptoms among Syrian refugee adolescents in Jordanian schools. A sample of 418 Syrian adolescent students (age range between 12-16 years) from Jordanian schools in the northern part of the country were enrolled in the study after informing on study context and objectives. The study questionnaire included sample demographics, smoking status, PTSD checklist - Civilian Version (PCL-C), two spirituality-targeting questions, and trauma and loss history. `Almost half of participants (N = 196) showed moderate PTSD symptoms while around 30% (N = 124) had a severe level of PTSD symptoms. On the other hand, 3 out of four students perceived themselves as highly spiritual. The study resulted in a positive correlation between belief in God and God's thankfulness. Furthermore, increased spirituality level did not appear to lower the risk of developing PTSD symptoms. Spiritual self-perception of Syrian refugee adolescents showed neither protective nor aggravating effect of on the occurrence of post-traumatic stress symptoms. Additional research and more accurate tools are needed to assess the potential impact of spiritual/religious values towards PTSD symptoms among adolescents.

The relationship between religiosity/spirituality and quality of life among female Eritrean refugees living in Norwegian asylum centres

BACKGROUND

Women are more vulnerable to mental health problems than men after migration, but little is known about the influence of religiosity/spirituality on their quality of life. The purpose of this study was to explore religiosity/spirituality, in relationships with various domains of quality of life, among female Eritrean refugees staying in Norwegian asylum centres.

METHOD

A questionnaire assessing sociodemographic characteristics was used together with the World Health OrganizationQuality of Life - Spirituality, Religiosity and Personal Beliefs (WHOQOL-SRPB) questionnaire, which assesses religiosity/spirituality and domains of quality of life. A total of 63 adult female Eritrean refugees who had been granted asylum but were still living in asylum reception centres located in southern and central Norway participated.

RESULTS

Religiosity/spirituality was independently associated with psychological quality of life (B = 0.367, p < .001), level of independence (B = 0.184, p = .028), social quality of life (B = 0.500, p = .003), environmental quality of life (B = 0.323, p < .001) and overall quality of life (B = 0.213, p < .001), but not with physical quality of life (B = 0.056, p = .679). There were no significant differences between religious affiliations on religiosity/spirituality or quality of life measures.

CONCLUSION

Consistent with previous research, this study highlights the correlation between religiosity/spirituality and overall quality of life. We recommend a longitudinal follow-up study of similar populations, after they are resettled and integrated into their host countries, to understand the associations between quality of life and religiosity/spirituality over time.

Religion, spirituality, and risk for incident posttraumatic stress disorder, suicidal ideation, and hazardous drinking in U.S. military veterans: A 7-year, nationally representative, prospective cohort study

While religion and spirituality (R/S) have been linked to positive mental health outcomes, most studies have employed cross-sectional designs, which do not allow one to evaluate the utility of R/S in predicting these outcomes. To address this gap, this study analyzed data from a 7-year nationally representative, prospective cohort study of U.S. military veterans to examine the effects of R/S on the development of incident mental health outcomes in this population. Specifically, we examined the association between organizational religious activity (ORA), non-organizational religious activity (NORA), and intrinsic religiosity (IR), and the risk of incident PTSD, suicidal ideation (SI), and hazardous drinking (HD). Multivariable logistic regression analyses revealed that ORA predicted a lower incidence of PTSD and SI; NORA a greater risk of developing HD; and IR a lower risk of developing HD. These results suggest that religion and spirituality, assessed in a nationally representative sample of military veterans, predict risk of developing PTSD, SI, and HD, over and above sociodemographic factors and perceived social support. Clinical implications and strategies for incorporating R/S into mental health assessment and interventions in this population are discussed.

Combat Deployment Experiences and Soldier Mental Health: Examining the Factor Structure of a Combat Experiences Scale

INTRODUCTION

Researchers and practitioners are invested in understanding how deployment experiences impact the nearly 193,000 U.S. service members who deploy in a given year. Yet, there remains a need to adequately identify salient deployment experiences through survey measurement tools and understand how differential experiences are uniquely related to mental health outcomes. Therefore, this study examined the factor structure of an established combat experiences measure from the Army Study to Assess Risk and Resilience in Service members (Army STARRS) dataset to identify underlying survey constructs that reflect nuanced deployment experiences. Then, we examined the association between diverse combat experiences and current mental health symptoms (i.e., anxiety and depressive symptoms) and the mediating role of coping.

MATERIALS AND METHODS

Data were drawn from the Army STARRS data (N = 14,860 soldiers), specifically the All Army Study component. A principal component analysis (PCA) was conducted to examine the dimensionality of the combat experiences scale, and then a path model was conducted to examine the relationships between combat experiences, coping with stress following a deployment, and mental health symptoms while controlling for relevant individual and interpersonal factors.

RESULTS

Results from the principal component analysis suggested that the Army STARRS combat experiences scale encompasses two components, specifically: "Expected combat experiences" and "Responsible for non-enemy deaths." Both "Expected combat experiences" and "Responsible for non-enemy deaths" were associated with higher levels of anxiety and depressive symptoms, respectively, and "Responsible for non-enemy deaths" was also indirectly linked to these mental health outcomes through coping with stress after deployment.

CONCLUSIONS

These findings provide insight into the dimensionality of combat experiences and offer practitioners a more nuanced understanding of how to process unique combat experiences that differentially relate to mental health symptoms.

Religiosity and Resilience: Cognitive Reappraisal and Coping Self-Efficacy Mediate the Link between Religious Coping and Well-Being

Qualitative evidence points to the engagement of religious coping strategies when facing adversity, and evidence also highlights the effectiveness of cognitive reappraisal in reducing the impact of distressing emotions on well-being. It has been suggested that religious practices could facilitate the use of reappraisal, by promoting reframing of negative cognitions to alter emotional states. However, the link between religiosity and reappraisal in influencing resilience against symptoms of distress is not known. The current study (N = 203) examined connections among these aspects, using self-reported measures of religious coping, habitual use of specific coping strategies (positive reappraisal) and perceived confidence in using coping strategies, as well as questionnaires assessing symptoms of distress (anxiety and depression). Results point to a mediating role of reappraisal and coping self-efficacy as part of mechanisms that provide a protecting role of religious coping against emotional distress. These results provide novel scientific evidence further validating millennia-old traditional coping practices and shed light on psychological factors influencing adaptive behaviors that promote increased resilience, reduce symptoms of distress, and maintain emotional well-being. These findings inform general counseling practices and counseling of religious clients alike.

Palestinian Adolescents' Prolonged Exposure to Political Violence, Self- Esteem, and Post-Traumatic Stress Symptoms

The goal of this study was to understand the relation between adolescents' long-term exposure to political violence (EPV) and post-traumatic stress symptoms (PTSS). We examined the relations among EPV, PTSS, and self-esteem to determine whether self-esteem could buffer the effects of EPV on PTSS. A systematic cluster random sample of 2,934 Palestinian adolescent boys and girls in the West Bank area of the Palestinian Authority and in East Jerusalem participated in a study using a self-administered questionnaire. Multiple regression analysis showed that the more Palestinian youth were exposed to political violence during the last year and during previous years, the more they exhibited PTSS and its three manifestations, that is, avoidance, intrusion, and arousal. In addition, EPV showed effects on PTSS after controlling for sociodemographic variables and self-esteem. Girls and residents of the West Bank reported more PTSS than boys and residents of East Jerusalem, respectively. Higher levels of EPV correlated with lower levels of self-esteem, and children with relatively low self-esteem were likely to report more PTSS than children with high self-esteem. Hence, the correlations between participants' EPV and some of the PTSS were found to be partially dependent on the levels of their self-esteem, indicating moderating and mediating effects for self-esteem on the relation between degree of EPV and PTSS. The limitations of the study and implications for future research are discussed.

Religion, Combat Casualty Exposure, and Sleep Disturbance in the US Military

Does religious involvement (i.e., attendance and salience) mitigate the association between combat casualty exposure and sleep disturbance among US military veterans? To address this question, we analyze cross-sectional survey data from the public-use version of the 2011 Health Related Behaviors Survey of Active Military Personnel. Results from multivariate regression models indicate: (1) Combat casualty exposure was positively associated with sleep disturbance; (2) religious salience both offset and moderated (i.e., buffered) the above association; and (3) religious attendance offset but did not moderate the above association. We discuss study implications and limitations, as well as some avenues for future research.

To lose an unborn child: Post-traumatic stress disorder and major depressive disorder following pregnancy loss among Israeli women

OBJECTIVES

Pregnancy loss (PL) can be a very difficult experience. However, the evidence regarding the prevalence and correlates of psychopathology following PL is inconsistent at best. The present study aimed to assess the prevalence of Post-Traumatic Stress Disorder (PTSD) and Major Depressive Disorder (MDD) following PL, and their differential predictors.

METHODS

Participants were 97 women, ages 23-47, who have experienced PL starting from the 2nd trimester. They were recruited at the Hadassah Ein-Kerem Medical Center in Jerusalem, Israel. The mean pregnancy week of loss was 27.92. Participants completed self-report questionnaires assessing PTSD (PCL-5), MDD (BDI-II), sociodemographic variables and factors related to the loss.

RESULTS

We have found high rates of probable PTSD (33.3%) and MDD (29.4%) among our sample, as well as high PTSD-MDD comorbidity. A more advanced gestational week of loss and shorter time since PL were positively associated with both PTSD and MDD. Younger age and lower religiosity were associated with more severe PTSD, but not MDD.

CONCLUSIONS

PL is a potentially-traumatic experience, entailing a heavy burden of PTSD and MDD. Mental health professionals are encouraged to closely monitor women following PL, particularly young mothers, who have experienced PL more recently, and at the advanced stages of pregnancy.

Coping, resilience and posttraumatic growth among Eritrean female refugees living in Norwegian asylum reception centres: A qualitative study

BACKGROUND

The links between migration and health are well documented. Being a refugee exacerbates migrants' vulnerability through trauma and loss. The aim of this study is to identify sources of resilience, coping and posttraumatic growth in female Eritrean refugees living in Norwegian asylum reception centres.

METHOD

The study had a qualitative, descriptive and explorative design with two focus group interviews and 10 individual in-depth interviews. Participants included 18 female Eritrean refugees aged 18-60, who had obtained refugee status and were still living in an asylum reception centre. A content-focused hermeneutic analytic approach was used.

RESULTS

Interviewees described the challenges of pre-flight and flight trauma, conditions at the refugee centre, communication difficulties and the 'endless' waiting for transfer to a municipality. To cope, they found it helpful to focus on the future and to think positively. Fellowship with and support from fellow Eritrean refugees were essential as they became a proxy family and provided a strong ethnic identity. Their religious belief also helped them cope and gave them hope for the future.

DISCUSSION

The interviewees in this study perceived their psychological problems as a normal reaction to what they had been through. Religious belief was an important resilience factor, as was social support, especially from peers.

CONCLUSION

The interviewees' coping was based on the realization of their psychological reactions being normal while doing their utmost to focus on their aims and hopes for the future.

Religion, spirituality, and mental health of U.S. military veterans: Results from the National Health and Resilience in Veterans Study

BACKGROUND

In the last three decades, there has been increased interest in studying the association between religion/spirituality (R/S), and mental health and functional outcomes.

METHODS

Using data from a contemporary, nationally representative sample of 3151 U.S. military veterans maintained by GfK Knowledge Networks, Inc., we evaluated the relation between R/S and a broad range of mental health, and psychosocial variables. Veterans were grouped into three groups based on scores on the Duke University Religion Index: High R/S (weighted 11.6%), Moderate R/S (79.7%) and Low R/S (8.7%).

RESULTS

A "dose-response" protective association between R/S groups and several mental health outcomes was revealed, even after adjustment for sociodemographic and military variables. High R/S was associated with decreased risk for lifetime posttraumatic stress disorder (odds ratio [OR]=0.46), major depressive disorder (MDD; OR=0.50), and alcohol use disorder (OR=0.66), while Moderate R/S was associated with decreased risk for lifetime MDD (OR=0.66), current suicidal ideation (OR=0.63), and alcohol use disorder (OR=0.76). Higher levels of R/S were also strongly linked with increased dispositional gratitude, purpose in life, and posttraumatic growth.

LIMITATIONS

In this cross-sectional study, no conclusions regarding causality can be made. The study provides a current snapshot of the link between R/S and mental health. The study also cannot determine whether religious coping styles (negative vs positive coping) contributed to observed differences.

CONCLUSIONS

Although the present study does not have treatment implications, our results suggest that higher levels of R/S may help buffer risk for certain mental disorders and promote protective psychosocial characteristics in U.S. military veterans.