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

Psychometric assessment of the Runyankole-translated Marlowe-Crowne Social Desirability Scale among persons with HIV in Uganda

BACKGROUND

Social desirability can negatively affect the validity of self-reported measures, including underreporting of stigmatized behaviors like alcohol consumption. The Marlowe-Crowne Social Desirability Scale (SDS) is widely implemented and comprised of Denial and Attribution Domains (i.e., tendencies to deny undesirable traits or attribute socially desirable traits to oneself, respectively). Yet, limited psychometric research has been conducted in sub-Saharan Africa, where the prevalence of unhealthy alcohol consumption is high as well as religiosity and hierarchical social norms. To address this gap, we (a) conducted an exploratory study assessing certain psychometric properties of the 28-item SDS (Runyankole-translated) among persons with HIV (PWH) in Uganda, and (b) examined the relationship between social desirability and self-reported alcohol use.

METHODS

We pooled baseline data (N = 1153) from three studies of PWH engaged in alcohol use from 2017 to 2021. We assessed the translated scale's construct validity (via confirmatory factor analysis), internal consistency, item performance, differential item functioning by gender, concurrent validity with the DUREL religiosity index domains, and the association between social desirability and self-reported alcohol use.

RESULTS

Participants had a mean age of 40.42 years, 63% were men, and 91% had an undetectable HIV viral load. The 28-item SDS had satisfactory construct validity (Model fit indices: RMSEA = 0.07, CFI = 0.84, TLI = 0.82) and internal consistency (Denial Domain ΩTotal = 0.82, Attribution Domain ΩTotal = 0.69). We excluded Item 14 ("I never hesitate to help someone in trouble") from the Attribution Domain, which mitigated differential measurement error by gender and slightly improved the construct validity (Model fit indices: RMSEA = 0.06, CFI = 0.86, TLI = 0.85) and reliability (Attribution Domain ΩTotal = 0.72) of the 27-item modified SDS. Using the 27-item SDS, we found that social desirability was weakly correlated with religiosity and inversely associated with self-reported alcohol use after adjusting for biomarker-measured alcohol use and other confounders (β = -0.05, 95% confidence interval: -0.09 to -0.01, p-value = 0.03).

CONCLUSIONS

We detected and mitigated measurement error in the 28-item Runyankole-translated SDS, and found that the modified 27-item scale had satisfactory construct validity and internal consistency in our sample. Future studies should continue to evaluate the psychometric properties of the Runyankole-translated SDS, including retranslating Item 14 and reevaluating its performance.

The Opioid Epidemic and Faith-Based Responses in Southern Appalachia, USA: An Exploration of Factors for Successful Cross-Sector Collaboration

This study aimed to identify factors for successful cross-sector collaboration with faith-based responses to the opioid epidemic in southern Appalachia. In-depth interviews were conducted with representatives from organizations responding to the opioid epidemic (N = 25) and persons who have experienced opioid dependency (N = 11). Stakeholders perceived that collaboration is hindered by stigma, poor communication, and conflicting medical and spiritual approaches to opioid dependency. Collaborations are facilitated by cultivating compassion and trust, sharing information along relational lines, and discerning shared commitments while respecting different approaches. The study concludes with theoretical and practical implications for both religious leaders and potential cross-sector collaborators.

Women's childbearing histories and their alcohol use at midlife

There has been increased alcohol use among mid-life women in recent decades. Given the association between alcohol use and childbearing earlier in life and the centrality of childbearing for other aspects of mid-life women's health, we examined how multiple components of childbearing histories were associated with mid-life alcohol use. Our analysis included 3,826 women from the National Longitudinal Survey of Youth 1979 (NLSY79). We estimated how nine components of childbearing were associated with women's alcohol use at age 50. We investigated these components independently and also created six childbearing profiles using Mixed-Mode Latent Class Analysis (MM-LCA). The most alcohol was consumed by women without any childbirths, with older ages at first birth, with low parity, and with the same or fewer births than expected. Women with older ages at first and last birth and more childbirths were less likely to abstain from alcohol compared to women with younger ages at first and last birth and fewer childbirths. Our MM-LCA demonstrated that women with multiple childbirths over a long period of time consumed the least alcohol compared to other groups. Binge drinking at mid-life was generally not associated with childbearing histories in our models. In summary, childbearing histories mattered for women's drinking behaviors at mid-life. Given that an increasing number of women do not have children, the age at first birth continues to trend older, and parity is decreasing, we may expect mid-life women's alcohol use to continue to increase in line with these observed fertility trends.

Religious and secular spirituality: Methodological implications of definitions for health research

The importance of spirituality as a research topic has been increasingly recognized, which has led to several studies on the topic. Areas including psychology, medicine, and nursing have produced studies on spirituality under a plurality of definitions and methods, which reveals the complexity of the theme. However, this has resulted in a range of potential problems, including: (1) the use of overlapping and contradictory terms between studies, or even within the same study, (2) research methodologies that do not fit the definitions (sometimes unreflectively) assumed by the authors, (3) difficulties, or even the impossibility, of comparing the results of studies, (4) controversies in respect of the inclusion/exclusion of secular groups in research on spirituality, and (5) ambiguous measurements, often being exclusively dependent on each participant's individual interpretation of what spirituality means. This article discusses these problems, recommends theoretical and methodological alternatives and presents taxonomy of definitions of spirituality.

Hazardous drinking and alcohol use disorders

Alcohol is one of the most widely consumed psychoactive drugs globally. Hazardous drinking, defined by quantity and frequency of consumption, is associated with acute and chronic morbidity. Alcohol use disorders (AUDs) are psychiatric syndromes characterized by impaired control over drinking and other symptoms. Contemporary aetiological perspectives on AUDs apply a biopsychosocial framework that emphasizes the interplay of genetics, neurobiology, psychology, and an individual's social and societal context. There is strong evidence that AUDs are genetically influenced, but with a complex polygenic architecture. Likewise, there is robust evidence for environmental influences, such as adverse childhood exposures and maladaptive developmental trajectories. Well-established biological and psychological determinants of AUDs include neuroadaptive changes following persistent use, differences in brain structure and function, and motivational determinants including overvaluation of alcohol reinforcement, acute effects of environmental triggers and stress, elevations in multiple facets of impulsivity, and lack of alternative reinforcers. Social factors include bidirectional roles of social networks and sociocultural influences, such as public health control strategies and social determinants of health. An array of evidence-based approaches for reducing alcohol harms are available, including screening, pharmacotherapies, psychological interventions and policy strategies, but are substantially underused. Priorities for the field include translating advances in basic biobehavioural research into novel clinical applications and, in turn, promoting widespread implementation of evidence-based clinical approaches in practice and health-care systems.

Religiosity and Attitudes towards Health, Disease, Death and the Use of Stimulants among Jehovah's Witnesses

Religiosity is considered as one of the many factors shaping an individual's health consciousness. The aim of the study is an analysis of the correlation between the religiosity of Jehovah's Witnesses and their attitudes towards health and disease. A cross-sectional study was performed on the convenience sample of 171 Jehovah's Witnesses from eastern Poland with the use of two research tools: the author's questionnaire, focusing on attitudes towards health, disease, death and the use of stimulants, and the Duke University Religion Index (DUREL). The research involved 99 females (57.9%) and 72 males (42.1%), with an average age of 37.25 (SD = 12.59) years. On average, they have been a Jehovah's Witness for 29.21 (SD = 13.22) years and are characterised by a high ratio of organisational religious activity (ORA) (M = 5.60; SD = 0.62) and intrinsic religiosity (IR) (M = 4.81; SD = 0.37). Those who had never smoked before becoming one of Jehovah's Witnesses had a higher IR (Z = -2.822; p = 0.005), similarly to those respondents who smoked cigarettes before they became Jehovah's Witnesses (Z = -2.977; p = 0.003) and those who did not abuse alcohol before they became Jehovah's Witnesses (Z= -1.974; p = 0.048). Jehovah's Witnesses are a group characterised by a high degree of consistency when it comes to religiosity, attitudes regarding health and disease and health behaviours. This means that they follow the teachings of their religion with regard to health issues. Knowledge about the association between religiosity and health behaviours is important to provide effective health education, health promotion and development of health prevention policy, specifically when dealing with more religious groups of clients.

Religion and Alcohol Use among Second Generation Korean Americans: Commentary on "Assessing the Associations between Religiosity and Alcohol Use Stages in a Representative U.S. Sample" by Lin et al, 2020

This commentary describes the extent to which church-attending Korean Americans engage in heavy drinking and treatment seeking behaviors. Methods: Using a church-based participatory approach, I conducted a rapid ethnographic assessment, part of which included an online survey (N=137). Results: I found that 54.74% of the sample of reported hazardous drinking over the past 12 months, 33.48% reported driving under the influence at some point in life, and 0% sought any treatment. Participant observation and unstructured interviews revealed that at this particular church, drunkenness was considered sinful among key informants, but many church members still drank heavily, often with other church members. Conclusion: We observed an interaction between religious and drinking cultures among second generation Korean American young and middle aged adults. Future research can explore the potential ways in which Korean Americans accommodate religious proscriptions and heavy drinking, and how awareness of discrepancies between behaviors and values may figure into preventive interventions.