Religiousness/spirituality and mental health among older male inmates

Reimbursing incarcerated individuals for participation in research: A scoping review

BACKGROUND

Little is known about global practices regarding the provision of reimbursement for the participation of people who are incarcerated in research. To determine current practices related to the reimbursement of incarcerated populations for research, we aimed to describe international variations in practice across countries and carceral environments to help inform the development of more consistent and equitable practices.

METHODS

We conducted a scoping review by searching PubMed, Cochrane library, Medline, and Embase, and conducted a grey literature search for English- and French-language articles published until September 30, 2022. All studies evaluating any carceral-based research were included if recruitment of incarcerated participants occurred inside any non-juvenile carceral setting; we excluded studies if recruitment occurred exclusively following release. Where studies failed to indicate the presence or absence of reimbursement, we assumed none was provided.

RESULTS

A total of 4,328 unique articles were identified, 2,765 were eligible for full text review, and 426 were included. Of these, 295 (69%) did not offer reimbursement to incarcerated individuals. A minority (n = 13; 4%) included reasons explaining the absence of reimbursement, primarily government-level policies (n = 7). Among the 131 (31%) studies that provided reimbursement, the most common form was monetary compensation (n = 122; 93%); five studies (4%) offered possible reduced sentencing. Reimbursement ranged between $3-610 USD in total and 14 studies (11%) explained the reason behind the reimbursements, primarily researchers' discretion (n = 9).

CONCLUSIONS

The majority of research conducted to date in carceral settings globally has not reimbursed incarcerated participants. Increased transparency regarding reimbursement (or lack thereof) is needed as part of all carceral research and advocacy efforts are required to change policies prohibiting reimbursement of incarcerated individuals. Future work is needed to co-create international standards for the equitable reimbursement of incarcerated populations in research, incorporating the voices of people with lived and living experience of incarceration.

Older adults deprived of liberty: "their pain hurts more"

This essay reflects on the incarceration of older adults in the United States (USA) and Brazil and mainly aims to observe how the situation is consistent and differs in the two countries. The bibliography on the subject is much more affluent and consolidated in the USA. Several discrepancies are noted among scholars between data and authors' views. However, they all agree regarding (1) the increased number of incarcerated older adults, (2) the inadequacy of prisons to house them, (3) the accelerated aging due to lack of healthcare, (4) the experiences of physical, musculoskeletal, and mental comorbidities, and (5) the high costs of treating them adequately. Most senior prisoners are poor Black and brown men and people with some specific social fragility. A positive factor underscored by Brazilian and North American researchers is the cultivation of spirituality, which helps older adults in prison keep some well-being. However, incarcerated older adults require much other care, and few initiatives consider the specific needs of this social group. The time has come for Brazil to face this issue, whether out of social responsibility or human solidarity.

Gratitude, Forgiveness, and Anger: Resources and Risk Factors for Italian Prison Inmates

The adjustment of prison inmates is recently becoming a social concern. In the current study we focused on the role of gratitude, interpersonal forgiveness, and anger, which have been widely addressed as likely to influence people's health and adaptive behaviors, in shaping prison inmates' psychological wellbeing and criminal attitudes. Participants were 104 male prison inmates aged between 24 and 75 (M_age = 46.63, SD = 11.38) imprisoned in Northern Italy who were asked to fill in an anonymous self-report questionnaire. Results highlighted that all dimensions considered play an important, albeit different and highly specific, role; Gratitude is a promotional factor that enhances psychological wellbeing, whereas interpersonal forgiveness appears to be a protective factor against the adoption of a criminal attitude as violence or antisocial intent. Finally, anger is a risk factor toward both psychological wellbeing and violent behaviors. Implications of these results and further developments of the study are discussed.

Standardized outcome measures of mental health in research with older adults who are incarcerated

PURPOSE

The targeted use of standardized outcome measures (SOMs) of mental health in research with older adults who are incarcerated promotes a common language that enables interdisciplinary dialogue, contributes to the identification of disparities and supports data harmonization and subsequent synthesis. This paper aims to provide researchers with rationale for using "gold-standard" measures used in research with community-dwelling older adults, reporting associated study sample psychometric indexes, and detailing alterations in the approach or measure.

DESIGN/METHODOLOGY/APPROACH

The authors highlight the mental health of older adults who are incarcerated. They also discuss the benefits of SOMs in practice and research and then identify gold-standard measures of mental health used in research with community-dwelling older adults and measures used in research with older adults who are incarcerated. Finally, the authors provide several recommendations related to the use of SOMs of mental health in research with this population.

FINDINGS

Depression, anxiety and post-traumatic stress disorder are common among older adults who are incarcerated. Researchers have used a variety of measures to capture these mental health problems, some parallel to those used with community-dwelling samples. However, a more targeted use of SOMs of mental health in research with this population will contribute to important strides in this burgeoning field.

ORIGINALITY/VALUE

This review offers several practical recommendations related to SOMs of mental health in research with older adults who are incarcerated to contribute to a rigorous evidence base and thus inform practice and potentially improve the health and well-being of this population.

Defining an age cut-off for older offenders: a systematic review of literature

PURPOSE

In the literature, 65 years is commonly used as the age to designate an older person in the community. When studying older prisoners, there is much variation. The purpose of this paper is to investigate how researchers define older offenders and for what reasons.

DESIGN/METHODOLOGY/APPROACH

The authors reviewed articles on health and well-being of older offenders to assess terminology used to describe this age group, the chosen age cut-offs distinguishing younger offenders from older offenders, the arguments provided to support this choice as well as the empirical base cited in this context.

FINDINGS

The findings show that the age cut-off of 50 years and the term "older" were most frequently used by researchers in the field. The authors find eight main arguments given to underscore the use of specific age cut-offs delineating older offenders. They outline the reasoning provided for each argument and evaluate it for its use to define older offenders.

ORIGINALITY/VALUE

With this review, it is hoped to stimulate the much-needed discussion advancing towards a uniform definition of the older offender. Such a uniform definition would make future research more comparable and ensure that there is no ambiguity when researchers state that the study population is "older offenders".

Forgotten Variables and Older Men in Custody: Negative Childhood Events, Forgiveness, and Religiosity

The study tested a mediational model linking negative childhood events through forgiveness of self and social support to religiosity using data from a convenience sample of 261 men aged 45-82 years residing behind prison walls. The Developmental Model of Adaptation provided the study's conceptual model for investigating the associations among the study variables. The study tested a mediational model linking the distal past (negative childhood events) to the outcome, religiosity, through forgiveness, and social support. The final model demonstrated the association of negative childhood events with religiosity through forgiveness of self (not forgiveness of others or situation) and social support. The study's findings suggest that at intake and during time in confinement, middle-aged and older men in prison should be assessed for and offered interventions aimed at helping them cope with the trauma of childhood events, achieve self-forgiveness, seek social support, and express religiosity as important for sustaining their well-being.

Differences in levels of psychological distress, perceived safety, trust, and efficacy amongst hospital personnel during the COVID-19 pandemic

The COVID-19 pandemic poses significant challenges to healthcare systems worldwide. A key consideration is the adverse psychological impact on healthcare workers (HCWs). This study aimed to investigate the variable levels of psychological distress, perceived safety, trust, and self- and collective-efficacy during the COVID-19 crisis amongst varied HCWs. A survey was disseminated to nurses, physicians, interns, and administrative and logistical staff at an acute-care hospital in Israel during the first wave of COVID-19. The survey consisted of items on a 5-point Likert scale, measuring HCW's perceptions concerning the aforementioned variables as well as demographic information. A total of 716 hospital personnel completed the survey. Nurses reported higher levels of psychological distress and lower levels of trust in the hospital's COVID-19 guidelines compared to physicians (2.3 vs. 2.0 and 3.7 vs. 4.0, respectively). Nurses and interns felt the least safe when working in the hospital. Nurses reported the highest levels of concern regarding fear of uncontrollable spread, infection, and family transmission of the virus. Interns reported the lowest levels of self- and collective-efficacy. In a regression model, the variables that predicted 32% of distress among nurses were age, gender, level of religiosity, indices of perceived safety, and self-efficacy. This study demonstrated differences in distress and perceived safety, trust, and efficacy between varied HCWs during COVID-19. This variability should be considered when designing policies to protect HCWs' wellbeing during future pandemics.

Aging With Mental Disorders in the Criminal Justice System: A Content Analysis of the Empirical Literature

To fill a current gap in the literature on aging, mental health, and the criminal justice system, a content analysis of international peer-reviewed research studies was conducted. A comprehensive literature search was conducted to identify English language research studies published in 2018-19. Forty-four articles were located using keyword search terms, such as aging, mental health, and criminal justice. The methods and major findings were analyzed using deductive and inductive approaches. It was found that the majority of the research studies were conducted in the United States and England. The results of the inductive analyses revealed major themes related to mental health detection and access to services, comorbid conditions, and the relationship of age, mental health, criminal behavior, and the social determinants of mental health. Findings from this review have significant implications for advancing epidemiological research, practice, and policy, especially as it relates to the influence of the social determinants of health of aging on life course mental health and criminal justice involvement. Research findings about the correlates and consequences of the social determinants of health, especially as it relates to aging, mental health, and criminal justice involvement, can be used to inform prevention and intervention efforts that target the social determinants of life course health and criminal justice involvement. It also provides a comprehensive assessment of the m methods used in prior studies to help improve future studies in this important area of investigation.

The Impact of Spiritual Intelligence, Gender and Educational Background on Mental Health Among College Students

The present study is conducted on 300 PG-level college students in Haridwar, Uttarakhand (India). The aim of the present study is to examine the level of spiritual intelligence and mental health, to observe relationship between these two variables and also to identify the difference in spiritual intelligence and mental health across gender and educational background (arts and science). The purposive sampling technique is used to select 300 college students of both disciplines of arts and science from the four different government degree colleges/campuses in Haridwar. Integrated Spiritual Intelligence Scale and Mithila Mental Health Status Inventory are used to observe the level of these variables among college students. In the present study, correlational design is employed. All the statistical analyses are done with the help of computer software SPSS. To observe relationship Pearson correlation and to identify the difference t test are used. Findings of the study revealed that spiritual intelligence and mental health relate significantly among arts students, and male and female arts students separately have significant relationship between spiritual intelligence and mental health. Spiritual intelligence and mental health relate significantly among science students, and male and female science students separately have significant relationship between spiritual intelligence and mental health. No significant difference is found between male and female students in terms of spiritual intelligence. No significant difference is found between arts and science students in terms of spiritual intelligence. No significant difference is found between male and female students in terms of mental health. No significant difference is found between arts and science students in terms of mental health.

Childhood Victimization, Recent Injustice, Anger, and Forgiveness in a Sample of Imprisoned Male Offenders

The links between childhood victimization, subsequent emotional dysregulation, and insufficient coping skills have been repeatedly documented in the scientific literature. However, there is a gap in the literature regarding the role of forgiveness as a coping strategy and relationships between offense-specific hurt, chronic anger, and early victimization. The goals of our study were (a) to explore how offenders cope with recent unjust treatment, and test the links between type of injustice, hurt experienced due to injustice, and use of forgiveness; (b) to test the links between childhood victimization, hurt, and chronic anger; and (c) to assess the mediating role of chronic anger in relation to hurt and forgiveness. The results reveal that multiplicity and severity of victimization exposure in the prison sample are positively associated with chronic anger, but not with hurt. The type of injustice affects the level of hurt and forgiveness, while chronic anger mediates the link between hurt and forgiveness. To improve coping and promote forgiving, offenders should be helped to identify everyday sources of stress and learn to express vulnerable feelings beneath anger.

The Health of America's Aging Prison Population

Older incarcerated individuals comprise the fastest growing demographic in the US prison system. Unhealthy lifestyles among incarcerated individuals and inadequate health care lead to earlier onset and more rapid progression of many chronic conditions that are prevalent among community-living older adults. There are limited peer-reviewed epidemiologic data in this area; however, there is growing interest in identifying strategies for housing aging incarcerated individuals, delivering appropriate health care in prisons, and coordinating after-release health care. In this systematic review, we summarize the epidemiologic evidence of the health challenges facing the aging US prison population. Our comprehensive literature search focused on health outcomes, including diseases, comorbid conditions, mental health, cognition, and mobility. From 12,486 articles identified from the literature search, we reviewed 21 studies published between 2007 and 2017. All the studies were observational and cross-sectional, and most (n = 17) were based on regional samples. Sample sizes varied widely, ranging from 25 to 14,499 incarcerated people (median, 258). In general, compared with their younger counterparts, older incarcerated individuals reported high rates of diabetes mellitus, cardiovascular conditions, and liver disease. Mental health problems were common, especially anxiety, fear of desire for death or suicide, and depression. Activities of daily living were challenging for up to one-fifth of the population. We found no empirical data on cognition among older incarcerated individuals. The findings of this review reveal few empirical data in this area and highlight the need for new data to drive policy and practice patterns that address critical health issues related to the aging prison population.

Religiosity and Health: A Holistic Biopsychosocial Perspective

The resurgence of interest in the influence of religion and spirituality on health is examined within the context of the holistic paradigm and historical connection between nursing and spirituality. While nursing and spirituality often intersect with end-of-life considerations, this article presents findings from studies that demonstrate that religious involvement favors health and longevity across the life course. Examples include protective associations with stress, depression, self-rated health, and infant birth weight. Theoretical and empirical explanations for this relationship are offered, such as social and psychological resources and healthy behaviors. The effects of religion on biological functioning, including allostatic load and telomere length, are also discussed, although this area is understudied. Considerations for the "dark-side" of religious involvement are also offered. Suggestions for nurses wishing to protect and promote the health of their patients using a holistic approach include expanding knowledge of research on religion and health and advocating for patients' spiritual needs by conducting a comprehensive spiritual assessment in primary, secondary, and tertiary clinical settings.

The individual experience of ageing prisoners: systematic review and meta-synthesis through a Good Lives Model framework

OBJECTIVE

The existing literature on ageing prisoners tends to focus on such aspects as diagnosis and physical ill-health. In contrast, the experience of imprisonment from the perspective of ageing prisoners has received less attention. Grounded in a Good Lives Model theoretical framework, we reviewed and meta-synthesised literature around their experience of life in prison, its impact on their wellbeing and how prison services are currently addressing their complex needs. We further identify potential areas of improvement.

METHODS

1. Systematic search on Assia, PsycInfo, MedLine, Embase, Web of Science, Google and Gov.uk. 2. Extraction and categorisation of data on NVivo. 3. Development of themes through thematic analysis and meta-synthesis. 4. Identification of potential areas of improvement.

RESULTS

We selected 25 studies for our review, of which 13 were from the USA, seven from the UK, two from Australia and one each from Ireland, Switzerland and Israel. We identified three themes: The hardship of imprisonment, addressing health and social care needs, and the route out of prison.

CONCLUSIONS

Ageing prisoners have unique and complex health and social care needs which, to varying degree across different countries, are mostly unmet. Promising initiatives to address their needs are emerging, but, at present time, the overall experience of incarceration for the ageing prisoner is quite poor, given the inconsistent physical, emotional and social care support offered from prison intake to release and beyond. Copyright © 2017 John Wiley & Sons, Ltd.

Does Self-Compassion Predict Spiritual Experiences of Turkish University Students?

The purpose of this study was to examine the predictive role of self-compassion on spiritual experiences. Participants were 285 university students. In this study, the self-compassion scale and the spiritual experiences scale were used. Self-kindness, common humanity, and mindfulness factors of self-compassion were found positively, and self-judgment, isolation, and over-identification factors of self-compassion were found negatively related to spiritual experiences. According to regression results, spiritual experiences were predicted negatively by self-judgment and over-identification. Further common humanity predicted spiritual experiences in a positive way. Self-compassion has explained 21 % of the variance in spiritual experiences.

[The role of religion in the promotion of health, in the prevention of violence and in the rehabilitation of individuals involved in criminal activity: literature review]

This is a review of the literature on the role of religion in the promotion of health, the prevention of violence and the rehabilitation of individuals involved in criminal activities. Research was conducted in the Medline through PubMed, Lilacs, Scopus, Social Index with full text, Sociological abstracts and Social services abstracts databases. Twenty-nine essays in Portuguese, English and Spanish were selected and analyzed between 1990 and 2011. The results indicate the function of the religious group and the role of religion in the rehabilitation of individuals, the prevention of criminal involvement, corrective orientations and in social iniquity environments. A debate is presented on the main themes revealed, highlighting the multiplicity of religious roles, their influence over prisoners, as a social control and support base and its influence on mental health promotion and quality of life. The relation between religion and the public sphere is discussed, emphasizing the role of religious groups and the fragility of the State in providing basic public policies. Despite revealing the successful role of religion in violence prevention and in rehabilitation, some studies question this relation and highlight the conflicts between the concepts employed and the final results.

[The assessment of spirituality and religiousness in patients with psychosis]

OBJECTIVES

There is evidence that psychiatrists are rarely aware of how religion may intervene in their patient's life. That is particularly obvious concerning patients with psychosis. Yet, even for patients featuring delusions with religious content, religious activities and spiritual coping may have a favourable influence. Indeed, patients with psychosis can use religion to cope with life difficulties related to their psychotic condition, in a social perspective but also in order to gain meaning in their lives. Also, religion may be part of explanatory models about their disorder with, in some cases, a significant influence on treatment adhesion.

PATIENTS AND METHODS

This paper describes a prospective randomized study about a spiritual assessment performed by the psychiatrists of patients with schizophrenia. The outpatient clinics in which the sample was collected are affiliated with the department of psychiatry at the university hospitals of Geneva. Eighty-four outpatients with psychosis were randomized into two groups: an experimental group receiving both traditional treatment and spiritual assessment with their psychiatrist and a control group of patients receiving only their usual treatment. Psychiatrists were supervised by a clinician (PH) and a psychologist of religions (PYB) for each patient in the spiritual assessment group. Data were collected from both groups before and after 3 months of clinical follow-up.

RESULTS

Spiritual assessment was well-tolerated by all patients. Moreover, their wish to discuss religious matters with their psychiatrist persisted following the spiritual assessment. Even though clinicians acknowledged the usefulness of the supervision for some patients, especially when religion was of importance for clinical care, they reported being moderately interested in applying spiritual assessments in clinical settings. Compared to the control group, there were no differences observed in the 3 months' outcome in terms of primary outcome measures for satisfaction with care, yet the attendance at the appointments was significantly increased in the group with spiritual assessment. The same result was found when restricting analyses to patients for whom an intervention was suggested or patients who invested more in religion. Areas of potential intervention were frequent both in a psychiatric and psychotherapeutical perspective.

CONCLUSIONS

Spiritual assessment appears to be useful for patients with psychosis. This is in accordance with the recommendations of the World Psychiatric Association which promotes considering the whole person in clinical care. Spiritual assessment is quite simple to perform, providing that clinicians do not prescribe or promote religion, and that no critical comments are made concerning religious issues. Clinicians do not need to know in depth the religious domains of each of their patients, as it appears that each patient accommodates his/her religious background his/her own way.

Deviating from Religious Norms and the Mental Health of Conservative Protestants

Although numerous studies show that religious involvement is associated with favorable mental health outcomes, research also suggests that religious struggles can be psychologically distressing. Building on previous research, this study examines the psychological consequences of deviating from religious norms among Conservative Protestants. Using data from a statewide probability sample of Texas adults (n = 463), this study tests the hypothesis that Conservative Protestants who fall short of religious norms for attending religious services, reading scripture, and praying will suffer more psychological distress, anxiety, and depressive symptoms than those who meet or exceed religious expectations. Findings indicate that falling short of population average levels for church attendance and reading of religious scripture is associated with higher levels of psychological distress. Interestingly, falling short of population averages for prayer is unrelated to psychological distress, depressive symptoms, and anxiety.

Religion in the lives of older women serving life in prison

This exploratory qualitative study examined the roles of religiousness in the lives of 21 older women (mean age = 63) serving life sentences in one southern state. Based on survey and focus group methodology, several themes emerged as important focal points, including early religious experiences prior to incarceration, imprisonment and religious doubt, participation in formal and informal religious activities, and use of religion in coping with stressors such as interpersonal relationships, trauma, and health statuses. Irrespective of their religious upbringing, all participants agreed that religiosity/spirituality played a key role in their ability to cope with their prison experience as well as for maintaining hope and the opportunity for release.

Religiousness and spirituality in patients with bipolar disorder

BACKGROUND

Religiousness and spirituality (R/S) are often neglected features among psychiatric patients but important both for quality of life and coping strategies for mental disorders. In patients affected by bipolar disorder (BD), R/S can sometimes be confused with symptoms related to the psychiatric disorder. This study aimed to perform a clinical review of the relationship between R/S and BD.

METHODS

Data sources included Medline (OvidSP), CINAHL (Ebsco), EMBASE (Ovid), PsychINFO (Ebsco), Angeline, Cochrane Database of Systematic Reviews and Database of Abstract of Reviews of Effects, searching for pertinent Keywords: 'religiousness', 'spirituality' and 'bipolar disorder'.

RESULTS

Nine works were found but only five used homogeneous samples with BD patients. R/S were important when facing symptoms and relapses in the lifeworld. These beliefs influenced the relationship with psychiatrists and spiritual figures of reference.

CONCLUSIONS

R/S play a role as a psychosocial variable in the course of BD. However, the hypothesis that the R/S factor can be relevant both in terms of providing a protective effect as well as a provocative element in depressive or hypomanic phases was not fully supported at the moment.

Spirituality and religion among French prisoners: an effective coping resource?

The aim of this study was to describe the role of spirituality and religiousness (SR) among detainees. Thirty detainees from a French short-stay prison were assessed with the World Health Organization Quality of Life-Spirituality Religion and Personal Beliefs questionnaire (WHOQOL-SRPB) and with open questions about SR. Forty percent of detainees described SR as an important way of coping with incarceration and stressful events, as a means of finding inner peace, showing altruism, and gaining the respect of others. SR involvement was associated with reports of decreased suicide risk and of the prevention of future offences. SR appears to be an important coping mechanism and may help the transition to the community following incarceration. This study endorses the view that SR should be considered when treating this population.

Support utilization by partners of self-identified sex addicts

This online survey examined the support resources used by partners of sex addicts. Partners (N = 92) answered questions about which sources of support they found most useful, relationship functioning, and demographic and background variables. Partners rated therapists, spirituality, support groups, and friends as most useful; and the mate, their children, and their other family members as least useful. Participants indicated that they used intrapersonal religious/spiritual activities (e.g., prayer and meditation) more than interpersonal religious/spiritual activities (e.g., religious services and support groups). Older partners sought more religious/spiritual support, and more educated partners rated therapy as more useful. Rating the mate as useful was most strongly associated with positive relationship outcomes. The authors conclude with recommendations for working with partners of sex addicts.

Does religiousness and spirituality moderate the relations between physical and mental health among aging prisoners?

OBJECTIVE

We examined positive and negative religious coping as moderators of the relation between physical limitations, depression, and desire for hastened death among male inmates incarcerated primarily for murder.

METHODS

Inmates over the age of 45 years who passed a cognitive screening completed face-to-face interviews (N = 94; mean age = 57.7 years; SD = 10.68). Multiple regression analyses included age, race/ethnicity, parole belief, physical health, positive or negative religious coping, and all two-way interactions represented by the product of health and a religious coping variable.

RESULTS

Older inmates and those who reported greater levels of positive religious coping endorsed fewer symptoms of depression, whereas those who reported greater levels of negative religious coping endorsed more symptoms of depression. Inmates who reported higher levels of depression endorsed a greater desire for hastened death. The effect of physical functioning on desire for hastened death is moderated by negative religious coping such that those who endorsed higher levels of negative religious coping reported a greater desire for hastened death.

CONCLUSIONS

Examinations of religious/spiritual practices and mindfulness-based interventions in prison research have assumed a positive stance with regard to the potential impact of religious/spiritual coping on physical and mental health. The current findings provide cautionary information that may further assist in selection of inmates for participation in such interventions.

Consideration of forgiveness to enhance the health status of older male prisoners confronting spiritual, social, or emotional vulnerability

Participants in this study included 261 men, aged 45 and older, residing within state-managed correctional facilities in Oklahoma. Path analysis was used to examine an integrated mediation model. Spiritual ambivalence, loneliness, and depressive affect had direct negative associations with forgiveness, controlling for age, race, education, and type of crime. Forgiveness also maintained a direct positive association with perceived health status, whereas depressive affect maintained a direct negative association with perceived health status. In addition, a significant indirect effect of depressive affect on perceived health through forgiveness emerged. Overall, the model explained 38% of the variance in forgiveness and 23% in perceived health. Greater spiritual ambivalence, loneliness, and depressive affect diminish forgiveness among older male prisoners, yet higher levels of forgiveness, are associated with greater perceived health.

Direct and indirect effects of religiosity on valuation of life through forgiveness and social provisions among older incarcerated males

PURPOSE OF THE STUDY

Few studies have investigated the influence of religiosity (REL), forgiveness, and social resources on incarcerated individuals' attachment to their lives, or valuation of life (VOL). We tested a model linking REL to VOL through 3 subscales of the Heartland Forgiveness Scale (Self, Others, and Situations) and social provisions (SPS).

DESIGN AND METHODS

Cross-sectional data were collected from 261 male prison inmates, aged 45-82, incarcerated in 8 state-managed correctional facilities. Participants were sampled from the prison census database (Oklahoma Department of Corrections or DOC). Exclusion criteria, per the Oklahoma DOC, were those housed in medical or psychiatric units, currently in solitary confinement, or sentenced to death row.

RESULTS

To account for possible violations of multivariate normality, we used the Satorra-Bentler chi-square statistic. The final model fit the data well, explaining 57% of the variance in VOL: χ(2) (N = 261; df = 3) = 7.40; p = .06; Comparative Fit Index = .99; root mean squared error of approximation = .08; standardized root mean squared residual = .02. Significant indirect effects of REL on VOL were present through Forgiveness of Others and SPS, and of REL on SPS through Forgiveness of Others. Analyses controlled for age, race, education, perceived physical health, and depressive symptoms.

IMPLICATIONS

Implications of the findings for those involved with prisoner care are discussed, particularly therapeutic interventions including process models of forgiveness.

Religion and mental health during incarceration: a systematic literature review

Religion and spirituality (RS) as a coping resource for facing stressful life events is encountered with increasing frequency in the medical literature. RS is associated with more favourable outcomes among people suffering from mental disorders. Detention is a stressful situation and the prevalence of mental disorders in places of detention is increased compared with the community. This literature review examined the association between RS and the mental health of detainees. PubMed, PsycINFO, Web of Science and the Internet were systematically searched from inception of each data base to August 1st 2010. Peer reviewed articles that reported primary empirical data about the impact of spirituality on the mental health and behaviour of detained persons were selected. Qualitative studies are also discussed. Twelve empirical studies including a total of 4,823 individuals met our inclusion criteria. RS is associated with lower frequency and severity of depressive episodes. The strongest reported effect of RS on prison life is a reduction of incidents and disciplinary sanctions. Prospective targeted studies are needed in order verify the hypothesis that RS reduces suicide among detainees.

Aging prisoners' treatment selection: does prospect theory enhance understanding of end-of-life medical decisions?

PURPOSE

With the rapid growth in the older inmate population and the economic impact of end-of-life treatments within the cash-strapped prison system, consideration should be given to inmate treatment preferences. We examined end-of-life treatment preferences and days of desired life for several health scenarios among male inmates incarcerated primarily for murder.

DESIGN AND METHODS

Inmates over the age of 45 who passed a cognitive screening completed face-to-face interviews (N = 94; mean age = 57.7; SD = 10.68).

RESULTS

We found a 3-way interaction indicating that the effect of parole expectation on desire for life-sustaining treatment varied by race/ethnicity and treatment. Minority inmates desired cardiopulmonary resuscitation or feeding tubes only if they believed that they would be paroled. The model predicting desire for palliative care was not significant. Future days of desired life were related to prospective health condition, fear of death, negative affect, and trust in prison health care. Caucasian inmates expressed a desire for more days of life out of prison, whereas minority inmates did not differ in days of desired life either in or out of prison. Minorities wanted more days of life than Caucasians but only if they believed that they would be paroled.

IMPLICATIONS

End-of-life care for the burgeoning inmate population is costly, and active life-sustaining treatments may not be desired under certain conditions. Specifically, expectation of parole but not current functional ability interacts with future illness condition in explaining inmates' desire for active treatment or days of desired life in the future.

Correlates of depressive symptoms among homeless men on parole

This study describes correlates of high levels of depressive symptoms among recently paroled men in Los Angeles who reside in a community substance abuse treatment program and report homelessness. Cross-sectional data were obtained from male residents who were released on parole within the last 30 days (N =157) to assess parental relationship, self-esteem, social support, coping behaviors, drug and alcohol use behaviors, depressive symptoms, and sociodemographic information. Results indicated that 40% of the participants were classified as experiencing high levels of depressive symptoms (CES-D ≥ 10). Results of a logistic regression analysis showed that the following were predictors of depressive symptoms (p <.05): physical abuse in childhood, non-residential alcohol treatment, violent behaviors, low self-esteem, and disengagement coping. Being Mexican-American, Mexican, American Indian, or Asian, and not displaying cognitive problems was inversely related to depressive symptoms in the final model (B =-2.39, p <.05). Findings support proper use of both prison and community assessment services to at-risk individuals eligible for parole to increase self-esteem and coping.

Religiosity, Spirituality, and Substance Abuse

With data from the 2004 General Social Survey, the study examined effects of religiosity and spirituality on substance abuse. Also explored was whether and how social bonding mediates religiosity's effects on substance abuse. The results show that religiosity was negatively associated with substance abuse and, further, that social bonding variables did somewhat mediate this negative relationship between the two. Additionally, and as expected, with religiosity controlled, the likelihood of substance abuse increased along with increasing spirituality, in the models. Policy implications and further research needs are discussed.

The relationship between religious involvement and clinical status of patients with bipolar disorder

OBJECTIVE

Religion and spirituality are important coping strategies in depression but have been rarely studied within the context of bipolar disorder. The present study assessed the association between different forms of religious involvement and the clinical status of individuals treated for bipolar disorder.

METHODS

A cross-sectional observation study of follow-up data from a large cohort study of patients receiving care for bipolar disorder (n = 334) at an urban Veterans Affairs mental health clinic was conducted. Bivariate and multivariate analyses were performed to assess the association between public (frequency of church attendance), private (frequency of prayer/meditation), as well as subjective forms (influence of beliefs on life) of religious involvement and mixed, manic, depressed, and euthymic states when demographic, anxiety, alcohol abuse, and health indicators were controlled.

RESULTS

Multivariate analyses found significant associations between higher rates of prayer/meditation and participants in a mixed state [odds ratio (OR) = 1.29; 95% confidence interval (CI) = 1.10-1.52, chi square = 9.42, df = 14, p < 0.05], as well as lower rates of prayer/meditation and participants who were euthymic (OR = 0.84; 95% CI = 0.72-0.99, chi square = 4.60, df = 14, p < 0.05). Depression and mania were not associated with religious involvement.

CONCLUSIONS

Compared to patients with bipolar disorder in depressed, manic, or euthymic states, patients in mixed states have more active private religious lives. Providers should assess the religious activities of individuals with bipolar disorder in mixed states and how they may complement/deter ongoing treatment. Future longitudinal studies linking bipolar states, religious activities, and treatment-seeking behaviors are needed.