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Aggarwal S, Wright J, Morgan A, Patton G, Reavley N. Religiosity and spirituality in the prevention and management of depression and anxiety in young people: a systematic review and meta-analysis. BMC Psychiatry 2023; 23:729. [PMID: 37817143 PMCID: PMC10563335 DOI: 10.1186/s12888-023-05091-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 08/08/2023] [Indexed: 10/12/2023] Open
Abstract
Historically, religion has had a central role in shaping the psychosocial and moral development of young people. While religiosity and spirituality have been linked to positive mental health outcomes in adults, their role during the developmental context of adolescence, and the mechanisms through which such beliefs might operate, is less well understood. Moreover, there is some evidence that negative aspects of religiosity are associated with poor mental health outcomes. Guided by lived experience consultants, we undertook a systematic review and quality appraisal of 45 longitudinal studies and 29 intervention studies identified from three electronic databases (Medline, PsycINFO and Scopus) exploring the role of religiosity and spiritual involvement (formal and informal) in prevention and management of depression and anxiety in young people aged 10 to 24 years. Most studies were from high-income countries and of low to moderate quality. Meta-analysis of high-quality longitudinal studies (assessed using Joanna Briggs Institute critical appraisal tools, n = 25) showed a trend towards association of negative religious coping (i.e., feeling abandoned by or blaming God) with greater depressive symptoms over time (Pearson's r = 0.09, 95% confidence interval (CI) -0.009, 0.188) whereas spiritual wellbeing was protective against depression (Pearson's r = -0.153, CI -0.187, -0.118). Personal importance of religion was not associated with depressive symptoms overall (Pearson's r = -0.024, CI-0.053, 0.004). Interventions that involved religious and spiritual practices for depression and anxiety in young people were mostly effective, although the study quality was typically low and the heterogeneity in study designs did not allow for a meta-analysis. The lived experience consultants described spirituality and religious involvement as central to their way of life and greatly valued feeling watched over during difficult times. While we require more evidence from low- and middle-income countries, in younger adolescents and for anxiety disorders, the review provides insight into how spirituality and religious involvement could be harnessed to design novel psychological interventions for depression and anxiety in young people.Review RegistrationThe systematic review was funded by Wellcome Trust Mental Health Priority Area 'Active Ingredients' 2021 commission and registered with PROSPERO 2021 (CRD42021281912).
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Affiliation(s)
- Shilpa Aggarwal
- Public Health Foundation of India, Gurgaon, Haryana, India.
- Centre for Adolescent Health, Murdoch Children's Research Institute, 50 Flemington Road, Melbourne, VIC, 3052, Australia.
- Deakin University, Geelong, Australia.
| | - Judith Wright
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Victoria, Australia
| | - Amy Morgan
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Victoria, Australia
| | - George Patton
- Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia
| | - Nicola Reavley
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Victoria, Australia
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Cowden RG, Nakamura JS, Chen ZJ, Case B, Kim ES, VanderWeele TJ. Identifying pathways to religious service attendance among older adults: A lagged exposure-wide analysis. PLoS One 2022; 17:e0278178. [PMID: 36445902 PMCID: PMC9707744 DOI: 10.1371/journal.pone.0278178] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 11/12/2022] [Indexed: 12/02/2022] Open
Abstract
We used prospective data (spanning 8 years) from a national sample of older U.S. adults aged > 50 years (the Health and Retirement Study, N = 13,771) to evaluate potential factors that lead to subsequent religious service attendance. We applied a lagged exposure-wide epidemiologic design and evaluated 60 candidate predictors of regular subsequent religious service attendance. Candidate predictors were drawn from the following domains: health behaviors, physical health, psychological well-being, psychological distress, social factors, and work. After rigorous adjustment for a rich set of potential confounders, we observed modest evidence that changes in some indices of physical health, psychological well-being, psychological distress, and social functioning predicted regular religious service attendance four years later. Our findings suggest that there may be opportunities to support more regular religious service attendance among older adults who positively self-identify with a religious/spiritual tradition (e.g., aid services for those with functional limitations, psychological interventions to increase hope), which could have downstream benefits for various dimensions of well-being in the later years of life.
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Affiliation(s)
- Richard G. Cowden
- Human Flourishing Program, Institute for Quantitative Social Science, Harvard University, Cambridge, Massachusetts, United States of America
- * E-mail:
| | - Julia S. Nakamura
- Department of Psychology, University of British Columbia, Vancouver, BC, Canada
| | - Zhuo Job Chen
- School of Nursing, University of North Carolina at Charlotte, Charlotte, NC, United States of America
| | - Brendan Case
- Human Flourishing Program, Institute for Quantitative Social Science, Harvard University, Cambridge, Massachusetts, United States of America
| | - Eric S. Kim
- Human Flourishing Program, Institute for Quantitative Social Science, Harvard University, Cambridge, Massachusetts, United States of America
- Department of Psychology, University of British Columbia, Vancouver, BC, Canada
- Lee Kum Sheung Center for Health and Happiness, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America
| | - Tyler J. VanderWeele
- Human Flourishing Program, Institute for Quantitative Social Science, Harvard University, Cambridge, Massachusetts, United States of America
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America
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Anderson MR, Wickramaratne P, Svob C, Miller L. Religiosity and Depression at Midlife: A Prospective Study. RELIGIONS 2021; 12. [PMID: 34900344 PMCID: PMC8664271 DOI: 10.3390/rel12010028] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objectives: Previously, authors found high personal importance of religion/spirituality (R/S) in early adulthood to predict a 75% decreased risk of recurrence of major depression in middle adulthood. Here, the authors follow up the original study sample to examine the association between R/S and major depression from middle adulthood into midlife. Method: Participants were 79 of 114 original adult offspring of depressed and non-depressed parents. Using logistic regression analysis, three measures of R/S from middle adulthood (personal importance, frequency of religious service attendance, and denomination) were used to predict Major Depressive Disorder (MDD) in midlife. Results: High R/S importance in middle adulthood was prospectively associated with risk for an initial onset of depression during the period of midlife. Frequency of attendance in middle adulthood was associated with recurrence of depression at midlife in the high-risk group for depression, as compared to the low-risk group. Conclusion: Findings suggest that the relation between R/S and depression may vary across adult development, with risk for depression associated with R/S at midlife potentially revealing a developmental process.
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Affiliation(s)
- Micheline R. Anderson
- Spirituality Mind Body Institute, Teachers College, Columbia University, New York, NY 10027, USA
| | - Priya Wickramaratne
- Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA
- Division of Epidemiology, New York State Psychiatric Institute, New York, NY 10032, USA
- Mailman School of Public Health, Columbia University, New York, NY 10032, USA
- Correspondence:
| | - Connie Svob
- Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA
- Division of Epidemiology, New York State Psychiatric Institute, New York, NY 10032, USA
| | - Lisa Miller
- Spirituality Mind Body Institute, Teachers College, Columbia University, New York, NY 10027, USA
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Balbuena L, Baetz M, Bowen R. Religious attendance after elevated depressive symptoms: is selection bias at work? PeerJ 2014; 2:e311. [PMID: 24688885 PMCID: PMC3961168 DOI: 10.7717/peerj.311] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2013] [Accepted: 02/26/2014] [Indexed: 11/20/2022] Open
Abstract
In an attempt to determine if selection bias could be a reason that religious attendance and depression are related, the predictive value of elevated depressive symptoms for a decrease in future attendance at religious services was examined in a longitudinal panel of 1,673 Dutch adults. Religious attendance was assessed yearly over five years using the single question, “how often do you attend religious gatherings nowadays?” Depressive symptoms were assessed four times within the first year using the Depression subscale of the Brief Symptom Inventory. Logistic regression models of change in attendance were created, stratifying by baseline attendance status. Attenders who developed elevated symptoms were less likely to subsequently decrease their attendance (relative risk ratio: 0.55, 95% CI [0.38–0.79]) relative to baseline as compared to those without elevated symptoms. This inverse association remained significant after controlling for health and demographic covariates, and when using multiply imputed data to account for attrition. Non-attenders were unlikely to start attending after elevated depressive symptoms. This study provides counter evidence against previous findings that church attenders are a self-selected healthier group.
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Affiliation(s)
- Lloyd Balbuena
- Department of Psychiatry, University of Saskatchewan , Saskatoon, Saskatchewan , Canada
| | - Marilyn Baetz
- Department of Psychiatry, University of Saskatchewan , Saskatoon, Saskatchewan , Canada
| | - Rudy Bowen
- Department of Psychiatry, University of Saskatchewan , Saskatoon, Saskatchewan , Canada
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Hayward RD, Maselko J, Meador KG. Recollections of Childhood Religious Identity and Behavior as a Function of Adult Religiousness. THE INTERNATIONAL JOURNAL FOR THE PSYCHOLOGY OF RELIGION 2012; 22:79-88. [PMID: 22844186 PMCID: PMC3404463 DOI: 10.1080/10508619.2012.635064] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
People have a strong motivation to maintain a self-concept that is coherent and consistent over time. Religion is an central source of social identity for many people, but its importance is prone to dramatic change across the life course. To maintain a consistent perception of self, recollections of one's own past religiousness may shift to better fit with the present. This study examined changes between early and middle adulthood in retrospective perceptions of religious behavior and identity in childhood. Data from a population-based birth cohort sample were matched with data from individuals who participated in at least two of three adult follow-up studies, at intervals of approximately 10 years. Logistic regression was used to analyze the association of final recollections of childhood behavior and identity with previous recollections and current religious characteristics. Consistent with the predictions of temporal self-appraisal theory, participants' perception of their religious identity as children tended to change over time to match their adult religious identity. Recollections of childhood religious behavior were more stable than recollections of religious identity, and change was unrelated to adult behavior. These results have implications for studying religious characteristics using retrospective measures, regarding their accuracy and their independence from contemporary measures.
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Dew RE, Daniel SS, Goldston DB, Koenig HG. Religion, spirituality, and depression in adolescent psychiatric outpatients. J Nerv Ment Dis 2008; 196:247-51. [PMID: 18340262 DOI: 10.1097/nmd.0b013e3181663002] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
This study examines in a preliminary manner the relationship between multiple facets of religion/spirituality and depression in treatment-seeking adolescents. One hundred seventeen psychiatric outpatients aged 12 to 18 completed the brief multidimensional measure of religiousness/spirituality, the Beck Depression Inventory (BDI), a substance abuse inventory. Controlling for substance abuse and demographic variables, depression was related to feeling abandoned or punished by God (p < 0.0001), feeling unsupported by one's religious community (p = 0.0158), and lack of forgiveness (p < 0.001). These preliminary results suggest that clinicians should assess religious beliefs and perceptions of support from the religious community as factors intertwined with the experience of depression, and consider the most appropriate ways of addressing these factors that are sensitive to adolescents' and families' religious values and beliefs.
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Affiliation(s)
- Rachel E Dew
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA.
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Affiliation(s)
- Lisa Miller
- Department of Psychology, Columbia University, New York City, NY 10027, USA
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Josephson AM, Dell ML. Religion and spirituality in child and adolescent psychiatry: a new frontier. Child Adolesc Psychiatr Clin N Am 2004; 13:1-15, v. [PMID: 14723297 DOI: 10.1016/s1056-4993(03)00099-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
This article introduces the interface between child and adolescent psychiatry and religion and spirituality. Developmental psychopathology has become increasingly diverse in its study of risk and protective factors for child and adolescent psychopathology. The effect of religion and spirituality on clinical conditions is among those factors. This review addresses (1) historical aspects of the relationship between psychiatry and religion/spirituality, (2) definitional issues, and (3) unique factors in child and adolescent work. Considering these factors and some general principles of intervention, it prepares the reader for other articles in this issue. The article concludes with some observations on the "secular family".
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Affiliation(s)
- Allan M Josephson
- Division of Child and Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, University of Louisville School of Medicine, Louisville, KY 40292, USA.
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Mabe PA, Josephson AM. Child and adolescent psychopathology: spiritual and religious perspectives. Child Adolesc Psychiatr Clin N Am 2004; 13:111-25, vii-viii. [PMID: 14723303 DOI: 10.1016/s1056-4993(03)00091-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
This article addresses the relationship between children's religious beliefs and spiritual practices and the presence of psychopathology. Study of this subject represents a formidable task due to the complexity and diversity of the constructs involved, heterogeneity in religious beliefs and practices, and the difficulty in discriminating between the independent effects of religion and culture. Nevertheless, broad links between child psychopathology and spiritual/religious beliefs and practices are proposed. On the whole, the available empiric data suggest that religion is primarily health promoting in direct, positive benefits for children and in indirect, positive effects through parent and family functioning, although there are isolated exceptions. When spirituality and religious beliefs/practices are associated with negative mental health outcomes in children or their families, evidence points to "poorness-of-fit," based on an interaction between the child's psychopathology and aspects and religious beliefs/practice. Clinical implications of the findings and proposels are outlined.
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Affiliation(s)
- P Alex Mabe
- Department of Psychiatry and Health Behavior, Medical College of Georgia, 1515 Pope Avenue, Augusta, GA 30912-3800, USA.
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