Depression, anxiety, and religious life: a search for mediators

Negative and positive mental health characteristics of affected family members: Findings from a cross-sectional Australian general population gambling study

Despite the impact of problem gambling on affected family members (AFMs), there are limited large-scale population level studies identifying the negative mental health (NMH) and positive mental health (PMH) characteristics of AFMs. Furthermore, no study has explored whether PMH characteristics are protective in the relationships between AFM status and NMH characteristics. This study involved secondary data analysis from the Third Social and Economic Impact Study of Gambling in Tasmania. Using a subsample of 1,869 adults (48.30 % male; meanage = 48.48; 4.67 % AFMs), this study aimed to explore whether: (1) AFM status is associated with NMH (depression, anxiety, panic, post-traumatic stress disorder, social anxiety, binge drinking, tobacco use, and drug use symptoms) and PMH (quality of life [QOL], personal growth/autonomy, interpersonal/social skills, coping skills) characteristics after separately controlling for sociodemographic, problem gambling severity, and other NMH characteristics; (2) PMH characteristics moderate (buffer) the relationships between AFM status and NMH characteristics; and (3) gender influences these relationships. AFM status, defined as exposure to family member gambling problems, significantly positively predicted NMH characteristics (depression, anxiety, panic, PTSD, and tobacco use symptoms) and negatively predicted QOL (physical, social) and planning coping. The strength of these relationships generally attenuated after controlling for various covariates. Gender did not moderate these relationships. Religious coping exacerbated the relationship between AFM status and panic disorder symptoms. These findings can inform the development of intervention initiatives for family members exposed to gambling problems. Future population-representative research is required using a range of affected other types, longitudinal study designs, and more comprehensive measures.

The Association between Dental Pain and Psychological Symptoms: Evidence from a Population-Based Study in Indonesia

OBJECTIVES

 This study aimed to determine the prevalence and distribution of dental pain and its association with psychological symptoms: stress and depression.

MATERIALS AND METHODS

 The 2014 Indonesia Family Life Survey data were used for the abovementioned purposes. Records of self-reported dental pain and stress as well as the occurrence of depression based on the 10-item Center for Epidemiologic Studies-Depression scale were analyzed. Multivariable ordinal regression models were fitted to test the hypothesized associations between dental pain and each of the psychological symptoms, controlling for age, sex, education, wealth, and religiosity.

RESULTS

 Dental pain prevalence among Indonesian population was approximately 15%. The adjusted odds ratios (ORs) from the ordinal regression models indicated that dental pain was related to the increase of the stress and depression level (OR: 1.31, 95% confidence interval [CI]: 1.14-1.49 and OR: 1.59, 95% CI: 1.41-1.79, respectively). Higher education, higher wealth, and being male are risk factors for stress. However, higher wealth and being male are protective factors for depression. Furthermore, higher religious level was a protective factor for both stress and depression.

CONCLUSION

 Dental pain was associated with a higher level of stress and a higher score of depression, even after being adjusted with age, sex, education, wealth, and religiosity.

Examining Racial/Ethnic Disparities in Coping and Stress Within an Environmental Riskscape

Existing research on racial/ethnic differences in stress and coping is limited by small samples, single-item measures, and lack of inclusion of Mexican Americans. We address these gaps by analyzing data from the Texas City Stress and Health Study, a cross-sectional sample of Black (N = 257), White (N = 304), US-born (N = 689), and foreign-born (N = 749) Mexican Americans residing in proximity to a petrochemical complex. We compared active and avoidant coping by race/ethnicity and explored multivariable associations between coping and perceived stress. Black and foreign-born Mexican American respondents had the highest stressor exposure yet displayed different patterns of coping and perceived stress patterns. Active coping may be particularly effective for African Americans but may not offset extreme stress disparities. For Mexican Americans, the lack of association between coping and stress underscores the need for more work focused on the culturally diverse coping experiences.

Religiosity, Religious Coping and Distress Among Outpatients with Psychosis in Singapore

This study aimed to investigate the prevalence of religious coping and explore the association between religious coping, religiosity, and distress symptoms amongst 364 outpatients diagnosed with psychosis in Singapore. Positive and Negative Religious Coping (PRC and NRC), religiosity (measuring the constructs of Organised Religious Activity (ORA), Non-Organised Religious Activity (NORA), and Intrinsic Religiosity (IR)) and severity of distress symptoms (depression, anxiety and stress) were self-reported by the participants. The majority of participants (68.9%) reported religion to be important in coping with their illness. Additionally, multiple linear regression analyses found that NRC was significantly associated with higher symptoms of distress. In contrast, ORA was significantly associated with lower anxiety symptom scores. Overall, the study indicates the importance of religion in coping with psychosis and the potential value in incorporating religious interventions in mental health care.

Depression in the African American Christian Community: Examining Denominational and Gender Differences

Depression among African American adults can diminish their daily functioning and quality of life. African American communities commonly uses religion and spirituality (R/S) to cope with life stressors; however, it is unclear whether R/S contribute to mental health risk or resilience. Since men and women differ in their R/S participation and Christian denominations have varying gender roles and expectations, it is critical to determine if they experience similar mental health effects. This study examines whether self-reported denominational affiliation predicts dissimilar odds of reporting elevated depressive symptoms among African American young adults and if these effects are different for women and men, using the National Longitudinal Study of Adolescent to Adult Health (Add Health). Results indicate that the odds of having elevated depressive symptoms are three times higher for Catholic women compared to Baptist women, but no denominational differences were found among men. This study highlights how unique denominational and gender subcultures within African American Christian communities may predict depression outcomes. Healthcare professionals and church-based outreach programs should consider the role of denomination and gender when designing and participating in efforts to support mental health equity.

Religious Involvement and Sleep Among Older African Americans

Objective: This study sought to determine whether religious involvement is associated with sleep quality in a nationally representative sample of older African Americans. Methods: The analytic sample included African American respondents aged 55+ from the National Survey of American Life-Reinterview (N = 459). Religious involvement variables included service attendance, reading religious texts, watching religious television programs, listening to religious radio programs, prayer, and subjective religiosity. Sleep outcomes were restless sleep and sleep satisfaction. Multiple linear regression analysis was used. Results: Watching religious television programs was associated with more restless sleep. Respondents who attended religious services less than once a year, at least once a week, or nearly every day reported greater sleep satisfaction than respondents who never attended religious services. Subjective religiosity was associated with lower sleep satisfaction. Discussion: The findings demonstrate the importance of examining a variety of religious involvement domains, which could point to different explanatory pathways between religious involvement and sleep.

Family function and life satisfaction of postgraduate medical students during the COVID-19 pandemic: the mediating role of meaning in life and depression

Recent studies have documented life satisfaction of people have changed during the COVID-19 pandemic. However, it is unknown about the influential factors and mechanisms of life satisfaction of postgraduate medical students during the COVID-19 pandemic. There is a strong link among life satisfaction and individual quality of life and achievement, so it is important to explore the influence mechanism of life satisfaction of postgraduate medical students and explore ways to improve life satisfaction for the development of postgraduate medical students. The current study was based on the Circumplex Model of Marital and Family System, The Theory of Family Functioning, The Meaning Maintenance Model, The Theory of Personal Meaning and Existential Theory to construct theoretical framework and examine whether meaning in life and depression would mediate the link between family function and postgraduate medical students’ life satisfaction. By convenient sampling method, a total of 900 postgraduate medical students (Mage = 27.01 years, SD = 3.33) completed questionnaires including Family APGAR Scale, Chinese Version of Meaning In Life Questionnaire, Patient Health Questionnaire, and Satisfaction With Life Scale. In this study, SPSS 25.0 was used for correlation analysis, regression analysis and common method bias test, and AMOS 23.0 was used for structural equation modeling analysis. The results showed that (a) family function could predict life satisfaction of postgraduate medical students significantly; (b) both meaning in life and depression mediated the association between family function and life satisfaction in a parallel manner; (c) meaning in life and depression sequentially mediated the link between family function and life satisfaction of postgraduate medical students. The study illuminates the role of meaning in life and depression in improving life satisfaction and implies that it is necessary to focus on the changes of life satisfaction of postgraduate medical students during the COVID-19 pandemic, and medical educator can improve the sense of meaning in life of postgraduate medical students through improving their family function, further decreasing the risk of depression, finally improving their life satisfaction.

'Mental health and self-rated health among U.S. South Asians: the role of religious group involvement'

Objectives: Only one community-based study has assessed religious group involvement and health outcomes among South Asians in the U.S., with mixed results. Here, using a large, South Asian community-based sample, the effects of six religious group involvement predictors - religious tradition, attendance, group prayer, giving/receiving congregational emotional support, congregational neglect, and congregational criticism - were examined in relation to four health outcomes: self-rated health, positive mental health functioning, trait anxiety, and trait anger.Design: The study used a new religion/spirituality questionnaire in the Mediators of Atherosclerosis Among South Asians Living in America (MASALA), the largest study of mental and physical well-being among U.S. South Asians. Associations were assessed cross-sectionally using OLS regression in both the full sample (N = 928) and a subsample of congregation members (N = 312).Results: Jains reported better self-rated health compared to Hindus and Muslims. Group prayer involvement, when measured ordinally, was positively associated with self-rated health and mental health functioning. In reference group comparisons, individuals who participated in group prayer once/day or more had lower levels of anxiety and anger compared to several comparison groups in which individuals prayed less than once a day. Religious service attendance was associated with higher levels of anxiety. Giving/receiving congregational emotional support was positively associated with self-rated health and mental health functioning, and inversely associated with anxiety. Congregational criticism was associated with higher levels of anger and anxiety.Conclusions: This study provided a new assessment of religious group involvement and health in the U.S. South Asian population. Religious group participation was associated with mental and self-rated health in well-controlled models, indicating this is a fruitful area for further research. Group religious involvement may be a health-promoting resource for U.S. South Asians who are religiously active, but it is not an unalloyed boon.

Clergy Perceptions of Mental Illness and Confronting Stigma in Congregations

Mental illness and stigma are key concerns in congregations and represent important threats to community health. Clergies are considered influential in how congregants think about and respond to mental health issues, especially in African American congregations. In-depth interviews with 32 African American and White clergies were conducted to understand their unique perspectives on mental health and how they interact with their congregations based on those perspectives. Findings include six themes related to mental health stigma, namely, holistic definitions of health; African Americans and different conceptions of mental health (only reported by African American clergies); code words and language; depression as a special case; perceptions of mental health counseling and treatment; and clergy strategies for addressing mental health stigma. The clergies in this study recognized their influence on ideas related to mental health in their congregations, and most expressed active efforts toward discussing mental health and reducing stigma.

Religiosity and Depression at Midlife: A Prospective Study

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.

Spirituality, religiousness, and mental health: A review of the current scientific evidence

Research in the field of “Spirituality and Health” has been growing, with spirituality/religiousness (S/R) being consistently related to both physical and mental health. The objective of this article is to provide an updated review of the current scientific evidence on the relationship between S/R and mental health, highlighting the most important studies. As a secondary objective, the mechanisms that explain this relationship and the interventions that utilize this information in treating mental disorders will be discussed. The findings reveal a large body of evidence across numerous psychiatric disorders. Although solid evidence is now available for depression, suicidality, and substance use, other diagnosis, such as post-traumatic stress disorder, psychosis, and anxiety, have also shown promising results. The effects of S/R on mental health are likely bidirectional, and the manner in which religious beliefs are used to cope with distress (i.e. negative and positive), may affect mental health outcomes. Despite these findings, the mechanisms that explain these associations and the role of S/R interventions need further study. Concerning clinical practice, mental health providers should ask patients about S/R that are important in their lives to provide holistic and patient-centered care.

Religion and Spirituality among American Indian, South Asian, Black, Hispanic/Latina, and White Women in the Study on Stress, Spirituality, and Health

Social scientists have increasingly recognized the lack of diversity in survey research on American religion, resulting in a dearth of data on religion and spirituality (R/S) in understudied racial and ethnic groups. At the same time, epidemiological studies have increasingly diversified their racial and ethnic representation, but have collected few R/S measures to date. With a particular focus on American Indian and South Asian women (in addition to Blacks, Hispanic/Latinas, and white women), this study introduces a new effort among religion and epidemiology researchers, the Study on Stress, Spirituality, and Health (SSSH). This multi-cohort study provides some of the first estimates of R/S beliefs and practices among American Indians and U.S. South Asians, and offers new insight into salient beliefs and practices of diverse racial/ethnic and religious communities.

Covid-19-Beyond virology: Potentials for maintaining mental health during lockdown

BACKGROUND

The current study aimed to assess prevalence of mental disorders during Covid-19 pandemic- and respective lockdown in Germany, and potential behaviors/states that can have protective functions on preventing severe mental problems. Assessing prevalence of mental disorders, as well as to find potential protective variables is very important in order to determine people's psychological suffering. It provides the basis for teaching possible coping styles in order to prevent a major breakdown on mental health. Prevalence on mental disorders was expected to increase during the pandemic, especially depression, (general-/and health-) anxiety, panic attacks- and disorder, as well as obsessive-compulsive disorder. Additionally, potentially protective variables, such as resilience and coping, were included.

METHODS

N = 949 subjects completed an online-survey that asked for symptoms regarding depression, (health) anxiety, panic disorder, obsessive-compulsive disorder, and lock-down related behavior-starting 14 days after lockdown in Germany.

RESULTS

Prevalence of mental disorders in the current sample was much higher than usual prevalence of mental disorders, with 50.6% expressing at least one mental disorder. Resilience was associated with lower risks for any mental disorder (OR = 4.23, p < .0001, 95%CI = 3.21-5.57), as well as with any other measured mental illness (all ORs between = 2.82 for obsessive-compulsive disorder and OR = 41.44 for panic disorder, all p < .001). Similar results were obtained regarding coping (focus on positive).

CONCLUSION

Results are highly relevant in order to provide a glance on what substantial influence the current pandemic- and lockdown situation has on mental health across the country, and possibly across the world. Possible ways in order to prevent deterioration and help coping with the current situation are being elaborated and discussed.

Religion and Health Behaviors in Primary Care Patients

BACKGROUND

Few studies have investigated the association between religion and health behaviors in Korea, where various religions coexist. The present study aimed to investigate the association between religion and health behaviors among primary care patients in Korea.

METHODS

We analyzed data from the Family Cohort Study in Primary Care. Among the 1,040 participants in the cohort, 973 of those who had reported their religion were included in the analysis. Participants completed standardized questionnaires that included religious status and lifestyle factors, such as physical activity, smoking status, drinking status, and dietary habits. The association between religion and health behaviors was analyzed using multivariate logistic regression models.

RESULTS

Among the 973 participants, 345 (35.5%) were Christian, 153 (15.7%) were Roman Catholic, 308 (31.7%) were Buddhist, and 163 (16.8%) did not have any religion. Compared with those without a religion, the odds ratio (OR) for vigorous physical activity (OR, 1.52; 95% confidence interval [CI], 1.01-2.28) increased, and that for binge drinking (OR, 0.67; 95% CI, 0.46-0.78) and problematic drinking (OR, 0.59; 95% CI, 0.35-0.99) decreased among participants with a religion. Compared with those without a religion, Catholics were more likely to engage in vigorous physical activity (OR, 2.20; 95% CI, 1.31-3.67), whereas Christians were less likely to engage in heavy (OR, 0.50; 95% CI, 0.30-0.84), binge (OR, 0.35; 95% CI, 0.22-0.54), and problematic drinking (OR, 0.46; 95% CI, 0.25-0.86). Smoking, meal regularity, and breakfast consumption were not associated with religion.

CONCLUSION

The status of drinking and physical activities were different according to religion. As religion is one of the psychosocial characteristics of patients, knowing patients' religion can be helpful for primary physicians.

Religion, social integration, and depression in Europe: Evidence from the European Social Survey

Western Europe's growing Muslim population has occasioned considerable debate regarding cultural integration, immigration, and social isolation. In this study I explore the relationship between religious identification and depression in European countries, focusing in particular on the situation of Muslims, but comparing across other religious groups, as well as those who are unaffiliated with any religion. The analysis is based on countries sampled in the sixth round of the European Social Survey, conducted in 2012. The results reveal the dueling effects of religious identity: religious involvement involves social integration among like-minded friends, but can also invite discrimination from others. This dueling effect implies significant differences between groups. Among Protestants and Catholics greater religious identification is associated with progressively lower depression, relative to those with no affiliation. Among Muslims lower levels of identification are associated with significantly more depression. Muslims of the highest level of identification are statistically indistinguishable from those with no religious affiliation. These patterns among Muslims are not born of poor social integration, but rather reflect more experiences with discrimination. Overall differences among religious groups are very strong: the difference in depression between Muslims and Protestants, for instance, exceeds the difference between men and women.

A Longitudinal Study of Religiosity, Spiritual Health Locus of Control, and Health Behaviors in a National Sample of African Americans

The present longitudinal study examined religious beliefs and behaviors, spiritual health locus of control (SHLOC), and selected health-related behaviors and outcomes in a national sample of 766 African American adults. Participants were interviewed by telephone three times over a 5-year period. Results indicated that stronger religious beliefs and religious behaviors were associated with greater changes in active SHLOC. There was some evidence of direct effects of religious beliefs and behaviors on changes in health behaviors. Religious behaviors were related to greater passive SHLOC over time across some health outcomes. Passive SHLOC was associated with some less desirable health outcomes over time.

Mind-Body Therapies in Childhood Cancer

PURPOSE OF REVIEW

Advances in the field of Pediatric Oncology have led to increased survival rates in children with cancer, and addressing the emotional well-being and quality of life of this specific population is a critical component of care. Mind-body therapies (MBTs) are an adjuvant modality of treatment that appears to have a positive impact on patient quality of life, patient mental health, and family perceptions toward illness. In this review, we describe several evidence-based MBTs, such as art therapy, meditation, prayer, music therapy, hypnosis and relaxation techniques, their use, and our personal experience with MBT in our institution.

RECENT FINDINGS

Current data suggests that MBTs have been effective in decreasing symptoms related to oncologic pathology in children. Based on experience in our institution, the administration of these therapies can be expanded with the use of technology and also foster family inclusion in care, which can lead to improved quality of life for the patient and family. Further studies are warranted to ascertain the effects of MBTs in childhood cancer. MBTs are increasingly important in the care of youth with oncologic disease. It is necessary to increase the quantity and quality of research for the selection and inclusion of MBT in this population.

An Age-Period-Cohort Analysis of Religious Involvement and Adult Self-Rated Health: Results from the USA, 1972-2008

This study conducts an age, period, cohort analysis of how religious involvement affects adult health across the life course and over time in the USA. Cross-classified random-effect models are used to examine data drawn from the General Social Survey, 1972-2008. The research shows clear life course patterns, time trends and birth cohort changes in the religious involvement and health relationship with period effects surpassing cohort effects. For the most part, the results show a loss of advantage in health with age for those who are more involved in religion. Period effects are mainly demonstrated by an overall downward trend of self-rated health (SRH) attributable to religious denominational differences and various levels of social integration. Unlike the period effects, the health disparities associated with religious denominational differences fluctuated when cohort progressed. These findings suggest that in general, the positive effect of religious involvement on SRH decreases with age and periods, but its influence on individual SRH fluctuates by cohort. It is expected that a downward trend in SRH attributable to religious involvement will carry on in future.

Sense of Coherence in Religious Christian Orthodox Women in Greece

Investigation of correlation between the way of life of women-secular and devoted (belonging to a Christian Orthodox fraternity)-and their stress management skills. Sample population consisted of 200 women, 100 belonging to an Orthodox Christian fraternity and 100 secular women, 18 years of age and older from the wider Thessaloniki area (North Greece). Antonovsky's Scale Sense of Coherence (SOC) was used for stress management skills evaluation. The mean SOC score was 138 (95 % CI 133.9-142.1) for secular and 149.9 (95 % CI 144.9-154.9) for devoted women. The presence of a strong sense of coherence for those women belonging to the fraternity (p = 0.004) and older age (p = 0.019) correlate with higher SOC scores. Religiousness appears to enhance stress management skills in women although additional evidence needs in support of the findings of this research.

Religiousness and Mental Health: Systematic Review Study

Many people use religious beliefs and practices to cope with stressful life events and derive peace of mind and purpose in life. The goal of this paper was to systematically review the recent psychological literature to assess the role of religion in mental health outcomes. A comprehensive literature search was conducted using medical and psychological databases on the relationship between religiosity and mental health. Seventy-four articles in the English and Arabic languages published between January 2000 and March 2012 were chosen. Despite the controversial relationship between religion and psychiatry, psychology, and medical care, there has been an increasing interest in the role which spirituality and religion play in mental health. The findings of past research showed that religion could play an important role in many situations, as religious convictions and rules influence the believer's life and health care. Most of the past literature in this area reported that there is a significant connection between religious beliefs and practices and mental health.

Hospital Social Work and Spirituality: Views of Medical Social Workers

This article is based on a study of 1,389 medical social workers in 108 hospitals across 12 countries, on their views on spirituality and spiritually sensitive interventions in hospital settings. Results of the logistic regression analyses and structural equation models showed that medical social workers from European countries, United States of America, Canada, and Australia, those had undergone spiritual training, and those who had higher self-reported spiritual experiences scale scores were more likely to have the view that spirituality in hospital settings is for facilitating integral healing and wellness of patients and were more likely to prefer spiritual packages of New Age movements as the form of spiritual program, understand spiritual assessment as assessing the patients' spiritual starting point, to then build on further interventions and were likely to attest the understanding of spiritual techniques as mindfulness techniques. Finally they were also likely to understand the spiritual goals of intervention in a holistic way, that is, as that of integral healing, growth of consciousness and promoting overall well-being of patients vis-à-vis only coping and coming to terms with health adversities. Results of the structural equation models also showed covariances between religion, spirituality training, and scores on the self-reported spiritual experiences scale, having thus a set of compounding effects on social workers' views on spiritual interventions in hospitals. The implications of the results for health care social work practice and curriculum are discussed.

Religious Participation is Associated with Increases in Religious Social Support in a National Longitudinal Study of African Americans

This study reports on the association between religious beliefs and behaviors and the change in both general and religious social support using two waves of data from a national sample of African Americans. The Religion and Health in African Americans (RHIAA) study is a longitudinal telephone survey designed to examine relationships between various aspects of religious involvement and psychosocial factors over time. RHIAA participants were 3173 African American men (1281) and women (1892). A total of 1251 men (456) and women (795) participated in wave 2 of data collection. Baseline religious behaviors were associated with increased overall religious social support from baseline to wave 2 (p < .001) and with increased religious social support from baseline to wave 2 in each of the following religious social support subscales: emotional support received (p < .001), emotional support provided (p < .001), negative interaction (p < .001), and anticipated support (p < .001). Religious beliefs did not predict change in any type of support, and neither beliefs nor behaviors predicted change in general social support. African Americans who are active in faith communities showed increases in all types of religious social support, even the negative aspects, over a relatively modest longitudinal study period. This illustrates the strength of the church as a social network and the role that it plays in people's lives.

The Influence of Religious Coping and Religious Social Support on Health Behaviour, Health Status and Health Attitudes in a British Christian Sample

Previous research has established a relationship between religion and health. However, the specific aspects of religion which may influence health are not fully understood. The present study investigates the effect of religious social support and religious coping on health behaviours, health status and attitudes to health whilst controlling for age and non-religious social support. The results indicate religious coping and religious social support positively impact on self-reported current health status, depression, health outlook and resistance susceptibility. However, negative religious coping was predictive of increased alcohol consumption. Overall congregational support and negative religious coping had the greatest impact on health.

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.

Religiosity After a Diagnosis of Cancer Among Older Adults

Aspects of religiosity are important to health and quality of life of cancer patients. This analysis examined changes in religiosity among community-dwelling cancer survivors. Previously diagnosed and newly diagnosed cancer survivors age 65+ were interviewed at baseline and four years later to understand how components of religiosity may change. Religiosity was assessed as organizational, non-organizational, and intrinsic using the Duke Religiosity Scale. At four years, 45 persons had a new diagnosis of non-skin cancer in addition to the 94 diagnosed at baseline. In comparison to persons without a cancer diagnosis and participants with a baseline diagnosis, newly diagnosed participants were more likely to decrease church attendance. Although not statistically significant, a larger proportion of recently diagnosed persons increased non-organizational religiosity behaviors and intrinsic religiosity compared to those with cancer at baseline and those without cancer. African Americans were more likely than Caucasians to show increased non-organizational religiosity. Caucasians with a cancer diagnosis showed increased intrinsic religiosity, perhaps because of a ceiling effect among African Americans. Although all groups showed declines and increases in the measures, baseline religiosity was the strongest predictor of religiosity at 48 months, indicating stability in religiosity over time, even in the context of a cancer diagnosis.

Religious participation and DSM IV major depressive disorder among Black Caribbeans in the United States

This study examines the relationship between religious involvement and 12-month and lifetime DSM-IV major depressive disorder (MDD) within a nationally representative sample of Black Caribbean adults. MDD was assessed using the DSM-IV World Mental Health Composite International Diagnostic Interview (WMH-CIDI). Religious involvement included measures of religious coping, organizational and nonorganizational involvement, and subjective religiosity. Study findings indicate that religious involvement is associated with 12-month and lifetime prevalence of MDD. Multivariate relationships between religious involvement and MDD indicate lower prevalence of 12-month and lifetime MDD among persons who use religious coping and characterize themselves as being religious (for lifetime prevalence only); persons who frequently listen to religious radio programs report higher lifetime MDD. Lower rates of 12-month and lifetime MDD are noted for persons who attend religious services at least once a week (as compared to both higher and lower levels of attendance), indicating a curvilinear relationship. The findings are discussed in relation to previous research on religion and mental health concerns, conceptual models of the role of religion in mental health (e.g., prevention, resource mobilization) that specify multiple and often divergent pathways and mechanisms of religious effects on health outcomes, and the role of religion among Caribbean Blacks.

Negative life events vary by neighborhood and mediate the relation between neighborhood context and psychological well-being

Researchers have speculated that negative life events are more common in troubled neighborhoods, amplifying adverse effects on health. Using a clustered representative sample of Chicago residents (2001-03; n = 3,105) from the Chicago Community Adult Health Survey, we provide the first documentation that negative life events are highly geographically clustered compared to health outcomes. Associations between neighborhood context and negative life events were also found to vary by event type. We then demonstrate the power of a contextualized approach by testing path models in which life events mediate the relation between neighborhood characteristics and health outcomes, including self-rated health, anxiety, and depression. The indirect paths between neighborhood conditions and health through negative life event exposure are highly significant and large compared to the direct paths from neighborhood conditions to health. Our results indicate that neighborhood conditions can have acute as well as chronic effects on health, and that negative life events are a powerful mechanism by which context may influence health.

Religion-based emotional social support mediates the relationship between intrinsic religiosity and mental health

Although previous research suggests that increased religiosity is associated with better mental health and many authors have conjectured that religion-based social support may help explain this connection, scant research has directly examined whether religion-based support mediates religiosity and mental health. The present study examined whether various dimensions of religion-based support (social interaction, instrumental, and emotional) mediated the relationship between religiosity and mental health in college students in the Midwest United States. As expected, of the support dimensions, perceived emotional support was the strongest predictor of decreased hopelessness, depression, and suicide behaviors; and the relationships among intrinsic religiosity and the mental health variables were fully mediated by emotional support. These findings provide strong support to the notion that the relationship between religiosity and mental health can be reduced to mediators such as social support. Research and theoretical implications are discussed.

Re-examining definitions of spirituality in nursing research

AIM

To discuss the definition of spirituality and its limitations for nursing research. It proposes a definition that will capture more accurately the role of spirituality in health outcomes.

BACKGROUND

Studies have increasingly examined spirituality in nursing research as a coping mechanism attenuating the negative impact of traumatic stress on mental health. Existing definitions of spirituality in nursing research include elements of positive emotional states (meaning, purpose, general well-being) which confound mental health outcomes.

DATA SOURCES

Medline and CINAHL databases were searched from 2007-2011 for research articles examining spirituality definitions and measures used by nurse researchers.

DISCUSSION

An analysis of the definitions of spirituality in nursing research reveals inconsistencies and confounding mental health concepts. The authors propose defining spirituality in the context of religious involvement when conducting research, while using a broader definition of spirituality when providing spiritual care. They argue such definition provides a more appropriate method of measuring this concept in research aimed at evaluating mental health outcomes while preserving the currently used patient-defined definition of spirituality when providing spiritual care.

NURSING IMPLICATIONS

A consistent definition of spirituality in nursing research evaluating mental health outcomes, distinct from 'spiritual care' in a clinical setting, is essential to avoid tautological results that are meaningless. Appropriate definitions will enable nursing researchers to more clearly identify resilience mechanisms and improved health outcomes in those exposed to traumatic stress.

CONCLUSION

A definition of spirituality that focuses on religious involvement provides a more uniform and consistent measure for evaluating mental health outcomes in nursing research.

A multifaith spiritually based intervention versus supportive therapy for generalized anxiety disorder: a pilot randomized controlled trial

OBJECTIVES

We have previously reported that a multifaith spiritually based intervention (SBI) may have efficacy in the treatment of generalized anxiety disorder (GAD). This randomized pilot trial tested whether the SBI had greater efficacy than a nonspecific control condition in GAD.

METHOD

Twenty-three participants with GAD of at least moderate severity were randomized to 12 individual sessions of the SBI (n = 11) or supportive psychotherapy (SP)--our control condition (n = 12).

RESULTS

Intent-to-treat analysis revealed the SBI fared better than SP in decreasing blind clinician ratings of anxiety and illness severity and self-report worry and intolerance of uncertainty, with large between-group effect sizes. The SBI also produced greater changes in spiritual well-being. Results remained the same when supplementary analyses were performed on the completer sample. Treatment gains were maintained at 3-months follow-up.

CONCLUSIONS

This small pilot trial demonstrates that a nondenominational SBI has greater efficacy than a rigorous control in improving symptoms of GAD and enhancing spiritual well-being. These results are encouraging and further research on the efficacy of the SBI and its underlying mechanisms is warranted.

Religiosity and Function Among Community-Dwelling Older Adult Survivors of Cancer

Aspects of religiosity/spirituality are important to health and quality of life of cancer patients. The three components of religiosity of the Duke Religiosity Scale: organizational (religious affiliation and attendance); non-organizational (prayer, meditation, and private study); and intrinsic religiosity (identification with a higher power and integration of spiritual belief into daily life) are used to determine whether religiosity was associated with physical and/or mental functioning among older cancer survivors of the UAB Study of Aging. Church attendance was independently associated with lower ADL and IADL difficulty and fewer depressive symptoms, while intrinsic religiosity was independently associated with lower depression scores.

Religiousness, religious coping methods and distress level among psychiatric patients in Malaysia

BACKGROUND

Patients having psychiatric diagnoses often experience high level of distress. Religiousness is often used by them as part of their coping mechanism and problem-solving strategies.

OBJECTIVE

To determine the level of religious commitment and coping methods in psychiatric patients and its relationship with distress level.

METHODS

Religious commitment and coping patterns were measured with the Duke University Religious Index (DUREL) and Brief RCOPE, respectively. Psychopathology was assessed using the Brief Psychiatric Rating Scale (BPRS) and distress level was assessed with the Depressive, Anxiety and Stress Scale (DASS). Social support and experiences of recent threatening events were measured with the Multidimensional Scale of Perceived Social Support (MSPSS) and Life Threatening Events (LTE).

RESULTS

A total of 228 patients were included in this study with a mean age of 40.2 years. The majority were male, Malay, Muslim, single and with psychotic disorder. The subjects had a high level of religious commitment and had used more positive coping methods. Negative religious coping, psychiatric symptoms and diagnosis of anxiety disorder or major depression were significantly associated with high distress level. Higher religious commitment was significantly associated with lower distress (p < .05).

CONCLUSION

Psychiatric patients were religiously committed and used more positive religious coping methods. Practices of negative religious coping, severe psychiatric symptoms and anxiety/depression were associated with higher distress.

Religious attendance and social adjustment as protective against depression: a 10-year prospective study

BACKGROUND

Previous research has identified elevated social adjustment and frequent religious attendance as protective against depression. The present study aims to examine the association of frequency of religious services attendance with subsequent depression, while accounting for the effects of social adjustment.

METHOD

Participants were 173 adult offspring of depressed and nondepressed parents, followed longitudinally over 25 years. Diagnosis was assessed with the Schedule for Affective Disorders and Schizophrenia-Lifetime Version. The Social Adjustment Scale-Self Report (SAS-SR) was used to assess social adjustment and frequency of religious services attendance was self-reported. In a logistic regression analysis, major depression at 20 years was used as the outcome measure and the frequency of religious services attendance and social adjustment variables at 10 years as predictors.

RESULTS

Frequent religious services attendance was found to protect against subsequent depression at a trend level. High functioning social adjustment was found to protect against subsequent depression, especially within the immediate and extended family. Adults without a depressed parent who reported attending religious services atleast once a month had a lower likelihood of subsequent depression. Among adults with a depressed parent, those with high functioning social adjustment had a lower likelihood of subsequent depression.

LIMITATIONS

Measurement of social adjustment was non-specific to religious services.

CONCLUSIONS

Frequent religious attendance may protect against major depression, independent from the effects of social adjustment. This protective quality may be attenuated in adults with a depressed parent. High functioning social adjustment may be protective only among offspring of depressed parents.

Assessing Gender Differences in the Relationship Between Negative Interaction With the Clergy and Health Among Older Mexican Americans

A rapidly growing literature indicates that supportive social relationships are associated with better physical and mental health. However, this research further reveals that interaction with others may also be conflicted and unpleasant. The purpose of the current study was to evaluate negative interaction that arises within a social context that is important to many older Mexican Americans (i.e., negative interaction with a member of the clergy). Findings from a nationwide survey of older Mexican Americans indicate that more frequent interpersonal conflict with a member of the clergy is associated with less favorable self-rated health as well as more acute and chronic health conditions. However, these effects were observed among older Mexican American women but not among older Mexican American men.

Religious involvement and DSM-IV 12-month and lifetime major depressive disorder among African Americans

This study explores relationships between lifetime and 12-month DSM-IV major depressive disorder and religious involvement within a nationally representative sample of African American adults (n = 3,570). MDD was assessed using the DSM-IV World Mental Health Composite International Diagnostic Interview. Multivariate findings indicate that reading religious materials were positively associated with 12-month (odds ratio [OR], 1.14; 95% confidence interval [CI], 1.001-1.29) and lifetime (OR, 1.12; 95% CI, 1.03-1.21) MDD, religious service attendance was inversely associated with 12-month and lifetime MDD, and religious coping was inversely associated with 12-month MDD (OR, 0.75, 95% CI, 0.57-0.99). Findings are discussed in relation to the role of religion for African American mental health, prior research on the effects of religious involvement on physical and mental health, and theoretical and conceptual models of religion-health connections that specify multiple and often divergent pathways (e.g., prevention and resource mobilization) by which diverse forms of religious involvement impact mental health.