Racial burdens in the work experiences of state-supported Black chaplains

To understand and improve the experiences of Black chaplains, it is essential to consider how they experience and are integrated into their workplaces. This article draws from interviews with ten Black chaplains in the military and prisons. In light of historic, state-sanctioned, discrimination in these institutions, we ask how these chaplains experience their workplaces racially. All experience racial burdens in the workplace as part of being the first or only Black chaplain or in response to overt racial discrimination. They identify few to no formal workplace efforts to support them as Black chaplains and spoke of resistance to informal efforts that have been tried over the years. State and federal workplaces must recognize the racial burdens Black chaplains' experiences and take action to respond to and support these systemic workplace issues.

Religion/Spirituality, Mental Health, and the Lifespan: Findings from a Representative Sample of Canadian Adults

Theories of adult development and aging suggest that older adults turn towards religion and spirituality (R/S) to increase meaning and purpose in life, and to assist in coping with adverse experience. We sought to examine the relationship between R/S and positive mental health and mental illness (i.e., psychological distress) in adulthood, and to determine the potential moderating role of age. Data from the 2012 Canadian Community Health Survey - Mental Health (CCHS-MH), a national population health study, were used. A multivariable linear regression model revealed a significant R/S by age interaction for positive mental health (p = 0.001). Although R/S was associated with positive mental health among all participants, there was a stronger relationship between R/S and positive mental health for older adults. No statistically significant relationship between R/S and psychological distress was observed. Findings highlight the importance of R/S to positive mental health across the adult lifespan. The differential relationships among R/S, positive mental health, and mental illness underscore the utility of using the dual-continua of mental health and mental illness in order to understand their respective determinants.

The antidepressant effect of physical exercise: Evidence from China Family Panel Studies

Multiple studies have proved that participating in sports can effectively reduce adults’ depression. This paper provides evidence from China by using the survey data from China Family Panel Studies (CFPS), which contains sport-types, personal characteristics, and CES-D20 depression-scale score data of 33,236 individuals. In addition to the Ordinary Least Squares regression model, we adopt the Two-way Fixed Effect and Propensity Score Matching method to alleviate the endogeneity. The empirical result shows that for every additional time of physical exercise, the depression level drops by an average of 0.152; the depression level of people who participate in sports is significantly lower than that of non-participants by 0.397 points. The lowering effect of physical activity on depression is not linear, and excessive exercise may lead to increased depression. Furthermore, heterogeneity analyses discover that with the increase of age and education, the impact continued to expand. For every increase in physical exercise of the group over 76-year old, the depression level decreased by 0.373 points; while for individuals with primary school education, their depression level decreased only by 0.124 points.

Depression, religiosity, and telomere length in the Study on Stress, Spirituality, and Health (SSSH)

Prospective studies on the association between depression and telomere length have produced mixed results and have been largely limited to European ancestry populations. We examined the associations between depression and telomere length, and the modifying influence of religion and spirituality, in four cohorts, each representing a different race/ethnic population. Relative leukocyte telomere length (RTL) was measured by a quantitative polymerase chain reaction. Our result showed that depression was not associated with RTL (percent difference: 3.0 95% CI: -3.9, 10.5; p = 0.41; p-heterogeneity across studies = 0.67) overall or in cohort-specific analyses. However, in cohort-specific analyses, there was some evidence of effect modification by the extent of religiosity or spirituality, religious congregation membership, and group prayer. Further research is needed to investigate prospective associations between depression and telomere length, and the resources of resilience including dimensions of religion and spirituality that may impact such dynamics in diverse racial/ethnic populations.

What Do Immigrants From Various Cultures Think Is the Best Way to Cope With Depression? Introducing the Cross-Cultural Coping Inventory

The aim of this study is to introduce a domain-specific instrument, the Cross-Cultural Depression Coping Inventory (CCD-CI), to assess ways in which people from different cultures prefer to cope with depression. Part 1 of this paper describes the development of CCD-CI. A combined etic and emic approach in generating items was used. Principal component analysis on data from a heterogeneous sample of immigrants (N = 458) supported a three-factor solution labeled: Engagement, disengagement, and spiritual coping. In Part 2 confirmatory factor analysis were conducted to test if the factors replicated in a mixed ethnic sample of immigrants from Russia (n = 164), Poland (n = 127), Pakistan (n = 128), Somalia (n = 114), and Norwegian students (n = 248). The three-factor model fits the data well and differentiated between the ethnic groups. Most significantly, Somali followed by the Pakistani immigrants scored higher on disengagement and spiritual coping. Inspection of item-level differences showed the largest ethnic variations in coping behavior of communal or social nature. The CCD-CI factors were validated against the Vancouver Index of Acculturation. Adoption to majority culture correlated positively with engagement and negatively with spiritual Coping. Maintenance of origin culture was positively associated with both spiritual coping and disengagement. In Part 3 the construct validity of the CCD-CI was tested in relation to the Brief Cope. The magnitude of the correlations was small to moderate. Taken together results indicate that CCD-CI is a reliable and valid measure of coping strategies related to depression, suitable for adults from different ethnic groups. Implications for research and clinical practice are discussed.

Religion, Health, and Life Satisfaction: Evidence from Australia

In this article, we examine the influence of religion on health and life satisfaction while controlling for an extensive range of demographic characteristics and life conditions-marital satisfaction, job satisfaction, financial stress, and social resources-using data drawn from the Household, Income and Labour Dynamics in Australia (HILDA) survey. Our findings suggest that, on average, high levels of faith and attendance at religious services are associated with lower health. In contrast, however, we find no relationship between high levels of faith, attendance, and life satisfaction. Further research is required to unravel how faith and attendance influence health and life satisfaction.

Clinical correlates of resilience factors in geriatric depression

ABSTRACTBackground:Traditional perspectives conceptualize resilience as a trait and depression as resulting from resilience deficiency. However, research indicates that resilience varies substantially even among adults who are clinically depressed, as well as across the lifespan of an individual. Few studies have investigated resilience in depression, and even fewer have examined resilience in depressed older adults.

METHODS

Three hundred thirty-seven adults ≥60 years with major depressive disorder completed the Connor-Davidson Resilience Scale (CD-RISC) and measures of mental health, quality of life (QOL), and medical comorbidity. Exploratory factor analysis was used to explore the factor structure of the CD-RISC. Correlations and general linear models were used to examine associations between resilience and other variables.

RESULTS

The rotated component matrix indicated a four-factor model. Sorting of items by highest factor loading revealed constructs associated with (1) grit, (2) active coping self-efficacy, (3) accommodative coping self-efficacy, and (4) spirituality. Resilience was significantly correlated with increased age, lower cognitive functioning, greater cerebrovascular risk, and greater medical comorbidity. Resilience was negatively associated with mental health symptoms (depression, apathy, and anxiety) and positively associated with QOL. The final optimal model identified less depression, less apathy, greater medical comorbidity, higher QOL, and minority (non-White) race as factors that significantly explained variability in resilience.

CONCLUSIONS

Resilience was significantly associated with a range of mental health constructs in a sample of older adults with depression. Future clinical trials and dismantling studies may help determine whether interventions targeting grit, active coping, accommodative coping, and spirituality can increase resilience and help prevent and treat depression in older adults.

Cyr N, Siddarth P. Resilience predicts remission in antidepressant treatment of geriatric depression

OBJECTIVES

With the world population rapidly aging, it is increasingly important to identify sociodemographic, cognitive, and clinical features that predict poor outcome in geriatric depression. Self-report measures of resilience-ie, the ability to adapt and thrive in the face of adversity-may identify those depressed older adults with more favorable prognoses.

METHODS

We investigated the utility of baseline variables including 4 factors of resilience (grit, active coping self-efficacy, accommodative coping self-efficacy, and spirituality) for predicting treatment response and remission in a 16-week randomized controlled trial of methylphenidate, citalopram, or their combination in 143 adults over the age of 60 with MDD.

RESULTS

Final logistic regression models revealed that greater total baseline resilience (Wald χ²  = 3.8, P = 0.05) significantly predicted both treatment response and remission. Specifically, a 20% increase in total resilience predicted nearly 2 times greater likelihood of remission (OR = 1.98, 95% CI = [1.01, 3.91]). Examining the individual factors of resilience, only accommodative coping self-efficacy (Wald χ²  = 3.7, P = 0.05; OR = 1.41 [1.00-2.01]) was significantly associated with remission. We found no relation between baseline sociodemographic factors (age, sex, race, education level) or measures of cognitive performance and posttreatment depressive symptoms.

CONCLUSIONS

Self-reported resilience may predict greater responsivity to antidepressant medication in older adults with MDD. Future research should investigate the potential for resilience training-and in particular, interventions designed to increase accommodative coping-to promote sustained remission of geriatric depression.

Religiosity and depressive symptoms in older adults compared to younger adults: Moderation by age

BACKGROUND

Previous research has suggested that individuals tend to become more religious with age. Research has also shown that as individuals become more religious, they report decreases in depressive symptoms, suggesting that increased levels of religiosity might help to improve one's mental health. The following study aimed to examine the effect of age on the relation between religiosity and depressive symptoms.

METHODS

Data was gathered using a religiosity questionnaire and depression questionnaire. The sample consisted of 201 adults, ranging from 21-67 years of age, recruited through the Amazon Mechanical Turk (MTURK) marketplace.

RESULTS

Hays' PROCESS model for SPSS (Hayes, 2013) was used to test age as a moderator between depressive symptoms and religiosity. Correlations showed that religiosity was positively correlated with age and negatively correlated with depressive symptoms. Further analysis of the data suggested that age serves as a moderator in the relation between religiosity and depressive symptoms for both middle-aged and younger adults.

LIMITATIONS

Participants included in the study were limited in age, further studies should consider including individuals >67 years of age to better test proposed relations.

CONCLUSIONS

High levels of religiosity were related to lower levels of depression in middle-aged and younger adults. Though further research on the development of such evidence-based programs is needed, involvement in religious activities may have a preventative role in both the development and duration of depressive symptoms in middle and older aged adults.

Does spirituality reduce the impact of somatic symptoms on distress in cancer patients? Cross-sectional and longitudinal findings

RATIONALE

When diagnosed with cancer, a patient has to cope with stressors such as pain, fatigue, and the experience of life-threat that can cause great distress. Spirituality may be a resource for coping with these problems, thereby reducing distress.

OBJECTIVE

Two questionnaire studies-the first a cross-sectional (Study 1; N = 216) and the second a one-year longitudinal (Study 2; N = 383)-investigated among Dutch cancer patients whether spirituality lessens the impact of pain, fatigue, and perceived life-threat on distress.

METHOD

Data for Study 1 were gathered in 2006-2007 and for Study 2 in 2009-2010. Spirituality was measured with the Spiritual Attitude and Involvement List, which assesses six distinct but related aspects of spirituality. Linear regression analysis and marginal effect plots were applied.

RESULTS

Limited evidence appeared for the hypothesis that spirituality reduces the impact of pain, fatigue, or perceived life threat on distress. Meaningfulness and acceptance might reduce a negative impact of increases in fatigue during the first year after the start of cancer treatment. In contrast, spirituality might enhance a negative impact of increases in perceived life threat.

CONCLUSIONS

Processes of appraisal might explain the findings. Experiences of meaningfulness and acceptance might help to reappraise fatigue in a less threatening way, thereby reducing distress. Conversely, appraising the cancer as life-threatening might conflict with spiritual experiences of meaning, acceptance, and awe about life. Future studies should focus on the processes by which the various aspects of spirituality influence the adjustment of cancer patients and use other outcome variables than non-specific distress. Such studies may provide further clues as to how the spirituality of patients can be harnessed to help them adjust to a serious life event such as the occurrence of cancer.

Effects of Pride and Regret on Geriatric Depression: A Cross-Cultural Study With Mixed-Methods Approaches

Pride and regret are self-conscious emotions that develop later in life and become a source of emotional struggle. This cross-cultural study examined the effect of the content and intensity of self-conscious emotions on Geriatric Depression Scale (GDS) scores. Among a convenience sample of 234 older adults (130 in the United States and 104 in South Korea), the contents and intensities of both life regrets and pride were examined. Although a greater variety of regrets was cited by Americans, overall Korean respondents reported higher intensity of regret. Regrets that were related to leisure and addiction among Americans and health and career among Koreans were predictors of the GDS scores. Pride in leisure activities for Americans and altruism among Koreans could alleviate depression. While regrets and pride explained a small amount of the variance in the GDS scores, current life stressors greatly contributed to geriatric depression.

Buried hatchets, marked locations: Forgiveness, everyday racial discrimination, and African American men's depressive symptomatology

Everyday racial discrimination (ERD) is linked to pronounced depressive symptomatology among African American men. Yet, many African American men do not experience depressive symptoms following ERD exposure often because they use positive coping strategies that offset its effects. Granting forgiveness is 1 coping strategy associated with less depression. However, extant findings about the mental health benefits of forgiveness are somewhat mixed and pay scarce attention to offenses which are fleeting, historically rooted, and committed outside of close personal relationships. Evidence further suggest age-related differences in forgiveness, ERD exposure, and depressive symptoms. We explore the extent to which 3 strategies of granting forgiveness of ERD-letting go of negative emotion (negative release), embracing positive emotion (positive embrace), or combining both (combined)-are associated with less depressive symptomatology in 674 African American men (ages 18 through 79). Building on past findings, we also test whether these forgiveness strategies moderate the ERD-depressive symptoms relationship for men in different age groups (18 through 25, 26 through 39, and 40). Higher combined and negative release forgiveness were directly related to lower depressive symptoms among 18 through 25 year olds. We also detected a less pronounced positive relationship between ERD and depressive symptoms among men reporting high levels of combined (18 through 25 and 26 through 39 groups) and negative release (26 through 39 and 40+ groups) forgiveness. We observed a more pronounced positive ERD-depressive symptoms relationship among 18 through 25 and 26 through 39 year olds reporting lower forgiveness. When faced with frequent ERD, younger African American men may have the most difficult time burying hatchets without marking their location but experience more positive mental health benefits when they do. (PsycINFO Database Record

My Body is a Temple: Eating Disturbances, Religious Involvement, and Mental Health Among Young Adult Women

A growing body of the literature outlines the undesirable mental health consequences of eating disturbances. However, little attention has been given to the possible mitigating effects of cultural institutions, such as religion, in the lives of women suffering from such pathologies. Our work contributes to the literature by (a) outlining a series of arguments linking eating disturbances, religion, and mental health; (b) specifying two conceptual models of these relationships; and (c) testing relevant hypotheses using data on a large nationwide sample of young women. Results indicate that religious involvement-organizational, non-organizational, and subjective religiousness-moderates the effects of eating disturbances on mental health, particularly for self-esteem. Study limitations are identified and several promising directions for future research are discussed.

Spirituality and positive psychology go hand in hand: an investigation of multiple empirically derived profiles and related protective benefits

We investigate the relationship between personal spirituality and positive psychology traits as potentially presented in multiple profiles, rather than monolithically across a full sample. A sample of 3966 adolescents and emerging adults (aged 18-25, mean = 20.19, SD = 2.08) and 2014 older adults (aged 26-82, mean = 38.41, SD = 11.26) completed a survey assessing daily spiritual experiences (relationship with a Higher Power and sense of a sacred world), forgiveness, gratitude, optimism, grit, and meaning. To assess the relative protective benefits of potential profiles, we also assessed the level of depressive symptoms and frequency of substance use (tobacco, marijuana, alcohol, and heavy alcohol use). Latent class analysis (LCA) was used to examine common subgroupings of study participants across report on personal spirituality and positive psychology scales in each age cohort, with potential difference between latent classes then tested in level of depressive symptoms and degree of substance use. LCA determined a four-class and a three-class best-fitting models for the younger and older cohorts, respectively. Level of personal spirituality and level of positive psychology traits were found to coincide in 83 % of adolescents and emerging adults and in 71 % of older adults, suggesting personal spirituality and positive psychology traits go hand in hand. A minority subgroup of "virtuous humanists" showed high levels of positive psychology traits but low levels of personal spirituality, across both age cohorts. Whereas level of depression was found to be inversely associated with positive psychology traits and personal spirituality, uniquely personal spirituality was protective against degree of substance use across both age cohorts. Overall interpretation of the study findings suggests that personal spirituality may be foundational to positive psychology traits in the majority of people.

Why underserved patients do not consult their general practitioner for depression: results of a qualitative and a quantitative survey at a free outpatient clinic in Paris, France

BACKGROUND

The prevalence of depression in the general population is 5 to 10% but can exceed 50% in the most socially vulnerable populations. The perceptions of this disease are widely described in the literature, but no research has been carried out in France to explain the reasons for not consulting a general practitioner during a depressive episode, particularly in people in the most precarious situations. The objective of this study was to describe the reasons for not seeking primary care during a depressive episode in a socially vulnerable population.

METHODS

An exploratory sequential design with a preliminary qualitative study using a phenomenological approach. Subsequently, themes that emerged from the qualitative analysis were used in a questionnaire administered in a cross-sectional observational study at a free outpatient clinic in Paris in 2010. Lastly, a logistic regression analysis was performed.

RESULTS

The qualitative analysis revealed four aspects that explain the non-consulting of a general practitioner during a depressive episode: the negative perception of treatment, the negative perception of the disease, the importance of the social environment, and the doctor-patient relationship. The quantitative analysis showed that close to 60% of the patients who visited the free clinic were depressed and that only half of them had talked with a care provider. The results of the statistical analysis are in line with those of the qualitative analysis, since the most common reasons for not seeing a general practitioner were the negative perception of the disease (especially among the men and foreigners) and its treatments (more often among the men and French nationals).

CONCLUSIONS

Close to 50% of the depressed individuals did not seek primary care during a depressive episode, and close to 80% of them would have liked their mental health to be discussed more often by a health professional. Better information on depression and its treatments, and more-systematic screening by primary care personnel would improve the treatment of depressed patients, especially those in the most precarious situations.

Self-reported experiences of discrimination and health: scientific advances, ongoing controversies, and emerging issues

Over the past two decades, research examining the impact of self-reported experiences of discrimination on mental and physical health has increased dramatically. Studies have found consistent associations between exposure to discrimination and a wide range of Diagnostic and Statistical Manual of Mental Disorders (DSM)-diagnosed mental disorders as well as objective physical health outcomes. Associations are seen in cross-sectional as well as longitudinal studies and persist even after adjustment for confounding variables, including personality characteristics and other threats to validity. However, controversies remain, particularly around the best approach to measuring experiences of discrimination, the significance of racial/ethnic discrimination versus overall mistreatment, the need to account for "intersectionalities," and the importance of comprehensive assessments. These issues are discussed in detail, along with emerging areas of emphasis including cyber discrimination, anticipatory stress or vigilance around discrimination, and interventions with potential to reduce the negative effects of discrimination on health. We also discuss priorities for future research and implications for interventions and policy.

Religious and Spiritual Coping. An Overview of the Western Studies

The article is aimed at getting familiar with the Western researches of spiritual and religious coping. The main categories, conceptual models and results of the empirical studies in the current research field are overviewed. For the Russian psychological theory this direction of research could serve as an example of a methodologically mature field that could enrich the instruments of studies in the field of psychology of religion and psychology of coping behavior. For the psychological practice it serves as an example of scientifically based look upon the connection between spiritual and religious phenomena and their input in the process of overcoming critical situations. Conclusions are made; future research perspectives and the development of the current field in Russia are discussed.

Religious involvement is associated with greater purpose, optimism, generosity and gratitude in persons with major depression and chronic medical illness

OBJECTIVE

Religious involvement may help individuals with chronic medical illness cope better with physical disability and other life changes. We examine the relationships between religiosity, depressive symptoms, and positive emotions in persons with major depression and chronic illness.

METHODS

129 persons who were at least somewhat religious/spiritual were recruited into a clinical trial to evaluate the effectiveness of religious vs. secular cognitive behavioral therapy. Reported here are the relationships at baseline between religious involvement and depressive symptoms, purpose in life, optimism, generosity, and gratefulness using standard measures.

RESULTS

Although religiosity was unrelated to depressive symptoms (F=0.96, p=0.43) and did not buffer the disability-depression relationship (B=-1.56, SE 2.90, p=0.59), strong relationships were found between religious indicators and greater purpose, optimism, generosity, and gratefulness (F=7.08, p<0.0001).

CONCLUSIONS

Although unrelated to depressive symptoms in the setting of major depression and chronic medical illness, higher religious involvement is associated with positive emotions, a finding which may influence the course of depression over time.

Differentiated effects of social participation components on suicidal ideation across age groups in South Korea

BACKGROUND

Suicide among adults in the Korean population merits study to improve the understanding of the salient risk and protective factors because suicide rates in Korea have increased dramatically over the past 20 years. However, the association between social participation and suicidal ideation is poorly understood. Thus, this study aimed to identify the components of social participation in Korean society and to examine the processes through which the components of social participation influence the degree of suicidal ideation people experience across age groups.

METHODS

This study used survey data from the 2010 Seoul Welfare Panel Study. The sample population was restricted to adults aged 20 or older and was categorised into three groups by respondents' ages. The groups were defined as 'young adults' (aged 20-39), 'middle-aged adults' (aged 40-64) and 'the elderly' (age 65 or more). Three dimensions of social participation were identified by factor analysis--friendship network and hobby group, religious involvement, and instrumental social participation.

RESULTS

In the young adult group, only instrumental participation was statistically significant (-0.10, p = 0.06). In the middle-aged adult group, only friendship network and hobby group had a strong association with suicidal ideation (-0.11, p = 0.01). Interestingly, for the elderly, religious involvement was related to suicidal ideation, but in a positive way (0.26, p = 0.02).

CONCLUSION

The study results supported the theory that different components of social participation are associated with a lower risk of suicidal ideation in different stages of adulthood.

The role of patient religiosity in the evaluation and treatment outcomes for chronic HCV infection

To determine the influence of patient religiosity on the outcome of treatment of hepatitis C infection, a prospective, blinded, cohort study was performed on hepatitis C-infected patients categorized as 'higher religiosity' and 'lower religiosity' based on responses to a religiosity questionnaire. Comparisons were made between high and low religiosity patients on demographics, pre-treatment laboratory values, and response to treatment. Eighty-seven patients with complete questionnaires were placed in either higher (38) or lower (49) religiosity cohort. The patients (60% female) were ethnically diverse: African-American 39%; Hispanic 31%; white 29%. African-American race (P = 0.001) and female gender (P = 0.026) were associated with higher religiosity. The frequency of being offered treatment, accepting treatment, and completing treatment was similar in both religiosity cohorts (P = 0.234, 0.809, 0.367). Fifty-six patients completed the 24- or 48-week treatment with peginterferon and ribavirin. Depression was more frequent in the low religiosity group (38.2% vs. 4.6%, P = 0.005). Sustained viral response rate at 3-6-month post-therapy was similar in the higher (50%) and lower (57.6%) religiosity cohorts (P = 0.580; n = 55). Logistic regression modeling revealed that males having higher religiosity gave greater odds of SVR than those with lower religiosity (OR 21.3; 95% CI 1.1-403.9). The level of religiosity did not affect the decision to begin treatment for chronic HCV infection and was not associated with a better treatment outcome. A higher level of religiosity was associated with less depression among patients.

Primary care physicians' and psychiatrists' approaches to treating mild depression

OBJECTIVE

To measure how primary care physicians (PCPs) and psychiatrists treat mild depression.

METHOD

We surveyed a national sample of US PCPs and psychiatrists using a vignette of a 52-year-old man with depressive symptoms not meeting Major Depressive Episode criteria. Physicians were asked how likely they were to recommend an antidepressant counseling, combined medication, and counseling or to make a psychiatric referral.

RESULTS

Response rate was 896/1427 PCPs and 312/487 for psychiatrists. Compared with PCPs, psychiatrists were more likely to recommend an antidepressant (70% vs. 56%), counseling (86% vs. 54%), or the combination of medication and counseling (61% vs. 30%). More psychiatrists (44%) than PCPs (15%) were 'very likely' to promote psychiatric referral. PCPs who frequently attended religious services were less likely (than infrequent attenders) to refer the patient to a psychiatrist (12% vs. 18%); and more likely to recommend increased involvement in meaningful relationships/activities (50% vs. 41%) and religious community (33% vs. 17%).

CONCLUSION

Psychiatrists treat mild depression more aggressively than PCPs. Both are inclined to use antidepressants for patients with mild depression.

The effects of a psychoneuroimmunology (PNI) based lifestyle intervention in modifying the progression of depression in clinically depressed adults

OBJECTIVE

Uncontrolled stress can lead to poorly controlled upsurges of cortisol and deregulation of the hypothalamus pituitary-adrenal axis (HPA), thereby leading to major depression. Psychoneuroimmunology (PNI) is the area of medicine dealing with the bidirectional pathways connecting the influences of brain, neuroendocrine, and immune system. Individual PNI-based lifestyle interventions such as humor and guided imagery have been shown to modulate the stress response. However, researchers have not examined the composite effect of a PNI-based lifestyle intervention among clinically depressed adults.

METHOD

This randomized interventional study examined the composite effect(s) of a PNI-based lifestyle intervention: progressive muscle relaxation, spiritual guided imagery, and humor as an adjunct therapy to modifying the progression of depression. Forty-one participants recruited from doctors' offices in San Bernardino and Riverside counties in Southern California, were randomized into two groups: treatment (N = 20) and control (N = 21). For a period of three weeks, participants in the treatment group listened to a 12-minute progressive muscle relaxation and spiritual guided imagery CD daily and watched 10 minutes of humorous DVDs. Participants in both groups were also receiving cognitive behavioral therapy and pharmacotherapy.

RESULTS

Depression, spirituality, humor, and stress were assessed at baseline and week 3. Depression significantly decreased from severe to mild from baseline to week 3 in the treatment group. Spirituality significantly increased in the treatment group but remained unchanged in the controls.

CONCLUSIONS

These findings offer depressed patients alternative approaches to preventing complications and managing their illness in the context of whole-person lifestyle optimization and integration of mind-body-spirit.

Moderating effect of Islamic religiosity on the relationship between chronic medical conditions and psychological well-being among elderly Malays

BACKGROUND

Research has found that physical health decline in later life is associated with poor psychological well-being. This study aimed to examine the possible moderating effect of Islamic religiosity on the relationship between chronic medical conditions and psychological well-being.

METHODS

The sample for this study consisted of 1415 elderly Malay Muslims. It was obtained from a cross-sectional survey entitled 'Patterns of Social Relationship and Psychological Well-Being among Older Persons in Peninsular Malaysia', which conducted from 2007 to 2009, using a multistage stratified sampling procedure. Data collection was performed through face-to-face interviews. A four-step moderated hierarchical regression analysis using SPSS software for Windows and the 'ModGraph-2' software program was used to test the hypothesis.

RESULTS

Results of bivariate analysis showed, at certain levels of chronic medical conditions, older persons with a high level of religiosity reported significantly higher levels of psychological well-being compared to their counterparts with a low level of religiosity. Four-step moderated hierarchical regression analysis revealed that the negative effect of chronic medical conditions on psychological well-being is reduced by both personal and social religiosity (β = 0.07, P ≤ 0.01), after controlling for selected sociodemographic factors.

CONCLUSION

Taken together, these findings indicate that the depressogenic effect of physical illness is decreased by religiosity in chronically ill elderly people. The implications and limitations of the current study are discussed and recommendations for future research are proposed.

Assessment of prevalence and determinants of posttraumatic stress disorder in survivors of earthquake in Pakistan using Davidson Trauma Scale

INTRODUCTION

Pakistan's 2005 earthquake claimed almost 87,000 lives and displaced millions. The present study sought to assess PTSD prevalence among earthquake survivors, to evaluate its determinants, and to identify protective factors that suggest future interventions in the aftermath of disasters.

METHODS

In a cross-sectional survey, three districts were selected based on their proximity to the epicenter and the presence, accessibility, and security of refugees, 300 earthquake survivors were enrolled.

RESULTS

Analysis revealed that after 30months, PTSD prevalence was high. Being female, older, unmarried, head of the family, and currently unemployed and having low income and living in temporary housing confer higher risks of PTSD. Having a high social capital and religious inclination seem to have protective, buffer effect and increase resilience against PTSD.

CONCLUSION

This is the first post-quake study in Pakistan that has utilized, adapted and validated Davidson Trauma Scale in the local context. Results imply the significance of continued psychological support, of drawing on resilience factors in PTSD management. Implications and directions for future research are discussed.

Predicting the trajectories of depressive symptoms among southern community-dwelling older adults: the role of religiosity

BACKGROUND

This study examined the effects of religiosity on the trajectories of depressive symptoms in a sample of community-dwelling older adults over a four-year period in a Southern state in the U.S.

METHODS

Data from the University of Alabama at Birmingham (UAB) Study of Aging were analyzed using a hierarchical linear modeling (HLM) method. This study involved 1000 participants aged 65 and above (M age = 75 at baseline, SD = 5.97) and data were collected annually from 1999 to 2003. The Geriatric Depression Scale measured depressive symptoms; the Duke University Religion Index measured religious service attendance, prayer, and intrinsic religiosity; and control variables included sociodemographics, health, and social and economic factors.

RESULTS

The HLM analysis indicated a curvilinear trajectory of depressive symptoms over time. At baseline, participants who attended religious services more frequently tended to report fewer depressive symptoms. Participants with the highest levels of intrinsic religiosity at baseline experienced a steady decline in the number of depressive symptoms over the four-year period, while those with lower levels of intrinsic religiosity experienced a short-term decline followed by an increase in the number of depressive symptoms.

IMPLICATIONS

In addition to facilitating access to health, social support and financial resources for older adults, service professionals might consider culturally appropriate, patient-centered interventions that boost the salutary effects of intrinsic religiosity on depressive symptoms.

Does social support mediate the moderating effect of intrinsic religiosity on the relationship between physical health and depressive symptoms among Jews?

Previous research in the general population suggests that intrinsic religiosity moderates (mitigates) the effect of poor physical health on depression. However, few studies have focused specifically on the Jewish community. We therefore examined these variables in a cross-sectional sample of 89 Orthodox and 123 non-Orthodox Jews. Based on previous research suggesting that non-Orthodox Judaism values religious mental states (e.g., beliefs) less and a collectivist social religiosity more, as compared to Orthodox Judaism, we hypothesized that the moderating effect of intrinsic religiosity would mediated by social support among non-Orthodox but not Orthodox Jews. As predicted, results indicated that the relationship between physical health and depression was moderated by intrinsic religiosity in the sample as a whole. Furthermore, this effect was mediated by social support among non-Orthodox Jews, but not among the Orthodox. The importance of examining religious affiliation and potential mediators in research on spirituality and health is discussed.

Religion, health, and psychological well-being

This study compares the effects of religiosity on health and well-being, controlling for work and family. With 2006 GSS data, we assess the effects of religiosity on health and well-being, net of job satisfaction, marital happiness, and financial status. The results indicate that people who identify as religious tend to report better health and happiness, regardless of religious affiliation, religious activities, work and family, social support, or financial status. People with liberal religious beliefs tend to be healthier but less happy than people with fundamentalist beliefs. Future research should probe how religious identity and beliefs impact health and well-being.

Testing a SEM model of two religious concepts and experiential spirituality

Guided by Atchley's Continuity Theory of the Spiritual Self as presented in Aging, spirituality, and religion, Fortress Press, Minneapolis, MN (1995), this study tested the validity of two dimensions of religiosity and one dimension of spirituality. It then examined the extent to which each dimension of religiosity influenced having spiritual experiences for 221 chronically ill older adults. Mean age of the sample was 80 years. Structural equation modeling was used to test a conceptual model. Substantive findings were that private religiosity (prayer and coping), but not public religiosity (participation and other church involvement) may influence reporting spiritual experiences by the older adults in the study. Findings revealed a good model fit to the data and strong factor loadings revealed sound construct validity for the latent variables (i.e., public and private religiosities, and experiential spirituality) in the model.

Unmet needs and depressive symptoms among low--income older adults

Previous studies have found that declining health, decreased social interaction, and inadequate financial resources were significant risk factors for late-life depression, and social support from families and friends and religiosity were significant protective factors. In this study, we examined if low-income older adults' perceived unmet need for home- and community-based services for many aging-associated problems would be independently associated with their depressive symptoms, controlling for these known risk and protective factors. We interviewed a total of 213 community-residing older adults to assess their depressive symptoms, using the Geriatric Depression Scale (GDS), and unmet needs in the areas of personal assistance, instrumental and environmental support, emotional support, and other facilitative/enabling services. We found that the number of unmet needs was significantly positively associated with these older adults' depressive symptoms, although it explained only a small proportion of the variance of the GDS scores. Future research and practice implications are discussed.

Life regrets and pride among low-income older adults: relationships with depressive symptoms, current life stressors and coping resources

We examined the contents and intensities of both life regrets and pride among a convenience sample of 213 low-income older adults and the associations between the contents and intensities of life regrets and pride, on the one hand, and the older adults' current life stressors, coping resources and depressive symptoms, on the other. Regrets about education, career and marriage were common, but intensities of regrets were higher for issues related to finance/money, family conflict and children's problems, loss and grief, and health. Common sources of pride were related to children and parenting, career, volunteering/informal caregiving, long/strong marriage and personal growth/self. Controlling for current life stressors of disability, money worries, loneliness and overdependence on others for management of daily life, and coping resources of social support and religiosity, the intensities of loss-and-grief related regrets and the pride in long/strong marriage were significant predictors of the Geriatric Depression Scale (GDS) scores. However, the regrets and pride explained a small amount of the variance in the GDS scores, while the current life stressors explained a large portion of the variance.

Like a prayer: the role of spirituality and religion for people living with HIV in the UK

Over 40,000 people are now living with diagnosed HIV in the UK. There is, however, uncertainty about how people with HIV use religion or spirituality to cope with their infection. Adopting a modified grounded theory approach, we analysed individual and group interviews with the people most affected by HIV in the UK: black African heterosexual men and women and gay men (mostly white). For the majority of black African heterosexual men and women in our study, religion was extremely important. We found that gay men in the study were less religious than black Africans, although many were spiritual in some way. Black African individuals constructed their spiritual narratives as largely Christian or collective, while gay men described more individualistic or 'New Age' approaches. We developed a six-level heuristic device to examine the ways in which prayer and meditation were deployed in narratives to modulate subjective wellbeing. These were: (i) creating a dialogue with an absent counsellor; (ii) constructing a compassionate 'life scheme'; (iii) interrupting rumination; (iv) establishing mindfulness; (v) promoting positive thinking, and (vi) getting results. That people with HIV report specific subjective benefits from prayer or meditation presents a challenge to secular healthcare professionals and sociologists.

The role of religious identity in the mental health of older working and retired adults

This study investigates whether religious identity explains unique variance of the self esteem and depressive symptoms of older working and retired adults. Data were collected from a larger, five-year project begun in 1992 that compared the well-being of older workers and with that of new retirees living in the Raleigh-Durham-Chapel Hill, North Carolina metropolitan area. Data are from the third and final wave, collected between March and June, 1997, during which 242 of the eligible 255 people participated. Net of religious attendance, religiosity, and various control variables, religious identity predicted both mental health outcomes. As predicted, self esteem increased and depressive symptoms decreased as religious identity increased (i.e., viewing oneself as more competent, confident, and sociable as a religious person). Though there was a trend towards religious identity being more strongly predictive of mental health among retirees than among the working adults, these interactions did not reach statistical significance.

Religiousness/spirituality and health: a meaning systems perspective

The existence of links between religion and spirituality (R/S) and health appear to be firmly established, but much less is known about how these various aspects of R/S are translated into health outcomes. Within a meaning systems framework, this article reviews and integrates findings regarding the many pathways through which R/S may influence physical health and well-being. In particular, evidence for the pathways of body sanctification, meaning in life, social support, health locus of control, health behaviors, positive and negative affect and stress moderation, treatment adherence, and coping is examined. The article concludes with suggestions for future research.

Does religiousness buffer against the fear of death and dying in late adulthood? Findings from a longitudinal study

We used longitudinal data (N = 155) to investigate the relation between religiousness and fear of death and dying in late adulthood. We found no linear relations between religiousness and fear of death and dying. Individuals who were moderately religious feared death more than individuals who scored high or low on religiousness. Fear of death also characterized participants who lacked congruence between belief in an afterlife and religious practices. We replicated the curvilinear relation between fear of death and religiousness in late adulthood with religiousness in middle adulthood, controlling for sociodemographic variables, life satisfaction, social support, and stressors. Older participants (in their mid-70s) who experienced more bereavement and illness feared the dying process less than younger participants (in their late 60s). The findings support the hypothesis that firmness and consistency of beliefs and practices, rather than religiousness per se, buffers against death anxiety in old age.