How spiritual values and worship attendance relate to psychiatric disorders in the Canadian population

The Relationship Between Religious Beliefs and Related Factors and Psychiatric Symptoms in Adolescents: A Cross-Sectional Secondary Analysis of Data From NIPHEAC, 2020

OBJECTIVE

This study aimed to explore the psychiatric symptoms and associated risk and protective factors among religious adolescents after 2-month home confinement against coronavirus disease-2019 (COVID-19) in China.

METHODS

11,603 Chinese adolescents in grades 7-9 were recruited in this survey. An online survey was designed to collect the data. Participants were measured using the Patient Health Questionnaire-9 and Generalized Anxiety Disorder-7 Scale.

RESULTS

Religious adolescents showed significantly more severe depressive and anxiety symptoms compared to non-religious. 249 (2.2%) reported COVID-19 exposure. Logistic regression analysis revealed that religiosity was a risk factor for the symptoms of depression (p=0.001) and anxiety (p<0.001). Moreover, among those adolescents with religious beliefs, psychological resilience was protective in preventing depressive and anxiety symptoms. At the same time, emotional abuse, emotional neglect, and a poor parent-child relationship were risk factors.

CONCLUSION

Our finding indicates that religious adolescents easily develop depressive and anxiety symptoms, compared to non-religious adolescents. Moreover, those with emotional abuse, emotional abuse, and poor parent-child relationships are more likely to suffer from mental distress and should pay more attention to cope with their mental health.

Correlations of religious beliefs with anxiety and depression of Chinese adolescents

Objective

This study was designed to investigate the prevalence of religious belief and its relationship with psychiatric symptoms among Chinese adolescents.

Methods

This study recruited 11,603 adolescents in Grades 7-9 from March 21 to 31, 2020 in five cities in China. The religious beliefs of adolescents were collected by asking whether they held religious beliefs and what type of religious beliefs they held. The Patient Health Questionnaire-9 (PHQ-9) and the Generalized Anxiety Disorder-7 Scale (GAD-7) were used to assess depressive and anxiety symptoms in all adolescents. Demographics, religious beliefs, and mental health status were collected through the professional version of Wenjuanxing.

Results

Of 11,069 valid questionnaires collected, 847 (7.7%) reported holding religious beliefs. Adolescents with religious beliefs showed significantly more severe symptoms of depression and anxiety compared to those without religious beliefs (both p<0.05). Logistic regression analysis revealed that religious belief was a risk factor for symptoms of depression (OR = 1.37, 95%CI: 1.16-1.61, p < 0.001) and anxiety (OR = 1.49, 95%CI: 1.23-1.79, p < 0.001) after controlling age, gender, and parental marital status.

Conclusions

Our findings suggest that religiousness in adolescents was associated with a higher likelihood of depression/more intense depressive symptoms. In addition, religious Chinese adolescents should be provided with more resources to help them cope with mental health concerns.

General and COVID19-specific emotional stress: Religious practice as a potential coping strategy

Using Spanish microdata from the Survey on mental health during the COVID-19 pandemic conducted in February 2021 by the Centre for Sociological Research (CIS), this paper aims at identifying individual factors associated with an increased risk of mental or emotional distress arising from two different sources: a general pattern of depression or anxiety and distress specifically associated with the pandemic as measured by fears and worries about one's own or others' lives and job and income insecurity due to the COVID-19 health crisis. We explore gender differences in both types of mental distress as well as the role of individual religiosity, measured as religious beliefs and behaviours, as a potential coping strategy. In both general and COVID-specific mental distress, our results provide evidence of gender differences in the risk of suffering these conditions, with a higher incidence among women. We also find that religious beliefs and practice seem to have served as a coping strategy that has allowed females to narrow the gender gap, particularly for practising Catholics. The evidence is stronger for mental distress associated with anxiety or depression. However, it is still present, albeit to a lesser extent, for suffering caused by pandemic-related mental stressors. Our results suggest that religious practices and beliefs might play a key role in alleviating additional distress symptoms caused by emergency situations such as those suffered during the COVID-19 pandemic.

Bipolar Disorder, Religion, and Spirituality: A Scoping Review

Mental health clinicians frequently study the religion and spirituality (R/S) of their patients. There is, however, a paucity of empirical research concerning R/S of patients with bipolar disorder. This lack is exacerbated by the absence of an evaluation of how these studies relate to each other. Reviews to date concern almost exclusively quantitative studies; a review that synthesizes quantitative and qualitative research is needed. The aim of this paper is to provide a synthesis of empirical studies that is useful in clinical practice. Systematic searches for relevant journal articles in SCOPUS, PubMed, and PsycInfo found 14 quantitative and four qualitative studies. The research reveals that intrinsic religiosity and positive religious coping are the dimensions of R/S that have the most positive correlations with improvement of bipolar disorder symptoms as revealed by measures of clinical outcomes. Patients struggle with their religious experiences, and they wish that R/S would be taken into account by mental health professionals. The quantitative studies are not in conflict with the patient/person-centered focus of qualitative studies. This integration of quantitative data with a patient/person-centered focus shows how belief and illness affect each other. The tensions inherent in such an integration provide new insights for research and treatment. Unfortunately, the qualitative literature has not caught up with quantitative approaches in terms of diagnostic rigor.

The Influence of Religiosity and Spirituality on Health in Canada: A Systematic Literature Review

The association between religion and health has been the subject of growing interest in academia. However, limited reviews of such studies in Canada exist. The paper systematically reviews and synthesizes existing literature on the relationship between spirituality and health in Canada. Available general databases such as: Medline; Web of Science, PubMed, Sociological abstract, Social Service Abstracts, Google scholar, Humanities International Index, JSTOR, CPI.Q Canadian Periodicals, and American Theological Library Association were searched for the period between 2000 and April 2019 inclusive. Collected data were then systematically analysed for common themes about spirituality and health in Canada. In total, 151 articles were found, but only 128 had relevance with the study objectives. Overall, the analysis showed that religion and spirituality do influence health behaviours, and well-being. However, more gender-based studies need to be conducted to tease out the differences in religion/spirituality and health across different genders, and ethnic groups in Canada.

Godless in the Great White North: Assessing the Health of Canadian Atheists Using Data from the 2011/2012 Canadian Community Health Survey

An overlooked reason to study atheism and health is that it provides a reasonably strong test of the broader religion-health relationship. Using data from the 2011/2012 Canadian Community Health Survey (n > 8000) I explored the health differences between atheists and eight categories of religious identities (nonreligious, Anglican, Baptist, Christian, Protestant, Catholic, United Church, and All Others). Surprisingly, results showed no substantive differences between atheists and non-atheists for self-rated health, emotional well-being, and psychological well-being. In contrast, results showed substantive and consistent differences between atheists and non-atheists with respect to social well-being. Results appear to suggest that while religious groups report superior scores on health proxies relative to atheists, this does not translate into substantive health differences.

The Association Between Religious Belief and Treatment Adherence Among Those with Mental Illnesses

This study was conducted to determine the association between religious belief and treatment adherence among those with mental illness. The sample size of this cross-sectional study was determined to be 255 patients diagnosed with mental illness via power analysis. A descriptive characteristics form prepared by the researcher, the Systems of Belief Inventory, and the Morisky Medication Adherence Scale were used to collect data. Patients were listed and chosen by using a simple random sampling method. This study found no significant correlation between religious belief and treatment adherence (p > .05). It was determined that treatment adherence was moderate in patients with high religious beliefs and that treatment adherence was low in patients with low religious beliefs. Religious belief was not a factor influencing treatment adherence among those with mental illness.

“Dies Irae?” The Role of Religiosity in Dealing with Psychological Problems Caused by The COVID-19 Pandemic—Studies on a Polish Sample

Based on Huber’s centrality of religiosity concept, a non-experimental research project was designed in a group of 178 women and 72 men, voluntary participants in online studies, quarantined at home during the first weeks (the first wave) of the pandemic, to determine whether and to what extent religiosity, understood as a multidimensional construct, was a predictor of the worsening of PTSD and depression symptoms in the conditions of the COVID-19 pandemic. The study made use of CRS Huber’s scale to study the centrality of religiosity, Spitzer’s PHQ-9 to determine the severity of depression, and Weiss and Marmar’s IES-R to measure the symptoms of PTSD. Our study, which provided interesting and non-obvious insights into the relationship between the studied variables, did not fully explain the protective nature of religiosity in dealing with pandemic stress. Out of five components of religiosity understood in accordance with Huber’s concept (interest in religious issues, religious beliefs, prayer, religious experience, and cult), two turned out to contribute to modifications in the severity of psychopathological reactions of the respondents to stress caused by the pandemic during its first wave. A protective role was played by prayer, which inhibited the worsening of PTSD symptoms, whereas religious experience aggravated them. This means that in order to interpret the effect of religiosity on the mental functioning of the respondents in a time of crisis (the COVID-19 pandemic), we should not try to explain this effect in a simple and linear way, because religious life may not only bring security and solace, but also be a source of stress and an inner struggle.

Religious Affiliation in Relation to Positive Mental Health and Mental Disorders in a Multi-Ethnic Asian Population

Background: This study investigated association of religious affiliation with positive mental health (PMH) and mental disorders. Methods: A cross-sectional survey of 2270 adults was conducted in Singapore. Participants reported their religious affiliation to Buddhism, Christianity, Hinduism, Islam, Sikhism, Taoism, or other religions. A PMH instrument measured total PMH and six subcomponents: general coping (GC), emotional support (ES), spirituality (S), interpersonal skills (IS), personal growth and autonomy (PGA), and global affect (GA). Lifetime history of mental disorders was assessed with the Composite International Diagnostic Interview. Results: Total PMH (mean ± SD) was 4.56 ± 0.66 for participants with any religion versus 4.12 ± 0.63 (p = 0.002) in those without any religion. After adjustment for all potential confounders, the mean difference in total PMH between these groups was 0.348 (95% CI: 0.248–0.448). Having any religion was significantly associated with higher scores for S, GC, ES, IS, but not with PGA, GA or mental disorders. Compared with individuals without any religion, total PMH and S levels were significantly higher across all religions. Additionally, Christianity was significantly associated with higher ES, Taoism with higher GC, Buddhism and Islam with higher GC, ES and IS, Hinduism with higher IS and Sikhism with higher ES and IS. Conclusion: Our results indicate that religious affiliation is significantly associated with higher PMH, but not with mental disorders in an Asian community setting. In addition, different religions showed unique patterns of association with PMH subcomponents.

With a little help from my (Canadian) friends: Health differences between minimal and maximal religiosity/spirituality are partially mediated by social support

RATIONALE

Higher levels of religion and spirituality (R/S) are associated with better health in both Canadian and American samples. One mechanism that can account forthis relationship is social support, which is positively associated with higher R/S and is positively associated with overall wellness. Although social support has been found to mediate the relationship between R/S and health in American samples, parallel research on Canadian samples is lacking.

OBJECTIVE

While having cultural similarities, Canada and the United States have noteworthy differences with respect to religion, politics, and demographics. Consequently, it is problematic to assume that social support accounts for the R/Shealth relationship for Canadians. The goal of the current study was to explore whether social support mediated the relationship between R/S and health outcomes.

METHOD

Using individuals ≥20 years of age from the 2012 Canadian Community Health Survey - Mental Health component (N ≥ 9043), we isolated people who had either the lowest or highest possible score on a composite measure of R/S. We then compared 'minimal R/S' respondents to 'maximal R/S' respondents on 11 health outcomes and investigated if these health disparities attenuated when accounting for differences in social support.

RESULTS

Maximal R/S was associated with better health for nine of the tested outcomes, but seven of these relationships were attenuated when social support was added to the model. The two remaining outcomes, drug abuse/dependence and alcohol abuse/dependence, were not significantly impacted by the inclusion of social support.

CONCLUSION

Social support plays a mediating role in many R/S-health relationships for Canadians. Although R/S appears to have a statistical relationship with many health outcomes, several of these lack practical significance.

Religion/Spirituality and Gender-Differentiated Trajectories of Depressive Symptoms Age 13-34

Studies examining religion/spirituality (R/S) and depressive symptoms report divergent findings, often depending on the types of variables considered. This study assessed whether subjective and experiential R/S variables were associated with increased depressive symptom burden from adolescence to young adulthood. Variations by gender were also assessed. Using group-based trajectory modeling with a cohort-sequential design, four distinct symptom trajectories were identified for women and five for men. 27.4% of women and 10.2% of men were classified on peak trajectory groups. Religious attendance was protective for men and women. Prayer was protective for women but linked to risk for men. Born-again and life-changing spiritual experiences, along with belief in supernatural leading and angelic protection, were broadly associated with increased classification on elevated symptom trajectories. In one exception, belief in supernatural leading was associated among some men with decreased risk of depressive symptoms during adolescence. Researchers must take a variety of R/S variables into account when assessing depressive symptoms, not simply religious attendance, prayer frequency, or affiliation as is commonly practiced. Religion and spirituality are multidimensional and in some cases may operate differently for men than women vis-à-vis mental well-being.

Mental Health and Quality of Life Among Adults With Single, Multiple, and No Religious Affiliations

Few studies have investigated the "multiple religious affiliations" phenomenon. This study aims to understand those with "multiple religious affiliations," describing its prevalence and investigating if there are differences in mental health and quality of life between this group and those with a single religious affiliation and those with no religious affiliation. A total of 1169 adults were included, and 58% had a single religious affiliation, 27.7% had multiple religious affiliations, and 12.3% had no religious affiliation. Participants with a single religious affiliation presented better mental health and quality of life than those with multiple or no religious affiliations. Although most outcomes were similar between multiple and no religious affiliations, happiness and optimism were higher in the multiple religious group, and anxiety was lower in the no religious group. Health care professionals should be aware of the secondary religious affiliations of their patients to identify possible conflicts and to treat them comprehensively.

The role of social support and spiritual wellbeing in predicting suicidal ideation among marginalized adolescents in Malaysia

Background

The high number of adolescents and young adults harbouring suicidal ideation, as reported by the Ministry of Health Malaysia, is alarming. This cross-sectional study aims to examine the association between social support and spiritual wellbeing in predicting suicidal ideation among Malaysian adolescents.

Methods

A total of 176 adolescents in selected urban areas in the states of Wilayah Persekutuan and Selangor were selected. The Suicide Ideation Scale (SIS) was used to measure the level of severity or tendency of suicidal ideation. The Multidimensional Scale of Perceived Social Support (MSPSS) was used to measure the perceived social support received by the respondent while the Spiritual Wellbeing Scale (SWBS) was used to measure the religious wellbeing (RWB), the existential wellbeing (EWB) and the overall score of spiritual wellbeing (SWB).

Results

The study found that both RWB and EWB showed significant negative correlation with suicidal ideation. Similarly, support from family and friends also showed a negative correlation with suicidal ideation. Further analysis using multiple regressions showed that RWB and SWB, and family support predict suicidal ideation in adolescents.

Conclusion

Spiritual wellbeing in combination with family support plays a major role in predicting suicidal ideation. Therefore, intervention for encompassing spirituality and family support may contribute to a more positive outcome in suicidal adolescents.

The association between spirituality and religiousness and mental health

The present study aims to investigate how different levels of spirituality and religiousness (high spirituality and high religiousness –S/R, high spirituality and low religiousness –S/r, low spirituality and high religiousness s/R and low spirituality and low religiousness – s/r) are associated with quality of life, depressive symptoms, anxiety, optimism and happiness among adults. A cross-sectional study was carried out among 1,046 Brazilian adults. Concerning the different levels of spirituality and religiousness, 49.2% had s/r, 26.5% S/R, 17.2% S/r and 7.1% s/R. Participants with S/R had better outcomes as compared to those with s/r and those with S/r in WHOQOL Psychological, Social Relationship and Environment, Optimism and happiness. Participants with s/R had better outcomes as compared to those with s/r in WHOQOL Psychological and Social Relationship, Optimism and happiness. Participants with S/r were different from those with s/r, with higher levels of WHOQOL Environment and happiness but also anxiety. The results revealed that, having higher levels of both spirituality and religiousness were more correlated to better outcomes than having just one of them or none of them. Likewise, having higher levels of religiousness in detriment of higher levels of spirituality was also associated with better outcomes in comparison to others.

Public attitudes towards psychiatrists in the metropolitan area of Hanoi, Vietnam

OBJECTIVES

Mental health associated stigmatization remains problematic in low and middle-income countries, thus preventing patients from adequate access to psychiatric care. Public attitudes towards psychiatrists have not been examined in many countries, especially not in Vietnam where merely one psychiatrist per 300.000 population is available. The study aims to explore attitudes towards psychiatrists in the Hanoi municipality and to identify socio-demographical factors that influence these attitudes.

METHODS

Between April and August 2013, a general population-based survey was carried out in the greater Hanoi area, Vietnam. The sample of 817 participants was stratified according to the latest Vietnamese census (2009) and micro-census (2013) with regards to socio-demographic factors. Multivariate analyses were conducted to determine the influence of these factors on attitudes towards psychiatrists.

RESULTS

Gender and religious beliefs significantly influenced public attitudes towards psychiatrists. Male participants reported significantly more negative perception towards psychiatrists compared to female respondents. Participants following a religion reported significantly more negative attitudes toward psychiatrists than those without self-reported religious attainment.

CONCLUSIONS

Negative attitudes towards psychiatrists are associated with religious beliefs and gender affiliation in the greater Hanoi area. A strategy that involves religious institutions in raising awareness about mental health issues while considering public's socio-cultural attitudes may pave the way for greater potentialities of adequate psychiatric care, destigmatize the mental health system, and care provider.

Including the 'Spiritual' Within Mental Health Care in the UK, from the Experiences of People with Mental Health Problems

Spirituality as a dimension of quality of life and well-being has recently begun to be more valued within person-centred treatment approaches to mental health in the UK. The aim of this paper is to provide indicators of the extent to which accessing a spiritual support group may be useful within mental health recovery from the view point of those in receipt of it. The study design was a small-scale exploratory study utilising mixed methods. Quantitative methods were used to map the mental health, general well-being and social networks of the group. These were complimented by a semi-structured open-ended interview which allowed for Interpretative Phenomenological Analysis (IPA) of the life-history accounts of nine individuals with mental health problems who attended a 'spirituality support group'. Data from unstructured open-ended interviews with five faith chaplains and a mental health day centre manager were also analysed using thematic analysis. The views of 15 participants are therefore recounted. Participants reported that the group offered them: an alternative to more formal religious organisations, and an opportunity to settle spiritual confusions/fears. The 'group' was also reported to generally help individual's subjective feelings of mental wellness through social support. Whilst the merits of spiritual care are appealing, convincing services to include it within treatment may still be difficult.

Different forms of spirituality and heavy episodic drinking among college students

OBJECTIVE

The current study examined prospective, bidirectional relationships between 3 measures of spirituality (Daily Spiritual Experiences, Positive Religious Coping, and Negative Religious Coping) and frequency of heavy episodic drinking.

PARTICIPANTS

Three hundred ninety-one students attending a large, public university in the Midwest.

METHODS

Electronic surveys assessing predictors of college alcohol use were sent to participants in the winter of their freshman and sophomore years. Structural equation modeling was used to analyze data.

RESULTS

A latent factor comprised of Daily Spiritual Experiences and Positive Religious Coping (ie, "positive spirituality") was negatively related to future frequency of heavy episodic drinking. Negative Religious Coping was unrelated to heavy episodic drinking. Additionally, heavy episodic drinking did not prospectively predict any measures of spirituality.

CONCLUSIONS

Data are supportive of continued efforts to integrate positive spirituality into interventions for collegiate heavy episodic drinking.

Spirituality and Its Relationship with Personality in Depressed People: Preliminary Findings

The relationship between spirituality and personality in patients with depression is complex and not much explored. The aim of our study is to examine the interconnection between the spiritual quality of life (QoL) and Cloninger's psychobiological model of personality in patients with depression. The sample consisted of 85 consecutive outpatients treated for depression. The measurements used were: Beck Depression Inventory, WHO-Quality of Life-Spiritual, Religious, Personal Beliefs, and Temperament and Character Inventory. The results have shown that higher harm avoidance, lower self-directedness and lower cooperativeness are personality dimensions associated with depression. The spiritual QoL has showed to play a significant role in depression, just as it has proved to be a unique predictor of lower depressive symptoms, adjusted for personality dimensions. The spiritual QoL itself is predicted by personality dimensions, self-directedness and self-transcendence implying that spirituality is a broader construct than the character dimension. Our findings may contribute to a more comprehensive understanding of depression, spirituality and personality.

Somatic symptoms and holistic thinking as major dimensions behind modern health worries

BACKGROUND

Modern health worries (MHWs) were related to somatic symptoms and to preference of holistic healing methods in previous studies.

PURPOSE

The study aimed to investigate the contribution of symptom-related and holism-related factors to MHWs.

METHODS

Participants (visitors of an Internet news portal; N = 16152; 64.1 % males) completed a questionnaire assessing MHWs, somatosensory amplification, somatic symptoms, positive and negative affect, spirituality, holistic health beliefs, and various aspects of health care utilization (both conventional and alternative).

RESULTS

Exploratory factor analysis with oblique rotation revealed two independent dimensions ("Somatic symptom distress" and "Holism") MHWs were involved with factor loadings of 0.294 and 0.417, respectively. The existence of two factors was supported by the results of confirmatory factor analysis. No practically significant interaction between the two factors was found in binary logistic regression analysis. Positive and negative affect, somatosensory amplification, spirituality, and holistic health beliefs were positively connected, while self-rated health status was negatively connected to MHWs even after controlling for socio-demographic and treatment-related variables.

CONCLUSIONS

Holistic thinking and symptom-related behavioral and psychological factors are independently associated with MHWs. Modern health worries can be conceptualized as symptom-related by-products of a holistic-spiritual worldview.

Hardiness, spirituality, and suicidal ideation among individuals with substance abuse: the moderating role of gender and marital status

OBJECTIVE

Substance abuse is a serious and major public health problem in Iran and potentially increases the risk of suicidal behavior; therefore, it is essential to increase our knowledge concerning the etiology of suicide among individuals with substance use disorders. The present study sought to examine the associations among hardiness, spirituality, and suicidal ideation in Iranian individuals with substance abuse.

METHODS

This cross-sectional study was conducted in 2012, and participants comprised 450 individuals seeking substance abuse treatment at 10 addiction treatment centers in Tehran, Iran. All data were collected via self-report questionnaires.

RESULTS

Sixty-seven percent of participants were male, 47% were married, and 59% were working. Structural equation modeling (SEM) suggested that, as expected, spirituality and hardiness were positively associated with each other. Findings also showed that spirituality and hardiness were negatively associated with suicidal ideation among this group of individuals with substance abuse, explaining 46% of the variance in suicidal ideation. That is, those with low levels of spirituality and low levels of hardiness were more likely to report suicidal ideation. There was a moderating effect of gender, such that greater hardiness predicted a lower likelihood of suicidal ideation for males but not for females.

CONCLUSIONS

These findings reinforce the importance of spirituality and hardiness as protective factors against suicidal ideation in individuals with substance abuse, as well as the particular role of hardiness for men.

The beneficial role of spiritual counseling in heart failure patients

To ascertain the beneficial role of spiritual counseling in patients with chronic heart failure. This is a pilot study evaluating the effects of adjunct spiritual counseling on quality of life (QoL) outcomes in patients with heart failure. Patients were assigned to "religious" or "non-religious" counseling services based strictly on their personal preferences and subsequently administered standardized QoL questionnaires. A member of the chaplaincy or in-house volunteer organization visited the patient either daily or once every 2 days throughout the duration of their hospitalization. All patients completed questionnaires at baseline, at 2 weeks, and at 3 months. Each of the questionnaires was totaled, with higher scores representing positive response, except for one survey measure where lower scores represent improvement (QIDS-SR16). Twenty-three patients (n = 23, age 57 ± 11, 11 (48 %) male, 12 (52 %) female, mean duration of hospital stay 20 ± 15 days) completed the study. Total mean scores were assessed on admission, at 2 weeks and at 3 months. For all patients in the study, the mean QIDS-SR16 scores were 8.5 (n = 23, SD = 3.3) versus 6.3 (n = 18, SD = 3.5) versus 7.3 (n = 7, SD = 2.6). Mean FACIT-Sp-Ex (version 4) scores were 71.1 (n = 23, SD = 15.1) versus 74.7 (n = 18, SD = 20.9) versus 81.4 (n = 7, SD = 8.8). The mean MSAS scores were 2.0 (n = 21, SD = 0.6) versus 1.8 (n = 15, SD = 0.7) versus 2.5 (n = 4, SD = 0.7). Mean QoL Enjoyment and Satisfaction scores were 47.2 % (n = 23, SD = 15.0 %) versus 53.6 % (n = 18, SD = 16.4 %) versus 72.42 % (n = 7, SD = 22 %). The addition of spiritual counseling to standard medical management for patients with chronic heart failure patients appears to have a positive impact on QoL.

Personal spiritual values and quality of life: evidence from Chinese college students

Values are guiding principles in our life. While some studies found spiritual values to be "healthier," Sagiv and Schwartz (Eur J Soc Psychol 30:177-198, 2000) showed that people holding non-spiritual values were higher on affective well-being. We examined the predictive power of these two types of values with a longitudinal data set collected from Chinese students mainly in Hong Kong. Structural equation modeling revealed that spiritual values (as well as family income) positively predicted quality of life a year later. Non-spiritual, self-enhancement values, did not show any association. Results suggest that developing spiritual values may promote well-being through enabling individuals to find meaning and purpose in life.

Spiritual and Religious Resources in African American Women: Protection from Depressive Symptoms Following Birth

Many women experience depressive symptoms after birth, and rates among African Americans are as high as 40 percent. Spirituality and religiosity are valued in African American communities, but their relevance to new mothers has not been empirically tested. We examined effects of religiosity and spirituality on trajectories of depressive symptoms during the year following childbirth. Data were collected by the Eunice Kennedy Shriver NICHD Community and Child Health Network (CCHN) focused on maternal-child health disparities. The sample consisted of 702 low SES African American predominantly Christian women. Participants were interviewed in their homes throughout the year following a birth. Spirituality and religiosity each independently predicted changes in depressive symptoms with low levels predicting increases over time. Effects of religiosity were mediated by a woman's spirituality. Religiosity and spirituality functioned as significant, interrelated protective factors in this study which provides novel insight about lower income African American women following birth.

Maternal and personal religious engagement as predictors of early onset and frequent substance use

BACKGROUND AND OBJECTIVE

This study examined whether maternal and offspring's religiosity independently predict age of onset and frequency of substance use in offspring, and whether gender differentiates these associations.

METHODS

Data were from the Mater Hospital and University of Queensland Study of Pregnancy, a birth cohort study. Participants were a cohort of 3,537 persons who were born during 1981-83 and were followed-up to 21 years. Odds ratio (OR) and 95% confidence interval (CI) were used to estimate relative risk of substance use.

RESULTS

Both maternal and offspring's religious practice were associated with later onset and less frequent substance use. After adjustment for potential confounding and maternal religious background, offspring who were not attending church were more likely to report early onset of tobacco smoking (OR = 5.1; 95% CI: 2.8-9.4), alcohol drinking (OR = 17.4; 95% CI: 8.9-33.9) and cannabis use (OR = 7.5; 95% CI: 3.4-16.0).

DISCUSSION AND CONCLUSIONS

Findings of this study suggest family and personal religious practices are predictors of less substance use problems in adolescents and young adult males and females.

SCIENTIFIC SIGNIFICANCE AND FUTURE DIRECTIONS

Religious engagement functions as a deterrent to adolescent tobacco, alcohol, and cannabis use.

Influence of religious aspects and personal beliefs on psychological behavior: focus on anxiety disorders

The current paper presents literature relevant to the relationship of religiosity, spirituality, and personal beliefs with mental health and, in particular, anxiety disorders as an empirical narrative review, providing an overview on the most important and clinically relevant research results on the topic. The relationship between religiosity/spirituality, personal beliefs (ie, magical ideation and paranormal beliefs), and mental health has lately been studied extensively, and results have indicated significant associations among these variables. However, scientific approaches to this field are complex and multidimensional, partly leading to poor operationalization, incomparable data, and contradictory results. Literature demonstrates that higher religiosity/spirituality and magical ideation scores have often been associated with increased obsessive–compulsive traits. Similar results could not be confidently replicated for other anxiety disorders. However, it is still unclear if these differences suggest a specific association with obsessive–compulsive traits and reflect deviating etiopathogenetic and cognitive aspects between obsessive–compulsive disorder and other anxiety disorders, or if these results are biased through other factors. Religiosity/spirituality and personal beliefs constitute important parameters of human experience and deserve greater consideration in the psychotherapeutic treatment of psychiatric disorders.

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.

Protective factors for mental disorders and psychological distress in female, compared with male, service members in a representative sample

OBJECTIVE

Although military interest in promoting psychological resilience is growing, resources protective against psychopathology have been understudied in female service members. Using a representative sample of Canadian Forces personnel, we investigated whether religious attendance, spirituality, coping, and social support were related to mental disorders and psychological distress in female service members, and whether sex differences occurred in these associations.

METHOD

Religious attendance and spirituality were self-reported. Coping items were taken from 3 scales and produced 3 factors (active, avoidance, and self-medication). Social support was assessed with the Medical Outcomes Study Social Support Survey. Past-year mental disorders were diagnosed with the World Mental Health Composite International Diagnostic Interview. The Kessler Psychological Distress Scale assessed distress. Multivariate regression models investigated links between correlates and psychological outcomes within each sex. For associations that were statistically significant in only one sex, sex by correlate interactions were computed.

RESULTS

In female service members, inverse relations were found between social support and MDD, any MDD or anxiety disorder, suicidal ideation, and distress. No associations were found between religious attendance and outcomes, and spirituality was associated with an increased likelihood of some outcomes. Active coping was related to less psychological distress, while avoidance coping and self-medication were linked to a higher likelihood of most outcomes. Although several statistically significant associations were found in only one sex, only one sex by correlate interaction was statistically significant.

CONCLUSIONS

Social support was found to be inversely related to several negative mental health outcomes in female service members. Few differences between men and women reached statistical significance. Future research should identify additional helpful resources for female service members.

Spiritual and religious beliefs as risk factors for the onset of major depression: an international cohort study

BACKGROUND

Several studies have reported weak associations between religious or spiritual belief and psychological health. However, most have been cross-sectional surveys in the U.S.A., limiting inference about generalizability. An international longitudinal study of incidence of major depression gave us the opportunity to investigate this relationship further.

METHOD

Data were collected in a prospective cohort study of adult general practice attendees across seven countries. Participants were followed at 6 and 12 months. Spiritual and religious beliefs were assessed using a standardized questionnaire, and DSM-IV diagnosis of major depression was made using the Composite International Diagnostic Interview (CIDI). Logistic regression was used to estimate incidence rates and odds ratios (ORs), after multiple imputation of missing data.

RESULTS

The analyses included 8318 attendees. Of participants reporting a spiritual understanding of life at baseline, 10.5% had an episode of depression in the following year compared to 10.3% of religious participants and 7.0% of the secular group (p<0.001). However, the findings varied significantly across countries, with the difference being significant only in the U.K., where spiritual participants were nearly three times more likely to experience an episode of depression than the secular group [OR 2.73, 95% confidence interval (CI) 1.59–4.68]. The strength of belief also had an effect, with participants with strong belief having twice the risk of participants with weak belief. There was no evidence of religion acting as a buffer to prevent depression after a serious life event.

CONCLUSIONS

These results do not support the notion that religious and spiritual life views enhance psychological well-being.

Ethnic and religious discrimination: the multifaceted role of religiosity and collective self-esteem

This study analyses the roles of collective self-esteem and religiosity in the relationship between discrimination and psychological distress among a sample of 432 recent immigrants from Haiti and Arab countries living in Montreal, Quebec. Collective self-esteem (CSE), religiosity, discriminatory experiences, and psychological symptoms of depression and anxiety were assessed. Regression analyses revealed direct negative effects of discrimination, CSE, and religiosity on psychological distress for the entire sample. CSE, however, also appeared to moderate the effects of discrimination on psychological distress. Participants with higher CSE reported lower levels of anxiety and depression as a result of discrimination compared to those who expressed lower CSE levels. The results suggest that the relationship between CSE, discrimination, and psychological distress must be reexamined in light of recent sociopolitical changes and the upsurge in ethnic and religious tensions following the war on terror.

Religion and the DSM: from pathology to possibilities

Many individuals seeking psychological services refer to their religious or spiritual beliefs during treatment (Shafranske and Maloney in Psychotherapy 27: 72-78, 1990). Although psychology has consistently pathologized religion and/or spirituality in the past, it is vital that clinicians understand their impact on diagnosis and treatment. The evolution of the DSM, as explored in this manuscript, is evidence of continued attempts to expand clinicians' religious and/or spiritual sensitivity. In order for religion to be incorporated as a cultural component, psychologists need appropriate training. The author concludes with a case illustration and recommendations for continued development of religion as a cultural factor in the DSM-V.

Religious attendance, spirituality, and major depression in Canada: a 14-year follow-up study

OBJECTIVE

Although there have been numerous studies on the relation of religion or spirituality and major depression, few used a longitudinal, nationally representative sample. Our study sought to examine the effect of religious attendance, self-declared importance of spiritual values, and self-identification as a spiritual person on major depression.

METHOD

Data coming from 8 waves (1994 to 2008) of the longitudinal Canadian National Population Health Survey were used. People (n = 12 583) who were not depressed at baseline (1994) were followed during 14 years. Depression at each cycle was assessed using the Composite International Interview-Short Form for Major Depression. Weibull proportional hazards regression was used to model longitudinal risk of depression, with religious attendance or spirituality as a predictor.

RESULTS

At baseline, monthly religious attenders tended to be older, female, and married, compared with occasional and nonattenders. The Weibull regression model revealed a 22% lower risk of depression for monthly attenders (hazard ratio 0.78, 95% CI 0.63 to 0.95), compared with nonattenders, after controlling for age, household income, family and personal history of depression, marital status, education, and perceived social support. Neither self-reported importance of spiritual values nor identification as a spiritual person was related to major depressive episodes.

CONCLUSION

Attending religious services at least monthly has a protective effect against major depression.

The relationship between forgiveness, spirituality, traumatic guilt and posttraumatic stress disorder (PTSD) among people with addiction

Spirituality and forgiveness have been shown to be associated with psychological well-being, while guilt has been associated with poor health. Little is known, however, about the relationship between forgiveness, spirituality, guilt, posttraumatic stress (PTSD) and psychological co-morbidity among people in recovery from addiction. Eighty-one people (F = 36, M = 45) in recovery from drug and alcohol addiction were recruited from two residential units and two drop-in centres in a city in the United Kingdom. They completed the Posttraumatic Stress Diagnostic Scale (PDS), the General Health Questionnaire-28 (GHQ-28), the Spiritual Involvement and Beliefs Scale (SIBS), the Heartland Forgiveness Scale (HFS), the Traumatic Guilt Inventory (TGI), the Michigan Alcoholism Screening Test (MAST-22) and the Drug Abuse Screening Test (DAST-20). The control group comprised of 83 (F = 34, M = 49) individuals who confirmed that they did not have addiction and completed the PDS & GHQ-28. 54 % of the addiction group met the criteria for full PTSD and reported anxiety, somatic problems and depression. They described themselves as spiritual, had strong feelings of guilt associated with their addiction, and had difficulty in forgiving themselves. Controlling for demographics, number of events and medication management, regression analyses showed that spirituality predicted psychological co-morbidity, whilst feelings of guilt predicted PTSD symptoms and psychological co-morbidity. Unexpectedly, forgiveness did not predict outcomes. This study supports existing literature, which shows that people with drug and alcohol addiction tend to have experienced significant past trauma and PTSD symptoms. Their posttraumatic stress reactions and associated psychological difficulties can be better understood in the light of guilt and spirituality. Meanwhile, their ability to forgive themselves or others did not seem to influence health outcomes.

Religion, spirituality, and health: the research and clinical implications

This paper provides a concise but comprehensive review of research on religion/spirituality (R/S) and both mental health and physical health. It is based on a systematic review of original data-based quantitative research published in peer-reviewed journals between 1872 and 2010, including a few seminal articles published since 2010. First, I provide a brief historical background to set the stage. Then I review research on R/S and mental health, examining relationships with both positive and negative mental health outcomes, where positive outcomes include well-being, happiness, hope, optimism, and gratefulness, and negative outcomes involve depression, suicide, anxiety, psychosis, substance abuse, delinquency/crime, marital instability, and personality traits (positive and negative). I then explain how and why R/S might influence mental health. Next, I review research on R/S and health behaviors such as physical activity, cigarette smoking, diet, and sexual practices, followed by a review of relationships between R/S and heart disease, hypertension, cerebrovascular disease, Alzheimer's disease and dementia, immune functions, endocrine functions, cancer, overall mortality, physical disability, pain, and somatic symptoms. I then present a theoretical model explaining how R/S might influence physical health. Finally, I discuss what health professionals should do in light of these research findings and make recommendations in this regard.

Exploring the relationship between religious service attendance, mental disorders, and suicidality among different ethnic groups: results from a nationally representative survey

BACKGROUND

To date, sufficient data have not been available to examine ethnic differences in religiosity and mental health in the general population. However, evidence exists to suggest that the protective effects of religion may differ across ethnic groups. This study examined the relationship between religious attendance and mental health across ethnic groups.

METHODS

The Collaborative Psychiatric Epidemiologic Survey (N = 20,130) is a large, ethnically diverse sample of adult, US respondents. Frequency of attendance at religious services was measured as: at least once per week (reference group), one to three times per month, less than once per month, or less than once per year. Multiple logistic regression analyses examined associations between religious attendance and mood, anxiety and substance use disorders, as well as suicidal ideation and attempts. Models adjusted for sociodemographics and comorbidity.

RESULTS

Results differed when performed within each ethnicity. Infrequent religious attendance was associated with substance use disorders in Whites and Africans only (Adjusted Odds Ratio (AOR) = 2.30 [95% CI = 1.77-2.99]; AOR = 1.86 [1.25-2.79], respectively), and with anxiety and suicidal ideation in Whites (AOR = 1.44 [1.10-1.88]; AOR = 1.58 [1.24-2.01]) and Hispanics only (AOR = 2.35 [1.17-4.73]; AOR = 1.70 [1.15-2.52]). Asians were the only group in which religious attendance was associated with mood disorders (AOR = 4.90 [1.54-15.60]). Interaction terms were nonsignificant.

CONCLUSIONS

The present study suggests that ethnicity is an important variable to consider in the relationship between religiosity and mental health. Future studies should attempt to either adjust for or stratify by ethnicity when examining these relationships.

Religiosity, magical ideation, and paranormal beliefs in anxiety disorders and obsessive-compulsive disorder: a cross-sectional study

The relation between religiosity/spirituality (R/S), personal beliefs, and mental health has been extensively studied. However, concerning anxiety disorders (ADs), empirical evidence is scarce. This study investigated the differences in R/S and magical/paranormal ideation among obsessive-compulsive disorder patients (OCD; n = 49), patients with other ADs (n = 36), and healthy controls (HCs; n = 35). Our results suggest negative religious coping as being the only parameter showing significantly higher scores in OCD and AD participants in comparison with HCs. Negative religious coping reflects negative functional expressions of R/S in stressful situations. Logistic regression also suggested negative religious coping as the strongest predictor of group affiliation to the nonhealthy group. Further results show no significant differences between other R/S, magical, and paranormal ideation traits among groups. This study underlines an important role of negative religious coping in ADs yet does not clearly indicate a specific causality. Religious-sensitive treatment targeting cognitive aspects of negative religious coping are discussed.

The relationship between forgiveness, spirituality, traumatic guilt and posttraumatic stress disorder (PTSD) among people with addiction

Spirituality and forgiveness have been shown to be associated with psychological well-being, while guilt has been associated with poor health. Little is known, however, about the relationship between forgiveness, spirituality, guilt, posttraumatic stress (PTSD) and psychological co-morbidity among people in recovery from addiction. Eighty-one people (F = 36, M = 45) in recovery from drug and alcohol addiction were recruited from two residential units and two drop-in centres in a city in the United Kingdom. They completed the Posttraumatic Stress Diagnostic Scale (PDS), the General Health Questionnaire-28 (GHQ-28), the Spiritual Involvement and Beliefs Scale (SIBS), the Heartland Forgiveness Scale (HFS), the Traumatic Guilt Inventory (TGI), the Michigan Alcoholism Screening Test (MAST-22) and the Drug Abuse Screening Test (DAST-20). The control group comprised of 83 (F = 34, M = 49) individuals who confirmed that they did not have addiction and completed the PDS & GHQ-28. 54 % of the addiction group met the criteria for full PTSD and reported anxiety, somatic problems and depression. They described themselves as spiritual, had strong feelings of guilt associated with their addiction, and had difficulty in forgiving themselves. Controlling for demographics, number of events and medication management, regression analyses showed that spirituality predicted psychological co-morbidity, whilst feelings of guilt predicted PTSD symptoms and psychological co-morbidity. Unexpectedly, forgiveness did not predict outcomes. This study supports existing literature, which shows that people with drug and alcohol addiction tend to have experienced significant past trauma and PTSD symptoms. Their posttraumatic stress reactions and associated psychological difficulties can be better understood in the light of guilt and spirituality. Meanwhile, their ability to forgive themselves or others did not seem to influence health outcomes.

The relationship between religion and mental disorders in a Korean population

OBJECTIVE

The question of whether religion has beneficial or detrimental effects on the mental well-being of the adult individual is debatable. Because most Korean citizens are free to select their own religion, there is a higher proportion of non-believers than believers among the Korean population. The aim of this research was to investigate the association between spiritual values and Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition mental disorders in Korea across all types of belief systems, including Koreans not affiliated with a particular religion.

METHODS

The Korean version of the Composite International Diagnostic Interview 2.1 was used to interview 6,275 people across South Korea in 2001. While controlling for age and sex, we used logistic regression to analyze the relationship between mental disorders (both current and past) and the types of religion and spiritual values.

RESULTS

Strong spiritual values were positively associated with increased rates of current depressive disorder and decreased rates of current alcohol use disorder. Using "atheist" as the reference category, Catholics had higher lifetime odds of single episodes of depression whilst Protestants had higher lifetime odds of anxiety disorder and lower lifetime odds of alcohol use disorders.

CONCLUSION

The results of this study suggest that depressive episodes often lead to a search for spirituality and that religion may be helpful in overcoming depression or becoming less vulnerable to relapsing. The associations between religion, spiritual values, and mental health have not been fully elucidated and warrant further exploration.

Distinguishing spirituality from other constructs: not a matter of well-being but of belief in supernatural spirits

We developed a new Spirituality Scale and tested the argument that the defining attribute of spirituality is belief in supernatural spirits. Study 1 (N = 1931) showed that religiosity and beliefs pertinent to supernatural spirits predicted most of the variation in spirituality. Study 2 (N = 848) showed that the stronger belief in supernatural spirits, the more the person experienced subjective spirituality; that belief in supernatural spirits had higher predictive value of spirituality than religiosity, paranormal beliefs, or values; and that most of the relationship between religiosity and spirituality could be explained through belief in supernatural spirits. Study 3 (N = 972) showed that mental or physical health, social relationships, or satisfaction in marriage or work were not associated with spirituality. In turn, finding life purposeful and inner peace in dealing with spiritual experiences correlated with spirituality. The results highlight the importance of differentiating spirituality from other psychological constructs.

Longitudinal relationships of religion with posttreatment depression severity in older psychiatric patients: evidence of direct and indirect effects

Psychiatric patients (age 59+) were assessed before study treatment for major depressive disorder, and again after 3 months. Measures taken before study treatment included facets of religiousness (subjective religiosity, private prayer, worship attendance, and religious media use), social support, and perceived stress. Clinician-rated depression severity was assessed both before and after treatment using the Montgomery-Åsberg Depression Rating Scale (MADRS). Structural equation modeling was used to test a path model of direct and indirect effects of religious factors via psychosocial pathways. Subjective religiousness was directly related to worse initial MADRS, but indirectly related to better posttreatment MADRS via the pathway of more private prayer. Worship attendance was directly related to better initial MADRS, and indirectly related to better post-treatment MADRS via pathways of lower stress, more social support, and more private prayer. Private prayer was directly related to better post-treatment MADRS. Religious media use was related to more private prayer, but had no direct relationship with MADRS.

Protective associations of importance of religion and frequency of service attendance with depression risk, suicidal behaviours and substance use in adolescents in Nova Scotia, Canada

PURPOSE

We examined relationships of measures of personal importance of religion and frequency of attendance at religious services with risk of depression and risk behaviours in high school students in Cape Breton, Canada. We examined the impact of confounding and explanatory factors on these relationships.

METHODS

Data were drawn from self-report surveys of adolescents aged 15-19 (N=1615) at three high schools in May, 2006. We used logistic regression to assess associations of religious importance and religious service attendance with risk of depression, suicidal behaviour, binge drinking and frequent marijuana use, controlling in multivariate models for sociodemographic factors, family structure and social capital.

RESULTS

Among females, higher personal importance of religion was associated with decreased odds of depression, suicidal ideation, drinking and marijuana use, while more religious attendance was protective for substance use behaviours and suicidal ideation. In males, both measures of religiosity were associated with decreased substance use. In multivariate models, religious importance had weak protective effects for depression and suicidal thinking in females, which were respectively modified by social trust and substance use. Attendance was protective for suicidal thinking in females, and was modified by depression. These associations were not seen in males. Attendance was consistently associated with less substance use in females, while importance was not. Importance was consistently protective for marijuana use and attendance was protective for binge drinking in males.

LIMITATIONS

This was a cross-sectional self-report survey and causality cannot be inferred.

CONCLUSION

Protective associations of measures of religiosity are seen in Canadian adolescents, as they are elsewhere.

Weber Revisited

Weber’s Protestant Ethic hypothesis holds that elements of theology gave Protestants a cultural affinity with the economic demands of early market capitalism, particularly compared with their Catholic neighbors, which led to more rapid economic development in nations where Protestant culture was dominant. Previous research has found inconsistent support for a Protestant inclination toward pro-market attitudes, depending on whether the level of analysis was at the individual or national level. The present study uses cross-national panel data to combine these approaches with multilevel modeling. Results showed effects at the national level; people living in nations with dominantly Protestant cultural histories had more pro-market economic attitudes. At the individual level, there were differences in the impact of religiosity by religious group affiliation; Protestants had relatively pro-market attitudes regardless of religiosity, while members of other groups tended to increase in market orientation as a function of religiosity. Together, these effects support the existence of a Protestant Ethic that is linked with cultural Protestantism, rather than with personal adherence to specific Protestant religious beliefs.

Longitudinal relationships of religious worship attendance and spirituality with major depression, anxiety disorders, and suicidal ideation and attempts: findings from the Baltimore epidemiologic catchment area study

We present findings on the longitudinal relationships of religious worship attendance and seeking spiritual comfort with subsequent major depression, anxiety disorders and suicidal ideation/attempts using data from Waves 3 and 4 of the Baltimore Epidemiologic Catchment Area Study (N = 1091). Respondents who attended religious services at least once per year had decreased odds of subsequent suicide attempts compared with those who did not attend religious services (AOR = 0.33, 95% CI: 0.13-0.84). Seeking spiritual comfort at baseline was associated with decreased odds of suicidal ideation (AOR = 0.55, 95% CI: 0.31-0.99). These finding were independent of the effects of the presence of the suicidal ideation/attempts, comorbid mental disorders, social supports and chronic physical conditions at baseline. These results suggest that religious attendance is possibly an independent protective factor against suicide attempts.