The dose-response relationship of adolescent religious activity and substance use: variation across demographic groups

In the Shadow of the Casinos: The Relationship between Religion and Health in Macau

Considerable research has shown that religion operates as a protective factor for one's health. However, there is still a lack of understanding of the mechanisms by which religion is linked to individual health and wellbeing, especially in predominantly secular societies. This study tried to address this gap by developing a theoretical model to examine how religiosity is related to life satisfaction and health perception in a non-Western culture. Macau, a Portuguese colony until 1999, remains a diversified culture because of its intermixed historical background from the East and the West. Through structural equation modeling, the analysis of data collected from a representative sample of Macau residents, using a multistage stratified sampling procedure, indicated a positive link between religiosity and health. Moreover, altruism and prejudice mediated a portion of the relationship between religiosity and health. Additionally, our results demonstrated that Macau residents who were more religious had a higher level of altruism and a lower level of prejudice. The link between religion and prejudice in Macau differs from that of many other cultures, indicating that the effect of religion on prejudice varies by cultural context. In sum, our study showed that even in the shadow of glittering casinos, religion is positively related to health.

Profiles of substance use related protective and risk factors and their associations with alcohol and tobacco use initiation among black adolescents

Insufficient attention to protective and risk factors of particular salience for Black youth (e.g., racial identity and racial discrimination) in population-based substance use studies has left gaps in our understanding of alcohol and tobacco use development in Black adolescents. The current study aimed to capture the clustering of such understudied factors and their collective influence on alcohol and tobacco use initiation among Black adolescents. Data were drawn from The National Survey of American Life (n = 1,170; age range = 13-17; 6.9% Afro Caribbean, 93.1% African American; 50.0% female). Latent profile analysis applied to 11 indicators representing family, community, and individual level protective and risk factors revealed (1) High Vulnerability (high risk, low protective factors; 17.5%), (2) Moderate Vulnerability (moderate on both; 63.2%), and (3) Low Vulnerability (high protective, low risk factors; 19.3%) classes. Classes differed significantly by religious community support, school bonding, quality of relationship with mother, religious involvement, and interpersonal trauma. Relative to Class 2, Class 1 had higher odds of alcohol (OR = 1.518, CI:1.092-2.109) and tobacco use (OR = 1.998, CI:1.401-2.848); Class 3 had lower odds of alcohol (OR = 0.659, CI:0.449-0.968) but not tobacco use (OR = 0.965, CI:0.611-1.523). Findings suggest that alcohol and tobacco use initiation among Black adolescents is shaped by the collective influence of community and family level support, with commonly experienced risk factors such as non-interpersonal trauma distinguishing liability to a lesser degree. The equally modest prevalence of tobacco use among low and moderate vulnerability classes further indicates that fostering these connections may be especially effective in reducing tobacco use risk.

Anxiety and Depression among Amphetamine-Type Stimulant Users: The Association with Religiosity and Religious Coping

BACKGROUND

Amphetamine-type stimulant (ATS) use brings severe adverse effects to the mental well-being of an individual and it is an essential contributor to the global disease burden. Meanwhile, religiosity and religious coping might improve one's conduct, physical and mental well-being. Hence, this study aims to determine the prevalence of anxiety and depression in ATS user and their association with religiosity and religious coping.

METHODS

It is a cross-sectional study conducted at the Department of Psychological Medicine, Universiti Malaya Medical Centre, Malaysia. The Hospital Anxiety and Depression Scale (HADS) was used to assess anxiety and depression among ATS users. Religiosity and religious coping were measured with Duke University Religious Index and Brief RCOPE.

RESULTS

This study involved 215 ATS users. Almost half of the ATS users had either anxiety (n = 96; 44.6%) or depression (n = 108; 50.2%), which were associated with polysubstance use or having an existing psychiatric disorder. Subjects with higher religiosity and positive religious coping were less anxious or depressed. However, negative religious coping was significantly associated with anxiety and depression in ATS users.

CONCLUSION

Anxiety and depression are prevalent in ATS users. Integrating religiosity and religious coping into the ATS users' treatment plan helps to improve their mental well-being.

Patterns of Tobacco Use and Related Protective Factors Among Somali Youth in the United States

Anti-smoking norms and educational aspirations are established tobacco prevention targets for general United States (U.S.) adolescent populations but protective factors remain poorly characterized for Somali-American youth. Here we describe patterns of past 30-day tobacco use and associated protective factors among eighth, ninth, and eleventh grade Somali adolescent respondents (n = 2009) to the 2016 Minnesota Student Survey using multivariate logistic regressions. E-cigarette (5.7%) and hookah (5.0%) use were most prevalent. Male youth reported higher levels of tobacco use across products. Adjusted odds ratios showed that internal developmental assets (e.g., e-cigarettes aOR 0.37, 95% CI 0.37, 0.79) and parental anti-smoking norms (e.g., e-cigarettes aOR 0.19, 95% CI 0.09, 0.38) protected against use of all tobacco products. E-cigarettes and hookah are prevalent among U.S. Somali youth, highlighting the need for prevention efforts that address emerging tobacco products and leverage protective factors such as internal assets and parental anti-smoking norms.

Public and private religious involvement and initiation of alcohol, cigarette, and marijuana use in Black and White adolescent girls

PURPOSE

This longitudinal study aimed to identify variation by race in the associations between religious involvement and initiation of alcohol, cigarette, and marijuana use, including distinctions by substance or type of religious involvement, in Black and White adolescent girls.

METHODS

Data were drawn from interviews conducted at ages 11 through 17 with 2172 Pittsburgh Girls Study participants (56.8% Black; 43.2% White). Two indicators of public religious involvement, religious service attendance and participation in other religious activities, and two indicators of private religious involvement, prayer, and importance of religion were queried. A series of Cox proportional hazards regression analyses were conducted to identify independent effects of religious involvement indicators on initiation of each substance.

RESULTS

Prior to adjusting for socioenvironmental and psychosocial factors (e.g., parental monitoring), importance of religion predicted initiation of alcohol use across race and cigarette and marijuana use in White but not Black girls. Participation in other religious activities also predicted marijuana use initiation only in White girls. In adjusted models, importance of religion remained significant for cigarette use initiation in White girls (hazard ratio [HR] = 0.68, 95% confidence intervals [CI]: 0.53-0.88) and participation in other religious activities remained significant for marijuana use initiation in White girls (HR = 0.63, CI: 0.47-0.83).

CONCLUSIONS

The protective effects of religious involvement against cigarette and marijuana use initiation are more robust for White than Black adolescent girls and overall relatively weak for alcohol use initiation. Furthermore, importance placed on religion may be a better indicator than religious service attendance of risk for adolescent substance use initiation.

Belief, Behavior, and Belonging: How Faith is Indispensable in Preventing and Recovering from Substance Abuse

This study reviews the voluminous empirical evidence on faith's contribution to preventing people from falling victim to substance abuse and helping them recover from it. We find that 73% of addiction treatment programs in the USA include a spirituality-based element, as embodied in the 12-step programs and fellowships initially popularized by Alcoholics Anonymous, the vast majority of which emphasize reliance on God or a Higher Power to stay sober. We introduce and flesh out a typology of faith-based substance abuse treatment facilities, recovery programs, and support groups. This typology provides important background as we then move on to make an economic valuation of nearly 130,000 congregation-based substance abuse recovery support programs in the USA. We find that these faith-based volunteer support groups contribute up to $316.6 billion in savings to the US economy every year at no cost to tax payers. While negative experiences with religion (e.g., clergy sex abuse and other horrendous examples) have been a contributory factor to substance abuse among some victims, given that more than 84% of scientific studies show that faith is a positive factor in addiction prevention or recovery and a risk in less than 2% of the studies reviewed, we conclude that the value of faith-oriented approaches to substance abuse prevention and recovery is indisputable. And, by extension, we also conclude that the decline in religious affiliation in the USA is not only a concern for religious organizations but constitutes a national health concern.

Intrinsic Religiosity and Health Risk Behaviours Among Black University Students in Limpopo, South Africa

Not much is known about religiosity's protective role against health risk behaviour in the South African context. As such, the study investigated the relationship between intrinsic religiosity and health risk behaviours in a sample of Black university students (N = 335). Two-way ANOVA showed that there were intrinsic religiosity main effects for alcohol use and sexual behaviour, gender and intrinsic religiosity main effects on tobacco and marijuana use, and gender main effects and gender and intrinsic religiosity interaction effects for engagement in physical activity. Thus, religiosity is an inner resource available to avert engagement in varied health risk behaviours.

"God put weed here for us to smoke": A mixed-methods study of religion and spirituality among adolescents with cannabis use disorders

BACKGROUND

A growing literature on adults with substance use disorders (SUDs) suggests that religious and spiritual processes can support recovery, such that higher levels of religiosity and/or spirituality predict better substance use outcomes. However, studies of the role of religion and spirituality in adolescent SUD treatment response have produced mixed findings, and religiosity and spirituality have rarely been examined separately.

METHODS

The present study examined religiosity and spirituality as predictors of outcomes in an outpatient treatment adolescent sample (N = 101) in which cannabis was the predominant drug of choice. Qualitative data were used to contextualize the quantitative findings.

RESULTS

Results showed that higher levels of spirituality at posttreatment predicted increased cannabis use at 6-month follow-up (β = .237, p = .043), whereas higher levels of baseline spirituality predicted a lower likelihood of heavy drinking at posttreatment (odds ratio [OR] = .316, P = .040). Religiosity did not predict substance use outcomes at later time points. When asked to describe the relation between their religious/spiritual views and their substance use, adolescents described believing that they had a choice about their substance use and were in control of it, feeling more spiritual when under the influence of cannabis, and being helped by substance use.

CONCLUSIONS

Together, findings suggest that for adolescents with SUDs, religion and spirituality may not counteract the use of cannabis, which may be explained by adolescents' views of their substance use as being consistent with their spirituality and under their control.

Genetic and environmental contributions to initiation of cigarette smoking in young African-American and European-American women

BACKGROUND

Distinctions in the relative contributions of genetic and environmental factors to initiation of cigarette smoking may explain, in part, the differences between African Americans and European Americans in the prevalence of smoking. The current investigation is the first to compare heritable and environmental influences on smoking initiation between African-American and European-American women.

METHODS

Data were drawn from Missouri Adolescent Female Twin Study participants and female Missouri Family Study participants (n=4498; 21% African-American, the remainder European-American). Mean ages at first and last assessments were 17.0 (SD=3.5) and 24.0 (SD=3.2), respectively. Twin-sibling modeling was conducted to estimate the proportion of variance in smoking initiation (i.e., ever trying a cigarette) attributable to additive genetic, shared environmental, special twin environmental, and unique environmental factors.

RESULTS

Additive genetic influences accounted for approximately half of the variance in smoking initiation in both African-American and European-American women. In the African-American subsample, the remaining variance was attributable primarily to unique environmental factors (46%; 95% CI: 28-71%). In the European-American subsample, only 12% (95% CI: 8-16%) of the variance was attributable to unique environmental factors, with the remainder accounted for by shared environmental (13%; 95% CI: 0-41%) and special twin environmental (24%; 95% CI: 0-52%) factors.

CONCLUSIONS

The estimated heritability of smoking initiation is substantial and nearly identical for African-American and European-American women, but the type of environmental factors that contribute to risk differ by race/ethnicity. Whereas the primary environmental influences on European-American women's smoking initiation are at the family level, those that impact African-American women's smoking initiation are primarily individual-specific.

Racial/ethnic differences in the relationship among cigarette use, religiosity, and social norms for U.S. adolescents

This study investigated the racial/ethnic differences in the role of social norms in the protective relationship between religiosity and cigarette smoking. The 2009 National Survey on Drug Use and Health was used to investigate the relationships between smoking, religiosity, and social norms of U.S. adolescents (N = 13,278). Significant indirect effects between religiosity and smoking were found through social norms for non-Hispanic White adolescents. Findings were mixed for non-Hispanic Black adolescents. Mechanisms driving the religiosity-smoking association differ across subpopulations. Smoking prevention efforts and messaging campaigns that include partnerships with religious communities may require consideration of these racial/ethnic differences when planning prevention strategies.

Distal and Proximal Religiosity as Protective Factors for Adolescent and Emerging Adult Alcohol Use

Data from emerging adults (ages 18-29, N = 900) in the National Comorbidity Survey Replication Study was used to examine the influence of childhood and emerging adult religiosity and religious-based decision-making, and childhood adversity, on alcohol use. Childhood religiosity was protective against early alcohol use and progression to later abuse or dependence, but did not significantly offset the influence of childhood adversity on early patterns of heavy drinking in adjusted logistic regression models. Religiosity in emerging adulthood was negatively associated with alcohol use disorders. Protective associations for religiosity varied by gender, ethnicity and childhood adversity histories. Higher religiosity may be protective against early onset alcohol use and later development of alcohol problems, thus, should be considered in prevention programming for youth, particularly in faith-based settings. Mental health providers should allow for integration of clients' religiosity and spirituality beliefs and practices in treatment settings if clients indicate such interest.

Predictors of co-occurring risk behavior trajectories among economically disadvantaged African-American youth: contextual and individual factors

PURPOSE

African-American youth, particularly those from low-income backgrounds, evidence high rates of negative outcomes associated with three problem behaviors, conduct problems, risky sexual behavior, and substance use. This study used a contextually tailored version of problem behavior theory (PBT) to examine predictors of the simultaneous development of problem behaviors in this specific cultural group.

METHODS

Sociocontextual and individual variables representing four PBT predictor categories, controls protection, support protection, models risk, and vulnerability risk, were examined as predictors of co-occurring problem behaviors among economically disadvantaged African-American adolescents (n = 949). Specifically, the likelihood of following three classes of multiple problem behavior trajectories spanning ages 12-18, labeled the "early experimenters," "increasing high risk-takers," and "adolescent-limited" classes, as opposed to a "normative" class, was examined.

RESULTS

Among other findings, controls protection in the form of a more stringent household curfew at age 12 was related to a lower likelihood of being in the "early experimenters" and "increasing high risk-takers" classes. Conversely, vulnerability risk manifested as stronger attitudes of violence inevitability was associated with a higher likelihood of being in the "early experimenters" class. However, the PBT category of support protection was not associated with risk trajectory class. More distal neighborhood-level manifestations of PBT categories also did not predict co-occurring behavior problems.

CONCLUSION

Guided by an incorporation of contextually salient processes into PBT, prevention programs aiming to decrease co-occurring problem behaviors among low-income African-American adolescents would do well to target both proximal systems and psychological constructs related to perceived security throughout adolescence.

The Associations of Financial Stress and Parenting Support Factors with Alcohol Behaviors During Young Adulthood

This study examined concurrent and prospective associations of financial stress (financial strain, lack of financial access, public assistance) and parenting support factors (relationship quality, living at home, financial support) with young adults' alcohol behaviors (alcohol use, heavy drinking, and problematic drinking) over a 5-year period. Analyses of National Longitudinal Study of Adolescent Health (Add Health) data (N = 7,159) showed that, over the study period, alcohol use and heavy drinking declined while problematic drinking increased. In addition, living at home and parental relationship quality were associated with fewer concurrent and prospective alcohol behaviors whereas financial strain and parents' financial support were associated with more alcohol behaviors. The implications for minimizing alcohol misuse in young adults amid uncertain economic conditions are discussed.

Religiosity and exposure to users in explaining illicit drug use among emerging adults

Religiosity is a protective factor against illicit drug use, but further investigation is needed to delineate which components of religiosity are protective against use. A racially diverse sample (N = 962) was surveyed about religiosity, exposure to users, and recent use of marijuana, powder cocaine, ecstasy, and nonmedical use of opioids and amphetamine. Results suggest that identifying as Agnostic increased odds of use for each of the five drugs; however, this effect disappeared when controlling for religious importance and attendance. High levels of religious attendance were protective against recent use of marijuana and cocaine, but protective effects diminished when controlling for exposure to users, which was a robust predictor of use of every drug. Religion is a protective mechanism against drug use, but this effect may diminish in light of exposure to users. Alternative preventative methods need to be directed toward individuals who are not religious or are highly exposed to users.

Religiosity and spirituality and the intake of fruit, vegetable, and fat: a systematic review

Objectives. To systematically review articles investigating the relationship between religion and spirituality (R/S) and fruit, vegetable, and fat intake. Methods. PubMed, CINAHL, and PsycInfo were searched for studies published in English prior to March 2013. The studies were divided into two categories: denominational studies and degree of R/S studies. The degree of R/S studies was further analyzed to (1) determine the categories of R/S measures and their relationship with fruit, vegetable, and fat intake, (2) evaluate the quality of the R/S measures and the research design, and (3) determine the categories of reported relationship. Results. Thirty-nine studies were identified. There were 14 denominational studies and 21 degree of R/S studies, and 4 studies were a combination of both. Only 20% of the studies reported validity and 52% reported reliability of the R/S measures used. All studies were cross-sectional, and only one attempted mediation analysis. Most studies showed a positive association with fruit and vegetable intake and a mixed association with fat intake. Conclusion. The positive association between R/S and fruit and vegetable intake may be one possible link between R/S and positive health outcome. However, the association with fat intake was mixed, and recommendations for future research are made.

Religiosity and substance use among Asian American college students: moderated effects of race and acculturation

BACKGROUND

Religiosity is a well-established protective factor against substance use among Caucasians, but limited research has examined its role among Asian Americans. The purposes of this study were (1) to examine whether the associations between religiosity and substance use outcomes differed across Caucasians and Asian Americans, and (2) to test whether acculturation moderated the associations between religiosity and substance use outcomes among Asian Americans.

METHOD

We utilized a large and diverse cross-sectional sample of 839 college students to test whether race moderated the associations between religiosity and substance use outcomes (Study 1). We then replicated and extended our findings in a separate college sample of 340 Asian Americans, and examined the moderating role of acculturation on the associations between religiosity and substance use outcomes (Study 2).

RESULTS

Controlling for age, gender, and paternal education, religiosity was protective against alcohol use, alcohol problems, and marijuana use among Caucasians but was unrelated to these outcomes among Asian Americans in Study 1. In Study 2, religiosity was protective against alcohol problems only at high levels of acculturation. Moreover, religiosity was protective against marijuana use at both high and mean levels of acculturation, but not at low levels of acculturation.

CONCLUSIONS

The protective effects of religiosity on alcohol use and problems varied across Caucasian and Asian American college students, and religiosity protected against alcohol problems and marijuana use only among more acculturated Asian Americans. These findings underscore the need to examine culturally-specific correlates of substance use outcomes among Asian Americans.

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.