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PubMed2005

Behavioural problems in Sri Lankan schoolchildren: associations with socio-economic status, age, gender, academic progress, ethnicity and religion.

Little is known about behavioural and emotional adjustment in children in Sri Lanka, and this study is the first attempt to assess mental health problems in this population. Using the Strengths and Difficulties Questionnaire (Goodman R (1994) A modified version of the Rutter parent questionnaire including items on children's strengths: a research note. J Child Psychol Psychiatry 35:1483-1494) with parent, teacher and child informants, in a large sample of 10- to 13-year-old school children from Colombo, we found rates and types of problems consistent with other international studies of child mental health. Problem rates were higher in boys and were associated with lower SES and poorer academic performance. Relationships between behavioural adjustment and Tamil ethnicity and Hindu religion emerged in this sample and could possibly be associated with the experience of longstanding ethnic conflict in Sri Lanka. The study confirms the need for development of child and adolescent health services in Sri Lanka.

Achievement↗
PubMed1992

The effect of family history of cancer, religion, parity and migrant status on survival in colorectal cancer. The Melbourne Colorectal Cancer Study.

The association between 5-year survival and several risk factors was investigated in 705 histologically confirmed, new cases of colorectal adenocarcinoma as one aspect of a comprehensive population-based study of large bowel cancer incidence, aetiology and survival--the Melbourne Colorectal Cancer Study. 5-year survival was not influenced by the previously determined risk of a family history of colorectal cancer in near-relatives. Similarly, other previously determined risk factors of religion, number of children, age at birth of first child and migrant status did not influence survival.

Adenocarcinoma↗
PubMed2004

Spirituality, religion, and healing in palliative care.

In end-of-life care, attending to spiritual needs ensures that a dying patient has the opportunity to find meaning in the midst of suffering and to have the opportunity for love, compassion, and partnership in their final journey. This article summarizes some of the beliefs and traditions from Judaism, Islam, and Christianity that affect people as they face their own dying and mortality. People who do not participate in any formal religion also have a drive to find meaning in the midst of suffering and dying. They may find this in personal ways. This article presents some practical tools to help clinicians address and respect spiritual and religious issues of patients. It is crucial that our culture and our systems of care for the dying include a spiritual approach so that dying can be meaningful and even filled with hope.

Adaptation, Psychological↗
PubMed2006

Secular values and the location of religion: a spatial analysis of an English medical centre.

What do contemporary controversies in healthcare reveal about secular values and the location of religion within an English medical centre? Using a socio-spatial methodology designed to break open ideological perspectives and normative values, we analyse the doctor-patient relationship, complementary and alternative medicine, and an issue that bridges the two, evidence-based medicine. In the physical, social and mental spaces of the medical centre we uncover the traces of religious activity and roles, and of alternative therapeutic regimes often informed by spiritual or religious systems. Furthermore, we disclose the heterogeneity of values that comprise the secular worldview of one group of contemporary general practitioners.

Cluster Analysis↗
PubMed2005

Religion and survival in a secular region. A twenty year follow-up of 734 Danish adults born in 1914.

The aim of the study was to analyse associations of religiosity and mortality in a secular region. The sample consisted of 734 Danish, community dwelling elderly persons, living in a secular culture, and all aged 70 when primary data were collected. Secondary data consisted of a 20 year follow-up on vital status or exact age of death. The study was designed to be highly comparable to studies conducted in more religious environments in order to compare results. Three variables of religion were investigated in relation to survival: importance of affiliation, church attendance and listening to religious media. Relative hazards (RH) of dying were controlled in models including gender, education, medical and mental health, social relations, help given and received, and health behaviour. The results showed significant and positive associations between claiming religious affiliation important and survival (relative hazard of dying=RH .70; 95% CI .58-.85) and church attendance and survival (RH .73; 95% CI .64-.87). Results decreased and only stayed significant regarding church attendance when controlled for covariates. Nearly all significant effects were seen in women, but not in men. The effect size of the full sample is less than in more religious environments in United States samples. Although the positive overall RHs are comparable to those of other studies, the mediating variables and pathways of effects seem dissimilar in this sample from a secular environment. Receiving and especially giving help to others are suggested as variables of explanatory value.

Aged↗
PubMed2005

A cross-cultural study of spirituality, religion, and personal beliefs as components of quality of life.

This paper reports on an international study in 18 countries (n=5087) to observe how spirituality, religion and personal beliefs (SRPB) relate to quality of life (QoL). SRPB is assessed using the World Health Organization's QoL Instrument (the WHOQOL), where eight additional facets were included to more fully address these issues as they pertain to QoL, along with physical, social, psychological and environmental domains. The facets address issues such as inner peace, faith, hope and optimism, and spiritual connection. The results showed that SRPB was highly correlated with all of the WHOQOL domains (p<0.01), although the strongest correlations were found with psychological and social domains and overall QoL. When all of the domain scores were entered into a stepwise hierarchal regression analysis, all of the domains contributed to overall quality of life (N=3636), explaining 65% of the variance. When this was repeated for those people who reported poor health (N=588), it was found that only four domains explain 52% of the variance. The first was the level of independence, followed by environment, SRPB and physical. Gender comparisons showed that despite showing lower scores for facets in the psychological domain, such as negative feelings and poorer cognitions, women still reported greater feelings of spiritual connection and faith than men. Those with less education reported greater faith but were less hopeful. It is suggested that SRPB should be more routinely addressed in assessment of QoL, as it can make a substantial difference in QoL particularly for those who report very poor health or are at the end of their life.

Activities of Daily Living↗
PubMed2006

Retaining the meaning of the words religiousness and spirituality: a commentary on the WHOQOL SRPB group's "a cross-cultural study of spirituality, religion, and personal beliefs as components of quality of life" (62: 6, 2005, 1486-1497).

Recent years have seen increasing recognition paid to the relation of religiousness/spirituality (R/S) to health care and research. This has led to the development of more inclusive and trans-culturally validated measurements of R/S. This paper comments on the WHOQOL SRPB Group's "A cross-cultural study of spirituality, religion, and personal beliefs as components of quality of life" (62: 6, 2005, 1486-1497), a recently published paper in Social Science & Medicine, and illustrates a possible problem in the measurement of R/S, especially as related to the study of mental health outcomes. Some scales have included questions about psychological well-being, satisfaction, connectedness with others, hopefulness, meaning and purpose in life, or altruistic values as part of their measure of R/S. These questions are really tapping indicators of mental health, and should not be included in the definition of R/S itself. Otherwise, tautology is the result, and it should not be surprising that such measures of R/S (defined by questions tapping mental health) are related to mental health outcomes.

Activities of Daily Living↗
PubMed2002

Ethical considerations in the integration of religion and psychotherapy: three perspectives.

The authors maintain that the integration of religion in psychotherapy is, at best, problematic and requires a respect for boundaries, but that the integration of a nonreligious but spiritual psychotherapy consisting of the three elements identified above (attention to the person, not the disease, considering one's work as vocation, and the pursuit of empathic understanding) is a therapeutic necessity and an ethical duty. The authors speak with distinct voices in the three major sections of the article but come to remarkably similar conclusions: (1) the ability to inquire into the religious and spiritual life of patients is an important element of psychotherapeutic competency; (2) information about the religious and spiritual lives of patients often reveals extremely important information; (3) the inquiry process must communicate respect and curiosity for this dimension of the patient's life even (and perhaps especially) when the content is at variance from that of the therapist; and (4) there is significant potential for therapeutic abuse when the therapist communicates in a manner reflecting a personal agenda that abandons the principle of psychotherapeutic neutrality. One area of potential disagreement came as the authors considered the possibility of different combinations of faith disciplines and therapy in designated religious settings that all parties recognize as such. One author (G.P.M.) believes that such combinations in these settings may be ethically permissible. The other two authors are concerned about such combinations because of the powerful but covert factor of transference in healing relationships. The authors eventually decided that this question was beyond the scope of the article and limited themselves to discussions about psychotherapy in secular settings. They each advocate the systematic inclusion of spiritual assessment as a core competency for psychotherapy education. In a way similar to the exploration of any deeply personal dimension of human experience, integrating spiritual and religious dimensions of our patients' lives into their treatment requires consummate professionalism, the highest quality of knowledge, skills, and attitudes, and thorough grounding in a sophisticated biopsychosocial model.

Delivery of Health Care, Integrated↗
PubMed2001

Culture, spirituality, and mental health. The forgotten aspects of religion and health.

Modern psychiatry has neglected the spiritual dimension of the human mind and the teleologic concept of illness as meaningful sufferings by clinging to the traditional causality principle and rationalistic orientations without clarifying the concepts of religion, spirituality, culture, and mental health. The Jungian viewpoint may bridge the age-old gap in the West between belief and science.

Cross-Cultural Comparison↗
PubMed2000

Sexual abstinence at age 21 in New Zealand: the importance of religion.

Most research on adolescent sexual behaviour has focused on early initiation and consequent risks. We have instead examined the circumstances of young people who have not had sexual intercourse before age 21, in order to throw light on the ways in which young people might resist societal pressures for early sexual intercourse. The sample was a cohort born in Dunedin, New Zealand in 1972/73, formed at age 3, and followed with regular assessments of personal, family and educational functioning to age 21. At age 18 and 21 information on sexual behaviour was collected, using a computer presented questionnaire. The response rate at age 21 was 935/1020 (91.7%) of the survivors of the original cohort. Overall 11.3% of the men and 8.1% of the women reported never having sexual intercourse. Sex with a man was reported by 20 men (4.5%), of whom only two reported having sex only with men. Being first born and being persistently involved in religious activities, measured at both 11 years and 21 years, were significant predictors of abstinence for both sexes. Examination of perceptions of an ideal lifestyle, sexual behaviour and religious involvement showed that religion was an important factor in decisions to delay sexual intercourse past age 20, especially for men. It would be helpful to examine further the features of moral decision making which are characteristic of religious experiences.

Adult↗
PubMed1998

Effect of religion and religiosity on alcohol use in a college student sample.

Two hundred and sixty-three alcohol using college students completed a questionnaire on their levels of alcohol use, problems with alcohol use, reasons for drinking, perceptions of control over drinking, impulsivity, venturesomeness, irrational beliefs, neuroticism, expectations of alcohol effects, depression, social norms, religious affiliation and intrinsic and extrinsic religiosity. Analyses of variance revealed that students with no religious affiliation reported significantly higher levels of drinking frequency and quantity, getting drunk, celebratory reasons for drinking and perceived drinking norms than those of either Catholic or Protestant religious affiliation, while no significant differences across groups were found for alcohol use problems. Protestants reported significantly higher levels of perceived drinking control than Catholics. Intrinsic religiosity, reflecting one's ego involvement with the tenets of one's religion, appeared to play a more important positive role over drinking behavior for Protestants than for Catholics.

Adult↗
PubMed2004

Formulation and treatment: integrating religion and spirituality in clinical practice.

Developing scientifically sound and clinically meaningful case formulations is so challenging that it may verge on becoming a "lost art." Pressures (scientific, economic, and cultural) remain that prevent child and adolescent psychiatrists from getting a complete understanding of the patient and family. Including a strong consideration of data related to religion, spirituality, and worldview may seem only to complicate an already arduous task. The clinician who includes these factors in treatment is faced with decisions of when to discuss these issues, how to discuss them and in what depth, and finally, when to refer to a religious/spiritual professional. Nonetheless, the importance of these factors in the lives of many children and families leaves no option but to address them as directly as possible. It is well worth the effort and, in many cases, will open new areas for clinical improvement in patients.

Adaptation, Psychological↗
PubMed2001

Religion as a cross-cultural determinant of depression in elderly Europeans: results from the EURODEP collaboration.

BACKGROUND: The protective effects of religion against late life depression may depend on the broader sociocultural environment. This paper examines whether the prevailing religious climate is related to cross-cultural differences of depression in elderly Europeans. METHODS: Two approaches were employed, using data from the EURODEP collaboration. First, associations were studied between church-attendance, religious denomination and depression at the syndrome level for six EURODEP study centres (five countries, N = 8398). Secondly, ecological associations were computed by multi-level analysis between national estimates of religious climate, derived from the European Value Survey and depressive symptoms, for the pooled dataset of 13 EURODEP study centres (11 countries, N = 17,739). RESULTS: In the first study, depression rates were lower among regular church-attenders, most prominently among Roman Catholics. In the second study, fewer depressive symptoms were found among the female elderly in countries, generally Roman Catholic, with high rates of regular church-attendance. Higher levels of depressive symptoms were found among the male elderly in Protestant countries. CONCLUSIONS: Religious practice is associated with less depression in elderly Europeans, both on the individual and the national level. Religious practice, especially when it is embedded within a traditional value-orientation, may facilitate coping with adversity in later life.

Aged↗
PubMed2006

Religion and spirituality among patients with localized prostate cancer.

OBJECTIVE: To examine: (1) daily religious and spiritual experiences among localized prostate cancer patients as compared to a national age and race-matched male sample; (2) cognitive-affective and clinical predictors of prostate cancer diagnosis-related increases in religiosity and spirituality; (3) short-term impact of daily religious and spiritual experiences on cancer recurrence worry. METHODS: Analyses of data from a longitudinal questionnaire study among patients (N = 254) diagnosed with localized prostate cancer and data from a random sample (N = 238) of respondents to the national General Social Survey. RESULTS: Compared to the national sample, prostate cancer patients reported higher levels of daily spiritual experiences. Patients with higher worry about prostate cancer and elevated levels of prostate-related symptoms around diagnosis were more likely to report a diagnosis-related increase in religiosity and spirituality. Positive benefits (reduced recurrence worry) of religious coping/practices were restricted to those patients with higher versus lower level of postdiagnosis increase in religiosity; patients not reporting postdiagnosis increases in religion who are not engaging in religious coping/practice adjusted equally well. Results suggest that the development of religious/spiritual interventions is premature. SIGNIFICANCE OF RESULTS: This is the first prospective study to report on the prevalence and influence of daily spiritual and religious experiences among prostate cancer patients.

Adaptation, Psychological↗
PubMed2001

Human ageing and the origins of religion.

During the evolution of hominids, the population could be sustained even with an expectation of life at birth of less than 20 years. Under these circumstances very few individuals reached old age. In these hunter-gatherer communities, altruistic behaviour was encouraged because it increased the likelihood of survival, whereas self-interest did not. An early moral code benefited the community as a whole. As social evolution progressed, the chances of survival increased, and for the first time very elderly individuals appeared. However, the reward for survival to old age was merely decrepitude and death. Under these circumstances, new incentives became a social necessity, and these took the form of a belief in an eternal afterlife. Religion then became the basis for the moral code, and it provided an assurance of continual survival after death.

Aging↗
PubMed2000

The view of religions toward euthanasia and extraordinary treatments in Japan.

388 Japanese religious groups--143 Shinto, 157 Buddhist, 58 Christian and 30 others--were asked to answer questions regarding several forms of euthanasia and extraordinary treatment during the dying process. Passive euthanasia and indirect euthanasia were accepted by around 70% of the respondents. Active euthanasia was favored by less than 20% of them. Christians were less supportive of euthanasia than practitioners of other religions. Shinto and Buddhist corporations advocated "being natural," when medical treatment became futile at the terminal stage. Religionists' views may deepen the discussion of end-of-life issues.

Attitude↗
PubMed1977

Breast cancer and religion in greater Bombay women: an epidemiological study of 2130 women over a 9-year period.

The resident female population of Greater Bombay consists of women professing different religious faiths, between which the frequency of breast cancer varies to a great extent. During the 9-year period 1964 to 1972 inclusive, a total of 2130 women with breast cancer were seen, with break-down by religion as follows: Hindus (1259), Muslims (306), Christians (264), Parsi (Zoroastrians) (226), Jains (25), Buddhists (26) and others (24). The average annual age-adjusted (world population) incidence rates, however, were found to be 48.5 and 18.2 per 100,000 in the Parsis and non-Parsis respectively, with an average of 19.9 per 100,000 for the total population. For reasons not yet clear, in every age group the incidence rate in Parsis was 2 to 3 times higher than in the non-Parsis. Time-trend analyses of our data do not reveal any statistically significant increase or decrease in the incidence of breast cancer in any particular age group. Data from death certificates for the same 9-year period show that the age-adjusted mortality rate (world population) is 9.2 per 100,000/year.

Adolescent↗
PubMed2003

Psychiatry, religion and cognitive science.

OBJECTIVE: To see whether certain findings in cognitive science can serve to bridge the conceptual gap between psychiatry, particularly in its psychotherapeutic aspects, and religious/spiritual understanding. METHOD: A brief review is given of certain basic differences between psychiatric understanding in its psychotherapeutic aspects, and much of Western religious/spiritual understanding. Reference is then made to certain findings in contemporary cognitive science which might challenge the implicit mind-body split of Western religious tradition and its parallel in psychotherapeutic practice. Attention is also drawn to elements in religious/spiritual tradition that run counter to this dualistic point of view. RESULTS AND CONCLUSIONS: Much of contemporary religious/spiritual understanding, and of modern psychiatric understanding, especially in terms of psychotherapy, appear to exist in quite separate domains. Psychotherapy and the greater part of Western religious thinking, however, share a belief in the existence of a transcendent mind. Recent developments in cognitive science and certain spiritual traditions, challenge this implicit mind-body split, providing an opportunity for a renewed dialogue between psychiatry and religion and the possibility of collaborative research.

Cognitive Science↗