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PubMed2003

Advances in the conceptualization and measurement of religion and spirituality. Implications for physical and mental health research.

Empirical studies have identified significant links between religion and spirituality and health. The reasons for these associations, however, are unclear. Typically, religion and spirituality have been measured by global indices (e.g., frequency of church attendance, self-rated religiousness and spirituality) that do not specify how or why religion and spirituality affect health. The authors highlight recent advances in the delineation of religion and spirituality concepts and measures theoretically and functionally connected to health. They also point to areas for areas for growth in religion and spirituality conceptualization and measurement. Through measures of religion and spirituality more conceptually related to physical and mental health (e.g., closeness to God, religious orientation and motivation, religious support, religious struggle), psychologists are discovering more about the distinctive contributions of religiousness and spirituality to health and well-being.

Health Status↗
PubMed2000

Religion and protective behaviours towards AIDS in rural Senegal.

OBJECTIVES: To describe the association between religion and factors related to sexually transmitted diseases (STD)/AIDS in a country where religious leaders were involved early in prevention. DESIGN: A cross-sectional study conducted in a rural area in central Senegal. METHODS: Questionnaire-based interviews of a random sample of 858 adults from the general population aged 15-59 years and in-depth interviews of four religious leaders and 50 people. RESULTS: Seventy-six per cent of the respondents were Muslim, 24% Catholic, 1% Animist and 0.2% Protestant. A total of 86% of men and 87% of women reported religion to be very important to them. Important prevention-related variables were inversely associated with the importance of religion. Men who considered religion to be very important were less likely to cite AIDS as a major health problem [odds ratio (OR) 0.4, P = 0.008] and were less likely to feel at risk of getting HIV (OR 0.5, P = 0.0005). Women who considered religion to be very important were less likely to report an intention to change to protect themselves from AIDS (OR 0.2, P = 0.0001), less likely to report having discussed AIDS with others (OR 0.4, P = 0.01) and much more likely to feel at risk of getting HIV (OR 9.3, P = 10(-4)). Individuals who considered religion to be very important were not more likely to report intending to or actually having become faithful to protect themselves from AIDS. CONCLUSION: These findings stress the need to intensify the involvement of religious authorities in HIV/STD prevention at the local level.

Adolescent↗
PubMed1999

Religion, social support, and health among the Japanese elderly.

We address three issues in this paper: (1) Is religion related to self-rated health, (2) do these salubrious effects arise because religion encourages people to provide help to significant others, and (3) is the relationship between religion and helping others more evident among older men than elderly women? We analyze the relationships among religion, support giving, and health with data provided by a national probability sample of 2,153 older people in Japan who were interviewed face-to-face in 1996. Greater involvement in religion is associated with providing help to others more often, but these effects emerge for older men only. Regardless of gender, elders who provide assistance to others more often rate their health more favorably than older adults who are less involved in helping others. These results confirm that religion is related to health, and that helping others may explain at least part of the reason for this relationship.

Age Factors↗
PubMed2005

A review of research on the effects of religion on adolescent tobacco use published between 1990 and 2003.

An electronic search of Medline and PsycInfo produced 29 studies that specifically investigated the effects of religion on adolescent tobacco use. Independent (religion) and dependent (tobacco use) variables and variables controlled for in statistical analyses were categorized. Twenty-two of the 29 studies reported at least one significant effect of religion on tobacco use, with 31 of 43 separate analyses of religious variables yielding significant negative correlations between religion and tobacco use. Religion was inversely related to all measures of tobacco use (lifetime, occasional, and regular use), but the findings suggest religion's primary effect is its prohibitive influence against ever using tobacco.

Adolescent↗
PubMed2001

Religion in the clinic: the role of physician beliefs.

BACKGROUND: Although studies have identified physician beliefs that may cause them to avoid spiritual topics in the clinic (eg, lack of time), it is unknown to what extent these beliefs predict behavior. The purpose of the present study was to identify physician beliefs about religion and medicine that predict attention to religious issues in the clinic. METHODS: The study was cross-sectional and correlational. Seventy-eight physicians completed a self-report survey of religious behavior in the clinic and beliefs about religion and medicine. RESULTS: Most physicians do not initiate religious discussions with patients, though a majority accept a link between religion and health. Physician personal discomfort with addressing religious topics was the sole multivariate predictor of clinical religious behavior. Time, role definition, health relevance of religion, and physician religiousness were not significant predictors. CONCLUSIONS: Avoidance of religion in the clinic may be primarily belief-based. Future research is needed to examine the role of medical education in creating and/or maintaining these beliefs.

Ambulatory Care↗
PubMed1999

Religion, community service, and identity in American youth.

The role of religion in identity development has, for many years, been a relatively neglected topic in psychology. To demonstrate the importance of religion to the formation of identity, this paper presents evidence connecting community service and religiousness in American youth. Data are reviewed that show (1) youth are heavily involved in volunteer service; (2) many youth view religion as important and those who do so are more likely to do service than youth who do not believe that religion is important in their lives; (3) involvement in church-sponsored service makes it more likely that youth will adopt the religious rationale in which service is couched; and (4) youth who do church-sponsored service are neither service "nerds" nor single-issue tunnel-visioned adolescents. These data from nationally representative samples strengthen the case that the many contemporary youth who take religion seriously are vibrantly engaged in their schooling, in the betterment of communities, and the development of identities which presage healthy lives.

Adolescent↗
PubMed2006

Religion, weight perception, and weight control behavior.

Religion's relationships with weight perception and weight control behavior were examined using data (3032 adults aged 25-74) from the National Survey of Midlife Development in the United States. Religion was conceptualized as denomination, religious attendance/practice, religious social support, religious commitment, religious application, and religious identity. Weight perception was conceptualized as underestimating body weight, overestimating body weight, and accurately assessing body weight. Respondents also reported whether they had engaged in any intentional weight loss (yes/no) in the last 12 months. Logistic regression was used, with significant results being set at a p-values of <.01 and <.05. Accurately assessing body weight was the reference category for all weight perception analyses. Women with greater religious commitment and men with greater religious application had greater odds of underestimating their body weight. This relationship remained significant, controlling for age, race/ethnicity, education, and income. Jewish women had greater odds of overestimating their body weight. There were no relationships between religion and weight control behavior. Relationships between religion, weight perception, and weight control behavior illustrate religion's multidimensionality.

Adult↗
PubMed2006

Effect of religion on suicide attempts in outpatients with schizophrenia or schizo-affective disorders compared with inpatients with non-psychotic disorders.

Little is known of the relations between psychosis, religion and suicide. One hundred and fifteen outpatients with schizophrenia or schizo-affective disorder and 30 inpatients without psychotic symptoms were studied using a semi-structured interview assessing religiousness/spirituality. Their past suicide attempts were examined. Additionally, they were asked about the role (protective or incentive) of religion in their decision to commit suicide. Forty-three percent of the patients with psychosis had previously attempted suicide. Religiousness was not associated with the rate of patients who attempted suicide. Twenty-five percent of all subjects acknowledged a protective role of religion, mostly through ethical condemnation of suicide and religious coping. One out of ten patients reported an incentive role of religion, not only due to negatively connotated issues but also to the hope for something better after death. There were no differences between groups (i.e. psychotic vs. non-psychotic patients). Religion may play a specific role in the decisions patients make about suicide, both in psychotic and non-psychotic patients. This role may be protective, a finding particularly important for patients with psychosis who are known to be at high risk of severe suicide attempts. Interventions aiming to lower the number of suicide attempts in patients with schizophrenia should take these data into account.

Adaptation, Psychological↗
PubMed2006

Despite their inevitable conflicts--science, religion and New Age spirituality are essentially compatible and complementary activities.

Until recently it seemed that the continued expansion of scientific ways of thinking was destined to render religion extinct and spirituality unfeasible. But the example of the United States disproves this, since America is the most successful scientific nation of this era, church-going remains strong and New Age spiritualities are thriving. Therefore, despite the obvious conflicts; science, religion and spirituality are essentially compatible. Future science will continue to win territory from religion since its validation procedures are more objective and reliable. However, churches can survive and grow by dropping those aspects of doctrine which clash with science, and expanding their social functions. The fast-growing US 'mega-church' movement shows the way - since these organizations are minimally dogmatic but instead provide a family-orientated and morally-cohesive social milieu. Like organized religion, New Age spirituality comes into conflict with science when it makes incredible or bizarre factual claims. However, in practice modern spirituality is based on subjective evaluations which do not clash with the procedures of science. Indeed, the reliance upon individual, emotion-based evaluations (e.g., 'my truth', 'whatever works for you') renders New Age spirituality 'science-proof', and has enabled it to expand massively in an age of science. Science, religion and spirituality perform different functions in the modern world, and their relationship is therefore one of mutual-dependence. Borderline disputes will inevitably occur, but as part of a broader context of complementarity. Science, 'social' churches and New Age spirituality all have a bright future.

Conflict, Psychological↗
PubMed2004

Religion's evolutionary landscape: counterintuition, commitment, compassion, communion.

Religion is not an evolutionary adaptation per se, but a recurring cultural by-product of the complex evolutionary landscape that sets cognitive, emotional, and material conditions for ordinary human interactions. Religion exploits only ordinary cognitive processes to passionately display costly devotion to counterintuitive worlds governed by supernatural agents. The conceptual foundations of religion are intuitively given by task-specific panhuman cognitive domains, including folkmechanics, folkbiology, and folkpsychology. Core religious beliefs minimally violate ordinary notions about how the world is, with all of its inescapable problems, thus enabling people to imagine minimally impossible supernatural worlds that solve existential problems, including death and deception. Here the focus is on folkpsychology and agency. A key feature of the supernatural agent concepts common to all religions is the triggering of an "Innate Releasing Mechanism," or "agency detector," whose proper (naturally selected) domain encompasses animate objects relevant to hominid survival--such as predators, protectors, and prey--but which actually extends to moving dots on computer screens, voices in wind, and faces on clouds. Folkpsychology also crucially involves metarepresentation, which makes deception possible and threatens any social order. However, these same metacognitive capacities provide the hope and promise of open-ended solutions through representations of counterfactual supernatural worlds that cannot be logically or empirically verified or falsified. Because religious beliefs cannot be deductively or inductively validated, validation occurs only by ritually addressing the very emotions motivating religion. Cross-cultural experimental evidence encourages these claims.

Anxiety↗
PubMed2004

Methodologic issues in research on religion and health.

This study examines several methodologic issues in research on religion and health, including the measurement of the concept of religion, research designs, sampling, and statistical controls for assessing the "net" effects of religion on health outcomes. It briefly discusses differences in analytical perspectives that have contributed to the debate about the effects of religion on health. The authors review some of the methodologic problems of past research in this area of study and address what needs to be done to enhance the quality of the research. The authors conclude that the research methodology used in studies of religion and health has improved over time and that it continues to do so.

Epidemiologic Methods↗
PubMed2006

Spirituality and religion in patients with HIV/AIDS.

BACKGROUND: Spirituality and religion are often central issues for patients dealing with chronic illness. The purpose of this study is to characterize spirituality/religion in a large and diverse sample of patients with HIV/AIDS by using several measures of spirituality/religion, to examine associations between spirituality/religion and a number of demographic, clinical, and psychosocial variables, and to assess changes in levels of spirituality over 12 to 18 months. METHODS: We interviewed 450 patients from 4 clinical sites. Spirituality/religion was assessed by using 8 measures: the Functional Assessment of Chronic Illness Therapy-Spirituality-Expanded scale (meaning/peace, faith, and overall spirituality); the Duke Religion Index (organized and nonorganized religious activities, and intrinsic religiosity); and the Brief RCOPE scale (positive and negative religious coping). Covariates included demographics and clinical characteristics, HIV symptoms, health status, social support, self-esteem, optimism, and depressive symptoms. RESULTS: The patients' mean (SD) age was 43.3 (8.4) years; 387 (86%) were male; 246 (55%) were minorities; and 358 (80%) indicated a specific religious preference. Ninety-five (23%) participants attended religious services weekly, and 143 (32%) engaged in prayer or meditation at least daily. Three hundred thirty-nine (75%) patients said that their illness had strengthened their faith at least a little, and patients used positive religious coping strategies (e.g., sought God's love and care) more often than negative ones (e.g., wondered whether God has abandoned me; P<.0001). In 8 multivariable models, factors associated with most facets of spirituality/religion included ethnic and racial minority status, greater optimism, less alcohol use, having a religion, greater self-esteem, greater life satisfaction, and lower overall functioning (R2=.16 to .74). Mean levels of spirituality did not change significantly over 12 to 18 months. CONCLUSIONS: Most patients with HIV/AIDS belonged to an organized religion and use their religion to cope with their illness. Patients with greater optimism, greater self-esteem, greater life satisfaction, minorities, and patients who drink less alcohol tend to be both more spiritual and religious. Spirituality levels remain stable over 12 to 18 months.

Adaptation, Psychological↗
PubMed2000

Religion and health: public health research and practice.

Research examining the relationships between religion and the health of individuals and populations has become increasingly visible in the social, behavioral, and health sciences. Systematic programs of research investigate religious phenomena within the context of coherent theoretical and conceptual frameworks that describe the causes and consequences of religious involvement for health outcomes. Recent research has validated the multidimensional aspects of religious involvement and investigated how religious factors operate through various biobehavioral and psychosocial constructs to affect health status through proposed mechanisms that link religion and health. Methodological and analytical advances in the field permit the development of more complex models of religion's effects, in keeping with proposed theoretical explanations. Investigations of religion and health have ethical and practical implications that should be addressed by the lay public, health professionals, the research community, and the clergy. Future research directions point to promising new areas of investigation that could bridge the constructs of religion and health.

Adaptation, Psychological↗
PubMed1984

Religion, psychology, and mental health.

Many mental health professionals look with suspicion upon religious involvement. This may be due to inadequate characterizations of religion or to the profound difference in religious involvement among professionals and nonprofessionals. These differences are examined and a theory of human nature is sketched which makes a place for both science and religion. Admittedly, religion frequently plays a role in psychopathology. This is not surprising, however, since religion as part of psychic life can be distorted. The common forms of such distortion are described and suggestions for management are given. Is there such a thing as "healthy" religion? Attempts to answer this question frequently reflect a bias toward the goals of contemporary psychotherapy--goals which may conflict with deeply held religious convictions. Therapist and client ought to explicitly recognize this potential for conflict before therapy continues.

Attitude of Health Personnel↗
PubMed2004

Grounding research and medical education about religion in actual physician-patient interaction: church attendance, social support, and older adults.

This article reviews the relation between social support and elder health, the social-support dimensions of religion, the relation between church attendance and elder health, the place of religion in the biopsychosocial model of medicine, and medical education's position on physician-patient communication about religion. It then examines the emergence of the topic of religion in actual visits. Data are 71 videotaped and transcribed, chronic-routine visits between 12 internal medicine physicians and their older patients. Religion was raised as a topic in 9 visits (13%). In every case, the topic was initiated by patients. The most frequent topic was church attendance (7 of 9 topics), which patients typically used as a contextualizing framework to relate and describe somatic problems. In no cases did physicians make efforts to support or facilitate patients' church attendance, as is advocated by medical education. Implications for medical education and the biopsychosocial model are discussed.

Aged↗
PubMed2001

The presence and influence of religion in American bioethics.

From the inception of the relatively short history of American bioethics in the mid-to-late 1960s, the place of religion in this field has been complex and controversial. It has also been a subject of more than casual interest and concern to bioethicists, and to an array of medical and non-medical groups in U.S. society for whom the activities and issues in which bioethics is engaged have ongoing import. The questions and the tensions linked to the status and influence of religion in the sphere of bioethics have ramifications that extend beyond bioethics and biomedicine into matters involving the relationship of religion to the institutional structure of American society--most particularly its political, legal foundations, and realm of public affairs--and to its cultural attributes and tradition. It is within this larger perspective that we will consider the association between American bioethics and religion. Our analysis includes two case studies: (1) how, in the early years of bioethics, a pioneering organization in the field dealt with the "redefinition of death" in its discussions and in a major medical journal publication; and (2) the way in which the most recently appointed federal bioethics commission, the National Bioethics Advisory Commission, involved religion in its work on cloning and stem cell research.

Attitude to Death↗
PubMed1996

Religion, spirituality and psychiatry: conceptual, cultural and personal challenges.

OBJECTIVE: Recent psychiatric literature and contemporary sociopolitical developments suggest a need to reconsider the place of religion and spirituality in psychiatry. This paper was written with the aim of encouraging dialogue between the often antithetical realms of religion and science. METHOD: Material from psychiatric, sociological and religious studies literature was reviewed, with particular emphasis on New Zealand sources. RESULTS: Despite the secularising effects of science, the presence and influence of 'religiosity' remains substantial in Western culture. The literature emphasises the central importance of religion and spirituality for mental health, and the difficulty of integrating these concepts with scientific medicine. Psychiatric tradition and training may exaggerate the 'religiosity gap between doctors and patients. In New Zealand, the politically mandated bicultural approach to mental health demands an understanding of Maori spirituality. CONCLUSIONS: Intellectual, moral and pragmatic arguments all suggest that psychiatry should reconsider its attitude to religion and spirituality. There are many opportunities for research in the field. Psychiatry would benefit if the vocabulary and concepts of religion and spirituality were more familiar to trainees and practitioners. Patients would find better understanding from psychiatrists, and fruitful interdisciplinary dialogue about mutual issues of 'ultimate concern' might ensue.

Culture↗
PubMed1996

[Religion and psychiatry: responses to a case of manslaughter in religious mania].

After having touched upon some modalities of the relationship between religion and psychiatry, a paradox is pointed out in a psychiatry segregated by denomination as was the case in the Netherlands: this type of psychiatry was stated to be different because of its religious basis and inclination. However, religion seems to have played no substantial role whatever in its psychiatric-medical practice. Sometimes, this paradox caused problems as is shown in a case of manslaughter in religious (i.c. Calvinistic) mania in Appeltern (The Netherlands) in 1900. The psychiatric involvement, the divergent opinions of theologians and of the press from different denominations are presented. Calvinistic psychiatrists found themselves between the different camps: their Calvinistic leaders questioned implicitly the paradox Calvinistic psychiatry had previously attained and the Roman-Catholic press wanted to blame the Calvinistic religion for the manslaughter. As physicians they wanted to remain loyal to their co-professionals who had claimed non-culpability for the people (and, in fact, for the religion) involved. Defending once more 'the paradox' (and the underlying medical model)', shortly after, even in circles of Calvinistic psychiatrists, questions on religion and mental insanity reemerged, provoked by the case in Appeltern.

Bipolar Disorder↗