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Lived religion and family therapy: what does spirituality have to do with it?

This review examines fundamental and methodological issues concerning the cross-disciplinary efforts of family therapists to involve spirituality in their clinical practice. Training requirements, challenges, and limitations are discussed. It is suggested that the construct lived religion is the best starting point for this work. Lived religion is a term that addresses the real, lived, experiential, and intimate dimensions of our religious life. It is also tied to a variety of academic disciplines that can guide and deepen thought. Significant problems and limitations are identified with the term spirituality. It is suggested that if clinicians continue to prefer spirituality as a construct, that it be seen as a form or expression of lived religion. This way the links to various discipliines are maintained and idiosyncratic efforts will be minimized. Methods that attempt to integrate spirituality and family therpay are also found to be lacking. For nearly a half century American divinity schools have developed various co-relational methods which foster more respectful and productive discourse calling for the goals and objectives of mental health and religion to be equally value and maintained. In this way the piftalls of reductionism, or oversimplification, and anti-institutional bias can be lessened.

Family Therapy↗

Race, religion, and abstinence from alcohol in late life.

OBJECTIVE: This study aimed to see whether involvement in religion helps explain why older Blacks are more likely to avoid drinking alcohol than older Whites. METHODS: Interviews were conducted with a nationwide sample of older Whites and older Blacks. Survey items were administered to assess whether study participants consume alcohol, whether they affiliate with fundamentalist congregations, how often they attend religious services, how often they pray privately, and whether they derive a sense of meaning from their faith. RESULTS: The findings reveal that older people who affiliate with fundamentalist churches and who find meaning in religion are more likely to avoid drinking. However, neither church attendance nor private prayer are related to alcohol use. Race differences in the odds of drinking were no longer statistically significant once the religion measures were added to the model. DISCUSSION: The findings highlight the importance of religion in shaping the health behaviors of older adults.

Black or African American↗

Death, dying and informatics: misrepresenting religion on MedLine.

BACKGROUND: The globalization of medical science carries for doctors worldwide a correlative duty to deepen their understanding of patients' cultural contexts and religious backgrounds, in order to satisfy each as a unique individual. To become better informed, practitioners may turn to MedLine, but it is unclear whether the information found there is an accurate representation of culture and religion. To test MedLine's representation of this field, we chose the topic of death and dying in the three major monotheistic religions. METHODS: We searched MedLine using PubMed in order to retrieve and thematically analyze full-length scholarly journal papers or case reports dealing with religious traditions and end-of-life care. Our search consisted of a string of words that included the most common denominations of the three religions, the standard heading terms used by the National Reference Center for Bioethics Literature (NRCBL), and the Medical Subject Headings (MeSH) used by the National Library of Medicine. Eligible articles were limited to English-language papers with an abstract. RESULTS: We found that while a bibliographic search in MedLine on this topic produced instant results and some valuable literature, the aggregate reflected a selection bias. American writers were over-represented given the global prevalence of these religious traditions. Denominationally affiliated authors predominated in representing the Christian traditions. The Islamic tradition was under-represented. CONCLUSION: MedLine's capability to identify the most current, reliable and accurate information about purely scientific topics should not be assumed to be the same case when considering the interface of religion, culture and end-of-life care.

Christianity↗

The influence of race and religion on abstinence from alcohol, cigarettes and marijuana among adolescents.

OBJECTIVE: Past research has not fully explained why black youth are less likely than white youth to use alcohol and other substances. One plausible yet underexamined explanation is the "religion hypothesis," which posits that black youth are more likely than white youth to abstain because they are more religious than white youth. The present study tested this hypothesis empirically. METHOD: The study examined data from large, nationally representative samples of white and black 10th graders from the Monitoring the Future project. RESULTS: Relative to white students, black students are more likely to abstain from alcohol, cigarettes and marijuana and are more highly religious. Consistent with the "religiosity hypothesis," race differences in abstinence are substantially reduced when race differences in religiosity are controlled. Unexpectedly, however, highly religious white youth are more likely than highly religious black youth to abstain from alcohol and marijuana use. CONCLUSIONS: Although religion is an important protective factor against alcohol and other substance use for both white and black adolescents, it appears to impact white youth at an individual level, whereas for black youth the influence of religion seems greatest at the group level. Future research should seek to better understand the mechanisms through which religion promotes adolescents' abstinence from the use of drugs and should seek to explain why the magnitude of its effect varies for black and white adolescents.

Adolescent↗

Body and spirit: Religion, spirituality, and health among adolescents.

Religion and spirituality are important in the lives of many adolescents. This article traces patterns of adolescent religious/spiritual belief and practice and summarizes theories about religious development as they pertain to this age group. Data are provided that explore possible relationships between religion and health-related behavior among adolescents. Much of this data shows that greater religiosity/spirituality may be associated with less involvement in high-risk behaviors and more involvement in health-promoting behaviors. Implications of these data are discussed as well as possible negative roles that religion may play in youths' lives. The doctor's role in approaching religion and spirituality with patients is controversial. Health care professionals should be prepared to discuss these issues with adolescents for whom they are important, especially with patients who are hospitalized. Yet, doctors should be sensitive to those adolescents who may not want to delve into spiritual/religious issues in a health care setting.

Adolescent↗

Gender, religion, and adolescent patterns of self-disclosure in the divided society of Northern Ireland.

Adolescence is a period when levels of self-disclosure are often lowest. While studies have revealed a clear preference for female targets of disclosure, little research has been carried out on the effects of religion upon disclosure. The impact of religion was of importance in this investigation, given that it was conducted in Northern Ireland, where religion affects almost every aspect of social life. The aim was to ascertain the effects of gender and religious affiliation on adolescent disclosure to friends and strangers. Results revealed that while females were significantly higher disclosers than were males, religion per se did not play a key role. This suggests that even in a highly polarized society, gender is the central determinant of disclosure and is even more important than political identity. The implications of these findings are discussed, particularly with regard to the difficulty young males have in terms of revealing personal information.

Adolescent↗

Religion, senescence, and mental health: the end of life is not the end of hope.

The authors review epidemiological and survey research relevant to the relationships between religiousness/spirituality and mental health in people at the end of life, with the end of helping psychiatrists, psychologists, and other mental health professionals dealing with older Americans. They give special attention to well-being, religious coping, cognitive dysfunction, anxiety, depression, and suicide, and consider the extent to which hope is a mediator of the purported salutary effects of religiousness. Studies were selected from the comprehensive and systematic review of 20th-century scientific literature concerning religion and health. Authors also review current studies relevant to religion and end-of-life issues. Religious persons reported generally higher levels of well-being. The review also found fairly consistent inverse associations of religiousness with rates of depression and suicide. There was some negative association between religious participation and cognitive dysfunction, but the association with anxiety was inconsistent, with some studies showing a correlation between higher levels of religion and anxiety. Religion's effects on mental health are generally protective in direction but modest in strength.

Adaptation, Psychological↗

Culture, religion, and fertility: a global view.

This study tries to assess the effects of culture and religion on fertility after accounting for a country's socioeconomic standing. Analysis of covariance models are estimated for 128 countries with time-series covering the period 1950-1975. The dependent variable is the gross reproduction rate; independent variables are the infant mortality rate, an aggregate indicator of female educational standing, and gross domestic product per person as well as categorical variables for religion and cultural region. It turns out that the European countries have generally lower fertility than could be expected from their socioeconomic standing. In the Arab countries, culture and religion tend to have strong positive effects on fertility. Across cultures, Catholicism has a fertility-increasing effect but it--like the effect of all religions except Islam--is diminishing over time. In contrast, the effect of culture (as measured by a regional variable) on the level of national fertility has been increasing at the expense of socioeconomic effects.

Birth Rate↗

[Traditional religion and terminal care in the Ryukyus, southern Japan].

The public health significance of traditional religions in terminal care was studied in the Ryukyu Archipelago. The traditional religious view of life, in which death at home is ideal, is still maintained: while inhabitants seek modern medical care in facilities outside of the island, they are transported back to die in their homes when their condition becomes critical. Most of the general hospitals, special nursing homes for the aged, and psychiatric hospitals of Okinawa allow bereaved families to perform "Nujifa", a traditional religious ritual for transferring soul of the dead from the death to their own home, that functions as a significant factor in relieving grief. In many of the special nursing homes for aged, not a few aged women practiced activities uniquely associated with traditional religion on strongly reflecting the fact that endemic religion is deeply embedded in their thinking. Although acculturation is in rapid progress in the Ryukyu Archipelago, such endemic religion still has a significant effect on the people. Therefore these religious factors should be considered in the terminal medical care of these people.

Aged↗

Science and religion.

Religion and science have often been in conflict throughout human history. There are many who think that they can never be reconciled. In this essay, it will be argued that religion and science are in harmony, and, in fact, they are both necessary for the advancement of human civilization. In essence, religion and sciences represent to pathways in the search for truth. In general, religion deals with spiritual matters and science with physical matters. In some cases they overlap. The very word, "science" has had different meanings throughout the centuries. The sciences studied in the ancient world, such as alchemy, would have no meeting today. It is likely that some sciences, which are considered very important today, will in future centuries become irrelevant. (Ref. 15.).

Humans↗

Religion, spirituality, and healthcare choices of African-American women: results of a national survey.

OBJECTIVE: This study describes the prevalence and patterns of use of religion and spirituality for health reasons among African-American women. METHODS: Respondents were asked about their use of religion/spirituality for health reasons as part of a larger study of the prevalence and correlates of complementary and alternative medicine (CAM) use among women. In 2001, a national survey of 3,172 women, aged 18 and older, was conducted in 4 languages, with over-sampling among African-, Mexican-, and Chinese-American participants. This paper focuses on the sub-sample of 812 African-American women. RESULTS: Overall, 43% of the African-American women reported using religion/spirituality for health reasons in the past year. Factors significantly associated with the use of religion/spirituality for health reasons included having an income of dollar 40,000-dollar 60,000, an education level of college graduate or more, or being 37-56 years of age; worse health status approached significance. African-American women utilized religion and spirituality most often for serious conditions such as cancer, heart disease, and depression. African-American women who had used religion/spirituality in the past year for health reasons were more than twice as likely to have used some form of CAM, and also more likely to have seen a medical doctor during the year prior to the interview, compared to their counterparts. CONCLUSION: Religion and spirituality are associated with health-seeking behaviors of African-American women. The use of religion and spirituality for health reasons warrants additional research, particularly its use for chronic and serious conditions, and its role in the health-seeking behavior of African-American women in conjunction with the utilization of conventional medicine and CAM.

Adult↗

Physician perspectives on the role of religion in the physician-older patient relationship.

A study of 160 family physicians and general practitioners found that the majority of physicians believed that religion has a positive effect on the mental health of older patients, and many believed that religion has a positive effect on physical health. While more than one half reported that patients only rarely, if ever, mentioned religious issues during a medical visit, a significant proportion of the physicians felt they should address religious issues when an older person indicates religion's importance and that religious issues should not be reserved completely for the clergy. Nearly two thirds of the physicians felt that prayer with patients was appropriate under certain circumstances, and over one third reported having prayed with older patients during extreme physical or emotional distress. Older physicians were less likely than younger to have positive attitudes toward addressing religious issues. The strongest predictors of physicians' belief in the appropriateness of addressing religious concerns were two attitudinal variables that indicated an understanding of the importance of religion in the lives of older adults and an awareness that patients might desire to engage in prayer with them. Hence, the beliefs and attitudes of the physician appear to be important factors in determining their receptivity to discussion of religious issues, which in turn may influence whether patients mention such issues in the context of the medical visit.

Aged↗

Exploring the natural foundations of religion.

A new cognitive approach to religion is bringing fresh insights to our understanding of how religious concepts are maintained, acquired and used to motivate and direct actions. This approach suggests that seemingly extraordinary thoughts and behaviours can be supported by quite ordinary cognition and may thus be termed 'natural'. Simultaneously, this research is expanding the domain of concepts and causal reasoning in general. This review examines recent research into religious rituals, communication and transmission of religious knowledge, the development of god-concepts in children, and the origins and character of religious concepts in adults. Together, these studies consistently emphasize and support the notion that the cultural phenomena typically labeled as 'religion' may be understood as the product of aggregated ordinary cognition. The new cognitive science of religion should eventually provide a fuller account of the distinctive and apparently extraordinary properties of religion.

Journal Article↗

Beliefs of primary care residents regarding spirituality and religion in clinical encounters with patients: a study at a midwestern U.S. teaching institution.

PURPOSE: To assess primary care residents' beliefs regarding the role of spirituality and religion in the clinical encounter with patients. METHOD: In 2003, at a major midwestern U.S. teaching institution, 247 primary care residents were administered a questionnaire adapted from that used in the Religion and Spirituality in the Medical Encounter Study to assess whether primary care house officers feel they should discuss religious and spiritual issues with patients, pray with patients, or both, and whether personal characteristics of residents, including their own spiritual well-being, religiosity, and tendency to use spiritual and religious coping mechanisms, are related to their sentiments regarding spirituality and religion in health care. Simple descriptive, univariate, and two types of multivariable analyses were performed. RESULTS: Data were collected from 227 residents (92%) in internal medicine, pediatrics, internal medicine/pediatrics, and family medicine. One hundred four (46%) respondents felt that they should play a role in patients' spiritual or religious lives. In multivariable analysis, this sentiment was associated with greater frequency of participating in organized religious activity (odds ratio [OR] 1.55, 95% confidence interval [CI] 1.20-1.99), a higher level of personal spirituality (OR 1.05, 95% CI 1.02-1.08), and older resident age (OR 1.11, 95% CI 1.02-1.21; C-statistic 0.76). In general, advocating spiritual and religious involvement was most often associated with high personal levels of spiritual and religious coping and with the family medicine training program. Residents were more likely to agree with incorporating spirituality and religion into patient encounters as the gravity of the patient's condition increased (p < .0001). CONCLUSIONS: Approximately half of primary care residents felt that they should play a role in their patients' spiritual or religious lives. Residents' agreement with specific spiritual and religious activities depended on both the patient's condition and the resident's personal characteristics.

Adult↗

Science and religion: friends or foes?

There is a widespread assumption that science and religion are incompatible with each other; it may be acceptable for a scientist to practise religion, but--it is believed--this should be seen as despite, not because of his or her scientific profession and knowledge. Such an assumption is wrong. Examination of conflicts between science and religion (such as those about evolution) show that they always arise through misinterpretation or tenacious presuppositions. Unfortunately protagonists (both anti-religion and anti-science) receive more publicity than conciliators. This paper reviews some of the background and development of arguments over creation and evolution and shows that there is no need to choose between a rigorous scientific approach and an avowedly religious acknowledgement of God as creator and sustainer.

Journal Article↗

Is frequent religious attendance really conducive to better health? Toward an epidemiology of religion.

Although hundreds of published studies have addressed the effects of religion on morbidity and mortality, many investigators may be unaware of this literature. This paper begins with an analysis of an important subset of these studies--those 27 which operationalize 'religiosity' as religious attendance--and which, taken as a whole, point to a consistent salutary effect for frequent attendance. Upon identifying several pervasive epistemological, methodological, and analytical problems with these studies, however, this paper shows that there is insufficient evidence to conclude that religious attendance is positively and significantly related to health. Nevertheless, the authors present a theoretical basis for expecting such associations. This framework is included in a brief primer on religion for epidemiologists and other sociomedical scientists interested in exploring the health-related effects of religious factors. Finally, a possible scenario for the development of an epidemiology of religion is discussed.

Attitude to Health↗

Galileo and the embryos: religion and science in parliamentary debate over research on human embryos.

Confrontation between science and religion was a significant feature of the lengthy public appraisal of research on human embryos in Britain during the 1880s. The series of formal debates over embryo research in the House of Lords is chosen as a particularly appropriate setting to study this confrontation. It is shown that religious opposition to embryo research was repeatedly attacked in these debates by means of a stereotyped contrast between religious and scientific styles of thought. Leading figures in the movement for embryo research attempted to discredit their opponents by claiming that, whereas their own case was built upon reasoned assessment of the facts, the other side relied on religious dogma, clerical authority and faith. It is shown that, although there were genuine differences between those critical of embryo research on religious grounds and those supporting such research on grounds furnished by scientists, this account of the differences is inaccurate: dogma, reliance on authority and faith were as characteristic of the discourse associated with science as they were of that associated with religion. It is argued that these features were not generated by the presence of religious or scientific beliefs as such, but by the struggle between advocates of science and religion for intellectual and moral dominance.

Beginning of Human Life↗

Religion and depression: a review of the literature.

We reviewed data from approximately 80 published and unpublished studies that examined the association of religious affiliation or involvement with depressive symptoms or depressive disorder. In these studies, religion was measured as religious affiliation; general religious involvement; organizational religious involvement; prayer or private religious involvement; religious salience and motivation; or religious beliefs. People from some religious affiliations appear to have an elevated risk for depressive symptoms and depressive disorder, and people with no religious affiliation are at an elevated risk in comparison with people who are religiously affiliated. People with high levels of general religious involvement, organizational religious involvement, religious salience, and intrinsic religious motivation are at reduced risk for depressive symptoms and depressive disorders. Private religious activity and particular religious beliefs appear to bear no reliable relationship with depression. People with high levels of extrinsic religious motivation are at increased risk for depressive symptoms. Although these associations tend to be consistent, they are modest and are substantially reduced in multivariate research. Longitudinal research is sparse, but suggests that some forms of religious involvement might exert a protective effect against the incidence and persistence of depressive symptoms or disorders. The existing research is sufficient to encourage further investigation of the associations of religion with depressive symptoms and disorder. Religion should be measured with higher methodological standards than those that have been accepted in survey research to date.

Depression↗