Mental Disorders, Religion and Spirituality 1990 to 2010: A Systematic Evidence-Based Review

Religion/spirituality has been increasingly examined in medical research during the past two decades. Despite the increasing number of published studies, a systematic evidence-based review of the available data in the field of psychiatry has not been done during the last 20 years. The literature was searched using PubMed (1990–2010). We examined original research on religion, religiosity, spirituality, and related terms published in the top 25 % of psychiatry and neurology journals according to the ISI journals citation index 2010. Most studies focused on religion or religiosity and only 7 % involved interventions. Among the 43 publications that met these criteria, thirty-one (72.1 %) found a relationship between level of religious/spiritual involvement and less mental disorder (positive), eight (18.6 %) found mixed results (positive and negative), and two (4.7 %) reported more mental disorder (negative). All studies on dementia, suicide, and stress-related disorders found a positive association, as well as 79 and 67 % of the papers on depression and substance abuse, respectively. In contrast, findings from the few studies in schizophrenia were mixed, and in bipolar disorder, indicated no association or a negative one. There is good evidence that religious involvement is correlated with better mental health in the areas of depression, substance abuse, and suicide; some evidence in stress-related disorders and dementia; insufficient evidence in bipolar disorder and schizophrenia, and no data in many other mental disorders.     

Religious experience,religious orientation and schizotypy

The present study examined the relationship between religious orientation and schizotypy, with the prediction that intrinsic religiosity would be negatively associated with schizotypy, and religious experience and extrinsic religiosity would be positively associated with schizotypy. A total of 308 UK adults (132 men; 176 women) completed measures of religious experience, intrinsic orientation towards religion, extrinsic orientation towards religion, schizotypal personality traits and borderline personality. Though the present findings also suggest that the significant relationships between religiosity and schizotypy traits are fragmented, particularly by sex, the findings are consistent with theory that an intrinsic orientation towards religion is associated with lower levels of schizotypy, and religious experience and an extrinsic orientation towards religion is associated with higher levels of schizotypy.     

The relationship between intrinsic and extrinsic religiosity and competitive anxiety

ABSTRACT

The present study examined the relationship between religiosity and competitive anxiety in college athletes and whether there were differences in competitive anxiety for intrinsically religious and extrinsically religious individuals. College athletes (N?=?95) from three separate sports from the NCAA completed a questionnaire that included the Age-Universal I/E Scale, the Competitive State Anxiety Inventory-2 Revised, open-ended questions on habits related to religion, and demographic items. Results revealed no significant relationship between intrinsic and extrinsic religiosity and competitive anxiety. Extrinsically religious athletes had higher somatic anxiety than intrinsically religious athletes. The majority of participants (77%) reported praying before games primarily for comfort. Athletes turn to religion to calm their nerves but it is important to understand that their approach to religion may relate to increased anxiety. This information is useful for sport practitioners and coaches as they seek to help their athletes seek an intrinsic approach to religion in sport.     

Religious intellectual humility,attitude change,and closeness following religious disagreement

Abstract

This study explored the role of intellectual humility (IH) in promoting attitude change and relationship closeness in the context of religious disagreement. Participants (N = 174) completed a preliminary survey that assessed their attitude on several contentious religious issues (e.g. gay marriage, abortion). Participants who disagreed about a contentious religious issue were then paired and engaged in a 10-min discussion. After the discussion, participants completed a series of questionnaires. The greatest degree of attitude change was seen in pairs with mutually high levels of IH, in which the participant self-reported high levels of IH and also perceived the discussion partner to have high levels of IH. Higher perceptions of the IH levels of the discussion partner predicted higher levels of closeness and trust. We discuss limitations, areas for future research, and practical implications.     

What Mediates the Relationship Between Religious Service Attendance and Aspects of Well-Being?

Religious service attendance predicts increased well-being across a number of studies. It is not clear, however, whether this relationship is due to religious factors such as intrinsic religiosity or due to nonreligious factors such as social support or socially desirable responding. The purpose of the present study was to examine the relationship between religious service attendance and well-being while simultaneously examining intrinsic religiosity, social support, and socially desirable responding as potential mediators of the relationship. A sample of 855 participants (71 % female, average age 19.5) completed questionnaires assessing religiosity, social support, socially desirable responding, and well-being. Path models were estimated using maximum likelihood estimation to analyze the data. Intrinsic religiosity was the strongest mediator of the relationship between religious service attendance and depressive and anxiety symptoms. This suggests that the mental health benefits of religious service attendance are not simply the result of increased social support or a certain response style on questionnaires; rather, it appears that the relationship is at least partly the result of people trying to live their religion in their daily lives.     

Relationship between religion and obsessive phenomena

The study examined the relationship between religion and symptoms of psychopathology, particularly obsessive‐compulsive (OC) and scrupulosity symptoms. Religious affiliation, religiosity variables (strength of faith, religious application, the beliefs about God's nature), and cognitive factors (e.g., obsessive beliefs) were studied as predictors of OC and scrupulosity symptoms in 179 non‐clinical participants. The main groups (Catholic, Protestant, and no religion) were not different with regard to measures of wellbeing or symptoms of general psychopathology (depression, anxiety, and stress), but were different with regard to OC symptoms. Consistent with cognitive theory, OC beliefs strongly predicted both OC and scrupulosity symptoms, even when general levels of psychopathology were controlled. Religion bore a less major but significant association with OC phenomena. Religious affiliation (being Catholic) was associated with higher levels of OC symptoms, and higher levels of personal religiosity (strength of faith) were associated with higher levels of scrupulosity.     

When Meaning Matters: Coping Mediates the Relationship of Religiosity and Illness Appraisal with Well-Being in Older Cancer Patients

When individuals face serious, traumatic illnesses such as cancer, religion can contribute to their coping processes and psychosocial adjustment. In the current study, we examined the relationship between religiosity conceptualized as the religious meaning system, illness appraisal, and psychological well-being with religious and nonreligious coping as potential mediators of this relationship among older cancer patients. In a cross-sectional design, 215 older Polish patients (60–83 years of age; 80% Catholic, 9% Protestant) with gastrointestinal cancer completed measures of religiosity, illness appraisal, religious coping, nonreligious coping, and psychological well-being. Using structural equation modeling analysis, we found support for our model depicting a mediated relationship between religiosity, illness appraisal, and psychological well-being. Three forms of coping—negative religious, problem focused, and meaning focused—were key mechanisms in the relationship between the religious meaning system, positive and negative illness appraisal, and psychological well-being. These findings suggest that both religious factors (religiosity and religious coping) and nonreligious factors (illness appraisal and nonreligious coping) can operate together in influencing older cancer patients’ well-being.     

Are Religiosity and Spirituality Associated with Obesity Among African Americans in the Southeastern United States (the Jackson Heart Study)?

There are several lines of evidence that suggest religiosity and spirituality are protective factors for both physical and mental health, but the association with obesity is less clear. This study examined the associations between dimensions of religiosity and spirituality (religious attendance, daily spirituality, and private prayer), health behaviors and weight among African Americans in central Mississippi. Jackson Heart Study participants with complete data on religious attendance, private prayer, daily spirituality, caloric intake, physical activity, depression, and social support (n = 2,378) were included. Height, weight, and waist circumference were measured. We observed no significant association between religiosity, spirituality, and weight. The relationship between religiosity/spirituality and obesity was not moderated by demographic variables, psychosocial variables, or health behaviors. However, greater religiosity and spirituality were related to lower energy intake, less alcohol use, and less likelihood of lifetime smoking. Although religious participation and spirituality were not cross-sectionally related to weight among African Americans, religiosity and spirituality might promote certain health behaviors. The association between religion and spirituality and weight gain deserves further investigation in studies with a longitudinal study design.     

Role of Religion in Preventing Youth Sexual Activity in Malaysia: A Mixed Methods Study

One of the popular approaches of preventing youth sexual activity in Malaysia is using religion to promote premarital sexual abstinence. Despite this intervention, youth continue to practise premarital sex. Thus, the purpose of this exploratory mixed methods study was to understand the role of religion on sexual activity among college students in Klang Valley, Malaysia. A self-administered questionnaire survey to determine the relationship between religiosity and youth sexual activity was carried out on 1026 students recruited from 12 randomly selected colleges. Concurrently, face-to-face interviews were conducted on 15 students to explore how religiosity had influenced their decision on sexual activity. The survey data were analysed using logistic regression, while the qualitative data from the interviews were examined using thematic analysis with separate analysis for each gender. Both quantitative and qualitative results were then compared and integrated. Religious activity significantly reduced the risk of continuing sexual activity among female students (AOR = 0.67, CI = 0.47, 0.95, p = 0.02) but not male students. There was no significant relationship of religious affiliation and intrinsic religiosity (inner faith) to sexual activity by gender. Having faith in religion and strong sexual desire were the main themes that explained participants’ sexual behaviour. Engaging in religious activity might be effective at preventing female students from being sexually active. However, when sexual urges and desires are beyond control, religiosity might not be effective.     

Divine Emotions: On the Link Between Emotional Intelligence and Religious Belief

There have been only few attempts to explore the relationship between emotional intelligence (EI) and religiosity. However, none of them included measures of ability EI. In two studies, we investigated the potential associations between various aspects of religious belief and ability and trait EI. In Study 1 (N = 240), we found that ability EI was positively associated with general level of religious belief. Study 2, conducted among Polish Christians (N = 159), replicated the previous result on the connection between ability EI and religion. Moreover, both trait and ability EI were negatively correlated with extrinsic religious orientation and negative religious coping. Additional analysis showed that extrinsic orientation mediated the relationship between ability EI and religiosity.     

Religiosity,subjective well-being,and neuroticism

The objective of the current research was to estimate the relation between religiosity and both subjective well-being (SW-B) and neuroticism (N). A sample (N = 487) of Muslim Kuwaiti undergraduates took part in the study. Their age ranged between 18 and 31 years. They responded to six self-rating scales to assess religiosity, religious belief, physical health, mental health, happiness, and satisfaction with life, as well as the Factorial Arabic Neuroticism Scale (FANS) and the N subscale of the revised NEO. It was found that all the correlations between the six self-rating scales were significant and positive, whereas these rating scales were significantly and negatively correlated with both the FANS and N (NEO) scale. In applying the principle components analysis to the correlation matrix (8 × 8), a high-loaded and bipolar factor was extracted and labelled “Well-being and religiosity versus neuroticism.” The main predictor of religiosity in the stepwise regression was religious belief and satisfaction with life. The present findings are comparable with the wider literature on the association between religion and SW-B among English-speaking participants as well as a Kuwaiti Muslim context. By and large, those who consider themselves as religious were healthier, enjoying SW-B, and obtained lower scores on neuroticism.     

Subjective Religiosity and Depression in the Transition to Adulthood

Does being more religious make one less susceptible to depression? We consider the association between subjective religiosity (religious self‐perception and coping) and depression in the context of social support (from family and friends) and stress exposure (recent negative life events, chronic stress, lifetime trauma, and discrimination). Data come from a sample of 1,803 Miami‐Dade County young adults interviewed between 1997 and 2000. We find higher levels of depression among the moderately religious than among either very religious or nonreligious respondents. Interestingly, when observations are made within gender, this relationship applies only to females. Controlling for socioeconomic status and social support largely accounts for the link between religiosity and depression. However, controlling for stress exposure reveals a suppressor effect wherein religiosity once again emerges as significant. Our interpretation is that, while established patterns of religious coping can routinely mitigate distress, heightened stress exposure may elicit increased prayer among the less religious.     

The Implicit Relationship Between Religious and Paranormal Constructs

Several decades worth of research have produced mixed results concerning the relationship between beliefs in religious and paranormal phenomena. While this previous work focused on the explicit measurement of these beliefs, these studies focused on a new level of analysis. Specifically, what is the implicit relationship between religious and paranormal constructs? In Study 1, participants completed a version of the Implicit Association Test (IAT) to assess the association between religious and paranormal stimuli, as well as completed measures of religiosity and paranormal belief. Results supported an association between these constructs that was moderated by intrinsic religiosity and faith in science. Study 2 again provided evidence for an association while addressing a methodological concern regarding the IAT. The results are discussed in their impact on the understanding of the cognitive representation of religious and paranormal constructs and the respective belief systems.     

Religiosity and Intimacy with an Extradyadic Partner in Emerging Adulthood: A Developmental Perspective

The present study examined the relationship between intrinsic religious motivation and both physical and emotional intimacy with an extraydadic partner (i.e., infidelity) in a sample of emerging adults (ages 18–25, N = 188) who were involved in dating romantic relationships. The study uniquely conceptualized religiosity in terms of personal and internal connection with religion; additionally, the study included both physical and emotional aspects of extradyadic intimacy behaviors. Contrary to previous research with married adult couples, analyses revealed that intrinsic religious motivation significantly and positively predicted physical and emotional intimacy with an extradyadic partner. Developmental implications are discussed.     

Religious Non-involvement Among African Americans, Black Caribbeans and Non-hispanic Whites: Findings from the National Survey of American Life

This study examines the association between race/ethnicity, socio-demographic characteristics, and religious non-involvement among a national sample of African Americans, Black Caribbeans and Non-Hispanic Whites. The relationship between religious non-involvement and selected measures of religious participation, spirituality, religious coping is also examined. The study utilizes data from a national multi-stage probability sample, the National Survey of American Life (n = 6,082). Very few individuals, <1 out of 20 respondents, both never attended religious services and have no current denomination. Overall, <8 % have never attended religious services since the age of 18. Both African Americans and Black Caribbeans were significantly less likely than non-Hispanic Whites to report never attending religious services and not having a current denomination. The greater reliance upon religious institutions for support and guidance among African Americans and Black Caribbean Americans relative to Non-Hispanic Whites may help explain the importance of race in predicting religious non-involvement. Women, married persons, Southerners, and the more highly educated are significantly more likely to be involved in religion. Finally, this study indicates that the religiously non-involved are less likely than others to participate in religious activities, to identify as spiritual, and to rely upon religion to cope with trying circumstances. Nonetheless, even respondents who never attend religious services and do not have a denomination still report some level of religious participation along with relatively high levels of religious coping. We posit that religious non-involvement is less indicative of apostasy, but rather likely reflects a critique of organized religion.     

Psychological distress,stressful life events,and religiosity in younger African American adults

Prior research has found that stressful life events relate to increased psychological distress as well as mental and physical morbidity, particularly in minority groups. However, there is limited understanding of factors that may influence this relationship. This paper examines psychological distress, stressful life events, and religiosity among younger African American adults between the ages of 18 and 43 (n?=?215). Stressful life events and religiosity levels did not differ by gender, though females reported greater levels of each distress category. Female gender and stressful events were predictive of increased levels of distress. Dimensions of religiosity related in unique ways to individual categories of distress. This would suggest that the role of religion in reduced distress differs according to the type of religious experience. Intrinsic religiosity was found inversely related to both total distress and depression; organizational religiosity inversely related to somatization and obsessive-compulsiveness; finally, non-organizational religiosity was inversely related to interpersonal sensitivity. Further research is needed across additional sociodemographic and economic categories to further clarify the relationship of religiosity, stressful events, and distress in younger African American adults.     

The means and ends of religiosity: A fresh look at Gordon Allport’s religious orientation dimensions

Following Allport (1950), religious orientation is portrayed as comprising two, and later three, independent dimensions of religion of means (extrinsic) and religion of ends (intrinsic). Pargament (1997), however, argued that means and ends are not mutually exclusive but fundamental parts of any religious orientation. This study investigated the relative merits of the two approaches. Christian British adults (N = 160) completed the Intrinsic/Extrinsic-Revised Scale along with questions on demographics and religious practices. Results obtained from Factor Analysis and Multidimensional Scaling support both arguments. Three independent and stable orientations were identified that were, however, meaningfully represented in a lower two-dimensional space defined by the social–personal (focus) and the means–ends (function) religiosity aspects. Means–ends elements may form an independent dimension, reflected in the performance of religiosity.     

Perfectionism and Life Aspirations in Intrinsically and Extrinsically Religious Individuals

Religiosity is related to positive health and life satisfaction but the pathways through which this occurs have not been clearly delineated. The purpose of this study was to examine potential mediators of the relationships between intrinsic and extrinsic religiosity and negative affect and life satisfaction. Perfectionism and life aspirations are two possible pathways through which religious orientation is related to outcome. It was hypothesized that adaptive perfectionism and intrinsic life aspirations would act as mediators between intrinsic religiosity and negative affect and life satisfaction, and that maladaptive perfectionism and extrinsic life aspirations would act as mediators between the extrinsic religiosity and negative affect and life satisfaction. Two consecutive samples of religious college students (N = 540 and N = 485) completed measures of the Age Universal Religious Orientation Index, the Frost Multi-Dimensional Perfectionism Scale, the Aspiration Index, the Beck Depression Inventory-II, the Spielberger State-Trait Anxiety Inventory, and the Satisfaction with Life Scale. Intrinsic religiosity had a direct negative relationship with negative affect and positive relationship with life satisfaction. Contrary to the hypotheses, intrinsic religiosity had its strongest indirect effect via maladaptive perfectionism such that increased intrinsic religiosity was related to decreased maladaptive perfectionism which in turn lead to better negative affect and life satisfaction. Extrinsic religiosity was related to increased maladaptive perfectionism and thereby indirectly contributed to worse negative affect and life satisfaction. Interestingly, when the effects of maladaptive perfectionism were controlled, the direct effects of extrinsic religiosity were related to reduced negative affect and increased life satisfaction. Overall, the strongest mediator in this study of both intrinsic and extrinsic religiosity was maladaptive perfectionism, with intrinsic religiosity related to decreased maladaptive perfectionism and extrinsic religiosity related to increased maladaptive perfectionism.     

The religion paradox: if religion makes people happy, why are so many dropping out?

As we estimate here, 68% of human beings--4.6 billion people--would say that religion is important in their daily lives. Past studies have found that the religious, on average, have higher subjective well-being (SWB). Yet, people are rapidly leaving organized religion in economically developed nations where religious freedom is high. Why would people leave religion if it enhances their happiness? After controlling for circumstances in both the United States and world samples, we found that religiosity is associated with slightly higher SWB, and similarly so across four major world religions. The associations of religiosity and SWB were mediated by social support, feeling respected, and purpose or meaning in life. However, there was an interaction underlying the general trend such that the association of religion and well-being is conditional on societal circumstances. Nations and states with more difficult life conditions (e.g., widespread hunger and low life expectancy) were much more likely to be highly religious. In these nations, religiosity was associated with greater social support, respect, purpose or meaning, and all three types of SWB. In societies with more favorable circumstances, religiosity is less prevalent and religious and nonreligious individuals experience similar levels of SWB. There was also a person-culture fit effect such that religious people had higher SWB in religious nations but not in nonreligious nations. Thus, it appears that the benefits of religion for social relationships and SWB depend on the characteristics of the society.