The relationship between spirituality and depressive symptom severity,psychosocial functioning impairment,and quality of life: examining the impact of age,gender, and ethnic differences

Research has documented the contribution of spirituality on overall health and mental health among college students. However, very few studies have explored the impact of cultural and ethnic differences on the effect of spirituality on mental health outcomes in this population. The aims of this study were to examine the relationships among spirituality, depressive symptom severity, psychosocial functioning impairment, and quality of life in a large multi-ethnic sample of college students and explore the impact of age, gender, and ethnicity on these relationships. The sample consisted of Latino, African-American, Caucasian, and Caribbean/West Indian college students. Findings indicated that spirituality, believing in God's presence, age, gender, and ethnicity were significantly related to depressive symptoms. These factors were also associated with impairment in psychosocial functioning and quality of life related to depression.     

Implementation and evaluation of a first-year university induction support programme for business students in Spain

This paper reports new evidence on students’ evaluation of a first-year induction experience programme and examines the relationship between gender and perceptions. The programme was provided to 610 business studies students at the University of Granada (Spain). The programme includes individual and group sessions providing psychosocial and instrumental support. Gender differences were investigated using nonparametric techniques. Structural equation models were used to test relationships between variables of overall satisfaction with the programme and its activities and the moderating effects of gender. The results obtained show that gender significantly influences enrolment and satisfaction with the programme and with the individual sessions. Satisfaction with group and individual activities is directly related to overall satisfaction with the programme. Gender has a moderating effect on the relation of overall satisfaction with individual sessions.     

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.     

A feasibility study of psychological strengths and well-being assessment in individuals living with recurrent depression

Current conceptualizations of mental illness focus on assessing psychopathology. A balanced approach would assess strengths that individuals bring to coping with illness. This study measures psychological strengths in individuals with recurrent depression, their coping strategies, and their perceptions of the usefulness of strengths assessment as a component of psychological assessment. Individuals (N?=?112) with recurrent depression completed an online questionnaire measuring several psychological strengths, including gratitude, forgiveness, spirituality, and hope. Participants also described their use of coping strategies and their reaction to the utility of the two-continua model of mental health. A subset (n?=?10) completed a follow-up telephone interview. Higher levels of gratitude, self-forgiveness, hope, and spirituality and lower levels of optimism were indicative of higher life satisfaction. Self-forgiveness, spirituality, and gratitude were predictors of happiness. Higher levels of hope and self-forgiveness predicted positive affect whereas lower levels of self-forgiveness predicted negative affect. Participants reported using a range of coping resources and indicated that they valued strengths assessment, perceiving the two-continua model of mental health as empowering. The researcher discusses implications for clinical practice.     

Short-term effects of a multi-disciplinary cardiac rehabilitation programme on psychological well-being, exercise capacity and weight in a sample of obese in-patients with coronary heart disease: a practice-level study

Given that many patients referred to cardiac rehabilitation (CR) are obese, diet therapy, exercise training, nutritional and psychological counselling for both obesity and psychological distress should be included as important components in all CR programmes. In this practice-level, observational study we evaluated the short-term within-group effects of a four-week multi-factorial inpatient CR programme specifically addressed to weight loss, fitness improvement and psychological health increase on 176 obese in-patients with coronary heart disease (CHD). Outcome measures were exercise capacity measured with estimated metabolic equivalents (METs), body mass index (BMI) and psychological well-being (PGWBI). Results show statistically significant improvements in all the PGWBI sub-scales and total score, except in general health (p = 0.393). No moderation effects were found for BMI class, age, diabetes and ejection fraction (EF). METs significantly increased by 30.3% (p < 0.001) and BMI decreased by 1.37 points (p < 0.001). Significant correlations were found between BMI and weight reductions with PGWBI anxiety and total score improvements. This multi-disciplinary CR programme including diet therapy, exercise training and psychological counselling provides indication for short-term within-group effectiveness on functional exercise capacity, BMI and PGWBI in a sample of obese in-patients with CHD. However, controlled studies are needed to corroborate the results we found.     

家庭累积风险与青少年心理健康的关系——心理资本的补偿效应和调节效应

对1473名初、高中生进行问卷调查,考察家庭累积风险与青少年心理健康的关系以及心理资本的补偿效应和调节效应。结果发现：（1）家庭累积风险负向预测生活满意度,正向预测焦虑/抑郁;（2）心理资本正向预测生活满意度,负向预测焦虑/抑郁;（3）心理资本只能调节家庭累积风险与焦虑/抑郁的关系,表现为心理资本缓冲家庭累积风险对青少年焦虑/抑郁的不利影响。因此,改善家庭环境和培养心理资本是提升青少年心理健康的重要途径,需注意心理资本的培育对焦虑/抑郁和生活满意度作用的差异。     

Spirituality and Cardiovascular Risk

This study extended current research linking spirituality to health by investigating the relationship between extrinsic and intrinsic spirituality and cardiovascular risk factors. Participants included 111 healthy males and females, ages 28 to 63. Measurements consisted of the Lifestyle Assessment Questionnaire (LAQ), a version of Kelly's Repertory Grid, hematological analysis, and blood pressure. A greater sense of spirituality was associated with lower cholesterol risk ratios (total cholesterol/HDL) and triglyceride levels. In addition, the structural or organizational characteristics of intrinsic spirituality were associated with several other hematological measures. Further research will help clarify the association between mechanisms underlying spirituality and health, including susceptibility to cardiovascular disorders.     

Effects of a post-hospitalization group health education programme for patients with coronary heart disease

Abstract

Effects of a post-hospitolization group health education programme for patients with coronary heart disease. A health education programme was offered to groups of coronary heart patients and their partners after discharge from hospital. A randomized pre-test post-test control group design was used to evaluate the effects of this experimental intervention. The health education programme was offered to 109 coronary heart patients in groups of between five and eight patients together with their partners in addition to standard medical care and physical training. A control group of 108 patients received only standard medical care and physical training.

The intervention consisted of eight weekly two-hour group health education sessions and one follow-up session. All sessions focused on the promotion of healthy habits and the reduction of adverse psychosocial consequences of the incident.

In the short term (about four months after the incident) the health education programme showed statistically significant intervention effects on knowledge about coronary heart diseases, smoking cessation, healthy eating habits and the number of consultations with the family physician, but no effects on emotional distress. In the long term (one year after the incident) there was only a significant intervention effect on smoking cessation.

These results suggest that the effects of the programme are modest, especially in terms of maintenance of behavioural change. As a consequence, it is suggested that the programme should not be offered to all coronary patients during cardiac rehabilitation, but only to those who can be expected to profit most from it.     

Spirituality and the Successful Aging of Older Latinos

Using face‐to‐face interviews and a self‐report questionnaire, the authors investigated the contributions of spirituality and religiosity to the well‐being and levels of depression of 60 Latino adults ages 50 to 84 after controlling for age, health, education, and economic strain. Religiosity and spirituality predicted well‐being; however, increases in well‐being were associated with lower levels of externalizing religiosity and higher levels of spirituality. Economic strain overshadowed all other variables in predicting depression. Thus, 2 factors predicted the psychological health of Latino elders: Economic strain predicted depression, and spiritual health predicted well‐being. Several suggestions for implementing the findings are presented.     

Domain Compensation in Quality of Life of Individuals with Vasovagal Syncope: a Test of Homeostasis Theory

Although health-related quality of life is often diminished in populations characterised by physical illness, this does not necessarily imply lower overall assessments of general life satisfaction (GLS) and greater incidence of mental illness. According to Homeostasis Theory, this limited impact of health on these more global wellbeing indices may be due to internal and external buffers that serve to maintain one’s overall sense of wellbeing and GLS in the face of adversity. Thus, the present study tested in a sample of 212 individuals (48 with vasovagal syncope, 62 cardiac patients, and 102 healthy control participants) the possibility that poor health-related quality of life (as expected for the cardiac and vasovagal syncope groups) may be offset by relatively higher satisfaction with other aspects of one’s life (the domain compensation hypothesis). Consistent with this view, present findings showed that although individuals in the two health-risk groups reported lower health satisfaction (HSat) than the control group, they had comparable levels of mental health, GLS satisfaction, and subjective wellbeing (minus health; PWI-H). Moreover, moderation analyses confirmed that the relationship between HSat and GLS reduced to non-significance for individuals with PWI-H higher than nationally representative, normative levels. Collectively, these findings suggest that a broader context is necessary to understand the impact that illness may have on one’s sense of GLS and mental health. In particular, the provision of support and satisfaction with other life domains may serve to buffer concerns about one’s health.     

Correlates of spirituality and well-being in a community sample of people living with HIV disease

While the past several years have witnessed an increase in the amount of research examining the spiritual perspectives of people living with HIV/AIDS, this literature is still insufficient to guide the conceptualization and development of spiritually based interventions to improve the life quality of people living with HIV illness. The present study assessed a community sample of 275 persons living with HIV disease to examine relationships among their spirituality, quality of life, perceptions of social support, and coping and adjustment efforts. This study found relationships between social support, active problem solving, life satisfaction, and gender and race with higher levels of spirituality among people living with HIV/AIDS. Mental health providers may need to routinely include assessments of spirituality and religious practices. Caregivers, faith communities, and mental health providers will need to assist in developing supportive environments that enhance the spiritual life and social well-being of people living with HIV infection. Additionally, caregiver training programs will need to focus on spiritual practices as a means of establishing a support system that increases the psychosocial well-being of people living with HIV/AIDS.     

Patient and spouse perceptions of the patient's heart disease and their associations with received and provided social support and undermining

Numerous empirical studies have investigated the relationships between cardiovascular diseases (CVD) and patients’ psychological well-being, with a focus almost exclusively on its dark side. Very little is known on the impact of illness severity on both negative and positive indicators of patients’ well-being, as well as on the psychosocial variables that may mediate this association. Aim of the study was to investigate the impact of illness severity on depression as well as on health satisfaction and life satisfaction of patients undergoing a cardiovascular rehabilitation. It also aimed at testing the mediation of illness perception and self-efficacy beliefs in managing cardiac risk factors. The study involved 172 patients (mean age?=?66.43?years; SD?=?9.99?years; 76.2% men). Illness severity was measured in terms of left ventricular ejection fraction at discharge from the cardiology department, whereas all psychological dimensions were assessed one week later. Results showed significant relationships among illness severity, depression and health satisfaction that were fully mediated by illness perception and self-efficacy beliefs, but not significant relation between disease severity and life satisfaction (χ ²(1)?=?2.30, p?=?n.s.). Overall, findings underline the importance of working on illness perception and self-efficacy beliefs to contrast depression and to improve health and life satisfaction in patients with CVD.     

Unusual but sound minds: Mental health indicators in spiritual individuals

Previous research has linked certain types of modern spirituality, including New Age and Pagan, with either benign schizotypy or insecure attachment. While the first view emphasizes a positive aspect of spiritual believers’ mental health (benign schizotypy), the second view emphasizes a negative aspect, namely the unhealthy emotional compensation associated with an insecure attachment style. This study addresses these two conflicting views by comparing a sample of modern spiritual individuals (N = 114) with a contrast group of traditional religious believers (N = 86). Measures of schizotypy and attachment style were combined with mental health scales of anxiety and depression. We further assessed death anxiety to determine whether modern spiritual beliefs fulfilled a similar function as traditional religious beliefs in the reduction of existential threat. Our results support a psychological contiguity between traditional and modern spiritual believers and reinforce the need to de‐stigmatize spiritual ideas and experiences. Using hierarchical regression, we showed that unusual experiences and ideas are the major predictor of engagement in modern spiritual practices. Anxiety, depression variables, and insecure attachment were not significant predictors of spirituality or correlated with them; on the other hand, the results show that spiritual believers report high social support satisfaction and this variable predicts involvement in modern spirituality. Further, spiritual practices were negatively correlated with and negatively predicted by death anxiety scores. Overall, the results strengthen the association between modern spirituality, good mental health, and general well‐being.     

Relational spirituality and depression among married couples in Antigua

The World Health Organization indicates depression is the leading cause of disability worldwide. At the same time researchers have found religion/spirituality is inversely associated with depression. However, the mechanisms by which spirituality/religion impacts mental health have not been clearly identified particularly in non-western populations. Relational spirituality is a concept that focuses attention on the ways people relate to the sacred. This study examines whether different ways of relating to the sacred are implicated in levels of depression and whether marital partners affect each other’s level of relational spirituality and depression. Ninety-one (n?=?91) married heterosexual couples in the Caribbean Island of Antigua completed measures of relational spirituality and depression. Data were analysed using path analysis and through Actor Partner Interdependence Model methods. Results of the analysis showed wives’ and husbands’ depression scores covaried (COV?=?6.59, Pearson r?=?.28, p?β?=??.24, unstandardised B?=??3.23, se?=?1.30), and higher instability scores (β?=?.49, unstandardised B?=?5.46, se?=?.96). The husbands’ disappointment (β?=?.21, unstandardised B?=?2.17, se?=?.95) and instability (β?=?.54, unstandardised B?=?4.65, se?=?.72) were positively related to their depression scores. The results demonstrate relational spirituality is a useful framework for addressing depression in individuals as well as married couples.     

The effect of religiosity and spirituality on psychological well-being among forensic psychiatric patients in Canada

All patients in a multilevel secure forensic psychiatric centre were surveyed to determine the relationship between religiosity and spirituality, and depression, anxiety and satisfaction with life. Of the whole population, 90% responded; 5% were females and 47% aboriginal. The mean anxiety and depression scores using the Beck anxiety and depression inventories were low at 11.4 and 17, respectively. Weekly attendance at worship and the private intrinsic religiosity scores were higher than comparable samples of Canadians and general mental-health inpatients. Satisfaction with life score was positively correlated with all religiosity and spirituality variables. There was an inverse relationship between the Existential Well-Being scale and depression scores. The Existential Well-Being scale also correlated positively with satisfaction with life. Weekly worship attendance was inversely correlated with depression scores. These results point to some important differences between this patient population and the general population.     

Religiosity and Spirituality as Resiliency Resources: Moderation,Mediation, or Moderated Mediation?

A growing body of literature indicates a modestly positive association between religiosity and spirituality as predictors of psychological health (anxiety and depression), suggesting they serve as personal resiliency factors. The purpose of this study was to expand our understanding of the relationships among these constructs. Using Lazarus's Transactional Model of Stress as a theoretical framework, we examined: (a) the extent to which spirituality and religiosity mediated and/or moderated the association between perceived stress and psychological health and (b) whether there was a moderated (religiosity) mediation (spirituality) between stress and health. The Perceived Stress Scale, Daily Spiritual Experiences Scale, Religious Commitment Inventory, and Hospital Anxiety and Depression Scale were administered to measure the following constructs: stress, spirituality, religiosity, and psychological health. This study utilized a nonexperimental, quantitative, correlational, cross‐sectional, moderated‐mediation design, and included a convenience sample of 331 research participants. Both spirituality and religiosity moderated stress and health. However, only spirituality partially mediated the relationship. In addition, religiosity did not moderate the mediating effects of spirituality. Overall, this study confirmed the role of both religiosity and spirituality as effective resiliency resources.     

Optimizing preoperative expectations in cardiac surgery patients is moderated by level of disability: the successful development of a brief psychological intervention

Patients’ expectations have shown to be a major psychological predictor of health outcome in cardiac surgery patients. However, it is unclear whether patients’ expectations can be optimized prior to surgery. This study evaluates the development of a brief psychological intervention focusing on the optimization of expectations and its effect on change in patients’ expectations prior to cardiac surgery. Ninety patients scheduled for coronary artery bypass graft were randomly assigned to (1) standard medical care, (2) additional expectation manipulation intervention (EMI), and (3) additional attention control group. Therapists’ fidelity to intervention manuals and patients satisfaction with the intervention were assessed for both active intervention conditions. Patients’ expectations about post-surgical disability, treatment control, personal control, and disease duration were assessed before and after the psychological intervention. Demographical, medical, and psychosocial characteristics and disability were assessed at baseline. Treatment fidelity and patient satisfaction was very high in both intervention conditions. Only patients receiving EMI developed higher personal control expectations and longer (more realistic) expectations of disease duration. The effect of intervention group on patients’ disability expectations and patients’ personal control expectations was moderated by patient’s level of disability. EMI patients with low to moderate disability developed positive expectations whereas patients with high disability did not. This study shows the successful development of a short psychological intervention that was able to modify patients’ expectations, especially in those with low to moderate disability. Given the robust association of expectations and surgery outcome, such an intervention might offer the opportunity to enhance patients’ health following cardiac surgery.     

Promoting emotional well-being through the use of humour

Humour skills programmes are believed to assist in improving emotional well-being by increasing self-efficacy, positive thinking, optimism and perceptions of control, while decreasing negative thinking, perceptions of stress, depression, anxiety and stress. The study aims to evaluate a programme investigating this possibility. Volunteers from the community (37 females and 18 males, aged M?=?38 years) were randomly assigned to a humour group, a social group or a non-intervention control group. The programme, consisting of a manual and a booklet of measures assessing indices of well-being, was administered over an 8-week period. Data were collected at baseline, post programme and at 3-month follow-up. Results revealed that unlike the control and social groups, the humour group demonstrated a significant increase in several indices of emotional well-being. Specifically, increases occurred with self-efficacy, positive affect, optimism and perceptions of control, while decreases were found in perceived stress, depression, anxiety and stress levels.     

Do Health Care Workplaces Affect Treatment Environments?

Previous research has demonstrated that characteristics of the health care workplace influence staff outcomes such as morale and burnout, but the potential effect of health care workplaces on the treatment environment has been little studied. Building on a model proposed by Schaefer and Moos (1993), we propose that the workplace factors of supervisory work environment (e.g. support from supervisors, managerial control) and programme philosophical orientation (e.g. disease model of addiction, psychosocial learning model of addiction) predict four treatment environment elements: patient autonomy, staff control, staff sensitivity, and patient alienation. Multiple regression analysis of data drawn from a survey (response rate = 86%) of 327 staff members at 15 Veterans Affairs (VA) inpatient substance abuse treatment programmes revealed that greater managerial control over staff predicted greater patient alienation, lower staff sensitivity towards patients, and greater staff control over patients. Stronger disease model programme orientations predicted less patient alienation and greater staff sensitivity, whereas stronger psychosocial model programme orientations predicted less staff control. These results suggest that health care workplaces may influence treatment environments. Implications for further research and practice are discussed. © 1997 John Wiley & Sons, Ltd.     

Comment on “The Impact of Cancer on Psychological and Social Outcomes (Costa et al., 2016)”

The review written by (Costa et al. 2016) summarises a broad range of topics associated with what is known about the psychosocial outcomes of cancer in patients and their families. This commentary supplements this review by expanding on three topics that were not covered in the review. First, the challenges in assessing and diagnosing anxiety, depression, and distress in cancer patients due to overlapping symptoms with the disease state are highlighted. Second, the contribution of biological pathways such as inflammation upon the genesis and maintenance of anxiety, depression, and distress is acknowledged. Third, the potential role of religion and spirituality in influencing the psychosocial outcomes of cancer is raised. These three points are used to emphasise the importance of firmly incorporating a biopsychosocial model in research and health‐care provisions with cancer patients and their families.