Moral Objections and Fear of Hell: An Important Barrier to Suicidality

This review explores the literature to test the hypothesis that ‘moral objections to suicide (MOS), especially the conviction of going to hell after committing suicide, exert a restraining effect on suicide and suicidality.’ Medline and PsycInfo were searched using all relevant search terms; all relevant articles were selected, rated and reviewed. Fifteen cross-sectional studies were available on this topic, and raise sufficient evidence to confirm a restraining effect of MOS, and sparse data on fear of hell. MOS seem to counteract especially the development of suicidal intent and attempts, and possibly the lethality of suicidal attempts. A differential pattern of influence of MOS on the suicidal continuum is suggested.     

Towards a multidisciplinary guideline religiousness,spirituality, and psychiatry: what do we need?

ABSTRACT

A multidisciplinary guideline on religion, spirituality (R/S), and psychiatry aims to address: (1) organising R/S consultation in mental health care, (2) categorising research findings, and (3) professionalism and education with respect to R/S. Contents are derived from brainstorm sessions with key participants in the field of R/S and psychiatry in the Netherlands, and from the position statements on R/S and psychiatry in the UK and by the World Psychiatric Association. The following chapters are proposed: (1) ethical and existential themes and R/S, (2) R/S in stages of mental health care practice, (3) R/S counselling, (4) collaboration, and (5) relationship to other guidelines. The core themes need verification by specialists in the field, nurses, therapists, counsellors, patient-practitioners, and psychiatrists. The author recommends to approach R/S in an easy way, to listen to matters of personal meaning, and to leave the task to others in case of a lack of affinity.     

Holy Apparition or Hyper-Religiosity: Prevalence of Explanatory Models for Religious and Spiritual Experiences in Patients with Bipolar Disorder and Their Associations with Religiousness

Pastoral Psychology - One point that emerges from qualitative research on religion and bipolar disorder (BD) is the problem patients with BD experience in distinguishing between genuine religious...     

God image and Five-Factor Model personality characteristics in later life: A study among inhabitants of Sassenheim in The Netherlands

Affective or emotional aspects of religiousness are considered to be crucial in the association between religiousness and well-being, especially in later life. Such affective aspects can be understood as pertaining to the God–object relationship, corresponding to feelings of trust towards God or to religious discontent. Personality characteristics, such as those defined by the Five-Factor Model of Personality, are expected to correspond with God image. A small sample of older mainline church members in Sassenheim, The Netherlands (n = 53), aged 68–93, filled out a questionnaire, including 120 items of the NEO-PI-R, the Questionnaire God Image, frequency of prayer, church attendance, and depressive symptoms. Neuroticism was associated with feelings of anxiety towards God as well as discontent towards God. Agreeableness was associated with perceiving God as supportive and with prayer. These findings persisted after adjustment for depressive symptoms. For the other three personality factors, no clear patterns emerged. Results were compared with those from studies of God image and the Five-Factor Model of personality among younger people.     

Revelation,delusion or disillusion: subjective interpretation of religious and spiritual experiences in bipolar disorder

The objective of this study is to explore the interpretation of religious and spiritual experiences during mania, depression and recovery, from the perspective of bipolar clients and to inquire into their expectations of treatment in relation to these experiences. For this purpose, a qualitative pilot study is designed, which includes interviews with 10 outpatients of Altrecht, a Dutch mental health institution. The meaning of religious and spiritual experiences and the question of their authenticity proved to be an important theme for the participants. The support of spirituality for illness management was brought to the fore, as well as the temporary lack of this support during depression by some participants. Participants considered it desirable that more attention be paid to the topic during treatment, and to establish better cooperation between spiritual counsellors of the institution and other professionals. Thus, a more existential or hermeneutical approach towards religious experiences in relation to bipolar disorder would be a desirable contribution to standard treatment. The exact outlines of such an approach demand more empirical research.     

Recognition of psychopathology with religious content by clergy members: a case vignette study

Clergy members (CMs) frequently offer support and counselling for people with mental health problems. The current study aims to obtain insight into the ability among CMs to recognise psychopathology and need for psychiatric treatment. A random sample of CMs (N?=?143) and a control sample of mental health professionals (MHPs, N?=?73), were compared as to their evaluations of four vignettes. CMs considered the psychiatric states to be related to religious or spiritual problems to a similar degree as they did for the non-psychiatric states. Sensitivity of CMs with regard to the need of psychiatric care for the psychiatric states was modest (66%) and differed significantly from MHPs (96%). Specificity of the CMs was 89%, which was significantly lower than the MHPs (97%). The CMs did recognise psychopathology with religious content but clearly to a lower extent than MHPs. Requests by CMs for education about recognising psychopathology may be considered as justified.     

Sweet Delight and Endless Night: A Qualitative Exploration of Ordinary and Extraordinary Religious and Spiritual Experiences in Bipolar Disorder

The authenticity of religious and spiritual experiences during mania is an important subject for bipolar patients. The exploration of such experience in bipolar disorder is the central point of this qualitative study. A psychiatrist and a hospital chaplain conducted 35 semi-structured interviews with recovered participants, recruited from mental health care institutions in the Netherlands, the patients’ association and via the internet, about their religious and spiritual experiences during illness episodes and in stable times. A variety in types (such as divine presence, unity, mission, meaningful synchronicity) during mania was reported, which were on a sliding scale with experiences/views in stable times in more than half of the interviews. During depression, absence of religious or spiritual experience was predominant. The reported experiences were viewed by most participants as both authentically religious or spiritual but also related to the disorder, requiring therefore language that transcended medical terminology. Also indicated is the relevance of the results for fundamental discussions about the nature or religious experience.     

An Item Response Theory Analysis of The Questionnaire of God Representations

The Dutch Questionnaire of God Representations (QGR) was investigated by means of item response theory (IRT) modeling in a clinical (n = 329) and a nonclinical sample (n = 792). Through a graded response model and IRT-based differential functioning techniques, detailed item-level analyses and information about measurement invariance between the clinical and nonclinical sample were obtained. On the basis of the results of the IRT analyses, a shortened version of the QGR (S-QGR) was constructed, consisting of 22 items, which functions in the same way in both the clinical and the nonclinical sample. Results indicated that the QGR consists of strong and reliable scales which are able to differentiate among persons. Psychometric characteristics of the S-QGR were adequate.     

TRAINING AND GENERALIZATION OF LAUNDRY SKILLS: A MULTIPLE PROBE EVALUATION WITH HANDICAPPED PERSONS

An instructional procedure composed of a graded sequence of prompts and token reinforcement was used to train a complex chain of behaviors which included sorting, washing, and drying clothes. A multiple probe design with sequential instruction across seven major components of the laundering routine was used to demonstrate experimental control. Students were taught to launder clothing using machines located in their school and generalization was assessed later on machines located in the public laundromat. A comparison of students' laundry skills with those of normal peers indicated similar levels of proficiency. Follow-up probes demonstrated maintenance of laundry skills over a 10-month period.     

The “religiosity gap” in a clinical setting: experiences of mental health care consumers and professionals

ABSTRACT

In Western countries, professionals in mental health care (“professionals”) tend to be less religious than “consumers”. This qualitative study explores the meaning of this “religiosity gap” for professionals and consumers in mental health care. Both a regular, secular and a Christian clinic in the Netherlands participated in this study. Content analysis was applied to 35 consumer interviews and 18 interviews with professionals. Consumers reported negative experiences (e.g., perceived disrespect and a lack of confidence) and/or negative expectations (e.g., misunderstanding and misinterpretation) related to a religiosity gap. They also mentioned advantages of a “religiosity match”, like safety and confidence and appreciated professionals’ religious/spiritual self-disclosure. Professionals in secular care setting tended to avoid religion and spirituality. In both clinics, they tended to neutralise religious/spiritual differences and be reticent in self-disclosure. Professionals are recommended to recognise the relevance of a religiosity gap and to consider different strategies in approaching religion/spirituality.