Religion and mental health

1
Religion and mental health
2
Methodological and conceptual points of contention

• Studies exploring religiosity and spirituality
  are highly dependent upon the definitions of the
  constructs being used
• Most researchers now agree that these constructs
  are multidimensional and include a variety of
  motivational and behavioural elements
• There is no clear consensus on what constitutes
  mental health either within the psychology of
  religion or clinical psychology

3
Methodological and conceptual points of contention

• Borrowing terms from anthropology, the etic
  versus emic demarcation is a useful heuristic in
  attempting to make sweeping statements about the
  potency of religiosity or spirituality in mental
  health
• Etic refers to human universals, and is applied
  to studies that use objective methods that are
  presumed to be consistent across cultural
  differences
• Emic is an experience close frame of reference,
  in which pure objectivity and universality are
  seen as unattainable and unrealistic, and
  therefore the subjective impressions of those
  studied and those studying receive paramount
  attention

4
Methodological and conceptual points of contention

• It is nearly impossible to conduct a study that
  takes either position in its pure form (Al-Issa,
  2000)
• Scholars are divided over the primary mechanisms
  of religious/spiritual influence on mental health
  
• Some postulate a specific quality of religious
  belief and practice, something above and beyond
  the secular variables that inform any belief
  system or behaviour pattern (e.g., Smith, 2003)
• Others find religious variables reducible to
  factors that have been previously hypothesized to
  buttress mental health such as positive emotions
  (e.g., Fredrickson, 2002)

5
Directionality of the relationship

• Religion might be magical in childhood, a social
  network in adolescence, a factor in choosing a
  life-mate and childbearing in adulthood, and a
  solace in old age
• Analyses can indicate a curvilinear relationship
  between religious variables and mental health
  outcomes over the life course
• Those at the far ends of the religious continuum
  are the most susceptible to suffering, and those
  that adhere to a more moderate practice or belief
  system show better functioning
• Direction of causality is unclear, but
  longitudinal studies suggest religion/spirituality
  causes well-being (e.g., Kendler et al., 1997)

6
Salient dimensions of religiosity for mental
health

• Salient dimensions commonly include factors such
  as prayer or ritual practice, social support,
  feeling closeness to the divine, and intensity of
  belief
• Kendler et al. (2003) illustrated the
  differential effect of distinct components of
  religiosity on psychopathological symptoms

7
Salient dimensions of religiosity for mental
health

• Extrinsic religiosity is generally found to
  correlate with higher levels of psychological
  distress, less effective coping abilities, and a
  higher likelihood of prejudice and intolerance
  (e.g., Batson et al., 1993)
• Intrinsic religiosity is related to greater
  well-being, more realistic and effective coping,
  and more appropriate social behaviour (Batson et
  al., 1993)
• The elements of doubt that can accompany the
  Quest orientation can account for the mixed
  findings regarding this outlooks relation to
  mental health
• Uncertainty could lead to anxiety, and doubts to
  depression, while the questing search can also be
  experienced as a rewarding spiritual path this
  could account for the positive association
  between Quest and open-mindedness (Batson et
  al., 1993)

8
Religiosity/spirituality, positive psychology and
well-being research

• Although the positive stance is a relatively
  recent zeitgeist in academic psychology, James
  (1902) pondered the association between religious
  faith and health mindedness at the turn of the
  20th century
• Empirical research and clinical wisdom suggests
  that religion has a positive influence on mental
  health and functioning (e.g., Levin Chatters,
  1998)
• Happiness is greater for the religious, although
  the effect is often small (Argyle, 1999)
• Argyle (1999) concludes that social support
  accounts for most of the impact of religiosity on
  well-being

9
Negative effects of religion/spirituality on
mental health

• For every diagnostic disorder we consider there
  are at least a few studies that display a
  positive correlation between religious belief or
  activity and pathological symptoms
• Mystical states or religious experiences are
  often difficult to distinguish from psychotic
  behaviour or hallucinations
• Elements of sudden religious conversion can be
  related to a weakened sense of ego or identity,
  psychopathological symptomology, or existential
  anxiety (Hunter, 1998)
• Research suggests that overly rigid orientations
  can have negative ramifications, such as bigotry,
  homophobia, and general intolerance of others
  beliefs (e.g., Altemeyer Hunsberger, 2005)

10
Religion and spirituality in children Effects on
mental health

• Studies have found a negative relationship
  between religiosity and psychotic symptoms in
  children (Francis, 1994), as well as symptoms of
  depression (Miller et al., 1997) and anxiety
  (Schapman Inderbitzen-Nolan, 2002)
• There is evidence that depression suffered in
  childhood can lead to decreased or distorted
  forms of religiosity in adulthood
• This may suggest that a foundation of
  psychological well-being is necessary in
  childhood to engender strong and protective
  religious/spiritual adherence in adulthood
  (Miller et al., 2002)

11
Religion and spirituality in children Effects on
mental health

• Children have been found to be closer to mothers
  who report attending church more often (Pearce
  Axin, 1998)
• Kirkpatrick and Shaver (1990) postulate a
  compensation hypothesis in which children who
  are reared with insecure attachment styles with
  their parents find solace in the notion of a
  loving and personal God
• The origin of childhood spirituality may not be
  entirely a socialization process, but could be
  either innate or an extension of other types of
  supernatural thinking (e.g., Glass et al., 1986)

12
Religion and spirituality in children Effects on
mental health

• Although affiliation is a culturally transmitted
  process, religious attitudes and practices are
  moderately influenced by genetic factors
  (Donofrio et al., 1999)
• Children of opiate addicts were eight times more
  likely to endorse spirituality as personally
  important than were their mothers (Miller et al.,
  2001)
• Studies suggest that a religious family or belief
  system is an effective buffer against many types
  of childhood psychopathology

13
Religion and spirituality in adolescence Effects
on mental health

• Adolescence is a time in which many psychiatric
  disorders have their root
• Teens are far more susceptible to peer and
  cultural influence than children
• Religious adolescents suffer from fewer
  depressive or anxiety symptoms, are at lesser
  risk for suicide, and overwhelmingly reject
  promiscuous or premarital sex and delinquent
  behaviours such as drug or alcohol abuse
• Reasons for positive effects can often reduce to
  the dual function of religion and spirituality as
  a major constituent and foundation of identity
  formation, and the related self-selection of a
  peer group that mutually reinforces prosocial and
  healthy lifestyles (e.g., Levenson Aldwyn, 2005)

14
Religion and spirituality in adolescence Effects
on mental health

• Religious social support provides
• A unique level of acceptance of the individual, a
  quality that must be reassuring during the
  transitions that characterize the adolescent
  years (Oman Reed, 1998)
• Potency from interpersonal religious experience,
  or from the spiritually minded treatment of one
  another (Miller et al., 2002)
• These two factors have been shown to be more
  protective than other more secular variables

15
Religion and spirituality and adult
psychopathology

• The DSM-IV-TR now includes a category that
  addresses religious/spiritual problems
• Problems include distressing experiences that
  involve loss or questioning of faith, problems
  associated with conversion to a new faith, or
  questioning of spiritual values

16
Mood disorders

• Depression is by far the most studied clinical
  disorder in relation to religion and spirituality
  
• Meta-analysis found inverse association between
  religious involvement and depressive symptoms
  (Smith et al., 2003)
• Religiosity generally protective against
  suicidality among adolescents and adults, across
  many world religions (e.g., Al-Issa, 1995)
• Private beliefs and activities that indicate high
  personal devotions, such as faith and prayer,
  were perceived as the most helpful in coping with
  depression compared with more social religious
  mechanisms (Loewenthal et al., 2001)

17
Mood disorders

• Wilson (1998) notes that religious experience can
  precipitate an attack of mania, and that common
  manic symptoms such as delusions and hurried
  anxious speech can often include religious
  elements
• It seems that religiosity is generally protective
  against psychopathology, and helpful in facing
  symptoms, but when that pathology does occur, the
  religious often incorporate religious elements
  into their symptomatic presentation

18
Schizophrenia spectrum disorders

• Religion and spirituality exert influence more on
  the expression of symptomatology and in coping
  with schizophrenia than in actual aetiology
  (Wilson, 1998)
• Patients evidencing religious delusions had
  higher symptom scores, functioned less well, and
  were prescribed more medication than those
  without religious symptoms (Siddle et al., 2002)
• Research findings suggest that the content of
  delusions and hallucinations is sensitive to the
  cultural, political, and religious climate the
  sufferer is embedded within

19
Obsessive compulsive disorder

• There is little evidence that religious adherents
  are universally more susceptible to OCD (e.g.,
  Raphael et al., 1996)
• Islam and Orthodox Judaism are both very
  ritualistic traditions, and the frequency of
  religious obsessions and compulsions has been
  found to be greater among Muslim and Jewish
  adherents in Middle Eastern countries than their
  European and American, Catholic and Protestant
  counterparts (Greenberg Witzum, 1994)

20
Cultural influences in the relationship between
religion/spirituality and mental health

• Findings from studies that seek to apply U.S.
  paradigms are ambiguous and often run counter to
  what is typically found among U.S.
  Judeo-Christian, white subjects
• Such findings serve as a caution against
  interpreting empirical results as human
  universals
• It is a challenge for researchers to tease apart
  the influence of culture from the doctrinally
  based differences of each respective religion
  practiced within those cultures (Tarakeshwar et
  al., 2003)

21
Cultural influences in the relationship between
religion/spirituality and mental health

• In some African communities a people would be
  considered insane not to believe that the spirits
  of the dead actively influence an individuals
  life (Boyer, 2001)
• Psychopathology can manifest through the
  religious convictions and behaviours of adherents
  of diverse world religions
• E.g., the whispering of the devil can disrupt a
  devout Muslims prayer ritual and force numerous
  repetitions of cleaning and absolution (Pfeiffer,
  1982)

22
Cultural influences in the relationship between
religion/spirituality and mental health

• Muslims in the U.K. endorsed all types of
  religious activity as more efficacious in coping
  with depression, above and beyond other, more
  Western treatments (Loewenthal et al., 2001)
• Much more cross-cultural research must take place
  in order to understand the role of specific
  theologies, practices, and ethnicities in
  impacting mental health