Carl E Thoresen

• Stanford University

Postmaterial spiritual psychology posits that consciousness can contribute to the unfolding of material events and that the human brain can detect broad, non-material communications. In this regard, this emerging field of postmaterial psychology marks a stark departure from psychology's traditional quantum measurements and tenets. The Oxford Handbo...

Exploring possible relationships among forgiveness, disease, and physical health is truly at the frontiers of forgiveness research. To date, no controlled studies have demonstrated that forgiveness affects physical health outcomes either positively or negatively. This chapter elaborates on why people are encouraged to pursue research on health and...

We report psychometric properties, correlates, and underlying theory of the Spiritual Modeling Self-Efficacy (SMSE) scale. The SMSE, the first spiritually oriented self-efficacy measure, is a 10-item self-report assessment of perceived efficacy for learning from spiritual models. Spiritual models are defined as community-based or prominent people w...

A substantial majority of people believe in God in some form and consider themselves to be spiritual, religious, or both. However, most psychologists and other mental health professionals perceive themselves as not religious and have little if any training in spirituality and religious diversity. Psychologists can use spiritual principles and pract...

Mindfulness-based stress reduction (MBSR) has shown effectiveness for a variety of mental health conditions. However, it is not known for whom the intervention is most effective. In a randomized controlled trial (N = 30), we explored whether individuals with higher levels of pretreatment trait mindfulness would benefit more from MBSR intervention....

An emerging scientific literature is investigating the construct of “compassionate love,” love that is “centered on the good of the other,” a construct empirically linked to physical and mental health. We evaluated effects of an 8-week, 16-hour programme for physicians, nurses, chaplains, and other health professionals, using nonsectarian, spiritua...

Objective: Although the Enhancing Recovery in Coronary Heart Disease (ENRICHD) treatment was designed to include individual therapy and cognitive behavioral group training for patients with depression and/or low perceived social support, only 31% of treated participants received group training. Secondary analyses classified intervention participan...

We report the theoretical background, psychometric properties, and correlates of the Spiritual Modeling Inventory of Life Environments (SMILE), a measure of perceptions of spiritual models, defined as everyday and prominent people who have functioned for respondents as exemplars of spiritual qualities, such as compassion, self-control, or faith. De...

Relational caregiving skills remain seldom studied in health professionals. We evaluated effects on health professional relational caregiving self-efficacy from an eight-week, 16-hour training in self-management tools. Physicians, nurses, chaplains, and other health professionals were randomized after pretest to treatment (n = 30) or waiting list (...

There has been great interest in determining if mindfulness can be cultivated and if this cultivation leads to well-being. The current study offers preliminary evidence that at least one aspect of mindfulness, measured by the Mindful Attention and Awareness Scale (MAAS; K. W. Brown & R. M. Ryan, 2003), can be cultivated and does mediate positive ou...

Educators from grade school to college have long taught about religion in fields such as history and social studies. By affirming the importance of religion and spirituality (RS) in the lives of people worldwide, such RS teaching may support and reinforce student assimilation of virtues and character strengths from their families or other committed...

The authors evaluated the effects on stress, rumination, forgiveness, and hope of two 8-week, 90-min/wk training programs for college undergraduates in meditation-based stress-management tools. After a pretest, the authors randomly allocated college undergraduates to training in mindfulness-based stress reduction (MBSR; n = 15), Easwaran's Eight-Po...

This study explored the associations of pain, distress, and social support with spiritual beliefs and experiences among persons living with HIV/AIDS. We reviewed the scientific literature linking different dimensions of spirituality to psychosocial functioning among persons with HIV/AIDS. A growing body of research suggests that spirituality is an...

Counseling psychology has a historical commitment to enhancing human strengths, a focus that has enjoyed broader interest with the recent emergence of positive psychology. However, theory and evidence linking strength enhancement to counseling goals are still relatively nascent. The authors outline rationales and practical strategies for integratin...

To assess the prospective relationship between spiritual experiences and health in a sample of patients surviving an acute myocardial infarction (AMI) with depression or low social support. A subset of 503 patients participating in the enhancing recovery in coronary heart disease (ENRICHD) trial completed a Daily Spiritual Experiences (DSE) questio...

Effects of two meditation and mindfulness-based spiritual interventions were examined in college undergraduates (N=44). Compared to a control group, both interventions decreased negative religious coping (d=−0.80, p<.01) and images of God as mainly controlling (d=−.73, p<.01). One intervention provided more training in tools for learning from commu...

All-night sleep recordings were obtained for 8 subjects who slept for 3 consecutive nights in a standard sleep laboratory and for 3 consecutive nights at home. The order of recording locations was counterbalanced across subjects. No first night effects were found in either location. Subjects' sleep in the two locations was highly correlated, with n...

A penchant for storytelling is a striking feature of all cultures, especially of religious and spiritual traditions. A common concern of many traditional stories--whether historically derived or parables--is to transmit the words and deeds of spiritual models, persons who exemplify positive spiritual qualities. For example, 2,000 years ago, Jesus u...

The authors evaluated an 8-week, 2-hr per week training for physicians, nurses, chaplains, and other health professionals using nonsectarian, spiritually based self-management tools based on passage meditation (E. Easwaran, 1978/1991). Participants were randomized to intervention (n = 27) or waiting list (n = 31). Pretest, posttest, and 8- and 19-w...

This qualitative study assesses the experience of an intervention that provided spiritually based self-management tools to hospital-based nurses. Drawing on wisdom traditions of the major world religions, the eight point program can be practiced by adherents to any religious faith, or those outside of all traditions. Five of eight program points we...

The goal of this study was to evaluate the effects of a 6-week forgiveness intervention on three outcomes: (a) offense-specific forgiveness, (b) forgiveness-likelihood in new situations, and (c) health-related psychosocial variables, such as perceived stress and trait-anger. Participants were 259 adults who had experienced a hurtful interpersonal t...

The goal of this article is to explore strategies to extend the influence of positive psychology interventions into environments where strength-promotion is not generally embraced. Particularly, we are interested in examining the potential benefits and barriers to extending positive psychology interventions into health care settings (really illness...

The Longitudinal Study of Aging (LSOA) assessed the health and social functioning of a representative sample of 7527 American community-dwelling older people (>70 years). We tested the hypothesis that frequent volunteering is associated with less mortality risk when the effects of socio-demographics, medical status, physical activity and social int...

In this brief chapter, the authors, by necessity, will focus on effects in one major area: health. They also focus on four major religious practices: attendance at religious services, prayer, meditation, and forgiveness. Doing so in no way implies that other religious or spiritual practices, such as music, are deemed less worthy of consideration. R...

Nonpharmacologic treatments for asthma may act as useful adjuncts to pharmacotherapy but should be recommended to patients only after several well-controlled studies provide evidence of efficacy. Research demonstrating that written emotional expression can improve pulmonary function in patients with asthma consists of one impressive yet unreplicate...

Replies to comments by D. J. McCormick (see record 2004-10043-013), L. J. Richmond (see record 2004-10043-014), C. A. Rayburn (see record 2004-10043-015), and F. J. Kier and D. S. Davenport (see record 2004-10043-016) on the special section on spirituality, religion, and health in the January 2003 issue of American Psychologist (2003, Vol 58,...

Spiritual modeling is proposed as an important but neglected component of traditional religious involvement, as well as of many spiritual practices. Religious and spiritual traditions often portray spirituality as primarily "caught, not taught," as transmitted through formal and informal observation of persons serving as exemplars of how to live a...

We respond to and expand on comments by Bandura and by Silberman that have enlarged the discussion of spiritual modeling. Support is offered for the notion that God can be scientifically regarded as a spiritual model, but it is suggested there are no advantages to appending the term role to the term spiritual model. Negative spiritual models are im...

The study investigated the effects of a gestalt therapy group with older adults. A total of 43 adults, 65 years or older, were randomised into treatment and assessment control groups of 22 and 21 respectively. ANCOVA results indicated that group therapy participants reported less anger control and more overall expression of anger than the control p...

The authors examined factors associated with four dimensions of functional quality of life (physical functioning, energy/fatigue, social functioning, and role functioning) in 142 men and women living with HIV/AIDS. Participants completed the Brief COPE inventory and the Medical Outcomes Study Health Survey, with HIV-relevant items added. Greater us...

The investigation of spiritual/religious factors in health is clearly warranted and clinically relevant. This special section explores the persistent predictive relationship between religious variables and health, and its implications for future research and practice. The section reviews epidemiological evidence linking religiousness to morbidity a...

Evidence is presented that bears on 9 hypotheses about the link between religion or spirituality and mortality, morbidity, disability, or recovery from illness. In healthy participants, there is a strong, consistent, prospective, and often graded reduction in risk of mortality in church/service attenders. This reduction is approximately 25% after a...

Obtaining a high response rate in survey research can bolster statistical power, reduce sampling error, and enhance the generalizability of the results to the population surveyed. We describe a mail survey designed to achieve a high return rate of completed questionnaires from members of the American Psychological Association who were engaged in cl...

The question, 'Does religion (or spirituality) cause physical health benefits?' may be given at least four diverging interpretations in terms of causal path diagrams. In common usage, the question may be interpreted to indicate that religion causally influences health by: (1) any mechanism, including well-established factors such as social support...

This study examined relationships between coping strategies and psychological quality of life (QOL) among people living with HIV/AIDS (N = 141). Participants completed baseline assessments, which included a demographic survey, the Brief COPE, the MOS-HIV, and a medical history questionnaire. Additionally, we obtained CD4 count information from medi...

In this article, we familiarize readers with some recent empirical evidence about possible associations between religious and/or spiritual (RS) factors and health outcomes. In considering this evidence, we believe a healthy skepticism is in order One needs to remain open to the possibility that RS-related beliefs and behaviors may influence health,...

To advance knowledge in the study of spirituality and physical health, we examined sociodemographic, behavioral, and attitudinal correlates of self-perceptions of spirituality. Participants were a nationally representative sample of 1,422 adult respondents to the 1998 General Social Survey. They were asked, among other things, to rate themselves on...

This exploratory study examined relationships between spirituality and immune function in 112 women with metastatic breast cancer. Spirituality was assessed by patient reports of frequency of attendance at religious services and importance of religious or spiritual expression. White blood cell counts, absolute numbers of lymphocytes, T-lymphocyte s...

Objective: Depression and low social support are risk factors for medical morbidity and mortality after acute MI. The ENRICHD study is a multicenter, randomized, controlled clinical trial of a cognitive-behavioral treatment for depression and low social support in post-MI patients. A total of 2481 patients were recruited (26% with low social suppo...

In recent years, concerns about the credibility of memories associated with childhood sexual abuse have prompted researchers and the public to scrutinize therapists' role in evaluating and treating patients reporting abuse histories. A national survey of 1008 psychologists was conducted examining factors associated with therapists' judgments and tr...

A meta-analysis of data from 42 independent samples examining the association of a measure of religious involvement and all-cause mortality is reported. Religious involvement was significantly associated with lower mortality (odds ratio = 1.29; 95% confidence interval: 1.20-1.39), indicating that people high in religious involvement were more likel...

A meta-analysis of data from 42 independent samples examining the association of a measure of religious involvement and all-cause mortality is reported. Religious involvement was significantly associated with lower mortality (odds ratio = 1.29; 95% confidence interval: 1.20–1.39), indicating that people high in religious involvement were more likel...

Studies show that people who volunteer are happier and healthier, perhaps due to enhanced social support, less self-focus, and fewer goal conflicts. Volunteering seems most beneficial for people whose social activities provide cognitive support for coping with major developmental challenges. (SK)

Psychosocial factors, particularly depression and tack of social support, are important predictors of morbidity and mortality in patients with coronary heart disease, This article describes the design and methods of the Enhancing Recovery in Coronary Heart Disease Patients (ENRICHD) study, a multicenter, randomized clinical trial involving 3000 pat...

This study examined the influence of sexual abuse history, gender, theoretical orientation, and age on beliefs about the prevalence of childhood sexual abuse among clinical and counseling psychologists. A mail survey design was used in this study. Participants were randomly selected from the American Psychological Association membership database. T...

The role of spiritual and religious factors in health, viewed from a scientific perspective, has been yielding interesting if not intriguing results. In general, studies have reported fairly consistent positive relationships with physical health, mental health, and substance abuse outcomes, mostly using cross-sectional or prospective designs. Some...

Older residents (N 5 1972) in California were investigated prospectively for association of volunteering service to others and all-cause mortality. Potential confounding factors were studied: demographics, health status, physical functioning, health habits, social support, religious involvement, and emotional states. Possible interaction effects of...

Controlled intervention studies offer considerable promise to better understand relationships and possible mechanisms between spiritual and religious factors and health. Studies examining spiritually augmented cognitive-behavioral therapies, forgiveness interventions, different meditation approaches, 12-step fellowships, and prayer have provided so...

The authors define the meaning of "health" and "spirituality" and discuss spiritual well-being as an important and too often overlooked dimension of health. Spiritual and religious involvement is not only common but is often important in clients' lives and has been generally linked to positive health outcomes. A client's spiritual perspective may b...

This study examined the effects of Type A modification on a sample of 49 male post—myocardial infarction patients. These patients were classified as showing Type A behavior, were below the age of 65, and did not have severe angina pectoris or arrythmias. They were randomly assigned either to Type A group treatment or to cardiologic counseling (cont...

This is an extension of previous research that has reported on psychosocial risk factors in women participants in the Recurrent Coronary Prevention Project (RCPP). The RCPP women (N = 83) were under 65 years of age, non-diabetic, non-smoking and had experienced a myocardial infarction (MI) at least 6 months prior to the study. Baseline data was ava...

The relationship between coronary heart-disease endpoints and attributional style in women has been previously unexamined. This study examined the attributions of 73 postmyocardial infarction (MI) women about their heart disease and explored the relationship between attributions and nonfatal coronary recurrence. Women's primary causal attributions...

This was an exploratory investigation of psychosocial risk factors for mortality in women with premature acute myocardial infarction (AMI). Subjects were 83 female participants in the Recurrent Coronary Prevention Project, who were between the ages of 30 and 63 in 1978, nonsmoking, nondiabetic, and at least 6 months beyond their index AMI. Follow-u...

Research on the Type A behavior pattern (TA) has been plagued by inadequate theory, insensitive assessment, and insufficient interventions. These problems (e.g., using global dichotomous ratings of TA) have contributed to several failures of TA to predict cardiovascular outcomes prompting concern for new approaches. Conceptual models are discussed,...

Reviews research on Type A behavior pattern (TA) and coronary heart disease (CHD) in women. Assessment of TA has been complicated by inadequate validation of instruments, single occasion assessment, global categorical measures, and socialization of women to be less overtly competitive or hostile than men. Studies suggest that time urgency and anger...

The hypothesis under investigation was that the beneficial effect of type A behavioral counseling on survival after acute myocardial infarction (AMI) was conditional on the functioning of the cardiovascular system, as determined by the severity of the prior AMI. Subjects were 862 nonsmoking coronary patients in the San Francisco Bay Area, randomize...

Emotional and behavioral correlates of Type A behavior in children and adolescents were examined in 184 fifth-, seventh-, and ninth-grade students, classified as high or low Type A, using self-report, teacher ratings (fifth grade only), and structured interview procedures. Measures included the Hunter-Wolf A-B Rating Scale, Behavioral Symptoms of S...

An instrument was developeted to measure appraisal and coping in older people with osteoarthritis (OA). Based on the Lazarus-Folkman model of stress and coping, our Arhtritis Appraisal and Ways of coping scale assessed the primary appraisal (perception of harm/loss) and coping thoughts and actions of OAs in response to specific incidents of pain. F...

Three hundred post infarction participants who had received type A behavioral counseling in the Recurrent Coronary Prevention Project, (RCPP) agreed to be followed for 1 additional year after stopping 4.5 years of continuous type A behavioral counseling. One hundred fourteen participants who had served for 4.5 years as controls in the RCPP Study, t...

Development of measures of Type A behavior in children and adolescents is described and the results of two studies to validate these measures are given. Children in the fifth, seventh, and ninth grades (n = 120 in Study I; n = 652 in Study II) were given five measures of the Type A Behavior Pattern (TABP): the Student Type A Behavior Scale (STABS);...

One thousand thirteen post myocardial infarction patients were observed for 4.5 years to determine whether their type A (coronary-prone) behavior could be altered and the effect such alteration might have on the subsequent cardiac morbidity and mortality rates of these individuals. Eight hundred sixty-two of these individuals were randomly assigned...

A physical examination including resting blood pressure, heart rate, Tanner scales, height, and weight was administered to 184 students in the fifth, seventh, and ninth grades. They completed the Physical Symptoms of Stress Inventory, Health Habits Inventory, and two self-monitoring logs of physical symptoms. School absenteeism, medical records, ph...

One hundred eighteen senior officer-students of the U.S. Army War College who were healthy but exhibited type A behavior volunteered to be randomly selected and enrolled into (1) a section of 62 officers who received group type A behavior counseling for 9 months and (2) a control section of 56 officers who received no counseling of any kind. Marked...

Brief consultation and stress management treatments to help insomniacs withdraw from sleep medication were evaluated with 12 drug-dependent women. The effects of treatment were assessed by all-night home polysomnographic recordings and questionnaires. All 12 subjects succeeded in withdrawing from sleep medication and showed a number of improvements...

We studied the accuracy of predictions of long-term prognosis after infarction in a sample of 118 non-smoking, post-coronary males using: behavioral indices only; physiologic risk factors only; and a combination of behavioral indices and physiologic risk factors. To isolate valid behavioral indices, we measured 49 signs and symptoms of a lifestyle...

Good health and chronic diseases exist essentially as matters of habit as well as context in how people routinely go about the business of everyday living. Recently the crucial roles of behavioral, cognitive, and environmental factors in health and disease have been recognized, giving rise to the new fields of health psychology and behavioral medic...

This study examined the prevalence and correlates of sleep disturbance in adolescents. Two hundred seventy-seven 9th- and 10th-grade students completed a questionnaire on sleep quality, sleep habits, beliefs about sleep, and daytime mood and functioning. Based on their responses, subjects were classified as good sleepers (66%), occasional poor slee...

Eight hundred sixty-two postmyocardial infarction patients volunteered to be randomly selected and enrolled into: (1) a control section of 270 patients, who received group cardiologic counseling; and (2) an experimental section of 592 patients, who received group type A behavior counseling in addition to group cardiologic counseling. Reduction in t...

The feasibility of altering a Type A style of life was investigated in 1012 nonsmoking predominantly male postinfarction volunteers in the San Francisco Bay area. A total of 862 were randomly allocated into an experimental section receiving a combination of Type A and cardiac counseling, or a control section receiving cardiac counseling alone. The...

Self-management programs for childhood asthma are reviewed from the perspective of the psychology of self-managed change. Three characteristics of self-control behavior are discussed: (1) conscious effort, (2) conflict of choice, and (3) focused attention. The predominant model of self-control, the three-stage model developed by Kanfer and Karoly,...

Sleepers were studied in their homes to obtain measures of relationships between (a) discrepancies between reported and recorded sleep, (b) degree of sleep difficulty, and (c) reported cognitive activity. Twelve good sleepers and 12 insomniacs were questioned immediately after lights out, at the occurrence of the first sleep spindle or K-complex, 1...

We studied 1035 consecutive postinfarction patients to determine the feasibility of altering type A behavior and the effect such alteration might have on subsequent rates of infarction and cardiovascular death. Approximately 300 subjects were enrolled in small groups and primarily received cardiologic counseling on the usually accepted coronary ris...

All-night sleep recordings were obtained from 12 good sleepers and 12 sleep-maintenance insomniacs (aged 20–60 yrs) on three consecutive postadaptation nights. Ss completed a sleep diary each morning and evening. Spouses of good sleepers completed independent reports of Ss' sleep. Insomniacs reported significantly more minutes to onset of Stage 1 s...

Twelve good sleepers and 12 insomniacs were recorded over three nights in their homes. Subjective assessment of sleep indicated minimal disruption due to sleep recording procedures. A cut point of 88 per cent sleep efficiency resulted in correct classification of nine poor sleepers and 10 good sleepers. Multiple discriminant function analyses, usin...

The Recurrent Coronary Prevention Project (RCPP) was established as a 5-year clinical trial to examine two basic questions: --1. Can the recurrence rate of post-coronary subjects be substantially reduced over a 5-year period by means of a programme of behavioural change, in comparison with treatment by cardiologists focussing on medication, diet, e...

A behavioural treatment programme, designed to modify type A behaviour, has been compared with cardiological measures (e.g. diet, exercise and adherence to medication), and with 'no treatment', for its ability to prevent reinfarction in patients who had suffered a myocardial infarct at least six months previously. Provisional results show fewer rei...

The Recurrent Coronary Prevention Project (RCPP) was established as a 5–year clinical trial to examine two basic questions: – To answer these questions, four major treatment groups are currently being compared: – Results to date show a significantly reduced rate of recurrence for subjects in the behavioural change group, compared to those in the gr...

The Type A behavior pattern, a risk factor for coronary heart disease, is described in terms of the expanded cognitive social learning model that takes into account the interdependent influences of behavioral, environmental, cognitive, and physiologic components. Six studies aimed at altering the behavior pattern are discussed in light of this conc...

The present study explored the relationships between treatment strategies, changes in eating behaviors and home environments, and weight loss. Two obese females were trained in weight management techniques over 10 weeks. Treatment for S2 was lagged 1 week behind treatment for S1. A third subject received a placebo treatment to control for the react...

Three controlled case studies are presented to demonstrate the application of behavioral self-management to two subtypes of sleep-maintenance insomnia. Patient 1 suffered from brief but frequent arousals to wakefulness and to NREM Stage 1 sleep. Patient 2 suffered from brief but frequent arousals and extended minutes awake after sleep onset. Patien...

Generalizability theory offers versatile techniques for assessing the accuracy of any measurement strategy. To date, generalizability theory has been applied exclusively to group designs. This paper extends generalizability theory to single subject designs and considers potential problems in such applications. Unique subjects, idiosyncratic experim...

Found that self-management training was associated with increased sleep efficiency, reduced number of arousals and minutes awake after sleep onset during the 1st 3rd of the night, reported improvements in the sleep quality, and less daytime sleepiness for a 58-yr-old female S. These effects were documented using laboratory and home sleep recordings...