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Religion, spirituality and mental health: Results from a national study of English households

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Background: Religious participation or belief may predict better mental health but most research is American and measures of spirituality are often conflated with well-being. Aims: To examine associations between a spiritual or religious understanding of life and psychiatric symptoms and diagnoses. Method: We analysed data collected from interviews with 7403 people who participated in the third National Psychiatric Morbidity Study in England. Results: Of the participants 35% had a religious understanding of life, 19% were spiritual but not religious and 46% were neither religious nor spiritual. Religious people were similar to those who were neither religious nor spiritual with regard to the prevalence of mental disorders, except that the former were less likely to have ever used drugs (odds ratio (OR) = 0.73, 95% CI 0.60-0.88) or be a hazardous drinker (OR = 0.81, 95% CI 0.69-0.96). Spiritual people were more likely than those who were neither religious nor spiritual to have ever used (OR = 1.24, 95% CI 1.02-1.49) or be dependent on drugs (OR = 1.77, 95% CI 1.20-2.61), and to have abnormal eating attitudes (OR = 1.46, 95% CI 1.10-1.94), generalised anxiety disorder (OR = 1.50, 95% CI 1.09-2.06), any phobia (OR = 1.72, 95% CI 1.07-2.77) or any neurotic disorder (OR = 1.37, 95% CI 1.12-1.68). They were also more likely to be taking psychotropic medication (OR = 1.40, 95% CI 1.05-1.86). Conclusions: People who have a spiritual understanding of life in the absence of a religious framework are vulnerable to mental disorder.
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10.1192/bjp.bp.112.112003Access the most recent version at DOI:
2013, 202:68-73.BJP
Michael King, Louise Marston, Sally McManus, Terry Brugha, Howard Meltzer and Paul Bebbington
study of English households
Religion, spirituality and mental health: results from a national
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It is often reported that, even after taking account of other
influences, such as age, gender and social support, people who
report religious belief and practice experience better mental and
physical health than those who do not.
1–3
However, in a meta-
analysis of 147 studies on religious belief and depression, Smith
et al found only a weak negative correlation (70.096) between
religiousness and depressive symptoms.
4
On average, positive
religiousness accounted for only 1% of the variance in the severity
of depressive symptoms. Furthermore, extrinsic religious
orientation and so-called negative religious coping (for example,
avoiding difficulties through religious activities, blaming God
for difficulties) were associated with higher levels of depressive
symptoms.
The way religiosity is measured in research can be
problematic, particularly when well-being is included as a
component of the measure itself.
5
Furthermore, most research
into this association has entailed Judeo-Christian concepts of
religion in White, North American populations, and has seldom
taken account of spiritual beliefs unconnected with personal or
public religious practice.
6
In a number of studies in the UK, we
have reported that religious and spiritual beliefs are not linked
to better physical health outcomes
7,8
and, in particular that
spiritual beliefs in the absence of a religious framework may be
associated with poorer mental health.
9
The third National
Psychiatric Morbidity Survey in England
10
was the first general
population survey in this country to include questions on
religious and spiritual beliefs. In this study we aimed to examine
the association between such beliefs and receipt of psychiatric
treatment, and a range of psychiatric symptoms and diagnoses
in a random sample of the English population.
Method
Survey methods
The third National Psychiatric Morbidity Study was conducted
between October 2006 and December 2007 across England, using
individual or groups of postcode sectors as sampling units.
10
In
the first stage of sampling, postcode sectors were divided into
regions based on strategic health authority. All the sampling units
within each strategic health authority were further stratified on
the basis of the proportion of people in non-manual classes,
and sorted by the proportion of households without a car based
on UK 2001 Census data. A total of 519 postal sectors were
selected by sampling from each stratum with a probability
proportional to size in terms of the number of delivery points.
In the second stage of sampling, 28 delivery points were randomly
selected within each of the selected postal sectors, providing a
sample of 14 532 delivery points. Interviewers visited the addresses
to identify private households containing at least one person aged
16 or over. When visited, 1318 of the selected addresses were
found not to contain a private household and were excluded from
the survey sample. After contact was made with each eligible
household, one person was randomly selected to take part, using
the Kish method.
11
Ethical constraints meant that data on people
refusing to participate could not be collected. Trained interviewers
conducted a structured, laptop computerised interview in
respondents’ homes, or elsewhere if requested, each interview
lasting on average 90 min. Interviewers were fully briefed on
the administration of the survey, and followed full sets of
written instructions. Topics covered on 1-day survey-specific
68
Religion, spirituality and mental health:
results from a national study of English
households
Michael King, Louise Marston, Sally McManus, Terry Brugha, Howard Meltzer
and Paul Bebbington
Background
Religious participation or belief may predict better mental
health but most research is American and measures of
spirituality are often conflated with well-being.
Aims
To examine associations between a spiritual or religious
understanding of life and psychiatric symptoms and
diagnoses.
Method
We analysed data collected from interviews with 7403 people
who participated in the third National Psychiatric Morbidity
Study in England.
Results
Of the participants 35% had a religious understanding of life,
19% were spiritual but not religious and 46% were neither
religious nor spiritual. Religious people were similar to those
who were neither religious nor spiritual with regard to the
prevalence of mental disorders, except that the former were
less likely to have ever used drugs (odds ratio (OR) = 0.73,
95% CI 0.60–0.88) or be a hazardous drinker (OR = 0.81, 95%
CI 0.69–0.96). Spiritual people were more likely than those
who were neither religious nor spiritual to have ever used
(OR = 1.24, 95% CI 1.02–1.49) or be dependent on drugs
(OR = 1.77, 95% CI 1.20–2.61), and to have abnormal eating
attitudes (OR = 1.46, 95% CI 1.10–1.94), generalised anxiety
disorder (OR = 1.50, 95% CI 1.09–2.06), any phobia (OR = 1.72,
95% CI 1.07–2.77) or any neurotic disorder (OR = 1.37, 95% CI
1.12–1.68). They were also more likely to be taking
psychotropic medication (OR = 1.40, 95% CI 1.05–1.86).
Conclusions
People who have a spiritual understanding of life in the
absence of a religious framework are vulnerable to mental
disorder.
Declaration of interest
None.
The British Journal of Psychiatry (2013)
202, 68–73. doi: 10.1192/bjp.bp.112.112003
training included introducing the survey, questionnaire content,
confidentiality and respondent distress.
The survey data were weighted to take account of likelihood of
selection and non-response, so that the results were representative
of the English household population aged 16 years and over.
Sample weights were first applied to take account of the different
probabilities of selecting respondents in different sized
households. Second, to reduce household non-response bias, a
household-level weight was calculated from a logistic regression
model using interviewer observation and area-level variables
(collected from Census 2001 data) available for responding and
non-responding households. Finally, calibration weighting based
on age, gender and region weighted the data to represent the
structure of the national population, and take account of
differential non-response between regions and age6gender groups.
We focus on the weighted results in the text, but provide
both weighted and unweighted bases in the table showing socio-
demographics and life views (online Table DS1). The unweighted
bases are presented where appropriate to show the number of
respondents included. The weighted base shows the relative size
of the various sample elements after weighting, reflecting their
proportions in the English population. The absolute size of the
weighted base has no particular significance, since it has been
scaled to the achieved sample size.
10
Measures
Following confirmation of demographic data, the following
standardised instruments were used.
(a) Six questions adapted from those in the questionnaire version
of the Royal Free interview for religious and spiritual beliefs,
which assesses the nature and strength of beliefs and
practice.
12,13
Because of the length of the overall interview,
questions on each topic had to be kept as brief as possible.
Participants were provided with the statement: ‘By religion,
we mean the actual practice of a faith, e.g. going to a
temple, mosque, church or synagogue. Some people do not
follow a religion but do have spiritual beliefs or experiences.
Some people make sense of their lives without any religious
or spiritual belief. Although slightly shorter than in the
Royal Free Interview, the words used are exactly the same,
in order not to lose the statement’s essential meaning or
threatening the validity of the original instrument. The
interview then went on: ‘Would you say that you have a
religious or spiritual understanding of your life?’ Participants
could indicate whether their understanding was
predominately (i) religious; (ii) spiritual or (iii) neither. If
they had a specific religion, they were asked to name it. If
religious or spiritual, they were asked to indicate on two
sliding scales of zero to ten how strongly they held to their
understanding of life and how important practice of their
faith (for example private meditation, religious services) was to
them. These respondents were also asked to report how often
they attended services, prayer meetings or places of worship.
(b) The revised Clinical Interview Schedule (CIS-R) collects data
on symptoms of common mental disorder and derives
psychiatric diagnoses according ICD-10.
14–16
The CIS-R
enquires about the presence and severity of 14 non-psychotic
psychiatric symptoms during the week prior to interview. The
CIS-R score may be analysed as: (i) a continuous score, along a
single continuum of severity; (ii) a dichotomous variable (case
threshold 512); and (iii) ICD-10 diagnostic categories.
15,17
Diagnostic algorithms for use with the CIS-R cover (i)
depressive episodes (classified as mild, moderate or severe);
(ii) four types of anxiety disorder, namely generalised
anxiety disorder, panic disorder, phobias (classified as
agoraphobia, social phobia and simple phobia), obsessive–
compulsive disorder (OCD); and (iii) mixed anxiety/
depressive disorder. The latter include those who scored
above the case threshold on the CIS-R, but do not meet
diagnostic criteria for any other ICD-10 disorder.
(c) The Psychosis Screening Questionnaire (PSQ) is a brief
schedule that screens for symptoms commonly found in
psychotic disorders.
18
Rather than making a definitive
diagnosis, it indicates whether a psychotic disorder may be
present.
(d) A shortened version of the Close Persons Questionnaire that
evaluates social support.
19
This had been used in previous
national surveys.
9,17
Seven questions enquire about the level of
intimacy and social support from close friends and family.
The answers are scored from one to three and are summed to
a total score; higher scores indicate higher social support.
(e) The Alcohol Use Disorders Identification Test (AUDIT)
questionnaire is a widely used and well validated instrument
that contains 10 questions about use of, and attitudes to,
alcohol consumption, in this instance over the preceding 12
months.
20,21
Men who scored more than seven and women
who scored more than four were classified as hazardous drinkers.
(f) The Trauma Screening Questionnaire (TSQ)
22
was used to
collect information on the presence of trauma-related
symptoms in the past week. A traumatic event is one in
which a person experiences, witnesses or is confronted with
a death or a serious injury or threat to self or close others.
It is more severe than a stressful life event. Scoring positively
on this questionnaire indicates the presence of trauma-
related symptoms in the preceding week and that a clinical
assessment for post-traumatic stress disorder (PTSD) is
warranted; it does not specify a diagnosis of PTSD, in
particular because it evaluates only two of the four criteria
taken to identify a traumatising event. As a screening tool it
has high sensitivity and specificity but lower positive
predictive value (0.48) as a result of the usually low prevalence
of PTSD (1%) in most populations.
22
(g) The SCOFF is a five-item screening tool for anorexia and bulimia
nervosa that enquires about eating attitudes and behaviour over
the preceding year.
23
Endorsement of two or more items
represented a positive screening for an eating disorder. A
further question (‘in the last year . . . did your feelings
about food interfere with your ability to work, meet personal
responsibilities, and/or enjoy a social life?’) was added to judge
the impact of such eating attitudes and behaviour.
(h) Problem gambling is gambling to a degree that compromises,
disrupts or damages family, personal or recreational pursuits.
This categorisation was based on the DSM-IV
24
criteria for
problem and pathological gambling. Participants who met
three or more of these diagnostic criteria were classified as
problem gamblers.
(i) Questions on use of recreational drugs came from the
Diagnostic Interview Schedule.
25
Use of a drug in the past
year and the presence of one of five symptoms were used to
indicate drug dependence. Dependence was categorised as
dependence on cannabis only and dependence on other
drugs (with or without cannabis dependence).
(j) One question explored how happy the participants felt
ranging from very, to fairly and not too happy.
(k) Finally, one binary variable summarised whether or not the
respondent was taking any form of psychotropic medication
69
Religion, spirituality and mental health
King et al
and one summarised whether or not they were receiving any
form of psychotherapy or counselling.
Statistical analysis
All analyses were conducted in Stata release 12.0, for Windows,
using the survey command to account for the unequal probability
of selection and to adjust the standard errors to account for
clustering in areas sampled in data collection. Our main
analyses concerned possible associations between holding a
religious, spiritual or secular life view and: receiving counselling/
psychotherapy or psychotropic medication for a mental disorder;
mental disorders classified by the CIS-R; possible PTSD, psychosis
or an eating disorder; hazardous drinking; recreational drug use
and dependence; and level of happiness.
We explored these associations using logistic regression, except
for happiness, which utilised ordered logistic regression and
for drug dependence where multinomial logistic regression was
used. We adjusted for gender, age group, ethnicity, educational
attainment, marital status or perceived social support if they were
significantly associated with the given outcome. Social support is
known to be associated with religious belief and practice.
26,27
The
reference group chosen for these analyses were participants
reporting a secular (neither religious nor spiritual) life view, given
it was the largest and most distinct of the three groups in terms of
absence of any spiritual belief.
Results
Response rates and description of the population
A total of 9% of sampled addresses contained no private
households and 4% were addresses of unknown eligibility. This
left a known eligible sample of 12 694 addresses. Applying the
eligibility rate among those where it was established, to those
where it was not, it was estimated that 91% of those of unknown
eligibility would have been eligible to take part. This increased the
set sample of households to 13 171. In total, 7403 respondents
(56.2%) provided a productive interview. The mean age of
the participants was 46.3 years (s.e. = 0.28, unweighted range
16–97), 4206 (51.4%) were women, 85% were White British,
26% had no educational qualifications and 52% were married
(online Table DS1).
Understanding of life
Of the participants 35% had a religious understanding of life, 19%
were spiritual (without religious participation) and 46% were
neither religious nor spiritual in outlook (online Table DS1). In
total 53% gave a nominal religious affiliation, with the majority
citing Christianity (86%). Demographic characteristics of the
sample stratified by understanding of life are shown in Table 1.
People with no religious or spiritual understanding were
significantly younger and more often White British, but were less
likely to have qualifications beyond secondary school or to be
married. Religious people had stronger beliefs and placed more
importance on practice of those beliefs than people with a purely
spiritual understanding (Table 1).
Mental disorders and substance use
People with a religious understanding of life were less likely to use
or be dependent on drugs, or be hazardous drinkers (Table 2).
People with a spiritual understanding of life were more likely to
have abnormal eating attitudes and any neurotic disorder. There
70
Table 1 Univariable associations with life view: sociodemographics (
n
= 7403)
Characteristics Neither religious or spiritual Spiritual Religious P
Male, % 55 44 43 50.001
Age, years: % 50.001
16–24 19 11 10
25–34 19 16 13
35–44 20 21 17
45–54 16 18 16
55–64 13 17 17
65–74 7 10 14
75+ 5 8 14
Ethnicity, % 50.001
White British 93 86 74
White non-British 4 6 6
Black 1 3 6
South Asian 1 2 9
Mixed or Other 2 3 4
Education, % 50.001
No qualifications 25 21 30
School or foreign qualifications 51 46 39
Post-school qualifications 24 32 30
Civil status, % 50.001
Married 46 53 60
Cohabiting 13 12 6
Single 28 21 17
Widowed 5 6 10
Divorced 6 7 5
Separated 2 2 2
Social support, mean 20.0 20.2 20.3 50.001
Strength of religious understanding, mean
a
6.2 7.0 50.001
Importance of religious practice, mean
a
4.4 6.2 50.001
a. Only applicable for those who are religious or spiritual.
Religion, spirituality and mental health
were no differences in overall happiness or level of social support.
People with no religious or spiritual understanding were least
likely to be taking psychotropic medication.
Comparison of groups after adjustment for other
influences
In a multivariate regression, we selected those people with neither
a religious nor spiritual understanding of life (the largest group)
to serve as a reference against which to compare the other two
groups, namely those with a religious understanding and those
with a spiritual understanding of life. After adjustment for
important associated influences, there were few substantial
differences in prevalence of mental disorder or receipt of
treatment between people with no religious or spiritual under-
standing and those who were religious, except for less drug use
and hazardous drinking in the latter (Table 3). However, people
with a spiritual understanding were more likely than those who
were neither religious nor spiritual to take psychotropic
medication, to use recreational drugs or be dependent on them,
to have a generalised anxiety disorder, phobia or any neurotic
disorder or to have abnormal eating attitudes.
Discussion
Main findings
Our main finding is that people who had a spiritual under-
standing of life had worse mental health than those with an
understanding that was neither religious nor spiritual. Those
who were religious were broadly similar, in terms of prevalence
of mental disorder and use of mental health treatments, to those
who were neither religious nor spiritual after adjustment for
potential confounders, except they were significantly less likely
to use, or be dependent on, drugs or alcohol. This supports
evidence from a national UK sample of people from a range of
Black and minority ethnic groups
9
on the vulnerability of people
who describe themselves as spiritual. It adds to the evidence that
people with a spiritual understanding in the absence of a religious
framework appear to have the worst mental health. It also
confirms that religious people are less likely to use alcohol
28
and
recreational drugs
29
but fails to confirm North American evidence
that holding a religious understanding of life provides protection
against mental disorders.
30
It also concurs with other evidence
from England that there is no clear relationship between religiosity
and happiness.
31
Strengths and limitations
The strengths of this study are the random selection of a nationally
representative sample of participants, the sample size, an in-depth
assessment of mental health and the use of standardised questions
on religion and spirituality that were developed and standardised
in the UK and do not overlap with questions on well-being.
However, there are also a number of limitations. First, our results
depend on the definitions of religion and spirituality that were
posed to participants. Although spirituality is notoriously difficult
to define,
32
this way of describing it to research participants has at
least been shown to be reliable.
12,13
However, we did not examine
religious belief in detail, nor to what extent it was intrinsic or
extrinsic.
33
Second, the cross-sectional nature of the data means
71
Table 2 Univariable associations with life view: outcomes (
n
= 7403)
%
Neither religious or spiritual Spiritual Religious P
Drug use
Ever used drugs 32 30 16 50.001
Used any drug in the past year 12 11 5 50.001
Drug dependent 4 5 2 50.001
Dependent on cannabis 3 4 1 50.001
Dependent on another drug (+/– cannabis) 1 1 1
Hazardous drinker 30 23 17 50.001
Problem gambling 0.8 0.6 0.7 0.880
Post-traumatic stress disorder 3 3 3 0.527
Eating attitudes
SCOFF 52 7 9 5 0.001
SCOFF score 52 and food interferes with life
a
2 2 1 0.646
Psychosis Screening Questionnaire
Definitely psychotic 0.1 0.4 0.4 0.106
Probably psychotic 0.3 0.6 0.5 0.118
Clinical Interview Schedule
Panic disorder 1 1 1 0.618
Generalised anxiety disorder 4 5 4 0.079
Mixed anxiety/depressive disorder 8 10 8 0.154
Obsessive–compulsive disorder 1 1 0.8 0.127
Any phobia 2 3 2 0.055
Depression 3 3 2 0.057
Any neurotic disorder 16 19 15 0.011
Happiness 0.764
Very happy 39 39 40
Fairly happy 53 52 52
Not too happy 8 9 8
Receiving pharmacological treatment 5 7 6 0.026
Receiving counselling/therapy 3 3 2 0.360
a. 52 on the SCOFF questionnaire and an affirmative reply to whether or not the eating difficulties has a serious impact on their lives.
King et al
that we cannot attribute cause and effect to any relationship
between spiritual beliefs and mental health.
Comparison with findings from other studies
A recent large USA internet survey of people who regarded
themselves as non-religious
34
also reported that non-religious
people who held spiritual beliefs (only 2% of the survey
population) had less emotional stability as measured by a
personality rating scale. However, it is difficult to know how far
we can compare such people with our spiritual group, which made
up 19% of the study population. Although the authors concluded
that belief is a measure of negative personality traits, their findings
(and ours) are in opposition to earlier evidence from the UK that
spirituality is associated with greater extraversion and optimism
(rather than neuroticism and psychoticism), particularly among
men.
35
The limitation of the latter study, however was that it
was based on a volunteer student population and is therefore
unlikely to be generalisable. Another possible explanation for
our finding concerning people with a spiritual life view is that they
are caught up in an existential search that is driven by their
emotional distress.
9,36
Why might findings in Europe concerning the emotional
stability of religious people vary from those in the USA? There
is considerable evidence that the UK is a less religious country
than the USA in terms of the number of people professing a belief
in God or attending places of worship.
37
We found that a relatively
low number of people expressed some sort of spiritual or religious
belief in this survey (54%) in comparison with that found in
recent surveys both in the UK and around the world where levels
have been closer to 70%.
38,39
Given that religious participation in
English society is a minority activity, it may be that the social
support intrinsic to a more religious society is missing. A further
possibility is the way in which we measured spiritual and religious
understanding. The Royal Free Interview for Religious and
Spiritual Beliefs was developed and standardised in the UK and
has not been used extensively in the USA. However, this is not
strictly a limitation as one could argue that instruments should
be most appropriate to the setting in which they were developed.
Certainly, the difference in the findings concerning religion and
mental health between the USA and the UK would bear greater
investigation.
We conclude that there is increasing evidence that people who
profess spiritual beliefs in the absence of a religious framework are
more vulnerable to mental disorder. The nature of this association
needs greater examination in qualitative and in prospective
quantitative research.
Michael King, MD, PhD, FRCP, FRCGP, FRCPsych, Unit of Mental Health Sciences,
Faculty of Brain Sciences, University College London Medical School, London;
Louise Marston, PhD, Department of Primary Care and Population Health, University
College London Medical School, Royal Free Campus, London; Sally McManus, MSc,
National Centre for Social Research, London; Terry Brugha, MD, FRCPsych, Howard
Meltzer, PhD, Academic Unit of Social and Epidemiological Psychiatry, Department
of Health Sciences, University of Leicester, Leicester; Paul Bebbington, PhD, FRCP,
FRCPsych, Unit of Mental Health Sciences, Faculty of Brain Sciences, University
College London Medical School, London, UK
Correspondence: Michael King, Unit of Mental Health Sciences, Faculty of Brain
Sciences, University College London Medical School, Charles Bell House, 67–73
Riding House Street, London W1W 7EH, UK. Email: michael.king@ucl.ac.uk
First received 16 Mar 2012, final revision 17 July 2012, accepted 17 Aug 2012
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Table 3 Regression modelling showing the relationship between psychiatric outcomes and life view
a
OR (95% CI)
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b
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b
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Receiving counselling or therapy 7325 1.15 (0.77–1.73) 1.00 (0.68–1.47)
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... Many studies, even if they try to measure as many factors as possible, end up with a scarcity of statistically robust conclusions. Thus, a broad study of 7403 participants in the United Kingdom (King et al. 2013) "confirms that religious people are less likely to use alcohol and recreational drugs but fails to confirm North American evidence that holding a religious understanding of life provides protection against mental disorders. It also concurs with other evidence from England that there is no clear relationship between religiosity and happiness" (p. ...
... They proposed a broader selection of study groups in terms of demographics and religious affiliation to produce more valid results. In the already cited British study by King et al. (2013), the authors could not establish a connection between anxiety disorders and R/S, neither in a positive nor in a negative sense, but they also commented that a religious or spiritual life is no guarantee for mental health. ...
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Background: Associations between psychiatric syndromes and religion/spirituality (R/S) are confounded by a diversity of descriptive instruments, the interpretation of statistical correlations, and the highly individual experience of illness. Method: This presentation focuses on three major syndromes in psychiatric patients: (a) delusions with religious content, (b) depressive conditions, and (c) anxiety disorders. Results: The content of delusions is marked by cultural factors, including religious concepts. There is empirical evidence that R/S may have a supportive role in patients with schizophrenia. Affective disorders show a more varied pattern of causality—a better outcome in about 60%, but in 10%, there seems to be a higher incidence in patients with a conservative, guilt-oriented, religious background. In anxiety disorders, a meta-analysis could not find a correlation between R/S and clinical syndromes. However, research into the emerging field of “spiritual struggles” has shown an interaction between subjective anxieties and religious conflicts, strongly influenced by the level of neuroticism beyond religious factors. Conclusions: The correlation of R/S and dysfunctional psychological experience may be summarized in three concepts (culture, conflict, and coping), modulated by the neurobiological basis of psychiatric disorders.
... 54.37%(n=87) were male and 45.63% (n=73) were females, frequency of depression in patients with religious inclination was recorded in 19.38%(n=31) while 80.62%(n=129) had no findings of the morbidity. King M also found associations between a spiritual or religious understanding of life and psychiatric symptoms and diagnoses and recorded that of the participants 35% had a religious understanding of life, 19% were spiritual but not religious and 46% were neither religious nor spiritual 30 . Religious people were similar to those who were neither religious nor spiritual with regard to the prevalence of mental disorders, except that the former were less likely to have ever used drugs (odds ratio (OR) = 0.73, 95% CI 0.60-0.88) ...
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Objective: To assess the frequency of depression in patients with religious inclination. Materials & Methods: It was a cross sectional survey conducted in outpatients’ department of Psychiatry of Sughra Shafi Medical Complex, Narowal over the period of 6 months. Sample size of 160 cases is calculated having age 40 to 75 years with 95% confidence level, 6% margin of error and taking expected percentage of depression was as 17% in subjects with religious inclination. Non-probability consecutive sampling was used. Depression was assessed according to HADS scale for depressive disorder of any severity. Results: Frequency of depression in patients with religious inclination was recorded in 19.38% (n=31) while 80.62% (n=129) had no findings of the morbidity. Conclusion: However, in observation of the above, we concluded that the frequency of depression in religiously inclined participants is not higher and some other factors i.e. socioeconomic was considerably greater, it may be the associated factor of depression in our study, further research in this field is necessary to validate our findings. Keywords: Depression, morbidity, religious inclination, socioeconomic status
... De acuerdo con Piedmont y Village (2010), la trascendencia espiritual es la capacidad humana universal de permanecer fuera de la propia existencia inmediata y ver la vida desde un todo más integrador y, la realización en la oración, es la sensación de satisfacción que resulta de PSIENCIA, 2022, 14(1), Enero-Junio, ISSN: 2250-5504 137 percibir la conexión con una realidad trascendente a partir de prácticas concretas tales como el rezo o la meditación. Si bien la mayoría de los estudios identifican aspectos positivos de la espiritualidad para sobreponerse a situaciones difíciles (Galea et al., 2007;Golden et al., 2004;Piedmont et al., 2014), distintos trabajos han observado que la espiritualidad, en ausencia de un marco religioso, podría suponer una mayor vulnerabilidad (King et al., 2013). Por este motivo, numerosos autores han relevado la necesidad de explorar el vínculo entre la espiritualidad y distintas variables psicológicas ligadas al afrontamiento de situaciones de estrés. ...
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... This finding is consistent with an earlier study, which showed that individuals with PD, though less likely to have religious beliefs than matched controls, are on the other hand more likely than controls to have spiritual beliefs (Giaquinto et al., 2011). As such, this study corroborates previous research which suggests that individuals who have a spiritual understanding of life in the absence of a religious framework, may be more vulnerable to developing neuropsychiatric disorders (King et al., 2013;Vitorino et al., 2018). ...
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Parkinson’s disease (PD) is associated with low religiosity cross-sectionally. Whether low religiosity might be associated with an increased risk for developing PD is unknown. This study investigated whether low religiosity in adulthood is associated with increased risk for developing PD. A population-based prospective cohort study was conducted. Participants from the English Longitudinal Study of Aging and the Midlife in the United States study who were free from PD at baseline (2004–2011) and completed questionnaires on self-reported religiosity, were included in a pooled analysis. Incident PD was based on self-report. Multivariable logistic regression was used to estimate odds ratios (OR) for developing PD according to baseline religiosity, with adjustment for sociodemographic characteristics, health and lifestyle factors and engagement in religious practices. Among 9,796 participants in the pooled dataset, 74 (0.8%) cases of incident PD were identified during a median follow-up of 8.1 years. In the fully adjusted model, compared with participants who considered religion very important in their lives at baseline, it was found that participants who considered religion “not at all important” in their lives had a tenfold risk of developing PD during follow-up (OR, 9.99; 95% CI 3.28–30.36). Moreover, there was a dose–response relationship between decreasing religiosity and increasing PD risk (P < 0.001 for trend). These associations were similar when adjusting for religious upbringing and when cases occurring within the first two years of follow-up were excluded from the analysis. The association was somewhat attenuated when religious practices were removed from the model as covariates, though it remained statistically significant (OR for “not at all important” vs. “very important”, 2.26; 95% CI 1.03–4.95) (P < 0.029 for trend). This longitudinal study provides evidence for the first time that low religiosity in adulthood may be a strong risk factor for developing PD.
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Chapter
Spirituality and Psychiatry addresses the crucial but often overlooked relevance of spirituality to mental well-being and psychiatric care. This updated and expanded second edition explores the nature of spirituality, its relationship to religion, and the reasons for its importance in clinical practice. Contributors discuss the prevention and management of illness, and the maintenance of recovery. Different chapters focus on the subspecialties of psychiatry, including psychotherapy, child and adolescent psychiatry, intellectual disability, forensic psychiatry, substance misuse, and old age psychiatry. The book provides a critical review of the literature and a response to the questions posed by researchers, service users and clinicians, concerning the importance of spirituality in mental healthcare. With contributions from psychiatrists, psychologists, psychotherapists, nurses, mental healthcare chaplains and neuroscientists, and a patient perspective, this book is an invaluable clinical handbook for anyone interested in the place of spirituality in psychiatric practice.
Chapter
In this chapter, the author sets out a unitive way of thinking about the relationship between spirituality, psychiatry and psychotherapy. An introduction to spirituality in mental health care is followed by a discussion of the meaning of ‘spirit’, ‘soul’ and ‘ego’ and how these terms may be understood with reference to ongoing developmental tasks. The poem I AM, written by the nineteenth-century poet John Clare, who suffered from enduring mental illness, is considered in depth from both psychoanalytic and Jungian approaches in order to illustrate different perspectives on Clare’s anguish and spiritual yearning. The evolution of transpersonal psychology, in which Jung’s concepts play an important part, is traced historically, with the increasing recognition of the value of spiritually orientated psychotherapy. The chapter concludes with several case studies by the author, illustrating how a range of soul-centred approaches can readily and helpfully engage with the spiritual reality of the patient. Referencing the poem I AM by John Clare, who suffered from mental illness. Psychoanalytic and Jungian therapies are compared in order to illustrate different perspectives on Clare’s anguish and spiritual yearning. A brief history of the evolution of transpersonal theory and of spiritually oriented therapeutic approaches is provided, and the chapter concludes with case studies illustrating how soul-centred therapy can readily and helpfully engage with the spiritual reality of the patient.
Chapter
Spirituality and Psychiatry addresses the crucial but often overlooked relevance of spirituality to mental well-being and psychiatric care. This updated and expanded second edition explores the nature of spirituality, its relationship to religion, and the reasons for its importance in clinical practice. Contributors discuss the prevention and management of illness, and the maintenance of recovery. Different chapters focus on the subspecialties of psychiatry, including psychotherapy, child and adolescent psychiatry, intellectual disability, forensic psychiatry, substance misuse, and old age psychiatry. The book provides a critical review of the literature and a response to the questions posed by researchers, service users and clinicians, concerning the importance of spirituality in mental healthcare. With contributions from psychiatrists, psychologists, psychotherapists, nurses, mental healthcare chaplains and neuroscientists, and a patient perspective, this book is an invaluable clinical handbook for anyone interested in the place of spirituality in psychiatric practice.
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he nonreligious segment of the population is not only increasing but is also increasingly visible in the public square. Still, self-described religious believers constitute the vast majority of the American population, and so more attention has been paid by social scientists and survey re- searchers to distinctions such as religious denomination (say, evangelicals vs. mainline) or political leanings than to charac- teristics descriptive of a nonreligious orientation. This article describes a survey that represents a departure from previous studies that have tended to use broad categories, often lumping together the nonreligious into artificial groupings that are actually heterogeneous. When surveys are conducted of the general population, the majority of which is religious, meaningful differences between distinct types of nonbelievers (say, secular humanist vs. athe- ist) have been neglected. Although commentators frequently speculate about distinctions among the godless, actual empir- ical studies of populations sufficiently large to permit reliable distinction between subtypes of nonreligious individuals are more difficult to come by. Given the stereotypical lens—if not manifestly negative outlook—with which the nonreligious are viewed, it is important to characterize the "varieties of nonre- ligious experience" to determine who precisely constitutes this growing demographic category. In Hunsberger and Altemeyer's Atheists: A Groundbreak- ing Study of America's Nonbelievers (2006), an exception to this dearth of research, a survey of several atheist groups revealed that these active atheists tended to be highly educat- ed, older males. Most had childhoods with little parental emphasis placed on religion, but a quarter of the sample had experienced at least a moderately religious childhood. One controversial interpretation of the study pertained to the dis- tinction between atheists and agnostics in regards to person- ality traits such as dogmatism. The results indicated that athe- ists saw themselves as being less likely to give up their views in the future, and thus their outlook could be interpreted as being more rigid. However, in contrast to other samples of reli-
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This book, the first of its kind, reviews and discusses the full range of research on religion and a variety of mental and physical health outcomes. Based on this research, the authors build theoretical models illustrating the various behavioural, psychological, and physiological pathways by which religion might affect health. They also review research that has explored the impact of religious affiliation, belief, and practice one use of health services and compliance with medical treatment. Finally, they discuss the implications of these findings, examine a number of possible clinical applications, and make recommendations for future research in this area
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Spirituality and religion have been seen as beneficial, harmful, and irrelevant to health. We examine the recent research on this topic. We focus on (a) defining spirituality and religion both conceptually and operationally; (b) the relationships between spirituality/religion and health; and (c) priorities for future research. Although the effect sizes are moderate, there typically are links between religious practices and reduced onset of physical and mental illnesses, reduced mortality, and likelihood of recovery from or adjustment to physical and mental illness. The three mechanisms underlying these relationships involve religion increasing healthy behaviors, social support, and a sense of coherence or meaning. This research is based on religion measures, however, and it should be emphasized that spirituality may be different.
Book
The "Handbook of Religion and Mental Health" is a resource for mental health professionals, religious professionals and counselors. The book describes how religious beliefs and practices relate to mental health and influence mental health care. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
Previous research indicates a qualitative difference in the religious expression of white and African-American congregations and suggests that these differences may influence the association between religion and health. The social support and religious consolation hypotheses are examined for main and interactive effects on health by race. A national sample of adults, Americans' Changing Lives, surveyed in 1986 is used for the analysis (N = 3,497). Three dimensions of religiosity are strongest among black adults and women; yet their health is generally poorer. Evidence for the social support hypothesis is found, but the effect on health is similar for black and white respondents. The religious consolation hypothesis is supported only among the black respondents. In addition, a positive link between religious practice and health was observed among African Americans.
Article
This research set out to establish which of four statements reflecting Christian commitment ('usually go to church on Sunday', 'have given my life to Jesus', 'read the Bible every week' and 'pray most days') were the most important predictors of never having smoked, drunk alcohol or tried drugs amongst a group of church affiliated young people. A self-report questionnaire was completed by 7661 participants aged 12-30. Agreement with the Christian commitment statements was generally associated with a lesser likelihood of having smoked, drunk alcohol or tried drugs, though different factors were found to be important in predicting lifetime substance use in the two age groups surveyed (12-16 years and age 17-30). Church attendance was the only factor which predicted each behaviour for the younger age group (12-16 years), but for older participants (age 17-30), statements suggesting a greater level of commitment were most important ('have given my life to Jesus', 'read the Bible every week'). The findings suggest that for church affiliated young people it is initially the socialization of religion that acts as a prohibitor against substance use, though, as age increases, a greater internalization of Christian commitment becomes more important.