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Religious Involvement and Children's Well-Being: What Research Tells Us (And What It Doesn't)

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Abstract

Against this backdrop, and in light of the interest generated by faith-based initiatives, this Research Brief summarizes findings from recent studies that examine linkages between adolescents' beliefs and practice of religion (sometimes referred to as "religiosity") and their well-being. Elements of religiosity include attending religious services, being involved in activities sponsored by faith-based organizations, praying, and ascribing value to one's religious beliefs. This brief also touches on parents' religious practices and beliefs in relation to their adolescents' well-being. Religiosity is an under-researched area of inquiry, and existing research on religion and child well-being has limitations. For example, the effect of religious attendance is often not distinguished from the effects of other family characteristics that may be associated with family religiosity, such as family structure or income, and most research to date focuses primarily on Christian and Jewish adherents. Nevertheless, the studies that have accumulated suggest that religious faith and involvement generally are positive influences on young people's development. The evidence is stronger in some areas than others, however, and the pathways that account for the connection between religiosity and child well-being have not been fully explored.
Religious Involvement and Children’s Well-Being:
What Research Tells Us (And What It Doesn’t)
By Lisa J. Bridges, Ph.D., and Kristin Anderson Moore, Ph.D. September 2002
Overview Opinion polls reinforce the commonly held view that religion is an important force in the
lives of adult Americans and that the majority profess a belief in God.1But what about children and
adolescents? How important are religious faith, beliefs, and activities in their lives? The evidence to date
suggests that religion is also important for many adolescents as well as for many younger children.
Although researchers have found a general trend for children to become less religious in adolescence,2
national survey data collected over the past three decades consistently show that more than 60 percent of
all American high school seniors agree that religion is “pretty” or “very” important to them.3And nearly
half report that they attend religious services at least monthly.4
Against this backdrop, and in light of the interest generated by faith-based initiatives, this Research Brief
summarizes findings from recent studies that examine linkages between adolescents’ beliefs and practice
of religion (sometimes referred to as “religiosity”) and their well-being. Elements of religiosity include
attending religious services, being involved in activities sponsored by faith-based organizations, praying,
and ascribing value to one’s religious beliefs. This brief also touches on parents’ religious practices and
beliefs in relation to their adolescents’ well-being.
Religiosity is an under-researched area of inquiry, and existing research on religion and child well-being
has limitations. For example, the effect of religious attendance is often not distinguished from the effects
of other family characteristics that may be associated with family religiosity, such as family structure or
income, and most research to date focuses primarily on Christian and Jewish adherents. Nevertheless,
the studies that have accumulated suggest that religious faith and involvement generally are positive
influences on young people’s development. The evidence is stronger in some areas than others, however,
and the pathways that account for the connection between religiosity and child well-being have not
been fully explored.
WHAT TEENS REPORT
Most studies on religion and well-being in childhood
and adolescence have been cross-sectional studies
conducted among adolescents. That is, they are
based on adolescents’ responses to survey questions
at one point in time. As such, these studies provide
a snapshot of respondents’ religious practices and
beliefs and the connection between these practices
and beliefs and positive and negative development.
The topics examined include general delinquen-
cy; drug and alcohol use and abuse; adolescent
sexual activity; socially beneficial (or “prosocial”)
behavior and moral values; and personality and
mental health. Overall, the empirical literature
finds moderate to weak associations between
religious practices and beliefs and these out-
comes in adolescence. In some cases, though,
caveats are in order.
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R
ESEARCH
B
RIEF
Delinquency
Most researchers have reported that high
levels of religiosity are linked with low lev-
els of delinquency (e.g., theft, vandalism,
violence against others), although the
linkages between the two are typically low
to moderate in strength.5Further, these link-
ages are frequently found to be relatively weak
when compared with such factors as peer behavior
and the quality of the parent-child relationship.
When researchers analyzing the data control for
such factors, the connection between religious
involvement and delinquent or nondelinquent
behavior is sometimes not statistically
significant.6In other cases, the association
remains. In addition, the pathways remain
unclear. Is it religious involvement that steers a
particular teen away from delinquent behavior,
for example, or is it that he or she has friends who
are a positive influence and parents who are sup-
portive, encouraging, and firm?
Substance Use
The evidence linking religious involvement
and teen drug and alcohol use is strong and
consistent.7This is perhaps as might be expect-
ed. After all, many religions specifically teach that
a healthy body and a healthy spiritual life go hand
in hand and actively proscribe unhealthy behavior
– including drug and alcohol abuse.8
One study of a high-risk sample of white high
school-age males, for example, found that the rate
of multi-drug use (alcohol, marijuana, barbitu-
rates or methedrine, psychedelics, and cocaine)
was more than three times higher among those
who never attended church services, compared
with those who did attend church services at least
once a week. This was based on the teens’ own
reports.9In a more recent study, researchers
found that religion played a bigger role in whether
or not teens used drugs for those who lived in
more distressed neighborhoods than for those liv-
ing in lower-risk environments.10 Teens in these
neighborhoods who went to church and attended
religious services were less likely to use drugs
than were teens who were less involved with
religion. Evidence about other measures of reli-
giosity (for example, the personal importance of
religion in a young person’s life and his or her reli-
gious denomination) is less consistent, but reli-
gious youth are almost never found to be more at
risk than nonreligious youth.
Sexual Behavior
Numerous studies indicate that being
involved in religion may help to steer teens
away from early sexual activity.11 More
specifically, researchers have found that teens
who exhibit high levels of religiosity (including
church attendance, valuing religion, and holding
strong religious beliefs) have lower levels of sexual
experience and more conservative attitudes about
sexual activity than other teens.12
Findings about contraception and disease-
prevention in relation to teens’ religious
beliefs and behavior have been less consis-
tent.13 One troubling piece of evidence is that
when female teens who consider themselves high-
ly religious do have sex for the first time, some
studies indicate that they are less likely to use
contraception, putting them at risk of pregnancy
and sexually transmitted diseases.14 Findings
involving later contraception (i.e., use at most
recent intercourse, frequency and consistency of
contraceptive use) are less consistent.15
Available evidence suggests that the
constraining effects of religiosity on male
adolescent sexual behavior are similar to
those for females.16 In one of the few studies in
this area, for example, high levels of religious
attendance were associated with a delay in the
onset of sexual activity and more conservative sex-
ual attitudes and behavior in a sample of 13- to
16-year-old males.17 In contrast to research with
female adolescents, however, some studies of con-
traceptive use with male adolescents have indicat-
ed that high levels of religiosity may be associated
with more consistent contraceptive use.18 One
should keep in mind, however, that most of the
research literature on adolescent sexual behavior
focuses on females.
2
Prosocial and Moral Values and Behavior
Research findings from early adolescence
are consistent in supporting a positive
association between religiosity and socially
beneficial (or “prosocial”) and altruistic
attitudes and behavior.19 Religions and
religious organizations generally promote the
ideas of helping others and concern for the
greater good by providing opportunities for com-
munity service.20 Moreover, acceptance of the
moral tenets of a religious faith may be instru-
mental in the development of a healthy sense of
responsibility and even guilt that may lead adoles-
cents to avoid wrongdoing or to make amends
when they have done wrong.21 Other findings
seem less clear-cut. For example, one study found
a somewhat stronger association between reli-
gious involvement and altruistic behavior than
between religious involvement and altruistic val-
ues.22 This may be due, in part, to the frequent
inclusion of service activities within religious edu-
cation and youth fellowship programs. For some
adolescents, altruistic behaviors (such as partici-
pating in charity events, and donating time and
effort to helping others) may reflect participation
in a group (such as a church youth group) in addi-
tion to, or rather than, a personal commitment to
helping others. In other words, religious activities
may represent a pathway to prosocial behavior.
Personality and Mental Health
Research is thin on the relationship
between adolescents’ involvement in reli-
gion and personality and mental health.
Theoretically, religiosity is expected to be linked
to better mental health and emotional well-being.
Religious beliefs can serve as a resource for coping
with life’s difficulties (“The Lord never gives you
more than you can bear”); moreover, belief in
God’s love and feelings of acceptance within a reli-
gious community may enhance one’s sense of self-
worth. Relatively few studies have been conduct-
ed in this area, however. And those studies that
do exist find that the association between reli-
gious involvement and belief and adolescents’
self-esteem (the most frequently examined topic)
is generally small and frequently not statistically
significant.23 However, while the evidence that
being religious has a positive effect on adoles-
cents’ mental health and personality tends to
be fairly weak, there is no indication in research
studies of negative effects of religiosity on any
aspect of well-being.
WHAT PARENTS REPORT
A great deal of research has been conducted that
links adults’ religious involvement and beliefs
with parenting and marital relations.24 Yet there
is only a rather limited body of research that
assesses both parents’ religiosity and outcomes
for their child.
What we do know from research provides
some empirical support for weak to moder-
ate associations between parents’ involve-
ment in religion and positive child out-
comes, particularly for older children and
adolescents. For example, a connection has
been found between parental religiosity and lower
levels of child behavior problems25 and with
higher levels of adolescent social responsibility.26
Researchers have not separated out whether such
positive outcomes reflect the direct effect of
parents’ own religious beliefs and involvement on
their children or whether these beliefs and
involvement shape the way parents “parent,” or
both. Generally, though, the research does not
support an hypothesis that parental religiosity
has a negative effect on children’s development.
A new analysis of data from one long-term
survey provides some fresh insights into
whether and how parents’ involvement in
religion affects their adolescent children.
Child Trends recently analyzed survey data from
the 1997 National Longitudinal Survey of Youth,
a nationally representative sample of about 5,000
adolescents who were ages 12-14 that year.27 As
part of the survey, information was also collected
from parents. For example, parents responding to
the survey were asked how often they attended a
worship service in the past year. They also were
asked whether they prayed more than once a
day; whether they often ask God for help with
3
decisions; whether they think God has nothing to
do with what happens to them personally; and
whether they don’t believe they need religion to
have good values.
Parent reports of religious belief were significant-
ly related to the adolescent’s reports of delinquent
activity, substance use, and sexual intercourse.
Moreover, these associations (particularly for sex-
ual activity and substance use) remained for ado-
lescents, over and above social and demographic
factors and adolescent reports of peer behaviors,
parent-child relationships, and parental monitor-
ing. These other influences were also important;
however, parent religiosity and family religious
practice were found to be associated with less
risk-taking even when these other influences
were controlled.
RESEARCH CONSIDERATIONS
Religious practice and belief are primarily person-
al issues, although they often have social, political,
and economic implications. However, religiosity
is also a research issue. Research on the relation-
ship between religious belief and involvement and
child well-being faces challenges on both method-
ological and conceptual fronts, that is, on how
information is gathered in this area and what
is studied.
Methodological Concerns
Current measures of religiosity in child-
hood and adolescence are inadequate. As
noted earlier, most studies of religiosity in adoles-
cence (and the very few studies of religiosity in
childhood) use “snapshot” measures of religious
practice and beliefs, which do not allow for track-
ing behavior or making comparisons over time.
(See the brief discussion in the next section.) Fur-
ther, no measures of religiosity unique to younger
children were found in our review, which explains
our emphasis in this brief on adolescents. In the
rare studies that do include preadolescent chil-
dren, measures tend to be adaptations of the same
measures used with older adolescents and adults.
The almost exclusive reliance on responses to
questionnaires represents another limitation of
existing research studies on religiosity and well-
being. Moreover, the questions used to tap
religiosity vary widely across different surveys,28
suggesting that the research literature would ben-
efit from greater standardization of terminology
and measures (although, given the inadequacy of
current measures, it is too soon to determine
which existing measures, if any, may be most use-
ful). Also, frequently the questionnaires used
include only one or a few questions (for example,
how often respondents attend religious services or
how central they consider religion to their life).
Information derived in this way may not be able
to capture the varying levels of religious belief
and practice or the complexity of the religious
experience in respondents’ lives.
The lack of longitudinal studies limits
understanding of the importance of
religiosity in childhood and adolescence in
a number of ways. In order to fully address the
individual, family, and community influences that
predict religiosity – or to examine the extent to
which religiosity in childhood and adolescence
promotes future well-being – studies are needed
that follow individuals across time. The dearth of
such long-term studies means, for example, that
we currently cannot say that participating in reli-
gious activities when an adolescent is 13, for
instance, is related to how well – or how poorly –
that adolescent will do at age 21 on varied
measures of well-being.
Few studies have used multivariate analyses that
take account of confounding factors that may be
associated with both religiosity and outcomes.
(Multivariate analysis is a method for examining
three or more variables at the same time.) Lack of
consideration of such factors may lead researchers
to overestimate the effects of religious involve-
ment on well-being. For example, being involved
in religion may be affected by family and neigh-
borhood factors, such as family structure, risks in
the neighborhood, and poverty. These can influ-
ence proximity to houses of worship and the
capacity to attend services frequently and become
actively involved.
4
Few studies have considered possible
differences in the impact of religious
involvement on subgroups of adolescents.
The strength of the effects of religious involve-
ment on adolescent well-being may be influenced
by gender, ethnicity, socioeconomic status, or
neighborhood characteristics. However, few stud-
ies to date have systematically evaluated the
effects of the characteristics of adolescents and
their environments. Failure to do so may lead to
over- or underestimation of the importance of reli-
gion for different groups of adolescents. For
example, in a study described earlier, it was found
that religion had a stronger positive influence
among adolescents living in distressed neighbor-
hoods than among adolescents living in more sta-
ble neighborhoods.29 Despite these limitations,
however, researchers have found meaningful dif-
ferences in behavioral well-being between individ-
uals responding differently to measures of reli-
gious involvement.
Conceptual Concerns
In addition to the methodological concerns noted
above, research on religiosity and child well-being
faces more fundamental challenges.
Research on non-Christian minority reli-
gions in the United States is almost entirely
absent from investigations of the effects of
religiosity on well-being, as is cross-cultural
research including non-Western religions.30
The small numbers of adherents to these religions
in the United States, relative to the Christian
majority, and the relatively recent growth of these
religions, may partially explain this lack. Another
reason is that most measures of religious salience
used in surveys have been specifically designed to
examine religiosity among Christians, and the
questions do not apply to non-Christian spiritual
beliefs. Greater attention needs to be paid to the
inclusion of minority religions in such surveys in
the future, particularly in light of the dramatic
social and demographic changes in the United
States over the past decade. Work on such meas-
ures is needed for any long-term studies on
religion and child well-being that are planned.
A somewhat related concern is the lack of
research on spirituality, as distinguished
from religion. The studies cited in this brief,
and the longer report on which it is based,31 focus
on individuals’ participation in religious organiza-
tions and activities and the personal importance
they place on religion. Few if any studies distin-
guished between adolescents for whom spiritual
matters are unimportant and those who may have
strong spiritual beliefs but do not adhere to any
particular religion or attend religious services.
Thus we know little about the effects of differ-
ences in the processes of religious and spiritual
thought, apart from snapshots of religious activity
and beliefs. In order to gain a better grasp on the
value of spirituality for positive well-being, it will
be necessary to broaden our research focus
beyond the parameters of traditional organized
religion. Again, longitudinal – as well as cross-sec-
tional – studies would be valuable in this context.
CONCLUSION
Overall, research on religiosity and well-being
in childhood and adolescence indicates small to
moderate but generally consistent associations
between religious upbringing and risk-taking
and with positive social and emotional functioning.
Two qualifications accompany this conclusion.
First, very little research has been conducted with
young children, and it is unclear whether the
effects of religious practices and beliefs are consis-
tent across childhood and adolescence. There are
many problems inherent in studying religiosity in
childhood. Cognitive changes across childhood
may cause children’s responses to questions about
their own religious beliefs to have very different
meanings from responses of adolescents and
adults. Further, many of the outcomes that have
been addressed in research on adolescent religiosi-
ty – sexual behavior, drug use, and delinquency –
are rare among school-age children. Nonetheless,
further research is warranted in order to under-
stand the impacts of religiosity on child well-
being. Longitudinal studies will be necessary to
determine whether and how evolving beliefs and
5
participation in religious communities in childhood
have long-term effects on well-being beyond
childhood.
Second, most of the research on religion and well-
being in childhood and adolescence suggests that the
effects of religiosity on well-being are partially
shaped and influenced by the effects of the interper-
sonal environment, such as family interaction pat-
terns, parenting characteristics, and the social sup-
port that is provided to children and adolescents
by peers and adults who are part of their religious
communities. Future research needs to address the
extent to which such factors account for the positive
outcomes that are seen, and which factors represent
the pathways by which religiosity affects outcomes.
IMPLICATIONS FOR POLICY
AND PRACTICE
Although religious adherents generally feel that reli-
gion is intrinsically important, available research also
has implications for prevention and intervention
efforts aimed at improving outcomes for children and
adolescents. Most clearly, perhaps, the consistent
finding that some level of ongoing involvement with
a religious institution is associated with lower adoles-
cent drug and alcohol use32 and delays in sexual
activity supports the view that religious communities
can contribute to the prevention of drug and alcohol
abuse and teen pregnancy.33
In addition, it should not be forgotten that though
religion is one potential source of such positive social
support, it is not necessarily the only one,34 and that
child and adolescent well-being can be promoted by
the availability of both religious and nonreligious
resources within communities. Nevertheless, chil-
dren and adolescents who are part of religious com-
munities are likely to have expanded networks of car-
ing and nurturing adults and peers who know them
well; who are sources of physical, social and emotion-
al support; who provide opportunities for positive
behaviors; and who facilitate resistance to negative
influences.
Religious communities have a long history and expe-
rience in providing physical and emotional support to
individuals and groups in need, and in exerting social
controls over adherents’ behavior, based on shared
religious principles. This experience, coupled with
the fact that most adolescents report some affiliation
with a religious denomination, suggests that faith
communities may be uniquely well-suited to provide
youth with support and encouragement for socially
positive and moral behavior. Such support and
encouragement may be particularly important in
neighborhoods where other sources of social support,
opportunity, and control have broken down.
Child Trends, founded in 1979, is an independent, non-
partisan research center dedicated to improving the
lives of children and their families by conducting
research and providing science-based information to the
public and decision-makers. For additional information
on Child Trends, including a complete set of available
Research Briefs, please visit our Web site at
www.childtrends.org.
This brief summarizes a longer report, Religion and
Spirituality in Childhood and Adolescence (Child
Trends, 2002, January). The full report can be ordered
through our Web site. Child Trends gratefully acknowl-
edges the National Institute of Child Health and Human
Development’s Family and Child Well-Being Research
Network for support of our research on religiosity and
child well-being and the John D. and Catherine T.
MacArthur Foundation for ongoing support of our
Research Brief series. Additional support for Child
Trends’ communications efforts is provided by the David
and Lucile Packard Foundation, the William and
Flora Hewlett Foundation, and the Annie E. Casey
Foundation.
This brief also complements Child Trends’ special
American Teens Research Brief series supported by the
John S. and James L. Knight Foundation.
Editor: Harriet J. Scarupa
Endnotes
1For example, U.S. News/PBS’ Religion & Ethics Newsweekly poll, as
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2Benson, P.L., Donahue, M.J., & Erickson, J.A. (1989). Adolescence and
religion: A review of the literature from 1970 to 1986. Research in the
Social Scientific Study of Religion, 1, 153-181; King, V., Elder, G.H., &
Whitbeck, L.B. (1997). Religious involvement among rural youth: An
ecological and life-course perspective. Journal of Research on Adolescence,
7, 431-456.
3Youniss, J., McLellan, J.A., & Yates, M. (1999). Religion, community serv-
ice, and identity in American youth. Journal of Adolescence, 22, 243-253.
6
4Donahue, M.J., & Benson, P.L. (1995). Religion and the well-
being of adolescents. Journal of Social Issues, 51, 145-160; see also,
Social and emotional development/Prosocial activities and atti-
tudes/Religious services attendance, Child Trends DataBank,
www.childtrendsdatabank.org. The DataBank, launched in June
2002, is a continuously updated online resource providing informa-
tion on more than 70 key indicators of child and youth well-being.
5For example, Elifson, K.W., Petersen, D.M., & Hadaway, C.K.
(1983). Religiosity and delinquency: A contextual analysis.
Criminology, 21, 505-527; Donahue, M.J., & Benson, P.L. (1995).
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away, R.G., Payne, G.L., & Kethineni, S.R. (1996). Religion, social
bonds, and delinquency. Deviant Behavior: An Interdisciplinary
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7For example, Moore, K., Hair, E., Bridges, L., & Garrett, S. (2002).
Parent religious beliefs and adolescent outcomes. Poster presenta-
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May; Benson et al. (1989); Booth, J., & Martin, J.E. (1998). Spiritu-
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In H.G. Koenig (ed.), Handbook of religion and mental health (pp.
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8For example, McBride, D.C., Mutch, P.B., & Chitwood, D.D.
(1996). Religious belief and the initiation and prevention of drug
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9Brownfield, D., & Sorenson, A.M. (1991).
10 Jang & Johnson. (2001).
11 Moore et al. (2002); Benson et al. (1989); Donahue & Benson
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Williams, S., & Ryan, S. (2001). Background for community-level
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12 For example, Afxentiou, D., & Hawley, C.B. (1997). Explaining
female teenagers’ sexual behavior and outcomes: A bivariate probit
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nomic Issues, 18, 91-106; Bearman, P.S., & Brückner, H. (2001).
Promising the future: Virginity pledges and first intercourse.
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R.R., & Guilkey, D.K. (1996). The initiation of adolescent sexual
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13 See, Moore et al. (1995).
14 For example, Cooksey et al. (1996); Kahn, J.R., Rindfuss, R.R.,
& Guilkey, D.K. (1990). Adolescent contraceptive choice. Demogra-
phy, 27, 323-335; however, see Bearman, P.S., & Bruckner,
H. (2001). Promising the future: Virginity pledges and the transi-
tion to first intercourse. American Journal of Sociology, 106(4),
859-912.
15 Brewster, K.L., Cooksey, E.C., Guilkey, D.K., & Rindfuss, R.R.
(1998). The changing impact of religion on the sexual and contra-
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(2001).
16 Moore et al. (2002); Whitehead et al. (2001).
17 Halpern, C.T., Udry, J.R., Campbell, B., Suchindran, C., &
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18 Ku, L., Sonenstein, F.L., & Pleck, J.H. (1993). Factors influenc-
ing first intercourse for teenage men. Public Health Reports, 108,
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(1996, Spring). Factors modifying male adolescent risk behavior.
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19 Benson et al. (1989); Donahue & Benson (1995); Kedem, P., &
Cohen, D.W. (1987). The effects of religious education on moral
judgment. Journal of Psychology and Judaism, 11, 4-14; King,
P.E., & Furrow, J.L. (2001). Developmental resources, moral
behaviors, and faith communities: Adolescent religiousness and
social capital. Paper presented at the Biennial Meeting of the Society
for Research in Child Development, Minneapolis, April; Youniss et
al. (1999).
20 Hodgkinson, V.A., & Weitzman, M.S. (1997). Volunteering and
giving among American teenagers 14 to 17 years of age: 1996 edi-
tion. Washington, DC: Independent Sector; Nolin, M.J., Chaney,
B., Chapman, C., & Chandler, K. (1997). Student participation in
community service activity. Washington, DC: National Center for
Educational Statistics.
21 Fischer, & Richards. (1998). Religion and guilt in childhood.
In J. Bybee (Ed.), Guilt and children (pp. 139-155). San Diego:
Academic Press.
22 Donahue & Benson. (1995).
23 For example, Bahr, H.M., & Martin, T.K. (1983). “And thy
neighbor as thyself”: Self-esteem and faith in people as correlates
of religiosity and family solidarity among Middletown high school
students. Journal for the Scientific Study of Religion, 22, 132-144;
Benson et al. (1989); Donahue & Benson (1995); however, see
Markstrom, C.A. (1999). Religious involvement and adolescent
psychosocial development. Journal of Adolescence, 22, 205-221.
24 See, Mahoney, A., Pargament, K.I., Tarakeshwar, N., & Swank,
A.B. (in press). Religion in the home in the 1980s and 90s: Meta-
analyses and conceptual analyses of links between religion, mar-
riage and parenting. Journal of Family Psychology.
25 Brody, G.H., Stoneman, Z., & Flor, D. (1996). Parental religiosi-
ty, family processes, and youth competence in rural, two-parent
African American families. Developmental Psychology, 32, 696-706.
26 Gunnoe, M.L., & Mariner, C.L. (1997). Toward a developmen-
tal/contextual model of the effects of parental spanking on
children’s aggression. Aggression and Violence: A Review Journal.
27 Moore et al. (2002).
28 Gorsuch, R.L., & Venable, G.D. (1983). Development of an “age
universal” I-E scale. Journal for the Scientific Study of Religion,
22, 181-187.
29 Jang & Johnson. (2001).
30 Mahoney, et al. (in press).
31 Bridges, L.J., & Moore, K.A. Religion and Spirituality in Child-
hood and Adolescence (2002, January). Washington, DC: Child
Trends.
32 Lindberg, L.D., Boggess, S., & Williams, S. (2000). Multiple
threats: The co-occurrence of teen health risk behaviors. Report to
the Office of the Assistant Secretary for Planning and Evaluation,
U.S. Department of Health and Human Services, by The Urban
Institute.
33 See, McBride et al. (1996); Whitehead et al. (2001).
34 King & Furrow. (2001).
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