Integrating Spirituality Into a Behavioral Model of Depression

Abstract

A protective association between spirituality and depression is well-established, but the processes driving this association, as well as its clinical implications, remain unclear. We postulate that one mechanism driving this relationship is frequency of spiritual behaviors, and propose framing this process in the context of value-driven behavioral activation (BA). To clarify the extent to which spiritual behaviors function in a value-driven BA framework, we examined whether intrinsic religiosity (value of religion) moderates the effect of spiritual behaviors on depression in a cross- sectional community sample. Results of a hierarchical linear regression indicate that for those with high intrinsic religiosity, greater engagement in spiritual behaviors was related to decreased depressive symptomatology, while for those low on intrinsic religiosity, greater spiritual behaviors was associated with higher depression. For those individuals at mean levels of intrinsic religiosity, spiritual behavior appeared to have little relationship with depression. Results of a logistic regression demonstrated that intrinsically-motivated spiritual behaviors predict clinical depression as well as depressive symptomatology. The clinical implications of these findings are discussed, including the utility of integrating spirituality into the value-driven behavioral treatment of depression.