Person:

Rosmarin, David

Depressive symptoms and religious/spiritual (R/S) practices are widespread around the world, but their intersection has received relatively little attention from mainstream mental health professionals. This paper reviews and synthesizes quantitative research examining relationships between R/S involvement and depressive symptoms or disorders during the last 50 years (1962 to 2011). At least 444 studies have now quantitatively examined these relationships. Of those, over 60% report less depression and faster remission from depression in those more R/S or a reduction in depression severity in response to an R/S intervention. In contrast, only 6% report greater depression. Of the 178 most methodologically rigorous studies, 119 (67%) find inverse relationships between R/S and depression. Religious beliefs and practices may help people to cope better with stressful life circumstances, give meaning and hope, and surround depressed persons with a supportive community. In some populations or individuals, however, religious beliefs may increase guilt and lead to discouragement as people fail to live up to the high standards of their religious tradition. Understanding the role that R/S factors play in preventing depression, facilitating its resolution, or leading to greater depression will help clinicians determine whether this is a resource or a liability for individual patients.

Demographic discrepancies in dental healthcare utilization and access to care have historically been studied and attributed to such factors as socioeconomic status, race, and ethnicity. Such potential discrepancies and contributing factors amongst the Jewish population have been little explore. OBJECTIVE: To examine the frequency of dental visits among Jewish subgroups and explored possible explanatory factors for differences in dental healthcare utilization, such as financial constraints, dental anxiety, religious perspectives on health, lack of perceived need, poor accessibility, and scheduling conflicts. BASIC RESEARCH DESIGN: Cross-sectional study. PARTICIPANTS: A religiously diverse non-clinical sample of 169 Jews completed measures on demographics, dental visit frequency, dental anxiety, and general religiousness. RESULTS: On average, Orthodox Jews visit the dentist less often than non-Orthodox Jews (OR = 0.43) and Ultra-Orthodox Jews markedly less (OR = 0.23). Moreover, differences between these groups in dental visits were largely mediated by differences in dental anxiety, poor accessibility, lack of perceived need and scheduling conflicts. CONCLUSION: These results identify a population that is at risk for poor oral health and suggests possible preventive and corrective interventions.

Dual-system models of cognition propose that the interplay between analytic and associative cognition determines emotions and behaviors. Scrupulosity, an OCD presentation dominated by religious or moral fears, involves fears that God is unreasonable and punitive, and previous research suggests that individuals with scrupulosity hold more negative concepts of God. The current research assessed if implicit associative aspects of these beliefs are relevant, both to bypass social desirability and to explore the role of non-conscious cognition. Participants were drawn from the Harvard Medical School Study on Judaism and Mental Health and completed an explicit assessment of beliefs about God, a related implicit association task (GNAT), and the Penn Inventory of Scrupulosity. Results indicated that explicit and implicit beliefs did not correlate, and that they both independently correlated with scrupulosity. Regression analyses indicated that only those with high explicit negative beliefs and relatively negative implicit associations reported elevated levels of scrupulosity. Beliefs about God, like other cognitive processes, appear to include both automatic and deliberate components that can be discordant, and symptoms of scrupulosity may require both explicit and implicit negative evaluations. Further research exploring the relevance of dual process models to scrupulosity, OCD, and affective disorders generally, appears warranted and necessary.

Attitudes toward spirituality and religion (S/R) have not been systematically surveyed among practitioners of cognitive– behavior therapy. We therefore administered a brief survey about S/R ton n = 262 members of the Association for Behavioral and Cognitive Therapies (ABCT). Approximately half the sample reported a strong sense of spirituality (54%) however, religious affiliation, belief in God, religious practice, and intrinsic religiosity were substantially lower than that of the general population in the United States. Further, 36% of respondents reported some discomfort in addressing S/R issues with clients, 19% reported never/rarely inquiring about S/R, and 71% reported little-to-no previous clinical training in this area. Higher levels of personal S/R involvement predicted greater perception that S/R is relevant to mental health and greater comfort/frequency of addressing S/R in treatment, however this interacted with previous training, suggesting that training can promote the provision of spiritually competent care regardless of practitioners’ levels of personal S/R involvement.

Caring for children is a known psychosocial stressor; however, its effects on psychological functioning may have substantial cross-cultural variance. We explored relationships between family size and a variety of psychological outcomes among Orthodox Jews in four separate studies: (1) an international treatment-seeking sample (n = 82), (2) a community sample from Canada (n = 226), (3) an out-patient clinical sample from greater New York (n = 82), and (4) a large dyadic sample of Israeli couples (n = 789). Surprisingly, results suggested that family size was not associated with greater stress, anxiety, depression, global functioning, family functioning, family communication, family satisfaction, or even parenting stress. It is possible that the high religious value placed on family life as well as structural adaptions in families buffer against potential stressors associated with child rearing, and further research on these potential effects is warranted.

Despite a surge in psychological research on gratitude over the past several years, a number of important questions remain unanswered about this highly valued trait. It is largely unknown, for example, how gratitude is maintained in times of distress. This article supports and extends existing theory and research on the relevance of benefit detection (the perception of having received a gain rendered intentionally and voluntarily by another), by testing a model in which religious involvement in general, and religious coping in particular, can help sustain gratitude in the face of negative emotions. Across 2 studies—1 in a community/college student sample (n 404) and another among individuals seeking psychological treatment (n 122)—we found initial support for our model. Implications for further research on gratitude and other areas of positive psychology are discussed.

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.

Objectives: We explored relationships between general religiousness, positive religious coping, negative religious coping (spiritual struggle), and affective symptoms among geriatric mood disordered outpatients, in the northeastern USA. Methods: We assessed for general religiousness (religious affiliation, belief in God, and private and public religious activity) and positive/negative religious coping, alongside interview and self-report measures of affective functioning in a diagnostically heterogeneous sample of n = 34 geriatric mood disordered outpatients (n = 16 bipolar and n = 18 major depressive) at a psychiatric hospital in eastern Massachusetts. Results: Except for a modest correlation between private prayer and lower Geriatric Depression Scale scores, general religious factors (belief in God, public religious activity, and religious affiliation) as well as positive religious coping were unrelated to affective symptoms after correcting for multiple comparisons and controlling for significant covariates. However, a large effect of spiritual struggle was observed on greater symptom levels (up to 19.4% shared variance). Further, mean levels of spiritual struggle and its observed effects on symptoms were equivalent irrespective of religious affiliation, belief, and private and public religious activity. Conclusions: Previously observed effects of general religiousness on (less) depression among geriatric mood disordered patients may be less pronounced in less religious areas of the USA. However, spiritual struggle appears to be a common and important risk factor for depressive symptoms, regardless of patients’ general level of religiousness. Further research on spiritual struggle is warranted among geriatric mood disordered patients.

The past three decades have witnessed a surge in research on spirituality and health. This growing body of literature has linked many aspects of spirituality as well as religion to both positive and negative indices of human functioning. However, studies have primarily been descriptive, focusing on identifying associations between spirituality and health, rather than explanatory, focusing on identifying mechanisms underlying observed relationships. Earlier research is also limited by failure to control for salient covariates, apply prospective design, and use sophisticated measurements with well defined and empirically-validated factors. Recent research, however, is advancing the study of spirituality and health by examining not only whether religious factors are relevant to human health, but also how spirituality may functionally impact medical and psychological wellbeing and illness. This article introduces a special issue on Spirituality and Health containing 12 full-length research reports to further this welcomed, emerging trend.