Negative religious coping versus spiritual struggles: Moderator or main effect?

OBJECTIVE: While previous research indicates that negative religious coping relates with distress, it is unclear if this represents generalized spiritual struggles or a specific vulnerability activated by negative events. Moreover, past research treats coping as a stable phenomenon, although it likely fluctuates. This research simultaneously tested both models longitudinally and examined the relationship between coping and distress. METHODS: The current study is a secondary analysis of longitudinal data collected online over 3 years from 397 participants. Life events, negative religious coping, and depressive symptoms were assessed on six occasions, and linear mixed-effect models were used to analyze data. RESULTS: Negative religious coping was largely stable with increases at times of stress. Participants with higher mean negative coping reported more depressive symptoms regardless of life circumstances (i.e., main effect), likely reflecting generalized spiritual struggles. In addition, those with higher mean coping or with particularly high levels at a given time reported even higher levels of symptoms when they experienced more negative life events (i.e., moderation effect). CONCLUSION: Results suggest that previous research merges two distinct phenomena-spiritual struggles and negative coping. This has important theoretical and research implications and suggests that integrating spirituality and religion into treatment can be warranted.

Effects of religion on the course of suicidality among geriatric patients with mood disorders.

BACKGROUND: A growing volume of research suggests that religion protects against late-life suicide, but it remains unclear whether effects are relevant to clinical samples, which facets of religion are most relevant, and variations over the course of mood disorders (e.g. during periods of euthymia, depression, and/or heightened suicidality). METHOD: Eighty adults aged 55-85 years with mood disorders completed assessments of religion (affiliation, service attendance, importance of religion, belief and faith in God), depression, and suicidality over time (M = 7.31 measurements over M = 727 days). We computed metrics to identify mean and maximum levels of depression and suicidality, and the number of episodes of significant depression and suicidality experienced by each participant. RESULTS: Religious affiliation and importance of religion, but not service attendance, belief, or faith in God, were associated with lower mean and maximum depression. Conversely, all facets of religion predicted significantly lower mean and maximum levels of suicidality (rs ranging from -0.24 to -0.39), and substantially less likelihood of experiencing significant suicidality during the study (ORs ranging from 0.19 to 0.33). Service attendance, belief, and faith in God predicted less suicidality even among individuals who did not affiliate with a religious group. CONCLUSIONS: Religious factors, particularly faith in God, are associated with substantially less suicidality over time among older adults with mood disorders, irrespective of religious affiliation.

Spirituality/Religion and Self-Harm Among Patients With Alcohol/Substance Use Versus Other Disorders.

ABSTRACT: Spirituality/religion (S/R) is clinically relevant to recovery from alcohol use disorders (AUDs)/substance use disorders (SUDs) and also associated with less self-injury; however, the interplay of these factors has not been adequately evaluated. Participants ( n = 1443) were culled from a larger study among psychiatric patients. We assessed for S/R using self-report measures, and medical records were reviewed for demographics, clinical diagnoses, psychiatric medications, and self-harm engagement. Self-harm engagement was significantly higher among patients without AUD/SUD. S/R distress was higher among participants with AUD/SUD, but S/R community activity and importance of religion were lower. Interest in discussing S/R in treatment did not significantly differ across patients. Religious affiliation, importance of religion, and belief in God were associated with less self-harm, but effects were not moderated by presence of AUD/SUD. S/R factors are associated with lower self-harm, irrespective of the presence or absence of AUD/SUD. In contrast with clinical lore, S/R may be equally salient to psychiatric patients with AUD/SUD versus other disorders.

Religious affiliation protects against alcohol/substance use initiation: A prospective study among healthy adolescents.

BACKGROUND: A substantial volume of the literature suggests that religious factors buffer against alcohol/substance use among adults, but research among adolescents is sparse. Further, few studies in this area have been prospective, and therefore it is unclear how religion may impact less alcohol/substance use among adolescents. METHOD: We prospectively evaluated effects of religious affiliation on initiation of alcohol/substance use in a sample of 81 psychiatrically healthy 13-14-year-olds from New England, over a 3-year period (from November 2015 to January 2019). Known risk factors were also evaluated including anxiety, depression, and impulsivity; family history of mental illness and alcohol/substance misuse; and volume of brain regions implicated in adolescent alcohol/substance misuse (assessed by Magnetic Resonance Imaging). RESULTS: Religiously affiliated adolescents were significantly less likely to initiate use of alcohol/substances (hazard ratio [HR] = 0.38). The addition of family history of alcohol/substance misuse to the model increased the predictive value of religious affiliation (HR = 0.34). Other risk factors did not diminish nor increase observed effects. CONCLUSIONS: These findings support and extend the current research by suggesting that religious affiliation protects against initiation of alcohol/substance use during early adolescence, particularly in individuals with elevated risk.

Religious Beliefs, Trust In Public Figures, And Adherence to COVID-19 Health Guidelines among American Orthodox and Non-Orthodox Jews.

The COVID-19 pandemic and resultant health crisis highlighted the lack of scholarly understanding of the effects of sociocultural factors and religious beliefs on compliance with public health guidelines. Orthodox Jews in particular were suspected of mistrusting medical experts and were singled out for alleged non-compliance with COVID-19 health guidelines. We surveyed American Jews (N = 1,141) during the early stages of the pandemic about their religious beliefs connected with the pandemic, trust in relevant public figures, and compliance with health guidelines to examine whether and how these factors are related. Generally, participants expressed high levels of trust in scientists, medical professionals, and religious leaders and a high degree of adherence to health guidelines. We examined how trust varies as a function of sociodemographic features, religious affiliation, and health-related religious beliefs (i.e., spiritual health locus of control). Overall, our research underscores the relevance of religious beliefs and trust in public figures to adherence to health guidelines and public health messaging.

Managerialism: A workforce health hazard in human service settings.

BACKGROUND: This study assesses the relationship between managerialism and health among human service workers. METHODS: A total of 2154 New York City human service workers participated in an electronic survey that included validated measures of a system of work organization (the Organizational Commitment to Managerialism scale [OCTM]) and a work stressor (the Effort Reward Imbalance scale [ERI]), and single items about physical, mental, and behavioral health. Controlling for demographic variables, logistic regression models were used to predict health outcomes assess the potential role of ERI as a mediator. RESULTS: Managerialism was associated with increased risk of high blood pressure, neck and back pain, gastrointestinal difficulties, sleeping disorders, anxiety, and depression. Mediation analyses suggested that the effects of managerialism on health were partially explained by ERI. CONCLUSIONS: Managerialism in human service agencies significantly increased the risk of adverse physical and mental health. Increased levels of a work stressor helped to explain part of this association.

Implicit/Explicit Beliefs About God, Uncertainty, and Anxiety.

ABSTRACT: Intolerance of uncertainty (IU) refers to the incapacity to cope with a perceived lack of information sustained by negative perceptions about uncertainty and its implications. Previous research regarding the role of religion and spirituality (R/S) in coping with uncertainty is unclear. The current research assessed if implicit and explicit beliefs about God are related to these discrepancies. Participants completed an explicit task, an implicit association task, the Intolerance of Uncertainty Scale, and the Hospital Anxiety and Depression Scale. Results indicated that explicit and implicit beliefs independently correlated with IU and anxiety. Regression analyses suggested that these correlations were primarily due to the relationship between negative beliefs of God and IU and that IU partially mediated the relationship between R/S and anxiety. The current findings add to the growing literature on IU and suggest the need to address R/S as a possible correlate of IU.

COVID-19, Religious Coping, and Weight Change in the Orthodox Jewish Community.

Given links between stress and obesity, it is likely that individuals gained weight during the COVID-19 lockdown. Research suggests that religiosity facilitates coping, which may have lessened the relationship between stress and weight gain during the COVID-19 lockdown. We examined this relationship among Orthodox Jews (n = 731). Results indicated that stress was marginally associated with weight gain, and that this was moderated by intrinsic religiosity (IR). For those with low IR, stress correlated with weight gain, while for those with mean or higher IR, stress and weight change were unrelated. Results suggest that for some, religiosity may moderate links between stress and weight gain during times of crisis.

COVID-19, Mental Health, and Religious Coping Among American Orthodox Jews.

The COVID-19 pandemic presents potential mental health challenges, and the American Orthodox Jewish population has been particularly affected by the virus. The current study assessed the impact of the pandemic and explored the relationships between exposure, religiosity, and distress in a sample of n = 419 American Orthodox Jews. Results indicated high levels of exposure, concern, and compliance with medical guidelines; however stress was generally low and we found evidence for positive impact. Direct exposure correlated with higher religiosity. Positive religious coping, intrinsic religiosity and trust in God strongly correlated with less stress and more positive impact, while negative religious coping and mistrust in God correlated with the inverse. While the study is limited by its design, findings highlight that for some, faith may promote resilience especially during crisis.

Psychological predictors of eating pathology in older adult women.

Eating pathology is generally considered to affect females during adolescence and early adulthood. However, in recent years, there has been an increased recognition that disordered eating occurs in middle-aged and elderly women and that the presentation is similar to that of eating disorders in younger women. In the research presented here, results of an Internet survey of older adult women (N = 245; aged 60-90 years) indicate that the factors significantly associated with eating pathology-perfectionism, depression, and sociocultural pressures to be thin-closely parallel those reported for both younger and middle-aged women.

A Paradigm to Assess Implicit Attitudes towards God: The Positive/Negative God Associations Task.

Psychological research on the relationship between spirituality/religion and mental health has grown considerably over the past several decades and now constitutes a sizable body of scholarship. Among dimensions of S/R, positive beliefs about God have been significantly related to better mental health outcomes, and conversely negative beliefs about God are generally associated with more distress. However, prior research on this topic has relied heavily upon self-report Likert-type scales, which are vulnerable to self-report biases and measure only explicit cognitive processes. In this study, we developed and validated an implicit social cognition task, the Positive/Negative God Go/No-go Association Task (PNG-GNAT), for use in psychological research on spirituality and religion (S/R). Preliminary evidence in a large sample (N = 381) suggests that the PNG-GNAT demonstrates internal consistency, test-retest and split-half reliability, and concurrent evidence of validity. Further, our results suggest that PNG-GNAT scores represent different underlying dimensions of S/R than explicit self-report measures, and incrementally predict mental health above and beyond self-report assessment. The PNG-GNAT appears to be an effective tool for measuring implicit positive/negative beliefs about God.

Depression stigma and treatment preferences among Orthodox and non-Orthodox Jews.

Anecdotal reports of increased stigma toward mental illness among Orthodox Jews seems to conflict with an existing literature describing less stigmatization toward depression among Jewish individuals. This online survey study investigated stigma toward depression and treatment preference among Orthodox and non-Orthodox Jews (N = 391). All participants were presented with a depression vignette to assess for stigma and then randomized to a vignette depicting a treatment modality (behaviorally oriented or insight oriented) to assess for treatment preference across several delivery options (individual, group, or Internet). Results indicated elevated depression stigma among Orthodox Jews as expressed by elevated levels of secrecy, treatment-seeking stigma, family/marriage stigma, and stigmatizing experiences, but not attitudinal social distancing. No group differences were found with respect to overall treatment preference, treatment modality, or manner of delivery. Overall, participants preferred individual therapy more than group and Internet therapy and preferred group therapy more than Internet therapy. Clinical and research implications are discussed.

"G-d, in you I trusted, let me never be ashamed": Shame and sexual abuse among Orthodox Jews.

OBJECTIVE: Previous research suggests that generalized shame is an important consequence of sexual abuse, and that it maintains symptoms and hampers recovery. Orthodox Jews view sexuality as a powerful experience that is sacred within a loving marriage yet profane and damaging outside of that context. Sexual abuse may, therefore, be perceived as a shameful violation of modesty and spiritually degrading. Accordingly, we hypothesized that abuse would be more strongly related to shame among Orthodox Jews and that this would at least partially mediated resulting distress. METHOD: We assessed sexual abuse history, shame, and distress in a convenience sample of 628 adult patients completing an intake process for outpatient psychotherapy, of which 109 reported an Orthodox Jewish religious affiliation. RESULTS: Among Orthodox patients, 43% reported a history of sexual abuse and this group reported substantially higher levels of shame compared to both Orthodox patients without a history of sexual abuse and non-Orthodox patients with a history of abuse. Moreover, elevated shame fully mediated the relationship between abuse and depressive symptoms, life satisfaction, and spiritual struggles. CONCLUSIONS: Results suggest that treatment of Orthodox survivors of sexual abuse requires particular attention to shame and that further research is warranted. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Response to anxiety treatment before, during, and after the COVID-19 pandemic.

BACKGROUND: The COVID-19 pandemic yielded a substantial increase in worldwide prevalence and severity of anxiety, but less is known about effects on anxiety treatment. OBJECTIVE: We evaluated effects of the COVID-19 pandemic on responses to Cognitive Behavioral Therapy for anxiety, in a clinically heterogeneous sample of patients. METHODS: A sample of 764 outpatients were separated into four groups: (1) Pre-pandemic (start date on or prior to 12/31/2019), (2) Pandemic-Onset (start date from 01/01/2020 to 03/31/2020), (3) During-Pandemic (start date from 04/01/2020 through 12/31/2020), and (4) Post-Pandemic (start date on or after 01/01/2021). We subsequently compared treatment trajectories and effects within and between these groups over 5621 total time points (mean of 7.38 measurements per patient). RESULTS: Overall, patients presented with moderate levels of anxiety (M = 13.25, 95%CI: 12.87, 13.62), which rapidly decreased for 25 days (M = 9.46, 95%CI: 9.09, 9.83), and thereafter slowly declined into the mild symptom range over the remainder of the study period (M = 7.36, 95%CI: 6.81, 7.91), representing clinically as well as statistically significant change. A series of conditional multilevel regression models indicated that there were no substantive differences between groups, and no increase in anxiety during the acute pandemic phase. CONCLUSIONS: Our results suggest that responses to treatment for anxiety were equivalent before, during, and after the COVID-19 pandemic. Among patients who were in treatment prior to the pandemic, we failed to detect an increase in anxiety during the pandemic's acute phase (March 20th, 2020 through July 1st, 2020).

Clinical differences between outpatients with and without internet addiction and emotional disorders: a prospective naturalistic outcome study.

Background/Objective: as internet use becomes increasingly ingrained in contemporary society, internet addiction (IA) has emerged as a global public health concern. There is ongoing debate regarding whether IA represents a distinct psychological disorder or a secondary manifestation of other existing disorders. This study aimed to examine the pathological relationship between IA and emotional disorders (ED). Method: this study compared pre-treatment characteristics and treatment process of three groups of patients (N=1292) in a naturalistic treatment setting: IA only, ED only, and comorbidity of IA and ED. Results: the IA only group differed from the other groups by reporting the highest levels of life satisfaction, adaptive emotion regulation, as well as risk behavior urges at intake. In addition, the IA only group displayed the lowest level of depressive and anxiety symptoms throughout the treatment. Conclusion: our findings contribute to a better understanding of the discreteness of IA as a potential psychological disorder and inform more effective treatment strategies for IA and its comorbid conditions.

Jewish spirituality, depression, and health: an empirical test of a conceptual framework.

BACKGROUND: Little is known about the links between spirituality and mental health among Jews. PURPOSE: This study assessed trust/mistrust in God and religious coping and examined their relationships to depressive symptoms and physical health. Religious affiliation and intrinsic religiousness were examined as moderating variables and religious coping was examined as a mediator. METHOD: Anonymous internet surveys were completed by 208 Jewish women and men of diverse denominations who resided primarily in the USA. RESULTS: Trust in God and positive religious coping were associated with lower levels of depressive symptoms and mistrust in God and negative religious coping were associated with greater depressive symptoms. Intrinsic religiosity showed a small moderation effect for mistrust in God and negative religious coping in relation to depressive symptoms and for trust in God in relation to physical health. Further, positive religious coping fully mediated the link between trust in God and less depressive symptoms and negative religious coping fully mediated the relationship between mistrust in God and greater depressive symptoms. CONCLUSION: The data lend themselves to a possible integrative cognitive-coping model, in which latent core beliefs about the Divine activate coping strategies during times of distress, which in turn impact psychological health. The findings highlight the potential clinical significance of spirituality to mental health among Jews and provide a basis for future longitudinal, experimental, and treatment outcome research.

Is the connection between religiosity and psychological functioning due to religion's social value? A failure to replicate.

Increasingly, religion and spirituality has been tied to well-being. However, the mediators are likely multifold, contextually dependent, and remain unclear. A recent report suggested that this is due to religion's social value and presented results indicating that religiosity was more strongly related to psychological adjustment within countries with higher mean religiosity. Effect sizes were small, and given previous research suggesting other more proximal mediators, it was my hypothesis that these findings would not be replicated. Analysis of data from the European Social Survey revealed no significant interactions between country-level religiosity and individual religiosity in predicting psychological well-being. These conflicting findings point to the nuanced nature of the religion-health relationship and suggest that this correlation is unlikely to be due to social valuation. Studies using cursory measures are likely to explain only a small proportion of the variance, yield contradictory findings, and fail to significantly enhance theory in this domain.

Internet Addiction and the Treatment of Depression? A Prospective Naturalistic Outcome Study.

The increasing prevalence of Internet addiction (IA) has been linked with a wide range of psychological disorders, including depression. We explored how IA was prospectively associated with effectiveness of treatment for adult patients with depressive symptoms (n = 241) in the context of a New York-based outpatient clinic. Although IA was not correlated with symptoms at intake, patients with higher IA attended fewer total sessions on average. Multilevel regression modeling also revealed that patients with higher IA scores terminated treatment with higher depression scores compared with those with lower IA scores. In addition, those with higher levels of IA were more likely to exhibit rising levels of depressive symptoms toward the end of the treatment, whereas patients with lower levels of IA maintained reduced depressive symptoms through termination. These results suggest that presence of IA may predict a less successful treatment outcome for adults with depression, as IA may slow down the process of symptom reduction and correlate with relapse.

Religion, ethnicity, and attitudes toward psychotherapy.

Many presume that White culture supports psychotherapy utilization. However, cultural analyses suggest that many aspects of White culture are antithetical to the values and practices underlying psychotherapy, which appear more congruent with Ashkenazic Jewish attitudes and values. The current research empirically tested this possibility by comparing older Jewish White people, non-Jewish Whites, and Black participants on attitudes relevant to psychotherapy. Results indicated that Jews had greater confidence in a therapist's ability to help, were more tolerant of stigma, and more open to sharing their feelings and concerns than participants in the other groups. Furthermore, initial differences between Whites and African Americans were lessened when Jewish identity was included in the analysis. Results suggest that Jewish culture is relatively accepting of psychotherapy, and that previous reports of different rates of mental health seeking attitudes and utilization by Whites and Blacks may be due, in part, to the inclusion of Jewish individuals in these samples.

Dual-Task Effects on Concurrent Speech Production in School-Age Children With and Without Stuttering Disorders.

PURPOSE: Contemporary motor theories indicate that well-practiced movements are best performed automatically, without conscious attention or monitoring. We applied this perspective to speech production in school-age children and examined how dual-task conditions that engaged sustained attention affected speech fluency, speech rate, and language productivity in children with and without stuttering disorders. METHOD: Participants included 47 children (19 children who stutter, 28 children who do not stutter) from 7 to 12 years of age. Children produced speech in two baseline conditions with no concurrent task and under a dual-task condition requiring sustained attention to on-screen stimuli. Measures of speech fluency, speech rate, and language productivity were obtained for each trial and compared across conditions and groups. RESULTS: Dual-task conditions resulted in a reduction in stutter-like disfluencies relative to the initial baseline speaking condition. Effects were similar for both groups of children and could not be attributed to decreases in language productivity or a simple order effect. CONCLUSIONS: Findings suggest that diverting attention during the process of speech production enhances speech fluency in children, possibly by increasing the automaticity of motor speech sequences. Further research is needed to clarify neurophysiological mechanisms underlying these changes and to evaluate potential clinical applications of such effects. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.19945838.