Religiosity,internalized homonegativity and outness in Christian men who have sex with men

When exposed to their congregations' negative views of homosexuality, Christian men who have sex with men frequently struggle to reconcile their religious and sexual identities, possibly contributing to negative emotional states and behaviors associated with HIV/STI infection. To examine the influence of religiousity on internalized homonegativity and outness among Christian men who have sex with men, we used survey data from 1165 men who answered questions about their religious beliefs and sexual behavior. We stratified participants based on religious affiliation groupings: Catholic, Mainline Protestant and Evangelical Protestant. After using confirmatory factor analysis to verify that the selected measures of religiosity were equivalent between groups, we used structural equation modeling to examine the relationship between religiosity, internalized homonegativity and outness. Among Catholics and Mainline Protestants, religiosity was not associated with internalized homonegativy or outness. However, among Evangelical Protestants – a group more likely to ascribe to religious fundamentalism – increased religiosity was associated with increased internalized homonegativity, which contributed to decreased outness. Our findings suggest that mental health providers and sexuality educators should be more concerned about the influence of religiosity on internalized homonegativity and outness when clients have a history of affiliation with Evangelical Protestant faiths more so than Catholic or Mainline Protestant faiths.

     

Religious and spiritual assessment of the child and adolescent

Assessment in child and adolescent psychiatry is a complex process that involves developmental, environmental, and experiential perspectives. Recently, there has been interest in including spiritual and religious assessment in the psychiatric assessment of children, but no well-recognized guidelines for such an assessment have been established. This article proposes an approach to spiritual assessment of children and adolescents that begins with developing an understanding of the family's spiritual and religious life, followed by a developmentally informed method of observing and talking with children and adolescents about their spiritual and religious beliefs. The article concludes with a discussion of ethical issues involved when the psychiatrist addresses issues of spirituality and religion with child and adolescent patients and their families.     

The Catholic child, adolescent, and family

This article identifies core features of Catholic spiritual and religious tradition and worldview. It reviews clinical implications of this worldview in working with the psychiatric problems of Catholic children and adolescents. Core Catholic beliefs and practices are discussed, with case examples illustrating principles of assessment and treatment. Collaboration between child and adolescent psychiatrists and Catholic clergy and counselors is encouraged, and recommendations for successful collaborative efforts are offered.     

Do people with mental illness deserve what they get? Links between meritocratic worldviews and implicit versus explicit stigma

Meritocratic worldviews that stress personal responsibility, such as the Protestant ethic or general beliefs in a just world, are typically associated with stigmatizing attitudes and could explain the persistence of mental illness stigma. Beliefs in a just world for oneself (“I get what I deserve”), however, are often related to personal well-being and can be a coping resource for stigmatized individuals. Despite these findings in other stigmatized groups, the link between worldviews and the stigma of psychiatric disorders is unknown. We measured just world beliefs for self and others as well as endorsement of the Protestant ethic in 85 people with schizophrenia, schizoaffective or affective disorders and 50 members of the general public. Stigmatizing attitudes toward people with mental illness (perceived responsibility, perceived dangerousness, general agreement with negative stereotypes) were assessed by self-report. Using a response-latency task, the Brief Implicit Association Test, we also examined guilt-related implicit negative stereotypes about mental illness. We found a consistent positive link between endorsing the Protestant ethic and stigmatizing self-reported attitudes in both groups. Implicit guilt-related stereotypes were positively associated with the Protestant ethic only among members of the public. Among people with mental illness, stronger just world beliefs for self were related to reduced self-stigma, but also to more implicit blame of persons with mental illness. The Protestant ethic may increase (self-)stigmatizing attitudes; just world beliefs for oneself, on the other hand, may lead to unexpected implicit self-blame in stigmatized individuals. Public anti-stigma campaigns and initiatives to reduce self-stigma among people with mental illness should take worldviews into account.     

Beliefs about alcohol among UK Jews and Protestants: Do they fit the alcohol-depression hypothesis?

BACKGROUND: Some research has suggested that Jews drink less alcohol than other cultural groups, and may have different beliefs about its use. Differences in beliefs about alcohol, and different patterns of use, may play a role in accounting for cultural and gender variations in depression prevalence. Alcohol may act as an escape route from depression, thus deflating depression rates in certain groups of people, in particular, men from Protestant backgrounds. METHODS: Self-reported use and beliefs about alcohol were assessed in a UK sample of 70 Jews and 91 Protestants, including non-practising people of Jewish and Protestant background. The effects of religious group and of gender on measures of alcohol behaviour and beliefs were examined. RESULTS: Some differences were found between Jews and Protestants. Jews had less favourable beliefs about alcohol and drank less than Protestants. More importantly, and in line with our hypotheses, there were gender differences in Protestants but not Jews with respect to some beliefs about alcohol and actual use of alcohol. CONCLUSIONS: The study goes some way in supporting the notion that religious-cultural and gender differences in beliefs and behaviour towards alcohol may contribute to religious-cultural and gender differences in rates of depression.     

Collaboration between psychiatrists and clergy in recognizing and treating serious mental illness

OBJECTIVE: A surprisingly high number of Americans seek clergy support for treatment of mental illness. However, little is known about how the clergy prepare for fulfilling this need or their beliefs regarding mental illness. This study examined the ability to recognize and treat mental illness among Hawaii's Protestant clergy. METHODS: Ninety-eight clergy members responded to the survey. RESULTS: Most (71%) reported feeling inadequately trained to recognize mental illness. The most common cause of mental illness that clergy members cited was medical (37%), yet when asked to comment on two case vignettes, many reported that they would provide counseling instead of referral. When referrals were made, 41% considered shared religious beliefs between parishioner and provider important, and 15% considered shared beliefs essential. CONCLUSIONS: These findings highlight the need for collaboration between mental health professionals and the clergy. Knowledge of a patient's belief system may help improve crisis interventions and treatment planning for religious patients.     

Sleep problems and their relation to cognitive factors,anxiety, and depressive symptoms in children and adolescents

Background: Existing research indicates sleep problems to be prevalent in youth with internalizing disorders. However, childhood sleep problems are common in the general population and few data are available examining unique relationships between sleep, specific types of anxiety and depressive symptoms among non‐clinical samples of children and adolescents. Methods: The presence of sleep problems was examined among a community sample of children and adolescents (N=175) in association with anxiety and depressive symptoms, age, and gender. Based on emerging findings from the adult literature we also examined associations between cognitive biases and sleep problems. Results: Overall findings revealed significant associations between sleep problems and both anxiety and depressive symptoms, though results varied by age. Depressive symptoms showed a greater association with sleep problems among adolescents, while anxiety symptoms were generally associated with sleep problems in all youth. Cognitive factors (cognitive errors and control beliefs) linked with anxiety and depression also were associated with sleep problems among adolescents, though these correlations were no longer significant after controlling for internalizing symptoms. Conclusions: Results are discussed in terms of their implications for research and treatment of sleep and internalizing disorders in youth. Depression and Anxiety, 2009. Published 2008 Wiley‐Liss, Inc.     

The influence of religion on sexuality: implications for sex therapy.

Religious beliefs are among the many factors that determine whether sexually dysfunctional persons will seek out a sex therapist. These beliefs may also generate resistance to therapy or influence patients to drop out of treatment before it is complete. Therapists who are sensitive to patients' religious beliefs enhance the likelihood of a successful treatment process. The authors present six case examples from their practice in which religious beliefs played an important role. They urge sex therapists to become more aware of the religious dynamic and to help address the paucity of clinical case material in the literature.     

Child and adolescent psychopathology: spiritual and religious perspectives

This article addresses the relationship between children's religious beliefs and spiritual practices and the presence of psychopathology. Study of this subject represents a formidable task due to the complexity and diversity of the constructs involved, heterogeneity in religious beliefs and practices, and the difficulty in discriminating between the independent effects of religion and culture. Nevertheless, broad links between child psychopathology and spiritual/religious beliefs and practices are proposed. On the whole, the available empiric data suggest that religion is primarily health promoting in direct, positive benefits for children and in indirect, positive effects through parent and family functioning, although there are isolated exceptions. When spirituality and religious beliefs/practices are associated with negative mental health outcomes in children or their families, evidence points to "poorness-of-fit," based on an interaction between the child's psychopathology and aspects and religious beliefs/practice. Clinical implications of the findings and proposels are outlined.     

Religion, spirituality, and depression in adolescent psychiatric outpatients

This study examines in a preliminary manner the relationship between multiple facets of religion/spirituality and depression in treatment-seeking adolescents. One hundred seventeen psychiatric outpatients aged 12 to 18 completed the brief multidimensional measure of religiousness/spirituality, the Beck Depression Inventory (BDI), a substance abuse inventory. Controlling for substance abuse and demographic variables, depression was related to feeling abandoned or punished by God (p < 0.0001), feeling unsupported by one's religious community (p = 0.0158), and lack of forgiveness (p < 0.001). These preliminary results suggest that clinicians should assess religious beliefs and perceptions of support from the religious community as factors intertwined with the experience of depression, and consider the most appropriate ways of addressing these factors that are sensitive to adolescents' and families' religious values and beliefs.     

Influence of religion and supernatural beliefs on clinical manifestation and treatment practices in patients with bipolar disorder

Background: Religious and supernatural beliefs influence help seeking and treatment practices in bipolar disorder, but these are rarely explored by clinicians. This study aimed to understand religiousness, magico-religious beliefs, prevalence of religious and supernatural psychopathology and treatment practices among patients with bipolar disorder in euthymic state. Methodology: A total of 185 patients of bipolar disorder currently in remission were assessed cross-sectionally for their clinical profile, current clinical status on the Hamilton Depression Rating Sscale (HDRS), Young Mania Rating Scale (YMRS) and the Global Assessment of Functioning (GAF). A semi structured instrument for magico-religious beliefs, aetiological models, treatment seeking and treatment practices was administered. Results: More than a third of patients (37.8%) had psychopathology with either religious or supernatural content or both in their lifetime. Almost half (45.4%) the patients believed in a supernatural/religious aetiology for their illness. Among the specific causes, planetary influences (13.5%) and God’s will (30.8%) were the most common supernatural and religious cause, respectively. Almost half (44.3%) of patients had first treatment contact with religious/supernatural treatment providers. More than 90% of patients reported belief in God, yet about 70% reported that their doctors did not ask them sufficient questions to understand their religiosity. Conclusion: Magico-religious beliefs are common in bipolar disorder and a large number of patients attribute these as aetiological factors for their illness. Consequently they tend to seek treatment from traditional practitioners prior to approaching medical practitioners and may continue treatment with them alongside medical management.     

Perceptions about intellectual disability: a qualitative study from Vellore,South India

Background Cultural and religious beliefs influence perceptions about health and illness. Data, from India, on perceptions about intellectual disability are scant. This study explored people's cultural beliefs and attitudes about intellectual disability, perceived needs and burden associated with care in Vellore, south India. Method A qualitative methodology using focus groups was employed. Eight focus groups were conducted in three settings and included the mothers of children and adolescents with intellectual disability (four groups, n = 29), community health workers (two groups, n = 17) and schoolteachers (two groups, n = 16). Results Our results suggest that cultural and religious beliefs perpetuated negative attitudes towards disability. This meant that caregivers bore a high burden of care with little support from family or society. The study confirmed the presence of diverse, multiple and contradictory models of disability drawing from biomedical and local religious, social and cultural constructs. Conclusions Public awareness, education and community‐level interventions for reducing the misconceptions and stigma related to intellectual disability are needed in addition to culturally sensitive treatment methods to improve the attitude towards and management of intellectual disability.     

The appreciation of the spiritual in mental illness: a qualitative study of beliefs among clergy in the UK

Clergy in the UK continue to provide health and social care services. However, collaboration between mental health services and clergy may be problematic, particularly in the resolution of conflicting beliefs and therapeutic modalities. For example, belief in demonic possession and other supernatural causes of mental illness, which are contentious among secular medical practitioners, remain prevalent in many ethnoreligious communities. Thus, interpretations of illness by clergy within health systems may be crucial to appropriate intervention for people with mental illness. However, clergy conceptualizations of suffering also reveal something about the secularization within religious institutions through the despiritualization of particular phenomena. This paper on Christian clergy beliefs and attitudes to supernatural explanations, describes how the negotiation of such beliefs are complex and often equivocal among mainstream clergy but integral to the Pentecostal churches and evangelical clergy in the mainstream, institutional churches. These beliefs and their implications for collaboration with psychiatry are discussed in the context of a rapidly changing religious and cultural landscape.     

Religious attitudes and practices of hospitalized medically ill older adults

Objectives. To examine the prevalence of religious beliefs and practices among medically ill hospitalized older adults and relate them to social, psychological and health characteristics. Methods and procedures. Consecutive patients age 60 or over admitted to the general medicine, cardiology and neurology services of Duke University Medical Center were evaluated for participation in a depression study. As part of the evaluation, information on religious affiliation, religious attendance, private religious activities, intrinsic religiosity and religious coping was collected. Demographic, social, psychological and physical health characteristics were also assessed. Bivariate and multivariate correlates of religious belief and activity were examined using Pearson correlation and linear regression. Results. Of the 542 patients evaluated, detailed information on religious beliefs and behaviors was collected on 455 cognitively unimpaired patients. Over one-half (53·4%) of the sample reported attending religious services once per week or more often; 58·7% prayed or studied the Bible daily or more often; over 85% of patients held intrinsic religious attitudes; and over 40% spontaneously reported that their religious faith was the most important factor that enabled them to cope. Religious variables were consistently and independently related to race (Black), lower education, higher social support and greater life stressors, and religious attendance was associated with less medical illness burden. Religious attendance was also related to lower depressive symptoms, although the association weakened when other covariates were controlled. Conclusions. Religious practices, attitudes and coping behaviors are prevalent among hospitalized medically ill older adults and are related to social, psychological and physical health outcomes. Implications for clinical practice are discussed. © 1998 John Wiley & Sons, Ltd.     

Religiosity, anxiety, and depression among a sample of Iranian medical students

OBJECTIVE: There are many studies of religion and mental health in a Christian context, but studies in Islamic countries are few. Most previous studies used only a single question for measuring religion, and several of them showed negative associations between religion and indexes of anxiety or depression among older people. This study preliminary assesses the associations between religious variables, anxiety, and depression in a sample of Muslim students. METHOD: This cross-sectional study examines a sample of medical students (N = 285) for association(s) between religiosity, anxiety, and depression. The subjects completed a Muslim religiosity questionnaire including religious beliefs, emotions, and behaviors subscales and the Beck anxiety and depression inventories during their psychiatry rotation at Roozbeh psychiatric hospital, Tehran, Iran. RESULTS: all the three religious subscales were negatively associated with and negatively predicted depression and anxiety; but only prediction of anxiety by the religious beliefs score was statistically significant. CONCLUSIONS: These findings provide further evidence for a protective role of religion against anxiety and depression but more studies are required.     

International note: Prediction of mathematics work ethic and performance from behavioral,normative, and control beliefs among Qatari adolescents

Over half-a-million adolescents take part in each cycle of the Program for International Student Assessment (PISA). Yet often, researchers and policy makers across the globe tend to focus their attention primarily on the academic trajectories of adolescents hailing from highly successful education systems. Hence, a vast majority of the adolescent population who regionally and globally constitute the ‘long tail of underachievement’ often remain unnoticed and underrepresented in the growing literature on adolescents' academic trajectories. The present study, therefore, explored the relations of dispositions toward mathematics, subjective norms in mathematics, and perceived control of success in mathematics to mathematics work ethic as well as mathematics performance; and the mediational role of mathematics work ethic in the association between dispositional, normative, and control beliefs and mathematics performance among adolescents in one of the lowest performing education systems, Qatar. Structural equation modeling (SEM) analyses revealed that Qatari adolescents' dispositional, normative, and control beliefs about mathematics were significantly associated with their mathematics work ethic and mathematics performance, and mathematics work ethic significantly mediated the relationship between dispositional, normative, and control beliefs about mathematics and mathematics performance. However, multi-group SEM analyses indicated that these relationships were not invariant across the gender and the SES groups.     

The beliefs among patients with epilepsy in Saudi Arabia about the causes and treatment of epilepsy and other aspects

PurposeThe current survey sought to identify the religious and cultural beliefs about the causes and treatment of epilepsy in people with epilepsy from Saudi Arabia and a number of other aspects relating to the possibility of cure, coping with the condition, and public awareness.MethodsStudy instruments were developed on the basis of the literature, a focus group of people with epilepsy, and feedback from people in the field with local knowledge. These were then piloted. A survey was then carried out among a total of 110 adults with epilepsy. Participants were asked to complete questionnaires inquiring into their beliefs about the causes and range of treatments used for epilepsy. Each participant was allowed to choose more than one cause and more than one treatment method. The questionnaires were administered face to face by a clinical psychologist (HAA) to improve the quality of the responses.ResultsWe found that most adults with epilepsy in Saudi Arabia believe that epilepsy is a condition with multifactorial causation and for which more than one treatment method should be applied. A test from God was the most commonly ascribed cause (83% as well as 40% who believed that some cases of the illness were a punishment from God). The belief in the concept of God's will helped many in the cohort to accept their illness as part of their destiny. Ninety-six percent of the patients believed that there were also medical causes (such as an illness, brain insult, inflammation, heredity, contagion), and a similar proportion believed that there were also religious causes. Smaller proportions believed epilepsy could be due to cultural (78%) or psychosocial causes (64%). Thirty-four percent of people believed that there could be sometimes no cause, but only 2% thought that epilepsy never had any identifiable cause. Most patients did not believe that one treatment alone would help. Ninety-three percent of patients believed in medical treatment, 93% in religious treatment, and 64% in traditional treatments, and 7% believed in changing lifestyle (eating balanced food and positive thinking). Seventy-eight percent of the sample believed that their epilepsy was a curable illness. Ninety-six percent believed that faith and practicing religious rituals helped in coping with epilepsy, and 92% believed that family support helped in coping with epilepsy. Nine percent of patients had stopped their medication for religious reasons or because of a sense of shame, and 7% had at one time been forced by their family to stop their medication. Ninety-two percent of the sample reported having enough family support. Ninety-five percent believed that Saudi society needs more awareness to understand epilepsy.ConclusionIn Saudi Arabia, religious and cultural beliefs about the causes and treatment of epilepsy exist alongside medical beliefs. The holding of religious beliefs, the practicing of religious rituals, and the presence of family support were found to be of great importance in coping with epilepsy, and their role needs to be fully appreciated in the medical management of the condition.     

Disordered eating in jewish adolescent girls

Objectives: To examine the presence and nature of disordered eating attitudes and behaviours among Jewish Canadian adolescents, as compared with non-Jewish Canadian adolescents in an urban community. A secondary goal was to examine whether rates of eating-disordered behaviour differed among the adolescents based on the degree of Jewish religious observance. Method: High school students (n = 868) from the Toronto area completed a demographic and religious practice questionnaire together with the Eating Attitudes Test (EAT), a self-report test that discriminated adolescents with syndromal eating disorders from normal adolescents. Results: Jewish females aged 13 to 20 years, but not males, reported significantly more disordered eating behaviours and attitudes, compared with their non-Jewish female counterparts. Twenty-five percent of Jewish females, as compared with 18% of non-Jewish females, scored above the clinical cut-off for the EAT. No differences in vulnerability to disordered eating were found within the group of Jewish females or males related to their degree of religious observance. Conclusions: Adolescent Jewish females, but not males, appear to be at greater risk for abnormal attitudes and behaviours related to eating, compared with their non-Jewish female peers. While the reasons for this finding are unclear, this study is a step toward improving understanding of the relations between sex, culture, religion, and the development of eating disorders. Culturally sensitive and sex-specific prevention strategies and treatment interventions are indicated.     

Psychiatrists’ religious attitudes in relation to their clinical practice: a survey of 231 psychiatrists

A total of 231 psychiatrists working in several London teaching hospitals were surveyed about their private religious attitudes and how these affected their reported clinical practice. Although only 27% reported a religious affiliation and 23% a belief in God, 92% felt that psychiatrists should concern themselves with the religious concerns of their patients. Although the psychiatrists who were religious were more likely to make referrals to religious leaders or to disclose their own beliefs to patients, contrary to reports from the United States there was no evidence that psychiatrists’ private religious beliefs had an important influence on their clinical practice.     

Comparing OCD-affected youth with and without religious symptoms: Clinical profiles and treatment response

BackgroundChildhood obsessive-compulsive disorder (OCD) is a heterogeneous psychiatric condition, with varied symptom presentations that have been differentially associated with clinical characteristics and treatment response. One OCD symptom cluster of particular interest is religious symptoms, including fears of offending religious figures/objects; patients affected by these symptoms have been characterized as having greater overall OCD severity and poorer treatment response. However, the extant literature primarily examines this symptom subtype within adults, leaving a gap in our understanding of this subtype in youth.MethodConsequently, this study examined whether presence of religious symptoms in OCD-affected children and adolescents (N = 215) was associated with greater clinical impairments across OCD symptoms and severity, insight, other psychiatric comorbidity, family variables, or worse treatment response.ResultsResults found that youth with religious OCD symptoms presented with higher OCD symptom severity and exhibited more symptoms in the aggressive, sexual, somatic, and checking symptom cluster, as well as the symmetry, ordering, counting, and repeating cluster. Religious OCD symptoms were also significantly associated with poorer insight and higher family expressiveness. No differences in treatment response were observed in youths with versus without religious OCD symptoms.ConclusionUltimately, youths with religious OCD symptoms only differed from their OCD-affected counterparts without religious symptoms on a minority of clinical variables; this suggests they may be more comparable to youths without religious OCD symptoms than would be expected based on the adult OCD literature and highlights the importance of examining these symptoms within a pediatric OCD sample.