Spiritual well-being and health

Data on empirical associations between religious variables and health outcomes are needed to clarify the complex interplay between religion and mental health. The aim of this study was to determine whether associations with health variables are primarily attributable to explicitly religious aspects of spiritual well-being (SWB) or to "existential" aspects that primarily reflect a sense of satisfaction or purpose in life. Three hundred forty-five pairs of twins from the Vietnam Era Twin Registry completed a diagnostic interview and questionnaires containing the 2-factor SWB Scale and general health items. Observed associations between SWB and health outcomes were uniquely explained by the SWB subscale of existential well-being, with much less of a unique explanatory contribution from religious well-being or "spiritual involvement." We concluded that studies of SWB and health should continue to distinguish between explicitly religious variables and others that more closely approximate the psychological construct of personal well-being.     

Gender differences in associations between religious attendance and mental health in Finland

We investigated in a nationwide sample of the Finnish general population (869 women and 773 men) whether there were gender-differences in associations between religious attendance and mental well-being. Respondents were asked during telephone interviews about sociodemographic variables, frequency of religious attendance and social contacts, and perceived social and family support. Mental health was screened by means of the 12-item General Health Questionnaire (GHQ-12). More women than men (62% vs. 50%) attended religious events, and there was a corresponding difference in percentages relating to regular religious attendance (17% vs. 10%). Regular religious attendance was most common among those over 65 years of age. In women, minor mental disorder (GHQ-12 score > or = 3) was more common among those who never attended religious events than among the others (25% vs. 16%). In men there was no difference. In women, religious attendance associated positively with social contacts, in men with happy family life. In multivariate analyses an independent positive association between religious attendance and absence of minor mental disorder was found in women (adjusted OR 1.58, 95% CI 1.12 to 2.24) but not in men. These results suggest that there may be gender-differences in associations between religious attendance, social and family life, and mental health.     

Religion and mental health among women veterans with sexual assault experience

OBJECTIVE: Religion has been shown to have a positive impact on well-being and to play an important role in coping with stressful life events. However, the buffering effect of religiosity on mental health, after a particularly stressful life event such as sexual assault, has not been studied. In this study we examined the buffering effect of religion on mental health and depression for women who report experiencing sexual assault while in the military. METHOD: The sample includes a nationally representative sample of 3,543 women veterans who use VA ambulatory care. Two dimensions of religiosity were used: organizational (frequency of religious service attendance) and subjective (the extent religious beliefs are a source of strength/comfort). Mental health was measured by the mental component summary (MCS) from the SF36 and depressive symptoms were measured by the Center for Epidemiologic Studies-Depression (CES-D) scale. RESULTS: Women veterans who reported experiencing sexual assault while in the military had lower mental health scores and higher levels of depression. Linear regression analysis indicated that these negative impacts diminished with increased frequency of religious service attendance, supporting the buffering effect of organizational religiosity on mental health and depression. Although the buffering effect of subjective religiosity was not evident, subjective religiosity was shown to be positively associated with better mental health in both groups of women with and without sexual assault experience in the military. CONCLUSIONS: Frequent religious service attendance buffers the negative impacts of sexual assault on mental health and depression of women veterans. The potential of integrating religiosity in designing interventions is discussed.     

Relationship between maternal church attendance and adolescent mental health and social functioning.

OBJECTIVE: This study compared maternal attendance at religious services with standard demographic characteristics such as race, type of religion, and mother's education in terms of their relative association with the behavioral and social functioning of young adolescents. METHODS: The Child Health and Illness Profile--Adolescent Edition and the Children's Depression Inventory were used to screen 445 youths age 11 through 13 who were randomly selected from two public middle schools in Baltimore. Based on the findings, the investigators selected a sample of 143 youths in which approximately two-thirds were at risk of having a psychiatric disorder and the remaining third were unlikely to have a psychiatric disorder. The youths and their mothers were interviewed at home to determine the mothers' frequency of participation in religious services and the youths' self-reported health and mental health status and social role functioning. RESULTS: Youths whose mothers attended religious services at least once a week had greater overall satisfaction with their lives, more involvement with their families, and better skills in solving health-related problems and felt greater support from friends compared with youths whose mothers had lower levels of participation in religious services. Maternal attendance at religious services had a strong association with the youths' outcome in overall satisfaction with health and perceived social support from friends, although family income was the strongest predictor of five other aspects of functioning, including academic performance. CONCLUSIONS: Frequent maternal participation in religious services was associated with healthy functioning and well-being in this sample of young adolescents. This association is as important as or more important than associations involving other traditional demographic variables, with the exception of family income.     

Inverse correlations between symptom scores and spiritual well-being among African American patients with first-episode schizophrenia spectrum disorders

Spirituality, religiosity, and spiritual/religious well-being are relatively understudied in the context of severe mental illnesses. Nonetheless, individuals dealing with such disorders, including schizophrenia, often make use of spirituality and religious affiliation as coping resources. In this preliminary study, we examined correlations between psychopathology severity and spiritual well-being among first-episode schizophrenia-spectrum disorder patients. The sample consisted of 18 African American patients hospitalized on an inpatient psychiatric unit in a large, urban, public hospital. After confirmation of diagnosis with the Structured Clinical Interview for DSM-IV Axis I Disorders, symptom severity was rated with the Positive and Negative Syndrome Scale, and self-reported spiritual well-being was evaluated with the Spiritual Well-Being Scale. Spearman correlations revealed that negative symptom scores were inversely correlated with religious well-being scores (rho = -.614; p = 0.007), and that general psychopathology symptom scores were inversely correlated with existential well-being scores (rho = -.539; p = 0.021). These preliminary findings indicate that negative symptoms and general psychopathology symptoms may have a detrimental effect on religious and existential well-being in patients with a first episode of a schizophrenia-spectrum disorder, or that religious and existential well-being may have an effect on symptomatology.     

Psychiatric symptoms, social disability, low wellbeing and need for treatment: data from a population-based study

BACKGROUND: Identifying need for treatment due to mental problems is necessary for rational health care planning. The aim of this study was to study reports of psychiatric symptoms, social disability and low wellbeing as indicators of meetable need of care. METHODS: An extensive questionnaire was sent out to a representative adult population in Stockholm, Sweden. Psychiatric symptom scales, social disabilities due to psychological distress and wellbeing were included. Of the 10,442 persons that answered 1093 were interviewed by psychiatrists. Meetable need of care was assessed and psychiatric diagnoses were made according to DSM-IV. RESULTS: Reports of psychiatric symptoms, social disabilities and low wellbeing were all associated with being female, younger, single, manual work and unemployed. Somatic disorders, a lower degree of social network and more negative life events were also associated. Of the interviewees persons with low wellbeing had the highest risk for being regarded as having meetable need of care. Additionally they were more likely to fulfil the criteria for a psychiatric disorder according to DSM-IV. CONCLUSION: Persons with low wellbeing had a higher risk of having meetable need of care than persons with psychiatric symptoms and/or social disabilities had.     

The association between spiritual and religious involvement and depressive symptoms in a Canadian population

Data from a large epidemiologic survey were examined to determine the relationship of religious practice (worship service attendance), spiritual and religious self-perception, and importance (salience) to depressive symptoms. Data were obtained from 70,884 respondents older than 15 years from the Canadian National Population Health Survey (Wave II, 1996-1997). Logistic regression was used to examine the relationship of the religious/spiritual variables to depressive symptoms while controlling for demographic, social, and health variables. More frequent worship service attendees had significantly fewer depressive symptoms. In contrast, those who stated spiritual values or faith were important or perceived themselves to be spiritual/religious had higher levels of depressive symptoms, even after controlling for potential mediating and confounding factors. It is evident that spirituality/religion has an important effect on depressive symptoms, but this study underscores the complexity of this relationship. Longitudinal studies are needed to help elucidate mechanisms and the order and direction of effects.     

Pilot study of spirituality and mental health in twins

OBJECTIVE: The goal of this study was to investigate associations between empirically defined dimensions of spirituality, personality variables, and psychiatric disorders in Vietnam era veterans. METHOD: One hundred pairs of male twins from the Vietnam Era Twin Registry were administered the self-report Spiritual Well-Being Scale and a pilot Index of Spiritual Involvement. Correlation analyses were supplemented with regression analyses that examined the relative influence of genetic and environmental factors on aspects of spirituality. RESULTS: Existential well-being was significantly associated with seven of 11 dimensions of personality and was significantly negatively associated with alcohol abuse or dependence and with two of three clusters of personality disorder symptoms. Associations between mental health variables and religious well-being or spiritual involvement were much more limited. CONCLUSIONS: Useful distinctions can be made between major dimensions of spirituality in studies of spirituality, religious coping, and mental health.     

The role of religious identity in the mental health of older working and retired adults

This study investigates whether religious identity explains unique variance of the self esteem and depressive symptoms of older working and retired adults. Data were collected from a larger, five-year project begun in 1992 that compared the well-being of older workers and with that of new retirees living in the Raleigh-Durham-Chapel Hill, North Carolina metropolitan area. Data are from the third and final wave, collected between March and June, 1997, during which 242 of the eligible 255 people participated. Net of religious attendance, religiosity, and various control variables, religious identity predicted both mental health outcomes. As predicted, self esteem increased and depressive symptoms decreased as religious identity increased (i.e., viewing oneself as more competent, confident, and sociable as a religious person). Though there was a trend towards religious identity being more strongly predictive of mental health among retirees than among the working adults, these interactions did not reach statistical significance.     

Spiritual issues in psychiatric care

This article differentiates between the concepts of spirituality and religion and analyzes the strengths and weaknesses of the research findings related to spirituality, religion, and mental health. To discuss the importance of clarifying values and becoming self-aware in relation to implementing spiritual and religious interventions. The components of spiritual assessment are presented as well as spiritual coping practices and interventions the nurse might use when working with clients. Review of literature from MEDLINE, CINAHL, and current texts. Spirituality and religion are too often neglected foci of psychiatric mental health assessment and intervention. In order to maximize therapeutic effectiveness, nurses should be aware that for many patients spirituality is a critical life factor. Accordingly, they should screen patients and strive to meet patient needs for spiritual expression, while recognizing that there are important boundary and ethical issues in psychiatric mental health settings.     

Religious involvement and depression in older Dutch citizens

It has been suggested that religiosity helps prevent depression in older people. This study examines the association between religious involvement and depression in older Dutch citizens and focuses on models of the mechanism in which religious involvement has an impact on other factors related to depression. The subjects were 2,817 older adults aged 55–85 years living in the community who participated in the Longitudinal Aging Study Amsterdam. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale (CES-D). Religious involvement was assessed using items on frequency of church attendance and strength of church affiliation. Further data were collected on physical health, size of social network, social suppoor, sense of mastery and selfesteem. As in North American studies, religious involvement appeared to be inversely associated with depression, both on symptom and syndrome levels. Controlling for sociodemographics, physical impairment and network support did not substantially affect this association, particularly among subjects aged 75–85 years. The inverse association between religious involvement and depression was not selectively more pronounced among older people with physical impairments. However, the association appeared to be most specific for subjects with a small social network and those with a low sense of mastery.     

Spirituality matters: creating a time and place for hope

Individuals with serious psychiatric disabilities may become demoralized or hopeless consequent to longstanding disability and stigma. Potential antidotes are social support from the religious community and use of personal spiritual resources as coping mechanisms. The "Spirituality Matters Group" offers comfort and hope through structured and innovative exercises focusing on spiritual beliefs and coping. Activities facilitate verbal expression and appropriate social interaction, and build a sense of community. Activities and themes from selected group sessions are discussed within a recovery-oriented "emotion-focused coping" framework.     

Stress and depression in Latin American immigrants: The mediating role of religiosity

ObjectiveMigrating implies a high level of stress that may destabilise immigrants’ mental health. The sense of spiritual fulfilment (feelings of faith, religiosity, and transcendence beyond ordinary material life) can mitigate the stress and benefit mental health. The objective of the present study was to analyze the relationship between migratory stress, religiosity and depression symptoms, as well as the mediating role of religiosity between migratory stress and depression symptoms.MethodParticipants were 295 Latin American immigrants living in Barcelona (Spain), 186 of whom (63.1%) were women and 109 (36.9%) were men. They were recruited from a Spanish NGO by means of a consecutive-case method.ResultsThe results showed an inverse relationship between religiosity and depression symptoms, but only in women. Likewise, in women, the sense of spiritual fulfilment had mediating value in buffering the relationship between stress and depression symptoms. This mediating value of spiritual fulfilment was not observed in men. For both genders religiosity was inversely related with stress. In addition, it was observed that the sense of religiosity decreases as the time since immigration passes.ConclusionsThese results may be of importance in clinical practice for prevention and therapeutic intervention with Latin American immigrants. As sense of transcendence and social support from the religious community are intertwined, it is difficult to specifically attribute the observed benefit of religiosity to the former versus the later.     

The impact of health status on work, symptoms, and functional outcomes in severe mental illness

This study evaluated the relationships between self-ratings of physical role functioning and general health, two components of the MOS SF-36, and a variety of demographic, quality of life, clinical, functional, and attitudinal variables in a cohort of adults living with severe and persistent mental illness (SPMI). We hypothesized that poorer self-perceptions of physical functioning and general health would be significantly related to more severe symptoms and poorer functioning and quality of life. Study subjects were 218 adults with SPMI enrolled in a randomized controlled trial comparing two vocational interventions for persons who were unemployed. Hierarchical regression analysis was used to determine whether psychiatric symptoms, poorer self-perceptions of role limitations due to physical health problems and overall general health independently contributed to more severe symptoms and poorer functioning and quality of life. Psychiatric symptoms were inversely related to size of social network and satisfaction with safety. Increased role limitations were associated with reduced medication compliance, general life satisfaction, and satisfaction with health, daily activities, and safety. Reduced general health was significantly associated with reduced work motivation, self-esteem, current inability to work, self-report of functioning, and almost all subjective life satisfaction domains. Within this group of people with severe mental illness, psychiatric symptoms were minimally associated with outcomes. Physical role limitations contributed more, and an integrated global measure of overall health perception was most important. If we are to help persons with severe mental illness maximize their quality of life and functioning, our clinical interventions should employ an approach that appreciates and recognizes the importance of the patients' experience of a holistic and integrated experience of health.     

A house is not a home: a network model perspective on the dynamics between subjective quality of living conditions,social support,and mental health of refugees and asylum seekers

Background:

Providing adequate living conditions for forcibly displaced people represents a significant challenge for host countries such as Germany. This study explores refugee mental health’s reciprocal, dynamic relationship with post-migration living conditions and social support.

Methods:

The study sample included 325 Arabic- or Farsi-speaking asylum seekers and refugees residing in Germany since 2014 and seeking mental health treatment. Associations between reported symptoms of post-traumatic stress and depression and the subjective quality of living conditions and perceived social support were analyzed using a two-level approach including multiple linear regression and network analyses.

Results:

Post-migration quality of living conditions and perceived social support were significantly associated with negative mental health outcomes on both levels. In the network, both post-migration factors were negatively connected with overlapping symptoms of psychiatric disorders, representing potential target symptoms for psychological treatment.

Conclusion:

Post-migration quality of living conditions and social support are important factors for refugee mental health and should be targeted by various actors fostering mental well-being and integration.

     

Spirituality and religion in psychiatric rehabilitation and recovery from mental illness

While mental health professionals frequently express concerns about the function of spirituality and religion in the lives of people diagnosed with severe mental disorders, there are both clinical and research bases for the increased acceptance of spirituality's potentially positive role in psychiatric rehabilitation and recovery. This paper first addresses issues of religious experience in diagnosis, including the importance of religiocultural context and overall functioning in diagnostic assessments. It then examines the roles of spirituality in recovery, exploring both positive and negative relationships between religion and consumers' well-being. Finally, it describes several specific ways in which spiritual and religious concerns may be integrated into psychosocial rehabilitation services: conducting spiritual assessments; offering spiritually-informed discussion groups; incorporating spiritual dimensions of psychotherapy; and facilitating linkages to faith communities and spiritual resources.     

Predicting Subjective Quality of Life in Workers with Severe Psychiatric Disabilities

Research has found that, although work may not provide comprehensive benefits for people with psychiatric disabilities, it does help them live more satisfactory lives. A self-report questionnaire that incorporated several scales was administrated to 134 persons with severe psychiatric disabilities working under different workplace conditions to find out what factors most contributed to perceptions of job satisfaction and quality of life. The study found that subjective quality of life was directly influenced by mental health functioning, informal social support, and job satisfaction, and indirectly influenced by perceived life stress and formal social support.     

Assessing the Effects of Maternal Symptoms and Homelessness on the Mental Health Problems in their Children

Objective:  This study examines the longitudinal association between measures of child well being and maternal posttraumatic stress disorder symptoms, homelessness, substance abuse, and other psychiatric conditions.
Method:  A sample of 142 mothers who were veterans of the US armed forces were assessed at program entry and every three months thereafter for one year. A repeated-measures with mixed-effects analytic strategy was used to assess the association of children's mental health, school enrolment and attendance with measures of maternal psychiatric symptoms and homelessness.
Results:  Significant associations between mothers' psychiatric symptoms and child well-being were identified. However, the multivariable mixed-models suggest that increased depression and anxiety symptoms among children were associated primarily with mothers' PTSD, and not depression, symptoms.
Conclusions:  These findings provide evidence of an association between maternal and child mental health and may suggest that treating maternal PTSD symptoms may also benefit children, regardless of whether the child was also exposed to the traumatic experience.     

The Nature and Dimensions of Social Support Among Individuals with Severe Mental Illnesses

Recent research suggests that social support is associated with recovery from chronic diseases, greater life satisfaction, and enhanced ability to cope with life stressors. To further research in the area of social support and serious psychiatric disabilities, more reliable and valid measures are needed to assess this construct. The purpose of this study was to assess the psychometric properties of a widely used measure of social support (the Interpersonal Support Evaluation Checklist) among people with severe mental illness. We collected data on the ISEL's relationship to quality of life, self-esteem, psychiatric symptoms and vocational status among 147 participants. Factor and reliability analyses, as well as correlational analyses were undertaken. We found evidence for the reliability and validity of the ISEL when used with persons with severe mental illness. Taken together, our findings suggested that self-esteem, quality of life, and psychiatric symptoms were able to predict 38% of the variance in perceived social support. More favorable social supports increased the odds of being employed at 9 months into the study and social support was predictive of experiencing fewer psychiatric symptoms. Some forms of social support were perceived less favorably with age, but no other demographic or clinical variables significantly predicted perceived social supports.