This document summarizes a presentation on a study that examined the relationship between religiosity and depressive symptomatology in college students. The study tested an explanatory model of how religiosity may moderate the relationship between cognitive vulnerability and stress in predicting depression. The study found that higher religiosity was associated with increased risk for depressive symptoms. Religiosity did not moderate the relationships as hypothesized but appeared to directly increase risk for depression. Possible explanations for the unexpected findings are discussed.

1. The Effects of
Religiosity on
Depressive
Symptomatology in
College-age Students
Devon Berry, PhD, RNC
College of Nursing, University of Cincinnati
MNRS Annual Research Conference
March 2007

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Presentation
Overview
Introduction
Depression
Religiosity
Explanatory Model
Description of Study
Methods
Results
Conclusions & Discussion

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Extent of problem
1990 Leading cause of disease burden in first world countries
(WHO, 2004)
In Young Adults
•10% college students are diagnosed with depression (ACHA, 2003)
•Suicide is the second leading cause of death in college
students (ACHA, 2003)
•Young adults with depression are at increased risk as adults
(Weissman, 1999)
Depression
Introduction

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Introduction
Known risk factors (Smith, 2003)
Intrapsychic
• Personality traits (dependency, introversion)
• Internalizing
• Emotional dysregulation
Environmental
• Social isolation
• Stressful life events
Biological
• Gender
• Genetic factors
Depression

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Definitions – various ranging from genetic to new age
explanations; any attitude, belief, motivation, pursuit, or
behavior involving spiritual or religious content or processes
(Smith, 2003; Goddard, 1995; Moffit, 1997; Kendler, 1997).
Characteristics – nonorganizational & organizational religiosity
activity, intrinsic & extrinsic religiosity, religious coping,
religious beliefs, etc. (Hill, 1999; Koenig, 2001).
Religiosity
Introduction

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Introduction
Current Research – New field characterized by many cross-
sectional studies that inconsistently define religiosity;
associations with physical, psychosocial, and psychological
measures, as well as gender, education, age, region, SES, and
marital status. (Shahabi, 2002)
Major critiques– Religiosity poorly defined and
operationalized, primarily cross-sectional research, poorly
controlled, many conclusions drawn from studies not designed
to measure religiosity (Sloan, 2002; Berry, in press)
Religiosity

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NIH Workgroup – Recommend controlling for sex, age,
health status, health behaviors, income, education, marital
status, race/ethnicity, social support, mental health,
geographic region, and employment status (Thoresen, 2002)
Introduction
Religiosity

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Religiosity, stress and psychological distress: no evidence
for an association among undergraduate students.
Personality & Individual Differences (in press).

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A Review of Some of the Most Recent Research Relating
Religiosity and Depression
•Religiously affiliated less likely to have history of suicide
attempts, moral objections may mediate relationship (Dervic, 2004)
•Religiousness and depressive symptomatology negatively
associated in elderly (Braam, 2004) college athletes (Storch, 2002), adolescents
(Pearce, 2003), review and meta-analysis (McCullough, 1999; Smith 2003)
•Negative associations are unsupported (Sloan, 2002; )
Introduction

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A Review of Some of the Most Recent Research Relating
Religiosity and Depression
Introduction
•Religiousness and Depression: Evidence for a Main Effect and
the Moderating Influence of Stressful Live Events (Smith, 2003): 147
studies, N~100,000, effect size .096, 24% unpublished studies,
support for a buffering effect of the stress – depression
relationship.

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…conducted without much regard to the major psychological,
sociological, or biological theories of depression… More often
than not, researchers seemed motivated simply to ask, “Are
depression and religiousness related?”…with little apparent
interest in using such hypothesis tests to evaluate the abilities
of existing theories of depression to explain new depression-
related phenomena. (Smith et al., 2003)
Although these associations tend to be consistent, they are
modest and are substantially reduced in multivariate
research… (McCullough, 1999)
Introduction

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Explanatory Model (1)
Diathesis-stress Model
vulnerability
continuum
vulnerable resilient
stresslevel
mild
disorder
mild
disorder
extremelow
severe
disorder •Historically defined as, “a nervous
system so sensitively constituted,
and illy adjusted to its surroundings,
that when brought in contact with
unusually exciting influences, there
may occur deranged instead of
natural mental action…” (Monroe &
Simons, 1991)
•Diathesis began with the Greeks and
was used to refer to more biological
predispositions to psychopathology
(Monroe & Simons, 1991)
•Model
Introduction
•Gained popularity in 1960s in
schizophrenia studies, adapted to
depression, invoking new factors such as
cognitive and social vulnerability, with
growing empirical support (Ingram, 2003; Kwon,
2002)

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Cognitive Vulnerability as Diathesis
Characteristics
Some pattern of thinking, perceiving, or believing
constitutes a vulnerability to depression that increases an
individual’s risk for developing depressive symptomatology
(Ingram, 2003) .
Example
Depressogenic Inferential Style (DIS): an individual’s
tendency to interpret the occurrence of a negative event to
mean that they are flawed in some way or that the negative
event will necessarily lead to other negative events (Abramson, 1998)
Introduction

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Religiosity as Moderator
of Diathesis-stress
Model
stress
cognitive
vulnerability
depression
stress
cognitive
vulnerability
depression
HighReligiosityLowReligiosity
IntroductionExplanatory Model (1)

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StressHigh CV Depression
Explanatory Model (2) Introduction
++++
StressLow CV Depression++
CV = Cognitive vulnerability

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Explanatory Model (3) Introduction
StressHigh CV Depression++
High
Religiosity
StressLow CV Depression+?
StressHigh CV Depression++++
StressLow CV Depression+?
Low
Religiosity
CV = Cognitive vulnerability

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Religiosity as Moderator of
Diathesis-stress Model
stress
cognitive
vulnerability
depression
stress
cognitive
vulnerability
depression
HighReligiosityLowReligiosity
Explores the effects of level of religiosity
on a diathesis-stress model of depression
as a possible mechanism explaining the
association between depression and
religiosity.
Related Work
Orthodoxy has been shown to moderate
relationship between depressive
symptomatology and perceived risk of
suicide in students who scored high on
depression (Greening, 2002).
Hopelessness has been shown to partially
mediate the relationship between
religious belief and depression (Murphy, 2000).
Explanatory Model (4) Introduction

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To test an explanatory model of the relationship between
religiosity and depressive symptomatology across time in
college students. A secondary purpose was to test the
dimensionality of the religiosity construct.
1. To examine the dimensionality of religiosity and its
function in the proposed model.
2. To test the moderating effects of religiosity on an
explanatory diathesis-stress model of depression in college
students.
Study Aims
Study Purpose
Introduction

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1. Four distinct but interrelated dimensions would represent
religiosity: spiritual meaning, transcendence, valuing, and
behavior. It was predicted that these dimensions would be
moderately and positively intercorrelated.
2. A multi-step hypothesis predicting the moderating effect
of religiosity on the diathesis-stress model: (a) test
diathesis-stress model; (b) test moderating effects of
religiosity.
Study Hypotheses
Introduction

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• College students 18 – 27 years of age (N = 122)
• One Midwestern, two Northwestern universities
• Approached via classroom presentations or bulk email
• 35 participants received $100 incentive payment
• Differences in subgroups – age, gender, school without
significant score differences on key variables
Participants
Methods
Design
Prospective repeated measures cohort design to examine the
dimensionality of religiosity and the effects of religiosity on the
diathesis-stress model of depression.

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• All data collection was completed via web-based survey over
the course of one academic quarter (spring quarter, 2004), in
efforts to see changes in depression across time.
• T1: baseline (depressive symptomatology, cognitive
vulnerability, stress, religiosity
• T2 (depressive symptomatology, stress)
• T3 (depressive symptomatology, stress)
• No significant differences in stress or depressive
symptomatology scores across time
Methods
Procedures

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Methods
Response Rate
Exposed to
Study Responded
Complete
Survey at T1
Complete
Survey at T1-T3
Classroom
Presentation
300 196 (65%) 91 (46%)
Email 500 39 (8%) 32 (82%)
Overall 800 235 (29%) 123 (52%) 93 (76%)

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Depression Symptomatology
Centers for Epidemiological Studies – Depression Scale
(CESD) (symptomatology viewed as on continuum with
disorder) (Radloff, 1977).
Cognitive Vulnerability
Cognitive Style Questionnaire (CSQ) 12 negative
scenarios, two items for each scenario assessing
implications regarding self (flawed in some way) and
future (more negative events) (Metalsky, 1992).
Stress
Negative Life Events Questionnaire (NLEQ), 66 items,
measuring life events and daily hassles for college
students (Saxe, 1987).
MethodsDefinitions & Operationalizations

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Definition: [a] level of faith, hope, and commitment in relation to a
worldview or belief system that provides a sense of meaning and
purpose to existence in general, and that offers an ethical path to
personal fulfillment which includes connectedness to self, others and a
higher power or larger reality (adapted from Hawks et al., 1995).
Operationalization
•Spiritual Meaning (Spiritual Meaning Scale) (Pargament, 1999)
•Transcendence (Daily Spiritual Experiences Scale) (Underwood, 2002)
•Valuing (Intrinsic Religious Motivation Scale) (Hoge, 1972)
•Private and Public Religious Practices (Private Religious Practices &
Organization Religious Practices) (Fezter, 1999)
•Religiosity
MethodsDefinitions & Operationalizations

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•Transformation of stress variables (NLEQ – Log)
•Mean-centering of predictors for moderating tests to reduce
multicollinearity among terms
•Aim 1: Dimensionality of Religiosity
•Item analysis, correlational, factor analysis studies
•Aim 2: Religiosity and Diathesis-Stress Model
•Multiple regression (controlling for age and gender)
Methods
Analysis

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Single 76%
Caucasian 85%
Female 89%
Catholic 40%
Midwestern 74%
Higher Power? 91% (yes)
Mean Age 21
Results
Sample Characteristics

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Religiosity measures correlate with CESD (r = -.16 to -.26)
DSES correlates with CSQ (r = -.17)
Intercorrelation among religiosity measures (r = .65 to .85)
Correlation Matrix
654321
1 CESD 1.000
2 CSQ .521** 1.000
3 NLEQ .589** .427** 1.000
4 SMS -.160* -.063 -.047 1.000
5 DSES -.263** -.170* -.093 .825** 1.000
6 IR -.226** -.073 -.142 .848** .810** 1.000
7 PPRA -.128 -.091 -.071 .689** .650** .732**
N = 122
* p < .05. **p < .01, (one-tailed).
Results
Aim 2: Correlations

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Hypotheses
• Diathesis-stress model of
depression
• Moderating effects of religiosity T1 stress
T1 cognitive
vulnerability
T2 depression
.46***
.14 (.46)***
2.18 (.27)**
R2 = .37
N = 93
T1 stress x
T1 cognitive
vulnerability
-.02 (-.08)
Results
Aim 2: Religiosity and Diathesis-Stress
Model
Cognitive vulnerability did not
moderate the relationship between
stress and depression, therefore,
moderating effects of religiosity were
not tested.

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T1 stress
T1 cognitive
vulnerability
T2 depression.46
.13 (.41)***
2.40 (.29)**
R2 = .37
N = 93
T1 stress
T1 cognitive
vulnerability
T2 depression
1.95 (.24)*
.13 (.43)***
R2 = .41
T1 religiosity-.51 (.10)
T1 stress
X
T1 religiosity
.003 (.17)*
Results
Aim 2: Religiosity and Diathesis-Stress
Model (Post Hoc Analysis)
Religiosity as moderator of the relationship
between stress and depression

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High Religiosity (n=46)Low Religiosity (n=46)
T1 stress
T1 cognitive
vulnerability
T2 depression
T1 stress
T1 cognitive
vulnerability
T2 depression.36*
.10 (.34)*
2.15 (.28)*
.56**
.16 (.49)**
2.45 (.30)*
Results
Aim 2: Religiosity and Diathesis-Stress
Model (Post Hoc Analysis)
Direct effects model at high and low levels of
religiosity

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T1 stress
T1 cognitive
vulnerability
T2 depression
Low Religiosity (n = 46)
.36*
.06
(.22)
1.32 (.17)
R2 = .33
T1 depression
.26 (.32)*
.48***
T1 stress
T1 cognitive
vulnerability
T2 depression
High Religiosity (n = 46)
.56***
.08
(.25)
.56 (.07)
R2 = .60
T1 depression
.45 (.54)**
.68***
T1 stress
T1 cognitive
vulnerability
T2 depression
Sample (N = 93)
.46***
.07
(.23)*
1.0 (.12)
R2 = .47
T1 depression
.37 (.44)***
.59***
Results
Aim 2: Religiosity and Diathesis-Stress
Model (Post Hoc Analysis)
Direct effects model at high and low levels of
religiosity controlled for individual differences in
depression

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Results
Aim 2: Religiosity and Diathesis-Stress
Model (Post Hoc Analysis)
•Hypothesis was not supported (diathesis-stress model,
moderating effects of religiosity)
•Stress and cognitive vulnerability are significant and
direct predictors of depression
•Religiosity appears to be increasing the risk for
depressive symptomatology in this sample

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Conclusions &
Discussion
Possible Explanations for Findings
Conceptual/Theoretical
•Immature faith (Wink, 2002; Koenig, 2001)
•Religiosity poorly dimensionalized (transcendence and intrinsic
religiosity strongest correlates across tests)
•Type of stress (Strawbridge, 1998)
•Content of belief (Koenig, 1998); negative interpersonal religious
experience (Pearce, 2003)
•Depression influencing religiosity (Ferraro, 2000, compensatory mechanism)
•Unmeasured influences common to both depression and
religiosity (Smith, 2003)

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Conclusions &
Discussion
Possible Explanations for Findings
Methodological
•Small sample (N=93)
•Sample bias (convenience sample)
•Measurement error (CV measure used in previously untested
form secondary to concerns re subject burden)
•Short period of measurement (10 weeks)

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Mean (SD) αa Scale Range
CESD 14.91 (10.96) .90 0–60
NLEQ 101.45 (29.32) — 66–315
CSQ 3.57 (1.10) .94 1–7
SMS 3.57 (0.88) .97 1–5
DSES 52.98 (14.74) .93 15–88
IR 2.68 (0.80) .90 1–4
PPRA 2.97 (1.41) .82 1–8
R.TOT 61.67 (17.77) — 18–105
Note. Center for Epidemiological Studies Depression Scale (CESD); Negative Life Events
Questionnaire (NLEQ); Cognitive Style Questionnaire (CSQ); Spiritual Meaning Scale (SMS);
Daily Spiritual Experiences Scale (DSES); Hoge’s Intrinsic Religiosity Motivation Scale (IR);
Public and Private Religious Activities (PPRA); Combined Religiosity Score (R.TOT). N =
122, all respondents at T1.
aCronbach’s index of internal consistency.
Table 4.2.
Measure Means and Standard Deviations at T1

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Table 4.3.
Correlation Matrix
654321
1 CESD 1.000
2 CSQ .521** 1.000
3 NLEQ .589** .427** 1.000
4 SMS -.160* -.063 -.047 1.000
5 DSES -.263** -.170* -.093 .825** 1.000
6 IR -.226** -.073 -.142 .848** .810**1.000
7 PPRA -.128 -.091 -.071 .689** .650** .732**
* p < .05. **p < .01, (one-tailed).
Table 4.4.
Factor Loadings
.847PPRA
.936IR
.908DSES
.932SMS
Loading
Component 1: Religiosity

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Partial mediating effects of cognitive vulnerability
T1 stress
T1 cognitive
vulnerability
T2 depression
.02 (.46)***
.17 (.55)*** 2.4 (.29)*
.13 (.41)**
T1 stress and T1 cognitive vulnerability
regressed simultaneously on T2
depression
T1 stress
T2 depression
T1 stress
T1 cognitive
vulnerability
(a)
(b) (c)
Significance of indirect effect (Sobel test: z = 2.562, p-value = .01)
.02 (.46)***
Results
Aim 2: Religiosity and Diathesis-Stress
Model