The contribution of spirituality and spiritual coping
to anxiety and depression in women with a recent
diagnosis of gynecological cancer
N. BOSCAGLIA*, D.M. CLARKE*, T.W. JOBLINGy & M.A. QUINNz
*Department of Psychological Medicine and General Practice, Monash University,
Melbourne, Australia; yDepartment of Obstetrics and Gynaecology, Monash Medical Centre,
Melbourne, Australia; and zDepartment of Obstetrics and Gynaecology, and Oncology Unit,
Melbourne University, Royal Women’s Hospital, Melbourne, Australia
Abstract. Boscaglia N, Clarke DM, Jobling TW, Quinn MA. The con-
tribution of spirituality and spiritual coping to anxiety and depression
in women with a recent diagnosis of gynecological cancer. Int J Gynecol
Cancer 2005;15:755–761.
The objective of this study was to determine whether, after accounting
for illness and demographic variables, spiritual involvement and beliefs
and positive and negative spiritual coping could account for any of the
variation in anxiety and depression among women within 1 year’s diag-
nosis of gynecological cancer (GC). One hundred patients from out-
patient GC clinics at two Melbourne-based hospitals completed a brief
structured interview and self-report measures of anxiety, depression,
spirituality, and spiritual coping. Using two sequential regression analy-
ses, we found that younger women with more advanced disease, who
used more negative spiritual coping, had a greater tendency towards
depression and that the use of negative spiritual coping was associated
with greater anxiety scores. Although not statistically significant, pa-
tients with lower levels of generalized spirituality also tended to be
more depressed. The site of disease and phase of treatment were not
predictive of either anxiety or depression. We conclude that spirituality
and spiritual coping are important to women with GC and that health
professionals in the area should consider these issues.
KEYWORDS: anxiety, coping, depression, gynecological cancer, spirituality.
In a recent issue of this journal, Ramondetta and
Sills(1) published a review of the literature concerning
the role of spirituality in gynecological cancer (GC).
The authors concluded that ‘‘concerns for the spiritual
health of patients may prove significant for both a
patient’s comprehensive sense of well-being and for the
relationship that is created between patients and
physicians.’’ In this study, we examined empirically
the relationship between spirituality and mood (ie,
anxiety and depression).
A diagnosis of cancer is a significant life event that
may have considerable psychological, physical, and
financial sequelae. In particular, a diagnosis of GC
Address correspondence and reprint requests to: Nadia Boscaglia,
Department of Psychological Medicine, Monash University,
Monash Medical Centre, 246 Clayton Rd., Clayton, Victoria 3800,
Australia. Email: [email protected]
# 2005 IGCS
Int J Gynecol Cancer 2005, 15, 755–761
may elicit disturbances to b.
Persistent link httpssearch-proquest-com.library.capella.edu.docxkarlhennesey
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This is the reference for this article:
Johnson, E. T., Kaseroff, A., Flowers, S., Sung, C., Iwanaga, K., Chan, F., . . . Catalano, D. (2017). Psychosocial mechanisms explaining the association between spirituality and happiness in individuals with spinal cord injuries. The Journal of Rehabilitation, 83(4), 34-42.
Abstract
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The main objective of this study was to examine health status, perceived stress, social support, self-esteem and psychological well-being as mediator variables for the relationship between spirituality and happiness. Quantitative descriptive research design using multiple regression and correlation techniques was used. Participants were 274 individuals with spinal cord injuries (SCI) recruited from the Alberta, Manitoba, Nova Scotia, Ontario, and Saskatchewan chapters of the Canadian Paraplegic Association. All of the five mediators were significantly associated with happiness. The five-mediator model accounted for 68% of the variance in happiness. The findings confirm spirituality is associated with happiness indirectly through its association with perceived stress, health status, social support, self-esteem, and psychological well-being, each of which is uniquely associated with happiness. Rehabilitation counselors should consider integrating spiritual interventions with health promotion interventions in vocational rehabilitation services for individuals with SCI to improve outcomes in life satisfaction.
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Headnote
The main objective of this study was to examine health status, perceived stress, social support, self-esteem and psychological well-being as mediator variables for the relationship between spirituality and happiness. Quantitative descriptive research design using multiple regression and correlation techniques was used. Participants were 274 individuals with spinal cord injuries (SCI) recruited from the Alberta, Manitoba, Nova Scotia, Ontario, and Saskatchewan chapters of the Canadian Paraplegic Association. All of the five mediators were significantly associated with happiness. The five-mediator model accounted for 68% of the variance in happiness. The findings confirm spirituality is associated with happiness indirectly through its association with perceived stress, health status, social support, self-esteem, and psychological well-being, each of which is uniquely associated with happiness. Rehabilitation counselors should consider integrating spiritual interventions with health promotion interventions in vocational rehabilitation services for individuals with SCI to improve outcomes in life satisfaction.
At the onset of a traumatic disability, such as a spinal cord injury (SCI), a person's spiritual beliefs may provide a mechanism for healing and coping with stress (Marini & Glover-Graf, ...
Henrietta Ayinor Topic 1 DQ 1Spirituality in my worldview has SusanaFurman449
Henrietta Ayinor : Topic 1 DQ 1
Spirituality in my worldview has a great connection with faith, and a search for meaning and purpose in life, connection with others and surpassing Oneself. This results in s sense of inner peace and wellbeing. A strong spiritual connection may improve can improve an individual's sense of satisfaction with life or enable accommodation to disability (Delgado 2005)
Phenwan et al. (2019) Spirituality is the essence of a human being The meaning of life, feeling of connectedness to the transcendental phenomena such as the universe or God. This connectedness may or may not be part of any religions. It is also part of comprehensive palliative care, defined by the World Health Organization. An individual's spiritual well-being is a feeling of one's contentment that stems from their inner self and is related to their quality of life
SSorajjakool (2017) Religious beliefs and customs can significantly shape a nurse- patients relationship this can also influence the expectations of the nurse and patient as well as their wishes and personal boundaries regarding daily routines such as dressing, diet, prayer and touch. Undoubtedly, the sensitivity with which clinicians communicate with patients and make decisions regarding appropriate medical intervention can be greatly increased by an understanding of religious as well as other forms of cultural diversity. As a nurse caring for a patient will be deliberate in making effort to understand a patient's religious preferences this way, I will not impose my religious believes on the patient while helping them to access and receive preternatural care as a provide my nursing care this is beacuse different patienst have their spiritual prereferences and health and illness means dieferent things to dieferent people spiritually.
Delgado C. (2005). A discussion of the concept of spirituality. Nursing science quarterly, 18(2), 157–162. https://doi.org/10.1177/0894318405274828
https://pubmed.ncbi.nlm.nih.gov/15802748/
Phenwan, T., Peerawong, T., & Tulathamkij, K. (2019). The Meaning of Spirituality and Well- Being among Thai Breast Cancer Patients: A Qualitative Study. Indian journal of palliative care, 25(1), 119–123.
https://doi.org/10.4103/IJPC.IJPC_101_18
SSorajjakool, S., Carr, M. F., Nam, J. J., Sorajjakool, S., & Bursey, E. (Eds.). (2017). World religions for healthcare professionals. Taylor & Francis ISBN 1317281020, 9 781317281023
Retrievedfromhttps://www.routledge.com/World-Religions-for-Healthcare-Professionals/SSorajjakool-Carr-Nam-Sorajjakool-Carr-Bursey/p/book/9781138189140
Yenly Fernandez Rodriguez
1 posts
Re: Topic 1 DQ 1
Topic 1 DQ 1
Individuals hold different worldviews about spirituality. The spiritual worldview of an individual depends on various factors, such as family beliefs, origin, and culture. In the world, multiple religions exist to influence an individual's connection with a supreme being (SSorajjakool, Carr, Nam, Sorajjakool & Bursey, 2017). Fo ...
The document summarizes a study that investigated the quality of life, spirituality, and social support among 25 caregivers of cancer patients compared to a control group of 25 individuals. Key findings included:
- Caregivers reported significantly lower psychological well-being and environmental quality of life than the control group.
- Caregivers reported significantly higher levels of spirituality and perceived social support compared to the control group.
- There was no significant difference between caregivers and the control group in terms of physical well-being.
Quality Of Life, Spirituality and Social Support among Caregivers of Cancer P...iosrjce
Caregiving can be both rewarding and challenging. Literature suggests that family caregivers may
experience increased symptoms of psychological and social malfunctioning. However, it may also provide one
with opportunities to renew relationships or feel connected to a higher power. The current study is an attempt to
investigate how caregiving influences a person’s general wellbeing. The sample consisted of 25 caregivers of
cancer patients and 25 appropriately matched control.World Health Organization- QOL (1991),
Multidimensional Scale of Perceived Social Support by Zimet, et al (1988) and Spiritual Perspective Scale by
Reed (1986) were used to asses QOL, Social support and spirituality respectively. The obtained data was
analyzed in SPSS using independent sample t-test. Results indicated a significant difference between Caregivers
and the control group on QOL, spirituality and social support.
Healing in a holistic sense has faded from medical attention and is rarely discussed in modern (“Western”) medicine especially in therapeutics. However, other disciplines like medical anthropology, sociology, alternate systems of medicine, and medical philosophy have continued an active contemplation of holistic healing. To heal is to achieve or acquire wholeness as a person. The wholeness of personhood involves physical, emotional, intellectual, social, and spiritual aspects of human experience (Egnew, 2005).
It is perhaps difficult to quantify the relative importance of the various factors that contribute to healing. It may vary depending on the kind of illness that is being studied. Of the various factors that contribute to healing of illnesses in a community, only 20% could be ascribed to rational treatment using medicines or surgery. The remaining 80% is divided among three faith-based factors (White, 1988).
i) Placebo effect (faith in drugs or procedural interventions)
ii) Hawthorne effect (faith in a health care system, a facility or a professional)
iii) Factor-X or “spiritual factor” (faith in oneself or in the supernatural)
The relative importance of these faith-based factors in holistic healing may be debatable. However, there is no denying that these factors play an important part in the recovery from illnesses.
352 BUMC PROCEEDINGS 2001;14:352–357
The technological advances of the past century tended tochange the focus of medicine from a caring, service-oriented model to a technological, cure-oriented model.
Technology has led to phenomenal advances in medicine and
has given us the ability to prolong life. However, in the past few
decades physicians have attempted to balance their care by re-
claiming medicine’s more spiritual roots, recognizing that until
modern times spirituality was often linked with health care.
Spiritual or compassionate care involves serving the whole per-
son—the physical, emotional, social, and spiritual. Such service
is inherently a spiritual activity. Rachel Naomi Remen, MD, who
has developed Commonweal retreats for people with cancer, de-
scribed it well:
Helping, fixing, and serving represent three different ways of see-
ing life. When you help, you see life as weak. When you fix, you
see life as broken. When you serve, you see life as whole. Fixing
and helping may be the work of the ego, and service the work of
the soul (1).
Serving patients may involve spending time with them, hold-
ing their hands, and talking about what is important to them.
Patients value these experiences with their physicians. In this
article, I discuss elements of compassionate care, review some
research on the role of spirituality in health care, highlight ad-
vantages of understanding patients’ spirituality, explain ways to
practice spiritual care, and summarize some national efforts to
incorporate spirituality into medicine.
COMPASSIONATE CARE: HELPING PATIENTS FIND MEANING IN
THEIR SUFFERING AND ADDRESSING THEIR SPIRITUALITY
The word compassion means “to suffer with.” Compassionate
care calls physicians to walk with people in the midst of their
pain, to be partners with patients rather than experts dictating
information to them.
Victor Frankl, a psychiatrist who wrote of his experiences in
a Nazi concentration camp, wrote: “Man is not destroyed by suf-
fering; he is destroyed by suffering without meaning” (2). One
of the challenges physicians face is to help people find meaning
and acceptance in the midst of suffering and chronic illness.
Medical ethicists have reminded us that religion and spiritual-
ity form the basis of meaning and purpose for many people (3).
At the same time, while patients struggle with the physical as-
pects of their disease, they have other pain as well: pain related
to mental and spiritual suffering, to an inability to engage the
deepest questions of life. Patients may be asking questions such
The role of spirituality in health care
CHRISTINA M. PUCHALSKI, MD, MS
From The George Washington Institute for Spirituality and Health (GWish), The
George Washington University Medical Center Departments of Medicine and
Health Care Sciences, and The George Washington University, Washington, DC.
Presented at Baylor University Medical Center on February 28, 2001, as the Baylor-
Charles A. Sammons Cancer Center Charlotte ...
Journal of Traumatic StressFebruary 2015, 28, 57–64Spiri.docxpriestmanmable
Journal of Traumatic Stress
February 2015, 28, 57–64
Spirituality Factors in the Prediction of Outcomes of PTSD
Treatment for U.S. Military Veterans
Joseph M. Currier,1 Jason M. Holland,2 and Kent D. Drescher3,4
1University of South Alabama, Psychology Department, Mobile, Alabama, USA
2University of Nevada, Las Vegas (UNLV), Department of Psychology, Las Vegas, Nevada, USA
3National Center for PTSD, VA Palo Alto Healthcare System, Menlo Park, California, USA
4The Pathway Home–California Transition Center for the Care of Combat Veterans, Yountville, California, USA
Spirituality is a multifaceted construct that might affect veterans’ recovery from posttraumatic stress disorder (PTSD) in adaptive and
maladaptive ways. Using a cross-lagged panel design, this study examined longitudinal associations between spirituality and PTSD
symptom severity among 532 U.S. veterans in a residential treatment program for combat-related PTSD. Results indicated that spirituality
factors at the start of treatment were uniquely predictive of PTSD symptom severity at discharge, when accounting for combat exposure
and both synchronous and autoregressive associations between the study variables, βs = .10 to .16. Specifically, veterans who scored
higher on adaptive dimensions of spirituality (daily spiritual experiences, forgiveness, spiritual practices, positive religious coping, and
organizational religiousness) at intake fared significantly better in this program. In addition, possible spiritual struggles (operationalized as
negative religious coping) at baseline were predictive of poorer PTSD outcomes, β = .11. In contrast to these results, PTSD symptomatology
at baseline did not predict any of the spirituality variables at posttreatment. In keeping with a spiritually integrative approach to treating
combat-related PTSD, these results suggest that understanding the possible spiritual context of veterans’ trauma-related concerns might
add prognostic value and equip clinicians to alleviate PTSD symptomatology among those veterans who possess spiritual resources or are
somehow struggling in this domain.
Spirituality might be relevant in treating combat-related post-
traumatic stress disorder (PTSD). Research has documented
that many people draw on spiritual teachings, beliefs/values,
and practices in coping with trauma (e.g., Pargament, Koenig,
& Perez, 2000; Pargament, Smith, Koenig, & Perez, 1998). In
this way, spirituality represents a multidimensional construct
that covers a range of intrapersonal or communal aspects that
might aid recovery from PTSD. For example, engagement in
a church or other organization can encourage healthy behav-
ioral norms and proscribe maladaptive forms of coping that can
create additional problems for traumatized individuals (e.g.,
substance misuse). Spirituality can also enhance coping skills
and provide a frame of intelligibility to support one’s con-
structive reappraisals of trauma (e.g., accepting finite nature of
human exist ...
Persistent link httpssearch-proquest-com.library.capella.edu.docxkarlhennesey
Persistent link
https://search-proquest-com.library.capella.edu/docview/1985859541/fulltextPDF/F5256BEE3BF74331PQ/1?accountid=27965
This is the reference for this article:
Johnson, E. T., Kaseroff, A., Flowers, S., Sung, C., Iwanaga, K., Chan, F., . . . Catalano, D. (2017). Psychosocial mechanisms explaining the association between spirituality and happiness in individuals with spinal cord injuries. The Journal of Rehabilitation, 83(4), 34-42.
Abstract
Translate
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The main objective of this study was to examine health status, perceived stress, social support, self-esteem and psychological well-being as mediator variables for the relationship between spirituality and happiness. Quantitative descriptive research design using multiple regression and correlation techniques was used. Participants were 274 individuals with spinal cord injuries (SCI) recruited from the Alberta, Manitoba, Nova Scotia, Ontario, and Saskatchewan chapters of the Canadian Paraplegic Association. All of the five mediators were significantly associated with happiness. The five-mediator model accounted for 68% of the variance in happiness. The findings confirm spirituality is associated with happiness indirectly through its association with perceived stress, health status, social support, self-esteem, and psychological well-being, each of which is uniquely associated with happiness. Rehabilitation counselors should consider integrating spiritual interventions with health promotion interventions in vocational rehabilitation services for individuals with SCI to improve outcomes in life satisfaction.
Full Text
Translate
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Headnote
The main objective of this study was to examine health status, perceived stress, social support, self-esteem and psychological well-being as mediator variables for the relationship between spirituality and happiness. Quantitative descriptive research design using multiple regression and correlation techniques was used. Participants were 274 individuals with spinal cord injuries (SCI) recruited from the Alberta, Manitoba, Nova Scotia, Ontario, and Saskatchewan chapters of the Canadian Paraplegic Association. All of the five mediators were significantly associated with happiness. The five-mediator model accounted for 68% of the variance in happiness. The findings confirm spirituality is associated with happiness indirectly through its association with perceived stress, health status, social support, self-esteem, and psychological well-being, each of which is uniquely associated with happiness. Rehabilitation counselors should consider integrating spiritual interventions with health promotion interventions in vocational rehabilitation services for individuals with SCI to improve outcomes in life satisfaction.
At the onset of a traumatic disability, such as a spinal cord injury (SCI), a person's spiritual beliefs may provide a mechanism for healing and coping with stress (Marini & Glover-Graf, ...
Henrietta Ayinor Topic 1 DQ 1Spirituality in my worldview has SusanaFurman449
Henrietta Ayinor : Topic 1 DQ 1
Spirituality in my worldview has a great connection with faith, and a search for meaning and purpose in life, connection with others and surpassing Oneself. This results in s sense of inner peace and wellbeing. A strong spiritual connection may improve can improve an individual's sense of satisfaction with life or enable accommodation to disability (Delgado 2005)
Phenwan et al. (2019) Spirituality is the essence of a human being The meaning of life, feeling of connectedness to the transcendental phenomena such as the universe or God. This connectedness may or may not be part of any religions. It is also part of comprehensive palliative care, defined by the World Health Organization. An individual's spiritual well-being is a feeling of one's contentment that stems from their inner self and is related to their quality of life
SSorajjakool (2017) Religious beliefs and customs can significantly shape a nurse- patients relationship this can also influence the expectations of the nurse and patient as well as their wishes and personal boundaries regarding daily routines such as dressing, diet, prayer and touch. Undoubtedly, the sensitivity with which clinicians communicate with patients and make decisions regarding appropriate medical intervention can be greatly increased by an understanding of religious as well as other forms of cultural diversity. As a nurse caring for a patient will be deliberate in making effort to understand a patient's religious preferences this way, I will not impose my religious believes on the patient while helping them to access and receive preternatural care as a provide my nursing care this is beacuse different patienst have their spiritual prereferences and health and illness means dieferent things to dieferent people spiritually.
Delgado C. (2005). A discussion of the concept of spirituality. Nursing science quarterly, 18(2), 157–162. https://doi.org/10.1177/0894318405274828
https://pubmed.ncbi.nlm.nih.gov/15802748/
Phenwan, T., Peerawong, T., & Tulathamkij, K. (2019). The Meaning of Spirituality and Well- Being among Thai Breast Cancer Patients: A Qualitative Study. Indian journal of palliative care, 25(1), 119–123.
https://doi.org/10.4103/IJPC.IJPC_101_18
SSorajjakool, S., Carr, M. F., Nam, J. J., Sorajjakool, S., & Bursey, E. (Eds.). (2017). World religions for healthcare professionals. Taylor & Francis ISBN 1317281020, 9 781317281023
Retrievedfromhttps://www.routledge.com/World-Religions-for-Healthcare-Professionals/SSorajjakool-Carr-Nam-Sorajjakool-Carr-Bursey/p/book/9781138189140
Yenly Fernandez Rodriguez
1 posts
Re: Topic 1 DQ 1
Topic 1 DQ 1
Individuals hold different worldviews about spirituality. The spiritual worldview of an individual depends on various factors, such as family beliefs, origin, and culture. In the world, multiple religions exist to influence an individual's connection with a supreme being (SSorajjakool, Carr, Nam, Sorajjakool & Bursey, 2017). Fo ...
The document summarizes a study that investigated the quality of life, spirituality, and social support among 25 caregivers of cancer patients compared to a control group of 25 individuals. Key findings included:
- Caregivers reported significantly lower psychological well-being and environmental quality of life than the control group.
- Caregivers reported significantly higher levels of spirituality and perceived social support compared to the control group.
- There was no significant difference between caregivers and the control group in terms of physical well-being.
Quality Of Life, Spirituality and Social Support among Caregivers of Cancer P...iosrjce
Caregiving can be both rewarding and challenging. Literature suggests that family caregivers may
experience increased symptoms of psychological and social malfunctioning. However, it may also provide one
with opportunities to renew relationships or feel connected to a higher power. The current study is an attempt to
investigate how caregiving influences a person’s general wellbeing. The sample consisted of 25 caregivers of
cancer patients and 25 appropriately matched control.World Health Organization- QOL (1991),
Multidimensional Scale of Perceived Social Support by Zimet, et al (1988) and Spiritual Perspective Scale by
Reed (1986) were used to asses QOL, Social support and spirituality respectively. The obtained data was
analyzed in SPSS using independent sample t-test. Results indicated a significant difference between Caregivers
and the control group on QOL, spirituality and social support.
Healing in a holistic sense has faded from medical attention and is rarely discussed in modern (“Western”) medicine especially in therapeutics. However, other disciplines like medical anthropology, sociology, alternate systems of medicine, and medical philosophy have continued an active contemplation of holistic healing. To heal is to achieve or acquire wholeness as a person. The wholeness of personhood involves physical, emotional, intellectual, social, and spiritual aspects of human experience (Egnew, 2005).
It is perhaps difficult to quantify the relative importance of the various factors that contribute to healing. It may vary depending on the kind of illness that is being studied. Of the various factors that contribute to healing of illnesses in a community, only 20% could be ascribed to rational treatment using medicines or surgery. The remaining 80% is divided among three faith-based factors (White, 1988).
i) Placebo effect (faith in drugs or procedural interventions)
ii) Hawthorne effect (faith in a health care system, a facility or a professional)
iii) Factor-X or “spiritual factor” (faith in oneself or in the supernatural)
The relative importance of these faith-based factors in holistic healing may be debatable. However, there is no denying that these factors play an important part in the recovery from illnesses.
352 BUMC PROCEEDINGS 2001;14:352–357
The technological advances of the past century tended tochange the focus of medicine from a caring, service-oriented model to a technological, cure-oriented model.
Technology has led to phenomenal advances in medicine and
has given us the ability to prolong life. However, in the past few
decades physicians have attempted to balance their care by re-
claiming medicine’s more spiritual roots, recognizing that until
modern times spirituality was often linked with health care.
Spiritual or compassionate care involves serving the whole per-
son—the physical, emotional, social, and spiritual. Such service
is inherently a spiritual activity. Rachel Naomi Remen, MD, who
has developed Commonweal retreats for people with cancer, de-
scribed it well:
Helping, fixing, and serving represent three different ways of see-
ing life. When you help, you see life as weak. When you fix, you
see life as broken. When you serve, you see life as whole. Fixing
and helping may be the work of the ego, and service the work of
the soul (1).
Serving patients may involve spending time with them, hold-
ing their hands, and talking about what is important to them.
Patients value these experiences with their physicians. In this
article, I discuss elements of compassionate care, review some
research on the role of spirituality in health care, highlight ad-
vantages of understanding patients’ spirituality, explain ways to
practice spiritual care, and summarize some national efforts to
incorporate spirituality into medicine.
COMPASSIONATE CARE: HELPING PATIENTS FIND MEANING IN
THEIR SUFFERING AND ADDRESSING THEIR SPIRITUALITY
The word compassion means “to suffer with.” Compassionate
care calls physicians to walk with people in the midst of their
pain, to be partners with patients rather than experts dictating
information to them.
Victor Frankl, a psychiatrist who wrote of his experiences in
a Nazi concentration camp, wrote: “Man is not destroyed by suf-
fering; he is destroyed by suffering without meaning” (2). One
of the challenges physicians face is to help people find meaning
and acceptance in the midst of suffering and chronic illness.
Medical ethicists have reminded us that religion and spiritual-
ity form the basis of meaning and purpose for many people (3).
At the same time, while patients struggle with the physical as-
pects of their disease, they have other pain as well: pain related
to mental and spiritual suffering, to an inability to engage the
deepest questions of life. Patients may be asking questions such
The role of spirituality in health care
CHRISTINA M. PUCHALSKI, MD, MS
From The George Washington Institute for Spirituality and Health (GWish), The
George Washington University Medical Center Departments of Medicine and
Health Care Sciences, and The George Washington University, Washington, DC.
Presented at Baylor University Medical Center on February 28, 2001, as the Baylor-
Charles A. Sammons Cancer Center Charlotte ...
Journal of Traumatic StressFebruary 2015, 28, 57–64Spiri.docxpriestmanmable
Journal of Traumatic Stress
February 2015, 28, 57–64
Spirituality Factors in the Prediction of Outcomes of PTSD
Treatment for U.S. Military Veterans
Joseph M. Currier,1 Jason M. Holland,2 and Kent D. Drescher3,4
1University of South Alabama, Psychology Department, Mobile, Alabama, USA
2University of Nevada, Las Vegas (UNLV), Department of Psychology, Las Vegas, Nevada, USA
3National Center for PTSD, VA Palo Alto Healthcare System, Menlo Park, California, USA
4The Pathway Home–California Transition Center for the Care of Combat Veterans, Yountville, California, USA
Spirituality is a multifaceted construct that might affect veterans’ recovery from posttraumatic stress disorder (PTSD) in adaptive and
maladaptive ways. Using a cross-lagged panel design, this study examined longitudinal associations between spirituality and PTSD
symptom severity among 532 U.S. veterans in a residential treatment program for combat-related PTSD. Results indicated that spirituality
factors at the start of treatment were uniquely predictive of PTSD symptom severity at discharge, when accounting for combat exposure
and both synchronous and autoregressive associations between the study variables, βs = .10 to .16. Specifically, veterans who scored
higher on adaptive dimensions of spirituality (daily spiritual experiences, forgiveness, spiritual practices, positive religious coping, and
organizational religiousness) at intake fared significantly better in this program. In addition, possible spiritual struggles (operationalized as
negative religious coping) at baseline were predictive of poorer PTSD outcomes, β = .11. In contrast to these results, PTSD symptomatology
at baseline did not predict any of the spirituality variables at posttreatment. In keeping with a spiritually integrative approach to treating
combat-related PTSD, these results suggest that understanding the possible spiritual context of veterans’ trauma-related concerns might
add prognostic value and equip clinicians to alleviate PTSD symptomatology among those veterans who possess spiritual resources or are
somehow struggling in this domain.
Spirituality might be relevant in treating combat-related post-
traumatic stress disorder (PTSD). Research has documented
that many people draw on spiritual teachings, beliefs/values,
and practices in coping with trauma (e.g., Pargament, Koenig,
& Perez, 2000; Pargament, Smith, Koenig, & Perez, 1998). In
this way, spirituality represents a multidimensional construct
that covers a range of intrapersonal or communal aspects that
might aid recovery from PTSD. For example, engagement in
a church or other organization can encourage healthy behav-
ioral norms and proscribe maladaptive forms of coping that can
create additional problems for traumatized individuals (e.g.,
substance misuse). Spirituality can also enhance coping skills
and provide a frame of intelligibility to support one’s con-
structive reappraisals of trauma (e.g., accepting finite nature of
human exist ...
Objective: Spirituality has been shown to be associated with various aspects of health. It has also been discussed as an aid in coping with adversities.
Methods: The present investigation examined four dimensions of spirituality – belief in God, mindfulness, quest for meaning and feeling of security – as possible mediators between childhood adversities and adult adaptation. Two samples of n ≈ 500 were examined via internet in a retrospective survey.
Results: Two pathways from childhood to adult adaptation via spirituality were detected, one via mindfulness and one via feeling of security. Both pathways began at maternal love, the opposite of emotional neglect. Childhood abuse or physical neglect was not associated with the development of spirituality. Associations were not only linear in nature, but also displayed interactions.
Objective: Spirituality has been shown to be associated with various aspects of health. It has also been discussed as an aid in coping with adversities.
Methods: The present investigation examined four dimensions of spirituality – belief in God, mindfulness, quest for meaning and feeling of security – as possible mediators between childhood adversities and adult adaptation. Two samples of n ≈ 500 were examined via internet in a retrospective survey.
RELIGION, RELIGIOSITY AND SPIRITUALITY IN THE BIOPSYCHOSOCIAL MODEL OF HEALTH...Masa Nakata
This document summarizes research on the relationship between religiosity, spirituality, and health outcomes in older adults. It finds that religiosity and religious coping increase with age, and are linked to better mental health outcomes like well-being and lower depression. Studies also associate religiosity with better physical health and lower mortality. However, the exact nature of the relationship is complex, with open questions around causality and possible psychological or social factors that may mediate the effects.
The effectiveness of a training program based on emotional freedom technique ...Alexander Decker
This document discusses a study that examined the effectiveness of a training program based on Emotional Freedom Technique (EFT) in improving feelings of happiness in diabetics in Gaza. The study included 36 diabetics split into a treatment and control group. The treatment group received EFT training while the control did not. Results showed statistically significant improvements in happiness for the treatment group compared to the control group after the program. EFT aims to help people overcome anxiety and illness by tapping on energy points in the body to transform negative energy into positive energy. The study suggests EFT may be an effective approach for improving psychological well-being in diabetics.
This study aimed to explain the inconsistent findings regarding the influence of prayer coping on mental health outcomes after cardiac surgery. The researchers hypothesized that prayer coping could influence outcomes through both positive and negative pathways - increasing optimism but also acute distress. They tested a model showing that prayer coping was positively associated with optimism, which predicted better outcomes, but also linked to higher preoperative stress symptoms, which counterbalanced the outcomes. The study drew on Hegel's dialectic view that contradictions can underlie realities and proposed prayer coping may influence outcomes through parallel positive and negative mediators.
This document discusses the relationship between spirituality and health. It defines spirituality and notes that while often associated with religion, personal spirituality can exist outside of religion. Several studies show that spiritual practices and beliefs are associated with improved health outcomes such as faster recovery from surgery, lower blood pressure, and better coping with chronic illnesses. Qualities of faith, hope, forgiveness, love, social support, and prayer are found to positively impact immune, cardiovascular, and nervous systems and reduce feelings of depression, anxiety, and stress. Certain religious groups also demonstrate healthier lifestyles and longer lifespans. While spirituality may benefit many conditions, it does not guarantee health and inappropriate spiritual guidance could potentially harm patients.
This document summarizes a proposed study on the impact of spirituality on counseling for families experiencing cancer in the Kentucky-Tennessee region. The study would use a mixed methods approach, beginning with a standardized spirituality assessment and then conducting semi-structured interviews to describe participants' perceptions of spirituality in their own words. Previous research has found that spirituality plays an important role in coping and quality of life for cancer patients and their families, but definitions and understandings of spirituality vary widely. The goal of this study is to better understand how spirituality impacts counseling needs for families dealing with cancer in this region. Participants would include cancer patients and their immediate family members from several treatment centers in Kentucky and Tennessee.
RESEARCH ARTICLE Open AccessThe spiritual distress assessm.docxronak56
The document describes the development of the Spiritual Distress Assessment Tool (SDAT) to assess spiritual distress in hospitalized elderly patients. A multidisciplinary group developed a Spiritual Needs Model identifying four dimensions of spirituality (Meaning, Transcendence, Values, Psychosocial Identity) and corresponding needs. Researchers then created the SDAT, a structured interview to identify unmet spiritual needs and score spiritual distress. Chaplains validated that the SDAT comprehensively assesses patients' spirituality. The SDAT shows potential as a clinically acceptable tool for integrating spiritual assessment into patient care plans.
This document discusses whether psychotherapy has a biological basis. It argues that psychotherapy can positively impact brain recovery from stress and facilitate healing by mediating neural networks. Studies have found psychotherapy alters brain regions involved in emotion regulation and reward processing. However, factors like culture, religion, and socioeconomic status can influence a client's view of psychotherapy. The clinician must consider these factors to avoid resistance and ensure effective treatment.
This document provides a summary of a critical review of a spirituality intervention developed by the author. It describes the development of the intervention which was grounded in research linking spirituality to improved health outcomes in patients with chronic illnesses. It then outlines a four-phase research model used to test the intervention with various clinical and non-clinical populations. The findings from these studies are reported to be mixed, with some preliminary studies showing benefits but subsequent clinical trials showing limited effects. The author discusses implications for further research on developing and testing spiritual interventions.
This document discusses the relationship between religion and various psychiatric disorders based on studies. It finds that religion can influence disorders both positively and negatively. Religiosity is generally associated with lower rates of depression, anxiety, and substance abuse, likely due to social support and coping resources. However, religious beliefs can also contribute to guilt, distress, and obsessions in some individuals with conditions like depression and OCD. The direction of causality between religion and mental health is complex and not fully understood.
One major role of psychology is to improve the lives of the people.docxcherishwinsland
One major role of psychology is to improve the lives of the people we touch. Whether through research, service, or provision of primary or secondary health care, we look forward to the day when we can adequately prevent, diagnose, and treat diseases, and foster positive states of being in balance with others and the environment. This is not an easy task; a multitude of forces influences our health and the development of diseases.
As we strive to meet this challenge, the important role of culture in contributing to the maintenance of health and the etiology and treatment of disease has become increasingly clear. Although our goals of maintaining health and preventing and treating diseases may be the same across cultures, cultures vary in their perceptions of illness and their definitions of what is considered healthy and what is considered a disease. From anthropological and sociological perspectives, disease refers to a “malfunctioning or maladaptation of biologic and psychophysiologic processes in the individual” and illness refers to the “personal, interpersonal, and cultural reactions to disease or discomfort” (Kleinman, Eisenberg, & Good, 2006; p. 141). Thus, how we view health, disease, and illness, is strongly shaped by culture.
This chapter explores how cultural factors sway physical health and disease processes, and investigates our attempts to treat both psychological and sociological influences. We begin with an examination of cultural differences in the definition of health and present three indicators of health worldwide: life expectancy, infant mortality, and subjective well-being. We will then review the considerable amount of research concerning the relationship between culture and heart disease, other physical disease processes, eating disorders, obesity, and suicide. Next, we will explore differences in health care systems across countries. Finally, we will summarize the research in the form of a model of cultural influences on health.
CULTURAL DIFFERENCES IN THE DEFINITION OF HEALTH
Comparison Across Cultures
Before we look at how culture influences health and disease processes, we need to examine exactly what we mean by health. More than 60 years ago, the World Health Organization (WHO) developed a definition at the International Health Conference, at which 61 countries were represented. They defined health as “a state of complete physical, mental, and social well-being, and not merely the absence of disease or infirmity.” The WHO definition goes on further to say that “The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being, without distinction of race, religion, political beliefs or economic and social conditions” (World Health Organization, 1948). This definition of health is still used by the WHO today.
In the United States, our views of health have been heavily influenced by what many call the biomedical model of health and disease (Kleinman et al., 2006). Trad.
This document provides information on chronic illness in adolescents including:
- Chronic illnesses are long-lasting health conditions that impact physical, mental, and social well-being. Examples include asthma, cancer, diabetes, and heart disease.
- Approximately 20-30% of adolescents in the US have a chronic illness, with 10-13% reporting substantial limitations. Depression and non-adherence to treatment plans are common issues.
- Several assessment tools are recommended to evaluate an adolescent's medical history, illness impact, depression, anxiety, quality of life, and treatment adherence.
- Suggested intervention strategies include cognitive behavioral therapy to challenge irrational thoughts and beliefs, develop coping skills, and improve treatment adherence.
Temperament, Childhood Illness Burden, and Illness Behavior in.docxmanningchassidy
Temperament, Childhood Illness Burden, and Illness Behavior in
Early Adulthood
Brittany L. Sisco-Taylor
University of California, Riverside
Robin P. Corley, Michael C. Stallings,
and Sally J. Wadsworth
University of Colorado, Boulder
Chandra A. Reynolds
University of California, Riverside
Objective: Illness behaviors— or responses to bodily symptoms—predict individuals’ recovery and
functioning; however, there has been little research on the early life personality antecedents of illness
behavior. This study’s primary aims were to evaluate (a) childhood temperament traits (i.e., emotionality
and sociability) as predictors of adult illness behaviors, independent of objective health; and (b) adult
temperament traits for mediation of childhood temperament’s associations. Method: Participants in-
cluded 714 (53% male; 350 adoptive family and 364 control family) children and siblings from the
Colorado Adoption Project (CAP; Plomin & DeFries, 1983). Structural regression analyses evaluated
paths from childhood temperament to illness behavior (i.e., somatic complaints, sick days, and medica-
tion use) at two adulthood assessments (CAP years 21 and 30). Analyses controlled for participant age,
sex, family type (adoptive or control), adopted status, parent education/occupation, and middle childhood
illnesses, doctor visits, and life events stress. Results: Latent illness behavior factors were established
across 2 adulthood assessments. Multilevel path analyses revealed that higher emotionality (fearfulness)
in adulthood— but not childhood temperament—predicted higher levels of illness behavior at both
assessments. Lastly, lower emotionality-fearfulness partially mediated the effect of higher childhood
sociability on adult illness behavior. Conclusions: Results suggest the importance of childhood illness
experiences and adult emotionality (fearfulness) in shaping illness behavior in early adulthood. They also
suggest a small, protective role of childhood sociability on reduced trait fearfulness in adulthood. These
findings broaden our understanding of the prospective links between temperament and illness behavior
development, suggesting distinct associations from early life illness experiences.
Keywords: illness behavior, temperament, burden of illness, young adult, health promotion
Supplemental materials: http://dx.doi.org/10.1037/hea0000759.supp
In 2013, United States health care expenditures reached $2.9
trillion, with an average personal health cost of $9,255 per capita
(National Center for Health Statistics, 2014). Such daunting ex-
penditures point to a need for increased efficiency in the delivery
and utilization of health services. As a first step, however, the
process of illness must be better understood. In other words, what
psychological and behavioral processes occur before people seek
(or choose not to seek) formal health services? Illness behavior—a
psychosocial construct defined as individuals’ perceptions, evalu-
ations, and res ...
Temperament, Childhood Illness Burden, and Illness Behavior in.docxbradburgess22840
Temperament, Childhood Illness Burden, and Illness Behavior in
Early Adulthood
Brittany L. Sisco-Taylor
University of California, Riverside
Robin P. Corley, Michael C. Stallings,
and Sally J. Wadsworth
University of Colorado, Boulder
Chandra A. Reynolds
University of California, Riverside
Objective: Illness behaviors— or responses to bodily symptoms—predict individuals’ recovery and
functioning; however, there has been little research on the early life personality antecedents of illness
behavior. This study’s primary aims were to evaluate (a) childhood temperament traits (i.e., emotionality
and sociability) as predictors of adult illness behaviors, independent of objective health; and (b) adult
temperament traits for mediation of childhood temperament’s associations. Method: Participants in-
cluded 714 (53% male; 350 adoptive family and 364 control family) children and siblings from the
Colorado Adoption Project (CAP; Plomin & DeFries, 1983). Structural regression analyses evaluated
paths from childhood temperament to illness behavior (i.e., somatic complaints, sick days, and medica-
tion use) at two adulthood assessments (CAP years 21 and 30). Analyses controlled for participant age,
sex, family type (adoptive or control), adopted status, parent education/occupation, and middle childhood
illnesses, doctor visits, and life events stress. Results: Latent illness behavior factors were established
across 2 adulthood assessments. Multilevel path analyses revealed that higher emotionality (fearfulness)
in adulthood— but not childhood temperament—predicted higher levels of illness behavior at both
assessments. Lastly, lower emotionality-fearfulness partially mediated the effect of higher childhood
sociability on adult illness behavior. Conclusions: Results suggest the importance of childhood illness
experiences and adult emotionality (fearfulness) in shaping illness behavior in early adulthood. They also
suggest a small, protective role of childhood sociability on reduced trait fearfulness in adulthood. These
findings broaden our understanding of the prospective links between temperament and illness behavior
development, suggesting distinct associations from early life illness experiences.
Keywords: illness behavior, temperament, burden of illness, young adult, health promotion
Supplemental materials: http://dx.doi.org/10.1037/hea0000759.supp
In 2013, United States health care expenditures reached $2.9
trillion, with an average personal health cost of $9,255 per capita
(National Center for Health Statistics, 2014). Such daunting ex-
penditures point to a need for increased efficiency in the delivery
and utilization of health services. As a first step, however, the
process of illness must be better understood. In other words, what
psychological and behavioral processes occur before people seek
(or choose not to seek) formal health services? Illness behavior—a
psychosocial construct defined as individuals’ perceptions, evalu-
ations, and res.
This document discusses perspectives on mental health from different cultures and societies. It begins by defining perspective and examining how people can hold multiple, sometimes contradictory beliefs about mental illness. It then explores how perspectives vary between psychiatrists, physicians, and public health specialists based on their disciplines. The document also defines stigma and discrimination related to mental illness, and how cultural and religious teachings can influence beliefs about the causes and nature of mental illness. Finally, it reviews how attitudes toward mental illness differ among individuals, families, ethnicities, cultures and countries.
Caregivers of persons with Alzheimer's disease and related disorders frequently use prayer and religious coping. They perceive prayer and trusting in God as effective coping mechanisms. The majority of caregivers in the study used internal religious activities like prayer to help them cope with the stresses of caregiving.
The document discusses applying spirituality clinically from two perspectives in dialogue. It begins with a declaration of conflict of interest as the author has religious faith. It then discusses how to define and measure spirituality versus religion. Several studies are summarized that examine relationships between religion, spirituality and health outcomes like depression, anxiety, blood pressure and mortality. The author suggests a respectful approach to discussing spirituality with patients and hopes to stimulate interest in further studying this topic to benefit primary care in Brazil.
The company you MUST use is Capital OneImpacts of .docxrtodd643
***** The company you MUST use is Capital One
Impacts of Value Added,
outline the goals and indicators for measuring development progress for a nation in which your selected corporation does business. Which ones are most important? How do they relate to the business of your corporation? Is the corporation working with integrity in this environment? Research the value adds the corporation is creating for the community and itself. What are the community reactions? How does this affect the corporation's success? Cite at least two sources.
.
The Comparison and Contrast Block Comparison Essay TemplateThe B.docxrtodd643
The Comparison and Contrast Block Comparison Essay Template
The BLOCK COMPARISON ORGANIZATIONstyleof a comparison/contrast essay has been formatted for you below. In this type of essay, you discuss three points about Topic A (person, place, thing) in your first body paragraph. Then you discuss the same three points about Topic B (person, place or concept) in Body Paragraph #2. Determine your paragraph order depending on the point you wish to make at the end of your essay.
This format is ideal for comparing or contrasting several of the same points about two persons, places or concepts. This format will enable you to draw a clear distinction between the two and make an insightful comment about what you perceive are their similarities and differences. Remember to use the same discussion points concerning Topic A with Topic B.
Not required, but a “Hook” -
Can capture the reader’s imagination and motivate him or her to read further. It is usually the first sentence in your introductory paragraph.
Hook:
The Introductory Paragraph
This introductory paragraph should include points that stay on message and develop your thesis/core idea. The strategies generally used in an introductory paragraph are general ideas to specific ones (General to Specific) which funnel down to your thesis statement. These general to specific ideas are usually draw from the content of your essay. You are essentially giving us a preview of what is to come. Also, you may use historical material (Facts, Historical or Research data) to reinforce your thesis statement and the merit of this essay. The final method for fashioning an introductory paragraph is a personal anecdote, either your own or someone else’s.
Each of the above techniques has to set up your thesis statement and motivate readers to venture on to determine the point of the essay.
Introductory Paragraph
Thesis statement or core idea.
What is the point of this essay? Your thesis statement has to hone in on the point (core idea) you are trying to make in this essay. This is the last sentence in your introductory paragraph.
Thesis Statement:
Body Paragraph #1:
Topic Sentence #1
This should allude to your thesis sentence or core idea in some way. This is the first sentence in Body Paragraph #1
Topic Sentence #1:
Body Paragraph #1 (Three or more discussion points about Topic A)
This paragraph should stay on message and clearly develop the three or more points you wish to develop as part of your thesis/core idea.
First Body Paragraph:
Item of Comparison/Contrast #1:
Item of Comparison/contrast #2
Item of Comparison/Contrast #3
A brief summation of Body Paragraph #1 that helps transition into Body Paragraph #2. This is the last sentence in Body Paragraph #1.
Brief Summation of Body Paragraph #1:
Body Paragraph #2
Topic Sentence #2
This paragraph should allude to your thesis sentence or core idea in some way. This is the first sentence in Body Paragraph #2.
Topic sentence #2:
Body Paragraph #2 (.
More Related Content
Similar to The contribution of spirituality and spiritual copingto anxi.docx
Objective: Spirituality has been shown to be associated with various aspects of health. It has also been discussed as an aid in coping with adversities.
Methods: The present investigation examined four dimensions of spirituality – belief in God, mindfulness, quest for meaning and feeling of security – as possible mediators between childhood adversities and adult adaptation. Two samples of n ≈ 500 were examined via internet in a retrospective survey.
Results: Two pathways from childhood to adult adaptation via spirituality were detected, one via mindfulness and one via feeling of security. Both pathways began at maternal love, the opposite of emotional neglect. Childhood abuse or physical neglect was not associated with the development of spirituality. Associations were not only linear in nature, but also displayed interactions.
Objective: Spirituality has been shown to be associated with various aspects of health. It has also been discussed as an aid in coping with adversities.
Methods: The present investigation examined four dimensions of spirituality – belief in God, mindfulness, quest for meaning and feeling of security – as possible mediators between childhood adversities and adult adaptation. Two samples of n ≈ 500 were examined via internet in a retrospective survey.
RELIGION, RELIGIOSITY AND SPIRITUALITY IN THE BIOPSYCHOSOCIAL MODEL OF HEALTH...Masa Nakata
This document summarizes research on the relationship between religiosity, spirituality, and health outcomes in older adults. It finds that religiosity and religious coping increase with age, and are linked to better mental health outcomes like well-being and lower depression. Studies also associate religiosity with better physical health and lower mortality. However, the exact nature of the relationship is complex, with open questions around causality and possible psychological or social factors that may mediate the effects.
The effectiveness of a training program based on emotional freedom technique ...Alexander Decker
This document discusses a study that examined the effectiveness of a training program based on Emotional Freedom Technique (EFT) in improving feelings of happiness in diabetics in Gaza. The study included 36 diabetics split into a treatment and control group. The treatment group received EFT training while the control did not. Results showed statistically significant improvements in happiness for the treatment group compared to the control group after the program. EFT aims to help people overcome anxiety and illness by tapping on energy points in the body to transform negative energy into positive energy. The study suggests EFT may be an effective approach for improving psychological well-being in diabetics.
This study aimed to explain the inconsistent findings regarding the influence of prayer coping on mental health outcomes after cardiac surgery. The researchers hypothesized that prayer coping could influence outcomes through both positive and negative pathways - increasing optimism but also acute distress. They tested a model showing that prayer coping was positively associated with optimism, which predicted better outcomes, but also linked to higher preoperative stress symptoms, which counterbalanced the outcomes. The study drew on Hegel's dialectic view that contradictions can underlie realities and proposed prayer coping may influence outcomes through parallel positive and negative mediators.
This document discusses the relationship between spirituality and health. It defines spirituality and notes that while often associated with religion, personal spirituality can exist outside of religion. Several studies show that spiritual practices and beliefs are associated with improved health outcomes such as faster recovery from surgery, lower blood pressure, and better coping with chronic illnesses. Qualities of faith, hope, forgiveness, love, social support, and prayer are found to positively impact immune, cardiovascular, and nervous systems and reduce feelings of depression, anxiety, and stress. Certain religious groups also demonstrate healthier lifestyles and longer lifespans. While spirituality may benefit many conditions, it does not guarantee health and inappropriate spiritual guidance could potentially harm patients.
This document summarizes a proposed study on the impact of spirituality on counseling for families experiencing cancer in the Kentucky-Tennessee region. The study would use a mixed methods approach, beginning with a standardized spirituality assessment and then conducting semi-structured interviews to describe participants' perceptions of spirituality in their own words. Previous research has found that spirituality plays an important role in coping and quality of life for cancer patients and their families, but definitions and understandings of spirituality vary widely. The goal of this study is to better understand how spirituality impacts counseling needs for families dealing with cancer in this region. Participants would include cancer patients and their immediate family members from several treatment centers in Kentucky and Tennessee.
RESEARCH ARTICLE Open AccessThe spiritual distress assessm.docxronak56
The document describes the development of the Spiritual Distress Assessment Tool (SDAT) to assess spiritual distress in hospitalized elderly patients. A multidisciplinary group developed a Spiritual Needs Model identifying four dimensions of spirituality (Meaning, Transcendence, Values, Psychosocial Identity) and corresponding needs. Researchers then created the SDAT, a structured interview to identify unmet spiritual needs and score spiritual distress. Chaplains validated that the SDAT comprehensively assesses patients' spirituality. The SDAT shows potential as a clinically acceptable tool for integrating spiritual assessment into patient care plans.
This document discusses whether psychotherapy has a biological basis. It argues that psychotherapy can positively impact brain recovery from stress and facilitate healing by mediating neural networks. Studies have found psychotherapy alters brain regions involved in emotion regulation and reward processing. However, factors like culture, religion, and socioeconomic status can influence a client's view of psychotherapy. The clinician must consider these factors to avoid resistance and ensure effective treatment.
This document provides a summary of a critical review of a spirituality intervention developed by the author. It describes the development of the intervention which was grounded in research linking spirituality to improved health outcomes in patients with chronic illnesses. It then outlines a four-phase research model used to test the intervention with various clinical and non-clinical populations. The findings from these studies are reported to be mixed, with some preliminary studies showing benefits but subsequent clinical trials showing limited effects. The author discusses implications for further research on developing and testing spiritual interventions.
This document discusses the relationship between religion and various psychiatric disorders based on studies. It finds that religion can influence disorders both positively and negatively. Religiosity is generally associated with lower rates of depression, anxiety, and substance abuse, likely due to social support and coping resources. However, religious beliefs can also contribute to guilt, distress, and obsessions in some individuals with conditions like depression and OCD. The direction of causality between religion and mental health is complex and not fully understood.
One major role of psychology is to improve the lives of the people.docxcherishwinsland
One major role of psychology is to improve the lives of the people we touch. Whether through research, service, or provision of primary or secondary health care, we look forward to the day when we can adequately prevent, diagnose, and treat diseases, and foster positive states of being in balance with others and the environment. This is not an easy task; a multitude of forces influences our health and the development of diseases.
As we strive to meet this challenge, the important role of culture in contributing to the maintenance of health and the etiology and treatment of disease has become increasingly clear. Although our goals of maintaining health and preventing and treating diseases may be the same across cultures, cultures vary in their perceptions of illness and their definitions of what is considered healthy and what is considered a disease. From anthropological and sociological perspectives, disease refers to a “malfunctioning or maladaptation of biologic and psychophysiologic processes in the individual” and illness refers to the “personal, interpersonal, and cultural reactions to disease or discomfort” (Kleinman, Eisenberg, & Good, 2006; p. 141). Thus, how we view health, disease, and illness, is strongly shaped by culture.
This chapter explores how cultural factors sway physical health and disease processes, and investigates our attempts to treat both psychological and sociological influences. We begin with an examination of cultural differences in the definition of health and present three indicators of health worldwide: life expectancy, infant mortality, and subjective well-being. We will then review the considerable amount of research concerning the relationship between culture and heart disease, other physical disease processes, eating disorders, obesity, and suicide. Next, we will explore differences in health care systems across countries. Finally, we will summarize the research in the form of a model of cultural influences on health.
CULTURAL DIFFERENCES IN THE DEFINITION OF HEALTH
Comparison Across Cultures
Before we look at how culture influences health and disease processes, we need to examine exactly what we mean by health. More than 60 years ago, the World Health Organization (WHO) developed a definition at the International Health Conference, at which 61 countries were represented. They defined health as “a state of complete physical, mental, and social well-being, and not merely the absence of disease or infirmity.” The WHO definition goes on further to say that “The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being, without distinction of race, religion, political beliefs or economic and social conditions” (World Health Organization, 1948). This definition of health is still used by the WHO today.
In the United States, our views of health have been heavily influenced by what many call the biomedical model of health and disease (Kleinman et al., 2006). Trad.
This document provides information on chronic illness in adolescents including:
- Chronic illnesses are long-lasting health conditions that impact physical, mental, and social well-being. Examples include asthma, cancer, diabetes, and heart disease.
- Approximately 20-30% of adolescents in the US have a chronic illness, with 10-13% reporting substantial limitations. Depression and non-adherence to treatment plans are common issues.
- Several assessment tools are recommended to evaluate an adolescent's medical history, illness impact, depression, anxiety, quality of life, and treatment adherence.
- Suggested intervention strategies include cognitive behavioral therapy to challenge irrational thoughts and beliefs, develop coping skills, and improve treatment adherence.
Temperament, Childhood Illness Burden, and Illness Behavior in.docxmanningchassidy
Temperament, Childhood Illness Burden, and Illness Behavior in
Early Adulthood
Brittany L. Sisco-Taylor
University of California, Riverside
Robin P. Corley, Michael C. Stallings,
and Sally J. Wadsworth
University of Colorado, Boulder
Chandra A. Reynolds
University of California, Riverside
Objective: Illness behaviors— or responses to bodily symptoms—predict individuals’ recovery and
functioning; however, there has been little research on the early life personality antecedents of illness
behavior. This study’s primary aims were to evaluate (a) childhood temperament traits (i.e., emotionality
and sociability) as predictors of adult illness behaviors, independent of objective health; and (b) adult
temperament traits for mediation of childhood temperament’s associations. Method: Participants in-
cluded 714 (53% male; 350 adoptive family and 364 control family) children and siblings from the
Colorado Adoption Project (CAP; Plomin & DeFries, 1983). Structural regression analyses evaluated
paths from childhood temperament to illness behavior (i.e., somatic complaints, sick days, and medica-
tion use) at two adulthood assessments (CAP years 21 and 30). Analyses controlled for participant age,
sex, family type (adoptive or control), adopted status, parent education/occupation, and middle childhood
illnesses, doctor visits, and life events stress. Results: Latent illness behavior factors were established
across 2 adulthood assessments. Multilevel path analyses revealed that higher emotionality (fearfulness)
in adulthood— but not childhood temperament—predicted higher levels of illness behavior at both
assessments. Lastly, lower emotionality-fearfulness partially mediated the effect of higher childhood
sociability on adult illness behavior. Conclusions: Results suggest the importance of childhood illness
experiences and adult emotionality (fearfulness) in shaping illness behavior in early adulthood. They also
suggest a small, protective role of childhood sociability on reduced trait fearfulness in adulthood. These
findings broaden our understanding of the prospective links between temperament and illness behavior
development, suggesting distinct associations from early life illness experiences.
Keywords: illness behavior, temperament, burden of illness, young adult, health promotion
Supplemental materials: http://dx.doi.org/10.1037/hea0000759.supp
In 2013, United States health care expenditures reached $2.9
trillion, with an average personal health cost of $9,255 per capita
(National Center for Health Statistics, 2014). Such daunting ex-
penditures point to a need for increased efficiency in the delivery
and utilization of health services. As a first step, however, the
process of illness must be better understood. In other words, what
psychological and behavioral processes occur before people seek
(or choose not to seek) formal health services? Illness behavior—a
psychosocial construct defined as individuals’ perceptions, evalu-
ations, and res ...
Temperament, Childhood Illness Burden, and Illness Behavior in.docxbradburgess22840
Temperament, Childhood Illness Burden, and Illness Behavior in
Early Adulthood
Brittany L. Sisco-Taylor
University of California, Riverside
Robin P. Corley, Michael C. Stallings,
and Sally J. Wadsworth
University of Colorado, Boulder
Chandra A. Reynolds
University of California, Riverside
Objective: Illness behaviors— or responses to bodily symptoms—predict individuals’ recovery and
functioning; however, there has been little research on the early life personality antecedents of illness
behavior. This study’s primary aims were to evaluate (a) childhood temperament traits (i.e., emotionality
and sociability) as predictors of adult illness behaviors, independent of objective health; and (b) adult
temperament traits for mediation of childhood temperament’s associations. Method: Participants in-
cluded 714 (53% male; 350 adoptive family and 364 control family) children and siblings from the
Colorado Adoption Project (CAP; Plomin & DeFries, 1983). Structural regression analyses evaluated
paths from childhood temperament to illness behavior (i.e., somatic complaints, sick days, and medica-
tion use) at two adulthood assessments (CAP years 21 and 30). Analyses controlled for participant age,
sex, family type (adoptive or control), adopted status, parent education/occupation, and middle childhood
illnesses, doctor visits, and life events stress. Results: Latent illness behavior factors were established
across 2 adulthood assessments. Multilevel path analyses revealed that higher emotionality (fearfulness)
in adulthood— but not childhood temperament—predicted higher levels of illness behavior at both
assessments. Lastly, lower emotionality-fearfulness partially mediated the effect of higher childhood
sociability on adult illness behavior. Conclusions: Results suggest the importance of childhood illness
experiences and adult emotionality (fearfulness) in shaping illness behavior in early adulthood. They also
suggest a small, protective role of childhood sociability on reduced trait fearfulness in adulthood. These
findings broaden our understanding of the prospective links between temperament and illness behavior
development, suggesting distinct associations from early life illness experiences.
Keywords: illness behavior, temperament, burden of illness, young adult, health promotion
Supplemental materials: http://dx.doi.org/10.1037/hea0000759.supp
In 2013, United States health care expenditures reached $2.9
trillion, with an average personal health cost of $9,255 per capita
(National Center for Health Statistics, 2014). Such daunting ex-
penditures point to a need for increased efficiency in the delivery
and utilization of health services. As a first step, however, the
process of illness must be better understood. In other words, what
psychological and behavioral processes occur before people seek
(or choose not to seek) formal health services? Illness behavior—a
psychosocial construct defined as individuals’ perceptions, evalu-
ations, and res.
This document discusses perspectives on mental health from different cultures and societies. It begins by defining perspective and examining how people can hold multiple, sometimes contradictory beliefs about mental illness. It then explores how perspectives vary between psychiatrists, physicians, and public health specialists based on their disciplines. The document also defines stigma and discrimination related to mental illness, and how cultural and religious teachings can influence beliefs about the causes and nature of mental illness. Finally, it reviews how attitudes toward mental illness differ among individuals, families, ethnicities, cultures and countries.
Caregivers of persons with Alzheimer's disease and related disorders frequently use prayer and religious coping. They perceive prayer and trusting in God as effective coping mechanisms. The majority of caregivers in the study used internal religious activities like prayer to help them cope with the stresses of caregiving.
The document discusses applying spirituality clinically from two perspectives in dialogue. It begins with a declaration of conflict of interest as the author has religious faith. It then discusses how to define and measure spirituality versus religion. Several studies are summarized that examine relationships between religion, spirituality and health outcomes like depression, anxiety, blood pressure and mortality. The author suggests a respectful approach to discussing spirituality with patients and hopes to stimulate interest in further studying this topic to benefit primary care in Brazil.
Similar to The contribution of spirituality and spiritual copingto anxi.docx (20)
The company you MUST use is Capital OneImpacts of .docxrtodd643
***** The company you MUST use is Capital One
Impacts of Value Added,
outline the goals and indicators for measuring development progress for a nation in which your selected corporation does business. Which ones are most important? How do they relate to the business of your corporation? Is the corporation working with integrity in this environment? Research the value adds the corporation is creating for the community and itself. What are the community reactions? How does this affect the corporation's success? Cite at least two sources.
.
The Comparison and Contrast Block Comparison Essay TemplateThe B.docxrtodd643
The Comparison and Contrast Block Comparison Essay Template
The BLOCK COMPARISON ORGANIZATIONstyleof a comparison/contrast essay has been formatted for you below. In this type of essay, you discuss three points about Topic A (person, place, thing) in your first body paragraph. Then you discuss the same three points about Topic B (person, place or concept) in Body Paragraph #2. Determine your paragraph order depending on the point you wish to make at the end of your essay.
This format is ideal for comparing or contrasting several of the same points about two persons, places or concepts. This format will enable you to draw a clear distinction between the two and make an insightful comment about what you perceive are their similarities and differences. Remember to use the same discussion points concerning Topic A with Topic B.
Not required, but a “Hook” -
Can capture the reader’s imagination and motivate him or her to read further. It is usually the first sentence in your introductory paragraph.
Hook:
The Introductory Paragraph
This introductory paragraph should include points that stay on message and develop your thesis/core idea. The strategies generally used in an introductory paragraph are general ideas to specific ones (General to Specific) which funnel down to your thesis statement. These general to specific ideas are usually draw from the content of your essay. You are essentially giving us a preview of what is to come. Also, you may use historical material (Facts, Historical or Research data) to reinforce your thesis statement and the merit of this essay. The final method for fashioning an introductory paragraph is a personal anecdote, either your own or someone else’s.
Each of the above techniques has to set up your thesis statement and motivate readers to venture on to determine the point of the essay.
Introductory Paragraph
Thesis statement or core idea.
What is the point of this essay? Your thesis statement has to hone in on the point (core idea) you are trying to make in this essay. This is the last sentence in your introductory paragraph.
Thesis Statement:
Body Paragraph #1:
Topic Sentence #1
This should allude to your thesis sentence or core idea in some way. This is the first sentence in Body Paragraph #1
Topic Sentence #1:
Body Paragraph #1 (Three or more discussion points about Topic A)
This paragraph should stay on message and clearly develop the three or more points you wish to develop as part of your thesis/core idea.
First Body Paragraph:
Item of Comparison/Contrast #1:
Item of Comparison/contrast #2
Item of Comparison/Contrast #3
A brief summation of Body Paragraph #1 that helps transition into Body Paragraph #2. This is the last sentence in Body Paragraph #1.
Brief Summation of Body Paragraph #1:
Body Paragraph #2
Topic Sentence #2
This paragraph should allude to your thesis sentence or core idea in some way. This is the first sentence in Body Paragraph #2.
Topic sentence #2:
Body Paragraph #2 (.
The company uses the periodic inventory system. A physical .docxrtodd643
The company uses the periodic inventory system. A physical count of inventory on December31 resulted in an inventory amount of $50,000.
Instructions
1. Prepare an income statement for the year ending December 31, 2019. Assume that twenty thousand shares of common stock were outstanding the entire year. (12 Marks)
a. using the Multi-Step form.
b. using the Single-Step form.
2. Prepare a retained earnings statement for the year ending December 31, 2019.
(4 Marks)
3. Prepare a Statement of Financial Position as at December 31, 2019. (12 Marks)
a. Report Form
b. Account Form
4. Calculate Earnings Per Share for the year ending December 31, 2019. (2 Marks)
----------END OF TASK-2----------
1
1
DebitsCredits
Sales- 1,533,600
Notes Receivable128,000 -
Investments (short Term)141,600 -
Accounts Payable- 81,600
Accumulated Depreciation—Equipment- 49,600
Sales Discounts16,800 -
Sales Returns28,000 -
Purchase Discounts- 12,800
Cash304,000 -
Accounts Receivable206,400 -
Rent Revenue- 22,400
Retained Earnings- 384,000
Salaries Payable- 35,200
Notes Payable- 120,000
Common Stock, $15 par- 480,000
Income Tax Expense108,800 -
Cash Dividends Declared112,000 -
Allowance for Doubtful Accounts- 10,400
Supplies on Hand17,600 -
Freight-In25,600 -
Short term Investment80,000 -
Freight-out24,000 -
Sales commission339,200 -
Correction for understatement of prior period net income (inventory error)- 80,000
Other Operating Expenses (30% Selling, 70% Administrative)182,400 -
Land104,000 -
Provision for Bad and Doubtful Account- 54,400
Equipment208,000 -
Merchandise Inventory126,400 -
Building166,400 -
Purchases800,000 -
Dividend Income- 40,000
Loss on Sale of Investment20,800 -
Interest Revenue- 14,400
Interest Expense20,000 -
Bonds Payable- 160,000
Gain on Sale of Land- 39,200
Accumulated Depreciation—Building32,000
Accumulated Depreciation—Land- 10,400
Totals3,160,000 3,160,000
Smart Corporation
ADJUSTED TRIAL BALANCE
December 31, 2019
EDU734: Teaching and
Learning Environment
Name of teacher:
Date:
Ages: Number of c.
The company that I decided to follow is Entercom Atlanta which a c.docxrtodd643
The company that I decided to follow is Entercom Atlanta which a company that owns several radio stations across the country. Each of their platforms serves a purpose, allowing them to better connect with listeners.
FACEBOOK: Facebook is the most used platform for this particular company based on the type of markets they are in. Facebook is used as a way to converse with their listeners. It used for not only station updates, but contests and videos as well. This week, they used to keep listeners engaged with their shows.
TWITTER: Twitter used to connect in the same sense. Entercom uses it to converse with listeners as well as give them a constant "play-by-play" of station news. This week, they use it to tweet constant station updates for each show.
YOUTUBE: While Entercom uses youtube, it isnt a successful way to market radio. Their youtube channels don't get nearly as much attention as they their other platforms, including Instagram. This week, YouTube has not been use, as it appears that do most of their postings on Instagram and Facebook.
BLOG: Their blogs are used to keep listeners update with what happened in previous shows as well as what is going in general. It is a way to talk to listeners to who prefer to read about their news, rather than listen to it. This week they used it post about the Super Bowl as well as station contests.
.
The company of choice is Take-Two InteractiveWrite a 1,050.docxrtodd643
The company of choice is Take-Two Interactive
Write
a 1,050-word paper in which you address the following:
Identify the major components of the strategic management process.
Discuss how these components work together to create value for the organization.
Evaluate the company's mission statement, vision statement, motivation strategy, innovation strategy, and people strategy. If the organization does not have one or more of these, how does that affect the organization and its people?
Explain the role of ethics and corporate social responsibility in strategic planning. How does this direct their strategy? How does the organization's vision and mission align with your own values and vision? If you are currently working for the organization, how does your role influence this and vice versa?
.
The Company to use is AppleCreate Microsoft® PowerPoint® .docxrtodd643
The Company to use is "Apple"
Create
Microsoft® PowerPoint® presentation slides with speaker notes
Briefly discuss the various methodologies and techniques that can be used to promote your product (Apple) in the global market - specifically e-commerce and social media.
.
The company I work for is WILDLAWNSubmit a detailed plan fo.docxrtodd643
The company I work for is "WILDLAWN
Submit a
detailed
plan for your class project based on the attached marketing plan outline
The plan should include:
A restatement of your goals, strategies and tactics
Depending on the organization you are working with and it's particular objectives, develop a list of recommended tactics for each strategy to achieve a their specific goals.
In most cases you should include a specific Media
strategy
--- a plan with
tactics, date, content
What are key characteristics of their target audience?
What platform should they use.
What content kinds of content should they share? (Attach to submission)
What about ad campaigns. (the $10 from the 10-10-10)
.
The Company I choose is AlibabaThe topic I will cover is C.docxrtodd643
The Company I choose is Alibaba
The topic I will cover is
Chap 2 & 4,
Chap 7,
Chap 9,
Chap 12
1,000 – 1,200 words
Chap 2 & 4:
Explain the company's culture, ethical, and social responsibility initiatives, and describe their impact on managerial action.
Chap 7:
Describe the type of organizational structure and why you believe the organization has chosen this structure over the others.
Chap 9:
Discuss the increasing diversity of the workforce and the organizational strategy and/or environment.
Chap 12:
Explain the steps taken to motivate and retain organizational members.
.
THE COMPANY ETHICAL ISSUES Student’s Name John Blair.docxrtodd643
THE COMPANY ETHICAL ISSUES
Student’s Name: John Blair
Institution Affiliation: Rasmussen College
Date : September 16, 2018
INTRODUCTION
The consumer electronics industry is highly changing as various players strive to drive strategies such as presenting customers with cutting edge devices.
More so, there are more and more new entrants that are changing the manner in which traditional players are meeting the needs of the consumers through intensive research and innovative strategies.
Therefore, it is important the organization to value the need of the consumer in effort of maintain the customers and most important, attracting new consumers of the products and services of the organization by providing quality products and services.
However, ethical issues impact negatively the performance of the organization and therefore, addressing ethical issues is important for any business.
ETHICAL EXPECTATION OF THE EMPLOYEES
Employees obligation to aligned with the guidelines and the expectation of the organization.
Training and recruitment
Employee Responsibility
Justice and caring
The employees are the key people contributing to the success of the organization. Therefore, the employees should reflect the moral obligation of the organization by flowing the guideline, policy and the rules to achieve the objectives and the goals of the organization. more so, it is important for the employees to acquire the essential skills required to perform duties to ensure he/she provide quality services and products to the consumers. Employees should be responsible for his/ her duties as well reflecting the sense of caring and justices when providing services to the employees. For instance, the ethical issues which have been coming up are that of companies manufacturing devices with materials which are of low quality. It means that materials of low quality are being used to make the devices. Therefore, the purchases department should supervise the type of materials before ordering and approving them for developing electronics for the company.
3
ETHICAL …CONT.
Good moral conduct
Job completion
Honest
When employers perform certain checkups on employees, often completing regular evaluations and other job-performance checks, managers cannot keep all employees under watch at the same time. Therefore, the employees are expected to complete all the task and reflects trustworthy aspect to ensure the company find solution regarding the ethical issues affecting the company.
4
TRENDING ISSUES
Partnership with different organization
Globalization
Marketing through different platforms
In the consumer electronics industry, players are competing with each other to create cutting edge devices that are more appealing to the consumers. Due to this need, majority of the manufacturers have employed various strategies such as partnering with third party manufacturers in a bid to lower operational costs hence being able to present consumers with c.
The company being used is COCA COLA 10 pages not including cover.docxrtodd643
The document provides instructions for a business report on Coca Cola including its name, mission statement, legal ownership, corporate social responsibility strategies, and code of ethics. The report should be 10 pages, not including cover and references, and follow APA format.
The community college’s career development center (CDC) was impres.docxrtodd643
The community college’s career development center (CDC) was impressed with your salary presentation. In your role as a compensation specialist and with your experience in Human Resources, they have now asked you to put together a presentation about benefits so that their students can understand what they need to look for in regards to benefits when they begin their job search. The CDC would like for you to discuss:
• the major components of a benefits program,
• what options students might see in various benefits programs, and
• what may be important to them from a short-term perspective and a long-term perspective.
You should use PowerPoint to create your slide presentation. Your presentation should be at least 12 slides (not including title and reference slide), and use at least one additional source other than your textbook
Chapter 17
Course Textbook
Henderson, R. I. (2006).
Compensation management in a knowledge-based world
(10th ed.). Upper Saddle River, NJ: Prentice Hall.
.
The Community as a StakeholderI The Business-Community R.docxrtodd643
The Community as a Stakeholder
I The Business-Community Relationship
II Philanthropy & Corporate Community Development
III Building Local Living Economies
Is this a community? Why or why not?
Is this a community? Why or why not?
How does this contribute to community?
Or this?
How does this contribute to community?
Or this?
How does this contribute to community?
http://www.youtube.com/watch?v=aq33c6FhRes
What kind of community is this?
What kind of community is this?
Is this a space that builds community?
The firm and its communities…
Site community: geographical location of a company’s offices, operations, or assets
Fenceline community: immediate neighbors receiving the positive and negative effects of company’s activities
Impact community: anyone affected by externalities from the firm
Cyber community: anyone that uses the internet to learn about or communicate with the company
Community of interest: stakeholders with a real interest in the company
Community of practice: those who engage in similar activities or practices
Employee community: those who work or live near the facility
http://www.phila.gov/phils/Docs/otherinfo/pname1.htm
What Community wants from BusinessSupport for art & cultural activitiesSupport for traffic managementParticipation in urban planning and community developmentSupport of local health care programsSupport of schoolsUnited Way Campaign supportAssistance for the less advantagedSupport for pollution control http://www.epa.gov/epahome/commsearch.htmParticipation in emergency planningSupport of local recycling programs
http://www.volunteermatch.org/
What Business wants from CommunityEducation and cultural resources that appeal to employeesFamily recreation facilitiesPublic services – police & fire protection; sewer, water, & electric servicesTaxes that are equitable and do not discourage business operationsBusiness participation in community lifeAdequate transportation systemsPublic officials who operate honestly and with integrity
https://www.bloomberg.com/news/videos/2017-03-13/quicktake-pros-and-cons-of-the-fracking-boom
https://www.youtube.com/watch?reload=9&v=Vr6b-WzIcyo
http://vimeo.com/44367635
Sunoco’s Marcus Hook Facility
http://www.dep.state.pa.us/dep/deputate/minres/oilgas/2011PermitDrilledmaps.htm
5
Department of Environmental Protection Bureau of Oil and Gas Management Marcellus Shale Formation
The Issues
Mariner 1 project reuses existing pipes
Much of the pipe dates from 1932 – 82 years old
Pressure to increase pressure from 800 to approximately 1,500 psi
18 new pump stations and 17 valve control stations
Scheduled for use for middle of 2015 for 70,00 barrels/day pure propane
No financial benefit to impacted communities, as 90% committed to shippers
Mariner 2 announced and has committed shippers
Official filings with the DEP as of April 2015
Increased demands for infrastructure buildup in the southeastern PA region
Scheduled to carry 275,.
The comments Good start ! Id loke to know more on the point you.docxrtodd643
This document contains questions for a student to answer in a 4-page paper regarding their experience studying in America and how it will help them upon graduating and returning to Kuwait. Specifically, the student is asked to provide more details on what American schools do better, how they differ from Kuwaiti schools, what specialty they encountered and overcame in America, and what advantages this experience will provide for them.
The color of an artwork can effect my feelings or moods by the war.docxrtodd643
The color of an artwork can effect my feelings or moods by the warmth or coolness of the colors and the lightness or darkness of the tones of colors. For example, art that includes dark tones of red, orange and yellow can remind someone of burning flames and could cause someone to feel uneasy or even anxious. If this color scheme were brighter toned, it may remind someone of the fall season and it could cause excitement and joy. Artwork with darker tones of green, blue and purple could remind someone of a rainstorm and cause them to feel depressed, whereas a work with lighter tones of this color scheme could remind someone of calming ocean waves and make them feel at peace. I would personally use color and composition in art to provoke a calming response because I tend to enjoy artwork that makes me feel calm and peaceful. I would use bright tones of cool colors along with white, cream colors, and even some light gray shades to evoke a laid-back feeling to the piece. I would also not use any sharp edged shapes and lines and i would use a more rounded technique to whatever type of art I would create in order to make the piece easy to look at and in turn make the viewer feel at ease.
This piece of artwork I have included is one of the canvas prints I have hanging up in my room. I don't know who it was created by since it was just something I bought from a popular store a long time ago, but it is one of my favorite pieces ever and if I had the means (or the talent) to create something like this, I would! I would make something like this because it has bright tones of cool colors like blue and purple and bits of bright pink and white, which are colors that bring me peace and make me think of things like ocean waves over a surfer. I like that it makes me imagine the surfer instead of a surfer being included in the work. I would also create this sort of piece because there are minimal harsh or pointed lines and shapes in it, and it flows effortlessly from one end of the canvas to the other.
ANCESTOR SCAVENGER HUNT
OVERVIEW
World History is an incredibly broad subject and we will just scratch the surface of some key historical events, figures, religions, and ideas; however, each of us has ancestors from around the world and this assignment focuses on our relationship to them and our past.
This assignment is designed for you to practice research on the web and locate Primary and Secondary Sources. Additionally we are developing several course competencies including acquiring information, breaking multiple sources down into parts, use of library resources, recognizing secondary sources and locating primary sources.
Be sure you understand the difference between Primary Sources and Secondary Sources when researching history by visiting the resources page and visiting websites that describe the difference, such as this LibGuide from American University.
INSTRUCTIONS
Step I: Select the culture of one of your earliest known ancestors. (For example, are.
THE COMETW.E.B. DuBoisHe stood a moment on the steps of .docxrtodd643
THE COMET
W.E.B. DuBois
He stood a moment on the steps of the bank, watching the human river that swirled down
Broadway. Few noticed him. Few ever noticed him save in a way that stung. He was outside the
world—"nothing!" as he said bitterly. Bits of the words of the walkers came to him.
"The comet?"
"The comet——"
Everybody was talking of it. Even the president, as he entered, smiled patronizingly at him, and
asked:
"Well, Jim, are you scared?"
"No," said the messenger shortly.
"I thought we'd journeyed through the comet's tail once," broke in the junior clerk affably.
"Oh, that was Halley's," said the president; "this is a new comet, quite a stranger, they say—
wonderful, wonderful! I saw it last night. Oh, by the way, Jim," turning again to the messenger, "I
want you to go down into the lower vaults today."
The messenger followed the president silently. Of course, they wanted him to go down to the
lower vaults. It was too dangerous for more valuable men. He smiled grimly and listened.
"Everything of value has been moved out since the water began to seep in," said the president;
"but we miss two volumes of old records. Suppose you nose around down there,—it isn't very
pleasant, I suppose."
"Not very," said the messenger, as he walked out.
"Well, Jim, the tail of the new comet hits us at noon this time," said the vault clerk, as he passed
over the keys; but the messenger passed silently down the stairs. Down he went beneath
Broadway, where the dim light filtered through the feet of hurrying men; down to the dark
basement beneath; down into the blackness and silence beneath that lowest cavern. Here with
his dark lantern he groped in the bowels of the earth, under the world.
He drew a long breath as he threw back the last great iron door and stepped into the fetid slime
within. Here at last was peace, and he groped moodily forward. A great rat leaped past him and
cobwebs crept across his face. He felt carefully around the room, shelf by shelf, on the muddied
floor, and in crevice and corner. Nothing. Then he went back to the far end, where somehow the
wall felt different. He sounded and pushed and pried. Nothing. He started away. Then something
brought him back. He was sounding and working again when suddenly the whole black wall
swung as on mighty hinges, and blackness yawned beyond. He peered in; it was evidently a
secret vault—some hiding place of the old bank unknown in newer times. He entered
hesitatingly. It was a long, narrow room with shelves, and at the far end, an old iron chest. On a
high shelf lay the two missing volumes of records, and others. He put them carefully aside and
stepped to the chest. It was old, strong, and rusty. He looked at the vast and old-fashioned lock
and flashed his light on the hinges. They were deeply incrusted with rust. Looking about, he
found a bit of iron and began to pry. The rust had eaten a hundred years, and it had gone deep.
Slowly, wearily, the old lid lifted, .
The Columbian Exchange.1. Select3items or elements.docxrtodd643
'The Columbian Exchange'
.
1. Select
3
items or elements
of the exchange in the Columbian Exchange that you think had the greatest impacts on the Old and New Worlds and history going forward. Explain in detail how and why?
2.
Decisions for slavery
:
Why did the colonists make the decisions that led to race based chattel slavery rather than adopting other forms of labor like wage based work or continuing to use indentured servants? What were the steps creating the legal framework? What factors went into these decisions?
Do you think slavery was inevitable under the circumstances or could things have gone differently?
3.
Research
a big
London slave trader, Humphrey
Morice,
at the link below or listed in the assignment folder.
Describe
his business operation in detail
. What is your reaction to his story? How do you explain his participation and that of those like him in this trade? What kind of a man was he?
http://www.ampltd.co.uk/collections_az/slavemorice/editorial-introduction.aspx
4. Search
the article from the
William and Mary Quarterly
to learn about the operation and economics of the British slave trade, which supported the American colonies. Use highlights from the article to describe the
many economic interests and persons involved
in the slave trade in England and the colonies. Prepare 2 paragraphs discussing the various
interests
involved in the operation of the slave trade and
what role
they played and how they profited.
Think outside the box to
include everyone
who was in some way connected with the trade and slavery itself or who benefited, even those who never saw a slave, not just traders and owners.
In light of all this, can you make a case that nearly every American's hands were in some way, directly or indirectly, sullied by slavery?
.
The Collision of Cultures, England’s Colonies, Colonial Ways of .docxrtodd643
The Collision of Cultures, England’s Colonies, Colonial Ways of Life, From Colonies to States, the American Revolution
Name:
Score:
Answer
three
of the following questions:
Describe the development of Spanish rule over its territory in America
In what ways the phrase “collision of cultures an accurate assessment of the early relationship between the Old and New Worlds?
By the early 18th century, the British had outstripped both the French and Spanish in the New World by becoming the most populous, prosperous, and powerful. Explain how this happened.
Georgia’s colonial beginnings are remarkably different than those of other colonies. Discuss how Spain’s presence in Florida affected the southern colonies
Describe the background, major events, and results of the French and Indian War. In what ways did the French and Indian War pave the way for the American Revolution?
Describe the details of both the Virginia and New Jersey Plans as they were presented at the Constitutional Convention.
.
The color of a defendant and victims skin plays a crucial and unacc.docxrtodd643
The document discusses how the race of a defendant and victim impacts who receives the death penalty in America, with people of color disproportionately represented among those executed and awaiting execution. Specifically, people of color accounted for 43% of total executions since 1976 and 55% of those currently awaiting execution, while 42% of those on death row in 2014 were black.
The Colonial Context of Filipino American Immigrants’ Psycholo.docxrtodd643
The Colonial Context of Filipino American Immigrants’ Psychological
Experiences
E. J. R. David
University of Alaska Anchorage
Kevin L. Nadal
John Jay College of Criminal Justice – City University of
New York
Because of the long colonial history of Filipinos and the highly Americanized climate of postco-
lonial Philippines, many scholars from various disciplines have speculated that colonialism and its
legacies may play major roles in Filipino emigration to the United States. However, there are no
known empirical studies in psychology that specifically investigate whether colonialism and its
effects have influenced the psychological experiences of Filipino American immigrants prior to their
arrival in the United States. Further, there is no existing empirical study that specifically investigates
the extent to which colonialism and its legacies continue to influence Filipino American immigrants’
mental health. Thus, using interviews (N ! 6) and surveys (N ! 219) with Filipino American
immigrants, two studies found that colonialism and its consequences are important factors to
consider when conceptualizing the psychological experiences of Filipino American immigrants.
Specifically, the findings suggest that (a) Filipino American immigrants experienced ethnic and
cultural denigration in the Philippines prior to their U.S. arrival, (b) ethnic and cultural denigration
in the Philippines and in the United States may lead to the development of colonial mentality (CM),
and (c) that CM may have negative mental health consequences among Filipino American immi-
grants. The two studies’ findings suggest that the Filipino American immigration experience cannot
be completely captured by the voluntary immigrant narrative, as they provide empirical support to
the notion that the Filipino American immigration experience needs to be understood in the context
of colonialism and its most insidious psychological legacy— CM.
Keywords: Filipino Americans, immigrants, colonial mentality, internalized oppression, mental health
Filipinos have one of the longest histories of immigration to the
United States, dating back to 1587 when Filipino slaves aboard
Spanish galleon ships landed in what is now known as Morro Bay,
California—making Filipinos the first Asians on U.S. soil (Cor-
dova, 1983). The first Asian settlement in the United States was
also established by Filipino immigrants— escapees from Spanish
galleon ships—in New Orleans, Louisiana, in 1763 (Espina, 1988).
These early settlements were very small, however, and thus they
do not account for the large numbers of Filipinos in the country
today. Indeed, the 2010 Census reported that there are currently 3.4
million Filipinos in the United States, 1.7 million of whom are
foreign born, making them the third largest American immigrant
group next to Mexicans and Chinese (Hoeffel, Rastogi, Kim, &
Shahid, 2012).
The more recent (beginning circa early 1900s) influx of
Filipino immigrants into the United States ca.
The collection of evidence is an activity that occurs with an endgam.docxrtodd643
The collection of evidence is an activity that occurs with an endgame in mind. For example, law enforcement professionals collect evidence to support a decision to charge those accused of criminal activity. Similarly, evidence-based healthcare practitioners collect evidence to support decisions in pursuit of specific healthcare outcomes.
In this Assignment, you will identify an issue or opportunity for change within your healthcare organization and propose an idea for a change in practice supported by an EBP approach.
To Prepare:
Reflect on the four peer-reviewed articles you critically appraised in Module 4.
Reflect on your current healthcare organization and think about potential opportunities for evidence-based change.
The Assignment:
(Evidence-Based Project)
Part 5: Recommending an Evidence-Based Practice Change
Create an 8- to 9-slide PowerPoint presentation in which you do the following:
Briefly describe your healthcare organization, including its culture and readiness for change. (You may opt to keep various elements of this anonymous, such as your company name.)Chicago Lakeshore Hospital
Describe the current problem or opportunity for change. Include in this description the circumstances surrounding the need for change, the scope of the issue, the stakeholders involved, and the risks associated with change implementation in general.
Propose an evidence-based idea for a change in practice using an EBP approach to decision making. Note that you may find further research needs to be conducted if sufficient evidence is not discovered.
Describe your plan for knowledge transfer of this change, including knowledge creation, dissemination, and organizational adoption and implementation.
Describe the measurable outcomes you hope to achieve with the implementation of this evidence-based change.
Be sure to provide APA citations of the supporting evidence-based peer reviewed articles you selected to support your thinking.
Add a lessons learned section that includes the following:
A summary of the critical appraisal of the peer-reviewed articles you previously submitted
An explanation about what you learned from completing the evaluation table (1 slide)
An explanation about what you learned from completing the levels of evidence table (1 slide)
An explanation about what you learned from completing the outcomes synthesis table (1 slide)
Rurbic:
Part 5: Recommending an Evidence-Based Practice Change
Create an 8- to 9-slide PowerPoint presentation in which you do the following:
· Briefly describe your healthcare organization, including its culture and readiness for change.
· Describe the current problem or opportunity for change. Include in this description the circumstances surrounding the need for change, the scope of the issue, the stakeholders involved, and the risks associated with change implementation in general.--Levels of Achievement:Excellent 18 (18%) - 20 (20%)
The prese.
MATATAG CURRICULUM: ASSESSING THE READINESS OF ELEM. PUBLIC SCHOOL TEACHERS I...NelTorrente
In this research, it concludes that while the readiness of teachers in Caloocan City to implement the MATATAG Curriculum is generally positive, targeted efforts in professional development, resource distribution, support networks, and comprehensive preparation can address the existing gaps and ensure successful curriculum implementation.
it describes the bony anatomy including the femoral head , acetabulum, labrum . also discusses the capsule , ligaments . muscle that act on the hip joint and the range of motion are outlined. factors affecting hip joint stability and weight transmission through the joint are summarized.
Introduction to AI for Nonprofits with Tapp NetworkTechSoup
Dive into the world of AI! Experts Jon Hill and Tareq Monaur will guide you through AI's role in enhancing nonprofit websites and basic marketing strategies, making it easy to understand and apply.
Strategies for Effective Upskilling is a presentation by Chinwendu Peace in a Your Skill Boost Masterclass organisation by the Excellence Foundation for South Sudan on 08th and 09th June 2024 from 1 PM to 3 PM on each day.
Executive Directors Chat Leveraging AI for Diversity, Equity, and InclusionTechSoup
Let’s explore the intersection of technology and equity in the final session of our DEI series. Discover how AI tools, like ChatGPT, can be used to support and enhance your nonprofit's DEI initiatives. Participants will gain insights into practical AI applications and get tips for leveraging technology to advance their DEI goals.
This slide is special for master students (MIBS & MIFB) in UUM. Also useful for readers who are interested in the topic of contemporary Islamic banking.
This presentation was provided by Steph Pollock of The American Psychological Association’s Journals Program, and Damita Snow, of The American Society of Civil Engineers (ASCE), for the initial session of NISO's 2024 Training Series "DEIA in the Scholarly Landscape." Session One: 'Setting Expectations: a DEIA Primer,' was held June 6, 2024.
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The contribution of spirituality and spiritual copingto anxi.docx
1. The contribution of spirituality and spiritual coping
to anxiety and depression in women with a recent
diagnosis of gynecological cancer
N. BOSCAGLIA*, D.M. CLARKE*, T.W. JOBLINGy & M.A.
QUINNz
*Department of Psychological Medicine and General Practice,
Monash University,
Melbourne, Australia; yDepartment of Obstetrics and
Gynaecology, Monash Medical Centre,
Melbourne, Australia; and zDepartment of Obstetrics and
Gynaecology, and Oncology Unit,
Melbourne University, Royal Women’s Hospital, Melbourne,
Australia
Abstract. Boscaglia N, Clarke DM, Jobling TW, Quinn MA. The
con-
tribution of spirituality and spiritual coping to anxiety and
depression
in women with a recent diagnosis of gynecological cancer. Int J
Gynecol
Cancer 2005;15:755–761.
The objective of this study was to determine whether, after
accounting
for illness and demographic variables, spiritual involvement and
beliefs
and positive and negative spiritual coping could account for any
of the
variation in anxiety and depression among women within 1
year’s diag-
2. nosis of gynecological cancer (GC). One hundred patients from
out-
patient GC clinics at two Melbourne-based hospitals completed
a brief
structured interview and self-report measures of anxiety,
depression,
spirituality, and spiritual coping. Using two sequential
regression analy-
ses, we found that younger women with more advanced disease,
who
used more negative spiritual coping, had a greater tendency
towards
depression and that the use of negative spiritual coping was
associated
with greater anxiety scores. Although not statistically
significant, pa-
tients with lower levels of generalized spirituality also tended
to be
more depressed. The site of disease and phase of treatment were
not
predictive of either anxiety or depression. We conclude that
spirituality
and spiritual coping are important to women with GC and that
health
professionals in the area should consider these issues.
KEYWORDS: anxiety, coping, depression, gynecological
3. cancer, spirituality.
In a recent issue of this journal, Ramondetta and
Sills(1) published a review of the literature concerning
the role of spirituality in gynecological cancer (GC).
The authors concluded that ‘‘concerns for the spiritual
health of patients may prove significant for both a
patient’s comprehensive sense of well-being and for the
relationship that is created between patients and
physicians.’’ In this study, we examined empirically
the relationship between spirituality and mood (ie,
anxiety and depression).
A diagnosis of cancer is a significant life event that
may have considerable psychological, physical, and
financial sequelae. In particular, a diagnosis of GC
Address correspondence and reprint requests to: Nadia
Boscaglia,
Department of Psychological Medicine, Monash University,
Monash Medical Centre, 246 Clayton Rd., Clayton, Victoria
3800,
Australia. Email: [email protected]
# 2005 IGCS
Int J Gynecol Cancer 2005, 15, 755–761
may elicit disturbances to body image; feelings of
helplessness, dependency, shame, guilt, and vulnera-
bility; a sense of loss of femininity and motherhood;
and sexual difficulties(1,2). Not surprisingly, women
with GC have a heightened frequency of depression,
anxiety, and adjustment disorders(3).
4. Certain factors that increase the risk for mood distur-
bance among women with GC include site of cancer
(ovarian cancer worst)(4,5), treatment with triple-agent
chemotherapy, younger age(6,7), and current treat-
ment(6,8). In general, more advanced cancers are associ-
ated with more frequent psychiatric complications(9).
Psychological health is important when faced with
a diagnosis of cancer. Depressive symptoms in associa-
tion with medical illness have been found to affect qual-
ity of life and social functioning, exert a negative impact
on treatment compliance(10), and lead to increased use
of healthcare services(11). Similarly, anxiety can interfere
with physical and psychosocial functioning; thus, for
those who are physically compromised by illness, high
levels of anxiety are of concern(12).
Recent research indicates that spirituality is one factor
that may contribute to good mental health during the
course of cancer. Spirituality is a set of beliefs and atti-
tudes that give meaning and purpose to life through
a sense of connectedness with the self, others, the natu-
ral environment, a higher power, and/or other super-
natural forces. These beliefs and attitudes empower
and transcend the self and are embodied in feelings,
thoughts, experiences, and behaviors(13–15). Spirituality
is a broader concept than religion or religiosity, which
refers to organized beliefs and practices such as those
found in formal denominations or recognized systems
of theological ideas; as such, religion can be viewed
as a dimension of spirituality(14,16). Among those with
life-threatening illnesses, spirituality has been found
to be positively associated with psychosocial adjust-
ment(17) and quality of life(18); and spiritual well-being
was inversely associated with death distress(19) and
5. anxiety(20).
Religion and spirituality may be incorporated as
part of one’s coping(21,22), whereby coping is defined
as the process by which individuals respond to stress-
ful stimuli. Within the coping process, there are two
subprocesses, appraisal and coping efforts (or meth-
ods). Appraisal refers to the individual’s evaluation of
the event(23); this evaluation influences one’s coping
efforts. Coping efforts are the actions through which
coping can resolve the stressful event and has effects
on physical and emotional health(24). Research shows
that an individual’s mood and quality of life after
receiving a cancer diagnosis can be, in part, accounted
for by his/her coping efforts(25–27).
People bring with them a general orienting system
to the coping process. A spiritual orientation (eg,
general beliefs, practices, aspirations, and relation-
ships) is but one part of a larger orienting system(22).
In the coping process, both the spiritual (general reli-
gious and spiritual beliefs, involvement, and practi-
ces) and nonspiritual elements of this orienting
system are translated into specific methods of coping.
It is these coping methods that have the most direct
implications for health and well-being(14,28–30). In-
deed, research indicates that specific spiritual coping
efforts are better predictors of event outcomes (eg,
mood, adjustment) than are measures of generalized
spirituality(21,28,31). Put simply, spiritual coping is the
use of religious/spiritual beliefs and practices to
reduce the emotional distress caused by loss or
change(32).
Researchers(30) have identified two patterns of spiri-
tual coping* (broadly termed, positive and negative)
6. that have important implications for health. Positive
spiritual coping methods reflect an expression of ‘‘a
sense of spirituality, a secure relationship with God,
a belief that there is meaning to be found in life, and
a sense of spiritual connectedness with others’’(30, p712).
In contrast, the negative spiritual coping pattern is an
expression of ‘‘a less secure relationship with God,
a tenuous and ominous view of the world, and a reli-
gious struggle in the search for significance’’(30, p712).
Each of the two patterns is made up of specific types
of spiritual coping methods (Table 1). Research dem-
onstrates that among various samples, the positive
spiritual coping pattern was associated with fewer
symptoms of psychological distress(30,33) and higher
levels of stress-related growth(30); and the negative
spiritual coping pattern was associated with more
depression(30,33) and poor quality of life(30).
There are few studies that have examined the
impact of spirituality on psychological state in women
with GC(1). This is surprising, given that there are sev-
eral factors that make salient the study of spirituality
in this particular group. Life-threatening events such
as cancer, particularly those that pose threats to self-
image or important areas of personal functioning,
often lead to people relying on their spiritual re-
sources(14,18). Further, religious and spiritual coping
appears to be used more often by women than
men(17). In this study, our aim was to determine
*While Pargament et al.(28–30) use the term ‘‘religious
coping,’’ we
prefer the term ‘‘spiritual coping.’’ This difference in
terminology is
reflective of each author’s definition of the terms religion and
spir-
7. ituality, that is, Pargament et al. view religion in much the same
was as we view spirituality.
756 N. Boscaglia et al.
# 2005 IGCS, International Journal of Gynecological Cancer 15,
755–761
whether spiritual involvement and beliefs and posi-
tive and negative spiritual coping accounted for any
of the variance in psychological distress (anxiety
and depression) among women with GC, over and
above that accounted for by illness and demographic
variables.
Materials and methods
One hundred and twenty-three patients were re-
cruited from outpatient GC clinics at the Royal Wom-
en’s Hospital and the Monash Medical Centre,
Melbourne. Exclusion criteria included age less than
18 or more than 70 years, inability to speak/read
English, diagnosis .12 months before, and the pres-
ence of known intracranial disease or cognitive
impairment. After obtaining written consent, patients
engaged in a 15-min interview about demographic
and illness information. At the end of the interview,
patients were given a questionnaire pack, which they
completed at home and returned by mail. After
excluding those women who did not complete all ele-
ments of the study, the sample was reduced to 100
women.
Patients (N ¼ 100) were aged between 20 and 70
8. years (mean ¼ 52.52, SD ¼ 12.17), and were within
a year ’s diagnosis of GC at interview (mean weeks
since diagnosis ¼ 22.21, SD ¼ 14.58). The women were
predominantly Australian born (71%), and the major-
ity of patients (70%) were married, with 80% having
had children. In terms of religion, 42% of the sample
was Christian, 33% Roman Catholic, 19% reported
having ‘‘no religion,’’ and 6% ‘‘other.’’ Disease charac-
teristics are presented in Table 2.
Measures
Depression was measured using the Beck Depression
Inventory for Primary Care(34), anxiety was assessed
using the State Anxiety Scale from the Spielberger
State Trait Anxiety Inventory(35), and spirituality was
assessed using the Spiritual Involvement and Beliefs
Scale-Revised(36). The Spiritual Involvement and Be-
liefs Scale-Revised comprises 22 items that examine
Table 1. Positive and negative spiritual coping methods
Positive spiritual
coping methods Explanation
Negative spiritual
coping methods Explanation
Benevolent religious
reappraisal
Redefining the stressor through religion
as benevolent and potentially beneficial
Spiritual discontent Expressions of confusion and
9. dissatisfaction with God
Collaborative religious
coping
Seeking control through a partnership
with God in problem solving
Interpersonal spiritual
discontent
Expressions of confusion and
dissatisfaction with clergy
or members
Seeking spiritual
support
Searching for comfort and reassurance
through God’s love and care
Punishing God
reappraisal
Redefining the stressor as a
punishment from God for the
individual’s sins
Religious forgiveness Looking to religion for help in letting
go of anger, hurt, and fear associated
with an offense
Demonic reappraisal Redefining the stressor as the
act of the Devil
Spiritual purification Searching for spiritual cleansing through
10. religious actions
Reappraisal of
God’s powers
Redefining God’s powers to influence
the stressful situation
Spiritual focus Seeking relief from the stressor
through a focus on one’s religion
or spirituality
Spiritual connection Seeking a sense of connectedness with
transcendent forces
Adapted from Pargament et al.(30, p711).
Table 2. Disease characteristics (N ¼ 100)
Characteristic Options for response N
Cancer site Endometrium 38
Ovary 32
Cervix 23
Vulva 5
Vagina 1
Fallopian tube 1
FIGO staging I 60
II 11
III 28
IV 1
Treatment type Surgery 87
Chemotherapy 41
Radiotherapy/brachytherapy 25
11. None 1
Currently in active treatment Yes 20
No 80
Contribution of spirituality to mood in women with
gynecological cancer 757
# 2005 IGCS, International Journal of Gynecological Cancer 15,
755–761
rituals and belief in a higher power, internalized beliefs
and spiritual growth, meditation and existential beliefs,
and humility and daily application of spiritual princi-
ples(36). The Brief RCOPE of Pargament et al.(30) was
used to assess positive and negative spiritual coping.
The Brief RCOPE comprises 14 items that divide into
two subscales, positive and negative religious coping.
The creators of the scale advise that the Brief RCOPE
is applicable to ‘‘a wide range of Judeo-Christian
groups . [and] may be applicable to members of other
ethnocentric religions as well, such as Islam’’(30, p722). To
make the scale more acceptable to nonbelievers of the
main monotheistic religions, certain aspects of the scale
were altered; in particular, in addition to the word God,
the phrase, a power greater than myself was added.
Statistical analyses
Data were analyzed using SPSS 10.0.7. Two sequential
regression analyses were employed to determine
whether spirituality (step 2) and then positive and
negative spiritual coping (step 3) accounted for any of
the variance in anxiety and depression, over and
12. above the variance accounted for by illness and demo-
graphic variables (step 1). The illness and demo-
graphic variables (ie, age, presence of ovarian cancer
relative to other forms of GC, active treatment vs no
active treatment, stage of disease—I or II vs III or IV,
and having had chemotherapy) were selected a priori,
according to the findings of past research. After data
screening, one multivariate outlier was removed
(reducing the data set to N ¼ 99), and skewed varia-
bles were transformed to meet assumptions.
Results
Use of the published cutoff scores of the Beck Depres-
sion Inventory for Primary Care(34) revealed that 24%
of the sample exhibited at least mild symptoms of
depression (13% of the sample had mild symptoms,
6% moderate symptoms, and 5% severe symptoms).
The mean anxiety score was 38.56 (where a higher
score indicates a greater level of anxiety), compared
with a mean anxiety score for women in the general
population (aged between 40 and 69) of 34.35(35). The
correlation coefficients among illness variables were in
the expected direction (eg, presence of ovarian cancer
correlated with having had chemotherapy) and
ranged from .50 to .70.
In the first regression (Table 3), depression scores
served as the criterion variable. R was not significantly
different from zero at the end of steps 1 or 2 but was
significantly different from zero after step 3. Step 1:
R ¼ .31, F(5,93) ¼ 1.92, P ¼ .098; step 2: R ¼ .31,
F(6,92) ¼ 1.61, P ¼ .153; and step 3: R ¼ .53, F(8,98) ¼
4.37, P , .01. In the final model, the predictors ac-
counted for 28% of the variance in depression scores,
13. change statistics: R2 ¼ .28, F(2,90) ¼ 11.54, P , .01.
Specifically, younger age, later stage of disease, and
greater use of negative religious coping predicted
significantly a higher level of depression. Although
not statistically significant, spirituality made a strong
contribution to the variance in depression scores
(b ¼ 2.378, P ¼ .053), whereby a lower level of spiritu-
ality was associated with a higher level of depression.
In the second regression (Table 4), anxiety served as
the dependent variable. Predictors were entered as for
the first regression. After each of the three steps, R
was not significantly different from zero (P . .10).
Nonetheless, we examined the change statistics and
unique contributions from each of the predictors. We
found that the addition of positive and negative spiri-
tual coping to the equation resulted in a significant
improvement in the model, change statistics: R2 ¼ .12,
F(2,90) ¼ 4.33, P , .05. Negative spiritual coping
was the only significant predictor of anxiety scores
Table 3. Summary of final model from the sequential regression
analysis for variables predicting transformed depression scoresa
Variable B Standard error of B b t P
Age 2.017 .008 2.185 22.015 .047*
Ovarian cancer .201 .294 .086 0.684 .496
Phase of treatment .086 .337 .032 0.255 .800
Chemotherapy .188 .291 .084 0.644 .521
Stage of disease .632 .276 .264 2.293 .024*
Spirituality 2.015 .008 2.378 21.959 .053
Positive spiritual copingb 29.020 4.891 2.365 21.844 .068
Negative spiritual copingb 214.766 4.128 2.352 23.577 .001**
aSquare root transformation applied.
14. bInverse transformation applied.
*P , .05.
**P , .01.
758 N. Boscaglia et al.
# 2005 IGCS, International Journal of Gynecological Cancer 15,
755–761
(b ¼ 2.25, P , .05), whereby more negative spiritual
coping was associated with higher levels of anxiety.
Discussion
This study was conducted to examine the contribution
of spirituality and positive and negative spiritual cop-
ing to mood in women within a year ’s diagnosis of
GC. Our results indicate that almost one quarter of the
sample experienced at least mild depressive symp-
toms and that levels of anxiety were higher than that
of women in the general population. Our findings also
show that among women diagnosed with GC within
the past year, those who were younger, had more
advanced disease, and who used more negative spiri-
tual coping had a greater tendency towards depressed
mood, and, although not statistically significant,
patients with lower levels of spirituality also tended to
be more depressed. The use of negative spiritual cop-
ing was associated with greater anxiety scores.
Turning first to the predictive role of age in mood
outcomes in GC, our results are not surprising. Youn-
ger women treated for GC may face the added stress
of potential infertility or be concerned about the future
15. of their families/children, thus, placing younger
women at increased risk for psychological distress(7).
Indeed, research has demonstrated that among
women with ovarian cancer, younger patients (,50
years) were more likely to be depressed than older
patients(6).
Later stage of disease was another significant pre-
dictor of depression in our sample; this is in agreement
with research findings that indicate that among
women with GC (and cancer patients in general) more
advanced disease is associated with higher levels of
depression(4,9). On the other hand, we found that
phase of treatment (active treatment vs no current
treatment) and site of GC (ovarian vs nonovarian
GC) were not predictive of depression or anxiety.
These findings contrast with the findings of other
studies(4–6,8) and may be reflective of the high degree
of support provided to women in the active phase of
treatment. Indeed, many studies have found that social
support is protective against mood disturbance(37).
In this study, the use of negative spiritual coping
significantly predicted depression and anxiety, and
there was a near significant (P ¼ .053) trend for lower
levels of spirituality to be predictive of higher levels
of depression. This is consistent with extant research
in which an association between higher levels of
spirituality and good psychological adjustment to
cancer(17–20) has been demonstrated. Findings such as
these are typically explained by the hypothesized
‘‘stress buffering’’ and ‘‘meaning-making’’ role of spiri-
tuality. Kim and Seidlitz(38) suggest that spirituality
can buffer the effects of stress through its influence on
thinking, emotions, and behavior. They argue that
16. spiritual beliefs may help a person to find meaning in
life, thus limiting the mental health consequences of
adverse experiences. God and related religious and
philosophical systems may offer a type of schemata
for explaining and predicting the vacillating course of
cancer(39), thus helping to give the illness meaning and
perspective and to provide answers to existential
questions that arise(40). Spiritual practices can also fos-
ter the development of supportive social networks
and thus promote health behaviors and reduce nega-
tive emotions(38). In addition, spiritual beliefs, in the
sense of beliefs related to a connection to something
bigger than the self, can help cancer patients tolerate
the difficulties of their illness(41). It appears then that
for women who are spiritually inclined, spirituality
may function as an important resource during the
course of GC.
What, then, of the finding that negative spiritual
coping significantly predicted both depression and
anxiety in our sample? As stated, the use of negative
spiritual coping expresses a less secure relationship
Table 4. Summary of final model from the sequential regression
analysis for variables predicting transformed anxiety scoresa
Variable B SE B b t P
Age 2.009 .009 2.094 20.930 .355
Ovarian cancer .061 .332 .025 0.183 .855
Phase of treatment .074 .381 .027 0.194 .847
Chemotherapy .287 .329 .127 0.873 .385
Stage of disease .192 .312 .078 0.616 .540
Spirituality 2.011 .009 2.264 21.234 .221
Positive spiritual copingb 25.776 5.529 2.229 21.045 .299
Negative spiritual copingb 210.505 4.667 2.245 22.251 .027*
17. aSquare root transformation applied.
bInverse transformation applied.
*P , .05.
Contribution of spirituality to mood in women with
gynecological cancer 759
# 2005 IGCS, International Journal of Gynecological Cancer 15,
755–761
with a higher power and a tenuous and ominous view
of the world. Perhaps then, those who use negative
spiritual coping methods are mobilizing their spiritual
resources ineffectively, translating their spiritual be-
liefs into unhelpful strategies that promote (rather
than protect from) depression and anxiety. However,
given that the study was cross-sectional, the possibil-
ity that the participants’ psychological distress pre-
ceded the use of negative religious coping methods
cannot be excluded.
In addition to its cross-sectional design, another lim-
itation to the present study is the lack of consideration
of other variables that may predict mood. In particu-
lar, we have not examined the role of non-spiritual
coping methods, disposition, or social support in
mood outcomes. A larger study that examines the con-
tribution of such variables to emotional outcomes and
well-being in women with GC is required. Alternately,
a qualitative approach, in which women are asked to
elaborate on their own methods of spiritual coping,
may help elucidate the most important aspects of spir-
ituality (if any) for women with GC.
18. This study adds empirical evidence to the sugges-
tion of Ramondetta and Sills(1) that spirituality is an
important consideration in the care of women with
GC, and also, raises questions for those working with
GC patients: What do I do if my patient is depressed
or spiritually distressed? To whom do I refer such a
patient? Considering the implications of depression
and anxiety, and the contribution of spirituality and
spiritual coping to mood outcomes, healthcare pro-
viders may need to consider such questions.
Acknowledgments
We are indebted to Ms Helen Sells for her help with
recruitment of participants.
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cer patients. Soc Sci Med 1988;26:625–33.
40 Holland JC, Passik S, Kash KM et al. The role of reli-
gious and spiritual beliefs in coping with malignant
melanoma. Psycho-oncology 1999;8:14–26.
41 Musick MA, Koenig HG, Larson DB, Matthews D. Reli-
gion and spiritual beliefs. In: Holland JC, ed. Psycho-
oncology. New York: Oxford University Press, 1998:
780–89.
Accepted for publication October 14, 2004
Contribution of spirituality to mood in women with
gynecological cancer 761
# 2005 IGCS, International Journal of Gynecological Cancer 15,
755–761
Relationship of Religious Beliefs with Anxiety and Depression
Aljohara
University
24. Running head: RELIGION AND MENTAL HEALTH
1
Relationship of Religious Beliefs with Anxiety and Depression
BOSCAGLIA, N., CLARKE, D. M., JOBLING, T. W., &
QUINN, M. A. (2005). The contribution of
spirituality and spiritual coping to anxiety and depression in
women with a recent diagnosis of gynecological
cancer. International Journal of Gynecological Cancer, 15(5),
755-761.
The objective of this study was to work out whether or not, once
accounting for religious involvement and beliefs, and positive
and negative religious header may account for any of the
variations in anxiety and depression among ladies among one
year's diagnosing of medical specialty cancer. The author
concludes that spirituality and spiritual coping are important to
women with cancer and that health professionals in the area
should consider these issues.
Koenig, H. G. (2009). Research on Religion, Spirituality, and
Mental Health: A Review. The Canadian Journal of
Psychiatry, 54(5), 283–291.
This article talk about the religious and religious factors are
more and more being examined in medical specialty analysis.
Non secular beliefs and practices have long been joined to
hysteria, neurosis, and psychotic delusions. However, recent
studies have known another facet of faith that will function a
psychological and social resource for dealing with stress. When
process the terms faith and spirituality, this paper reviews
analysis on the relation between faith and (or) spirituality, and
25. psychological state, that specialize in depression, suicide,
anxiety, psychosis, and misuse. The results of Associate in
nursing earlier systematic review are mentioned, and newer
studies within us, Canada, Europe, and alternative countries are
delineated. Whereas non secular beliefs and practices will
represent powerful sources of comfort, hope, and which means,
they're typically elaborately entangled with neurotic and
psychotic disorders, typically creating it tough to work out
whether or not they are a resource or a liability.
Moreira-Almeida, A., Lotufo Neto, F., & Koenig, H. G. (2006).
Religiousness and mental health: a review. Revista brasileira de
psiquiatria, 28(3), 242-250.
This paper reviews the scientific proof offered for the
connection between faith and mental state. Conjointly the
authors gift the most studies and conclusions of a bigger
systematic review of 850 studies on the religion-mental health
relationship printed throughout the twentieth Century known
through many databases. This paper conjointly includes
associate update on the papers printed since 2000, together with
researches performed in Brazil and a short historical and
method background. And Theoretical pathways of the
religiousness-mental health association and clinical implications
of those findings are mentioned.
Ross, C. E. (1990). Religion and psychological distress. Journal
for the Scientific Study of Religion, 236-245.
The author did this paper by employing a sample of Illinois
residents (and dominant for sociodemographics and disposition
to specific feelings). And he found that the stronger an
individual's faith, the lower the extent of psychological distress.
This supports the concept that faith reduces demoralization and
provides hope and that means. However, the author found that
persons with no faith likewise had low levels of distress. Thus,
there was a curving impact of nonsecular belief on distress.
Additionally, the author found that Protestants had very cheap
distress levels, followed by Catholics, Jews, and others.
Variations in belief systems, however, particularly a belief
26. within the Yankee Protestant ethic, didn't make a case for
variations in distress among nonsecular teams. The strength of
nonsecular beliefs seems to be a lot of vital than content in
explaining the impact of faith on psychological distress.
Williams, D. R., Larson, D. B., Buckler, R. E., Heckmann, R.
C., & Pyle, C. M. (1991). Religion and psychological distress in
a community sample. Social Science & Medicine, 32(11), 1257-
1262.
This paper examines the result of nonsecular group action and
affiliation on psychological distress in a very longitudinal
community study of 720 adults. nonsecular affiliation is
unrelated to mental state standing. In distinction, though
nonsecular group action doesn't directly scale back
psychological distress, it buffers the hurtful effects of stress on
mental state. That is, within the face of nerve-racking events
and physical health issues, nonsecular group action reduces the
adverse consequences of those stressors on psychological well-
being.
Running head:sentencing programs and aggressive tendencies 1
Running head:sentencing programs and aggressive tendencies
2The effect of sentences programs on aggressive
tendencies amongst adolescent offenders
Student Name
Effat University
Abstract
Purpose: The purpose of this research proposal is to plan and
carry out a study that will evaluate the relationship between
family attachment and social interaction. Social interaction is of
special importance due to how current students spend their time,
either between real life social interactions or social
27. media.Methods: A cross-sectional design will be employed to
measure students’ beliefs, behaviors, and personality at one
point in time. Various measures will be given to measure social
interaction, family attachments, and personality. Implications:
The implications of this study, if it is carried out, is a better
understanding of social isolation during a student’s move to a
university dormitory. Moreover, if family attachment is found
to be associated with better adjustment, then perhaps better
inventions can be made to prevent or reduce adjustment
problems.
Keywords: SocialInteraction, Family Relationships,
Adjustment, Moving
The effect of sentences programs on aggressive tendencies
amongst adolescent offenders
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planet Earth.
Variable 1 (Dependent Variable)
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Variable 2 (Independent Variable)
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planet Earth.
Conceptual Framework
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Gaps in Existing Knowledge Base
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Purpose of Research
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29. Research Questions
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become the most incredible psychologist to have existed on
planet Earth.Conceptual Definitions
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Hypotheses
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Proposed MethodsSample
Because the best time to establish a habit is considered to be
with individual in early adulthood, our target population will be
young adults in college.
Measures
Executive Functioning.Measured by the NIH ToolBox.
Measures of working memory, flexible switching, processing
30. speed, inhibition, and initiation will be measured to determine
the overall level of executive functioning for each subject.
Final Numerical Grade. measured by each subject’s cumulative
assignments and tests.Design & Procedure
A correlational cross-sectional design will be used in order to
gather the data and analyze it.
Analytic Plan
A standard independent samples t-test will be performed to
determine statistical significant mean differences on the
dependent variables.
Anticipated Results
We hypothesize that students who receive the intervention of
HIT will have higher post-test EF as well as higher final
numerical grades.
Implications of Results
The results from this study will have both practical and
theoretical implications. From a practical standpoint, the results
will demonstrate that a more practical type of exercise can both
be beneficial physiologically as well as academically.
Therefore, this approach can accommodate to younger adults
who tend to be busy with school and work. From a theoretical
perspective, the data can provide very important empirical
support for psychological and academic benefits of HIT.
References
Last Name, F. M. (Year). Article Title. Journal Title, Pages
From - To.
Last Name, F. M. (Year). Book Title. City Name: Publisher
Name.
31. Sot Scr Med Vol 3.2, No 11, pp 1257-1262, 1991
Pnnted m Great Bntam All nghts reserved
0277-9536/91 $3 00 + 0 00
Copyright 0 1991 Pergamon Press plc
RELIGION AND PSYCHOLOGICAL DISTRESS IN A
COMMUNITY SAMPLE
DAVID R WILLIAMS,’ DAVID B LARSON,* ROBERT E
BUCKLER,.’ RICHARD C HECKMANN~
and CAROLINE M PYLE’
I Departments of Sociology and Epldemlology and Pubhc
Health, Yale Umverslty, P 0 Box 1965, Yale
Statlon, New Haven, CTO6520, US A, *NatIonal Institute of
Mental Health, 5600 Fishers Lane,
Rockvdle, MD 20857, U S A, ‘Department of Psychology,
Western Seminary, 5511 E Hawthorne,
Portland, OR 97215, U S A 4Department of Psycluatry,
Umverslty of Colorado School of MedIcme, 4200
E 9th Ave. Denver, CO 80262, U S A and SDepartment of
Epldemlology and Pubhc Health, Yale School
of Medlcme, 60 College Street, New Haven, CT 06520, U S A
Abstract-This paper exammes the effect of [email protected]
attendance and affibatlon on psychologlcal distress
m a lonptudmal commumty study of 720 adults Rebglous
atlibatlon IS unrelated to mental health status
In contrast, although rehgous attendance does not directly
reduce psychologlcal distress, It buffers the
deletenous effects of stress on mental health That IS, m the face
of stressful events and physlcal health
problems, rebgous attendance reduces the adverse consequences
of these stressors on psychologlcal
32. well-bemg
Key words-rehglon, psychologlcal &stress, stress
The relationshIp between rehglon and health status
has been recelvmg mcreasmg sclentlfic attention in
recent years One mdlcator of this interest 1s the
growing number of reviews focused on rehglous
vanables that have appeared m the medical and social
science hterature [l-7] In terms of mental health
outcomes, the literature indicates that more often
than not, religion measures are inversely associated
with indicators of psychological distress Bergm [S]
revlewed 26 studies that assessed the assoclatlon be-
tween rehglon and mental health status He reported
that almost half of the studies found an inverse
assoclatlon between rehglon and psychological symp-
toms with the remainder about equally divided be-
tween those that found a positive relationship and
those that reported no assoclatlon However, given
that 80% of the studres reviewed by Bergm [S] utlhzed
student samples, it IS difficult to draw conclustons
about the generahzablhty of these findings
Studies employmg more representative samples
present a slmllar mixed pattern of findings Two
studies based on national probability samples have
reported an inverse assoclatlon between rehglous
attendance and psychological distress [8,9] Slml-
larly, several community studies have reported m-
verse assoclatlons between measures of religion and
scores on screening scales of global distress [IO-131
At the same time, other community studies report no
assoclatlon between rehglon and mental health status
[14-161
33. The hterature assessing the mental health conse-
quences of rehglon IS plagued with conceptual and
methodological hmltatlons which require that great
caution should be exercised m mterpretmg the find-
mgs For example, with few exceptions [16, 171
most of the existing studies have used cross-sectional
designs m which rehglous mvolvement and mental
health status are measured simultaneously A given
level of psychological functlonmg can be either
a cause or a consequence of rehglous behefs and
behavior In cross-sectional analyses it 1s lmposslble
to detect causal dlrectlonahty m the relatlonshlps
observed Researchers have also given inadequate
attention to the measurement of the rehglous vanabie
and to the underlying processes by which rehglon
may affect health status [2, IO, 17-201
One way m which rehglous mvolvement may affect
health status 1s by modlfymg the relatlonshlp between
stress and illness Stress has been shown to have
pervasive negative effects on physical and mental
health [21], but psychosocial resources can compen-
sate for or moderate the impact of stress on health
[22] Recently, Krause and Van Tran [23] docu-
mented that rehglous mvolvement 1s a cntlcal psycho-
social factor that counteracts the adverse effects
of stress on feelings of self-esteem and mastery The
literature on stress recognizes that a given psychoso-
cial resource, such as rehglon, may affect psychologl-
cal distress by directly enhancing mental health
status, lrrespectlve of the level of stress, and/or by
buffenng the effects of stress on health [22] The
buffenng hypothesis postulates that m the face of
stress, religion can protect the mdlvldual from the
potentially negative consequences of stress To our
34. knowledge, there have been no attempts to empln-
tally assess the dynamics of the assoclatlon between
religion, stress and psychological distress
This paper seeks to enhance our understandmg
of the relatlonshlp between rehglous behavior and
mental health by exammmg how two measures of
rehglous mvolvement, rehglous attendance and reh-
glous affiliation, combme with stress to affect psycho-
logical distress In 1967, a random sample of rest-
dents of metropolitan New Haven were mtervlewed
Lmdenthal et al [13] have reported on the cross-
sectional assoclatlons between rehglon and mental
health status They found that both rehglous affiha-
tlon and rehglous attendance were inversely assocl-
1257
1258 DAVID R WILLIAMS et ~1
ated with psychological distress Two years later, a
second wave of data was collected from these New
Haven residents To date, no analyses have related
the 1967 religion measures to distress m 1969 In
addition, although controls were utilized for SOCIO-
demographic vanables m the ongmal study, no
attempts were made to assess the extent to which
the assoclatlon between religion and psychological
distress vanes for structural charactenstlcs such as
race or socloeconomlc status A growing body of
evidence indicates that stress, the resources to cope
with stress, and the efficacy of these resources vary
for groups occupying different structural positions m
society [22]
35. This paper focuses on the ongmal respondents who
were reinterviewed m 1969 We assess the extent to
which the pattern of findings m the cross-sectional
analyses remam robust m the more ngorous prospec-
tive analyses Specifically, we address the followmg
research questions
1 How do religious attendance and affiliation
relate to psychological distress?
2 Do the consequences of religious mvolvement
vary by major soclodemographlc charactenstlcs
such as age, race, education and gender7
3 To what extent can measures of rehglous
mvolvement buffer or moderate the effects of
stress on health?
METHODS
The analyses reported here use data from the
Myers et al [24,25] lonBtudma1 study of mental
health m New Haven, Connecticut The sample con-
sists of 720 adults who were reinterviewed m 1969
from an ongmal random sample of 938 respondents
who were first interviewed m 1967 Table 1 lists the
means, standard deviations and mtercorrelatlons
among the vanables utilized Our sample IS 44%
male, 11% black, 26% unmarned, and has a median
education level of 12 years and a mean age of 44 8
years
Psychological distress 1s measured by the Gurm
ef al [8] symptom checklist scale This scale consists
of 20 statements of psychophysiological symptoms
36. that indicate the presence of moods of depression
and anxiety. The symptoms of the Gurm scale
were selected from among those most frequently
mentioned by patients m treatment and they allow
for respondents to be ordered on a contmuum
of reported distress Respondents reported the fre-
quency with which each symptom was expenenced
Scores on the Gunn scale thus range from 20 (all
symptoms expenenced ‘often’) to 80 (all symp-
toms occurrmg ‘never’) In contrast to our use of the
Gunn scale as a contmuous measure, the scale 1s
sometimes used qualitatively to dlstmgmsh between
the mentally impaired (score = 66 or lower), and
the non-impaired We believe that our contmuous
measure of psycholoDca1 distress 1s more theoreti-
cally appropnate for the study of the assoclatlon
between religion and mental health than a more
qualitative dlstmctlon between psychlatnc cases and
normals If rehglon has positive effects on mental
health, they are hkely to be evident throughout the
continuum of mental health status and not only at
the extreme of the dlstnbutlon
Two measures of rehglous commitment at
wave one (1967) are utilized Religious attendance
measures the usual frequency of attending rehglous
services (values range from 1 = never to 6 = more
than once a week) To facilitate interpretation of
product terms m the regression analyses, the religious
attendance measure was converted to a standard
score based on the mean and standard devlatlon
of the total sample, and a constant was added to
this standardized vanable so that the lowest actual
value 1s zero The religious affiliation measure IS
based on the response to the questlon “Are you
37. affiliated with any church or religious group?”
(1 = yes, 0 otherwise)
Two summary measures of stressful life expen-
ences, occurnng dunng the two years between the
mtervlews, are utlhzed Both measures of stress are
listed m the Appendix The first 1s an index of
undesirable life events The second stress measure 1s
a sum of the number of physical health problems
experienced To avoid confounding between the
measure of psychological distress and the health
problems index, followmg Kessler and Cleary [26], we
excluded those health complamts that mtultlvely
appeared to have a strong psychosomatic compo-
nent From a list of 44 symptoms, we selected those
16 health complamts for which a psychosomatic
component would be muumal
Ordinary least squares (OLS) regression analyses
utlhzmg the regression program m SAS [27] are
used for estimating the magmtude and statistIca
slgmficance of the relatlonshlps among religious
Table I Means, standard dewatmn and mtercorrelatmns (dwmals
onutted) among vdrldbles
I 2 3 4 5 6 7 8 9 IO II I2
Standard
Mean dewauon
I Age -
2 Education’ -39 -
3 Marital staus (married) -08 06 -
4 Gender (male) IS 05 I4
5 Race (black) -15 -15 -20
39. 00 41 27 -04 -01 09 02 - 0 75 049
‘The education vanable IS coded as follows 1 = less than 7
years, 2 = 7-9 years, 3 = 10-11 years, 4 = 12 years, 5 = 13-15
years, 6 = college graduate and 7 = graduate on professional
tranung
Rehgon and psychologrcal dtstress m a commumty sample 1259
mvolvement, stress and psychological distress OLS
regression is fully appropnate for our continuous
dependent vanable The correlation matnx from
whtch the regression models were estimated is pre-
sented m Table 1 Pauwtse present correlations were
used m all regression analyses The analyses pro-
ceeded m a senes of steps m which we estimated
the effects of rehgrous mvolvement on psychological
distress This relationship was then adlusted for
potentially confounding sociodemograpmc factors
The soctodemographrc vanables utrhzed are age (m
years), education (nommally scaled vanable coded
from 1 = less than 7 years of education to 7 =
graduate or professtonal training), gender (1 = male),
manta1 status (1 = marned, 0 otherwtse), and race
(1 = black, 0 otherwtse) Subsequent regression
models assessed the association between stress
and psychological distress and the extent to which
rehgtous mvolvement may buffer the effects of stress
on health
A final step m all analyses mvolved entenng the
Time 1 Gunn score as a predictor of Time 2 Gunn
The use of the Ttme 1 distress measure effectively
40. converts the Time 2 outcome mto change scores, Thts
1s appropnate m these analyses because tt allows
us to determine the extent to whtch any improved
mental health functiontng found among those high
on rehgtous mvolvement ts stgmficantly greater than
any improvement found among those having lower
scores on the rehgion measures
RESULTS
Relrglon and psychologrcaI dzstress
Table 2 presents the results of three regression
analyses that assess the assoctation between psycho-
logical distress and religion In the first model, Ttme
2 (1969) Gunn scores are regressed on the Time 1
(1967) religious attendance and affihatton In the
second regression model, controls are introduced for
soctodemographtc factors (age, education, manta1
status, gender and race) that were measured at Time
1 The final model adds the Time 1 (1967) Gunn score
as a predictor of the Time 2 Gunn score
The first model m Table 2 indicates that although
rehgtous affiliation IS unrelated to psychological drs-
tress, rehgrous attendance IS positively associated
with the Time 2 (1969) Gunn score Persons who
attend rehgtous services regularly report lower levels
of psychologtcal distress than infrequent attenders
and non-attenders This relattonshtp remains robust
when adlusted for the soctodemographtc variables
but tt IS reduced to non-stgmficance when controlled
for Time 1 (1967) psychologtcal distress Religious
attendance at Time 1 is not associated with increases
m psychologtcal well-being, as measured by the Gurm
scales. Thus, m the face of ngorous statistical con-
41. trols for the possible confounding of public rehgtous
partictpatton with scores on the Gurm scale, we find
that attendance IS unrelated to psychological d:stress
Our prospecttve analyses have failed to replicate the
inverse assoctattons between religious commitment
and psychologtcal distress that were reported for the
cross-secttonal analyses at Time 1 [ 131
We tested for nonhneanty m the assoctatton be-
tween rehgtous attendance and mental health status
Table 2 Analyses of the assoclatlon between Tune 2
(1969) Gunn scores and the rehgton measures at
Tlmc 1 (1967)
i
II III
Independent
vanables (SE) (A) (&
Attendance 0 83’. 0 84.’ 0 16
(0 32) (0 32) (0 28)
Affihatlon -046 -0 88 -0 88
(0 75) (0 74) (0 64)
Age 003
(0 02) (%5
Education 0 94.1 0 48’.
(0 22) (0 19)
Mamed 0 87 0 II
(0 69) (0 60)
42. Sex (men= 1) I 60** 0 54
(0 60) (0 52)
Race (black = 1) 0 63 I 30
(0 97) (0 84)
Gunn 1967 0 49”
(0 03)
Constant 71 80 66 14 35 81
R2 0010 0 050 0290
** = P < 0 01, 2-taded tests
b = unstandardized regrewon coefficients
Shaver et al [28] reported a curvihnear relatton-
ship between religion measures and psychologtcal
symptoms The very rehgtous and the non-rehgtous
enloyed the best reported health Accordingly, to a
regression equation that included the demographic
vanables and Ttme 1 (1967) rehgious attendance,
we added the squared coefficient for religious attend-
ance (quadratic term) A srgmficant quadratic term
would indicate that the associatton between rehgtous
attendance and distress ts curvtltnear The quadrattc
term was not stgmficant (analysts not shown), mdicat-
mg the absence of curvihneanty m the assoctatton
between religion and psychological distress
We also explored the extent to which vanattons
exist by race, gender and educattonal level m the
assoctatton between the rehgton measures and
psychological distress Specifically, for each of these
soctodemographtc vanables, we regressed Time 2
(1969) Gunn scores on the two religion vanables, all
43. of the soclodemographlc vanables, and the relevant
muthphcatlve term for the interaction between each
rehgion measure and the soclodemographlc correlate
under consideration In these analyses (not shown),
none of the interaction tests were slgmficant
In cross-sectional studies researchers frequently
assume that the reported level of rehglous mvolve-
ment IS a stable characteristic of the respondent In
contrast, religious behavior may be a fairly transient
phenomenon Lmdenthal et al [ 131, for example,
noted that when faced with stress, respondents
reported a decline m rehgtous attendance The fact
that we are workmg with panel data allows us to
explore the nature of changes m rehgtous attendance
between 1967 and 1969 and the consequences that
these changes could have for mental health status
Ftrst, we noted that attendance levels were relattvely
stable over the course of 2 years Table 1 reveals
that the correlation between rehgtous attendance at
Time 1 (1967) and Time 2 (1969) was 0 54
Second, we divided our sample mto subgroups
based on the combmatlon of the level of rehglous
attendance reported at Ttme 1 (1967) and Time 2
1260 DAVID R WILLIAMS et al
(1969) At each tzme point, all respondents were
classified into one of three categories. high attenders
(persons who attended rehgzous services once a
week or more), moderate attenders (zndzvzduals who
attended once a month to two or three times a month)
and low attenders (those who never attended as
44. well as those who attended a few times a year
or less) Respondents were then assigned to one of
five categones based on their 1967 and 1969 attend-
ance. The stub/y hzgh group (n = 216) consists of
persons who were hzgh attenders at both time points
The newly hzgh (n = 70) are hzgh attenders m 1969
who were either moderate or low attenders m 1967
The declznzng attendance group (n = 99) 1s com-
pnsed of hzgh attenders at Tzme I who were moderate
or low attenders at Time 2 The moderate group
(n = 152) consists of persons who were moderate
attenders at both time pomts, as well as those who
fluctuated from the moderate to low level or vice
versa between the two data collectzon points Finally,
the stably low (n = 149) were low attenders at both
time points
Table 3 presents the results of analyses that exam-
med the relatzonshzp between attendance patterns
and psychologzcal distress. We anticipated that those
who reported conszstently high levels of attendance
and those who increased then attendance would have
lower levels of [email protected] distress than persons
with consistently low attendance levels The first
model m Table 3 indicates that the stably high, the
newly hzgh and the declzmng attendance group all
had szgmficantly higher scores on the Gurm scale
(that zs, less psychologzcal distress) than the stably
low attendance group Thus, a high level of rehgzous
attendance m 1967 or m 1969, irrespective of their
attendance level at the other tzme point, zs predictive
of psychologzcal well-being However, szmzlar to the
findings m Table 2, these assoczatzons do not remam
szgnzficant when adJusted for Tzme 1 (1967) distress
scores
45. Relzgzon, stress and mental health
We have noted that rehgzon does not directly
enhance the psychologzcal well-being of zts adherents
Table 3 Analyses of the assOclauon between Time
2 (1969) Gunn scores and attendance at Time I
(1967) combmed wth Time 2 (1969)’
I II
Independent
vanables (Si (A)
Rehgmus attendance
a Stably high 1 63. 0 23
(0 73) (0 67)
b Newly high 2 06’ 0 58
(0 99) (0 90)
c Dechnmg I 90. 041
(0 88) (0 ‘30)
d Moderate 0 68 001
(0 79) (0 71)
e Stably low (omnted)
Time I Gunn 0 40”
(0 03)
Constant
RZ
l P < 0 05. l *P < 0 01, 2-taded tests
46. ‘Both models mclude controls for age, education,
manta1 status, gender and race
b = Unstandardized regressIon coefficients
We now turn to examme the buffenng hypothesis
Can rehgzon protect mdzvzduals from at least some of
the negative consequences of stress’ Table 4 presents
four models that explored the assoczatzons among
rehgzon, stress and psychologzcal distress The use of
the Time 1 measures of religion m these analyses
excludes the posszbzhty that any modifying effects
that we observe are due to changes m rehgzous
mvolvement resulting from stress The first model
shows the assoczatzon of the two stress measures and
the two rehgzon measures to the Time 2 (1969) Gunn
scale, controlhng for the soczodemographzc vanables
The second model adds adJustment for the Time 1
(1967) Gunn score, and models three and four tests
for mteractzons between relzgzous attendance and
hfe events, and attendance and health problems,
respectively
Table 4 shows that both hfe events and health
problems are szgnzficantly inversely associated with
scores on the Gunn scale As expected, stress IS
posrtzvely related to psychologzcal distress Model II
indicates that the coefficients for stress are reduced
Table 4 Analyses of the assoclatlon between Time 2 (1969)
Gunn scores. Time I (I 967)
measures of rehgon and mdlcators of stress’
Independent
vanables
49. (0 60)
-I 55”
(0 21)
- 2 70”
(0 44)
0 40.’
(0 03)
(021)
Attendance x HP 0 52.
(0 23)
Constant 70 11 44 53 45 4 453
R’ 0 251 0 399 0 403 0404
l P < 0 05, l *P < 0 01, 2-taded tests
‘All models m&de controls for age, education, manta1 status,
gender and race
b = unstandardued regresston coefficients
Rehgon and psychologxal distress m a commumty sample 1261
but remam slgnrficant when controlled for Time 1
(1967) psychologtcal distress Model II also reveals
that the relationship between attendance and distress
IS reduced to non-sigmficance when controlled for
Tl distress Models three and four reveal that both of
the multtphcative terms for interactions between
stress and rehgious attendance are significant The
interaction terms capture operant religious effects
that would go unnoted otherwise Moreover, the
50. sign is positive for both mteraction coefficients This
pattern of results reflects classic buffenng effects
That is, at low levels of religious attendance, stress
IS associated with increased levels of psychological
distress However, as the level of religious attendance
increases, the adverse consequences of stress are
reduced Surular analyses for the associatton between
religious affiliation and the stress measures were not
significant
In sum, consistent with other research [7], we find
that our measure of rehgious behavior (religious
attendance) is more consequential for health status
than our mdicator of rehgious affiliation The affiha-
tion measure is unrelated to psychological distress
In contrast, although rehgious attendance does not
directly reduce psychological distress, it does buffer
the impact of stressful life events and physical health
complamts on psychological well-being
DISCUSSION
The findings reported here underscore the import-
ance of giving more systematic research attention to
the consequences of rehgious beliefs and behavior for
health and well-being. National surveys reveal the
contmumg importance of public and pnvate rehgtous
mvolement m contemporary Amencan hfe [29] Our
results indicate that rehgion may be a potent coping
strategy that facihtates adjustment to the stress of hfe
Further exploration of this issue merits serious and
sustained research attention
One compellmg reason to replicate the analyses
reported here is the possibihty that they may reflect
period or cohort effects The data utilized m this
51. study are over 20 years old It is possible that the
findings documented here are true only for that
earlier time period and would not apply today In a
comprehensive review of the literature on rehgious
involvement and sublective well-bemg, Wetter et al.
[30] found a stronger relationship between religion
and SubJective well-being m earlier studies than m
more recent ones
Our use of longitudmal survey data is clearly an
improvement over merely studying cross-sectional
associations but analyses of two wave panel data
are not without serious hnntanons [31] For example,
the inclusion of Time 1 health status adjusts for
baseline differences among respondents m the levels
of health However, if health status at Time 2
IS also affected by other unmeasured causes, the
Time 1 health status indicator IS an inadequate proxy
for the mynad factors that are not mcluded m the
prediction equation The presence of measurement
error is another serious hmitation Errors of measure-
ment can create spurious covanance among the
variables in the regression models Theoretically-
grounded research that utilizes multiple indicators
of religion and that employs structural equation
modeling procedures [32] can begm to address these
lirmtations
This paper also illustrates some of the cnucal
shortcommgs m current research on religion and
mental health Rehgious attendance and religious
affiliation are the only measures of religious commit-
ment that we utihzed These are two of the most
commonly used measures m research on religion [l]
In contrast, religious mvolvement is a complex multi-
52. dimensional phenomenon [33-351 Kmg and Hunt
[33], for example, have tdentified more than a dozen
different ways of being rehgious, and have developed
and tested scales to measure each component &ml-
larly, Levm and associates [2.6,20,36] have pro-
posed numerous theoretically mformed mechamsms
by which religion can affect health status that clearly
constttute the most fruitful extant starting ground for
empirical mvestigations of the effects of religion on
health. The advancement of our understandmg of the
nature of the association between religion and health,
is contingent on efforts to comprehensively assess
religion, and identify the cnttcal dimensions of reh-
gious commitment that are linked to health status
Research efforts of thts kmd are necessary
to understand even the results presented here We
reported that religious attendance buffers or moder-
ates the relationship between stress and health How-
ever, we are unable to tell if this effect 1s hnked
to anything mtnnsmally rehgtous Although we
employ controls for formal education m all of the
analyses, it IS still possible that the attendance
measure is a proxy for some aspect of social status
Sociologists have long noted that religious partici-
pation IS frequently a badge of socioeconomic status,
secular m character, and of no greater rehgious
sigmficance than participation m other community
orgamzations [37] And there is abundant evidence
that participation m formal and informal social
groups, rehgious and non-rehgious, can promote
health, reduce stress and buffer the effects of stress on
health [22] Moreover, besides social class, rehgious
attendance may be confounded with functtonal
health [36]
53. It follows that a simple measure of the frequency
of religious attendance does not adequately cap-
ture public religious participation A comprehensive
assessment of public rehgious mvolvement must
include attendance at rehgious meetings other than
the main weekly worship service, financial support
of religious organizations, and holdmg leadership
and volunteer positions m rehgious groups [35].
Researchers must then seek to identify how these
public aspects of rehgious mvolvement relate to pn-
vate dimensions of religious beliefs and behavior and
how they combme to affect levels of health and
well-being.
Acknowledgements-An earlier version of this paper was
presented at the Ntnety-Seventh Annual Meettngs of the
Amertcan Psychologtcal Assoctatton, New Orleans, August,
1989 We wish to thank Jerome K Myers for permIssIon to
use the data and the anonymous renewers for very helpful
comments on an earlier version of this paper. The research
was supported, m part, by grant Rl l-8812285, from the
National Science Foundation
1262 DAVID R WILLIAMS er al
1
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tudmal studv J Hlth Sot Behav 13. 398-406. 1972
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59. APPENDIX
Life events
Measures of Stress
The 28 undesirable events are (1) failed school or trammg
program, (2) problems m school, (3) moved to a worse
nelghborhood, (4) wldowed, (5) divorced, (6) separated, (7)
trouble with m-laws, (8) serious physical illness, (9) serious
injury or accident, (10) death of a loved one, (11) stdlblrth,
(12) frequent minor illness, (13) mental illness, (14) death
of a pet, (15) demoted or changed to a less responsible Job,
(16) laid off temporarily, (17) busmess faded, (18) trouble
with boss, (19) out of work for over a month, (20) fired,
(21) financial status a lot worse than usual, (22) foreclosure
of mortgage or loan, (23) appearance m court, (24) deten-
tion m Jail, (25) arrested, (26) law suit or legal action,
(27) loss of dnver’s license, and (28) change m relations
with neighbor, friend and relative such as serious or maJor
disagreement
Health problems
The 16 health problems are (I) eye trouble, (2) ear
trouble, (3) sinus trouble, (4) throat trouble, (5) bronchitis,
(6) pneumoma, (7) tuberculosis, (8) bolls and abscesses,
(9) diabetes, (10) kidney trouble, (11) bodily injury,
(12-14) operations, (15) cancer or tumors, and (16) tooth
trouble, excluding routme prophylaxis
In Review
60. Research on Religion, Spirituality, and Mental Health:
A Review
Harold G Koenig, MD
1
Key Words: religion, spirituality, depression, anxiety,
psychosis, substance abuse
Despite spectacular advances in technology and science,90% of
the world’s population is involved today in some
form of religious or spiritual practice.1 Nonreligious people
make up less than 0.1% of the populations in many Middle-
Eastern and African countries. Only 8 of 238 countries have
populations where more than 25% say they are not religious,
and those are countries where the state has placed limitations
on religious freedom. Atheism is actually rare around the
world. More than 30 countries report no atheists (0%) and in
only 12 of 238 countries do atheists make up 5% or more of
the population. In Canada, 12.5% of the population are non-
religious and 1.9% atheist.
Evidence for religion playing a role in human life dates back
500 000 years ago when ritual treatment of skulls took place
during China’s paleolithic period.2 Why has religion endured
over this vast span of human history? What purpose has it
served and does it continue to serve? I will argue that religion
is a powerful coping behaviour that enables people to make
sense of suffering, provides control over the overwhelming
forces of nature (both internal and external), and promotes
social rules that facilitate communal living, cooperation, and
mutual support.
Until recent times, religion and mental health care were
closely aligned.3 Many of the first mental hospitals were
61. The Canadian Journal of Psychiatry, Vol 54, No 5, May 2009 �
283
Religious and spiritual factors are increasingly being examined
in psychiatric research.
Religious beliefs and practices have long been linked to
hysteria, neurosis, and psychotic
delusions. However, recent studies have identified another side
of religion that may serve
as a psychological and social resource for coping with stress.
After defining the terms
religion and spirituality, this paper reviews research on the
relation between religion and
(or) spirituality, and mental health, focusing on depression,
suicide, anxiety, psychosis, and
substance abuse. The results of an earlier systematic review are
discussed, and more recent
studies in the United States, Canada, Europe, and other
countries are described. While
religious beliefs and practices can represent powerful sources of
comfort, hope, and
meaning, they are often intricately entangled with neurotic and
psychotic disorders,
sometimes making it difficult to determine whether they are a
resource or a liability.
Can J Psychiatry. 2009;54(5):283–291.
Clinical Implications
� Religious beliefs and practices may be important resources
for coping with illness.
� Religious beliefs may contribute to mental pathology in some
cases.
62. � Psychiatrists should be aware of patients’ religious and
spiritual beliefs and seek to understand
what function they serve.
Limitations
� My review of recent studies is selective, not systematic.
� Studies without statistically significant findings are not
discussed.
� Clinical applications are not addressed.
located in monasteries and run by priests. With some excep-
tions, these religious institutions often treated patients with far
more compassion than state-run facilities prior to 19th-
century mental health reforms (reforms often led by religious
people such as Dorothea Dix and William Tuke). In fact, the
first form of psychiatric care in the United States was moral
treatment, which involved the compassionate and humane
treatment of people with mental illness—a revolutionary
notion at a time when patients were often put on display and
(or) housed in despicable conditions in the back wards of hos-
pitals or prisons.4 Religion was believed to have a positive,
civilizing influence on these patients, who might be rewarded
for good conduct by allowing them to attend chapel services.
However, in the late 19th century, the famous neurologist
Jean Charcot and his star pupil, Sigmund Freud, began to
associate religion with hysteria and neurosis. This created a
deep divide that would separate religion from mental health
care for the next century, as demonstrated by the writings of 3
generations of mental health professionals from Europe, the
63. United States, and Canada.5–8
Today, attitudes toward religion in psychiatry have begun to
change. The American College of Graduate Medical Educa-
tion now states in its Special Requirements for Residency
Training for Psychiatry9 that all programs must provide train-
ing on religious or spiritual factors that influence psychologi-
cal development. Part of this change has been driven by
scientific research during the past 2 decades that suggests reli-
gious influences need not always be pathological, but can
actually represent resources for health and well-being.
Definitions
Before reviewing the research, religion and spirituality must
be defined, because these terms have ambiguous meanings
that may affect the interpretation of research findings. The
definition of religion is generally agreed on and involves
beliefs, practices, and rituals related to the sacred. I define the
sacred as that which relates to the numinous (mystical, super-
natural) or God, and in Eastern religious traditions, to Ulti-
mate Truth or Reality. Religion may also involve beliefs about
spirits, angels, or demons. Religions usually have specific
beliefs about life after death and rules about conduct that
guide life within a social group. Religion is often organized
and practiced within a community, but it can also be practiced
alone and in private. However, central to its definition is that
religion is rooted in an established tradition that arises out of a
group of people with common beliefs and practices concern-
ing the sacred.
In contrast with religion, spirituality is more difficult to
define. It is a more popular expression today than religion, as
many view the latter as divisive and associated with war, con-
flict, and fanaticism. Spirituality is considered more per-
sonal, something people define for themselves that is largely
64. free of the rules, regulations, and responsibilities associated
with religion. In fact, there is a growing group of people cate-
gorized as spiritual-but-not-religious, who deny any connec-
tion at all with religion and understand spirituality entirely in
individualistic, secular terms. However, this contemporary
use of spirituality is different from its original meaning.
According to Philip Sheldrake,10 professor of applied theol-
ogy at the University of Durham, England, the origin of the
word spiritual lies in the Latin term spiritualis, which is
derived from the Greek word pneumatikos, as it appears in
Paul’s letters to the Romans and Corinthians. A spiritual per-
son was considered someone with whom the Spirit of God
dwelt, often referring to the clergy.10, p 3 In the Second
Vatican Council, spirituality replaced terms such as ascetical
theology and mystical theology. Although the Greeks used
the word spiritual to distinguish humanity from nonrational
creation, spiritual and (or) spirituality has been distinctly reli-
gious throughout most of Western history. It was not until
much later that Eastern religions adopted the term. Then,
spiritual people were a subset of religious people whose lives
and lifestyles reflected the teachings of their faith tradition.
Spiritual people were those such as Teresa of Ávila, John of
the Cross, Siddhartha Gautama, Mother Teresa, or Mahatma
Gandhi.
The term spirituality in health care has now expanded far
beyond its original meaning. This expansion has resulted
from attempts to be more inclusive in pluralistic health care
settings, to address the needs both of religious and of non-
religious people. This degree of inclusiveness, while admira-
ble in the clinic, makes it impossible to conduct research on
spirituality and relate it to mental health, as there is no unique,
distinct, agreed-on definition. Thus researchers have strug-
gled to come up with measures to assess spirituality.
65. When measured in research, spirituality is often assessed
either in terms of religion or by positive psychological,
social, or character states. For example, standard measures of
spirituality today contain questions asking about meaning
and purpose in life, connections with others, peacefulness,
� La Revue canadienne de psychiatrie, vol 54, no 5, mai
2009284
In Review
Abbreviations used in this article
5-HT 5-hydroxytryptamine (serotonin)
5-HT1A 5-beta hydroxytryptamine receptor 1
CASA National Center on Addiction and Substance Abuse
MADRS Montgomery-Asberg Depression Rating Scale
MDD major depressive disorder
RCT randomized controlled trial
RS religion and (or) spirituality
existential well-being, and comfort and joy. This is
problematic, as it assures that spirituality in such studies will
be correlated with good mental health. In other words,
spirituality—defined as good mental health and positive
psychological or social traits—is found to correlate with good
mental health. Such research is meaningless and tautological.
To avoid this methodological problem and to maintain the
66. purity and distinctiveness of the construct, I have proposed
that spirituality be defined in terms of religion,11 where reli-
gion is a multidimensional construct not limited to institu-
tional forms of religion. Thus I will either refer to religion or
use the terms religion and spirituality synonymously (for
example, as RS).
Religion as a Coping Behaviour
Systematic research in many countries around the world finds
that religious coping is widespread. For the general popula-
tion, research published in The New England Journal of Medi-
cine found that 90% of Americans coped with the stress of
September 11th (2001) by “turning to religion.”12, p 1507
During
the week following the attacks, 60% of Americans attended a
religious or memorial service and Bible sales rose 27%.13
Even prior to the year 2000, more than 60 studies had docu-
mented high rates of religious coping in patients with an
assortment of medical disorders ranging from arthritis to dia-
betes to cancer.14 One systematic survey of hospitalized medi-
cal patients (n = 330) found that 90% reported they used
religion to cope, at least to a moderate extent, and more than
40% indicated that religion was the most important factor that
kept them going.15
Psychiatric patients also frequently use religion to cope. A
survey of patients (n = 406) with persistent mental illness at a
Los Angeles County mental health facility found that more
than 80% used religion to cope.16 In fact, most patients spent
as much as one-half of their total coping time in religious prac-
tices such as prayer. Researchers concluded that religion
serves as a “pervasive and potentially effective method of
coping for persons with mental illness, thus warranting its
integration into psychiatric and psychological practice.”16, p
67. 660
In another study, conducted by the Center for Psychiatric
Rehabilitation at Boston University, adults with severe mental
illness were asked about the types of alternative health care
practices they used.17 A total of 157 people with schizophre-
nia, bipolar disorder, or MDD responded to the survey. People
with schizophrenia and MDD reported that the most common
beneficial alternative health practice was an RS activity (more
than one-half reported this); for those with bipolar disorder,
only meditation surpassed RS activity (54%, compared with
41%).
Religious coping is likewise prevalent outside the United
States. A study of psychiatric patients (n = 79) at Broken Hill
Base Hospital in New South Wales found that 79% rated spir-
ituality as very important, 82% thought their therapist should
be aware of their spiritual beliefs and needs, and 67% indi-
cated that spirituality helped them to cope with psychological
pain.18 A survey of patients (n = 52) with lung cancer in
Ontario asked about sources of emotional support. The most
commonly reported support systems were family (79%) and
religion (44%).19 Finally, a study of outpatients (n = 292)
with cancer seen at the Northwestern Ontario Regional Can-
cer Centre, Thunder Bay, found that, among all coping strate-
gies inquired about, prayer was used by the highest number
(64%).20
Why is religious coping so common among patients with
medical and psychiatric illness? Religious beliefs provide a
sense of meaning and purpose during difficult life circum-
stances that assist with psychological integration; they usu-
ally promote a positive world view that is optimistic and
hopeful; they provide role models in sacred writings that
facilitate acceptance of suffering; they give people a sense of
68. indirect control over circumstances, reducing the need for
personal control; and they offer a community of support, both
human and divine, to help reduce isolation and loneliness.
Unlike many other coping resources, religion is available to
anyone at any time, regardless of financial, social, physical,
or mental circumstances.
I will review studies examining the relation between religion
and mental health in 5 areas: depression, suicide, anxiety,
psychotic disorders, and substance abuse. While some stud-
ies report no association between religious involvement and
mental health, and a handful of studies have reported nega-
tives associations, the majority (476 of 724 quantitative stud-
ies prior to the year 2000, based on a systematic review)
reported statistically significant positive associations.21
Because space is limited, I will briefly mention the results of
that systematic review and then examine, in more detail, stud-
ies that exemplify research published more recently.
Depression
Prior to 2000, more than 100 quantitative studies had exam-
ined the relation between religion and depression.22 Among
93 observational studies, two-thirds found significantly
lower rates of depressive disorder or fewer depressive symp-
toms among the more religious. Among 34 studies that did
not, only 4 found being religious was associated with signifi-
cantly more depression. Among 22 longitudinal studies, 15
found that greater religiousness at baseline predicted fewer
depression symptoms or faster remission of symptoms at
follow-up. Among 8 RCTs, 5 found that religious-based psy-
chological interventions resulted in faster symptom improve-
ment, compared with secular-based therapy or with control
subjects. Supporting these findings was a more recent
69. Research on Religion, Spirituality, and Mental Health: A
Review
The Canadian Journal of Psychiatry, Vol 54, No 5, May 2009 �
285
independently published meta-analysis of 147 studies that
involved nearly 100 000 subjects.23 The average inverse cor-
relation between religious involvement and depression was
–0.10, which increased to –0.15 for studies in stressed popula-
tions. While this correlation appears small and weak, it is of
the same magnitude as seen for sex (a widely recognized fac-
tor influencing the prevalence of depression).
Moreover, individual studies in stressed populations, particu-
larly people with serious medical illness, find a more substan-
tial impact for religion on the prevalence and course of
depression. For example, depressed medical inpatients (n =
1000) aged 50 years or older with either congestive heart fail-
ure or chronic pulmonary disease were identified with depres-
sive disorder using the Structured Clinical Interview for
Depression.24 The religious characteristics of these patients
were compared with those of nondepressed patients (n = 428).
Depressed patients were significantly more likely to indicate
no religious affiliation, more likely to indicate spiritual but not
religious, less likely to pray or read scripture, and scored
lower on intrinsic religiosity. These relations remained robust
after controlling for demographic, social, and physical health
factors. Among the depressed patients, severity of depressive
symptoms was also inversely related to religious indicators.
Among these 1000 depressed patients, investigators followed
865 for 12 to 24 weeks, examining factors influencing speed
of remission from depression.25 The most religious patients
70. (those who attended religious services at least weekly, prayed
at least daily, read the Bible or other religious scriptures at
least 3 times weekly, and scored high on intrinsic religiosity)
remitted from depression more than 50% faster than other
patients (hazard ratio = 1.53, 95% CI 1.20 to 1.94), controlling
for multiple demographic, psychosocial, psychiatric, and
physical health predictors of remission. Several other studies
have similarly shown a positive impact for religion on course
of depression.26–28
However, for psychiatric patients there have been few studies
on the course of depression. Bosworth et al29 interviewed
elderly psychiatric inpatients (n = 104), assessing public and
private religious practices and religious coping. Depressive
symptoms were assessed at baseline and 6 months later by a
psychiatrist using the MADRS. Baseline positive religious
coping predicted significantly less depression on the MADRS
at the 6-month evaluation, an effect independent of social sup-
port measures, demographics, use of electroconvulsive ther-
apy, and number of depressive episodes.
At least 2 studies (both cross-sectional) have examined rela-
tions between religious involvement and depression in
Canada, one reporting an inverse relation and the other find-
ing a positive relation. O’Connor and Vallerand30 examined
associations between religious motivation and personal
adjustment in a sample of elderly French-Canadians (n =
176) drawn from nursing homes in the greater Montreal area.
Intrinsic religiosity was inversely related to depression and
positively related to life satisfaction, self-esteem, and mean-
ing in life. In the second study, Sorenson et al31 followed
teenaged mothers (n = 261) (87% unmarried) before delivery
and 4 weeks after delivery in southwestern Ontario. They
examined the relation between religion and depressive symp-
toms during the first few weeks after babies were born. Cath-
71. olics and teenagers affiliated with more conservative
religious groups scored significantly higher on depression,
and those who attended religious services more frequently
also had higher depression scores. However, the highest
depression scores were among girls who cohabitated with
someone while continuing to attend religious services.
Baetz and colleagues32,33 have shown in large cross-sectional
community surveys of the Canadian population that religious
attendance is associated with less depression and fewer psy-
chiatric disorders. However, participants indicating that spir-
itual values were important or perceived themselves as
spiritual or religious had higher levels of psychiatric symp-
toms. The researchers speculated that these people could
have turned to RS to reframe difficult life circumstances
associated with psychiatric illness. Bear in mind that the stud-
ies were conducted in largely healthy community-dwelling
adults with relatively low stress levels.
Two additional unpublished dissertations34,35 report studies
of RS and depression in Canadian men with prostate cancer
and in bereaved caregivers of Canadians dying from AIDS.
Both demonstrated positive effects for RS involvement on
posttraumatic growth and coping with illness. Supporting the
findings of the Canadian caregiver study, Fenix et al36 at Yale
University recently followed caregivers (n = 175) of recently
deceased cancer patients for 13 months, examining associa-
tions between religiousness and the development of MDD.36
Religious caregivers were significantly less likely to have
developed MDD by the 13-month follow-up, a finding that
persisted after adjusting for other risk factors. The same
results have been reported for caregivers of patients with
Alzheimer disease.37,38
Thus studies in medical patients, older adults with serious
72. and disabling medical conditions, and their caregivers sug-
gest that religious involvement is an important factor that
enables such people to cope with stressful health problems
and life circumstances. However, this may not be true in all
populations, as studies of pregnant unmarried teenagers and
nonstressed community populations above suggest.
Critics say that most studies reporting positive results are
observational and that some unmeasured characteristic may
be related both to religion and to depression, confounding the
� La Revue canadienne de psychiatrie, vol 54, no 5, mai
2009286
In Review
relation. In particular, genetic factors have been implicated. In
a fascinating study that examined the relation of spirituality to
brain 5-HT1A binding using positive emission tomography,
investigators found that 5-HT1A binding was lower in people
who were more spiritually accepting. Note that lower 5-HT1A
binding—the same pattern seen with spirituality—has been
found in patients with anxiety and depressive disorders.39–41
Thus, rather than being genetically less prone to depression,
RS-oriented people may be at increased risk for mood
disorders based on their 5-HT receptor binding profile.
Suicide
In Koenig et al’s42 systematic review of research conducted
before 2000, 68 studies were identified that examined the
religion–suicide relation. Among those studies, 57 found
fewer suicides or more negative attitudes toward suicide
73. among the more religious, 9 showed no relation, and 2
reported mixed results. Seven of the studies were conducted in
Canada, and of those, 5 found fewer suicides or more negative
attitudes toward suicide among the more religious, 1 found no
association, and 1 reported mixed results.
While recent research suggests that religion prevents suicide
primarily through religious doctrines that prohibit suicide,43
there is also evidence that the comfort and meaning derived
from religious beliefs may be relevant44 and may be especially
important in people with advanced medical illness.45 Reli-
gious involvement may also help to prevent suicide by sur-
rounding the person at risk with a caring, supportive
community.46
Anxiety
While religious teachings have the potential to exacerbate
guilt and fear that reduce quality of life or otherwise interfere
with functioning, the anxiety aroused by religious beliefs can
prevent behaviours harmful to others and motivate pro-social
behaviours. Religious beliefs and practices can also comfort
people who are fearful or anxious, increase sense of control,
enhance feelings of security, and boost self-confidence (or
confidence in Divine beings).
Prior to 2000, at least 76 studies had examined the relation
between religious involvement and anxiety.47 Sixty-nine
studies were observational and 7 were RCTs. Among the
observational studies, 35 found significantly less anxiety or
fear among the more religious, 24 found no association, and
10 reported greater anxiety. However, all 10 of the latter stud-
ies were cross-sectional, and anxiety and (or) fear is a strong
motivator of religious activity. People pray more when they
are scared or nervous and feel out of control (“There are no
74. atheists in foxholes”). Then, cross-sectional studies are less
useful than longitudinal studies or RCTs. Among the 7 RCTs
examining the effects of a religious intervention on subjects
with anxiety (usually generalized anxiety disorder), 6 found
that religious interventions in religious patients reduced anx-
iety levels more quickly than secular interventions or control
subjects. Studies of Eastern spiritual techniques, such as
mindfulness meditation (from the Buddhist tradition), report
similar effects,48,49 although their efficacy in anxiety disor-
ders has recently been questioned.50
More recent longitudinal studies add to this literature, and
provide information on mechanisms. Wink and Scott51 fol-
lowed subjects (n = 155) for nearly 30 years, from middle age
into later life, studying the impact of religious beliefs and
involvement on death anxiety. Analyses revealed no linear
relations between religiousness, fear of death, and fear of
dying. Subjects with the lowest anxiety levels were those
who were either high or low on religiousness. Anxiety was
highest among subjects who were only moderately religious,
and in particular, those who affirmed belief in an afterlife but
were not involved in any religious practices. Researchers
concluded that it was the degree of religious involvement that
was important in lessening death anxiety not simply belief in
an afterlife.
Religious involvement may also interact with certain forms
of psychotherapy to enhance response to therapy. Investiga-
tors at the University of Saskatchewan explored coping and
motivation factors related to treatment response in patients
(n = 56) with panic disorder participating in a clinical trial.52
Subjects were treated with group cognitive-behavioural ther-
apy, and then were followed up at 6 and 12 months after base-
line evaluation. Self-rated importance of religion was a