Session 3
Religion, Spirituality and Mental Health
Chair: Arjan Braam
1. Change of Perspective: Alcoholism as a Spiritual Crisis
Indrek Linnuste
Background: Alcohol dependence syndrome is a particularly important complication of substance use, it is not best understood in isolation. Rather, it is a problem that emerges when, of a group of people who engage in psychoactive substance use, only some become dependent. It is therefore a problem of appetitive behaviour, an aspect of human experience in which we are all involved.
Mainstream healthcare provision and scientific research within the addictions field in the Western society have tended to focus on physical, social and psychological interventions not so much the existential point or any spiritual change. But It almost impossible to discuss problems of metapathologies (Maslow) as alcoholism without a spiritual dimension.
Alcohol dependence is in society stigmatized phenomenon that is often onsidered as velleity, not disease. This attitude inhibits prevention, treatment, rehabilitation and development of support systems
Aim: The study aims to describe and analyse quality of life of alcohol dependent men in Estonia.
Methods: Consequtive sample of men who participated in the study had been diagnosed with alcohol dependence and been on treatment in Pärnu Hospital, Estonia. The social-demographic indicators and exposure to alcohol were assessed using a questionnaire. General index of quality of life and six broader domains (physical health, psychological, level of independence, social relationships, environment, spirituality/religion, personal beliefs) of quality of life were investigated using WHOQOL-100. The survey was carried out 2010-2011 in Pärnu Hospital. For data analysis statistical program STATA and Mann-Whitney test was used.
Results: In the final analysis answers of 57 men were used. The lowest average index of quality of life was for physical health (12.06), psychological wellbeing (11.88) and spirituality (11.86). Compared to European average, all domains for the study group had lower values. Men who were participating in self-help groups and/or were believers of some religion had higher estimation of their spirituality. Those men, who had had their longest period of non-drinking more than six and/or were in relatsionship, had higher estimations of social relationships.
Conclusions: In broader context, deeper cooperation of medical, scientific, political and non-governmental sphere is needed to gain success in the struggle against alcohol dependence. The practical work should start from better sharing of information about alcohol and co-morbid problems, more strict official alcohol policy, restructuring of treatment process to integrate medical and psychological and spiritual supporting methods.
PowerPoint slides of the presentation (PDF)
2. Living Between Llonging for… and Addiction - Effect of Spirituality on Addictive Bbehaviour
Janusz Surzykiewicz
Katholische Universität Eichstätt-Ingolstadt, Germany; Uniwersytet Stefana Kardynała Wyszynskiego, Poland
Background: Literature suggests that spirituality is negatively associated with heavy drinking and other forms of addictive behavior.
Aim: Aiming to explain these results in more detail, individual protective factors were included to test their specific impact on the protective correlation between spirituality and addictive tendencies (e.g. heavy drinking, excessive shopping, internet addiction).
Methods: Testing this hypothesis, a survey study with 268 people aged between 17 and 45 years was conducted, measuring their addictive tendencies and behaviors along with their spirituality (including spiritual needs, spiritual coping, positive emotions with god and spiritual behaviors) as well as life satisfaction, self-efficacy, hope, goal orientation and stress coping.
Results and Conclusion: It was shown that spirituality associated with the assessed protective factors (e.g. life satisfaction) in fact operates as a coping resource for dealing with stress by providing alternative ways of managing problems, increasing positive affect as well as purpose of life and thus moderates addictive tendencies.
3. Can Prayer Be Used in Spiritual Care and Treatment? An Examination on the Relationship between Prayer and Psychological Well-Being
Nurten Kimter
All prayers in the religion of Islam have a lot of physical as well as spiritual benefits. It can especially be stated that the prayer in the religion of Islam that is practiced with the body, tongue, heart and mind encompassing the praying methods of all creatures can be considered as a prescription for health for today’s contemporary people who complain of various mental disorders. In this regard, “Personal Information Form” and “Psychological Well-Being Scale” were used as tools for measurement in our study, the objective of which was to examine the relationship between prayer and psychological well-being for people between the ages of 15 and 65 and above.
Sample scanning method and survey technique were used to reach the goals of this study. SPSS 18.0 package software and SPPS Amos program were used for the analysis of the study data, and pearson correlation and regression analysis were carried out to put forth the relationships between the variables.
It was observed as a result of the study that their status of praying five times a day and futile prayers have a positive and significant effect on the psychological well-being states of people. In addition, it has been determined that certain variables such as age, gender, income and education levels have moderating effects on the relationship between praying and the psychological well-being. It was also observed in the study that the psychological well-being of the sample group increased as the level of belief to the idea of “praying because there are five pillars of Islam and to gain the consent and love of Allah”.
At the end of the study, these results were discussed with regard to prayers and mental health after which various evaluations and suggestions were made with regard to the place and importance of prayer for spiritual care and treatment.
4. Spiritual-Health Education (SHE) in Schools for Promoting Mental Health Among School Children in India: Perspectives of Teachers and Parents
Andrew Baccari, Parameshwaran Ramakrishnan
Background: Medical school curriculum and continuing education programs increasingly focus on the topics of Spirituality in order to improve health-care professionals’ mental health and skills in: coping, stress management, empathy, and interpersonal awareness. Primary and Secondary level students would benefit from such courses, but there has been less effort to bring SHE into these types of school settings. Furthermore, little information is known regarding whether SHE would be endorsed by such schools.
Aims and Objectives: To understand the perspectives of school teachers and parents to introduce spirituality as a health education subject in primary/ secondary school and university.
Materials and Methods: Using an adapted version of the RSMPP (Religion, Spirituality and Medicine, Physician Perspectives) questionnaire, a cross-sectional survey was conducted at seven primary-secondary grade schools in India. Our sample population included a total of 300 participants (N=150 teachers and 150 parents); 30 teachers and 30 parents from each of India’s predominant religious groups, Buddhist, Christian, Hindu, Muslim, and Sikh were selected. Hindu and Sikh participations were randomly recruited into this study from the Indus World Schools (IWS); snowball sampling allowed us to fulfill the remaining sub-groups. The primary criterion variable tested was participants level of dis/ agreement with the statement: “'Spiritual-Health' education is important for one’s own, personal, psychological/emotional growth and development.” The data findings of teacher and parent groups were compared using parametric and regression analysis using STATA statistical software.
Results and Discussion: Preliminary finding reveal that over 90% of teachers and parents felt comfortable including SHE as part of the school’s standard curriculum. Furthermore, a majority teachers (75%) and parents (84.6%) believed that students would benefit emotionally and psychologically from this curriculum. Additionally, (>92%) of teachers and parents believed that SHE would help students gain coping, stress management, and pro-social skills. Ways to develop SHE and possible ways to deliver it through teachers’ training are discussed.
Conclusion: Inclusion of SHE as an academic subject is endorsed by both teachers and parents within our sample. Concerns surrounding SHE include: teaching SHE in a non-devotional manner that emphasizes tolerance and mutual understanding across religious traditions.
5. Religion and Spirituality in Prospective Atudies: A Review
Arjan Braam, Peter Verhagen
Background: Koenig, King and Benner Carson (2012) conclude from their extensive review of the literature about religion and spirituality (R/S) and depression that by its ability to neutralize life stress, R/S might help both to prevent the onset of depression, and if depression develops, shorten the time it takes to resolve. They point to the value of long-term prospective studies, including multidimensional measures of R/S, multiple time points, parental religiosity, personality traits and genetic traits. As such studies are still scarce, it may be good to get a systematic insight in the existing prospective studies.
Research questions: The general research question for the current review of the literature is: What patterns of findings about the relation over time between R/S and depression can be derived from the literature so far? More specific questions are:
- Which particular aspects of R/S seem to be the most prominent or relevant with respect to the association with depression over time?
- Which other factors are possibly decisive in understanding these associations? These factors may include: stage of life (age), physical conditions, being in mental health treatment, religious culture (America vs Europe, Bible Belt regions, Islamic subgroups, other cultures), or other roles or phases in life (caregiving, grief).
- Do findings depend on how depression has been operationalized, either as continuous (depressive symptom scales) or as syndromal variable (employing diagnostic criteria, or using validated cut-off scores)?
- Do findings depend on the methodological quality and statistical approach?
Results: The literature search in Psychlit and Pubmed yielded (so far up to June 30 2015) 105 studies. The most prevalent aspect of R/S under study was church attendance. On average, the studies included two measures on R/S (range 1-7). When considering all R/S aspects in the studies, 55% of the studies contained an association between R/S and better course of depression / depressive symptoms over time, 6% showed a worse course, and 39% showed a mixed or non-significant result. In some subpopulations, such as the general population and psychiatric patients, R/S tended to be more often protective over time, but this was not found in samples of patients with a physical disease.
Conclusions: The pattern of results of studies on R/S and course of depression over time contains many significant findings. Many findings, however, are of modest strength. The risk of publication bias has not been ruled out. The studies do not correct for multiple comparisons. R/S is not a major determinant of the course depression for all, but reflects a relevant existential resource for some, at least in the general population and among psychiatric patients. Further studies about religious distress among patients with a somatic disease seem to be warranted, as well on their need of R/S care.