Bruce Nelson

Religious involvement is associated with greater purpose, optimism, generosity and gratitude in persons with major depression and chronic medical illness

OBJECTIVE Religious involvement may help individuals with chronic medical illness cope better with physical disability and other life changes. We examine the relationships between religiosity, depressive symptoms, and positive emotions in persons with major depression and chronic illness. METHODS 129 persons who were at least somewhat religious/spiritual were recruited into a clinical trial to evaluate the effectiveness of religious vs. secular cognitive behavioral therapy. Reported here are the relationships at baseline between religious involvement and depressive symptoms, purpose in life, optimism, generosity, and gratefulness using standard measures. RESULTS Although religiosity was unrelated to depressive symptoms (F=0.96, p=0.43) and did not buffer the disability-depression relationship (B=-1.56, SE 2.90, p=0.59), strong relationships were found between religious indicators and greater purpose, optimism, generosity, and gratefulness (F=7.08, p<0.0001). CONCLUSIONS Although unrelated to depressive symptoms in the setting of major depression and chronic medical illness, higher religious involvement is associated with positive emotions, a finding which may influence the course of depression over time.

Religious vs. conventional cognitive behavioral therapy for major depression in persons with chronic medical illness: A pilot randomized trial.

Abstract We examine the efficacy of conventional cognitive behavioral therapy (CCBT) versus religiously integrated CBT (RCBT) in persons with major depression and chronic medical illness. Participants were randomized to either CCBT (n = 67) or RCBT (n = 65). The intervention in both groups consisted of ten 50-minute sessions delivered remotely during 12 weeks (94% by telephone). Adherence to treatment was similar, except in more religious participants in whom adherence to RCBT was slightly greater (85.7% vs. 65.9%, p = 0.10). The intention-to-treat analysis at 12 weeks indicated no significant difference in outcome between the two groups (B = 0.33; SE, 1.80; p = 0.86). Response rates and remission rates were also similar. Overall religiosity interacted with treatment group (B = −0.10; SE, 0.05; p = 0.048), suggesting that RCBT was slightly more efficacious in the more religious participants. These preliminary findings suggest that CCBT and RCBT are equivalent treatments of major depression in persons with chronic medical illness. Efficacy, as well as adherence, may be affected by client religiosity.

Religious Involvement and Telomere Length in Women Family Caregivers.

Abstract Telomere length (TL) is an indicator of cellular aging associated with longevity and psychosocial stress. We examine here the relationship between religious involvement and TL in 251 stressed female family caregivers recruited into a 2-site study. Religious involvement, perceived stress, caregiver burden, depressive symptoms, and social support were measured and correlated with TL in whole blood leukocytes. Results indicated a U-shaped relationship between religiosity and TL. Those scoring in the lowest 10% on religiosity tended to have the longest telomeres (5743 bp ± 367 vs. 5595 ± 383, p = 0.069). However, among the 90% of caregivers who were at least somewhat religious, religiosity was significantly and positively related to TL after controlling for covariates (B = 1.74, SE = 0.82, p = 0.034). Whereas nonreligious caregivers have relatively long telomeres, we found a positive relationship between religiosity and TL among those who are at least somewhat religious.

EFFECTS OF RELIGIOUS VERSUS STANDARD COGNITIVE‐BEHAVIORAL THERAPY ON OPTIMISM IN PERSONS WITH MAJOR DEPRESSION AND CHRONIC MEDICAL ILLNESS

We compared the effectiveness of religiously integrated cognitive behavioral therapy (RCBT) versus standard CBT (SCBT) on increasing optimism in persons with major depressive disorder (MDD) and chronic medical illness.

Religious Involvement and Adaptation in Female Family Caregivers

To examine the relationship between religious involvement (RI) and adaptation of women caring for family members with severe physical or neurological disability.

Religious Involvement, Inflammatory Markers and Stress Hormones in Major Depression and Chronic Medical Illness

Background: Religious practices/experiences (RPE) may produce positive physiological changes in patients with major depressive disorder (MDD) and chronic medical illness. Here, we report cross-sectional relationships between depressive symptoms, RPE and stress biomarkers (pro-/anti-inflammatory measures and stress hormones), hypothesizing positive associations between depressive symptoms and stress biomarkers and inverse associations between RPE and stress biomarkers. Methods: We recruited 132 individuals with both MDD and chronic illness into a randomized clinical trial. First, stress biomarkers in the baseline sample were compared to biomarker levels from a community sample. Second, relationships between depressive symptoms and biomarkers were examined, and, finally, relationships between RPE and biomarkers were analyzed, controlling for demographics, depressive symptoms, and physical functioning. Results: As expected, inflammatory markers and stress hormones were higher in our sample with MDD compared to community participants. In the current sample, however, depressive symptoms were largely unrelated to stress biomarkers, and were unexpectedly inversely related to proinflammatory cytokine levels (TNF-α, IL-1β). Likewise, while RPE were largely unrelated to stress biomarkers, they were related to the anti-inflammatory cytokine IL-1RA and the stress hormone norepinephrine in expected directions. Unexpectedly, RPE were also positively related to the proinflammatory cytokine IFN-γ and to IFN-γ/IL-4 and IFN-γ/IL-10 ratios. Conclusions: Little evidence was found for a consistent pattern of relationships between depressive symptoms or religiosity and stress biomarkers. Of the few significant relationships, unexpected findings predominated. Future research is needed to determine whether religious interventions can alter stress biomarkers over time in MDD.

Effects of Religious Versus Conventional Cognitive-Behavioral Therapy on Gratitude in Major Depression and Chronic Medical Illness: A Randomized Clinical Trial

ABSTRACT This study examined whether religiously-integrated cognitive behavioral therapy (RCBT) was more effective than conventional CBT (CCBT) on generating gratitude among religious persons with major depressive disorder (MDD) and chronic medical illness (CMI). Participants at least somewhat religious/spiritual with MDD and CMI were randomized to receive 10 sessions of RCBT or CCBT. Both RCBT and CCBT predicted an increase in gratitude over time. Higher baseline religiosity predicted increases in gratitude among those receiving CCBT and RCBT. Higher levels of baseline gratitude predicted a faster decline in depressive symptoms independent of treatment group at 12 and 24 weeks.