Harold G. Koenig

Patterns of positive and negative religious coping with major life stressors : Symposium on religion, health, and well-being

This study attempted to identify positive and negative patterns of religious coping methods, develop a brief measure of these religious coping patterns, and examine their implications for health and adjustment. Through exploratory and confirmatory factor analyses, positive and negative religious coping patterns were identified in samples of people coping with the Oklahoma City bombing, college students coping with major life stressors, and elderly hospitalized patients coping with serious medical illnesses. A 14-item measure of positive and negative patterns of religious coping methods (Brief RCOPE) was constructed. The positive pattern consisted of religious forgiveness, seeking spiritual support, collaborative religious coping, spiritual connection, religious purification, and benevolent religious reappraisal. The negative pattern was defined by spiritual discontent, punishing God reappraisals, interpersonal religious discontent, demonic reap praisal, and reappraisal of Gods powers. As predicted, people made more use of the positive than the negative religious coping methods. Furthermore, the two patterns had different implications for health and adjustment. The Brief RCOPE offers an efficient, theoretically meaningful way to integrate religious dimensions into models and studies of stress, coping, and health.

The many methods of religious coping: Development and initial validation of the RCOPE

The purpose of this study was to develop and validate a new theoretically based measure that would assess the full range of religious coping methods, including potentially helpful and harmful religious expressions. The RCOPE was tested on a large sample of college students who were coping with a significant negative life event. Factor analysis of the RCOPE in the college sample yielded factors largely consistent with the conceptualization and construction of the subscales. Confirmatory factor analysis of the RCOPE in a large sample of hospitalized elderly patients was moderately supportive of the initial factor structure. Results of regression analyses showed that religious coping accounted for significant unique variance in measures of adjustment (stress-related growth, religious outcome, physical health, mental health, and emotional distress) after controlling for the effects of demographics and global religious measures (frequency of prayer, church attendance, and religious salience). Better adjustment was related to a number of coping methods, such as benevolent religious reappraisals, religious forgiveness/purification, and seeking religious support. Poorer adjustment was associated with reappraisals of Gods powers, spiritual discontent, and punishing God reappraisals. The results suggest that the RCOPE may be useful to researchers and practitioners interested in a comprehensive assessment of religious coping and in a more complete integration of religious and spiritual dimensions in the process of counseling.

Religious involvement and mortality: a meta-analytic review.

A meta-analysis of data from 42 independent samples examining the association of a measure of religious involvement and all-cause mortality is reported. Religious involvement was significantly associated with lower mortality (odds ratio = 1.29; 95% confidence interval: 1.20-1.39), indicating that people high in religious involvement were more likely to be alive at follow-up than people lower in religious involvement. Although the strength of the religious involvement-mortality association varied as a function of several moderator variables, the association of religious involvement and mortality was robust and on the order of magnitude that has come to be expected for psychosocial factors. Conclusions did not appear to be due to publication bias.

Research on Religion, Spirituality, and Mental Health: A Review

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.

Religious coping methods as predictors of psychological, physical and spiritual outcomes among medically ill elderly patients: A two-year longitudinal study

A total of 268 medically ill, elderly, hospitalized patients responded to measures of religious coping and spiritual, psychological and physical functioning at baseline and follow-up two years later. After controlling for relevant variables, religious coping was significantly predictive of spiritual outcome, and changes in mental and physical health. Generally, positive methods of religious coping (e.g. seeking spiritual support, benevolent religious reappraisals) were associated with improvements in health. Negative methods of religious coping (e.g. punishing God reappraisal, interpersonal religious discontent) were predictive of declines in health. Patients who continue to struggle with religious issues over time may be particularly at risk for health-related problems.

Religiousness and mental health: a review

OBJETIVO: A relacao entre religiosidade e saude mental tem sido uma perene fonte de controversias. O presente artigo revisa a evidencia cientifica disponivel sobre a relacao entre religiao e saude mental. METODO: Os autores apresentam os principais estudos e as conclusoes de uma revisao sistematica abrangente dos estudos sobre a relacao religiao-saude mental. Utilizando-se de varias bases de dados, a revisao identificou 850 artigos publicados ao longo do seculo XX. O presente artigo tambem inclui uma breve contextualizacao historica e metodologica, alem de uma atualizacao com artigos publicados apos 2000 e a descricao de pesquisas conduzidas no Brasil. DISCUSSAO: A ampla maioria dos estudos de boa qualidade encontrou que maiores niveis de envolvimento religioso estao associados positivamente a indicadores de bem estar psicologico (satisfacao com a vida, felicidade, afeto positivo e moral mais elevado) e a menos depressao, pensamentos e comportamentos suicidas, uso/abuso de alcool/drogas. Habitualmente, o impacto positivo do envolvimento religioso na saude mental e mais intenso entre pessoas sob estresse (idosos, e aqueles com deficiencias e doencas clinicas). Mecanismos teoricos da conexao religiosidade-saude mental e as implicacoes clinicas destes achados sao discutidos. CONCLUSOES: Ha evidencia suficiente disponivel para se afirmar que o envolvimento religioso habitualmente esta associado a melhor saude mental. Atualmente, duas areas necessitam de maior investimento: compreensao dos fatores mediadores desta associacao e a aplicacao deste conhecimento na pratica clinica.

Concerns about measuring "spirituality" in research.

Spirituality is increasingly being examined as a construct related to mental and physical health. The definition of spirituality, however, has been changing. Traditionally, spirituality was used to describe the deeply religious person, but it has now expanded to include the superficially religious person, the religious seeker, the seeker of well-being and happiness, and the completely secular person. Instruments used to measure spirituality reflect this trend. These measures are heavily contaminated with questions assessing positive character traits or mental health: optimism, forgiveness, gratitude, meaning and purpose in life, peacefulness, harmony, and general well-being. Spirituality, measured by indicators of good mental health, is found to be correlated with good mental health. This research has been reported in some of the worlds top medical journals. Such associations are meaningless and tautological. Either spirituality should be defined and measured in traditional terms as a unique, uncontaminated construct, or it should be eliminated from use in academic research.

Religion, Spirituality, and Health in Medically Ill Hospitalized Older Patients

Objectives: To examine the effect of religion and spirituality on social support, psychological functioning, and physical health in medically ill hospitalized older adults.

Religion, Spirituality, and Medicine: Research Findings and Implications for Clinical Practice

A growing body of scientific research suggests connections between religion, spirituality, and both mental and physical health. The findings are particularly strong in patients with severe or chronic illnesses who are having stressful psychologic and social changes, as well as existential struggles related to meaning and purpose. Recent studies indicate that religious beliefs influence medical decisions, such as the use of chemotherapy and other life-saving treatments, and at times may conflict with medical care. This article addresses the ways physicians can use such information. Spirituality is an area that makes many physicians uncomfortable, since training in medical schools and continuing medical education programs are limited. Not only do most physicians lack the necessary training, they worry about spending additional time with patients and overstepping ethical boundaries. While these concerns are valid, each can be addressed in a sensible way. Taking a spiritual history, supporting the patients beliefs, and orchestrating the fulfillment of spiritual needs are among the topics this article will address. The goal is to help physicians provide medical care that is sensitive to the way many patients understand and cope with medical illness.

Religion, Spirituality, and Health: The Research and Clinical Implications

This paper provides a concise but comprehensive review of research on religion/spirituality (R/S) and both mental health and physical health. It is based on a systematic review of original data-based quantitative research published in peer-reviewed journals between 1872 and 2010, including a few seminal articles published since 2010. First, I provide a brief historical background to set the stage. Then I review research on R/S and mental health, examining relationships with both positive and negative mental health outcomes, where positive outcomes include well-being, happiness, hope, optimism, and gratefulness, and negative outcomes involve depression, suicide, anxiety, psychosis, substance abuse, delinquency/crime, marital instability, and personality traits (positive and negative). I then explain how and why R/S might influence mental health. Next, I review research on R/S and health behaviors such as physical activity, cigarette smoking, diet, and sexual practices, followed by a review of relationships between R/S and heart disease, hypertension, cerebrovascular disease, Alzheimers disease and dementia, immune functions, endocrine functions, cancer, overall mortality, physical disability, pain, and somatic symptoms. I then present a theoretical model explaining how R/S might influence physical health. Finally, I discuss what health professionals should do in light of these research findings and make recommendations in this regard.