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Spiritual and Religious Factors in Depression : The State of the Science. Michael E. McCullough University of Miami. Religion and Health: Damned by Overstatement?.

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Spiritual and religious factors in depression the state of the science l.jpg

Spiritual and Religious Factors in Depression : The State of the Science

Michael E. McCullough

University of Miami

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Religion and Health: Damned by Overstatement? the Science

“Based on the research data we how have at hand, your doctor could--from a strictly scientific point of view--recommend religious involvement to improve your chances of being able to . . . Stay healthy and avoid life-threatening and disabling diseases like cancer and heart disease...[and] live longer.” (p. 15).

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Religion and Health: Damned by Understatement? the Science

“Serious methodological and empirical issues continue to plague the literature on religion and health. Even well-conducted studies demonstrate only a weak or nonexistent association.” (p. 350)

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Our Approach the Science

  • Based on ALL available evidence, what can we say about the relationship of religious/spiritual factors and health (viz., depression)?

  • For whom, and under what conditions, does the association apply?

  • What do we know about the temporal dynamics of the association?

  • What are the active ingredients?

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Religiousness and Well-Being in Adulthood the Science

  • Meta-analysis of 56 effect sizes

  • Mean ES of r = .16

  • Mean ES for religious activity of r = .18

  • Mean ES for subjective religiousness of r = .13

    Witter et al. (1985)

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N the Science = 34,706, National Opinion Research Center, 1972-1996

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Dimensions of Religiousness and Likelihood of Diagnosis with Nine Major Mental Disorders

Kendler et al., 2002

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Religiousness and Recovery from Depression Nine Major Mental Disorders

  • 87 patients aged  60 admitted for physical illness with co-morbid depression.

  • Patients with higher intrinsic religiousness scores (score range 10-50) experienced faster recovery

  • Every 10 point increase in intrisinc religiousness score associated with 70% increase in speed of remission.

  • Koenig HG, et al.Am J Psychiatry 1998;155(4):536-542

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Meta-Analysis Nine Major Mental Disorders

  • A family of statistical methods for aggregating observations from multiple studies

  • Each study contributes an estimate of the association of religious involvement and mortality

  • Estimates aggregated into one population estimate

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Advantages of Meta-Analysis Nine Major Mental Disorders

  • Allows researchers to examine the consistency of findings across studies

  • Permits statistically based estimates for an entire body of research

  • Permits empirical investigation of the sources of variability among studies

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Weaknesses of Meta-Analysis Nine Major Mental Disorders

  • Garbage In, Garbage Out

  • Apples and Oranges

  • Publication Bias (or the “File Drawer” Problem)

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150 Studies Nine Major Mental Disorders

Mean Correlation of Religiousness and Depressive Symptoms = -.126

Findings almost = for both genders and across ethnic groups

Effects of Positive vs. Negative Religious Coping

Effects of Intrinsic vs. Extrinsic Religiousness

Age differences


Smith, McCullough, & Poll, 2003

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Religious and Spiritual Coping With Stress Nine Major Mental Disorders

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Stress Buffering Effects Nine Major Mental Disorders

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How Do People Use Religious and Spiritual Beliefs to Cope? Nine Major Mental Disorders

  • Styles of Religious Coping

    • Self-Directing

    • Deferring

    • Collaborative

  • Specific Ways of Religious Coping

    • Positive vs. Negative

    • Specific Religious Coping Processes (Demonic Reappraisal, Seeking Congregational Support, etc.)

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Pargament, Smith, Koenig, & Perez, 1998 Nine Major Mental Disorders

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Exploring Temporal Dynamics Nine Major Mental Disorders

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Religion and Age-Related Declines in Self-Rated Health al., 2004)

McCullough & Laurenceau, 2005

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Spiritual Strengths al., 2004)

  • Gratitude

  • Forgiveness

  • Hope/Optimism

  • Humility/Accurate Self-Esteem

  • Control of the Self

  • (Giving and Receiving) Love

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The Religion-Mental Health Connection: Not Magic al., 2004)

“It seems to me most important for the whole problem of religion and health to recognize that the magical world view is not religion. . .Religion is not magic, and magic is not religion.”

Paul Tillich, 1958, “Religion and Health”