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Tuesday, November 26, 2013

Are Religous People at Higher Risk for Depression?

  photo 1893_Edvard_Munch_The_Scream-WR400.jpg


There is another study atheists have dredged up to show that religous experience doesn't work. This is a real study, it's international and it's part of a larger study and none of them have any intended of destroying religion per se, the larger overarching study is about depression. While atheists are promoting it in the media as a disproof of "religious experience" as a transformational thing, the study is not really about religious experience in terms of mystical or peak experience. Their only measurement of religious belief is chruch going. The main thing to remember is they are not comparing religious experience to non expedience but chruch going to non chruch going. Not only is this not refutation of my long standing argument that there are no studies showing that peak experience, mystical experience, the sense of numinous or feeling God's presence is bad for you, but this is not even a fair study of chruch going and depression becuase they didn't study charismatic churches.

Don't get me wrong, I value more than just charismatic churches. I'm strangely happy in a good quite "dead" Methodist service (drives my sister nuts). I guess it reminds me of Perkins School of Theology. Moreover, charismatic churches have their problems. I hate the concept of the "the mega chruch." I defy anyone to go to a chruch where people clapping their hands and jumping up and down and going "yea God" then feel depressed. You have to work at getting back into the depression (unless it's really clinical).

This study is just flat out wrong for several reasons.

Huff post blog, "being religious or spiritual is linked with getting more depressed."
Dr. Raj Persaud and Dr. Peter Bruggen.

Previously studies appeared to show that religious and spiritual beliefs may be protective for depression, and were associated with better well-being. It was a widely held view amongst psychiatrists (who are not, as a group, particularly religious) that religion and spirituality protected your mood from the vicissitudes of life's misfortunes.
But now, a very large study, which followed up people for a year, has found there is an opposite relationship between religious belief and depression. Religion, and even more, spirituality not tied to formal religion, appears to be unhelpful in terms of protecting you from low mood, and could even be linked with more depression.

A key finding of the study, conducted in several different counties, is that a spiritual life view predisposed to major depression, especially significantly in the UK, where spiritual participants were nearly three times more likely to experience an episode of depression than the secular group.[1]
Of course when we actually look at the study itself we find the reference to "spiritual" in the title is just a reference to church going as is the reference to "being religious." Their concept of all that those words mean is going to chruch. Of cousre we have to distinguish bewteen the coat tail riders and the study itself.  The Huff post blog guys are the coat tail riders they had nothing to do with the study they are just using it to make their point about how they hate religion.
 
The actual study is by Leurent B. Nazareth et al.
Here is he abstract on Pub med.


Abstract of the Study on Pub Med.

Psychol Med. 2013 Oct;43(10):2109-20. doi: 10.1017/S0033291712003066. Epub 2013 Jan 29.

Spiritual and religious beliefs as risk factors for the onset of major depression: an international cohort study.

Source

Mental Health Sciences Unit, Faculty of Brain Sciences, University College London Medical School, UK.

Abstract

BACKGROUND:

Several studies have reported weak associations between religious or spiritual belief and psychological health. However, most have been cross-sectional surveys in the U.S.A., limiting inference about generalizability. An international longitudinal study of incidence of major depression gave us the opportunity to investigate this relationship further.

METHOD:

Data were collected in a prospective cohort study of adult general practice attendees across seven countries. Participants were followed at 6 and 12 months. Spiritual and religious beliefs were assessed using a standardized questionnaire, and DSM-IV diagnosis of major depression was made using the Composite International Diagnostic Interview (CIDI). Logistic regression was used to estimate incidence rates and odds ratios (ORs), after multiple imputation of missing data.[2]

The results indicate that 10.5% had episode of depression in the following year,compared to 10.3% of religious participants and 7.0% of non religious. Those with strong belief were at twice the risk of depression.


Two things to look for there. First, the method it says they talked to some chruch goers (attendees) and they asked  them questions about their take on life and things relating to depression. For that they used a standardized scale of depression. Their only measure of religiosity is their chruch going and maybe some views about life. They did not use the M scale so they are not talking about actual spiritual experience. They say people with strong belief had a greater risk but how did they access strong belief? Those who go to chruch more?

A vast array of studies show that those who have religious experiences, such as peak experience, and those who particulate in a religious tradition are less likely to be depressed. A major literature search by Bonelli and Dew, et al, indicates that religious affiliation and participation are much greater hedges against depression than not being involved. They show that with 444 studies, 60% report less depression for religion/spirituality, while only 6% show more.


Depressive symptoms and religious/spiritual (R/S) practices are widespread around the world, but their intersection has received relatively little attention from mainstream mental health professionals. This paper reviews and synthesizes quantitative research examining relationships between R/S involvement and depressive symptoms or disorders during the last 50 years (1962 to 2011). At least 444 studies have now quantitatively examined these relationships. Of those, over 60% report less depression and faster remission from depression in those more R/S or a reduction in depression severity in response to an R/S intervention. In contrast, only 6% report greater depression. Of the 178 most methodologically rigorous studies, 119 (67%) find inverse relationships between R/S and depression. Religious beliefs and practices may help people to cope better with stressful life circumstances, give meaning and hope, and surround depressed persons with a supportive community. In some populations or individuals, however, religious beliefs may increase guilt and lead to discouragement as people fail to live up to the high standards of their religious tradition. Understanding the role that R/S factors play in preventing depression, facilitating its resolution, or leading to greater depression will help clinicians determine whether this is a resource or a liability for individual patients.[3]
This is a very comparable, if not more important, study than the Nazareth study becuase it summarizes 444 other studies. Now the Bonelli study shows that Pentecostals have high rates of depression. Does that disprove my statement about hand clapping at the top? No it does not. The authors give two reasons, first, the Pentecostals have high rates of depression might be because they are selected by people with depression who need cheering up. These people go the service jump up and down, feel better, and go back every Sunday because it relieves their depression. They don't go into it deeply enough, or don't seek a medical solution to overcome the problem long term.Second reason, the authors also speculate that it may be that the emphasis on evangelism causes high anxiety.[4] In any case they are using more standards for religiosity than just chruch going.[5]

The studies were rated on a scale of 1-10 from H.M. Cooper [6] "Cooper emphasized the definition of variables, validity, and reliability of measures, how representative the sample was, quality of the research methods, how well the execution of the study conformed to the design, appropriateness of statistical tests, and the interpretation of results." [7] They study followed Cooper's guide lines, with 40% rated 7 or higher. "Of these methodologically more rigorous studies, 119 (67%) found less depression, faster recovery, or greater responsiveness to R/S interventions, whereas 13 studies (7%) reported the opposite. Thus, overall, 61% of studies find less depression among the more religious, and as the quality of the study increases, this proportion remains the same or increases slightly (67%).."[8]


Another study found on Pub med says that religious people who are deeply involved in their faith have less risk of depression than those who don't. This study invovles U.S. Population:

McCullough ME, Larson DB.

Source

National Institute for Healthcare Research, Rockville, MD 20850, USA. Mike@nihr.org
People with high levels of general religious involvement, organizational religious involvement, religious salience, and intrinsic religious motivation are at reduced risk for depressive symptoms and depressive disorders. Private religious activity and particular religious beliefs appear to bear no reliable relationship with depression. People with high levels of extrinsic religious motivation are at increased risk for depressive symptoms. Although these associations tend to be consistent, they are modest and are substantially reduced in multivariate research. Longitudinal research is sparse, but suggests that some forms of religious involvement might exert a protective effect against the incidence and persistence of depressive symptoms or disorders. The existing research is sufficient to encourage further investigation of the associations of religion with depressive symptoms and disorder. Religion should be measured with higher methodological standards than those that have been accepted in survey research to date.[9]
This is also a literature search. This is part of the famous Larson study where he analyzed a number of sources. The Institute for Health Research are related to the guys who give the Tempelton prises so atheists will criticize that as bias. But it's a good source their reserach is good. It's Larson who must be be dealt with his research is good. I had one of his studies many years ago.

Columbia study by Lisa Miller:

This study found the opposite of the Nazareth study, that strong spiritual or religious beliefs may reduce the likelihood of depression. She studied 114 adult children of depressed and non depressed parents. "Miller and her team found that individuals reporting that they attached a high personal importance to religion or spirituality had approximately one-fourth the risk of other participants of experiencing major depression. Neither frequent attendance at religious services nor any particular denomination appeared to factor into participants' likelihood of suffering from a major depressive episode."[10] The Miller study has some important findings that may refute the idea of those with stronger faith being more depressed. This study found that those with stronger faith had risk depression due to a  parent being depressed, they were one tenth as likely to be depressed as other participants. They also found that self-reported religiosity/spirituality protected those at high risk for depression.


John Peteet, Harvard.

Ten year longitudinal study studied offspring of participants in an earlier decade long study and found that the offspring of the religious/spiritually committed had less risk of depression.
This well-designed study provides more striking results than previous research investigating the role that religion and spirituality can play in limiting depression," said John Peteet, M.D., an associate professor of psychiatry at Harvard Medical School and fellowship site director at the Dana-Farber Cancer Institute's Adult Psychosocial Oncology Program, who was not involved in the study. "Hopefully, it will make some psychiatrists more aware of and open to exploring spiritual resources in meeting the needs of their patients.[11]
Newberg and Waldman

The Author of Why God Wont Go Away, Adrew Newberg, did a study with M. Waldman which found that hundreds of studies show that prayer and meditation and even minimial religous commitment helps reduce risk of depression:

Hundreds of medical, neurological, psychological and sociological studies on religion [show] .... even minimal religious participation is correlated with enhancing longevity and personal health....Activities involving meditation and intensive prayer permanently strengthen neural functioning in specific parts of the brain that are involved with lowering anxiety and depression, enhancing social awareness and empathy, and improving cognitive and intellectual functioning.[12]

Abdel-Khalek and Lester study, Kuwait University

[Abstract:] INTRODUCTION: The aim of the present study was to explore the associations of religiosity with subjective well-being (SWB) and psychopathology (anxiety and depression) among college students recruited from two
different cultures, Kuwait (n = 192) and the USA (n= 158). METHOD: The students responded to the following scales in
their native languages, Arabicand English, respectively: the Oxford Happiness Questionnaire, the Love of Life Scale, the Kuwait University Anxiety Scale and the Center for Epidemiological Studies-Depression Scale. They also responded to six self-rating scales assessing happiness, satisfaction with life, mental health, physical health,religiosity and strength of religious belief. RESULTS: The Kuwaiti students obtained higher mean scores on religiosity, religious belief and depression than did their American counterparts, whereas American students had higher mean scores on happiness and love of life. Two factors were extracted: 'SWB versuspsychopathology'and'Religiosity'. CONCLUSION: Based onthe responses of the present two samples,it wasconcluded that those who consider themselves as religious experienced greater well-being.[13]
This one makes it sound like the Kuwaiti students were all depressed it say they scored high on depression. The conclusion makes it clear that it means they scored high on not being depressed. This is an important finding because there is an argument that religious commitment, participation, belief, experience, only help psychological where religion is highly valued in a culture. Atheists make this argument because they think they are showing that it's not connected to any kind of supernatural miracle that religion helps depression. Of no one says that it is supernatural. If used in apologetic it's better made as a fitness argument: we are fit to be religious that's an indication of design. There's a more subtle argument that "it works" is a sign of truth content. Ask any atheist how they know science is true they will say "it works."

The argument can also be made that U.S. is unique in religion working positively on people and in other countries the depression rates are higher for religious people. Clearly not true becuase of the Kuwaiti students. On the other hand they do live in a place where their religious commitment (presumably Muslim) is valued and encouraged. One needs to account for the specific culture in which one is working. We can assume that in situation where religion is dis-valued the religious coping skills will be harder. That just stands to reason.




Sources


[1] Dr. Raj Peraud and Dr. Peter Bruggen, "Getting Religous or Spiritual is Linked With Getting more Depressed." Huff Post Lifestyle, blog. Posted: 16/09/2013 00:00
http://www.huffingtonpost.co.uk/dr-raj-persaud/religion-depression_b_3928675.html

[2]Leurent B, Nazareth I, Bellón-Saameño J, Geerlings MI, Maaroos H, Saldivia S, Svab I, Torres-González F, Xavier M, King M. "Spiritual and religious beliefs as risk factors for the onset of major depression: an international cohort study." Psychol Med. 2013 Oct;43(10):2109-20. doi: 10.1017/S0033291712003066. Epub 2013 Jan 29.
http://www.ncbi.nlm.nih.gov/pubmed/23360581
accessed 11/25/13
Nazareth and colleagues are form Mental Health Sciences Unit, Faculty of Brain Sciences, University College London Medical School, UK.

[3] Raphael Bonelli,1 Rachel E. Dew,2 Harold G. Koenig,3,4 David H. Rosmarin,5 and Sasan Vasegh6 "Religious and Spiritual Factors in Depression: Review and Integration of the Research" Literatrere review, Depression Research and Treatment,Volume 2012 (2012), Article ID 962860,
Publsihed online reseource
Received 14 May 2012; Revised 29 June 2012; Accepted 4 July 2012

Academic Editor: Charles B. Nemeroff

Copyright © 2012 Raphael Bonelli et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

http://www.hindawi.com/journals/drt/2012/962860/
accessed 11/25/13

1Departments of Psychiatry and Neurology, Sigmund Freud University, 1030 Vienna, Austria
2Division of Child Adolescent Psychiatry, Duke University Medical Center, Durham, NC 27710, USA
3Center for Spirituality, Theology and Health, Duke University Medical Center, Box 3400, Durham, NC 27705, USA
4Department of Medicine, King Abdulaziz University (KAU), Jeddah 21589, Saudi Arabia
5Department of Psychiatry, Harvard Medical School, Boston, MA 02215, USA
6Department of Psychiatry, Ilam University of Medical Sciences, Tehran, Iran

[4] Ibid

[5] Ibid

[6] H. M. Cooper, The Integrated Research Review: A Systematic Approach, Sage, Beverly Hills, Calif, USA, 1984.

[7] Bonelli, Op cit.

[8] Ibid.


[9] McCullough ME, Larson DB. "Religion and depression: a review of the literature. "
National Institute for Healthcare Research, Rockville, MD 20850, USA. Mike@nihr.org
1999 Jun;2(2):126-36.
http://www.ncbi.nlm.nih.gov/pubmed/10480747
accessed 11/25/13

[10] Jonathan Wolfe, "Depression Recurrence Less Likely When Religion is Important." Psychiatric News, American Psychiatric Association. Oct 7 (2011). on line copy  http://psychnews.psychiatryonline.org/newsarticle.aspx?articleid=179690&RelatedNewsArticles=true
accessed 11/26/13.

[11] Ibid.

[12] Andrew Newbert, Mark Robert Waldman, How God Changes Your Brain:Breakthrough Findings From a Leading Neuroscientist. Ballaintine Books, 2010, 149.

[13] Chaplain John W. Ehman, "Spirituality and Health, a Select Biboliography of Medline indexed articles Published in 2012" Lon ine resource, pdf. revised June 14, 2013.
http://www.uphs.upenn.edu/pastoral/resed/bib2012.pdf  accessed 11/25/13. Quoting:
Abdel-Khalek, A. M. and Lester, D. [Kuwait University, Kuwait]. "Constructions of religiosity, subj
ective well-being, anxiety, and depression in two cultures: Kuwait and USA."
International Journal of Social Psychiatry58, no. 2 (Mar 2012): 138-145.



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