Wednesday, November 13, 2013

Here’s to your health…maybe

Religion & Health 

Religion &

Laura attends church but her sister Ashley does not. Who is likely to live longer?

Jo announced her husband has been cancer free for two years! And she thanks God for healing in answer to prayer.

Research suggests people who attend church live longer. And many offer testimonies of healing in response to prayer. Not surprisingly, the stories are enough to peak the interest of medical and psychological scientists. Is there more to faith than superstition? Are there measurable effects linked to religious or spiritual practices? I take a look at some of the evidence. And follow up on a previous post about prayer.

We know there are some studies showing a relationship between biopsychology and spirituality. I like to use questions to carve out issues.

1. What biopsychological changes, if any, occur when people practice their faith?
2. What is the evidence for a link between spirituality and general health?
3. What is the evidence for a link between spirituality and mental health?
4. What type of relationship exists between spirituality and biopsychology?

What do all the terms mean?
You can probably guess that scientists use words like religion and spirituality in different ways. So, the answer to the question about terminology will depend on how the scientists use the words in their research reports. Let me suggest some guidelines for those new to this area of study.

Religiosity: a way of practicing faith tied to the beliefs and practices of an organized religion—for example, prayer, fasting, meditation, baptisms.

Spirituality: a relational concept—the nature of a relationship between people and their sense of the sacred. In a recent article, I drew on the distinctions by Don Davis and his colleagues who clarify the term spirituality based on the understanding of the sacred. I have included other terms at the end of this post.

1. What biopsychological changes, if any, occur when people practice their faith?
Andrew Newberg M D (neurology) has studied a large number of people who pray in tongues and meditate. He finds changes in the frontal lobes associated with such prayer. He also reports on mystical experiences and near death experiences (NDE). See youtube video.

A number of people have observed a connection between seizure activity and reports of heightened religious experience. Example: Devinsky & Lai, 2008. Also See Dr. Coles for one example.

There is some evidence linking attendance at religious services to reduced cardiovascular diseases. This includes lower risk factors such as systolic and diastolic ambulatory blood pressure and fasting glucose.

There is some evidence that forgiveness reduces stress related indices such as cortisol levels and biofeedback measures.

There is some evidence (noted under forgiveness) that the practice of forgiveness may link to changes in the limbic system components regulating anger.

There is evidence that during Muslim Dhuha prayer, prostrate posture is associated with increased alpha wave activity as measured by an electroencephalogram (EEG). Alpha wave activity has been linked to relaxation. Study by Doufesh and others (2012).

2. What is the evidence for a link between spirituality and general health?

There are some reasonably consistent findings linking attendance at religious services and a reduction in mortality.

There is some evidence suggesting that a variety of religious practices reduce stress and anxiety and thereby enhance general health and well-being. These practices include prayer, meditation, participating in community with attendant support, forgiveness, confession, and expressions of compassion toward others.

Gratitude is a common component of spirituality. Gratitude has been linked to increased exercise and fewer physical symptoms. Many benefits were obtained for a sample of adults with neuromuscular disease. See Emmons lab for more about gratitude and health.

Hope is another components of some religious traditions. For example, Christians hope in a future restoration that is both personal and for all of creation. Research on hope has been linked to increased tolerance of pain. Also, hopeful children are more likely to follow doctor's orders. Much of the work on hope can be found in publications by C. Richard Snyder (now deceased) and his colleagues.

The practice of male circumcision, a religious practice for some, has been linked to positive health benefits in some studies according to the CDC.

3. What is the evidence for a link between spirituality and mental health?
There is some evidence linking attendance at religious services to less substance abuse- alcohol, tobacco, and other drugs.

There is some evidence linking spiritual practices such as forgiveness and compassion to lower anxiety and stress and increased resiliency, hope, and peace.

Pietrini and others have studied brain correlates of responses to anger inducing stimuli using positron emission tomography (PET). The brain area involved is the limbic system tied to emotional responses and linked to the medial orbitofrontal cortex. It appears possible that ruminating about anger-inducing situations increases not only negative emotions but also interferes with the capacity to reason and elicit more peaceful responses. Additional work using functional magnetic resonance imaging (fMRI) holds promise for the effectiveness of forgiveness interventions to address biologically based emotional responsiveness.

Recently, Loren Toussaint (2012) and his colleagues studied a representative sample of the US (N = 1,232). The people were ages 66 and older. The used a number of forgiveness measures and found that conditional forgiveness of others was a significant predictor of mortality after controlling for religious, socio-economic and health behavior variables. Using a mathematical model, they find that conditional forgiveness of others influences physical health, which in turn influences mortality.

In addition to the link between gratitude and physical health, Bob Emmons and his colleagues have found links between gratitude interventions and positive mental health status such as positive moods and optimistic responses as well as increased attentiveness and energy. See Emmons lab for more on the positive effects of gratitude interventions.

4. What type of relationship exists between spirituality and biopsychology? And what are the research problems?

  • When a relationship is found, we often do not know the causal direction of the relationship. And we are not even sure what would happen if the researchers measured the variables in a different way.
  • The experimental evidence is sparse.
  • Most studies rely on self-reported survey responses, which do not necessarily represent what people actually do.
  • Most studies are correlational, which leaves open the question of what caused what?
  • In some cases, different researchers used different measures so it is hard to make comparisons across studies. For example, there are many measures of spirituality, forgiveness, and health.
  • Most studies have poor controls and offer only suggestions at potential relationships without explaining what aspect of spirituality might work within a person to produce either beneficial or harmful effects.
  • When a relationship has been documented, the direction of the benefit is often not clear. For example, the causal relationship could be one of the following:
1. Better health can yield high levels of spirituality.
2. High levels of some aspect of spirituality (e.g., prayer) can yield better health.
3. There may be cyclical patterns in which health status and spiritual status continually interact.

Is there a downside? Does religion or spirituality ever lead to negative health outcomes?
Yes. There is a downside. Here are a few examples.
Some people refuse medical treatments on religious grounds. When a highly effective procedure is denied people die or suffer pain.
Some people take actions based on religious beliefs that destroy the lives of others as in war or based on beliefs that God has ordered the death of a particular person or group of persons.
Some parents hold religious beliefs that compel them to mutilate the genitals of girls (WHO).
Some religious practices of male circumcision lead to death or infection. See for example, The Jewish Chronicle.
Some people attribute some forms of mental illness to demon possession, which would lead to prayers for deliverance rather than medical treatment. 
Some people attribute some forms of mental illness to lifestyle choices or personal sin. This becomes a problem if a serious mental illness is not treated.

Other spirituality and health links
Some religious beliefs influence choices related to sexual activity and reproductive health. The beliefs influence the probability of a woman becoming pregnant and under what conditions, if any, she may end a pregnancy. Other beliefs relate to health choices affecting fertility options, sexual orientation, and sexual activity.

The future is exciting. There is a greater openness and respect developing between people of faith and scientists interested in learning more about the connections between spirituality and many facets of health.

Most people on the planet practice some sort of spirituality. In fact, most people are connected with one of the major religions. So it becomes important to understand how spirituality connects to well-being.

In recent decades, many scientists and clinicians have seen enough potential benefit to warrant continued study to learn more about the health benefits and risks of spirituality.

There is a possibility of bias in this and my other posts. 1. I am a Christian. 2. Most research on the Psychology of Religion has been done with Christians in the USA and other Western countries. The research has gradually expanded to include people from other faith traditions.

Read more news on the Psychology of Religion on Facebook or follow me on twitter @GeoffWSutton 

More terms related to Religion and Biopsychology

Religious spirituality- when the sacred is religious
Humanistic spirituality- when the sacred is humanity
Nature spirituality- when the sacred is nature
Transcendent spirituality- when the sacred is beyond the physical body- for example spirit
Biopsychology- the study of the interaction between the brain and behavior. Essentially, all of psychology is biopsychology in that all behavior is linked to biological structures and processes.
NDE- near death experiences
Neurotheology- the study of the relationship between spirituality and the human brain.
Theobiopsychosocial model-- a term I constructed to capture the idea that people are holistic beings— we have several dimensions: Spiritual, cognitive (thoughts, beliefs, mental images), emotional (feelings, motivations), physical, and behavioral (observable behavior patterns), which operate within a social context.
Health—I use the word health to refer to one’s general wellbeing with an emphasis on those aspects normally addressed by physicians, nurses, and psychologists in western cultures. When only referring to the brain-behavior states or disorders I will use the common term, mental health.

Additional Sources

 Berg, C.J., Rapoff, M., Snyder C.J., & Belmont, J.M. (2007). The relationship of children’s hope to pediatric asthma treatment adherence. Journal of Positive Psychology, 176-84.

Bergin, A. E. & Richards, P. S. (2000). Religious values and mental health. In A. E. Kazdin (Ed.).  Encyclopedia of psychology, Volume 7, (pp. 59-62). Washington, DC: American Psychological Association.

Davis, D. E., Hook, J. N., Van Tongeren, D. R., Gartner, A. L., & Worthington, E. L., Jr. (2012). Can religion promote virtue? A more stringent test of the model of relational spirituality and forgiveness. The International Journal of the Psychology of Religion, 22, 252-266.

Hill, P. C. & Pargament, K. I. (2003). Advances in the conceptualization and measurement of religion and spirituality: Implications for physical and mental health research. American Psychologist, 58, 64-74. DOI: 10.1037/0003-066X.58.1.64

Holt-Lunstad, J., Steffen, P.R., Sandberg, J., & Jensen, B. (2011). Understanding the connection between spiritual well-being and physical health: an examination of ambulatory blood pressure, inflammation, blood lipids and fasting glucose. Journal of Behavioral Medicine, 34, 477-488. DOI 10.1007/s10865-011-9343-7

Newberg, A. & Newberg, S. (2010). Psychology and neurobiology in a postmaterialist world. Psychology of Religion and Spirituality, 2, 119-121.

Synder, C.R. et al. (2005). Hope against the cold: Individual differences in trait hope and acute pain tolerance on the cold pressor task.  73 Journal of Personality, 287-312.

Thoresen, C. E. & Harris, A. H.S. (2004). Spirituality, religion, and health: A scientific perspective. In J. M. Raczynski & L. C. Leviton, (Eds.), Handbook of clinical health psychology, Volume 2: Disorders of behavior and health (pp. 269-298). Washington, DC: American Psychological Association.

Toussaint, L L, Owen A D, Cheadle, A. (2012). Forgive to live: forgiveness, health, and longevity. Journal of Behavioral Medicine, 35, 375-386. DOI 10.1007/s 10865-011-9362-4
Worthington, E. L. Jr., Witvliet, C V O, Pietrini, P. Miller A J 2007 Forgiveness, health, and well-being: A review of evidence for emotional versus decisional forgiveness, dispositional forgivingness, and reduced unforgiveness. Journal of Behavioral Medicine, 30, 291-302. DOI 10.1007/s 10865-007-9105-8

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