Faith and Health: Psychological Perspectives

Overview

This volume reviews and integrates the growing body of contemporary psychological research on the links between religious faith and health outcomes. It presents up-to-date findings from empirical studies of populations ranging from healthy individuals to those with specific clinical problems, including cancer, HIV/AIDS, and psychological disorders. Drawing on multiple perspectives in psychology, the book examines such critical questions as the impact of religious practices on health behaviors and health risks; ...
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Overview

This volume reviews and integrates the growing body of contemporary psychological research on the links between religious faith and health outcomes. It presents up-to-date findings from empirical studies of populations ranging from healthy individuals to those with specific clinical problems, including cancer, HIV/AIDS, and psychological disorders. Drawing on multiple perspectives in psychology, the book examines such critical questions as the impact of religious practices on health behaviors and health risks; the role played by faith in adaptation to illness or disability; and possible influences on physiological functioning and mortality. Chapters reflect the close collaboration of the editors and contributing authors, who discuss commonalities and differences in their work, debate key methodological concerns, and outline a cohesive agenda for future research.
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Editorial Reviews

From the Publisher

"...a very useful compendium....Faith and Health provides food (manna?) for thought and for reflection and the editors should be complimented for the care with which they have defined the problems. The book will provide a valuable summary of current research and much needed caveats about too much rapture about conclusions."--Medscape

"Kudos to Plante, Sherman, and their contributors. This fine volume demonstrates that the study of religion and health is not a passing fancy. Faith and Health presents an up-to-date, comprehensive account of the impressive advances that are taking place in theory, research, and practice. It reveals a field whose landscape is shifting to greater richness and complexity. Wonderfully balanced, the book helps bridge the gap between openness and skepticism, the bitter and the sweet, what we know and what questions remain. This cutting-edge volume should find its place in the library of every student of religion and health."--Kenneth I. Pargament, PhD, Department of Psychology, Bowling Green State University, author of The Psychology of Religion and Coping: Theory, Research, Practice

"The study of religion, spirituality, and health is one of the most intriguing and controversial areas of health science. This volume provides a much needed survey of progress to date in this field. The book is an ideal introduction to the findings and methodological challenges in the study of religion and health, and will be of great use to researchers and students alike. I highly recommend it."--Norman Anderson, PhD, Professor, Harvard School of Public Health, Former Associate Director, National Institutes of Health

"With the emerging interest in positive psychology, the scientific study of religion has resurfaced as a compelling focus for research. And, in this new field, there can be no more fascinating question than whether religious faith influences beliefs, emotions, and behaviors that are relevant to health and illness. Plante and Sherman have assembled an excellent volume that examines the health consequences of religious practice and faith. The range of perspectives is impressive, from the historical to the psychoneuroimmunological, with a strong emphasis on application. This is a book with a broad audience, and I am likely to use it in my undergraduate and graduate courses in the psychology of emotion and health psychology. Allied health professionals will find much of interest here as well."--Peter Salovey, PhD, Department of Psychology, Yale University

"This rich and wide-ranging collection of essays offers essential resources for addressing the highly complex issues raised by the search for relationships between religion or spirituality and health. No researcher in the field can afford to be uninformed by the provocative findings, trenchant criticisms, and astute recommendations that fill this volume, just as no practitioner should undertake religion-related interventions without considering the scientific, ethical, and practical issues raised therein."--David M. Wulff, PhD, Department of Psychology, Wheaton College

Doody's Review Service
Reviewer: Patricia E. Murphy, PhD (Rush University Medical Center)
Description: This is an edited book by authors who have been in the forefront of research in religion and health. The chapters provide both a report of the research by topic as well as a chapter on the problems about design and data analysis in religious and health research in general. It also includes a chapter on the ramifications for clinical practice.
Purpose: "The book aims to provide an updated assessment of what we know about the relationship of faith and health with a focus on both research and clinical agenda. "
Audience: Those interested in the ongoing debate about the research in religion and health will enjoy this work. Clinicians might find some of the suggestions for assessment quite helpful. The researcher will benefit from the explication of some of the pitfalls in research in this field.
Features: "In addition to reporting current research, the book also includes some of the public criticism of this area. The chapter pointing to design flaws and issues about statistical analyses has much to offer. The chapter describing instruments used to measure aspects of religion and spirituality will be very useful for the researcher. "
Assessment: The book is worthwhile for the interested researcher. The research reviewed comes from a variety of sources, some respected journals and some with less rigorous review processes. The book would have more to offer if it had included the careful kind of analysis of the quality of each study that Koenig provides in Handbook of Religion and Mental Health (Academic Press, 1998).
From The Critics
Reviewer: Patricia E. Murphy, PhD(Rush University Medical Center)
Description: This is an edited book by authors who have been in the forefront of research in religion and health. The chapters provide both a report of the research by topic as well as a chapter on the problems about design and data analysis in religious and health research in general. It also includes a chapter on the ramifications for clinical practice.
Purpose: "The book aims to provide an updated assessment of what we know about the relationship of faith and health with a focus on both research and clinical agenda. "
Audience: Those interested in the ongoing debate about the research in religion and health will enjoy this work. Clinicians might find some of the suggestions for assessment quite helpful. The researcher will benefit from the explication of some of the pitfalls in research in this field.
Features: "In addition to reporting current research, the book also includes some of the public criticism of this area. The chapter pointing to design flaws and issues about statistical analyses has much to offer. The chapter describing instruments used to measure aspects of religion and spirituality will be very useful for the researcher. "
Assessment: The book is worthwhile for the interested researcher. The research reviewed comes from a variety of sources, some respected journals and some with less rigorous review processes. The book would have more to offer if it had included the careful kind of analysis of the quality of each study that Koenig provides in Handbook of Religion and Mental Health (Academic Press, 1998).

3 Stars from Doody
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Product Details

  • ISBN-13: 9781572306820
  • Publisher: Guilford Publications, Inc.
  • Publication date: 8/28/2001
  • Edition description: New Edition
  • Edition number: 1
  • Pages: 416
  • Product dimensions: 6.00 (w) x 9.00 (h) x 1.30 (d)

Meet the Author


Thomas G. Plante, PhD, is Associate Professor and Chair of the Psychology Department at Santa Clara University. He is also Clinical Associate Professor of Psychiatry and Behavioral Sciences at Stanford University School of Medicine, and Consulting Associate Professor in the School of Education at Stanford University. The author or editor of several books and more than 80 journal articles, Dr. Plante is a licensed psychologist, Diplomate in Clinical Psychology, and Fellow of the American Psychological Association. His research interests include faith and health, ethics, and the psychological benefits of exercise. He has a private practice in Menlo Park, California.

Allen C. Sherman, PhD, is Clinical Director of Behavioral Medicine and Associate Professor in the Department of Otolaryngology at Arkansas Cancer Research Center, University of Arkansas for Medical Sciences. He is a licensed psychologist and marriage and family therapist. Dr. Sherman's research focuses on quality of life and psychosocial adjustment among cancer patients, psychological interventions, and psychosocial predictors of disease outcome.

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Read an Excerpt

Faith and Health

Psychological Perspectives

The Guilford Press

Copyright © 2001 The Guilford Press
All right reserved.

ISBN: 1-57230-682-3


Chapter One

RESEARCH ON FAITH AND HEALTH

New Approaches to Old Questions

THOMAS G. PLANTE ALLEN C. SHERMAN

In recent years there has been a surge of interest in relationships between religious faith and health. Domains that traditionally have been viewed as separate are coming together in new ways. This heightened interest is evident not only in academic conferences and journals but also in the popular press. Social and biomedical scientists have focused on religion for more than 100 years and have forged a rich research tradition within psychology, as well as in sociology, gerontology, epidemiology, and nursing (e.g., Durkheim, 1897/1951; James, 1902/1985; Osler, 1910; for reviews see Johnstone, 1997; Levin & Vanderpool, 1991; Wulff, 1991). Typically, however, this work was regarded with a measure of indifference or derision within mainstream psychology and medicine (Levin & Schiller, 1987; Wulff, 1991). Science and faith were viewed as separate worlds with little common ground. Thus the breadth and intensity of current interest, particularly with respect to health, represents a significant change. The landscape has shifted.

Does religious faith influence health? Are religious practices associated with altered risks for morbidity or mortality? Do religiousor spiritual individuals tend to enjoy better well-being or mental health across the lifespan? Does spiritual or religious involvement change the way individuals adapt to the demands of chronic illness? This volume brings together some of the leading investigators who have explored these intriguing questions. Though research is in its early phases, the chapters that follow review some of what we have learned and begin to trace the outlines of the many mysteries that remain.

FAITH AND HEALTH: IRRECONCILABLE DIFFERENCES?

Historically, religion and healing have been closely tied. In Western culture, according to Kuhn (1988), the first known medical license was issued by the church in the 12th century; the license was forfeited in the event of excommunication. These links were largely eroded as medicine became increasingly grounded in Enlightenment rationalist sensibilities and Cartesian philosophy of science, which viewed mind and body as fundamentally separate. The body and corporeal world were seen as the appropriate focus for science, whereas the mind and soul were the purview of the church. Over the past several decades, the dualistic, biomedical model that evolved from this perspective has been increasingly supplanted by a broader, biopsychosocial paradigm (Engel, 1977). Health and illness are viewed as a reflection of reciprocal interactions among biological, psychological, and social influences. This change has been driven in part by massive evidence that psychological and cultural factors have an important impact on health. Is it possible that religious faith is among the tapestry of psychosocial factors that influence health and morbidity?

Some individuals are uncomfortable with inquiry in this area. Methodological and ethical objections have been raised both by scientists (Sloan, Bagiella, & Powell, 1999) and by clergy (Christian Century, 1999). Interestingly, some of these reservations would sound familiar to social scientists who embarked on the study of religion a century ago. Some researchers have been hesitant to endorse this line of investigation because the methodological and conceptual challenges seem too daunting. How can one approach scientifically something so ineffable, intangible, and mysterious as religious experience? The arena seems inherently too "fuzzy" and obscure to be conducive to empirical investigation. As noted, however, there is a long history of research on religion in the social and health sciences; although the scientific rigor of these studies varies widely, a broad foundation is in place to support investigations concerning the health correlates and consequences of faith. Moreover, as in any complex field of study, one can expect the methodology to become more rigorous and the questions more refined as the field progresses.

Conversely, another objection is that scientific inquiry will obscure the vitality and richness of religious expression. Attempts to approach religion from a scientific vantage point are destined to be grossly reductionistic and oversimplified. Clearly, spirituality is, at its core, intensely personal and experiential, and cannot be distilled in a test tube or captured on a questionnaire. The question is whether there are modest traces of the experience that are conducive to scientific investigation, and that can be approached in a meaningful way. We believe the answer to that question is yes, that the question can be approached in much the same manner in which investigators have sought to explore other complex, dynamic experiences (e.g., emotions, family dynamics) without confusing the map with the territory.

Others have objected that focusing on the health correlates of religiousness conveys an implicit message that religion should be evaluated based on whether it is functional according to some arbitrary criterion: "Does it work?" Challenging a utilitarian approach to religion, VandeCreek (1999) argues that "such attempts are degrading to religious faith and practice whose driving force can never be intentional self-enhancement.... We need to remind ourselves regularly that true religiousness is a positive end in itself even if it contributes to poorer health" (pp. 200-201). Obviously, irrespective of whether some aspects of religious observance are associated with favorable or unfavorable health outcomes for some individuals, the value of a religious life rests on much broader concerns and commitments. Health researchers do not study religion per se; they do not "test" the veracity of doctrinal beliefs or pass judgment on the merits of different theological positions (Hood, Spilka, Hunsberger, & Gorsuch, 1996). Happily, their task is much more modest and prosaic-to study the psychosocial functioning and medical status of human beings engaged in religious pursuits.

TRACING THE CONNECTIONS BETWEEN FAITH AND HEALTH

In their attempts to understand the relationships between psychosocial factors and health, health psychologists have focused on several broad areas of inquiry. One area concerns health behaviors and beliefs, which influence risk of morbidity and mortality (e.g., diet, smoking, alcohol consumption, hygiene, contraceptive use, seeking medical care). A second area concerns adjustment to illness (e.g., coping, quality of life). Life may change in dramatic ways in response to a particular disease-how do patients and their families manage these burdens? A third area concerns physiological functioning and disease end points. How do psychosocial factors influence neuroendocrine activity, immune function, or disease onset and progression?

Religious or spiritual involvement may have relevance for each of these broad areas. It is widely recognized that some health behaviors, such as alcohol consumption or premarital sex, are strongly influenced by religious proscriptions among certain religious communities (Levin & Vanderpool, 1991; Vaux, 1976). As Van Ness (1999) wryly observes, "violent deaths among pacifist Quakers and automobile fatalities among the mostly pedestrian Amish are relatively infrequent" (p. 17). The health implications of religious guidelines are usually positive (e.g., lower rates of smoking-related cancer among Mormons; Troyer, 1988), but they may be negative as well. For example, teenagers from denominations with strict prohibitions against drinking are more likely than other adolescents to abstain from alcohol, but they may be at elevated risk for binge drinking when they decide to indulge (Kutter & McDermott, 1997). Aside from their impact on risky health behaviors, religious beliefs may also shape attitudes toward preventative health practices, such as contraceptive use, cancer screening, and vaccinations (Conyn-van Spaendonck, Oostgvogel, van Loon, van Wijngaarden, & Kromhout, 1996; Erwin, Spatz, Stotts, & Hollenberg, 1999, Studer & Thornton, 1987)

Once an illness is diagnosed, religiousness or spirituality may also be important in understanding how individuals adapt. A growing number of studies have focused on faith as a resource for coping with illness and its impact on adjustment and quality of life (Baider et al., 1999; Hughes, McCollum, Sheftel, & Sanchez, 1994; Keefe et al., 2000; Koenig, Pargament, & Nielsen, 1998; Saudia, Kinney, Brown, & Young-Ward, 1991; Tix & Frazier, 1998). In the wake of a debilitating disease, religion may offer a reassuring sense of comfort, a source of social support from other church members, a framework for deriving meaning in adversity, or guidelines for how to cope. Alternately, for a Christian Scientist who has recently discovered a breast lump, religious convictions may contribute to dangerous avoidance of conventional medical care. For a lesbian woman raised in a Fundamentalist Church, with HIV, religion may evoke depleting feelings of shame and guilt. How patients interpret symptoms, define the type of assistance that is needed, and communicate about their problems may all be colored by religion (Walsh, 1999).

More provocatively, religious or spiritual engagement may influence physiological functioning and host vulnerability to disease. A growing number of epidemiological studies point to connections between attendance at services and all-cause mortality among community residents (e.g., Hummer, Rogers, Nam, & Ellison, 1999; Oman & Reed, 1998; Strawbridge, Cohen, Shema, & Kaplan, 1997; McCullough, Hoyt, Larson, Koenig, & Thoresen, 2000; see McCullough, Chapter 3, this volume). Other studies have examined associations between religiousness and survival among individuals who are seriously ill (e.g., Kune, Kune, & Watson, 1992; Oxman, Freeman, & Manheimer, 1995; Ringdal, 1996). These findings are intriguing, though their interpretation is not without controversy (see Sloan, Bagiella, & Powell, 1999; Sloan, Bagiella, & Powell, Chapter 14, this volume). Relative to the large number of population-based studies on religion and health, there are fewer clinical studies that examine medical outcomes among patients with established disease (e.g., myocardial infarction among patients with coronary heart disease), and still fewer physiological investigations that focus on putative mechanisms of action (e.g., ischemic episodes). Moreover, most studies have examined only very narrow aspects of religion and spirituality, such as church attendance. Nevertheless, research in these areas is expanding rapidly, and our knowledge base is apt to become appreciably more sophisticated in the next few years.

Aside from the potential impact of religious faith on health, interesting questions are also being raised about the potential impact of health on faith (Andrykowski et al., 1996; Collins, Taylor, & Skokan, 1990; Feher & Maly, 1999; Moschella, Pressman, Pressman, & Weissman, 1997). How does a brush with serious illness or disability influence one's spiritual concerns? Under what circumstances does illness usher in stronger faith or painful doubts? How do these responses change over time, and how do they color other areas of life?

Thus there are compelling reasons for both health professionals and students of religion to focus on the interface between religion and health. For those interested in health, religious orientation carries with it a broad array of potential health influences, risk moderators, and coping responses, both positive and negative. For those interested in religion, major health changes are among the nodal transitions in life that may call forth the deepest spiritual needs and responses. There is ample room for collaboration.

DEFINING RELIGIOUSNESS AND SPIRITUALITY: BEYOND THE QUAGMIRE

Among the innumerable challenges of studying religion and health, one of the most fundamental problems concerns definitions. Religiousness and spirituality are both complex, multidimensional constructs-how are they best defined and distinguished? Like love, most of us "know it when we see it," but operationalizing these terms proves elusive. Unfortunately, research, theory building, and clinical coordination all require some reasonable consensus about how these terms are to be delineated.

Despite more than a century of research and theoretical work devoted to religion, there is no widely accepted definition. Research on spirituality is of a more recent vintage, and attempts to define it are even more challenging. Some writers have steadfastly refused to address issues of definition, whereas others have devoted endless pages to it (Hood et al., 1996). Most would probably agree with the conclusion reached by sociologist J. Milton Yinger more than 30 years ago: "any definition of religion is likely to be acceptable only to its author" (1967, cited by Hood et al., 1996, p. 4). For most health researchers, "religion" involves a social or institutional dimension. It includes the theological beliefs, practices, commitments, and congregational activities of an organized institution. "Spirituality" has increasingly come to mean a more personal experience, a focus on the transcendent that may or may not be rooted in an organized church or a formal creed (Burkhardt, 1989; Fetzer Institute/National Institute on Aging, 1999; King, Speck, & Thomas, 1994). Not everyone accepts these distinctions, however. Investigators in the field of psychology of religion often use the terms "personal religion" or "faith" to encompass some of what health researchers usually mean by "spirituality"-internalized beliefs and experiences, as opposed to the social and institutional aspects of organized religion (Hood et al., 1996; Wulff, 1991). "Religion" is seen as reflecting both personal and institutional qualities (Hill et al., 1998; Pargament, 1997). And, of course, the personal and social domains of religion are not always readily separated.

Just as definitions of religion differ in their emphasis on personal versus institutional dimensions, they also differ in their emphasis on substantive versus functional perspectives. Substantive approaches try to illuminate the central characteristics of religion, such as beliefs about God or the sacred, whereas functional approaches are concerned with how individuals make use of religion (e.g., as a means of managing the ultimate, existential challenges in life; Pargament, 1997; Zinnbauer et al., 1997). Pargament (1997) offers a useful definition that attempts to combine substantive and functional approaches.

Continues...


Excerpted from Faith and Health Copyright © 2001 by The Guilford Press. Excerpted by permission.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
Excerpts are provided by Dial-A-Book Inc. solely for the personal use of visitors to this web site.

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Table of Contents


1. Research on Faith and Health: New Approaches to Old Questions, Thomas G. Plante and Allen C. Sherman
I. Faith and Health in the General Population: Research and Theory
2. Spirituality, Religion, and Health: Evidence, Issues, and Concerns, Carl E. Thoresen, Alex H. S. Harris, and Douglas Oman
3. Religious Involvement and Mortality: Answers and More Questions, Michael E. McCullough
4. Religious Involvement and Health Outcomes in Late Adulthood: Findings from a Longitudinal Study of Women and Men, Paul Wink and Michele Dillon
5. Unforgiveness, Forgiveness, Religion, and Health, Everett L. Worthington, Jr., Jack W. Berry, and Les Parrott III
6. Assessment of Religiousness and Spirituality in Health Research, Allen C. Sherman and Stephanie Simonton
II. Faith and Health in Special Populations
7. Religious Involvement among Cancer Patients: Associations with Adjustment and Quality of Life, Allen C. Sherman and Stephanie Simonton
8. Religion and Health in HIV/AIDS Communities, R. Corey Remle and Harold G. Koenig
9. Tobacco and Alcohol Use among Young Adults: Exploring Religious Faith, Locus of Health Control, and Coping Strategies as Predictors, A. Sandra Willis, Kenneth A. Wallston, and Kamau Johnson
10. Religious Faith and Mental Health Outcomes, Thomas G. Plante and Naveen K. Sharma
III. Faith and Health in the Clinic
11. Assessing Religious and Spiritual Concerns in Psychotherapy, John T. Chirban
12. Spiritual Interventions in Healing and Wholeness, Siang-Yang Tan and Natalie J. Dong
13 Religious Beliefs, Attitudes, and Personal and Professional Practices of Physicians and Psychologists Specializing in Rehabilitation Medicine, Edward P. Shafranske
IV. Commentaries on Research Concerning Faith and Health
14. Without a Prayer: Methodological Problems, Ethical Challenges, and Misrepresentations in the Study of Religion, Spirituality, and Medicine, Richard P. Sloan, Emilia Bagiella, and Tia Powell
15. Religion and Spirituality in the Science and Practice of Health Psychology: Openness, Skepticism, and the Agnosticism of Methodology, Timothy W. Smith
16 Conclusions and Future Directions for Research on Faith and Health, Allen C. Sherman and Thomas G. Plante
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