JOURNAL OF CLINICAL PSYCHOLOGY.

Exline, J. J., Yali, A. M. Sanderson, W. C. (2000) Guilt, discord, and alienation: The role of religious strain in depression and suicidality Vol. 56(12), 1481-1496

The authors of this article hypothesize that religious strain is associated with depression and suicidality, regardless of a person's religiosity or degree of comfort found in religion. They discuss that although religion is often considered a source of social support, it can work against people when religious conflict leaves people feeling alone or unwanted. Further, self-critical attitudes may manifest itself in religious beliefs, such as doubting that one's sins can be forgiven.

In the first study, the authors surveyed 200 undergraduates raking psychology courses at a public university. The students completed a religious comfort and strain questionnaire, which factored into one subscale for religious comfort and three subscales for religious strain (alienation from God, fear and guilt, and religious rifts). The students also completed a religiosity index, measuring the salience of one's religious beliefs and one's participation in religious activities. Last, the students filled out the Beck Depression Inventory (BDI) to assess for cognitions, affects, and behaviors related to depression.

In this study, the authors found that participants overall reported higher levels of religious comfort than strain. Further, they found that religious strain was significantly associated with depression, even when religiosity and religious comfort were held constant. The subscales of religious rifts and alienation from God were independently associated with depression.

In the second study, the authors wanted to assess when religious strain was associated with interest in addressing religious issues in treatment; they surveyed 54 adults seeking treatment in an out-patient clinic. The participants completed the same measure as the students for religious comfort and strain, an abbreviated measure of religiosity, the BDI for depression, the 19-item Suicide Ideation Scale, and a 5-point scale to rate opinions about the helpfulness of addressing religious issues in treatment.

In this study, the participants still reported higher levels of religious comfort than strain, but less comfort than the students in Study 1. As found earlier, the clinical sample also correlated religious strain with depression, specifically alienation from God as the major predictor of depression. Suicidality was also found to correlate with religious strain, and the fear and guilt subscale was the primary predictor, particularly when participants believed they had committed a sin too heinous to be forgiven. As expected, religiosity and religious strain were associated with interest in addressing religious issues in treatment.

In the Discussion section, the authors reflect that the presence of religious strain may warrant attention for treatment. They comment that future research may help determine the factors that cause people to feel alienated from God, and they specifically mention a potential factor of belief in God's grace as influencing one's sense of alienation. In regards to suicidality, the authors wonder if a suicidal client is attempting to escape the feelings of punishment by annihilating the self, and they emphasize the need for further research on forgiveness within psychology. The authors also suggest that therapists assess for the presence of religious strain in their clients, which may yield mental health benefits if the strain is addressed. In their conclusion, the authors point out that some degree of strain may be inherent in religiosity, and growth may result in constructively responding to one's suffering. Overall, this article is helpful in regards to how religion can be comforting and distressing, encouragi ng the reader to consider assessment of religious strain with his or her clients. Also helpful are examples of aspects of religious strain ,such as guilt versus godly sorrow, that help pinpoint the source of the client's pain.

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