Journal File.

This section of the Journal attempts to keep readers informed of current resources of an integrative nature or those related to the general field of the psychology of religion appearing in other professional journals. A wide range of psychological and theological journals are surveyed regularly in search of such resources. The editor of the Journal File welcomes correspondence from readers concerning relevant theoretical or research articles in domestic or foreign journals which contribute directly or indirectly to the task and process of integration and to an understanding of the psychology of religion.

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JOURNAL OF CLINICAL PSYCHOLOGY 

Rochlen, A., Zach, J., & Speyer, C. (2004).

Online Therapy: Review of relevant definitions, debates, and current empirical support.

Vol. 69(3), 502-510.

This article reviews the most recent literature addressing the definitions, ethical considerations, and potential strengths and limitations of online therapy. The integration of technology with the practice of psychotherapy has been a salient topic of debate and discussion within the past 10 years. One point of agreement is that online mental health services are under way and likely to expand in the future.

The authors define online therapy as "any type of professional therapeutic interaction that makes use of the Internet to connect qualified mental health professionals and their clients." Today, the majority of online therapy takes place via e-mail. Pricing arrangements include flat fees for standard message lengths, by-the-minute charges for time spent replying, or package deals for a set number of e-mails. Less common is the practice of synchronous online therapy that takes place in real time, often using instant messaging interfaces. As high-speed Internet connections become more prevalent, therapists are beginning to use videoconference sessions.

The most frequently cited benefit of online therapy is convenience and increased access for both clients and therapists. Online therapy has the potential to serve people with limited mobility, time restrictions, and limited local access to mental health services. Also, observers of Internet behavior have noticed a disinhibiting effect of online communication, which encourages therapeutic expression and self-reflection. Clients tend to "cut to the chase" of core issues. Another benefit of online therapy is that the contemplative process of writing about one's problems or conflicts may in itself be therapeutic for some clients.

Some online therapy supporters claim that text-only communication carries clients past the distracting, superficial aspects of a person's existence and connects the person more directly to the other's psyche. This feeling of being in someone's presence without sharing any immediate physical space is called telepresence.

The article also noted some challenges in the therapeutic process of online therapy. The first and most important con is the lack of visual cues. Because there is no access to non-verbal behaviors, certain therapeutic approaches will be limited or ruled out. Along with this lack of visual input is the potential risk for misreading or misunderstanding. There are also the difficult issues of time delay, writing skill deficiency, restricted crisis intervention, and identity theft.

The authors suggest that one way to mitigate the challenges of online therapy is to carefully screen clients and to work only with those who will be able to benefit from the service. Ideally, clients should be drawn from outpatient settings, but not hospitals or inpatient units.

Regarding the type of therapist best suited for online therapy, he or she must be comfortable with computers and communicating through text. The authors consider ethics the most important factor. An ethical online therapist should acquire additional specialized training, either through self-study or formal seminars, while also joining professional organizations devoted to the practice of online mental health.

CLINICAL PSYCHOLOGY REVIEW

Luecken, L., & Lemery, K. (2004).

Early caregiving and physiological stress responses.

Vol. 24, 171-191.

Inadequate early caregiving has been associated with risks of stress-related psychological and physical illnesses over the life span. The authors argue that unusual physiological stress responses may show how early caregiving is linked to health outcomes. This article reviews evidence linking early caregiving to physiological responses that can increase vulnerability to stress-related illness.

There are a number of high-risk family characteristics that contribute to the development of stress vulnerability. The authors describe them as conflict, parental loss, divorce, abuse, poor affection, and parental depression. These environmental factors can permanently alter and hardwire the early postnatal brain.

The article summarizes some research on the long-term neurobiological impact of early caregiving. The strongest demonstrations have used animal models of maternal separation. For example, research done by Kuhn, Pauk, & Schanberg (1990) showed that rat pups separated from their mothers have a series of physiological changes including decreased serum growth hormone secretion and increase of other hormonal secretions. For monkeys, maternal separation has been shown to result in long-term physiological changes including increases in heart rate, plasma cortisol, cerebrospinal fluid, and cortisol reactivity during stress.

Animal models have also shown that independent of maternal separation, the quality of caregiving can also impact the development of physiological stress responses. Rosenblum and Andrews (1994) found that in monkeys, erratic and dismissive parenting was associated with nor-epinephrine hyper-reactivity.

Although less conclusive, there is growing evidence from studies with human infants and children that is supportive of the findings from animal models. For human infants, appropriate responses of the caregiver may promote the development of adaptive physiological responses to stress. The primary caregiver plays a critical role in the regulation of stress responses by modulating the physiological arousal of infants as they explore the environment, and by soothing these infants when they become overly stressed and aroused.

The authors describe three theoretical pathways linking caregiving to physiological stress responses. The first conduit is the genetic factor, including parental traits, genetic vulnerabilities, temperament, and gene-environment interaction. Another way parental traits correlate with children is through psychosocial factors such as depression, anxiety, hostility, and social isolation. The third theoretical pathway illustrated by the authors is the cognitive-affective factor including self-regulatory ability, coping, threat appraisal, and emotion regulation.

The article concludes with the authors suggesting directions for future research. They acknowledge that there is limited empirical research examining physiological responses following the high-risk family characteristics put forth in this paper. Furthermore, the mechanisms behind the influences of early caregiving on long-term physiological responses have yet to be determined.

THE JOURNAL OF PHILOSOPHY

Borges, M. (2004).

What can Kant teach us about emotions?

Vol 101(3), 140-158

In this article, the author analyzes Kant's theory of emotions by challenging two models that have been used to explain his theory. Borges begins by critiquing Sabini and Silver's position. Their position is that for Kant, emotions follow the pain model: they are precognitive and involuntary phenomena. They claim that emotions have no moral value because they follow the pain model. Just like pain, which is a fact about humans regardless of values, emotions do not fall under the command of reason. If morality is the will expressed in action, then we are responsible for our morality. But emotions are beyond the will, and therefore have no intrinsic moral value.

Sabini and Silver describe emotions as precognitive: they are mere undifferentiated states of the sympathetic nervous system. They say that emotions, like pain, are nothing more than the stimulation of nerves, disconnected from values, character, and reason.

The second model the author evaluates is by Baron, who criticizes the Sabini/Silver position by objecting that the pain model is not the one Kant uses for explaining emotion. Baron's position is very different from Sabini and Silver's position. She states that according to Kant, we are responsible for our emotions. Baron uses the example of emotions like sympathy and gratitude, which can be cultivated.

Finally, Borges offers her own position. She argues that both interpretations of Kant are misleading. First of all, she shows that there is not a unique model for emotions in any of Kant's writing. In his work, there is a continuum from uncontrollable emotions, like anger, to those that are capable of being cultivated and rationally controlled. The voluntariness or involuntariness of emotions, as well as their capacity for being cultivated, depends on their relation to the passive, reactive, or active self.

Secondly, Borges argues that Kant's account of emotion includes both physiological aspects and cognitive contents, which are mainly evaluative beliefs. Kant never even used the word emotion. We have termed emotion what Kant called affect, moral feeling, and passions. These inclinations are mainly related to the faculty of pleasure and displeasure, and to the faculty of desire. The former is a result of bodily sensations or imaginations, while the latter is triggered by a concept or idea. She attempts to illustrate that emotions can originate physiologically or cognitively.

The author concludes by proposing that Kant believed we are not responsible for emotion, although we can be held responsible for action motivated by emotion. The key to understanding emotions is to grasp their complexity and the different weight of rational and irrational components each emotion possesses.

PROFESSIONAL PSYCHOLOGY: RESEARCH AND PRACTICE

Hathaway, W., Scott, S., & Garver, S. (2004).

Assessing religious/spiritual functioning: A neglected domain in clinical practice?

Vol. 35 (1), 97-104

Currently, the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) requires that psychopathological symptoms result in a "clinically significant impairment" to qualify as a mental disorder. Also, this impairment must be in "one or more important areas of functioning." Yet this concept of a clinically significant criterion is not thoroughly explained or defined as to the range of possible functioning. It merely says that the impairment must be in social, occupational, or other important areas of functioning. This article attempts to clarify what is included in the other areas of functioning. The authors present the religious/spiritual domain as a valid component of functioning, which should be considered in determining severity of functioning within diagnosis.

The authors define clinically significant religious/spiritual impairment (CSRI) as a reduced ability to perform religious/spiritual activities, achieve religious/spiritual goals, or experience religious/spiritual states because of a psychological disorder. Hathaway, Scott, and Garver first summarize the rationale for viewing religious/spiritual functioning as a clinically relevant functional domain before considering whether it is a neglected area of assessment.

A small amount of research has been done on the relationship between specific disorders and religious functioning. However, most of it has not addressed the issue of whether psychological disorders might impair religious functioning. The existing studies have focused on the correlation between facets of religiousness and pathology, which have used overly broad definitions of both spirituality and psychopathology.

Although there is a V-code added to the DSM-IV for religious or spiritual problems, the authors do not believe that it is a strong enough statement of importance to make to clinicians. They suggest that the V-code provides a useful tool in some clinical situations but probably provides little incentive for clinicians to regularly consider religiousness/spirituality during their assessment and treatment.

In a national survey, most of the surveyed psychologists (93%) had never given a religious/spiritual problem V-code to a client as part of the diagnosis. This is despite the fact that almost 50% of all respondents reported that they had received client reports of changes in religious/spiritual functioning associated with their disorders. Also, the majority of psychologists in the sample reported that they did not regularly assess whether their client's disorders resulted in impaired religious/spiritual functioning. The authors believe this neglect should be addressed.

AMERICAN PSYCHOLOGIST 

Seeman, T., Dubin, L., & Seeman, M. (2003).

Religiosity/Spirituality and health: A critical review of the evidence for biological pathways.

Vol. 58 (1), 53-63

This article reviews evidence regarding the biological processes that may link religiosity/spirituality to health. A growing body of observational evidence supports the hypothesis that this link to physiological processes exists. Although much of the earliest evidence came from questionable cross-sectional studies, more recent research, done by multivariate analyses, provides stronger evidence related to Judeo-Christian religious practices. The strongest evidence comes from randomized interventional trials reporting the beneficial physiological impact of meditation.

After analysis of current research on this topic, the authors present three evidence-related propositions: (a) that religiosity/spirituality is associated with lower blood pressure and less hypertension, (b) that religiosity/spirituality is associated with better lipid profiles (i.e. lower LDL and higher HDL cholesterol), and (c) that religiosity/spirituality is associated with better immune function.

The authors found that the literature they reviewed had several striking features. First, relatively limited attention has been given to the physiological aspects of religious/spiritual orientation. Second, for the most part, the studies that do engage this topic have been conducted on special populations and/or Eastern forms of spiritual practice. Available data for Judeo-Christian religious practices are largely based on evaluation of relationships between frequency of church attendance and blood pressure or immune function. The authors recommend further research be done on individual and group prayer, reading of religious texts, and other aspects of religious services.

Overall, the authors conclude that available evidence is generally consistent with the hypothesis that religiosity/spirituality is linked to positive health-related physiological processes, including cardiovascular, neuroendocrine, and immune function. They qualify that this data is preliminary and relatively sparse, and more solid evidence is needed.

FURTHER READINGS:

Avants, S., Marcotte, D., Arnold, R., & Margolin, A. (2003). Spiritual beliefs, world assumptions, and HIV risk behavior among heroin and cocaine users. Psychology of Addictive Behaviors, 17(2), 164-173.

Briggs, M. K., Apple, K. J., & Aydlett, A. E. (2004). Spirituality and the events of September 11th. Counseling and Values, 48(3), 174-182.

Dlugos, R., & Friedlander, M. (2001). Passionately committed psychotherapists: A qualitative study of their experiences. Professional Psychology: Research and Practice, 32(3), 298-304.

Wilkinson, W. (2004). Religiosity, authoritarianism, and homophobia: A multidimensional approach. The International Journal for the Psychology of Religion, 14(1), 55-68.