RELIGIOUS ORIENTATION AND VULNERABILITY TO ANXIETY IN ADULTS.
Objective: The role of religion in mental health issues is greatly understudied. The purpose of the present research is to determine the role of religious orientation in the development of anxiety in adults.
Research Design: Correlational Study.
Place of study: Karachi, Pakistan
Subjects and Methods: After a detailed literature review it is assumed that there will be a relationship between religious orientation and anxiety. The sample used in order to test this hypothesis consisted of 212 participants out of whom 53 were Muslims, 53 were Christians, 53 were Hindus and 53 were Parsis. Their ages ranged between 25 to 45 years. The entire sample had at least a graduation degree. To measure the variables of religious orientation and anxiety, a general scale of religious orientation, Age Universal I-E scale1 was used. The SA-452 was used to tap the level of anxiety. Descriptive statistics and linear regression analysis were computed to translate the data in statistical language.
Results: The results reveal significant predictive relationship between religious orientation and anxiety (R2.036, F=7.919, pless than.01). These findings are very critical considering the present global circumstances. Their implications for future research and applications are also discussed.
KEY WORD: Religious orientation; Anxiety; Correlational Study
Religion and mental health are two topics that have continued to intrigue people through out the passage of time. In the recent decades this topic has started receiving a lot of attention because of the circumstances the world has seen. Since both religious orientation and mental health have been viewed in a number of perspectives, hence ample controversies surround both these areas. Some argue that religious beliefs foster security of mind and mental stability, maintaining that they offer a sense of hope, meaning and purpose; provide a reassuring fatalism that enables the believer to better withstand suffering and pain; and give people a sense of power and control through association with an omnipotent force. Others assert however, that religious beliefs can undermine mental health in ways that include generating excessive levels of guilt, encouraging the unhealthy repression of anger, and creating anxiety and fear with threats of punishment for sinful behavior.
Mental health and religious orientation when considered together reveals a very small body of empirical work. This body of work certainly does not match the need of it. Most of us like to venture in the direction that religion is generally beneficial to mental health while others would disagree. Schumaker3 further elaborated by saying that a large proportions of thinkers take a well-reasoned middle ground, maintaining that religion has the potential to be either positive or negative in its effects on mental health. They claim that religion is subject to endless variations in structure, content, and orientation, all of which serve to establish any particular religion as a psychological asset or liability, or neither. In this vein, Roberts4 wrote that religion can be health giving and beneficial, or inhibiting and pathological. Spika, Hood and Gorsuch 5 concluded that religion can serve several different functions.
It can safeguard mental health by acting as a haven from life's difficulties, or it can be a hazard by infusing people with "abnormal mental content and abnormal motives". They add that religion has the potential to be a "therapy" but that religion itself can "sponsor the expression of psychological abnormality" also.
The ominous sense of being menaced by an unspecified threat is usually termed 'anxiety', and it has the same clinical features-the same acceleration of breathing muscular tension, perspiration and so forth as fear. 6 Although everyday experiences of fear and anxiety are not pleasant, they have an adaptive function: they prepare us for action-for "flight or fight"- when danger threatens. Unfortunately some people suffer such continuous and disabling fear and anxiety that they cannot lead a normal life. Their discomfort is too severe, too frequent; it lasts too long; it is triggered too readily by what the sufferers themselves recognize as minimal, unspecified, or non existent threats. These people are said to have an anxiety disorder. 7
Anxiety Disorders are considered the most common mental disorders, affecting one in four people in the United States. 8 9 The DSM-IV-TR includes the following disorders in the Anxiety disorders; panic disorder, agoraphobias, specific phobias, social phobias, obsessive compulsive disorder, post traumatic stress disorder, acute stress disorder, generalized anxiety disorder, anxiety disorder due to a general medical condition, substance induced anxiety disorder and anxiety disorder not otherwise specified. 10
When considering religious orientation and anxiety the key question is: whether religious factors reduce anxiety, by offering spiritual or social support and purpose in life, or do religious beliefs arouse anxiety, by encouraging guilt and worry over failure to carry out obligations?
Generally speaking it can be safely said that religion has the potential either to increase or to decrease anxiety, depending on various socio cultural, situational or individual factors.
Mathers11 extends the metaphor by linking repentance with a "working through" of anxiety. Repentance is seen a change of mind in the direction of reconciliation with God and brethren. Repentance begins with anxiety, but this interpersonal anguish has pertinent interpersonal implications; communion with fellow humans is restored and intensified, anxiety is reduced. On the other hand Bower12 points out that there are idiosyncrasies of religious conviction that are carriers of pathologic ideation; for example, the distortion of the God-idea with fierce superego demand and expectations of punishment.
More over in the absence of developmental or situational forces, culture itself colors the impact of religion. Lambert, Triandis and Wolf 13 demonstrated that societies with aggressive deities tend to be less nurturant of infants and to have elevated levels of anxiety in the child. The reverse situation was found in groups with more benevolent deities.
Findings on the causal relationship between religion and anxiety are difficult to evaluate since most studies are cross - sectional. Research is obviously needed to clarify causal directionality in the relationships observed. It seems self evident that socio cultural and psychological factors may be either the cause or consequence of religious beliefs or behavior.
Sanua14 reported that the research literature indicates that the "religious person" may alternately show greater and less anxiety than one who is not religious. Bergin15 also found confusing results in studies of manifest anxiety In the most recent review, Gartner and colleagues16 found four studies reporting that religious subjects were more anxious,17 18 19,20 three studies that found lower anxiety , and fear of death. In J. F. Schumaker (Ed.), Religion and mental health (pp. 98-109). New York: Oxford University Press. anxiety in religious subjects21 or less anxious after participation in religious pilgrimage, 22 and three studies that found no relationship between anxiety and religiosity. 23 24 25
A possible discrepancy in findings is the form of religiousness under study. DeFigueirdo, and Lemkan 26 found that somatic manifestations of anxiety were negatively associated with public religious participation, but positively associated with private religiosity.
Bergin, Masters and Richards27 addressed styles of religious commitment. They found "intrinsic" religiousness28 a style valuing religion for interpersonal enhancement, to be correlated with lower anxiety. In contrast is "extrinsic" religiousness, a style that values religion for its interpersonal benefits (i.e., social status, acceptance), which was associated with higher levels of anxiety.
Pfeifer and Waelty 29 found no overall relationship between neuroticism and religiosity in a group of psychiatric patients, nor in a group of healthy controls. There were interesting contrasts between the view of the patients and controls on the relations between anxiety and religion. The patients thought that their anxiety interfered with their practice of religion, while the controls thought that 'religion can make a person sick'.
The theoretical and empirical literature on religion and anxiety reduction is patchy, full of promises and conflicting effects, and dominated with the paradox of the ease with which cross sectional co relational study can be done, followed by the difficulty of interpreting and drawing sound conclusions about causal relationships. There are probably two dominant effects, and these effects would mutually cancel each other in the cross sectional studies. Those under stress may become anxious and start using religious coping strategies. This effect on its own would give a positive association between anxiety and many measures of religion. However, many religious coping strategies have a soothing effect, leading to a negative statistical association between anxiety and many measures of religion.
There is a relationship between religious Orientation and anxiety.
The total sample consisted of 212 adults. These 212 participants comprised of the dominant group of Muslims (n= 53), and three other major minorities, i.e., Hindus (n= 53), Christians (n= 53), and Parsis (n= 53). The age of the participants ranged from 25- 45 years. The respondents consisted of people with at least a graduate degree. Those participants were selected for the sample, who had no history of psychological problems and had never been on any kind of psychiatric treatment (psychotropic medication /psychotherapy). The selected sample also had no history of any major physical illness, for e.g. head injury, heart disease, cancer etc. The reason for this screening was to control the effect of any prior psychological and medical problems acting as vulnerability factors independently on their own, and on the variables understudy.
Following tests were individually done on each respondent. The order of presenting the tests to each respondent was kept the same always.
The Symptom Assessment-45 questionnaire2 is a brief yet comprehensive assessment of general psychiatric symptomology. This questionnaire asks respondents to rate their symptoms on a 5 point scale with the responses ranging from "not at all" to "extremely". This questionnaire consists of nine symptom domain scales and two summary indices are also measured through this the subscale used in the present research contains items from this scale that inquire about symptoms related to fearfulness, panic, tension and restlessness. The reliability of SA-45 is such that it has good internal consistency with each of its 11 scales of 0.71 (cronbach's alpha coefficients). It also has a good test-retest reliability, generally in 0.80's. Its validity has also been established through numerous studies.
The Age Universal I-E scale for Religious Orientation1: The "Religious orientation scale" was originally developed by Allport and Ross in 1967. It has been extensively used in the past few decades for the purpose of researches religious orientation. Due to this many versions of the Allport and Ross scale have come out as adaptations to the original. The specific one used in this present study is called the 'Age universal I-E scale. 1 This has been widely used in adults to measure the intrinsic and extrinsic religious orientation. A total score is also obtained to get the overall level of religious orientation. This scale has a total of 20 items. These consist of items from two subscales of intrinsic religious orientation and extrinsic religious orientation. All the items are marked on a three point Likert scale with the options ranging between 'yes', 'no' and 'not certain'. Items 3, 14 and 20 are reversed scored.
The age universal I-E scale has been reported as containing alpha reliability coefficients of .66 and .77, and the validity measures of this scale have also been established.
The procedure of the study was such that initially all the participants were approached through emails and telephonic conversations. The time and place of meeting was discussed and then the participants were approached accordingly. In the best possible way made sure that the participant is seated
comfortably in a relaxed place, where the lighting and the noise level was also controlled. At the start of the meeting the first few moments were always spent in building rapport. For this purpose the researcher first introduced herself briefly and then gave a brief description of the research project along with an explanation of the purpose of the research. A written consent form was signed by each respondent. After taking consent the participants were asked to fill in a demographic form then they are asked to give information about any previous history of psychiatric/psychological problems or treatment and any major physical issues. The purpose of this brief interview was to rule out any clinical manifestation and to screen them according to the established research's inclusion/exclusion criterion. After this the respondents were asked to fill in the next form, which was the Symptom Assessment- 452 questionnaire, after whichthey filled out the Age Universal I-E scale for religious Orientation.
After collection and careful examination, the data was transferred on to the answer sheets and scored according to the instructions given in the manuals of Symptom Assessment -45 and the Age Universal I- E scale for religious Orientation. In order to examine and study the hypothesis and to facilitate the interpretation of results, data was analyzed by applying various statistical techniques. The entire sample left after screening them for any prior physical or psychological problems was used for statistical treatment of data. The statistical package for social sciences (SPSS, V-16), and expert guidance were employed to analyze the data.
Since most of the previous researches reveal the use of correlations. To take this a step further Linear regression analysis was selected to find out the predictive relationship of religious orientation with anxiety. Along side this multiple regression analysis was also used to further see the effect that intrinsic and extrinsic religious orientation were having on these variables. Other than this descriptive statistics, including means and standard deviations etc were also utilized.
To test this hypothesis linear regression analysis was employed. The presentation of regression analysis includes model summary (Table 1), analysis of variance (Table 2) and coefficients (Table 3). It was seen that Religious
orientation is statistically significant at the .005 level with a variance of 3.6 %. [R2= 0.036, F (1,210) = 7.919, pless than.05]. After this using multiple regression the effect of intrinsic and extrinsic religious orientation on psychopathology was seen, it was seen that together they have a 8. 3 % variance, significant at the .001 level [R 2 0.083, F (2, 209) = 9.397, p less than .05). Individually seen extrinsic religious orientation has a highly significant effect on anxiety at the .001 level, whereas intrinsic religious orientation plays an insignificant role on the development of anxiety in a person.
Summary of simple linear regression of religious orientation as a predictor of anxiety in adults
Analysis of Variance for simple Linear Regression of religious orientation as a predictor of anxiety in adults
Coefficients for simple linear regression analysis of religious Orientation as a predictor of anxiety in adults
Summary of multiple regression analysis of Intrinsic, extrinsic religious orientation as predictors of anxiety in adults
Analysis of variance of multiple regression analysis of Intrinsic, extrinsic religious orientation as predictors of anxiety in adults
Coefficients of variance of multiple regression analysis of Intrinsic, extrinsic religious orientation as predictors of anxiety in adults
Second hypothesis of the present study was that there is a relationship between religious orientation and anxiety. The results as indicated in table 1, 2 and 3 show that religious orientation plays a significant role in the development of anxiety in a person. This implies that the level of religious orientation has an effect on the amount of anxiety that an individual goes through, therefore
supports the idea that religious orientation plays a role in the development of anxiety in a person.
The troubled times that the world is seeing today, especially living in a country like Pakistan where uncertainties prevail, there is hardly anyone who has not experienced anxiety at one point or the other in their lives.
Previous literature done in this area reveals that people who are more anxious may also be more religious; however, this does not mean that those who are religious are more susceptible to anxiety. Another explanation of this could also be that Miller and Kelley30 believed that the clinically diagnosed anxious subjects experienced religion as a source of support, but they also perceived their symptoms as interfering with the expression of their faith. Meaning that despite the fact that one might actually believe and view religion's positiveness in terms of support and solace, the person might be so overwhelmed with the stress, worry, fear or anxiety that behavior that conveys and displays the religiousness might get effected, and since the person is unable to get involved in the practical aspects of religion he hence does not benefit from them. This has a dual effect because the more he is unable to fulfill his religious obligations the more anxious he becomes.
In order to understand the relationship even further and to make it more reliable and feasible it is imperative to study which aspect of religious orientation has an effect on anxiety. When this was studied in our present research, very interestingly it was found that extrinsic religious orientation has a significant role in exacerbating anxiety, where as intrinsic religious orientation has a totally insignificant role as far as anxiety is concerned. Harris and colleagues31 also found that it is quite likely that people who have strong religious beliefs, they exuberate more confidence concerning the existential issues. Where as those who are less sure of their beliefs are more likely to be anxious about them.
If the above assumption is viewed in the light of extrinsic religious orientation and intrinsic religiousness orientation then it becomes even clearer because since an intrinsically orientated person finds his major motivation in religion, he tends to internalize the happenings around him which means that the locus of control of such a person lies within himself or is internal. Hence this implies that such a person since he seems relatively more in control of himself and the situation, his level of anxiety will be lower as well.
Whereas the extrinsically oriented person since he views religion as a means to an end, his locus of control is external and therefore he shifts the responsibility of his current surroundings giving it the shape of 'blame', where he blames God and others around him for the situation he is in. Since the focus of control is handed over to an external force, the solution also seems to come from the same direction. One major implication of a belief system such as this is the fact that the person assumes a helpless demeanor, waiting for some external force, be it God or others around them to bring about the change and hence their anxieties increase. Therefore extrinsically religious people come across as more anxious as compared to intrinsically oriented people.
Another viable explanation of this is that a person, who has a tendency to be anxious, will affect all areas of his life, religion being one of them. As mentioned earlier it is very difficult to ascertain whether the symptoms of anxiety started first or whether the person started to become religiously inclined first. Hence this would mean that the important thing to understand is that anxiety may be independent of this and that a religious or a non religious person both can be quite anxious or quite placid. The difference between them is not in the level of anxieties they experience but in the content of anxieties. As a religious person views most things in the perspective of religion, hence the themes of his anxieties tend to revolve around his religious beliefs. For example he can have anxieties related to death, life hereafter, goodness, sins, heaven, and hell etc. which in return will increase his anxiety level.
Clinical Psychologist, Associate Professor, Institute of Clinical Psychology, University of Karachi
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29 Pfeifer, S., and Waelty, U. (1999). Anxiety, depression, and religiosity- a controlled clinical study. In P. Pressman, J. S. Lyons, D. B. Larson, and J. Gartner (1992), Religion, anxiety, and fear of death. In J. F. Schumaker (Ed.), Religion and mental health (pp. 98-109). New York: Oxford University Press.
30 Miller, L., Kelley, B. S. (2005), Relationship of religiosity and spirituality with mental health and psychopathology. In R. F. Paloutzian and C. L. Park (Eds.), Handbook of the psychology of religion and spirituality (pp. 460-478). New York: Guildford Press.
31 Harris, J. I., Schoneman, S. W., and Carrera, S. R. (2002). Approaches to religiosity related to anxiety in college students. In L. Miller and B. S. Kelley (2005), Relationship of religiosity and spirituality with mental health and psychopathology. In R. F. Paloutzian and C. L. Park (Eds.), Handbook of the psychology of religion and spirituality (pp. 460-478). New York: Guildford Press.
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|Author:||Zain, Saba; Ansari, Kausar|
|Publication:||Pakistan Journal of Clinical Psychology|
|Date:||Jun 30, 2011|
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