Skip to main content
Log in

Religiousness, Spirituality, and Psychological Distress in Taiwan

  • Original Paper
  • Published:
Review of Religious Research

Abstract

Most of the previous research on religion and mental health has focused solely on Western, predominantly Christian societies. Using a 2004 national survey of 1,881 adults in Taiwan, this study investigates the relationships between multidimensional measures of religiousness/spirituality and psychological distress in an Eastern context. Our findings differ from previous studies in the West, showing that: (1) religious-based supernatural beliefs are associated with more distress; (2) daily prayer is associated with less distress; (3) engaging in secular-based supernatural activities like fortune-telling is related to more distress; and (4) the frequency of religious attendance is unrelated to levels of distress. Broader theoretical and empirical implications of these findings are discussed.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

Notes

  1. We acknowledge that this response rate is less than ideal. Indeed, obtaining good response rates is becoming increasingly difficult in this type of research. According to the TSCS summary report, only 12% contacts personally refused to participate in the survey. Others were not available for interview mainly because of random events such as natural disasters, migration, prison, marriage, death, missing, disease, outside-town work, outside-town education, outside-town business, travel, and other affairs. The 2004 TSCS data were weighted to reflect the population parameters in the 2003 Taiwanese census data. According to Yinghwa Chang, Principal Investigator of the TSCS project, TSCS is the most important general survey with a representative sample in Taiwan (personal communication). In addition, Chiu Hei-yuan, former Principle Investigator of the TSCS project, indicates that there is no significant difference between the weighted 2004 TSCS data and the Taiwanese census data (personal communication). More information about the validity and representativeness of the 2004 TSCS, as well as contact information, can be found in the official summary report of the Taiwan Social Change Survey at http://www.ios.sinica.edu.tw/sc/cht/datafile/tscs04.pdf.

  2. All items to measure psychological distress were carefully considered in the cultural context of Taiwanese society. The validity, internal consistency, and factor structure of these items have been established in previous research (Cheng and Williams 1986; Chong and Wilkinson 1989; Cheng et al. 1990). Translation and back-translation procedures were performed on all items by bilingual scholars familiar with this type of research.

  3. Although in preliminary analyses we had combined these to create an index of religious/spiritual practices, a more fine-grained analysis revealed that only one item (daily prayer) is associated with distress. Therefore, in the analyses presented here, we decided it was more appropriate to report the results for each of these items individually. Analyses based on the index of religious/spiritual practices are available upon request.

  4. We also employed list-wise deletions for comparison, and results were substantively similar.

  5. Some readers may wonder whether or not each of these items in the supernatural beliefs index is associated with distress in the same way. To check this, we performed additional analyses that regressed distress on each item of the supernatural beliefs index (separately), net of the other conditions shown in model 1. Results reveal that the overall patterns are consistent. Each item in the index is associated with more distress. All coefficients range from .18 to .37 and are statistically significant at the p < .05 (with one exception: belief in karma and reincarnation is marginally significant at p < .10).

  6. The single item of “Giving thanks, repenting, or praying every day” combines three elements and cannot be examined separately. This limitation should be considered in future research, since each of these three components may represent different forms of religious practice—and each may have different implications for well-being.

  7. We also estimated a number of interaction effects to further explore relationships between religiousness/spirituality and distress. Three interaction terms were statistically significant. One was negatively associated with psychological distress: age * practice of fortune-telling (b = −.03, standard error = .01). It shows that the distress-reducing effect of practice of fortune-telling is more likely as they get older, while it was not significant for all ages combined (see Model VII of Table 2). The other two significant interaction terms are: folk religion * frequency of attendance (b = .29, standard error = .14) and folk religion * belief in divine control (b = .56, standard error = .25). Frequency of attendance may have stress-exacerbating effect for believers of folk religion, although this might not be the case for other traditions. The positive effect of belief in divine control is especially strong for believers of Chinese folk religion, which abounds in beliefs in violent gods and deities.

References

  • Allison, P.D. 2002. Missing data. Thousand Oaks, CA: Sage

  • Antonovsky, A. 1987. Unraveling the mystery of health. London: Jossey-Bass.

    Google Scholar 

  • Austin, J. 1999. Zen and the brain: Toward an understanding of meditation and consciousness. Cambridge, MA: MIT.

    Google Scholar 

  • Berger, P.L. 1967. The sacred canopy. Garden City, NY: Doubleday.

    Google Scholar 

  • Berger, P.L. 1970. A Rumour of Angels. Garden City, NY: Doubleday.

    Google Scholar 

  • Branden, N. 1994. The six pillars of self-esteem. New York: Bantam Books.

    Google Scholar 

  • Ch’en, K. 1964. Buddhism in China: A historical survey. Princeton, NJ: Princeton University Press.

    Google Scholar 

  • Cheng, Ta, Wu JT, M.Y. Chong, and P. Williams. 1990. Internal consistency and factor structure of the Chinese Health Questionnaire. Acta Psychiatrica Scandinavica 82: 304–308.

    Article  Google Scholar 

  • Cheng, Tai-Ann, and Paul Williams. 1986. The design and development of a screening questionnaire (CHQ) for use in community studies of mental disorders in Taiwan. Psychological Medicine 16: 415–422.

    Google Scholar 

  • Ching, J. 1993. Chinese religions. Maryknoll, NY: Orbis Books.

    Google Scholar 

  • Chiu, H.Y. 1997. Social political analysis of religious change in Taiwan. Taipei, Taiwan: Gui-Guan Press. .

  • Chiu, H.Y. 2006. Religions, occults, and social change. Taipei, Taiwan: Gui-guan Publishing House. .

  • Chong, Mian.-Yoon., and Greg. Wilkinson. 1989. Validation of 30- and 12-item versions of the Chinese Health Questionnaire (CHQ) in patients admitted for general health screening. Psychological Medicine 19: 495–505.

    Article  Google Scholar 

  • Davis, W. 1980. Dojo: Magic and exorcism in modern Japan. Stanford, CA: Stanford University Press.

    Google Scholar 

  • Ellis, A. 1962. Reason and emotion in psychotherapy. New York: Lyle Stuart.

    Google Scholar 

  • Ellis, A. 1980. Psychotherapy and atheistic values: A response to A. E. Bergin’s ‘psychotherapy and religious values’. Journal of Consulting and Clinical Psychology 48: 635–639.

    Article  Google Scholar 

  • Ellis, A. 1988. Is religiosity pathological? Free Inquiry 8: 27–32.

    Google Scholar 

  • Ellison, C.G. 1991. Religious involvement and subjective well-being. Journal of Health and Social Behavior 32: 80–99.

    Article  Google Scholar 

  • Ellison, C.G. 1993. Religious involvement and self-perception among Black Americans. Social Forces 71: 1027–1055.

    Google Scholar 

  • Ellison, C.G. 1994. Religion, the life stress paradigm, and the study of depression. In Religion in aging and health: Theoretical foundations and methodological frontiers, ed. Jeffrey S. Levin, 78–121. Thousand Oaks, CA: Sage.

    Google Scholar 

  • Ellison, C.G., J.D. Boardman, D.R. Williams, and J.S. Jackson. 2001. Religious involvement, stress, and mental health: Findings from the 1995 Detroit area study. Social Forces 80: 215–249.

    Article  Google Scholar 

  • Ellison, C.G., D.A. Gay, and T.A. Glass. 1989. Does religious commitment contribute to individual life satisfaction? Social Forces 68: 100–123.

    Google Scholar 

  • Ellison, C.G., and J.S. Levin. 1998. The religion–health connection: Evidence, theory, and future directions. Health Education and Behavior 25: 700–720.

    Article  Google Scholar 

  • Ellison, C.G., M.A. Musick, and A.K. Henderson. 2008. Balm in Gilead: Racism, religious involvement and psychological distress among African American adults. Journal for the Scientific Study of Religion 47: 291–309.

    Article  Google Scholar 

  • Flannelly, K., K. Galek, C.G. Ellison, and H.G. Koenig. 2010. Beliefs about God, psychiatric symptoms, and evolutionary psychiatry. Journal of Religion and Health 49: 246–261.

    Google Scholar 

  • Freedman, M. 1974. On the sociological study of Chinese religion. In Religion and ritual in Chinese society, ed. Arthur P. Wolf, 19–41. Stanford, CA: Stanford University Press.

  • Freud, S. 1976. The future of an illusion, ed. J. Strachey. New York: Norton, W. W. & Company, Inc.

  • Froese, P., and C.D. Bader. 2007. God in America: Why theology is not simply the concern of philosophers. Journal for the Scientific Study of Religion 46: 465–481.

    Article  Google Scholar 

  • George, L.K., C.G. Ellison, and D.B. Larson. 2002. Explaining the relationships between religious involvement and health. Psychol Inquiry 13: 190–200.

    Article  Google Scholar 

  • Gilkes, C.T. 1980. The Black Church as a therapeutic community: Suggested areas for research into the Black religious experience. Journal of the Interdenominational Theological Center 8: 29–44.

    Google Scholar 

  • Griffith, E.E., T. English, and V. Mayfield. 1980. Possession, prayer, and testimony: Therapeutic aspects of the wednesday night meeting in a Black Church. Psychiatry 43(2): 120–128.

    Google Scholar 

  • Griffith, E., J. Young, and D. Smith. 1984. An analysis of the therapeutic elements of a Black Church service. Hospital Community Psychiatry 35: 464–469.

    Google Scholar 

  • Hackney, C.H., and G.S. Sanders. 2003. Religiosity and mental health: A meta-analysis of recent studies. Journal of Scientific Study of Religion 42(1): 43–55.

    Article  Google Scholar 

  • Hahn, C.Y., M.S. Yang, and M.J. Yang. 2004. Religious attendance and depressive symptoms among community dwelling elderly in Taiwan. International Journal of Geriatric Psychiatry 19: 1148–1154.

    Article  Google Scholar 

  • Idler, E.L. 1987. Religious involvement and the health of the elderly: Some hypotheses and an initial test. Social Forces 66: 226–238.

    Google Scholar 

  • Jang, S.J., and J.A. Lyons. 2006. Strain, social support, and retreatism among African Americans. Journal of Black Studies 37: 251–274.

    Google Scholar 

  • Jang, S.J., and B.R. Johnson. 2004. Explaining religious effects on distress among African Americans. Journal for the Scientific Study of Religion 37: 695–709.

    Google Scholar 

  • Jochim, C. 1986. Chinese religions: A cultural perspective. Englewood Cliffs, NJ: Prentice-Hall.

    Google Scholar 

  • Kao, T.W., D.M. Tsai, K.D. Wu, C.J. Shiah, B. Hsieh, and W.Y. Chen. 2003. The impact of religious activity on depression and quality of life of chronic peritoneal dialysis patients in Taiwan. Journal of the Formosan Medical Association 102: 127–130.

    Google Scholar 

  • Koenig, H.G. 2008. Medicine, religion, and health: Where science and spirituality meet. West Conshohocken, PA: Templeton Foundation Press.

    Google Scholar 

  • Koenig, H.G., L.K. George, D.G. Blazer, J.T. Pritchett, and K.G. Meador. 1993. The relationship between religion and anxiety in a sample of community-dwelling elder adults. Journal of Geriatric Psychiatry 26: 65–93.

    Google Scholar 

  • Koenig, H.G., M.E. McCullough, and D.B. Larson. 2001. Handbook of religion and health. New York: Oxford University Press.

    Book  Google Scholar 

  • Krause, N. 2002. Exploring race differences in a comprehensive battery of Church-based social support measures. Review of Religious Research 44: 126–149.

    Article  Google Scholar 

  • Krause, N., B. Ingersoll-Dayton, J. Liang, and H. Sugisawa. 1999. Religion, social support, and health among the Japanese elderly. Journal of Health and Social Behavior 40: 405–421.

    Article  Google Scholar 

  • Krause, N., J. Liang, B.A. Shaw, H. Sugisawa, H.K. Kim, and Y. Sugihara. 2002. Religion, death of a loved one, and hypertension among older adults in Japan. Journal of Gerontology: Social Sciences 57B: S96–S107.

    Article  Google Scholar 

  • Kwilecki, S. 2004. Religion and coping: A contribution from religious studies. Journal for the Scientific Study of Religion 43: 477–489.

    Article  Google Scholar 

  • Laungani, E. 1994. Cultural differences in stress: India and England. Counselling Psychology Review 9(4): 25–37.

    Google Scholar 

  • Liu, E.Y. 2006. Expanding the new paradigm: Winners and losers among exclusive and nonexclusive religious firms in the Chinese and Japanese communities in the United States, 18501945. Thesis, Department of Sociology, Baylor University, Waco, TX.

  • Liu, E.Y. 2009. Beyond the West: Religiosity and the Sense of mastery in modern Taiwan. Journal for the Scientific Study of Religion 48(4): 774–788.

    Article  Google Scholar 

  • Liu, E.Y. 2010. Are risk-taking persons less religious? Risk preference, religious affiliation, and religious participation in Taiwan. Journal for the Scientific Study of Religion 49(1): 172–178.

    Article  Google Scholar 

  • Liu, E.Y., and Carson. Mencken. 2010. Fatalistic Voluntarism and life happiness in post-socialist China. Sociological Spectrum 30: 270–288.

    Article  Google Scholar 

  • Malinowski, B. 1954. Magic, science and religion: And other essays. Garden City, NY: Doubleday.

    Google Scholar 

  • Manikonda, J.P., S. Störk, S. Tögel, A. Lobmüller, I. Grünberg, S. Bedel, et al. 2008. Contemplative meditation reduces ambulatory blood pressure and stress-induced hypertension: A randomized pilot trial. Journal of Human Hypertension 22(2): 138–140.

    Article  Google Scholar 

  • Marx, K., and F. Engels. 1964. On Religion. New York: Schocken Books

  • McConnell K.M., K.I. Pargament, C.G. Ellison, and K.J. Flannelly. 2006. Examining the links between spiritual struggles and symptoms of psychopathology in a national sample. Journal of Clinical Psychology 62(12): 1469–1484

    Google Scholar 

  • Mirowsky, J., and C.E. Ross. 2003. Social causes of psychological distress, 2nd ed. New York: Aldine De Gruyter.

    Google Scholar 

  • Moore, T. 1991. The African-American Church: A source of empowerment, mutual help, and social change. Religion and Prevention in Mental Health 10(1): 147–167.

    Google Scholar 

  • Musick, M.A., J.W. Traphagan, H.G. Koenig, and D.B. Larson. 2000. Spirituality in physical health and aging. Journal of Adult Development 7(2): 73–86.

    Article  Google Scholar 

  • Overmyer, D.L. 1986. Religions of China: The world as a living system. San Francisco: Harper.

    Google Scholar 

  • Pargament, K.I. 1997. The psychology of religion and coping: Theory, research, practice. New York: Guilford Press.

    Google Scholar 

  • Pargament, K. I. 2002. The bitter and the sweet: An evaluation of the costs and benefits of religiousness. Psychological Inquiry 13: 168–181

    Google Scholar 

  • Pearlin, Leonard I. 1999. Stress and mental health: A conceptual overview. In A handbook for the study of mental health, ed. A.V. Horwitz, and T.L. Scheid, 161–175. New York: Cambridge University Press.

    Google Scholar 

  • Petersen, L.R., and A. Roy. 1985. Religiosity, anxiety, and meaning and purpose: Religion’s consequences for psychological well-being. Review of Religious Research 27: 49–62.

    Article  Google Scholar 

  • Pollner, M. 1989. Divine relations, social relations, and well-being. Journal of Health and Social Behavior 30: 92–104.

    Article  Google Scholar 

  • Rani, N.J., and P.V. Rao. 2000. Effects of meditation on attention processes. Journal of Indian Psychology 18(1): 52–59.

    Google Scholar 

  • Salsman, J.M., and C.R. Carlson. 2005. Religious orientation, mature faith, and psychological distress: Elements of positive and negative associations. Journal for the Scientific Study of Religion 44: 201–209.

    Article  Google Scholar 

  • Schieman, S., T. Pudrovska, and M.A. Milkie. 2005. The sense of divine control and the self-concept: A study of race differences in late life. Research on Aging 27(2): 165–96

    Google Scholar 

  • Schieman, S., T. Pudrovska, L.I. Pearlin, and C.G. Ellison. 2006. The sense of divine control and psychological distress: Variations across race and socioeconomic status. Journal for the Scientific Study of Religion 45: 529–549.

    Article  Google Scholar 

  • Schnittker, J. 2001. When is faith enough? The effects of religious involvement on depression. Journal for the Scientific Study of Religion 40: 393–411.

    Article  Google Scholar 

  • Shahar, M., and R.P. Weller. 1996. Unruly Gods: Divinity and society in China. Honolulu, Hawaii: University of Hawai’i Press.

    Google Scholar 

  • Smith, T.W., J. Kim, A. Koch, and A. Park. 2006. Social science research and the general social surveys. Comparative Sociology 5(1): 33–43.

    Article  Google Scholar 

  • Smith, T.B., M.E. McCullough, and Justin Poll. 2003. Religiousness and depression: Evidence for a main effect and the moderating influence of stressful life events. Psychological Bulletin 129(4): 614–636.

    Article  Google Scholar 

  • Spilka, B., R.W. Hood, R.W. Jr., and R.L. Gorsuch. 1985. The psychology of religion: An empirical approach. Englewood Cliffs, NJ: Prentice-Hall.

    Google Scholar 

  • Stark, R. 2004. Exploring the religious life. Baltimore, CA: Johns Hopkins University Press.

    Google Scholar 

  • Stark, R., and R. Finke. 2000. Acts of faith: Explaining the human side of religion. Berkeley, CA: University of California Press.

    Google Scholar 

  • Stark, R., and C.Y. Glock. 1968. American piety: The nature of religious commitment. Berkeley, CA: University of California Press.

    Google Scholar 

  • Stark, R., and J. Maier. 2008. Faith and happiness. Review of Religious Research 50(1): 120–125.

    Google Scholar 

  • Tarakeshwar, N., J. Stanton, and K.I. Pargament. 2003. Religion: An overlooked dimension in cross-cultural psychology. Journal of Cross-Cultural Psychology 34: 377–394.

    Article  Google Scholar 

  • Taylor, R.J., and L.C. Chatters. 1988. Church members as a source of informal social support. Review of Religious Research 30: 193–202.

    Article  Google Scholar 

  • Taylor, R.J., L.M. Chatters, and J.S. Jackson. 1997. Changes over time in support network involvement among Black Americans. In Family life in Black America, ed. R.J. Taylor, J.S. Jackson, and L.M. Chatters, 293–316. Thousand Oaks, CA: Sage.

    Google Scholar 

  • Traphagan, J.W. 2005. Multidimensional measurement of religiousness/spirituality for use in health research in cross-cultural perspective. Research on Aging 27(4): 387–419.

    Article  Google Scholar 

  • Tsai, S., and M.S. Crockett. 1993. Effects of relaxation training, combining imagery and meditation on the stress level of Chinese nurses working in modern hospitals in Taiwan. Issues in Mental Health Nursing 14(1): 51–66.

    Article  Google Scholar 

  • Tseng, W.S. 1999. Culture and psychotherapy: Review and practical guidelines. Transcultural Psychiatry 36: 131–179.

    Article  Google Scholar 

  • Vermander, S.J. Beniot. 1997. Religions in Taiwan: Between mercantilism and millenarianism. Inter-Religio 32: 63–75.

  • Veroff, J., E. Douvan, and R.A. Kulka. 1981. The inner American: A self-portrait from 1957 to 1976. New York: Basic Books.

    Google Scholar 

  • Wachholtz, A.B., and K.I. Pargament. 2005. Is spirituality a critical ingredient of meditation? Comparing the effects of spiritual meditation, secular meditation, and relaxation on spiritual, psychological, cardiac, and pain outcomes. Journal of Behavioural Medicine 28(4): 369–384.

    Article  Google Scholar 

  • Wachholtz, A.B., and K.I. Pargament. 2008. Migraines and meditation: Does spirituality matter? Journal of Behavioral Medicine 31: 351–366.

    Article  Google Scholar 

  • Wahass, S., and G. Kent. 1997. Coping with auditory hallucinations: A cross-cultural comparison between Western (British) and Non-Western (Saudi Arabian) patients. Journal of Nervous and Mental Disease 185(11): 664–668.

    Article  Google Scholar 

  • Wang, C.W., C.L.W. Chan, S.M. Ng, and A.H.Y. Ho. 2008. The Impact of spirituality on health-related quality of life among Chinese older adults with vision impairment. Aging and Mental Health 12: 267–275.

    Article  Google Scholar 

  • Watson, P.J., R.W. Hood Jr., S.G. Foster, and R.J. Morris. 1988. Sin, depression, and narcissism. Review of Religious Research 29(3): 295–305.

    Article  Google Scholar 

  • Watson, L.C., and M. Watson-Franke. 1977. Spirits, dreams, and the resolution of conflict among urban Guajiro women. Ethos 5(4): 388–408.

    Article  Google Scholar 

  • Watters, W. 1992. Deadly doctrine: Health, illness, and Christian God-talk. Buffalo, NY: Prometheus.

    Google Scholar 

  • Weber, M. 1951. The religion of China: Confucianism and Taoism. Glencoe, IL: Free Press.

    Google Scholar 

  • Wilson, B. 1982. Religion in sociological perspective. Oxford: Oxford University Press.

    Google Scholar 

  • Yang, C.K. 1961. Religion in Chinese society. Berkeley, CA: University of Californian Press.

    Google Scholar 

  • Yeager, D.M., D.A. Glei, M. Au, H. Lin, R.P. Sloan, and M. Weinstein. 2006. Religious involvement and health outcomes among older persons in Taiwan. Social Science and Medicine 63: 2228–2241.

    Article  Google Scholar 

Download references

Acknowledgment

This study was supported in part by a grant from the National Natural Science Foundation of China (No. 70973132). Special thanks go to Rodney Stark at Baylor University, Christopher G. Ellison at The University of Texas at San Antonio, Yinghwa Chang and Hei-Yuan Chiu at the Academia Sinica of Taiwan, and anonymous reviewers for their helpful comments on early drafts of this article.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Eric Y. Liu.

Appendix

Appendix

See Table 3.

Table 3 Correlation matrix and descriptive statistics of religion variables

Rights and permissions

Reprints and permissions

About this article

Cite this article

Liu, E.Y., Schieman, S. & Jang, S.J. Religiousness, Spirituality, and Psychological Distress in Taiwan. Rev Relig Res 53, 137–159 (2011). https://doi.org/10.1007/s13644-011-0011-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13644-011-0011-8

Keywords

Navigation