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Spirituality and health: What’s the evidence and what’s needed?

  • Published:
Annals of Behavioral Medicine

Abstract

In this article, we familiarize readers with some recent empirical evidence about possible associations between religious and/or spiritual (RS) factors and health outcomes. In considering this evidence, we believe a healthy skepticism is in order. One needs to remain open to the possibility that RS-related beliefs and behaviors may influence health, yet one needs empirical evidence based on well-controlled studies that support these claims and conclusions. We hope to introduce the dismissing critic to suggestive data that may create tempered doubt and to introduce the uncritical advocate to issues and concerns that will encourage greater modesty in the making of claims and drawing of conclusions. We comment on the following questions: Do specific RS factors influence health outcomes? What possible mechanisms might explain a relation, if one exists? Are there any implications for health professionals at this point in time ? Recommendations concern the need to improve research designs and measurement strategies and to clarify conceptualizations of RS factors. RS factors appear to be associated with physical and overall health, but the relation appears far more complex and modest than some contend. Which specific RS factors enhance or endanger health and well-being remains unclear.

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References

  1. Rosen G:A History of Public Health. New York: Johns Hopkins University Press, 1993.

    Google Scholar 

  2. Frank J: The faith that heals.Johns Hopkins Medical Journal. 1975,28:306–319.

    Google Scholar 

  3. Thoresen CE: Spirituality, health, and science: The coming revival? In Roth-Roemer S, Robinson SK, Carmin C (eds),The Emerging Role of Counseling Psychology in Health Care. New York: Norton, 1998, 409–431.

    Google Scholar 

  4. Larson DB, Sawyers JP, McCullough ME (eds):Scientific Research on Spirituality and Health: A Consensus Report. Rockville, MD: National Institute for Healthcare Research, 1998.

    Google Scholar 

  5. Dawkins R: You can’t have it both ways: Irreconcilable differences.Skeptical Inquirer. 1999,23:62–64.

    Google Scholar 

  6. Koenig HG:Is Religion Good for Your Health? Binghamton, NY: Haworth Pastoral, 1997.

    Google Scholar 

  7. Benson H:Timeless Healing: The Power and Biology of Belief. New York: Scribner’s, 1996.

    Google Scholar 

  8. Sloan RP, Bagiella E, VandeCreek L, et al.: Should physicians prescribe religious activities?New England Journal of Medicine. 2000,342: 1913–1916.

    Article  PubMed  CAS  Google Scholar 

  9. Sloan RP, Bagiella E, Powell T: Religion, spirituality, and medicine.Lancet. 1999,353:664–667.

    Article  PubMed  CAS  Google Scholar 

  10. Post SG, Puchalski CM, Larson DB: Physicians and patient spirituality: Professional boundaries, competency, and ethics.Annals of Internal Medicine. 2000,132: 578–583.

    PubMed  CAS  Google Scholar 

  11. Shafranske EP, Malony HN: Religion and the clinical practice of psychology: A case for inclusion. In Shafranske EP (ed),Religion and the Clinical Practice of Psychology. Washington, DC: American Psychological Association, 1996, 561–586.

    Chapter  Google Scholar 

  12. Miller WR, Thoresen CE: Spirituality, religion, and health: An emerging research field.American Psychologist (in press).

  13. Miller WR, Thoresen CE: Spirituality and health. In Miller WR (ed),Integrating Spirituality Into Treatment: Resources for Practitioners. Washington, DC: American Psychological Association, 1999, 3–18.

    Chapter  Google Scholar 

  14. Levin JS: Religion and health: Is there an association, is it valid, and is it causal?Social Science and Medicine. 1994,38:1475–1482.

    Article  PubMed  CAS  Google Scholar 

  15. Levin JS, Chatters LM: Research on religion and mental health: An overview of empirical findings and theoretical issues. In Koenig HG (ed),Handbook of Religion and Mental Health. New York: Academic, 1998, 34–47.

    Google Scholar 

  16. George LK, Larson DB, Koenig HG, McCullough ME: Spirituality and health: What we know, what we need to know.Journal of Social and Clinical Psychology. 2000,19:102–116.

    Google Scholar 

  17. Powell LH, Shahabi L, Thoresen CE: Religion and spirituality: Linkages to physical health.American Psychologist (in press).

  18. Koenig HG, McCullough M,Larson DB: Religion and Health: A Century of Research Reviewed. New York: Oxford University Press, 2000.

    Google Scholar 

  19. Thoresen CE, Harris AHS: Spirituality, religion, and health. In Raczynski JM, Leviton LL, Bradley L ({ededs}),Handbook of Health Psychology (Vol. 2). Washington, DC: American Psychological Association (in press).

  20. James W:Varieties of Religious Experience. New York: Random House, 1902.

    Google Scholar 

  21. Simpson J, Weiner E (eds),The Oxford English Dictionary (2nd Ed.). New York: Oxford University Press, 1989.

    Google Scholar 

  22. Pargament KI: Psychology of religion and spirituality.International Journal for the Psychology of Religion. 1999,9:3–16.

    Article  Google Scholar 

  23. Thoresen CE: Spirituality and health: Is there a relationship?Journal of Health Psychology. 1999,4:291–300.

    Google Scholar 

  24. Walsh R, Vaughn F:Paths Beyond Ego: The Transpersonal Vision. New York: Plenum, 1995.

    Google Scholar 

  25. Pargament KI:The Psychology of Religion and Coping: Theory, Research, and Practice. New York: Guilford, 1997.

    Google Scholar 

  26. Woods TE, Ironson GH: Religion and spirituality in the face of illness: How cancer, cardiac, and HIV patients describe their spirituality and religion.Journal of Health Psychology. 1999,4:393–412.

    Article  Google Scholar 

  27. Shahabi L, Powell L, Musick MA, et al.: Correlates of self-perceptions of spirituality in American adults.Annals of Behavioral Medicine. 2002,24:59–68.

    Article  PubMed  Google Scholar 

  28. Matthews DA, Koenig HG, Thoresen CE, Friedman, R: Physical health. In Larson DB, Swyers JP, McCullough ME (eds),Scientific Research on Spirituality and Health: A Consensus Report. Rockville, MD: National Institute for Healthcare Research, 1998, 31–54.

    Google Scholar 

  29. Comstock GW, Partridge KB: Church attendance and health.Journal of Chronic Diseases. 1972,25:665–672.

    Article  PubMed  CAS  Google Scholar 

  30. Larson DB, Koenig HG, Kaplan BH: The impact of religion on men’s blood pressure.Journal of Religion and Health. 1989,28:265–278.

    Article  Google Scholar 

  31. Madalie JH, Kahn HA, Neufeld HN: Five-year myocardial infarction incidence: II. Association of single variables to age and birthplace.Journal of Chronic Disease. 1973,26:329–349.

    Article  Google Scholar 

  32. Harris RC, Dew MA, Lee A, et al.: The role of religion in heart-transplant recipients’ long-term health and well being.Journal of Religion and Health. 1995,34:17–32.

    Article  Google Scholar 

  33. Yates JW, Chalmer BJ, St.James P: Religion in patients with advanced cancer.Medical and Pediatric Oncology. 1981,9:121–128.

    Article  PubMed  CAS  Google Scholar 

  34. Frankel BG, Hewitt WE: Religion and well-being among Canadian university students: The role of faith groups on campus.Journal for the Scientific Study of Religion. 1994,33:62–73.

    Article  Google Scholar 

  35. Idler EL, Kasl SV: Religion among disabled and nondisabled persons: II. Attendance at religious services as a predictor of the course of disability.Journals of Gerontology: Series B: Psychological Sciences and Social Sciences. 1997,52:S306-S316.

    CAS  Google Scholar 

  36. Idler EL, Kasl SV: Religion among disabled and nondisabled persons: I. Cross-sectional patterns in health practices, social activities, and well being.Journals of Gerontology: Series B: Psychological Sciences and Social Sciences. 1997,52:S294-S305.

    CAS  Google Scholar 

  37. Idler EL, Kasl SV: Religion, disability, depression, and the timing of death.American Journal of Sociology. 1992,97:1052–1079.

    Article  Google Scholar 

  38. Hummer RA, Rogers RG, Nam CB, Ellison CG: Religious involvement and U.S. adult morality.Demography. 1999,36:272–285.

    Article  Google Scholar 

  39. Musick MA, House JS, Williams DR: Attendance at religious services and mortality in a national sample. Annual Meeting of the American Sociological Association. Chicago: 1999.

  40. Oman D, Reed D: Religion and mortality among the community-dwelling elderly.American Journal of Public Health. 1998,88:1469–1475.

    PubMed  CAS  Google Scholar 

  41. Strawbridge WJ, Cohen RD, Shema SJ, Kaplan GA: Frequent attendance at religious services and mortality over 28 years.American Journal of Public Health. 1997,87:957–961.

    PubMed  CAS  Google Scholar 

  42. McCullough ME, Hoyt WT, Larson DB, Koenig HG, Thoresen C: Religious involvement and mortality: A meta-analytic review.Health Psychology. 2000,19:211–222.

    Article  PubMed  CAS  Google Scholar 

  43. Strawbridge W, Shema S, Cohen RD, Kaplan G: Religious attendance increases survival by improving and maintaining good health behaviors mental health and social relationships.Annals of Behavioral Medicine. 2001,23:68–74.

    Article  PubMed  CAS  Google Scholar 

  44. Sloan RP, Bagiella E: Religion and health [Letter to the editor].Health Psychology. 2001,20:228.

    Article  PubMed  CAS  Google Scholar 

  45. McCullough ME, Hoyt WT, Larson DB: Small, robust and important: Reply to Sloan and Bagiella [Letter to the editor].Health Psychology. 2001,20:228–229.

    Article  Google Scholar 

  46. Ellison CG, Levin JS: The religion-health connection: Evidence, theory and future directions.Health Education and Behavior. 1998,25:700–720.

    Article  PubMed  CAS  Google Scholar 

  47. Thoresen CE, Harris AHS, Oman D: Spirituality, religion, and health: Evidence, issues, and concerns. In Plante TG, Sherman AC (eds),Faith and Health. New York: Guilford, 15-52.

  48. Chatters LM: Religion and health: Public health research and practice.Annual Review of Public Health. 2000,21: 335–367.

    Article  PubMed  CAS  Google Scholar 

  49. WorthingtonJr. EL, Kurusu TA, McCullough ME, Sandage SJ: Empirical research on religion and psychotherapeutic processes and outcomes: A 10-year review and research prospectus.Psychological Bulletin. 1996,119:448–487.

    Article  Google Scholar 

  50. Kabat-Zinn J, Wheeler E, Light T, et al.: Influence of a mindfulness meditation-based stress reduction intervention on rates of skin clearing in patients with moderate to severe psoriasis undergoing phototherapy (UVB) and photochemotherapy (PUVA).Psychosomatic Medicine. 1998,60:625–632.

    PubMed  CAS  Google Scholar 

  51. Harris AHS, Thoresen CE, McCullough ME, Larson DB: Spiritually and religiously-oriented health interventions.Journal of Health Psychology. 1999,4:413–434.

    Google Scholar 

  52. Dossey L: Prayer and medical science: A commentary on the prayer study by Harris et al and a response to critics.Archives of Internal Medicine. 2000,160:1735–1737.

    Article  PubMed  CAS  Google Scholar 

  53. Byrd RB: Positive therapeutic effects of intercessory prayer in a coronary care unit population.Southern Medical Journal. 1988,81:826–829.

    Article  PubMed  CAS  Google Scholar 

  54. Sicher F, Targ E, Moore D, Smith H: A randomized double-blind study of the effect of distant healing in an advanced AIDS population.Western Journal of Medicine. 1998,169:356–363.

    PubMed  CAS  Google Scholar 

  55. Harris WS, Gowda M, Kolb JW, et al.: A randomized, controlled trial of the effects of remote, intercessory prayer on outcomes in patients admitted to the coronary care unit.Archives of Internal Medicine. 1999,159:2273–2278.

    Article  PubMed  CAS  Google Scholar 

  56. Kirsch I, Lynn SJ: Automaticity in clinical psychology.American Psychologist. 1999,54:504–515.

    Article  PubMed  CAS  Google Scholar 

  57. Oman D, Thoresen CE, McMahon K: Volunteerism and mortality.Journal of Health Psychology. 1999,4:301–316.

    Article  Google Scholar 

  58. Pargament KI, VandeCreek L, Cole B, et al.: The vigil: Religion and the search for control in the hospital waiting room.Journal of Health Psychology. 1999,4:327–342.

    Article  Google Scholar 

  59. Keefe FJ, Affleck G, Lefebvre J, {eaet al.}: Living with rheumatoid arthritis: The role of daily spirituality and daily religious and spiritual coping.Pain (in press).

  60. Bergin AE: Religiosity and mental health: A critical reevaluation and meta-analysis.Professional Psychology: Research and Practice. 1983,14:170–184.

    Article  Google Scholar 

  61. Gartner J, Larson DB, Allen GD: Religious commitment and mental health: A review of the empirical literature. Spirituality: Perspectives in theory and research.Journal of Psychology and Theology. 1991,19:6–25.

    Google Scholar 

  62. Asser S, Swan R: Child fatalities from religion-motivated medical neglect.Pediatrics. 1998,101:625–629.

    Article  PubMed  CAS  Google Scholar 

  63. Exline JJ, Yali AM, Lobel M: When God disappoints: Difficulty forgiving God and its role in negative emotion.Journal of Health Psychology. 1999,4:365–380.

    Google Scholar 

  64. Galanter M: “Moonies” get married: A psychiatric follow-up study of a charismatic religious sect.American Journal of Psychiatry. 1986,143:1245–1249.

    PubMed  CAS  Google Scholar 

  65. Pargament KI, Smith BW, Koenig HG, Perez L: Patterns of positive and negative religious coping with major life stressors.Journal for the Scientific Study of Religion. 1998,37:710–724.

    Article  Google Scholar 

  66. Booth L:When God Becomes a Drug: Breaking the Chains of Religious Addiction and Abuse. Los Angeles: JP Tarcher, 1992.

    Google Scholar 

  67. Miller WR: Diversity training in spiritual and religious issues. In Miller WR (ed),Integrating Spirituality Into Treatment: Resources for Practitioners. Washington, DC: American Psychological Association, 1999, 253–264.

    Chapter  Google Scholar 

  68. Puchalski CM, Larson DB: Developing curricula in spirituality and medicine.Academic Medicine. 1998,73:970–974.

    Article  PubMed  CAS  Google Scholar 

  69. Plante TG, Sherman AC (eds):Faith and Health. New York: Guilford, 2001.

    Google Scholar 

  70. Miller WR (eds):Integrating Spirituality Into Treatment. Washington, DC: American Psychological Association, 1999.

    Google Scholar 

  71. Miller WR, Thoresen CE: Spirituality, religion, and health: Definitions and constructs [Special issue].American Psychologist (in press).

  72. Ellison CG, Levin JS: The religion-health connection: Evidence, theory, and future directions.Health Education and Behavior. 1998,25:700–720.

    Article  PubMed  CAS  Google Scholar 

  73. Hilliard RB: Single-case methodology in psychotherapy process and outcome research.Journal of Consulting and Clinical Psychology. 1993,61:373–380.

    Article  PubMed  CAS  Google Scholar 

  74. Richard TA, Folkman S: Spiritual aspects of loss at the time of a partner’s death from AIDS.Death Studies. 1997,21:527–552.

    Article  Google Scholar 

  75. Keefe FJ, Affleck G, Lefebvre JC, et al.: Pain coping strategies and coping efficacy in rheumatoid arthritis: A daily process analysis.Pain. 1997,69:35–42.

    Article  PubMed  CAS  Google Scholar 

  76. Gallup G:The Gallup Poll: Public opinion 1995. Wilmington, DE: Scholarly Resources, 1995.

    Google Scholar 

  77. Myers D:Spiritual Hunger in a Land of Plenty. New Haven, CT: Yale University Press, 2000.

    Google Scholar 

  78. Putnam R:Social Capital Community Benchmark Survey, 2001. Retrieved from http://www.cfsv.org/communitysurvey.

  79. McCullough ME, Pargament KI, Thoresen CE: The psychology of forgiveness: History, conceptual issues, and overview. In McCullough ME, Pargament KI, Thoresen CE (eds),Forgiveness: Theory, research, and practice. New York: Guilford, 2000, 1–16.

    Google Scholar 

  80. Calaprice, A.The Quotable Einstein. Princeton NJ: Princeton University Press, 1996.

    Google Scholar 

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Authors and Affiliations

  1. School of Education, Stanford University, 94305-3096, Stanford, CA

    Carl E. Thoresen Ph.D. & Alex H. S. Harris M.S.

Authors
  1. Carl E. Thoresen Ph.D.
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  2. Alex H. S. Harris M.S.
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Correspondence to Carl E. Thoresen Ph.D..

Additional information

Preparation of this article was supported, in part, by grants to Carl E. Thoresen from the Fetzer Institute, John Templeton Foundation, and from participation on the Spirituality, Religiousness and Health: State of the Science Panel, Office of Behavioral and Social Sciences Research (OBSSR/NIH). Work by Alex H. S. Harris was partially supported by a Stanford Presidential Graduate Fellowship.

Portions of this article were presented at the Annual Meeting of the Society of Behavioral Medicine, Nashville, Tennessee (2000). Part of this article will appear in the forthcoming Handbook of Health Psychology (Vol. 2), edited by J. Raczynski, L. L. Leviton, and L. Bradley (American Psychological Association), and do appear in Faith and Healing: Psychological Perspectives, edited by T. Plante and A. Sherman (Guilford, 2001). The major contributions of several researchers in this area are gratefully acknowledged, including Harold Koenig, David Larson, Michael McCullough, William R. Miller, Ken Pargament, and Everett Worthington, Jr.

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Thoresen, C.E., Harris, A.H.S. Spirituality and health: What’s the evidence and what’s needed?. ann. behav. med. 24, 3–13 (2002). https://doi.org/10.1207/S15324796ABM2401_02

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