Research on Health & Spirituality at Nyack College

Summary of Research Workshops in August 2013 on Spirituality and Health

at Duke University Medical Center with Dr. Harold G. Koenig, MD & Colleagues

Presenter: James Chin, Ph.D.

Spirituality In The USA• Gallup Poll 92% Americans believe in God or a Higher Power

(2011)• 63% report membership-church, synagogue or mosque (2009)• 43% attend religious services weekly or almost weekly (2009)• 40 to 45% psychologists in survey report belief in a God• 23 to 70% psychiatrists in survey report belief in a God• APA requires all APA grad schools to teach multiculturalism &

spirituality & all have a course to address this yet survey indicated poor grad school compliance (Cooke, et al., 2012)

• 90% medical schools have course spirituality and health yet 43% indicated more content/training necessary

• Physicians report 90% patients use spirituality in coping w. chr medical illness yet only 39% physicians believe it is important.

Operational Definition of SpiritualitySpirituality is distinguished from its consequences – human values, morals, meaning, purpose, peace, connectedness to others, feelings of awe and wonder – by its link to the transcendent. The transcendent is that which is outside of the self, and yet also within the self – and in Western traditions is called God, Allah, Ha Shem or a Higher Power, and in Eastern traditions is called Ultimate Truth or Reality, Vishnu, Krishna, or Buddha. Spirituality is intimately connected to religion, and in fact, lies at its core (the traditional understanding). Spirituality is a process that involves traveling along the path that leads from non-consideration of the transcendent, to a decision to believe, to the conforming of life to that belief, to devotion and worship of the transcendent, and ultimately to total surrender of all (Koenig, 2010).

Selected Measurement of Spirituality• Duke University Religion Index (DUREL): A 5 Item Measure for Use in

Epidemiological Studies (Koenig & Bussing, 2010), Religions, 1, 78-85.• Paloutzian, R. & Ellison, C.W.; The Spiritual Well-Being Scale (SWBS, 1982);

Bufford, R., SWBS Short Form.• Pargament, K.I., Koenig, H.G., & Perez, L.M. (2000). The many methods of

religious coping: development and initial validation of the RCOPE. Journal of Clinical Psychology, 56(4), 519-543.

• C.W. Ellison’s Psycho-Spiritual Needs Inventory (PNI, 1994); Chin & Chen, PNI Factor Analysis, underway. In From Stress To Well-Being, Ellison, CW.

• Benson, P., Donahue, M. & Erikson, J. (1993). The faith maturity scale: conceptualization, measurement and empirical validation. In Lynn & Moberg (1993) Research in the Social Scientific Study of Religion, JAI Press.

• Hill, P. & Hood, R. (1999). Measures of Religiosity, Religious Educational Press; compendium of published scales through 1999.

• Allport, G. & Ross, J. (1967). Personal religious orientation and prejudice. Journal of Personality and Social Psychology, 5, 432-443; (11 item measure of intrinsic-extrinsic religiosity).

Current State of Research on the Relationship Between Health & Spirituality • Robust Findings From Replicated Correlational Large

Scale Epidemiological Surveys and Studies.• Findings Applicable to Intrinsically Religious Only,

And Not To Extrinsically Religious.• Randomized Controlled Trials (RCTs) Currently

Underway at Duke University & Other Sites.• Limited Empirically Supported Psychotherapy

Treatment (EST) Research on Christian Accommodated Physical and Mental Health Interventions (See IVP Book By Worthington, Johnson, Hook & Atien, 2013).

Selected Empirical Findings Thus Far

• Religious involvement is related to greater well-being and happiness.

• Religious involvement is related to less depression & faster recovery from depression.

• Religious involvement is related to greater meaning, hope & purpose in life.

• Religious involvement is negatively related to suicide & suicidal ideations.

• Religious involvement is related to less alcohol & drug use, especially among youth.

Selected Empirical Findings Thus Far

• Religious involvement is related to greater social support.

• Religious involvement is related to more exercise and physical activity.

• Religious involvement is related to less cigarette smoking, esp. among youth.

• Religious involvement is related to lower blood pressure & less coronary artery disease.

• Religious involvement is related to longevity.

Highest Priorities in Research AgendaAs Recommended by H. G. Koenig, MD

• IN MENTAL HEALTH: 1. Course of mental disorders & spirituality, 2. Course & exacerbations of chronic mental disorders & spirituality, 3. emotional and behavioral disorders in children including substance abuse & delinquency & spirituality, 4. mental disorders in the elderly & spirituality.

• IN PHYSICAL HEALTH: 1. Prospective studies of common medical illnesses with psychosomatic influences (e.g., heart disease, cancer, hypertension, stroke, asthma, Alzheimer’s) & spirituality, 2. outcomes following surgery, physiology of healing & spirituality, 3. Interactions with biological treatments (e.g., antibiotics in infection or chemotherapy in cancer) & spirituality, 4. studies on immune parameters (e.g., cytokines, NK cells, CD-4 count, t-lymphocytes) & spirituality.

• IN DISEASE PREVENTION AND HEALTH PROMOTION: 1. Studies of health behaviors (e.g., diet, exercise, weight control) in religiously active vs non-religious, 2. Studies of disease screening & detention in religiously active vs non-religious people, 3. Studies of outcome effectiveness of health ministries in faith communities (esp. in minority communities).

Theoretical Considerations in the Research Agenda

• Ellison, C.W. (1994). From Stress to Well-Being, Word Press, Waco, TX.

• Johnson, E.L. (2007). Foundations for Soul Care: A Christian Psychology Proposal, Inter Varsity Press, Downers Grove, IL.

• Johnson, E.L., Ed. (2010). Psychology & Christianity: Five Views, IVP Academic, Downers Grove, IL.

• Chin, J. & Ellison, C.W. (2012). Expanded psycho-spiritual model: foundations and implications, Edification, 5(2), 125-136.

• Theological/psychological work of: Apostle Paul, St. Augustine, Thomas Aquinas, John Calvin, Jonathan Edwards

• Work of William James, Varieties of Religious Experience, 1902

Published Studies/Texts/Articles That Supports These Research Findings By H.G. Koenig, MD

• Handbook of Religion and Health, 2nd ed., 2012, Oxford University Press.

• Spirituality in Patient Care, 3rd ed., 2013, Templeton Press.• Medicine, Religion and Health, 2008, Templeton Press.• The Link Between Religion and Health: Psychoneuro-

immunology and the Faith Factor, 2002, HGK with Harvey J. Cohen, Oxford University Press.

• Baetz, M., Griffin, R., Bowen, R., Koenig, H.G., Marcoux, E. The relationship between spiritual and religious involvement and depressive symptoms in a Canadian population. Journal of Nervous and Mental Disease, Vol 192(12), Dec 2004, 818-822

• Koenig, H.G., Zaben, F.A., Khalifa, D.A. Religion, spirituality and mental health in the West and the Middle East. Asian Journal of Psychiatry, 2012, 5(2), 180-182.

Additional Studies/Texts/Articles That Supports These Research Findings

• Worthington, E.L, Kurusu, T.A., McCullough, M.E. & Sandage, S.J. (1996). Empirical research on religion and psycho-therapeutic processes and outcomes: a 10 year review and research prospectus, Psychological Bulletin, 119(3), 448-487.

• McCullough, M.E. & Willoughby, B.L.B. (2009). Religion, Self-regulation and self control: associations, explanations and implications, Psychological Bulletin, 135(1), 69-93.

• Levin, J., Chatters, L.M., Taylor, R.J. (2011). Theory of religion, aging and health: an overview. Journal of Religion and Health, 50(2), 180-182.

• Worthington, E.L., Hook, J.N., Davis, D.E., McDaniel, M.A. (2011). Religion and spirituality. Journal of Clinical Psychology, 67(2), 204-214.

• Atien, J.D., McMinn, M.R. & Worthington, E.L. (Eds, 2011). Spiritually Oriented Interventions for Counseling and Psychotherapy. APA Press, Wash. DC.

• Huguelett, Philippe and Koenig, Harold G. (Eds., 2012). Religion and Spirituality in Psychiatry, Cambridge University Press.

• Worthington, E.L., Johnson, E.L., Hook, J.N. & Atien, J.D. (Eds., 2013). Evidence-Based Practices for Christian Counseling and Psychotherapy. Inter-Varsity Press, Downers Grove, IL.

Resources in Writing & Funding Research Grants

• Inouye, S.K & Fielin, D.A. (2005), An evidence-based guide to writing grant proposals for clinical research, Annals of Internal Medicine, 142, 274-282.

• Reif-Lehrer, L. (2004). Grant Application Writer’s Handbook, 4th edition, Jones & Bartlett Learning.

• NIH Grant Writing Tutorial; http://www.niaid.nih.gov/ncn/grants/default.htm

• Templeton Foundation Funding Inquiry, http://templeton.org/what-we-fund/

• George Family Foundations Grants; http://www.georgefamilyfoundation.org/about/

Newsletters, Internet & Contacts

• For Crossroads Newsletter, http://spiritualityandhealth.duke.edu/publications/crossroads.htm/

• For Christian Psychology Around the World Newsletter, http://emcapp.ignis.de/

• For Society of Christian Psychology, http://christianpsych.org

• For American Association of Christian Counselors (AACC), http://aacc.net

Addressing the Research Agenda at Nyack College

Stimulating a Research Atmosphere with Ongoing Research Studies at Nyack College, Supported by Faculty & Administration, Research Training for Students

Foster a Community of Empirical Researchers with Mutual Support and Academic Collaboration

Establishment of a Formal Institutional Review Board (IRB) Budgeting for Personnel and Resources to Promote an

Empirical Research Agenda, Support Grant Writing Policies and Procedures to Promote and Reward Published

Empirical Research(ers) More Fulfillment of Institution’s Core Values for: Academically

Excellent, Socially Relevant and Globally Engaged.

Committee• Dr. Kwi-Ryung Yun, Professor, Director of Social

Work, NCMC• Dr. Brian Roland, Assistant Professor, Dept. of Social

Work, NCMC• Dr. Ching-Ching Ruan, Assistant Professor, Marriage

and Family Program, AGSC, Nyack• Dr. James Chin, Professor, Mental Health Counseling

& Director Psy.D. Program, NCMC• WHAT EMPIRICAL RESEARCH STUDIES HAVE YOU

BEEN THINKING ABOUT?• COME JOIN US IN THE DISCUSSION, TO “ENCOURAGE

ONE ANOTHER TO LOVE AND GOOD WORKS”