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17.08.2018 | Original Paper

Religious Involvement, Anxiety/Depression, and PTSD Symptoms in US Veterans and Active Duty Military

verfasst von: Harold G. Koenig, Nagy A. Youssef, Rev. John P. Oliver, Donna Ames, Kerry Haynes, Fred Volk, Ellen J. Teng

Erschienen in: Journal of Religion and Health | Ausgabe 6/2018

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Abstract

Religious involvement is associated with mental health and well-being in non-military populations. This study examines the relationship between religiosity and PTSD symptoms, and the mediating effects of anxiety and depression in Veterans and Active Duty Military (V/ADM). This was a cross-sectional multi-site study involving 585 V/ADM recruited from across the USA. Inclusion criteria were having served in a combat theater and PTSD symptoms. Demographics, military characteristics, and social factors were assessed, along with measurement of religiosity, PTSD symptoms, depression, and anxiety. Bivariate and multivariate analyses examined the religiosity–PTSD relationship and the mediating effects of anxiety/depression on that relationship in the overall sample and stratified by race/ethnic group (White, Black, Hispanic). In bivariate analyses, the religiosity–PTSD relationship was not significant in the overall sample or in Whites. However, the relationship was significant in Blacks (r = − 0.16, p = 0.01) and in Hispanics (r = 0.30, p = 0.03), but in opposite directions. In the overall sample, religiosity was inversely related to anxiety (r = − 0.07, p = 0.07) and depression (r = − 0.21, p < 0.0001), especially in Blacks (r = − 0.21, p = 0.001, and r = − 0.34, p < 0.0001, respectively); however, in Hispanics, religiosity was positively related to anxiety (r = 0.32, p = 0.02) as it was to PTSD symptoms. When anxiety/depression was controlled for in multivariate analyses, the religiosity–PTSD relationship in the overall sample reversed from negative to positive, approaching statistical significance (B = 0.05, SE = 0.03, p = 0.079). In Blacks, the inverse association between religiosity and PTSD was explained by quality of relationships, whereas the positive relationship in Hispanics was explained by anxiety symptoms. In conclusion, religiosity was inversely related to PTSD symptoms in Blacks, positively related to PTSD in Hispanics, and unrelated to PTSD in the overall sample and in Whites. Anxiety/depression partially mediated the relationship in the overall sample and in Hispanics. Although longitudinal studies will be necessary to determine how these relationships come about, consideration should be given to spiritual/religious interventions that target anxiety/depression in V/ADM with PTSD.

Abraído-Lanza, A. F., Vasquez, E., & Echeverría, S. E. (2004). En las manos de Dios [in God’s hands]: Religious and other forms of coping among Latinos with arthritis. Journal of Consulting and Clinical Psychology, 72, 91–102.CrossRefPubMedPubMedCentral

Alim, T. N., Graves, E., Mellman, T. A., Aigbogun, N., Gray, E., Lawson, W., et al. (2006). Trauma exposure, posttraumatic stress disorder and depression in an African-American primary care population. Journal of the National Medical Association, 98(10), 1630–1636.PubMedPubMedCentral

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5 ^® ). Washington, DC: American Psychiatric Publishing.CrossRef

Ashbaugh, A. R., Houle-Johnson, S., Herbert, C., El-Hage, W., & Brunet, A. (2016). Psychometric validation of the English and French versions of the Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5). PLoS ONE, 11(10), e0161645.CrossRefPubMedPubMedCentral

Blevins, C. A., Weathers, F. W., Davis, M. T., Witte, T. K., & Domino, J. L. (2015). The posttraumatic stress disorder checklist for DSM-5 (PCL-5): Development and initial psychometric evaluation. Journal of Traumatic Stress, 28(6), 489–498.CrossRefPubMed

Bovin, M. J., Marx, B. P., Weathers, F. W., Gallagher, M. W., Rodriguez, P., Schnurr, P. P., et al. (2016). Psychometric properties of the PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (PCL-5) in veterans. Psychological Assessment, 28, 1379–1391.CrossRefPubMed

Chang, B. H., Skinner, K. M., & Boehmer, U. (2001). Religion and mental health among women veterans with sexual assault experience. The International Journal of Psychiatry in Medicine, 31(1), 77–95.CrossRefPubMed

Chang, B. H., Skinner, K. M., Zhou, C., & Kazis, L. E. (2003). The relationship between sexual assault, religiosity, and mental health among male veterans. International Journal of Psychiatry in Medicine, 33(3), 223–239.CrossRefPubMed

Chatters, L. M., Taylor, R. J., Bullard, K. M., & Jackson, J. S. (2008). Spirituality and subjective religiosity among African Americans, Caribbean Blacks and Non-Hispanic Whites. Journal for the Scientific Study of Religion, 47, 725–737.CrossRefPubMedPubMedCentral

Cornish, M. A., Lannin, D. G., Wade, N. G., & Martinez, M. (2017). Can use of positive religious coping predict greater distress? An examination of Army soldiers on deployment. Journal of Counseling Psychology, 64(3), 302–310.CrossRefPubMed

Currier, J. M., Holland, J. M., & Drescher, K. D. (2015). Spirituality factors in the prediction of outcomes of PTSD treatment for U.S. military veterans. Journal of Traumatic Stress, 28(1), 57–64.CrossRefPubMed

Currier, J. M., Smith, P. N., & Kuhlman, S. (2017). Assessing the unique role of religious coping in suicidal behavior among US Iraq and Afghanistan veterans. Psychology of Religion and Spirituality, 9(1), 118–123.CrossRef

Daskalakis, N. P., Lehrner, A., & Yehuda, R. (2013). Endocrine aspects of post-traumatic stress disorder in implications for diagnosis and treatment. Endocrinology and Metabolism Clinics of North America, 42(3), 503–513.CrossRefPubMed

Downey, R. G., & King, C. V. (1998). Missing data in Likert ratings: A comparison of replacement methods. Journal of General Psychology, 125(2), 175–191.CrossRefPubMed

Dursa, E. K., Reinhard, M. J., Barth, S. K., & Schneiderman, A. I. (2014). Prevalence of a positive screen for PTSD among OEF/OIF and OEF/OIF-era veterans in a large population-based cohort. Journal of Traumatic Stress, 27(5), 542–549.CrossRefPubMed

Ghafoori, B., Barragan, B., Tohidian, N., & Palinkas, L. (2012). Racial and ethnic differences in symptom severity of PTSD, GAD, and depression in trauma-exposed, urban, treatment-seeking adults. Journal of Traumatic Stress, 25(1), 106–110.CrossRefPubMedPubMedCentral

Gough, K., & Hudson, P. (2009). Psychometric properties of the Hospital Anxiety and Depression Scale in family caregivers of palliative care patients. Journal of Pain and Symptom Management, 37, 797–806.CrossRefPubMed

Greenawalt, D. S., Tsan, J. Y., Kimbrel, N. A., Meyer, E. C., Kruse, M. I., Tharp, D. F., et al. (2011). Mental health treatment involvement and religious coping among African American, Hispanic, and white veterans of the wars of Iraq and Afghanistan. Depression Research and Treatment, article ID, 192186, 1–10.

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

Hall-Clark, B. N., Kaczkurkin, A. N., Asnaani, A., Zhong, J., Peterson, A. L., Yarvis, J. S., et al. (2017). Ethnoracial differences in PTSD symptoms and trauma-related cognitions in treatment-seeking active duty military personnel for PTSD. Psychological Trauma, 9(6), 741–745.CrossRefPubMed

Hasanović, M., & Pajević, I. (2010). Religious moral beliefs as mental health protective factor of war veterans suffering from PTSD, depressiveness, anxiety, tobacco and alcohol abuse in comorbidity. Psychiatria Danubina, 22(2), 203–210.PubMed

Hoge, C. W., Riviere, L. A., Wilk, J. E., Herrell, R. K., & Weathers, F. W. (2014). The prevalence of post-traumatic stress disorder (PTSD) in US combat soldiers: A head-to-head comparison of DSM-5 versus DSM-IV-TR symptom criteria with the PTSD checklist. Lancet Psychiatry, 1, 269–277.CrossRefPubMed

Hourani, L. L., Williams, J., Forman-Hoffman, V., Lane, M. E., Weimer, B., & Bray, R. M. (2012). Influence of spirituality on depression, posttraumatic stress disorder, and suicidality in active duty military personnel. Depression Research and Treatment, Article ID, 425463, 1–9.

Koenig, H. G. (2018). Religion and mental health: Research and clinical applications. San Diego, CA: Academic Press.

Koenig, H. G., Ames, D., Youssef, N., Oliver, J. P., Volk, F., Teng, E. J., et al. (2018). The Moral Injury Symptom Scale—Military version. Journal of Religion and Health, 57, 249–265.CrossRefPubMed

Koenig, H. G., Cohen, H. J., Blazer, D. G., Pieper, C., Meador, K. G., Shelp, F., et al. (1992). Religious coping and depression in elderly hospitalized medically ill men. American Journal of Psychiatry, 149, 1693–1700.CrossRefPubMed

Koenig, H. G., King, D. E., & Carson, V. B. (2012). Handbook of religion and health (2nd ed.). NY, NY: Oxford University Press.

Koenig, H. G., Nelson, B., Shaw, S. F., Al Zaben, F., Wang, Z., & Saxena, S. (2015a). Belief into Action scale: A brief but comprehensive measure of religious commitment. Open Journal of Psychiatry, 5(1), 66–77.CrossRef

Koenig, H. G., Wang, Z., Al Zaben, F., & Adi, A. (2015b). Belief into Action Scale: A comprehensive and sensitive measure of religious involvement. Religions, 6(3), 1006–1016.CrossRef

Kulka, R. A., Schlenger, W. E., Fairbank, J. A., Hough, R. L., Jordan, B. K., Marmar, C. R., et al. (1990a). Trauma and the Vietnam war generation: Report of findings from the National Vietnam Veterans Readjustment Study. New York: Brunner/Mazel.

Kulka, R. A., Sclilenger, W. E., Fairbank, J. A., Hough, R. L., Jordan, B. K., Marmar, C. R., et al. (1990b). The National Vietnam Veterans Readjustment Study: Tables of findings and technical appendices. New York: Brunner/Mazel.

Nad, S., Marcinko, D., Vuksan-Æusa, B., Jakovljevic, M., & Jakovljevic, G. (2008). Spiritual well-being, intrinsic religiosity, and suicidal behavior in predominantly Catholic Croatian war veterans with chronic posttraumatic stress disorder: A case control study. Journal of Nervous and Mental Disease, 196(1), 79–83.CrossRefPubMed

Park, C. L., Smith, P. H., Lee, S. Y., Mazure, C. M., McKee, S. A., & Hoff, R. (2017). Positive and negative religious/spiritual coping and combat exposure as predictors of posttraumatic stress and perceived growth in Iraq and Afghanistan veterans. Psychology of Religion and Spirituality, 9(1), 13–20.CrossRefPubMedPubMedCentral

Parker, K., Cilluffo, A., & Stepler, A. (2017). 6 facts about the U.S. military and its changing demographics. Pew Research Center, April 13. Retrieved on 5/29/18 from, http://www.pewresearch.org/fact-tank/2017/04/13/6-facts-about-the-u-s-military-and-its-changing-demographics/.

Patel, R., Spreng, R. N., Shin, L. M., & Girard, T. A. (2012). Neurocircuitry models of posttraumatic stress disorder and beyond: A meta-analysis of functional neuroimaging studies. Neuroscience and Biobehavioral Review, 36(9), 2130–2142.CrossRef

Pietrzak, R. H., & Cook, J. M. (2013). Psychological resilience in older US veterans: Results from the national health and resilience in veterans study. Depression and Anxiety, 30(5), 432–443.CrossRefPubMed

Pole, N., Best, S. R., Metzler, T., & Marmar, C. R. (2005). Why are Hispanics at greater risk for PTSD? Cultural Diversity and Ethnic Minority Psychology, 11(2), 144–161.CrossRefPubMed

Robinson, J. A., Bolton, J. M., Rasic, D., & Sareen, J. (2012). Exploring the relationship between religious service attendance, mental disorders, and suicidality among different ethnic groups: Results from a nationally representative survey. Depression and Anxiety, 29, 983–990.CrossRefPubMed

Ruef, A. M., Litz, B. T., & Schlenger, W. E. (2000). Hispanic ethnicity and risk for combat-related posttraumatic stress disorder. Cultural Diversity and Ethnic Minority Psychology, 6(3), 235–251.CrossRefPubMed

Sharma, V., Marin, D. B., Koenig, H. K., Feder, A., Iacoviello, B. M., Southwick, S. M., et al. (2017). Religion, spirituality, and mental health of US military veterans: Results from the National Health and Resilience in Veterans Study. Journal of Affective Disorders, 217, 197–204.CrossRefPubMed

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

Steenkamp, M. M., Schlenger, W. E., Corry, N., Henn-Haase, C., Qian, M., Li, M., et al. (2017). Predictors of PTSD 40 years after combat: Findings from the National Vietnam Veterans Longitudinal Study. Depression and Anxiety, 34(8), 711–722.CrossRefPubMed

Tait, R., Currier, J. M., & Harris, J. I. (2016). Prayer coping, disclosure of trauma, and mental health symptoms among recently deployed United States veterans of the Iraq and Afghanistan conflicts. International Journal for the Psychology of Religion, 26, 31–45.CrossRef

Taylor, R. J., Chatters, L. M., Bullard, K. M., Wallace, J. M., & Jackson, J. S. (2009). Organizational religious behavior among older African Americans: Findings from the national survey of American life. Research on Aging, 31, 440–462.CrossRefPubMedPubMedCentral

Taylor, R. J., Chatters, L. M., & Levin, J. (2003). Religion in the lives of African Americans: Social, psychological, and health perspectives. Thousand Oaks, CA: Sage Publications.

Tran, C. T., Kuhn, E., Walser, R. D., & Drescher, K. D. (2012). The relationship between religiosity, PTSD, and depressive symptoms in veterans in PTSD residential treatment. Journal of Psychology and Theology, 40(4), 313–322.CrossRef

Trevino, K. M., Archambault, E., Schuster, J., Richardson, P., & Moye, J. (2012). Religious coping and psychological distress in military veteran cancer survivors. Journal of Religion and Health, 51(1), 87–98.CrossRefPubMedPubMedCentral

Tsai, J., El-Gabalawy, R., Sledge, W. H., Southwick, S. M., & Pietrzak, R. H. (2015). Post-traumatic growth among veterans in the USA: Results from the National Health and Resilience in Veterans Study. Psychological Medicine, 45(1), 165–179.CrossRefPubMed

VA. (2016). Population tables: The nation. National Center for Veterans Analysis and Statistics. Retrieved on 8-11-18 from, https://www.va.gov/vetdata/veteran_population.asp.

Wang, Z., Ma, H., Rong, Y., & Koenig, H. G. (2016). Psychometric properties of Belief into Action Scale among university students in China. International Journal of Social Science Studies, 4(3), 82–92.CrossRef

Zigmond, A. S., & Snaith, R. P. (1983). The hospital anxiety and depression scale. Acta Psychiatrica Scandinavica, 67, 361–370.CrossRefPubMed

Titel: Religious Involvement, Anxiety/Depression, and PTSD Symptoms in US Veterans and Active Duty Military
verfasst von: Harold G. Koenig
Nagy A. Youssef
Rev. John P. Oliver
Donna Ames
Kerry Haynes
Fred Volk
Ellen J. Teng
Publikationsdatum: 17.08.2018
Verlag: Springer US
Erschienen in: Journal of Religion and Health / Ausgabe 6/2018
Print ISSN: 0022-4197
Elektronische ISSN: 1573-6571
DOI: https://doi.org/10.1007/s10943-018-0692-1

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