Relationship of Religious Beliefs with Anxiety and Depression))
Religion and Psychological Distress Author(s): Catherine E. Ross Source: Journal for the Scientific Study of Religion, Vol. 29, No. 2 (Jun., 1990), pp. 236- 245 Published by: Wiley on behalf of Society for the Scientific Study of Religion Stable URL: https://www.jstor.org/stable/1387431 Accessed: 15-11-2018 15:01 UTC
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Research Note
Religion and Psychological Distress*
CATHERINE E. ROSST
The positive emotional function of religion has been well accepted, but the evidence has not been
conclusive. Furthermore, research has rarely made explicit comparisons to persons who claim to have
no religion. Using a representative sample of Illinois residents (and controlling for sociodemographics
and willingness to express feelings), I found that the stronger a person's religious belief, the lower
the level of psychological distress. This supports the idea that religion reduces demoralization and
provides hope and meaning. However, I also found that persons with no religion likewise had low levels of distress. Thus, there was a curvilinear effect of religious belief on distress. In addition, I
found that Protestants had the lowest distress levels, followed by Catholics, Jews, and others. Differences in belief systems, however, especially a belief in the American Protestant ethic, did not
explain differences in distress among religious groups. Strength of religious beliefs appears to be
more important than content in explaining the effect of religion on psychological distress.
RELIGIOSITY AND WELL-BEING
The emotional function of religion has been well accepted, although the empirical evidence
has not been conclusive. Religious belief is expected to reduce psychological distress,
especially depression, anxiety, and related physiological symptoms. Religion is thought
to comfort, relieve pain and suffering, make life worth living (Stark et al. 1983; Stack
1983a), provide hope and meaning (Hadaway 1978), and help people cope with problems
(Stack 1983b). Even theorists with a negative view of religion have described it as providing
(false) comfort.
Community mental health surveys have found that, among Protestants and Catholics,
religiosity (as indicated by church attendance) was associated with lower levels of
psychological distress, better adjustment and happiness, less worry about "having a
nervous breakdown" (Gurin et al. 1960), and less psychological impairment (Lindenthal
et al. 1970). Self-reported religiousness has been associated with higher levels of life
satisfaction (Hadaway 1978; Clemente and Sauer 1976). More recently, Idler (1987) found
that when sociodemographic characteristics and health status were controlled, attendance
at services and religious belief were both associated with low levels of depression for all
*Data collection was funded by grants from the Research Board and the Sociology Department, University of
Illinois. Data were collected by the Survey Research Laboratory and by participants in a course on survey research
methods, taught by Gunther Luschen and Joe Spaeth.
tCatherine E. Ross is an associate professor of sociology at the University of Illinois at Urbana-Champaign,
Urbana, IL 61801.
? Journal for the Scientific Study of Religion, 1990, 29 (2): 236-245 236
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RELIGION AND DISTRESS 237
women and for men with health disabilities. Pollner (1989) found that feeling close to God,
praying, and feeling close to a spiritual force were associated with happiness and
satisfaction, given adjustments for background characteristics and for church attendance.
Related research has found that church attendance and religious belief are associated with
better physical health (Levin and Markides 1986; Zuckerman et al. 1984; Berkman and
Syme 1979).
However, not all community studies support the proposition that religiousness is
associated with well-being (Levin and Markides 1986; Brown and Gary 1987). Only about
half of the 24 studies (mostly with student samples) in a meta-analysis found a positive
association between religion and mental health (Bergin 1983). In addition, community
studies have rarely included comparisons with those who say they have no religion, a
small but crucial comparison group if one is going to claim that religion has a positive
emotional function.
No Religion
To have no religion in America is to be marginal to mainstream culture. A large
majority of Americans have some religious affiliation, go to services, pray, and believe
in God (Gallup 1985). Although adherence to religion has decreased slightly, in 1987
approximately 93% of persons in the U.S. reported a religious affiliation; in the Detroit
area, 95% reported they believed in God, 77% reported that they attended religious services
in the past year, and 91% reported that they prayed (Alwin 1988). Furthermore, the
marginal status of unaffiliated persons may result from their rejection of organized religious
identity (Hadaway and Roof 1979). People who say they have no religion do not say it
lightly; they are not indifferent. They have made a conscious choice to reject religion,
and this is quite different from saying, for example, that one is Protestant but has only
a very weak belief. Those who claim "no religion" or "no belief" are an important com-
parison group; I do not think they should be combined with persons who claim very weak
beliefs (as in Pollner 1989), nor should they be excluded from the analysis (as in Gurin
et al. 1960; Lindenthal et al. 1970; Srole and Langner 1969).
Past literature leads us to expect that those with no religion should have high distress
levels, since they are marginal and lack the meaning and commitment that come from
religious belief. On the other hand, they may have made commitments to other non-
religious institutions that serve an emotional function similar to that of religion. We might
then expect that both persons with strong religious belief and persons who have rejected religion would have low distress levels (Shaver et al. 1980).
Content of Beliefs
Specific content of religious beliefs may also affect well-being. Two generalized attributions may be important here. Both may be considered American modifications of
the Protestant ethic. The first, called self-efficacy, is the belief that success is due to hard
work, ability, and effort. As Bouma (1973) has noted, researchers testing the Protestant
ethic have rarely measured beliefs explicitly, measuring instead SES, plans for education, upward mobility, etc. The second belief is that life's outcomes are in God's hands, that
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238 JOURNAL FOR THE SCIENTIFIC STUDY OF RELIGION
success in life is due to trust and belief in God, and that God will reward those who try
to do their best. Although Calvinist doctrine stressed the importance both of hard work
and of fate being in the hands of God, success in this life was explicitly rejected (Weber
1958). The American modification is reflected by Ben Franklin's saying, "God helps those
who help themselves," and has thus been called the "American Protestant ethic."
In this research, I examined whether these beliefs affected distress, and whether they
explained differences in the association between religious preference (especially between
Protestants and other denominations) and distress.
METHODS
Sample
This research was based on a 1984 telephone survey of a probability sample of Illinois
residents. Random digit-dialing was used in Chicago and surrounding suburbs to ensure
the inclusion of unlisted numbers. Systematic selection of numbers from telephone
directories was made in other areas of the state, where the percentage of unpublished
phone numbers was small. For each household, respondents were selected on the criteria
of age (18 years or older) and birthdate (most recent birthday among members of each
household). The response rate was 70.1%, for a total of 401 cases, aged 18 to 83.
Measurement of the Variables
The final dependent variable was psychological distress, as measured by symptoms
of depression and anxiety. This was an interval-level variable coded from high levels of
psychological well-being to high levels of psychological distress. It was measured by eight
psychological items from the Langner index (1962). Respondents were asked, "In the past
past 12 months, how often have you: 1) wondered if anything is worthwhile? 2) been in
low spirits? 3) had trouble sleeping (i.e., waking up in the middle of the night and not
being able to get back to sleep)? 4) had periods when you could not "get going"? 5) felt
that things never turn out right? 6) had trouble remembering things? 7) felt irritable,
fidgety or tense? 8) felt restless?" Responses were coded "never" (0), "seldom" (1),
"sometimes" (2), or "often" (3). The index, coded from 0 to 24, had an alpha reliability
of .77. Of these symptoms, items 1 through 6 were measures of depression. Items 7 and
8 (feeling irritable, fidgety, tense, and restless) were part of the syndrome of depression,
although they were also measures of anxiety. Thus, the measure of psychological
distress/well-being measured symptoms of depression and anxiety. In order to minimize response bias, I controlled for willingness to express emotions, as measured by the degree
of agreement with the statement, "I keep my feelings to myself." Responses were coded
"strongly agree" (1), "agree" (2), "neutral" (2.5), "disagree" (3), "strongly disagree" (4).
Persons who scored high were willing to express their feelings.
I also controlled for sociodemographic characteristics. Age and education were
measured in number of years. Marital status contrasted married (1) with not married (0).
Family income was coded in thousands of dollars. Gender was coded male (1), female (0).
Race was coded white (1), nonwhite (0).
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RELIGION AND DISTRESS 239
Religious preference was measured by asking respondents, "Is your religious
preference: Protestant, Catholic, Jewish, other, or no religion?"1 Protestants were asked, "What specific denomination are you, if any: Baptist, Methodist, Lutheran, Presbyterian,
Episcopalian, Nondenominational, other?" We examined religious preference in two ways:
first, with each Protestant denomination separate, and second (given no significant
differences among denominations), with Protestants grouped together. In the second case,
religious preference was a series of dummy variables in which Protestants were the omitted
category. Thus, Catholics, Jews, others, and no religion were compared to Protestants.
Strength of religious belief was measured by asking respondents, "Would you call yourself a strong, somewhat strong, or not very strong ?" (religious preference
filled in). Responses were coded "not very strong" (1), "somewhat strong" (2) and "strong"
(3). Persons who reported no religion were scored as 0, not as missing because this would
have excluded them from the regression analyses. I felt they were an important group
to include.
Content of beliefs was measured by two aspects of generalized attributions for success:
personal efficacy and trust in God. Personal efficacy was measured by responses to the
question, "How much do the following contribute to success in life: 1) hard work and
perseverance, and 2) your own abilities?" and by the amount of agreement with the state-
ment, 3) "each person is responsible for his/her own destiny." Responses were coded from
"not at all" (1) to "very much" (5) and were summed to produce an index scored from
a low to a high belief in personal efficacy. Trust in God was measured by asking
respondents, "How much does the following contribute to success in life: 1) trast and
belief in God?" and by amount of agreement with the statement, 2) "God will reward
those who try to do their best." Responses were coded from "not at all" (1) to "very much"
(5) and were summed to produce an index scored from low to high belief that outcomes
in life are due to God.
RESULTS
Table 1 shows the associations of religious preference, strength of religious belief,
and content of beliefs with psychological distress, with controls for sociodemographic
characteristics and willingness to express feelings. First, persons with stronger religious
beliefs had significantly lower distress levels than did those with weak beliefs. Second,
Protestants and those with no religion had the lowest distress levels, followed by Catholics,
who were significantly higher, and then by Jews and others, who had the highest distress
levels. Protestants were the omitted, or comparison, category in the series of dummy
variables, which means they had an implied value of zero.2 Table 1 shows that persons
1. Other religions in these data included people who identified themselves as Muslim, Greek Orthodox, Hindu,
Nondenominational, Buddhist, and Deist. Persons with other religious affiliations were grouped together because each was a very small group, less than 1% of the sample. It would be risky to compare results to other samples in which the "other religions" group may be composed of different groups or of the same groups in different numbers.
2. The different Protestant denominations were combined because they were not significantly different from
each other in their effects on distress, when sociodemographic characteristics were controlled. Without such controls, nondenominational Protestants and Baptists had higher distress levels than did others. However, these differences were not due to religion; they occurred because these two denominations tended to have lower levels
of education and income than did other denominations.
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240 JOURNAL FOR THE SCIENTIFIC STUDY OF RELIGION
TABLE 1
PSYCHOLOGICAL DISTRESS REGRESSED ON RELIGIOUS PREFERENCE,
STRENGTH OF RELIGIOUS BELIEF, CONTENT OF BELIEFS, WILLINGNESS
TO EXPRESS FEELINGS, AND SOCIODEMOGRAPHICS
b
(Seb) Beta
Religion:a
Catholic 1.100* .118*
(.477)
Jewish 2.872* .101* (1.462)
Other 3.072** .151**
(.987)
No Religion - .942 - .051 (1.048)
Strength of belief -.495* -.119* (.238)
Content of beliefs:
Personal efficacy - .345** - .132**
(.131) Trust in God -.104 -.047
(.142)
Sociodemographics:
Age -.027* - .100*
(.014)
Male -.509 -.057
(.437) White -.586 -.045
(.653) Married -.380 -.042
(.457) Education -.132 -.077
(.098)
Income -.033** -.141**
(.013)
Wilingness to express feelings - 1.279** -.186**
(.335)
Constant 24.868 R 2 .159
aProtestants are the omitted (or comparison) group in the series of dummy variables.
*p < .05 **p < .01
b = Unstandardized regression coefficient; Seb = Standard error of regression coefficient; Beta = Standardized regression coefficient.
who reported no religion did not differ significantly from Protestants, whereas Catholics, Jews and others had significantly higher levels of distress.
The associations of religious belief and non-belief with distress are shown in Figure 1. Persons with strong religious beliefs had lower distress levels than did persons with weak
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RELIGION AND DISTRESS 241
beliefs. Persons with no religion also had low distress levels. On the other hand, persons
who reported a religious affiliation but believed only weakly in their religions had high
distress levels. The effect of religious belief on distress was the same for every religious
preference: There were no significant interactions between religious preference and strength
of belief.
FIGURE 1
RELIGIOUS BELIEF AND PSYCHOLOGICAL DISTRESS
Strong
Moderate
Religious Belief
Weak
None
- 1.0 -0.5 0.0 0.5 1.0
Distress (Deviations from the Mean)
*With adjustments for age, sex, minority status, marital status, education, income, and willingness to
express feelings.
Persons with high levels of education and income had low distress levels.3 In addi- tion, older persons had low distress levels. Persons who were willing to express their feelings
also had low distress levels. (This contradicts response-bias arguments that people who
are unwilling to express emotions will always report lower levels of distress.) Further-
more, controlling for willingness to express emotions did not affect the associations between
religion or religious belief and psychological distress.
Strong religious belief decreased distress for all persons, not just for those at high
levels of disadvantage or suffering. Two interaction terms were tested (religious belief
X poverty and religious belief X poor health) and were found to be insignificant. Poverty
was defined as a family income of less than $14,000 a year, and poor health as the report
3. Without adjustment for personal efficacy, education was significantly associated with low distress levels (b = -.231, Seb = .093, p < .05). With adjustment, education was no longer significant, indicating that the well-educated had low levels of psychological distress partly because of a belief in personal efficacy. Table 2 shows that education had the largest effect of any variable on the belief in personal efficacy.
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242 JOURNAL FOR THE SCIENTIFIC STUDY OF RELIGION
that one's health was bad or not so good. Strong religious belief did not decrease distress
more for the poor than for the well-to-do, or more for the sick than the healthy.
Thus, either strong religious belief or complete non-belief decreased distress. In
addition, type of religion affected distress: Protestants had the lowest distress levels,
Catholics were intermediate, and Jews and other religious groups had the highest distress
levels. However, the content of beliefs did not explain the effect of religious preference
on distress. Belief in personal efficacy decreased distress, while belief that one's destiny
is in the hands of God had no significant effect on distress. Neither belief explained the
effects of religion on distress, since religious preference was still strongly and significantly
associated with distress (see Table 1).
These two aspects of the American Protestant ethic were not associated even with
Protestantism. Table 2 shows the effects of religious preference on these two beliefs, with
sociodemographic characteristics controlled. Jews and those with no religious affiliation
were much less likely to attribute outcomes to God. Protestants, Catholics, and those
with other religions did not differ from each other. Religious preference was not
TABLE 2
BELIEF IN PERSONAL EFFICACY (COLUMN 1) AND TRUST IN GOD (COLUMN 2)
REGRESSED ON RELIGIOUS PREFERENCE AND SOCIODEMOGRAPHIC CHARACTERISTICS.
UNSTANDARDIZED REGRESSION COEFFICIENTS ARE SHOWN, WITH STANDARD ERRORS IN PARENTHESES
Personal Trust
Efficacy In God
Religion:a Catholic .244 .113
(.189) (.185)
Jewish .037 -2.744***
(.559) (.547) Other -.702* -.353
(.389) (.381)
No Religion -.160 -3.337***
(.356) (.348)
Sociodemographics: Age -.312*** .018**
(.005) (.005) Male .333** -.292*
(.171) (.167)
White .313 -.525**
(.257) (.252)
Education .096*** -.164***
(.036) (.035)
Income .009* -.007
(.005) (.005)
Constant 11.598 10.517
R 2 .086 .370
aProtestants are the omitted (or comparison) group in the series of dummy variables.
*p < .10 **p < .05 ***p < .01
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RELIGION AND DISTRESS 243
significantly associated with the belief in personal efficacy, except for a small tendency
for those with other religions to reject this belief. Protestants were no more likely than
others to believe that success in life is due to hard work and ability. Thus, the effect of
religious preference on distress was not explained by differences in the belief systems
of different religions. In fact, there were few differences among religions.
The most interesting differences in belief systems had little to do with religion. Instead,
persons who were well educated were more likely to believe that success in life is due
to personal efficacy and were less likely to believe that it is due to God. Males were more
likely than females to believe in personal efficacy. Older persons and non-whites were more
likely to believe that outcomes are determined by God.
DISCUSSION
Those who believed strongly in their religion had lower distress levels than did those
who professed a weak belief. Those who rejected all religious belief also had low distress
levels.4 The latter group are probably not indifferent; instead, they have likely rejected
religion and have commitments to other, non-religious beliefs. The highest distress levels
were found among those who have not made a commitment, who belong to a religion not
out of choice but out of indifference. Likewise, Hannay (1980) found that while active
religious allegiance was associated with decreased mental symptoms, passive allegiance
was associated with increased symptoms. Pargament et al. (1979) also found that persons
who scored low on intrinsic religiousness (living one's religion) but attended church
frequently had low psychosocial competence. They suggested that persons who participate
in religion without religious conviction were in the worst condition psychologically.
Identification with institutions, religious or non-religious, by choice versus by default,
may be the important factor in psychological well-being. Persons who say they have no
religion have typically made a conscious choice to reject the religion in which they were
reared (Newport 1979). Eighty-two percent of those who say they have no religion were
reared with a religion. The modal switching pattern has been from some religion to none.
Otherwise, people have tended to remain affiliated with the religion in which they were reared, with the exception of some Protestants switching from low status denominations
to higher status denominations as they have become upwardly mobile. "The present
evidence argues against the notion that Americans ... choose their religious affiliation
on the basis of some well-thought-out and theologically based criteria" (Newport 1979:550).
The large majority of persons in all religious groups belong by default, whereas the large
majority of those who claim no religion belong by choice.
4. The U-shaped association provides evidence for causal order. Because the data are cross-sectional, causal order cannot be established, but results reinforce causal order assumptions. If we had found that distress in- creased in a linear fashion with religiousness, some might argue that very distressed persons seek comfort in religious belief. Alternatively, if we had found that distress decreased in a linear fashion with religiousness, it could be argued that the very distressed renounce religion. However, we found neither. The fact that distress was lowest among the very religious and among the non-religious suggests that religion probably affects distress rather than vice versa. It is unlikely that low levels of distress would lead a person to become either very religious or not at all religious.
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244 JOURNAL FOR THE SCIENTIFIC STUDY OF RELIGION
High levels of commitment (as opposed to self-estrangement), both of the very religious
to their religions and of the non-religious to other institutions, may explain the low distress
levels in both cases. The group that claims a religious preference without much belief
may be most self-estranged. In such cases, affiliation may be imposed or taken for granted
rather than being a voluntary choice. Possibly, such persons grew up Protestant or Catholic
and still identify themselves as such but do not really believe in the church, do not find
fulfillment in it, and do not see their affiliation as an expression of themselves. Self-
estrangement, as opposed to commitment, is one type of subjective alienation that affects
distress (Mirowsky and Ross 1986) and may explain these patterns of religion and
psychological distress.
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