Religion and Mental Health Edited by John F. Schumaker New York Oxford OXFORD UNIVERSITY PRESS 1992 Oxford University Press Contents Oxford New York Toronto Delhi Bombay Calcutta Madras Karachi Kuala Lumpur Singapore Hong Kong Tokyo Nairobi Dar es Salaam Cape Town Melbourne Auckland and associated companies in Berlin Ibadan Copyright © 1992 by Oxford University Press, Inc. Published by Oxford University Press, Inc. 200 Madison Avenue, New York, NY 10016 Oxford is a registered trademark of Oxford University Press All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior permission of the publisher. Library of Congress Cata!oging-in-Publication Data Religion and mental health / edited by John F. Schumakcr. p. cm. Includes index. ISBN 0-19-506985-4 1. Psychology. Religious. 2. Mental health—Religious aspects. I. Schumaker, John F., 1949- BL53.R435 1992 29U'78322—dc20 92-3775 Contributors, vii Introduction, 3 John F. Schumaker I Historical Perspectives 1. The Psychopathoiogy of Religion: European Historical Perspectives, 33 Jacob A. Belzen 2. Religion and the Mental Health of Women, 43 Robert A. Bridges and Bernard Spilka 3. Mental Health Consequences of Irreligion, 54 John F. Schumaker 4. Religion and Sexual Adjustment, 70 John D. Shea £1-^71-so? m >» $ 'N 13 5 7 9 8 6 4 2 Printed in the United States of America on acid-free paper II Affective and Cognitive Consequences 5. Religiosity, Depression, and Suicide, 87 Steven Stack 6. Religion, Anxiety, and Fear of Death, 98 Peter Pressman, John S. Lyons, David B. Larson, and John Gartner 7. Sin and Guilt in Faith Traditions: Issues for Self-Esteem, 110 Ralph W, Hood, Jr. 8. Religion and Rationality, i 22 James E. Alcock 9. Religion and Self-Actualization, 132 Joseph B. Tamney 10. Religiosity, Meaning in Life, and Psychological Well-Being, 138 Kerry Chamberlain and Sheryl Zika III Psychosocial Dimensions 12. Religon and Mental Health in Early Life, 163 Edward P. Shafranske 13. Religion and Mental Health in Later Life, 177 Harold G. Koenig 14. Religion and Marital Adjustment, 189 Gary L. Hansen 15. Crime, Delinquency, and Religion, 199 WH/iam Sims Bainbridge 16. Religion and Substance Use, 211 Peter L. Benson 17. Religious Orientation and Mental Health, 221 Kevin S, Masters and Allen E. Bergin 18. Mental Health of Cult Consumers: Legal and Scientific Controversy, 233 James T. Richardson 19. Religious Diagnosis in Evaluations of Mental Health, 245 H. Newton Malony IV Cross-Cultural Perspectives 20. Religion as a Mediating Factor in Culture Change, 259 Erika Bourguignon 21. Buddhism and Mental Health: A Comparative Analysis, 270 Gary Grath-Marnal 22. Religious Experience and Psychopathology: Cross-Cultural Perspectives, 281 Raymond H. Prince 23. Religious Ritual and Mental Health, 291 Janet L. Jacobs 24. Content and Prevalence of Psychopathology in World Religions, 300 David Greenberg and Eliezer Witztum Index, 315 Contributors James E. Alcock is Professor of Psychology at Glendon College, York University, in Toronto, Canada. William Sims Bainbridge is Professor and Chairman of the Department of Sociology and Anthropology at Towson State University, near Baltimore, Maryland. Jacob A. Beizen is an Associate Professor at Titus Brandsma Instituut, University of Nijmegen, The Netherlands. Peter L. Benson is President of Search Institute in Minneapolis, Minnesota. Allen E. Bergin is Professor and Director of Clinical Psychology at Brigham Young University in Provo, Utah. Erika Bourguignon is Professor Emeritus of Anthropology at Ohio State University, in Columbus, Ohio. Robert A. Bridges is the Adult Outpatient Clinic Director for Addiction, Treatment and Recovery at St. Luke's Hospital in Denver, Colorado. He is also Adjunct Professor at the University of Denver and the Metropolitan State College in Denver. Kerry Chamberlain is a Senior Lecturer in Psychology at Massey University, in Pal-merston North, New Zealand. Leslie J. Francis is Mansel Jones Fellow at Trinity College, Carmarthen. Wales. John Gartner is a Clinical Assistant Professor of Psychology at The Johns Hopkins University, in Baltimore, Maryland. David Greenberg is a psychiatrist and Director of the Jerusalem Mental Health Center, in Jerusalem, Israel. Gary Groth-Marnat is a Lecturer in Psychology at Curtin University, in Perth, Australia. Gary L. Hansen is an Associate Extension Professor of Sociology at the University of Kentucky, in Lexington, Kentucky. Ralph W. Hood, Jr. is Professor of Psychology at the University of Tennessee at Chattanooga. Harold G. Koenigis Assistant Professor of Psychiatry at Duke University Medical Center in Durham, North Carolina. David B. Larson is an Associate Professor of Psychiatry on the Clinical Faculty of Duke University Medical Center in Durham, North Carolina. John S. Lyons is Associate Professor of Psychology at Northwestern University Medical School in Chicago, Illinois. H. Newton Malony is Professor of Psychology in the Graduate School of Psychology at Fuller Theological Seminary, Pasadena, California. Kevin S. Masters is Assistant Professor of Psychological Science at Ball State University, in Muncie, Indiana. Peter Pressman is a doctoral candidate in clinical psychology at Northwestern University Medical School, in Chicago, Illinois. Raymond H. Prince is Director of the Division of Social and Transcultural Psychiatry at McGill University, Montreal, Canada. James T. Richardson is Professor of Sociology and Judicial Studies at the University of Nevada, Reno. John F. Schumaker is Senior Lecturer in Psychology, Department of Psycho-Social Health Studies, at the University of Newcastle, in Newcastle, Australia. Edward P. Shafranske is Associate Professor of Psychology, Graduate School of Education and Psychology, Pepperdine University, in CulverCity, California. John D, Shea is a Senior Lecturer in Psychology at the University of Newcastle, in Newcastle, Australia. Bernard Spilka is Professor of Psychology at the University of Denver, in Denver, Colorado. Steven Stack is Professor of Sociology at Wayne State University, in Detroit, Michigan. Joseph B. Tamney is Professor of Sociology at Ball State University, in Muncie, Indiana. Eliezer Witztum is a Senior Psychiatrist at the Jerusalem Mental Health Center, in Jerusalem, Israel. Sheryl Zika is a doctoral candidate in psychology at Massey University, in Pal-merston North, New Zealand. Introduction John F. Schumaker Religion and mental health are two topics that continue to intrigue specialists and lay people alike. Each has been viewed in any number of lights, and ample controversy surrounds both areas of study. The same is true for the ways in which religion and mental health are thought to relate to one another, which is precisely the subject matter of this book. Many people have ventured the argument that religion is generally beneficial to mental health. Among the numerous rationales to support this position is that religion (!) reduces existential anxiety by offering cognitive structure whereby pacifying explanations and attributions serve to order an otherwise chaotic world; (2) offers a sense of hope, meaning, and purpose along with a resultant sense of emotional well-being; (3) provides a reassuring fatalism that enables one to better withstand suffering and pain; (4) affords solutions to a wide array of situational and emotional conflicts; (5) partially solves the disturbing problem of mortality Dy way of afterlife beliefs; (6) gives people a sense of power and control through association with an omnipotent force; (7) establishes self-serving and other-serving moral guidelines, while suppressing self-destructive practices and lifestyles; (8) promotes social cohesion; (9) offers a well focused social identity and satisfies belongingness needs by uniting people around shared understandings; and (10) provides a foundation for cathartic collectively enacted ritual. Such a list of purported functions reminds one of Pruyser's (1971) assertion that, psychologically, religion is equivalent to an elaborate human "rescue operation" (p. 80). Some people would want to qualify these and other claims about the purported ability of religion to act in the service of mental health, while others would disagree altogether with the notion that religion constitutes psychological "rescue." !n fact, a number of individuals have elaborated on the ways in which religion (or some types of religion) can be detrimental to psychological health. Among other things, it has been argued that religion has the potential to: (1) generate unhealthy levels of guilt; (2) promote self-denigration and low self-esteem by way of beliefs that devalue our fundamental nature, or aspects of our nature; (3) establish a foundation for the unhealthy repression of anger; (4) create anxiety and fear by way of beliefs in punishment (e.g., hell) for our "evil" ways; (5) impede self-direction and a s^nse of internal control, while acting as an obstacle to personal growth and autonomous 3 over-reliance on íurues ui giuups caiumai w uuwv.h, v ' t w *"*■»•-'" ^* sexual feelings, and pave the way for sexual maladjustment; (8) encourage the view that the world is divided into camps of mutually exclusive "saints" and "sinners" which, in turn, increases hostility and lowers tolerance toward the "other"; (9) instill an ill-founded paranoia concerning malevolent forces that threaten one's moral integrity; and (10) interfere with rational and critical thought. Certain theoretical approaches have even considered religion itself to be a direct expression of either mental illness or mental health. For example, Spiro (1965) asked, "How can we be sure that religious behavior is not abnormal behavior, requiring psychiatric, rather than sociocultural analysis?" (p. 100). He justified this question on the grounds that religion involves serious impairment of psychological functioning in the form of (1) cognitive distortion in which logically unfounded beliefs are entertained as true; (2) perceptual distortion wherein stimuli are perceived as something other than what they are; and (3) affective distortion that is associated with religious activity and experience. Spiro concluded that religion should be regarded as "absolute insanity" that serves as health-giving culturally constituted defense mechanisms (also see Schumaker, 1990, 1991). Ellis (1975) depicted religion as "mental sickness... that must make you self-depreciating and dehumanized" (p. 440). Then there is Freud's (1964/1927) frequently cited allegation that religion is a "universal neurosis" which spares us "the task of forming a personal neurosis" (p. 77). By sharp contrast, people of differing persuasions have viewed religion as a direct display of optimal reality contact and psychological health. From this view have emerged various psychotherapies that employ religion to ameliorate psychological disturbance. A large proportion of thinkers take a well-reasoned middle ground, maintaining that religion has the potential to be either positive or negative in its effects on mental health. They claim that religion is subject to endless variations in structure, content, and orientation, all of which serve to establish any particular religion as a psychological asset or liability, or neither. In this vein, Roberts (1953) wrote that religion can be health-giving and beneficial, or inhibiting and pathological. Spilka, Hood, and Gorsuch (1985) concluded that religion can serve several different functions. It can safeguard mental health by acting as a haven from life's difficulties, or it can be a hazard by infusing people with "abnormal mental content and abnormal motives" (Spilka et al., 1985, p. 305). They add that religion has the potential to be a "therapy" but that religion itself can "sponsor the expression of psychological abnormality" (p. 291). This book was not approached with the intention of resolving the argument in an either-or fashion. In fact, the contributors themselves come from various backgrounds and have widely differing personal views about religion. Instead, this volume strives to present some recent theory and research that promises to enhance understanding of the complex interface between religion and mental health. Although a great deal remains to be learned, the past decade has afforded a large corpus of work in this area. It has also seen a general resurgence of investigative interest in the myriad of relationships between religion and various specific dimensions of mental health. Liz inv^ it/jijui vii iiiiiimuuiu iimi iiavi, ^>iaguw una aita ui siuuy. 1VIU»1 MLLU- ies are correlational in nature, making it impossible to draw conclusions about the impact of religion on mental health or the impact of a person's mental health status on religious belief. In many cases, ill-conceived sample selection makes meaningful generalization difficult or impossible. A great many studies have employed college students as the sample population, while others included in their samples only people who were religious or who were members of a church. Very little research has used experimental methodologies that permit mental health comparisons between individuals of widely varying religious intensities. This is a serious problem since it is becoming apparent that the relationship of religion to mental health is not a linear one. In fact, Masters and Bergin (chapter 17) raise the possibility that small amounts of religion may do nothing but "bug" people, while other investigators have suggested that only very high levels of religion are associated with significant mental health advantages. Completely irreligious people are an especially neglected group, and we have yet to appreciate the ways in which a very low level of religious belief/involvement relates to psychological adjustment. Likewise, not enough attention has been paid to religiosity among populations with specific patterns of psychopathology. The sparsity of longitudinal research limits understanding of the interaction between religion and mental health variables as people progress through the life cycle. Other research shortcomings reveal themselves in this book, limitations that should inhibit any tendency to rush toward definitive statements and final conclusions. Nevertheless increased awareness of the need to upgrade the quality of research on religion and mental health has resulted in improved research methods that continue to become more sophisticated. As new patterns begin to emerge, longstanding confusions and contradictions are becoming clarified. Much of the historical difficulty in understanding the interconnectedness between religion and mental health lies in the extremely broad nature of these constructs. Each can be defined in any number of ways. What is clear above all else is that the relationship between religion and mental health is largely dependent upon the definitions one chooses. In fact, some definitions differ so dramatically from one another that the actual valence of the relationship between religion and mental health can shift. Since this is an ongoing complication, we might consider briefly some of the ways in which the two concepts have been circumscribed. Conceptualizing Religion It is generally conceded that religion must be understood as a multidimensional form of behavior, and also one that has almost endless potential modes of expression. This point is made explicitly by Wilson (1978) who wrote that "Religion is not a homogenous whole. Individuals who are religious in one respect might not be in another. .. religion is multidimensional" (p. 442). The different definitions of religion tend to emphasize selected aspects of the overall process. For example, Spiro (1966) stressed social involvement with deities tion with culturally postulated superhuman beings (p. yo). aucn aenmuuns nave been criticized on the grounds that some religions (e.g.. Buddhism) do not involve obvious deities. By contrast, Smith (1978) focused on intrapersonal elements in defining religion as "a dialectical process between the mundane and the transcendent ... whose locus is in the personal faith and lives of men and women, not altogether observable and not to be confined within any intelligible limits" (p. 187). Lenski (1963) highlighted the cognitive and ritualistic aspects of religion in defining religion as "a system of beliefs about the nature of the force(s) ultimately shaping man's destiny, and the practices associated therewith, shared by members of a group" (p. 331). Religion was viewed by Geertz (1966) largely in terms of meaning and motivation and the methods by which these are integrated in action systems: "Religion is a system of symbols which acts to establish powerful, pervasive and long-lasting moods and motivations... by formulating conceptions of a general order of existence and clothing these conceptions with such an aura of factu-ality that the moods and motivations seem uniquely realistic" (p. 4). Religion is sometimes understood within the context of the existential dilemmas into which the human being is born. For instance, Bellah (1971) postulated that religion and its related rituals were a direct consequence of the fundamentally problematic nature of existence. Accordingly, religion is "that symbolic form through which man comes to terms with the antimonies of his being'1 (Bellah, 1971, p. 50). Allport (1950) also emphasized existential concerns and goals when he described religion as "a man's audacious bid to bind himself to creation and the Creator. It is his ultimate attempt to enlarge and to complete his own personality by finding the supreme context in which he rightly belongs." (p. 142). Likewise, Erikson (1958) described religion as an ordering force capable of offering a meaningful translation of "the exceeding darkness which surrounds man's existence, and the light which pervades it beyond all discrete comprehension" (p. 21). AsGiddens (1989) noted regarding the multifaceted nature of religion, all religions share certain common elements. They all involve a set of symbols which invoke feelings of reverence or awe. These are associated with rituals which, in turn, are practiced by people who entertain a specific belief. Clock (1962) put forward a five-part model of religion consisting of the following dimensions: (1) ideological (a person's beliefs); (2) intellectual (information and knowledge about faith, scriptures, etc.); (3) ritualistic (overt, institutional actions culturally defined as "religious"); (4) periential (direct knowledge of ultimate reality arising from religious emotion and/or experience); and (5) consequential (the secular effects of the other four dimensions of religious involvement). Fromm's (1950) definition of religion addressed the cognitive, interactional, and ritualistic dimensions of religion in defining it as "a system of ideas, norms, and rites that satisfy a need that is rooted in human existence, the need for a system of orientation and an object of devotion" (see Funk, 1982, p. 294). While some of the above definitions might be useful, controversy will certainly continue to surround the nearly impossible task of delineating what is meant by religion. Some thinkers, such as Allport (1967), have suggested that the concept of siuviy, many icscmujcis imvc iuuiiu u iictcaiaij iu suiuoiuw niaiu; me cunccpt oi religion operational so that its relation to mental health can be studied. Without question, knowledge has increased considerably through the resulting quantitative analysis in this area. However, for practical purposes, many studies have quantified religion in such a way that they do not take into account its multidimensional nature. Some research has used range or intensity of religious belief as the pri mary measure, thus concentrating on the cognitive dimension of religion. Other studies have measured religion on the basis of frequency of church attendance or degree of participation in church-related activities. Such measures might allow assessment of the relative benefits of social affiliation and ritual enactment in the religious context, but care must be taken not to generalize beyond the limits of the specific index of religiosity. In fact, King and Hunt (1975) assert that there are as many as 21 different factors that make up religiosity. So, in drawing conclusions about the relationship of religion to mental health, it should be remembered that most studies only deal with a small number of these factors, and sometimes only a single factor. A great deal more work is necessary to more exactly delineate religious factors. The same is true with regard to the different "types" or "kinds" of religion that have emerged in the literature. For instance, a distinction is often made between "intrinsic" and "extrinsic" religion, a basic dichotomy deriving from the work of Allport and Ross (1967). Although these types of religion are themselves a subject of debate, intrinsic religiousness usually refers to religion as a "meaning-endowing framework" (Donahue, 1985) that constitutes some sort of end in a person's life. By contrast, extrinsic religion is usually regarded as a means, or more specifically, a self-serving vehicle by which to achieve comfort and to adapt to social convention. See Masters and Bergin (chapter 17, this volume) for a detailed discussion of the development of the intrinsic-extrinsic dichotomy, and for an overview of the relationships between different religious orientations and mental health. Much of the motivation underlying recent typologies has stemmed from the desire to separate "healthy" religion from "unhealthy" religion. This dates back at least as far as William James (1902), who differentiated between "healthy-mind-edness" and the "sick soul." Allport (1950) extended his theory of mature versus immature personality to include the concepts of mature and immature religion. He described mature, or healthy, religion as "a disposition, built up through experience, to respond favorably ... to conceptual objects and principles that the individual regards as of ultimate importance in his own life, and as having to do with what he regards as permanent or central in the nature of things" (Allport, 1950, p. 56). Allport's efforts to separate healthy from unhealthy religion were then further developed in the distinction between intrinsic and extrinsic religion (Allport & Ross, 1967). The intrinsic-extrinsic dichotomy was extended by Batson and Ventis (1982) to include a generally positive religious orientation in the form of "quest." Their rationale for this stemmed from their feeling that Allport's dichotomy did not leave room for a mature type of religiosity entailing "skepticism of traditional orthodox also wrote of the quest orientation that it is an "open-enaea anu quesuouing iypc of religion, one that "involves honestly facing existential questions in all their complexity, while resisting clear-cut, pat answers" (p. 150). Adorno. Frenkel-Brunswik, Levinson, and Sanford (1950) contrasted "serious" religion with "neutralized" religion. Serious religion was thought to be healthier since it revolved around personally experienced belief, whereas neutralized religion was used "to gain some immediate practical advantage or to aid in the manipulation of other people" (Adorno etal., 1950. p. 733). In a somewhat similar way, Ash-brook (1966) distinguished between "moral commitment" and "calculative involvement." Erich Fromm (1950) argued for a qualitative division between "humanistic" and "authoritarian" religion. Of these, humanistic religion was seen to be healthier since it centered on human strength and the virtue of self-realization. In this religious mode, God was viewed as a symbol of humankind's own power and not as an entity having power over human beings. By contrast, in authoritarian religion, human beings allow themselves to be controlled by a deity that is regarded as deserving of reverence, worship, and obedience. In Fromm's words, "the main virtue of this type of religion is obedience, its cardinal sin is disobedience" (p. 35). Allen and Spilka (1967) contrasted "committed" and "consensual" forms of religiosity. Of these two, committed religion was more health-giving since it entailed "a high sense of perspective combined with a flexible approach to faith and life" (Spilka & Werme, 1971, p. 465). This pattern of religious involvement was thought to be more likely to provide life meaning, expressive emotional outlets, and therapeutic resolution of personal and situational conflict. On the other hand, consensual religion was described as less conducive to psychological health since such religionists were "marked by a shallow and restrictive mode of thinking which results in a simple conformist orientation to life" (Spilka & Werme, 1971, p. 465). In the process, the individual becomes a mere extension of conventional cultural dictates, which leads to suppression of personal feeling and emotion. Pruyser (1977) contrasted "healthy religion" with "neurotic religion," or what he referred to as the potentially "seamy side of religion" (p. 329). More recently, Spilka (1989) drew on General Attribution Theory in classifying religion as either "functional" or "dysfunctional" in nature. In that dichotomy, religion served a functional role if it fostered attributions that met a person's need for meaning, self-esteem, and a sense of personal control. Additionally, this kind of religion was seen to contain religious meanings that furthered freedom and advanced a person's potential and development. Conversely, Spilka wrote that dysfunctional religion involves religious meanings "that lead to dogmatism, restrict thought and limit freedom and opportunity, distort reality, separate people, and arouse fear and anxiety" (p. 6). Much of this book deals with the specific conditions under which religion is either beneficial, detrimental, or of no consequence in relation to mental health. Given the highly complex and multidimensional nature of religion, the reader should appreciate that it is not possible to arrive at a single, all-embracing conclusion. Certain individual, social, or situational factors will reveal religion's "func- Conceptualizing Mental Health Allport (1967) made the cogent observation that, in the broadest sense, all human life is "psychologically marginal" (p. 83). Consequently, to say that someone is "mentally healthy" may be to ignore the ongoing psychological struggles and adjustment problems that are an inevitable feature of human existence. Conversely, to conclude that a person somehow lacks mental health is almost certain to ignore the many ways in which that individual operates effectively and in accord with guidelines for appropriate behavior. Like religion, there are many ways to understand and define "mental health." The construct overlaps with that of "mental disturbance" (or mental illness) in that both usually assume a continuum (or set of continua) along which it is possible to gauge degrees of mental health or ill-health. Yet, it is an exceedingly slippery concept that is inextricably tied to the equally elusive concept of "normality." Some of the difficulty in coming to terms with the notion of normality can be traced to the language used to describe and judge behavior. We usually attach primary meaning to the word "abnormal," which in turn inclines us to define "normal" as "not abnormal." The same is true for the vast array of words that imply abnormality. For instance, our vocabulary would allow us quite easily to describe a person who is compulsive, the reason again being that "compulsive" has primary meaning. But most people would be at a loss to adequately describe someone who is "normal" on the basis of not being compulsive. Furthermore, it is insufficient to depict normality in this case as the opposite of compulsiveness. A person who is the opposite of compulsive could be equally maladjusted (maybe uncontrollably "expulsive," as Freud described that trait). In general, then, our system of language predisposes us to depict normality and mental health as extensions of our conceptions (and verbalizations) of abnormality and mental ill-health. For this reason, most treatises on "mental health" are at least partially contextualized in terms of behaviors deemed to be abnormal, or mentally unhealthy. The situation is further complicated by the numerous ways in which abnormality can be defined and understood. These include: (1) personal suffering; (2) maladaptiveness, wherein a behavior interferes with individual or social well-being; (3) irrationality or incomprehensibility; (4) unpredictability and/or loss of control; (5) unconventionally; (6) observer discomfort; or (7) violation of moral or ideal standards (Rosenhan & Seligman, 1984). Moreover, in the context of cross-cultural variations in normative behavior, the actual concepts of normality and abnormality become virtually useless. Some humanistically oriented thinkers have urged us to recognize that normality (in the sense of being not abnormal) does not necessarily imply that one is living in a healthy or satisfying manner. Jahoda (1958) referred to "positive mental health" while Rosenhan and Seligman (1984) preferred the term "optimal living." Both allow mental health to be evaluated according to degrees of positive attributes, ity, the realization of one's potential, the joy derived from life, and so forth. The concept of "self-actualization" (Maslow, 1971; Rogers, 1961) embraces many of these healthy qualities (see chapter 9, this volume, by Joseph B. Tamney). A conceptualization of mental health (or its lack) is additionally hampered by the existence of distinctly different schools of thought in psychology and related fields of study. Each has a somewhat different notion of what underlies mental health, and each has a different view on the way that psychological health expresses itself behaviorally. Without spelling these out in detail, their disparate assertions mean that religion's perceived influence on mental health will vary depending upon the school of thought that one endorses. The reason for this is obvious. In one school, the behaviors considered indicative of mental health may relate closely to the behavioral ideals within society's dominant religion(s). By contrast, the mentally "healthy" behaviors of another theoretical school may be at relative odds with religion's behavioral ideals. Stated otherwise, religion may engender behaviors and attitudes that are consonant with mental health for some psychological schools, but not others. One might speculate, for example, that religion is more likely to be viewed as having a deleterious effect on mental health when humanistic definitions of mental health are employed. In defending such a hypothesis, one could isolate key features of humanistic mental health, such as .^//actualization, ^//-fulfillment, ^//-knowledge, ^-determination, emancipation from external sources of control, and so forth. It could then be argued that at least some types of religion (e.g., fundamentalist Christianity) foster behaviors and behavioral ideals that are somewhat incompatible with humanistic models of optimal psychological health. Batson and Ventis (1982) demonstrated quite clearly that the way in which one defines mental health will, to some extent, determine how religion appears to affect mental health. They analyzed the direction of the relationship between religion and mental health by applying seven different definitions for mental health. Whether mental health was positively related, negatively related, or unrelated to religion was determined by the mental health criteria employed. Their work indicated that humanistic criteria of mental health (e.g., self-actualization, self-acceptance) are more likely than other sets of criteria to depict religion as detrimental to psychological health. It has since been shown, however, that the relationship between religion and humanistic mental health criteria (e.g., self-actualization) changes as a function of specific religious orientations (Watson, Hood, & Morris, 1984; Watson, Morris, & Hood, 1990). Instead of identifying themselves with a single definition, many mental health professionals have come to view mental health as a composite of emotion, cognition, perception, and sensation. In any one person, this composite translates into a pattern of experience and behavior by which to assess that person's overall state of psychological health. But, in viewing mental health as a composite, one would expect to find a considerable amount of variation among the numerous factors that contribute to the totality of mental health/ill-health. Therefore everyone's psychological world probably contains both "healthy" and "unhealthy" elements. Fur- It seems unrealistic to expect that definitive conclusions will ever be possible concerning religion and all-encompassing conceptions of mental health. A more reasonable approach assumes that mental health is, in fact, a constellation of variables that have differing relationships to religion. In line with this logic, the present volume is structured in such a way that religion is discussed in relation to specific dimensions of behavior. It will become apparent that religion (and the different types of religion) has a much different effect on some areas of functioning than others. Before proceeding, however, let us briefly examine the conclusions of previous attempts to summarize the relationships between religion and mental health. Previous Reviews Different approaches have been used in an effort to synthesize and generalize about the relationships between religion and mental health. In some reviews, this relationship was summarized in terms of a finite number of factors related to mental health and situational adjustment. Other people preferred to group large numbers of studies, regardless of mental health category, in trying to uncover broader, more wide-ranging connections between religion (and religious types) and mental health. Argyle and Beit-Hallahmi In a chapter from The Social Psychology of Religion, Argyle and Beit-Hallahmi (1975/1958) reviewed empirical studies on what they termed "religion and personal adjustment." Of direct concern here are their conclusions about the associations of religion with (1) overall "personal adequacy," (2) ability to adjust to life crises, (3) suicide potential, (4) alcohol use/abuse, and (5) crime and delinquency. On the matter of the relationship of religion to "personal adequacy," these investigators arrived at two generalizations: (1) in student populations, religiosity is related to personal inadequacy; (2) in adults (and especially the elderly) participation in public religious activities is positively related to measures of personal adjustment. They cautioned that these generalizations were based on correlational data, so they reserved judgment about the direction of causation. However, they did comment on their conclusion that religious orthodoxy was associated with better overall adjustment, or adequacy. In this regard, Argyle and Beit-Hallahmi speculated that the positive relationship between personal adjustment and formal religious participation can be explained on the basis that (1) a certain degree of personal functioning is a prerequisite for this and other forms of social participation, and (2) once involved, the group itself affords its members support, companionship, and a sense of identity and belonging. Argyle and Beit-Hallahmi did not arrive at a clear conclusion regarding the ability of religion to function as an effective coping mechanism during times of situational crisis. While some research showed religion to be marginally helpful during do resort 10 prayer, wnen emouonauy uisluiucu yy. iti;. m aumuuu, mcj- saw reason to suspect that religion is being used less and less as a source of support during periods of crisis. This review concluded that there was "some evidence" that religious involvement is associated with lower rates of suicide. However Argyle and Beit-Hallahmi did not find evidence that religious affiliation or degree of religiosity had a significant effect on likelihood of suicide attempts. According to their analysis, Protestants no longer have a higher risk of suicide than Catholics. Research on religion and alcohol use led Argyle and Beit-Hallahmi to conclude that religion plays a role in the control of impulsive behavior, including alcohol consumption. They cited the possible exception of extremely strict religions which demand absolute abstinence. In their view, a "rebellion" response may explain the higher rates of alcoholism for people from such backgrounds. Argyle reviewed research related to delinquent behavior, church membership, and church attendance. However, the findings were mixed and they did not generalize about that relationship. These reviewers also summarized research relating criminal activity to religious affiliation, but concluded that many previously cited differences could be understood in terms of social class variations. James E. Dittes Dittes's review chapter in The Handbook of Social Psychology (Vol. 5) (1969) is somewhat controversial since it operates from the assumption that people with "weak egos" are attracted to religion and that religion generally is associated with "deficiencies of personality" (p. 636). While conceding that religion can serve people in times of need, he stated that religion is associated with personal inadequacy, intellectual inadequacy, hypersuggestibility, and "desperate and generally unadap-tive defensive maneuvers" (p. 636). Dittes analyzed several studies dealing with religion and self-esteem and found contradictory results. If there was a trend regarding self-esteem, he added, it was that religion was "correlated with indices of pathology and deficiency" (p. 637). According to Dittes's interpretation of the research, religion was also associated with unhealthy levels of dependency, as well as a pathological degree of suggestibility. He offered three potential explanations for religion's relationship to aberrant suggestibility: (1) hypersuggestibility represented a "general personal weakness or frustration" (p. 639) that sought and found support in the form of religion; (2) it indicated an "inhibition of personal initiative and a submissiveness to authority, reminiscent of'superego' religion;" and (3) inordinately suggestible people might be drawn to institutional religion which is conventional and part of the cultural status quo. In terms of research related to religion, personality constriction, and the use of defense mechanisms, Dittes commented that "a generally consistent correlation has been reported between orthodox religious commitment and a relatively defensive, constricted personality" (p. 639). The limited research available at the time prevented him from extending this generalization into the areas which he labeled "mental illness," "intropumtiveness," and "extrapunitiveness." Sanua's research review in the American Journal ofPsychiatry {\ 969) covered mental health variables under the headings of "psychological adjustment" and "devi-ancy and social pathology." In addition, he reviewed empirical work on the relationship between religion and personality, with specific focus given to prejudice, authoritarianism, and humanitarianism. At the outset, he made the sweeping statement that "the contention that religion as an institution has been instrumental in fostering general well-being, creativity, honesty, liberalism, and other qualities has not been supported by empirical data" (p. 1203). With specific regard to religion and "psychological adjustment," Sanua concluded that "most studies show no relationship between religiousness and mental health, while others point out that the religious person may at times show greater anxiety and at times less anxiety" (p. 1206). He cited the lack of clear patterns as reason for additional research. Sanua made passing reference to the intrinsic-extrinsic religious dichotomy of Allport and Ross (1967), while advancing the view that "intrinsic" religion carried more psychology benefits at both the individual and collective levels. He even speculated about the possibility of restructuring religious education in such a way that would maximize the "intrinsic" orientation and minimize the "extrinsic" orientation. On the subject of "deviancy and social pathology," Sanua examined a small and divergent body of research related to delinquency, antisocial behavior, alcoholism, and "moral integration of the community" (as measured by concern for the welfare of one's neighbors). In most instances, Sanua reaffirmed his general theme, namely that there is no convincing evidence that religion serves to deter deviancy or social pathology. This can be seen in his summational statement that "the evidence regarding the relationship between social pathology and religion points out that the latter may not necessarily fulfill the function ascribed to it—namely, that of an integrating force in society and a contributor to the mental health of the members of that society" (p. 1207). Despite what he termed this "startling" conclusion, he reiterated the need for further research in this subject area. Rodney Stark In an article in Review of Religious Research, Rodney Stark (1971) challenged the "hoary proposition . . . that religion is associated with psychopathology" (p. 165). After discounting the theory and logic sustaining this proposition, he analyzed the "scarce, dated, and usually very inferior" (p. 167) research in this area. He grouped studies into four categories: (1) religion and mental illness; (2) religion and psychic inadequacy; (3) religion and neurotic distrust; and (4) religion and authoritarianism. Stark's analysis of data on outpatient mental patients revealed that psychiatric patients were far more likely than "normal" individuals to be of "no religious affiliation," more likely to view religion as "unimportant," and less likely to belong to a church congregation. He concluded that those data constituted support for his hypothesis "that mental illness and religious commitment are negatively related" (p. 169). proncness to loneliness, lack of self-perceived coping ability, and so forth. Four religious denomination groups were included in the analysis and, in each case, Stark found a negative relationship between religious commitment and psychopathol-ogy. Specifically, Stark deduced that "persons scoring high on psychic inadequacy are less likely to be high on religious orthodoxy than are persons scoring low on psychic inadequacy" (p. 169). However, Stark did concede that a time-order issue precluded a final decision regarding the direction of the relationships involved. That is, it remained unclear whether psychological health was the end result or the source of religious commitment. Stark's conclusions about "neurotic distrust" were very similar to those for "psychic inadequacy." He concluded his survey analysis by saying that people with high degrees of neurotic distrust were significantly less likely to be high on religious orthodoxy, and to attend church regularly (regardless of religious denomination). Stark's review led him to the overall conclusion that "whether psychopathology is measured by clinical diagnosis of severe impairment or by more inclusive and less severe survey indices, there is a negative relationship with religious commitment" (pp. 170-71). He further deduced that conventional expressions of religion were not a product of psychological processes. Rather, argued Stark, "psychopathology seems to impede the manifestation of conventional religious beliefs and I activities" (p. 175). [ RussellJ. Becker In a chapter from the book Research on Religious Development, Becker (1971) summarized the interaction of religion and psychological functioning while grouping previous research as follows: (1) religious belief studies; (2) religious practice studies; (3) religious feeling and subjective experience studies; (4) religious knowledge studies; and (5) religious effects (the "consequential" dimension) studies. However, in each case, he pointed to research shortcomings and methodological problems that precluded any definitive conclusions. Becker did comment, very tentatively, that "certain favorable correlations" existed between religious identity/activity and psychological health as measured by "absence of mental illness and neurotic symptoms" (p. 415). But he tempered this by remarking that "the attempt to find detailed points of relationship between pos- j itive psychological traits and religion has produced very few clues" (p. 415). j Gary Lea j A review by Gary Lea (1982), which appeared in the Journal of Religion and j Health, highlighted some of the methodological inadequacies that have plagued the j study of religion and mental health. Among these was his observation that all but two percent of studies have been correlational in nature, thus rendering meaningful | interpretation very difficult. Attention was also drawn to inadequate sampling tech- j niques wherein subjects were drawn entirely from student groups or populations of [ ethnic background. While Lea's review was not organized around clearly circumscribed categories of religion or mental health variables, he nonetheless arrived at some general conclusions about the previous two decades of research on this subject. Of direct relevance to the interface of religion and mental health were the following conclusions: (1) religiosity is detrimental to personal adjustment in students, but positively related to psychological health in adults, and especially the elderly (i.e., the previous summation by Argyle & Beit-Hallahmi, 1975/1958); (2) religiosity does not relate significantly to either social deviancy or moral behavior; (3) the hallmark of "healthy" religion is "social responsibility, and relatedness to other parts of life and to a being greater than oneself, however defined" (p. 347); and (4) "unhealthy" religion involves a preoccupation with guilt-generating concerns (e.g., sin, imperfection, one's "evil" nature), as well as "rigidity with respect to healthy sexual and emotional functioning, and idiosyncratic and literal interpretation of religious symbolism" (p. 347). C. Daniel Batson and W. Larry Ventis Batson and Ventis (1982) devoted a chapter of their book The Religious Experience to a review of religion and mental health. Their strategy was to condense numerous different measures of mental health into seven categories; (1) absence of mental illness (i.e., lack of symptoms); (2) appropriate social behavior; (3) freedom from worry and guilt; (4) personal competence and control; (5) self-acceptance and self-actualization; (6) unification and organization; and (7) openmindedness and flexibility. They then grouped previous studies of religion and mental health according to these seven sets of mental health criteria. This allowed Batson and Ventis to ascertain the valence of the relationship between religion and mental health as a function of the type of definition used to specify mental health. Batson and Ventis demonstrated that the relationship between religion and mental health changes in relation to one's definition of mental health. More specifically, they found that religion tends to have a positive effect on mental health when mental health is defined in the traditional sense as an absence of psychological symptoms. However, when employing other definitions, they found that religion was more likely to be associated with impaired psychological functioning. This was especially the case when mental health was defined according to (1) personal competence and control; (2) self-acceptance or self-actualization; and (3) openmindedness and flexibility. The direction of the relationship was unclear in the other categories. This review also attempted to establish the relative merits of intrinsic, extrinsic, and quest orientations in relation to the above-mentioned conceptions of mental health. The extrinsic religious orientation tended to have a negative relationship to mental health. In terms of specific definitions of mental health, extrinsic religion had a negative relationship to appropriate social behavior, freedom from worry and guilt, personal competence and control, and openmindedness and flexibility. making firm conclusions regarding the "quest" orientation. The lack of data in some mental health categories is one reason that the Batson and Ventis summation should be viewed with some caution. Additionally, theoretical and interpretive problems arise when one collapses a large number of mental health variables into a limited group of definitional categories. Unwittingly, one could easily include in the same category variables that have opposing relationships to religion. Another problem is that some of their definitions are themselves almost impossible to define. For example, concepts such as "unification" or "flexibility" or "competence" can have any number of meanings. Allen E. Bergin Bergin {1983) provided a review and "critical evaluation" of the relationship of religiosity and mental health in an article in the journal Professional Psychology: Research and Practice. This entailed a meta-analysis of 24 selected studies from the period 1951-1979. Bergin presented his review as evidence against the contentious assertion of Ellis (1980) who wrote of people that "the less religious they are, the more emotionally healthy they will be" (p. 637). In the words of Bergin, his review offered "no support for the preconception that religiousness is necessarily correlated with psychopa-thology" (p. 170). In fact, only 23 percent of the effects examined showed a negative relationship between religion and mental health. This review offered more support for claims that religion is beneficial to mental health. Bergin found that 47 percent of his selected research outcomes showed a positive relationship between religious and mental health variables, whereas a zero relationship was obtained in 30 percent of cases. However, this changed somewhat when only statistically significant results were included. When this was done, 77 percent showed no significant relationship between religion and mental health, 17 percent had a positive relationship, and 6 percent had a negative relationship. Bergin concluded that religion is "a complex phenomenon with numerous correlates and consequences" (p. 170), most of which cannot be explained simply. Bergin stated that the confusing mixture of positive and negative results were indicative of religion's multidimensional nature. In his view, the slight positive relationship between religion and mental health may be a deceptive average that disguises powerful relationships between specific religious and mental health variables. Of this, Bergin wrote that "positive effects of some kinds of religiosity are being balanced by negative effects of other kinds, which yield unimpressive or ambiguous average effects" (p. 180). /. Reed Payne, Allen E. Bergin, KimberlyA. Bielema, and Paul H. Jenkins In a review article appearing in Prevention in Human Services, I. Reed Payne and coworkers (1991) summarize religion in relation to the domains of (1) psychological adjustment; (2) social conduct; and (3) mental illness. Their overriding conclu- any jju3h.iv>-. luti^iu m ttn ui uivjv ai i/ud. in lviiii cioi, v/vliiiioiv ivngivu u uv^jju^ii^u ao putting up impediments to optimal functioning in each of these areas. It is argued that differential findings in terms of the intrinsic-extrinsic religious modes serve to dispel the "uniformity myth," the myth that all religious beliefs, practices, and commitments have an equal impact on psychological and psychosocial processes. With regard to religion and psychological adjustment variables, Payne and his colleagues conclude that (intrinsic) religion tends to relate positively to a subjective sense of well-being, as well as measures of self-esteem. In examining religion's effect on mental health across the life span, their literature analysis leads them to describe religion as a promoter of mental health at all stages of life. However, they do not disregard the possibility that, in some cases, religious belief/activity can strengthen maladaptive defenses while offering only temporary escape from emotional conflict. A subsection is included to emphasize further the need to understand the interaction of religion and mental health in the context of healthy (i.e., intrinsic) and unhealthy (i.e., extrinsic) religious orientations. On the matter of social conduct, the review considers the effect of religion on family functioning, premarital sex, alcohol and drug abuse, and suicide. While acknowledging certain limiting factors, the authors ascertain that religious affiliation/involvement shows a consistent positive correlation with a variety of prosocial behaviors. Specifically, they interpret available evidence as indicative of religious ability to foster marital adjustment, mitigate marital conflict and divorce, and enhance overall family cohesion. Religion is also portrayed as a socialization agent capable of inhibiting premarital sexual behavior and permissive sexual attitudes, while also serving as a potent deterrent to alcohol and drug abuse. According to the authors, available research points to an overall inverse relationship between suicide and degree of religious belief and involvement. Payne and coworkers describe as ambiguous the relationship between undifferentiated religion and indexes of mental illness. They state that the studies conducted on truly disturbed populations can be divided into (1) those showing a disturbance among the more religious and (2) those showing no relationship between religion and disturbance. They add that this pattern bears a general resemblance to that found with normal populations, but they observe that mental illness has yet to be studied in relation to religious subtypes (e.g., intrinsic, extrinsic). This review culminates with a series of generalizations and speculations about healthy religion. Most of these concur with Clinebell's (1970) analysis of religion as a "sleeping giant" (p. 46) with vast untapped potential to prevent psychological maladjustment, while simultaneously fostering positive mental health and personal growth. John Gartner, David B. Larson, and George D. Allen In their article in Journal of Psychology and Theology, Gartner, Larson, and Allen (1991) reviewed research on religion and twenty-one different measures of mental health. After doing so, they created three categories reflecting either a positive, negative, or ambiguous relationship between religion and mental health. marital satisfaction, psychological well-being, and depression. Physical health and longevity were also found to be positively related to religion. Moreover, this review indicated that participation in religious activities and religiously-based psychotherapeutic interventions tended to be followed by improvement in psychological functioning. Religion was found to relate negatively to five mental health variables: authoritarianism, self-actualization, suggestibility/dependency, temporal lobe epilepsy, and dogmatism/tolerance of ambiguity/rigidity. It revealed mixed findings for religion's relationship to six dimensions of mental health. Among these were anxiety, psychosis, self-esteem, sexual disorders, prejudice, and intelligence/education. According to these researchers, many of the discrepant and contradictory findings are the result of the ways in which we measure both religion and mental health. They pointed out that most studies that reported a negative relationship between religion and mental health tended to rely on "soft" mental health measures (i.e., paper and pencil tests). By contrast, they observed that studies showing a positive relationship were more likely to use "hard variables" such as suicide rates, objective measures of drug and alcohol use, rates of delinquency, and so forth. This concurred with the findings of Bergin (1983) and Donahue (1985), who also observed that studies linking religion and psychopathology tended to use "intrapsychic" measures of mental health, while behavioral measures were more typical of research which found religion to be an asset to psychological health. A few additional patterns derived from this review. For example, the authors concluded that a lack of religious commitment was associated with disorders of "impulse control," (e.g., antisocial behavior, suicide, drug and alcohol abuse). On the other hand, religious involvement increased the likelihood of "over-control" problems, such as "rigidity." They also concluded that certain measures of religious behavior (most notably church attendance and other forms of religious participation) were more strongly related to mental health than religiosity as measured by attitude scales. This, they added, was especially true in cases where positive relationships were reported between religion and mental health. Finally, Gartner, Larson, and Allen noted that the intrinsic-extrinsicdichotomy can be useful in explaining a number of apparently inconsistent findings in this area. Organization and Content of this Volume This book is divided into four sections. The first, titled "Historical Perspectives," includes chapters that trace the development of thought on the subject of religion and mental health. In addition, this section includes chapters that cover specialized subject areas within a larger historical framework. Parti Chapter I. Jacob A. Belzen provides historical background of European views on the relationship between religion and psychological disturbance. This area of study, and Aristotle as starting points, Belzen recounts the ways in which spiritual and/or somatic origins have been postulated in an effort to understand culturally deviant patterns of behavior. In the process he distinguishes between two broad schools of thought, namely the "psychicists" and the "somaticists." The former stressed the unity of body and soul, a stance that precluded the possibility that mental illness was only a manifestation of defective bodily processes. By contrast, the "somaticists" argued for a dualism of body and soul, but one in which the soul was deemed impervious to dysfunction. As Belzen shows, this paved the way for monistic materialism and reductionistic theories that accounted for mental disturbance in strictly physical terms. He brings this discussion forward in time and shows how contemporary theories (e.g., psychoanalysis, phenomenology, historical-cultural theory) address the age-old differentiation of spirit ("psyche") and body ("soma"). Belzen concludes his analysis with a general discussion and critique of the way in which various psychological schools have dealt with the matter of religion. Chapter 2. Robert A. Bridges and Bernard Spilka write about religion with special reference to the mental health of women. They call attention to the ways in which the majority of world religions (including Judaism, Christianity, Islam, Hinduism, and Buddhism) have placed women in a secondary position to men. They maintain that, as an integral part of the religio-cultural heritage of many nations, this organization of sex roles has been a major cause of conflict, frustration, stress and mental disorder among women. With special reference to the Judeo-Christian tradition, Bridges and Spilka offer a general perspective on religion and mental health that emphasizes the human needs for meaning, control, and self-esteem. They discuss scripture, theology, and psychological research and theory in showing how religion offers negative meanings to women, thus reducing their sense of personal control and lowering their self-esteem. According to these authors, the result may be depression, agoraphobia, and other adjustment problems that disproportionately affect women. However, Bridges and Spilka do not discount the complexity of religion or the ways in which it can enhance mental health. They conclude with a discussion of new and constructive theological developments as well as some new directions for research related to religion and women's psychological health. Chapter 3. John F. Schumaker examines theory and research concerning the mental health consequences of irreligion. The chapter begins with a discussion of the prevalence of irreligion in various societies, as well as some demographic factors that are related to irreligiosity. Space is devoted to theories which attempt to explain modern irreligion. It is pointed out that irreligion in its present form did not exist prior to the eighteenth century, and that its emergence was the result of several social developments originating at that time. Although mental health studies of irreligious people are rare and methodologically flawed, available evidence suggests that very low levels of irreligiosity are associated with increased symptoms of psychopathology. Schumaker attempts to explain this historically in terms of the "cognitive crisis" brought about by an absence of transcendent explanation, as well as pie often substitute for traditional modes of religiosity. However, he points out that such religious surrogates are less conducive to psychological health than their more conventional religious counterparts. Schumaker concludes by noting the ways in which traditional religion itself has changed and partially succumbed to irreligious forces. The result is that religious people are themselves partially divested of age-old pathways to mental health. Chapter 4. John D. Shea gives a historical discussion of the relationship between religion and sexual expression/adjustment. He examines the pagan origins of Christian antipathy to sex, noting the break from the mainstream tolerance of diverse sexual experience in the ancient world. Reference is made to the ways in which church rules about sex became more specific, with certain key figures adding their own qualities to the message of repression. Shea observes that the medical profession, spurred on by an extraordinary commitment to its Christian origins, eventually joined Christianity in the repression of sexuality. It introduced a body of pseudo-scientific nonsense, including the infamous theory of masturbatory insanity which condemned people (and especially women) to another couple of centuries of sexual fear and anxiety. Shea takes the topic into the twentieth century and offers data that demonstrate a direct association between Christian religious conviction and sexual inhibition, with the consequences extending into the areas of marriage, the experience of childbirth, and childrearing. He also uses the data to argue that changes in sexual experience during the twentieth century can be interpreted as a move away from the limitations imposed by Christian beliefs and teachings, in Shea's analysis, the weakened influence of the Christian church has also weakened its power to destroy the binding force in human intimate relationships. Yet he cautions that it may be some time before a stable new sexual philosophy will replace the sexual negativism of Christianity. Shea refers to certain non-Christian religions which offer more sex-positive models of sexuality. Part H The seven chapters of Part II examine religion in relation to different aspects of emotion and cognition. Chapter 5. Steven Stack's chapter discusses the relationships between religiosity, depression, and suicide. His literature review shows that recent research has not supported Durkheim's theory that religions with a high number of rules and activities (e.g.. Catholicism) are relatively more effective in reducing suicide risk. Stack describes a second theory, developed in the early 1980s, that targets certain specific beliefs as more effective than others in deterring suicide. One example might be the belief that those who persevere will be rewarded with a favorable afterlife. Stack's review shows that a slight majority of recent studies support such a theory. He also elaborates on a new "networks" perspective wherein it is contended that religion However, he also comments on certain contradictions in available research in this area. Stack's research review suggests that religion is able to muster a protective shield against depression. However, he calls for large scale epidemiological work in this area, especially in light of the nonrepresentative samples that were typically used in this research area. Chapter 6. The interactions of religion, anxiety, and fear of death are the focus of this chapter by Peter Pressman, John S. Lyons, David B. Larson, and John Gartner. They make the observation that anxiety, like religion, is a ubiquitous and insufficiently understood phenomenon. Their analysis of the confusing literature on the linkages between religion and anxiety suggests that religion has the potential to increase or decrease anxiety, depending on various factors. Some of the discrepancies in the research are explained in terms of the forms of religiousness that were chosen for study. For example, they cite evidence that somatic manifestations of anxiety correlate negatively with religious participation of a public nature, but positively with private religiosity. They describe age as another variable that might mediate the value of religion in relation to the regulation of anxiety. It is also suggested that different religious orientations (e.g., intrinsic versus extrinsic) correlate differently with the experience of anxiety. Pressman and colleagues also describe the rather complicated relationship between religion and death anxiety. They cite research that indicates that religiosity has an effect on certain aspects of death anxiety, but possibly not the global construct of "death anxiety" as that term is generally defined. In this context, they discuss "fear of the unknown" (i.e., what happens after death) in terms of religious motivation. They also raise the possibility that there is a curvilinear relationship between religion and death anxiety, with extremes of religiosity being associated with lower levels of anxiety. These authors conclude with a discussion of various methodological problems that have made it difficult to understand the influence of religion on anxiety, including death anxiety. Specific guidelines for future research are outlined in an effort to promote more rigorous and potentially fruitful methods of investigation in this area. Chapter 7. Ralph W, Hood, Jr., integrates a diverse literature on sin, guilt, and shame within different faith traditions, while concentrating on implications for self-esteem. In so doing, Hood makes reference to empirical, psychoanalytic, and phe-nomenological studies in this area. Hood draws attention to the crude measures of religiosity that have characterized empirical research, and observes that no consistent relationship between religion and self-esteem emerges when religion is measured globally. However, patterns do appear when more sophisticated measures of religion are employed. For example, intrinsic religion is associated with positive self-esteem and lower levels of guilt. By contrast, extrinsic religion is related to poorer self-esteem and enhanced guilt feelings. Hood also discusses these variables in relation to God images while showing that intrinsic religion is associated with benevolent God images, less guilt, and and phenomenological literature, as well as the hermeneutical work on St. Augustine's Confessions. Hood concludes with empirical clarifications indicating that, within faith traditions, guilt, sin, and self-esteem operate in a complex manner. In this regard, he writes that the religiously devout (especially the intrinsic type) are allowed to experience both guilt and relief from guilt, thereby paving the way for enhanced self-esteem. Chapter 8. James E. Alcock discusses the relationship between religion and rationality. He notes that religion continues to play a central role in the lives of many millions of people around the world. Alcock adds that, in our era of science and technology, supernatural belief (both religious and nonreligious) survives because it gives meaning to life and offers relief from anxiety, including existential anxiety. It is argued that most people partition their beliefs so that religious principles rarely intrude into domains where rationality is most efficacious. However, Alcock notes that, for some, religion dominates everything, not only jeopardizing rational thought and behavior, but sometimes also producing detrimental effects on their psychological well-being. In this regard, he observes that fundamentalism, dogmatism, and authoritarianism, rather than religion per se, constitute the real threats to Reason. Chapter 9. Joseph B. Tamney expounds on the relationship between religion and self-actualization, both at the level of the individual and society. It is pointed out that Maslow's ideal (i.e., self-actualized) person is not anti-spiritual. In fact, as Tamney explains, Maslow's truly healthy person is priestlike, mysticlike, and godlike. Nonetheless, we are reminded that Maslow did consider organized religion to be an obstacle to self-actualization. This reflects the difficulty in reconciling religion based on belief in a transcendent deity with a model of mental health wherein the ultimately healthy person is seen as godlike in nature. Tamney reviews empirical research that shows a consistent negative relationship between religiosity and measures of self-actualization. However, Tamney notes that most studies failed to measure directly those Christian attributes that are incongruent with self-actualization. While again noting that Maslow did not regard self-actualizers as anti-religious, Tamney stresses the importance of analyzing the effects of specific religious traditions on the self-actualization process. He also discusses self-actualization in the context of a cultural shift toward "postmaterialism," one that facilitates self-actualization on a large scale, but also one whereby traditional religion diminishes in importance. He summarizes his own research, which reveals that self-actualization is least valued by Christian Rightists since they actively reject the goals of self-actualization. Tamney also mentions the possibility that religion can indirectly influence self-actualization by swaying public opinion and shaping structural and cultural conditions. Chapter 10. Kerry Chamberlain and Sheryl Zika present research findings on the relationship between religiosity, psychological well-being, and meaning in life. usuy, as a uuiiipuiiem ui weii-uemg, ui as an muepeiiueni construct, iney argue that religion may provide one, among many, possible sources of meaning in life, and that meaning is best considered as a separate construct. Chamberlain and Zika elaborate on two of their own studies, the first of which involved mothers of young children as well as a group of elderly people. Religiosity was found to have a limited positive association with well-being, one that was reduced when meaning in life was controlled for. Confirmation of this finding came from the second study, which used two religious groups (Roman Catholics and Pen-tecostals), as well as a multidimensional measure of religiosity. They conclude that religiosity may influence well-being more strongly as the salience of religion increases, and that any association of religiosity with well-being may have its route through meaning. Chapter 11. Leslie J. Francis reviews research related to religion and the Eysenck-ian constructs of neuroticism and psychoticism. He begins with a discussion of fundamental issues related to the definition of religion and mental health, and what it is that constitutes a positive or negative relationship between the two. With these in mind, Francis presents psychometric equations utilizing Eysenck's dimensional model of personality, according to which neurotic and psychotic disorders lie towards the extreme poles of two orthogonal dimensions of normal personality. He then reviews theoretical and empirical relationships between religion and these two variables. Francis draws the overall conclusion that there is no evidence to suggest that religious people experience lower levels of mental health, but some clear evidence that they enjoy higher levels of mental health. Specifically, Francis's research review shows a consistent inverse relationship between religion and psychoticism, and a consistent absence of a relationship between religion and neuroticism. Part III The eight chapters in Part III deal with religion and different dimensions of behavior that involve both social and psychological elements. Chapter 12, Edward P. Shafranske reviews theoretical and empirical perspectives on the role that religion serves in the mental health of children. In pointing out that religion is an important element in the lives of most children, he writes that, within childhood, religion should be viewed as a complex, multidimensional experience that includes religious representations, beliefs, attributions, and practices. In Shaf-ranske's analysis, these interrelated features are a determining factor with regard to a child's sense of self and others, and the code of prescribed and proscribed behaviors that a child assumes. In addition, they are an essential aspect of the attributions and systems of social support that promote coping and adaptation to developmental transitions and life challenges. However, Shafranske observes that religion also has the potential to be destructive to the mental health of children. On this subject, he makes reference to critical and sadistic God representation, as well as belief systems that condemn humane- aiso wrues umi ucnam spcuniu icngiuus uiicmaiiuna