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356 REVERSIBLE DISORDERS OF BRAIN DEVELOPMENTchanging expectations about outcome and control of outcome, and focusing oncontrollable aspects of the stressor. Acceptance is not to be confused with resignation,which is giving up or coping passively. Acceptance has been linked withbetter physical and psychological health and lower levels of distress in motherscoping with children who are undergoing bone marrow transplantation (Manneet al., 2003), in pediatric traumatic injury (Wade et al., 2001), and in women undergoingbreast cancer treatment (Carver et al., 1993). Individuals who had an acceptingcoping style were also found to have fewer PTSD symptoms followingthe terrorist attacks of September 11, 2001 (Silver et al., 2002).Moral Compass: Religion, Spirituality and AltruismAnother characteristic of resilient individuals is a strong moral compass. Developingand maintaining a framework of belief that few things can shatter is thoughtto enhance an individual’s ability to find meaning in and cope adaptively withadversity (Southwick et al., 2005). This construct includes adherence to a religiousor spiritual system and an altruistic outlook toward others.Recent research has indicated that religion and spirituality may have a protectiveeffect on physical and psychological well-being in healthy individuals andmay help people cope with illness. A recent meta-analysis of 126,000 individualsin 42 independent samples indicated that religious practice or involvement had arobust relationship with higher probability of survival (lower risk of all-causemortality; McCullough et al., 2000). In addition, higher levels of religious beliefhave been correlated with lower incidence of depression in numerous populations,including college students (Donahue, 1985), bereaved adults (Borestein et al.,1973), medically ill older patients (Koenig et al., 1998, 2004), and communitydwellingelderly people in the United States and Europe (Braam et al., 2001).Recent longitudinal studies have indicated that level of religiousness also predictsrate of remission from depression in medically hospitalized and nonhospitalizedolder adults (Braam et al., 1997; Koenig et al., 1998). Along the same lines, religiousadolescents tend to have lower suicide rates than nonreligious adolescents(Donahue & Benson, 1995). Interestingly, the specific religious affiliation is notimplicated in the overall relationship between religiousness and improved psychologicaland physical health.There is some neurobiological evidence from PET studies to indicate that spiritualor self-transcendent experiences are associated with density of available serotonin5-HT(1A) receptors, implicated in the pathophysiology of depression,(reviewed by Hasler et al., 2004) in the dorsal raphe nuclei, hippocampus, andneocortex in healthy adult males (Borg et al., 2003). The role of the serotoninsystem in spiritual experience is further supported by studies showing that drugsknown to impact serotonin (e.g., LSD, mescaline, psilocybin) often produce spiritualawareness, a sense of insight, and religious ecstasy (Borg et al., 2003). Chronicstress has been shown to increase CRH and cortisol levels, which in a sequence of