Religion and Spirituality in Psychiatry

Personality, Spirituality, Religiousness, and the Personality Disorders 181sense of emotional stability. It has also been demonstratedthat spirituality was a causal predictorof psychological growth and maturity.(39)Further, spirituality was shown to be a predictorof religious involvement. Certainly these findingshave far-reaching implications for how the socialsciences conceptualize individuals and openthe possibility for the development of a wholenew class of potential therapeutic strategies thatinvolve numinous-related motivations.Given the empirical robustness of the ASPIRESscales and their relatedness to emotional stability,it is a reasonable next step to examine how theseconstructs relate to Axis II functioning. Are theysignificant causal predictors of characterologicaldysfunctioning? Can disturbances in our relationshipwith the transcendent create intrapsychicconflicts? Or, does the development of mental illnessundermine spiritual and religious strivings?6. SPIRITUALITY, RELIGIOUSNESS,AND PSYCHOPATHOLOGYAs noted above, the majority of research withnuminous constructs has focused on generalfactors of well-being and life satisfaction. Whenresearch includes clinical dimensions, they aremostly affective in nature (for example, depression,anxiety, and hopelessness).(41) Findingshere show significant relationships betweennuminous constructs and affective dysphoria.An epidemiologic survey of Canadians showedthat religious involvement was related negativelyto depression.(42) MacDonald and Holland (43)examined the relationship between measures ofspirituality and religious involvement with theMinnesota Multiphasic Personality Inventory-2(MMPI-2) scales. In general, involvement inreligious activities and higher levels of spiritualitywere associated with lower levels ofpathology. Interestingly, both studies found thatreligious involvement was a better predictor thanspirituality.Very little research has been done examininghow explicit psychopathologic variables (forexample, symptom dimensions and diagnosticcriteria) are related to spiritual and religiousconstructs. One study examined the relationshipbetween symptom scores and spiritual well-beingin a sample of African-American patients with afirst-episode schizophrenic disorder. Consistentwith the literature for nonclinical samples, therewas a negative correlation between these twosets of constructs.(44) Carrico et al.(45) applieda path model to examine the role of spiritualityon depressive symptoms in HIV-positive persons.They found that a model specifying spiritualityas a causal input (albeit an indirect effect)into the experience of depressive symptoms fitthe data well. In contrast to the above research,both of the studies found spirituality negativelyrelated to symptom experiences. Lavin (46)employed a cross-lagged panel design to demonstratein a sample of adults that negative imagesof God (that is, high on neuroticism and lowon agreeableness) led to higher self-ratings ofsymptomological distress over time. Althoughthese studies provide support for the causal precedenceof numinous constructs, it remains yetto determine the power of religious involvementand spirituality relative to each other in predictingsymptom experience.Piedmont, Hassinger, Rhorer, Sherman,Sherman, and Williams (47) provided the onlyknown data linking measures of spirituality andreligiousness to Axis II constructs. The relationshipbetween the five ASPIRES scales and two measuresof Axis II functioning (the SCID-IIP PD Scalesdescribed above and the Schedule for Nonadaptiveand Adaptive Personality [SNAP (48) ]) were examinedwhile controlling for the predictive effectsof the FFM personality domains. SEM analyseswere also conducted comparing different modelsthat varied the causal relationship between thetwo sets of constructs. Because the findings weresimilar for both Axis II measures, only the resultswith the SCID-IIP PD scales will be discussedhere. The data for these findings are based on theresponses of 342 undergraduate volunteers froma midwestern state university.Table 13.3 presents the partial correlationsbetween each of the ASPIRES scales and theSCID-IIP PD scales, controlling for the predictiveeffects of personality. Thus, these coefficients