Motivation and emotion/Book/2022/Religiosity and coping

Overview


The relationship between religiosity and coping is a nuanced and fascinating area of psychological research with many practical applications in health, education, counselling and personal development (McCullough et al., 2000; Murphy et al., 2003; Xu, 2016). According to Pew Research Centre, approximately 85% of the world's population identifies as religious (see Figure 1). Such prevalence of religion highlights the importance for psychologists to understand how people with spiritual beliefs cope. However, the rate of religiosity among younger generations has decreased since the 1990s (Brenner, 2016). Understanding the implications that this may have on future generations is vital, as it is possible that by disengaging with religion people have inadvertently lost a crucial coping mechanism. To explore the relationship between religiosity and coping, it is first necessary to develop a brief understanding of religion, stress, and coping.

Focus questions:
 * How might religion assist someone to engage in problem-focussed coping?
 * How might religion be used as a maladaptive coping mechanism?
 * Do you think that religion could help someone overcome the death of a loved one? If so how?

Religion


Religion is a complex personal, social and cultural phenomenon, typically conceptualised as a system of beliefs offering moral guidance on how one should behave in the world. Religious doctrines often provide explanations for philosophical questions like "where did humans come from?", "what does it mean to be a good person?", and "what happens after we die?". Most religious beliefs incorporate supernatural, spiritual or transcendental phenomena to answer such questions (see Figure 2).

There are many theories surrounding why humans have the propensity to create and pursue religion. In regards to coping, terror management theory proposes that religion was created to help people cope with mortality. While at first glance this may seem like an appealing theory, there are many other theories containing evidence from psychological and anthropological literature. For instance, cultural evolutionary theory proposes that hunter-gatherer tribes with religious cooperation would outcompete non-religious tribes. Self control theory suggests that religion enhances cognitive processes associated with self-control. Given that there are many theories with sound rationale and evidence, it is likely that the origin of religion was catalysed by a range of factors. Nevertheless, one of the factors associated with the origin of religion may be it's role in helping people to cope with stress (Carver et al., 1989).

Stress and stressors
Psychological stress is often described as a feeling of emotional pressure when faced with threat, harm, or challenge (See Figure 3). Despite many peoples' intuition of the word, stress is not always bad. For instance, the stress that a student might experience when they have an assessment due can be adaptive by motivating them to start working (Gibbons et al., 2008). Stress with a positive effect is known as eustress, while stress with a negative effect is known as distress. Adversities that cause stress are known as 'stressors'. The four main categories of stressors are:
 * 1) crises/catastrophes
 * 2) major life events
 * 3) daily hassles
 * 4) chronic stressors.

For a list of stress related definitions see Table 1.



Coping
In psychology, the term 'coping' refers to how individuals respond to the threat, harm, and challenge associated with stressors. Threat is the expectation of a negative event which has not yet occurred, harm is the experience of a negative event that has already occurred, and challenge is the perception that one can achieve personal improvement from an event (Folkman & Moskowitz, 2004). There are five main coping strategies which people utilise when faced with threat, harm, and challenge. These are 1) Problem-focused, 2) Emotion-focused, 3) Social support, 4) Religious coping, and 5) Meaning making (Folkman & Moskowitz, 2004). Coping mechanisms can also be categorised as i) adaptive, or ii) maladaptive, based upon whether they reduce stress in an effective/healthy way or ineffective/unhealthy way (Folkman & Moskowitz, 2004). Resilience is another important term used to describe the effectiveness of an individual's ability to cope with stressors (Schwalm et al., 2022). Finally, coping mechanisms can also be described as a) active, or b) avoidant, based upon whether coping involves a conscious effort to solve the problem, or the problem is ignored. These terms are crucial to understand because religious coping can be related to all other coping mechanisms and categorised according to adaptive, maladaptive, active, and avoidant properties (Ano & Vasconcelles, 2005). See Table 2 for a comprehensive list of coping definitions.

Models of stress and coping
There are two main models of stress and coping. The first is a general model, while the second focusses specifically on religious coping.

Lazarus' transactional model of stress and coping


Lazarus' transactional model of stress and coping is a cognitive model describing how people evaluate stressors and their own ability to cope (Lazarus & Folkman, 1984) (see Figure 4). First, an individual must perceive a stressor from the environment. Then they engage in primary appraisal whereby the event is considered in terms of it's likely effects. If a stressor is evaluated as a challenge, threat, or harm individuals will move to secondary appraisal. During secondary appraisal an individual will evaluate their own ability to cope with the stressor. If an individual decides during secondary appraisal that they have insufficient resources to deal with the stressor, they become stressed. Finally, the individual uses coping strategies in an attempt to overcome the stress. The transactional model of stress and coping is crucial to understand because religiosity has been shown to influence both primary and secondary appraisals (Folkman & Moskowitz, 2004). Definitions associated with Lazarus' transactional model can be seen in Table 3.

Pargament's theoretical model of religious coping


Kenneth Pargament is arguably the most prolific psychological researcher in the field of religiosity and spirituality. According to Pargament, Lazarus & Folkman's (1984) transactional model of stress and coping was a foundational influence on his theoretical model of religious coping (see Figure 5) (Folkman et al., 2010, p. 270). In this model the three primary components of religion are: sacredness, search and significance (Pargament et al., 2005). Furthermore, within this framework religious coping is described as the dynamic process of searching, maintaining and transforming significance to deal with stressors (Pargament et al., 2005). Individuals are said to engage in religious coping by:


 * 1) Discovering something of significance in life.
 * 2) Maintaining a relationship with the significant 'thing'.
 * 3) Transforming what one holds as significant when necessary (eg. when a stressor appears).

According to the theoretical model of religious coping, when an individual experiences a major life event they will first attempt to confront the stress using their pre-existing religious significance (conservational coping). If the stress is too strong or is not compatible with pre-existing religious significance, the individual will then undergo transformational coping. This involves redefining religious significance in a way that allows them to cope. The newly defined religious significance is then maintained and applied to future coping scenarios until further transformation is required (Pargament et al., 2005).

Following an institutional religion is not a requirement to use this model as a method of coping. For example, an atheist who feels a sense of spirituality and connectedness with the universe through some form of scientific rationale could use Pargament's model to cope by searching, conserving, and transforming the significance that sustains them.

Example Scenario (utilising Pargament's theoretical model of religious coping): Sarah is completing an undergraduate degree. However, her grades haven't been at a level that she's happy with (stressor). This causes lots of stress because Sarah wants to become a clinical psychologist (conservational coping). She now has doubts that this is possible. Sarah decides that she will pray to God and discuss her situation. She sits on the edge of her bed and closes her eyes. Sarah begins her conversation with God and eventually discovers that the significance of being a clinical psychologist was mainly surrounding her desire to help others (discovery). Sarah reframes her sense of significance to align more with her desire to help others and away from the role of clinical psychologist. Sarah decides that she will continue working hard, and that as long as she is able to make a difference in other peoples' lives she will be satisfied (transformational coping).

The relationship between religiosity and coping
Religion is often used as a coping mechanism to overcome stress (Ano & Vasconcelles, 2005). However, religious coping can also be the source of maladaptive strategies (Krägeloh et al., 2012). Analysis of religious coping reveals two distinct underlying factors known as positive religious coping (PRC) and negative religious coping (NRC) (Pargament et al., 2011). While PRC is associated with adaptive coping, NRC is associated with maladaptive coping (see Table 4) (Krägeloh et al., 2012). According to a study by Krägeloh et al., (2012), people with lower levels of religiosity are also more likely to engage in maladaptive or avoidant coping strategies. Positive religious coping involves:


 * 1) A secure relationship with a transcendent force.
 * 2) A sense of spiritual connectedness with others.
 * 3) A benevolent world view.

Negative religious coping involves:


 * 1) Underlying spiritual tensions and struggles within oneself, others, and the divine.

Measures of religious coping
There are two main measures of religious coping widely used within the psychological literature: The RCOPE and the Brief RCOPE. The RCOPE involves in-depth analysis while the Brief RCOPE is designed for faster administration.

RCOPE
The RCOPE is an extensive measure of religious coping developed by Pargament and colleagues in the late 1990s (Pargament et al., 2000). The RCOPE measures the extent to which individuals employ religious coping strategies to deal with stressors. The test is comprised of 85-items which measure five overarching factors of religious coping. The factors measured by the RCOPE include methods of coping to:
 * 1) find meaning
 * 2) gain control
 * 3) gain comfort and closeness to god
 * 4) gain intimacy with others and closeness to god
 * 5) achieve a life transformation

Brief RCOPE
The Brief RCOPE was developed by Pargament et al. (2011) as a faster alternative to the RCOPE. It contains 14-items and produces a two-factor structure comprised of PRC and NRC (see Table 5).

Religiosity and coping mechanisms
One of the main utilities of religion as a coping mechanism is that it facilitates the ability to engage in all other coping mechanisms (see Table 2). Perhaps the most intuitive example is the emotion-focused coping that can be achieved through prayer or meditation.

A meta-analysis by Salsman et al. (2015) found a moderate relationship between religiosity and effective coping with the emotion-based mental health impacts of cancer. Meaning making is another clear coping mechanism provided by religion, as religion offers a foundation from which individuals can provide meaning to their lives. Murphy et al. (2003) conducted a study on parents' meaning making following the death of a child. Religious coping was one of the main predictors of effective meaning-making. Social support can be accessed through religious gatherings and has effects on coping that are absent from secular social support (Krause, 2006). For example, church-based social support has been shown to reduce the impact of financial strain on health while non-religious social support does not produce a similar effect (Krause, 2006). Finally, problem-focused coping is also often addressed through religious coping. For instance, religious breast cancer survivors seem to exhibit greater levels of impulse control and problem-solving (Gall & Cornblat, 2002). A study by Krägeloh et al. (2012) also found that those with higher levels of religiosity are more likely to utilize problem-focused coping.



Religiosity and resilience
An effective method of conceptualising people's ability to cope with life stressors is through measures of resilience (see Figure 6). A systematic review and meta-analysis by Schwalm et al. (2021) found a moderate positive relationship between religiosity and resilience (r = 0.40). Such results suggest that religiosity accounts for ~16% of the variance in resilience. Although the exact causes of this relationship are unknown, Schwalm et al. (2021) suggest that common underlying factors between religiosity and coping may be responsible. Some of these common factors include optimism, positive emotions, social support and the search for meaning and purpose (Schwalm et al., 2021).

Religiosity and appraisal
Religion has been shown to influence Lazarus & Folkman's (1984) primary and secondary appraisals (see Table 3) (Folkman & Moskowitz, 2004). In terms of primary appraisal, religious people often perceive reduced threat, harm, and loss by mapping a stressor against what they hold to be spiritually significant (Park & Cohen 1993). For instance, religious individuals often perceive stressors as less harmful by reframing them as life lessons from God (Pendleton et al., 2002). Furthermore, religious adherents often believe that they will meet their deceased relatives in the afterlife, reducing the perceived loss associated with death (Smith, 2002). Regarding secondary appraisal, religious individuals often perceive that God has bestowed them with the resources needed to overcome their trials and tribulations (Newton & McIntosh, 2009). Interestingly, people of different religious backgrounds seem to vary in their appraisals. Park et, al. (1990) in a study on religious coping with uncontrollable negative events, found that Protestants experienced less psychological distress than Catholics.

 {What percentage of the variance in resilience is explained by religiosity?}


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- ~1% - ~4% - ~8% +~16%

Religiosity and mental health
Coping is related to overall measures of mental health (Hong, 2007). For example, depression and anxiety are mediated by the reduced capacity to cope (Hong, 2007). Religion also effects mental health through its' relationship with coping. Meta-analyses have found a relationship between religiosity and long-term positive mental health outcomes (Garssen et al., 2021). Typically such studies find an effect size of ~r = 0.1, meaning that ~1% of the variance in positive mental health can be attributed to religiosity (Garssen et al., 2021). However, meta-analyses designed in this way also tend to mix PRC and NRC rather than investigating these constructs separately.

When investigating positive and negative religious coping separately much larger effect sizes have been obtained. For instance Ano & Vasconcelles' (2005) meta-analysis found a relationship between PRC and positive psychological adjustment of r = 0.33. This means that ~10.9% of the variance in positive psychological adjustment could be explained by PRC, and that as PRC increases so too does positive psychological adjustment. A relationship between NRC and negative psychological adjustment was also obtained with an effect size of r = 0.22 explaining ~4.8% of the variance. Nevertheless, these results are correlational meaning that causality cannot be attributed. It is possible that PRC causes an increase in positive psychological adjustment, but it is equally possible that positive psychological adjustment causes people to engage in more PRC. Furthermore, a third unknown factor could be responsible for causing this relationship.

Conclusion
Religion has the power to influence the ways that people cope, making it a highly influential coping mechanism. Attempting to engage in more positive religious coping strategies would help people improve their resilience to stress. Furthermore, people who are not religious can also gain benefits by following Pargament's theoretical model. This requires a sense of spirituality akin to religion but not necessarily adherence to any religious doctrines. The finding that ~16% of the variance in resilience relates to religiosity is worthy of more attention than it seems to receive, and there are many studies corroborating such findings. With declining levels of religiosity, perhaps it would be best for people to search out their own forms of spiritual significance, as this may help sustain them through the hardships of life.