Seeing Depression Through the Prism of Faith: Does Religious Affiliation Alter Assessment of Depression and Hopelessness?
Nidal Moukaddam, M.D., Ph.D., Assistant Professor, Baylor College of Medicine
Religious backgrounds, and spiritual faith in general, may convey profound benefits on individual mental and physical health. Psycho-religious well-being is increasingly the focus of therapeutic work. By virtue of providing support, sometimes a social network, and a sense of purpose and meaning in life, faith can serve a protective function in context of depression. However, this protective effect and its potential underlying mechanisms are not well understood, nor well studied. There is some evidence that although faith may ultimately lead to a better mental adjustment, specific aspects of faith can relate negatively to psychological functioning.
Depression is often associated with helplessness and hopelessness. Much cognitive work has focused on the concept of learned helplessness, a paralyzing feeling/thought pattern that leads individuals to not be able to fight off depression, or make necessary life changes to perpetuate improvements in their life. Individuals with religious affiliations may attribute adversity to the will of a higher power, and this may soften the impact of helplessness and hopelessness, yet may also hinder treatment.
Assessment of depression in such scenarios may be fraught with complications, and highly subjective. To the outside observer, by accepting God’s will, and tolerating adversity, a person may be placing themselves in a position of helplessness as well, even though the depression connotation is then lacking. Not much is known about how providers respond to the influence of faith when assessing depression. That faith is a protective factor for self-harm is widely taught, but the influence of faith in assessing depression severity is an unexplored topic.
In this paper, I will present results of work summarizing the influence of faith in the assessment of depression. The overarching question of this study is whether faith affects how providers gauge hopelessness/helplessness severity. We compare the reactions of providers (psychiatrists, therapists) to three standardized patient encounters depicting depressed individuals. The vignettes represent patients of Christian faith, Muslim faith, and one of agnostic orientation. The patients present with similar life stories, and theoretically similar degrees of depression.
Many questions arise in this realm: what role does countertransference (CT) play in assessing depression in patients openly professing religious faith? Do providers rate hopelessness higher or lower when depressed individuals present as religious versus not? And does the discussion of faith bias treatment in favor of medications versus psychotherapy?
Results reported will cover the above-mentioned questions. First, by using a Therapist Response Questionnaire, feelings elicited by various degrees and types of religious faith will be elicited along eight operationalized domains of CT. Second, providers are asked to rate hopelessness in patients they just saw. Both CT and religious faith moderate perceptions of hopelessness, helplessness, and these will be discussed. Third, we will discuss choices of treatment as moderated by above factors.
Religious backgrounds, and spiritual faith in general, may convey profound benefits on individual mental and physical health. Psycho-religious well-being is increasingly the focus of therapeutic work. By virtue of providing support, sometimes a social network, and a sense of purpose and meaning in life, faith can serve a protective function in context of depression. However, this protective effect and its potential underlying mechanisms are not well understood, nor well studied. There is some evidence that although faith may ultimately lead to a better mental adjustment, specific aspects of faith can relate negatively to psychological functioning.
Depression is often associated with helplessness and hopelessness. Much cognitive work has focused on the concept of learned helplessness, a paralyzing feeling/thought pattern that leads individuals to not be able to fight off depression, or make necessary life changes to perpetuate improvements in their life. Individuals with religious affiliations may attribute adversity to the will of a higher power, and this may soften the impact of helplessness and hopelessness, yet may also hinder treatment.
Assessment of depression in such scenarios may be fraught with complications, and highly subjective. To the outside observer, by accepting God’s will, and tolerating adversity, a person may be placing themselves in a position of helplessness as well, even though the depression connotation is then lacking. Not much is known about how providers respond to the influence of faith when assessing depression. That faith is a protective factor for self-harm is widely taught, but the influence of faith in assessing depression severity is an unexplored topic.
In this paper, I will present results of work summarizing the influence of faith in the assessment of depression. The overarching question of this study is whether faith affects how providers gauge hopelessness/helplessness severity. We compare the reactions of providers (psychiatrists, therapists) to three standardized patient encounters depicting depressed individuals. The vignettes represent patients of Christian faith, Muslim faith, and one of agnostic orientation. The patients present with similar life stories, and theoretically similar degrees of depression.
Many questions arise in this realm: what role does countertransference (CT) play in assessing depression in patients openly professing religious faith? Do providers rate hopelessness higher or lower when depressed individuals present as religious versus not? And does the discussion of faith bias treatment in favor of medications versus psychotherapy?
Results reported will cover the above-mentioned questions. First, by using a Therapist Response Questionnaire, feelings elicited by various degrees and types of religious faith will be elicited along eight operationalized domains of CT. Second, providers are asked to rate hopelessness in patients they just saw. Both CT and religious faith moderate perceptions of hopelessness, helplessness, and these will be discussed. Third, we will discuss choices of treatment as moderated by above factors.