When Shepherds Shed: Trajectories of Weight-Related Behaviors in a Holistic Health Intervention Tailored for US Christian Clergy

Maintaining healthy behaviors is challenging. Based upon previous reports that in North Carolina (NC), USA, overweight/obese clergy lost weight during a two-year religiously tailored health intervention, we described trajectories of diet, physical activity, and sleep. We investigated whether behavior changes were associated with weight and use of health-promoting theological messages. Improvements were observed in sleep, calorie-dense food intake, and physical activity, with the latter two associated with weight loss. While theological messages were well-retained, their relationship with behaviors depended on the specific message, behavior, and timing. Findings offer insights into weight loss mechanisms, including the role of theological messages in religiously tailored health interventions.

Religious Belief and Workplace Safety Behavior Among the Informal Automobile Workers in Nigeria

It is well known that informal workers in developing countries are exposed to occupational health problems (OHPs), and they work unsafely. However, little is known about how their religious beliefs influence their safety behavior at the workplace. This study explores the interaction between the automobile artisans' religious beliefs and their workplace safety behavior. Forty three male artisans (either Christian: n = 17; or Muslim: n = 26) were purposively interviewed. Even though their religious teachings are against risk-taking, the artisans took risks at their workplace. Specific programs like seminars and various outreaches for workers in religious settings influence their perception of OHP prevention. Religious organizations have a role to play in OHP prevention.

In Search of Safe Spaces: An Exploratory Study of the Anticipated Help-Seeking Needs and Preferences of Protestant Christian Women in Singapore with Respect to a Hypothetical Abortion Scenario

Research suggests that religious beliefs may contribute to abortion stigma, resulting in increased secrecy, reduced social support and help-seeking as well as poor coping and negative emotional consequences such as shame and guilt. This study sought to explore the anticipated help-seeking preferences and difficulties of Protestant Christian women in Singapore with regard to a hypothetical abortion scenario. Semi-structured interviews were conducted with 11 self-identified Christian women recruited through purposive and snowball sampling. The sample was largely Singaporean and all participants were ethnically Chinese females of a similar age range (late twenties to mid-thirties). All willing participants were recruited regardless of denomination. All participants anticipated experiences of felt, enacted and internalized stigma. These were affected by their perceptions of God (e.g., how they see abortion), their personal definitions of "life" and their perceptions of their religio-social environment (e.g., perceived social safety and fears). These concerns contributed to participants choosing both faith-based and secular formal support sources with caveats, despite a primary preference for faith-based informal support and secondary preference for faith-based formal support. All participants anticipated negative post-abortion emotional outcomes, coping difficulties and short-term decision dissatisfaction. However, participants who reported more accepting views of abortion also anticipated an increase in decision satisfaction and well-being in the longer term.

Reflections on Doing Counseling and Christian Family Therapy

Reflecting on his long career that integrated medicine, therapy, and Christian theology, the author shares his insight to help future students to have a simple framework of doing counseling, family therapy, and relating to the Christian faith. This article offers his personal views on how to do therapy, and proposes a way of looking at a Christian theory of personality, and towards a Christian theory of marriage and family therapy.

Saints, demons, and faith - A review of the historical interaction between Christianity and epilepsy

The view that epilepsy is caused by demonic possession prevailed throughout the Middle Ages and re-emerges in rare cases of misguided exorcisms even in modern Western societies. This review reflects on the biblical sources of the demonic understanding of seizures and the subsequent marginalization of people with epilepsy. While the development of science led to a decline in beliefs of supernatural causes of seizures, the link between Christianity and epileptology is sustained through recurrent considerations of epileptic phenomena among religious figures. The influence of epilepsy on the legacy of historical persons of Christianity should be regarded with caution because of limited clinical evidence in historical documents. However, it should be acknowledged that religious experiences, as well as general religiosity, can be important in modern-day epilepsy care as they are shown to have psychological, societal, and even clinical implications. Further studies should expand our knowledge on the contemporary importance of the Christian tradition for people with epilepsy.

Playing God? Religious Perspectives on Manipulating the Genome

The Human Genome Project (HGP) is a remarkable medical science breakthrough that enables the understanding of genetics and the intervention of human health. An individual's health is influenced by physical, emotional, social, intellectual, and religious factors. Among these, religious beliefs shape our thinking on cloning, stem cells, and gene editing, affecting healthcare decisions and the motivation for seeking treatment. Is the human genome sacred? Does editing it violate the idea that we're made in God's image or allow us to "play God"? Understanding the perspectives behind the fundamental religious doctrines of Islam, Christian, Hindu, and Buddhist on gene editing/therapy in somatic and germline cells would ensure a right balance between geneticists and theologians in providing the best healthcare while catering to individual beliefs.

Religiosity and Quality of Life in Older Christian Women in Ireland: A Mixed Methods Analysis

This study used a mixed methods approach to understand the ways in which religion and quality of life (QoL) are associated in later life in Ireland. Longitudinal quantitative data from 2112 Christian women aged 57 and over at baseline (2009-10) participating in the Irish Longitudinal Study on Ageing (TILDA), as well as qualitative data from semi-structured interviews from 11 Christian women aged 65 and over in 2018, were used. The quantitative data showed an association between lower religiosity and lower QoL. Qualitative data supported an effect of religious involvement on QoL although certain aspects of being religious in Ireland were accompanied by distress. The data suggested that the relationship between religious attendance and higher QoL could be driven by multifactorial pathways, including psychological, social, and practical benefits.

God Representation Types Are Associated With Levels of Personality Organization and Christian Religious Orthodox Culture

ABSTRACT

This exploratory study shows that God representation types are associated with levels of personality organization. Among two Dutch samples of psychiatric patients (n = 136) and nonpatients (n = 161), we found associations between the psychotic, borderline, and neurotic personality organizations, and passive-unemotional, negative-authoritarian, and positive-authoritative God representation types, respectively. Both patients and nonpatients reported positive God representations, but only nonpatients and higher-level functioning patients reported an integrated God-object relation. For persons with personality pathology, the relationship with God can be a struggle and might have a defensive and/or compensating function. In addition to personality organization, Christian religious orthodox culture is a statistical predictor of God representations, but not of anger toward God. We offer suggestions for how psychotherapeutic work with God representations might differ for patients with different levels of personality organization.

The Future of Nursing: Creating A Culture of Equity

As development of the Future of Nursing 2020-30 Report by the National Academy of Medicine is underway, the nursing profession is positioned to continue positively impacting health and health equity in the United States. Progress to date engenders hope that nurses will continue to take a significant role in reducing health disparities. The work to create a culture of health aligns with the Christian imperative to "love your neighbor as yourself."

Differences in the Factor Structure of the Eating Attitude Test-26 (EAT-26) in Different Cultures in Israel: Jews, Muslims, and Christians

BACKGROUND

In recent years, there has been a shift in the clinical presentation and, hence, diagnostic definitions of eating disorders (EDs), reflected in a dramatic change in the diagnostic criteria of EDs in the DSM-5. The Eating Attitudes Test-26 (EAT-26) is currently considered an accepted instrument for community studies of EDs, although it features an inconsistent factorial structure in different cultures. Therefore, it is essential to investigate whether the EAT-26 can still be considered an adequate instrument for identifying the risk of developing EDs in different cultures. The aim of the present study was to examine the construct validity and internal consistency of the EAT-26.

METHOD

The study used exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) among different cultural populations in Israel.

RESULTS

Findings indicated different factors in different ethnic groups, most of which do not correspond with the original EAT-26 three-factor structure.

RESULTS

The analysis yielded two main factors among Israeli Jews, four main factors among Israeli Muslim Arabs, and three main factors among Israeli Christian Arabs.

CONCLUSION

These findings shed light on cultural factors affecting perceptions of the EAT-26 items. This calls for a reconsideration of the generalization of the original three-factor structure of the questionnaire in different cultures.

Longitudinal Changes in Posttraumatic Stress Disorder After Resettlement Among Yazidi Female Refugees Exposed to Violence

IMPORTANCE

Posttraumatic stress disorder (PTSD) is highly prevalent among refugees surviving mass atrocities, especially among women. Longitudinal studies investigating factors associated with PTSD course are essential to enable adequate treatment yet widely lacking.

OBJECTIVE

To identify longitudinal changes in PTSD severity and posttraumatic coping among severely traumatized female refugees as well as risk and protective factors for PTSD course.

DESIGN, SETTING, AND PARTICIPANTS

This prospective cohort study took place in 14 German cities in the context of a humanitarian admission program that resettled 1000 especially vulnerable women and children from northern Iraq to Germany. Approximately 400 adult beneficiaries of the humanitarian admission program were eligible for the study. At baseline, a total of 116 of the 400 beneficiaries (29.0%) participated, with 96 (82.8%) of these women participating in the follow-up assessment. The study included a baseline assessment conducted 2 years after resettlement (September 1, 2017, to January 12, 2018) and a 1-year follow-up (August 29, 2018, to January 15, 2019).

EXPOSURES

Violence and/or captivity during the 2014 genocide in northern Iraq by the so-called Islamic State.

MAIN OUTCOMES AND MEASURES

Posttraumatic stress disorder severity and coping strategies were assessed in interpreter-aided interviews using the Impact of Event Scale-Revised.

RESULTS

A total of 116 women (mean [SD] age, 32.2 [8.2] years; 115 [99.1%] Yazidi; 1 [0.9%] Christian) participated at baseline. According to the Impact of Event Scale-Revised, a high PTSD severity was found (mean [SD] raw sum score, 60.88 [15.75] of 88, with higher scores indicating greater distress), with no significant change over time. Helpful coping strategies included prayer, belief in collective strength, and belief in personal strength. Earlier symptoms of intrusions (β = 0.389, P = .007) and longer captivity (β = 0.218, P = .02) were identified as being associated with PTSD severity 1 year later. Longer captivity was associated with PTSD aggravation over time (β = 0.227, P = .04). Posttraumatic strengthening in faith (β = -0.206, P = .05) and in social relationships (β = -0.221, P = .03) were associated with a reduction in PTSD symptoms.

CONCLUSIONS AND RELEVANCE

These findings suggest that female refugee survivors of genocide are at high risk for severe and chronic PTSD beyond the initial years of resettlement. The findings provide suggestions for mental health care specialized for particularly vulnerable populations.

Mental well-being in ancient Greece: Comment on Graiver (2021)

In her thought-provoking article, Graiver (see record 2021-21903-001) argues that many early Christian monks achieved sustained psychological health, perceived as joyful serenity by their contemporaries, and admired within their milieu and the society at large. This state was attained by means of dispassion (apatheia) and culminated in spiritual enlightenment. In the author's opinion, conclusions of this historical research call for a reassessment of modern attitudes to psychological health that can be construed only "in a culturally sensitive manner" (p. 1). In my opinion, limitation of the evidence on mental health in Ancient Greece to medical authors only is hardly justified. The word psuchê is virtually ignored by Greek medical authors. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

A historical perspective on mental health: Proposal for a dialogue between history and psychology

This contribution aims to promote a dialogue between history and psychology by outlining a direction for future research at the intersection of these disciplines. In particular, it seeks to demonstrate the potential contributions of history to psychology by employing the category of mental health in a historical context. The analysis focuses on notions of psychological health that were developed in late antiquity, especially the equation between "health of the soul" and dispassion (apatheia) within the Christian monastic movement. This theologically informed notion of what constitutes positive human functioning and well-being is examined in view of modern attempts, in mainstream and positive psychology, to define mental health. The optimism concerning the naturalness of virtue and the malleability of human nature that underlies late antique notions of "health of the soul" becomes noticeable in its absence once we turn to modern notions of mental health. It thus provides an illuminating counter-example against which to compare and analyze modern attempts to define mental health. A comparison of these alternative notions human flourishing offers an opportunity to reflect on and test the validity of contemporary attempts to define this condition in a culturally sensitive manner. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Growth in Adult Ego Development and Mentalizing Emotions for an Increasingly Multidimensional God Image

Growth in cognitive complexity in the framework of adult ego development has shown to enable sophistication in mentalizing interpersonal emotions. This has implications for cultivating a more multidimensional God Image for spirituality in the Judeo-Christian tradition. The construct of mentalization will be used to understand the integration of these concepts. Empirical findings that support this conceptual integration will be explored. Clinical applications for spiritually integrated psychotherapy will follow.

Investigating Denominational and Church Attendance Differences in Obesity and Diabetes in Black Christian Men and Women

Prior investigations of the relationships between religious denomination and diabetes and obesity do not consider the nuance within black faith traditions. This study used data from the National Survey of American Life (n = 4344) to identify denominational and religious attendance differences in obesity and diabetes among black Christian men and women. Key findings indicated that black Catholics and Presbyterians had lower odds of diabetes than Baptists. Black men that attended church almost daily were nearly twice as likely to be obese than those that never attend services. These results indicate that denomination and gender should inform faith-based and placed health promotion approaches.

Prayer in Marriage to Improve Wellness: Relationship Quality and Cardiovascular Functioning

This study examined daily partner-focused petitionary prayer (PFPP) on relationship communication and quality as well as novel indices of cardiovascular functioning in a sample of 90 adults. PFPP was compared to waitlist and meditation conditions over a 4-week period. Aortic hemodynamics via pulse wave analysis were assessed before and after the intervention. Factorial repeated measures analyses indicated that for those in the prayer condition, there were significant improvements in coronary perfusion, decreased left ventricular work, and increased coronary blood flow. Additionally, the perceived positive aspects of one's relationship improved for those in the prayer condition. Similar changes did not occur in waitlist and meditation conditions. Findings suggest that daily PFPP improves relationship quality and cardiovascular efficiency via improving protective cardiovascular mechanisms. Practical implications are briefly discussed.

Christian and Political Conservatism Predict Opposition to Sexual and Gender Minority Rights through Support for Christian Hegemony

Although significant strides have been made for sexual and gender minority (SGM) rights in the United States, there continues to be opposition to SGM rights from many conservative Christians and political conservatives. In this study, we investigate this opposition by examining support for Christian hegemony (i.e., the idea that Christianity should be the norm and Christians should be in power in the United States) and unawareness of Christian privilege (i.e., unearned advantages for Christians) as religiopolitical variables that help to explain the association between Christian and political conservatism and opposition to a host of SGM rights (same-sex marriage, same-sex adoption, nondiscrimination policies in jobs and housing for SGMs, and bills regarding transgender public bathroom use). Based on structural equation modeling analysis with heterosexual cisgender Christian (n = 688) and Areligious (n = 327) students, we demonstrate that support for Christian hegemony and unawareness of Christian privilege help to explain the association between Christian and political conservatism and opposition to SGM rights. These findings advance our understanding of a new type of religious-based variable focused on religious power and privilege to help understand conservative religious and political opposition to SGM rights. Limitations, implications, and directions for future research also are discussed.

Leaving My Religion: How Ex-Fundamentalists Reconstruct Identity Related to Well-Being

There is a well-established, steady trend of religious disaffiliates in the USA. However, little qualitative research has been devoted to documenting the experience of religious disaffiliation or "exiting," specifically in the context of identity reconstruction and well-being. This study investigates an understudied subgroup of exiters-individuals who have left Christian fundamentalist religions. Drawing on 24 in-depth interviews, this research reveals the social psychological processes through which former religious participants reconstruct their identity and self-concepts related to their well-being. The results demonstrate that while it is challenging in the beginning stages of the exiting process to develop a new identity and improve self-concepts, over time the construction of a nonreligious identity eventually contributed to participants' greater well-being.

Abortion attitudes, religious and moral beliefs, and pastoral care among Protestant religious leaders in Georgia

OBJECTIVE

The purpose of this study is to explore Protestant religious leaders' attitudes towards abortion and their strategies for pastoral care in Georgia, USA. Religious leaders may play an important role in providing sexual and reproductive health pastoral care given a long history of supporting healing and health promotion.

METHODS

We conducted 20 in-depth interviews with Mainline and Black Protestant religious leaders on their attitudes toward abortion and how they provide pastoral care for abortion. The study was conducted in a county with relatively higher rates of abortion, lower access to sexual and reproductive health services, higher religiosity, and greater denominational diversity compared to other counties in the state. Interviews were audio-recorded, transcribed verbatim, and analyzed by thematic analysis.

RESULTS

Religious leaders' attitudes towards abortion fell on a spectrum from "pro-life" to "pro-choice". However, most participants expressed attitudes in the middle of this spectrum and described more nuanced, complex, and sometimes contradictory views. Differences in abortion attitudes stemmed from varying beliefs on when life begins and circumstances in which abortion may be morally acceptable. Religious leaders described their pastoral care on abortion as "journeying with" congregants by advising them to make well-informed decisions irrespective of the religious leader's own attitudes. However, many religious leaders described a lack of preparation and training to have these conversations. Leaders emphasized not condoning abortion, yet being willing to emotionally support women because spiritual leaders are compelled to love and provide pastoral care. Paradoxically, all leaders emphasized the importance of empathy and compassion for people who have unplanned pregnancies, yet only leaders whose attitudes were "pro-choice" or in the middle of the spectrum expressed an obligation to confront stigmatizing attitudes and behaviors towards people who experience abortion. Additionally, many leaders offer misinformation about abortion when offering pastoral care.

CONCLUSION

These findings contribute to limited empirical evidence on pastoral care for abortion. We found religious leaders hold diverse attitudes and beliefs about abortion, rooted in Christian scripture and doctrine that inform advice and recommendations to congregants. While religious leaders may have formal training on pastoral care in general or theological education on the ethical issues related to abortion, they struggle to integrate their knowledge and training across these two areas. Still, leaders could be potentially important resources for empathy, compassion, and affirmation of agency in abortion decision-making, particularly in the Southern United States.

Trauma exposure and PTSD prevalence among Yazidi, Christian and Muslim asylum seekers and refugees displaced to Iraqi Kurdistan

BACKGROUND

There is unreliable, and negligible information on the mental health and trauma-exposure of asylum-seekers and displaced refugees in the Iraqi Kurdistan region.

OBJECTIVES

To evaluate how responsible the ethno-religious origins are, for the prevalence of trauma exposure and post-traumatic stress disorder (PTSD) in displaced Iraqi asylum-seekers and refugees residing in the Iraqi Kurdistan region.

METHODS

Structured interviews with a cross-sectional sample of 150 individuals, comprised of three self-identified ethno-religious groups (50 participants in each): Christians, Muslims, and Yazidis.

RESULTS

100% prevalence of trauma exposure and 48.7% of current PTSD among refugees, 70% PTSD rate of Yazidi participants, which is significantly higher (p < 0.01) compared to 44% of Muslim participants and 32% of Christian participants. These findings were corroborated using the self-rated PTSD, DSM-5 Checklist, with more severe PTSD symptom scores (p < 0.001) obtained among Yazidis (43.1; 19.7), compared to Muslims (31.3; 20.1) and Christians (29.3; 17.8). Self-rated depressive symptoms (Patient Health Questionnaire-9) were also higher (p < 0.007) among Yazidis (12.3; 8.2) and Muslims (11.7; 5.9), compared to Christians (8.1; 7).

Religion and Caregiving for Orphans and Vulnerable Children: A Qualitative Study of Caregivers Across Four Religious Traditions and Five Global Contexts

Studies of caregivers of orphans and vulnerable children (OVC) rarely examine the role religion plays in their lives. We conducted qualitative interviews of 69 caregivers in four countries: Ethiopia, Kenya, Cambodia, and India (Hyderabad and Nagaland), and across four religious traditions: Christian (Orthodox, Roman Catholic, and Protestant), Muslim, Buddhist, and Hindu. We asked respondents to describe the importance of religion for their becoming a caregiver, the way in which religion has helped them make sense of why children are orphans, and how religion helps them face the challenges of their occupation. Using qualitative descriptive analysis, three major themes emerged. Respondents discussed how religion provided a strong motivation for their work, reported that religious institutions were often the way in which they were introduced to caregiving as an occupation, and spoke of the ways religious practices sustain them in their work. They rarely advanced religion as an explanation for why OVC exist-only when pressed did they offer explicitly religious accounts. This study has implications for OVC care, including the importance of engaging religious institutions to support caregivers, the significance of attending to local religious context, and the vital need for research outside of Christian contexts.

Prospective Associations Among Youth Religiosity and Religious Denomination and Youth Contraception Use

This study prospectively investigates associations among youth religiosity, religious denomination, and contraception use. Associations between youth religiosity and religious denomination, and type of contraceptive used and consistent contraceptive use among sexually active youth (N = 757) were analyzed using multinomial and binomial logistic regression. Identifying with a religious denomination was a predictor of dual contraceptive use relative to using no method of contraception (AOR = 2.17). There was no association between youth religiosity and type of contraceptive use or contraceptive consistency. Religious leaders and public health practitioners should collaborate to develop strategies to engage in conversations with sexually active youth about contraceptive use.

Religiosity/Spirituality and Mental Health Outcomes in Mothers of Children with Autism Spectrum Disorder: The Mediating Role of Positive Thinking

This study examines associations between dimensions of religiosity/spirituality (R/S) and anxiety symptoms in mothers of children with autism spectrum disorder (ASD). Mothers' positive ways of thinking and romantic relationship satisfaction were examined as mediators of associations. The extent to which child ASD symptom severity and maternal broad autism phenotype (BAP) behaviors predicted interactions with religious community members was also examined. Seventy-three Christian mothers of a child with ASD completed online surveys. Higher levels of spirituality were associated with viewing their child with ASD as providing a positive contribution to the family. These positive views were, in turn, associated with less anxiety symptoms. Mothers of children with more severe ASD symptoms also reported greater negative interactions with members of their congregation.

The Differential Impact of Religion on Self-Reported Health Among Serbian Roma Women

The present paper offers an account of how self-reported health varies with religious affiliation and reproductive effort among Serbian Roma women. Data were collected in 2014-2018 in two Roma semi-urban settlements in central Serbia. The sample consisted of 177 Christian and 127 Muslim women, averaging 54 years of age. In addition to religious affiliation (Christianity/Islam), demographic data, reproductive histories, data on self-reported and children's health were collected, along with height and weight, and smoking status. Christian and Muslim Roma women differed significantly on a number of variables, with Muslim women reporting poorer health and higher reproductive effort. Among Roma women religion may be an important determinant of reproductive and fertility patterns, largely because it may have formed an important foundation upon which identity is based. This study adds to the literature on the cross-cultural relevance of the ways religion shapes reproductive behaviors for understanding the health variations of women from the same ethnic group who profess different religions.

Church-Based Social Support's Impact on African-Americans' Physical Activity and Diet Varies by Support Type and Source

The objective of this study was to examine sources (friends, family, church members, and pastors) and type (positive or negative) of social support and their association with eating and physical activity behaviors. Study participants consisted of 41 African-American adults (78% female), with an average age of 43.5 years (standard deviation = 15.7). Participants were recruited from churches in southwest, Ohio. Mean comparisons showed family members, and friends had the highest positive and negative social support scores for healthy eating and physical activity. Pastors and church members received the lowest social support scores related to these behaviors. Using a linear regression analysis, social support in the form of physical activity rewards from family members was positively associated with fruit and vegetable consumption after adjusting for gender, age, education level, and church location. Based on these findings, future research should continue examining how different social support sources and types influence physical activity and healthy eating behaviors among African-Americans.

Mental disorder and mysticism in the late medieval world

During the later Middle Ages, a number of religiously oriented people behaved in ways that we would consider unusual, yet it was unusual for them to be regarded as mentally disordered. This article reviews late medieval thinking and practice with regard to mental disorder and also with regard to the discernment of spirits, that is, how it could be decided whether an experience or impulse to do something was the consequence of God or a good spirit, an evil spirit, or some purely human cause. Many of the criteria for discerning a good spirit were behavioral, for example, consistently showing humility and discretion, and were clearly distinct from those displayed in mental disorder. A comparison of the criteria for mental disorder with those used to discern spirits shows how the distinction between mental disorder and religious experience could have been made and why confusion of the two seems to have been rare. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Anxiety as a Main Cause of Church Conflicts Based on Bowen Family Systems Theory

I propose that an examination of churches with Bowen Family Systems Theory suggests that ineffective handling of anxiety within the church as a system is a main cause of conflicts within congregations. In this paper, by examining two case studies with Bowen Family Systems Theory, I demonstrate that inattention to anxiety within the church as a system is a main cause of conflicts within congregations. I will then propose pastoral strategies to address church conflicts.

Suffering for Others While Making Others Suffer: Military Narratives of Sacrifice

Voices from theology seldom participate in a contemporary conversation on military cultures and identities; this article attempts to stimulate this conversation from such a perspective. The article combines a literature review with narratives of sacrifice from real-life cases. It presents a reflective perspective on the formation of military identities with regard to responsibilities and sacrifices. Forgiveness and atonement are discussed as pathways to cultivate growth which can lessen feelings of guilt and regret.

Understanding Face and Shame: A Servant-Leadership and Face Management Model

Clergy can have a negative impact on churches and other individuals when they knowingly or unknowingly attempt to save face, that is, try to protect their standing or reputation. The desire to gain face and the fear of losing face and feeling ashamed will likely permeate clergy's decision-making processes without even being noticed. This study explores the essence of face and face management and the relationship between face management and two characteristics of servant-leadership-awareness and healing-in both Chinese and American churches through the methodology of hermeneutic phenomenology. Prior to this study, to my knowledge, no hermeneutic phenomenological research of face management has been conducted in a church setting. Through a review of the literature, four areas are explored: face and shame, face management, servant-leadership, and face, shame, and face management within the church. This study obtained approval from the Institutional Review Board and informed consent from the participants. Three Chinese and three American Christian ministers were chosen to complete a question sheet and participate in two semi-structured interview sessions. A first cycle of open coding and second cycle of pattern coding were used during data analysis. Face experiences are discussed in light of eight major themes: body, triggers, becoming, face concepts, strategies, emotions, servant-leadership, and the church. Findings from the study help build a servant-leadership and face management model, which can offer an anchored approach for clergy and pastoral counselors to address face and shame and to develop therapeutic interventions.

Are Happiness and Life Satisfaction Different Across Religious Groups? Exploring Determinants of Happiness and Life Satisfaction

This study explores whether different religions experience different levels of happiness and life satisfaction and in case this is affected by country economic and cultural environment. Using World Value Survey (from 1981 to 2014), this study found that individual religiosity and country level of development play a significant role in shaping people's subjective well-being (SWB). Protestants, Buddhists and Roman Catholic were happier and most satisfied with their lives compared to other religious groups. Orthodox has the lowest SWB. Health status, household's financial satisfaction and freedom of choice are means by which religious groups and governments across the globe can improve the SWB of their citizens.

Talking about time: temporality and motivation for international Christian humanitarian actors in South Sudan

We investigate ways in which international evangelical Christian humanitarians talk about time as they engaged in humanitarian assistance and development work in South Sudan. Our focus on Christian development work is motivated by a desire to understand how and why people persevere in humanitarian work and reconcile seemingly impossible circumstances and to further elaborate sociological conceptions of time as experienced by people in their own lives. We argue that their faith commitments produce ways of understanding time and causality which make possible their attachment to risky and dangerous work. Our work is based on in-depth interviews with people who work or have recently worked for Christian faith-based organizations in South Sudan (n = 30). Drawing on Tavory and Eliasoph's () concepts of life narratives and life projects, we treat our participants as culturally competent actors who skilfully construct their stories through drawing on collectively shared faith-inflected ideas about temporality and causation. We argue that these ideas represent an important resource for getting through the risks, challenges and uncertainties of doing humanitarian work in complex crises.

The Boundaries of Trust: Cross-Religious and Cross-Ethnic Field Experiments in Mauritius

Several prominent evolutionary theories contend that religion was critical to the emergence of large-scale societies and encourages cooperation in contemporary complex groups. These theories argue that religious systems provide a reliable mechanism for finding trustworthy anonymous individuals under conditions of risk. In support, studies find that people displaying cues of religious identity are more likely to be trusted by anonymous coreligionists. However, recent research has found that displays of religious commitment can increase trust across religious divides. These findings are puzzling from the perspective that religion emerges to regulate coalitions. To date, these issues have not been investigated outside of American undergraduate samples nor have studies considered how religious identities interact with other essential group-membership signals, such as ancestry, to affect intergroup trust. Here, we address these issues and compare religious identity, ancestry, and trust among and between Christians and Hindus living in Mauritius. Ninety-seven participants rated the trustworthiness of faces, and in a modified trust game distributed money among these faces, which varied according to religious and ethnic identity. In contrast to previous research, we find that markers of religious identity increase monetary investments only among in-group members and not across religious divides. Moreover, out-group religious markers on faces of in-group ancestry decrease reported trustworthiness. These findings run counter to recent studies collected in the United States and suggest that local socioecologies influence the relationships between religion and trust. We conclude with suggestions for future research and a discussion of the challenges of conducting field experiments with remote populations.

A Hermeneutic Phenomenological Study of the Lived Experience of Spiritual Conversion in a Neo-Charismatic Evangelical Context

Hermeneutic phenomenology was used to illuminate the lived experience of posttraumatic, born-again conversion among members of a Neo-Charismatic Evangelical church (n = 11). Data were analyzed using a six-step process that yielded six core constituents: (1) Catalysts for transformation; (2) Courses of spiritual conversion; (3) Relationship with God; (4) Receiving the love of God; (5) Transformed by the love of God; (6) Changes in relationships. The essence of the phenomenon was confident knowing. Methodological rigor was maximized via maintenance of an audit trail and memo-writing. Findings highlight the essence of a spiritual conversion experience that is central to the faith and lives of many people, but remains poorly understood. The insights provided can build understanding of conversion among mental health providers, thereby reducing avoidance of the topic and promoting informed assistance for individuals experiencing a conversion process.

A pilot study: Considering spirituality in an inclusive model of practice in clinical audiology

BACKGROUND

 A patient-orientated approach in medical clinical practice is emerging where patients and practitioners are considering and including the spiritual, emotional and psychosocial aspects of the individual. This practice is an important change in health care, specifically in the field of audiology as a holistic view of the patient now alters the perspective on the management of individuals with hearing impairments. Objectives: This article explored the experiences of a participant who reported supernatural healing of his sensorineural hearing loss (SNHL). Hence, this study focuses on the consideration of spirituality in the inclusive model of care. Method: An exploratory, qualitative narrative inquiry was used to obtain data from a single pilot case study of a 27-year-old man who reported healing of his permanent profound hearing loss. Results: Four themes were identified within the narrative obtained: prayer and faith, deaf culture, identity and purpose. The participant stated that he believed that he was partially healed to fulfil his purpose in life. The partial healing allowed him to belong to the deaf community and the hearing world simultaneously. Conclusion: South Africans live in a diverse society where most people accept spirituality as part of their search for meaning in life. Health care for individuals should therefore consider the person as a holistic being more than a medical entity. The exploration of narratives of individuals who report supernatural healing of a SNHL will assist health care practitioners and audiologists in managing individuals in an inclusive manner. This pilot study thus has implications for policy and practice in health care contexts.

Sedation and care at the end of life

This special issue of Theoretical Medicine and Bioethics takes up the question of palliative sedation as a source of potential concern or controversy among Christian clinicians and thinkers. Christianity affirms a duty to relieve unnecessary suffering yet also proscribes euthanasia. Accordingly, the question arises as to whether it is ever morally permissible to render dying patients unconscious in order to relieve their suffering. If so, under what conditions? Is this practice genuinely morally distinguishable from euthanasia? Can one ever aim directly at making a dying person unconscious, or is it only permissible to tolerate unconsciousness as an unintended side effect of treating specific symptoms? What role does the rule of double effect play in making such decisions? Does spiritual or psychological suffering ever justify sedation to unconsciousness? What are the theological and spiritual aspects of such care? This introduction describes how the authors in this special issue wrestle with such questions and shows how each essay relates to the author's individual position on palliative sedation, as developed in greater detail within his contribution.

Reckoning with the last enemy

Developing the ethics of palliative sedation, particularly in contrast to terminal sedation, requires consideration of the relation between body and soul and of the nature of death and dying. Christianly considered, it also requires attention to the human vocation to immortality and hence to the relation between medicine (as aid for the body) and discipline (as aid to the soul). Leaning on Augustine's rendering of the latter, this paper provides a larger anthropological and soteriological frame of reference for the ethics of palliative sedation, organized by way of nine briefly expounded theses. It argues that palliative sedation, like other elements of medicine, is appropriate where, and only where, it properly orders care for the body to the requirements of care for the soul.

Attributional Biases in Psychiatric Patients, a Religious, and a Control Group in the Assessment of a Hallucinatory Experience: The "White Christmas Test"

The aim of this study was to evaluate the auditory hallucinatory experience in a clinical sample of patients with psychiatric symptoms (e.g. Schizophrenia), a religious group (eg. Christians) and a "control" group (with no mental disorder and non-religious). The sample consisted of individuals of both sexes. The patient sample was recruited in two psychiatric hospitals of Buenos Aires City, the religious from an evangelical cult, and people with no religious beliefs or previous psychiatric symptoms (control group). The Hallucinatory Experiences Questionnaire and the Oxford-Liverpool Inventory Feelings and Experiences were the measurement tools used. The White Christmas Test was also administered in order to assess the degree of vivid imagery hearing based on a version of signal detection paradigm in which the subjects think that they hear a song in the background of white noise. The results showed that patients showed greater attributional bias (compared with evangelicals and the control group), but the religious group also tended to show greater bias (although less) than the control group. In addition, patients tended to show greater schizotypal and hallucinatory experiences compared with the evangelicals and the control group, but surprisingly, the control group showed higher negative schizotypy than the religious group, which indicates that religious practices could help reduce the negative effects of schizotypy.

Explorations in the Aesthetic Pastoral Theology of Donald E. Capps

This paper will examine the curative effects of art and the reorienting perspective of poetry in the aesthetic pastoral theology of Donald E. Capps by exploring two key volumes, The Poet's Gift and At Home in the World. The paper identifies some of the key contributions of Capps's exploration of art and poetry including the recovery of perception, the advancement of reframing perspective, the notion of embodied pastoral conversation and the roots of religious sensibility. The therapeutic effect of the imaginative aesthetic pastoral theology in these two volumes is further developed by integrating three corollary themes in Capps's particular orientation to pastoral theology, namely hope, freedom and authenticity.

Spirituality and religiosity of non-directed (altruistic) living kidney donors

AIMS AND OBJECTIVES

To describe the spirituality and religiosity of 30 non-directed (altruistic) living kidney donors in the USA and explore how they may have affected their motivations to donate and donation process experiences.

BACKGROUND

The rise in non-directed donors and their ability to initiate kidney chains offer a novel approach to help alleviate the overextended kidney transplant wait list in the USA. However, little is known about the non-directed donors' motivations, characteristics and experiences.

DESIGN

We conducted a qualitative-dominant study and used a grounded theory approach to analyse data.

METHODS

Thirty participants completed in-depth interviews between April 2013-April 2015. Three analysts independently read and coded interview transcripts. Grounded theory techniques were used to develop descriptive categories and identify topics related to the non-directed donors donation experience.

RESULTS

Sixteen of the 30 non-directed donorss discussed the topic of spirituality and religiosity when describing their donation experiences, regardless of whether they were actively practising a religion at the time of donation. Specifically, three themes were identified within spirituality and religiosity: motivation to donate, support in the process, and justification of their donation decisions postdonation.

CONCLUSIONS

Findings from this study are the first to describe how spirituality and religiosity influenced the experiences of U.S. non-directed donorss and may help improve non-directed donors educational resources for future spiritual or religious non-directed donors, and the overall non-directed donors donation experience in efforts to increase the living donor pool.

RELEVANCE TO CLINICAL PRACTICE

Spirituality and religiosity are often overlooked yet potentially influential factors in Western medicine, as demonstrated through the experiences of Jehovah's Witnesses and their religious restrictions while undergoing surgery and the beliefs of Christian Scientists against taking medications and receiving medical procedures. Understanding needs of non-directed donors specifically with spirituality and religiosity can better position kidney transplant centres and teams to improve predonation screening of non-directed donor candidates and provide support services during the donation process.

Handling Stereotypes of Religious Professionals: Strategies Hospice Chaplains Use When Interacting with Patients and Families

Stereotypes of religious professionals can create barriers for those who provide spiritual/pastoral care. Through interviews and journal entries, hospice chaplains ( n = 45) identified the following stereotypes that affected their work: chaplains as people whom others try to impress, who only talk about spiritual and religious topics, who are male, and who try to convert others. Participants reported using a variety of communication strategies to counteract stereotypes and make meaningful connections with the people they serve.

Pastoral power in HIV prevention: Converging rationalities of care in Christian and medical practices in Papua New Guinea

In his conceptualisation of pastoral power, Michel Foucault argues that modern healthcare practices derive a specific power technique from pastors of the early Christian church. As experts in a position of authority, pastors practise the care of others through implicitly guiding them towards thoughts and actions that effect self-care, and towards a predefined realm of acceptable conduct, thus having a regulatory effect. This qualitative study of healthcare workers from two Christian faith-based organisations in Papua New Guinea examines the pastoral rationalities of HIV prevention practices which draw together globally circulated modern medical knowledge and Christian teachings in sexual morality for implicit social regulation. Community-based HIV awareness education, voluntary counselling and testing services, mobile outreach, and economic empowerment programs are standardised by promoting behavioural choice and individual responsibility for health. Through pastoral rationalities of care, healthcare practices become part of the social production of negative differences, and condemn those who become ill due to perceived immorality. This emphasis assumes that all individuals are equal in their ability to make behavioural choices, and downplays social inequality and structural drivers of HIV risk that are outside individual control. Given healthcare workers' recognition of the structural drivers of HIV, yet the lack of language and practical strategies to address these issues, political commitment is needed to enhance structural competency among HIV prevention programs and healthcare workers.

Changing attitudes about spanking among conservative Christians using interventions that focus on empirical research evidence and progressive biblical interpretations

This study examined how interventions that include either empirical research evidence about spanking, progressive biblical interpretations, or both, affect attitudes and intentions about spanking. A sample of 129 college students (70% female; 30% male; M_age=19) attending a private, Christian university was randomly assigned to one of three intervention conditions: (1) Research Only, (2) Religion Only, or (3) Research and Religion. Four weeks prior to the intervention sessions, students completed a Demographic Form, the Religious Fundamentalism Scale, and the Attitudes Toward Spanking (ATS) scale. Following the intervention, students completed the ATS scale a second time. A two-way ANOVA indicated a significant main effect for the intervention condition and an interaction effect between intervention condition and religious fundamentalism, indicating that positive spanking attitudes declined most significantly in the Research and Religion intervention condition (F(2, 123)=4.05, p=.02, hp²=.06) with the greatest change in attitudes among the Religious Fundamentalism Group in that condition (F(2, 123)=4.50, p=.01, hp²=.07). A second two-way ANOVA indicated a significant main effect for Conservative Protestant Affiliation (F(2, 123)=4.39, p=.04, hp²=.03) indicating that positive spanking attitudes declined most significantly for participants identifying with a conservative religious affiliation. Overall, the findings suggest that, especially among Conservative Protestants, interventions that focus on both empirical research and progressive biblical interpretations of scripture can reduce positive attitudes toward, and intentions to use, spanking. This study has implications for decreasing spanking use among Conservative Christians and for the development of training programs to reduce parents' use of spanking.

Sense of Coherence (SOC) in Christian Orthodox Monks and Nuns in Greece

This paper aims to investigate the stress management skills of Christian Orthodox monks and nuns, as measured by Antonovsky's scale sense of coherence (SOC). A case-control study was designed to test the hypotheses whether monks and nuns have higher SOC than secular people. The study population consisted of 193 individuals, 96 monks and nuns (study group) and 97 secular men and women (control group). SOC score was higher in monks and nuns as compared to the secular population (p = 0.002), men as compared to women (p = 0.012) and persons of older age (p = 0.004) as compared to younger individuals.

Celibate Gay Christians: Sexual Identity and Religious Beliefs and Practices

The purpose of the study is to explore the experiences of gay Christians who choose celibacy. Chief milestone events, beliefs and attitudes toward God and faith, as well as participants' experiences of church climate toward gay Christians were assessed through a structured interview. Eight interviews were analyzed, using grounded theory methodology and consensual qualitative analysis to identify several salient themes.

Preparation for Pastoral Counseling and Spiritual Care: Strengthening Pastoral "Felt Knowledge" and Empathy through the Appreciation and Use of Contemporary Films

Contemporary film offers something unique in the preparation and practice of pastoral counselors and spiritual caregivers by expanding both "felt knowledge" and strengthening empathic responses to care seekers. By experiencing well-chosen films, pastoral counselors and other spiritual caregivers will be better prepared to work with relevant feelings in various caregiving contexts, and clients will gain many rewards, as both their healing and growth will be enhanced. This will be especially true when pastoral and spiritual caregivers are working in areas of need where they have limited personal or professional experience.

Well-Being and Wellness in the Twenty-First Century: A Theanthropocosmic Approach

In this paper, clarification and definition of the concept well-being of human beings are reflected upon from a faith perspective. The author will define well-being and wellness within the following conceptual definitions: firstly, well-being and wellness will be defined in term of African-Christian approach (the interconnectedness of God-human-and-world approach). Secondly, the author will focus on differentiation of well-being and wellness in a human being. Thirdly, the focal point will be on the mixing of holistic, dualist and triadic approaches to define well-being.

Locating the Social Origins of Mental Illness: The Explanatory Models of Mental Illness Among Clergy from Different Ethnic and Faith Backgrounds

Clergy have historically provided 'healing' through various spiritual and medical modalities and even in modern, developed welfare economies they may still be an important help-seeking resource. Partnerships between religion and psychiatry are regularly advocated, but there is scant research on clergy explanatory models of illness. This paper aimed to explore their relationship with psychiatry and to examine how clergy in various faith groups conceptualised mental health problems. In this qualitative study using in-depth interviews, these issues were explored with 32 practising clergy in the UK from a range of different Christian, Muslim and Jewish faith organisations and ethnic backgrounds. This paper presents findings related to clergy explanatory models of mental illness and, in particular, how the social factors involved in causation are tinged with spiritual influences and implications, and how the meanings of mental distress assume a social and moral significance in distinctive localised matters.

Competing Claims: Religious Affiliation and African Americans' Intolerance of Homosexuals

Literature on religion and political intolerance indicates competing expectations about how Black Protestant church affiliation affects African Americans' attitudes about civil liberties. On the one hand, Black Protestant theology emphasizes personal freedom and social justice, factors generally linked to more tolerant attitudes. On the other hand, Black Protestants tend to be conservative on family and social issues, factors often linked to intolerance of gays and lesbians. Data from the General Social Survey are used to examine the influence of religious group identification, as well as other relevant aspects of religiosity, on political intolerance among African Americans. Results indicate that although other aspects of religion (beliefs and behaviors) help explain variation in political intolerance, Black Protestant church affiliation has no relationship with attitudes about the civil liberties of homosexuals. However, additional tests show that Black Protestant church affiliation significantly predicts intolerance of other target groups (atheists and racists).

Do Social Workers Apply "Love Thy Neighbor as Thyself" to Gay, Lesbian, Bisexual, and Transpersons in the South?

Across the United States there has been a spate of legislative bills and initiatives that blatantly stigmatize and discriminate against the lesbian, gay, bisexual, and transgender (LGBT) community. This study was a cross-sectional, exploratory survey designed to measure the attitudes, perceptions, and behaviors of Tennessee social workers and future social workers toward the LGBT population and toward proposed discriminatory legislation. A 3-way factorial ANOVA investigated the effects of political affiliation, religious affiliation, and social contact on the dependent measures. Significant main effects were found. Self-reported political affiliation was found to be the most important factor predicting LGBT acceptance and LGBT respect among this sample.