Spirituality or religiosity: is there any difference?

We read with interest the letter published by Dr. Abayomi¹ concerning our article entitled “Religious beliefs and alcohol control policies: a Brazilian nationwide study.”² We agree that cultural values, personality, and stressful life events can have an important influence on alcohol use. In our study, the population was predominantly composed by Catholics (67.3%), followed by Evangelical Protestants (23.3%). These religious affiliations usually have stronger opinions regarding public policy than do other religious traditions, including advocating for more restrictive alcohol policies.² There are distinct differences in alcohol use between religious traditions, as we reported in a recent article.³ For instance, Afro-Brazilian religions (i.e., Umbanda) utilize alcohol in their rituals, whereas some Brazilian Protestant Evangelicals forbid its use entirely, whether for religious or non-religious purposes.

With regard to the concepts of spirituality and religiosity and their measurement, we agree that these are distinct constructs, sometimes difficult to distinguish. According to Koenig et al.,⁴ spirituality is “the personal quest for understanding answers to ultimate questions about life, about meaning and about relationship to the sacred or transcendent, which may (or may not) lead to or arise from the development of religious rituals and the formation of community.” Several authors have examined relationships between spirituality, religiosity, and mental health, with varying results. For example, King et al.⁵ investigated associations between a spiritual or religious understanding of life and psychiatric symptoms in 7,403 people in England. They found religious people were similar to those who were neither religious nor spiritual with regard to the prevalence of mental disorders, except that those who were religious were less likely to have ever used drugs or to be a hazardous drinker. On the other hand, spiritual people were more likely than those who were neither religious nor spiritual to have ever used or to be dependent on drugs and to have abnormal eating attitudes, generalized anxiety disorder, any phobia, or any neurotic disorder. Furthermore, Laurent et al.⁶ found that those who indicated that they were spiritual but not religious in the UK were nearly three times more likely to develop an episode of major depressive disorder during a 12-month follow-up period compared to those who were neither religious nor spiritual (OR 2.73, 95%CI 1.59-4.68).

In contrast, in a much smaller study, Farias et al.⁷ compared modern spiritual individuals (n=114) with traditional religious believers (n=86) in England. The authors found anxiety, depression, and insecure attachment were not significant predictors of spirituality. The results of this study also revealed that spiritual believers reported high satisfaction with social support, with this variable predicting involvement in modern spirituality. Furthermore, spiritual practices correlated negatively with death anxiety scores. These conflicting results are not easy to reconcile. First, since all these studies were conducted in the United Kingdom, cultural context would not seem to play a significant role. Second, as only one study⁶ actually followed participants over time, the other two cross-sectional studies provide no information about the time sequence. Third, important psychiatric outcomes such as depression and anxiety were addressed in both studies. Some major differences between these three studies also warrant mention. The instruments used to assess religiosity/spirituality and mental health were different, which could help to explain the varying results; the enrollment of patients was diverse (two nationwide studies vs. one convenience sample); and the same psychiatric outcomes were not assessed in all three studies.

In view of these findings, more research needs to be done comparing those who are religious and spiritual with those who are spiritual but not religious in a variety of locations and cultural settings to elucidate the role that spiritual and religious beliefs play in mental health and substance use.

References

• ¹
  Abayomi O. Still on religiosity and alcohol use. Rev Bras Psiquiatr. 2014;36:360-1.
• ²
  Lucchetti G, Koenig HG, Pinsky I, Laranjeira R, Vallada H. Religious beliefs and alcohol control policies: a Brazilian nationwide study. Rev Bras Psiquiatr. 2014;36:4-10.
• ³
  Lucchetti G, Peres MF, Lucchetti AL, Koenig HG. Religiosity and tobacco and alcohol use in a Brazilian shantytown. Subst Use Misuse. 2012;47:837-46.
• ⁴
  Koenig HG, McCullough ME, Larson DB. Handbook of religion and health. New York: Oxford University Press; 2001.
• ⁵
  King M, Marston L, McManus S, Brugha T, Meltzer H, Bebbington P. Religion, spirituality and mental health: results from a national study of English households. Br J Psychiatry. 2013;202:68-73.
• ⁶
  Leurent B, Nazareth I, Bellon-Saameno J, Geerlings MI, Maaroos H, Saldivia S, et al. Spiritual and religious beliefs as risk factors for the onset of major depression: an international cohort study. Psychol Med. 2013;43:2109-20.
• ⁷
  Farias M, Underwood R, Claridge G. Unusual but sound minds: mental health indicators in spiritual individuals. Br J Psychol. 2013;104:364-81.

Publication Dates

• Publication in this collection
  Jan-Mar 2015

History

• Received
  7 May 2014
• Accepted
  9 May 2014