Relationship between religiosity domains and traits from borderline and schizotypal personality disorders in a Brazilian community sample

Abstract Introduction Research suggests that religiosity domains are associated with mental health constructs. Some studies have focused on the relationship between religiosity and personality disorders. Objective To investigate the relationship between religiosity domains and pathological traits of the borderline (BPD) and schizotypal (SZPD) personality disorders. Methods Participants were 751 adults from the general population who answered the Multidimensional Inventory for Religious/Spiritual Well-Being (MI-RSWB-E), the Attachment to God Inventory (AGI), and factors of the Dimensional Clinical Personality Inventory 2 (IDCP-2). Pearson’s correlation and regression analysis were conducted with pathological traits as independent variables and religiosity domains as dependent variables. Results Correlation and regression analyses indicated slightly higher associations between religiosity domain and BPD traits in comparison to SZPD traits. BPD traits showed higher associations with the hope immanent, forgiveness and hope transcendent domains, while SZPD presented higher associations with connectedness. The SZPD-related paranormality factor presented the highest correlation observed in the study and was the best SZPD predictor of religiosity domains. The BPD-related hopelessness factor was the predictor with significant contribution to most regression models. BPD traits presented slightly higher average association with religiosity domains, whereas spiritual-related domains (e.g., connectedness) tended to show higher associations with SZPD traits. Conclusions Our findings help explain the relationship between specific pathological traits and religiosity domains.


Background
Religiosity is characterized by religious experience and faith, which impact on individual perceptions, values, daily experiences, and notions of self. 12 Religiosity is also related to a particular ritualistic cultural component, and to a particular religion, in which there is a belief in a doctrine, attributing practices and customs of worship to a faith that is shared with a group. 13,14 Although not consensual in literature, 14,15 in this study we considered 1  According to Unterrainer et al., 11 religiosity can be grouped in two broad belief components, namely general religiosity and connectedness. General religiosity refers to institutions, traditions and religious communities. It is related to extrinsic and intrinsic religiosity, i.e., the use of religiosity for its own benefit (extrinsic), and the spiritual and religious internal experience (intrinsic). 16 Connectedness is the deinstitutionalized expression of beliefs, related to the concept of spirituality, i.e., connectivity with a superior power or entity.
Previous studies have suggested that the level and expression of religiosity is associated with personality traits, 6,8,17 although mixed findings have been observed regarding the direction of this relationship. Evidence of positive associations suggests religiosity to be a protective factor for personality trait expressions, while negative associations suggest religiosity to be a risk factor for the manifestation of pathological traits.
Pathological traits composing borderline personality disorder (BPD) and schizotypal personality disorder (SZPD) seem to present the strongest association with religiosity domains in comparison to other pathological traits. 8 BPD is characterized by emotional instability, impulsivity, risk exposure, and a tendency to be hostile, including impairment of emotional expression, selfimage, and interpersonal relationship. 18,19 SZPD, in turn, refers to a pattern of eccentric behavior and thoughts, with an impaired ability to establish interpersonal relationship and emotional closeness, as well as a tendency to be interpersonally suspicious. 18,20 Evidence points to negative associations between BPD traits and religiosity domains, specifically, religious and spiritual well-being, 19 while religious practice and general religiosity are associated with traits such as aggressivity, mood instability, feeling of emptiness, and self-mutilating tendency. 21 For SZPD traits, although mixed findings have been observed (e.g., Diduca & Joseph 22 ), positive associations were found for religious attachment, while negative associations were found for religious and spiritual well-being. 4 Moreover, positive associations between religiosity/spiritual well-being and neuroticism and magical thinking have been reported, 11 as well as positive associations between spirituality scores (e.g., connectedness) and several SZPD traits. 9 Even though an increase can be observed in the number of studies investigating associations between religiosity domains and pathological traits, evidence presented in previous literature is insufficient to allow more stable conclusions. Our aim in this study was to investigate the relationship between religiosity domains and pathological traits typical of BPD and SZPD. We tested two hypotheses: h1) BPD and SZPD traits should present moderate negative associations with religiosity domains, although BPD traits should show higher associations 19,21 ; and h2) spiritual-related domains (i.e., connectedness and experiences of sense and meaning) should present positive moderate associations with SZPD traits, including insecure religious attachment. 4,9,11

Participants
Using a cross-sectional design, we recruited a non-

Multidimensional Inventory for Religious/Spiritual Well-Being (MI-RSWB-E)
The MI-RSWB-E is a self-report measure used to assess religious and spiritual well-being, defined by the developers 17 as the ability to experience and integrate meaning and purpose into existence through a connection with self, others or a higher entity. The scale is composed of six dimensions: general religiosity Psychometric properties of the scale were previously investigated. 11 Reliability ranged between 0.70 (hope transcendent) and 0.95 (general religiosity).

Attachment to God Inventory (AGI)
The self-report AGI (Beck & McDonald, 2004) is designed to measure attachment with God through two dimensions: intimacy avoidance (14 items) and abandonment anxiety (14 items). Higher scores are related to insecure attachment to God. Psychometric properties were suitable in a previous study. 23 Internal consistency for our sample was 0.53 (intimacy avoidance factor) and 0.84 (abandonment anxiety).

Dimensional Clinical Personality Inventory 2 (IDCP-2)
The IDCP-2 is a self-report tool used to measure pathological traits (a technical manual in Brazilian Portuguese is currently under development). 24 The scale is based on pathological traits from Millon, 25 axis II from the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, Text Revision (DSM-IV-TR), 26 and PD chapters from DSM-5. 18 It comprises 12 dimensions, to a total of 47 factors. In this study, according to the hypotheses, we administered the following factors: self-devaluation (7 items), abandonment avoidance (6 items), vulnerability

Results
Correlations are presented in Tables 1 and 2, showing associations between religiosity domains and BPD traits (Table 1) and SZPD traits ( Table 2). Bold type indicates r > 0. 10 (Cohen, 1988) and significance (p ≤ 0.05): * significant at the 0.01 level; † significant at the 0.05 level. Avoidance = intimacy avoidance; Anxiety = abandonment anxiety; BPD = borderline personality disorder; ESM = experience of sense and meaning; GR = general religiosity; HI = hope immanent; HT = hope transcendent; Mr = mean of correlations; SDr = standard deviation of correlations. Regression analysis results are presented in Table 3 (BPD traits) and   At least one SZPD trait was a significant predictor for each religiosity domain. The paranormality factor was the best predictor, appearing in almost all regression models, always with a significant positive contribution.
When adding sociodemographic variables to the model, emotional inexpressiveness, distrust in relationships and paranormality were no longer significant predictors. The religiosity domains best explained by pathological traits were connectedness and hope immanent, while general religiosity and connectedness were best explained after inclusion of sociodemographic variables.

Discussion
Even though religiosity domains have been linked to mental health outcomes, 1-3,6,7 little knowledge has been generated to date on the relationship with pathological traits that comprise PDs. In this study, we aimed to extend evidence on this relationship, investigating associations between religiosity and pathological traits from two specific PDs, i.e., BPD and SZPD. Overall, we found associations between traits and religiosity domains, as detailed in the next paragraphs. third, the PD trait scale is a self-report instrument, not a diagnostic assessment tool; and fourth, even though the religiosity scales administered covered several domains, we did not use specific scales for spirituality.

Disclosure
No conflicts of interest declared concerning the publication of this article.