Spirituality/Religiousness, Personality, and Mental Health: An Article Critique

This was one of my assignments this semester, but I enjoyed writing it so much that I thought I would share it. Those of you who are averse to statistical analysis and correlational designs may find the following nauseating. I would love to get your feedback!

Critique of the Article by Lockenhoff et al. (2009): ‘Five-Factor Model Personality Traits, Spirituality/Religiousness, and Mental Health Among People Living with HIV’

Lockenhoff, Ironson, O’Cleirigh, and Costa, Jr. (2009) attempt to demonstrate a link between personality and spirituality/religiousness (S/R), and to correlate these two factors with mental health in people living with HIV. Finding a relationship between world-views and mental health has been of clinical interest to many researchers (e.g., Bagwell-Reese & Brack, 1997; Dein, Cook, Powell, & Eagger, 2010; and McKnight & Kashdan, 2009); therefore, any significant results found linking personality and S/R to mental health would help to reinforce such research.

The main criticism to be made of this study, as with any studies looking at factors such as personality and S/R, is the theoretical complexity of the constructs themselves. Lockenhoff et al. suggest that spirituality and religiosity (or religiousness) are “distinct concepts.” Further, they attribute primacy to underlying personality traits for S/R. This critique will argue that 1) spirituality and religiosity are overlapping concepts that cannot be effectively deconstructed to create measures that retain sufficient construct validity, and 2) that S/R and personality are weak covariates, i.e., one does not predispose an individual to the other.

Distinguishing Between Spirituality and Religiousness

Some argue that studies that use differential measures of spirituality and religiousness are creating erroneous distinctions between two very interrelated concepts (Zinnbauer et al. 1997; Zinnbauer, Pargament, & Scott, 1999). This may stem from the biases of Western secularism and/or religious purism. Zinnbauer et al. (1999) argue that “…opposing ‘institutional’ religion to ‘personal’ spirituality ignores the fact that virtually every major religious institution is ardently concerned with spiritual matters…if religion and spirituality continue to be polarized as the institutional and the personal, we run the risk of losing sight of the individual mission of the religious institution, and the social context of spirituality.”

Lockenhoff et al. employ the Ironson-Wood Spirituality/Religiousness Index (IWSRI) as their measure of S/R. This index differentiates between personal spirituality’s “serene outlook on life and a sense of meaning, tolerance, compassion, and a feeling of connectedness with humanity,” and an institutional religiousness that believes in “God and his role in aiding recovery from illness, participation in religious rituals and services.” This measure subsumes the same false dichotomies discounted by Zinnbauer et al. (1999), and should not be used in and of itself as a measure of S/R.

Linking Personality with Spirituality/Religiosity

Lockenhoff et al. attribute primacy to underlying personality traits for S/R. For their measure of personality the authors focus on the Five-Factor Model of personality traits (Goldberg, 1993; McCrae & Costa, 2003). The authors argue that Saroglou (2002) found religiosity to be “primarily associated with high Conscientiousness and Agreeableness and, to a lesser extent, to high Extraversion.” Also, that spirituality showed its “strongest association to high Openness; more moderate relations to high Agreeableness, Conscientiousness, and Extraversion; and weak association to low Neuroticism.” In this case, the authors’ agenda, i.e., to show distinctions between spirituality and religiousness and to connect S/R to the five-factor model in a way that accommodates the needs of their study, interfered with their interpretation of Saroglou’s results. A close examination of Saroglou’s data clearly shows that Saroglou did not make simple S/R distinctions in his measures; rather, he looked at four types of religiousness: overall religiosity, open-mature religion and spirituality, religious fundamentalism, and extrinsic religion. Incidentally, the authors had specifically remarked on the association between religiosity and Conscientiousness/Agreeableness; however, the correlation was very small for both (Agreeableness, r =.20; Conscientiousness, r =.17). The highest correlate was between Openness to Experience and Open, Mature religion and spirituality (r =.22). The data in Saroglou’s study demonstrated small correlations across the board; therefore, it should not be used to attribute primacy to underlying personality traits for S/R.

Subsequently, the results of Lockenhoff et al.’s (2009) study demonstrates “moderate correlations between personality traits and S/R at both the factor and the facet level, with the strongest associations found for Conscientiousness, Agreeableness, Openness, Neuroticism, Extraversion.” Again, a closer analysis of the data shows that the correlations in this study were too small to conclude spirituality and religiousness as  “characteristic adaptations based on core personality dimensions.”

Ethnicity, Age, and Design

The authors’ attempts to consider ethnicity as a covariate does not demonstrate any interesting differences between ethnic sub-populations since 93% of the ethnic sub-groups used (i.e., African American, Caucasian, and Hispanic) represent a predominantly Western-Christian representation. This means that the S/R measures do not account for the differences in religious worldviews found in many eastern religious traditions and practices. Another covariate that may be confounding the data is age. The age range for this study is 18-66, which begs a number of questions: is personality static or generational? Does wisdom borne of experience change perceptions of religiousness/spirituality? What is the overall relationship between age, religious practice, spirituality, and personality? Finally, the authors used a longitudinal design; therefore, I cannot be sure that the participants’ resultant mental health after the passing of a year was directly related to S/R and Personality, or other extraneous factors, i.e., social/family support, therapy, biological factors, or the normal improvement that occurs with the passage of time.

Conclusions

Lockenhoff et al. suggest that populations affected by HIV/AIDS may be more likely to describe themselves as spiritual but not religious. This argument is unfounded since neither their data, nor the studies they cite, have effectively demonstrated a true distinction between these two constructs. Furthermore, recent studies (Cotton et al., 2006) have demonstrated that “most patients with HIV/AIDS belonged to an organized religion and use their religion to cope with their illness.” Their next conclusion is that if one adopts the view that S/R “can be understood as characteristic adaptations based on core personality dimensions” than the beneficial effects of S/R are “at least partially accounted for by the effects of underlying personality traits.” Again, this relationship between S/R and personality is like the chicken and egg argument: does personality predispose an individual to spirituality/religiousness, or does spirituality/religiousness effect a change in cognition and personality? The latter can be supported by recent studies in the cognitive effects of mindfulness practice by Lazar et al. (2010).

To close their article, the authors suggest that interventions aiming to encourage individuals to seek religious help to improve mental health may be misguided because, they argue, “the benefits of S/R for mental health are largely dependent on…underlying personality traits.” This conclusion does not reflect the small correlations found in their results and in previous studies. Therefore, I would argue that physicians should not abandon religious interventions based on the findings of this study; rather, an integrative approach catered to the specific needs of the patient should be employed. This could include, but should not be limited to, religious interventions.

References

Bagwell-Reese, M., & Brack, G. (1997). The therapeutic use of reframing and worldview in mental health counseling. Journal of Mental Health Counseling, 19, 78-86. Retrieved from EBSCOhost.

Costa, P. r., & McCrae, R. R. (2008). The Revised NEO Personality Inventory (NEO-PI-R). In G. J. Boyle, G. Matthews, D. H. Saklofske, G. J. Boyle, G. Matthews, D. H. Saklofske (Eds.), The SAGE handbook of personality theory and assessment, Vol 2: Personality measurement and testing (pp. 179-198). Thousand Oaks, CA US: Sage Publications, Inc. Retrieved from EBSCOhost.

Cotton, S., Puchalski, C. M., Sherman, S. N., Mrus, J. M., Peterman, A. H., Feinberg, J., Pargament, K.I., Justice, A.C., Leonard, A.C., & Tsevat, J. (2006). Spirituality and religion in patients with HIV/AIDS. Journal of General Internal Medicine, 21, S5-S13. Doi:10.1111/j.1525-1497.2006.00642.x

Dein, S., Cook, C.C.H., Powell, A, & Eagger, S. (2010). Religion, spirituality and mental health. The Psychiatrist, 34, 63-64. doi: 10.1192/pb.bp.109.025924

Goldberg, L. R. (1993). The structure of phenotypic personality traits. American Psychologist, 48, 26-34. doi:10.1037/0003-066X.48.1.26

Hölzel, B.K., Carmody, J., Vangel, M., Congleton, C., Yerramsetti, S.M., Gard, T., Lazar, S.W., (2010).
Mindfulness practice leads to increases in regional brain gray matter density. Psychiatry Research: Neuroimaging,191, 36-43. doi:10.1016/j.pscychresns.2010.08.006

Lockenhoff, C.E., Ironson, G.H., O’Cleirigh, C., & Costa, Jr., P.T. (2009). Five-factor model personality traits, spirituality/religiousness, and mental health among people living with HIV. Journal of Personality, 77, 1411-1436. Doi: 10.1111/j.1467-6494.2009.00587.x

McKnight, P.E., & Kashdan, T.B. (2009). Purpose in life as a system that creates and sustains health and well-being: An integrative, testable theory. Review of Clinical Psychology, 13, 242-251. Doi: 10.1037/a0017152

Saroglou, V. (2002). Religion and the five factors of personality: a meta-analytic review. Personality and Individual Differences, 32, 15-25. Doi 10.1016/S0191-8869(00)00233-6

Zinnbauer, B.J., Pargament, K.I., & Scott, A.B. (1999). The emerging meanings of religiousness and spirituality: Problems and prospects. Journal of Personality, 67, 889-919. Doi: 10.1111/1467-6494.00077




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