Proeschold-Bell Rae Jean, Miles Andrew, Toth Matthew, Adams Christopher, Smith Bruce W, Toole David
Duke Global Health Institute, Center for Health Policy and Inequalities Research, Duke University, Durham, NC, USA,
J Prim Prev. 2013 Dec;34(6):439-53. doi: 10.1007/s10935-013-0321-4.
The clergy occupation is unique in its combination of role strains and higher calling, putting clergy mental health at risk. We surveyed all United Methodist clergy in North Carolina, and 95% (n = 1,726) responded, with 38% responding via phone interview. We compared clergy phone interview depression rates, assessed using the Patient Health Questionnaire (PHQ-9), to those of in-person interviews in a representative United States sample that also used the PHQ-9. The clergy depression prevalence was 8.7%, significantly higher than the 5.5% rate of the national sample. We used logistic regression to explain depression, and also anxiety, assessed using the Hospital Anxiety and Depression Scale. As hypothesized by effort-reward imbalance theory, several extrinsic demands (job stress, life unpredictability) and intrinsic demands (guilt about not doing enough work, doubting one's call to ministry) significantly predicted depression and anxiety, as did rewards such as ministry satisfaction and lack of financial stress. The high rate of clergy depression signals the need for preventive policies and programs for clergy. The extrinsic and intrinsic demands and rewards suggest specific actions to improve clergy mental health.
神职人员职业因其角色压力和更高使命感的结合而独具特色，这使神职人员的心理健康面临风险。我们对北卡罗来纳州的所有联合卫理公会神职人员进行了调查，95%（n = 1726）做出了回应，其中38%通过电话访谈进行回应。我们将使用患者健康问卷（PHQ - 9）评估的神职人员电话访谈抑郁率与同样使用PHQ - 9的美国代表性样本中的面对面访谈抑郁率进行了比较。神职人员的抑郁患病率为8.7%，显著高于全国样本5.5%的患病率。我们使用逻辑回归来解释抑郁情况，同时也解释使用医院焦虑抑郁量表评估的焦虑情况。正如努力 - 回报不平衡理论所假设的那样，一些外在需求（工作压力、生活不可预测性）和内在需求（对工作做得不够的内疚感、怀疑自己从事神职的使命感）显著预测了抑郁和焦虑，神职工作满意度和无经济压力等回报因素也有同样的作用。神职人员的高抑郁率表明需要针对神职人员制定预防政策和项目。外在和内在的需求及回报提示了改善神职人员心理健康的具体行动。
