Koenig Harold G, Youssef Nagy A, Oliver Rev John P, Ames Donna, Haynes Kerry, Volk Fred, Teng Ellen J
Duke University Medical Center, Box 3400, 2301 Erwin Rd, Durham, NC, 27710, USA.
Durham Veterans Affairs Health Care System, Durham, NC, USA.
J Relig Health. 2018 Dec;57(6):2325-2342. doi: 10.1007/s10943-018-0692-1.
Religious involvement is associated with mental health and well-being in non-military populations. This study examines the relationship between religiosity and PTSD symptoms, and the mediating effects of anxiety and depression in Veterans and Active Duty Military (V/ADM). This was a cross-sectional multi-site study involving 585 V/ADM recruited from across the USA. Inclusion criteria were having served in a combat theater and PTSD symptoms. Demographics, military characteristics, and social factors were assessed, along with measurement of religiosity, PTSD symptoms, depression, and anxiety. Bivariate and multivariate analyses examined the religiosity-PTSD relationship and the mediating effects of anxiety/depression on that relationship in the overall sample and stratified by race/ethnic group (White, Black, Hispanic). In bivariate analyses, the religiosity-PTSD relationship was not significant in the overall sample or in Whites. However, the relationship was significant in Blacks (r = - 0.16, p = 0.01) and in Hispanics (r = 0.30, p = 0.03), but in opposite directions. In the overall sample, religiosity was inversely related to anxiety (r = - 0.07, p = 0.07) and depression (r = - 0.21, p < 0.0001), especially in Blacks (r = - 0.21, p = 0.001, and r = - 0.34, p < 0.0001, respectively); however, in Hispanics, religiosity was positively related to anxiety (r = 0.32, p = 0.02) as it was to PTSD symptoms. When anxiety/depression was controlled for in multivariate analyses, the religiosity-PTSD relationship in the overall sample reversed from negative to positive, approaching statistical significance (B = 0.05, SE = 0.03, p = 0.079). In Blacks, the inverse association between religiosity and PTSD was explained by quality of relationships, whereas the positive relationship in Hispanics was explained by anxiety symptoms. In conclusion, religiosity was inversely related to PTSD symptoms in Blacks, positively related to PTSD in Hispanics, and unrelated to PTSD in the overall sample and in Whites. Anxiety/depression partially mediated the relationship in the overall sample and in Hispanics. Although longitudinal studies will be necessary to determine how these relationships come about, consideration should be given to spiritual/religious interventions that target anxiety/depression in V/ADM with PTSD.
宗教参与与非军事人群的心理健康和幸福感相关。本研究考察了退伍军人和现役军人（V/ADM）中宗教虔诚度与创伤后应激障碍（PTSD）症状之间的关系，以及焦虑和抑郁的中介作用。这是一项横断面多地点研究，涉及从美国各地招募的585名V/ADM。纳入标准为曾在战区服役且有PTSD症状。评估了人口统计学、军事特征和社会因素，同时测量了宗教虔诚度、PTSD症状、抑郁和焦虑。双变量和多变量分析考察了宗教虔诚度与PTSD的关系，以及焦虑/抑郁在总体样本中对该关系的中介作用，并按种族/族裔群体（白人、黑人、西班牙裔）进行分层。在双变量分析中，宗教虔诚度与PTSD的关系在总体样本或白人中不显著。然而，在黑人中该关系显著（r = -0.16，p = 0.01），在西班牙裔中也显著（r = 0.30，p = 0.03），但方向相反。在总体样本中，宗教虔诚度与焦虑（r = -0.07，p = 0.07）和抑郁（r = -0.21，p < 0.0001）呈负相关，尤其是在黑人中（分别为r = -0.21，p = 0.001和r = -0.34，p < 0.0001）；然而，在西班牙裔中，宗教虔诚度与焦虑（r = 0.32，p = 0.02）以及与PTSD症状一样呈正相关。在多变量分析中控制焦虑/抑郁后，总体样本中宗教虔诚度与PTSD的关系从负向转为正向，接近统计学显著性（B = 0.05，SE = 0.03，p = 0.079）。在黑人中，宗教虔诚度与PTSD之间的负相关由人际关系质量解释，而在西班牙裔中，正向关系由焦虑症状解释。总之，宗教虔诚度在黑人中与PTSD症状呈负相关，在西班牙裔中与PTSD呈正相关，在总体样本和白人中与PTSD无关。焦虑/抑郁在总体样本和西班牙裔中部分介导了这种关系。尽管需要纵向研究来确定这些关系是如何产生的，但应考虑针对有PTSD的V/ADM中焦虑/抑郁的精神/宗教干预措施。
