Institute for Social Medicine, Epidemiology and Health Economics, Charité University Medical Center, Berlin, Germany.
Contilia Academy, Contilia GmbH, Essen, Germany.
PLoS One. 2023 Aug 3;18(8):e0289203. doi: 10.1371/journal.pone.0289203. eCollection 2023.
The coherence hypothesis assumes that sense of coherence (SOC) explains the positive link between religion/spirituality (R/S) and mental health. The aim of our meta-analysis is to evaluate the evidence for the association between SOC (sensu Antonovsky) and different aspects of R/S and thus to contribute to the verification of the coherence hypothesis. Eighty-nine English- and German-language primarily cross-sectional studies with 67,913 participants met the inclusion criteria. The R/S scales of all included studies were subjected to item-by-item qualitative content analysis in order to determine whether scales do actually measure religion or spirituality and which R/S aspects dominated the instrument. Based on this classification, overall and subgroup meta-analyses were conducted using a random effects model. The adjusted effect size between SOC and all positive R/S measures was r+ = .120, 95% CI [.092, .149]. Particularly significant (r+ < -.180 or > .180) were correlations with negative R/S scales (r+ = -.405, 95% CI [-.476, -.333]), R/S instruments measuring primarily positive emotions (r+ = .212, 95% CI [.170, .253]) or meaning-making (r+ = .196, 95% CI [.126, .265]). Both sample characteristics (age, culture, gender, health status, religious affiliation) and study characteristics (e.g., publication year) had a moderating effect on the R/S-SOC connection. The correlation was particularly high in studies from Southern Asia (r+ = .226, 95% CI [.156, .297]), the African Islamic cultural value zone (r+ = .196, 95% CI [.106, .285]), and in a small subgroup of Iranian studies (r+ = .194, 95% CI [.117, .271]). The results confirm that R/S and SOC are clearly associated and suggest that there are different religious/spiritual pathways to a strong SOC. The strength of the associations presumably depends not only on individual differences, but also on cultural embeddedness and social plausibility of R/S. Trial registration. PROSPERO registration number: CRD42021240380. https://www.crd.york.ac.uk/prospero/display_record.php?ID = CRD42021240380.
连贯性假说假设，心理韧性（SOC）解释了宗教/精神信仰（R/S）与心理健康之间的积极联系。我们的荟萃分析旨在评估 SOC（Antonovsky 意义上的）与 R/S 的不同方面之间关联的证据，从而有助于验证连贯性假说。89 项以英语和德语发表的主要横断研究纳入了 67913 名参与者，符合纳入标准。为了确定量表实际上是否测量了宗教或精神信仰，以及哪些 R/S 方面主导了工具，我们对所有纳入研究的 R/S 量表进行了逐项目的定性内容分析。在此分类的基础上，使用随机效应模型进行了总体和亚组荟萃分析。SOC 与所有积极的 R/S 测量之间的调整后效应大小为 r+ =.120，95%CI [.092，.149]。与消极 R/S 量表（r+ = -.405，95%CI [-.476，-.333]）、主要测量积极情绪的 R/S 量表（r+ =.212，95%CI [.170，.253]）或意义建构量表（r+ =.196，95%CI [.126，.265]）的相关性特别显著（r+ < -.180 或 >.180）。样本特征（年龄、文化、性别、健康状况、宗教信仰）和研究特征（例如，发表年份）对 R/S-SOC 联系具有调节作用。在南亚（r+ =.226，95%CI [.156，.297]）、非洲伊斯兰文化价值区（r+ =.196，95%CI [.106，.285]）和一小部分伊朗研究（r+ =.194，95%CI [.117，.271]）中，相关性特别高。结果证实 R/S 和 SOC 明显相关，并表明存在不同的宗教/精神途径来获得强大的 SOC。关联的强度可能不仅取决于个体差异，还取决于 R/S 的文化嵌入和社会合理性。试验注册。PROSPERO 注册号：CRD42021240380。https://www.crd.york.ac.uk/prospero/display_record.php？ID = CRD42021240380。
