by
Roman Palitsky;
Zhuo Job Chen;
Kelly E. Rentscher;
Sydney E. Friedman;
Da' Mere T. Wilson;
John M. Ruiz;
Daniel Sullivan;
George H. Grant;
Mary-Frances O'Connor
Bereavement increases in prevalence as people age and is associated with multiple psychological and health risks, including cardiovascular risk. Religious and existential variables may play an important role in the health impacts of bereavement. Theorized pathways linking religious and existential variables with health have suggested these associations are due to intermediary psychosocial variables, but have not been tested in bereavement. This research empirically tested these pathways in a bereaved population. In N = 73 adults within 1 year of bereavement (mean age = 64.36), this study examined associations between (1) religious and existential characteristics (religious and spiritual struggles, intrinsic religiosity, and existential quest) and intermediary psychosocial variables (depression, loneliness, and difficulties in emotion regulation), and between (2) intermediary psychosocial variables and bereavement‐relevant health outcomes (self‐reported health, change in health since last year, grief severity, and cardiovascular biomarkers). Cardiovascular biomarkers (heart rate, heart rate variability, and blood pressure) were collected before, during, and after a laboratory grief recall emotion elicitation. Anticipated associations between self‐reported religious and existential characteristics and intermediary variables, and between intermediary variables and self‐reported bereavement‐relevant outcomes, were consistently observed. However, associations between intermediary variables and cardiovascular biomarkers were largely unobserved. This study examined the role of religious and existential variables in whole‐person health after bereavement and is among the first to include biomarkers of cardiovascular risk. Results suggest that although religious and existential variables are associated with important bereavement‐related outcomes, these associations may be “skin‐deep,” and extensions to cardiovascular functioning should be re‐examined.
Background: Depression is the largest source of global medical disability, highlighting the importance of translating and validating depression screening instruments to improve our understanding of differences in the prevalence of depression in divergent cultures around the world. The aim of this study was to translate and evaluate a widely used depression screening and diagnostic instrument, the Patient Health Questionnaire-9 (PHQ-9), for use with Tibetan populations. A secondary aim was to use the Tibetan-PHQ-9 (T-PHQ-9) to estimate the prevalence of depression symptoms in a population of Tibetan-speaking Buddhist monastic scholars engaging in a 6-year science curriculum in India, the Emory Tibet Science Initiative (ETSI).
Methods: Three-hundred-eighty-four monastics (363 monks, 21 nuns) completed the T-PHQ-9. We computed measures of internal consistency and conducted factor analysis to evaluate scale performance. Following this, we evaluated the prevalence of depressive symptoms among the monastic population. We also conducted cognitive interviews with six monastics to explore their thought processes when completing the instrument and when thinking about depression symptoms.
Results: The T-PHQ-9 had acceptable reliability and demonstrated a single-factor structure. While having low energy was the most commonly endorsed symptom, monastics did not have overall higher endorsement rates of other somatic symptoms when compared with endorsement rates of emotional symptoms. Over 10% of the monastics scored in the moderately severe to severe range and met criteria for major depressive disorder using standard diagnostic criteria cut-offs. First year monks had the highest mean score, and there was not a significant difference between monks and nuns. Cognitive interviews revealed some variation in the cognitive processes used to complete the instrument, particularly with symptoms related to energy and concentration.
Conclusion: These preliminary findings indicate that the Tibetan PHQ-9 is a reliable instrument for assessing depressive symptoms, as evidenced by its ability to inform how symptoms are experienced, interpreted, and communicated among Buddhist monastics. Results from the cognitive interviews may be important for further refining the instrument.
This keynote address for the 2012 Womanist Consultation with the Circle of Concerned African Women Theologians in Ghana offers an African diasporan perspective on an understudied approach to theorizing Africana women’s activisms. In Africana cultures, the mother symbol has hermeneutical and epistemological relevance to the ethical project of community building and social transformation. The address explores the mother concept and its noble significations as an originary symbol that traverses many of the Indigenous African, Christian and Islamic religious heritages claiming the allegiance of Africana communities. Specifically, it offers a figurative exploration of the mother symbol that draws from the scholarship of African and African diaspora feminist/womanist scholars. Considered together, the works of thinkers such as Ifi Amadiume, Oyèrónkẹ́ Oyěwùmí and Cheryl Townsend Gilkes resurrect from a transatlantic legacy of Africana women’s kinship connections and responsibilities, buried virtues of relational life that all humans can strive to embody and enact. Mothering is interrogated, then, as a term whose semantic purview expands well beyond the literal to register the metaphorical and even the socio-ontological.
It is often remarked that one cannot imagine the Unmoved Mover loving or caring for anything—and, in fact, this is the gist of both Christian and atheist attacks on Aristotle’s Unmoved Mover. Richard Dawkins, for instance, reminds us that even if God is the end of the regress of movement, this does not mean we can ascribe to such a principle properties that are normally considered divine, such as omniscience, goodness, creativity in design, answering prayers, forgiving sins, and so on (The God Delusion, Boston, 2006, 110). In other words, any adoption of versions of the cosmological or teleological arguments, such as we might find at the beginning of Aquinas’ Summa Theologica, do not lead to the Christian notion of God as personal, loving and caring; and, of course, on Dawkins’ well known view, the Christian loving God is a chimera, anyway, a product of wishful human thinking.
Objective
The purpose of this study is to explore Protestant religious leaders’ attitudes towards abortion and their strategies for pastoral care in Georgia, USA. Religious leaders may play an important role in providing sexual and reproductive health pastoral care given a long history of supporting healing and health promotion.
Methods
We conducted 20 in-depth interviews with Mainline and Black Protestant religious leaders on their attitudes toward abortion and how they provide pastoral care for abortion. The study was conducted in a county with relatively higher rates of abortion, lower access to sexual and reproductive health services, higher religiosity, and greater denominational diversity compared to other counties in the state. Interviews were audio-recorded, transcribed verbatim, and analyzed by thematic analysis.
Results
Religious leaders’ attitudes towards abortion fell on a spectrum from “pro-life” to “pro-choice”. However, most participants expressed attitudes in the middle of this spectrum and described more nuanced, complex, and sometimes contradictory views. Differences in abortion attitudes stemmed from varying beliefs on when life begins and circumstances in which abortion may be morally acceptable. Religious leaders described their pastoral care on abortion as “journeying with” congregants by advising them to make well-informed decisions irrespective of the religious leader’s own attitudes. However, many religious leaders described a lack of preparation and training to have these conversations. Leaders emphasized not condoning abortion, yet being willing to emotionally support women because spiritual leaders are compelled to love and provide pastoral care. Paradoxically, all leaders emphasized the importance of empathy and compassion for people who have unplanned pregnancies, yet only leaders whose attitudes were “pro-choice” or in the middle of the spectrum expressed an obligation to confront stigmatizing attitudes and behaviors towards people who experience abortion. Additionally, many leaders offer misinformation about abortion when offering pastoral care.
Conclusion
These findings contribute to limited empirical evidence on pastoral care for abortion. We found religious leaders hold diverse attitudes and beliefs about abortion, rooted in Christian scripture and doctrine that inform advice and recommendations to congregants. While religious leaders may have formal training on pastoral care in general or theological education on the ethical issues related to abortion, they struggle to integrate their knowledge and training across these two areas. Still, leaders could be potentially important resources for empathy, compassion, and affirmation of agency in abortion decision-making, particularly in the Southern United States.
Early in the planning the Emory-Tibet Science Initiative, we realized that the encounter between Buddhism and contemporary science demanded that Buddhist logic and epistemology encounter Anglophone philosophy of science. A titanic clash of world views was anticipated, but as we began the conversation, we found something different. Many philosophical concerns were shared, but these problems were understood differently. While fundamental elements of epistemology, like observation and inference, had similar functions in both traditions, subtle differences in conceptualization challenged mutual intelligibility. Through thousands of years of erudite debate, each tradition had honed their tools. While each cut cleanly, they carved in different joints. This essay will briefly discuss the linguistic, philosophical, and pedagogical adjustments that made for mutual comprehensibility.
Sacred values, such as those associated with religious or ethnic identity, underlie many important individual and group decisions in life, and individuals typically resist attempts to trade off their sacred values in exchange for material benefits. Deontological theory suggests that sacred values are processed based on rights and wrongs irrespective of outcomes, while utilitarian theory suggests that they are processed based on costs and benefits of potential outcomes, but which mode of processing an individual naturally uses is unknown. The study of decisions over sacred values is difficult because outcomes cannot typically be realized in a laboratory, and hence little is known about the neural representation and processing of sacred values. We used an experimental paradigm that used integrity as a proxy for sacredness and which paid real money to induce individuals to sell their personal values. Using functional magnetic resonance imaging (fMRI), we found that values that people refused to sell (sacred values) were associated with increased activity in the left temporoparietal junction and ventrolateral prefrontal cortex, regions previously associated with semantic rule retrieval. This suggests that sacred values affect behaviour through the retrieval and processing of deontic rules and not through a utilitarian evaluation of costs and benefits.
Background: Cancer survivors and their informal caregivers (family members, close friends) often experience significant impairments in health-related quality of life (HRQOL), including disruptions in psychological, physical, social, and spiritual well-being both during and after primary cancer treatment. The purpose of this in-progress pilot trial is to determine acceptability and preliminary efficacy (as reflected by effect sizes) of CBCT® (Cognitively-Based Compassion Training) compared with a cancer health education (CHE) attention control to improve the primary outcome of depressive symptoms and secondary outcomes of other HRQOL domains (e.g., anxiety, fatigue), biomarkers of inflammation and diurnal cortisol rhythm, and healthcare utilization-related outcomes in both cancer survivors and informal caregivers. Methods: Forty dyads consisting of solid tumor survivors who have completed primary treatments (chemotherapy, radiation, surgery) and their informal caregivers, with at least one dyad member with ≥ mild depressive symptoms or anxiety, will be recruited from Tucson, Arizona, USA. Survivor-caregiver dyads will be randomized together to complete either CBCT or CHE. CBCT is a manualized, 8-week, group meditation-based intervention that starts with attention and mindfulness and builds to contemplative practices aimed at cultivating compassion to the self and others. The goal of CBCT is to challenge unexamined assumptions about feelings and behaviors, with a focus on generating spontaneous self-compassion and increased empathic responsiveness and compassion for others. CHE is an 8-week, manualized group intervention that provides cancer-specific education on various topics (e.g., cancer advocacy, survivorship wellness). Patient-reported HRQOL outcomes will be assessed before, immediately after (week 9), and 1 month after CBCT or CHE (week 13). At the same time points, stress-related biomarkers of inflammation (e.g., plasma interleukin-6) and saliva cortisol relevant for survivor and informal caregiver wellness and healthcare utilization will be measured. Discussion: If CBCT shows acceptability, a larger trial will be warranted and appropriately powered to formally test the efficacy of this dyadic intervention. Interventions such as CBCT directed toward both survivors and caregivers may eventually fill a gap in supportive oncology care programs to improve HRQOL and healthcare utilization in both dyad members. Trial registration: Clinicaltrials.gov, NCT03459781. Prospectively registered on 9 March 2018.
One of the goals of the historic Emory-Tibet Science Initiative (ETSI) is to catalyze cross-cultural thinking among scientists and Buddhists. Over a decade into the project to elicit such thinking the project sponsored an essay competition among the monastics. Here we feature two of the winners reflecting on different aspects of western sciences and Buddhism, physics and Buddhism respectively, demonstrating how modern science is integrating with the monastics’ traditional training and culture. A key aspect of ETSI is also translation, and these essays, in that spirit were translated from Tibetan to English by one of the project translators.