Most studies report positive associations between religiosity and spirituality and aspects of mental health, while a small proportion report mixed or fully negative associations. The aim of this study was to assess the associations of religiosity measured more specifically, with mental health in a secular environment, using a nationally representative sample of Czech adults (n = 1795). We measured religious affiliation, conversion experience, non-religious attitudes and the stability of these attitudes, mental health problems, and anxiety levels. Compared to stable non-religious respondents, unstable non-religious and converted respondents who perceived God as distant were more likely to experience anxiety in close relationships, and had higher risks of worse mental health. Our findings support the idea that the heterogeneity of findings in associations between religiosity/spirituality and mental health could be due to measurement problems and variation in the degree of secularity. A shift towards religiosity could be expected to be seen in a substantial part of non-religious respondents in problematic times.
1. Introduction
Most studies report a positive association between religiosity and spirituality (R/S) and aspects of mental health (MH) [1], such as a higher life-satisfaction and meaning in life [2], a lower prevalence of anxiety and depression [3,4], suicidal tendencies [5] and substance abuse [6], and better cognitive functioning [7]. Some authors even present spiritual health as a fundamental dimension of peopleās overall health and well-being, permeating and integrating all other dimensions of health [8]. However, a small proportion of such studies report either mixed or negative associations [1]. Understanding why these findings deviate may add to our understanding of the underlying process.
Among the possible explanations, problems with measurement [9] are most often mentioned, related to the fact that both spirituality and religiosity are hard to measure as multidimensional constructs [10]. Religiosity is most often seen as participation in an organised religion (i.e., in an organized system of beliefs and practices) [1], while spirituality can be understood in many ways, ranging from a traditional understanding of spirituality as an expression of religiosity, in search of the sacred, through to a humanistic view of spirituality devoid of religion [8]. Recently, spirituality has mostly been considered to be a more personal, subjective experience [11] that often includes a connection to the transcendent (e.g., oneās relationship to God); a connectedness to oneself, others and the world; feelings of peace, love and harmony; and the sense of an ultimate meaning of life [12]. Thus, definitions can differ to a high degree, especially regarding spirituality [9]. This hinders comparison of the various studies, because results might differ due to the definitions used. Approaches that would touch both the external and internal aspect of R/S are probably the best solution.
Another explanation of the heterogeneous findings on R/S and mental health could be a failure to take socio-cultural factors and context into account [13]. To date, most research has been performed in predominantly religious countries [14], but associations may be different for those living in more secular countries. Some studies report that religious individuals show better subjective health only in countries in which religiosity is common and socially desirable [15,16] and that having the same religion in two different cultural contexts may have opposing outcomes [17]. Hayward and Elliott [18] found R/S in secular countries to be associated with adverse health outcomes and linked explanations for this with the social norms and governmental policies in the country concerned. However, there is a lack of research that takes such individual factors into greater account.
A third explanation for some heterogeneous findings on the association of R/S and MH regards more internal factors, such as attachment styles, which also differ between various cultures [19]. Moreover, attachment style has already been associated with some dimensions of R/S. Research shows that a believerās perceived relationship with God meets the defining criteria for attachment relationships and can function psychologicallyāmuch like other attachments [20], and that this relationship is also associated with mental [21] and physical health [22]. In line with these findings, Fisher [23] showed that relating to God also contributes to personal happiness and that it has a strong positive impact on spiritual well-being [24]. Taking into account participantsā image of God may therefore represent another way of taking into account the heterogeneous nature of religiosity and spirituality.
Kirkpatrick [25] also linked attachment theory with the process of religious conversion and found that women with an anxious attachment style were more likely to become religiously converted than women with a secure or avoidant attachment style. Other studies support these findings [26,27], which imply that religious instability may have similar roots as those of unstable emotional attachment. Religious conversion, or the stability of religious attitudes in general, could also contribute to the heterogeneity of the findings regarding R/S and MH in association with the socio-cultural context. In line with the personāenvironment fit model [28], which is defined as the degree to which individual and environmental characteristics match, we can assume a different conversion process in religious and secular countries. People often convert to religion in times of distress in a difficult life situation [29,30]. Nevertheless, while people might turn to religion more easily in predominantly religious countries because conversion is socially acceptable, in secular ones, the ācost of the conversionā [31] is higher. Where a difficult life situation represents the main reason for conversion, we could expect a higher level of stress (i.e., a worse psychological condition) among converts. The Czech Republic is one of the most secular countries in the world. According to some sources, it is the country with the highest percentage (76.4%) of religiously unaffiliated people in the world [32], which represents a unique setting to assess the effects of conversion.
Therefore, the aim of this study was to assess the associations of religiosity measured more specifically (i.e., as perceived closeness to God and of the stability of religious attitudes) with MH (i.e., the attachment insecurity and other mental health problems) in a secular environment.
