CENTER ON BEHAVIORAL MEDICINE
Positive Emotions: Research Article
Seeman, T. E., et al. (2002). Religiosity/Spirituality and Health
A Critical Review of the Evidence for Biological Pathways.
Psychologist, Vol. 58, No. 1, 53-63.
ABSTRACT: The authors review evidence regarding the biological processes that may link religiosity/spirituality to health. A growing body of observational evidence supports the hypothesis that links religiosity/spirituality to physiological processes. Although much of the earliest evidence came from cross-sectional studies with questionable generalizability and potential confounding, more recent research, with more representative samples and multivariate analysis, provides stronger evidence linking Judeo-Christian religious practices to blood pressure and immune function. The strongest evidence comes from randomized interventional trials reporting the beneficial physiological impact of meditation (primarily transcendental meditation). Overall, available evidence is generally consistent with the hypothesis that religiosity/spirituality is linked to health-related physiological processes—including cardiovascular, neuroendocrine, and immune function—although more solid evidence is needed.
American Psychiatric Association Task Force on Biofeedback (1980). Biofeedback: Report of the Task Force on Biofeedback of the American Psychiatric Association (Task Force Report No. 19). Washington, DC: American Psychiatric Association.
Astin, J. A. (1997). Stress reduction through mindfulness meditation: Effects on psychological symptomology, sense of control, and spiritual experiences. Psychotherapy and Psychosomatics, 66, 97-106.
Barber, T., DiCara, L. V.,
Miller, N. E., Shapiro, D., & Stoyva, J. (Eds.) (1971).
Biofeedback and self-control: An Aldine reader on the regulation of
processes and consciousness. Chicago:
Benson, H., Malhotra, M. S., Goldman, R. F., Jacobs, G. D., & Hopkins, J. (1990). Three case reports of the metabolic and electroencephalographic changes during advanced Buddhist meditation techniques. Behavioral Medicine, 16, 90-95.
Benson, H., Rosner, B. A., Marzetta, B. R., & Klemchuk, H. M. (1974). Decreased blood pressure in pharmacologically treated hypertensive patients who regularly elicited the relaxation response. The Lancet, 1, 289-291.
Cousins, N. (1979). Anatomy of an illness. New York: Norton.
Cousins, N. (1989). Head first: The biology of hope and the healing power of the human spirit. New York: Dutton.
Durkheim, E. (1951). Suicide: A study in sociology. Glencoe, IL: Free Press. (Original work published 1897)
Ellison, C. G., & Levin, J. S. (1998). The religion-health connection: Evidence, theory, and future directions. Health Education and Behavior, 25, 700-720.
Friedlander, Y., Kark, J. D., Kaufmann, N. A., & Stein, Y. (1985). Coronary heart disease risk factors among religious groupings in a Jewish population sample in Jerusalem. American Journal of Clinical Nutrition, 42, 511-521.
Friedlander, Y., Kark, J. D., & Stein, Y. (1987). Religious observance and plasma lipids and lipoproteins among 17-year-old Jewish residents of Jerusalem. Preventive Medicine, 16, 70-79.
Garfinkel, M. S., Singhal, A., Katz, W. A., Allan, D. A., Reshetar, R., & Schumacher, H. R. (1998). Yoga-based intervention for carpal tunnel syndrome: A randomized trial. JAMA, 280, 1601-1603.
Graham, T. W., Kaplan, B. H., Cornoni-Huntley, J. C., James, S. A. Q., Becker, C., Hames, C. G., & Heyden, S. (1978). Frequency of church attendance and blood pressure elevation. Journal of Behavioral Medicine, 1, 37-43.
Hafner, R. J. (1982). Psychological treatment of essential hypertension: A controlled comparison of meditation and meditation plus biofeedback. Biofeedback and Self Regulation, 7, 305-316.
Hirai, T. (1974). Psychophysiology of Zen. Tokyo: Igaku Shoin.
Hixson, K. A., Gruchow, H. W., & Morgan, D. W. (1998). The relation between religiosity, selected health behaviors, and blood pressure among adult females. Preventive Medicine, 27, 545-552.
Infante, J. R., Reran, F., Martinez, M., Roldan, A., Poyatos, R., Ruiz, C. et al. (1998). ACTH and beta-endorphin in transcendental meditation. Physiology and Behavior, 64, 311-315.
Ironson, G., Solomon, G. F.,
G., O'Cleirigh, C., George, M. A., Kumar, M. et al. (2002).
Jacobs, G. D., Benson, H., & Friedman, R. (1996). Topographic EEG mapping of the relaxation response. Biofeedback and Self-Regulation, 21, 121-129.
James, W. (1902). The varieties of religious experience: A study of human nature. New York: Random House.
Jevning, R., Anand, R., Biedebach, M., & Fernando, G. (1996). Effects on regional blood flow of transcendental meditation. Physiology and Behavior, 59, 399-402.
Jevning, R., Wilson, A. F., & Davidson, J. M. (1978). Adrenocortical activity during meditation. Hormones and Behavior, 10, 54-60.
Kabat-Zinn, J., Massion, A. O., Kristeller, J., Peterson, L. G., Fletcher, K. E., Pbert, L. et al. (1992). Effectiveness of a meditation-based stress reduction program in the treatment of anxiety disorders. American Journal of Psychiatry, 149, 936-943.
Kabat-Zinn, J., Wheeler, E., Light, T., Skillinos, A., Scharf, M. J., Cropley, T. G. et al. (1998). Influence of a mindfulness meditation-based stress reduction intervention on rates of skin clearing in patients with moderate to severe psoriasis undergoing phototherapy (UVB) and photochemotherapy (PUVA). Psychosomatic Medicine, 60, 625-632.
Kiecolt-Glaser, J. K., Glaser, R., Williger, D., Stout, J., Messick, G., Sheppard, S. et al. (1985). Psychosocial enhancement of immunocompetence in a geriatric population. Health Psychology, 4, 25-41.
Koenig, H. G., Cohen, H. J., George, L. K., Hays, J. C., Larson, D. B., & Blazer, D. G. (1997). Attendance at religious services, interleukin-6, and other biological parameters of immune function in older adults. International Journal of Psychiatry in Medicine, 27, 233-250.
Koenig, H. G., George, L. K., Hays, J. C., Larson, D. B., Cohen, H. J., & Blazer, D. G. (1998). The relationship between religious activities and blood pressure in older adults. International Journal of Psychiatry in Medicine, 28, 189-213.
Larson, D. B., Koenig, H. G., Kaplan, B. H., Greenberg, R. S., Logue, E., & Tyroler, H. A. (1989). The impact of religion on men's blood pressure. Journal of Religion and Health, 28, 265-278.
Lazar, S. W., Bush, G., Gollub, R. L., Fricchione, G. L., Khalsa, G., & Benson, H. (2000). Functional brain mapping of the relaxation response and meditation. NeuroReport, 11, 1581-1585.
Levin, J. S., & Chatters, L. M. (1998). Research on religion: An overview of empirical findings and theoretical issues. In H. Koenig (Ed.), Handbook of religion and mental health (pp. 33-50). San Diego, CA: Academic Press.
Livingston, I. L., Levine, D. M., & Moore, R. D. (1991). Social integration and Black intraracial variation in blood pressure. Ethnicity and Disease, 1, 135-149.
Lou, H. C., Kjaer, T. W., Friberg, L., Wildschiodtz, G., Holm, S., & Nowak, M. (1999). A 0-15-H2O PET study of meditation and the resting state of normal consciousness. Human Brain Mapping, 7, 98-105.
MacLean, C. R. K., Walton, K. G., Wenneberg, S., Levitsky, D. K., Mandarino, J. P., Waziri, R. et al. (1997). Psychoneuroimmunology
MacLean, C. R. K., Walton, K. G., Wenneberg, S. R., Levitsky, D. K., Mandarino, J. V., Waziri, R., & Schneider, R. H. (1994). Altered responses of cortisol, GH, TSH, and testosterone to acute stress after four months' practice of transcendental meditation (TM). Annals of the New York Academy of Sciences, 746, 381-384.
Mandle, C. L., Domar, A. D., Harrington, D. P., Leserman, J., Bozadjian, E. M., Friedman, R., & Benson, H. (1990). Relaxation response in femoral angiography. Radiology, 174, 737-739.
Marcer, D. (1986). Biofeedback and related therapies in clinical practice. Rockville, MD: Aspen.
Matthews, D. A., McCullough, M. E., Larson, D. B., Koenig, H. G., Swyers, J. P., & Milano, M. G. (1998). Religious commitment and health status: A review of the research and implications for family medicine. Archives of Family Medicine, 7, 118-124.
Miller, W. R., & Thoreson, C. E. (2003). Spirituality, religion, and health: An emerging research field. American Psychologist, 58, 24-35.
Mueller, P. S., Plevak, D. J., & Rummans, T. A. (2001). Religious involvement, spirituality, and medicine: Implications for clinical practice. Mayo Clinic Proceedings, 76, 1225-1235.
Newberg, A., Alavi, A., Baime, M., Pourdehnad, M., Santanna, J., & d'Aquili, E. (2001). The measurement of regional cerebral blood flow during the complex cognitive task of meditation: A preliminary SPECT study. Psychiatry Research: Neuroimaging Section, 106, 113-122.
Patel, C., Marmot, M. G., Terry, D. J., Carruthers, M., Hunt, B., & Patel, M. (1985). Trial of relaxation in reducing coronary risk: Four year follow up. British Medical Journal, 290, 1103-1106.
Patel, C., & North, W. R. (1975, July 19). Randomised controlled trial of yoga and bio-feedback in the management of hypertension. The Lancet, 2, 93-95.
Pollack, A. A., Case, D. B., Weber, M. A., & Laragh, J. H. (1977). Limitations of transcendental meditation in the treatment of essential hypertension. The Lancet, 1, 71-73.
Rosenau, P. M. (1992). Post-modernism and the social sciences. Princeton, NJ: Princeton University Press.
Sapolsky, R. M. (1990). Adrenocortical function, social rank, and personality among wild baboons. Biological Psychiatry, 28, 862-878.
Schmidt, T., Wijga, A., Von Zur Muhlen, A., Brabant, G., & Wagner, T. O. F. (1997). Changes in cardiovascular risk factors and hormones during a comprehensive residential three month kriya yoga training and vegetarian nurtition. Acta Physiologica Scandinavica: Supplementum, 160, 158-162.
Schneider, R. H., Nidich, S. I., Salerno, J. W., Sharma, H. M., Robinson, C. E., Nidich, R. J., & Alexander, C. N. (1998). Lower lipid peroxide levels in practitioners of the transcendental meditation program. Psychosomatic Medicine, 60, 38-41.
Schneider, R. H., Staggers, F., Alexander, C. N., Sheppard, W., Rainforth, M., Kondwani, K. et al. (1995). A randomized controlled trial of stress reduction for hypertension in older African Americans. Hypertension, 26, 820-827.
Scotch, N. A. (1963). Sociocultural factors in the epidemiology of Zulu hypertension. American Journal of Public Health, 8, 1205-1213.
Sephton, S. E., Koopman, C., Schaal, M., Thoresen, C., & Spiegel, D. (2001). Spiritual expression and immune status in women with metastaic breast cancer: An exploratory study. The Breast Journal, 7, 345-353.
Sephton, S. E., Sapolsky, R. M., Kraemer, H. C., & Spiegel, D. (2000). Diurnal cortisol rhythm as a predictor of breast cancer. Journal of the National Cancer Institution, 92, 994-1000.
Steffen, P. R., Hinderliter, A. L., Blumenthal, J. A., & Sherwood, A. (2001). Religious coping, ethnicity, and ambulatory blood pressure. Psychosomatic Medicine, 63, 523-530.
Sudsuang, R., Chentanez, V., & Veluvan, K. (1991). Effect of Buddhist meditation on serum cortisol and total protein levels, blood pressure, pulse rate, lung volume, and reaction time. Physiology and Behavior, 50, 543-548.
Sundar, S., Agrawal, S. K., Singh, V. P., Bhattacharya, S. K., Udupa, K. N., & Vaish, S. K. (1984). Role of yoga in management of essential hypertension. Acta Cardiologica, 39, 203-208.
Timio, M., Lippi, G., Venanzi, S., Gentili, S., Quintaliani, G., Verdura, C. et al. (1997). Blood pressure trend and cardiovascular events in nuns in a secluded order: A 30-year follow-up study. Blood Pressure, 6, 81-87.
Walsh, A. (1998). Religion and hypertension: Testing alternative explanations among immigrants. Behavioral Medicine, 24, 122-130.
Walton, K. G., Pugh, N. D., Gelderloos, P., & Macrae, P. (1995). Stress reduction and preventing hypertension: Preliminary support for a psychoneuroendocrine mechanism. Journal of Alternative and Complementary Medicine, 1, 263-283.
Wenneberg, S. R., Schneider, R. H., Walton, K. G., Maclean, C. R. K., Levitsky, D. K., Salerno, J. W. et al. (1997). A controlled study of the effects of the transcendental meditation program on cardiovascular reactivity and ambulatory blood pressure. International Journal of Neuroscience, 89, 15-28.
Werner, O. R., Wallace, R. K., Charles, B., Janssen, G., Stryker, T., & Chalmers, R. A. (1986). Long-term endocrinologic changes in subjects practicing the Transcendental Meditation and TM-Sidhi Program. Psychosomatic Medicine, 48, 59-66.
Woods, T. E., Antoni, M. H., Ironson, G. H., & Kling, D. W. (1999). Religiosity is associated with affective and immune status in symptomatic HIV-infected gay men. Journal of Psychosomatic Research, 46, 165-176.
Worthington, E., Kurusu, T.,
M., & Sandage, S. (1996). Empirical research on religion and
psychotherapeutic processes and outcomes: A 10-year review and research
prospectus. Psychological Bulletin, 119, 448-487.