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Religion and Medicine



CITATION:
  Koenig, Harold G.  (2001). Religion and Medicine III: Developing a Theoretical Model. Incl. J. Psychiatry in Medicine;31 (2):199-216.


ABSTRACT:  In this third of a four-article series on religion and medicine, I describe a theoretical model to illustrate the complex pathways by which religion may influence physical health. Genetic factors, childhood training, psychological and social influences, health behaviors, and healthcare practices are discussed as part of this model. Considerable space is given to recent advances in psychoneuroimmunology and to stress-induced cardiovascular changes that demonstrate physiological pathways by which cognitive, emotional, and behavioral processes may influence susceptibility to disease and disease course. I also discuss research illustrating the important role that social support plays in moderating the physiological effects of stress and improving health outcomes. If religious beliefs and practices improve coping, reduce stress, prevent or facilitate the resolution of depression, improve social support, promote healthy behaviors, and prevent alcohol and drug abuse, then a plausible mechanism exists by which physical health may be affected.

References

1. Steinberg KK, Pernarelli JM, Marcus M, Khoury MJ, Schildraut JM, Marchbanks PA. Increased risk for familial ovarian cancer among Jewish women. Genetic Epidetniolog ' 1998;15:51-59.

2. Egan KM, Newcomb PA, Longnecker MP, TrenthamDietz A, Baron JA. I'richopoulos D, Stampfer MJ, Willett WC. Jewish religion and risk of breast cancer. Lancet 1996;347(9016):1645-1646.

3. Dreyfuss F. The incidence of myocardial infarction in various communities in Israel. American Heart Journal 1953;45:749-755.

4. Striver CR, Beaudet AL, Sly WS, Valle D. The metabolic and molecular bases of
inherited disease. 7th Edition, New York: McGraw-Hill, 1995:2839-2882.

5. Kendler KS, Gardner CO, Prescott CA. Religion, psychopathology, and substance
use and abuse: A multimeasure, genetic-epidemiologic study. American Journal of
Psychiatry 1997;154:322-329

6. Selye H. Syndrome produced by diverse noculous agents. Nature 1936;138:32.

7. Cannon WB. The emergency function of the adrenal medulla in pain and the major emotions. American Journal of Physiology 1941;33:356.

8. Rabin BS. Stress, immune function, and health: The connection. New York: Wiley-Liss & Sons, 1999.

9. Dreier A, Albus M, Pickar D, Zahn TP, Wolkowitz OM, Paul SM. Controllable and uncontrollable stress in humans: Alterations in mood and neuroendocrine and psychophysiological function. American Journal o%Psychiatry 1987;144:1419-1425.

10. Cacioppo JT, Malarkey WB, Kiecolt-Glaser JK, Uchino BN, Sgoutas-Emch SA, Sheridan JF, Berntson GG, Glaser R. Heterogeneity in neuroendocrine and immune responses to brief psychological stressors as a function of autonomic cardiac activation. Psychosomatic Medicine 1995;57:154-164.

11. Kiecolt-Glaser JK, Malarkey WB, Chee M, Newton T, Cacioppo JT, Mao HY, Glaser R. Negative behavior during marital conflict is associated with immunological down-regulation. Psychosomatic Medicine 1993;55:395-409.

12. Kiecolt-Glaser JK, Glaser R, Cacioppo JT, MacCallum RC, Snydersmith M, Kim C, Malarkey WB. Marital conflict in older adults: Endocrinological and immunological correlates. Psychosomatic Medicine 1997;49:339-349.

13. Schleifer SJ, Keller SE, Bond RN. Major depressive disorder and immunity. Archives of General Psychiatry 1989;46:81-87.

14. Irwin M, Smith TL, Gillis JC. EEG sleep and natural killer activity in depressed patients and control subjects. Psychosomatic Medicine 1992;54:10-21.

15. Bartrop RW, Lazarus L, Luckhurst E, Kiloh LG, Penny R. Depressed lymphocyte function after bereavement. Lancet April 16, 1977:834-836.

16. Leserman J, Petitto JM, Perkins DO, Folds JD. Severe stress, depressive symptoms, and changes in lymphocytes subsets in human immunodeficiency virus-infected men. A 2-year follow-up study. Archives of General Psychiatry 1997;54:279-285.

17. Glaser R, Rabin B, Chesney Ni, Cohen S, Natelson B. Stress-induced immuno-modulation: Are there implications for infectious diseases? Journal of the American Medical Association 1999;2812268-2270.

18. Kiecolt-Glaser JK, Dura JR, Speicher CE, Trask OJ, Glaser R. Spousal caregiver of dementia victims: Longitudinal changes in immunity and health. Psychosomatic Medicine 1991;53:345-362.

19. Kiecolt-Glaser JK, Glaser R, Gravenstein S, Malarkey WB, Sheridan J. Chronic stress alters the immune response to influenza virus vaccine in older adults. Proceedings of the National Academy of Sciences 1996;93:3043-3047.

20. Vedhara K, Cox NKM, Wilcock GK, Perks P, Ilunt M, Andersen S, Lightman SI., Shanks NM. Chronic stress in elderly caregivers of dementia patients and antibody response to influenza vaccine. Lancet 1999;353:627-63I

21. Kiecolt-Glaser,IK, Garner W, Speicher C. Psychosocial modifiers of immunocompetence in medical students. Psychosomatic Medicine 1984;46:7-14.

22. Cohen S, Tyrell DAJ, Smith AP. Psychological stress and susceptibility to the common cold. New England Journal of Medicine 1991;325:606-612.

23. Evans DL, Leserman J, Perkins DO, Stern RA, Murphy C, Meng 13, Genes I), I ongmate JA, Silva SG, van der Horst CM, Hall CD, Folds JD, Golden RN, Petitro JM. Severe life stress as a predictor of early disease progression in HIV infection. American JournaloJ Psychiauy 1997;154:630-634.

24. Shekelle RH, Raynor WJ, Ostfeld AM, Carron DC, Bieliauskas I.A. Liu SC. Maliza C, Oglesby P. Psychological depression and I 7-year risk of death from cancer. Psycho-somatic Medicine 1981;43:1 I 7-125.

25. 1'rigerson HG, Bierhals Al, Kasl SV, Reynolds Cf, Shear MK, Day N. Beery LC, Newsom JT, Jacobs S. Traumatic grief as a risk factor for mental and physical morbidity. American Journal of Psychiatry 1997;1 54:616-623.

26. Herberman RB. Principles of minor immunology. In Ilulleb Al, Fink DJ, Murphy GP. editors. Textbook of clinical oncology. Atlanta, GA: American Cancer Society, 199 I: 69-79.

27. Akinwto M, Nakajima Y, Tan M, Ishii H, Iwasaki Ii, Abe R. Assessment of host immune response in breast cancer patients. Cancer Detection &. Prevention 1986; 9:311-317.

28. Levy S, Lippman M, d'Angelo T. Correlation of stress factors with sustained suppression of natural killer cell activity and predictive prognosis in patients with breast cancer. Journal of Clinical Oncology 1987;5:348-353.

29. Levy S, Lee J, Bagley C, Lippman G. Survival hazards analysis in first recurrent breast cancer patients: The seven-year    ow-up. Psychosomatic Medicine 1988;50:520-528.

30. Roberts D, Andersen BL, Lubaroff A. Stress and immunity at cancer diagnosis. Unpublished manuscript. Department of Psychology, Ohio State University. Columbus, Ohio, 1994.

31. Kiecolt-Glaser JK, Mancha PT, Malarkey WB, Mercado AM, Glaser R. Slowing of wound healing by psychological stress. Lancet 1996;346(.8984):1194-1196.

32. Marucha PT, Kiecolt-Glaser JK, Favagehi M. Mucosal wound healing is impaired by examinations stress. Psychosomatic Medicine 1998;60:362-365.

33. lichino BN, Cacioppo.JR, Kiecolt-Glaser JK. The relationship between social support and physiological processes: A review with emphasis on underlying mechanisms and implications for health. Psychological Bulletin 1996;119:488-531.

34. Kiecolt-Ulaser JK, Kicker u, George J. urinary curuse,i leve,., ccuwa, unman, competence, and loneliness iii psychiatric inpatients 1'strhosomane A4edicine 1984; 46:15-23.

35. Cohen S, Doyle WJ, Skoner DP, Rabin BS, Gwaltney JM. Social ties and susceptibility to the common cold. Journal of the American Afedical Association 1997; 277:1940-1944.

36. Baron RS, Cutrona CF., Hicklin D, Russel DW, Lubarott DM. Social support and immune function among spouses of cancer patients. Journal of Personalist' d Social Psychology 1990;59:344-352.

37. Fsterling BA, Kiecolt-Glaser JK, Glaser R. Psychosocial modulation of cytok induced natural killer cell activity in older adults. Psychosomatic Medicine 1996; 58:264-272.

38. Levy S, TTerbennan RB, Lee J, Whiteside I, Kirkwood J, McFeeley S. Estrogen receptor concentration and social factors as predictors of natural hiller cell activity in early-stage breast cancer patients. Natural Immunity & Cell Growth Regulation 1990; 9:313-324.

39. Spiegel D, Bloom JR, Kraemer HC, Gottheil F. Effect of psychosocial treatment on survival of patients with metastatic breast cancer. Lancet I989?(8668I:888-891.

40. Fawzy FL, Fawzy NW, Hyun C, Elashoff R, Guthrie D, Fahey JL. Morton DI-. Malignant melanoma: Effects of an earlier structured psychiatric intervention. coking, and affective state on recurrence and survival six years later. Archives of General Psychiatry 1993;50:681-689.

41. Musselman DL, Turner A, Manatunga AK, Knight BT, Porter MR, Kasey S. Exaggerated platelet reactivity in major depression. American Journal of Psychiatry 1996; 153:1313-1317.

42. Veith RC, Lewis N, Linares OA, Barnes RF, Raskind MA, Villacres EC. Sympathetic nervous system activity in major depression—basal and desipramine-induced alterations in plasma norepinephrine kinetics. Archives of General Psychiatry 1993; 50:1-12.

43. Carney RM, Saunders RD, Freedland KE, Stein P, Rich MW, Jaffe AS. Association tri depression with reduced heart rate variability in coronary artery disease. American Journal of Cardiology 1995;76:562-564.

44. Rosengren A, Tibblin G. Wilhelmsen L. Self-perceived psychological stress and incidence of coronary artery disease in middle-aged men. American Journal of Cardiology 1991;68:1171-1175.

45. Pratt LA, Ford DE, Crum RM. Depression, psychotropic medication, and risk of myocardial infarction. Circulation 1996;94:3123-3129.

46. Everson SA, Kaplan GA, Goldberg DE, Salonen R, Salonene JT. Hopelessness and 4-year progression of carotid atherosclerosis. The Kuopio Ischemic Heart Disease Risk Factor Study. Arteriosclerosis. Thrombosis cc. Vascular Biology 1997; 17:1490-1495.

47. Ford DE, Mead LA, Chang PP, Cooper-Patrick I,, Wang NY, Klag M.I. Depression is the risk factor or coronary artery disease in man. Archives of internal Medicine 1998;158:1422-1426.

48. Ahern DK, Corkin F, Anderson JL, Tierney C, Hallstroin A, Ewart C. Biobehaviaral variables and mortality or cardiac arrest in the Cardiac Arrhythmias Pilot Study (CA PS) Aineru CIII Journal of 'Cardiolo~'y 1990;66:59-62.

49. Kennedy GF, Hofer MA, Cohen D, Shindledecker R, Fisher JD. Significance of depression and cognitive impairment in patients undergoing programmed stimulation of cardiac arrhythmias. Psychosomatic Medicine 1987;49:410-421.

50. Carney RM, Rich MW, Freedland KE, Sanini J, teVelde A, Simeone C. Major depressive disorder predicts cardiac events in patients with coronary artery disease. Psychosomatic Medicine 1988;50:627-633.

51. Barefoot JC, Helms MJ, Mark DB, Blumenthal 7A, Califf RM, Haney TL. Depression and long-term mortality risk int patients with coronary artery disease. 1merieaa Journal of Cardiology 1996;78:613-617.

52. Frasure-Smith N, Lesperance F, Talajic M. Depression following myocardial infarction: Impact on 6-month survival.. Journal (tithe American Medical Association 1993?70:1819-1825.

53. Greenwood DC, Muir KR, Packham CJ, Madley RJ. Coronary heart disease: A review of the role ofpsychosocial stress and social support. Journal of Public Health Medicine 1996;18:221-231.

54. Seeman T, Syme SL. Social networks and coronary artery disease: A comparison of the structure and function of social relations as predictors of disease. Psychosomatic Medicine 1987;49:341-354.

55. Williams RB, Barefoot JC. Califf RM. Haney TL, Saunders W I3, Pryor DB, Iilatky MA, Siegler IC, Mark DB. Prognostic importance of social and economic resources among medically treated patients with angiographically documented coronary artery disease. Journal of the American Medical Association 1992267:520-524.

56. Frasure-Smith N, In-hospital symptoms of psychological stress as predictors of long-term outcome after acute myocardial infarction in men. American Journal of Cardiology 1991;67:121-127.

57. Marlatt GA. Relapse prevention: Theoretical rationale and overview of the model. In Marlatt GA, Gordon JR, editors. Relapse prevention. New York: Guilford Press, 1985:3-70.

58. Anonymous. Alcohol effects on the immune system: Third Annual Meeting of the Alcohol and Drug Abuse Immunology Symposium, Vail, Colorado, March 25-29 (abstracts). Alcohol 1993;10:335-342.

59. MacGregor RR. Alcohol and immune defense. Journal of the Al    at Medical Association 1986;256:1474-1479.

60. Holt PG. Immune & inflammatory function in cigarette smokers. Thorax 1987;42:241-249.

61. Meliska CJ, Strunkard ME, Gilbert DJ, Jensen RA, Martinko JM. Immune function in cigarette smokers who quit smoking for 31 days. Journal of Allergy Ai. Clinical Immunology 1995;95:901-910.

62. Friedman H, Klein T, Specter S. Immunosupression by marijuana and components. In Ader R, Felten DL, Cohen N, editors. Psychoneuroimmunology. San Diego, CA: Academic Press, 1991:66-85.

63. Dorff EN. The Jewish Tradition. In Numbers RL, Amundsen DW, editors. Caring and curing: Health and medicine in the western religious traditions. Baltimore: Johns Hopkins University Press, 1998.

64. Rahman F. Islam and health/medicine: A historical perspective. In Sullivan LE, editor. Healing and restoring: Health and medicine in the world's religious traditions.. New York: Macmillan Publishing Co., 1989.

65. Koenig HG, George IK, Cohen III, Hays JC, Blazer DG, Larson DB. The relationship between religious activities and blood pressure in older adults. International Journal of Psychiatry in Medicine 1998;28:189-213.

66. Koenig JIG. Use of acute hospital services and mortality among religious and non-religious topers with medical illness. Journal of Religious Gerontology 1995; 9(3):1-22.