Intolerance of Uncertainty & Faith -The Implications of Religiosity on Mental Health
Despite the secularization of the United States in recent years, a 2020 survey showed that nearly half of Americans belong to a church, synagogue, or mosque in 2020 (Gallup, 2021). Why do people turn to religion in modern times? Some think of religion as a mechanism for community support and connection based on shared belief systems. Others find peace during times of hardship through faith in an afterlife or an all-knowing, all-powerful, and all-loving god.
Psychologists seek to understand the motives and personality traits that lead individuals to religion and the effect of religious involvement on mental health outcomes. For example, the Terror Management Theory (TMT) theorizes that “religion serves to manage the potential terror engendered by the uniquely human awareness of death by affording a sense of psychological security and hope of immortality” (Vail et al, 2010).
The pioneering personality psychologist Gordon Allport theorized that religiosity could be either intrinsically or extrinsically motivated (Allport et al, 1967). Expanding upon Allport’s framework, researchers Brewcynski J., and MacDonald differentiated religious motivators even further by identifying three categories of religious motivation: intrinsic (wherein an individual seeks out religion for its own sake devoid of external motivators), extrinsic-personal (an individual uses religion to bring psychological relief), and extrinsic-social motivations (maintaining religious affiliation for social reasons) (Brewczinksky et al, 2006).
Researching religiosity by motivation style yields meaningful results, such as evidence of a positive correlation between religiosity and depression when an individual’s religiosity is extrinsically motivated (Howell et al, 2019, p. 99).
The 2019 article in the Journal of Clinical Psychology titled “Intolerance of Uncertainty Moderates the Relations Among Religiosity and Motives for Religion, Depression, and Social Evaluation Fears” contributes to this body of research. The article by Ashley N. Howell, R. Nicholas Carleton, Samantha C. Horswill, Holly A. Parkerson, Justin W. Weeks, and Gordon J.G. Asmundson explores the connection between the psychological concept of Intolerance of Uncertainty (IU), religious motivation, depression, and social evaluation anxiety (Howell, et al, 2019).
The Intersection of Intolerance of Uncertainty (IU), Religious Motivation, Depression, and Social Anxiety
Howell et al focus on the moderating effect of Intolerance of Uncertainty (IU) upon religiosity and mental health outcomes. IU has been defined as a “dispositional incapacity to endure the aversive response triggered by the perceived absence of […] sufficient information” (Carleton, 2016). IU can be further divided into prospective IU (negative affect concerning uncertain future events) and inhibitory IU (the behaviors used to reduce the discomfort of uncertainty) (Howell et al, 2019, p.97).
According to researchers, “IU has been argued to be a foundational and predominant factor across psychological disorders, especially emotional disorders pertaining to depression and anxiety”. IU is also connected to two other variables in this study: fear of negative evaluation (FNE) and fear of positive evaluation (FPE). Fear of evaluation (whether positive or negative) is a major contributing factor to social anxiety. FNE and FPE are exacerbated by high IU because affected individuals have no way of knowing whether the social evaluation is positive or negative, leading to a measure of uncertainty. Thus FNE and FPE can lead to inhibitory behaviors in individuals with high IU such as social avoidance and disordered eating to control body image evaluations (Howell et al, 2019, p. 97).
However, for some, religiosity may be a protective factor for IU. Howell et al state, “some theories for why individuals are motivated to engage with a religion…is that higher powers introduce sources of external control and connect stressful events with meaning — alleviating distress about how perceived personal control or purpose, uncertainty, or discrepancy between event appraisals and pre-existing world views after stressful life events” (Howell et al, 2019).
While religiosity has been linked to well-being in several studies, “mixed results emerge when studying the relation between religiosity and psychological health” (Howell et al, 2019, p.98) Howell et al suggest that these mixed results could be a result of some moderators (such as IU) and that, “there is still much for scientists and practitioners to learn about the impacts of religion on psychopathology onset, maintenance, and treatment” (Howell et al, 2019, p.97).
How Does Religiosity Affect Mental Health?
After addressing the above theories and correlations, Howell et al comment that “one may deduce that only some people, who are at elevated risk of acute distress and/or psychological disorders due to being intolerant of uncertainty, and who are motivated toward religion for particular reasons such as coping, are likely to experience significant protective or ameliorative psychological gains from religion, especially for depression” (Howell et al, 2019, p.98). Thus the research team presented three hypotheses regarding the moderating relationship between IU, religious motivation, depression, fear of negative evaluation (FNE), and fear of positive evaluation (FPE).
The hypotheses are as follows: 1) that individuals with higher prospective IU would have an extrinsic-personal motivation for religiosity (namely that they would use religion to gain relief from IU), 2) that individuals with higher inhibitory IU would report higher religious behavior and belief; using religion as an avoidant behavior to reduce feelings of uncertainty, and 3) that for individuals with high IU, depression and social fear “would be positively related to relief motives and inversely related to religiosity” (Howell et al, 2019).
Methods Used to Study IU & Religiosity
In order to test these hypotheses, the researchers conducted two separate studies. Data for the first study was drawn from a previously published article from 2016 (Admundson et al, 2016) that analyzed risk factors and resilience in individuals with post-traumatic stress disorder. The study included 512 participants who filled out a self-report survey via online survey software. Significantly, all participants were over 18 years of age, had experienced a traumatic event, and were either agnostic, atheist, Catholic, Jewish or Protestant. No participants from non-monotheistic or eastern religions were included in the study. The second study comprised 488 undergraduate students who completed an online self-report survey about cross-cultural factors (like religion) and symptoms of depression and anxiety.
The first survey included items from 4 separate psychological measures. First, the Revised Intrinsic/Extrinsic Religious Orientation Scale (ROS-R) developed by Gorsuch & McPherson in 1989 which “measures facets of orientation (i.e. motives) toward religion” (Howel, et al, 2019, 101) using a Likert-type scale. Second, the Intolerance of Uncertainty Scale-12 (IUS-12), developed by Carleton Norton & Asmundson in 2007; a 12-item measure of “reactions to uncertainty, ambiguous situations, and the future” (Howell, et al, 2019, p. 101). And third, the Center for Epidemiologic Studies Depression Scale (CES-D) developed by Radloff in 1977 that measures depressive symptoms experienced in the past week on a 4-point scale. Finally, the Social Interaction and Phobia Scale (SIPS) developed by Carleton et al in 2009 was used which measures symptoms of social anxiety in a Likert-type rating scale.
The second study tested religiosity with selected items from the Baylor Religion Survey (BRS) developed at Baylor University in 2005. The Beck Depression Inventory-Second Edition, a 21-item self-report measure of depression symptoms was used to test for depression and the Brief Fear of Negative Evaluation Scale (BFNES) and Fear of Positive Evaluation Scales were used to evaluate FNE and FPE respectively.
Religion & Mental Health
Howell et al found that “there were significant, moderate, and positive bivariate relations among IU (total and subscales), depression, and social anxiety or evaluative fears…providing additional reliability and validity for the interrelated nature of these psychological constructs” (Howell et al, 2019, p. 108). Consistent with the first hypothesis, prospective IU was positively correlated with extrinsic-personal religious motives but not with extrinsic-social and intrinsic motivations. This hypothesis was further supported by findings that “people who reported high cognitive-affective aspects of IU (i.e. above-average prospective IU) were more likely to seek personal relief through religion when highly depressed” (Howell et al, 2019, p.108). In sum, having a high IU is related to using religion as a coping mechanism to relieve negative psychological symptoms associated with uncertainty.
The second hypothesis was also confirmed by the studies. The researchers found that “religiosity thinking or behavior was bivariately positively associated with IU-related inhibitory behavior and overall IU” (Howell et al, 2019, p.109). This means that the results support the conclusion that individuals with high IU use religion as an inhibitory behavior to reduce uncomfortable feelings of uncertainty. Interestingly, “only individuals with high IU experienced lower symptoms of depression and FNE in tandem with greater religiosity” (Howell et al, 2019, p.109). The third hypothesis (that depression and social fear would be positively related to relief motives and inversely related to religiosity) was confirmed in all but one aspect. There was not a significant relationship between religiosity and FPE.
There are significant limitations to this study that do not permit sweeping statements about the connections found between IU, religiosity, and mental health. Particularly, the demographics of the sample were not representative of a diverse racial, gender, or cultural sample. When the study uses the term “religion” they refer only to Western monotheistic religions. While the researchers were cognizant of the differences in eastern and western religious philosophy (they deliberately discarded survey responses from Buddhists and Hindus), future studies will need to address this gap. Different religions approach the mysteries of human existence with differing theological mechanisms. Some emphasize a religious worldview and future hope more than others. Thus individuals who seek relief from IU may gravitate to certain religions over others.
The results of this study contribute to the growing understanding of religion’s impact on mental health. At times, clinicians may be reluctant to address religion in the therapy room. They may even feel that psychotherapy should be kept separate from religion. However, if psychopathology is based on IU, clinicians may “refer patients to theological experts (e.g. chaplain) about religion-specific uncertainty and distress” (Howell et al, 2019).
However, the client’s motivation for religiosity level of IU would need to be considered before practitioners extend the authority of the church into the therapy room. While religion may provide relief for some (such as those with IU), this may not be the case for others with extrinsic motivations for religious affiliation.
Paradoxically, as the experience of many disillusioned religionists bears out, religion has the potential to increase psychological suffering or provide fulfillment, depending on the disposition of the client. It will be important for researchers to identify the psychological dimensions codified in religious theology and social systems and their impact on mental health so that clinicians can be discerning with their use of spirituality in the therapy room.
References:
Allport, G. W., & Ross, J. M. (1967). Personal religious orientation and prejudice. Journal of personality and social psychology, 5(4), 432.
Asmundson, G. J. G., LeBouthillier, D. M., Parkerson, H. A., & Horswill, S. C. (2016). Trauma‐exposed community‐dwelling women and men respond smilarly to the DAR‐5 Anger Scale: Factor structure invariance and differential item functioning. Journal of Traumatic Stress, 29(3), 214–220. https://doi.org/10.1002/jts.22098
Brewczynski, J., & MacDonald, D. A. (2006). Confirmatory factor analysis of the Allport and Ross religious orientation scale with a polish sample. The International Journal for the Psychology of Religion, 16, 63–76. https://doi.org/10.1207/ s15327582ijpr1601_6
Carleton, R. N. (2016a). Fear of the unknown: One fear to rule them all? Journal of Anxiety Disorders, 41, 5–21. https://doi. org/10.1016/j.janxdis.2016.03.011
Church Membership falls below majority for the first time (Gallup) 2021. Retrieved from https://news.gallup.com/poll/341963/church-membership-falls-below-majority-first-time.aspx
Vail, K. E., Rothschild, Z. K., Weise, D. R., Solomon, S., Pyszczynski, T., & Greenberg, J. (2010). A Terror Management Analysis of the Psychological Functions of Religion. Personality and Social Psychology Review, 14(1), 84–94. https://doi.org/10.1177/1088868309351165
