Abstract
This study used a cross-sectional design to examine the role of religious involvement within a stress-process framework. Participants were 252 urban, low-income HIV-seropositive African American mothers. The relationships among religious involvement, stress, coping responses, social support, and psychological distress were examined using structural equation modeling. The number of stressors reported by the mother was related to greater religious involvement, which in turn was negatively related to psychological distress. Furthermore, the results suggest that social support, active coping, and avoidant coping responses mediated the relationship between religious involvement and psychological distress. According to the present results, interventions to attenuate psychological distress in HIV-seropositive African American mothers might focus on increasing social support, promoting active coping, and decreasing avoidant coping. The present findings suggest that this may be accomplished, in part, by promoting involvement in religious institutions and practices. However, in light of the cross-sectional design used in the present study, and given that religion may have both positive and negative consequences, further research is needed to determine the extent to which promoting religiosity may increase or alleviate distress.
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REFERENCES
Antoni, M. H., Cruess, D. G., Cruess, S., Lutgendorf, S., Kumar, M., Ironson, G., Kilmas, N., Fletcher, M. A., and Schneiderman, N. (2000). Cognitive-behavioral stress management intervention effects on anxiety, 24-hr urinary norepinephrine output, and t-cytotoxic/suppressor cells over time among symptomatic HIV-infected gay men. Journal of Consulting and Clinical Psychology, 68, 31–45.
Bandalos, D. L., and Finney, S. J. (2001). Item parceling issues in structural equation modeling. In G. A. Marcoulides and R. E. Schumacker (Eds.), New developments and techniques in structural equation modeling (pp. 269–296). Mahwah, NJ: Erlbaum.
Barnard, K. E. (1989). Difficult life circumstances (DLC). Seattle, WA: NCAST.
Baron, R. M., and Kenny, D. A. (1986). The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology, 51, 1173–1182.
Bentler, P. M., and Bonett, D. G. (1980). Significance tests and goodness of fit in the analysis of covariance structures. Psychological Bulletin, 88, 588–606.
Bentler, P. M., and Stein, J. A. (1992). Structural equation modeling in medical research. Statistical Methods in Medical Research, 1, 159–181.
Biggar, H., Forehand, D., Devine, D., Brody, G., Armistead, L., Morse, E., and Simon, P. (1999). Women who are HIV infected: The role of religious activity in psychosocial adjustment. AIDS Care, 11, 195–199.
Blaney, N. T., Goodkin, K., Feaster, D., Morgan, R., Millon, C., Szapocznik, J., and Eisdorfer, C. (1997). A psychosocial model of distress over time in early HIV-1 infection: The role of life stressors, social support and coping. Psychology and Health, 12, 633–653.
Byrne, B. M. (2001). Structural equation modeling with AMOS: Basic concepts, applications, and programming. Mahwah, NJ: Erlbaum.
Carver, C. S. (1997). You want to measure coping but your protocol's too long: Consider the Brief COPE. International Journal of Behavioral Medicine, 4, 92–100.
Centers for Disease Control and Prevention. (2002a). HIV infection cases by sex, age at diagnosis, and race/ethnicity, reported through December 2001, from areas with confidential HIV infection reporting. Available at http://www.cdc.gov/hiv/stats/hasr1302/table8.htm
Centers for Disease Control and Prevention. (2002b). Age-specific prevalence of diagnosed diabetes, by race/ethnicity and sex, United States, 1999. Available at http://www.cdc.gov/diabetes/statistics/prev/national/fig51999.htm
Centers for Disease Control and Prevention. (2002c). Estimated female adult/adolescent AIDS incident, by exposure category and race/ethnicity, diagnosed in 2000, and cumulative totals through 2000. Available at http://www.cdc.gov/hiv/stats/hasr1301/table20.htm
Centers for Disease Control and Prevention. (2003). HIV/ AIDS among African-Americans. Available at http://www.cdc.gov/hiv/pubs/Facts/afam.htm
Cohen, S., and Wills, T. A. (1985). Stress, social support, and the buffering hypothesis. Psychological Bulletin, 98, 310–357.
Cruess, D. G., Antoni, M. H., Schneiderman, N., Ironson, G., Mccabe, P., Fernandez, J. B., Cruess, S. E., Klimas, N., and Kumar, M. (2000a). Cognitive-behavioral stress management increases free testosterone and decreases psychological distress in HIV-seropositive men. Health Psychology, 19, 12–20.
Cruess, S., Antoni, M., Kilbourn, K., Ironson, G., Klimas, N., Fletcher, M. A., Baum, A., and Schneiderman, N. (2000b). Optimism, distress, and immunologic status in HIV infected gay men following Hurricane Andrew. International Journal of Behavioral Medicine, 7, 160–182.
Derogatis, L. R. (1993). Brief Symptom Inventory: Administration, scoring, and procedures manual. Minneapolis, MN: National Computer Systems.
Ellison, C. G. (1994). Religion, the life stress paradigm, and the study of depression. In J. S. Levin (Ed.), Religion in aging and health: Theoretical foundations and methodological frontiers (pp. 78–121). Thousand Oaks, CA: Sage.
Ellison, C. G. (1995). Race, religious involvement, and depressive symptomatology in a southeastern US community. Social Science and Medicine, 40, 1561–1572.
Ellison, C. G. (1997). Religious involvement and the subjective quality of family life among African Americans. In R. J. Taylor and J. J. Sidney (Eds.), Family life in Black America (pp. 117–131). Thousand Oaks, CA: Sage.
Ellison, C. G., Boardman, J. D., Williams, D. R., and Jackson, J. S. (2001). Religious involvement, stress, and mental health: Findings from the 1995 Detroit area study. Social Forces, 80, 215–249.
Ellison, C. G., and George, L. K. (1994). Religious involvement, social ties, and social support in southeastern community. Journal for the Scientific Study of Religion, 33, 46–61.
Feaster, D. J., and Szapocznik, J. (2002). Interdependence of stress processes among African American family members: Influence of HIV serostatus and a new infant. Psychology and Health, 17, 339–363.
Feaster, D. J., Szapocznik, J., Smith, L., Samuels, D., Dadson, M. J., and Antoni, M. (2000). The influence of stress, family problems, support, and coping on psychological distress among HIV+ and HIV–urban low-income African American mothers. Technical report, University of Miami School of Medicine.
Feldt, L. S. (2002). Estimating the internal consistency reliability of tests composed of testlets varying in length. Applied Measurement in Education, 15, 33–48.
Fields, J. (2003). Children's living arrangements and characteristics: March 2002 (Current Population Report P20–547). Washington, DC: U.S. Census Bureau.
Folkman, S., and Lazarus, R. S. (1988a). The relationship between coping and emotion: Implications for theory and research. Social Science and Medicine, 26, 309–317.
Folkman, S., and Lazarus, R. S. (1988b). Coping as a mediator of emotion. Journal of Personality and Social Psychology, 54, 466–475.
Fornell, C. R., and Lacker, D. F. (1981). Two structural equation models with unobservable variables and measurement error. Journal of Marketing Research, 18, 39–50.
Furukawa, T., Sarason, I., and Sarason, B. R. (1998). Social Support and adjustment to a novel social environment. The International Social Psychiatry, 44, 56–70.
Goodkin, K., Blaney, N. T., Feaster, D. J., Fletcher, M. A., Baum, M., Mantero-Atienza, E., Klimas, N., Millon, C., Szapocznik, J., and Eisdorfer, C. (1992). Active coping style is associated with natural killer cell cytotoxicity in asymptomatic HIV-1 seropositive homosexual men. Journal of Psychosomatic Research, 36, 635–650.
Goodwin, R., and Plaza, S. H. (2000). Perceived and received social support in two cultures: Collectivism and support among British and Spanish students. Journal of Social and Personal Relationships, 17, 282–291.
Hill, P. C., and Pargament, K. L. (2003). Advances in the conceptualization and measurement of religion and spirituality. American Psychologist, 58, 64–74.
Ironson, G., Solomon, G. F., Balbin, E. G., O'Cleirigh, C., George, A., Kumar, M., Larson, D., and Woods, T. E. (2002). The Ironson-Woods Spirituality/Religiousness Index is associated with long survival, health behaviors, less distress, and low cortisol in people with HIV/AIDS. Annals of Behavioral Medicine, 24, 34–48.
Jenkins, R. A. (1995). Religion and HIV: Implications for research and intervention. Journal of Social Issues, 51, 131–144.
Kaminsky, S., Kurtines, W., Hervis, O. E, Millon, C., Blaney, N., and Szapocznik, J. (1989). A family systems perspective in counseling HIV infected persons and their families. In P. Van Steijn (Ed.), AIDS: A combined environmental and systems approach (pp. 119–135). Amsterdam, The Netherlands: Swets and Zeitlinger.
Kline, R. B. (1998). Principles and practice of structural equations modeling. New York: Guilford.
Koenig, H. G., Cohen, H. J., Blazer, D. G., Pieper, C., Meador, K. G., Shelp, F., Goli, V., and DiPasquale, B. (1992). Religious coping and depression among elderly, hospitalized medically ill men. American Journal of Psychiatry, 149, 1693–1700.
Koenig, H. G., Hays, J. C., George, L. K., Blazer, D. G., Larson, D. B., and Landerman, L. R. (1997). Modeling the cross sectional relationship between religion, physical health, social support, and depressive symptoms. American Journal of Geriatric Psychiatry, 5, 131–144.
Lazarus, R. S., and Folkman, S. (1984). Stress, appraisal and coping. New York: Springer.
Levin, J. S., Chatters, L. M., and Taylor, R. J. (1995). Religious effects on health status and life satisfaction among Black Americans. Journal of Gerontology: Social Sciences, 50, 154–163.
Levin, J. S., and Taylor, R. J. (1998). Panel analysis of religious involvement and well-being in African Americans: Contemporaneous vs. longitudinal effects. Journal for the Scientific Study of Religion, 37, 695–709.
Lincoln, C. E., and Mamiya, L. H. (1990). The black church in the African American experience. Durham, NC: Duke University Press.
MacCallum, R. C., Browne, M. W., and Sugawara, H. M. (1996). Power analysis and determination of sample size for covariance structure modeling. Psychological Methods, 1, 130–149.
Moneyham, L., Hennessy, M., Sowell, R., Demi, A., Seals, B., and Mizuno, Y. (1998). The effectiveness of coping strategies used by HIV-seropositive women. Research in Nursing and Health, 21, 351–362.
Morse, E. V., Morse, P. M., Klebba, K. E., Stock, M. R., Forehand, R., and Panayotova, E. (2000). The use of religion among HIV-infected African American women. Journal of Religion and Health, 39, 261–276.
Nelson, C. J., Rosenfeld, B., Breitbart, W., and Galietta, M. (2002). Spirituality, religion, and depression in the terminally ill. Psychosomatics, 43, 213–220.
Nooney, J., and Woodrum, E. (2002). Religious coping and church-based social support as predictors of mental health outcomes: Testing a conceptual model. Journal for the Scientific Study of Religion, 41, 359–368.
Pargament, K., Cole B., Vandecreek, L., Belavich, T., Brant, C., and Perez, L. (1999). The vigil: Religion and the search for control in the hospital waiting room. Journal of Health Psychology, 4, 327–341.
Pargament, K. I. (1997). The Psychology of religion and coping: Theory, research, and practice. New York: Guilford.
Pargament, K. I., Ensing, D. S., Falgout, K., Olsen, H., Reilly, B., Haitsma, K. V., and Warren, R. (1990). God help me: (1): Religious coping efforts as predictors of the outcomes to significant negative life events. American Journal of Community Psychology, 18, 793–823.
Pargament, K. I., Koenig, H. G., and Perez, L. M. (2000). The many methods of religious coping: Development and initial validation of the RCOPE. Journal of Clinical Psychology, 56, 519–543.
Pargament, K. I., Smith, B., Koenig, H., and Perez, L. (1998). Patterns of positive and negative religious coping with major life stressors. Journal for the Scientific Study of Religion, 37, 710–724.
Pargament, K. L., Tarakeshwar, N., Ellison, C. G., and Wulff, K. M. (2001). Religious coping among the religious: The relationship between religious coping and well-being in a national sample of Presbyterian clergy, elders, and members. Journal for the Scientific Study of Religion, 40, 497–513.
Pearlin, L. I., Menaghan, E. G., Lieberman, M. A., and Mullan, J. T. (1981). The stress process. Journal of Health and Social Behavior, 22, 337–356.
Pearlin, L. I., and Schooler, C. (1978). The structure of coping. Journal of Health and Social Behavior, 19, 2–21.
Roberts, C. S., and Feetham, S. L. (1982). Assessing family functioning across three areas of relationship. Nursing Research, 31, 231–235.
Sarason, I. G., Sarason, B. R., Shearin, E. N., and Pierce, G. R. (1987). A brief measure of social support: Practical and theoretical implications. Journal of Social and Personal Relationships, 4, 497–510.
Schmitz, M. F., and Crystal, S. (2000). Social relations, coping, and psychological distress among persons with HIV/AIDS. Journal of Applied Social Psychology, 30, 665–683.
Siegel, K., and Schrimshaw, E. W. (2002). The perceived benefits of religious and spiritual coping among older adults living with HIV/AIDS. Journal of the Scientific Study of Religion, 41, 91–102.
Simoni, J. M., Demas, P., Mason, H., Drossman, J. A., and Davis, M. L. (2000). HIV disclosure among women of African descent: Associations with coping, social support, and psychological adaptation. AIDS and Behavior, 4, 147–158.
Simoni, J. M., Martone, M. G., and Kerwin, J. F. (2002). Spirituality and psychological adaptation among women with HIV/AIDS: Implications for counseling. Journal of Counseling Psychology, 49, 139–147.
Simoni, J. M., and Ortiz, M. Z. (2003). Mediational models of spirituality and depressive symptomatology among HIV-positive Puerto Rican women. Cultural Diversity and Ethnic Minority Psychology, 9, 3–15.
Sowell, R., Moneyham, L., Hennessy, M., Guillory, J., Demi, Al., and Seals, B. (2000). Spiritual activities as a resistance resource for women with Human Immunodeficiency Virus. Nursing Research, 49, 73–82.
Spilka, B., Hood, R. W., and Gorsuch, R. L. (1985). The psychology of religion: An empirical approach. Englewood Cliffs, NJ: Prentice-Hall.
Spilka, B., and Schmidt, G. (1983). General attribution theory for the psychology of religion: The influence of event-character on attributions to God. Journal for the Scientific Study of Religion, 22, 326–329.
Spitzer, R., Williams, J., Gibbon, M., and First, M. (1989). Structural clinical interview for DSM-III-R disorders. New York: New York State Psychiatric Institute, Biometrics Research Department.
Szapocznik, J., Feaster, D. J., Mitrani, V. B., Prado, G., Smith, L., Robinson, B. C., Schwartz, S. J., Mauer, M. H., and Robbins, M. S. (2004). Structural ecosystems therapy for HIV-seropositive African American women: Effects on psychological distress, family hassles, and family support. Journal of Consulting and Clinical Psychology, 72, 288–303.
Taylor, R. J., and Chatters, L. M. (1988). Church members as a source of informal social support. Review of Religious Research, 30, 193–203.
Williams, D. R., Larson, D. B., Buckler, R., Heckman, R., and Pyle, C. (1991). Religion and psychological distress in a community sample. Social Science and Medicine, 32, 1257–1262.
Woods, T. E., Antoni, M. H., Ironson, G. H., and Kling, D. W. (1999). Religiosity is associated with affective status in symptomatic HIV-infected African American women. Journal of Health Psychology, 4, 317–326.
Wright, S. D., Pratt, C. C., and Schmall, V. L. (1985). Spiritual support for caregivers of dementia patients. Journal of Religion and Health, 24, 31–38.
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Prado, G., Feaster, D.J., Schwartz, S.J. et al. Religious Involvement, Coping, Social Support, and Psychological Distress in HIV-Seropositive African American Mothers. AIDS Behav 8, 221–235 (2004). https://doi.org/10.1023/B:AIBE.0000044071.27130.46
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DOI: https://doi.org/10.1023/B:AIBE.0000044071.27130.46