Religious

Beliefs

52 Psychiatric

Jerome

and Practices
Inpatients

Kroll,

M.D.,

and

in Minnesota

William

Sheehan,

religiously

The authors
studied
the religious
beliefs,
practices,
and experiences
of 52 psychiatric
inpatients.
The rate
of belief
in the major
tenets
of faith
(God,
the Devil,
and an afterlife)
was uniformly
high
and in accord
with national
and local public
poll results.
Patients
with
depressive
and anxiety
disorders
tended
to score lower
than those
with
other
diagnoses
on a wide
variety
of
indexes
of religion.
The authors
conclude
that religion
is an important
factor
in most
patients
lives and that
individual
inquiry
and systematic
research
into
this
neglected
area are both feasible
and important.
(Am J Psychiatry
1989;
146:67-72)

Among

against
religious
tellectual
confined

M.D.

oriented

mental

health

(7, 8)

professionals

the more
traditional
psychiatric
attitude
that
faith is evidence
of psychopathology.
This inand
empirical
debate,
however,
has been
mainly
to the psychological
literature.
The

religious

life

of

psychiatric

patients

has

rarely

been

either
the subject
of or an important
variable
in psychiatric
studies.
With
these
considerations
in mind,
we undertook
a study of the religious
beliefs
and practices of a group
of psychiatric
inpatients
at a university
hospital.

METHOD

n a review
published
in 1986 in the Journal,
Larson
et al. (1) reported
that
only
59 (2.5%)
of 2,348
psychiatric
articles
using
quantitative
data
and published
in four major
psychiatric
journals
from
1978 to
1982
included
a quantified
religious
variable
within
the study.
Furthermore,
they
stated,
the
religious
variable
chosen
was often
a single
static
measure
of
religion
rather
than multiple
dynamic
measures.
This
relative
lack of psychiatric
interest
in religion
is made
all the more striking
by the disparity
between
the religiosity
of the majority
of the U.S. population
and the
majority
of those in the mental
health
professions.
Sunveys have reported
that more
than 90%
of the general
public
(2, 3) profess
a belief
in God,
compared
with
40%-70%
of psychiatrists
(4) and 43%
of psychologists (5).
The divergence
between
mental
health
professionals
and the general
public
is further
highlighted
by the
well-documented
shift
toward
conservative,
charismatic,
and fundamentalist
religious
practices
and beliefs that has occurred
primarily
in urban
and subunban, white-collar,
and managerial
populations
during
the past 20 years
in the United
States
(6). Paralleling
this

shift

gious

of

Received
July

22,

Jan.
1988.

Minnesota

America

has

revision
Department

the

School,

146:1,

conservative

a spirited

25, 1988;

Box 393 Mayo,

MN 55455.
1989
American

Psychiatry

toward

been

From

Medical

to Dr. Knoll,
Minneapolis,
Copyright

Am

middle

practices

received

Minneapolis.
University
Psychiatric

January

of

reli-

counterattack

June 14,
Psychiatry,
Address
of

1989

1988;
accepted
University
of

reprint

Minnesota

Association.

by

requests

The purpose
of the study
was
patients
on a locked
psychiatric
these
patients
provided
informed
noid

patients

refused

to

consent

explained
to all 54
ward.
Fifty-two
of
consent.
Two
parato

the

interview

and

are not included

in the study.
We obtained
demographic
data from the patients
and from their medical
records.
Diagnoses
were
the primary
discharge
diagnoses,
made according
to DSM-III
by the resident
and
attending
psychiatrist.
The
patients
were
asked
to
complete
a Beck Depression
Inventory
at the time of
the
interview.
Religious
attitudes
and
involvement
were
measured
by using
a questionnaire
of religious
beliefs,
practices,
and personal
experiences
developed
by Littlewood
and Lipsedge
(9). (The questionnaire
is
available
from Dr. Knoll on request.)
Categorical
variables
such
as urban
and suburban
versus
rural
and never
married
versus
ever married
were examined
for their potential
relationship
to mdividual
beliefs,
practices,
and experiences
by using
chisquare
tests with
Yates
correction.
The Beck
scores
were
examined
by using
two-tailed
t tests.
Potential
relationships
among
religious
beliefs,
practices,
and
experiences
were
examined
by using
Pearsons
correlation
coefficient.
For all comparisons,
psO.O5
was
considered
significant.

RESULTS

Hospitals,

Of the 52 patients
men and 33 (63.5%)

in the study,
19 (36.5%)
were
were women.
Thirty-five
(67.3%)

67

RELIGIOUS

BELIEFS

AMONG

INPATIENTS

patients
were under
age 35; 17 (32.7%)
were 35 years
old or older.
Thirty-two
(61.5%)
of the patients
had
never been married;
20 (38.5%)
had been or were currently
married.
Thirty-five
(67.3%)
were
raised
in an
urban
or suburban
environment,
and 17 (32.7%)
were
raised
in a rural environment.
Fifteen
(30.6%)
were in
social
class II, 25 (51.0%)
were in social
class III, and
nine
(18.4%)
were
in social
class
IV. Three
patients
were not classified
because
of insufficient
information.
Nineteen
(36.5%)
of the patients
had less than a high
school
education,
and 33 (63.5%)
had a high school
education
or more.
The data
on religious
beliefs,
practices,
and expeniences are presented
in tables
1 and 2. The Gallup
poll
of 1981
(2) and a Minnesota
poll of 1987
(3) provide
comparison
figures
for several
of the major
religion
items.
To the question,
Do you believe
in God?
95%
of our patients,
95%
of the Gallup
sample,
and 95%
of the Minnesota
poll respondents
answered
affirmatively.
To the question,
Do
you believe
in an afterlife?
79%
of our patients,
71%
of the Gallup
sample,
and 76%
of the Minnesota
po11 respondents
answered
affirmatively.
There
was
no directly
corresponding
question
in the two public
polls to our query,
Do you
believe
in the Devil?
to which
67%
of our patients
answered
positively.
The only near comparison
available is that 53%
of the Gallup
sample
believed
in the
existence
of Hell.
Religious
practices
in general
lagged
behind
religious
beliefs.
Practices
indicative
of a more
actively
fundamentalist
involvement,
such as bearing
witness
in
public
or avoiding
proscribed
food,
drinks,
or activities, were
seldom
reported.
Most
of the patients
did
not endorse
many
of the personal
religious
experience
items that are usually
associated
with charismatic
and
fundamentalist
church
membership,
such
as speaking
in tongues
or having
a mission
(see tables
1 and 2).
Among
the eight
religious
belief
variables,
significantly
more
women
than
men believed
that they had
sinned
in the past week
(2=8.794,
df=1,
p=O.OO3).
The meanSD
Beck score
of the 22 patients
who meported
that they believed
they had sinned
that
week
was
18.712.4,
compared
with
9.39.4
for the 24
patients
who
did
not
endorse
it (t2.93,
df44,
p=O.OOS).
Several
items
on the religious
practices
scale
were
found
to be related
to demographic
and diagnostic
variables.
Consulting
the Bible or praying
before
making
important
decisions
was endorsed
by 25 (62.5%)
of 40
patients
from
socioeconomic
classes
II and III compared
with
only
one (11.1%)
of nine
patients
from
class IV (2S.863,
df=1,
p=O.OlS)
(data
not shown
in table
1). Patients
who
helped
with the running
of
their church
were
more
likely
to have been born
in a
rural
than
an urban
or suburban
setting
(26.299,
df= 1, p=O.Ol2)
(see table
1) and were more
likely to
have
changed
religious
denominations
(2=4.873,
df=1,
p=O.O27)
(see table
1).
Although
it did not attain
statistical
significance
because
the overall
level of belief
and practice
was so

68

high,
there
were
trends
for church
involvement
to be
higher
among
rural
than
among
urban
or suburban
patients
and for those
involved
with charismatic
practices
to be male,
young,
urban,
and unmarried
(see
table
1).
The diagnoses
of 5 1 of the patients
are shown
in
table 2. One patient
was undiagnosed.
The mean
Beck
scores
for the 52 patients
are shown
in table
3. Beck
scores
were
found
to be related
to gender
(t=2.80,
df=47,
p=O.OO7),
whether
the patient
was
rural
or
urban-suburban
(t4.80,
dfr47,
p<OOO
1),
and
whether
the diagnosis
was
manic
episode
or some
other
diagnosis
(t=4.19,
df=47,
p<O.OO1).
Although
it did

not

reach

statistical

significance

because

of

the

small number
of patients,
the highest
Beck scores
were
found
in the two patients
with
borderline
personality
disorder
(mean
score=3253.S)
and the five patients
with eating
disorders
(mean
score=
22.814.5).
To examine
further
the relationship
of gender
and
Beck score with belief in having
sinned
during
the past
week,
a discniminant
analysis
was performed
with gender and Beck
score
as discriminating
variables.
The
analysis
demonstrated
that gender
was most
useful
in
discriminating
between
patients
who
did or did not
believe
that they
had sinned
in the past week;
Beck
score
did not significantly
improve
discrimination
because
of its strong
correlation
with gender.

DISCUSSION
Caplow
et al. (10),
in their
1978
follow-up
of the
classic
1926
Middletown
study
of religious
attitudes
and practices
in a small Midwestern
city (11), observed
that we appear
to be caught
in contradictory
beliefs
that the United
States
is becoming
both
more
secular
and more
religious.
Further,
they pointed
out that amguments
asserting
an increasing
secularization
coincident
with
an increasingly
technological
culture
have
been based
on the romantic
assumption
that there was
an earlier
period
in which
the majority
of the population adhered
to a simple
consuming
Christian
faith.
Neither
the assumption
of increasing
secularization
nor that
of an earlier
age of faith
in America
(12)
appears
supported
by the facts,
as best we can know
them.
Certainly
any concern
(or relief)
about
a diminution
in religious
fervor
that may have obtained
20
years ago is contradicted
by fairly strong
evidence
of a
fundamentalist
and evangelical
religious
revival
in the
1980s.
Our survey
shows
that our group
of inpatients
were
very much
in accord
with
the country
in general
according
to the Gallup
poll and with Minnesota
according to a state poll concerning
belief
in God.
The overwhelming
majority
of all three
groups
expressed
this
belief.
Similarly,
between
70%
and 80%
of all three
groups
surveyed
endorsed
a belief
in an afterlife.
Furthermore,
our Minnesota
patients
appeared
to be in
the mainstream
of American
religious
belief;
their prac-

Am

Psychiatry

146:1,

January

1989

JEROME

TABLE

1. Demographic

Characteristics

and Religious

Beliefs,

Practices,

and Experiences

KROLL

AND

of 52 Psychiatric

WILLIAM

SHEEHAN

Inpatients

Environment
Sex

Beliefs, Practices,
Experiences

Male
(N=19)

and

Beliefs
In God (N=49)
In the Devil (N=35)
In an afterlife(N=41)
That the Bible refers
to daily events
(N=39)
In Bible

Female
(N=33)

<35
(N=35)

(years)
35
(N=17)

Never
(N=32)

Urban
or
Suburban
(N=35)

Ever
(N=20)

Education:
High
Rural
(N=17)

No
(N=19)

Through
School
Yes
(N=33)

18
14
16

95
74
84

31
21
25

94
64
76

33
24
27

94
69
77

16
11
14

94
65
82

30
23
24

94
72
75

19
12
17

95
60
85

32
22
26

91
63
74

17
13
15

100
76
88

18
14
16

95
74
84

31
21
25

94
64
76

14

74

25

76

28

80

11

65

24

75

14

70

28

80

11

65

14

74

25

76

17

89

29

88

31

89

15

88

28

88

18

90

32

91

14

82

18

95

28

85

16

19

58

17

49

29

15

48

30

15

43

41

42

14

42

15

79

26

79

29

83

12

71

26

81

15

75

29

83

12

71

17

89

24

73

16

84

28

85

29

83

15

88

26

81

18

90

29

83

IS

88

18

95

26

79

16

10

12

11

11

58

22

67

22

63

11

65

20

63

12

60

20

57

13

77

13

68

20

61

47

18

55

18

51

53

16

50

10

50

15

43

12

71

11

58

16

49

47

18

55

21

60

35

18

55

10

50

19

54

47

47

18

55

37

21

26

29

22

30

23

35

26

27

26

21

17

35

13

40

11

47

26

21

16

11

13

11

11

18

17

12

13

15

14

18

11

18

12

11

37

24

11

31

24

26

35

10

29

29

32

27

13

68

11

33

18

SI

35

15

48

40

17

49

41

47

15

46

miracles

(N=46)
That

Age

Marital
Status:
Married

I have

sinned

this

week (N22)
That Christ will return
(N=41)
In Gods

concern

with

all that is happening (N=44)

Practices

Avoid certain foods or

dninks(N=4)
Am a church member
(N=33)
Attend church weekly
(N=27)
Consult
pray

the Bible or
about
dcci-

sions (N=27)
Have

friends

in the

same church
(N=14)
Help

in church

(N=12)
Bear

public

testimony

(N=4)
Read

the

Bible

daily

(N=8)
Experiences
Joined charismatic
church(N=3)
Changed

religion

(N=1S)
Have

had

a personal

religious
expenience (N=24)
God or spirits communicate

with

me

(N=19)

37

12

36

16

46

18

30

12

34

41

32

11

18

17

12

13
5

42

Haveamission(N=8)
Speak
in tongues

16

15

17

12

16

13
5

39
15

(N=2)
God speaks through
me (N=16)
God or the Devil

12

21

12

36

11

31

29

26

40

26

41

26

11

33

16

14

13

10

11

12

21

S
19

14

54

53

11

5
58

S
17

15
52

makes
me do
things
(N=6)
Have
the power
heal (N=6)

to

Pray daily (N=28)

tices were
not
ately represented
Our
findings

Am

Psychiatry

16

11

12

13

10

37

21

64

17

49

11

65

14

45

14

70

deviant,
nor were
they disproportionin charismatic
and cultic movements.
regarding
personal
religious
experi-

146:1,

January

1989

ences
can be compared
with
those
of the National
Opinion
Research
Center
survey
of 1,460
respondents
done
by Greeley
(13) in 1973.
In both
studies,
a sur-

69

RELIGIOUS

TABLE

BELIEFS

AMONG

2. Diagnoses

INPATIENTS

and Religious

Beliefs,

Practices,

and Experiences

of 51 Psychiatric

Major

Manic

Depression

Practices,

and

Experiences

Personality
DisorderL

Schizophrenia

Episode

(N=16)
Beliefs,

lnpatientsa

(N=11)

(N=10)

Anxiety
Disorder

(N=10)

(N=4)

14

88

11

100

10

100

10

100

75

9
13

56
81

10

63

12
7

75
44

7
8
9
10
4

12
13

75
81

8
9

64
73
82
91
36
73

6
8
7
10
3
9
9

60
80
70
100
30
90
90

9
8
9
10
7
8
9

90
80
90
100
70
80
90

3
3
3
3
1
2
3

75
75
75
75
25
50
75

0
11

0
69

2
6

18
55

9
8

56
SO

46
73

25

0
4
3
1
1

0
100
75
25
25

31

5
8
S
1

10
70
60
30
20

0
3

0
19

3
3

27
27

Beliefs

InGod(N=48)
In the Devil (N=34)
In an afterlife

That

(N=40)

the Bible

In Bible

refers

miracles

to daily

events

(N=38)

(N=45)

That I have sinned this week (N=22)

That Christ will return (N=39)
In Gods concern
with all that is happening
Practices
Avoid
certain
foods
Amachurchmemben(N=32)

Attend
Consult

or drinks

church weekly (N=26)

the Bible or pray about

Have

friends

in the

same

church

(N43)

(N3)

decisions

(N=26)

(N=14)

Help in church
(N=11)
Bear public testimony
(N=4)
Read the Bible daily (N=8)
Experiences
Joined

charismatic

church
(N=3)
(N=14)
had a personal
religious
experience
(N=23)
or spirits
communicate
with
me (N
19)
a mission
(N=8)
in tongues
(N=2)
speaks through
me (N= 15)
or the Devil
makes
me do things
(N=6)
the power
to heal (N=6)

Changed
Have

God
Have

Speak
God
God
Have

Pray
aOne
blld

religion

daily

TABLE

diagnosed.
with eating

Patients

Never
Ever

35

married

8.7
16.7

years

(N=35)

(N=17)

(N=20)

Urban or suburban
(N=35)
Rural (N=17)
Less than high school education
High
school
Diagnoses

Major

education

depression

or more

aOne
blld

patient
was not
five patients

20

20

25

1
1

10
10

0
1

0
10

0
0

0
0

10

10

70

60

4
5
3

40
50
30

1
1
0

25
25
0

1
6
2
2

25
3 1
31
6
38
13
13

27
55
46

SO

18
9
46
9
9
64

0
0
2
3
1
6

0
0
20
30
10
60

1
0
2
0
2
4

10
0
20
0
20
40

0
0
0
0
0
2

0
0
0
0
0
50

5
2
1

5
1
1
7

general,
however,
the percentage
of believers
in God,
the Devil,
and an afterlife
was slightly
higher
in patients
who were single,
rural,
and less educated.
This
SD

7.2
12.8

5.2

12.1

10.8
11.2

10.4
12.0

15.4

11.4

14.3

12.1
10.9

13.6

12.5

(N=33)

13.8

11.4

1 7.4

1 1.5
3.5
10.0
14.7
14.6
11.7

6.2
10.1
20.1
11.3
13.7
disorders.

prisingly
high percentage
of respondents
indicated
that
they had had a personal
religious
experience
(46%
in
our study,
35%
in Greeleys),
and, in both polls,
such
respondents
were more
likely to be male and urban.
In

70

12.5

10)b

diagnosed.
with eating

60
20

(N19)

(N= 16)

Manic
episode
(N=11)
Schizophrenia
(N=10)
Personality
disorder
(N=
Anxiety
disorder
(N=4)
Total

6
2

1
7
6
3
2

31

Inpatients

Mean

Demographic
characteristics
Male (N=19)
Female (N=33)
old or older
married
(N=32)

40
30

Score

than

4
3

disorders.

3. Mean Beck Scores of 52 Psychiatric

Younger
35 Years

46

S
S
S

(N=27)

patient
was not
five patients

82

discrepancy

between

religious

beliefs

and

personal

me-

ligious
experiences
has held up consistently
in Caucasian populations:
straightforward
belief
in God tends
to be more common
in rural and less educated
persons,
and personal
experiences
of a mystical
or transcendental nature
are more
common
in college-educated
and
higher-income
persons.
When
one looks
at the data
in terms
of diagnoses,
there
is the somewhat
surprising
finding
that
the patients
with
major
depression
and
anxiety
disorders
contained
the lowest
percentage
of believers
in God;
in
fact, they were the only diagnostic
groups
that did not
report
100%
belief
in God,
although
this difference
was

not

statistically

significant.

Patients

with

a diag-

nosis of major
depression
were below
the mean
in their
rate of belief in the Devil, were in the low-mid
range
in
their mate of believing
that they had sinned
during
the
past week,
and had the lowest
religious
experiences
score
and the lowest
mate of believing
that they cornmunicated
with
God or the Devil.
This is contrary
to
expectations
in terms
of either
phenomenological
descriptions
guilt

of
and

depressive

patients

blameworthiness

or

Am

Psychiatry

as
in

terms

146:1,

feeling
of

excessive
psychody-

January

1989

JEROME

namic
formulations
postulating
anger
and
guilt
as
mechanisms
underlying
depression.
Prosen
et al. (14), in a study
of guilt and conscience
in 93 depressed
patients,
23 schizophrenic
patients,
and 43 normal
control
subjects,
reported
considerable
variability

within

the

depressed

group:

about

20%

of

this group
showed
extreme
guilt,
but 35%
showed
a
moderate
level and a surprising
44%
showed
little or
no guilt.
Prosen
et al. also reported
that the degree
of
guilt was not related
to the severity
of depression.
These
findings
are in accord
with
our own,
even
though
the two studies,
because
of different
methodologies
and vocabularies,
are not directly
comparable.
Our depressed
patients,
along
with
the patients
with
anxiety
disorder,
were the least religiously
oriented
diagnostic
group
(although
a fairly
high percentage
of
these patients
were so oriented)
and the least preoccupied with sin and, by inference,
with guilt to the extent
that it is related
to issues of conventional
religious
morality. It is possible
that depressed
patients
have extensive guilt related
to more interpersonal
and humanistic
concerns.
We did not query
for this, but the evidence
from
Prosen
et al. argues
against
this likelihood.
The
alternative
hypothesis
to consider
is that the role of
guilt in depression
has been traditionally
exaggerated.
Positive
responses
to the item, I believe
that I have
sinned
this week,
were received
significantly
more often from women
and were correlated
with Beck scores.
The correlation
between
gender
and belief
in having
sinned
appears
related
to the fact the two diagnostic
groups
among
our
patients
composed
entirely
of
women
(patients
with
eating
disorders
and patients
with borderline
personality
disorder)
were also the two
groups
most
absorbed
with
their
own
sinfulness.
Whether
one can extrapolate
broader
social
meaning
from our finding
that more
female
than
male patients
believed
they had sinned
in the past week is a matter
of
debate.
We are investigating
patients
beliefs
about
the
causes
of their illnesses
in a separate
study.
The relationship
between
religiosity
and depression
reported
here raises
more questions
than answers,
but
it is instructive

to

spell

out

some

possible

implications

for further
investigation.
At the very least, we can say
that depression
is not correlated
with greater
religiousness. In line with this, Watson
et al. (15), in a study of
normal
subjects
(college
students),
reported
that intninsic religiosity
and sin-related
beliefs
were
correlated
with less depression
and less exploitativeness
(the later
concept
derived
from
a scale
measuring
narcissism).
Similarly,
Willits
and
Cnider
(16),
in a 37-year
follow-up
study
of 2,806
mural high school
sophomores,
found
that personal
reports
of overall
well-being
and
of community
and
marital
satisfaction
in men
and
women
were
correlated
with
positive
religious
attitudes
and
current
church
attendance.
Sharkey
and
Malony
(8), in a study
of 28 clients
at Albert
Elliss
Institute
for Rational-Emotive
Therapy,
found
that
there was no significant
tendency
for the very religious
to report
more
problems.
Bergin
(7), in a 1983 review
and meta-analysis
of studies
on religiosity
and mental

Am

Psychiatry

146:1,

January

1989

health,

concluded

that

support

for

essarily

correlated

gin

found

the
that

KROLL

AND

WILLIAM

24 pertinent

preconception

with
religiosity

SHEEHAN

studies

that

revealed

religiousness

psychopathology.
correlated

no
is nec-

Indeed,
slightly

Ber-

with

pos-

itive mental
health.
Bergin
pointed
out, however,
that
most data suffer
from the same
methodological
problems and ambiguities
that have formerly
characterized
psychotherapy
research.
In essence,
as the studies
cited
here have indicated,
religiosity
itself is a multidimensional
concept
that
needs
to be operationalized
into
smaller

units

if

meaningful

investigations

are

to

be

done.
The question
still remains
as to whether
religious
beliefs
as well as participation
in a religious
community tend
to insulate
individuals
somewhat
from
the
twentieth-century
maladies
of anxiety
and depression.
Even Freud
(17), although
pejoratively
describing
religion
as a universal
neurosis,
thought
that
believers
were safeguarded
to a high degree
against
developing
certain
kinds
of neurotic
illnesses.
Andreasen
(18) has
sensitively
described
the loss of faith in reason,
in man,
and

in

ones

ability

to

effect

changes

in

the

environ-

ment
that has come
in the wake
of the constant
warfare of this century.
She suggested
that religion
has a
positive
value
in filling
a void and supplying
strength
and meaning
in life. Providing
as well as questioning
the meaning
of life has, of course,
been the traditional
role of religions
in all cultures.
To consider
alternative
hypotheses,
it is possible
that
some
depressed
people
feel alienated
from
God
and
their
religious
community
and therefore
report
their
own religiousness
more
negatively
than
they might
if
they were
not in a depressed
state.
Our
findings
are
based
on a relatively
small
number
of patients;
therefore, we return
to our initial
position
that these
issues
recommend
further
research
rather
than closure.
From
a therapeutic
viewpoint,
we can only
iterate
what
others
have stated
(19, 20). Religious
beliefs
and
practices
take an important
and often
central
place
in
the lives of many of our patients.
We are speaking
here
of basic
faith
issues
and
not of religiously
colored
symptoms.
Belief
in God and in the teachings
of the
Bible,
the sense of an afterlife,
and social
and personal
involvement
within
a church
community
are relevant
dimensions

of our

patients

lives

that

certainly

deserve

more consideration
than the psychiatric
profession
has
customarily
provided.
Finally,
our study has demonstrated
the feasibility
of
inquiring
into religious
variables
for other
clinical
and
research
purposes.
Instruments
for such
studies
are
readily
available.
Our
patients,
with
few exceptions,
were open and interested
in replying
in detail
about
the
nature
of their religious
beliefs
and how they perceived
these
beliefs
affecting
their
lives.
Religious
concerns
that have direct
relevance
for working
with psychiatric
patients
and that are in need of research
studies
include
1) the influence
of religious
beliefs
on suicidal
behavior, 2) the belief
that sin or other
perceived
immoral
behavior
causes
illnesses,
and 3) the influence
of religious
beliefs
on willingness
to seek psychiatric
consul-

71

RELIGIOUS

BELIEFS

tation
and/or
psychotropic

AMONG

to comply
medication.

INPATIENTS

with

recommendations

for

10.

Caplow

T, Bahr

Change

and Continuity

University
1 1.
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