J Relig Health

DOI 10.1007/s10943-016-0341-5

ORIGINAL PAPER

Role of Religiosity in Psychological Well-Being Among

Medical and Non-medical Students

Shemaila Saleem1 Tamkeen Saleem2

Springer Science+Business Media New York 2016

Abstract Religion has been generally considered as a protective factor for the psycho-
logical health of the people. As many studies have publicized a high prevalence of psy-
chological morbidities among the medical students during their academic stages of medical
schools, it is significant to investigate whether religiosity functions as a protective factor, to
explore religiosity as a predictor of psychological well-being in a sample of medical
students, and to compare the results of medical students as well as non-medical students
with respect to religiosity and psychological well-being. The study is carried out in Federal
Medical and Dental College and International Islamic University, Islamabad. The present
study examined a sample of 120 medical students from Federal Medical and Dental
College and 120 non-medical students from International Islamic University, Islamabad.
Purposive sampling was used. The respondents completed religious orientation scale and
scale of psychological well-being scale along with a demographic data sheet. In order to
measure the study variables, linear regression and t test were used. The findings revealed
that religiosity is a strong predictor of psychological well-being. Extrinsic and intrinsic
religiosity predicts psychological well-being among the students. The results indicated a
significant difference in psychological well-being between medical and non-medical stu-
dents. No significant difference was found in religiosity of medical and non-medical
students. The gender differences in religiosity and psychological well-being were found to
be insignificant. The results emphasize that psychological well-being is prophesied by
religiosity. The present research suggests further investigations and also endows with
trends for psychological evaluation, development of religious beliefs, and interventions for
augmenting psychological well-being among the medical students.

& Shemaila Saleem

drshemailasaleem@gmail.com
Tamkeen Saleem
tamkeen.saleem@iiu.edu.pk
1
Department of Physiology, Federal Medical and Dental College, Chak Shehzad, Islamabad,
Pakistan
2
Department of Psychology, International Islamic University, Islamabad, Pakistan

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Keywords Religiosity
Psychological well-being
Psychological
Medical student

Religion

Introduction

Contemporary studies have indicated that religiosity is a significant factor in preventing

poor health, complaints, endorsement of wellness, and thriving adjustment to the ever
changing circumstance of life (Pargament et al. 2005). This is an imperative contribution
made by researchers within the psychology of religion, to study psychological well-being
with religiosity. Previously a number of researchers argued on the subject that whether
religion has favorable or detrimental effects on the mental well-being of individuals
(Crawford et al. 1989; Sharkey and Malony 1986).
The Islamic literature highlights that religious orientation, beliefs, and practices are
utilized as resources in order to tackle the difficulties of life. Islamic teachings guide
people to have trust in Allah, be tolerant, to offer prayers, and turn to Allah in times of
need. Islamic teachings also provide people with noteworthy interpretation of difficulties in
life. The Holy Quran evidently underscores that the hardships faced by people in the world
are to test the believer as well as to make them learn enduring patterns to face the problems
(Aflakseir 2012). Various research on religiosity and mental health among Muslims shows
significant association between the variables (Amer et al. 2008; Hafeez and Rafique 2013;
Loewenthal et al. 2001).
Psychological well-being denotes positive mental health (Edwards 2005). Literature
reveals that the construct of psychological well-being is a multidimensional phenomenon
(MacLeod and Moore 2000; Wissing and Van Eeden 2002). It grows through a blend of
emotional regulation, life experience, and personality traits (Helson and Srivastava 2001).
Psychological well-being can enhance with age, education, extraversion, and conscious-
ness, and decreases with neuroticism (Keyes et al. 2002).
Research findings indicate a positive relationship between religiosity and mental health
aspects, comprising of a faster recovery from depression, lower anxiety, lower rate of
suicide, and reduction in drug abuse (Koenig 2004). Additionally, religiosity has also been
connected with general psychological well-being, including meaning in life, happiness, life
satisfaction, hope and optimism, marital satisfaction, and social support (Koenig 2001).
Research literature reveals that psychological well-being has a substantial relationship
with spirituality and religiosity. In another study, the population (85 females and 65 males;
age range = 1860 years) showed a positive relationship among religiosity and miscel-
laneous aspects of psychological well-being, whereas a negative relationship with solitude.
In the study a linear regression analysis was conducted to discover the remarkable fore-
casters of psychological well-being. Among the independent variables, religiosity was
found to be the imperative predictor of psychological well-being. The study also aimed at
identifying gender differences in religiosity, spirituality and psychological well-being of
old houses dwellers (Hafeez and Rafique 2013).
Intrinsic orientation and psychological well-being are positively related, whereas extrinsic
and quest orientations possess a negative relationship (Alandete and Valero 2013).
Another research was done on Muslim students to investigate their understanding and
views toward life and to determine the relationship between personal meaning, religiosity,
and psychological well-being. An explicit relationship was observed between numerous
parameters of personal meaning and various elements of spirituality, religiosity and psy-
chological well-being (Aflakseir 2012).

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Recent years have observed a well-documented surge in interest in this area of research,
and the available data provides contrasting outcomes that are hard to assimilate. The results
of meta-reviews of quantitative studies indicate a positive correlation between religious
conviction and psychological health. A bulk of research work measured diverse specific
aspects of religiosity, e.g., church attendance, salience of beliefs. These effects have
contributed to a budding accord about the prerequisite of multidimensional conceptual-
izations of religiosity.
The religion aspects help in getting a deeper understanding any community. On the
basis of the existing literature, it is worth investigating to have more facts in regard to
religiosity and psychological well-being. The present study will assist in noting the
influence of religiosity on the psychological well-being of the Pakistani community,
especially the students. This will also advocate that religiosity is central to the welfare of
medical and non-medical students, and therefore, it necessitates integrating religion and
related aspects into their educational learning fields for inculcation of a healthy nation.
Additionally, the study findings may point out that in the circumstances where religiosity
provides resilient subjective advantages, it may provide collective advantages as well. This
means that if larger number of individuals performs activities reflective of religiosity, it
will provide a benefit at a larger level and overall general public will be resilient and
healthy. But all this needs to be affirmed by strong evidences. Thus, the present study was
designed to examine the impact of religion on psychological well-being among the stu-
dents from medical and non-medical background.

Methodology

The study was conducted after getting approval by the Departmental Ethical Committee.
Informed written consent was obtained from the participants. The study was based on a
correlational research design. The study sample consisted of 240 students (medical
n = 120 and non-medical = 120). The sample was selected through purposive sampling.
The sample age range was 1626 years. The sample was selected from Federal Medical
and Dental College and International Islamic University of Islamabad. The instruments
used for data collection consisted of demographic sheet (measuring the variables like
age, education, marital status, family income, socioeconomic status, birth order, and
number of siblings), psychological well-being scale, and religious orientation scale. The
questionnaires comprised of only self-reported closed-ended type of questions for the
generation of quick and straightforward responses of respondents.

Measures

Demographic Information Sheet

A demographic information sheet comprising of information regarding the age, gender,

educational status, medical/non-medical student, birth order, family income, and socioe-
conomic status was used in the present study.

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Religious Orientation Scale

Revised Intrinsic/Extrinsic Religious Orientation Scale developed by Tiliopoulos et al.

2007 measuring intrinsically and extrinsically orientation of participants was used for
measuring religiosity. The scale comprise of 14 items developed on a five-point Likert
scale with responses ranging from strongly disagree = 1 to strongly agree = 5. The scale
has two subscale, i.e., intrinsic (I) and extrinsic (E). Intrinsic scale comprise of eight items,
five positively scaled (1,4,5,7,12) and three reversed coded items (3,10,14). The second
subscale extrinsic measures two traits: extrinsic social (ES) and extrinsic personal (EP).
Extrinsic subscale comprises of total six items three items of EP (6,8,9) and three for ES
(2,11,13). The scoring is done for each subscale through summation of related items. The
score ranges between 8 and 40 for intrinsic scale and 315 for each extrinsic scale. The
alpha reliability estimated for intrinsic scale is .83. The alpha reliability for extrinsic scale
is .65 and separately for the two traits is .57 for extrinsic personal and .58 is extrinsic
social.

Psychological Well-Being Scale

Psychological well-being was measured with Ryffs Psychological Well-Being Scale (Ryff
and Keyes 1995). It consists of 43 items. The scale determines six theoretical dimensions
of psychological well-being, including autonomy, environmental mastery, self-acceptance,
personal growth, positive relations with others, and purpose in life having alpha reliability
of .51, .57, .81, .66, .68, and .55, respectively. Reliability of the full scale is .86. Each
dimension consists of seven items. It has been developed on a five-point Likert format
where responses range from strongly disagree = 1 to strongly agree = 6. It consists of 10
positively worded item and 22 negatively phrased items. Scores for each subscale can be
generated by summating the score for its related items. The total summated score on the
measure indicates the psychological well-being with high scores indicating higher psy-
chological well-being.

Procedure

The study was based on a correlational research design. The study sample consisted of 240
students. The sample was selected from Federal Medical and Dental College and Inter-
national Islamic University Islamabad from Pakistan.
After the consent from the respondents, they were briefly explained the objective of
the study. They were directed to complete the study questionnaires according to the
response categories and were asked not to leave any item. The respondents proceeded
with completing the demographic sheet measuring the variables like age, education,
marital status, family income, socioeconomic status, birth order, and number of siblings,
and afterward they completed the religiosity orientation scale and psychological well-
being scale. The respondents were thanked for their participation and cooperation for
the study.

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Results

Table 1 shows the demographic variables. Students were more of the age range
1621 years. 52% of the students were males and 48% females. Most of the students were
unmarried with only 6.7% married. Out of the total 87.5% of the students were doing their
bachelors degree, and 12% were doing the masters degree. 50% of the students were from
the medical profession and 50% from the non-medical profession. Majority of the students
were living in the nuclear family system. A large percentage of students had their family
income above 40,000 and came off from an above average socioeconomic background.
Birth order results were not very significant. Majority of the students did not have large
families. Since the study was conducted in Islamabad, most of the students were from
Punjab.
Table 2 shows the reliability analysis which indicates that the scales are reliable for use
with the study sample. The values of skewness and kurtosis for all scales are less than 2,
which indicates that univariate normality is not problematic.

Table 1 Descriptive analysis of demographic variables

Variable f % Variable f %

Age Gender
1621 164 68.3 Male 124 51.7
2226 76 31.7 Female 116 48.3
Marital status Education program
Single 224 93.3 Bachelors 210 87.5
Married 16 6.7 Masters 30 12.5
Student type Family system
Medical 120 50 Joint family 89 38.3
Non-medical 120 50 Nuclear family 151 62.9
Family income Socioeconomic condition
500015,000 21 8.8 Above average 88 36.7
16,00026,000 11 4.6 Average 143 59.6
27,00036,000 21 8.8 Below average 9 3.7
40,000 above 187 77.9 No. of siblings
Birth order 0 8 3.3
First born 82 34.2 1 6 2.5
Middle born 87 36.3 2 66 27.5
Last born 63 26.3 3 64 26.7
Only child 8 3.3 4 53 22.1
Regional background 5 32 13.3
Punjab 154 64.2 6 5 2.1
Khyber Pakhtoon khwa 28 11.7 7 3 1.3
Balochistan 19 7.9 8 3 1.3
Azad Jammu Kashmir 8 3.3
Sindh 22 9.2
Gilgit-Baltistan 9 3.8

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Table 2 Psychometric properties of variables (N = 240)

Variable n M SD a Range Skewness Kurtosis

Potential Actual

Psychological well-being 240 157.56 14.72 .61 42252 100201 .02 1.34
Religiosity 240 49.34 5.25 .67 1470 3665 .16 .30

Table 3 Linear regression analysis indicating religiosity as the predictor of psychological well-being
(N = 240)
Model b SE b t p

Constant 130.13 9.22 14.10 .000

Religiosity .55 .18 .19 2.99 .003
R2 = .03
DR2 = .03

df = 238

Table 3 indicates that religiosity positively predicts psychological well-being. The

values of DR2 of .03 indicates a 3% variance in the mental health by the predictor which is
religiosity with F = 8.94, p \ .001. Thus, the results indicate that the predictor religiosity
has an effect on the outcome, i.e., psychological well-being.
Table 4 indicates that medical and non-medical students differed in psychological well-
being. It specifies that non-medical students had higher psychological well-being as
compared to medical students. The table also reveals that there is no significant difference
in medical and non-medical students in religiosity.
Table 5 indicates that male and female students do not differ in psychological well-
being and religiosity. Results disclose that no significant difference exists in male and
female students in religiosity and psychological well-being.

Discussion

Religion of various kinds is practiced in all societies, and it has thoughtful effects on the
lives of those who exercise it. Substantial associations have been recognized between
religion and mental health in pragmatic research studies. Religion is an issue of pro-
nounced concern for psychologists and social scientists as it plays an imperative part in
leading, shaping, and casting social behavior at individual and group levels (Pandey 1988).
Adherence to religion influences the personality, manners, attitudes, and complete
outlook of the individuals remarkably. Religion is meticulously associated with the growth
and modification of beliefs and attitudes, the stimulation and attenuation of remorse and
anxiety, and the determination of motivation and intellectual processes (Verma and
Upadhya 1984).
The goal of the present research was to determine whether religiosity is a predictor of
psychological well-being among the medical and non-medical students. Furthermore the

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Table 4 Mean, standard deviation, and t value of medical and non-medical students on psychological well-
being and religiosity
Medical (n = 120) Non-medical (n = 120) p 95% CL Cohens d

Variables Mean SD Mean SD t LL UL

Psychological well-being 155.55 12.23 159.80 16.01 2.04 .04 -7.38 -.13 .26
Religiosity 49.05 5.38 49.65 5.17 .88 .30 -1.94 .74 .00

Table 5 Mean, standard deviation, and t value of male and female students on psychological well-being
and religiosity
Male (n = 124) Female (n = 116) p 95% CL Cohens d

Variables M SD M SD t LL UL

Psychological well-being 156.55 12.74 159.80 15.82 1.41 .74 -6.26 1.01 .22
Religiosity 49.27 5.77 49.43 4.71 .23 .10 -1.50 1.18 .03

current research work explored the variances in religiosity and psychological well-being
among the medical and non-medical students. The demographic data of our study showed
that students were more of the age range 1621 years. Age range of our students was
similar to the age group used by Garcia-Alandete and Valero (2013) in their research work.
52% of the students were males and 48% females. Most of the students were unmarried
with only 6.7% married. Out of the total, 87.5% of the students were doing their bachelors
degree and 12% were doing the masters degree. 50% of the students representation was
from the medical profession and 50% from the non-medical profession. Majority of the
students were living in the nuclear family system. A large percentage of students had their
family income above 40,000 and came off from an above average socioeconomic back-
ground. Birth order results were not very significant. Majority of the students have small
families. Since the study was conducted in Islamabad most of the students were from
Punjab. There is paucity of data stating the importance of variables like socioeconomic
background and family setup with religiosity.
It was conjectured that religiosity predicts psychological well-being. The results of our
study specify that religiosity positively predicts psychological well-being. The values of
linear regression indicate a 3% variance in the mental health by the predictor which is
religiosity. Therefore, results indicate that the predictor religiosity has an effect on the
outcome, i.e., psychological well-being of the medical as well as non-medical students.
Aflakseir in his study upon Muslim students (39 men and 21 women) of England
showed that Muslim students practicing their religion had high sense of existential
meaning. It was perceived by the respondents that self-transcendence gives meaning to life.
This study also emphasized that students with greater level of personal meaning had higher
scores on various dimensions of psychological well-being like self-acceptance, individual
growth, positive relation with others and environmental mastery. The study revealed that
spirituality and religious beliefs are vital constituents in making life meaningful (Aflakseir
2012). Another study also revealed a positive relationship between the internal orientation
and the psychological well-being dimensions except for Autonomy. Spanish

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undergraduates (138 women and 42 men) aged 1855 years, were included in this study,
whereas we considered 240 students (medical n = 120 and non-medical = 120) with age
range of 1626 years (Garcia-Alandete and Valero 2013).
A research work done in 2001 also found the significant and generally beneficial effects
of religious engrossment on the practice of religious services, on both anguish and well-
being. Effects of religion appear stronger for well-being than for distress, where the
variable belief served as a significant predictor of well-being (Ellison et al. 2001).
A research study conducted upon inhabitants of old homes also highlights that psy-
chological well-being is predicted by religiosity. The sample consisted of 30 male and 30
female, aged 60 years or more unlike the sample population (240 medical and non-medical
students aged 1626 years) of our study (Hafeez and Rafique 2013).
Another research study concurrent with our research work showed that a strong positive
association does exist between religiosity and life satisfaction while a strong negative
relation exists between religiosity and psychological distress. This study was done with
Pakistani Muslims as the target population, and we took medical and non-medical students
as our target population. Our sample population includes 240 students, whereas 155
individuals were included in the study by Zeenat et al. Moreover, no comparison between
any of the subgroups of population has been made in their study (Ismail and Deshmukh
2012).
Our study showed that medical and non-medical students differed in psychological
well-being. It specifies that non-medical students had higher psychological well-being as
compared to medical students. The study also reveals that there is no significant difference
in medical and non-medical students in religiosity. Studies have been done in which
psychological well-being of students is assessed keeping in view various areas of possible
stressful events in medical education (Ogunsemi et al. 2013). A multicultural study also
revealed results congruent to our study by showing associations between mental health,
subjective well-being, and religiosity (Abdel-Khalek 2013). Research work showed that
majority of medical students believed that patients health (71.2%) is positively (68.2%)
influenced by spirituality. No comparisons between target population in this study were
made (Lucchetti et al. 2013). Significant positive, however moderate, association between
religiosity and anxiety among medical students was also found (Lupo and Strous 2011).
There is paucity of data stating the comparison of psychological well-being and reli-
giosity among medical and non-medical students. Our study shows that medical students
have a lower psychological well-being. Studies have shown that medical students form a
vulnerable group that has a high prevalence of psychiatric morbidity due to exaggerated
anxiety and depression as a result of nerve-wracking medical life. Anxiety and depression
are believed to be higher in medical students than in the general population which
accentuates the significance of watchfulness to mental health matters among students,
especially during the early years of college life (Jadoon et al. 2010; Aktekin et al. 2001;
Khan et al. 2006; Alvi et al. 2010; Ibrahim and Abdelreheem 2015; Lupo and Strous 2011).
Our research outcomes disclose that there is no significant difference in male and
female students in religiosity and psychological well-being. Gender differences in mental
health or in presumed impact of religion on mental health have been only minimally
explored. Another research showed that no significant gender differences in religiosity and
psychological well-being exist (Hafeez and Rafique 2013). A research study conducted by
Emily A. Greenfield found no evidence for gender differences in the relationship between
formal religious participation and psychological well-being, but did find evidence for
differences in the male and female target population, in the associations between day-to-
day psychological well-being and spiritual experiences (Greenfield 2007). Aly and his

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colleagues found out that significant differences are present between Muslim males and
females on existential and spiritual well-being with males getting higher scores in the said
parameters. Gender differences on religiosity or religious well-being were observed to be
insignificant (Alvi et al. 2010).
Some contrasting studies also show that gender and age differences prevail, with women
and older adults having the sturdiest spiritual and religious beliefs (Davie and Vincent
1998; Ellison 1991; Idler and Kasl 1997a, b; King et al. 2001).
Our studys findings are important for medical educators. Psychological distress,
depression, and anxiety may accompany the students during the medical college years as
well as during their post-graduation and in clinical practice due to the tedious medical
academics, and it may thus adversely influence the quality of medical care. The results of
this study reveal that religiosity is protective against depression and anxiety in students.
Physicians can recommend religious activity as one of the coping strategies during periods
of emotional stress and difficulty. Integration of behavioral medicine into the curriculum
can provide an effective platform for creating awareness among students about the psy-
chological problems and the coping mechanisms. It may also be imperative to monitor for
these disorders and introduce psychological counseling services as an important modality
to fight depression and anxiety. Bearing in mind the gauge of the problem, further research
is required to further define, comprehend and handle the phenomenon.

Conclusion

Our study revealed that religiosity is a strong predictor of psychological well-being. It also
showed significant difference in psychological well-being between medical and non-
medical students. No significant difference was found in religiosity of medical and non-
medical students. No significant gender differences in religiosity and psychological well-
being were found. The present research opens horizons for future research and also provide
with guidelines for psychological evaluation, development of religious beliefs, and inter-
vention to augment psychological well-being among the medical students.

Limitations

The study sample employed in the present study was small, non-random, and non-repre-
sentative. A larger sample can enhance the generalizability of the study.
Compliance with the Ethical standards

Conflict of interest None.

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