TE

MA

S LIVR

ES FR

EE

TH

EM

ES

2105

1 Departamento de Biologia,Universidade Estadual daParaíba. Av. das Baraúnas351, Campus Universitário.58109-753 CampinaGrande PB.romulo_nobrega@yahoo.com.br2 Projovem/JP, PrefeituraMunicipal de João Pessoa.3 Programa de PósGraduação em CiênciasBiológicas (Zoologia),Universidade Federal daParaíba.

The influence of religiosity on health

Influência da religiosidade na saúde

Resumo Historicamente, as relações entre reli-gião e saúde foram assuntos de interesse no passa-do e,atualmente, tornaram-se crescentemente vi-síveis nas reuniões sociais, de comportamento eciências da saúde. Dentre as várias questões a se-rem consideradas, o presente trabalho apresentauma breve discussão sobre as relações entre a saú-de e a religiosidade no processo de cura e trata-mento de doenças. Várias investigações mostramque a participação religiosa está relacionada aefeitos benéficos para pessoas que estão em recu-peração de doenças físicas e mentais, inclusive apsicologia aborda questões especiais sobre as cor-relações positivas entre convicção e prática reli-giosa, saúde mental, física e longevidade. Por ou-tro lado, a religião também pode ser associada aresultados negativos e usos impróprios de serviçosde saúde, como fanatismo, asceticismo, mortifi-cações e tradicionalismo opressivo. O potencialpara efeitos positivos e negativos de espiritualis-mo em saúde, combinado com os altos níveis decompromisso com a espiritualidade, evidencia anecessidade de pesquisas futuras. Independente dospossíveis mecanismos, se os indivíduos lucram emtermos de saúde por conta da religião, esses deve-riam ser motivados, respeitando as convicçõesindividuais de cada um.Palavras-chave Relações, Crenças religiosas, Saú-de, Espiritualidade

Abstract The relationship between religion andhealth has been a subject of interest in the pastand in the latest years becoming increasingly vis-ible in the social, behavioral, and health sciences.Among several approaches to be considered, thepresent work provides a briefly discuss concern-ing the bond between health and religiosity inthe cure process and diseases treatment. Severalinvestigations show that religious participationis related with better outcomes for persons whoare recovering from physical and mental illness,also the psychology science have committed spe-cial issues to positive correlations between reli-gious belief and practice, mental and physicalhealth and longevity. On the other hand, religionmay also be associated with negative outcomesand the inappropriate use of health services asfanaticism, asceticism, mortifications and oppres-sive traditionalism. The potential for both posi-tive and negative effects of spirituality on health,combined with the high levels of engagement withspirituality suggests that this area is ripe for fu-ture sustained research. Independent of the possi-ble mechanisms, if individuals receive health prof-its by the religion; those should be motivated, re-specting the individual faith of each one.Key words Relationship, Religious belief, Health,Spirituality

Rômulo Romeu da Nóbrega Alves 1

Humberto da Nóbrega Alves 2

Raynner Rilke Duarte Barboza 3

Wedson de Medeiros Silva Souto 3

2106A

lves

RR

N e

t al.

Introduction

The relationship between religion and health hasbeen of longstanding interest in the health, so-cial, and behavioral sciences, spanning a periodof >100 years1-4. Research examining the relation-ships between religion and the health of individ-uals and populations has become increasinglyvisible in the social, behavioral, and health sci-ences5. Systematic programs of research investi-gate religious phenomena within the context ofcoherent theoretical and conceptual frameworksthat describe the causes and consequences of re-ligious involvement for health outcomes5. Despitesustained attention to these concerns, healthresearch (i.e. epidemiological and medical re-search) is generally unfamiliar with extant devel-opments in the conceptualization and measure-ment of religion involvement6.

There are many reasons why studies Religionand Health Relationships and their implicationsshould be carried out and recorded. Among sev-eral approaches to be considered, this paper brieflydiscusses those concerning the bond between thehealth and the religiosity in the cure process anddiseases treatment.

Religions and health in history

Historically, traditional cultures recognized theimportance of belief and expectancy within thehealing encounter and created complex rituals andceremonies designed to elicit or foster the expect-ancy and participation of healer and patient, aswell as the community as a whole. Spiritual heal-ing techniques have been a fundamental compo-nent of the healing rituals of virtually all societiessince the advent of man7. Early Egyptian andGreek civilizations depicted the ancient healingpractice of the laying on of hands in their hiero-glyphics, pictographs and cuneiform writings8.Biblical reference to healing performed by Jesus,Peter, John and others helped make spiritual heal-ing a commonly accepted practice of early Chris-tianity9. Whether used for curing illness or pre-venting disease, the primary purpose of mostforms of spiritual healing was to maintain thephysical, psychological and spiritual well-beingof the individual and the community.

Traditionally, spiritual healing practitionersbelieved that illness manifested on the physicallevel due to an imbalance in the psychological orspiritual aspects of the individual. The role of thehealer was to correct this imbalance by utilizing

culturally accepted and proven methods of heal-ing10,11. Within this framework, the diagnosis ofillness and the development of a treatment regi-men were undertaken from a holistic perspectivewhich cultivated the patient’s belief and expect-ancy of healing12-14.

With the advent of modern medicine, how-ever, the significance of cultivating belief and ex-pectancy within the healing encounter was aban-doned in reliance upon a reductionist, mechanis-tic and non-ritualistic approach to healing15. Thisapproach ignored the psychological and spiritu-al aspects of health and focused on biologicalabnormalities and specific microorganisms as theprimary cause of disease7. Recently, however, re-search within the field of mind/body medicinehas re-examined the relationship between the in-dividual’s psychological and spiritual perspectiveand their physical health16,17.

Religion and health researches

Despite recognized methodological and analyti-cal issues5, overall the findings indicate a consis-tent and salutary influence of religious factors onindividual and population health3,18. In the pastseveral years, systematic research on religiousinvolvement and physical and mental health hasbegun to explore the functional mechanisms link-ing these constructs19-24.

In recent years, several books have been pub-lished21,25-31 and major journals in public healthand medicine have featured empirical research,literature reviews, and special issues on these andrelated topics3,19-21,27,28,32-36.There are a numberof excellent reviews of studies of religious andspiritual healing and the nature, functional prop-erties, and efficacy of various healing modalities37.

Studies involving Christian denominationsand sects currently dominate research into theeffects of religion on health38-40. Evidence fromepidemiological and clinical studies and medicalresearch supports the impact of religious affilia-tion and involvement on a diverse array of men-tal and physical health indicators and diseasestates. This literature encompasses studies of can-cer, hypertension, stroke, other cardiovascularconditions, gastrointestinal diseases, overall andcause-specific mortality, indicators of physicaldisability, self ratings of health status, and re-ports of symptomatology41-52, encompassingnumerous disease entities or types of rates23.

Several investigations indicate that religiousinvolvement is associated with better outcomes

2107C

iência & Saúde C

oletiva, 15(4):2105-2111, 2010

for persons who are recovering from physicaland mental illness53-55. One recent study of im-mune system function in a sample of olderadults56 found a weak association between reli-gious-service attendance and immune system sta-tus, independent of effects of depression and neg-ative life events. Overall, better physical healthstatus, as measured by a variety of indicators, ismoderately associated with higher levels of reli-gious involvement, even when defined by numer-ous indicators and examined within diversegroups (i.e. as defined by clinical disorder, gen-der, age cohort, denomination, race/ethnicity, andsocial class) within the population6,20,23.

Evidence concerning the impact of religion onindicators of mental health22 indicates strongpositive associations between religious involve-ment and mental health outcomes. Studies (pri-marily epidemiologic) indicate that religious fac-tors have a salutary influence on a diverse set ofoutcomes, including depression, drug and alco-hol use, delinquent behavior, suicide, psycholog-ical distress, and certain functional psychiatricdiagnoses57-60.

Religious strategies may be particularly im-portant for coping with mental and physical ill-ness and disability. Persons who use religiouscoping appear to handle their conditions moreeffectively than those who do not53,61,62.

Several studies indicate that religious copingis significant for mental and physical health out-comes for a variety of life circumstances, espe-cially health problems53,63 and bereavement64,65.Religious coping also appears to reduce levels ofdepression and anxiety60,66 in connection withbereavement and other loss events67.

The significance and relationship of a givenreligious factor to health outcomes will poten-tially vary across distinct social categories (e.g.race/ethnicity, denomination, age, social class, andregion)5. That religion is instrumental in shapingbehaviors (e.g. risk taking and protective behav-iors) that are consequential for physical andmental health. This includes directly and formal-ly proscribing specific behaviors that are healthrisks (e.g. dietary restrictions and prohibitionsagainst the use of alcohol and tobacco), as wellas encouraging behaviors that are conducive tohealth (e.g. regular exercise). These distinctivepatterns of lifestyle and health behaviors couldresult in lower rates of chronic and acute illnesseswithin identified religious groups5. Additionally,religious adherents may have reduced risk forstressful life circumstances because religiousteachings embody general guidelines for behav-

ior (e.g. moderation and conformity) that dis-courage individual deviance and encourage in-terpersonal harmony68.

Participation in religious groups confers anumber of benefits in terms of enhanced socialresources. These advantages include the size of one’ssocial networks, frequency of interactions with net-work members, both actual and anticipated (sub-jective-support) exchanges of various types of in-formal and formal assistance (i.e. instrumental,socioemotional, and appraisal assistance), andpositive perceptions of support relationships (e.g.satisfaction and anticipated help)68,69.

The use of religion to promote individual andcommunity healing (i.e. restorative activities) hasbeen associated with the experience of strong,positive emotions regarding the self, such as feel-ings of self-worth, competence, and connectionwith others70.

While the literature contains over two hun-dred experimental studies examining variousforms of spiritual healing such as TherapeuticTouch, Intercessory Prayer, Reiki, LeShan, etc. onlya small percentage of these studies have attempt-ed to systematically assess the outcome of spiri-tual healing therapies and correlate the results withpsychological aspects of health and illness includ-ing patient and healer belief or expectancy71-75.

Research in religion and health has suggestedpositive relationships, and most recently has con-centrated on the experience of religion, or spiri-tuality76. Levin77,78 investigated the effects of reli-giosity on numerous conditions, including chron-ic disease, functional disability, psychologicalwellbeing, and subjective perceptions of health,while controlling for age, race, ethnicity, gender,social class, denomination, as well as other socialand psychological factors. Kaplan79 found reli-gious protections, such as increased hope, socialpersonal regulation, and regulation of depres-sion, fear and anxiety, to have positive effects ona patient’s cardiovascular system. Benson80

showed how prayer provided emotional com-fort, and thus, improved health. Idler81 conclud-ed that religious beliefs may indeed alter a per-son’s perception of illness and disabilities andprovide greater comfort. Koenig66 detailed thenumerous ways that the “healing power of faith”can improve one’s health, including relaxationeffects, coping and social support. An increasingreplication of studies finds a correlation betweenreligious belief and practice and mental and phys-ical health and longevity82.

Several major journals in the field of psychol-ogy have recently devoted special issues to posi-

2108A

lves

RR

N e

t al.

tive correlations between religious belief and prac-tice and mental and physical health and longevi-ty82. In addition, this research suggests that reli-gious belief and practice involve both ordinarypsychological processes and unique psychologi-cal-spiritual contents. On one hand, religion ex-erts its influence through common psychologi-cal channels like social support, healthy behav-ior, a sense of coherence, and medical compli-ance. On the other hand, by orienting motiva-tion towards matters of ultimate concern andattributing sacredness to ordinary activities, reli-gion also plays a distinctive role in human life82.

Along with the presumed benefits of religiousinvolvement for health, religion may also be as-sociated with negative outcomes, such as poorermental and physical health status, negative cop-ing behaviors, and inappropriate use of healthservices20,21. Ness83 verified negative and positiveaspects of the religious convictions in the physicaland mental health; among the negatives could bementioned the fanaticism, asceticism, mortifica-tions and oppressive traditionalism; the positiveaspects are personal health, community health,complementarity of the religious conceptions withthe medical conceptions of human well being.

In summary, the religion seems to be a psy-chosocial factor and the biological benefit in therecovery of the physical and mental diseases. In-dependent of the possible mechanisms, if indi-viduals receive health profits by the religion; thoseshould be motivated, respecting the faith indi-viduality of each one.

Investigations of religion and health have eth-ical and practical implications that should beaddressed by the public, health professionals, theresearch community, and the clergy. Future re-search directions point to promising new areas

of investigation that could bridge the constructsof religion and health. The potential for bothpositive and negative effects of spirituality onhealth, combined with the high levels of engage-ment with spirituality, suggests that this area isripe for future sustained research. Additionalprospective studies are also needed to enhanceour understanding of the temporal ordering ofthe relationship between exposure to spiritualityand the timing of health consequences, and tostrengthen our confidence in causal inferences.

Conclusion

In summary, the religion seems to be a psycho-social factor and the biological benefit in the re-covery of the physical and mental diseases. Inde-pendent of the possible mechanisms, if individu-als receive health profits by the religion; thoseshould be motivated, respecting the faith indi-viduality of each one. Investigations of religionand health have ethical and practical implicationsthat should be addressed by the lay public, healthprofessionals, the research community, and theclergy. Future research directions point to prom-ising new areas of investigation that could bridgethe constructs of religion and health.

The potential for both positive and negativeeffects of spirituality on health, combined withthe high levels of engagement with spiritualitysuggests that this area is ripe for future sustainedresearch. Additional prospective studies are alsoneeded to enhance our understanding of the tem-poral ordering of the relationship between expo-sure to spirituality and the timing of health con-sequences, and to strengthen our confidence incausal inferences.

2109C

iência & Saúde C

oletiva, 15(4):2105-2111, 2010

Collaborators

RRN Alves and HN Alves worked in the biblio-graphical classification, conception and the arti-cle final composition; RRD Barboza worked inthe conception, final composition and final lan-guage translation of the article; WMS Soutoworked in the conception, composition and finalformatting.

References

Levin JS, Schiller PL. Is there a religious factor inhealth?. J. Relig. Health 1987; 26:9-36.Levin JS, Tobin SH. Religion and psychological well-being. In: Kimble MA, McFadden SH, Ellor JW,Seeber JJ, editors. Aging, Spirituality, and Religion:A Handbook. Minneapolis: Fortress; 1996. p. 30–46.Levin JS, Vanderpool HY. Is frequent religious at-tendance really conducive to better health: towardan epidemiology of religion. Soc. Sci. Med. 1987;24:589–600Levin JS, Vanderpool HY. Is religion therapeutical-ly significant for hypertension?. Soc. Sci. Med. 1989;29:69–78.Chatters LM. Religion and health: public healthresearch and practice. Annu. Rev. Public Health 2000;21:335–367.Matthews DA, McCullough ME, Larson DB, KoenigHG, Swyers JP, Milano MG. Religious commitmentand health status. Arch. Fam. Med. 1998; 7:118–124.Wirth DP. Implementing spiritual healing in mod-ern medical practice. Adv. J. Mind-Body Health 1993;9:69-81.Krieger D. The imprimatur of nursing. Am. J. Nurs-ing 1975; 5: 784-787.Bresler DE. Free Yourself From Pain. 1st ed. NewYork: Simon & Schuster; 1979.Krippner S, Villoldo A. The Realms of Healing. 3rd

ed. Millbrae: Celestial Arts; 1976.Achterberg J. Imagery in Healing: Shamanism andModern Medicine. 1st ed. Boston: New Science Li-brary; 1985.Pelletier K. Mind as Healer, Mind as Slayer. 8th ed.New York: Dell; 1977.Kleinman A. Patients and Healers in the Context ofCulture: an Exploration of the Borderland BetweenAnthropology, Medicine, and Psychiatry. Berkeley:University of California Press; 1980.Kleinman A, Eisenberg L, Good B. Culture, illness,and care: clinical lessons from anthropologic andcross-cultural research. Ann. Int. Med. 1978; 88:251-258.Myers SS, Benson H. Psychological factors in heal-ing: a new perspective on an old debate. Behav.Med. 1991; 18:5-11.Ader R, Felten DL, Cohen N. Psychoneuroimmu-nology..... 2nd ed. New York: Academic Press; 1991.Houldin AD, Lev E, Prystowsky MB, Redei E, Low-ery BJ. Psychoneuroimmunology: a review of liter-ature. Holist. Nursing Pract. 1991; 5:10-21.Levin JS, Chatters LM, Ellison CG, Taylor RJ. Reli-gious involvement, health outcomes, and publichealth practice. Curr. Issues Public Health 1996;2:220–225.Chatters LM, Levin JS, Ellison CG. Public healthand health education in faith communities. HealthBehav. Educ. 1998; 25:689–699.Ellison CG, Levin JS. The religion health connec-tion: evidence, theory and future directions. HealthEduc. Behav. 1998; 25:700–720.Levin JS. Religion and health: is there an associa-tion, is it valid and is it causal?. Soc. Sci. Med. 1994;38:1475–1482.

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

13.

14.

15.

16.

17.

18.

19.

20.

21.

2110A

lves

RR

N e

t al.

Hill PC. An overview of measurement issues andscales in the scientific study of spirituality. In: Study-ing Spirituality and Alcohol. Bethesda: National In-stitute of Alcohol Abuse and Alcoholism/FetzerInstitute; 1999.Hood RW Jr, Spilka B, Hunsberger B, Gorsuch RL.The Psychology of Religion: An Empirical Approach.New York: Guilford; 1996.Bryant S, Rakowski W. Predictors of mortality amongelderly African Americans. Res. Aging 1992; 14:50–67.Colantonio A, Kasl SV, Ostfeld AM. Depressionsymptoms and other psychosocial factors as pre-dictors of stroke in the elderly. Am. J. Epidemiol.1992; 136:884–894.Craigie FC, Larson DB, Lieu IY. References to reli-gion in the Journal of Family Practice: dimensionsand valence of spirituality. J. Fam. Pract. 1990;30:477–480.Dwyer JW, Clarke LL, Miller MK. The effect ofreligious concentration and affiliation on countycancer mortality rates. J. Health Soc. Behav. 1990;31:185–202Ferraro KF, Albrecht-Jensen CM. Does religion in-fluence adult health? J. Sci. Stud. Relig. 1991; 30:193–202.Hummer RA, Nam CB, Ellison CG. Religious in-volvement and U.S. adult mortality. Demography1999; 36:273–285.Kennedy GJ, Kelman HR, Thomas C, Chen J. Therelation of religious preference and practice to de-pressive symptoms among 1,855 older adults. J. Ger-ontol. B Psychol. Sci. 1996; 51:301–308.Koenig HG, Hays JC, George LK, Blazer DG, Lar-son DB, Landerman LR. Modeling the cross-sec-tional relationships between religion, physicalhealth, social support, and depressive symptoms.Am. J. Geriatr. Psych. 1997; 5:131–145.Koenig HG, Hays JC, Larson DB, Cohen HJ, BlazerDG. The relationship between religious activitiesand blood pressure in older adults. Int. J. Psych.Med. 1998; 28:189–213.Krause N. Neighborhood deterioration, religiouscoping, and changes in health during later life. Ger-ontology 1998a; 38:653–664.Krause N. Stressors in highly valued roles, religiouscoping, and mortality. Psychol. Aging 1998b; 13:242–255.Larson DB, Koenig HG, Kaplan BH, Greenberg RF,Logue E, Tyroler HA. The impact of religion onblood pressure status in men. J. Relig. Health 1989;28:265–278.Oxman TE, Freedman DH, Manheimer ED. Lack ofsocial participation or religious strength and com-fort as risk factors after cardiac surgery in the elder-ly. Psychosom. Med. 1995; 57:5–15.

39.

40.

41.

42.

43.

44.

45.

46.

47.

48.

49.

50.

51.

52.

53.

Levin JS, Chatters LM. Research on religion andmental health: an overview of empirical findingsand theoretical issues. In: Koenig HG. Handbook ofReligion and Mental Health. San Diego: Academic;1998. p. 34–50.Levin JS, Chatters LM, Ellison CG, Taylor RJ. Reli-gious involvement, health outcomes, and publichealth practice. Curr. Issues Public Health 1996;2:220–225.Newberg AB, d’Aquili EG. The neuropsychology ofspiritual experience. In: Koenig HG. Handbook ofReligion and Mental Health. San Diego: Academic;1998. p. 75–94.Koenig HG. Research on Religion and Aging. West-port: Greenwood; 1995.Koenig HG. Religious attitudes and practices ofhospitalized medically ill older adults. Int. J. Geri-atr. Psychiatry 1998; 13:213–224.Levin JS, Tobin SH. Religion and psychological well-being. In: Kimble MA, McFadden SH, Ellor JW,Seeber JJ, editors. Aging, Spirituality, and Religion:A Handbook. Minneapolis: Fortress; 1996. p. 30–46.Levin JS, Vanderpool HY. Religious factors in phys-ical health and the prevention of illness. In: Parga-ment KI, Maton KI, Hess RE, editors. Religion andPrevention in Mental Health: Research, Vision, andAction. New York: Haworth; 1992. p. 83–103.Pargament KI. The Psychology of Religion and Cop-ing: Theory, Research, Practice. New York: Guilford;1997. 548 p.Pargament KI, Maton KI, Hess RE, editors. Reli-gion and Prevention in Mental Health. New York:Haworth; 1992.Schumaker JF, editor. Religion and Mental Health.New York: Oxford University Press; 1992.Larson DB, Sherrill KA, Lyons JS, Craigie FC Jr,Theilman SB. Associations between dimensions ofreligious commitment and mental health reportedin the American Journal of Psychiatry and Archivesof General Psychiatry: 1978– 1989. Am. J. Psych.1992; 149:557–559.Levin JS. Religious factors in aging, adjustment,and health: a theoretical overview. J. Rel. Aging1988; 4:133–146.McFadden SH. Religion, spirituality and aging. In:::::Birren JE, Schaie KW. Handbook of the Psychology ofAging. San Diego: Academic; 1996. p. 162–77.Vanderpool HY, Levin JS. Religion and medicine:how are they related? J. Relig. Health 1990; 29:9–20.Weaver AJ, Samford JA, Larson DB, Lucas LA, KoenigHG, Patrick V. A systematic review of research onreligion in four major psychiatric journals, 1991–1995. J. Nerv. Ment. Dis.1998; 186:187–189.Jonas WB, Levin LK. Essentials of Complementaryand Alternative Medicine. Baltimore: Lippincott,Williams & Wilkins; 1999.Gorsuch RL. Measurement in psychology of reli-gion revisited. J. Psychol. Christianity 1990; 9:82–92.

22.

23.

24.

25.

26.

27.

28.

29.

30.

31.

32.

33.

34.

35.

36.

37.

38.

2111C

iência & Saúde C

oletiva, 15(4):2105-2111, 2010

Pressman P, Lyons JS, Larson DB, Strain JS. Reli-gious beliefs, depression, and ambulation status inelderly women with broken hips. Am. J. Psych. 1990;147:758–760.Propst LR, Ostrom R,Watkins P, Dean T, MashburnD. Comparative efficacy of religious and nonreli-gious cognitive behavioral therapy for the treat-ment of clinical depression in religious individu-als. J. Consult. Clin. Psychol. 1992; 60:94–103.Koenig HG, Cohen HJ, George LK, Hays JC, LarsonDB, Blazer DG. Attendance at religious services,interleukin- 6, and other biological parameters ofimmune function in older adults. Int. J. Psych. Med.1997; 27:233–250.Cochran JK, Beegley L, Bock EW. The influence ofreligious stability and homogamy on the relation-ship between religiosity and alcohol use among Prot-estants. J. Sci. Stud. Relig. 1992; 32:441–456.Gartner JD, Larson DB, Allen GD. Religious com-mitment and mental health: a review of the empir-ical literature. J. Psychol. Theol. 1991; 19:6–25Idler EL, Kasl SV. Religion among disabled andnondisabled persons II: Attendance at religious ser-vices as predictors of the course of disability. J.Gerontol. 1997; 52b:S306–S316.Williams DR, Larson DB, Buckler RE, Heckman RC,Pyle CM. Religion and psychological distress in acommunity sample. Soc. Sci. Med. 1991; 32:1257–1262.Pargament KI, Ensing DS, Falgout K, Olsen H, Reil-ly B, Van Haitsma K, Warren R. Religious copingefforts as predictors of the outcomes of significantnegative life events. Am. J. Commun. Psych. 1990;18:793–824.Pargament KI, Smith BW, Koenig HG, Perez L. Pat-terns of positive and negative coping with majorlife stressors. J. Sci. Stud. Relig. 1998; 37:710–724.Koenig HG, Cohen HJ, Blazer DG, Kudler HS, Krish-nan KPP, Sibert TE. Religious coping and cognitivesymptoms of depression in elderly medical patients.Psychosomatics 1995; 36:369–375.Krause N. Stress, religiosity, and psychological well-being among older blacks. . . . . J. Aging Health 1992;4:412–439.McIntosh DN, Silver RC, Wortman CB. Religion’srole in adjustment to a negative life event: copingwith the loss of a child. J. Pers. Soc. Psych. 1993;65:812–821.Koenig, HG. The Healing Power of Faith: ScienceExplores Medicine’s Last Great Frontier. New York:Simon & Schuster; 1999.Mattlin JA, Wethington E, Kessler R. Situationaldeterminants of coping and coping effectiveness. J.Health Soc. Behav. 1990; 31:103–122.Ellison CG. Religion, the life-stress paradigm, andthe study of depression. In: Levin JS, editor. Reli-gion in Aging and Health: Theoretical Foundationsand Methodological Frontiers. Thousand Oaks: Sage;1994. p. 78–121

Ellison CG, George LK. Religious involvement, so-cial ties, and social support in a southeastern com-munity. J. Sci. Stud. Relig. 1994; 33:46–61.Maton KI, Wells E. Religion as a community re-source for well-being: prevention, healing and em-powerment pathways. J. Soc. Issues 1995; 51:177–193.Benor DJ. Survey of spiritual healing research. Com-plement. Med. Res. 1990; 4:9-33.Wirth DP, Cram JR. Multi-site electromyographicanalysis of noncontact therapeutic touch. Int. J.Psychosom. 1993; 40:47-55.Wirth DP, Cram JR. Psychophysiology of nontradi-tional prayer. Int. J. Psychosom. 1994; 41: 68-75.Solfvin J. Mental healing. In: Krippner S, editor.Advances in Parapsychological Research. Jefferson:McFarland; 1984.Wirth DP, Barrett MJ. Complementary healing ther-apies. Int. J. Psychosom. 1994; 41:61-67.Sutherland J, Poloma MM, Pendleton B. Religion,Spirituality, and Alternative Health Practices: TheBaby Boomer and Cold War Cohorts. J Relig Health2003; 42:315-338.Levin JS. Religion in Aging and Health: TheoreticalFoundations and Methodological Frontiers. ThousandOaks: Sage; 1994.Levin JS. Religion, Health, and Psychological Well-Being in Older Adults. J Aging Health 1998; 10:504–531.Kaplan BH. A Note on Religious Beliefs and Coro-nary Heart Disease. . . . . J S C Med Assoc 1976; 72:60–64.Benson H. The Relaxation Response. New York: Wil-liam Morrow; 1975.Idler EL. Religious Involvement and Health of theElderly: Some Hypotheses and an Initial Test. So-cial Forces 1987; 66:226–238.Jones JW. Religion, Health, and the Psychology ofReligion: How the Research on Religion and HealthHelps Us Understand Religion. J Relig Health 2004;43(4):317-328.Ness PHV. Religion and public health. J Relig Health1999; 38(1):15-26.

Artigo apresentado em 05/01/2008Aprovado em 04/04/2008

54.

55.

56.

57.

58.

59.

60.

61.

62.

63.

64.

65.

66.

67.

68.

69.

70.

71.

72.

73.

74.

75.

76.

77.

78.

79.

80.

81.

82.

83.