- Email: [email protected]
Spirituality, religiosity and alcohol related beliefs among college students
Asian Journal of Psychiatry 6 (2013) 66–70
Contents lists available at SciVerse ScienceDirect
Asian Journal of Psychiatry journal homepage: www.elsevier.com/locate/ajp
Spirituality, religiosity and alcohol related beliefs among college students Mahima Sukhwal *, L.N. Suman Department of Clinical Psychology, NIMHANS, Hosur Road, Bangalore 560029, India
A R T I C L E I N F O
A B S T R A C T
Article history: Received 23 April 2012 Received in revised form 22 August 2012 Accepted 30 August 2012
The aim of the present study was to examine spirituality, religiosity, and alcohol-related beliefs among college students. The sample consisted of 236 college students – 120 girls and 116 boys. The age range of the sample was between 18 and 21 years. The tools used in the study were Personal Information Data Sheet, Scale for Assessment of Attitudes toward Drinking and Alcoholism (SAADA), Alcohol Expectancy Questionnaire – Adult Form (AEQ), Beliefs and Values Scale (BVS), and The Religious Background and Behavior Questionnaire (RBBQ). The data were analyzed using t-test and Pearson’s product moment correlation. Higher spirituality, religiosity, and both the components of religiosity – God Consciousness and Formal Practices, were all associated with less acceptance of drinking and alcoholism. Positive affect and higher spirituality were both associated with religiosity as well as its components. A positive correlation was found among religiosity and both its components. The results revealed gender differences in that the God Consciousness component of religiosity was found to be higher in girls, but not boys, who did not have exposure to alcohol through prior use or alcohol use in family. The implications for primary prevention for college students are discussed. ß 2012 Elsevier B.V. All rights reserved.
Keywords: Spirituality Religiosity College students Alcohol related beliefs
1. Introduction Krohn and Brandon (2000) reported the problem of student drinking as the number one health problem on college and university campuses across the world. College students are at a higher risk for alcohol related problems because they have high rates of heavy consumption (binge drinking), tend to drink more recklessly than others, and are heavily targeted by advertising and promotion of alcohol. Research has found certain protective factors that prevent drinking. Hodge et al. (2001) reported that there is strong evidence that spiritual or religious involvement is generally associated with decreased risk of alcohol or drug abuse, problems and dependence. Almeida and Koenig (2006) offered the definition of spirituality as ‘‘the personal quest for understanding answers to ultimate questions about life, about meaning, and about relationship with the sacred or transcendent, which may (or may not) lead to or arise from the development of religious rituals and the formation of community. They defined religiosity as ‘‘an organized system of beliefs, practices, rituals, and symbols designed to facilitate closeness to the sacred or transcendent (God, higher power, or ultimate truth or reality).
* Corresponding author. Tel.: +91 98806 05896. E-mail addresses: [email protected] (M. Sukhwal), [email protected] (L.N. Suman). 1876-2018/$ – see front matter ß 2012 Elsevier B.V. All rights reserved. http://dx.doi.org/10.1016/j.ajp.2012.08.012
According to Hodge et al. (2001) spirituality may counteract self-rejection and derogation by fostering a positive self-image and providing personal norms that inhibit the use of substances. Walker et al. (2007) gave an account of pathways from religiosity to substance use outcomes, such as an attitudinal process, and an association of religiosity with self-control and coping processes. These findings imply that religious participation and spiritual beliefs can be encouraged as a part of prevention strategies. Few studies in India have examined the influence of religiosity and spirituality on alcohol related cognitions among college students. The current study is a part of a larger study that examined alcohol related beliefs among college students in relation to their affect and religious and spiritual beliefs. 2. Materials and methods The aim of the study was to examine spirituality, religiosity and alcohol-related beliefs among college students. The objectives were to examine the following in the study sample: 1. 2. 3. 4. 5. 6.
Attitudes toward alcohol use. Alcohol related expectancies. Positive and negative affect. Nature of spirituality and religiosity. To examine gender differences in the above variables. To examine the relationships among all the above variables.
M. Sukhwal, L.N. Suman / Asian Journal of Psychiatry 6 (2013) 66–70
The sample consisted of 236 college students (116 boys and 120 girls). Undergraduate students between 18 and 21 years of age and studying in English medium colleges were included. Students enrolled in professional courses, employed in part-time jobs, belonging to a Foreign Nationality and those staying in hostels were excluded. 2.1. Tools used Personal Information Data Sheet: Part 1. This was used to obtain socio-demographic information about the subjects. This included the subject’s name, age, sex, education, and information about family members. Part 2 was used to obtain information about exposure to alcohol use. This included prior use of alcohol, alcohol use in family, and alcohol use by friends. Scale for Assessment of Attitudes toward Drinking and Alcoholism (SAADA): This scale was developed by Basu et al. in 1998. It is a 29item self-report scale for assessment of attitudes toward drinking and alcoholism (SAADA). It has four factors named ‘‘Acceptance’’, ‘‘Rejection’’, ‘‘Avoidance’’ and ‘‘Social Dimension’’. The test–retest reliability ranges from 0.64 to 0.96. Cronbach’s alpha coefficients were high to moderate for all the factors as well as for the whole scale. Other tests of internal consistency included item–item and item–total correlations in each factor. Generally high positive correlations were found in both the cases. Alcohol-Expectancy Questionnaire (Adult) (AEQ): This 120 item questionnaire was developed by Brown et al. in 1980. It is an empirically derived research instrument designed to assess positive effects attributed to moderate alcohol consumption. Six kinds of positive expectancies are assessed: positive global changes in experience; sexual enhancement; social and physical pleasures; assertiveness; relaxation or tension reduction; and arousal or interpersonal power. Content validity, criterion validity and construct validity have been found to be satisfactory. The Positive and Negative Affect Schedule (PANAS): This scale was developed and validated by Watson et al. in 1988. It includes 20 items (ten in each scale). It was developed to measure the two primary dimensions of mood – positive and negative affect. The alpha reliabilities range from 0.86 to 0.90 for PA and from 0.84 to 0.87for NA. The test–retest reliability of 0.79 for PA, and 0.81 for NA was found. Both PANAS scales are very highly correlated with their corresponding regression-based factor scores in each solution, with convergent correlations ranging from 0.89 to 0.95, whereas the discriminant correlations are quite low, ranging from .02 to 0.18. In the present study, the PANAS has been used to assess the students’ proneness to positive or negative affect, and to study its relationship with alcohol-related beliefs. Beliefs and Values Scale (BVS): This scale was developed by King et al. in 2005. It includes 20 items. It is a measure to assess strength of spiritual beliefs that is based on the narratives and responses of a wide range of people. It characterizes the core components of spirituality, such as a search for meaning in the world, relationships, circumstances; ideas on God and religion; and reactions to the world. Test–retest reliability according to Cronbach’s alpha for all statements was high at 0.93. Internal consistency was 0.94. Pairwise correlation for agreement between total score on the final twenty-item Beliefs and Values Scale and the criterion scale score was 0.70. The Religious Background and Behavior Questionnaire (RBBQ): This scale was developed by Connors et al. in 1996. It includes 13 items. It is a brief measure of lifetime and recent religious practices. The RBB includes two factors, God Consciousness and Formal Practices. The God Consciousness factor contains five items reflecting prayer, thinking about God, and religious self-description. The Formal Practices factor includes eight items assessing meditation, worship service, attendance, reading scriptures, and
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experiences of God. Both the components and the total RBBQ score had acceptable to good internal item consistency; and the similar correlation between components across samples (0.60) indicated a stable construct structure. Test–retest correlations for the components were exceptionally high (r = 0.94 or higher), indicating strong replicability. The Religious Background and Behavior Questionnaire was developed specifically for application in the area of substance use research. 2.2. Procedure Ethical clearance for the study was obtained from the Institute Ethics Committee. Students meeting the inclusion and exclusion criteria from four English medium undergraduate colleges in the city of Bangalore were contacted after obtaining permission from the college administration. Written informed consent was obtained from all the participating students and the questionnaires were administered in group settings in the college premises. 2.3. Analysis of data The protocols were scored, and the means and standard deviations of the test scores for the different groups were calculated. T-tests were applied for analyzing gender differences, and Pearson product moment correlation was used to examine the direction and degree of association among all the variables. 3. Results Results obtained on SAADA, AEQ and PANAS have been reported elsewhere (Sukhwal and Suman, 2008). As shown in Table 1, no significant difference was found between the strength of spiritual beliefs of boys and girls on BVS. Table 2 indicates that on RBBQ, no significant difference surfaced in the lifetime and recent religious practices of boys and girls. This signifies that there is no considerable difference between the religious inclinations of boys and girls. As can be seen in Table 3, girls whose family members did not use alcohol were higher on factor I of RBBQ, i.e. God Consciousness. Hence, the God Consciousness component of religiosity can be concluded to be higher in girls whose family members did not use alcohol. Table 4 shows that girls who had never used either alcohol or tobacco were higher on the God Consciousness factor of RBBQ. Hence, girls with no prior use of alcohol or tobacco are higher on religiosity, at least on the component of God Consciousness. On the other hand no significant difference can be seen between the male students with prior use of alcohol or tobacco and those with no prior use of these substances on any of the factors. Table 1 Mean, standard deviation and t-values on BVS. Boys Total
Girls
57.87
13.66
57.11
t-test 9.77
0.49
Table 2 Mean, standard deviation and t-values on RBBQ. Factors
Boys M
Girls SD
M
t-test SD
God Consciousness Formal Practices
18.16 13.31
4.99 8.24
18.42 12.28
3.87 8.20
0.45 0.97
Total
31.47
11.73
30.93
10.37
0.37
M. Sukhwal, L.N. Suman / Asian Journal of Psychiatry 6 (2013) 66–70
68 Table 3 Alcohol use in family and religiosity/spirituality.
Girls
Boys Absent
BVS RBBQ total I II *
Present
t
M
SD
M
SD
58.13 32.41 18.34 14.06
13.96 11.95 4.88 8.63
57.56 30.31 17.92 12.38
13.42 11.45 5.18 7.71
Absent
0.22 0.96 0.45 1.09
Present
t
M
SD
M
SD
58.23 32.36 19.08 13.14
8.87 10.53 3.08 8.86
55.82 29.30 17.66 11.29
10.63 10.01 4.52 7.31
1.36 1.62 2.03* 1.24
Significant at 0.05 level of significance.
Table 4 Prior use of alcohol/tobacco and religiosity/spirituality. Girls
Boys Absent
Present
BVS RBBQ total I II **
t
M
SD
M
SD
56.41 30.75 17.77 12.98
12.87 11.71 5.25 7.85
59.23 32.13 18.52 13.62
14.34 11.79 4.76 8.64
Present
1.11 0.63 0.81 0.41
Absent
t
M
SD
M
SD
55.13 28.53 16.55 11.48
10.99 10.89 5.12 7.80
58.10 32.14 19.35 12.68
9.01 9.95 2.63 8.41
1.58 1.82 3.96** 0.76
Significant at 0.01 level of significance.
more formal religious practices. BVS scores can be seen to have similar positive association with RBBQ and both its factors. RBBQ total scores have also been found to be positively correlated with both its factors – God Consciousness as well as Formal practices. This indicates that the higher the religiosity, the higher the God Consciousness as well formal practices in the subjects. Also, RBBQ factor I, namely God Consciousness has been found to be positively correlated to factor II, Formal practices. This translates into higher God Consciousness being associated with more involvement in formal religious practices.
In Table 5 it can be seen that both male and female students with friends using alcohol and those with no such friends do not differ significantly on any of the factors. Table 6 illustrates the inter-correlations among all the variables that have been examined in the present study. The table shows a negative correlation between the total SAADA scores, and the BVS scores. This indicates that higher acceptance of alcohol is associated with lower spirituality. Similarly, the negative correlation of the total SAADA scores with the total RBBQ scores, and both its factors, indicates that higher acceptance of alcohol is associated with less religiosity, as well as less God Consciousness, and less formal practices. Positive affect is seen to be positively correlated with RBBQ score, as well as both of its factors – God Consciousness and Formal Practices. Hence, high positive affect appears to be associated with higher religiosity, higher God Consciousness, and carrying out of
4. Discussion The results indicate that the God Consciousness component of religiosity was higher in girls whose family members did not use alcohol. Those who scored high on the God Consciousness factor of
Table 5 Alcohol use among friends and religiosity/spirituality. Girls
Boys Present
BVS RBBQ total I II
Absent
t
M
SD
M
SD
57.97 31.13 18.09 13.05
13.73 11.98 5.20 8.32
56.91 34.64 18.82 15.82
13.65 8.78 2.27 7.24
Present
-0.24 0.94 0.46 1.06
Absent
t
M
SD
M
SD
56.82 31.78 18.11 13.26
10.43 11.28 4.43 8.72
57.54 29.67 18.88 10.79
8.76 8.79 2.80 7.18
0.40 1.09 1.06 1.63
Table 6 Correlations among the variables. SAADA (total) SAADA (total) AEQ (total) PA NA BVS RBBQ (total) RBBQ-Factor I RBBQ- Factor II * **
– – – – – – – –
Significant at 0.05 level of significance. Significant at 0.01 level of significance.
AEQ (total) 0.05 – – – – – – –
PA 0.02 0.01 – – – – –
NA 0.06 0.08 0.02 –
BVS 0.19 0.07 0.09 0.02 – – – –
RBBQ (total) **
**
0.18 0.05 0.19** 0.02 0.63** – – –
RBBQ-Factor I *
0.16 0.03 0.18** 0.05 0.62** 0.74** – –
RBBQ-Factor II 0.16* 0.07 0.17** 0.05 0.51** 0.94** 0.49** –
M. Sukhwal, L.N. Suman / Asian Journal of Psychiatry 6 (2013) 66–70
RBBQ reported praying or thinking about God quite often. Similarly, Merrill et al. (2005) examined the influence of family religiosity on alcohol use, and found that parental religiosity during the participants’ adolescent years was associated with lower substance use among Latter-day Saints (LDS). Girls with no prior use of alcohol or tobacco were found to be higher on the God Consciousness component of religiosity. However, no significant difference could be seen between the male students with prior use of alcohol or tobacco and those with no prior use of these substances on any of the factors. Similarly, the God Consciousness component of religiosity was found to be higher in girls whose family members did not use alcohol, whereas no significant difference could be seen between the male students with alcohol use in their families and those with no alcohol use in families, on this factor. The gender difference between girls and boys pertaining to the influence of religiosity on health behaviors, including alcohol, has been demonstrated in earlier studies as well. Templin and Martin (1999) examined the relationship between Roman Catholic college students’ intrinsic and extrinsic approaches toward religion, and their drinking behavior. The results indicated that there was a significant inverse relationship between an intrinsic orientation toward religion, and alcohol consumption and problems associated with alcohol consumption for females, but not for males. In another study, Strawbridge et al. (2001) tested the hypothesis that religious attendance served to improve and maintain good health behaviors, mental health, and social relationships. The results showed the prevalences of health behaviors, namely quitting smoking and alcohol consumption, and regular medical checkups to be much higher for weekly religious attenders, as compared to those with less attendance. The establishment and maintenance of good health behaviors associated with religious attendance was found to be stronger for women than for men. In the present study, spirituality was found to be associated with less favorable attitudes toward drinking and alcoholism. Those who scored high on spirituality generally agreed to statements like ‘I believe I have a spirit or soul that can survive my death’, or ‘I believe God is an all pervading presence’. Spirituality being associated with less favorable attitude toward alcohol is corroborated by TurnerMusa and Lipscomb’s study in 2007, where they found that low spiritual well-being significantly increased the odds of alcohol use. Sussman et al. (2006) also examined the relationship between spirituality and alcohol use, and found that non-drug-use-specific spirituality was found to be negatively predictive of alcohol use. These findings support the association between spirituality and less favorable attitudes toward alcohol. Higher religiosity, and both its factors, God Consciousness and Formal Practices have been shown to be significantly correlated with less acceptance of drinking. Bazargan et al. (2004) also found that religious participation had a significant negative impact on the odds of having alcohol six hours prior to seeking emergency care. Hence, religious participation emerged as a protective factor in this study. Wills et al. (2003) also found that religiosity has a buffering effect for adolescent stressors, thus reducing the impact of life events on alcohol and other substance use. This once more corroborates the relationship of higher religiosity and less acceptance of drinking behavior. Hope and Cook (2001) found in their study that agreement with statements reflecting Christian commitment (e.g., ‘usually go to church on Sunday’ and ‘have given my life to Jesus’) can successfully predict whether or not church affiliated young people are more likely to have ever drunk. More importantly, they found that agreement with these statements was generally associated with a lesser likelihood of having engaged in such behavior. These findings provide robust support for less acceptance of drinking being associated with both more praying, worship service, attendance, reading scriptures, etc.
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The results of the present study showed high Positive affect to be associated with higher religiosity, higher God Consciousness, and carrying out of more formal religious practices. Loewenthal et al. (2000) also found religious coping cognitions associated with raised positive affect, which in turn was associated with lowered distress. Rowatt and Kirkpatrick (2002), in their study on the relationship between attachment to God, religiosity and affect, found that religiousness predicted positive affect. Thus, Religiosity has a beneficial effect by its influence on affect. In the present study, higher spirituality was found to be associated with higher religiosity, higher God Consciousness, and carrying out of more formal practices. Beckwith and Morrow (2005) found similar results in their study to examine religiosity and spirituality to determine their impact on the sexual attitudes of college students. Religiosity and spirituality were found to be significantly positively related. Students who were more spiritual (e.g., experienced meaning and faith, held a spiritual perspective, was able to personally apply spiritual principles) also tended to be more religious. However, Saroglou and OzGarci’a (2008) found spirituality as both similar and distinct from classic religiosity. Spirituality shared with religion both a prosocial tendency and conscientiousness, but not the emphasis on conservation versus openness to change and to experience. Similarly Berkel et al. (2004) found some aspects of religiosity as more similar to spirituality than others, and vice versa. They concluded that although some ways of being religious may be an expression of one’s spirituality, other ways of being religious may fulfill other needs (e.g., social, personal) that may be unrelated to spirituality. These findings lend support to the multidimensionality of both religiosity and spirituality. RBBQ total scores were found to be positively correlated with both its factors – God Consciousness as well as Formal practices. This indicates that the higher the religiosity, the higher the God Consciousness as well as Formal Practices in the subjects. Also, RBBQ factor I, God Consciousness was found to be positively correlated to factor II, Formal practices. This translates into higher God Consciousness being associated with more involvement in formal practices related to religion. The high positive correlation in the present study between the total scores on the questionnaire and both the factors indicates that all these behaviors are interrelated. This indicates the high internal consistency of the measure, and confirms its validity. In conclusion, the study highlights the importance of spirituality and religiosity in abstinence from alcohol. Spiritual interventions and promotion of religiosity are implied as effective strategies. The gender effect observed suggests that young women require specific targeting. Knowledge of such patterns and mechanisms needs to be incorporated in prevention and intervention programs. Role of funding source No external funding was used for this study. Contributors The second author (Dr. L.N. Suman) conceived and designed the study. The first author (Ms. Mahima Sukhwal) acquired the data, and analyzed and interpreted it. She also drafted the article. The second author revised it critically, and gave the final approval of the version to be published. No other contributors. Conflict of interest All authors declare that they have no conflicts of interest.
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M. Sukhwal, L.N. Suman / Asian Journal of Psychiatry 6 (2013) 66–70
References Almeida, A.M., Koenig, H.G., 2006. Retaining the meaning of the words religiousness and spirituality: a commentary on the WHOQOL SRPB group’s. A cross cultural study of spirituality, religion, and personal beliefs as components of quality of life. Social Science and Medicine 63, 843–845. Basu, S., Malhotra, A., Varma, V.K., Malhotra, R., 1998. Development of a scale to assess attitudes toward drinking and alcoholism. Indian Journal of Psychiatry 40 (2), 158–164. Bazargan, S., Sherkat, D.E., Bazargan, M., 2004. Religion and alcohol use among African-American and Hispanic inner-city emergency care patients. Journal for the Scientific Study of Religion 43 (3), 419–428. Beckwith, H.D., Morrow, J.A., 2005. Sexual attitudes of college students: the impact of religiosity and spirituality. College Student Journal 39 (2), 357–366. Berkel, L.A., Armstrong, T.D., Cokley, K.O., 2004. Similarities and differences between religiosity and spirituaiity in African American college students: a preliminary investigation. Counseling and Values 49, 2–14. Brown, S., Goldman, M., Inn, A., Anderson, L., 1980. Expectations of reinforcement from alcohol: their domain and relation to drink patterns. Journal of Consulting and Clinical Psychology 48, 419–426. Connors, G.J., Tonigan, J.S., Miller, W.R., 1996. A measure of religious background and behaviour for use in behaviour change research. Psychology of Addictive Behaviors 10 (2), 90–96. Hodge, D.R., Cardenas, P., Montoya, H., 2001. Substance use: spirituality and religious participation factors among rural youths. Social Work Research 25 (3), 153–161. Hope, L.C., Cook, C.H., 2001. The role of Christian commitment in predicting drug use amongst church affiliated young people. Mental Health, Religion & Culture 4 (2), 109–117. King, M., Jones, L., Barnes, K., Low, J., Walker, C., Wilkinson, S., Mason, C., Sutherland, J., Tookman, A., 2005. Measuring spiritual belief: development and standardization of a Beliefs and Values Scale. Psychological Medicine 36, 417–425. Krohn, F.B., Brandon, M., 2000. Alcohol prohibition versus moderation. College Student Journal 34 (3), 459–467.
Loewenthal, K.M., MacLeod, A.K., Goldblatt, V., Lubitsh, G., Valentine, J.D., 2000. Comfort and joy? Religion, cognition, and mood in Protestants and Jews under stress. Cognition and Emotion 14 (3), 355–374. Merrill, R.M., Folsom, J.A., Christopherson, S.S., 2005. The influence of family religiosity on adolescent substance use according to religious preference. Social Behavior & Personality 33 (8), 821–836. Rowatt, W.C., Kirkpatrick, L.A., 2002. Two dimensions of attachment to God and their relation to affect, personality, and religiosity constructs. Journal for the Scientific Study of Religion 41, 637–651. Saroglou, V., OzGarci’a, 2008. Individual differences in religion and spirituality: an issue of personality traits and/or values. Journal for the Scientific Study of Religion 47 (1), 83–101. Strawbridge, W.J., Shema, S.J., Cohen, R.D., Kaplan, G.A., 2001. Religious attendance increases survival by improving and maintaining good health behaviours, mental health, and social relationships. Annals of Behavioral Medicine 23 (1), 68–74. Sukhwal, M., Suman, L.N., 2008. Alcohol related beliefs among college students. Indian Journal of Clinical Psychology 35 (2), 138–146. Sussman, S., Skara, S., Rodriguez, Y., Pokhrel, P., 2006. Non drug use- and drug usespecific spirituality as one-year predictors of drug use among high-risk youth. Substance Use and Misuse 41, 1801–1816. Templin, D.P., Martin, M.J., 1999. The relationship between religious orientation, gender, and drinking patterns among catholic college students. College Student Journal 33 (4), 488–495. Turner-Musa, J., Lipscomb, L., 2007. Spirituality and social support on health behaviours of African American undergraduates. American Journal of Health Behavior 31 (5), 495–501. Walker, C., Ainette, M.G., Wills, T.A., Mendoza, D., 2007. Religiosity and substance use: test of an indirect effect model in early and middle adolescence. Psychology of Addictive Behaviors 21 (1), 84–96. Watson, D., Clark, L.A., Tellegen, A., 1988. Development and validation of brief measures of positive and negative affect: the PANAS scales. Journal of Personality and Social Psychology 54 (6), 1063–1070. Wills, T.A., Yaeger, A.M., Sandy, J.M., 2003. Buffering effect of religiosity for adolescent substance use. Psychology of Addictive Behaviors 17 (1), 24–31.
Contents lists available at SciVerse ScienceDirect
Asian Journal of Psychiatry journal homepage: www.elsevier.com/locate/ajp
Spirituality, religiosity and alcohol related beliefs among college students Mahima Sukhwal *, L.N. Suman Department of Clinical Psychology, NIMHANS, Hosur Road, Bangalore 560029, India
A R T I C L E I N F O
A B S T R A C T
Article history: Received 23 April 2012 Received in revised form 22 August 2012 Accepted 30 August 2012
The aim of the present study was to examine spirituality, religiosity, and alcohol-related beliefs among college students. The sample consisted of 236 college students – 120 girls and 116 boys. The age range of the sample was between 18 and 21 years. The tools used in the study were Personal Information Data Sheet, Scale for Assessment of Attitudes toward Drinking and Alcoholism (SAADA), Alcohol Expectancy Questionnaire – Adult Form (AEQ), Beliefs and Values Scale (BVS), and The Religious Background and Behavior Questionnaire (RBBQ). The data were analyzed using t-test and Pearson’s product moment correlation. Higher spirituality, religiosity, and both the components of religiosity – God Consciousness and Formal Practices, were all associated with less acceptance of drinking and alcoholism. Positive affect and higher spirituality were both associated with religiosity as well as its components. A positive correlation was found among religiosity and both its components. The results revealed gender differences in that the God Consciousness component of religiosity was found to be higher in girls, but not boys, who did not have exposure to alcohol through prior use or alcohol use in family. The implications for primary prevention for college students are discussed. ß 2012 Elsevier B.V. All rights reserved.
Keywords: Spirituality Religiosity College students Alcohol related beliefs
1. Introduction Krohn and Brandon (2000) reported the problem of student drinking as the number one health problem on college and university campuses across the world. College students are at a higher risk for alcohol related problems because they have high rates of heavy consumption (binge drinking), tend to drink more recklessly than others, and are heavily targeted by advertising and promotion of alcohol. Research has found certain protective factors that prevent drinking. Hodge et al. (2001) reported that there is strong evidence that spiritual or religious involvement is generally associated with decreased risk of alcohol or drug abuse, problems and dependence. Almeida and Koenig (2006) offered the definition of spirituality as ‘‘the personal quest for understanding answers to ultimate questions about life, about meaning, and about relationship with the sacred or transcendent, which may (or may not) lead to or arise from the development of religious rituals and the formation of community. They defined religiosity as ‘‘an organized system of beliefs, practices, rituals, and symbols designed to facilitate closeness to the sacred or transcendent (God, higher power, or ultimate truth or reality).
* Corresponding author. Tel.: +91 98806 05896. E-mail addresses: [email protected] (M. Sukhwal), [email protected] (L.N. Suman). 1876-2018/$ – see front matter ß 2012 Elsevier B.V. All rights reserved. http://dx.doi.org/10.1016/j.ajp.2012.08.012
According to Hodge et al. (2001) spirituality may counteract self-rejection and derogation by fostering a positive self-image and providing personal norms that inhibit the use of substances. Walker et al. (2007) gave an account of pathways from religiosity to substance use outcomes, such as an attitudinal process, and an association of religiosity with self-control and coping processes. These findings imply that religious participation and spiritual beliefs can be encouraged as a part of prevention strategies. Few studies in India have examined the influence of religiosity and spirituality on alcohol related cognitions among college students. The current study is a part of a larger study that examined alcohol related beliefs among college students in relation to their affect and religious and spiritual beliefs. 2. Materials and methods The aim of the study was to examine spirituality, religiosity and alcohol-related beliefs among college students. The objectives were to examine the following in the study sample: 1. 2. 3. 4. 5. 6.
Attitudes toward alcohol use. Alcohol related expectancies. Positive and negative affect. Nature of spirituality and religiosity. To examine gender differences in the above variables. To examine the relationships among all the above variables.
M. Sukhwal, L.N. Suman / Asian Journal of Psychiatry 6 (2013) 66–70
The sample consisted of 236 college students (116 boys and 120 girls). Undergraduate students between 18 and 21 years of age and studying in English medium colleges were included. Students enrolled in professional courses, employed in part-time jobs, belonging to a Foreign Nationality and those staying in hostels were excluded. 2.1. Tools used Personal Information Data Sheet: Part 1. This was used to obtain socio-demographic information about the subjects. This included the subject’s name, age, sex, education, and information about family members. Part 2 was used to obtain information about exposure to alcohol use. This included prior use of alcohol, alcohol use in family, and alcohol use by friends. Scale for Assessment of Attitudes toward Drinking and Alcoholism (SAADA): This scale was developed by Basu et al. in 1998. It is a 29item self-report scale for assessment of attitudes toward drinking and alcoholism (SAADA). It has four factors named ‘‘Acceptance’’, ‘‘Rejection’’, ‘‘Avoidance’’ and ‘‘Social Dimension’’. The test–retest reliability ranges from 0.64 to 0.96. Cronbach’s alpha coefficients were high to moderate for all the factors as well as for the whole scale. Other tests of internal consistency included item–item and item–total correlations in each factor. Generally high positive correlations were found in both the cases. Alcohol-Expectancy Questionnaire (Adult) (AEQ): This 120 item questionnaire was developed by Brown et al. in 1980. It is an empirically derived research instrument designed to assess positive effects attributed to moderate alcohol consumption. Six kinds of positive expectancies are assessed: positive global changes in experience; sexual enhancement; social and physical pleasures; assertiveness; relaxation or tension reduction; and arousal or interpersonal power. Content validity, criterion validity and construct validity have been found to be satisfactory. The Positive and Negative Affect Schedule (PANAS): This scale was developed and validated by Watson et al. in 1988. It includes 20 items (ten in each scale). It was developed to measure the two primary dimensions of mood – positive and negative affect. The alpha reliabilities range from 0.86 to 0.90 for PA and from 0.84 to 0.87for NA. The test–retest reliability of 0.79 for PA, and 0.81 for NA was found. Both PANAS scales are very highly correlated with their corresponding regression-based factor scores in each solution, with convergent correlations ranging from 0.89 to 0.95, whereas the discriminant correlations are quite low, ranging from .02 to 0.18. In the present study, the PANAS has been used to assess the students’ proneness to positive or negative affect, and to study its relationship with alcohol-related beliefs. Beliefs and Values Scale (BVS): This scale was developed by King et al. in 2005. It includes 20 items. It is a measure to assess strength of spiritual beliefs that is based on the narratives and responses of a wide range of people. It characterizes the core components of spirituality, such as a search for meaning in the world, relationships, circumstances; ideas on God and religion; and reactions to the world. Test–retest reliability according to Cronbach’s alpha for all statements was high at 0.93. Internal consistency was 0.94. Pairwise correlation for agreement between total score on the final twenty-item Beliefs and Values Scale and the criterion scale score was 0.70. The Religious Background and Behavior Questionnaire (RBBQ): This scale was developed by Connors et al. in 1996. It includes 13 items. It is a brief measure of lifetime and recent religious practices. The RBB includes two factors, God Consciousness and Formal Practices. The God Consciousness factor contains five items reflecting prayer, thinking about God, and religious self-description. The Formal Practices factor includes eight items assessing meditation, worship service, attendance, reading scriptures, and
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experiences of God. Both the components and the total RBBQ score had acceptable to good internal item consistency; and the similar correlation between components across samples (0.60) indicated a stable construct structure. Test–retest correlations for the components were exceptionally high (r = 0.94 or higher), indicating strong replicability. The Religious Background and Behavior Questionnaire was developed specifically for application in the area of substance use research. 2.2. Procedure Ethical clearance for the study was obtained from the Institute Ethics Committee. Students meeting the inclusion and exclusion criteria from four English medium undergraduate colleges in the city of Bangalore were contacted after obtaining permission from the college administration. Written informed consent was obtained from all the participating students and the questionnaires were administered in group settings in the college premises. 2.3. Analysis of data The protocols were scored, and the means and standard deviations of the test scores for the different groups were calculated. T-tests were applied for analyzing gender differences, and Pearson product moment correlation was used to examine the direction and degree of association among all the variables. 3. Results Results obtained on SAADA, AEQ and PANAS have been reported elsewhere (Sukhwal and Suman, 2008). As shown in Table 1, no significant difference was found between the strength of spiritual beliefs of boys and girls on BVS. Table 2 indicates that on RBBQ, no significant difference surfaced in the lifetime and recent religious practices of boys and girls. This signifies that there is no considerable difference between the religious inclinations of boys and girls. As can be seen in Table 3, girls whose family members did not use alcohol were higher on factor I of RBBQ, i.e. God Consciousness. Hence, the God Consciousness component of religiosity can be concluded to be higher in girls whose family members did not use alcohol. Table 4 shows that girls who had never used either alcohol or tobacco were higher on the God Consciousness factor of RBBQ. Hence, girls with no prior use of alcohol or tobacco are higher on religiosity, at least on the component of God Consciousness. On the other hand no significant difference can be seen between the male students with prior use of alcohol or tobacco and those with no prior use of these substances on any of the factors. Table 1 Mean, standard deviation and t-values on BVS. Boys Total
Girls
57.87
13.66
57.11
t-test 9.77
0.49
Table 2 Mean, standard deviation and t-values on RBBQ. Factors
Boys M
Girls SD
M
t-test SD
God Consciousness Formal Practices
18.16 13.31
4.99 8.24
18.42 12.28
3.87 8.20
0.45 0.97
Total
31.47
11.73
30.93
10.37
0.37
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68 Table 3 Alcohol use in family and religiosity/spirituality.
Girls
Boys Absent
BVS RBBQ total I II *
Present
t
M
SD
M
SD
58.13 32.41 18.34 14.06
13.96 11.95 4.88 8.63
57.56 30.31 17.92 12.38
13.42 11.45 5.18 7.71
Absent
0.22 0.96 0.45 1.09
Present
t
M
SD
M
SD
58.23 32.36 19.08 13.14
8.87 10.53 3.08 8.86
55.82 29.30 17.66 11.29
10.63 10.01 4.52 7.31
1.36 1.62 2.03* 1.24
Significant at 0.05 level of significance.
Table 4 Prior use of alcohol/tobacco and religiosity/spirituality. Girls
Boys Absent
Present
BVS RBBQ total I II **
t
M
SD
M
SD
56.41 30.75 17.77 12.98
12.87 11.71 5.25 7.85
59.23 32.13 18.52 13.62
14.34 11.79 4.76 8.64
Present
1.11 0.63 0.81 0.41
Absent
t
M
SD
M
SD
55.13 28.53 16.55 11.48
10.99 10.89 5.12 7.80
58.10 32.14 19.35 12.68
9.01 9.95 2.63 8.41
1.58 1.82 3.96** 0.76
Significant at 0.01 level of significance.
more formal religious practices. BVS scores can be seen to have similar positive association with RBBQ and both its factors. RBBQ total scores have also been found to be positively correlated with both its factors – God Consciousness as well as Formal practices. This indicates that the higher the religiosity, the higher the God Consciousness as well formal practices in the subjects. Also, RBBQ factor I, namely God Consciousness has been found to be positively correlated to factor II, Formal practices. This translates into higher God Consciousness being associated with more involvement in formal religious practices.
In Table 5 it can be seen that both male and female students with friends using alcohol and those with no such friends do not differ significantly on any of the factors. Table 6 illustrates the inter-correlations among all the variables that have been examined in the present study. The table shows a negative correlation between the total SAADA scores, and the BVS scores. This indicates that higher acceptance of alcohol is associated with lower spirituality. Similarly, the negative correlation of the total SAADA scores with the total RBBQ scores, and both its factors, indicates that higher acceptance of alcohol is associated with less religiosity, as well as less God Consciousness, and less formal practices. Positive affect is seen to be positively correlated with RBBQ score, as well as both of its factors – God Consciousness and Formal Practices. Hence, high positive affect appears to be associated with higher religiosity, higher God Consciousness, and carrying out of
4. Discussion The results indicate that the God Consciousness component of religiosity was higher in girls whose family members did not use alcohol. Those who scored high on the God Consciousness factor of
Table 5 Alcohol use among friends and religiosity/spirituality. Girls
Boys Present
BVS RBBQ total I II
Absent
t
M
SD
M
SD
57.97 31.13 18.09 13.05
13.73 11.98 5.20 8.32
56.91 34.64 18.82 15.82
13.65 8.78 2.27 7.24
Present
-0.24 0.94 0.46 1.06
Absent
t
M
SD
M
SD
56.82 31.78 18.11 13.26
10.43 11.28 4.43 8.72
57.54 29.67 18.88 10.79
8.76 8.79 2.80 7.18
0.40 1.09 1.06 1.63
Table 6 Correlations among the variables. SAADA (total) SAADA (total) AEQ (total) PA NA BVS RBBQ (total) RBBQ-Factor I RBBQ- Factor II * **
– – – – – – – –
Significant at 0.05 level of significance. Significant at 0.01 level of significance.
AEQ (total) 0.05 – – – – – – –
PA 0.02 0.01 – – – – –
NA 0.06 0.08 0.02 –
BVS 0.19 0.07 0.09 0.02 – – – –
RBBQ (total) **
**
0.18 0.05 0.19** 0.02 0.63** – – –
RBBQ-Factor I *
0.16 0.03 0.18** 0.05 0.62** 0.74** – –
RBBQ-Factor II 0.16* 0.07 0.17** 0.05 0.51** 0.94** 0.49** –
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RBBQ reported praying or thinking about God quite often. Similarly, Merrill et al. (2005) examined the influence of family religiosity on alcohol use, and found that parental religiosity during the participants’ adolescent years was associated with lower substance use among Latter-day Saints (LDS). Girls with no prior use of alcohol or tobacco were found to be higher on the God Consciousness component of religiosity. However, no significant difference could be seen between the male students with prior use of alcohol or tobacco and those with no prior use of these substances on any of the factors. Similarly, the God Consciousness component of religiosity was found to be higher in girls whose family members did not use alcohol, whereas no significant difference could be seen between the male students with alcohol use in their families and those with no alcohol use in families, on this factor. The gender difference between girls and boys pertaining to the influence of religiosity on health behaviors, including alcohol, has been demonstrated in earlier studies as well. Templin and Martin (1999) examined the relationship between Roman Catholic college students’ intrinsic and extrinsic approaches toward religion, and their drinking behavior. The results indicated that there was a significant inverse relationship between an intrinsic orientation toward religion, and alcohol consumption and problems associated with alcohol consumption for females, but not for males. In another study, Strawbridge et al. (2001) tested the hypothesis that religious attendance served to improve and maintain good health behaviors, mental health, and social relationships. The results showed the prevalences of health behaviors, namely quitting smoking and alcohol consumption, and regular medical checkups to be much higher for weekly religious attenders, as compared to those with less attendance. The establishment and maintenance of good health behaviors associated with religious attendance was found to be stronger for women than for men. In the present study, spirituality was found to be associated with less favorable attitudes toward drinking and alcoholism. Those who scored high on spirituality generally agreed to statements like ‘I believe I have a spirit or soul that can survive my death’, or ‘I believe God is an all pervading presence’. Spirituality being associated with less favorable attitude toward alcohol is corroborated by TurnerMusa and Lipscomb’s study in 2007, where they found that low spiritual well-being significantly increased the odds of alcohol use. Sussman et al. (2006) also examined the relationship between spirituality and alcohol use, and found that non-drug-use-specific spirituality was found to be negatively predictive of alcohol use. These findings support the association between spirituality and less favorable attitudes toward alcohol. Higher religiosity, and both its factors, God Consciousness and Formal Practices have been shown to be significantly correlated with less acceptance of drinking. Bazargan et al. (2004) also found that religious participation had a significant negative impact on the odds of having alcohol six hours prior to seeking emergency care. Hence, religious participation emerged as a protective factor in this study. Wills et al. (2003) also found that religiosity has a buffering effect for adolescent stressors, thus reducing the impact of life events on alcohol and other substance use. This once more corroborates the relationship of higher religiosity and less acceptance of drinking behavior. Hope and Cook (2001) found in their study that agreement with statements reflecting Christian commitment (e.g., ‘usually go to church on Sunday’ and ‘have given my life to Jesus’) can successfully predict whether or not church affiliated young people are more likely to have ever drunk. More importantly, they found that agreement with these statements was generally associated with a lesser likelihood of having engaged in such behavior. These findings provide robust support for less acceptance of drinking being associated with both more praying, worship service, attendance, reading scriptures, etc.
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The results of the present study showed high Positive affect to be associated with higher religiosity, higher God Consciousness, and carrying out of more formal religious practices. Loewenthal et al. (2000) also found religious coping cognitions associated with raised positive affect, which in turn was associated with lowered distress. Rowatt and Kirkpatrick (2002), in their study on the relationship between attachment to God, religiosity and affect, found that religiousness predicted positive affect. Thus, Religiosity has a beneficial effect by its influence on affect. In the present study, higher spirituality was found to be associated with higher religiosity, higher God Consciousness, and carrying out of more formal practices. Beckwith and Morrow (2005) found similar results in their study to examine religiosity and spirituality to determine their impact on the sexual attitudes of college students. Religiosity and spirituality were found to be significantly positively related. Students who were more spiritual (e.g., experienced meaning and faith, held a spiritual perspective, was able to personally apply spiritual principles) also tended to be more religious. However, Saroglou and OzGarci’a (2008) found spirituality as both similar and distinct from classic religiosity. Spirituality shared with religion both a prosocial tendency and conscientiousness, but not the emphasis on conservation versus openness to change and to experience. Similarly Berkel et al. (2004) found some aspects of religiosity as more similar to spirituality than others, and vice versa. They concluded that although some ways of being religious may be an expression of one’s spirituality, other ways of being religious may fulfill other needs (e.g., social, personal) that may be unrelated to spirituality. These findings lend support to the multidimensionality of both religiosity and spirituality. RBBQ total scores were found to be positively correlated with both its factors – God Consciousness as well as Formal practices. This indicates that the higher the religiosity, the higher the God Consciousness as well as Formal Practices in the subjects. Also, RBBQ factor I, God Consciousness was found to be positively correlated to factor II, Formal practices. This translates into higher God Consciousness being associated with more involvement in formal practices related to religion. The high positive correlation in the present study between the total scores on the questionnaire and both the factors indicates that all these behaviors are interrelated. This indicates the high internal consistency of the measure, and confirms its validity. In conclusion, the study highlights the importance of spirituality and religiosity in abstinence from alcohol. Spiritual interventions and promotion of religiosity are implied as effective strategies. The gender effect observed suggests that young women require specific targeting. Knowledge of such patterns and mechanisms needs to be incorporated in prevention and intervention programs. Role of funding source No external funding was used for this study. Contributors The second author (Dr. L.N. Suman) conceived and designed the study. The first author (Ms. Mahima Sukhwal) acquired the data, and analyzed and interpreted it. She also drafted the article. The second author revised it critically, and gave the final approval of the version to be published. No other contributors. Conflict of interest All authors declare that they have no conflicts of interest.
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