Differing Pathways Between Religiousness, Spirituality, and Health: A Self-Regulation Perspective

The literature on religiousness, spirituality (R/S), and health has increased dramatically in the past decade, but suffers from a lack of integrative theoretical models and well-defined constructs. Drawing on self-regulation theory, we hypothesized that the effects of religiousness (e.g., affiliation, service attendance) on health affects behavioral self-regulation of health habits; in contrast, the effects of spirituality (e.g., meditation, self-transcendence) on health are thought to be mediated primarily via the effects of emotion regulation on the inflammatory processes underlying chronic illnesses such as cardiovascular disease and cancer. The adverse effects of religious alienation are thought to be mediated by both pathways. We conducted database searches to identify current models of R/S and health as well as the empirical literature linking specific aspects of R/S and physical health. We then reviewed the extent to which the literature supports this model. Our review largely supported the proposed model. Religiousness was strongly associated with better health behavior habits, including lower smoking and alcohol consumption and greater likelihood of medical screenings, but only weakly related to inflammatory biomarkers. Measures of spirituality were more strongly linked to biomarkers, including blood pressure, cardiac reactivity, immune factors, and disease progression. Religious alienation had adverse effects on both pathways. This distinction between religiousness and spirituality and the better delineation of health behavior and biomarker pathways can inform and improve clinical applications and interventions.