Annual Meeting: 2010 Paper Sessions

Categories

Interdisciplinary Research
Mediators & Pathways
Religious Organizations & Public Health
Spirituality & Clinical Care
Theological Considerations

Presenters

Berry Dell Kinghorn Nguyen Smith
Cotton Greenstein Larson Owen Steffen
Cowchock Hirsch Lomax Piderman Velasquez
Danely Holt MacKinlay Sexton Williams
Day Jensen McKnight Shapiro Young

Interdisciplinary Research

Wednesday 2:00
"Spirituality, Mental Health and Art: An Interdisciplinary Research Project in Aged Care"
Elizabeth MacKinlay, PhD, RN, MEd, BTh
Director, Centre for Ageing & Pastoral Studies
Professor of Pastoral Theology
Charles Sturt University
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Co-authors: Alan Niven, PhD; Libby Byrne; Beverley Borig; Vicky Kingston
Abstract: Many activities are used in aged care to improve resident wellbeing. Few programs have been evaluated for effectiveness, especially for dementia. Working across disciplines with older people offers valuable experiences for both practitioners and residents. This research project drew a multi-disciplinary group of practitioners together around a common concern for older people, and a desire to work collaboratively. Team disciplines included: theologian, psychologist, art therapist, nurse, lifestyle coordinator, pastoral carers and spiritual director. This paper reports ONE component of a study evaluating programs that may improve mental health and wellbeing of participants diagnosed with dementia and depression. A strategic factor in the project was the meeting of all practitioners before commencement; the interdisciplinary team planned, designed, implemented and evaluated an art therapy program. They shared skills and insights, merging these into a program allowing participants to express and understand spirituality and life experiences through the medium of art, while enhancing individual and group practice.

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Wednesday 2:45
"Predicting Patients’ Expectations of Chaplain Visitation: A Multisite Survey"
Katherine M. Piderman, PhD
Staff Chaplain, Coordinator of Research
Assistant Professor of Psychiatry
Mayo College of Medicine
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Co-authors: Dean V. Marek, BA; Sarah M. Jenkins, MS; Mary E. Johnson, MA; James F. Buryska, STL; Floyd G. O’Bryan, MS; Patrick D. Hansen, MA; Priscilla H. Howick, MDiv; Heidi L. Durlan, BS; Kandace Lackore, BA; Tait D. Shanafelt, MD; Paul S. Meuller, MD
Abstract: To predict patients' expectations of chaplain visitation. Multi-site survey. 4500 medical and surgical patients. Hospitals in Minnesota, Arizona, and Florida. Three weeks post-discharge, surveys were mailed to patients regarding expectations of chaplain visitation. Categorical variables were summarized with frequencies/percentages. Chi-square tests were used to examine associations between responses and site. Multivariable logistic regression was used to determine the likelihood of wanting chaplain visitation. Approximately one-third responded from each site. The majority was male, married, ≥56 years, Protestant or Catholic. Nearly 70% reported wanting chaplain visitation. Predictors of wanting visitation were denomination, as compared to those with no reported religious affiliation (Catholic:OR=7.97;CI=4.42-4.38;p<.001;Evangelical Protestant:OR=4.96;CI=2.74-8.98;p<.001;Mainline Protestant:OR=4.29; CI=2.55-7.20;p<.001); being female (OR=1.52; CI=1.08-2.15;p= 0.02), and endorsing chaplains’ importance as reminders of God’s care/presence (OR=4.37;CI=2.58-7.40;p<0.001) and providers of prayer/scripture reading (OR=2.54;CI=1.53-4.2;p<0.001). Length of stay, reason for hospitalization, hospital unit, age or marital status did not predict wanting chaplain visitation.

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Thursday 4:00
"Modifying Measures of Religiosity for Measurement in Diverse Populations"
Devon M. Berry, PhD, RN
Assistant Professor
University of Cincinnati
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Abstract: As the evidence supporting the protective effect of R/S on the lives of young adults grows, efforts to increase the diversity of the populations being researched are needed. Key to this effort is developing measures which assess similar constructs across religious groups while allowing for fidelity to the characteristics and expressions of each particular faith. The aim of this study was to modify existing measures of religiosity and spirituality to be appropriate for Jewish and Muslim young adult populations and to verify their psychometric properties. Expert review and focus groups with Jewish and Muslim young adults were used to inform an iterative process of evaluation and refinement of existing measures. The modified measures were given to groups of Jewish and Muslim high school students via web-based surveys to establish the psychometric qualities. All modified measures were found to have strong to acceptable psychometric qualities, enhancing our ability to assess diverse populations.

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Thursday 4:45
"Mapping Aging and Religion in a Japanese Community"
Jason Danely, PhD
Postdoctoral Fellow
University of Wisconsin Milwaukee
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Abstract: This paper illustrates the cultural construction of healthy aging in urban Japan by examining a neighborhood pilgrimage. Although anthropologists have developed theoretical models of the psychosocial and health effects of pilgrimage, few mention the significance of age or generational cohort. This paper argues that in Japan, where the majority of religious pilgrims are older adults, greater interdisciplinary engagement is needed to understand the connection between aging and religious practice. Using ethnographic data, this paper describes how anthropological and gerontological theories can be used together to explain religious practices. It describes a pilgrimage organized by and for older adults and shows how this pilgrimage draws upon widely shared cultural concepts and symbols that support a sense of purpose and social integration in ways that blur the boundary between religious and secular humanistic concerns. This paper will consider the implications of viewing pilgrimage as a practice for cultivating physical, social and spiritual health.

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Thursday 5:30
"Social Capital, Religious Capital and Latino Immigrant Health"
Ephraim Shapiro, PhD, MPA, MBA
Columbia University
Abstract: While religious involvement has been associated with better health, there is a paucity of theory-driven empirical research on its relationship with immigrants’ health, which typically worsens with acculturation, and an insufficient theoretical framework. The paper will examine the relationship of religious involvement with health status and behaviors for Latino immigrants and explore mechanisms underlying the relationship. Immigrants from Mexico, Guatemala and El Salvador were surveyed as part of the randomized New Immigrant Survey. Outcome measures included health status and behaviors. Multivariate analyses were performed using measures of religious involvement and extensive immigrant and demographic variables. Over 1200 immigrants were surveyed. An association was found between church attendance and health outcomes, with partial mediation by behaviors and support for the hypothesized mechanisms of social capital, social capital magnified and religious capital. Opportunities exist to leverage widespread Latino immigrant church-going by creating innovative church-based interventions to reduce disease and potentially counteract worsening Latino immigrant health.

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Wednesday 2:00
"How Women with Advanced Cancer Pray: A Report from Two Focus Groups"
Amy Rex Smith, DNSc, RN, ACNS, BC
Associate Professor
College of Nursing and Health Sciences
University of Massachusetts Boston
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Co-authors: Susan DeSanto-Madeya, PhD, RN; John Perez, PhD; Elizabeth Tracey, PhD, RN; Rebecca Norris, MA
Abstract: While it is well known that prayer is an effective way of coping for many patients with cancer diagnoses, little is known about how patients actually pray. Qualitative data from two focus groups was collected as part of a pilot cross-sectional study exploring prayer and coping in cancer. All participants were female and had advanced cancer (Stages III and IV). The two groups were outpatients with ovarian cancer (n=8) and lung cancer (n=5). Participants were asked to talk about how they prayed and what prayer did for them. Content analysis of the focus group data identified themes of (1) Finding my own way to transcend; (2) Renewed appreciation for life; (3) Provision of strength and courage; and (4) Gaining a stronger spiritual connection. Findings suggest potential mechanisms in the link between prayer and well-being among female cancer patients. NOTE: This study was funded by 1 U-56 CA118635-01, awarded to the University of Massachusetts Boston and the Dana Farber Cancer Institute, National Institutes of Health, National Cancer Institute.

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Wednesday 2:45
"Inspired by Faith: Using African American Cancer Survivors Testimonies to Promote Breast Cancer Awareness"
Elizabeth A. Williams, PhD
Associate Director of Minority Affairs
Vanderbilt-Ingram Cancer Center
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Co-author: Mary Kelton Smith, RN
Abstract: Communal-contextual pastoral care grounds faith in experience, cultural knowledge and community assets. African American breast cancer survivors‚Äô testimonies can support such care. Testimonies offer catharsis and meaning making for survivors, with added benefits. They can also inspire other‚Äôs cancer prevention. Survivors‚Äô testimonies become forms of community-centered care that aid survivors as they help others. Using Community-based Participatory Research and communal-contextual care approaches, Sisters NetworkÆ Nashville, an African American cancer organization, partnered with Vanderbilt-Ingram Cancer Center and Roland‚Äôs Photography creating an 18-month calendar featuring survivors, faith testimonies, and prevention information. The Fashioned in Faith calendar, part of a pilot, was disseminated during an annual survivorship gala. The project also included an on-line survey measuring the calendar‚Äôs influence on viewers‚Äô behavior. The project‚Äôs rationale, care influences, design, and findings are presented. Findings indicate that culturally-tailored calendars, grounded in communal-contextual care, can effectively communicate information and encourage prevention among those affected by cancer.

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Mediators & Pathways

Wednesday 2:00
"Mediators of Religiosity/Spirituality and Health Outcomes in Adolescents with Asthma"
Sian Cotton, PhD
Research Assistant Professor
Department of Family and Community Medicine
University of Cincinnati Academic Health Center
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Co-authors: Meghan E. McGrady, MA; Paul Succop, PhD
Abstract: Though various mechanisms have been proposed to help explain the R/S-health relationship including social support, optimism, and meaning, few have been tested in adolescents with asthma. This paper will examine possible mediators of the R/S-health relationship in a sample of primarily African-American urban adolescents with asthma. One-hundred fifty-one adolescents (ages 11-18) with asthma completed various measures of R/S, optimism, social support, depression/anxiety, health-related quality of life, risk behaviors, and other measures at 2 time points. Structural equation modeling was used to examine proposed mediators. Social support and optimism did not mediate the R/S-health relationship. Distal R/S variables (e.g., prayer) operated primarily through proximal R/S variables (e.g., meaning) in relation to health outcomes, χ2 =103.9, df=142, p=.99, CFI=1.0. Meaning and comfort/strength from faith were particularly important in explaining the R/S-health link in adolescents with asthma. Meaning-centered interventions and testing competing models should be explored.

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Wednesday 2:45
"Assessing Spiritual Health Locus of Control Beliefs in a Jewish Population"
Cheryl L. Holt, PhD
Associate Professor
School of Public Health, University of Maryland, College Park
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Co-authors: David Hillel Rosmarin, MA; Robert Feldman, PhD; Lee Caplan, MD, PhD; Steven Pirutinsky, BTS
Abstract: Spiritual health locus of control beliefs reflect the perceived role of a higher power (e.g., God) in one’s health outcomes. The psychometric properties of the Spiritual Health Locus of Control scale were examined in a Jewish population. The 13-item instrument was administered to 251 self-identified Jewish people as part of an online survey. The four-factor structure remained intact; however there were several item shifts within the structure resulting from several item adaptations and/or measurement invariance. Subscale internal reliabilities were acceptable, from α = .82 to α = .89. Subscale scores were associated with cancer screening, smoking, alcohol consumption, and physical activity. However, scores were not predictive of depression or physical and emotional functioning. Spiritual health locus of control beliefs appear to function differently in their role in health behaviors/outcomes across demographic subpopulations. This work represents the first examination of the role of these beliefs in health behaviors/outcomes in Jewish people.

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Thursday 4:00
"Spirituality is related to Error-Related Negativity during EEG Measurement"
Michael J. Larson, PhD
Assistant Professor, Clinical Neuropsychology
Brigham Young University
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Co-authors: Patrick R. Steffen, PhD; Daniel Good, BS
Abstract: Recent research suggests religious zeal and belief in God are inversely correlated with a neural reflection of performance monitoring—the error-related negativity (ERN) component of the scalp-recorded event-related potential (ERP). The purpose of this study was to expand upon this research and determine the specific aspects of spirituality that are related to the ERN. Forty-two neurologically and psychiatrically healthy participants completed the Spiritual Assessment Inventory (SAI) and an Eriksen Flanker task while ERPs were recorded. Pearson’s correlation analyses and partial correlations controlling for the potential contribution of negative affect indicated that error-trial minus correct-trial ERN amplitude was positively correlated with the Disappointment and Instability Scales of the SAI. Smaller ERN amplitudes were associated with higher levels of disappointment and instability in participants’ reported relationships with God. These findings stand in contrast to previous research indicating increased belief in God decreases error-related ERPs. Implications and potential mechanisms are discussed.

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Thursday 4:45
"Religious Factors, Hippocampal Atrophy, and Mental Health Outcomes in Late Life"
Amy Owen, PhD
Postdoctoral Fellow
Center for Spirituality, Theology and Health
Duke University Medical Center
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Co-authors: R. David Hayward, PhD; Harold G. Koenig, MD; David C. Steffens, MD, MHS; Martha E. Payne, PhD, MPH, RD
Abstract: Religious factors such as group membership and practice have been found to decrease the occurrence and severity of late-life depression. Late-life depression and cognitive impairment have been associated with atrophy of the hippocampus, a brain region critical to long-term memory and one that is highly susceptible to stress-related damage. Religious factors may also be linked to rates of decline in hippocampal volumes. The current study explores potential physiological pathways (including hippocampal atrophy) by which religion may influence late-life depression and cognitive impairment. Longitudinal data from a 15-year study of depressed older adults were examined, including religious factors, changes in brain structure identified using magnetic resonance imaging (MRI) scans, depression severity, and cognitive impairment. These findings have important implications for both theory related to spirituality and health, and treatment of depression in older adults.

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Thursday 5:30
"Understanding the Connection between Spiritual Well-Being and Physical Health: An Examination of Ambulatory Blood Pressure, Inflammation, and Cholesterol"
Patrick R. Steffen, PhD
Associate Professor, Clinical Health Psychology
Brigham Young University
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Co-authors: Julianne Holt-Lunstad, PhD; Jonathan Sandberg, PhD; Bryan Jensen, BS Abstract: Growing research is demonstrating a link between spirituality and better health; however, little is known about possible physiological mechanisms. In a sample of healthy male and female adults (n=74) ages 19-59 (m=28.28) we examined the influence of spiritual well-being, as measured by the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being (FACIT-SP), on physiological risk factors for CHD. Specifically we examined 24-hour ambulatory blood pressure (ABP), inflammation (hs-CRP), glucose, and cholesterol. Regression analyses reveal that higher levels of spiritual-wellness (total FACIT-SP score) was significantly related to lower ASBP (β=-.34; p<.01), ADBP (β=-.25; p<.05), hs-CRP (β=-.34; p<.01), glucose (β=-.39; p=.001), and marginally lower for triglycerides (β=-.21; p=.09) and VLDL (β=-.21; p=.10) controlling for age, gender, and church attendance. Results remained consistent across the Meaning, Faith and Additional Spiritual Concerns subscales but not for the Peace subscale of the FACIT-SP. Therefore spiritual well-being may be cardioprotective.

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Religious Organizations & Public Health

Thursday 4:00
"Interdisciplinary Professional Education: Spirituality, Health and the Common Good"
Mark Jensen, PhD
Professor of Pastoral Care
Wake Forest University School of Divinity
Co-presenters: Steven Virgil, JD; Mark Knudson, MD; Steven Block, MBBCH; Jill Crainshaw, PhD
Abstract: This paper describes a cross-disciplinary course offered by WFU Schools of Medicine, Law, and Divinity, in which students from the three professional schools engaged in a travel course of observation and participation with NGOs in Managua, Nicaragua, focusing on public health. The aim of the course is to facilitate reflection and cross-disciplinary encounter and discussion on the role of the professions in promoting the public good. Particular discussions will focus on study in the cross-cultural context of places where law, medicine, and religion/theology intersect in matters of health access and health practices. The paper will reflect on issues in professional education, with particular emphasis on how an experiential, cross-disciplinary course affects professional identity.

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Thursday 4:45
"The Face of Mosque-Based Emotional Support"
Ann Nguyen
Doctoral Student
University of Michigan, Ann Arbor
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Co-authors: Aaron Ahuvia, PhD; David Chatkoff, PhD; Elif Izberk-Bilgin, PhD; Fiona Lee, PhD; Susana Pecina, PhD
Abstract: Congregational support has been extensively examined within the Christian population but not among Muslim Americans. The purpose of this study is to identify factors that predict the receiving and giving of mosque-based emotional support. Multiple regression analyses were based on a sample of 143 respondents. Results showed that women were more likely to receive support. Receipt of support was negatively related to age and positively related to mosque attendance. Similar results were found in terms of anticipated emotional support. Women were more likely to anticipate receipt of support. Anticipated receipt of support was negatively associated with age and positively related to mosque attendance. With reference to giving emotional support to congregation members, women were also more likely to give support. Giving support was positively related to mosque attendance. Overall, the results of this study are consistent with trends of Christian congregational support. Moreover, these findings have implications for Muslim mental and physical health.

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Thursday 5:30
"Baby Boomer Spirituality in Transition to the Third Age"
Dale Alan Young, DMin, BCC
Director, Congregational Health
Baptist Health South Florida
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Abstract: The doctoral project, "Baby Boomer Spirituality: Exploring Models of Spirituality in Preparation for the Third Age" explores the spirituality of mainline protestant baby boomers in Miami who are in transition to retirement. The project identifies social, spiritual and health challenges faced by boomers in transition to the Third Age. The research question is: Are baby boomers able to connect their life story to their spiritual narrative in a way that prepares them to plan for their Third Age? The research method: a before/ after comparison of boomers who participated in a baby boomer spirituality course. Additionally, boomers who did not take the course were asked the same questions. The research evaluates the results, hoping to better understand the ability of boomers to integrate their life story with their spiritual narrative and the implications for health and a meaningful Third Age.

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Spirituality & Clinical Care

Wednesday 2:00
"Assessments of Spiritual Expression in the Workplace from over 6000 Caregivers: Unit-level Effects and Relationships to Teamwork and Patient Safety Norms"
J. Bryan Sexton, PhD, MA
Director of Patient Safety, Research and Training
Duke University Health System
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Co-authors: Laura Maynard, MDiv; Keith R. Doram, MD, MBA, FACP; Karen S. Frush, MD
Abstract: Spirituality makes a substantial contribution to many people's private and public identities. Theory and research in psychology, organizational behavior, and quality improvement however, have largely neglected the intersection of spirituality and the workplace. Here, we attempt to examine individual attitudes regarding spiritual expression in the workplace. Using surveys collected from 3,831 providers (physicians, nurses, and technicians) of 68 hospital operating rooms (ORs) and 2,688 providers of 85 intensive care units (ICUs) we examine the relationship between organizational membership and individual attitudes regarding spiritual expression in the workplace. In both the OR sample and the ICU sample, unit membership explains a significant portion of the variance in individual attitudes (p<.0001). Said differently, there is more variability in individual assessments of workplace spiritual expression between units than there is within units. Additionally, there were significant positive relationships between respondent comfort with expressing spirituality, and positive assessments teamwork and patient safety norms.

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Wednesday 2:45
"Anomalous, Paranormal, or Sacred Moments in Psychotherapy"
James W. Lomax, MD
Karl Menninger Professor of Psychiatry
Baylor College of Medicine and Rice University
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Co-presenters: Jeff Kripal, PhD; Kenneth Pargament, PhD
Abstract: This paper begins with a clinical vignette describing a powerful emotional experience which could be characterized a variety of ways including sacred, paranormal, or anomalous. Dr. Lomax will focus on the clinical material and understanding. Dr. Kripal provides a historical perspective on paranormal phenomena and how they may relate to a particular religious experience. Dr. Pargament describes the concept of Sacred moments in Psychotherapy from a clinical and research perspective.

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Thursday 4:00
"Noli me tangere: Art History and the Touch of Healthcare Chaplaincy"
Michael Hirsch, MDiv
Chaplain
Dana-Farber Cancer Institute
Adjunct Professor of Art History
Post University
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Abstract: Western medicine is fundamentally a medicine of touch. Whether feeling for swollen glands or massaging the heart, Western medicine constitutes a haptic relationship between clinician and patient. The chaplain’s touch however is discretionary; it is spiritual. We accept the physician’s "therapeutic" touch, but touch and its communicative significance, biopolitical consequences, and theological implications have recently fallen under the scrutiny of philosophically-minded thinkers. Jean-Luc Nancy’s recent study of noli me tangere paintings from the Renaissance explores the problem of a resurrected Christ who wishes not to be held back from his providential assumption into heaven and demands not to be touched. This paper explores the touch of chaplaincy in the places where spiritual touch is experienced as transgressive or lacking. A study of art history can prepare chaplains for a ministry of spiritual care in which one recognizes the complexity and sacrality of the human body in all its political and theological dimensions.

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Thursday 4:45
"Coping in the Next Pregnancy after a Traumatic Loss"
F. Susan Cowchock, MAHL, MD
Senior Research Associate
Center for Spirituality, Theology and Health
Duke University Medical Center
Co-authors: Keith G. Meador, MD, ThM, MPH, Sarah C. Ellestad, MD; Geeta K. Swamy, MD
Abstract: We wanted to determine how well women are coping and to evaluate the role of religion in positive coping during pregnancy after a traumatic loss. Thus far, 13 women have completed the Hoge Intrinsic Religiosity scale, questions about congregational support, the Impact of Event Scale (IES), the short form of the Perinatal Grief Scale (PGS), the GAD-7 (generalized anxiety), and the Duke Brief Depression Scale. 77% interviewed had scores above the screening cutoff values on 1 or more scales. PGS scores correlated with IES scores and GAD scores. Scores on the Hoge scale were inversely correlated with PGS scores. Women pregnant again after a traumatic loss are very likely to suffer from symptoms of acute and complicated grief. This is true even when the mother has other children and after she has received reassuring prenatal test results. Higher levels of religiosity are associated with lower levels of grief.

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Thursday 5:30
"Culturally Supportive Spiritual Care with Latino/Hispanic Families of Limited English Proficiency (LEP) in Western Medicine and U.S. Socio-Political Contexts"
Roger Velasquez, DMin, MDiv
Chaplain
Duke University Medical Center
Co-presenters: Annette Olsen, MDiv, BSSW; Rebecca Reyes, MDiv, MSW Abstract: This panel of presenters will (1) define terms & briefly reference cultural histories while addressing the spectrum of religious/spiritual and demographic diversity within U.S. Latino & Hispanic communities, (2) explore respectful strategies for clinically & pastorally approaching Latino/Hispanic families of LEP that are founded upon theological, social, and linguistic analysis, (3) narratively review case examples describing the effects of cultural barriers & cultural brokering on families experiences of "care", and (4) offer handouts, bibliography, and suggested methods for personal, professional, and institutional growth/commitment to routinely offer members of U.S. based Latino/Hispanic communities culturally supportive medical & spiritual care, particularly those experiencing the compounding negative effects of LEP.

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Theological Considerations

Wednesday 2:00
"Agents of God, Agents of Health"
Jackson H. Day, MDiv, MPH, DMin
Wesley Theological Seminary
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Abstract: "Agents of God, Agents of Health," a fourteen-week curriculum intended for congregational audiences, was developed and conducted in 2009 in five United Methodist congregations with the objective of helping participants link their faith understanding with contemporary issues in the field of health. The curriculum links fourteen biblical stories with a range of contemporary health issues. For insteance, the Canaanite Woman session (Matthew 15:21-29), links hutzpah with health disparities, and Ezekiel (34:1-4) focuses on the health care obligations of government. An underlying theological thread is the identification, celebration, and promotion of agency – individual, divine and community – as an essential component of health. A Knowledge, Attitudes and Practice survey administered at the first and last class session provided insights into participant thinking on the issues discussed and suggests that some changes were achieved during the time period of the course. Participants rated the experience highly in a post-course evaluation.

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Wednesday 2:45
"Feeding Your Demons: An Appropriate Intersection of Buddhism, Psychology, and Western Needs?"
Daphna McKnight, MEd, MA
Graduate Student, Program for Buddhist Studies
University of the West
Abstract: "Experts" are staking claims in the emerging market of "Western-Buddhist Psychology." While some are suspect, others legitimately attempt to translate Asian-Buddhist practices for Western cultures. As the public becomes more aware of the efficacy of some Buddhist meditation, emerging Westernized practices should be investigated for legitimacy of both Buddhist heritage and health benefits. This paper investigates the "Western-Buddhist Psychology" practice, "Feeding Your Demons." The paper examines whether the practice can legitimately claim lineage with Tibetan Buddhist practices of Chöd; it then analyzes aspects attributed more readily to Western psychology, determining the extent of influence and whether connection to Western modalities could indicate efficacy and research potential of "Feeding Your Demons." Upon initial investigation, this practice appears to be primarily Buddhist-influenced, yet draws its psychological techniques from both East and West. This practice merits further study of its psychological benefits and its attempts to integrate Buddhism into Western cultures.

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Thursday 4:00
"Ordering ‚ Mental Disorder: Theology and the Disputed Boundaries of Psychiatric Diagnosis"
Warren Kinghorn, MD, MTS
Consulting Associate in Psychiatry
Duke University Medical Center
Student, Doctor of Theology Program
Duke Divinity School
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Abstract: The concept of "mental disorder" exerts great power within health care delivery systems, including many "faith-based" organizations, and yet – as recent controversy surrounding the in-process revision of the _Diagnostic and Statistical Manual of Mental Disorders (DSM)_ makes clear – it remains a disputed and conceptually elusive term. This paper will engage the proposed definition of "mental disorder" for _DSM-V_ (forthcoming 2013) in order to argue that, despite considerable philosophical effort, the _DSM_ architects are unable to define "distress," "disability," and "dysfunction" other than by recourse to subjective patient or clinician judgment, providing no internal safeguard against the consumer-driven medicalization of suffering or against Foucauldian/Nietzschean deconstructive critiques. Coherent psychiatric diagnosis "at the margins" requires, rather, a tradition-centered conception of the proper human good sufficient to render the concepts of "disability," "dysfunction," and "disorder" philosophically and practically intelligible. But this, for religious practitioners, makes the determination of "mental disorder" a properly theological task.

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Thursday 4:45
"The Effects of Negative Religious Rhetoric and Stereotype Priming on People with Disabilities and Chronic Health Conditions"
Devorah Greenstein, MDiv, PhD
Visiting Fellow
Yale Divinity School
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Abstract: Dominant Christian symbolism from the Old and New Testaments uses rhetoric that perpetuates negative cultural understandings of what it means to be a person with a disability or chronic health condition. Contemporary religious leaders commonly use negative stereotypical scriptural images and metaphors that link disabilities and chronic health conditions with sin, despair, affliction, and lack of faith. An individual’s exposure to negative race- or gender-related stereotypic rhetoric in one setting is linked to stereotype priming that contributes to negative attitudes toward people of color and women in other settings. I argue that similar priming occurs around disability and chronic health conditions. I suggest this as a reason that only 7% of people with disabilities attend church, depriving them of key sources of support. Further, exposure to negative disability/illness rhetoric in religious settings primes and unintentionally distorts attitudes of health providers and others without disabilities, further marginalizing people with disabilities/health conditions.

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Thursday 5:30
"Lament as a Practical Theological Lens for Autism Spectrum Disorders"
Mary Lynn Dell, MD, DMin
Associate Professor of Psychiatry, Pediatrics, and Bioethics
Case Western Reserve University School of Medicine
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Abstract: Autism spectrum disorders raise unique theological and pastoral issues for clergy and faith communities. Little education about autism, theological reflection, and discussion of the pastoral needs have occurred in the life and work of the church. Similarly, medical and psychiatric practitioners may not have a framework for understanding the complex relationships of religious/spiritual beliefs and practices and the grief, anger, fatigue, and other emotional stresses associated with individuals with autistic spectrum disorders and their caregivers. This project seeks to fill this void, utilizing the biblical genre of lament, the book of Lamentations, and the scholarship of Kathleen O’Connor and Walter Brueggemann to establish a theological framework for understanding autistic individuals and those who love and care for them. This work also provides an overview of medical information about autism spectrum disorders in terms accessible and helpful to pastors, congregations, and medical professionals unfamiliar with practical concerns associated with daily life.

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