Evidence is presented that bears on 9 hypotheses about the link between religion or spirituality and mortality, morbidity, disability, or recovery from illness. In healthy participants, there is a strong, consistent, prospective, and often graded reduction in risk of mortality in church/service attenders. This reduction is approximately 25% after adjustment for confounders. Religion or spirituality protects against cardiovascular disease, largely mediated by the healthy lifestyle it encourages. Evidence fails to support a link between depth of religiousness and physical health. In patients, there are consistent failures to support the hypotheses that religion or spirituality slows the progression of cancer or improves recovery from acute illness but some evidence that religion or spirituality impedes recovery from acute illness. The authors conclude that church/service attendance protects healthy people against death. More methodologically sound studies are needed.

To advance knowledge in the study of spirituality and physical health, we examined sociodemographic, behavioral, and attitudinal correlates of self-perceptions of spirituality. Participants were a nationally representative sample of 1,422 adult respondents to the 1998 General Social Survey. They were asked, among other things, to rate themselves on the depth of their spirituality and the depth of their religiousness. Results indicated that, after adjustment for religiousness, self-perceptions of spirituality were positively correlated with being female (r = .07, p < .01), having a higher education (r = .12, p < .001), and having no religion (r = .10, p < .001) and inversely correlated with age (r = -.06, p < .05) and being Catholic (r = -.08, p < .01). After adjustment for these sociodemographic factors, self-perceptions of spirituality were associated with high levels of religious or spiritual activities (range in correlations = .12-.38, all p < .001), low cynical mistrust, and low political conservatism (both r = -.08, p < .01). The population was divided into 4 groups based on their self-perceptions of degree of spirituality and degree of religiousness. The spiritual and religious group had a higherfrequency of attending services, praying, meditating, reading the Bible, and daily spiritual experience than any of the other 3 groups (all differences p < .05) and had less distress and less mistrust than the religious-only group (p < .05 for both). However, they were also more intolerant than either of the nonreligious groups (p < .05 for both) and similar on intolerance to the religious-only group. We conclude that sociodemographicfactors could confound any observed association between spirituality and health and should be controlled. Moreover, individuals who perceive themselves to be both spiritual and religious may be at particularly low risk for morbidity and mortality based on their good psychological status and ongoing restorative activities.

Autonomic dysregulation has been hypothesized to play a role in the relationships between psychopathology and cardiovascular risk. An important transdiagnostic factor that has been associated with autonomic dysfunction is perseverative cognition (PC), mainly present in Major Depressive Disorder (MDD) in the form of rumination. As the ability to adaptively let our mind wander without ruminating is critical to mental health, this study aimed to examine the autonomic concomitants of functional vs. dysfunctional intrusive thoughts in MDD. Ambulatory heart rate (HR) and variability (HRV) of 18 MDD subjects and 18 healthy controls were recorded for 24 h. Approximately every 30 min during waking hours subjects reported their ongoing thoughts and moods using electronic diaries. Random regression models were performed. Compared to controls, MDD subjects were more often caught during episodes of PC. In both groups, PC required more effort to be inhibited and interfered more with ongoing activities compared to mind wandering (MW) (ps < 0.0001). This cognitive rigidity was mirrored by autonomic inflexibility, as PC was characterized by lower HRV (p < 0.0001) compared to MW. A worse mood was reported by MDD patients compared to controls, independently of their ongoing cognitive process. Controls, however, showed the highest mood worsening during PC compared to being on task and MW. HRV during rumination correlated with self-reported somatic symptoms on the same day and several dispositional traits. MDD subjects showed lower HRV during sleep, which correlated with hopelessness rumination. Results show that PC is associated with autonomic dysfunctions in both healthy and MDD subjects. Understanding when spontaneous thought is adaptive and when it is not may clarify its role in the etiology of mood disorders, shedding light on the still unexplained association between psychopathology, chronic stress, and risk for health.

With limited efficacy of medications for symptom relief, non-medication treatments may play an important role in the treatment of irritable bowel syndrome (IBS), the most common functional gastrointestinal (GI) disorder. This study aimed to evaluate the efficacy of two self-regulation strategies for symptom relief and mood management in IBS patients. Thirty-five adult participants meeting ROME III criteria for IBS were enrolled, 27 of the 35 participants (77%) completed treatment and pre- and post-treatment visits (89% women, 11% men; M (SD) age = 36 (13)), and 20 of the 27 (74%) completed a 6-month follow-up. Participants were randomly assigned to 16 biweekly group sessions of Iyengar yoga or a walking program. Results indicated a significant group by time interaction on negative affect with the walking treatment showing improvement from pre- to post-treatment when compared to yoga (p < .05). There was no significant group by time effect on IBS severity. Exploratory analyses of secondary outcomes examined change separately for each treatment condition. From pre- to post-treatment, yoga showed significant decreases in IBS severity measures (p < .05), visceral sensitivity (p < .05), and severity of somatic symptoms (p < .05). Walking showed significant decreases in overall GI symptoms (p < .05), negative affect (p < .05), and state anxiety (p < .05). At 6-month follow-up, overall GI symptoms for walking continued to significantly decline, while for yoga, GI symptoms rebounded toward baseline levels (p < .05). When asked about self-regulated home practice at 6 months, significantly more participants in walking than in yoga practiced at least weekly (p < .05). In sum, results suggest that yoga and walking as movement-based self-regulatory behavioral treatments have some differential effects but are both beneficial for IBS patients, though maintenance of a self-regulated walking program may be more feasible and therefore more effective long term.

Objective This study was conducted to present evidence of differences in autonomic regulation of cardiovascular activity and its role in the severity of specific (disease-related) and non-specific (negative affect and chronic pain-related) symptoms in individuals with Irritable Bowel Syndrome (IBS). Methods Seventy-eight female patients with IBS and 27 healthy women age 18–62 years were assessed for IBS symptoms, negative affect, and baroreceptor sensitivity (BRS), blood pressure (BP), heart rate, and heart rate variability (HRV) at rest. Direct and indirect regression effects were examined with application of the bootstrap procedure to validate findings. Results IBS was reliably related to lower resting BRS, higher BP, and higher negative affect compared to healthy controls. Longer disease duration (chronicity) was related to BRS decrease coupled with systolic BP increase (95% CIs = -0.14 to -0.01). Three autonomic mechanisms associated with BRS decrease were found to further regulate severity of IBS symptoms. Lower BRS was related to higher IBS severity in general if the effect was transferred through the decrease of low frequency power of HRV (e.g., 95% CIs = -0.039 to -0.001 for abdominal pain severity). However, lower BRS was related to lower IBS severity in general if the effect was transferred through diastolic BP increase (95% CIs = 0.01 to 0.11 for abdominal pain severity). Lower BRS was related to higher abdominal pain severity coupled with high negative affect if the effect was transferred through the decrease of higher frequency power of HRV (95% CIs = -0.026 to -0.003). Conclusions These findings indicate that different cardiovascular mechanisms are associated with IBS development and the increase and decrease of severity of IBS symptoms. Their assessment suggests ways to personalize treatment of IBS.