Religion, Spirituality and Longevity is Stress Buffering a Explaining Variable?

Transkript

1 Conference on Research in Faith and Health in Secular Society, May 17-19, 2010, University of Southern Denmark Paper Session: Religion and long life what are the confounders, what are explaining variables? Religion, Spirituality and Longevity is Stress Buffering a Explaining Variable? René Hefti, M.D. Head of Psychosomatic Department, Clinic SGM Lecturer for Psychosocial Medicine, University of Bern Research Institute of Spirituality and Health

2 Personal Background - Medical School at the University of Zurich - Clinical training in internal medicine and noninvasive cardiology - Interest in psychosomatic medicine and religion/spirituality & health - Head of psychosomatic department and lecturer at the University of Bern - Head of the Research Institute for Spirituality and Health (RISH)

3 Psychosomatic Department

4 Introduction - There is growing evidence for a link between religion/ spirituality and health (Koenig et al.) - There is also evidence that religious involvement is associated with lower mortality (Chida et al.)

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7 salutogenetic aspect of religiosity/spirituality

8 not a clear association/influence of r/s

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12 20% risk reduction in coronary death

13 Possible Mechanims Life stile factors = healthier life stile Improved social support, better networks Improved coping behavior, religious coping More positive emotions, optimism better mental health less psychological distress Stress buffering effect of R/S?

14 Cardiovascular Reactivity - Important concept in psychosomatic medicine - Cardiovascular response to mental (Stroop), social (TSST) and physical challenges - Typical measures: - Heart Rate (HR) and Heart Rate Variability (HRV) - Blood Pressure (BP), Blood Pressure Variability (BPV) - Cardiac output (CO) and pre-ejection period (PEP) - Psychophysiological risk factor for cardiovascular disease (Hypertension, CAD) - Individual differences in cv reactivity are determined by complex mechanisms (Lovallo)

15 Cardiovascular Reactivity Religiositiy Three level model - The fronto-limbic system (cognitions and emotions) - Hypothalamus and brainstem (regulatory centers, configure outputs to the body) - Peripheral Organs (different response characteristic) - Lovallo 2005

16 CVR and Religiosity Masters et al. 2004

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18 CV REACTIVITY PROJECT Clinic SGM & RISH Universitiy of Bern

19 CV REACTIVITY PROJECT Master thesis of Sibylle Probst & Robert Pfandl, psychology students at the University of Bern 40 patients with mild to severe depression Assessment of medical history and medications (cardiovascular. psychiatric) Assessment of BDI, SCL, S-R-T (centrality, emotions towards God) and RCOPE Mental stress testing = Color-Stroop

20 Structure of Religiosity Test

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22 Stress testing / protocol We assessed BP (syst/diast), HR and HRV according the following protocol info baseline Stroop test 1 recov 1 Stroop test 2 recov 2 Verlauf HF HF BL HF Stroop1 HF Rec1 HF Stroop2 HF Rec2

23 Sample characteristics

24 Sample Characteristics

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26 Physiological Parameters

27 Physiological Parameters

28 Physiological Parameters

29 Course of HR/HRV during Stroop Verlauf HF HF BL HF Stroop1 HF Rec1 HF Stroop2 HF Rec2 Verlauf HRV HRV BL HRV Stroop1 HRV Rec1 HRV Stroop2 HRV Rec2

30 BP-Reactivity during Stroop Verlauf SBD SBD BL SBD Stroop1 SBD Rec1 SBD Stroop2 SBD Rec2 Verlauf DBD DBD BL DBD Stroop1 DBD Rec1 DBD Stroop2 DBD Rec2

31 Linear Regression Model Modell Aufgenommene/Entfernte Variablen b Aufgenomme Entfernte ne Variablen Variablen Methode sex Geschlecht, age Alter a. Eingeben BDIeS1 BDI-Wert a. Eingeben RSTeS10 Zentralität a. Eingeben a. Alle gewünschten Variablen wurden aufgenommen. b. Abhängige Variable: DSt1SBD Reaktivität SBD Stroop1-BL Results: - Religiosity (centrality) explained 20% of the variance of BP-reactivity - Age, sex and BDI explained less than 10% Modellzusammenfassung Modell Änderungsstatistiken Standardf Änderung in Korrigiertes ehler des Änderung in Signifikanz R R-Quadrat R-Quadrat Schätzers R-Quadrat Änderung in F df1 df2 von F.282 a b c a. Einflußvariablen : (Konstante), sex Geschlecht, age Alter b. Einflußvariablen : (Konstante), sex Geschlecht, age Alter, BDIeS1 BDI-Wert c. Einflußvariablen : (Konstante), sex Geschlecht, age Alter, BDIeS1 BDI-Wert, RSTeS10 Zentralität

32 Discussion /Conclusion There is evidence for a stress buffering effect of religiosity on cardiovascular reactivity in depressed patients Clearly for BP-reactivity Possibly also for HR/HRV How does medication influence this association? Further analyses and testing of the hypotheses is needed