Abstract
We examined the association between different types of prayer and depressive symptoms—with rumination and social support as potential mediators—in a sample of predominantly White, Christian, and female ambulatory cancer patients. In a cross-sectional design, 179 adult cancer outpatients completed measures of prayer, rumination, social support, depressive symptoms, and demographic variables. Type and stage of cancer were collected from electronic medical charts. Depressive symptoms were negatively correlated with adoration prayer (r = −.15), reception prayer (r = −.17), thanksgiving prayer (r = −.29), and prayer for the well-being of others (r = −.26). In the path analysis, rumination fully mediated the link between thanksgiving prayer and depressive symptoms (β for indirect effect = −.05), whereas social support partially mediated the link between prayer for others and depressive symptoms (β for indirect effect = −.05). These findings suggest that unique mechanisms may link different prayer types to lower depressive symptoms among cancer patients.
Similar content being viewed by others
References
Ai, A. L., Corley, C. S., Peterson, C., Huang, B., & Tice, T. N. (2009a). Private prayer and quality of life in cardiac patients: Pathways of cognitive coping and social support. Social Work in Health Care, 48, 471–494. doi:10.1080/00981380802589829
Ai, A. L., Park, C. L., Huang, B., Rodgers, W., & Tice, T. N. (2007). Psychosocial mediation of religious coping styles: A study of short-term psychological distress following cardiac surgery. Personality and Social Psychology Bulletin, 33, 867–882. doi:10.1177/0146167207301008
Ai, A. L., Tice, T. N., Huang, B., Rodgers, W., & Bolling, S. F. (2008). Types of prayer, optimism, and well-being of middle-aged and older patients undergoing open-heart surgery. Mental Health, Religion & Culture, 11, 131–150. doi:10.1080/13674670701324798
Ai, A. L., Tice, T. N., & Kelsey, C. L. (2009b). Coping after 9/11: Deep interconnectedness and struggle in posttraumatic stress and growth. In M. Morgan (Ed.), The impact of 9/11 on psychology and education: The day that changed everything? (pp. 115–138). New York: Palgrave MacMillan.
Ai, A. L., Tice, T. N., Peterson, C., & Huang, B. (2005). Prayers, spiritual support, and positive attitudes in coping with the September 11 national crisis. Journal of Personality, 73, 763–791. doi:10.1111/j.1467-6494.2005.00328.x
Borgonovi, F. (2008). Doing well by doing good: The relationship between formal volunteering and self-reported health and happiness. Social Science and Medicine, 66, 2321–2334. doi:10.1016/j.socscimed.2008.01.011
Breslin, M. J., & Lewis, C. A. (2008). Theoretical models of the nature of prayer and health: A review. Mental Health, Religion and Culture, 11, 9–21. doi:10.1080/13674670701491449
Emmons, R. A., & Kneezel, T. T. (2005). Giving thanks: Spiritual and religious correlates of gratitude. Journal of Psychology and Christianity, 24, 140–148.
Emmons, R. A., & McCullough, M. E. (2003). Counting blessings versus burdens: An experimental investigation of gratitude and subjective well-being in daily life. Journal of Personality and Social Psychology, 84, 377–389. doi:10.1037/0022-3514.84.2.377
Evans, D. L., Charney, D. S., Lewis, L., Golden, R. N., Gorman, J. M., Krishnan, K. R. R., et al. (2005). Mood disorders in the medically ill: Scientific review and recommendations. Biological Psychiatry, 58, 175–189. doi:10.1016/j.biopsych.2005.05.001
Folkman, S., & Moskowitz, J. T. (2000). Positive affect and the other side of coping. American Psychologist, 55, 647–654. doi:10.1037/0003-066X.55.6.647
Foster, R. (1992). Prayer: Finding the heart’s true home. New York: Harper Collins.
Fox, J. (1991). Regression diagnostics. Newbury Park, CA: Sage Publications.
Gall, T. L., & Cornblat, M. W. (2002). Breast cancer survivors give voice: A qualitative analysis of spiritual factors in long-term adjustment. Psycho-Oncology, 11, 524–535. doi:10.1002/pon.613
Hann, D., Winter, K., & Jacobsen, P. (1999). Measurement of depressive symptoms in cancer patients: Evaluation of the Center for Epidemiological Studies Depression Scale (CES-D). Journal of Psychosomatic Research, 46, 437–443. doi:10.1016/S0022-3999(99)00004-5
Howsepian, B. A., & Merluzzi, T. V. (2009). Religious beliefs, social support, self-efficacy and adjustment to cancer. Psycho-Oncology, 18, 1069–1079. doi:10.1002/pon.1442
Jöreskog, K., & Sörbom, D. (1996). LISREL 8: User’s reference guide. Chicago, IL: Scientific Software International.
Koenig, H. G., McCullough, M. E., & Larson, D. B. (2001). Handbook of religion and health. New York: Oxford University Press.
Koenig, H. G., Pargament, K. I., & Nielsen, J. (1998). Religious coping and health status in medically ill hospitalized older adults. Journal of Nervous and Mental Disease, 186, 513–521. doi:10.1097/00005053-199809000-00001
Krause, N. (2003). Praying for others, financial strain, and physical health status in late life. Journal for the Scientific Study of Religion, 42, 377–391. doi:10.1111/1468-5906.00189
Krause, N. (2009). Church-based volunteering, providing informal support at church, and self-rated health in late life. Journal of Aging and Health, 21, 63–84. doi:10.1177/0898264308328638
Krause, N., Chatters, L. M., Meltzer, T., & Morgan, D. L. (2000). Using focus groups to explore the nature of focus groups in late life. Journal of Aging Studies, 14, 191–212. doi:10.1016/S0890-4065(00)80011-0
Ladd, K. L., & McIntosh, D. N. (2008). Meaning, God, and prayer: Physical and metaphysical aspects of social support. Mental Health, Religion & Culture, 11, 23–38. doi:10.1080/13674670701475053
Ladd, K. L., & Spilka, B. (2002). Inward, outward, and upward: Cognitive aspects of prayer. Journal for the Scientific Study of Religion, 41, 475–484. doi:10.1111/1468-5906.00131
Ladd, K. L., & Spilka, B. (2006). Inward, outward, upward prayer: Scale reliability and validation. Journal for the Scientific Study of Religion, 45, 233–251. doi:10.1111/j.1468-5906.2006.00303.x
Laird, S. P., Snyder, C. R., Rapoff, M. A., & Green, S. (2004). Measuring private prayer: Development, validation, and clinical application of the multidimensional prayer inventory. International Journal for the Psychology of Religion, 14, 251–272. doi:10.1207/s15327582ijpr1404_2
Lambert, N. M., Fincham, F. D., Braithwaite, S. R., Graham, S. M., & Beach, S. R. H. (2009). Can prayer increase gratitude? Psychology of Religion and Spirituality, 1, 139–149. doi:10.1037/a0016731
Lambert, N. M., Fincham, F. D., Stillman, T. F., Graham, S. M., & Beach, S. R. H. (2010). Motivating change in relationships: Can prayer increase forgiveness? Psychological Science, 21, 126–132. doi:10.1177/0956797609355634
Levine, E. G., Aviv, C., Yoo, G., Ewing, C., & Au, A. (2009). The benefits of prayer on mood and well-being of breast cancer survivors. Supportive Care in Cancer, 17, 295–306. doi:10.1007/s00520-008-0482-5
Masters, K. S., & Spielmans, G. I. (2007). Prayer and health: Review, meta-analysis, and research agenda. Journal of Behavioral Medicine, 30, 329–338. doi:10.1007/s10865-007-9106-7
Masters, K. S., Spielmans, G. I., & Goodson, J. T. (2006). Are there demonstrable effects of distant intercessory prayer? A meta-analytic review. Annals of Behavioral Medicine, 32, 21–26. doi:10.1207/s15324796abm3201_3
McCullough, M. E. (2000). Forgiveness as human strength: Theory, measurement, and links to well-being. Journal of Social and Clinical Psychology, 19, 43–55.
McCullough, M. E., Emmons, R. A., & Tsang, J. (2002). The grateful disposition: A conceptual and empirical topography. Journal of Personality and Social Psychology, 82, 112–127. doi:10.1037/0022-3514.82.1.112
McCullough, M. E., & Larson, D. B. (1999). Prayer. In W. R. Miller (Ed.), Integrating spirituality into treatment: Resources for practitioners (pp. 85–110). Washington, DC: American Psychological Association.
Meraviglia, M. G. (2002). Prayer in people with cancer. Cancer Nursing, 25, 326–331. doi:10.1097/00002820-200208000-00010
Mor, N., & Winquist, J. (2002). Self-focused attention and negative affect: A meta-analysis. Psychological Bulletin, 128, 638–662. doi:10.1037/0033-2909.128.4.638
Nolen-Hoeksema, S. (1991). Responses to depression and their effects on the duration of depressive episodes. Journal of Abnormal Psychology, 100, 569–582. doi:10.1037/0021-843X.100.4.569
Nolen-Hoeksema, S., Wisco, B. E., & Lyubomirsky, S. (2008). Rethinking rumination. Perspectives on Psychological Science, 3, 400–424. doi:10.1111/j.1745-6924.2008.00088.x
Norris, R. L., Pérez, J. E., & Canenguez, K. (2009). From cancer to caring: Survivors experience well-being through positive reappraisal and giving back within a religious community. Poster session presented at the American Psychological Association Division 36 mid-year conference on religion and spirituality, Columbia, MD.
O’Laoire, S. (1997). An experimental study of the effects of distant, intercessory prayer on self-esteem, anxiety, and depression. Alternative Therapies in Health and Medicine, 3, 38–53.
Onitilo, A. A., Nietert, P. J., & Egede, L. E. (2006). Effect of depression on all-cause mortality in adults with cancer and differential effects by cancer site. General Hospital Psychiatry, 28, 396–402. doi:10.1016/j.genhosppsych.2006.05.006
Pargament, K. I. (2002). The bitter and the sweet: An evaluation of the costs and benefits of religiousness. Psychological Inquiry, 13, 168–181. doi:10.1207/S15327965PLI1303_02
Pérez, J. E., Chartier, M., Koopman, C., Vosvick, M., Gore-Felton, C., & Spiegel, D. (2009a). Spiritual striving, acceptance coping, and depressive symptoms among adults living with HIV/AIDS. Journal of Health Psychology, 14, 88–97. doi:10.1177/1359105308097949
Pérez, J. E., Little, T. D., & Henrich, C. C. (2009b). Spirituality and depressive symptoms in a school-based sample of adolescents: A longitudinal examination of mediated and moderated effects. Journal of Adolescent Health, 44, 380–386. doi:10.1016/j.jadohealth.2008.08.022
Poloma, M. M., & Pendleton, B. F. (1989). Exploring types of prayer and quality of life: A research note. Review of Religious Research, 31, 46–53.
Poloma, M. M., & Pendleton, B. F. (1991). The effects of prayer and prayer experiences on measures of general well-being. Journal of Psychology and Theology, 19, 71–83.
Radloff, L. S. (1977). The CES-D scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1, 385–401. doi:10.1177/014662167700100306
Rood, L., Roelofs, J., Bögels, S. M., Nolen-Hoeksema, S., & Schouten, E. (2009). The influence of emotion-focused rumination and distraction on depressive symptoms in non-clinical youth: A meta-analytic review. Clinical Psychology Review, 29, 607–616. doi:10.1016/j.cpr.2009.07.001
Ross, L. E., Hall, I. J., Fairley, I. J., Taylor, Y. J., & Howard, D. L. (2008). Prayer and self-reported health among cancer survivors in the United States, National Health Interview Survey, 2002. Journal of Alternative and Complementary Medicine, 14, 931–938. doi:10.1089/acm.2007.0788
Satin, J. R., Linden, W., & Phillips, M. J. (2009). Depression as a predictor of disease progression and mortality in cancer patients. Cancer, 115, 5349–5361. doi:10.1002/cncr.24561
Schwarzer, F., Dunkel-Schetter, C., & Kemeny, M. (1994). The multidimensional nature of received social support in gay men at risk of HIV infection and AIDS. American Journal of Community Psychology, 22, 319–339. doi:10.1007/BF02506869
Seeman, T. E., Dubin, L. F., & Seeman, M. (2003). Religiosity/spirituality and health: A critical review of the evidence for biological pathways. American Psychologist, 58, 53–63. doi:10.1037/0003-066X.58.1.53
Smith, T. B., McCullough, M. E., & Poll, J. (2003). Religiousness and depression: Evidence for a main effect and the moderating influence of stressful life events. Psychological Bulletin, 129, 614–636. doi:10.1037/0033-2909.129.4.614
Strawbridge, W. J., Cohen, R. D., Shema, S. J., & Kaplan, G. A. (1997). Frequent attendance at religious services and mortality over 28 years. American Journal of Public Health, 87, 957–961. doi:10.2105/AJPH.87.6.957
Tabachnick, B. G., & Fidell, L. S. (2007). Using multivariate statistics (5th ed.). Boston, MA: Pearson Education, Inc.
Taylor, E. J., & Outlaw, F. H. (2002). Use of prayer among persons with cancer. Holistic Nursing Practice, 16, 46–60.
Taylor, E. J., Outlaw, F. H., Bernardo, T. R., & Roy, A. (1999). Spiritual conflicts associated with praying about cancer. Psycho-Oncology, 8, 386–394. doi:10.1002/(SICI)1099-1611(199909/10)8::5<386:AID-PON407>3.0.CO;2-C
Toussaint, L., & Friedman, P. (2009). Forgiveness, gratitude, and well-being: The mediating role of affect and beliefs. Journal of Happiness Studies, 10, 635–654. doi:10.1007/s10902-008-9111-8
Treynor, W., Gonzalez, R., & Nolen-Hoeksema, S. (2003). Rumination reconsidered: A psychometric analysis. Cognitive Therapy and Research, 27, 247–259. doi:10.1023/A:1023910315561
van’t Spijker, A., Trijsburg, R. W., & Duivenvoorden, H. J. (1997). Psychological sequelae of cancer diagnosis: A meta-analytical review of 58 studies after 1980. Psychosomatic Medicine, 59, 280–293.
Watkins, P. C., Woodward, K., Stone, T., & Kolts, R. L. (2003). Gratitude and happiness: Development of a measure of gratitude and relationships with subjective well-being. Social Behavior and Personality, 31, 431–452. doi:10.2224/sbp.2003.31.5.431
Weisman, A. D., & Worden, J. W. (1976–1977). The existential plight of cancer: Significance of the first 100 days. International Journal of Psychiatry in Medicine, 7, 1–15. doi:10.2190/UQ2G-UGV1-3PPC-6387
Whittington, B. L., & Sher, S. J. (2010). Prayer and subjective well-being: An examination of six different types of prayer. International Journal for the Psychology of Religion, 20, 59–68. doi:10.1080/10508610903146316
Wood, A. M., Froh, J. J., & Geraghty, A. W. A. (2010). Gratitude and well-being: A review and theoretical integration. Clinical Psychology Review, 30, 890–905. doi:10.1016/j.cpr.2010.03.005
Wood, A. M., Joseph, S., & Maltby, J. (2009). Gratitude predicts psychological well-being above the Big Five facets. Personality and Individual Differences, 46, 443–447. doi:10.1016/j.paid.2008.11.012
Acknowledgments
This study was funded by a National Cancer Institute U56 Comprehensive Cancer Partnership Program Grant (U56 CA118635). We gratefully acknowledge the contributions of Sarah Ahmad, Esteban Barreto, Laurel Radwin, Geraldine Sanon, Max Stewart, and the participants in this research. We especially thank Karen Emmons and Adan Colon-Carmona for their support and skillful leadership of the DF/HCC-UMass Boston U56 collaboration.
Author information
Authors and Affiliations
Corresponding author
Additional information
An erratum to this article can be found at http://dx.doi.org/10.1007/s10865-011-9365-1
Rights and permissions
About this article
Cite this article
Pérez, J.E., Rex Smith, A., Norris, R.L. et al. Types of prayer and depressive symptoms among cancer patients: the mediating role of rumination and social support. J Behav Med 34, 519–530 (2011). https://doi.org/10.1007/s10865-011-9333-9
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10865-011-9333-9