166 VOLUME 82, NUMBERS 3 & 4 RELIGION AND DEPRESSION AMONG U.S. COLLEGE STUDENTS By RICK PHILLIPS and ANDREA HENDERSON Introduction Studies show that religious people have lower rates of depression than non-religious people.' Most of these studies focus on the U.S. population as a whole, or on specific subgroups such as the elderly.^ To date, little has been written about how religious affiliation and religious devotion affects depression among the college-age population. This study will analyze data based on a representative sample of U.S. college students to determine whether religious participation is associated with lower rates of depression for this important subgroup. Religion and Depression There are three main components that define the relationship between religion and mental health. First, religious participation offers people opportunities for regular social interaction with others who share their beliefs and values. These social networks supply companionship and comfort during stressfiil times.^ Second, religion helps people make sense of undesirable life events and conditions, and helps them cope with personal setbacks such as grief and health problems.* Third, religion promotes healthy lifestyles. Studies show that religious participation decreases the likelihood that one will abuse alcohol or drugs, two key factors associated with mental health problems.' It is thus not surprising that studies indicate that religious people are less likely to be depressed than nonreligious people.' Depression and College Students Recent research conducted by the National Institute of Mental Health shows that depression is becoming more frequent among young adults ages eighteen to twenty-five. This is precisely the time when many in this age group are enrolled in colleges and universities. College students face a variety of stressors that are linked to depression. Many are living away from their homes and parents for the first time. They must also cope with exposure to new people and ideas, issues related to sexuality, and anxiety about life after graduation. Studies show that over ten percent of college students have contemplated suicide, a common manifestation of depression and the second leading killer ofthe collegeage population.' Since there are nearly twelve million students enrolled in American colleges and universities, depression on campus is a serious concern. RICK PHILLIPS is an Assistant Professor of Sociology at University of North Florida in Jacksonville, Florida. ANDREA HENDERSON is a graduate student in Sociology at University of Texas-Austin.
INTERNATIONAL SOCIAL SCIENCE REVIEW 167 While studies indicate that rehgion is negatively correlated with depression in the general population and in certain subgroups like the elderly, it is not known if religion significantly affects depression among college students. There are, however, several studies of college students that examine how religion affects behaviors that are known correlates of depression. For instance, students who report that religion is important to them consume less alcohol, drugs, and tobacco than those who are not religious.* They are also less likely to contemplate suicide.' But these behaviors are correlates of depression. How does religion affect students' responses on scales that are used to measure depression itself? To address this question, the authors of this study analyze a nationally representative sample of undergraduate students in the U.S. to determine the effect of religious affiliation and devotion on levels of depressive symptoms among college students. Based on previous research with other groups, we hypothesize that: (1) students who profess a religious faith will have fewer symptoms of depression than those with no religious affiliation; and, (2) students who describe themselves as more religious will have fewer symptoms of depression than those who are less religious or not religious. Data The data for this study is derived from the National College Alcohol Study collected in 1997 by the Harvard School of Public Health.'" Almost all participants were full-time undergraduate students from 116 four-year institutions across the United States. The study is comprised of 14,521 self-administered surveys. The sample is 59.9 percent female and 39.8 percent male. Respondents' class rank is fairly evenly distributed, with freshmen accounting for 23.1 percent ofthe sample, sophomores 21.2 percent, juniors 23.3 percent, and seniors 21.9 percent. Only 1.7 percent of respondents are graduate students. Most students (78.9 percent) are white, with Hispanics constituting 8 percent ofthe sample, African Americans 4.9 percent, Asian and Pacific Islanders 7.6 percent, and Native Americans.6 percent. Another 7.9 percent of respondents identify their ethnicity as "other."" In addition to numerous questions concerning alcohol use, the survey asks students about their religious affiliation and self-reported religiousness. It also includes a scale to measure symptoms of depression. The religious affiliation question asks: "In what religion were you raised?" and offers a variety of major faiths as responses, including an open-ended "other" category. The religious composition of the sample is as follows: Catholic 36.8 percent, Protestant 25.3 percent, Jewish 3.3 percent, Muslim.8 percent, "other" 20.8 percent, and none 12.9 percent. The religiousness measure asks students: "How religious are you?" and offers four response categories ("very," "some," "a little," and "not at all").'^ The frequency of symptoms of depression is measured by a nine-item scale that asks each respondent to indicate how often in the past thirty days he or she has experienced a number of acknowledged indicators of depression, including nervousness, ennui, fatigue, and melancholy. Six response categories for each item range from "none of the time" to "all ofthe time." This scale is typical of those used in survey research, and is based on the widely accepted Center for Epidemiological Studies Depression Scale (or CES-D). The CES-D measures the frequency of depressive symptoms in aggregate, non-clinical samples. It is not used to diagnose clinical depression in individuals.'^ The scale has excellent criterion validity, and is closely correlated with diagnoses of clinical depression in epidemiological studies.'" The scores reported for this scale should be interpreted as levels of
168 VOLUME 82, NUMBERS 3 & 4 depressive symptomology among different groups of college students, not as actual rates of clinical depression. Since items in the CES-D exhibit a high degree of inter-item reliability, it is common for surveys to use abbreviated versions of the scale and subsets of its questions." For instance, nine-, eight-, and even four-item scales based on the CES-D have been developed."" The nine-item scale from the National College Alcohol Study employed in this study appears in the appendix. The authors of this study added these nine items together to produce a symptom scale ranging from nine to sixty-three, where lower scores denote fewer symptoms of depression. The mean score for all respondents on this scale is 28.9. Symptom Differences and Religious Affiliation This analysis begins by examining the mean depressive symptom scores for the various religious groups in the sample. The authors of this study use analysis of variance (ANOVA) to uncover statistically significant differences between these means. Table 1 lists the number of cases (N), means, and standard deviations (s) on the depression scale for each group. The statistically significant value of F (F=7.02 p<.05) ensures that there is more variation in levels of depressive symptoms between the various religions than within them. Table 1 shows that both Protestants and those in the "other" category have mean scores lower than non-religious respondents. This difference is statistically significant at the.05 level. Symptoms of depression among Catholics, Jews, and Muslims do not differ significantly from those with no religion. This is consistent with previous findings which suggest that Catholics and Jews in the U.S. tend to suffer from somewhat higher rates of depression than other religious groups." Table 1: Means and Standard Deviations for Depression by Religious Affiliation Non-Religious Catholic Jewish Muslim Protestant Other N 1705 4825 442 96 3349 2716 Mean 29.2 29.1 29.1 29.7 28.7* 28.8 F statistic = 7.02,/7<.O5 * Mean difference from non-religious significant S 3.99 4.03 3.81 3.37 3.98 4.10 The finding in Table 1 supports our first hypothesis for Protestants and those who describe their religion as "other," but not for Catholics, Jews, or Muslims. The utility of this finding, however, is limited. It is likely that many respondents to the survey who selected "other" as their religion are actually members of groups that sociologists would classify as Protestant. For instance. Mormons and many non-denominational Christians would be as likely to select "other" on the survey as would Buddhists or Wiccans. Thus, the survey's measure of religious affiliation is rather rudimentary, which explains why more than one in five respondents claim to be "other." In addition, simply knowing one's religion reveals little about that person's level of religious devotion. Some individuals are nominally affiliated with their faith while others are very devout. For the purpose of this
INTERNATIONAL SOCIAL SCIENCE REVIEW 169 Study, it is important to know how symptoms of depression are related to levels of subjective religiousness. Symptom Differences and Subjective Religiousness Earlier we hypothesized that students who describe themselves as more religious will exhibit fewer symptoms of depression than those who are less religious or not at all religious. To test this hypothesis, the authors of this study examined respondents' mean symptom scores for each response category ofthe question measuring religiousness. The results of an ANOVA comparing these means appear in Table 2. The statistically significant value of F (F=41.93 p<.05) denotes that there is more variability in symptoms of depression between the categories of the religiousness variable than within them. The analysis also shows that respondents who rate themselves as "very," "some," or "a little" religious have significantly fewer symptoms of depression than those who declare that they are "not at all" religious (p<.05). This is consistent with the hypothesis outlined above. Those who report that they are "very" religious rank the lowest on the depression scale (mean=28.2), followed by those who say "some" (mean=29.0), and those who say that they are "a little" religious (mean=29.1). The differences between these three groups, however, are not statistically significant. This suggests that the presence or absence of religious devotion in the population under investigation matters more than the intensity of that devotion. Table 2: Means and Standard Deviations for Depression by Level of Religiousness Very Some A Little Not at all N 2826 4609 3089 2731 Mean 28.2* 29.0* 29.1 * 29.4 s 4.01 3.94 3.89 4.19 F statistic = 41.93. D<.05 * Mean difference from non-religious significant at p<.os Conclusion Recently, there has been renewed interest in the effects of religious belief and participation on mental health. This study addresses the effects of religious affiliation and selfreported religiousness on symptoms of depression among U.S. college students. This analysis is among the first to examine the link between these variables for this important demographic. The authors of this study find that while the relationship between religious denomination and depressive symptoms among college students is difficult to interpret, there is a clear link between self-reported religiousness and symptoms of depression, with those students who profess some level of religiousness having fewer symptoms than those who claim none. These findings are generally consistent with previous research done on the U.S. population as a whole, and on subgroups like the elderly. To be sure, this study has limitations. Since the data set employed here was specifically designed to assess alcohol problems among college students, the survey's measures of religious affiliation and devotion are rather narrow. Future studies on this topic must use data with adequate measures of religiousness before conclusive claims can be asserted
170 VOLUME 82, NUMBERS 3 & 4 regarding the relationship between religion and depression in this population group. Further, while the authors of this study find that differences in mean scores on the depression scale between religious and non-religious students are statistically significant, they are not widely disparate and are partly an artifact of the large sample of the data set employed here. We therefore suggest that corroborating the existence of this relationship is an important priority for future research in this area. Appendix: The Nine-Item Depression Scale The depression scale included in the National College Alcohol Study measures the following nine items on a scale of one to six, where one constitutes "none ofthe time," and six denotes "all ofthe time." Items a, d, e, and h are reverse coded to avoid response sets.'* How much ofthe time during the past thirty days... a. Did you feel fiill of pep? b. Have you been a very nervous person? c. Have you felt so down in the dumps that nothing could cheer you up? d. Have you felt calm and peaceful? e. Did you have a lot of energy? f. Have you felt downhearted and blue? g. Did you feel worn out? h. Have you been a happy person? i. Did you feel tired? ENDNOTES 'Kenneth I. Pargament, Nalini Tarakeshwar, Christopher G. Ellison, and Keith M. Wulff, "Religious Coping among the Religious: The Relationships between Religious Coping and Well-Being in a National Sample of Presbyterian Clergy, Elders, and Members," Journal for the Scientific Study of Religion 40:3 (September 2001):497-513. See also Mark Townsend, Virginia Kladder, Hana Ayele, and Thomas Mulligan, "Systematic Review of Clinical Trials Examining the Effects of Religion on Health," Southern MedicalJournal 95:12 (December 2002): 1429-36. 'Ellen L. Idler, "Religious Involvement and the Health ofthe Elderly: Some Hypotheses and an Initial Test," Social Forces 66:1 (September 1987):226-38; Harold G. Koenig, Linda K. George, and Bercedis L. Peterson, "Religiosity and Remission of Depression in Medically 111 Older Patients," American Journal of Psychiatry 155:4 (April 1998):536-42; Amy Argue, David R. Johnson, and Lynn K. White, "Age and Religiosity: Evidence from a Three Wave Panel Analysis," Journal for the Scientific Study of Religion 38:3 (September 1999):423-35. 'Darren E. Sherkat and Christopher Ellison, "Recent Developments and Current Controversies in the Sociology of Religion," Annual Review of Sociology 23 (1999):373-74. "Thomas Plante and Allen C. Sherman, "Research on Faith and Health: New Approaches to Old Questions," in Faith and Health: Psychological Perspectives, eds. Thomas Plante and Allen C. Sherman (New York: Guilford Press, 2001), 1-8. 'See Christopher Ellison, Jason D. Boardman, David R. Williams, and James S. Jackson, "Religious Involvement, Stress, and Mental Health: Findings from the 1995 Detroit Area Study," Social Forces 80:1 (September 2001):215-55.
INTERNATIONAL SOCIAL SCIENCE REVIEW 171 "^See Jason Schnittker, "When is Faith Enough? The Effects of Religious Involvement on Depression," Journal for the Scientific Study of Religion 40:3 (September 2001):393-411. 'Kathy A. Douglas, Janet L. Collins, Charles W. Warren, Laura Kann, Robert S. Gold, S. Clayton, James G. Ross, and Lloyd J. Kolbe, "Results from the 1995 National College Health Risk Behavior Survey," Journal of American College Health 46:2 (September 1997):59-60. See also Linda Sax, "Health Trends among College Freshman," Journal of American College Health 45:6 (May 1997):252-62. 'Julie A. Patock-Peckham, Geoffrey T. Hutchinson, Jeewon Cheong, and Craig T Nagoshi, "Effect of Religion and Religiosity on Alcohol Use in a College Student Sample," Drug and Alcohol Dependence 49:2 (January 1998):85. See also Sandra A. Willis, Kenneth Wallston, and Kamau Johnson, "Tobacco and Alcohol Use among Young Adults: Exploring Religious Faith, Locus of Health Control, and Coping Sfrategies as Predictors" in Faith and Health, eds. Plante and Sherman, 213-40. 'Ted W. Grace, "Health Problems of College Students," Journal of American College Health 45:6 (May 1997):243-50. " Henry Wechsler, Harvard School of Public Health College Alcohol Study, 1997 [computer file], second ICPSR version, http://www.icpsr.com. Boston: Harvard School of Public Health [producer], 2003, Ann Arbor, MI: Inter-University Consortium for Political and Social Research [distributor], 2004. "The 1997 questionnaires were mailed to 26,508 students attending the 116 schools. Of these, 2,368 were eliminated because of incorrect addresses, withdrawal from school, or leaves of absence, reducing the sample size to 24,140. Sixty percent ofthe students who were reached responded, for a total of 14,521 returned questionnaires Ibid "Ibid. ''Government of South Austrailia Department of Health, "Identifying Depression as a Comorbid Condition," http://idacc.healthbase.info/questionnaires.html (accessed June 10 2005), L "John Mirowsky and Catherine E. Ross, Social Causes of Psychological Distress (New York: Aldine de Gruyter, 1989), 22-23, 41, 187-89. "Two examples of widely used data sets that employ abbreviated versions ofthe CES-D are the National Survey of Families and Households and the University of Michigan's Americans' Changing Lives data set. See James A. Sweet, Larry L. Bumpass, and Vaughn Call, "The Design and Content ofthe National Survey of Families and Households," NSFH Working Paper 1, Center for Demography and Ecology, University of Wisconsin-Madison, 1988. See also Adam D. Shapiro, "Explaining Psychological Distress in a Sample of Remarried and Divorced Persons: The Influence of Economic Distress," Journal of Family Issues 17:2 (February 1996): 191-93; Adam D. Shapiro and David Lambert, "Longitudinal Effects of Divorce on the Quality ofthe Father-Child Relationship and on the Fathers' Psychological Well-Being," Journal of Marriage and the Family 61 (May 1999):400-02. Liter-item reliability means that the various items in a scale all exhibit similar responses when administered to different populations. For instance, in the scale used to measure how religious one is, the respondent is asked (a) how much do you pray; (b) how oflen do you read scripture; and, (c) how often do you attend church? One would expect that, all else being equal, individuals who score high on (a) would also be likely to score high on (b) and (c). The statistical term for this is "inter-item reliability." "Lisa A. Melchoir, G.J. Huba, Vivian B. Brown, and Cathy J. Rebaek, "A Short Depression Index for Women," Educational and Psychological Measurement 53 (Winter 1993): 1117-25.
172 VOLUME 82, NUMBERS 3 & 4 "Harold G. Koenig, Michael E. McCullough, and David B. Larson, Handbook of Religion and Health (New York: Oxford University Press, 2001), 119-21. "Reverse coded refers to items in a scale coded as follows: Strongly Agree (SA), Agree (A), Disagree (D), and Strongly Disagree (SD). Respondents can fall into a trap of giving the same answer repeatedly. Reverse coding means that sometimes strongly agreeing means you are "high" on a variable, and sometimes you are "low" on a variable. Consider these two questions: 1. t often forget to pray: SA, A, D, SD 2.1 attend church whenever I can: SA, A, D, SD If one answered strongly agree in response to the first question, this would indicate low religiousity. But if one answered strongly agree to the second question, this would indicate high religiousity. Reverse coding keeps respondents on their toes when they are answering questions so that they do not just circle the same answer repeatedly.