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Mental Health, Religion & CultureDecember 2005; 8(4): 263–276

Religious attributions pertaining to the causes and

cures of mental illness

KRISTINE HARTOG & KATHRYN M. GOW

School of Psychology & Counselling, Queensland University of Technology, Australia

AbstractIn this Australian study, 126 Protestant Christian participants, 52 females and 74 males, wereassessed for their beliefs about the importance of 26 causal variables and 25 treatment variablesfor two mental disorders: Major Depression and Schizophrenia. Factor analysis revealed fourcausal factors, common to both conditions, labelled as religious factors, physical factors, copingstyle and social/environmental stressors. Furthermore, four treatment factors emerged: religiousmeans, professional help, help from others (non-professional) and self-initiated means.Explanatory variables for these beliefs were assessed using: a Religious Beliefs Inventory (RBI) tomeasure religious beliefs; a Values Survey (VS) including a measure of Christian religious values;and a Religion and Mental Health Inventory (RMHI) to measure cognitive dissonance (cf.

Festinger, 1957) between religious faith and perceptions of mental-health principles. The resultsrevealed that religious beliefs, religious values and cognitive dissonance function as predictors of the attribution of the causes and treatments, for Major Depression and Schizophrenia, to religiousfactors. An additional finding of this study was that 38.2% of the participants endorsed a demonicaetiology of Major Depression, and 37.4% of the participants endorsed a demonic aetiology of Schizophrenia.

Introduction

While religion, modern psychiatry and psychology address the same subjects, significantdifferences exist between them with respect to fundamental world views, concepts and

vocabularies used to describe, explain and understand human behaviour, adjustment,

well-being and illness (Theilman, 1998; Tjeltveit, 1991). This paper focuses primarily

on the Christian religion, which is uniquely based upon a religious text called the Bible.

The Christian faith centres around God, his son Jesus Christ and the internal work of

the Holy Spirit (Favier, O’Brien, & Ingersoll, 2000; Loewenthal, 1996).

The historic relationship between psychology and religion has been characterized by

conflict and mutual disregard. Naturalism, agnosticism and humanism have dominated

the field of psychology (Bergin, 1980; Guinee & Tracey, 1997; Kudlac, 1991). However,

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a growing body of recent research into the area of ‘‘psychology and religion’’ shows that the

psychology profession has begun to consider seriously the importance of religion in people’s

lives. With regard to psychotherapy and counselling, it has been proposed that religion is

almost as integral to the religious client as their family structures and relationships

(Payne, Bergin, & Loftus, 1992). Research suggests that if the therapist does not integratetherapeutic solutions that take into account religious values, then effective outcomes may be

temporary and benefits can be restricted (Bergin, 1980; Cunningham, 1983; Gass, 1984;

Kuyken, Brewin, Power, & Furnham, 1992).

Gass (1984) constructed a ‘‘values’’ survey to measure specific beliefs, attitudes and

values, which might test the hypothesis that Christians possess a distinctive set of beliefs

and preferences related to the process of psychotherapy, and conceptualize and define

mental health in a particular way. Gass’s results supported this hypothesis and revealed a

strong preference in Christian clients towards consulting religious, rather than secular,

mental-health services. Religious communities have tended to foster stereotypical beliefs

about health professionals, which in turn have influenced the uptake or non-uptake of mental-health services (Nickerson, Helms, & Terrel, 1994).

Prior to the 1940s, few systematic studies of public attitudes towards mental illness had

been conducted. This situation was partly rectified in a six-year study conducted by

Nunnally (1961), which involved an exploration of general public knowledge of mental

illness, in terms of their causes and treatments. However, this study, like previous ones,

was characterized by ambiguous and inconsistent responses. This prompted Furnham

(1988) later to design an investigation of the possible reasons for individual or group

differences in the structure and content of beliefs (Furnham, 1988). The results of this

investigation showed systematic features of the general population including their

education, sex, age, class and religion, which significantly influenced their attitudes and

beliefs (Furnham & Henley, 1988).

Origin of Christian beliefs about mental illness

Prior to the 18th century, social and religious sanctions ensured that the mentally ill were

isolated and treated with both fear and neglect. This is still true in some developing coun-

tries where a mixture of religious and cultural beliefs about the nature of mental problems

and issues stigmatize patients (see the chapter by Gureje and Alem in Arboleda-Florez,

2003). While most Protestant religious groups have ‘‘officially’’ renounced belief in the

demonic aetiology of mental illness, replacing it with natural and psychological explana-

tions, several recent qualitative studies conducted by Loewenthal (1996) have revealedthat among lay Christians, there are still widespread views of mental illness being caused

by separation from God and demonic possession (Dain, 1992; Favazza, 1982;

Loewenthal, 1996). How did mental illness first come to be associated with demon posses-

sion? Key elements of early biblical Christianity were the healing of both physical and

mental illness through religious practices (Idler & George, 1998). There are numerous

accounts, in the Bible, of Jesus healing people of illnesses caused by demon possession

(Favazza, 1982).

Favazza (1982) conducted a comprehensive investigation of the practices and techniques,

utilized by many modern Christian healers, in relation to mental illness. The most

frequently endorsed practices included regular prayer, scripture reading, receivingsacraments and participating in a supportive Christian community (Favazza, 1982;

Loewenthal & Cinnirella 1999)

264 Kristine Hartog & Kathryn M. Gow

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General attribution theory

General attribution theory provides a widely applied theoretical explanation for how

individuals come to terms with illness. It begins with the assumption that people seek to

make sense of their own experiences, and the events they witness, in an attempt to controland predict these events (Spilka, Shaver, & Kirkpatrick, 1985). Pargament and Hahn

(1986) observed that the religious framework and meaning system provides the religious

person with an understanding and means of dealing with life’s challenges, while maintaining

a sense of justice and control in their lives (Loewenthal & Cornwall, 1993; Pargament et al.,

1990; Spilka et al., 1985). Various social influences, such as upbringing and education,

influence whether the cause of events is attributed to either naturalistic or religious factors

(Spilka et al., 1985). However, the plausibility of a religious, or non-religious, explanation

still rests on the amount of knowledge the attributer has about that particular issue (Spilka

et al., 1985).

Different protestant perspectives

Among the Protestant Christian religious denominations, there are significant differences in

the perceived relationship between religion and mental illness. These denominations can be

identified along a continuum, ranging from Fundamentalism to Liberalism (Malony, 1998).

At the Fundamentalist end of the continuum, the predominant view is that there is no entity

such as mental health that is not synonymous with spiritual health. To the fundamentalist,

much of mental and emotional suffering is due to sin or moral failings; therefore therapy, to

address such suffering, should consist primarily of confession and forgiveness (Adams,

1970; Bobgan & Bobgan, 1979; Dain, 1992; Ferngren, 1986; Ritzema, 1979). LiberalProtestants, however, do not deny the reality of a separate mental-health entity (Malony,

1998). They recognize that there are psychological, as well as spiritual, dimensions to

human life, and therefore not all personal problems have easy religious solutions

(Malony, 1998).

Cure of mental illness

Furnham (1988) conducted specific research to test the hypothesis that the type of

explanation or attribution people offer for a particular problem relates to the type of

remedy they consider necessary to cure or eradicate it. The findings of Lederach andLederach’s (1987) study of cognitive dissonance in nursing students lend support to

this hypothesis. The focus of their study was on nursing students with strong Christian

affiliations, who were tested for cognitive dissonance at the commencement of, and

eight weeks into, their psychiatric nursing training. The researchers observed considerable

conflict between the nursing students’ faith values and their beliefs about how these

values did, or did not, appear to fit with the mental-health principles they were being

taught. Among the nursing students who participated in the study, those who indicated

a stronger allegiance to ‘‘faith’’ values also attributed a high responsibility to God’s

necessary intervention for the healing of mental illness, while the commonly accepted

psychiatric approach to healing was considered less important. This resulted in a stateof cognitive dissonance, given the demands of their future nursing role in the treatment

of patients with a mental illness According to Henley and Furnham (1988), beliefs

Causes and cures of mental illness: Religious attributions 265

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about the ways in which problems may be overcome or treated are likely to influence

help-seeking behaviour, as well as responsiveness and compliance with different treatment

strategies.

Several studies have focused on cultural and religious differences in the definition and

categorization of two prevalent mental disorders: Schizophrenia and Major Depression.Cinnirella and Loewenthal (1999) conducted a qualitative interview study in Britain

that focused specifically on the degree to which beliefs about religion were seen to inter-

twine with lay beliefs about depression and schizophrenia. Responses revealed significant

variances between groups, in their perception of religious coping strategies in the face of

depressive and schizophrenic symptoms. While religious coping strategies were endorsed

by a significant number of participants, Schizophrenia was seen as more serious and

more likely to be associated with organic problems, thus reducing the perceived relevance

of religion as a coping strategy for this condition (Henley & Furnham, 1988). A team of

researchers, led by Loewenthal (2000), recognized that one of the limitations of these

previous studies was their reliance on qualitative thematic analyses of beliefs. Theysuggested that the results of these qualitative studies should be seen as a complement

to more quantitative, large-scale survey methods, thus enabling an improved exploration

of the causal processes that might impact upon belief systems. Consequently, on the

basis of previous qualitative responses (Loewenthal et al., 2000), a questionnaire was

constructed to measure participants’ beliefs about both the causes and cures of depres-

sion. Religious participants, asked to complete this questionnaire in the original study

(Loewenthal et al., 2000), generally endorsed an active style-coping pattern, involving

religious coping, and social support resources, as well as the possible use of medical

and other professional help.

The current study aimed to explore in greater depth the relationship between religion and

mental health, with a particular focus on the relationship between religious beliefs, religious

values and beliefs about the causes and cures of mental illness. It sought to identify to what

extent religious attributions could provide an additional contribution to traditional causal

and treatment attributions for Major Depression and Schizophrenia.

Hypothesis 1

Following the work of Lederach and Lederach (1979), it was hypothesized that Christians,

with low scores on the counselling/psychology knowledge component variables of the

Values Survey (VS) and scoring highly on the Religious Belief Inventory (RBI), would

show high scores on the Religion and Mental Health Inventory (RMHI). (High scoresindicate high levels of cognitive dissonance between participants’ religious beliefs/values

and perceptions of mental-health principles.)

Hypothesis 2

Following the work of Loewenthal and Cinnirella (2000) and Loewenthal and Cornwall

(1993), it was hypothesized that religious beliefs/values and cognitive dissonance, would

function as significant predictors of religious attributions for the causes and treatments

for Major Depression and Schizophrenia.

An exploration was made into the frequency with which participants endorsed the belief that ‘‘mental illness is related to demon possession/influence/oppression.’’ This was meas-

ured by responses to question 5 of the RMHI and responses to question 26 on both the


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Method

Participants

The participants ( N ¼126) included 52 females and 74 males. Sixteen participants were

aged 18–22, 37 were aged 23–35, 38 were aged 36–50, 18 were aged 51–65, and 17were aged 66–80. The participants’ education levels are presented in Table I.

The participants were drawn from the following Protestant Christian Church denomina-

tions: Baptist, Reformed, Wesleyan Methodist, Uniting, Anglican, Brethren, Churches of

Christ, Presbyterian, Christian Life Centre, Assemblies of God, Evangelical and The

Christian Missionary Alliance. Prospective participants were excluded from the survey if

they were currently seeing, or had in the immediate past seen, a medical practitioner for

any psychiatric reason, or if they were on any form of psychotropic medication.

Materials

Subject Information Package. The Subject Information Package provided details including

the project title, the names of researchers involved, assurance of confidentiality, a brief

outline of the study, the potential benefits of the study and contact details should they

have any further queries or concerns.

Instruction Page. The Instruction Page detailed how to complete the questionnaires con-

tained within the package. Instructions were also given regarding the return of the question-

naires via post, using the supplied self-addressed, stamped envelope.

Background details. Participants indicated their sex, age, highest education level attained,occupation, religion, nationality, parents’ religion and parents’ nationality.

Religious Belief Inventory. This RBI questionnaire is a replica of Holland et al.’s (1998)

Systems of Belief Inventory (SBI-15R). The 15 items have been designed to measure

both religious beliefs and practices. The 10 items loading onto Subscale 1 (Beliefs and

Practices) met tests of internal consistency, with a Cronbach alpha of 0.86. The five

items loading onto Subscale 2 (Social support) also satisfied tests of internal consistency,

with a Cronbach alpha of 0.79. Convergent validity of the original scale was demonstrated,

following high correlations (r ¼0.84) with the Religious Orientation Inventory (ROI).

Discriminant validity of the original scale was demonstrated through a significant difference

Table I. Frequency of participants’ highest education level completed.

Highest education level completed Frequency

Grade 8 1Grade 9 2Grade 10 5Grade 11 6Grade 12 24

University 27Post-graduate university degree 24Post-school education other than university 25


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between religious and lay groups (t (295)¼11.23, p < 0.001, two-tailed). Participants were

scored on each subscale, with high scores indicating greater agreement.

Values Survey. This 51-item, Likert-type instrument was constructed by Gass (1984) forthe purpose of measuring Christian beliefs and values related to psychotherapy and mental

health. Analysis of the original survey included a principal-components analysis with a

varimax rotation yielding seven orthogonal factors. Differences between mean item scores

of the group on each factor revealed significant results to t tests for: Factor 1 Orthodox

Christian Values, t (202)¼4.73, p < 0.001; Factor 5 Conformity: Social-practical,

t (202)¼2.19, p < 0.05; and Factor 6 Self-Reliance, t( 202)¼4.55, p < 0.001. In the current

study, items loading onto the original Orthodox Christian Values factor met tests for inter-

nal consistency (¼0.91).

Religion and Mental Health Inventory. The RMHI, developed by Lederach (1979),

comprises positive and negative statements with a 5-point Likert-type response. Items 4

and 14 are negatively scored. The inventory was originally developed to measure cognitive

dissonance between nursing students’ religious values and perceptions of mental-health

principles. However, in this study, cognitive dissonance referred to a poor fit between

religious beliefs and perceptions of mental-health principles, leading to psychological

discomfort and tension.

A good test–retest reliability was demonstrated (0.71). A two-tailed t test yielded a signif-

icance level of p < 0.01. In this study, the 18 items constituting the RMHI met tests for

internal consistency (¼0.70).

Beliefs about Major Depression and Schizophrenia. This four-part ‘‘Beliefs about Major

Depression and Schizophrenia’’ questionnaire investigates beliefs about the ‘‘causes’’ and

‘‘treatments’’ for each disorder. Loewenthal et al. (2000) developed the questionnaire, on

the basis of 59 semi-structured interviews reported in Cinnirella and Loewenthal (1999)

and Loewenthal and Cinnirella (1999). The questionnaire is in a 7-point Likert format,

with causes of Schizophrenia and Major Depression being rated between 1¼ very unlikely

and 7¼ very likely. Treatments for Schizophrenia and Major Depression were rated

between 1¼not at all helpful to 7¼ very helpful.

Procedure

Participants were contacted initially by notices in the churches’ newsletters and by a public

address. Interested persons collected a questionnaire following the church service, to be

completed and returned via post within 2 weeks.

Design

The study was a single group design. The independent variables were religious beliefs

(measured by the RBI), Christian values (measured by the VS) and cognitive dissonance

(measured by the RMHI). The dependent variables were beliefs about the causes andtreatments for Major Depression and Schizophrenia. This study focused on the additional

contributions of religious beliefs over traditional beliefs about mental illness (Pargament


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Following the deletion of three incongruent items, factors for Major Depression were

found to be very reliable (¼0.94 for Factor 1; ¼0.80 for Factor 2; ¼0.81 for

Factor 3) and moderately reliable (¼0.66 for Factor 4). Factors for Schizophrenia were

found to be very reliable (¼0.94 for Factor 1; ¼0.79 for Factor 2; ¼0.88 for

Factor 3) and moderately reliable (¼0.57 for Factor 4).

‘‘Beliefs about treatment for Major Depression’’

Data reduction was repeated for items 1 to 25 of the ‘‘Beliefs about treatment for Major

Depression’’ questionnaire. Factorability was confirmed (msa¼0.87; Bartlett’s Test of

Sphericity: p < 0.001). Following the extraction of six factors with eigenvalues greater

than 1, which accounted for 70.14% of the variance in the data, and an examination of

the scree slope, it was decided to retain four factors for further analysis.

An exploratory factor analysis, employing principal axis factoring with promax rotation,

with a suppressor value of 0.3 was then performed on the data. Factor 1 was labelled‘‘religious means,’’ Factor 2 was labelled ‘‘help from others (non-professional),’’ Factor 3

was labelled ‘‘professional help,’’ and Factor 4 was labelled ‘‘self initiated means.’’

These four factors accounted for 61.62% of the total variance explained.

‘‘Beliefs about treatment for Schizophrenia’’

This data-reduction technique was replicated with the ‘‘Beliefs about treatment for

Schizophrenia’’ questionnaire. Factorability was confirmed (msa¼0.87: Bartlett’s Test of

Sphericity: p < 0.001). Following the extraction of six factors with eigenvalues greater

than 1, which accounted for 70.26% of the variance in the data, and an examination of

the scree slope, four factors were again retained for further analysis.Three correlations between the factors exceeded 0.3, and therefore an oblique rotation

was selected. Factor 1 was labelled ‘‘self initiated means,’’ Factor 2 was labelled ‘‘religious

means,’’ Factor 3 was labelled ‘‘professional help,’’ and Factor 4 was labelled ‘‘help from

others.’’ These four factors accounted for 61.17% of the total variance explained.

Following the deletion of three incongruent items, Major Depression factors were found

to be very reliable (¼0.91 for Factor 1; ¼0.86 for Factor 2; ¼0.72 for Factor 6 and

¼0.89 for Factor 4). Factors for Schizophrenia were found to be very reliable (¼0.86

for Factor 1; ¼0.90 for Factor 2; ¼0.80 for Factor 3; and ¼0.86 for Factor 4).

Bio data tests

Visual inspection of the means for gender, age, education and Church denomination

revealed no meaningful pattern, and so further exploration of significant differences was

considered unnecessary.

Hypothesis 1: Findings

The results supported the validity of utilizing Lederach’s (1979) RMHI in the current

study. In support of Hypothesis 1, the results showed that little familiarity with the area

of psychology/counselling and high measures on the RBI were significant predictors of cog-

nitive dissonance. A standard multiple regression revealed that, overall, religious beliefs andcounselling/psychology knowledge accounted for significant amounts of variance in levels of

cognitive dissonance R¼0 48 R2adj ¼0 21 F(2 120)¼17 49 p < 0 001 Stronger reli


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p < 0.001) were each significant predictors of cognitive dissonance. This suggested that the

more important the participants considered their religious beliefs, the more cognitive disso-

nance they would experience. Additionally, the less knowledge participants had of the area

of counselling/psychology, the more cognitive dissonance would be experienced.


Following the work of Loewenthal and colleagues (Lederach & Lederach, 1987;

Loewenthal & Cinnirella, 2000; Loewenthal & Cornwall, 1993), it had been hypothesized

that religious beliefs, religious values and cognitive dissonance, would function as predictors

of the attribution of the causes and treatments for Major Depression and Schizophrenia, to

religious factors. At the first step, correlations between the independent and dependent vari-

ables were examined (see Table II).

According to Hair, Anderson, Tatham, and Black (1995), reduced predictive power—

associated with the moderate to high correlations between the RBI Subscale 1, RBISubscale 2 and Orthodox Christian Values—could be expected (see Table III). A

second-order principal-components factor analysis was subsequently run on these three

variables, in order to reduce the number of variables. Factorability was confirmed

(msa¼0.71; Bartlett’s Test of Sphericity: p < 0.001). A single factor emerged (see

Table IV for factor loadings for each variable), thereby supporting a decision to

combine the scores of these three independent variables into a single religious beliefs/

values predictor variable in further regression analyses. According to Wearing and Brown

(1972), although there are conceptual differences between religious beliefs and religious

values, these distinctions do not necessarily imply any empirical difference given their

close functional relationship.

Table II. Correlations between scores on the Religious Beliefs Inventory, Religion and Mental Health Inventory,

Values Survey, Causal and Treatment Religious Factors.

VariableRBI

Subscale 1RBI

Subscale 2 RMHI VSDC

ReligionSC

ReligionDT

ReligionST

Religion

RBI Subscale 1 1.00RBI Subscale 2 0.63 1.00RMHI 0.40 0.34 1.00OCV 0.75 0.61 0.43 1.00DC Religion 0.41 0.24 0.66 0.47 1.00

SC Religion 0.37 0.25 0.63 0.40 0.70 1.00DT Religion 0.53 0.44 0.29 0.58 0.43 0.34 1.00ST Religion 0.49 0.37 0.25 0.48 0.38 0.34 0.83 1.00

Note. p < 0.001. RBI¼Religious Beliefs Inventory; RMHI¼Religion and Mental Health Inventory; VS¼ValuesSurvey; DC Religion¼Causes of Major Depression Religion Factor; SC Religion¼Causes of SchizophreniaReligion Factor; DT Religion¼Treatments for Major Depression Religion Factor; and ST Religion¼Treatments for Schizophrenia Religion Factor.

Table III. Component Matrix for Religious Beliefs/Values Factor.

Variable Component 1

Religious Beliefs Inventory: Subscale 1 0.917Christian Values 0.909Religious Beliefs Inventory: Subscale 2 0.834


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At the second step, utilizing a standard multiple regression design, scores relating to

religious beliefs/values and cognitive dissonance were used to predict beliefs about the

causes of, and treatment for, Major Depression and Schizophrenia. Sixteen separate

multiple regression analyses were performed for each of the dependant variables (factors).

The interplay between sample size ( N ¼123), the significance level ( p < 0.01) and two

independent variables (religious beliefs/values combined and cognitive dissonance), was

examined to assess the predictive power in detecting a significant R2. The results (see

Table IV) showed that the R2 in each instance exceeded the minimum R2 of 0.13 for a

power of 0.80 (Cohen & Cohen, 1975).

The results showed that religious beliefs/values and cognitive dissonance were significant

predictors of the attribution of religious causes for Major Depression and Schizophrenia

(see Table IV), accounting for 40% of the variance. These two variables accounted for

42% of the variance in the attribution of religious causes for Schizophrenia. The results

also indicated that while religious beliefs/values were a significant predictor of the attribu-

tion to religious factors for Major Depression and Schizophrenia, cognitive dissonance

was not found to be a significant predictor (see Table IV).

The two religious predictors, religious beliefs/values (combined) or cognitive dissonance,applied in a multiple regression design to the remaining non-religious dependent variables,

failed to show significant results.


The frequency distribution of scores in question 5 of the RMHI, item 26 of the ‘‘Beliefs

about the causes of Major Depression’’ questionnaire and item 26 of the ‘‘Beliefs about

the causes of Schizophrenia’’ questionnaire were examined to investigate participants’

endorsement of the belief that mental illness is related to demon possession/influence/

oppression.The results revealed that 38.2% of participants disagreed that mental illness might be the

result of demon possession 25 2% were neutral while 36 6% agreed that mental illness

Table IV. Standard Multiple Regression Analyses of religious beliefs/values and cognitive dissonance, functioning

as predictors of the attribution of religious causes and religious treatments for Major Depression and

Schizophrenia.

DV Variable B SE B R2

Causes of Major Depression 0.40Religious Beliefs/Values 0.05 0.018 0.25**Cognitive Dissonance 0.83 0.013 0.49*

Causes of Schizophrenia 0.42Religious Beliefs/Values 0.04 0.018 0.16***Cognitive Dissonance 0.10 0.013 0.56*

Treatments for Major Depression 0.35Religious Beliefs/Values 0.20 0.028 0.58*Cognitive Dissonance 0.01 0.021 0.04

Treatments for Schizophrenia 0.26Religious Beliefs/Values 0.20 0.035 0.50*Cognitive Dissonance 0.01 0.027 0.03

Note. DV: dependent variable; B: B weight; SE B: standard error; : beta weight; R2: multiple coefficient of determination.* p < 0.001; ** p < 0.01; *** p < 0.05.


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The results revealed that 38.2% of the participants considered it unlikely that Major

Depression could be caused by demonic influence/oppression, 23.64% were neutral,

whereas 38.2% considered it likely that Major Depression could be caused by demonic

influence/oppression. The results also revealed that 44.8% of the participants considered

it unlikely that Schizophrenia could be caused by demonic influence/oppression, and17.9% were neutral, whereas 37.4% considered it likely that Schizophrenia could be

caused by demonic influence/oppression.

Discussion

These findings provided support for the predictions made on the basis of previous empirical

research and literature. Following a summary of the data and the resultant status of the

hypotheses, the implications of these findings for mental-health service providers, educators

and the Christian religious population will be discussed.

Cognitive Dissonance

The third hypothesis, which predicted that Christians, with low scores on the counselling/

psychology knowledge component variables of the VS and scoring highly on the RBI, would

show high scores on the RMHI, was supported. This finding is consistent with that of

Lederach and Lederach (1987), who found that the magnitude of dissonance experienced

by the Christian individual was a direct function of the two elements in conflict: religion and

psychology. While religious beliefs increased cognitive dissonance, knowledge of the area of

counselling/psychology served to reduce cognitive dissonance.

Religious causal and treatment attributions

The findings of this study supported the second hypotheses, which predicted that religious

beliefs, religious values and cognitive dissonance, would function as significant predictors

of the attribution of the causes and treatments of Major Depression and Schizophrenia to

religious factors.

The ‘‘religious’’ causal and treatment factors, identified in this study, indicate that

previous studies of lay beliefs concerning mental illness had failed to detect the significance

of religious beliefs (Furnham & Henley, 1988; Pargament et al., 1990).It is important to note, from the results of the current study, that perceptions of religion,

as a causal factor, did not diminish the likelihood of seeing other agents as causes

(Loewenthal & Cornwall, 1993). Furthermore, it might have been expected that partici-

pants who rated religious means as a likely treatment for mental disorders would be less

likely to endorse help from professionals, friends and family. However, the pattern of

results from this study suggests an active style of treatment involving religious means, use

of social support, self-initiated means and the use of professional help. This pattern is

consistent with findings in an earlier study, conducted by Loewenthal et al. (2000) that

employed the ‘‘beliefs about causes’’ and ‘‘belief about treatment’’ questionnaire. The

findings of both studies identify a contemporary Christian approach to the healing of mental illness that accepts psychiatric interpretations as a likely cause (Favazza, 1982).

In fact in the current study it is rated as the most likely cause of both Major Depression


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Demon possession

The findings of this study also testify to the continuing belief in demonic activity by as many

as one-third of the participants in this study. According to Weber (1986), in the majority of

Protestant denominations, sanctioned belief in the demonic aetiology of mental illness hasbeen replaced by natural and psychological explanations.

Limitations

Several limitations of this study have been identified, in association with the particular

participant sample used. First, given that this study was of an exploratory nature, resources

did not allow a large enough representative probability sample to be used. The character-

istics of this sample were clearly homogeneous in terms of ethnic origin, geographical loca-

tion and Christian tradition, thus limiting the generalizablity of the findings. The cultural

homogeneity in this sample also prevents any conclusions from being made, regardingthe potential confounding effect of culture of origin and participants’ current nationality,

on the relationship between religion and causal/cure attributions. Further, it could be

argued that because the participants volunteered for the study, their responses may have

been contaminated by social desirability. Despite assurances of confidentiality, participants

may have been motivated to respond to the questionnaire in ways believed appropriate for a

religious person to respond.

Future research and implications

Future research may overcome some of the limitations inherent in the present investigation,by implementing designs to extend the generalizability of the findings. This would involve

the inclusion of participants from other religious groups, cultural backgrounds and

Protestant denominations.

Despite the apparent limitations, it is compelling that the beliefs emerging from the

data overlap with those found by researchers investigating similar domains (Cinnirella

& Loewenthal, 1999). The findings of the current study add to a growing understanding

of religiously based beliefs and practices of different religious groups that have the poten-

tial to conflict with those of orthodox medicine and psychiatry (Loewenthal, 1995).

However, while theological explanations of mental illness may conflict with scientific

explanations, they may also contribute to, or be complementary to, science (Tjeltveit,1991). The outcomes of this study may assist Christians to increasingly rise above the

pre-eighteenth century tradition of seeing mental illness solely as demonic possession or

the result of sin, and therefore something to be feared and kept at distance.

Psychology’s disciplinary tools and strong emphasis on research can give both science

and religion careful attention and thus help to reduce the science–faith tension

(Tjeltveit, 1991).

The results also verify the importance for further integration of religious concepts within

the general attribution literature (Pargament & Hahn, 1986). It is apparent, in the findings

of this study, that religious faith provides cognitive resources for interpreting and under-

standing mental illness (Idler & George, 1998).Finally, the outcomes of this study have provided support for the employment of quanti-

tative in addition to qualitative methodology for future research exploring the link between


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References

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