Clinically significant religious impairment

Abstract

Recent psychodiagnostic practice, as embodied in the DSM IV, requires that psychopathological features result in a "clinically significant impairment" to qualify as a "mental disorder" in many cases. The impairment must be in social, occupational, or other important areas of functioning. The current proposal is that clinicians should consider the potential impairment in religious functioning arising from mental disorders in diagnostic process. It is suggested that psychopathology may result in a clinically significant religious impairment that is defined as a reduced ability to perform religious activities, achieve religious goals, or to experience religious states, due to a psychological disorder. Various existing approaches to studying the relationship between religious functioning and psychopathology are briefly reviewed and roughly categorized as either focused on 'symptomatic religiosity' or reflecting a 'religiously sympathetic' posture. Yet, in both of these approaches, religion has predominantly been construed as an exogenous variable contributing to mental health in some fashion (for good, for ill, or for both). The current proposal suggests that clinicians should also consider religion in endogenous perspective. So construed, religion is a significant domain of adaptive functioning, which may be adversely impacted by psychopathology. A discussion of various clinical, research and ethical issues involved in realizing the proposal is provided.