title: Religiosity and decreased risk of substance use disorders: is the effect mediated by social support or mental health status?
abstract: OBJECTIVE
  The negative association between religiosity (religious beliefs and church attendance) and the likelihood of substance use disorders is well established, but the mechanism(s) remain poorly understood. We investigated whether this association was mediated by social support or mental health status.
  
  
  METHODS
  We utilized cross-sectional data from the 2002 National Survey on Drug Use and Health (n = 36,370). We first used logistic regression to regress any alcohol use in the past year on sociodemographic and religiosity variables. Then, among individuals who drank in the past year, we regressed past year alcohol abuse/dependence on sociodemographic and religiosity variables. To investigate whether social support mediated the association between religiosity and alcohol use and alcohol abuse/dependence we repeated the above models, adding the social support variables. To the extent that these added predictors modified the magnitude of the effect of the religiosity variables, we interpreted social support as a possible mediator. We also formally tested for mediation using path analysis. We investigated the possible mediating role of mental health status analogously. Parallel sets of analyses were conducted for any drug use, and drug abuse/dependence among those using any drugs as the dependent variables.
  
  
  RESULTS
  The addition of social support and mental health status variables to logistic regression models had little effect on the magnitude of the religiosity coefficients in any of the models. While some of the tests of mediation were significant in the path analyses, the results were not always in the expected direction, and the magnitude of the effects was small.
  
  
  CONCLUSIONS
  The association between religiosity and decreased likelihood of a substance use disorder does not appear to be substantively mediated by either social support or mental health status.
authors.affiliation: Division of Health Services Research, Department of Psychiatry, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA. mjedlund@uams.edu
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Edlund
authors.forename: Katherine M
authors.initials: KM
authors.lastname: Harris
authors.forename: Harold G
authors.initials: HG
authors.lastname: Koenig
authors.forename: Xiaotong
authors.initials: X
authors.lastname: Han
authors.forename: Greer
authors.initials: G
authors.lastname: Sullivan
authors.forename: Rhonda
authors.initials: R
authors.lastname: Mattox
authors.forename: Lingqi
authors.initials: L
authors.lastname: Tang
mesh_terms: D000293:Adolescent; D000328:Adult; D019973:Alcohol-Related Disorders / Q000453:epidemiology / Q000523:psychology; D003430:Cross-Sectional Studies; D005260:Female; D006296:Health Services; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D016013:Likelihood Functions; D016015:Logistic Models; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology*; D008875:Middle Aged; D012067:Religion; D012307:Risk Factors; D012944:Social Support; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D011795:Surveys and Questionnaires