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Original Investigation |

Neuroanatomical Correlates of Religiosity and Spirituality:  A Study in Adults at High and Low Familial Risk for Depression

Lisa Miller, PhD1,2; Ravi Bansal, PhD2,3; Priya Wickramaratne, PhD2,4,5; Xuejun Hao, PhD2,3; Craig E. Tenke, PhD6; Myrna M. Weissman, PhD2,4,5; Bradley S. Peterson, MD2,3
[+] Author Affiliations
1Teachers College, Columbia University, New York, New York
2Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, New York
3Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York
4Division of Epidemiology, New York State Psychiatric Institute, New York
5Mailman School of Public Health, Columbia University, New York, New York
6Division of Cognitive Neuroscience, New York State Psychiatric Institute, New York
JAMA Psychiatry. 2014;71(2):128-135. doi:10.1001/jamapsychiatry.2013.3067.
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Importance  We previously reported a 90% decreased risk in major depression, assessed prospectively, in adult offspring of depressed probands who reported that religion or spirituality was highly important to them. Frequency of church attendance was not significantly related to depression risk. Our previous brain imaging findings in adult offspring in these high-risk families also revealed large expanses of cortical thinning across the lateral surface of the right cerebral hemisphere.

Objective  To determine whether high-risk adults who reported high importance of religion or spirituality had thicker cortices than those who reported moderate or low importance of religion or spirituality and whether this effect varied by family risk status.

Design, Setting, and Participants  Longitudinal, retrospective cohort, familial study of 103 adults (aged 18-54 years) who were the second- or third-generation offspring of depressed (high familial risk) or nondepressed (low familiar risk) probands (first generation). Religious or spiritual importance and church attendance were assessed at 2 time points during 5 years, and cortical thickness was measured on anatomical images of the brain acquired with magnetic resonance imaging at the second time point.

Main Outcomes and Measures  Cortical thickness in the parietal regions by risk status.

Results  Importance of religion or spirituality, but not frequency of attendance, was associated with thicker cortices in the left and right parietal and occipital regions, the mesial frontal lobe of the right hemisphere, and the cuneus and precuneus in the left hemisphere, independent of familial risk. In addition, the effects of importance on cortical thickness were significantly stronger in the high-risk than in the low-risk group, particularly along the mesial wall of the left hemisphere, in the same region where we previously reported a significant thinner cortex associated with a familial risk of developing depressive illness. We note that these findings are correlational and therefore do not prove a causal association between importance and cortical thickness.

Conclusions and Relevance  A thicker cortex associated with a high importance of religion or spirituality may confer resilience to the development of depressive illness in individuals at high familial risk for major depression, possibly by expanding a cortical reserve that counters to some extent the vulnerability that cortical thinning poses for developing familial depressive illness.

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Figure 1.
Associations of Religious and Spiritual Importance With Cortical Thickness

Methods for false discovery rate (FDR) (A) and gaussian random field (GRF) (B) were applied to correct for the multiple comparisons. The GRF method is more conservative but has lower statistical power than the FDR method; therefore, the GRF-corrected maps have fewer significant findings. The corrected P values were color encoded and displayed on the surface. The color bar shows the color encoding for the P values. Red and yellow indicate positive correlations, and violet and blue indicate negative correlations between the measures of cortical thickness and importance of religion. C, The plot of the mean thicknesses and SEs (error bars) for a region in the mesial right hemisphere showed that the mean cortex was 1-mm thicker in the individuals with high compared with low importance for religion. These maps show that the higher importance for religion was associated with thicker cortical mantle bilaterally across the occipital cortex and superior parietal lobe, in the mesial right hemisphere, and in the precuneus and cuneus of the left hemisphere.

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Figure 2.
The Effects of Stable Importance During a 5-Year Period

A and B, Although the participants with either stable high or unstable importance for religion had thicker cortical mantle in the left posterior parietal and occipital cortex and mesial right hemisphere, the expanse of regions with a thicker cortex was smaller in the participants with unstable than those with stable high importance. C and D, The plots of the mean thickness showed that the cortex was approximately 0.69-mm thicker in the occipital lobe for the stable high participants and in the posterior parietal lobe for the unstable participants compared with participants with stable low importance for religion.

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Figure 3.
Differing Effects of Religious and Spiritual Importance in the High- Compared With Low-Risk Group

The interaction map of familial risk by religious importance at 25 years (T25) shows differing effects of religious importance on cortical thickness in the high- compared with low-risk group across the orbital frontal cortex and the mesial left and right hemispheres. In the 67 high-risk adults, bilateral increases in cortical thickness across the entire brain were associated with higher importance for religion at T25. In the 36 low-risk adults, thinning in the orbital frontal cortex and mesial left hemisphere and thickening in the right mesial hemisphere were associated with high importance for religion. We applied the false discovery rate to correct for multiple comparisons. P values were color encoded and plotted on the surface of the brain. ACC indicates anterior cingulate cortex; CUN, cuneus; mPFC, mesial prefrontal cortex; PCUN, precuneus; SPL, superior parietal lobe.

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