If you talk to God, you are praying; if God talks to you, you have schizophrenia : distinctions between psychosis and spiritual experience among Christians

Many clients within the current system who are diagnosed with psychotic spectrum disorders, such as schizophrenia, present with what mental health professionals often consider to be hallucinations and delusions with religious or spiritual content. However, these presentations often have striking similarities to spiritual experiences, in which an individual may report having a prophetic-type experience or some type of otherworldly communication that is embedded within their value and belief-system. The present study seeks to explore how these attributions are made and which contextual factors are associated with individuals\u27 interpretations of these ambiguous presentations. A sample of 177 Christian adults living in the United States were surveyed to explore how variation in religious beliefs are related to the way Christians interpret ambiguous psychotic-like spiritual presentations. This mixed-method study investigates how variations in religiosity predicts Christians\u27 understandings of these ambiguous presentations as either being rooted in a religious/spiritual experience or indications of psychopathology. Results suggested that religiosity predicted whether or not participants\u27 relied on religious or psychological/medically-based meaning-making frameworks to understand the ambiguous presentation in the vignette. Specifically, those with stronger beliefs in divine communication, higher reliance on God, and more frequent participation in religious activities were more likely to interpret the vignette as representing a religious experience and less likely to understand the vignette as being rooted in mental illness even after controlling for several background characteristics. Additionally, mental health professionals included in the present study were more likely to interpret the vignette as being indicative of mental illness and less likely to interpret it as a religious experience than those who have not worked in the field, while controlling for the same covariates. These findings indicate that even highly religious mental health professionals may have different understandings of ambiguous psychotic-like spiritual presentations than their highly religious clients. The findings of the present study offer support for the integration of a Biopsychosocial-spiritual model of care, in order to create more space for potential spiritually-based interpretations that clients may hold, despite the entrenchment of medicalized thought in the current mental health system. This study has important implications for both diagnosis and treatment with clients with psychotic-like spiritual experiences and emphasizes the need for greater attention to issues related to religion and spirituality in the education of mental health professionals