Background: In most studies, religiosity and spirituality (R/S) are positively associated with altruism, whereas depression is negatively associated. However, the cross-sectional designs of these studies limit their epidemiological value. We examine the association of R/S and major depressive disorder (MDD) with altruism in a five year longitudinal study nested in a larger prospective study. Methods: Depressed and non-depressed individuals and their first- and second-generation offspring were assessed over several decades. At Year30 after baseline, R/S was measured using participants’ self-report; MDD, by clinical interview. At Year35, participants completed a measure of altruism. Adjusted odds ratios (AOR) were calculated using multivariate logistic regression; statistical significance, set at p<.05. two-tailed. Results: In the overall sample, both R/S and MDD were significantly associated with altruism, AOR 2.52 (95% CI 1.15–۵٫۴۹) and AOR 2.43 (95% CI 1.05–۵٫۶۴), respectively; in the High Risk group alone, the corresponding AORs were 4.69 (95% CI 1.39–۱۵٫۸۴) and 4.74 (95% CI 1.92–۱۱٫۷۲). Among highly R/S people in the High Risk group, the AOR for MDD with altruism was 22.55 (95% CI 1.23–۴۱۴٫۶۰) p<.04; among the remainder, it was 3.12 (95% CI 0.63–۱۵٫۳۰), a substantial but non-significant difference. Limitations: Altruism is based on self-report, not observation, hence, vulnerable to bias. Conclusions: MDD’s positive association with elevated altruism concurs with studies of posttraumatic growth in finding developmental growth from adversity. The conditions that foster MDD’s positive association with altruism and the contribution of R/S to this process requires further study

Introduction

Empathy, compassion, pro-sociality and altruism (synopsized here as altruism), prized in nearly all cultures (Decety, 2010), constitute principal forms of human engagement (Eisenberg and Miller, 1987) and are essential for the survival of communal life. An established body of research has documented that clinical depression and depressive symptoms can reduce empathic capacities, inhibit social engagement, and compromise the wish and will towards altruistic and prosocial actions (Kupferberg et al., 2016). Donges and colleagues (Donges et al., 2005) find compromised empathic responses (measured with a questionnaire) among inpatients with MDD as compared with healthy controls. Much the same results are reported by Cusi et al. (2011) for outpatients diagnosed with MDD. Studies by Nejati et al. (2012), Clark et al. (2013) and Ekinci and Ekinci (2016) assessed empathic accuracy with Baron-Cohen’s “reading the mind in the eyes” protocol (Baron-Cohen et al., 2001), or capacity for empathy using economic game paradigms or standard measures of perspective-taking and empathic concern. These investigations, nearly all of which were cross-sectional in nature, found that healthy controls substantially outperformed patients with MDD on each of these markedly different tools for measuring aspects of empathy.