Mediation and Moderation of Religion-Substance Abuse Relationships By Genotype

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Rachel Dew Bernard Fuemmeler Harold Koenig



The negative correlation between substance abuse and religiosity is well-established, and often cited as a mechanism through which religiosity affects general health.  However, little research has examined the mechanism underlying the addiction/religiosity relationship itself.  Previous literature on substance abuse documents significant relationships of substance abuse disorders with dopamine and serotonin transporters genes.  Other studies demonstrate genetic underpinnings to religiosity.  The current study sought to evaluate how religiosity, substance abuse, and genetics may interact.


Data were drawn from the National Longitudinal Study of Adolescent Health (Add Health), which surveyed over 15000 subjects in four waves, from age 12 to 38. Genotyping was performed for candidate genes previously correlated with mental health: the serotonin transporter promoter (5HTTLPR), dopamine transporter (DAT1), dopamine receptor subtype 4 (DRD4), and monoamine oxidase A (MAOA).  For this analysis genotypes were dichotomized by activity levels, per previous literature.  Religious variables (attendance, importance of religion, and prayer) were modeled across Waves I-IV using growth mixture modeling. To these models, genotypes were added to assess mediation relationships.  Stratified analyses were performed to test for moderation of religion/addiction relationships by genotype.


Evidence of mediation of the religion/substance abuse relationship was apparent for 5HT and DAT.  DAT appeared to mediate the relationship of baseline binge drinking to later religious attendance. Multiple relationships of religious importance and frequency of prayer to future substance abuse became non-significant when controlled for 5HTTPLR.  Moderation analysis found substantial variation in religion/substance use relationships according to genotype. 


This analysis indicates that religiosity may relate to addiction partially through correlation with genes, and that religion/substance use relationships may vary by genotype. Further research on the relationship of 5HTLLPR to religious phenomena, particularly personal prayer, is warranted. Improved understanding of how religion reduces substance abuse will inform prevention and treatment efforts.

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How to Cite
DEW, Rachel; FUEMMELER, Bernard; KOENIG, Harold. Mediation and Moderation of Religion-Substance Abuse Relationships By Genotype. Medical Research Archives, [S.l.], v. 5, n. 4, apr. 2017. ISSN 2375-1924. Available at: <>. Date accessed: 17 apr. 2024.
religion; substance abuse; genetics
Research Articles


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