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. Author manuscript; available in PMC: 2024 Jan 1.
Published in final edited form as: Psychol Men Masc. 2022 Aug 11;24(1):76–82. doi: 10.1037/men0000409

Religion, Psychiatric Symptoms, and Gender Role Conflict Among Incarcerated Black Men

Shemeka Thorpe 1, Danelle Stevens-Watkins 1, Shawndaya Thrasher 2, Natalie Malone 1, Jardin N Dogan 1
PMCID: PMC10427125  NIHMSID: NIHMS1858659  PMID: 37589030

Abstract

Extant literature is mixed on the role of religiosity as a protective factor for mental health concerns and the effectiveness of faith-based prison programs on a reduction in recidivism. Religiosity and psychiatric symptoms are associated with gender role conflict, yet little is known about these relationships among Black incarcerated men. Undergirded by gender role conflict theory, this study aimed to investigate the relationship between religiosity, 30-day psychiatric symptoms, and three measures of gender role conflict: emotional restrictiveness, work-family conflict, and affectionate behavior towards men. In a sample of 206 Black men nearing community re-entry, our results indicated strong religious beliefs and psychiatric symptoms were associated with less emotional restrictiveness. Religious influence and psychiatric symptoms were positively associated with perceived work-family conflict. Further, strong religious beliefs moderated the association between psychiatric symptoms and work-family conflict. Implications for faith-based prison support programs as mechanisms for reducing recidivism among Black men are discussed.

Keywords: religion, gender role conflict, Black men, incarceration, psychiatric symptoms

Over the last 20 years, there has been an increase in faith-based prison programs designed to reduce recidivism rates among incarcerated individuals nearing re-entry (Dodson, et al., 2011; Mowen et al., 2017). Research on the success of these programs show conflicting results (Mowen et al., 2017; Dodson et al., 2011; Kelley et al., 2015). For Black incarcerated men, religion has often been linked with increased mental health concerns like increased gender role conflict (GRC) and less help-seeking for psychiatric symptoms. According to the US Department of Justice, 37% of prisoners have a history of mental health problems (US Department of Justice, 2017). Further, mental health problems among incarcerated populations are more than triple that of the general population (US Department of Justice, 2017). Since Black men are six times more likely to be incarcerated than White men (Carson, 2020), they have a higher likelihood of developing mental health disorders when compared to the general population. Further, lifetime incarceration is associated with higher levels of psychological distress and delayed treatment among Black men (Addison et al., 2022). High underreported rates of mental health disorders among Black men (Hudson et al., 2018) and exacerbated mental health concerns among incarcerated populations (US Department of Justice, 2017), highlight the importance of investigating if religiosity protects against GRC and psychiatric symptoms - especially among incarcerated Black men nearing community re-entry.

Gender Role Conflict Theory

GRC theory provides a framework for investigating the relationship between religiosity, psychiatric symptoms, and GRC among incarcerated Black men. GRC theory (O’Neil, 1990, p. 25) posits that men encounter conflicting messages about how to participate in or perform stereotypical masculine roles to avoid being perceived as feminine. There are four aspects of GRC: 1) restricted emotionality; 2) restricted affectionate behavior between men; and 3) work-family conflict, and 4) success, power, and competition (Mahalik & Lagan, 2001; O’Neil, 1990). Restricted emotionality refers to men’s difficulty in expressing emotion and to not appear weak or vulnerable. Restrictive affectionate behavior is limited affectionate expression between men due to physical and emotional discomfort. Barriers to positive displays of affection between men may be linked to homophobia in Black communities (Ward, 2005) and exacerbated in prison environments. Religiosity often promotes hypermasculinity and homophobia (Ward, 2005) among Black populations, thus understanding the role of religiosity and GRC among Black incarcerated men is needed. Work-family conflict refers to men’s struggles to balance work, family relationships, and leisure activities (O’Neil, 1990). For Black incarcerated men, pressure to provide for their families financially and the desire to make up for lost time while in prison, can lead to anticipated work-family conflict upon community re-entry (Williams et al., 2019). Religion may be a protective factor against GRC among Black incarcerated men by providing them with hope and support.

GRC & Mental Health

Psychologically, GRC limits masculinity and encourages adherence to traditional gender roles (e.g., hypermasculinity, being a provider, being strong) (O’Neil, 2015). Pressures to adhere to these traditional gender roles could come from religious doctrines and result in negative psychological outcomes for Black men, including anger, anxiety, and depression (Liu et al., 2005; O’Neil, 1990). As psychiatric symptoms increase in severity, men may struggle to outwardly express mental and emotional turmoil or seek treatment (Holden et al., 2012), thus leading to increased GRC.

Justice involvement exacerbates mental health concerns (Assari et al., 2018). Black incarcerated men are less likely to receive and seek psychiatric care compared to their White counterparts both while in prison (Holliday et al, 2016) and upon re-entry (Mahaffey et al., 2018). Further, men across race/ethnicities have lower rates of mental healthcare utilization when compared to women (Cadaret & Speight, 2018). These gender differences may be explained by men’s adherence to traditional masculinity norms (Addis & Mahalik, 2003; Holden et al., 2012). For incarcerated Black men, cultural norms like mental health stigma could also result in underreports of mental health service needs (Holden et al., 2012; Scott et al., 2022). For example, only half of Black people who need mental health treatment receive it (National Institute on Minority Health & Health Disparities, 2021). Missed opportunities to address psychiatric symptoms may lead to Black men going untreated while incarcerated and exacerbated mental health problems after re-entry (Mahaffey et al., 2018).

Religion: Protective Factor or Risk Factor?

Approximately 69% of Black men indicate that religion is important to them (Cox & Diamant, 2018). Unfortunately, many Black people who are religious may be less likely to admit psychological distress and seek services due to perceptions of lacking in faith (Jang & Johnson, 2004). In some cases, religiosity is associated with many mental health benefits, such as decreased psychological distress (Lesniak et al., 2006) and improved quality of life (Ramirez et al., 2012). As a protective factor, religion is a source of encouragement, community restoration, and hope among Black Americans (Brewer & Williams, 2019; Holt et al., 2014). However, religious coping strategies (e.g., prayer, community support) can lead to delayed mental health treatment and help seeking for Black people (Garner & Kunkel, 2020).

Extant literature indicates a relationship between religion and masculinity (Cokley et al., 2013; Ward, 2005; Ward & Cook, 2011). In prisons, hypermasculinity is employed to counter feelings of powerlessness and marginalization among incarcerated Black men (Karp, 2010). Therefore, men may experience psychological distress due to GRC while incarcerated (Kupers, 2005). Black incarcerated men may use religion to cope with a loss of freedom while in prison (Clear & Sumter, 2002). Simultaneously, male prisoners may reject religiosity because they need to embody masculinity to align with prison cultural norms (Clear & Sumter, 2002). The setting and context of prison likely informs the relationship between religiosity and GRC for incarcerated Black men (Gordon et al., 2013).

The Current Study

Based on the contradictory findings on religiosity and the increase in faith-based prison programs, more research is needed to understand the impact of religiosity on incarcerated Black men. To date, literature on GRC has not considered the situational context of prison among religious Black men (Boyd-Franklin, 2000; Wade & Rochlen, 2013). This study investigates the association between religiosity, 30-day psychiatric symptoms, and GRC among incarcerated Black men nearing community re-entry. Using the conceptual models from Isacco & Wade (2019), we believe that the relationship between religiosity and psychiatric symptoms are influenced by measures of masculinity (e.g., GRC). We hypothesize a negative relationship between religiosity and GRC, such that stronger religious beliefs and religious influence increase GRC. Second, we hypothesize that religiosity moderates the relationship between psychiatric symptoms and GRC. We hypothesize that psychiatric symptoms increases gender role conflict more for those that do not report strong religious beliefs or religious influence. Additionally, we explore the correlation between employment factors, psychiatric symptoms, religion, and GRC, specifically work-family conflict.

Methods

This study uses secondary data from the Helping Incarcerated Men study (see Wheeler et al., 2018), which examined Black men’s mental health, substance use, and HIV risk behaviors. A non-probability sample of N = 206 men nearing 120 days of release was used to investigate the relationship between religiosity and GRC among Black men. Participants were recruited from four medium-to-low security Kentucky prisons with the highest percentages of Black male prisoners. Eligible men were recruited through mailed letters inviting them to participate in a health study. Participants consented to in-person interviews using Audio Computer Assisted Self-Interviewing (ACASI) techniques with trained study staff. They received $25 in their prison accounts as an incentive. This study was approved by the University’s Institutional Review Board and Department of Corrections.

Participants

Our sample consisted of mostly high school graduates (Md = 12 years, SD = 2.50), who were an average age of 36 years old (SD = 11.09; Range 19–88) and reported being incarcerated before age 18 (n = 128; 62.1%; see Table 1). Most participants reported belonging to a religious group (n = 124; 59.6%) and strong religious beliefs (n = 160; 77.7%). Among those that reported being a part of a religious group majority were Baptist (n=48; 39.0%) followed by Christian (n=36, 29.3%). More than a third of participants reported attending religious services regularly (n = 81; 38.9%) and more than half reported that religious beliefs influenced their decisions (n = 114; 55.3%). Participants reported moderate GRC scores for all three subscales and an average of one psychiatric symptom over the last 30 days. However, 60.6% did not report any psychiatric symptoms in the last 30-days. The most frequently reported psychiatric symptom was anxiety (n=83; 40.1%) in the last 30 days. For descriptive on employment factors see Table 2.

Table 1.

Demographics, Dependent, and Independent Variables (N=206)

N (%) M+SD (Range)
Age 35.93+10.56 (19–69)
Education (years) 11.43 + 2.55 (0–33)
Months Incarcerated 98.3 + 102.16 (1–920)
Incarcerated Before Age 18 128 (62.1)
Religiosity
Member of A Religious Group 124 (59.6)
Religious Affiliation
 Baptist 48 (39.0)
 Christian 36 (29.3)
 Muslim 19 (15.4)
 Methodist 3 (2.4)
 Pentacostal 3 (2.4)
 Apostolic 3 (2.4)
 Native American Church 1 (.08)
 Other religious group 10 (8.1)
Attends Religious Services Regularly 81 (38.9)
Has Strong Religious Beliefs 160 (77.7)
Religious Beliefs Influences Decisions 114 (55.3)
30-day Psychiatric Symptoms 1.00 + 1.54 (0–7)
 Serious depression 34 (16.7)
 Serious anxiety 62 (29.8)
 Experienced hallucinations 10 (4.9)
 Trouble understanding, concentrating, and/or remembering 40 (24.2)
 Suicidal thoughts 3 (1.5)
 Suicide attempt 1 (0.5)
 Prescribed medication for psychiatric problems 21 (10.1)
Gender Role Conflict
 Emotional Restrictiveness 31.37+13.66 (10–60)
 Restricted Affection Towards Men 35.18+9.84 (8–48)
 Work Family Conflict 18.55+9.01 (6–30)
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Note: The percentages for each psychiatric symptom represent the percentage of participants that reported that symptom in the last 30 days. Although the range of possible psychiatric symptom scores were 0–8 no one reported six or eight symptoms.

Table 2.

Employment Factors

Factors N (%) or M± SD (Range)
Have a profession, trade, or skill 250 (72.1)
Have a valid driver’s license 82 (39.4)
Have a car upon release 59 (72.0)
Someone contributes support to them 172 (82.7)
Support from others makes up majority of support 101 (59.1)
Troubled/Bothered By Employment Problems in Last 30 days
 Not at all 140 (67.6)
 Slightly 24 (11.6)
 Moderately 16 (7.7)
 Extremely 27 (13.0)
Importance of Counseling Now for Employment Problems
 Not at all 124 (60.2)
 Slightly 28 (13.6)
 Moderately 18 (8.7)
 Extremely 36 (17.5)
Type of Employment Prior to Incarceration
 Full Time (40 hrs/week) 82 (40.8)
 Part Time (regular set hours) 18 (8.7)
 Part Time (irregular hours/day work) 10 (4.9)
 Student 15 (7.3)
 Retired/disability 10 (4.9)
 Unemployed 26 (12.6)
 Illegal Activities 42 (20.4)
 In controlled environment 1 (0.5)
Months worked in a row at full-time job 32.55+76.33 (0–666)
Number of People Depending On Them for Food, Shelter, Etc. 2.74±3+60 (0–22)
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Note: Only participants who reported that they had a valid driver’s license received the question about having a car available for use upon release. Only participants who reported that someone contributes support to them were asked if support from others makes up majority of their financial support.

Measures

Gender Role Conflict Scale.

Participants self-reported their GRC across three components of the Gender Role Conflict Scale (O’Neil, 1986): (1) Restrictive Emotionality Subscale (10-items; range = 10–60; α = .90), (2) Restrictive Affectionate Behavior between Men Subscale (8-items; range = 8–48; α = .83), and (3) Conflicts between Work and Family Relations Subscale (6-items, range = 6–36, α = .89). Response categories for the three subscales range from (1) Strongly disagree to (6) Strongly agree, with higher scores indicating greater levels of GRC. Sample items included, “I do not like to show my emotions to other people,” “expressing my emotions to other men is risky,” and “when I am released, I am concerned that my job or school may affect the quality of my free time or family life.” All subscales had good internal consistency with Cronbach’s alpha coefficients ranging from 0.83–0.90.

Strong Religious Beliefs.

Participants indicated if they considered their religious beliefs to be very strong with binary responses of yes (1) or no (0).

Religious Influence.

Participants self-reported if they considered their religious beliefs to influence their decision making with binary responses of yes (1) or no (0).

Psychiatric Symptoms.

Participants completed the modified Addiction Severity Index (ASI-V), Fifth Edition (McLellan et al., 1992). A total of eight items assessed 30-day experiences of psychiatric symptoms with responses of yes (1) and no (0). Items were summed to create a composite measure with possible scores ranging from 0–8. Items measured 30-day reports of serious depression, anxiety and tension, hallucinations, inability to control violent behavior, thoughts of suicide, suicide attempts, trouble concentrating and remembering, and if they were prescribed medications. Sample items included “have you had a significant period that was not a direct result of drug/alcohol use, in which you have experienced serious anxiety or tension in the last 30 days,” and “…prescribed medication for any psychological or emotional problem in the last 30 days?”

Demographics.

Participants self-reported their age, number of months spent in prison prior to data collection, and if they ever were incarcerated before age 18 (juvenile incarceration status; no = 0; yes =1).

Employment factors.

Participants were asked a series of yes/no questions including if they have a profession, trade or skill, if they have a driver’s license, if they have access to a car upon release, if they have support in any way, if financial support from others was majority of their support, if they were troubled by employment in the last 30 days, and if they thought it was important to get counseling for their employment problems.

Analysis

Data analysis was conducted using SPSS version 27. Pre-analysis screening was conducted to address assumptions for a multivariate linear regression. Bivariate and multivariate regression analyses were conducted to examine the relationships between religion, psychiatric symptoms, and GRC (three subscales): restrictive emotionality, restrictive affectionate behavior, and conflicts between work/family relations (see Model 1). Moderators are tested through multiple regression analyses using interaction terms when the moderator is categorical the outcome variable is continuous (Baron & Kenney, 1986; Frazier et al., 2004). Interaction terms were created between religious influence and psychiatric symptoms and strong religious beliefs and psychiatric symptoms to test for moderation effects between psychiatric symptoms and GRC. Moderation analyses were conducted for each subscale (see Model 2). An exploratory bivariate correlation was conducted to examine the relationship between employment factors, psychiatric symptoms, religiosity, and work-family conflict. Age and juvenile incarceration status were controlled for in each model.

Results

Three separate multivariate regression analyses were performed for each GRC subscale (see Table 3). Findings indicated that men who considered their religious beliefs to be very strong had significantly lower restrictive emotionality than those who did not (β = −.23, p = .002), controlling for other variables in the model. However, religious influence and psychiatric symptoms were not significantly associated with restrictive emotionality. Religious influence, strong religious beliefs, nor psychiatric symptoms were associated with restrictive affectionate behavior. Religious influence was significantly associated with work-family conflict. Psychiatric symptoms were significantly positively associated with work-family conflict (p=.02) when controlling for other variables in the model. Religious influence was positively significantly associated with work-family conflict (p=.003). Once the interaction terms were added to Model 2, psychiatric symptoms remained significant (p<.001). Strong religious beliefs were not significantly associated with work-family conflict (p = .20), but significantly moderated the relationship between psychiatric symptoms and work-family conflict (p=.03;). Specifically, participants who did not have strong religious beliefs had a positive relationship between psychiatric symptoms and work-family conflict and reported higher work-family conflict overall. The relationship between psychiatric symptoms and work-family conflict was weaker for those with strong religious beliefs. Despite religious influence being a significant predictor of work-family conflict, it did not moderate the association between psychiatric symptoms and work-family conflict.

Table 3.

Multiple Regression and Moderation Models: Religioisity, 30-Psychiatric Symptoms, and Gender Role Conflict

Restrictive Emotionality Restrictive Affectionate Behavior Conflicts between Work/Family Relations
Model 1 β p-value β p-value β p-value
30-day psychiatric symptoms .06 .40 -.07 .32 2.34* .02
Strong religious beleifs −.23** .002 −.02 .85 −1.29 .20
Religious influence −.02 .75 −.10 .20 3.01** .003
Age 1.00 .16 .01 .85 −1.84 .07
Juvenile incarceration .14* .049 −.14 .06 .80 .42
Model 2
30-day psychiatric symptoms .10 .56 −.14 .39 3.67*** <.001
Strong religious beleifs −.27** .005 −.03 .78 .10 .92
Religious influence .04 .66 −.11 .24 3.01** .003
Age .10 .15 .01 .85 −1.88 .06
Juvenile incaracreation .13 .06 −.13 .06 .69 .49
Strong relgious beleifs*30-day psychiatric symptoms (int) .09 .60 .04 .79 −2.12* .03
Religious influence* 30-day pychiatric symptoms (int) −.16 .24 .05 .73 −1.42 .16
Model 1
Adjusted R 2 .06 .01 .07
F 3.46** 1.44 4.23**
Model 2
Adjsuted R 2 .05 .002 .10
F 2.67* 1.06 4.36***
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Note. β (Beta) indicates standardized coefficients. p,.05*, p<.01**, p<.001*** (int)= interaction term

Results of the bivariate correlation showed that participants with a profession/trade/skill (r= −.19, p=.007) and a driver’s license (r= −.24, p<.001) reported less work-family conflict. Men who were troubled or bothered by employment problems in the last 30 days (r=.18, p=.01) and those who believed that counseling was needed now for their employment problems (r=.22, p=.001) reported higher work-family conflict and more psychiatric symptoms (r=.26, p<.001; r=.23, p<.001 respectively). However, those who had strong religious beliefs felt that counseling was not necessary was their employment problems (r= −.20, p=.005). Religious influence was correlated with having a driver’s license (r=.17, p=.012) and more months worked prior to incarceration (r=.17, p=.013).

Discussion

This study aimed to examine the relationship between religiosity, psychiatric symptoms, and GRC among incarcerated Black men. Incarcerated Black men who have stronger religious beliefs had less emotional restrictiveness. This finding contradicts previous research, which shows that strong religious views are sometimes associated with more emotional restrictiveness, (Ward, 2005; Ward & Cook, 2011) especially if Black men choose to operate within a traditional paradigm of masculinity that is commonly upheld in Black faith-based communities.

Men with higher religious influence reported more psychiatric symptoms and anticipated greater work-family conflict upon release from prison. Additionally, strong religious beliefs significantly moderated (or weakened) the relationship between psychiatric symptoms and work-family conflict. Incarcerated men may anticipate anxiety from gendered and religious expectations of being a financial provider. Notably, the intersection of being Black, male, and previously incarcerated hinders the ability to secure employment upon re-entry (Palmer & Christian, 2019), which may cause increased mental health concerns and gender role strain (Addison et al., 2022). In fact, 60.8% of Black men reported that finances and money were common stressors (Meldrum & Brown., 2014).

In the current study, Black men who had higher work-family conflict also experienced employment problems in the last 30 days and wanted counseling for their employment distress. However, Black men with stronger religious beliefs felt that counseling was unimportant, possibly relying on their faith to cope with work-family conflict, employment stress, and psychiatric symptoms. Since Black men are among the least likely to seek professional mental health services (Keating & Robertson, 2004), addressing mental health struggles within faith-based prison programs could provide them with positive coping skills to reduce their GRC. A study on Black Pentecostal preachers found that some of their sermons suggested mental health issues, such as depression, were a weakness. Congregants were told that “saints don’t cry” and discouraged from seeking help (Payne, 2008). These statements reaffirm patriarchal messages and support hypermasculinity. Faith-based programs that promote the value of mental health counseling is important and can reframe the narrative about mental health treatment and masculinity.

Limitations

Although these findings significantly contribute to the religious-based research on incarcerated Black men, there are limitations. First, data was collected from incarcerated Black men nearing re-entry in Kentucky; therefore, findings may not be generalizable. Secondly, these data are cross-sectional, so we cannot assess relationships over time nor test the potentially bidirectional relationship between GRC and psychiatric distress. The work-family conflict GRC subscale was based on what participants anticipated would happen upon re-entry; therefore, their responses were hypothetical in nature. Concerns of power in using hierarchical linear regression to test moderation are also a limitation of this study as the effect size is considered small according to Cohen (1992). Finally, the major limitation of this study is the use of two dichotomous questions to measure the complex construct of religiosity. Validated and reliable religiosity scales would increase study rigor.

Implications

Prison faith-based programs have been shown to reduce recidivism (Dodson et al., 2011). In our study, psychiatric symptoms were associated with GRC. However, religious beliefs moderated this association. Although Black religious communities may acknowledge mental health issues among Black men (Bryant et al., 2014), there is a need for faith-based programs to focus on reducing the stigma and negative perceptions that may prevent Black men from seeking psychiatric help while incarcerated and at re-entry. These programs can encourage incarcerated Black men to rely not only on their religious beliefs but their support systems to foster emotional expressiveness and seek professional help. For many Black men, feelings of fear and hopelessness arise upon community re-entry. Faith-based programs can ease the transition and psychological distress associated with reintegration (Addison et al., 2022).

In this study, incarcerated Black men anticipated work-family conflict before community release. Formally incarcerated Black men usually do not seek mental health services after reintegration because they prioritize other factors like housing, employment, and safety (Sun et al., 2018; Wallace et al., 2016). Faith-based programs and churches could aid by providing tangible tools and resources to meet essential needs and avoid mental health crises exacerbated by managing multiple stressful tasks such as seeking employment, rebuilding connections with family members, and adhering to traditional gender roles.

Public Significance Statement:

The present study highlights the influence of religiosity on incarcerated Black men’s 30-day psychiatric symptoms and gender role conflict, specifically work-family conflict. Faith-based organizations can provide counseling and support to men upon community re-entry and should encourage Black men to seek mental health counseling for their psychiatric symptoms.

Funding:

The study was funded by the National Institute on Drug Abuse, K08-DA032296, PI: Stevens-Watkins. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

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