Journal of Spirituality in Mental Health
Journal of Spirituality in Mental Health, 15:107–122, 2013 Copyright © Taylor & Francis Group, LLC ISSN: 1934-9637 print/1934-9645 online DOI: 10.1080/19349637.2013.776442
Assessing Spirituality: The Relationship Between Spirituality and Mental Health
DAVID R. BROWN Department of Behavioral Sciences, Cincinnati Christian University,
Cincinnati, Ohio, USA
JAMIE S. CARNEY Department of Special Education, Rehabilitation, Counseling/School Psychology,
Auburn University, Auburn, Alabama, USA
MARK S. PARRISH Department of Counseling and Educational Psychology, University of West Georgia,
Carrollton, Georgia, USA
JOHN L. KLEM Department of Rehabilitation and Counseling, University of Wisconsin-Stout,
Menomonie, Wisconsin, USA
This research study investigated the possible relationship between two spirituality variables (religious coping styles and spiritual well-being) and two psychological variables (anxiety and depression). Also studied were differences between those who self-disclosed a spiritual/religious identify and those who did not. Although a relationship was not noted between religious coping styles and the psychological variables, significance was reported in the relationship between spiritual well-being and both psy- chological variables. Overall, this study finds that individuals reporting higher levels of religiosity and spiritual well-being may also experience a reduction in mental and emotional illness.
KEYWORDS spirituality, religiosity, anxiety, depression
Over the past few decades, spirituality has become an increasingly impor- tant consideration in the mental health profession (Richards & Bergin, 2005; Young, Wiggins-Frame, & Cashwell, 2007). This has included an emphasis
Address correspondence to David R. Brown, Department of Behavioral Sciences, Cincinnati Christian University, Cincinnati, OH 45204. E-mail: david.brown@ccuniversity.edu
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and awareness of the importance of integrating spirituality and religion within the counseling process (Parker, 2011; Seybold & Hill, 2001). The inte- gration of spirituality into the counseling process is reflective of recognition that spirituality can be beneficial to client welfare (Koenig, 2010; Miller & Thoresen, 2003; Seybold & Hill, 2001). Moreover, there is significant evi- dence that spirituality may be related to or positively impact overall mental health or well-being (Hodges, 2002; Townsend, Kladder, Ayele, & Mulligan, 2002). This point is reflected in the growing body of research examining the physical, emotional, and psychological effects of spirituality and religios- ity (Hayman et al., 2007). For many individuals, spirituality and religion are central and foundational aspects of their lives and their well-being, and thus critical elements of the counseling process and interpersonal dynamic (Miller & Thoresen, 2003; Parker, 2011; Seybold & Hill, 2001).
As previously noted, evidence suggests that spirituality may be linked to physical health and well-being (Hodges, 2002; Townsend et al., 2002), and that spirituality is a significant component of holistic wellness (Myers & Williard, 2003). From a mental health perspective, religion and spiritual- ity may be involved in how individuals and groups make decisions, solve problems, and cope with life experiences; all of these activities incorporate spiritual themes and subsequently can correspond to overall improved men- tal health (Thurston, 1999; Pargament et al., 1988). In addition, spirituality may be an asset or a coping strategy for dealing with negative life events, as well as with psychological concerns (Koenig, 2010; Pargament et al., 1988); for example, Hayman et al. (2007) reported that spirituality helped buffer the negative effect of stress on self-esteem. There are also indicators that spiritu- ality may relate to how an individual deals with or is affected by depression (Srinivasan, Cohen, & Parikh, 2003; Westgate, 1996) and anxiety (Graham, Furr, Flowers, & Burke, 2001).
LIMITATIONS OF CURRENT RESEARCH IN SPIRITUALITY AND RELIGIOSITY
Although research has supported that spirituality is linked to both positive physical health (Miller & Thoresen, 2003; Townsend et al., 2002) and pos- itive mental health (Koenig, 2010; Hayman et al., 2007), the same research also notes a number of complicating factors in studying spirituality and reli- giosity. A review of literature reveals that similar limitations are noted in many research studies, the most common problem being the definition of spirituality. When questioning if spirituality can be measured, Oakes and Raphel (2008) noted that a common concern is defining the constructs: “these definitional problems make it difficult to know what a measure of spiritu- ality actually assesses” (p. 243). This problem in defining spirituality echoes Speck’s (2005) concerns regarding the inherent difficulty in determining a
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consensual definition of spirituality because of its epistemological nature. Further, Seybold and Hill (2003) suggested that the inconsistencies in defin- ing spirituality and religiosity have resulted in an ambiguous nature of research findings, which then leads to conflicted reporting when linking research outcomes to the mental and physical health issues being treated.
Other noted limitations in studying spirituality and religiosity are that quantitative measures may not fully assess the subjective nature of spirituality (Moberg, 2002) and that a majority of spiritually related assessment instru- ments are developed from a Judeo-Christian perspective (Stanard, Sandhu, & Painter, 2000). Moberg (2002) suggested that qualitative assessments may provide more useful and specific information about an individual’s spiritual- ity than a quantitative measure, as individual responses may better express spiritual needs and experiences. As noted by Stanard et al. (2000), many measures of spirituality and religiosity also lack normative information, thus limiting their usefulness in clinical settings. Because a lack of normative information inhibits the ability to generalize assessed results, Moberg’s (2002) suggestion for a qualitative assessment of spirituality reflects an understand- ing of the individualistic nature of spiritual experience and expressions, as well as articulating the difficulty in even developing a normative under- standing of spirituality. Miller and Thoresen (2003) stated that spirituality and religiosity are best described as latent constructs, which are complex and multidimensional variables. Therefore, such complexity in a construct implies that no single assessment instrument can adequately capture its meaning.
Research in spirituality and religiosity has attempted to address this com- plexity through the development of a multitude of assessment instruments. Hill and Hood (1999) published a review of 125 spirituality/religiosity assess- ment instruments, which were placed into 17 categories; each designed to assess a different construct of spirituality and religiosity. These 17 categories were defined as (a) religious beliefs and practices, (b) religious attitudes, (c) religious orientation, (d) religious development, (e) religious commitment and involvement, (f) religious experience, (g) religious/moral values or per- sonal characteristics, (h) multidimensional religiousness, (i) religious coping and problem solving, (j) spirituality and mysticism, (k) God concept, (l) reli- gious fundamentalism, (m) death/afterlife, (n) divine intervention/religious attribution, (o) forgiveness, (p) institutional religion, and (q) related con- structs. Unfortunately, as noted by Stanard et al. (2000), most of the assessment instruments reviewed by Hill and Hood (1999) suffered from a lack of normalizing data, questionable design, and most were devel- oped from a Judeo-Christian perspective. Some instruments, although initially developed from a Judeo-Christian view, have shown promise through the development of normalized information, validation through repeated use within numerous research studies, and refinement of nonspecific religious vocabulary. Assessment instruments, such as the Spiritual Well-Being Scale (Ellison, 1983; Paloutzian & Ellison, 1982) and the Religious Problem-Solving
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Scale (Pargament et al., 1988), have demonstrated high levels of validity and reliability, thus suggesting greater utility in research and practice.
The increase of interest in the study of spirituality and religiosity has resulted in the development and improvement of assessment instru- ments designed to evaluate various constructs of spirituality and religiosity. Research studies, such as Hayman et al. (2007) and Davis, Kerr, and Robinson-Kurpius (2003), used assessment instruments designed to measure faith maturity and levels of spiritual well-being and religious orientation, respectively, related to various mental health concerns. Davis et al.’s (2003) study reported that “greater spiritual well-being predicted lower trait anxi- ety among at-risk adolescents” (p. 361), although they did caution against over-generalization of these results. Similarly, Hayman et al.’s (2007) study reported that higher levels faith maturity correlated with higher levels of self-esteem and lower levels of stress and body-image concerns. Although further study in the areas of spirituality and religiosity is recommended, suffi- cient evidence has already been collected to demonstrate correlations among spirituality and religiosity with both mental and physical health. It appears that further research should focus in refining an understanding of various spiritual constructs with physical and mental health, as well as determining how to resolve the deficiencies in the qualitative assessment of spirituality and religiosity, as noted previously.
THE CURRENT STUDY
The current study was designed to evaluate the relationship of spiritual well-being and religious problem-solving with anxiety and depression. The…
