A systematic review of research on religion and spirituality in the Journal of Traumatic Stress: 1990–1999

Surveys reveal that religion and spirituality are highly valuable to many people in times of crisis, trauma, and grief. The relationship between coping with trauma and the use of various spiritual beliefs is well established. The importance of clergy in trauma recovery is also well documented. A review of the 469 research and non-research articles published between 1990 and 1999 in the Journal of Traumatic Stress revealed that 8.7% (6/69) of non-research articles, 4.1% (15/366) of quantitative research articles and 2.9% (1/34) of qualitative research articles considered religion or spirituality in their work. Analysis of variance found a significant overall increase in the percentage of articles that mentioned religion/spirituality between the first half (1990–1994) and the second half (1995–1999) of the study period. The results are discussed in the context of the trauma research and in comparison to related disciplines. Recommendations for future research and clinical application are suggested for both traumatologists and religious scholars.     

Religious Doubt and Spiritual Growth Among Adults Bereaved of a Grandparent

Religious beliefs and bereavement provide contexts for personal growth (Benore & Park, 2004). The death of a grandparent may be especially well-suited to prompt such growth. Using data from 164 adults, ages 18 to 51 years, bereaved of a grandparent, the authors examined whether religious doubt relates to current grief via perceived spiritual growth. Mediation analyses showed that fewer religious doubts were associated with spiritual growth in bereavement, but spiritual growth was associated with higher levels of current grief. Results are discussed within a framework for including family processes in bereavement research that includes religious doubt and spiritual growth.     

Marriage and Family Therapy Graduate Students’ Satisfaction with Training Regarding Religion and Spirituality

Marriage and family therapists are likely to encounter religious or spiritual clients in their career and thus are encouraged to be aware of their clients’ religious and spirituality. This awareness is often fostered within graduate training programs. This study aims to examine graduate students’ incorporation of religion and spirituality in therapy and their satisfaction with the quality and amount of training programs’ adherence to religion and spirituality. A sample of 135 graduate students from American Association for Marriage and Family Therapy accredited programs completed the survey. Findings showed that graduate students with greater levels of religiosity and spirituality were more likely to perceive it important to address religion/spirituality in therapy and to perceive there is a need for religious/spiritual education. When controlling for religious and spiritual orientations, overall regression results revealed that not having a course on religion and spirituality and perceiving a need for religious/spirituality in education predicted lower satisfaction with the amount and quality of current training surrounding these dimensions. Implications demonstrate the need to address religious/spiritual concepts in the curriculum, supervision, and in marriage and family therapy training.     

The Social Milieu of the Church and Religious Coping Responses: A Longitudinal Investigation of Older Whites and Older Blacks

The purpose of this study is to see if the social environment of the church influences the use of religious coping responses over time. The following theoretical relationships were embedded in the conceptual model that was developed to evaluate this issue: (a) People who go to church more often are more likely to feel their congregation is highly cohesive (e.g., share the same values and beliefs); (b) individuals who worship in highly cohesive congregations are more likely to receive spiritual support (i.e., encouragement to adopt religious teachings and principles) from their fellow church members; and (c) people who receive more spiritual support will be more likely to adopt religious coping responses. In the process of evaluating this model, tests were performed to examine the influence of racial culture. Data from a nationwide longitudinal survey of older adults provide support for each link in the conceptual model. Pervasive racial cultural differences were also found: Older Blacks were more likely to be deeply involved in each facet of religion than older Whites.     

Role of Religion and Spirituality in Stress Management Among Nurses

Religion and spirituality play a significant role as coping resources under stressful circumstances. Nursing professionals confront with a variety of stressors repeatedly and are found to employ religious/spiritual coping techniques in managing the negative impact of work stress. The present review explores different religious and spiritual coping strategies utilized by nurses of different socio-cultural and religious backgrounds and highlights the importance of treating religion and spirituality as two separate entities in studying their stress-buffering effect. The MEDLINE, CINAHL, PsycINFO, PsycArticles databases and Google Scholar were searched from 2006 to 2017 with the key words nursing, stress, religious coping, religiosity and spirituality. Various notions of the divine/transcendent aspect of life have led to lack of consensus over a functional definition of religion as well as spirituality. This is found to be the core element of methodological inadequacy in studying individuals’ reliance on religion and spirituality during stress. Further, most of the existing measures do not adequately explore spirituality as a construct independent of religion. Measures should be more culture sensitive to discover culturally enriched religious practices and rituals adopted by individuals belonging to different socio-cultural milieu to overcome stress. The role of religion and spirituality in stress resilience, emotion regulation and burnout among nurses around the globe needs further empirical support. Multiple levels at which religious and spiritual coping may moderate/mediate the relationship between work stress and behavioral/emotional outcomes among human service personnel who face high emotional labor demands should be more comprehensively analyzed.     

Exploring the Role of Religiosity and Spirituality in Amniocentesis Decision-Making Among Latinas

Given the complex array of emotional and medical issues that may arise when making a decision about amniocentesis, women may find that their spiritual and/or religious beliefs can comfort and assist their decision-making process. Prior research has suggested that Latinas’ spiritual and/or religious beliefs directly influence their amniocentesis decision. A more intimate look into whether Latinas utilize their beliefs during amniocentesis decision-making may provide an opportunity to better understand their experience. The overall goal of this study was to describe the role structured religion and spirituality plays in Latinas’ daily lives and to evaluate how religiosity and spirituality influences health care decisions, specifically in prenatal diagnosis. Semi-structured interviews were conducted with eleven women who were invited to describe their religious beliefs and thoughts while considering the option of amniocentesis. All participants acknowledged the influence of religious and/or spiritual beliefs in their everyday lives. Although the women sought comfort and found validation in their beliefs and in their faith in God’s will during their amniocentesis decision-making process, results suggest the risk of procedure-related complications played more of a concrete role than their beliefs.     

The Perceived Benefits of Religious and Spiritual Coping Among Older Adults Living with HIV/AIDS

Although religious and spiritual beliefs and practices have been frequently associated with greater psychological well-being among illness populations, little is known about the specific benefits individuals perceive they receive from these beliefs and practices. This issue was examined in interviews with 63 older HIV-infected adults. Participants reported a variety of benefits from their religious and spiritual beliefs and practices, including: (1) evokes comforting emotions and feelings; (2) offers strength, empowerment, and control; (3) eases the emotional burden of the illness; (4) offers social support and a sense of belonging; (5) offers spiritual support through a personal relationship with God; (6) facilitates meaning and acceptance of the illness; (7) helps preserve health; (8) relieves the fear and uncertainty of death; (9) facilitates self-acceptance and reduces self-blame. These perceived benefits suggest potential mechanisms by which religion/spirituality may affect psychological adjustment.     

Religious Coping Style, Concept of God, and Personal Religious Variables in Threat, Loss, and Challenge Situations

This study explored the important mediating role of personal religious variables and God concept in the use of religious coping in threat, loss, and challenge situations. One hundred and twenty-nine undergraduates completed questionnaires which included a God concept adjective checklist (Schaefer and Gorsuch 1992), a stressor scenario (Bjorck and Cohen 1993), and a measure of religious coping adapted from the BAV model (Gorsuch 1988). Results suggest that personal variables such as God concept and perception of others' beliefs played important mediating roles in religious coping in stressor situations. The relationship between coping style and stressor scenario was not entirely state-dependent, but influenced by personal variables. Strong relationships existed among God concept, the importance individuals placed on their religious and spiritual lives, and participation in religious activities.     

Religion as a Predictor of Psychological Distress in Two Religious Communities

Although spirituality and religion play a role in the lives of many North Americans, the relationship of these variables to symptoms of affective disorders has not been rigorously studied. The authors, therefore, evaluated the extent to which religious factors predicted symptoms of distress in a large community sample of 354 individuals (120 Christian and 234 Jewish). Results indicated that religious denomination was a poor predictor of distress. However, general religiousness (e.g. importance of religion), religious practices (e.g. frequency of prayer), and positive religious core beliefs predicted lower levels of worry, trait anxiety, and depressive symptoms, whereas negative religious core beliefs predicted increased symptoms. These variables accounted for a small but significant portion of the variance in reported symptoms after controlling for covariates. These findings are taken to indicate that religion is an important factor to consider when evaluating and treating distress in religious individuals. Implications for clinical practice of empirically supported treatments with religious individuals are explored.     

Research and Theory Religion and Spirituality in Coping With Stress

Relations among and between religion, spirituality, and the ability to cope with stress were examined using a sample of 115 graduate students in counseling. Religion and spirituality positively correlated with coping with stress. Counseling students who expressed spirituality through religious beliefs had greater spiritual health and immunity to stressful situations than counseling students who identified themselves as spiritual but not religious. Counseling students with a religious/spiritual affiliation indicated more discomfort counseling clients hostile to religion compared with counseling students with a spiritual‐only affiliation. The results have implications for preparing counseling students to work with clients with religious/spiritual issues.     

Stress and quality of life in international and domestic university students: cultural differences in the use of religious coping

Studying overseas entails a number of transitions and challenges, and the present study investigated the strategies international university students use to cope with stressors. Previous research suggests that international students may be more likely than domestic students to draw on religion/spirituality as a source of dealing with stress, but the direct links between stress, religious coping and quality of life are yet to be documented explicitly. A sample of 679 university students in New Zealand completed the quality of life scale WHOQOL-BREF with an additional WHOQOL module used to assess spiritual, religious, and personal beliefs (SRPB). The students also completed the Perceived Stress Scale and the Brief COPE inventory. Irrespective of stress levels encountered or whether participants were international or domestic students, Asian students were more likely to use religious coping strategies than European students. Unlike European students, Asian students’ use of religious coping was effective in improving psychological and social quality of life. The findings also provide support for the main effects hypothesis of religion/spirituality. The present study demonstrates that cultural factors play an important role in the manner in which individuals maintain mental health and quality of life.     

Religion and spirituality along the suicidal path

The inner experience of spiritual and religious feelings is an integral part of the everyday lives of many individuals. For over 100 years the role of religion as a deterrent to suicidal behavior has been studied in various disciplines. We attempt to systematize the existing literature investigating the relationship between religion/spirituality and suicide in this paper. After an overview of the attitudes of the dominant religions (e.g., Catholicism, Islam, and Buddhism) toward suicide, the three main theories that have speculated regarding the link between religion and suicide are presented: "integration theory" (Durkheim, 1897/1997), "religious commitment theory" (Stack, 1983a; Stark, 1983), and "network theory" (Pescosolido & Georgianna, 1989). Subsequent to this theoretical introduction, we report on studies on religion/spirituality keeping the suicidal path as a reference: from suicidal ideation to nonlethal suicidal behavior to lethal suicidal behavior. Studies presenting indications of religious beliefs as a possible risk factor for suicidal behavior are also presented. The last section reviews possible intervention strategies for suicidal patients and suicide survivors. Indications for future research, such as more studies on nonreligious forms of spirituality and the use of qualitative methodology to achieve a better and deeper understanding of the spiritual dimension of suicidal behavior and treatment, are offered.     

Spiritual But Not Religious? Evidence for Two Independent Dispositions

Some psychologists treat religious/spiritual beliefs as a unitary aspect of individual differences. But a distinction between mysticism and orthodox religion has been recognized by scholars as well as laypersons, and empirical studies of "ism" variables and of "spirituality" measures have yielded factors reflecting this distinction. Using a large sample of American adults, analyses demonstrate that subjective spirituality and tradition-oriented religiousness are empirically highly independent and have distinctly different correlates in the personality domain, suggesting that individuals with different dispositions tend toward different styles of religious/spiritual beliefs. These dimensions have low correlations with the lexical Big Five but high correlations with scales (e.g., Absorption, Traditionalism) on some omnibus personality inventories, indicating their relevance for studies of personality.     

The Efficacy of Adult Christian Support Groups in Coping with the Death of a Significant Loved One

Psychologists sometimes minimize important resources such as religion and spiritual beliefs for coping with bereavement. Alienation of therapeutic psychology from religious values contrasts to professional and public interest in religious experience and commitment. A supportive viewpoint has come about partially as a result of recognizing important values which clinicians have found absent in many of their clients. Until spiritual belief systems become integrated into the work of clinicians, clients may not be fully integrative in coping with loss. The key finding of this study was that individuals who participated in Christian and secular support groups showed no statistically significant difference in their mean endorsement of negative criteria on the BHS, and no statistically significant difference for their mean score endorsement of positive criteria on the RCOPE. However, a Christian-oriented approach was no less effective than a psychological-oriented one. In both groups, a spiritual connection to a specific or generalized higher power was frequently identified which clients ascribed to facilitating the management of their coping.     

Religious Non-involvement Among African Americans, Black Caribbeans and Non-hispanic Whites: Findings from the National Survey of American Life

This study examines the association between race/ethnicity, socio-demographic characteristics, and religious non-involvement among a national sample of African Americans, Black Caribbeans and Non-Hispanic Whites. The relationship between religious non-involvement and selected measures of religious participation, spirituality, religious coping is also examined. The study utilizes data from a national multi-stage probability sample, the National Survey of American Life (n = 6,082). Very few individuals, <1 out of 20 respondents, both never attended religious services and have no current denomination. Overall, <8 % have never attended religious services since the age of 18. Both African Americans and Black Caribbeans were significantly less likely than non-Hispanic Whites to report never attending religious services and not having a current denomination. The greater reliance upon religious institutions for support and guidance among African Americans and Black Caribbean Americans relative to Non-Hispanic Whites may help explain the importance of race in predicting religious non-involvement. Women, married persons, Southerners, and the more highly educated are significantly more likely to be involved in religion. Finally, this study indicates that the religiously non-involved are less likely than others to participate in religious activities, to identify as spiritual, and to rely upon religion to cope with trying circumstances. Nonetheless, even respondents who never attend religious services and do not have a denomination still report some level of religious participation along with relatively high levels of religious coping. We posit that religious non-involvement is less indicative of apostasy, but rather likely reflects a critique of organized religion.     

“There's a deeper level of meaning as to what suffering's all about”: experiences of religious and spiritual growth following trauma

Some survivors of trauma report experiencing beneficial changes in self-perception, relationships, and philosophy of life, and positive changes in the realm of existential, spiritual, or religious matters. The purpose of the present study was to examine participants’ phenomenological experiences of spiritual and religious posttraumatic growth (PTG). Transcribed data from semi-structured interviews with 10 women, self-identified as Christian, who had experienced spiritual or religious growth following various trauma were analysed using Interpretative Phenomenological Analysis. Results indicated how religion provided a framework that assisted participants to incorporate life changes, and to find meaning in their suffering. The most salient themes identified in relation to religious and spiritual PTG included: process of spiritual and religious growth, strengthening of religious and spiritual beliefs, and personal and spiritual growth and healing. Participants’ trauma and associated distress prompted a process of questioning and meaning-making that facilitated deeply experienced personal and spiritual growth, and was related to intrinsic religiosity.     

The Impact of a Breast Cancer Diagnosis on Religious/Spiritual Beliefs and Practices in the UK

The use of religious/spiritual resources may increase when dealing with the stress of a cancer diagnosis. However, there has been very little research conducted into changes in religious/spiritual beliefs and practices as a result of a cancer diagnosis outside the USA. The aim of this study was to examine the impact of a breast cancer diagnosis on patients’ religious/spiritual beliefs and practices in the UK where religious practice is different. The study used two methods. One compared the religious/spiritual beliefs and practices of 202 patients newly diagnosed with breast cancer with those of a control group of healthy women (n = 110). The other examined patients’ perceived change in religious/spiritual beliefs and practices at the time of surgery with those in the year prior to surgery. The aspects of religiousness/spirituality assessed were: levels of religiosity/spirituality, strength of faith, belief in God as well as private and public practices. Patient’s perceived their belief in God, strength of faith and private religious/spiritual practices to have significantly increased shortly after surgery compared with the year prior to surgery. However, there were no significant differences in religious/spiritual beliefs and practices between patients and healthy participants. Change scores demonstrated both a reduction and an increase in religious/spiritual beliefs and practices. Although belief in God, strength of faith and private religious/spiritual practices were perceived by patients to be significantly higher after their cancer diagnosis, no significant differences in religious/spiritual beliefs and practices were found between the cancer group at the time of surgery and the control group. Different methodologies appear to produce different results and may explain contradictions in past US studies. Limitations of this study are discussed and suggestions for future research are made.     

Religious coping in highly religious psychiatric inpatients

This study among highly religious psychiatric patients in a mental hospital in the Netherlands focused on the following issues: their religious and spiritual beliefs and activities; their religious coping activities, measured using Pargament's three coping styles and a positive religious coping scale; the influence of religious coping on psychological and existential well-being; and the predictive value of general religiousness, as compared with religious coping activities, regarding psychological and existential well-being.

For this population of inpatients, religion had a positive influence on their ways of dealing with mental problems; religious coping was positively correlated with existential and psychological well-being. General religiousness as well as religious coping were positively correlated with existential well-being, whereas psychological well-being primarily was predicted by positive religious coping.

Results are discussed in the context of theoretical notions of religious coping, addressing in particular the positive influence of religious beliefs, relying on God, religious activities and religious social support in psychological and existential times of crisis.     

Early trauma and serious mental illness: what role does spirituality play?

For many who experience serious mental illness, spirituality and religion can be common vehicles that provide a sense of coherence and meaning to life. However, in the presence of early trauma, spiritual and religious beliefs may be enhanced or destroyed, or never develop. This paper explores the relationship between spirituality/religion, early trauma, and serious mental illness. Three case examples from a qualitative phenomenological study are presented to illustrate spiritual and religious struggles that can arise and how a person can work through these over time to use spirituality and religion as positive resources for recovery. Tentative implications for practice are offered.