Researchers at the University of Alabama at Birmingham (UAB) say spiritual coping strategies such as finding strength in a higher power or feelings of spiritual punishment are predictors of mental health in youth with chronic conditions, and they recommend clinicians assess spirituality in distressed adolescents.
Nina Reynolds, M.A., a doctoral student at UAB and lead author, said her findings, recently published online in the Journal of Adolescent Health, support an interdisciplinary approach to health care.
“Providers should screen for spiritual distress when there are signs of emotional distress to determine if a patient’s spiritual beliefs are reinforcing their emotional distress,” said Reynolds. “Physicians, psychologists, chaplains and other health-care providers should collaborate to provide care for a patient’s physical, emotional and spiritual health.”
Reynolds and her team studied 128 adolescents, including 82 diagnosed with type 1diabetes and 46 diagnosed with cystic fibrosis. Participants and their caregivers self-reported measures of positive and negative spiritual coping strategies. Answers revealed that positive spiritual coping, such as the use of spiritual beliefs for decision-making or finding strength, was associated with fewer emotional problems, such as depression or anxiety, as well as fewer behavioral problems, such as aggression or hyperactivity.
| Answers revealed that positive spiritual coping, such as the use of spiritual beliefs for decision-making or finding strength, was associated with fewer emotional problems, such as depression or anxiety, as well as fewer behavioral problems, such as aggression or hyperactivity. |
Negative spiritual coping, such as beliefs of spiritual punishment or abandonment, was related to more behavioral problems in both chronic illnesses. Negative spiritual coping was related to more emotional problems only among patients with cystic fibrosis, which may be due to the more progressive, life-threatening nature of the disease.
UAB Department of Psychology Associate Professor Sylvie Mrug, Ph.D., co-authored the study.
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| Nina Reynolds, M.A. |
“We do not believe that patients, or anyone, should be forced to be spiritual or religious, as it is a matter of personal choice,” said Mrug. “However, patients may benefit from opportunities to discuss spiritual concerns, so it would certainly be helpful to include spiritual and psychological aspects in the education and training of health care providers.”
The research was conducted during outpatient medical visits to a children’s hospital in the southeast United States during 2008 and 2009. Results revealed the adolescents were more likely to report using positive spiritual coping strategies compared to negative. Reynolds’ team wondered if the geographic location of the study may also contribute to this finding.
A recent survey by the Pew Forum on Religion & Public Life said the South has more members of evangelical Protestant churches than any other region in the United States by a wide margin, but the forum also says nearly 8 in ten adults in the U.S. identify themselves with some form of Christianity.
Reynolds said the results of her research may not generalize to other geographic regions in the U.S., but she has observed through her clinical work with pediatric patients that existential and spiritual concerns often arise for patients facing serious or life-threatening illness.
“These youth face difficult physical symptoms, complicated medical regimens and social isolation due to hospitalizations that put them at increased risk for depression, anxiety and behavioral problems,” said Reynolds. “Positive spiritual coping may buffer children from these negative outcomes and serve as a unique coping resource that clinicians can assess, particularly during hospitalizations when these patients are more isolated from other resources like friends and family.”
The research was supported in part by grants from the Cystic Fibrosis Foundation and from the Sigma Xi Grants-in-Aid of Research program to the third author, Kimberly Guion, Ph.D., a pediatric psychologist at Oregon Health and Science University, as well as a grant from the National Institutes of Health awarded to Mrug.