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2009 ACHA Annual 2009 ACHA Annual Meeting, San FranciscoMeeting, San Francisco

Spiritual Wellness: A Spiritual Wellness: A Comparison of Models and Comparison of Models and

Consideration of Consideration of Applications in College Applications in College

HealthHealthPaul Myers, Ph.D. Paul Myers, Ph.D.

University of PortlandUniversity of Portland

Spirituality, Religion and Student Health Spirituality, Religion and Student Health Coalition of ACHACoalition of ACHA

ObjectivesObjectives

• Identify and describe models of Identify and describe models of spiritual healthspiritual health

• UCLA HERI prevalence dataUCLA HERI prevalence data

• Correlates of health risk and spiritual Correlates of health risk and spiritual healthhealth

• Proposals for the futureProposals for the future

2009 ACHA Annual 2009 ACHA Annual Meeting, San FranciscoMeeting, San Francisco

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CaveatsCaveatsDo not prove existence of GodDo not prove existence of GodReligious matters can make scientists Religious matters can make scientists

and clinicians uncomfortableand clinicians uncomfortableDo not prove one religion is better Do not prove one religion is better

than anotherthan anotherCannot perform random assignment Cannot perform random assignment

to faith tradition or belief system to faith tradition or belief system Still there are interesting things to Still there are interesting things to

consider given religious diversity of consider given religious diversity of studentsstudents

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Correlational Studies of Correlational Studies of Spirituality/Religion and Student Spirituality/Religion and Student HealthHealthCorrelation not necessarily causationCorrelation not necessarily causationVariance accounted for is often smallVariance accounted for is often smallChallenges in operationalization of Challenges in operationalization of

referent constructsreferent constructsPrejudices in academe about doing Prejudices in academe about doing

research on matters related to religionresearch on matters related to religionComplex co-variatesComplex co-variates

Models of Spiritual HealthModels of Spiritual Health

What is Health?What is Health?

• Old English word Old English word halehale, meaning Whole, meaning Whole

• W.H.O.’s 1948 Definition: W.H.O.’s 1948 Definition:

““health is a complete [whole] state of health is a complete [whole] state of physical, mental, and social well-physical, mental, and social well-being and not merely the absence of being and not merely the absence of disease or infirmity.”disease or infirmity.”

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Whole Health as …Whole Health as …

Promotion of health in mind, body and Promotion of health in mind, body and spirit.spirit.

But what do we mean by health of the But what do we mean by health of the spirit?spirit?

What does spirit contribute to overall What does spirit contribute to overall health?health?

2009 ACHA Annual Meeting, 2009 ACHA Annual Meeting, San Francisco, CASan Francisco, CA 66

Models of Spiritual HealthModels of Spiritual Health

A religious view in contrast to a health A religious view in contrast to a health promotion view: Spiritual Health is promotion view: Spiritual Health is the wholeness and completeness of the wholeness and completeness of one’s relationship with the divine, one’s relationship with the divine, and the divine’s creation.and the divine’s creation.

2009 ACHA Annual Meeting, 2009 ACHA Annual Meeting, San Francisco, CASan Francisco, CA 77

Traditional Models of Traditional Models of Spiritual HealthSpiritual Health (Wholeness)(Wholeness)What is spiritual?What is spiritual?• Things of God (gods): Human-Divine Things of God (gods): Human-Divine

RelationshipRelationship

• Things of meaning and purpose: Alpha and Things of meaning and purpose: Alpha and Omega Omega

• Things of life and animation: “Breath of Life”Things of life and animation: “Breath of Life”

• Things of motivation and passion: of the Things of motivation and passion: of the spirits of darkness and light (good and evil)spirits of darkness and light (good and evil)

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Religious Causal Models of Religious Causal Models of Healing (Illness) ActionHealing (Illness) Action• Nature has God-installed restorative processesNature has God-installed restorative processes

• People learn how to alter God’s natural laws to People learn how to alter God’s natural laws to influence restorative processesinfluence restorative processes

• People ask for case-specific Divine People ask for case-specific Divine interventionintervention

• God intervenes without request to teach God intervenes without request to teach

• Some combination of the above (all of above)Some combination of the above (all of above)

• None of the aboveNone of the above

2009 ACHA Annual 2009 ACHA Annual Meeting, San Fran., CAMeeting, San Fran., CA 99

The Spiritual: Popular The Spiritual: Popular Models In the MediaModels In the Media

• Serving others promotes better healthServing others promotes better health

• Dietary alterations create healthDietary alterations create health

• Meditation and breathing practices Meditation and breathing practices cure, heal and preventcure, heal and prevent

• Social support groupsSocial support groups

• Sampling from eastern religions: Sampling from eastern religions: cleansing, focusing, emptying, fastingcleansing, focusing, emptying, fasting

2009 ACHA Annual Meeting, 2009 ACHA Annual Meeting, San Francisco, CASan Francisco, CA 1010

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1212

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Research Models of Spirituality and Research Models of Spirituality and ReligionReligion

• Religion is an organized system of beliefs, practices, rituals and Religion is an organized system of beliefs, practices, rituals and symbols designed (a) to facilitate closeness to the sacred or symbols designed (a) to facilitate closeness to the sacred or transcendent (God, higher power, or ultimate truth/reality) and transcendent (God, higher power, or ultimate truth/reality) and (b) to foster an understanding of one’s relationship and (b) to foster an understanding of one’s relationship and responsibility to others in living together in a community.responsibility to others in living together in a community.

• Spirituality is the personal quest for understanding answers to Spirituality is the personal quest for understanding answers to ultimate questions about life, about meaning, and about ultimate questions about life, about meaning, and about relationship to the sacred or transcendent, which may (or may relationship to the sacred or transcendent, which may (or may not) lead to or arise from the development of religious rituals not) lead to or arise from the development of religious rituals and the formation of community. and the formation of community.

(From: (From: Handbook of Religion and HealthHandbook of Religion and Health, p. 18), p. 18)

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Definition of TermsDefinition of Terms

ReligionReligion SpiritualitySpiritualityCommunity focusedCommunity focused Individualistic (not always)Individualistic (not always)

Observable, measurable, Observable, measurable, objectiveobjective

Less visible & measurable, Less visible & measurable, subjectivesubjective

Formal, orthodox, organizedFormal, orthodox, organized Less formal, less orthodox, Less formal, less orthodox, less systematicless systematic

Behavior oriented, outward Behavior oriented, outward practicespractices

Emotionally oriented, inward Emotionally oriented, inward directed, directed,

Authoritarian in terms of Authoritarian in terms of behaviorsbehaviors

Not authoritarian, little Not authoritarian, little accountabilityaccountability

Doctrine separating good Doctrine separating good from evilfrom evil

Unifying, not doctrine Unifying, not doctrine orientedoriented

From Koenig, McCullough, & Larson (2001)

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Koenig, McCullough and Larson’s Koenig, McCullough and Larson’s (2001) (2001) 12 Measurement Approaches to 12 Measurement Approaches to ReligiosityReligiosity• BeliefsBeliefs

• KnowledgeKnowledge

• AffiliationAffiliation

• CommitmentCommitment

• Religious Religious experience/conversiexperience/conversionon

• Organizational Organizational religiosityreligiosity

• Non-organizational Non-organizational

religiosityreligiosity

• Subjective Subjective religiosityreligiosity

• Religious questReligious quest

• Religious well beingReligious well being

• Religious copingReligious coping

• Religious Religious consequencesconsequences

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Koenig, McCullough and Larson’s Koenig, McCullough and Larson’s (2001) (2001) 5 Approaches to Spirituality5 Approaches to Spirituality

Five categories of spiritualityFive categories of spirituality– Moored Western type II (moderated) Moored Western type II (moderated)

(60%)(60%)– Moored Western type I (fundamental) Moored Western type I (fundamental)

(25%)(25%)– Humanistic (6%) (agnostic or atheistic)Humanistic (6%) (agnostic or atheistic)– Unmoored (6%) (power, nature, energy)Unmoored (6%) (power, nature, energy)– Moored Eastern type (<3%) Moored Eastern type (<3%)

Spiritual PracticesSpiritual Practices

– MeditationMeditation– PrayerPrayer– ChantChant– Prostration practices (e.g., bow, genuflect)Prostration practices (e.g., bow, genuflect)– Doctrines to remind and organize Doctrines to remind and organize – Sacred stories to inspire and instructSacred stories to inspire and instruct– Sacred meals to remind and focusSacred meals to remind and focus– Sacred role models to know and emulateSacred role models to know and emulate

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Ways that Spiritual or Religious Factors Influence Health:

Health BehaviorsPsychological StatesCoping StrategiesSocial and Emotional Support

– From Spirit, Science and Health: How the spiritual mind fuels physical wellness. Plante and Thoreson (Eds.) (2007)

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What Religions Say about What Religions Say about Health Risk Behaviors:Health Risk Behaviors:• What to eat, when to eat, how to prepare foodWhat to eat, when to eat, how to prepare food• Sexual behavior expectationsSexual behavior expectations• Cleanliness expectationsCleanliness expectations• Meaning of suffering and sacrificeMeaning of suffering and sacrifice• Alcohol and or tobacco use/prohibitionsAlcohol and or tobacco use/prohibitions• Pro-Social expectations (e.g., alms, service, loan Pro-Social expectations (e.g., alms, service, loan

interest, tithing, honesty, pilgrimage, work/rest)interest, tithing, honesty, pilgrimage, work/rest)• Punishment, various rejection for sinsPunishment, various rejection for sins• Aspirational/purposeful teachings about the Aspirational/purposeful teachings about the

futurefuture• Prohibitions against suicide, homicide, violenceProhibitions against suicide, homicide, violence• Prayer, centering, perspective taking, social Prayer, centering, perspective taking, social

virtuesvirtues

Health Risk Studies Then:Health Risk Studies Then:

Negative Correlations between Negative Correlations between Church Attendance and substance Church Attendance and substance use, sexual behavior, tobacco use.use, sexual behavior, tobacco use.

World Health Organization Study of World Health Organization Study of Adolescents and Religion found Adolescents and Religion found participation in religious community participation in religious community decreased substance use, increased decreased substance use, increased school success and delayed sexual activityschool success and delayed sexual activity

2009 ACHA Annual 2009 ACHA Annual Meeting, San Fran, CAMeeting, San Fran, CA 2020

Psychological States: Psychological States: Balance and Well-BeingBalance and Well-Being

• Relaxation Response, Meditation, Relaxation Response, Meditation, Mindfulness, Breathing Exercises, Mindfulness, Breathing Exercises, Yoga, Chant, PrayerYoga, Chant, Prayer

• Purification rituals (cleansing)Purification rituals (cleansing)

• Alms giving, service to othersAlms giving, service to others

• Value of aesthetics--beautyValue of aesthetics--beauty

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Physiological mechanisms Physiological mechanisms involved in involved in religiosity/spirituality & healthreligiosity/spirituality & health

Religious meditation/prayer Religious meditation/prayer →→

↑ ↑ blood flow in frontal cortices (focused attention) blood flow in frontal cortices (focused attention)

↓ ↓ blood flow in the parietal cortices (reports of blood flow in the parietal cortices (reports of “oneness” with the transcendent) “oneness” with the transcendent)

↑ ↑ levels of GABA, melatonin, serotonin, ↑ left levels of GABA, melatonin, serotonin, ↑ left hemisphere activity (positive affect, elevated immune hemisphere activity (positive affect, elevated immune responses, antibody titers, natural killer cell activity)responses, antibody titers, natural killer cell activity)

Possible regulation of autonomic nervous Possible regulation of autonomic nervous functions→↑ability to cope with stressfunctions→↑ability to cope with stress

Prevalence of Prayer as Prevalence of Prayer as Alternative Health Alternative Health InterventionIntervention43% prayed for their own health43% prayed for their own health

24% had prayer from others for one’s 24% had prayer from others for one’s own healthown health

9% participate in prayer group for 9% participate in prayer group for one’s own healthone’s own health

7% Meditate for health7% Meditate for health--http://nccam.nih.gov/news/camstats/2002/--http://nccam.nih.gov/news/camstats/2002/

report.pdfreport.pdf

2009 ACHA Annual Meeting, 2009 ACHA Annual Meeting, San Francisco, CASan Francisco, CA 2323

CopingCoping

• Meaning of suffering Meaning of suffering

• Meaning and purpose of life Meaning and purpose of life

• Meaning of relationships to self, Meaning of relationships to self, others or Godothers or God

• Strategies and tactics to mitigate Strategies and tactics to mitigate suffering, redirect attention, and suffering, redirect attention, and build connectionbuild connection

2009 ACHA Annual Meeting, 2009 ACHA Annual Meeting, San Francisco, CASan Francisco, CA 2424

Prayer Styles and HealthPrayer Styles and Health

Prayer Type Correlational Outcome

Colloquial prayer (conversational) Only style correlated with happiness

Ritual prayer (published) Correlated with higher sadness, loneliness, tension and fear

Meditative prayer (focus or clearing)

Higher existential well-being, higher religious satisfaction

Petitionary (request for outcome) Most commonly for someone else’s health and well-being

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(cited in Plante and Thoresen 2007)

Poloma, MM & Pendleton, BF (1991). The effects of prayer and prayer experiences on measures of general well-being. Journal of Psychology and Theology, 19, 71-93.

Social and Emotional Social and Emotional SupportSupport

– Correctives for egotism, pride, Correctives for egotism, pride, selfishness, greed, fearselfishness, greed, fear

– Correctives toward meaning, purpose, Correctives toward meaning, purpose, structure, otherness structure, otherness

– Connect the isolated and increase Connect the isolated and increase positive interactionspositive interactions

– Love and compassion toward self and Love and compassion toward self and toward others, and toward our toward others, and toward our environmentenvironment

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UCLA Higher Education UCLA Higher Education Research InstituteResearch Institute

College Student Spirituality StudyCollege Student Spirituality Study

2009 ACHA Annual Meeting, 2009 ACHA Annual Meeting, San Francisco, CASan Francisco, CA 2727

http://www.spirituality.ucla.edu

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Higher Education Research Institute: Higher Education Research Institute: Study of College Student SpiritualityStudy of College Student Spirituality

What proportion of students from What proportion of students from which tradition?which tradition?

How are the traditions similar or How are the traditions similar or different?different?

How are religious or spiritual How are religious or spiritual variables related to health or well-variables related to health or well-being?being?

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Spirituality in Higher Spirituality in Higher EducationEducation• Attended relig. services, past yr. Attended relig. services, past yr.

80%80%• Discuss religion with friends/famDiscuss religion with friends/fam

79%79%• PrayPray 66% 66%• Believe in GodBelieve in God 79% 79%• Very important to follow religion Very important to follow religion

40%40%every dayevery day

HERI study at UCLA (2005)HERI study at UCLA (2005)

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Diverse manifestations of Diverse manifestations of spiritual and religious spiritual and religious experience among college experience among college studentsstudents

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Spirituality in Higher Spirituality in Higher EducationEducation• Believe in sacredness of lifeBelieve in sacredness of life

83%83%

• Have interest in spiritualityHave interest in spirituality80%80%

• Search for meaning/purposeSearch for meaning/purpose76%76%

• Discuss meaning/purposeDiscuss meaning/purpose 74%74%

• Spirituality is source of joySpirituality is source of joy 64%64%

• Seek opps to grow spirituallySeek opps to grow spiritually 47%47%

HERI study at UCLA (2005)HERI study at UCLA (2005)

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Spirituality in Higher Spirituality in Higher EducationEducation• Roman CatholicRoman Catholic 28%28%• Mainline ProtestantMainline Protestant 17%17%• No ReligionNo Religion 17%17%• BaptistBaptist 13%13%• Other ChristianOther Christian 11%11%• Other non-ChristianOther non-Christian approx. 14%approx. 14%

(also 26% self describe as born-(also 26% self describe as born-again)again)

From: Higher Education Research Institute at UCLA (2005)From: Higher Education Research Institute at UCLA (2005)

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Higher Education Research Higher Education Research Institute (HERI) Factor Institute (HERI) Factor AnalysisAnalysis• Religious Factors: commitment, Religious Factors: commitment,

engagement, skepticism, struggle & engagement, skepticism, struggle & social conservatismsocial conservatism

• Spirituality Factors: spirituality, Spirituality Factors: spirituality, spiritual quest, & equanimityspiritual quest, & equanimity

• Combined Factors: charitable Combined Factors: charitable involvement, compassionate self-involvement, compassionate self-concept, ethic of caring & concept, ethic of caring & ecumenical world viewecumenical world view

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Spirituality in Higher Spirituality in Higher EducationEducation

• Two clusters of religions based on Two clusters of religions based on students’ response patterns:students’ response patterns:– Strongly spiritual, religious, Strongly spiritual, religious,

religiously/socially conservative, little religiously/socially conservative, little religious skepticismreligious skepticism• Mormon, 7Mormon, 7thth Day Adventists, Baptists, and “Other” Day Adventists, Baptists, and “Other”

– Low on religiousness and high on religious Low on religiousness and high on religious skepticismskepticism• Unitarians, Buddhists, Hindus, Episcopalians, Unitarians, Buddhists, Hindus, Episcopalians,

Eastern Orthodox and Jewish studentsEastern Orthodox and Jewish students

HERI study at UCLA (2005)HERI study at UCLA (2005)

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Spirituality in Higher Spirituality in Higher EducationEducation

Roman Catholics tend to score below the Roman Catholics tend to score below the overall average on religious commitment, overall average on religious commitment, religious engagement, religious/social religious engagement, religious/social conservativism, conservativism,

and religious skepticismand religious skepticism

HERI study at UCLA (2005)HERI study at UCLA (2005)

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Spirituality in Higher Spirituality in Higher EducationEducation• ““Adhering to religious and spiritual Adhering to religious and spiritual

beliefs and practices plays a role in beliefs and practices plays a role in students’ psychological and physical students’ psychological and physical well-being. While spirituality and well-being. While spirituality and religiousness generally related to religiousness generally related to physical well-being, the relationships physical well-being, the relationships with psychological health are with psychological health are nuanced and complex.”nuanced and complex.”

http://www.spirituality.ucla.edu/spirituality/reports/http://www.spirituality.ucla.edu/spirituality/reports/FINAL_EXEC_SUMMARY.pdfFINAL_EXEC_SUMMARY.pdf

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Religiosity/spirituality and Religiosity/spirituality and substance usesubstance use• Studies generally show that religiosity Studies generally show that religiosity

decreases use of alcohol and other decreases use of alcohol and other substances – current studies focus on substances – current studies focus on mechanisms of effectmechanisms of effect

• Study of 516 college students showed that Study of 516 college students showed that religious involvement was inversely religious involvement was inversely related to alcohol consumption via social related to alcohol consumption via social influences and negative beliefs about influences and negative beliefs about alcohol with social influences having the alcohol with social influences having the most effect. Religious struggle was most effect. Religious struggle was associated with alcohol problems via associated with alcohol problems via spiritual well-being and social motives.spiritual well-being and social motives.

– Johnson TJ, Sheets VL, Kristeller JL (2008) Identifying mediators of the relationship between Johnson TJ, Sheets VL, Kristeller JL (2008) Identifying mediators of the relationship between religousness/spirituality and alcohol use. Journal for Study of Alcohol Drugs 69(1): 160-70.religousness/spirituality and alcohol use. Journal for Study of Alcohol Drugs 69(1): 160-70.

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Effects of religiosity on sexual Effects of religiosity on sexual minority youth and substance minority youth and substance useuse• Longitudinal study of 764 adolescents over Longitudinal study of 764 adolescents over

6 years found that religiosity at baseline 6 years found that religiosity at baseline had no effect on past-year substance use had no effect on past-year substance use in sexual minority young adults 6 years in sexual minority young adults 6 years later. For heterosexual young adults each later. For heterosexual young adults each unit increase in religiosity reduced the unit increase in religiosity reduced the odds of binge drinking by 9%, marijuana odds of binge drinking by 9%, marijuana use by 20% and cigarette smoking by use by 20% and cigarette smoking by 13%.13%.

Rostosky SS, Danner, F, Riggle EDB (2007) Is religiosity a protective factor against substance use in young adulthood? Only if Rostosky SS, Danner, F, Riggle EDB (2007) Is religiosity a protective factor against substance use in young adulthood? Only if you’re straight!you’re straight!

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Spirituality and Health Risk Spirituality and Health Risk BehaviorsBehaviors

• Study of 211 African American college Study of 211 African American college students showed low spiritual well-being students showed low spiritual well-being increased odds of smoking and alcohol use increased odds of smoking and alcohol use but had no effect on drug or sexually risky but had no effect on drug or sexually risky behaviorbehavior

Turner-Musa, J & Lipscomb, L (2007) Spirituality and Social Support on Health Behaviors of African Turner-Musa, J & Lipscomb, L (2007) Spirituality and Social Support on Health Behaviors of African

American Undergraduates, Am J Health Behav, 31(5), 495-501.American Undergraduates, Am J Health Behav, 31(5), 495-501.

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Religiosity and sexual Religiosity and sexual behaviorsbehaviors• Sample of 205 college students found Sample of 205 college students found

religious behavior associated with sexual religious behavior associated with sexual abstinence but not with age of first abstinence but not with age of first intercourse or condom use. Frequent intercourse or condom use. Frequent church attendance was associated with church attendance was associated with decreased perceived vulnerability to HIV decreased perceived vulnerability to HIV and increased perceived barriers to using and increased perceived barriers to using condoms.condoms.

Lefkowitx, ES, Gillen, MM, Shearer, CL, Boone, TL (2004) Religiosity, sexual behaviors, and sexual Lefkowitx, ES, Gillen, MM, Shearer, CL, Boone, TL (2004) Religiosity, sexual behaviors, and sexual attitudes during emerging adulthood, J Sex Res, 41(2): 150-9.attitudes during emerging adulthood, J Sex Res, 41(2): 150-9.

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National Research Consortium of National Research Consortium of Counseling Centers in Higher Counseling Centers in Higher EducationEducationN=26,000 studentsN=26,000 students

70 institutions70 institutions

Demographics comparable to NCHADemographics comparable to NCHA

HLM analyses showed significantly lower HLM analyses showed significantly lower rates for life time and past 12 month rates rates for life time and past 12 month rates of serious suicidal ideation among those of serious suicidal ideation among those religiously affiliated. religiously affiliated.

Future ProposalsFuture Proposals

• Increase in Diversity Workshops that Increase in Diversity Workshops that Include Religious and Spiritual DifferencesInclude Religious and Spiritual Differences

• Increased training in comparative religionIncreased training in comparative religion

• Increased research into the health links to Increased research into the health links to spirituality and religionspirituality and religion

• Training relative to the ethical issues Training relative to the ethical issues attendant with religion and health careattendant with religion and health care

2009 ACHA Annual Meeting,2009 ACHA Annual Meeting, San Francisco, CASan Francisco, CA 4242

ConclusionConclusion

• I offer this prayer: that we all may I offer this prayer: that we all may have more complete and fulfilling have more complete and fulfilling relationships with our God, with our relationships with our God, with our fellow human beings and with fellow human beings and with ourselves. And may these deeper ourselves. And may these deeper and richer relationships inspire whole and richer relationships inspire whole health in one another and in ALL of health in one another and in ALL of our students. Amen.our students. Amen.

2009 ACHA Annual Meeting, 2009 ACHA Annual Meeting, San Francisco, CASan Francisco, CA 4343

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Diversity of Measures –Diversity of Measures –Measures of General Measures of General ReligiousnessReligiousness• A trend away from descriptive measures to A trend away from descriptive measures to

functional measures which give quantitative datafunctional measures which give quantitative data• Intrinsic/extrinsic religiosity measures – religious Intrinsic/extrinsic religiosity measures – religious

motivation. Intrinsic Religious Motivation Scale motivation. Intrinsic Religious Motivation Scale (Hoge, 1972)(Hoge, 1972)

• Santa Clara Strength of Religious Faith Santa Clara Strength of Religious Faith Questionnaire (Plante & Boccaccini, 1997) – Questionnaire (Plante & Boccaccini, 1997) – strength of religious faithstrength of religious faith

• Duke Religious Index (Koenig, Meador & Duke Religious Index (Koenig, Meador & Parkerson, 1997) – organizational religious Parkerson, 1997) – organizational religious expression, non organizational religious expression, non organizational religious expression and intrinsic religiosityexpression and intrinsic religiosity

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Is Religion a Negative Is Religion a Negative Factor?Factor?• Some studies show not only no effect, Some studies show not only no effect,

some indicate a negative effect on some indicate a negative effect on health outcomes.health outcomes.

• What predicts a negative relationship?What predicts a negative relationship?– Small sample sizes, complex covariate Small sample sizes, complex covariate

relationships related to SES, social and relationships related to SES, social and educational opportunities, harmful educational opportunities, harmful experiences that occur in religious experiences that occur in religious context, etc.context, etc.

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Diversity of Measures – Diversity of Measures – Measures of Religious CopingMeasures of Religious Coping

• Coping Orientations of Problems Coping Orientations of Problems Experienced (COPE) (Carver, Scheier & Experienced (COPE) (Carver, Scheier & Weintaub, 1989) – coping patternsWeintaub, 1989) – coping patterns

• RCOPE (Pargament, Keonig & Perez, 2000) RCOPE (Pargament, Keonig & Perez, 2000) – religious approaches to coping– religious approaches to coping

• Brief RCOPE (Pargament, Smith, Koenig & Brief RCOPE (Pargament, Smith, Koenig & Perez, 1998) – positive and negative Perez, 1998) – positive and negative religious copingreligious coping

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Diversity of Measures – Diversity of Measures – Measures of Spiritual Well-Measures of Spiritual Well-BeingBeing• McGill Quality of Life Questionnaire (Cohen McGill Quality of Life Questionnaire (Cohen

et al., 1997) – existential well-beinget al., 1997) – existential well-being

• Spiritual Well-Being Scale (Ellison, 1983) – Spiritual Well-Being Scale (Ellison, 1983) – Religious and existential well-beingReligious and existential well-being

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Research References of Research References of InterestInterest• Adams, T.B., Besner, J.R., Drabbs, M.E., Zambarano, R.J., Steinhardt, M.A. Adams, T.B., Besner, J.R., Drabbs, M.E., Zambarano, R.J., Steinhardt, M.A.

(2000). Conceptualization and measurement of the spiritual and (2000). Conceptualization and measurement of the spiritual and psychological dimensions of wellness in a college population. psychological dimensions of wellness in a college population. Journal of Journal of American College HealthAmerican College Health, , 4848, 165-173. , 165-173.

• Hill, P.C. & Pargament, K.I. (2003). Advances in the conceptualization and Hill, P.C. & Pargament, K.I. (2003). Advances in the conceptualization and measurement of religion and spirituality: Implications for physical and measurement of religion and spirituality: Implications for physical and mental health research. mental health research. American PsychologistAmerican Psychologist, , 5858, 64-74., 64-74.

• Miller, W.R. & Thoreson, C.E. (2003). Spirituality, Religion and Health: An Miller, W.R. & Thoreson, C.E. (2003). Spirituality, Religion and Health: An emerging research field. emerging research field. American PsychologistAmerican Psychologist, , 5858, 24-35., 24-35.

• Muller, S.M. & Dennis, D.L. (2007). Life change and spirituality among a Muller, S.M. & Dennis, D.L. (2007). Life change and spirituality among a college student cohort. college student cohort. Journal of American College HealthJournal of American College Health, , 5656, 55-59., 55-59.

• Peteet, J. (2007). Selected annotated bibliography on spirituality and Peteet, J. (2007). Selected annotated bibliography on spirituality and mental health. mental health. Southern Medical JournalSouthern Medical Journal, , 100 (6100 (6), 654-659.), 654-659.

Other resources:Other resources:

• Journal for the Scientific Study of ReligionJournal for the Scientific Study of Religion

• APA Division 36, Psychology and Religion APA Division 36, Psychology and Religion

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Websites Worth A VisitWebsites Worth A Visit• http://www.indstate.edu/psych/cshrs/presentation-c

opies.htm

• http://www.dukespiritualityandhealth.org/

• http://www.scu.edu/ecppm/shi/

• http://www.gwish.org/index.htm

• http://www.spiritualityandhealth.ufl.edu/default.asp

Books

Koenig, H., McCullough, D. & Larson, D. (2001). Handbook of Religion and Health.

Marty, M.E. & Vaux, K.L. (Eds.) (1982). Health/Medicine and the Faith Traditions: An Inquiry Into Religion and Medicine. Philadelphia: Fortress Press.

Mauk, K.L. & Schmidt, N.K. (Eds.) (2004). Spiritual Care in Nursing Practice. New York: Lippencott Williams & Wilkins

Neihardt, J.G. (1932/1959). Black Elk Speaks. New York: Washington Square Press.

O’Brien, M.E. (2008). Spirituality in Nursing: Standing on Holy Ground, 3rd Edition. Boston: Jones & Bartlett.

Plante, T.G. &, C.E. (2007) Spirit, Science and Health: How the spiritual mind fuels physical wellness. Westport, CT: Praeger.