Abstract
While the field of empirical study on religion and spirituality in relation to mental health has rapidly expanded over the past decade, little is known about underlying dimensions of spirituality cross-culturally conceived. We aimed to bridge this gap by inductively deriving potential universal dimensions of spirituality through a large-scale, multi-national data collection, and examining the relationships of these dimensions with common psychiatric conditions. Five-thousand five-hundred and twelve participants from China, India, and the United States completed a two-hour online survey consisting of wide-ranging measures of the lived experience of spirituality, as well as clinical assessments. A series of inductive Exploratory Factor Analysis (EFA) and cross-validating Exploratory Structural Equation Modeling (ESEM) were conducted to derive common underlying dimensions of spirituality. Logistic regression analyses were then conducted with each dimension to predict depression, suicidal ideation, generalized anxiety, and substance-related disorders. Preliminary EFA results were consistently supported by ESEM findings. Analyses of 40 spirituality measures revealed five invariant factors across countries which were interpreted as five dimensions of universal spiritual experience, specifically: love, in the fabric of relationships and as a sacred reality; unifying interconnectedness, as a sense of energetic oneness with other beings in the universe; altruism, as a commitment beyond the self with care and service; contemplative practice, such as meditation, prayer, yoga, or qigong; and religious and spiritual reflection and commitment, as a life well-examined. Love, interconnectedness, and altruism were associated with less risk of psychopathology for all countries. Religious and spiritual reflection and commitment and contemplative practice were associated with less risk in India and the United States but associated with greater risk in China. Education was directly associated with dimensions of spiritual awareness in India and China but inversely associated with dimensions in the United States. Findings support the notion that spirituality is a universal phenomenon with potentially universal dimensions. These aspects of spirituality may each offer protective effects against psychiatric symptoms and disorders and suggest new directions for treatment.
Highlights
The field of empirical study on religion and spirituality (R/S) in relationship to mental health has rapidly expanded in the past decade
There exist five peer-reviewed international journals that publish on R/S and its relationship to mental health (Journal of Religion and Health, Psychology of Religion and Spirituality, Spirituality in Clinical Practice, International Journal of Psychology, and Religion and Social Scientific Study of Religion), and over 4000 articles in this field have been published in the past decade
Five inductively derived dimensions of spirituality were found across the three countries: love, in the fabric of relationships and as a sacred reality; unifying interconnectedness, as a sense of energetic oneness with other beings in the universe; altruism, as a commitment beyond the self with care and service; a contemplative practice, such as meditation, prayer, yoga, or qigong; and religious and spiritual reflection and commitment, as a life well-examined
Summary
The field of empirical study on religion and spirituality (R/S) in relationship to mental health has rapidly expanded in the past decade. There exist five peer-reviewed international journals that publish on R/S and its relationship to mental health (Journal of Religion and Health, Psychology of Religion and Spirituality, Spirituality in Clinical Practice, International Journal of Psychology, and Religion and Social Scientific Study of Religion), and over 4000 articles in this field have been published in the past decade Research from this body of work has shown that spirituality and religiosity serve as protective factors against a variety of psychiatric conditions, including for depressive disorders (Koenig et al, 1998; Miller et al, 2012; Barton et al, 2013), anxiety disorders (Azhar et al, 1994; Kaplan et al, 2005), suicide (Dervic et al, 2004; Rasic et al, 2009), and substance-related disorders (Miller and Gur, 2002; Harden, 2010). Greater diurnal regulation of cortisol was found in people with a strong personal spirituality (Dedert et al, 2004)
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