Do Spirituality and Faith Make a Difference? Report from the Southern European Psycho-Oncology Study Group

OBJECTIVE: In the last decade, some attention has been given to spirituality and faith and their role in cancer patients' coping. Few data are available about spirituality among cancer patients in Southern European countries, which have a big tradition of spirituality, namely, the Catholic religion. As part of a more general investigation (Southern European Psycho-Oncology Study--SEPOS), the aim of this study was to examine the effect of spirituality in molding psychosocial implications in Southern European cancer patients. METHOD: A convenience sample of 323 outpatients with a diagnosis of cancer between 6 to 18 months, a good performance status (Karnofsky Performance Status > 80), and no cognitive deficits or central nervous system (CNS) involvement by disease were approached in university and affiliated cancer centers in Italy, Spain, Portugal, and Switzerland (Italian speaking area). Each patient was evaluated for spirituality (Visual Analog Scale 0-10), psychological morbidity (Hospital Anxiety and Depression Scale--HADS), coping strategies (Mini-Mental Adjustment to Cancer--Mini-MAC) and concerns about illness (Cancer Worries Inventory--CWI). RESULTS. The majority of patients (79.3%) referred to being supported by their spirituality/faith throughout their illness. Significant differences were found between the spirituality and non-spirituality groups (p ≤ 0.01) in terms of education, coping styles, and psychological morbidity. Spirituality was significantly correlated with fighting spirit (r = -0.27), fatalism (r = 0.50), and avoidance (r = 0.23) coping styles and negatively correlated with education (r = -0.25), depression (r = -0.22) and HAD total (r = -0.17). SIGNIFICANCE OF RESULTS: Spirituality is frequent among Southern European cancer patients with lower education and seems to play some protective role towards psychological morbidity, specifically depression. Further studies should examine this trend in Southern European cancer patients.

EXPLORING THE DEVELOPMENT AND PSYCHOSOCIAL CORRELATES OF SPIRITUALITY /RELIGIOSITY ACROSS ADOLESCENCE

The goal of the four studies that comprised this dissertation was to examine how spirituality/religiosity (SIR), as both an institutional and personal phenomenon, developed over time, and how its institutional (i.e., religious activity involvement) and personal (i.e., sense of connection with the sacred) components were uniquely linked with psychosocial adjustment. In Study 1, the differential longitudinal correlates of religious service attendance, as compared to involvement in other clubs, were evaluated with a sample of adolescents (n=1050) who completed a survey in grades 9, 11 and 12. Religious attendance and involvement in non-religious clubs were uniquely associated with positive adjustment in terms of lower substance use and better academic marks, particularly when involvement was sustained over time. In Study 2, the direction of effects was tested for the association between religious versus non-religious activities and both substance use and academic marks. Participants (n= 3993) were surveyed in grades 9 through 12. Higher religious attendance (but not non-religious club involvement) in one grade predicted lower levels of substance use in the next grade. Higher levels of nonreligious club involvement (but not religious service attendance) in one grade predicted higher academic achievement in the next grade, and higher academic achievement in one grade predicted more frequent non-religious club involvement in the next grade. The results suggest that different assets may be fostered in religious as compared to nonreligious activities, and, specifically, religious activity involvement may be important for the avoidance of substance use. The goal of Study 3 was to assess the unique associations between the institutional versus personal dimensions of SIR and a wide range of domains of psychosocial adjustment (namely, intrapersonal well-being, substance use, risk attitudes, parental relationship quality, academic orientation, and club involvement), and to examine the direction of effects in these associations. Participants (n=756) completed a survey in grades 11 and 12. Personal and institutional dimensions of SIR were differentially associated with adjustment, but it may only be in the domain of risk-taking (Le., risk attitudes, substance use) that SIR may predict positive adjustment over time. Finally, in Study 4, the goal was to examine how institutional and personal aspects of SIR developed within individual adolescents. Configurations of mUltiple dimensions of spirituality/religiosity were identified across 2 time points with an empirical classification procedure (cluster analysis), and sample- and individual-level development in these configurations were assessed. A five cluster-solution was optimal at both grades. Clusters were identified as aspirituallirreligious, disconnected wonderers, high institutional and personal, primarily personal, and meditators. With the exception of the high institutional and personal cluster, the cluster structures were stable over time. There also was significant intraindividual stability in all clusters over time; however, a significant proportion of individuals classified as high institutional and personal in Grade 11 moved into the primarily personal cluster in Grade 12. This program of research represented an important step towards addressing some of the limitations within the body of literature; namely, the uniqueness of religious activity involvement as a structured club, the differential link between institutional versus personal SIR and psychosocial adjustment, the direction of effects in the associations between institutional versus personal SIR and adjustment, and the way in which different dimensions of SIR may be configured and develop within individual adolescents over time.

The relationship between religion, spirituality, psychological adjustment, and quality of life among people with multiple sclerosis

The present research was comprised of two studies that aimed to explore the role of religious and spiritual variables in the psychological adjustment and quality of life of people with Multiple Sclerosis (MS). In study 1, religious behavior and objective levels of spirituality and religiosity were not significantly related to psychological adjustment or quality of life among people with MS. Positive religious coping was negatively related to psychological adjustment and quality of life. In study 2, Intrinsic religious orientation and Quest religious orientation were related to poor psychological adjustment. Implications of the present research for people with MS and other chronic illnesses are discussed.

Ignatian spirituality and the rebuilding of self-esteem

Of all the relationships in my life, one that has been among the most difficult is the relationship with myself; overcoming low self-confidence is an ongoing struggle. One might contend that self-denigration is a form of self-mutilation, and at times it has been a powerfully destructive force in my life. All too often, low self-esteem has limited the opportunities available to me, and has had an impact on the relationships with significant others in my life, including God. It has even been suggested that it has been one of the inordinateattachments from which I have needed liberating (Exx 23). While the problem is now much less severe than it has been, maintaining a functional level of self-esteem requires ongoing effort. In this paper, it is my aim to tell of my own journey into Ignatian prayer, using illustrations from my own journals, and to explain why it has become important in my efforts to preserve a sense of my own value.

Spirituality and sexual abuse: issues and dilemmas for survivors

Sexual abuse profoundly affects survivors to the extent that they are unable to maintain previously held viewpoints or ways of being, including those relating to their spirituality. Certainly the experience has considerable potential to complicate the spiritual lives of survivors. For Christian survivors, this may include how they perceive and relate to both themselves and God as well as affect participation in sacraments such as eucharist and reconciliation. Spiritual traditions often promote the embracing of silence, but this may be problematic for survivors who have been silenced and unable to give expression to their experiences. Similarly, socialization resulting in beliefs that Christians should always forgive and/or never be angry needs to be overcome. While negotiating these pitfalls may result in explorations of spirituality being even less straightforward for survivors of sexual abuse than it is for others, a transformative spirituality within a Christian framework can be realized.

Arthur Miller: Spirituality Explored

Following the overview of his life, I will discuss in depth various theme that Miller presents in his writing by closely analyzing four of Miller's plays. I will give you a brief setting into which Miller wrote the various plots.

Space and loss: spirituality and symbolic connectedness in contemporary culture

This paper examines the significance of space in the experience, stories and memories of loss and grief. While for many religions the earth is an important element in rituals around birth, death and burial, in increasingly secular and multi-cultural societies, church and public cemeteries are no longer the dominant sacred sites, nor is religion the only way of defining ‘spirituality’. The paper describes shifts in religious and secular practices in dealing with loss and grief, presents case studies of traditional and contemporary frameworks in which ritual, storytelling and space are important elements of meaning making processes, and invites further examination of the ways in which artmaking restores a sense of control and meaning after the experience of loss.

Social work and spirituality in a secular society

• Summary: In an increasingly secular era which finds only a small minority of the population regularly participating in organized religion, there is emerging interest in how spirituality can be incorporated into social work practice. This article proposes one way in which this might occur in `deliberately secular' nations such as Australia.

• Findings: A framework in which spirituality is considered to be an aspect of lived experience is proposed. Dimensions of life which can be incorporated into such a framework include life rituals, creativity, social action, and sense of place.

• Applications : Conceptualizing spirituality in a way which does not use specifically religious language or concepts, may enable discussion of spiritual issues to be incorporated into social work practice when either practitioners or service users have or no religious background or affiliation or no shared religious background.

Developing and validating a questionnaire to measure spirituality : a psychometric process

The purpose of the paper is to describe the processes undertaken to evaluate the psychometric properties of a questionnaire developed to measure spirituality and examine the relationship between spirituality and coping in young adults with diabetes.

The specific validation processes used were: content and face validity, construct validity using factor analysis, reliability and internal consistency using test-retest reliability and Cronbach’s alpha correlation coefficient.

The exploratory factor analysis revealed four factors: self-awareness, the importance of spiritual beliefs, spiritual practices, and spiritual needs. The items on the Spirituality Questionnaire (SQ) revealed factor loading ≥ 0.5. Reliability processes indicated that the SQ is reliable: Cronbach’s alpha 0.94 for the global SQ and between 0.80-0.91 for the four subscales. Test-retest statistic examination revealed stability of the responses at two time points 10 weeks apart.

The final questionnaire consists of 29 items and the psychometrics indicated that it is valid and reliable.