Religiousness, meaning, and quality of life: Test of a mediational model among adults seeking a spiritually integrated inpatient program.

OBJECTIVE: Religious beliefs and practices may augment a sense of meaning in life that could support quality of life (QOL) in physical, social, and emotional domains amid mental health crises. However, these associations have not been thoroughly tested among persons with serious mental illness (SMI). METHODS: Focusing on 248 adults who had recently enrolled in a spiritually integrated acute psychiatric hospitalization program, we incorporated structural equation modeling to examine whether (1) religiousness would be associated with better overall QOL; and (2) inpatients' sense of meaning in life would at least partially account for the religiousness-QOL link. RESULTS: Religiousness was linked indirectly with QOL at the time of admission: religiousness was associated with greater meaning in life, and a higher degree of meaning in life was associated with QOL. CONCLUSIONS: Findings underscore the crucial role of religiousness for meaning and wellness among many individuals with SMI who seek stabilization and healing.

A practice-based evidence investigation of God representations in spiritually integrated psychotherapies.

OBJECTIVE: This practice-based evidence study examined trajectories of God representations and psychological distress among Christians participating in spiritually integrated psychotherapies (SIPs). METHODS: In total, 17 clinicians practicing SIPs in a mid-sized city on the US Gulf Coast implemented session-to-session assessments of these outcomes with 158 clients over a 4-month period and also reported their use of specific spiritual interventions after each session (e.g., affirmed client's divine worth). RESULTS: Multivariate growth modeling revealed clients' psychological distress decreased over the study period whereas authoritarian God representations increased and benevolent God representations remained stable. In addition, clients who increased in benevolent representations of God had a greater likelihood of experiencing alleviation of psychological distress. CONCLUSION: These findings affirm the potential efficacy of SIPs and cultural importance of belief in a benevolent deity as a source of strength, identity, and potential healing among Christians clients who prefer a spiritually integrated approach in psychotherapy.

Understanding Preferences for Addressing Spirituality Among Adults Seeking Outpatient Mental Health Care.

Focusing on 472 religiously heterogenous adult patients seeking psychotherapy at a university-based outpatient clinic, this brief report examined (1) these patients' preferences about clinicians appreciating their religion and/or spirituality (R/S) backgrounds (spiritually affirming) and addressing spiritual concerns in treatment (spiritually integrated) and (2) role of demographic factors and psychological functioning in predicting preferences for R/S integration. Analyses revealed that more than half of patients reported moderate or greater importance for spiritually affirming care and one-third hoped to address spiritual issues. Furthermore, these factors emerged as indicators of stronger preferences for R/S integration: female sex, racial minority status (African American, Native American), history of marriage (past and present), affiliation to organized religion (Christianity, Islam), and importance placed on R/S. In general, findings suggest that most patients seeking psychotherapy in a university-based clinic in southern Alabama might desire a spiritually affirming approach, and a smaller subset prefer an approach in which R/S is integrated into treatment.

Validation of the Expressions of Moral Injury Scale-Military version-Short Form.

Military personnel may encounter morally injurious events that lead to emotional, social, and spiritual suffering that transcend and/or overlap with mental health diagnoses (e.g., post-traumatic stress disorder [PTSD]). Advancement of scientific research and potential clinical innovation for moral injury (MI) requires a diversity of measurement approaches. Drawing on results from the bifactor model in Currier et al.'s (2017) psychometric evaluation of the Expressions of Moral Injury Scale-Military version (EMIS-M), this study validated a four-item short form of the instrument with two samples of veterans with a history of war-zone service. Namely, despite the reduced number of items, the EMIS-M-Short Form (SF) yielded favourable internal consistency and comparable levels of convergent validity with theoretically related constructs (e.g., PTSD and struggles with morality and ultimate meaning) as the full-length version. Notwithstanding the possible utility of distinguishing between self- and other-directed forms of MI, factor analytic results further revealed that the EMIS-M-SF was best conceptualized with a unidimensional factorial model that might allow for a general assessment of MI-related outcomes. Overall, these initial results suggest that the EMIS-M-SF may hold promise as a short, reliable, and valid assessment of overall outcomes related to a possible MI.

Moral Injury and Spiritual Struggles in Military Veterans: A Latent Profile Analysis.

War-related traumas can lead to emotional, relational, and spiritual suffering. Drawing on two community samples of war zone veterans from diverse military eras (Study 1, N = 616 and Study 2, N = 300), the purpose of this study was to examine patterns of constellations between outcomes related to moral injury (MI) and common ways in which veterans may struggle with religion or spirituality, defined as divine, morality, meaning, interpersonal, and doubt. Results from latent profile analyses revealed three distinct classes across the samples, based on psychometrically validated instruments: (a) no MI-related outcomes or spiritual struggles (nondistressed group; Study 1 = 72.7%, Study 2 = 75.0%); (b) MI-related outcomes and equivalent or lower degrees of spiritual struggles relative to MI-related outcomes (psychological MI group; Study 1 = 19.2%, Study 2 = 17.0%); and (c) MI-related outcomes and salient struggles with religious faith or spirituality, both within their own profiles and compared to other groups (spiritual MI group; 8.1% and 8.0% in the two samples). When we compared severity of spiritual struggles within MI groups, turmoil with God or a higher power emerged as a defining feature of the spiritual MI group in both samples. In addition, secondary analyses revealed membership in this third group was linked with greater importance of religion or spirituality before military service, χ2 (1, N = 616 and 300) = 4.468-8.273. Overall, although more research is needed, these findings highlight the possible utility of differentiating between psychological and spiritual subtypes of MI according to war zone veterans' religious or spiritual backgrounds.

Spanish Abstracts by Asociación Chilena de Estrés Traumático (ACET) Daño moral y luchas espirituales en veteranos de guerra: Un análisis de perfil latente DAÑO MORAL Y LUCHAS ESPIRITUALES Los traumas relacionados con la guerra pueden llevar al sufrimiento emocional, relacional, y espiritual. Basado en dos muestras comunitarias de veteranos de la zona de guerra de diversas épocas militares (Estudio 1, N = 616 y Estudio 2, N = 300), el objetivo de este estudio fue examinar los patrones de las constelaciones entre los resultados relacionados con el daño moral (DM) y las formas comunes en las que los veteranos pueden lidiar con la religión y/o la espiritualidad, definidas como divinas, moralidad, significado, interpersonal, y duda. Los resultados de los análisis de perfiles latentes revelaron tres clases distintas, basadas en instrumentos validados psicométricamente, en todas las muestras, aquellas con: (a) Los resultados no relacionados con el DM o luchas espirituales (grupo sin malestar psicológico, Estudio 1 = 72.7%, Estudio 2 = 75.0); (b) Los resultados relacionados con el DM y grados equivalentes o más bajos de luchas espirituales en relación con los resultados relacionados con el DM (grupo de DM psicológico; Estudio 1 = 19.2%, Estudio 2 = 17.0); y (c) Los resultados relacionados con el DM y las luchas salientes con la fe religiosa y/o la espiritualidad, tanto dentro de sus propios perfiles como en comparación con otros grupos (grupo de DM espiritual; 8.1 y 8.0% en las dos muestras). Cuando comparamos la severidad de las luchas espirituales dentro de los grupos DM, la confusión con Dios o un poder superior emergió como una característica definitoria del grupo espiritual DM en ambas muestras. Además, los análisis secundarios revelaron que la pertenencia a este tercer grupo se relacionaba con una mayor importancia de la religión y/o la espiritualidad antes del servicio militar, χ2 (1, N = 616 y 300) = 4.468-8.273. En general, aunque se necesita más investigación, estos hallazgos resaltan la posible utilidad de diferenciar entre los subtipos psicológicos y espirituales de DM según los antecedentes religiosos y/o espirituales de los veteranos de la zona de guerra.

Prospective Patterns of Help-Seeking Behavior Among Military Veterans With Probable Posttraumatic Stress Disorder and Major Depressive Disorder.

This study examined help-seeking behavior from professional, informal, and religious sources in veterans with a probable need for treatment. In total, 93 veterans who screened positive for posttraumatic stress disorder/major depressive disorder completed assessments of help-seeking at two time points spaced apart by 6 months. Less than half (40%) reached out to a mental health professional or physician; only 1 in 10 engaged with providers who specialize in evidence-based therapies to a minimally adequate degree. Although roughly two thirds pursued help from informal sources, less than 10% similarly sought help nine or more times. Veterans with high willingness to seek help from specific sources at baseline were more likely to report sustained engagement in help-seeking behavior along these same lines at follow-up. Assessing veterans' help-seeking intentions may add prognostic value in predicting engagement in services. Veterans may also benefit from tailoring service delivery models according to preferred sources of help in their families and communities.

Moral injury and chronic pain among military veterans in an integrated behavioral health clinic.

OBJECTIVE: Military service may place veterans at increased risk for perpetrating, witnessing, or failing to prevent events that violate deeply held moral values. In some cases, veterans may develop moral injury (MI) symptoms that transcend and/or overlap with mental health conditions such as posttraumatic stress disorder (PTSD) and major depressive disorder (MDD). Further, PTSD and MDD are 2 established risk factors for chronic pain. However, research has not examined the association between MI symptoms and chronic pain. METHOD: We tested whether MI would emerge as a salient correlate of concurrent reports of chronic pain in the presence of PTSD and MDD symptom severity among 59 veterans seeking integrated behavioral health care. RESULTS: Findings indicated the severity of MI symptoms was significantly linked with veterans' concurrent reports of chronic pain. Self-directed MI symptoms emerged as a correlate of worse pain in the presence of PTSD and MDD. CONCLUSIONS: Preliminary findings demonstrate possible associations between MI and chronic pain among veterans with a need for holistic health care. Future research should examine mechanisms for an apparent MI-chronic pain link. (PsycInfo Database Record (c) 2023 APA, all rights reserved).