"God was with me": A qualitative study of Christian meaning-making among refugees.

In this consensual qualitative research study, we investigated the role of refugees' Christian faith in meaning-making coping. High percentages of religiosity in refugee populations support the need to understand the role of religion in their coping processes. Interviews with 20 Christian refugees from 10 African and Asian countries revealed that participants drew heavily from their faith resources to cope with their experiences. Specifically, refugees reported coping practices that included trust in God, prayer, intimacy with God, spiritual surrender, lament, worship, and social support. Although many participants described spiritual struggles, including doubting God, feeling distant from God, and questioning God, most found meaning amid refugee-related suffering and reported perspective shifts, a deepening of faith, seeing suffering as part of God's plan, experiencing a deepened sense of purpose, and growing in the likeness of Christ. Refugees also reported growth through suffering in the form of gratitude, altruism, testimony, and humility. Clinical implications include encouraging the use of religious resources for meaning-making and supporting the resolution of spiritual struggles.

The multilevel correlates, contributions, and consequences of leader humility in humanitarian aid work.

Objective: Leader humility has been linked to many positive outcomes but not examined in humanitarian aid work. Three studies examined the multilevel correlates, contributions, and consequences of leader humility in Medair-a large, multinational, faith-based aid organization. Study 1 examined correlates of leader humility in a sample of 308 workers and 167 leaders. Study 2 explored multilevel contributions of leader humility in 96 teams comprised of 189 workers. Study 3 utilized a subsample (50 workers, 34 leaders) to explore consequences of Time 1 leader and team humility on outcomes 6 months later. Method: Participants completed measures of humility (general, relational, team), leader and team attributions (e.g., effectiveness, cohesion, and growth-mindedness), organizational outcomes (e.g., job engagement and satisfaction; worker and team performance), and psychological outcomes (e.g., depression, anxiety, compassion satisfaction, and flourishing). Results: Leader and team humility contributed to multilevel positive attributions about leaders (as effective and impactful), teams (as cohesive, psychologically safe, and growth-minded), and oneself (as humble), and those attributions contributed to organizational and psychological outcomes. Teams' shared attributions of their leader's humility contributed to higher worker job satisfaction and team performance. Longitudinally, for workers and leaders, leader and team humility were associated with some positive organizational and psychological outcomes over time. Conclusion: In humanitarian organizations, leader humility seems to act as an attributional and motivational social contagion that affects aid personnel's positive attributions about their leaders, teams, and themselves. In turn, these multilevel positive attributions contribute to several positive team, organizational, and psychological outcomes among workers and leaders.

"God wastes nothing": A consensual qualitative study of coping among Catholic individuals with cancer diagnoses.

While religious meaning-making has been extensively studied, emic religious coping remains largely unexplored. This consensual qualitative research study explored Catholic cancer survivors' (N = 22) descriptions of drawing on their religious framework throughout their cancer journeys. Findings revealed distinctive Catholic resources such as the power of blessings, drawing comfort from the saints and sacraments, and "offering up" suffering as a form of spiritual surrender, suggesting the existence of underlying theodicies of divine purpose as well as potential clinical resources. While many participants described spiritual struggles and questions, most found meaning through deepening their faith, helping others, and re-examining their priorities. Exploratory mixed-method analyses suggest that questioning God may promote turning toward faith, while being angry at God is associated with difficulty in doing so. The findings have implications for research, pointing to emic practices that merit further study.

When suffering contradicts belief: measuring theodical struggling.

Global meaning systems help people make sense of their experiences, but suffering can violate global meaning and create distress. One type of potential violation is conflict between one's experience of suffering and one's deeply-held beliefs about God as loving, powerful, and just. The problem of theodicy-why an all-powerful and all-loving God would allow suffering-has long been an important theological and philosophical concern, but little is known about how theodicy plays out psychologically for religious individuals facing serious life difficulties. To address this issue within a specific religious tradition, Christianity, we drew upon philosophy, Christian theology, and psychology to develop the construct of theodical struggling. Through theological and philosophical input, we generated a 28-item pool and conducted 10 cognitive interviews with a diverse sample of Christian adults. In three consecutive online studies of Christian adult samples, we reduced the scale to 11 items through PCA, found a strong one-factor solution using EFA, and found support for the one-factor solution along with preliminary reliability and validity. This newly-developed Theodical Struggling Scale represents an important advance in understanding individuals' experiences of ruptures in their beliefs regarding God's goodness and paves the way for future research on this topic. Supplementary Information: The online version contains supplementary material available at 10.1007/s12144-023-04642-w.

Resource loss and mental health during COVID-19: Psychosocial protective factors among U.S. older adults and those with chronic disease.

Across the globe, COVID-19 has disproportionately affected the physical and mental health of several vulnerable groups. In a series of two cross-sectional studies conducted April to July 2020, we examined its acute mental health effects on two vulnerable U.S. community samples-home-bound older adults who were at or below the poverty line (Study 1, N = 293, Mage  = 76.94, SD = 8.64; 75.1% female, 67.9% Black) and adults with chronic disease (Study 2, N = 322, Mage  = 62.20, SD = 12.22; 46.3% female, 28.3% racial/ethnic minorities). Based on the conservation of resources theory, we hypothesised that pandemic-related resource loss would be associated with greater mental distress, but perceived social support and positive psychological characteristics (trait resilience and optimism) would buffer against this adverse effect. Across both samples of vulnerable adults, pandemic-related resource loss was related to mental distress. Perceived social support was related to lower mental distress but did not consistently buffer the effect of resource loss on mental health. However, in Study 2, both trait resilience and optimism buffered this relationship. Findings are discussed in terms of their implications for the conservation of resources theory.

Testimony and meaning: A qualitative study of Black women with cancer diagnoses.

OBJECTIVE: Research has established religion and spirituality as important resources for Black people in the U.S. coping with adversity. Most research has been from an etic perspective, examining religious variables that are valid across multiple religions. In the present study, we asked what emic aspects of the Black church's practices and theological emphases women with cancer drew on in constructing meaning-making narratives from their cancer experience. METHOD: In this consensual qualitative research study, we interviewed 30 Black women with cancer histories with an average age of 64.5. RESULTS: The religious practice of testimony emerged as the predominant theme. Testimony (a) provided a meaningful purpose to the cancer experience; (b) had a specific content of describing what God had done in their lives as well as some common theological emphases; (c) had dual desired outcomes of helping others and bringing glory to God; and (d) had an associated practice of giving testimony. CONCLUSION: We discuss testimony as a narrative structure and highlight its importance in informing culturally sensitive interventions aimed at supporting Black women with cancer. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Psychological and spiritual outcomes during the COVID-19 pandemic: A prospective longitudinal study of adults with chronic disease.

OBJECTIVE: This prospective longitudinal study examined whether coronavirus disease 2019 (COVID-19) has led to changes in psychological and spiritual outcomes among adults with chronic disease. METHOD: Participants (N = 302) were a stratified, nonrandom sample of adults (Mage = 64.46, SD = 10.86, 45.7% female). The sample was representative of the chronically ill, U.S. adult population in gender, race/ethnicity, region, and religious affiliation but older in age and higher in socioeconomic status. Participants completed online-administered measures 1 month before the March 11 pandemic declaration (T1) and then 1 and 3 months after it (T2 and T3). At T1 through T3, they completed measures of depression, anxiety, personal suffering, psychological well-being, trait resilience, optimism, hope, grit, spiritual struggles, spiritual fortitude, and positive religious coping. At T2 and T3, they also completed measures of social support, physical health, resource loss, perceived stress, and COVID-19 fears and exposure. RESULTS: Overall, people did not change substantially in psychological or spiritual outcomes over time. However, trait resilience increased and personal suffering declined. People highest in prepandemic suffering increased in spiritual fortitude. Racial/ethnic minorities increased in religious importance. Roughly half (48.9%) of participants exhibited psychological resilience (no/minimal depression or anxiety symptoms) at both T2 and T3. Perceived stress and psychological resource loss were associated with adverse mental health outcomes, but social support and physical health were not. COVID-19 fears contributed more to mental health than COVID-19 exposure. CONCLUSIONS: Even among vulnerable populations such as adults with chronic disease, during pandemic conditions like COVID-19, many people may exhibit-or even increase slightly in-psychological and spiritual resilience. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Perceived and actual posttraumatic growth in religiousness and spirituality following disasters.

OBJECTIVE: Religious/spiritual (R/S) growth is a core domain of posttraumatic growth (PTG). However, research on R/S growth following disasters has over-relied on retrospective self-reports of growth. We therefore examined longitudinal change in religiousness/spirituality following two disasters. METHOD: Religious survivors of Hurricanes Harvey (Study 1) and Irma (Study 2) completed measures of perceived R/S PTG, general religiousness/spirituality ("current standing"-R/S PTG), and subfacets of religiousness/spirituality (spiritual fortitude, religious motivations, and benevolent theodicies). In Study 1, 451 participants responded at 1-month and 2-month postdisaster. In Study 2, participants responded within 5-days predisaster and at 1-month (N = 1,144) and 6-months postdisaster (N = 684). RESULTS: In both studies, perceived R/S PTG was weakly related to longitudinal increases in general religiousness/spirituality and in most of its subfacets, but reliable growth in any R/S outcome was rare. Additionally, Study 2 revealed evidence that actual change in psychological well-being is associated with actual (but not perceived) R/S PTG, but disaster survivors tend to exhibit declines in their religiousness/spirituality, spiritual fortitude, and religious motivations. CONCLUSIONS: Results suggest disaster survivors are only modestly accurate in perceiving how much positive R/S change they experience following a disaster. We discuss implications for clinical practice, scientific research, and empirical and conceptual work on PTG more broadly.

Why humility is vital to effective humanitarian aid leadership: a review of the literature.

Organisational scientists are paying increasing attention to humility, following a larger trend in scholarship highlighting the relational and interdependent nature of leadership and business. A growing body of evidence identifies humility as vital to effective organisational leadership, facilitating positive organisational outcomes, such as lower voluntary turnover and greater follower job satisfaction. To date, research on the subject has focused on certain specific organisational contexts, including businesses, hospitals, and schools. This paper reviews the existing literature and explores why humility may be an especially important leader trait in international humanitarian aid organisations and relief work-a context that is not only uniquely challenging, but also one that would seemingly stand to benefit keenly from the quality. It argues that humility is essential for effective leadership because it is normative of good character, it is predictive of positive outcomes, and it corresponds to a genuine representation of the nature of humanitarian aid.

Resource Loss and Stress Outcomes in a Setting of Chronic Conflict: The Conservation of Resources Theory in the Eastern Congo.

The purpose of this cross-sectional study was to examine conservation of resources (COR) theory in the context of armed conflict in Africa. Specifically, within the setting of ongoing chronic conflict in the eastern Democratic Republic of the Congo (DRC), we tested the COR theory prediction that resource loss contributes to various stress outcomes. A randomly selected sample of 312 adults (125 men, 187 women) from villages in North Kivu, DRC completed orally administered measures of resource loss, daily stressors, and four stress outcomes: depression symptoms, anxiety symptoms, posttraumatic distress, and general distress. Consistent with COR theory, resource loss predicted all four stress outcomes above and beyond the contribution of demographics, relocation experiences, and daily stressors; however, this effect was small, ΔR2 = .02-.06. The most consistent and strongest predictors of stress outcomes were daily stressors, ßs = .42-.62; number of relocation experiences, ßs = .33-.43; and psychosocial resource loss (e.g., loss of hope, meaning or purpose in life, intimacy with friends and family, physical health of family), ßs = .17-.26. Additionally, male sex predicted depression, anxiety, and trauma symptoms, and lower educational status predicted anxiety symptoms and general distress. Our exploratory mediation analysis showed that daily stressors partially mediated all four pairs of associations between psychosocial resource loss and mental health outcomes. We discuss the findings with consideration of research on disasters generally and armed conflicts specifically. We also discuss implications for humanitarian interventions with conflict-affected populations in Africa and beyond.

Development and validation of a measure of spiritual fortitude.

OBJECTIVE: In this article, we develop and validate a measure of spiritual fortitude (SF). SF is defined as a character trait enabling people to endure and make redemptive meaning from adversity through their sacred connections with God, others, and themselves. METHOD: First, we summarize its conceptual distinctions from related constructs such as grit, hardiness, and resilience. Then, in three independent studies (N = 1,104), we provide evidence for a three-factor SF Scale (SFS-9), consisting of subscales labeled Spiritual Endurance, Spiritual Enterprise, and Redemptive Purpose. RESULTS: In Study 1 (N = 410), an exploratory factor analysis revealed three SFS-9 subscales, each of which demonstrated evidence of internal consistency. Study 2 (N = 393) confirmed this factor structure on a separate sample and provided additional evidence for internal consistency. In Study 3 (N = 301), we present evidence of its discriminant, convergent, and incremental validity. SFS-9 scores predicted variance in meaning in life, spiritual well-being, religious coping, and adversity-related anxiety, above and beyond the contribution of grit and resilience. CONCLUSIONS: Spiritual fortitude appears to be a useful construct in understanding the process of adjusting to, and thriving, in the midst of adversity, suffering, and trauma. Future hypotheses and research directions are provided to catalyze work in this new area of inquiry. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Religious support buffers the indirect negative psychological effects of mass shooting in church-affiliated individuals.

OBJECTIVE: Religion has been shown to protect against the negative effects of traumatic events. The current pilot study explored the extent to which religious support (i.e., sense of comfort and support from the Sacred, religious leaders, and fellow faith participants) buffered against the indirect negative psychological symptoms (i.e., religious/spiritual struggle, depression, anxiety, posttraumatic stress disorder [PTSD]) following the 2015 mass shooting on the campus of Umpqua Community College in Roseburg, Oregon. METHOD: The study examined 34 individuals (12 male, 22 female) that were indirectly affected by the mass shooting (i.e., did not directly witness the shooting and were not physically harmed by the shooting), recruited from the surrounding religious community. Participants completed measures of resource loss, religious support, religious and spiritual struggle, depression, anxiety, and PTSD symptoms. RESULTS: Religious support buffered the relationship between resource loss and negative psychological symptoms for religious and spiritual struggle, depression, and PTSD symptoms but not anxiety. CONCLUSIONS: Religious and spiritual support may be an important factor for helping church-affiliated individuals cope with the negative effects of resource loss that occur when a community is affected by a mass shooting. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

The psychological study of religion and spirituality in a disaster context: A systematic review.

OBJECTIVE: The purpose of this systematic review is to synthesize the existing empirical psychology of religion/spirituality (R/S) and disaster research and offer a prospectus for future research. METHOD: Searches were conducted in PsycINFO, PsycARTICLES, Medline databases, and through personal communication with study authors covering a period from 1975 (from the earliest identified study meeting our criteria) to 2015. Studies that took an empirical approach to studying the impact of disasters on R/S phenomena, as well as the relationship between R/S phenomena, cognition, behavior, and well-being in disaster contexts were included. RESULTS: A total of 51 articles met the inclusion criteria. We organized the empirical findings under five main categories, which emerged from sorting studies by their primary R/S focus: (a) general religiousness, (b) God representations, (c) religious appraisals, (d) R/S meaning making, and (e) religious coping. On the whole, R/S appears to generally lead to positive outcomes among disaster survivors. Results suggest positive benefits of R/S comes more from how one engages faith and access to resources via R/S communities. CONCLUSIONS: This review revealed several emerging patterns regarding what is known as well as existing gaps in the literature, including the need for more rigorous methodological designs and ongoing systematic programs of study. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Conserving resources during chronic disaster: Impacts of religious and meaning-focused coping on Botswana drought survivors.

OBJECTIVE: This study explored the trauma symptoms of those who have endured a multiyear drought in Botswana, an arid, pastoral, and primarily Christian Southern African nation. Particularly, this study used conservation of resources theory to consider the effects of disaster-related resource loss (DRL) and the psychology of religion literature to investigate the roles of religious or spiritual (R/S) and meaning-focused coping. METHOD: Three hundred undergraduates in Botswana completed culturally adapted measures of their DRL, positive and negative R/S coping, search for meaning in life (meaning-focused coping), lifetime trauma exposure, and current trauma symptoms. Data were collected in the 4th year of the record-setting drought. RESULTS: Hierarchical regression analysis was used to add predictors sequentially and demonstrated that both DRL of energies (e.g., time, money) and coping behaviors (both negative R/S and meaning-focused) positively predicted current trauma symptoms beyond one's personal trauma exposure. Further, positive R/S coping was observed to moderate (buffer) the influence of DRL on trauma symptoms, whereas negative R/S and meaning-focused coping appeared to partially mediate the influence of DRL. CONCLUSION: This study extends research on DRL and coping to the context of chronic disasters. A nuanced treatment of resource loss (accounting for specific item wordings) suggests that although DRL in general may influence negative R/S coping, only some types of resource loss (energetic) from an ongoing-chronic disaster affect both one's current meaning-focused coping and trauma symptoms. In contrast to negative R/S coping behaviors (e.g., doubt), positive ones (e.g., seeking divine connection) were shown to mitigate those effects. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Faith in the wake of disaster: A longitudinal qualitative study of religious attachment following a catastrophic flood.

OBJECTIVE: This longitudinal qualitative study explores the impact of natural disasters on religious attachment (perceived relationship with God). We sought to validate and conceptually extend the religion-as-attachment model in a postdisaster context. METHOD: At 4 weeks (T1; n = 36) and 6 months postdisaster (T2; n = 29), survivors of the 2016 Louisiana flood completed a disaster-adapted version of the Religious Attachment Interview (Granqvist & Main, 2017). RESULTS: At T1 and T2, survivors emphasized God being a safe haven (source of protection, comfort, or nurturance). This emphasis was especially pronounced for survivors who were directly affected (their home or business flooded) or had previous disaster exposure to Hurricane Katrina. Overall, survivors consistently emphasized God serving as a stronger and wiser attachment figure, and it was rare for them to report experiencing perceived separation or loss of intimacy from God. At T1 and T2, around 85% of survivors described their current religious attachment as either having a positive affective quality (e.g., closer, stronger) or as no different from before the disaster; around 15% said it had a negative affective quality (e.g., disappointed, strained). In describing their postdisaster religion/spirituality, survivors highlighted (a) God being a source of love, comfort, strength, and hope; (b) actively putting trust/faith in God; and (c) experiencing God through family/community. CONCLUSION: Results support and conceptually extend the religion-as-attachment model in a postdisaster context. Findings suggest disasters activate the attachment system, and survivors commonly view and relate with God as an attachment figure, especially one who serves as a safe haven. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

"My heart is in his hands": The lived spiritual experiences of Congolese refugee women survivors of sexual violence.

The Democratic Republic of Congo (DRC) has experienced widespread violence, including sexual violence. Sexual violence toward women includes rape, genital mutilation, and sexual slavery. Many Congolese have sought to escape such conditions as refugees in the USA. In the present study, we examined lived spiritual experiences of nine Congolese refugee women survivors of sexual violence. Overall, this study provides new insights into participants' experiences of spirituality in the aftermath of sexual trauma and in living as a refugees. Consensual qualitative research (CQR) methods were used to analyze participants' responses to a semistructured interview protocol. Participants endorsed faith that God was in control, reliance on prayer, gratitude toward God, and difficulty practicing their faith in the USA relative to Africa. Results indicated that religion/spirituality is an integral part of the women's lives and that it appears to facilitate coping. Clinical and community mental health implications are discussed.

Cultural Humility and Hospital Safety Culture.

Hospital safety culture is an integral part of providing high quality care for patients, as well as promoting a safe and healthy environment for healthcare workers. In this article, we explore the extent to which cultural humility, which involves openness to cultural diverse individuals and groups, is related to hospital safety culture. A sample of 2011 hospital employees from four hospitals completed measures of organizational cultural humility and hospital safety culture. Higher perceptions of organizational cultural humility were associated with higher levels of general perceptions of hospital safety, as well as more positive ratings on non-punitive response to error (i.e., mistakes of staff are not held against them), handoffs and transitions, and organizational learning. The cultural humility of one's organization may be an important factor to help improve hospital safety culture. We conclude by discussing potential directions for future research.

Trauma in sub-Saharan Africa: review of cost, estimation methods, and interventions.

Trauma is a widely acknowledged problem facing individuals and communities in developing countries. In sub-Saharan Africa-a region that is home to some of the world's worst human rights violations, ethnic and civil conflicts, disease epidemics, and conditions of poverty-trauma is an all-too-common experience in citizens' daily lives. In order to address these conditions effectively, the impact of trauma must be understood. The authors reviewed recent literature on the cost and consequences of psychological trauma in sub-Saharan Africa to provide a substantive perspective on how trauma affects individuals, communities, and organizations and to inform the effort to determine a method for measuring the impact of trauma in sub-Saharan Africa and the efficacy of trauma interventions in the region. Several recommendations are offered to help broaden and deepen the current approaches to conceptualizing trauma, evaluating its cost, and intervening on behalf of those impacted by trauma in sub-Saharan Africa.

Church attendee help seeking priorities after Hurricane Katrina in Mississippi and Louisiana: a brief report.

After a disaster, survivors find themselves seeking many types of help from others in their communities. The purpose of this exploratory study was to assist in mental health service planning by determining the type and priority of support services sought by church attendees after Hurricane Katrina. Surveys were given to church attendees from two Mississippi coast and four New Orleans area churches that were directly affected by Hurricane Katrina participants were asked to review a list of 12 potential sources of help and were asked to rank the items chronologically from whom they had sought help first after Hurricane Katrina. Overall, participants sought out assistance from informal social networks such as family and friends first, followed by governmental and clergy support. This study also showed there may be differences in help-seeking behaviors between church attendees in more urban areas versus church attendees in more rural areas. Moreover, findings highlighted that very few church attendees seek out mental health services during the initial impact phase of a disaster. Since timely engagement with mental health services is important for resolving trauma, strategies that link professional mental health services with clergy and government resources following a disaster could improve the engagement with mental health professionals and improve mental health outcomes. Disaster mental health clinical implications and recommendations are offered for psychologists based on these findings.

Psychotherapy with rural religious fundamentalist clients.

Successful psychotherapy with rural fundamentalist Christians requires psychologists to understand the clients' culture and worldview. They often rely heavily on religious authorities, interpret Scriptures literally, adhere to strict moral codes of behavior, and believe that they should evangelize those around them. Common therapeutic challenges include: spiritualizing problems, relational conflicts related to gender role expectations, addiction problems, and the religious agendas of family and clergy. We recommend that psychotherapists evaluate their own attitudes, collaborate with community gatekeepers, sensitively address clients' rigid beliefs, address religious differences, and take a holistic approach to treatment. A case example illustrates this approach.