Religiosity, Spirituality, and Socioemotional Functioning in Mothers of Children with Autism Spectrum Disorder

  • Naomi V. Ekas
  • Thomas L. Whitman
  • Carolyn Shivers
Original Paper

DOI: 10.1007/s10803-008-0673-4

Cite this article as:
Ekas, N.V., Whitman, T.L. & Shivers, C. J Autism Dev Disord (2009) 39: 706. doi:10.1007/s10803-008-0673-4

Abstract

Religious beliefs, religious activities, and spirituality are coping resources used by many mothers of children with autism spectrum disorder (ASD). This study examined whether and how these resources were related to maternal socioemotional functioning. Mothers of children with ASD completed questionnaires assessing religiosity, spirituality, and a wide range of outcome variables, including stress, depression, self-esteem, life satisfaction, positive affect, and sense of control. Analyses revealed that religious beliefs and spirituality were associated with better positive outcomes and, to a lesser extent, lower levels of negative outcomes. Of the two predictors, spirituality accounted for more unique variance in positive outcomes. In contrast, religious activities were related to more negative outcomes and lower levels of positive outcomes.

Keywords

Autism Parenting stress Social support Religiosity Socioemotional functioning 

Introduction

Autism is a developmental disorder that is characterized by social interaction and communication deficiencies, restricted and repetitive behavior patterns, and, frequently, a wide variety of other symptoms (American Psychiatric Association 2000). Raising a child with autism spectrum disorder (ASD) is typically a challenging experience for parents. These challenges include obtaining a diagnosis, finding appropriate treatment and educational programs, and coping with the financial burden of paying for services. As a result of coping with these and many other challenges associated with raising a child with ASD, parents report greater levels of stress, poorer mental health, lower levels of intimacy within their marriage, and greater levels of marital discord (Dunn et al. 2001; Olsson and Hwang 2001).

Recently, researchers have begun to investigate the specific factors that may serve to directly reduce the negative psychological effects of raising a child with ASD. Social supports have been identified as one such critical factor for parents of children with ASD and other disabilities (Bishop et al. 2007; Bromley et al. 2004; Hassall et al. 2005). Social supports refer to the specific people on whom an individual relies during times of stress (Pearlin 1989). Social support can be formal, such as those provided by community agencies, or informal, particularly those provided by family and friends. Informal support has been shown to be more effective in reducing stress. Studies have shown that when coping with raising a child with ASD, mothers first turn to their spouse for support, then to their immediate family, and finally to other parents of children with disabilities (see Boyd 2002 for a review). Such supports have been found to be associated with better personal adaptation and mental health in parents of children with autism (Bristol 1984). For example, mothers of children with autism who perceived receiving higher levels of support, especially from spouses and relatives, reported lower levels of depression-related somatic symptoms and fewer marital problems (Dunn et al. 2001).

Another type of social support utilized by some individuals in times of stress is religious and/or spiritual in nature. Studies estimate that over 90% of individuals in the United States have some sort of belief in God (Graham et al. 2001). The efficacy of this coping resource appears to vary depending on a person’s specific religious beliefs and the role these beliefs serve in everyday life (Graham et al. 2001). Several studies report that spirituality and religion are related to both physical and psychological health. For example, religious affiliation has been associated with decreased mortality rates (Koenig et al. 1999) and fewer depressive symptoms (Patrick and Kinney 2003). Graham et al. (2001) found that students who were both spiritual and religious had greater immunity to stressful situations compared with students who were spiritual but not religious. Other studies suggest that collaborative religious coping, that is a sense of working together with God, is associated with greater depressive symptoms (Kinney et al. 2003). Taken together, these results suggest that the role of religion as a coping resource is complex and warrants further study.

According to Maltby and Day (2003), individuals can have one of three primary religious orientations: intrinsic, extrinsic, or quest. Individuals with an intrinsic orientation are completely committed to their religious beliefs, with their religion playing a routine and dynamic role in everyday life. In contrast, individuals with an extrinsic orientation use their religious orientation for specific reasons, such as becoming involved in a religious community, to achieve social status, or to gain feelings of protection or consolation. Individuals with quest orientations are spiritually marked by their desire for growth and constant search for answers in life. Within each of these orientations, individuals can use either positive or negative coping styles. Positive styles include mechanisms such as a feeling of collaboration with God and spiritual connection, whereas negative styles include methods such as blaming God for difficulties or believing that problems are deserved as a result of sin. In coping with autism, religious belief structures seem to vary widely. For example, some parents believe their child is a gift from God, sent to bring their family closer together or help them attain greater spiritual growth. On the other hand, some parents view their child with ASD as a punishment from God or view God as unavailable to them in times of need (Tarakeshwar and Pargament 2001).

When studying religiosity, some researchers utilize an approach that includes multiple dimensions, including religious beliefs, religious activities, and spirituality. Religious beliefs generally refer to a set of beliefs and values that revolves around an individual’s relationship with ‘God’ and the religious community (Fetzer Institute 1999). Religious activities refer to an individual’s participation and involvement in organizational (e.g., attending church services) and nonorganizational (e.g., devotional reading) events (Bonner et al. 2003). Finally, spirituality refers to meaning gained from life experiences, which may or may not be theistic in nature (Graham et al. 2001). Separating these constructs appears important because previous research has shown that they have differential effects on well-being and behavior. For example, Bonner et al. (2003) found, in a population of older adults, that lower levels of involvement in religious activities were associated with lower levels of depressive affect, whereas higher levels of spirituality were associated with greater prosocial behavior.

Only a few studies have examined the role of religion in families of children with autism. Investigating the relationship of organized religion and personal beliefs to personal health among parents of children with ASD, Coulthard and Fitzgerald (1999) found that only 5% of families of children with ASD report that they would turn to members of their congregation for help. In contrast, the same study found that 66% of families were likely to express their personal beliefs through private prayer. Moreover, support from personal beliefs and seeking comfort in prayer were related to better health outcomes. Tarakeshwar and Pargament (2001) explored the relationship between positive and negative religious coping, stress and depression among families of children with ASD. Positive coping was defined as seeking a positive relationship with God and experiencing closeness and harmony with God, whereas negative coping involved blaming God or the believing that God had abandoned or punished them. Results indicated that positive coping was associated with positive changes in social relationships and personal resources. In contrast, the use of negative coping methods was associated with increases in depressive affect and anxiety.

Despite the recognition that religion can serve as a supportive factor among parents of children with ASD, there are still many unanswered questions. Research in the general population suggests that different dimensions of religiosity may be related to different types of psychological outcomes (Bonner et al. 2003), however, systematic comparisons of these dimensions and their impact in families of children with ASD have not been examined. Therefore, one purpose of the current study was to investigate the influence of three of these dimensions of religiosity, religious beliefs, religious activities, and spirituality, on maternal socioemotional functioning. In order to explore this relationship a greater range of maternal socioemotional outcomes, both positive and negative, were examined than in previous studies within this population.

The current study investigated the effects of the three dimensions of religiosity on general life stress, parenting stress, negative affect, depression, self-esteem, life satisfaction, positive affect, psychological well-being, optimism, and locus of control. Past research has suggested that positive and negative socioemotional functioning, under typical circumstances, may be separate continua with different antecedent influences, whereas in times of great stress these two continua become interwoven (Zautra et al. 2001). We hypothesized that higher religiosity and spirituality in mothers of children with ASD would be associated with less negative outcomes, such as lower stress and depression, and more positive outcomes, such as higher life satisfaction. Based on the results of past research (e.g., Bonner et al. 2003), we also hypothesized that involvement in religious activities would be associated with more negative maternal outcomes and fewer positive outcomes. No specific hypotheses were made, however, concerning the possible differential effects of these dimensions on positive versus negative socioemotional outcomes.

Method

Participants

Participants consisted of 119 mothers who were part of a larger study examining stress and well-being in families of children with ASD. Mothers included in the present study had at least one child younger than 18 years of age who had been diagnosed with an ASD. The majority of mothers were married (82.9%); the remaining mothers were separated, divorced, or widowed (11.9%) or single (5.1%). Mothers were predominantly Caucasian (95%) and middle class; specifically, 8.7% had annual household incomes below $24,999, 55.7% earned $25,000–74,999, and 35.7% made $75,000 or more annually. The majority of mothers had some college or completed college (75.4%) or completed postgraduate training (14.4%), while a smaller percentage of mothers had a high school degree or less (10.1%). Mothers ranged in age 23–61 (M = 40.13, SD = 7.38). Children were between the ages of 2 and 18 (M = 9.45, SD = 4.08), and were predominantly male (82.9%). Ten of the families had at least one other child who was also diagnosed with an ASD.

Procedure

Participants were recruited with the assistance of local autism support groups and a regional autism service center. A total of 311 families, who indicated preliminary interest in being part of a research project, were contacted and sent packets with a cover letter explaining the study, consent forms, and the survey material. Families who did not wish to participate in the study returned a prepaid postcard indicating their decision. A total of 123 families completed and returned the questionnaire in a prepaid envelope, resulting in a 39.5% response rate. Four of the families were not included in the final data analysis because they did not meet the study requirements of having a child under the age of 18 who was diagnosed with an ASD.

Measures

Religiosity

The 38-item brief multidimensional measure of religiousness/spirituality, developed by the Fetzer Institute (1999) was used to obtain information about religious beliefs, religious activities, and spirituality. The measure contains various subscales, each measuring a unique aspect of religiosity. In the current study we utilized three subscales that contain a total of 27 questions. For each subscale mothers were instructed to use an interpretation or definition of “God” that was consistent with their personal beliefs. The religious beliefs subscale was created to assess the extent of the participants’ relationship with “God” and religious communities using a 4-point Likert-type scale (1 = always to 4 = never). Sample items included: “I work together with God, as partners,” and “I try hard to carry my religious beliefs over into all my other dealings in life.” Four items assessing religious support from a congregation were omitted from the current study due to a low response rate. Positively worded items were reverse scored so that a high score indicated stronger religious beliefs. Possible scores for this subscale ranged from 12 to 48. Cronbach’s alpha in the current study was .87, indicating good internal consistency for this subscale. The religious activities subscale measured the frequency with which participants engaged in various religious practices, using an 8-point Likert-type scale (1 = never to 8 = more than one a day). Sample items included: “How often do you pray privately in places other than a church or synagogue?,” “How often do you go to religious services?,” and “How often do you read the Bible or other religious literature?” A total score was computed with a high score indicating greater religious activity. Possible scores for this subscale ranged from 7 to 56. Cronbach’s alpha in the current study was .85, indicating good internal consistency for this subscale. Finally, the spirituality subscale evaluated general feelings of closeness and harmony with “God” and creation using a 6-point Likert-type scale (1 = never or almost never to 6 = many times a day). Sample items included: “I feel God’s presence,” “I feel deep inner peace or harmony,” and “I am spiritually touched by the beauty of creation.” A total score was created with a high score indicating a stronger spiritual orientation. Possible scores ranged from 6 to 36. Cronbach’s alpha in the current study was .92, indicating high internal consistency. Adequate internal consistency for each of the subscales has also been found by the Fetzer Institute (1999).

Child-Related Stress

The child-related stress measure is an eight-item inventory developed for this study to assess the stress experienced by mothers in response to various autism-related symptoms. For each item, mothers indicated whether their child had manifested the specific symptom in the previous 2 week period; if the mother indicated yes, they were then instructed to indicate the degree of stress they experienced in response to that symptom using a 5-point Likert scale (1 = not at all to 5 = extremely). The scale was created by using symptom domains commonly associated with ASD. Symptoms included motor, emotional, sensory, cognitive, communication/comprehension, social interaction, self-regulation, and behavioral difficulties. A total score was computed with a high score indicating higher stress. Possible scores ranged from 0 to 40. Cronbach’s alpha for the measure was .84, indicating good internal consistency.

Parenting Stress Index—Short Form

The parenting stress index—short form (PSI–SF; Abidin 1990) is a 36-item self-report measure that assesses total parenting stress as well as parenting stress in multiple domains. Only a total stress score was used in this study. Mothers rated their agreement with statements using a 5-point Likert-type scale (1 = strongly agree to 5 = strongly disagree). Three items utilized a different answer choice, and these items were removed from analyses due to a low response rate. Items were reverse coded so that a high score indicated high levels of overall stress. Total scores ranged from 33 to 165. Cronbach’s alpha in the current study was .90. The scale has shown high internal consistency and adequate test–retest reliability and has been widely used in studies of parents of children with autism and developmental disabilities (Abidin 1995).

Parenting Affect

This measure of parenting stress was adapted from the parental stress items scale (Pearlin and Schooler 1978). The original seven-item scale instructed mothers to indicate the extent to which they experienced distressed feelings about parenting. Sample items included: “How worried do you feel?” and “How unhappy do you feel?” In an adapted version used in this study, four positively worded items were added to reduce response bias and increase the reliability of the scale (Bonds et al. 2002). A sample item asked “How satisfied do you feel?” Mothers responded to all items on a 4-point Likert-type scale (1 = not at all to 4 = very much so). Positively worded items were reverse coded so that a higher score indicated higher levels of parenting stress. Possible scores ranged from 11 to 44. Cronbach’s alpha in the current study for this scale was .89. An internal consistency of .87 for the adapted version of the scale has been reported (Bonds et al. 2002).

Positive and Negative Affect

The positive and negative affect schedule (PANAS; Watson et al. 1988) is a 20-item questionnaire designed to measure two dimensions of mood, ten items reflecting positive mood and ten items reflecting negative mood. Participants were instructed to indicate the extent to which they experienced each mood state, using a 5-point Likert-type scale (1 = not at all to 5 = extremely). A total score was created for the two mood dimensions with a high score indicating high levels of that emotion. Possible scores ranged from 10 to 50 for each domain. In the present study, Cronbach’s alphas were .86 for negative mood and .89 for positive mood. High internal consistency, adequate test-retest reliability, and external validity with measures of distress and psychopathology have been reported (Watson et al. 1988).

Depression

The center for epidemiologic studies depression inventory (CES-D; Devins et al. 1988; Radloff 1977) is a 20-item self-report questionnaire designed to assess depressive symptoms in adults. Mothers were asked to indicate how frequently they experienced various symptoms during the last week, using a 4-point Likert-type scale (1 = rarely or none of the time to 4 = most or all of the time). Positively worded items were reverse coded so that a high score indicated greater overall depression. Possible scores ranged from 20 to 80. Cronbach’s alpha for the current study was .92, indicating high internal consistency. Previous studies have reported high internal consistency, adequate test-retest reliability, and good criterion and discriminant validity coefficients (Devins et al. 1988; Radloff 1977).

Negative Small Life Events

The small life events scale (Zautra et al. 1986) was used to evaluate how stressful mothers found events that were not directly related to their child or their role as a parent. For this study, 16 events were chosen from several domains including friend/acquaintance, spouse, family member other than spouse, and health. Participants were asked to indicate if the event had occurred in the previous 2 weeks. If the event did occur, participants used a 5-point Likert-type scale to indicate how stressful the event was (1 = not at all to 5 = extremely). One item representing ‘other events not previously described’ was omitted due to a low response rate. A total score was computed with a high score indicating higher stress. Possible scores ranged from 0 to 75. Cronbach’s alpha for the measure in this study was .82, indicating good internal consistency.

Child-Related Enjoyment

The child-related enjoyment measure is a eight-item inventory developed for this study to assess mothers’ affective evaluation of their child’s competencies and accomplishments. The child competencies and achievements were evaluated in domains in which children with autism frequently show delays or are challenged, including competencies in challenging sensory, motor, emotional, cognitive, communication and comprehension, social, and self-regulation situations. For each domain, mothers indicated whether their child had displayed competency in the previous 2 week period; if the mother indicated yes, they were then instructed to indicate the degree of enjoyment their experienced in response to that event using a 5-point Likert scale (1 = not at all to 5 = extremely). A total score was computed with a high score indicating higher enjoyment. Possible scores ranged from 0 to 40. Cronbach’s alpha for the measure was .77, indicating good internal consistency.

Self-Esteem

To measure maternal self-esteem, the Rosenberg self-esteem scale was used (Rosenberg 1965). This is a ten-item measure that assesses participants’ general feelings about themselves using a 4-point Likert-type scale (1 = strongly agree to 4 = strongly disagree). Sample items included: “At times, I think I am no good at all,” and “I take a positive attitude toward myself.” Negatively worded items were reverse coded so that a higher score indicates lower self-esteem. Possible scores ranged from 10 to 40. Cronbach’s alpha in the current study was .89, indicating high internal consistency. This widely used scale has adequate test-retest reliability and internal consistency has been established (Rosenberg 1965).

Life Satisfaction

The satisfaction with life scale (SWLS; Pavot and Diener 1993) is a five-item questionnaire developed to measure global cognitive judgments about one’s life. Using a 7-point Likert-type scale, mothers indicated the extent to which they agreed with each statement (1 = strongly disagree to 7 = strongly agree). Sample items included: “In most ways my life is close to my ideal,” and “If I could live my life over, I would change almost nothing.” Possible scores range from 5 to 35, with a high score indicating higher satisfaction. Cronbach’s alpha in the current study was .85, indicating high internal consistency. High internal consistency and test-retest reliability have been previously reported (Pavot and Diener 1993).

Positive Small Life Events

The small life events scale (Zautra et al. 1986) was used to evaluate how mothers’ enjoyment of events not directly related to their child or their role as a parent. For this study, 24 events were chosen from several domains including friend/acquaintance, spouse, family member other than spouse, work, and health. Participants were asked to indicate if the event had occurred in the previous 2 weeks. If the event did occur, participants used a 5-point Likert-type scale to indicate how enjoyable the event was (1 = not at all to 5 = extremely). One item representing ‘other events not previously described’ was omitted due to a low response rate. A total score was computed with a high score indicating higher stress. Possible scores ranged from 0 to 115. Cronbach’s alpha for the measure in this study was .86, indicating good internal consistency.

Psychological Well-Being

The psychological well-being scale (PWB; Ryff and Keyes 1995) is a 42-item self-report measure that assesses well-being in multiple domains. A personal growth scale assesses feelings of continued development, openness to new experiences, and improvement in self and behavior over time. An environmental mastery scale includes items that evaluate the individual’s sense of mastery and competence in managing the environment and controlling external activities. A Purpose in life scale assesses the extent to which the individual has goals in life and a sense of directedness, feels there is meaning to present and past life, and has aims and objectives for living. Participants indicated their agreement with each statement using a 5-point Likert-type scale (1 = strongly agree to 5 = strongly disagree). Selected items were reverse coded so that a high score reflected a higher degree of overall well-being. An overall score reflecting psychological well-being was employed in this study. Total scores ranged from 42 to 210. Cronbach’s alpha for this measure in the current study was .92 for overall psychological well-being. Previous studies have found moderate to strong associations between this measure and measures of positive affect, negative affect, life satisfaction, and depression (Ryff and Keyes 1995).

Sense of Control

Perceived control was evaluated by summing two control subscales (personal mastery and perceived constraints) consisting of 12 items (Lachman and Weaver 1998; Prenda and Lachman 2001). The personal mastery subscale assesses one’s sense of efficacy in carrying out goals. The perceived constraints subscale evaluates personal beliefs regarding the presence of obstacles or factors beyond one’s control that interfere with goal achievement. Each of the items was assessed on a 5-point scale (1 = strongly agree to 5 = strongly disagree). Personal mastery items included: “What happens to me in the future mostly depends on me,” and “I can do just about anything I really set my mind to.” Perceived constraint items included: “I often feel helpless in dealing with the problems of life,” and “There is really no way I can solve the problems I have.” Items on the personal mastery were reverse coded so that a high total score indicates a high sense of control. Possible scores ranged from 12 to 60. Cronbach’s alpha for this measure in the current study was .87, indicating high internal consistency. Adequate internal consistency has been previously reported (Lachman and Weaver 1998; Prenda and Lachman 2001).

Perceived Control of Internal States

The perceived control of internal states scale (PCOISS; Pallant 2000) was used to measure the degree to which participants felt they have control over their emotions, thoughts, and physical reactions. The PCIOSS contains 18 items asking participants to indicate their agreement using a 4-point Likert-type scale (1 = strongly disagree to 4 = strongly agree). Sample items included: “I can usually talk myself out of feeling bad,” and “Even when under pressure I can usually keep calm and relaxed.” Negatively worded items were reverse coded. A total score was created with a high score indicating a high control of internal states. Possible scores ranged from 18 to 72. Cronbach’s alpha for this measure in the current study was .90, indicating high internal consistency. Pallant (2000) found that the PCOISS was a better indicator of scores on a range of adjustment measures than other control scales. In addition, adequate internal consistency was previously reported (Pallant 2000).

Optimism and Pessimism

The life orientation test (LOT; Scheier and Carver 1985) was designed to measure dispositional optimism as it relates to outcome expectancies. The LOT contains eight items asking participants to indicate their agreement using a 4-point Likert-type scale (1 = strongly agree to 4 = strongly disagree). Sample items included: “In uncertain times, I usually expect the best,” and “I hardly ever expect things to go my way.” Negatively worded items were reverse coded. A total score was created with a high score indicating greater pessimism and lower optimism. Possible scores ranged from 8 to 32. Cronbach’s alpha for this measure in the current study was .86, indicating high internal consistency. Adequate internal consistency and test-retest reliability has been previously established (Scheier and Carver 1985).

Results

Data analyses proceeded in several steps. First we conducted descriptive analyses and the correlations between religiosity measures, maternal positive and negative outcomes were examined as a preliminary indication of the overall degree of association between variables. Second, we conducted analyses to determine whether any potential covariates, such as maternal demographics and child gender needed to be included in further analyses. Third, hierarchical regressions were used to determine which dimension of religiosity, religious beliefs, religious activities, or spirituality, accounted for significant and unique sources of variance in maternal outcomes. Problems of missing data were minimal, as follow-up correspondence was sent to participants to obtain missing information. For individual items missing on a scale score, a mean score was imputed if 90% of the items on the scale had been completed.

Descriptive Statistics and Correlations

All variables were tested for skewness and kurtosis, and were found to be normally distributed. Table 1 presents descriptive statistics for each of the measures. In general, in comparison to low risk samples, mothers reported higher degrees of stress (Abidin 1995; Bonds et al. 2002), higher negative affect (Watson et al. 1988), and levels of depression that were severe enough to warrant a clinical diagnosis of depression (Radloff 1977), lower positive affect (Watson et al. 1988), lower self esteem (Goldstein et al. 2006), lower mean life satisfaction scores (Pavot and Diener 1993), and higher levels of pessimism (Scheier and Carver 1985). For the other measures, listed in Table 2, normative comparison data was not available. Although not reported in Table 1, 79.8% of mothers reported being moderately to very spiritual and 73.9% of mothers reported being moderately to very religious. Further, 73.1% of mothers reported being both moderately to very religious and moderately to very spiritual, whereas 17.6% of mothers reported being slightly or not at all religious or spiritual. Finally, .8% of mothers reported being religious but not spiritual, whereas 6.6% of mothers reported being spiritual but not religious.
Table 1

Descriptive statistics

 

n

Mean

SD

Religiosity variables

  Religious beliefs

106

37.29

6.05

  Religious activities

107

25.15

11.09

  Spirituality

112

22.39

7.78

Negative outcomes

  Child-related stress

119

14.08

8.89

  PSI–SF

116

89.31

19.40

  Parenting affect

113

24.80

6.03

  Negative affect

115

20.67

6.58

  Depression

112

33.60

9.90

  Negative life events

119

16.11

12.68

Positive outcomes

  Child-related enjoyment

119

16.82

10.46

  Self esteem

114

18.96

4.88

  Life satisfaction

117

21.99

6.63

  Positive life events

119

41.45

21.63

  Positive affect

116

33.95

6.96

  Overall well-being

117

157.36

19.33

  Optimism

113

17.57

3.62

  Control of internal states

115

49.89

6.87

  Sense of control

114

44.40

7.38

Table 2

Correlations between religiosity variables and maternal socioemotional outcomes

 

Religious beliefs

Religious activities

Spirituality

Negative outcomes

  Child-related stress

−.02

−.04

−.13

  PSI–SF

−.17

.04

−.19

  Parenting affect

−.27**

−.05

−.32**

  Negative affect

−.29**

−.13

−.28**

  Depression

−.43***

−.14

−.35***

  Negative life events

−.14

−.01

−.02

Positive outcomes

  Child-related enjoyment

.09

−.03

.11

  Self esteem

−.42***

−.09

−.36***

  Life satisfaction

.44***

.20*

.40***

  Positive life events

.38***

.31**

.43***

  Positive affect

.29**

.11

.34***

  Well-being

.35***

.14

.38***

  Optimism

−.46***

−.26**

−.35***

  Control of internal states

.31**

.05

.35***

  Sense of control

.36***

.16

.32**

p < .05; ** p < .01; *** p < .001

As shown in Table 2, the correlations support, in part, our hypotheses concerning the relation between the three religiosity/spirituality variables and maternal outcomes. Specifically, a significant positive association was found between both religious beliefs and spirituality and the majority of the positive maternal outcomes. Mothers who reported higher levels of religious beliefs and spirituality, also reported higher levels of life satisfaction, life enjoyment, positive affect, self-esteem, overall well-being, optimism, and locus of control. Further, consistent with our hypotheses, a significant negative association was found between both religious beliefs and spirituality and several of the negative outcomes. Mothers who reported higher levels of religious beliefs and spirituality, also reported lower levels of depression, negative affect, and parenting affect. The strength of the associations was similar for religious beliefs and spirituality. In contrast, the religious activities variable was only related to three maternal outcomes. Contrary to expectations, mothers who reported greater involvement in religious activities also reported higher, not lower, levels of life satisfaction and enjoyment and greater optimism. Additional correlational analyses, not reported in Table 2, indicated an overall inverse, albeit low, relationship between negative maternal and positive outcome measures (M = −.24).

Demographic Relationships

Correlational analyses revealed that maternal age was not significantly related to any predictor or outcome variables. Child age was significantly related to one maternal measure, child-related stress (r = −.21, p < .05); mothers of older children experienced less stress. In addition, number of additional children with ASD was significantly associated with maternal negative affect (r = .29, p < .01), depression (r = .31, p < .01), life satisfaction (r = −.23, p < .05), positive life events (r = −.19, p < .05), psychological well-being (r = −.20, p < .05), control of internal states (r = −.21, p < .05), sense of control (r = −.27, p < .01), and optimism (r = .22, p < .05). Mothers of more than one child with ASD were less satisfied with life and experienced a lower overall sense of well-being and enjoyment, lower levels of optimism and internal locus of control, as well as greater parental distress, negative affect, and depression. Because of these significant relationships, child age and the number of additional children with ASD were included as covariates in all analyses. ANOVAs indicated no pattern of significant differences in maternal outcomes as a function of marital status, maternal education, household income, maternal employment, maternal ethnicity, or child gender.

Hierarchical Regression Models of Religiosity Predicting Maternal Outcomes

Hierarchical regression was employed to examine the contribution of each dimension of religiosity as a predictor of maternal outcomes. Variables were entered into the regression model in steps representing different predictors. Step one consisted of demographic variables, including child age and the number of additional children with autism. The second step contained the religious beliefs variable. The religious activities variable was entered in step three, followed by the spirituality variable entered in step four. This model was tested for each of the dependent variables. In addition, Tables 3, 4, and 5 present, in the final entry columns, the standardized regression coefficient and Part R2 reflecting the relative strength of and the unique variance associated with each predictor.
Table 3

Hierarchical regression analyses of religiosity predicting negative maternal socioemotional outcomes

 

Stepwise entry

Final entry

Beta (SE B)

β

ΔR2

Beta (SE B)

β

Part R2

Child-related stress

  1. Child age

−.42 (.22)

−.20

 

−.42 (.22)

−.19

.04

    Other child

2.84 (2.72)

.11

.06

3.05 (2.88)

.11

.01

  2. Beliefs

.04 (.15)

.03

.00

.24 (.26)

.17

.01

  3. Activities

.08 (.11)

.10

.01

.16 (.12)

.19

.02

  4. Spirituality

−.36 (.22)

−.32

.03

−.36 (.22)

−.32

.03

  Total R2

  

.09

   

PSI–SF

  1. Child age

−.39 (.48)

−.08

 

−.39 (.47)

−.08

.01

    Other child

11.17 (6.30)

.18

.05

9.66 (6.36)

.16

.02

  2. Beliefs

−.35 (.34)

−.11

.01

−.46 (.55)

−.15

.01

  3. Activities

.65 (.23)

.36**

.08**

.81 (.25)

.45**

.10

  4. Spirituality

−.75 (.47)

−.30

.02

−.75 (.47)

−.30

.02

  Total R2

  

.16

   

Parenting affect

  1. Child age

−.14 (.15)

−.10

 

−.12 (.14)

−.09

.01

    Other child

4.08 (1.86)

.22*

.07*

2.90 (1.85)

.16

.02

  2. Beliefs

−.19 (.10)

−.20

.04

−.10 (.17)

−.10

.00

  3. Activities

.16 (.07)

.29*

.05*

.23 (.08)

.42**

.08

  4. Spirituality

−.35 (.14)

−.46*

.05*

−.35 (.14)

−.46*

.05

  Total R2

  

.20

   

Negative affect

  1. Child age

−.07 (.17)

−.04

 

−.03 (.17)

−.02

.00

    Other child

5.63 (2.02)

.28**

.09*

4.12 (2.12)

.21

.04

  2. Beliefs

−.23 (.11)

−.21*

.04*

−.09 (.19)

−.08

.00

  3. Activities

.03 (.08)

.05

.00

.08 (.09)

.13

.01

  4. Spirituality

−.22 (.17)

−.26

.02

−.22 (.17)

−.26

.02

  Total R2

  

.14

   

Depression

  1. Child age

−.13 (.26)

−.05

 

−.04 (.24)

−.02

.00

    Other child

8.74 (3.14)

.28**

.09*

5.22 (3.08)

.17

.03

  2. Beliefs

−.61 (.17)

−.37***

.12***

−.63 (.29)

−.38*

.04

  3. Activities

.21 (.12)

.23

.03

.27 (.13)

.28*

.04

  4. Spirituality

−.27 (.24)

−.20

.01

−.27 (.24)

−.20

.01

  Total R2

  

.24

   

Negative life events

  1. Child age

−.59 (.31)

−.19

 

−.62 (.31)

−.20

.04

    Other child

7.04 (3.89)

.18

.08*

6.26 (4.12)

.16

.02

  2. Beliefs

−.19 (.22)

−.10

.01

−.64 (.37)

−.31

.03

  3. Activities

.19 (.15)

.17

.02

.13 (.17)

.11

.01

  4. Spirituality

.30 (.32)

.18

.01

.30 (.32)

.18

.01

  Total R2

  

.11

   

p < .05; ** p < .01; *** p < .001

Table 4

Hierarchical regression analyses of religiosity predicting positive maternal socioemotional outcomes

 

Stepwise entry

Final entry

Beta (SE B)

β

ΔR2

Beta (SE B)

β

Part R2

Child-related enjoyment

  1. Child age

−.68 (.27)

−.26*

 

−.70 (.27)

−.26*

.07

    Other child

−3.01 (3.33)

−.09

.07*

−2.26 (3.54)

−.07

.00

  2. Beliefs

.14 (.19)

.08

.01

.10 (.32)

.06

.00

  3. Activities

−.16 (.13)

−.16

.01

−.22 (.14)

−.22

.02

  4. Spirituality

.27 (.27)

.20

.01

.27 (.27)

.20

.01

  Total R2

  

.10

   

Self-esteem

  1. Child age

−.08 (.13)

−.07

 

−.03 (.11)

−.03

.00

  Other child

1.14 (1.57)

.08

.01

−1.02 (1.48)

−.07

.00

  2. Beliefs

−.35 (.08)

−.45***

.17***

−.26 (.13)

−.33*

.03

  3. Activities

.10 (.06)

.22

.03

.15 (.06)

.34*

.06

  4. Spirituality

−.25 (.12)

−.40*

.04*

−.25 (.12)

−.40*

.04

  Total R2

  

.25

   

Life satisfaction

  1. Child age

.06 (.16)

.04

 

−.00 (.15)

−.00

.00

    Other child

−6.15 (2.03)

−.30**

.10**

−3.38 (1.93)

−.17

.02

  2. Beliefs

.42 (.11)

.39***

.13***

.13 (.17)

.12

.01

  3. Activities

−.05 (.07)

−.08

.00

−.14 (.08)

−.23

.03

  4. Spirituality

.44 (.15)

.51**

.07**

.44 (.15)

.51**

.07

  Total R2

  

.30

   

Positive life events

  1. Child age

.30 (.55)

.06

 

.09 (.52)

.02

.00

    Other child

−12.30 (6.81)

−.19

.04

−3.92 (6.80)

−.06

.00

  2. Beliefs

1.23 (.36)

.35**

.11**

.33 (.61)

.09

.00

  3. Activities

.16 (.25)

.08

.00

−.04 (.27)

−.02

.00

  4. Spirituality

.92 (.52)

.33

.03

.92 (.52)

.33

.03

  Total R2

  

.18

   

Positive affect

  1. Child age

.07 (.19)

.04

 

.04 (.18)

.02

.00

    Other child

−2.60 (2.30)

−.12

.02

−.53 (2.30)

−.02

.00

  2. Beliefs

.32 (.13)

.28*

.07*

.08 (.21)

.07

.00

  3. Activities

−.11 (.09)

−.17

.02

−.21 (.09)

−.32*

.05

  4. Spirituality

.46 (.18)

.50*

.06*

.46 (.18)

.50**

.06

  Total R2

  

.16

   

Well-being

  1. Child age

.79 (.49)

.16

 

.64 (.46)

.13

.02

    Other child

−11.79 (6.10)

−.20

.08*

−5.44 (5.99)

−.09

.01

  2. Beliefs

1.01 (.33)

.32**

.09**

.42 (.53)

.13

.01

  3. Activities

−.29 (.23)

−.16

.01

−.54 (.24)

−.30*

.04

  4. Spirituality

1.17 (.46)

.46*

.06*

1.17 (.46)

.46*

.06

  Total R2

  

.23

   

p < .05; ** p < .01; *** p < .001

Table 5

Hierarchical regression analysis summary for predicting positive maternal socioemotional outcomes

 

Stepwise entry

Final entry

Beta (SE B)

β

ΔR2

Beta (SE B)

β

Part R2

Optimism

  1. Child age

−.17 (.10)

−.19

 

−.15 (.09)

−.16

.02

    Other child

2.61 (1.21)

.22*

.10**

1.11 (1.18)

.09

.01

  2. Beliefs

−.25 (.06)

−.42***

.16***

−.28 (.10)

−.46**

.06

  3. Activities

.04 (.04)

.10

.01

.04 (.05)

.12

.01

  4. Spirituality

−.02 (.09)

−.04

.00

−.02 (.09)

−.04

.00

  Total R2

  

.26

   

Control of internal states

  1. Child age

.11 (.17)

.07

 

.07 (.16)

.04

.00

    Other child

−4.16 (2.12)

−.20

.05

−2.26 (2.11)

−.11

.01

  2. Beliefs

.30 (.11)

.27*

.07*

.11 (.19)

.10

.00

  3. Activities

−.12 (.08)

−.19

.02

−.21 (.09)

−.33*

.05

  4. Spirituality

.41 (.16)

.48*

.06*

.41 (.16)

.48*

.06

  Total R2

  

.20

   

Sense of control

  1. Child age

.20 (.19)

.11

 

.17 (.18)

.09

.01

    Other child

−7.74 (2.54)

−.30**

.12**

−5.32 (2.60)

−.21*

.04

  2. Beliefs

.35 (.13)

.28**

.07**

.40 (.21)

.33

.03

  3. Activities

−.13 (.09)

−.18

.02

−.15 (.10)

−.21

.02

  4. Spirituality

.11 (.18)

.11

.00

.11 (.18)

.11

.00

  Total R2

  

.21

   

p < .05; ** p < .01; *** p < .001

Negative Outcomes

Hierarchical regression analyses yielded an interesting pattern of results when predicting negative outcomes. As shown in Table 3, the demographic variables accounted for significant variance in the parenting affect, negative affect, depression, and negative life events models. Specifically, mothers with more than one child with ASD reported higher levels of stress, negative affect, and depression. However, after controlling for the religiosity and spirituality variables, the demographic variables were not found to be uniquely associated with maternal negative outcomes.

Examining the religiosity variables, the religious beliefs variable, upon initial entry, accounted for significant variance in the negative affect and depression models. Mothers with greater religious beliefs reported lower levels of depression and negative affect. However, after controlling for the demographic variables and remaining religiosity variables, this dimension of religiosity was a unique predictor of only maternal depression (β = −.38, p < .05, Part R2 = .04). Mothers who reported greater levels of religious beliefs also reported lower levels of depression. The religious activities variable, upon initial entry, accounted for significant variance in the parenting affect and PSI–SF models. Mothers who reported a greater frequency of involvement in religious activities reported higher levels of parenting stress. After controlling for the remaining variables, the pattern remained the same. Religious activities were a unique predictor of the PSI–SF (β = .45, p < .01, Part R2 = .10) and parenting affect (β = .42, p < .01, Part R2 = .08). Finally, spirituality, after controlling for the remaining variables, was a significant and unique predictor of parenting affect (β = −.46, p < .05, Part R2 = .05). In contrast to the religious activities finding, mothers who reported higher levels of spirituality reported lower rather than higher levels of parenting stress.

Positive Outcomes

An equally interesting pattern of results emerged when predicting positive outcomes. As shown in Tables 4 and 5, the demographic variables accounted for significant variance in the child-related enjoyment, life satisfaction, psychological well-being, optimism, and sense of control models. Specifically, having an older child with ASD was associated with lower levels of child-related enjoyment. In addition, mothers with more than one child with ASD reported lower levels of life satisfaction, well-being, sense of control, as well as higher levels of pessimism. After controlling for the religiosity and spirituality variables, the age of the child emerged as a significant predictor of child-related enjoyment (β = −.26, p < .05) while more than one child with ASD was a significant predictor of sense of control (β = −.21, p < .05, Part R2 = .04).

Examining the religiosity variables, the religious beliefs variable, upon initial entry, accounted for significant variance in the self-esteem, life satisfaction, positive life events, positive affect, psychological well-being, optimism, control of internal states, and sense of control models. Mothers with greater religious beliefs reported higher levels of self-esteem, life satisfaction, psychological well-being, positive affect, optimism and greater control of internal states and sense of control. However, after controlling for the demographic variables and remaining religiosity variables, this dimension of religiosity was only a unique predictor of self-esteem (β = −.33, p < .05, Part R2 = .03) and optimism (β = −.46, p < .01, Part R2 = .06). Mothers who reported higher levels of religious beliefs also reported higher self-esteem and a more optimistic outlook.

The religious activities variable, upon initial entry, was not a significant predictor of maternal positive outcomes. However, after controlling for the other variables, religious activities uniquely predicted self-esteem (β = .34, p < .05, Part R2 = .06), positive affect (β = −.32, p < .05, Part R2 = .05), psychological well-being (β = −.30, p < .05, Part R2 = .04), and control of internal states (β = −.33, p < .05, Part R2 = .05). Mothers who reported a higher frequency of involvement in religious activities also reported lower self-esteem, psychological well-being, positive affect, and control of internal states.

The spirituality variable accounted for significant variance in the self-esteem, life satisfaction, positive affect, psychological well-being, and control of internal states models. After controlling for the remaining variables, spirituality was a unique predictor of each of these dimensions: self-esteem (β = −.40, p < .05, Part R2 = .04), life satisfaction (β = .51, p < .001, Part R2 = .07), positive affect (β = .50, p < .01, Part R2 = .06), psychological well-being (β = .46, p < .05, Part R2 = .06), and control of internal states (β = .48, p < .05, Part R2 = .06). Mothers with higher levels of spirituality also reported higher self-esteem, life satisfaction, positive affect, well-being, and control of internal states.

Discussion

Research suggests that religiosity is a complex construct, both in terms of its compositions and its psychological impact (Coulthard and Fitzgerald 1999; Tarakeshwar and Pargament 2001). The present study extends this research by systematically examining the relationship of multiple dimensions of religiosity to socioemotional functioning of mothers of children with ASD. We focused on three dimensions of religiosity, including religious beliefs, religious activities, and spirituality, and their influences on both positive and negative maternal socioemotional outcomes. Our primary goal was to determine whether these dimensions of religiosity were differentially related to the maternal outcomes. Results indicated that religious beliefs and spirituality were associated with less negative and greater positive maternal socioemotional outcomes. In contrast, the regression analyses indicated that religious activities were associated with more negative and less positive outcomes. The results of the present study highlight the importance of a multidimensional approach when studying religiosity.

The current study indicates both similarities and differences in the relationships between religious beliefs, spirituality, and maternal negative outcomes. Examination of the relationship between religious beliefs and spirituality and maternal outcomes indicated that, in general, both of these dimensions were associated with less negative outcomes. Correlational analyses indicated that both of these dimensions were significantly related to maternal negative affect, parenting affect, and depression, with higher levels of religious beliefs and spirituality associated with lower levels of negative outcomes. Examination of the regression results further indicated that only religious beliefs uniquely predicted maternal depression, whereas only spirituality uniquely predicted parenting affect. These results are generally consistent with previous findings suggesting that positive coping, defined as a feeling of closeness and harmony with God, is associated with lower levels of depression (Tarakeshwar and Pargament 2001). Although speculative, it seems likely that beliefs in God and a feeling of closeness help counter the feelings of alienation and isolation that are characteristic of depressed individuals. Similarly, it is plausible that the broader beliefs of those who are spiritually oriented help individuals focus on what is really important in their lives. Given the cross-sectional nature of the study, it is also possible that a depressed individual may lack the capacity to engage in spiritual activities.

Examination of the relationship of religious beliefs, spirituality, and positive maternal outcomes also indicated that both of these dimensions were significantly correlated with positive maternal socioemotional outcomes. These relationships were more consistent and generally more pronounced than the relationship of religious beliefs and spirituality to negative maternal outcomes. Higher scores on the religious beliefs and spirituality measures associated with higher self esteem, life satisfaction, positive life events, positive affect, psychological well-being, optimism, and internal locus of control. Examination of the regression analyses again revealed that the two measures differed, specifically in the positive outcomes that they uniquely predicted, with spirituality being more robust in the number of outcomes to which it was uniquely related. Whereas spirituality uniquely predicted life satisfaction, positive affect, well-being, and control of internal states, religious beliefs uniquely predicted only optimism. Both religious beliefs and spirituality uniquely predicted self-esteem. These findings suggest that religious beliefs and spirituality not only serve as a protection from negative outcomes, but also promote positive outcomes. Strong religious and spiritual beliefs appear to assist an individual in appraising life and its’ challenges in a different more positive light. Tunali and Power (2002) found that mothers of children with autism often redefine what is important to them. Religious beliefs and spirituality appear to assist in this cognitive reappraisal, with mothers spending less time focusing on their child’s disability and more time on the importance and meaning of life. It may also be the case that high levels of religious beliefs and spirituality catalyze methods of positive religious coping, in which mothers feel a sense of collaboration and spiritual connection with God (Maltby and Day 2003) and become more proactive as they confront the challenges associated with raising a child with ASD.

While religious beliefs and spirituality seem to offer benefits against negative outcomes, great involvement in religious activities is associated with increased negative outcomes and decreased positive outcomes. Although the correlational analyses suggested that greater involvement in religious activities were associated with more positive outcomes, the regression analyses told a different story once covariates were entered into the equation which apparently were masking a negative relationship between religious activities and maternal outcomes. Specifically, religious activities uniquely predicted parenting stress, parenting affect, and depression, with greater involvement in religious activities associated with more negative outcomes. In addition, the regression analyses revealed that religious activities uniquely and negatively predicted self-esteem, positive affect, well-being, and control of internal states, with greater involvement in religious activities associated with less positive outcomes.

The results of the present study contrasts with previous research suggesting that organizational religious activities have positive effects on psychological well-being among low-risk populations (Bonner et al. 2003), but supports research suggesting that parents of children with autism do not find organized religion to be supportive (Tarakeshwar and Pargament 2001). It may be that the results reflect that mothers in times of stress become more actively involved in religious activities in an effort to cope with that stress. Conversely, it may be that mothers find that involvement in religious activities is not satisfying. It is possible that the hassles associated with taking their children with ASD to religious services are stress producing and/or that religious institutions do not offer the supports mothers are seeking (Baker-Ericzen et al. 2005).

A study by Joseph (1998) offers other insights into possible reasons for the contrasting effects of religious beliefs and spirituality versus religious activities on maternal outcomes. This study found that individuals who use religion solely as a means to an end (extrinsic religion) do not obtain the same psychological benefits as those who view religion as an end unto itself (intrinsic religion). It may be that the religious beliefs and spirituality assessments employed in the present study are indices of an intrinsic orientation. In contrast, the religious activities assessment may be an index of an external orientation, with individuals praying or attending services in the hopes of attaining certain goals such as health for their child or stress relief. In the current study, the religious activities measure included items assessing organizational (e.g., attendance at church services) as well as nonorganizational (e.g., private prayer) involvement. Future research needs to examine whether organizational expressions of religious involvement operate differently than nonorganizational expressions as support mechanisms. For example, it may be that private prayer at home is protective while public involvement is stress inducing, or at least not stress relieving.

There are several limitations to the present study. Because the sample consisted of mainly Caucasian, upper–middle class families, the generalizability of the results are limited. The study is also limited by its cross-sectional design. Without longitudinal data, it is not possible to determine whether religiosity and spirituality are change agents or outcomes produced by mothers’ socioemotional status. Moreover, it is also not possible to determine whether the benefits of religious and spiritual beliefs are short-term or long-term. A longitudinal design would also help in understanding how religious coping changes across time. For example, it is possible that religion serves as a protective mechanism only after families have exhausted other forms of support. Finally, future studies should include separate measures of religiosity in order to disentangle the effects of the different types of supernatural and religious beliefs and different types of religious practices.

The current study is an important first step in understanding the multidimensional nature of religiosity and its relationship to the socioemotional functioning of mothers of children with ASD. However, there is still much to be studied in the area of religious coping in families of children with ASD. For example, future research might examine whether fathers and mothers share similar religious beliefs and practices, and how this congruence or lack thereof influences family functioning. Also, different religions and spiritual orientations could be studied, to determine how they influence coping strategies. Future research might also examine more systematically how personality traits, such as the two assessed in the present study, optimism and sense of control, engender or are engendered by specific patterns of beliefs and practices. Once the intricacies of these relationships are better understood, intervention programs can be specifically tailored to better support families of children with ASD including, if appropriate, a spiritual or religious element.

Acknowledgments

This research was supported in part by an NIMH training grant (2 T32 HD007184-28) and by the Institute for Scholarship in the Liberal Arts at the University of Notre Dame. We thank the various parent support groups for their help and support in participant recruitment. We are also indebted to the families who gave their time to participate in this research. We are indebted to Cindy Bergeman and Anthony Ong for their help in the development of this project.

Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • Naomi V. Ekas
    • 1
  • Thomas L. Whitman
    • 1
  • Carolyn Shivers
    • 1
  1. 1.Department of PsychologyUniversity of Notre DameNotre DameUSA

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