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Associations Between Religious/Spiritual Coping and Depression Among Adults with Cystic Fibrosis: A 12-Month Longitudinal Study

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Abstract

Individuals with cystic fibrosis (CF) face a challenging disease, and depression is a significant concern. Many patients draw on religious/spiritual resources to assist them in managing the demands of chronic illness; however, these coping efforts rarely have been evaluated among adults with CF. This longitudinal study examined relationships between distinct types of positive and negative religious/spiritual coping at baseline (assessed with the RCOPE) and depression screening outcomes 12 month later (assessed with the Hospital Anxiety and Depression Scale). In logistic regression analyses controlling for disease severity (FEV1% predicted), lower likelihood of depression caseness at 12 months was predicted by higher general religiousness at baseline, greater use of benevolent religious reappraisal coping, greater use of spiritual connection coping, and lower spiritual discontent. Results suggest that distinct aspects religious/spiritual coping have differential associations with subsequent depression outcomes. Findings extend prior research to an important, understudied medical population, and address a clinically meaningful outcome.

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Notes

  1. The terms “positive” and “negative” coping in the RCOPE instrument convey likely emotional valence; they are not intended as value judgments regarding the rich diversity of coping strategies that people use in response to taxing circumstances. The efficacy of a particular strategy used by particular individuals in a specific context is viewed as an empirical question.

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This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Author notes

  1. Dianne Campbell

    Present address: Department of Social Work, Central Arkansas Veterans Healthcare System, Little Rock, AR, USA

  2. Raghu M. Reddy

    Present address: St. Vincent’s Hospital, Little Rock, AR, USA

  3. Bethany Guinee

    Present address: Pharmacy Department, Select Specialty Hospital, Orlando, FL, USA

  4. Laura D. Wagner

    Present address: Primary Care Clinic, Arkansas Children’s Hospital, University of Arkansas for Medical Sciences, Little Rock, AR, USA

Authors and Affiliations

  1. Behavioral Medicine Division, University of Arkansas for Medical Sciences, Little Rock, AR, USA

    Allen C. Sherman & Stephanie Simonton-Atchley

  2. Department of Pharmacy Practice, University of Arkansas for Medical Sciences, Little Rock, AR, USA

    Catherine E. O’Brien, Bethany Guinee & Laura D. Wagner

  3. Cystic Fibrosis Clinic, University of Arkansas for Medical Sciences, Little Rock, AR, USA

    Dianne Campbell

  4. Department of Internal Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA

    Raghu M. Reddy & Paula J. Anderson

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  1. Allen C. Sherman
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Appendix: RCOPE* Items

Appendix: RCOPE* Items

Instructions were keyed to participants’ efforts to cope with their cystic fibrosis illness in the past month, and items were rated on a 4-point Likert scale (1 = “not at all” to 4 = “a great deal”).

Benevolent religious reappraisal

Tried to find a lesson from God in this situation

Tried to see how God might be trying to strengthen me in this situation

Saw my situation as part of God's plan

Trusted that God would be by my side

Tried to see how the situation could be beneficial spiritually

Spiritual connection

Thought about how my life is part of a larger spiritual force

Tried to experience a stronger feeling of spirituality

Tried to build a strong relationship with a higher power

Spiritual discontent

Wondered if God really cares

Felt angry that God was not there for me

Questioned God's love for me

Wondered whether God had abandoned me

Voiced anger that God didn't answer my prayers

Punishing god reappraisal

Wondered if God allowed this to happen to me because of my sins

Decided that God was punishing me for my sins

Felt punished by God for my lack of devotion

Wondered whether God was punishing me because of my lack of faith

Wondered what I did for God to punish me

  1. *Items from Pargament et al. (2000). The many methods of religious coping: Development and initial validation of the RCOPE. Journal of Clinical Psychology, 56, 519–543. For the current study, the 5 items with the highest factor loadings were selected from each scale, expect for the Spiritual Connection scale, which includes only 3 items in the original factor.

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Sherman, A.C., Simonton-Atchley, S., O’Brien, C.E. et al. Associations Between Religious/Spiritual Coping and Depression Among Adults with Cystic Fibrosis: A 12-Month Longitudinal Study. J Relig Health 60, 2646–2661 (2021). https://doi.org/10.1007/s10943-021-01185-x

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