Cultural Influences on Leadership

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MultidimensionalMeasurement of

Religiousness/

Spiritualityfor Use in

HealthResearch:

A Report of the Fetzer Institute/National Institute on Aging Working Group


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A publication of the John E. Fetzer Institute

Fetzer Institute, National Institute on Aging Working Group: MultidimensionalMeasurement of Religiousness, Spirituality for Use in Health Research. A Report of aNational Working Group. Supported by the Fetzer Institute in Collaboration with theNational Institute on Aging. Kalamazoo, MI: Fetzer Institute, 2003 (1999).

The interpretations and conclusions contained in this publication represent the views ofthe individual working group members and do not necessarily express any official opinionor endorsement by either the National Institute on Aging, the U.S. Department of Healthand Human Services, the Fetzer Institute, its trustees, or officers.

Please contact the Fetzer Institute for additional copies of this publication, which may beused and reprinted without special permission.


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October 1999Reprinted October 2003

Multidimensional Measurementof Religiousness/Spirituality

for Use in

Health Research:A Report of the Fetzer Institute/National Institute on Aging Working Group

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This project was initially designed to bringtogether experts interested in addressingmeasurement issues around religiousness/spirituality and health from a multidimen-sional perspective. The booklet, which in-cluded the Brief Multidimensional Measureof Religiousness/Spirituality (BMMRS), waspublished as a step to encourage the exami-nation of religion/spirituality and health withsensitivity to the depth and complexity of thetopic.

The response to this effort has been muchgreater than anticipated. We continue toreceive daily requests for the booklet. To date,2,000 copies of the publication have beendistributed and another 1,200 have beendownloaded from the Internet.

In a recently completed survey of booklet usersassisted by the Kercher Center for SocialResearch at Western Michigan University,more than 80 percent of respondents believedthe booklet was useful in enabling researchersto enter, or to conduct better research in thefield of religiousness/spirituality and healthoutcomes. The most popular subscales beingused are the Religious/Spiritual Coping andthe Daily Spiritual Experiences Scales (DSES).One fourth of respondents have used the booklet

in either a course that they teach, in a seminar,or in a symposium. Practitioners in clinical workare also using the booklet and the measure-ment instruments in addition to researchers.

As BMMRS and subscales are increasinglyused in research projects, the number ofpublications citing the booklet indicates thatresearch projects are beginning to be published.

The journals represented includeAmericanJournal of Psychiatry, Annals of BehavioralMedicine, Gerontologist Medical Care, Journal ofHealth Psychology, Journal of the Scientific Studyof Religion, and the Journal of Adult Development.

A paper on the conceptual background to thework and the development of the BMMRS wasrecently published in the journalResearch on

Aging: Measuring Multiple Dimensions ofReligion and Spirituality for Health Research,Ellen L. Idler, Marc A. Musick, ChristopherG. Ellison, Linda K. George, Neal Krause,Marcia G. Ory, Kenneth I. Pargament, LyndaH. Powell, Lynn G. Underwood, David R.Williams, 2003, 25:4.

In a joint request for applications entitled

Studying Spirituality and Alcohol, sponsoredby the National Institute on Alcohol Abuseand Alcoholism of the National Institutes ofHealth and the Fetzer Institute, many of the16 funded research projects used the mea-sures from this booklet.

Please check for additional informationregarding the DSES on page 17.

We want to thank all researchers and scholarswho have provided us with thoughtful comments

and suggestions concerning their projects andthe needs of the field. We remain interestedin learning about the general disseminationof work that utilizes a multidimensionalapproach and the BMMRS, as well as learningmore about clinical uses of the booklet andBMMRS. Continue to give us feedback on theuse and development of this collection ofscales by e-mailing us at [email protected].

Prefaceadded October 2003

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Table of Contents

Page

Preface ................................................................................................ ii

Introduction ..................................................................................... 1

Daily Spiritual Experiences............................................................ 11

Meaning ........................................................................................... 19

Values ............................................................................................... 25

Beliefs ............................................................................................... 31

Forgiveness ...................................................................................... 35

Private Religious Practices ............................................................. 39

Religious/Spiritual Coping .............................................................. 43

Religious Support ............................................................................ 57

Religious/Spiritual History ............................................................. 65

Commitment .................................................................................... 71

Organizational Religiousness ......................................................... 75

Religious Preference ........................................................................ 81

Brief Multidimensional Measure ofReligiousness/Spirituality: 1999 ..................................................... 85

Appendix A: Additional Psychometric andPopulation Distribution Data ......................................................... 89

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This publication is the product of a nationalworking group supported by the FetzerInstitute in collaboration with The NationalInstitute on Aging (NIA), part of the NationalInstitutes of Health (NIH). The workinggroup examined key dimensions of religious-ness/spirituality as they relate to physicaland mental health outcomes. The 12 papersin this report include brief literature reviews,recommended instruments, and bibliogra-phies for each identified domain. Also in-cluded is the current draft of the Brief Multi-dimensional Measure of Religiousness/Spirituality: 1999, an instrument developedby the working group, which is substantiallybased on select questions from each domain.

Core members of the working group include

(in alphabetical order):

Ronald Abeles, PhD, National Institute onAging, National Institutes of Health,Bethesda, Md

Christopher Ellison, PhD, Department ofSociology, University of Texas-Austin,

Austin, TexasLinda George, PhD, Department of Sociology,

Duke University Medical School,Durham, NC

Ellen Idler, PhD, Department of Sociology,

Rutgers University, New Brunswick, NJNeal Krause, PhD, School of Public Health,

University of Michigan, Ann Arbor, MichJeff Levin, PhD, National Institute for

Healthcare Research, Rockville, MdMarcia Ory, PhD, National Institute on

Aging, National Institutes of Health,Bethesda, Md

Introduction

Kenneth Pargament, PhD, Department ofPsychology, Bowling Green StateUniversity, Bowling Green, Ohio

Lynda Powell, PhD, Department ofPreventive Medicine, Rush-Presbyterian-St. Lukes Medical Center, Chicago, Ill

Lynn Underwood, PhD, Fetzer Institute,Kalamazoo, Mich

David Williams, PhD, Department ofSociology, University of Michigan,

Ann Arbor, Mich

Background

In recent years, a growing body of literaturehas explored the implications of religion andspirituality for various mental and physicalhealth outcomes (for reviews see Koenig1994, Levin 1994). While the findings are

not univocal, mounting evidence indicatesthat various dimensions of religiousness andspirituality may enhance subjective states ofwell-being (Ellison 1991), lower levels ofdepression and psychological distress (Idler1987, Williams et al 1991), and reduce mor-bidity and mortality (for a review see Levin1996). Such findings have elicited consider-able attention from medical researchers inepidemiology, psychology, sociology, gerontol-ogy, and other fields.

Health researchers who seek to includereligious or spiritual domains in their studiestypically confront various problems. Fewhealth researchers have a scholarly back-ground in religiousness/spirituality and mostare not acquainted with the long history ofattempts to conceptualize and measuremultiple dimensions of religiousness (Krause

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Multidimensional Measurement of Religiousness/Spirituality for Use in Health Research

1993, Williams 1994). It is becoming clearthat religious/spiritual variables cannotsimply be combined into a single scale thatexamines the effects of a single variable,religiosity; rather, each relevant dimensionof religiousness and spirituality should be

examined separately for its effects on physi-cal and mental health. Until recently, certainaspects of religiousness and spirituality thatare arguably most germane to the study ofhealth outcomes have received minimalempirical attention from social and behav-ioral scientists. Consequently, we currentlyhave no widely used and validated set ofstandard measures for key religious/spiritualdomains to recommend to interestedhealth researchers.

To address these issues and the growing bodyof evidence demonstrating links betweenreligious and spiritual variables and healthoutcomes, the NIA and the Fetzer Instituteconvened a panel of scholars with expertisein religiousness/spirituality and health/well-being. The initiative began with a largeconference held at the NIH in March 1995.Participants agreed that collecting abundantdata on religiousness is not feasible for manyhealth researchers because they have limited

time in which to inquire about a wide rangeof topics germane to health outcomes. Oneprimary recommendation from the conferencewas that future studies focus on isolatingmechanisms that relate religiousness/spiritu-ality to health over a lifetime. Isolating suchmechanisms could aid researchers in select-ing specific measures that best explicate theassociation between religiousness/spiritualityand health.

Subsequent to the conference, the NIA and

the Fetzer Institute established a core work-ing group to:

Identify those domains of religiousness/spirituality most likely to impact health;

Suggest potential mechanisms wherebythese variables might operate; and

Provide a short multidimensional surveyfor use in clinical research.

In their work to conceptualize andmeasure key health-relevant domains ofreligiousness/spirituality, the workinggroup identified 3 importantconsiderations.

It became important to articulate thedistinction between religiousness andspirituality. While some may regard the2 as indistinguishable, others believereligiousness has specific behavioral,social, doctrinal, and denominationalcharacteristics because it involves asystem of worship and doctrine that isshared within a group. Spirituality isconcerned with the transcendent,addressing ultimate questions about

lifes meaning, with the assumption thatthere is more to life than what we see orfully understand. Spirituality can callus beyond self to concern and compas-sion for others. While religions aim tofoster and nourish the spiritual lifeand spirituality is often a salient aspectof religious participationit is possibleto adopt the outward forms of religiousworship and doctrine without having astrong relationship to the transcendent.Combining the 2 areasreligiousnessand spiritualityin 1 instrument was agoal that realized this distinction.

Although much of the existing literatureaddresses salutary effects of religiousinvolvement on health outcomes, sometypes of religious belief and experiencemay undermine health and well-being.Thus, the group also included measuresto gauge potentially unhealthy attitudesor behaviors.

The projects focus was to identify andmeasure domains believed to be signifi-cant for health outcomes, not to rein-

vent previous work. Many of thedomains included in this publicationhave been largely ignored in healthresearch. Furthermore, the measure-

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Introduction

Potential Mechanismsfor Health Outcomes

The working group began with the assump-tion that there are many ways religiousnessand spirituality may be connected to healthoutcomes. Behavioral, social, psychological,and even directly physiological causalpathways were considered. The net was cast

broadly to link dimensions of religiousnessand spirituality to as many of these potentialmechanisms as possible.

Behavioral Mechanisms: Religiousness/spirituality may protect against diseaseindirectly by association with healthylifestyles. Certain religious denominationsadvocate healthy diets and advise againstsmoking (Cochran, Beeghley, and Bock 1988).The association between less alcohol or druguse and religiousness is relatively well-

established: highly religious people areconsistently less likely to abuse drugs oralcohol than less religious people. Socialconnectednessa concomitant of participa-tion in organized religionand absence ofdepression have been associated withimproved information about health careresources, better compliance with health careregimens, and quicker response to acute

health crises (Umberson 1987, Doherty et al1983, Blumenthal et al 1982). While not allreligions have specific teaching regardingthese health-risk behaviors, theologians haveargued that purity of life is a genericreligious value and that most religious and

spiritual traditions have beliefs about main-taining the health of mind, body, and soul.

Social Mechanisms: Religious and spiritualgroups may also provide supportive, integra-tive communities for their members. Reli-gious group membership is considered 1 ofthe major social ties, along with family,friends, and other social groups. In a numberof epidemiological studies, such ties, includ-ing religious group membership, havereduced mortality in a linear fashion as thenumber of ties increases (Berkman and Syme1979, House et al 1988). The support offeredby these social ties is often conceptualized aseither emotional (sharing feelings, sympathy,or encouragement) or instrumental (tangibleoffers to assist with tasks, materials, ormoney). Religious congregations are potentialsources of many types of support, both be-tween members who know one another andthose who may not. In 1 North Carolinastudy, frequent attendees of religious services

had larger social networks, and more con-tacts and social support from people withinthose networks than infrequent attendees ornonattendees; these findings have since beenreplicated in a US national sample (Bradley1995) and in a large sample of elderly resi-dents of a northeastern city (Idler andKasl 1997, Patel 1985).

Psychological Mechanisms: Religious groupsoffer members a complex set of beliefs aboutGod, ethics, human relationships, and life

and death, beliefs which are directly relevantto health. Research in the US shows that thesubjective beneficial effects of participatingin religious services, prayer, and Bible read-ing are primarily due to their role instrengthening religious belief systems: indi-

viduals who describe themselves as having astrong religious faith report being happierand more satisfied with their lives.

ment instruments were to address spiri-tuality and health in a unified orbi-dimensional framework.

The working groups primary mission was

to develop items for assessing health-relevant domains of religiousness andspirituality as they are broadly under-stood. While many of the items have astrong Judeo-Christian focus (appropri-ately so, given the current distribution ofreligious preferences in the US), thegroup also proposed a number of itemsrelevant to the growing proportion of

Americans who engage in spiritualactivities outside the context of churchesand synagogues.

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Religious involvement also appears to havesignificant protective effects for the emo-tional and physical well-being of individualsin crisis. Religious coping, when comparedwith other ways of coping, appears to beespecially helpful in situations, such as

bereavement or serious illness, where littledirect control is possible. Additional studiesof heart surgery patients, hospitalized veter-ans, elderly women with hip fractures, menwith severe disabilities, recent widowers, andparents who have lost a child found signifi-cantly less depression among those who hadreligious resources. Whether the stressor is alife-threatening disease or disability, anenvironmental disaster, or an interpersonalconflict, the subjects perceived support fromGod or other members of the congregationmay reduce reaction to the stressor (Seemanand McEwen 1996). Experience of a deepinner peace, often in association with medita-tion and prayer, may signal a shift fromsympathetic arousal to parasympatheticrelaxation, which is known to dampen physi-ological reactions (Seeman and McEwen1996, Benson 1975, Patel 1985).

Physiological Mechanisms: Religiousness/spirituality may provide a cushion against

both major and minor stressors throughdirect physiological pathways. Through suchneuroendocrine messengers as catechola-mines, serotonin, and cortisol, negativeemotions have been associated with keypathogenic mechanisms including myocardialischemia (Jiang 1996), arrhythmias(Kamarck and Jennings 1991), increasedplatelet aggregation (Levine et al 1985),suppressed immune response (Stone andBovbjerg 1994), and elevations in risk factors(Brindley and Rolland 1989). Certain

religious/spiritual practices elicit the relax-ation response, an integrated physiologicalreaction that opposes the stress response.Repeated elicitation of the relaxationresponse results in reduced muscle tension,less activity of the sympathetic branch of theautonomic nervous system, less activity ofthe anterior pituitary-adrenocortical axis,lower blood pressure, lower heart rate, and

improved oxygenation, in addition to alteredbrain wave activity and function.

These potential mechanisms for healthoutcomes led the working group to focus onaspects of religiousness/spirituality that have

possible connections to areas of healthresearch in which there are knownbiobehavioral or psychosocial processes atwork. While some of the recognized pathwayshave a direct cushioning effect, it could beargued that religiousness/spirituality en-hances coping precisely in situations wherepredictability and control (concepts central tomost models of stress reduction) are limited.

Identified Domains

The working group identified the followingkey domains of religiousness/spirituality asessential for studies where some measure ofhealth serves as an outcome. In addition, thesedomains were chosen because of the strength oftheir conceptualization and theoretical orempirical connection to health outcomes.

Daily Spiritual ExperiencesMeaning

ValuesBeliefs

ForgivenessPrivate Religious PracticesReligious/Spiritual CopingReligious SupportReligious/Spiritual HistoryCommitmentOrganizational ReligiousnessReligious Preference

Additional aspects of religiousness/spiritual-ity that affect health may be identified andstudies are currently in process for some ofthem (see Current Research Efforts). Possibleadditional aspects include spiritual maturity,mystical experiences, compassion, hope,prayer, and spiritual integration, most ofwhich have never been studied in relation tohealth and await empirical documentation. Ifsuch efforts are made, the working grouprecommends beginning with a strong con-ceptualization of the relationship to health.

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Introduction

How to Use This Report

This publication was developed as a resourcethat provides an extensive listing of ques-tions relevant to religiousness/spirituality asit relates to health outcomes. It is organized

by domain. Each section identifies a domain,describes its relationship to health, recom-mends measures, discusses previous psycho-metric work, recommends uses, and discusseskey questions and concerns. The religious-ness/spirituality domains included in thisdocument are intended for use in studies thatevaluate the relationship between religious-ness/spirituality and health.

Frequently, health studies present space andtime limitations. Because of these limita-

tions, we found it useful to develop a briefmeasure based substantially on select itemsfrom each of the domains. There are severalways to use the instruments included here.Researchers who wish to look merely at thedirect effects of select domains of religious-ness/spirituality on health can use therecommended measures for a specificdomain. For example, an investigatormight simply assess the interface betweenprivate religiousness/spirituality andhealth, or religious support and health, or

daily spiritual experiences and health, andso on. Such an approach is simple and easy toimplement but may overlook the fact thatthere are potentially important interrelation-ships among the different domains. Evaluat-ing these, as well as their more immediateeffects on health, is likely to lead to a moreinformed view of the health effects of reli-giousness/spirituality.

Investigators who wish to take a more com-prehensive approach can assess the interplaybetween multiple domains of religiousness/spirituality and their association with health.For example, a researcher may hypothesizethat people committed to their faith are morelikely to turn to coreligionists for socialsupport during difficult times than to indi-

viduals who are less religious. Fellow parish-ioners are also more likely to recommend

religious-coping responses. Finally, thesereligious-coping responses may eliminate orresolve the stressful probe, thereby preserv-ing or improving the health of the person.Such a hypothesis suggests a model of reli-gious commitment that has both direct and

indirect effects on health, with the indirecteffects operating through religious support aswell as religious coping. This researchercould, therefore, use the multidimensionalinstrumentalone in its brief form or supple-mented with long forms for specific domains,such as Religious Support and Religious/Spiritual Coping.

Current Research Efforts

The domains represented in this publication

do not address all dimensions of religious-ness/spirituality. There are other areas thathave not yet been fully developed, either fromtheoretical or empirical perspectives. Toaddress these areas, the Fetzer Institutesupported a request for applications toencourage instrument development foradditional domains. Such projects beginwith a conceptual foundation, work througha qualitative phase, and end withquantitative measures.

Proposals from the following institutionswere selected for funding.

Duke University Medical Center, Durham,NC: Spiritual History in Relationship toPhysical and Mental Health

University of California-San Francisco,San Francisco, Calif: SpiritualDimensions of the Compassionate Life

University of Missouri-St. Louis, St. Louis,Mo: Spiritual Integration and Contempla-tive Development

Indiana University School of Medicine,Indianapolis, Ind: Assessment of PerceivedRelationship with God

Bowling Green University, Bowling Green,Ohio: Sacred Purpose: Exploring theImplications of Spiritual Meaning forPhysical and Mental Health

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The NIA also included Religion, Aging andHealth as a topic of interest in its FY1997Small Grant (R03) solicitation. The SmallGrant Program provides support for pilotresearch that is likely to lead to individualresearch grants. Research projects focusing

on the complex interrelationships amongreligious and spiritual variables, other psy-chosocial-mediating factors, and health andfunctioning throughout a lifetime wereencouraged. Specific topics of interest in-cluded the biopsychosocial mechanisms bywhich religion, spirituality and/or religiousaffiliations affect health; and the develop-ment of rigorous, but parsimonious scalesand indices that can be embedded in moregeneral studies of health and aging.

The following institutions are conductingresearch projects currently supported by theBehavioral and Social Science ResearchProgram at NIA.

Relationship Between Religionand Health Outcomes

Arlene R. Gordon Research Institute, NewYork, NY: Religiousness and Spirituality inVision-Impaired Elders

Rutgers University, New Brunswick, NJ:Religion and Spirituality in Recoveringfrom Cardiac Surgery

University of Michigan, Ann Arbor, Mich:Religion, Stress, and Physical/MentalHealth in African-Americans

University of Michigan, Ann Arbor, Mich:Role of Spirituality in Adjustment afterCardiac Surgery

John W. Traphagen: Religion, Well-Being,and Aging in Japan

Measurement of Religiousness/Spirituality

University of Florida-Gainesville,Gainesville, Fla: Refining and Testinga Spirituality Scale in the Elderly

University of Michigan, Ann Arbor, Mich:Religion, Aging, and Health

Eastern Virginia Medical School, Norfolk,Va: Religion, Health, and PsychologicalWell-being in the Aged

Public Health Institute, Calif: Spiritualityand Aging in the Alameda County Study

Bonnie Walker and Associates, Bowie, Md:

Spirituality Among the Elderly in Long-term Care

Tulane University, New Orleans, La:Religion, Health, and Aging:Quantitative Issues


Conclusion

Religiousness and spirituality are importantand vital features of many peoples lives. Theworking papers included here conclude thatthese factors play an important role in healthand health outcomes. Discussion of religious-ness, spirituality, and health in leading

Recent Developments

Since the initial publication of thisreport, the Brief MultidimensionalMeasure of Religiousness/Spirituality:1999 was embedded in the 1997-1998

General Social Survey (GSS), a randomnational survey of the National DataProgram for the Social Sciences. Thebasic purpose of this survey is to gatherand disseminate data on contemporary

American society in order to monitorand explain trends in attitudes andbehaviors, and to compare the UnitedStates to other societies.

The tables in Appendix A: AdditionalPsychometric and Population Distri-bution Data include the questions anddomains, percentage distributions, andpsychometric data from the GSS andreflect the efforts of the working group inanalyzing the data, the findings of whichhave been prepared as a manuscript andsubmitted for publication (Idler et al1999). The Fetzer Institute will havecopies of article reprints available uponpublication.

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journals of psychosomatic medicine, publichealth, and gerontology, as well as in generalmagazines suggests there is widespreadinterest in these issues. Therefore, theutmost conceptual and methodological clarityis critically important. This report is in-

tended to encourage further research that isconceptually and methodologically sound,and should, therefore, make a lasting andsignificant contribution to the study ofreligion, spirituality, and health.

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ment: a longitudinal analysis.JGerontol. 1983;38:621-625.

Markides KS, Levin JS, Ray LA. Religion,aging, and life satisfaction: an eight-year, three-wave longitudinal study.Gerontologist.1987;27:660-665.

Mattlin JA, Wethington E, Kessler RC.Situational determinants of coping andcoping effectiveness.J Health Soc Behav.1990;31:103-122.

Mauger PA, Perry J, Freeman T, Grove D,McBride A, McKinney K. The measure-

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McCullough M, Worthington E. Models ofinterpersonal forgiveness and theirapplications to counseling: review andcritique. Counseling Values. 1994;39:2-14.

McEwen BS, Stellar E. Stress and theindividual mechanisms leading to disease.

Arch Intern Med. 1993;153:2093-2101.Meador KG, Koenig HG, Hughes DC, Blazer

DG, Turnbull J, George LK. Religiousaffiliation and major depression.HospCommunity Psychiatry. 1992;43:1204-1208.

Oxman TE, Freeman DH, Manheimer ED.Lack of social participation or religiousstrength and comfort as risk factors fordeath after cardiac surgery in the elderly.

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Sapolsky RM.Stress, the Aging Brain, andthe Mechanisms of Neuron Death.Cambridge, Mass: The MIT Press; 1992.

Seeman TE, McEwen BS. Impact of socialenvironment characteristics onneuroendocrine regulation.Psychosom

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Sweet L.Health and Medicine in the Evan-gelical Tradition. Phila, Penn: TrinityPress International; 1994.

Taylor RJ, Chatters LM. Church members asa source of informal social support.Rev

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religious participation among elderlyblack adults.J Gerontol: Soc Sci.

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Umberson D. Family status and healthbehaviors: social control as a dimensionof social integration.J Health Soc Behav.1987;28:306-319.

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Domain of Measurement

This domain is intended to measure theindividuals perception of the transcendent(God, the divine) in daily life and the percep-tion of interaction with, or involvement of,the transcendent in life. The items attempt to

measure experience rather than cognitiveconstructions. Although a variety of thedomains in the more complete Brief Multidi-mensional Measure of Religiousness/Spiritu-ality: 1999 address spirituality, this domainmakes spirituality its central focus and canbe used effectively across many religiousboundaries.

Description of Measures

This domain attempts to capture those

aspects of life that represent day-to-dayspiritual experience particularly well. Thedomain was designed to be a more directmeasure of the impact of religion and spiritu-ality on daily life. The items assess aspects ofday-to-day spiritual experience for an ordi-nary person, and should not be confused withmeasures of extraordinary experiences (suchas near-death or out-of-body experiences),which may tap something quite different andhave a different relationship to health out-comes. The experiences reflected in this

domain may be evoked by a religious contextor by daily life. They may also reflect theindividuals religious history and/or religiousor spiritual beliefs.

Cognitive interviews conducted with thisinstrument across a variety of cultural,religious, and educational groups haveencouraged the use of the word God to

Daily Spiritual ExperiencesLynn G. Underwood, PhD

Vice President-Health ResearchFetzer Institute

Kalamazoo, Michigan

describe the transcendent. Even the fewpeople for whom the word God is not theusual descriptor of the transcendent seemcapable of connecting the term with theirexperience. Although this instrument as-sumes a predominantly Judeo-Christianresearch population, the items have shownpromise in preliminary evaluations for usewith other groups and may require onlyminor modifications for such application.

This complete domain has not been sepa-rately addressed in any published, testedinstrument. In developing this instrument,the author drew on in-depth interviews andfocus groups conducted over a number ofyears, exploring in an open-ended way theexperiences of a wide variety of individuals

from many religious perspectives. Thesereports of individual experience, plus areview of features of the spiritual life ashighlighted in theological, spiritual andreligious writings (Buber 1937, van Kaam1991, Merton 1969, Hanh 1994, Underhill1927, De Wit 1991), were used to developthis instrument. A review of current scalesthat attempt to measure some aspect ofspiritual experience was also conducted(Hood 1975, Elkins et al 1988, Idler and Kasl1992). Some of the most helpful insights

came from reading works by those who havea deep understanding of the spiritual as anintegral aspect of life, and seeing manysimilar issues emerge in the open-endedinterviews. Cognitive interviews on earlierdrafts of the instrument led to further refine-ments, and efforts were repeatedly made toground the questions in daily experience.

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The interviews revealed that connection wasan important concept. Western spiritualityemphasizes a more personal connection withGod and other people, while Eastern spiritu-ality places more emphasis on connectionwith all of life, and connection in unity. Many

people have frequent interaction with thetranscendent on a daily basis, looking to Godfor strength, asking for help, and feelingguidance in specific circumstances. Emo-tional support from the transcendent ismanifested in feelings of being loved andcomforted. A concept that emerges frequentlyin the spiritual literature of both Eastern andWestern traditions is the concept of spiritualintegration, with a resulting sense of innerharmony or wholeness.

Another concept that emerged was the sensethat one can have an existence that does notsolely depend on physical or mental aspectsof self or social definitions: that one is con-nected to something beyond self or deeperwithin self. The ability to transcend thelimits of ones present situation frequentlycomes from a spiritual and religious context.

van Kamm (1986) suggests that awe is thecentral quality of the spiritual life and allother aspects flow from that. Awe comes from

a realization that one is not the center of theuniverse, and from a sense of wonder ormystery that the universe itself speaks of thetranscendent and can frame ones approach.David Steindal-Rast (1984) describes howgratefulness can provide a resting place formuch of the rest of spiritual life. An attitudeof gratefulness suggests that life is a giftrather than a right.

Compassion is a central component to manyspiritual traditions (Smith 1991) and its

capacity to benefit the one who is compas-sionate might be profitably explored in thesetting of health. Forgiveness, while devel-oped as its own domain in the larger instru-ment, is linked with the concept of mercy,which is employed in this scale. Giving othersthe benefit of the doubt, dealing with othersfaults in light of ones own, and being gener-ous are possible ways in which the spiritualis evident in everyday life.

In developing this instrument, the notionthat one might not have a connection withthe transcendent, but that one might long forsuch a connection was discussed. Longing forconnections with God, or the divine, is anaspect of the spiritual life that crops up in

the mystical literature of many traditionsand can easily be considered an element ofdaily spiritual experience of ordinary people.Such yearning is also manifested in a senseof wanting to be closer to God, or to mergewith the divine.

In developing this domain, 9 key dimensionswere identified: connection with the tran-scendent, sense of support from the transcen-dent, wholeness, transcendent sense of self,awe, gratitude, compassion, mercy, andlonging for the transcendent. The responsecategories, except for question 16, relate tofrequency, and make use of the followingscale: many times a day, every day, mostdays, some days, once in a while, never oralmost never.

Connection with the Transcendent1. I feel Gods presence.2. I experience a connection to all of life.

As in our relationships with each other, thisquality of intimacy can be very important.These questions were developed to addressboth people whose experience of relationshipwith the transcendent is one of personalintimacy and those who describe a moregeneral sense of unity as their connectionwith the transcendent.

Sense of Support from the TranscendentA sense of support is expressed in 3 ways:strength and comfort, perceived love, and

inspiration/discernment.

Strength and Comfort4. I find strength in my religion or spirituality.5. I find comfort in my religion or spirituality.

This dimension has been described as socialsupport from God. The Index of ReligiositymeasureI obtain strength and comfort

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Daily Spiritual Experiences

from my religion (Idler and Kasl 1992)was broken into 2 parts, based on cognitiveinterviews that revealed a perception thatstrength and comfort were distinct. Theitems intend to measure a direct sense ofsupport and comfort from the transcendent.

They may prove highly correlated and maybe combined as this instrument undergoesfurther testing.

Perceived Love9. I feel Gods love for me directly.

10. I feel Gods love for me through others.

Individuals can believe that God is lovingwithout feeling loved themselves. The emo-tional support of feeling loved may proveimportant in the relationship of religious/spiritual issues to health outcomes. Thequality of love imputed to God has potentialdifferences from the love humans give eachother, and there is a kind of love from otherswhich many attribute to God. Gods love canbe experienced as affirming, and can contrib-ute to self-confidence and a sense of self-worth independent of actions.

Inspiration/Discernment7. I ask for Gods help in the midst of

daily activities.8. I feel guided by God in the midst ofdaily activities.

These items address the expectation of divineintervention or inspiration and a sense that adivine force has intervened or inspired. Theguidance item was most often deemedsimilar to a nudge from God and morerarely as a more dramatic action.

Sense of Wholeness, Internal Integration

6. I feel deep inner peace or harmony.

This item attempts to move beyond merepsychological well-being. In the cognitiveinterviews, individuals were asked repeat-edly whether a person could experience asense of wholeness while feeling over-whelmed, stressed, or depressed. Thoseinterviewed generally felt that a sense of

wholeness would be harder to experienceunder adverse circumstances, but that suchinternal integration was still possible. Theword deep allows people to consider factorsother than psychological ease.

Transcendent Sense of Self3. During worship, or at other times when

connecting with God, I feel intense joywhich lifts me out of my daily concerns.

This item attempts to identify the experienceof a lively worship service where ones day-to-day concerns can dissolve in the midst ofworship. Transcending the difficulties ofpresent physical ills or psychological situa-tions may also be possible through an aware-ness that life consists of more than the physi-cal and psychological. For further explorationof this concept, see Underwood 1998. Thiswas a particularly difficult dimension totranslate from metaphysical terms into morepractical lay language.

Sense of Awe11. I am spiritually touched by the beauty of

creation.

This dimension attempts to capture the ways

in which people experience the transcendent.A sense of awe can be provoked by exposureto nature, human beings, or the night sky,and has an ability to elicit experience of thespiritual that crosses religious boundariesand affects people with no religious connec-tions (van Kaam 1986).

Sense of Gratitude12. I feel thankful for my blessings.

This aspect of spirituality is considered

central by many people and has potentialconnection to psychologically positive ways of

viewing life. Because of the potential connec-tions between gratitude and circumstances oflife, external stressors may modify a respon-dents feelings of thankfulness. It is impor-tant to note, however, that some people findblessings even in the most dire circumstances.

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Sense of Compassion13. I feel a selfless caring for others.

This item was preferred to I care for otherswithout expecting anything in return, whichcan reflect negative connotations about

expectations of others. Selfless caring, aseemingly unwieldy term, was easily under-stood by diverse individuals. Compassion is

valued in Buddhist, Christian, and Jewishtraditions, and may be a useful measurebeyond these traditions.

Sense of Mercy14. I accept others even when they do things

I think are wrong.

This item addresses the felt sense of mercy,rather than the mere cognitive awarenessthat mercy is a good quality. As demonstratedin the cognitive interviews, this measure wassuccessful in presenting mercy as a neutral,easily understood concept. Mercy, as pre-sented in this item, is closely linked to for-giveness, yet is a deeper experience thanisolated acts of forgiveness.

Longing for the Transcendent15. I desire to be closer to God or in union

with Him.

This item should always be paired withquestion 16 to fully evaluate the concept oflonging. There are 2 opposed ways ofresponding to this item: some people feel theyare so close to God that it is not possible toget closer; others have no desire to becomecloser. To clarify a respondents view, item 16has been added.

16. In general, how close to God do you feel?

Item 15 was included to evaluate experiencesof being drawn to the spiritual, to assessdesire or longing. Question 16 assesses theindividuals current degree of intimacy orconnection with God.

These dimensions form a starting point andwill likely be expanded as this work

progresses. We hope that a number of thedimensions will be strongly correlated. Thewide variety of items seeks to elucidate a fewcommon elements.

Previous Psychometric Work

The instrument has been incorporated into 3large studies of physical health outcomes,including the Chicago site of a multicentermenopause study, an Ohio University painstudy, and a study at Loyola University ofChicago. In addition, the instrument hasbeen incorporated into 3 ongoing healthstudies as well as a qualitative and quantita-tive evaluation on a non-Judeo-Christian

Asian population at the University of Califor-nia, San Francisco.

Reliability and exploratory factor analysisfrom the different samples support the use ofthe instrument to measure daily spiritualexperiences. The scale is highly internallyconsistent, with alphas ranging from .91 to.95 across samples. Preliminary construct

validity was established by examination ofthe mean scale scores across sociodemographicsubgroups, and preliminary exploratoryfactor analyses support a unidimensional set.The analysis has been included in an article

submitted for publication (Underwood andTeresi 1999).

A shortened version of the instrument wasembedded in the 1997-1998 wave of theGeneral Social Survey. A summary of thatpsychometric data is included in

Appendix A of this report.

Association with Health

While existing scales for mystical or spiritual

experience attempt to capture aspects of thisdomain associated with psychological well-being, little empirical work links the spiritualexperiences of daily life with health out-comes. However, one of the items moststrongly predictive of positive health outcomein the Oxman study of cardiovascular disease(Oxman et al 1995) was incorporated intothis scale: I obtain strength and comfortfrom my religion.


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The emotional and physical feelings describedby these items may buffer individuals frompsychological stress, which has been exten-sively linked to health through specific physi-ologic effects (Cohen et al 1995). Positive emo-tional experiences have also been connected

with positive effects on the immune system,independent of the negative effects of stress(Stone 1994). Likewise, positive expectationsfor outcomes have been linked to positiveimmune effects (Flood et al 1993, Roberts et al1995). There may also be overlap betweenendorsing a sense of deep peace and thecondition that leads to or emanates from directneurologic and endocrine effects similar tothose identified during meditation (Benson 1975).

The inclusion of this domain in health stud-ies has great potential for establishing apathway by which religiousness and spiritu-ality might influence health, providing apossible link between certain religious/spiritualpractices and/or cognition and health outcomes.This domain also provides an opportunity toassess direct effects of daily spiritual experi-ences on physical and mental health.

Estimated Completion Time

Less than 2 min.

Other Considerations

We are hoping to tap into a trait. However,since this domain measures perceptions andfeelings, scores may vary according to exter-nal stressors and emotional state. Ideally,psychosocial variables (such as emotionalstates, traits, and levels of stressors) wouldbe addressed in concurrently administeredmeasures, allowing researchers to account forconfounding by these factors.

Please note: When introducing the DailySpiritual Experience items to subjects, pleaseinform them, The list that follows includesitems you may or may not experience. Pleaseconsider if and how often you have these

experiences, and try to disregard whether youfeel you should or should not have them. Inaddition, a number of items use the wordGod. If this word is not a comfortable one,

please substitute another idea that calls tomind the divine or holy for you.

Proposed Items

DAILY SPIRITUAL EXPERIENCES-

LONG FORMYou may experience the following in yourdaily life. If so, how often?

1. I feel Gods presence.1 - Many times a day2 - Every day3 - Most days4 - Some days5 - Once in a while6 - Never or almost never

2. I experience a connection to all of life.1 - Many times a day2 - Every day3 - Most days4 - Some days5 - Once in a while6 - Never or almost never

3. During worship, or at other times whenconnecting with God, I feel joy whichlifts me out of my daily concerns.

1 - Many times a day2 - Every day3 - Most days4 - Some days5 - Once in a while6 - Never or almost never

4. I find strength in my religion or spirituality.1 - Many times a day2 - Every day3 - Most days4 - Some days

5 - Once in a while6 - Never or almost never

5. I find comfort in my religion or spirituality.1 - Many times a day2 - Every day3 - Most days4 - Some days5 - Once in a while6 - Never or almost never


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6. I feel deep inner peace or harmony.1 - Many times a day2 - Every day3 - Most days4 - Some days5 - Once in a while

6 - Never or almost never

7. I ask for Gods help in the midst ofdaily activities.


8. I feel guided by God in the midst ofdaily activities.


9. I feel Gods love for me, directly.1 - Many times a day2 - Every day

3 - Most days4 - Some days5 - Once in a while6 - Never or almost never

10. I feel Gods love for me, through others.1 - Many times a day2 - Every day3 - Most days4 - Some days5 - Once in a while6 - Never or almost never

11. I am spiritually touched by thebeauty of creation.


12. I feel thankful for my blessings.1 - Many times a day2 - Every day3 - Most days4 - Some days5 - Once in a while

6 - Never or almost never

13. I feel a selfless caring for others.1 - Many times a day2 - Every day3 - Most days4 - Some days5 - Once in a while6 - Never or almost never

14. I accept others even when they do thingsI think are wrong.


The following 2 items are scored differently.

15. I desire to be closer to God or in unionwith Him.

1 - Not at all close2 - Somewhat close3 - Very close4 - As close as possible

16. In general, how close do you feel to God?1 - Not at all close2 - Somewhat close3 - Very close4 - As close as possible

DAILY SPIRITUAL EXPERIENCES-

SHORT FORM

None provided.

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Additional information regardingDSES Survey:

The Daily Spiritual Experience Scale (DSES)has been included in a number of researchstudies, including the alcohol studies

mentioned in the preface as well as projectsfunded from the Fetzer Institute request forproposals, Scientific Research on AltruisticLove and Compassionate Love. We found thatmany investigators without current self-reportmeasures directly addressing compassionatelove included two items from the DSES intheir study as a measure of compassion andmercy. These items are DSES #13, I feel aselfless caring for others, and DSES #14,I accept others even when they do things I

think are wrong.

These same two items were also placed in thelatest 2002 wave of the General Social Sur-

vey in a National Study of Altruism, (Na-tional Opinion Research Center/University ofChicago). The results are as follows:

Including the DSES as measurement of aspiritual component along with more organi-zational religious measures may present animportant method to examine religiousness/spirituality in health studies.

I accept othersI feel a even when they

selfless caring do things Ifor others think are wrong

Many timesa day 9.8 9.4

Every day 13.2 15.5

Most days 20.3 32.4

Some days 24.0 23.0

Once ina while 22.3 14.8

Never oralmost never 10.4 4.9

A copy of the article, The Daily SpiritualExperience Scale: Development, TheoreticalDescription, Reliability, Exploratory Factor

Analysis, and Preliminary Construct ValidityUsing Health-Related Data by Underwoodand Teresi,Annals of Behavioral Medicine2002, 24(1): 22-33, can be found atwww.fetzer.org or by contacting [email protected].

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Bibliography

Benson H. The Relaxation Response. NewYork, NY: Avon; 1975.

Buber M.I and Thou. New York, NY:Charles Scribners & Sons; 1970.

Cohen S, Kessler R, Underwood-Gordon L.Measuring Stress: A Guide for Healthand Social Scientists. New York, NY:Oxford Press; 1995.

De Wit HF. Contemplative Psychology. Pitts-burgh, Penn: Duquesne Press; 1991.

Elkins DN, Hedstrom LJ, Hughes LL, LeafJA, Saunders C. Toward a humanistic-

phenomenological spirituality: defini-tion, description, and measurement.

J Humanistic Psychol. 1988;28(4):5-18.Flood AB, Lorence DP, Ding J, et al. The role

of expectations in patients reports ofpost-operative outcomes and improve-

ment following therapy.Med Care.1993;31(11):1043-1056.Hanh TN.A Joyful Path: Community,

Transformation and Peace. Berkeley,Calif: Parallax Press; 1994.

Hood R. The construction and preliminaryvalidation of a measure of reported

mystical experience.J Sci Study Reli-gion. 1975;22:353-365.Howden J.Development and Psychometric

Characteristics of the SpiritualityAssessment Scale [dissertation]. TexasWomens University; 1992.

Idler EL. Religiousness involvement andhealth of the elderly: some hypotheses

and an initial test.Soc Forces.1987;66:226-238.

Idler EL, Kasl S. Religion, disability,depression and the timing of death.

Am J Sociol. 1992;97(4):1052-1079.Koenig HG, Smiley M, Gonzales J.Religion,

Health, and Aging. Westport, Conn:Greenwood Press; 1988.

Merton, T.Life & Holiness. New York, NY:Doubleday; 1969.

Oxman TE, Freeman DH, Manheimer ED.Lack of social participation or religiousstrength and comfort as risk factors fordeath after cardiac surgery in the elderly.

Psychosom Med. 1995;57:5-15.

Roberts AH, Kewman DG, et al. The powerof nonspecific effects in healing:implications for psychosocial andbiological treatments. Clin Psychol Rev.1995;13:375-391.

Smith H. The Worlds Religions: Our Great

Wisdom Traditions. Rev ed. SanFrancisco, Calif: Harper; 1991.

Steindal-Rast D. Gratefulness, the Heart ofPrayer: An Approach to Life in Fullness.New York, NY: Paulist Press; 1984.

Stone AA, Bovbjerg DH. Stress and humoralimmunity: a review of the human studies.

Adv Neuroimmunol. 1994;4:49-56.Underhill E.Practical Mysticism. United

Kingdom: Shaw Publications; 1927.Underwood LG. A working model of health:

spirituality and religiousness asresources: applications to persons with

disability.J Religion Disability Rehabil.In press.Underwood L., Teresi J. Development,

theoretical description, reliabilityand exploratory factor of the daily spiritualexperience (DSE) scale. In press.

van Kaam A.Formation of the Human Heart.In:Formative Spirituality Series.

Vol 3. New York, NY: Crossroads; 1991.van Kaam A.Fundamental Formation. In:

Formative Spirituality Series. Vol 1.New York, NY: Crossroads; 1986.

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Constructing meaning from lifes events is anessentially human endeavor. Less clear is themeans for measuring a persons search formeaning (the process) and the success orfailure of that search (the outcome). Although

many items pertaining to meaning arepresent in a variety of scales, none could becalled definitive.


Attempts to measure the construct of mean-ing grow largely out of the theoretical work of

Viktor Frankl, who asserted that the will tomeaning is an essential human characteris-tic, one that can lead to physical and mentalsymptomatology if blocked or unfulfilled

(Frankl 1963). Others have also spoken of theimportance of meaning or purpose in life aspart of a sense of coherence (Antonovsky1979), an essential function of coping withmajor life stresses (Park and Folkman inpress), or an element of psychological well-being (Ryff 1989).

The search for meaning has also been definedas one of the critical functions of religion.Frankl himself viewed meaning in religiousterms. Meaning as he saw it was something

to be discovered rather than created, thatis, every individual was said to have aunique, externally given purpose in life.Other theorists have also defined religion asthat individual and social force concernedwith existential questions and their solutions(Batson, Schoenrade, and Ventis 1993; Geertz1966).

MeaningKenneth I. Pargament, PhD

Bowling Green State UniversityDepartment of Psychology

Bowling Green, Ohio

In support of the religion-meaning connec-tion, several studies have demonstratedsignificant relationships between measuresof religiousness (particularly conservativereligiousness) and a sense of purpose in life(Dufton and Perlman 1986, Paloutzian 1981).


Current Scales for Assessing Meaning:Several scales have been developed to meas-ure aspects of meaning or purpose in life.These include: The Purpose-in-Life scale (PIL), which

assesses the degree to which the individualexperiences a sense of meaning or purpose(Crumbaugh 1968);

The Seeking of Noetic Goals scale (SONG),which measures the strength of motivation

to find meaning in life (Crumbaugh 1977); The Life Regard Index (LRI), which

assesses whether the individual has aframework from which meaning can bederived and the degree to which theselife goals are being fulfilled (Battista and

Almond 1973); The Life Attitude Profile (LAP), which

contains items from the PIL and SONG, aswell as other items (Reker 1992);

The Sense of Coherence scale (SOC), whichassesses the degree to which the world andlife events are perceived as comprehensible,manageable, and meaningful (Antonovsky1979, 1987); and

Ryff s Purpose-in-Life subscale, whichassesses the degree to which the individualhas goals in life, holds beliefs that give lifepurpose, and perceives meaning in thepresent and past (Ryff and Keyes 1995).

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Meaning

sharper), or the PIL subscale from Ryff (linkedto a larger theory of psychological well-being).It is also important to note that these scalesgenerally focus more on the attainment ofmeaning (the outcome) than the search formeaning (the process). Rekers subscales,

however, do recognize this distinction.

No scales measure meaning from a substan-tive religious perspective. The developmentof a more explicit religious and/or spiritualmeaning scale would be a useful addition tothe literature. Because religious/spiritualmeaning lies at the core of meaning itself,according to some theorists, an explicitlyreligious/spiritual meaning may add power tothe study of meaning (for example, a spiri-tual meaning measure may predict healthabove and beyond the effects of traditionalmeaning measures). An explicitly theisticmeaning scale would consist of items such as:The events in my life unfold according to adivine plan; and Without God, my lifewould be meaningless. A spiritual meaningscale would consist of items such as: Myspirituality gives meaning to my lifes joysand sorrows; and What gives meaning tomy life is the knowledge that I am a part ofsomething larger than myself. These illus-

trative items are also better indicators of theattainment of religious/spiritual meaning(the outcome) than the search for religious/spiritual meaning (the process).

Studies of the search for religious/spiritualmeaning are also needed. Batsons questscale provides 1 useful tool for assessing thedegree to which the individual is engaged inefforts to answer fundamental existentialquestions (Batson, Schoenrade, and Ventis1993). Emmons research on personal

strivings could also be extended to includestudies of religious and spiritual strivings, orthe degree to which personal strivings aresanctified (Emmons in press).


A number of studies have found significantrelationships between the sense of meaning

in life and indices of health, particularlymental health (Crumbaugh 1968, Zika andChamberlain 1987, Padelford 1974, Ryff1989).

Proposed Items

MEANING-LONG FORM

Instructions: Please circle how much youagree or disagree with the following state-ments on the scale below.

1 - Strongly disagree2 - Disagree3 - Neutral4 - Agree5 - Strongly agree

1. My spiritual beliefs give meaning to mylifes joys and sorrows.


2. The goals of my life grow out of my under-standing of God.

1 - Strongly disagree2 - Disagree

3 - Neutral4 - Agree5 - Strongly agree

3. Without a sense of spirituality, my dailylife would be meaningless.


4. The meaning in my life comes from feel-ing connected to other living things.


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5. My religious beliefs help me find a pur-pose in even the most painful and confus-ing events in my life.

1 - Strongly disagree2 - Disagree3 - Neutral

4 - Agree5 - Strongly agree

6. When I lose touch with God, I have aharder time feeling that there ispurpose and meaning in life.


7. My spiritual beliefs give my life a sense ofsignificance and purpose.


8. My mission in life is guided/shaped by myfaith in God.

1 - Strongly disagree

2 - Disagree3 - Neutral4 - Agree5 - Strongly agree

9. When I am disconnected from thespiritual dimension of my life, I losemy sense of purpose.

1 - Strongly disagree2 - Disagree3 - Neutral4 - Agree

5 - Strongly agree

10. My relationship with God helps me findmeaning in the ups and downs of life.


11. My life is significant because I am part ofGods plan.


5 - Strongly agree

12. What I try to do in my day-to-day life isimportant to me from a spiritualpoint of view.


13. I am trying to fulfill my God-givenpurpose in life.


14. Knowing that I am a part of somethinggreater than myself gives meaningto my life.

1 - Strongly disagree

2 - Disagree3 - Neutral4 - Agree5 - Strongly agree

15. Looking at the most troubling orconfusing events from a spiritualperspective adds meaning to my life.


5 - Strongly agree

16. My purpose in life reflects what I believeGod wants for me.



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17. Without my religious foundation, my lifewould be meaningless.


5 - Strongly agree

18. My feelings of spirituality add meaning tothe events in my life.


19. God plays a role in how I choose mypath in life.


20. My spirituality helps define the goals Iset for myself.

1 - Strongly disagree2 - Disagree3 - Neutral

4 - Agree5 - Strongly agree

MEANING-SHORT FORM

None provided. See Brief MultidimensionalMeasure of Religiousness/Spirituality: 1999,

Appendix.

Bibliography

Antonovsky A.Health, Stress, and Coping.San Francisco, Calif: Jossey-Bass; 1979.

Antonovsky A. Unraveling the Mystery ofHealth. San Francisco, Calif:Jossey-Bass; 1987.

Batson CD, Schoenrade P, Ventis WL.Religion and the Individual: A Social-Psychological Perspective. New York, NY:Oxford; 1993.

Battista J, Almond R. The development ofmeaning in life.Psychiatry.1973;36:409-427.

Chamberlain K, Zika S. Measuring meaningin life: an examination of three scales.

Pers Individual Differences. 1988;9:589-596.

Crumbaugh JC. Cross-validation of Purposein Life Test based on Frankls concepts.

J Individual Psychol. 1968;24:74-81.Crumbaugh JC. The Seeking of Noetic Goals

Test (SONG): a complementary scaleto the Purpose in Life Test (PIL).J Clin

Psychol. 1977;33:900-907.Dufton BD, Perlman D. The association

between religiosity and the Purpose-in-Life test: does it reflect purpose orsatisfaction.J Psychol Theology.1986;14:42-48.

Dyck MJ. Assessing logotherapeutic con-structs: conceptual and psychometricstatus of the Purpose in Life and Seekingof Noetic Goals tests. Clin Psychol Rev.1987;7:439-447.

Emmons RE. Assessing spirituality throughpersonal goals: implications for researchon religion and subjective well-being.Soc

Indicators Res. In press.Emmons RE. Personal strivings: an approach

to personality and subjective well-being.

J Pers Soc Psychol. 1986;51:1058-1068.Frankl V.Mans Search for Meaning. NewYork, NY: Washington SquarePress; 1963.

Geertz C. Religion as a cultural system. In:Banton M, ed.Anthropological

Approaches to the Study of Religion.London: Tavistock; 1966:1-46.

Padelford BL. Relationship between druginvolvement and purpose in life.J Clin

Psychol. 1974;30:303-305.Paloutzian RF. Purpose in life and value

changes following conversion.J PersSoc Psychol. 1981;41:1153-1160.

Pargament KI. The Psychology of Religionand Coping: Theory, Research, Practice.New York, NY: GuilfordPublications; 1997.

Meaning

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Pargament KI, Mahoney AM.SacredPurpose: Exploring the Implications ofSpiritual Meaning for Physical andMental Health. Unpublished manuscript.

Park CL, Folkman S. Meaning in the contextof stress and coping. Gen Psychol Rev.

In press.Reker GT. The Life Attitude Profile-Revised

(LAP-R). Peterborough, Ont: StudentPsychologists Press; 1992.

Reker GT, Peacock EJ. The Life AttitudeProfile (LAP): a multidimensionalinstrument for assessing attitudes towardlife. Can J Behav Sci. 1981;13:264-273.

Ryff CD. Happiness is everything, or is it?Explorations on the meaning ofpsychological well-being.J Pers Soc

Psychol. 1989;57:1069-1081.Ryff CD, Keyes CLM. The structure of

psychological well-being revisited.J Pers Soc Psychol. 1995;69:719-727.

Zika S, Chamberlain K. Relation of hasslesand personality to subjective well-being.

J Pers Soc Psychol. 1987;53:155-162.


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This domain is intended to measure dimen-sions distinct from the value the individualplaces on religion itself (How important isreligion in your life?), which is currentlycovered under the domain entitled Commit-

ment. This domain is not about the sheerpresence or absence of values per se;presumably everybody values something.Instead, this domain is based on the approachof Merton (1968), who described values asgoals, and norms as the means to those goals.Other theorists viewed values as criteriapeople use to select and justify actions (Wil-liams 1968, Kluckhohn 1951). This domainattempts to assess the extent to which anindividuals behavior reflects a normativeexpression of his/her faith or religion as the

ultimate value.


The Short Form for this domain directlyassesses the influence of faith on everydaylife. Three items have been proposed, 1 fromBenson (1988) and 2 from the Intrinsic/Extrinsic (I/E) Revised Scale (Gorsuch andMcPherson, 1989). One of the 3 items isphrased negatively and 1 includes amoral dimension.

The Long Form assesses the importance of awide range of possible values, placing reli-gious values in a more general context ofcompeting values. The advantage of thisapproach is that it minimizes the knownsocial desirability problems of the I/E Scale(Leak and Fish 1989). The best known workin the comprehensive measurement of values

ValuesEllen Idler, PhD

Rutgers UniversityDepartment of Sociology

Institute for Health, Health Care Policy, and Aging Research

New Brunswick, New Jersey

is that of Rokeach (1973). His Value Surveyasks respondents to rank 18 terminal (goal)

values and 18 instrumental (process) values.Rokeachs research reflects a strong interestin the relationship between values andreligiousness (Rokeach 1969a, 1969b) andreveals some differences between AmericanChristians and American Jews. It also dem-onstrates differences by religiousness: the

values of salvation and forgiving are moresalient for those who attend church/syna-gogue more often and say religion is moreimportant to them. An important feature ofthe Rokeach scale is that respondents areasked to rank their values, necessitating thatsome be placed ahead of others.

More recently, Schwartz (Schwartz and

Bilsky 1987, Schwartz 1992, Schwartz andHuismans 1995) has developed and tested anexpanded and modified version of the Rokeachscale. Respondents are asked to rate each of56 values in terms of their importance asguiding principles in their life on a scale

varying from opposed to my principles (-1)through not important (0) to of supremeimportance (7). Schwartzs original workused the same ranking technique as Rokeach,but the later work added more values andshifted to a rated scoring system. The rank-

ing tasks can be time-consuming. Schwartzswork demonstrated that the 56 values can becategorized into a smaller number of domains,and that results from a survey organized inthis manner can be replicated across popula-tions as diverse as German students, Israeliteachers, Greek Orthodox, Dutch Protestants,and Spanish Catholics. He also found thatreligiousness among respondents correlates

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negatively with the individualist valuedomains of hedonism, stimulation, achieve-ment, and self-direction, and positively withthe collectivist domains of tradition, con-formity, benevolence, and security. Some

value domains, such as power and universal-

ism, show little association with religion.

According to Schwartz and Huismans:

Theological analyses suggest thatmost and possibly all major contempo-rary religions promote transcendenceof material concerns. Religionsencourage people to seek meaningbeyond everyday existence, linkingthemselves to a ground of beingthrough belief and worship. Mostfoster attitudes of awe, respect, andhumility by emphasizing the place ofthe human being in a vast, unfathom-able universe, and exhort people topursue causes greater than theirpersonal desires. The opposed orienta-tion, self-indulgent materialism, seekshappiness in the pursuit and con-sumption of material goods. In this

view, the primary function of religionis to temper self-indulgent tendencies

and to foster transcendental concernsand beliefs. Religions seek to do thisby promulgating religious creeds,moral prescriptions, and ritualrequirements. If greater religiositysignifies acceptance of these priorities,we would expect religiosity to corre-late positively with values thatemphasize reaching toward andsubmitting to forces beyond the selfand negatively with values thatemphasize gratification of material

desires. (1995:91).

Other researchers have also identified theprosocial orientation of religious respondents.Ellison (1992), Pollner (1989), and othersargue along these lines: modeling humanrelationships after divine ones providesgodlike models for behavior; there are

direct teachings in many faiths on the subjectof love and concern for others; feelings ofdivine protection may encourage feelings ofsecurity and friendliness to strangers. Ellisonfound that religious people were generallykind, as judged by the interviewers for the

National Survey of Black Americans (1992).


For the Short Form, the I/E Scale is thesingle most frequently used measure in thesocial scientific study of religion (Allport andRoss 1967). One of the items from the I/EScale was determined to be the highestloading item on the I/E Scale, and Gorsuchand MacPherson (1989) suggest it can beused as a single item if the survey sample is

large enough.

The Long Form comes from Schwartz, whohas tested his instrument for reliability and

validity in numerous international samples(Schwartz 1992, Schwartz and Bilsky 1987,Schwartz and Huismans 1995).


There is no obvious, direct connection betweenvalues and health, and virtually no research

has been done in this area. The link wouldhave to be through behaviors that are pro-moted by the value or criteria of faith.Schwartz and Huismans (1995) found thatreligious people consistently show a morecollectivist orientation and place less valueon self-indulgence or sensation-seeking.

A collectivist orientation that places littlevalue on self-stimulation, pleasure, andexcitement might cause a person to avoidrisky behaviors, such as heavy drinking, fast

driving, and/or promiscuous sex. Such acollectivist orientation may also be reflectedin larger or more supportive social networks.Ellison and George (1994) and Bradley (1995)found that religiously active people reportlarger social networks, especially of friends,which would provide another link to health.

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Values

Another effect of the value of concern forothers, especially those less fortunate thanoneself, may be the facilitation of socialcomparisons. In health research, downwardcomparisons, or the tendency of people tocompare themselves with others who are

worse off, is commonly shown to enhancefeelings of well-being and reduce depression(Wood, Taylor, and Lichtman 1985; Gibbons1986; Affleck and Tennen 1991). Volunteeringtime to others in the community is said toproduce an altruistic helpers high (Luks1993). If religiously motivated values causepeople to expose themselves to the physicalor social needs of others, and perhaps to helpothers in some way, feelings of relative well-being may be an unintentional but neverthe-less real benefit.

Suggested Administration

The Short Form items are easily self-admin-istered or administered by phone or in-person.The Long Form items must be self-administered.

Time Referent

Both scales refer to the present only.

Estimated Completion TimeShort Form: 15-20 sec.Long Form: approximately 10 min.

Proposed Items

VALUES-LONG FORM

Instructions: Please rate the following valuesAS A GUIDING PRINCIPLE IN MY LIFE.Begin by reading the first column (1-30).Then, from that column only, choose and ratethe most important value and the leastimportant value. Next read the second col-umn (31-56), and select the most important

value and the least important value in thatcolumn. Finally, rate each value in bothcolumns using the following scale.

First Column1. ___ Equality (equal opportunity for all)2. ___ Inner harmony (at peace with myself)3. ___ Social power (control over others,

dominance)4. ___ Pleasure (gratification of desires)

5. ___ Freedom (freedom of actionand thought)

6. ___ A spiritual life (emphasis on spiritualnot material matters)

7. ___ Sense of belonging (feeling thatothers care about me)

8. ___ Social order (stability of society)9. ___ An exciting life (stimulating

experiences)10. ___ Meaning in life (a purpose in life)11. ___ Politeness (courtesy, good manners)12. ___ Wealth (material possessions, money)13. ___ National security (protection of my

nation from enemies)14. ___ Self-respect (belief in ones

own worth)15. ___ Reciprocation of favors (avoidance of

indebtedness)16. ___ Creativity (uniqueness, imagination)17. ___ A world at peace (free of war

and conflict)18. ___ Respect for tradition (preservation of

time-honored customs)

19. ___ Mature love (deep emotional andspiritual intimacy)20. ___ Self-discipline (self-restraint,

resistance to temptation)21. ___ Detachment (from worldly concerns)22. ___ Family security (safety for loved ones)23. ___ Social recognition (respect, approval

by others)24. ___ Unity with nature (fitting into nature)25. ___ A varied life (filled with challenge,

novelty, and change)26. ___ Wisdom (a mature understanding

of life)27. ___ Authority (the right to lead or

command)28. ___ True friendship (close, supportive

friends)29. ___ A world of beauty (beauty of nature

Cultural Influences on Leadership

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