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Does Spirituality Matter? Effects of Meditative Content

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Does Spirituality Matter? Effects of Meditative Content DOES SPIRITUALITY MATTER? EFFECTS OF MEDITATIVE CONTENT AND ORIENTATION ON MIGRAINEURS Amy B. Wachholtz A Dissertation Submitted to the Graduate College of Bowling Green State University in partial fulfillment of the requirements for the degree of DOCTOR OF PHILOSOPHY May 2006 Committee: Kenneth I. Pargament, Advisor Haliu Kassa Graduate Faculty Representative Robert A. Carels Dara R. Musher-Eizenman ii ABSTRACT Kenneth I. Pargament, Advisor Migraine headaches are associated with high depressive and anxiety symptoms (Waldie & Poulton, 2002) as well as low feelings of self-efficacy, which can negatively impact pain tolerance and positive active coping (French, et al., 2000). Previous research suggests that religion can have a positive effect on physical and mental health (Koenig, McCullough, & Larson, 2001, for a review), and specifically, spiritual meditation may ameliorate some of these negative traits associated with migraine headaches (Wachholtz & Pargament, 2005). Spiritual meditation is one method that may help migraineurs to increase their spiritual experiences, reduce depression and anxiety, and improve their self-efficacy to improve both their quality of life. This study examined two primary questions: 1) Do different meditation types create different outcomes among migraineurs? and, 2) How does meditation orientation affect mental, physical, and spiritual health outcomes among migraineurs? Eighty-three meditation naïve, frequent migraineurs were gathered from the Bowling Green State University undergraduate community. Participants were taught Spiritual Meditation, Internally Focused Secular Meditation, Externally Focused Meditation, or Relaxation techniques. Participants independently practiced their techniques for twenty minutes a day for one month. Pre-post tests measured pain tolerance (with a cold pressor task), and headache frequency, as well as a number of mental, and spiritual health variables. Results indicated that over the course of the intervention in comparison to the other three groups, those who practiced spiritual meditation had greater decreases in the frequency of migraine headaches, anxiety, and depression, as well as greater increases in pain tolerance, headache-related self-efficacy, daily iii spiritual experiences, and existential well being. By providing participants with a simple method to access their spiritual resources, spiritual meditation may offer migraineurs a means to improve their spiritual, emotional, and physical health. iv DEDICATION To Chris – No words could ever be enough. v ACKNOWLEDGEMENTS I would like to thank my advisor, Dr. Kenneth Pargament, for his invaluable assistance in developing and refining this project. From our first meeting as a first-year graduate student, he faithfully guided me through hours of conversation, countless drafts, and innumerable questions. I have grown to appreciate his wisdom, as both a professor, and as a mentor. I would also like to thank my committee members, Dr. Robert Carels, and Dr. Dara Musher-Eizenman for their constructive feedback and valuable contributions to this process. I appreciate their efforts and look forward to the opportunity to consider them colleagues in the field of psychology. Thank you as well to Dr. Haliu Kassa, for his unique contributions to the psychology dissertation committee. My research assistants, Tawana Jackson, Ashley Armstrong, and Nichole Calvert deserve significant praise for their assistance in teaching the intervention classes, and their extensive efforts in data entry. The fact that they returned each week despite cold water, paper cuts, and computer crashes speaks volumes about their levels of pain tolerance. Finally, I would like to thank my friends and family who have encouraged me and sustained me throughout this process, particularly, my mother, Natalie, my father, Gene, my brother, Adam, my friend Melissa, and my fiancé Chris. Thank you for listening, for supporting, for teaching, and for challenging. Most of all, thank you for reminding me to laugh. vi TABLE OF CONTENTS Page INTRODUCTION .......................................................................................................................... 1 Migraine Headaches ................................................................................................................... 3 Spirituality and Health.............................................................................................................. 12 Summary of Previous Research................................................................................................ 29 METHOD ..................................................................................................................................... 31 Participants................................................................................................................................ 31 Screener .................................................................................................................................... 31 Adherence ................................................................................................................................. 32 Objective Measures................................................................................................................... 32 Psychological Measures............................................................................................................ 33 Headache Specific Surveys....................................................................................................... 35 Spirituality Measures ................................................................................................................ 36 Power Analyses......................................................................................................................... 38 Procedure .................................................................................................................................. 38 RESULTS ..................................................................................................................................... 41 Adherence Analyses ................................................................................................................. 41 Manipulation Check Analyses.................................................................................................. 41 Objective Measures................................................................................................................... 42 Psychological Measures............................................................................................................ 43 Headache Specific Surveys....................................................................................................... 44 Spiritual Measures .................................................................................................................... 45 vii DISCUSSION............................................................................................................................... 47 Pain and Spiritual Meditation ................................................................................................... 47 Mental Health and Spiritual Meditation ................................................................................... 48 Spiritual Health and Spiritual Meditation................................................................................. 50 Implications .............................................................................................................................. 52 Limitations and Future Directions ............................................................................................ 53 Conclusions............................................................................................................................... 54 REFERENCES ............................................................................................................................. 56 APPENDIX A. POTENTIAL LINKS BETWEEN SPIRITUAL MEDITATION AND QUALITY OF LIFE ..................................................................................................................... 65 APPENDIX B. ID MIGRAINE SCREENER ............................................................................. 66 APPENDIX C. DAILY ADHERENCE DIARY......................................................................... 67 APPENDIX D. POSITIVE AND NEGATIVE AFFECT SCALE.............................................. 68 APPENDIX E. STATE-TRAIT ANXIETY INVENTORY, STATE SCALE............................ 69 APPENDIX F. STATE-TRAIT ANXIETY INVENTORY, TRAIT SCALE ............................ 70 APPENDIX G. CENTER EPIDEMIOLOGICAL STUDIES DEPRESSION SCALE .............. 71 APPENDIX H. MIGRAINE SPECIFIC QUALITY OF LIFE ................................................... 72 APPENDIX I. HEADACHE MANAGEMENT SELF-EFFICACY SCALE............................. 76 APPENDIX J. RELIGIOUS MEASURES QUESTIONNAIRE................................................. 77 APPENDIX K. SPIRITUAL WELL BEING SCALE ................................................................ 78 APPENDIX L. DAILY SPIRITUAL EXPERIENCES SCALE ................................................. 79 APPENDIX M. MYSTICISM SCALE ....................................................................................... 80 APPENDIX N. PROCEDURES.................................................................................................. 82 viii APPENDIX O. MEDITATION TRAINING SCRIPT...............................................................
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