Multidimensional Measurement of Religiousness/ Spirituality for Use in Health Research: A Report of the Fetzer Institute/ National Institute on Aging Working Group 1999b A publication of the John E. Fetzer Institute Fetzer Institute, National Institute on Aging Working Group: Multidimensional Measurement of Religiousness, Spirituality for Use in Health Research. A Report of a National Working Group. Supported by the Fetzer Institute in Collaboration with the National Institute on Aging. Kalamazoo, MI: Fetzer Institute, 2003 (1999). The interpretations and conclusions contained in this publication represent the views of the individual working group members and do not necessarily express any official opinion or endorsement by either the National Institute on Aging, the U.S. Department of Health and Human Services, the Fetzer Institute, its trustees, or officers. Please contact the Fetzer Institute for additional copies of this publication, which may be used and reprinted without special permission. 1999b Multidimensional Measurement of Religiousness/Spirituality for Use in Health Research: A Report of the Fetzer Institute/ National Institute on Aging Working Group October 1999 Reprinted October 2003 1999b i Preface added October 2003 This project was initially designed to bring The journals represented include American together experts interested in addressing Journal of Psychiatry, Annals of Behavioral measurement issues around religiousness/ Medicine, Gerontologist Medical Care, Journal of spirituality and health from a multidimen- Health Psychology, Journal of the Scientific Study sional perspective. The booklet, which in- of Religion, and the Journal of Adult Development. cluded the Brief Multidimensional Measure of Religiousness/Spirituality (BMMRS), was A paper on the conceptual background to the published as a step to encourage the exami- work and the development of the BMMRS was nation of religion/spirituality and health with recently published in the journal Research on sensitivity to the depth and complexity of the Aging: “Measuring Multiple Dimensions of topic. Religion and Spirituality for Health Research,” Ellen L. Idler, Marc A. Musick, Christopher The response to this effort has been much G. Ellison, Linda K. George, Neal Krause, greater than anticipated. We continue to Marcia G. Ory, Kenneth I. Pargament, Lynda receive daily requests for the booklet. To date, H. Powell, Lynn G. Underwood, David R. 2,000 copies of the publication have been Williams, 2003, 25:4. distributed and another 1,200 have been downloaded from the Internet. In a joint request for applications entitled Studying Spirituality and Alcohol, sponsored In a recently completed survey of booklet users by the National Institute on Alcohol Abuse assisted by the Kercher Center for Social and Alcoholism of the National Institutes of Research at Western Michigan University, Health and the Fetzer Institute, many of the more than 80 percent of respondents believed 16 funded research projects used the mea- the booklet was useful in enabling researchers sures from this booklet. to enter, or to conduct better research in the field of religiousness/spirituality and health Please check for additional information outcomes. The most popular subscales being regarding the DSES on page 17. used are the Religious/Spiritual Coping and the Daily Spiritual Experiences Scales (DSES). We want to thank all researchers and scholars One fourth of respondents have used the booklet who have provided us with thoughtful comments in either a course that they teach, in a seminar, and suggestions concerning their projects and or in a symposium. Practitioners in clinical work the needs of the field. We remain interested are also using the booklet and the measure- in learning about the general dissemination ment instruments in addition to researchers. of work that utilizes a multidimensional approach and the BMMRS, as well as learning As BMMRS and subscales are increasingly more about clinical uses of the booklet and used in research projects, the number of BMMRS. Continue to give us feedback on the publications citing the booklet indicates that use and development of this collection of research projects are beginning to be published. scales by e-mailing us at [email protected]. ii 1999b 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 of Religiousness/Spirituality: 1999 ..................................................... 85 Appendix A: Additional Psychometric and Population Distribution Data ......................................................... 89 1999b iii iv 1999b Introduction This publication is the product of a national Kenneth Pargament, PhD, Department of working group supported by the Fetzer Psychology, Bowling Green State Institute in collaboration with The National University, Bowling Green, Ohio Institute on Aging (NIA), part of the National Lynda Powell, PhD, Department of Institutes of Health (NIH). The working Preventive Medicine, Rush-Presbyterian- group examined key dimensions of religious- St. Luke’s Medical Center, Chicago, Ill ness/spirituality as they relate to physical Lynn Underwood, PhD, Fetzer Institute, and mental health outcomes. The 12 papers Kalamazoo, Mich in this report include brief literature reviews, David Williams, PhD, Department of recommended instruments, and bibliogra- Sociology, University of Michigan, phies for each identified domain. Also in- Ann Arbor, Mich cluded is the current draft of the Brief Multi- dimensional Measure of Religiousness/ Background Spirituality: 1999, an instrument developed In recent years, a growing body of literature by the working group, which is substantially has explored the implications of religion and based on select questions from each domain. spirituality for various mental and physical health outcomes (for reviews see Koenig Core members of the working group include 1994, Levin 1994). While the findings are (in alphabetical order): not univocal, mounting evidence indicates that various dimensions of religiousness and Ronald Abeles, PhD, National Institute on spirituality may enhance subjective states of Aging, National Institutes of Health, well-being (Ellison 1991), lower levels of Bethesda, Md depression and psychological distress (Idler Christopher Ellison, PhD, Department of 1987, Williams et al 1991), and reduce mor- Sociology, University of Texas-Austin, bidity and mortality (for a review see Levin Austin, Texas 1996). Such findings have elicited consider- Linda George, PhD, Department of Sociology, able attention from medical researchers in Duke University Medical School, epidemiology, psychology, sociology, gerontol- Durham, NC ogy, and other fields. Ellen Idler, PhD, Department of Sociology, Rutgers University, New Brunswick, NJ Health researchers who seek to include Neal Krause, PhD, School of Public Health, religious or spiritual domains in their studies University of Michigan, Ann Arbor, Mich typically confront various problems. Few Jeff Levin, PhD, National Institute for health researchers have a scholarly back- Healthcare Research, Rockville, Md ground in religiousness/spirituality and most Marcia Ory, PhD, National Institute on are not acquainted with the long history of Aging, National Institutes of Health, attempts to conceptualize and measure Bethesda, Md multiple dimensions of religiousness (Krause 1999b 1 Multidimensional Measurement of Religiousness/Spirituality for Use in Health Research 1993, Williams 1994). It is becoming clear that religious/spiritual variables cannot In their work to conceptualize and simply be combined into a single scale that measure key health-relevant domains of examines the effects of a single variable, religiousness/spirituality, the working “religiosity”; rather, each relevant dimension group identified 3 important of religiousness and spirituality should be considerations. examined separately for its effects on physi- cal and mental health. Until recently, certain • It became important to articulate the aspects of religiousness and spirituality that distinction between religiousness and are arguably most germane to the study of spirituality. While some may regard the health outcomes have