Are Spiritual Struggles the Cause or Effect of Psychological Problems (or Both)?: Empirical Findings and Their Implications for Research and Practice

Adversity impacts people not only psychologically, socially, and physically, but spiritually as well. In times of stress, many people experience spiritual struggles, defined as tensions, strains, and conflicts about spiritual matters within oneself, with other people, and/or with the supernatural. In well over 100 empirical studies, spiritual struggles have been robustly linked to psychological problems. However, because much of the research on this topic has been cross-sectional, a key question remains: Are spiritual struggles the cause of psychological problems (the primary model of spiritual struggles), the effect of psychological problems (the secondary model of spiritual struggles) or both a cause and effect of psychological problems (the complex model of spiritual struggles)? This paper reviews emerging longitudinal research that examines this causal question and, more specifically, the three models of the causal relationship between spiritual struggles and psychological problems. The findings show the strongest support for the primary model of spiritual struggles (the model that has been tested most often). Research has also shown modest support for the secondary and complex models of spiritual struggles; however, more studies are needed before firm conclusions can be drawn. The paper concludes with a discussion of the implications of these findings for further study and for practical work with people who are struggling spiritually.