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Empirical studies have identified significant links between The Meanings of Religion and
religion and spirituality and health. The reasons for these Spirituality
associations, however, are unclear. Typically, religion and
spirituality have been measured by global indices (e.g., Through most of the history of modern psychology, the
frequency of church attendance, self-rated religiousness term religion has been both an individual and an institu-
and spirituality) that do not specify how or why religion tional construct. William James (1902) distinguished a
and spirituality affect health. The authors highlight recent “firsthand” (p. 328) experiential religion that is direct and
advances in the delineation of religion and spirituality immediate from a secondhand institutional religion that is
concepts and measures theoretically and functionally con- an inherited tradition. For James, both elements fell under
nected to health. They also point to areas for growth in the purview of religion. More recently, however, the mean-
religion and spirituality conceptualization and measure- ing of religion has evolved in a different direction. The
ment. Through measures of religion and spirituality more term religion is becoming reified into a fixed system of
conceptually related to physical and mental health (e.g., ideas or ideological commitments that “fail to represent the
closeness to God, religious orientation and motivation, dynamic personal element in human piety” (Wulff, 1996, p.
religious support, religious struggle), psychologists are 46). At the same time, the term spirituality is increasingly
used to refer to the personal, subjective side of religious
discovering more about the distinctive contributions of
experience. Thus, one is witnessing, particularly in the
religiousness and spirituality to health and well-being.
United States, a polarization of religiousness and spiritual-
ity, with the former representing an institutional, formal,
outward, doctrinal, authoritarian, inhibiting expression and
T
the latter representing an individual, subjective, emotional,
here is now a substantial literature that connects inward, unsystematic, freeing expression (Koenig et al.,
religion and spirituality to physical health (George, 2001).
Ellison, & Larson, 2002; Koenig, McCullough, & Although some researchers may find such contrasts a
Larson, 2001; Larson, Swyers, & McCullough, 1998; Sey- useful heuristic, there are several dangers to this bifurcation
bold & Hill, 2001; Thoresen, 1999; Thoresen, Harris, & of religion and spirituality (Hill et al., 2000; Pargament,
Oman, 2001; see also Powell, Shahabi, & Thoresen, 2003, 1999). First, the polarization of religion and spirituality into
this issue; Seeman, Dubin, & Seeman, 2003, this issue) and institutional and individual domains ignores the fact that all
mental health (Larson et al., 1998; Plante & Sherman, forms of spiritual expression unfold in a social context and
2001). What is it about religion and spirituality that ac- that virtually all organized faith traditions are interested in
counts for their link to health? Researchers have suggested the ordering of personal affairs (Wuthnow, 1998). Second,
various possible psychological, social, and physiological implicit in the evolving definitions is the sense that spiri-
mediators that may account for the religion and spirituality– tuality is good and religion is bad; this simplistic perspec-
health connection. However, it is possible that the expla- tive overlooks the potentially helpful and harmful sides of
nation for these effects may also lie in the nature of religion
and spirituality themselves. More finely delineated mea-
Editor’s note. This section was developed by William R. Miller and Carl
sures of these constructs might relate more directly to E. Thoresen. Stanton L. Jones served as action editor for this section.
physical and mental health. In this article, we highlight
some of the advances that have been made in delineating Author’s note. Peter C. Hill, Rosemead School of Psychology, Biola
religious and spiritual concepts and measures that are func- University; Kenneth I. Pargament, Department of Psychology, Bowling
tionally related to physical and mental health. We conclude Green State University.
Author order was determined alphabetically.
by pointing to promising areas for growth in the concep- Correspondence concerning this article should be addressed to Peter
tualization and measurement of religion and spirituality in C. Hill, Rosemead School of Psychology, Biola University, 13800 Biola
studies of health. Avenue, La Mirada, CA 90639. E-mail: peter.hill@biola.edu
Table 1
Measures and Illustrative Items of Religion and Spirituality Constructs Functionally Related to Health
Construct and measure Illustrative item
Closeness to God
Spiritual Support Scale (Maton, 1989b) I experience a close personal relationship with God.
Religious Problem Solving Scale (Pargament et al., 1988) When faced with a question, I work together with God
to figure it out.
Spiritual Assessment Inventory (Hall & Edwards, 1996) I am aware of God attending to me in times of need.
Index of Core Spiritual Experiences (Kass et al., 1991) How close do you feel to God?
Religious support
Religious support (Krause, 1999) How often do people in your congregation make you
feel loved and cared for?
Perceived religious support (Fiala et al., 2002) I have worth in the eyes of others in my congregation.
Religious Coping Scale (Pargament et al., 2000) Asked others to pray for me.