Are You Angry – or Grateful?

Spiritual coping among teens with chronic illness affects behavior and depression

/ Author:  / Reviewed by: Robert Carlson, M.D

(RxWiki News) Seeking strength from God to deal with illness is just as common as being angry at God for an illness. But the way these two attitudes affect an individual is quite different.

A recent study looked at how teens with chronic illness cope with their diseases using spirituality.

The study found that negative spirituality, like being angry at God, was linked to more behavior problems in the teens.

The teens who used spirituality in a positive way to cope with their illness did not have those behavior problems. They also tended to be more optimistic, less depressed and less anxious.

"Help your teens cope - call a therapist."

The study, led by Nina Reynolds, MA, from the Department of Psychology at the University of Alabama at Birmingham, aimed to find out how using spirituality to cope affects teenagers with a chronic illness The research included 128 teens, with an average age of 14, in their study. All the teens had been diagnosed with either diabetes or cystic fibrosis.

The teens filled out questionnaires to assess how much they relied on their spirituality to help them cope with their illness and whether they tended to be more optimistic or pessimistic.

The teens and their parents (or caregivers) also filled out questionnaires to assess mental health symptoms related to "internalizing" and "externalizing."

Externalizing problems refer to behavior issues like acting out, aggression, rule breaking and hyperactivity. Internalizing refer to issues like depression, anxiety and antisocial behavior.

While analyzing the results, the researchers took into account the teens' age, race/ethnicity, gender, annual household income, disease severity (rated by doctors on a scale of 1 to 4) and how long since they had been diagnosed with their disease.

The analysis revealed that teens who used their spirituality to cope in a positive way with their illness (such as deriving strength from a higher being) were more likely to be optimistic as well.

These teens also showed fewer behavioral problems reported by their caregivers and reported fewer internalizing problems, such as depression and anxiety, themselves.

However, the teens who reported more negative spiritual coping (such as being angry at God for their illness) also tended to have more outward behavioral problems, such as aggression.

While the teens with diabetes who use negative spiritual coping did not show more depression or anxiety, the teens using negative spiritual coping for their cystic fibrosis did tend to have more depression and anxiety symptoms.

The researchers did not find any link between teens who used negative spiritual coping and whether they tended to be more or less optimistic.

"The results provide support for the importance of spiritual coping in both internalizing and externalizing problems of pediatric patients," the researchers wrote. These findings highlight the need for clinicians to assess spiritual coping when they suspect adjustment difficulties, and to consider spiritual issues as an important part of the adolescent’s psychosocial functioning."

They noted that helping teens deal with the way they respond to their illness in terms of their spirituality might help the teens cope better overall.

"Helping adolescents address negative spiritual coping and explore positive spiritual coping, while also developing more optimistic general attributions, may translate into better psychosocial adjustment," they wrote.

They also explored how the differences in positive and negative spiritual coping might be affecting the teens' behavioral and depression/anxiety issues.

"It is possible that positive spiritual coping strategies are used to buffer not only feelings of anxiety and depression, but also behavior problems that might arise from the illness experience," they wrote. "It is possible that negative spiritual coping may contribute to behavior problems by increasing adolescents’ perceptions that difficult situations are not within their control."

The study was published November 17 in the Journal of Adolescent Health. The research was funded by the Cystic Fibrosis Foundation, the National Institutes of Health and the Sigma Xi Grants-in-Aid Research program.

Reviewed by: 
Review Date: 
December 26, 2012
Last Updated:
December 30, 2013