Patterns of Spiritual Connectedness during Adolescence: Links to Coping and Adjustment in Low-Income Urban Youth

Spirituality in Adolescents and Young Adults With Cancer: An Evolutionary Concept Analysis

Background: Despite an increased focus on the importance of spirituality to human health, including adolescent health outcomes there remains an absence of evidence-based programs to address the spiritual needs of patients and families. A critical barrier is the absence of a clear conceptual understanding and operational definitions of spirituality for adolescents/young adults (AYAs) with cancer. The purposes of this concept analysis were to (a) clarify the concept of spirituality in the context of the AYAs' cancer experience and (b) generate a definition based on a review of the literature examining spiritual development and the role of spirituality in AYAs' health and cancer treatment. Method: We used Roger's evolutionary concept analysis method to identify antecedents, attributes, and consequences of spirituality in the context of AYAs' cancer using thematic analysis and included identification of case exemplars. Results: Of the 86 articles identified, 21 met our inclusion criteria. Analysis revealed four attributes of spirituality in AYAs with cancer: meaning and purpose, connectedness, life-long universal experience, and independent of or related to religion and faith traditions. Identified antecedents included the presence of spiritual resources, chronic illness, belief, or wonder about a higher power, and existential questions. Identified consequences included hope, meaning, feelings of peace, and enhanced well-being and illness acceptance. Based on the findings, we generated a definition of spirituality in AYAs with cancer. Discussion: Findings inform the development of measures and spiritual care interventions specific to AYAs with cancer. An important limitation to address in future research is the absence of AYAs' first-person accounts of their own spirituality.

Adolescent Connectedness: A Scoping Review of Available Measures and Their Psychometric Properties

Introduction

Adolescent connectedness, a key component of positive youth development, is associated with various positive health outcomes. Several measures have been developed to assess this construct. However, no study has summarized data on the existing measures of adolescent connectedness. We conducted this scoping review to fill this gap. We specifically aimed to: (i) identify the existing measures of adolescent connectedness, (ii) determine the most frequently used measures among the identified measures, and (iii) summarize the psychometric properties of these measures with a keen interest in highlighting their cross-cultural utility and validity.

Methods

We searched CINAHL, Embase, PsycInfo, PubMed, and Web of Science databases for relevant articles published since database inception to 7th February 2021. Our search structure contained the key words "Adolescents", "Connectedness", and "Measures". We also searched Open Gray for potentially relevant gray literature.

Results

We identified 335 measures from 960 eligible studies assessing various domains of adolescent connectedness, including school, family, community, peer, ethnic, racial, cultural, religious/spiritual, and self-connectedness. Most of the included studies (72.1%) were from North America and Europe. Most of the measures (n = 132, 39.4%) were measures of school connectedness among adolescents. Of the identified measures, 60 of them met our criteria of frequently used measures (i.e., the top five most used measures per domain of connectedness). These frequently used measures were used across 481 of the included studies with 400 of them reporting their psychometric properties. The reported reliability of these measures was adequate (Cronbach's alpha ≥ 0.70) in 89.8% of these studies. These measures also appeared to be valid in terms of their face, content, construct, criterion, convergent, discriminant, concurrent, predictive, measurement invariance, and cross-cultural validity.

Conclusions

There exists a wide array of measures of adolescent connectedness. Sixty of these measures have been frequently used across studies and appear to be reliable and/or valid. However, this evidence is mostly from North America and Europe. This is a reflection of the limitation of this review where only studies published in English were considered. It might also reflect the paucity of research in other regions of the world. More research is needed for clearer insights.

Psychological Adaptation to Serious Illness: A Qualitative Study of Culturally Diverse Patients With Advanced Chronic Kidney Disease

CONTEXT

Psychological distress is associated with adverse health outcomes in serious illness and magnified among patients of low socioeconomic status. Aspects of one's culture, such as religion and spirituality, can influence these patients' coping response to distress. Advanced chronic kidney disease (CKD) is a serious illness that disproportionately affects patients of low socioeconomic status, but a theory-based understanding of this group's lived experience of CKD is lacking.

OBJECTIVES

We explored the cognitions, emotions, and coping behaviors of patients with CKD with emphasis on those of low socioeconomic status. We further inquired into any influences of religion or spirituality.

METHODS

We interviewed 50 English-speaking or Spanish-speaking adults with advanced CKD from three medical centers in Nashville, Tennessee. Analyses occurred with isolation of themes; development of a coding system; and creation of a conceptual framework using an inductive-deductive approach.

RESULTS

Median age was 65 years; median annual income was $17,500 per year; and 48% of participants had not progressed beyond high school. Key beliefs (awareness of mortality and lack of control) influenced patients' emotions (existential distress in the form of death anxiety, prognostic uncertainty, and hopelessness) and coping behaviors (acceptance, avoidance, emotion regulation via spirituality, and seeking socialsupport via a religious community).

CONCLUSION

Individuals with advanced CKD and low socioeconomic status lack control over disease progression, experience death anxiety and existential distress, and emphasize spirituality to cope. Our study identifies novel components for a psychotherapeutic intervention for patients with advanced CKD at high risk for adverse health outcomes.

Facing the Ills of Unemployment: The Role of Religiosity and Social Support

The study examined the role of religiosity and social support in coping with mental health problems associated with unemployment among 362 Ghanaian youths. Through a cross-sectional survey, participants' mental health (i.e., depression, cognitive distortions, and suicidality), religiosity, and degree of social support were assessed. The data revealed significant buffering effects of religiosity on mental health problems associated with unemployment. Social support had direct, but not buffering, effects on mental health. The findings highlight the need to promote religiosity as a coping mechanism for the adverse effects of unemployment, especially in the absence of immediate economic interventions.

Religiosity in adolescence

Person-centered approaches to religious development across adolescence reveal diverse trajectories of change, which are differentially subject to environmental and genetic influences. Studies support the robust protective effects of religiosity on adolescent internalizing and externalizing symptoms. However, some specific religious beliefs may predict poor adjustment. Evidence also suggests adolescent religiosity may exacerbate sexual identity conflicts and increase prejudice toward proscribed outgroups. Researchers demonstrate robust mediating effects of effortful control for explaining religiosity's influence on outcomes, and approaches to establish mediation through assessment intraindividual variability in the daily dynamics of religiosity and positive outcomes are promising. Inclusion of non-Western, non-Christian samples has allowed scholars to begin identifying the universal versus culturally specific elements of religiosity trajectories and processes in adolescence.

Developmental Changes in Emotion Regulation during Adolescence: Associations with Socioeconomic Risk and Family Emotional Context

Although theoretical work proposes that emotion regulation development exhibits a positive growth trajectory across adolescence as prefrontal brain regions continue to mature, individual differences in developmental changes of emotion regulation merit elucidation. The present study investigates longitudinal links between the family environment (i.e., socioeconomic risk and family emotional context) and emotion regulation development. The sample included 167 adolescents (53% males) who were first recruited at 13-14 years of age and assessed annually four times. Latent change score analyses identified family emotional context as a mediator between socioeconomic risk and emotion regulation development, such that lower socioeconomic risk (higher socioeconomic status and lower household chaos) at Time 1 was associated with a more positive family emotional context (parent emotion regulation, parenting practices, and parent-adolescent relationship quality), which in turn was associated with larger year-to-year increases in emotion regulation. The findings highlight the important role of the family emotional context as a process explaining how the challenges of growing up in a household laden with socioeconomic risk may be associated with emotion regulation development during adolescence.

Spirituality and subjective well-being of Ghanaian parents of children with special needs: The mediating role of resilience

The study explored the mediating role of resilience in the relationship between spirituality and subjective well-being of 107 Ghanaian biological parents raising children with special needs. Results from mediational analyses revealed that spirituality indirectly influenced life satisfaction, positive affect and negative affect through resilience. Specifically, greater levels of spirituality predicted greater resilience, which successively led to greater life satisfaction, greater positive affect and reduced negative affect. These findings emphasize the necessity of targeting parents' well-being through resilience to help them deal with the burden of providing care for their children with special needs.

Maternal and Family Correlates of Intrinsic Religiosity Profiles Among Low-Income Urban African American Adolescents

National trends show that African American adolescents, relative to most other demographic groups, are more religious, and show fewer declines in religiosity, despite drastic decreases in religiosity among youth over the past 25 years. These broad findings are limiting because they fail to acknowledge religious heterogeneity among African American teens. Further, there are few empirical investigations of the transmission of religiosity within African American families. Building on a recent study that identified three distinctive profiles of intrinsic religiosity in a sample of low-income African American adolescents who were followed over four years (N = 326; Youth M_age = 12.1, SD = 1.6 years; 54% female), the present study examined contributions of maternal religiosity and family emotional climate in distinguishing these profiles. Univariate analyses revealed that maternal religious attendance and commitment, adolescents' felt acceptance from mothers and the emotional climate in the home differentiated youth who retained high levels of intrinsic religiosity (41%) from youth who declined in religiosity (37%) or who had low levels of religiosity (22%). Multivariate analyses showed that after accounting for demographic covariates, felt acceptance from mothers differentiated adolescents with high versus low levels of religiosity; both maternal religious attendance and felt acceptance from mothers distinguished adolescents who retained high levels of religiosity from youth who declined in religiosity. Implications for family dynamics in African American adolescent religious development and well-being are discussed.