Research indicates that spirituality and adolescent well-being are positively related. Whether or not the different domains of spirituality equally influence mental health in adolescents remains unclear. The four domains of spirituality typically discussed in the literature consist of connections to self, others, nature, and the transcendent. This study explored the strength and consistency of associations between these four domains of spiritual health and positive mental health of adolescents across countries and genders.
Data for this study was based on adolescent health surveys conducted in Canada, England, and Scotland during 2013–2014. Sections of the Health Behaviour in School-aged Children (HBSC) assessment were embedded in the survey. Included sections focused on adolescent spiritual health, subjective health, socio-demographic factors, and social supports. The spiritual health section consisted of eight questions, with two questions for each of the four domains. The subjective health section assessed the frequency of subjective health complaints, including both psychological (e.g., feeling nervous, depressed, etc.) and somatic symptoms (e.g., headache, stomachache, etc.). The subjective health complaints were assumed to be an indicator of the adolescents' mental health status. The socio-demographic section collected information about the adolescents' age, gender, immigration status, and family economic situation. The social supports section included questions about the quality of social relations, neighborhood safety, and trust.
Findings from surveys completed by 28,178 adolescents (age 11-15) showed strong and consistent associations between positive mental health and higher scores for each of the four spiritual health domains, before controlling for other variables and the relationships among the spiritual health domains. When other variables were controlled, the association between the "self" domain and mental health remained strong, more so for girls than boys. However, the relationships involving the other domains of spirituality weakened, depending on the country and gender. Further analysis of the data indicated that associations between connections of “others,” “nature” and the “transcendent” to mental health may be mediated through connections to “self.” The assessment of “connection to self” included two items – one relating to the importance of experiencing meaning in life; the other, positive experiences of joy. These two qualities seem to work synergistically. The sum of these two items proved to be “a particularly powerful correlate, and potentially determinant, of positive mental health status.”
Overall findings indicate that internal connections to self may provide the most direct route(s) to positive mental health in adolescents. This research highlights the importance of interventions that nurture a sense of meaning and that foster a sense of joy in life. A focus on the connections to self domain may foster connections within the other three domains of spiritual health, resulting in more positive mental health outcomes for adolescents. While a focus on all four domains of spirituality for research and/or the development of mental health interventions is important, such efforts “may be incomplete without considering internalized connections with “self” that seem fundamental to positive mental health status.”
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