Religious and Spiritual Struggles and Their Links to Psychological Adjustment: A Meta-Analysis of Longitudinal Studies

In light of a growing body of longitudinal research on religious and spiritual (r/s) struggles and adjustment, a meta-analysis was conducted in order to synthesize literature on whether r/s struggles predict decrements in psychological adjustment over time. Multiple databases were searched for journal articles and dissertations reporting on studies that met inclusion criteria. For each study, necessary statistical information was extracted to calculate or estimate the standardized regression coefficient predicting follow-up psychological adjustment from baseline r/s struggles, controlling only for autoregressive effects. The search and screening process yielded 32 studies meeting inclusion criteria for which the necessary statistics were able to be extracted or obtained from study authors. Results indicated that r/s struggles significantly predicted increases in negative psychological adjustment (32 studies), Z ( r ) = 0.08, 95% CI [0.04, 0.10]. Results for positive psychological adjustment were non-significant (12 studies), Z ( r ) = -0.04, 95% CI [-0.11, 0.03]. These findings are consistent with a primary r/s struggles model in which r/s struggles lead to worsening psychological adjustment. This study underscores the importance of attending to spiritual struggles within clinical practice. Future studies on this topic could add to our understanding by examining longer time frames and testing secondary and complex models of the longitudinal relationship between r/s struggles and psychological adjustment.