Use of religious and spiritual responses after trauma to prevent posttraumatic stress symptoms and suicidality: The role of meaning in life

Clin Psychol Psychother. 2023 Sep 5. doi: 10.1002/cpp.2902. Online ahead of print.

Abstract

Background: The present study examined the relationship between religious/spiritual (R/S) responses to trauma, meaning in life, and psychopathology among US veterans (n = 729).

Methods: Participants (66.7% male and 83.2% White) completed study questionnaires assessing positive religious coping, divine spiritual struggle, meaning in life, posttraumatic stress symptoms (PTSS), and suicidality severity. Assessments were conducted via telephone interviews at baseline (T1), 3 months (T2) and 6 months (T3).

Results: Divine spiritual struggle was associated with lower meaning in life, higher suicidality and higher PTSS at all time points. Positive religious coping was associated with higher meaning in life at all time points and lower suicidality at T2. Meaning in life fully mediated relationships between divine spiritual struggle and both PTSS and suicidality. While higher levels of T1 positive religious coping predicted increased T3 PTSS when controlling for T1 PTSS, meaning in life partially mediated this relationship, with a negative indirect effect. Meaning in life also fully mediated the relationship between positive religious coping and later suicidality, with a negative indirect effect.

Discussion: These findings suggest that divine spiritual struggle consistently predicts both higher PTSS and suicidality. Further, a sense of meaning plays a large role in linking R/S responses to trauma and psychological outcomes. It holds promise as a means through which positive religious coping may exert beneficial effects. Clinicians should be particularly mindful of negative R/S responses after trauma as a risk factor for adverse psychological outcomes. Future research should examine whether meaning-based interventions are beneficial after trauma.

Keywords: beliefs/world views; coping; mediation; military; protective factors; suicide.