The Impact of Sexual Abuse,Family Violence/Conflict,Spirituality,and Religion on Anger and Depressed Mood Among Adolescents

Abstract

Stressful life experiences, such as sexual abuse and family violence/conflict, relate to an increased risk of mental health problems. Religion and spirituality may prevent this negative impact, but religion and spirituality are lower among survivors of stressful life experiences. To explore this effect, we examined the relationship between childhood sexual abuse and family violence/conflict on anger and depressed mood. Survey data were collected from a large population–based sample of Icelandic adolescents (N = 7,365) on their stressful life experiences, religion, spirituality, and mental health. Survivors of stressful life experiences (sexual abuse or family violence/conflict) were significantly lower on religion and spirituality than others. A hierarchical linear regression showed that stressful life experiences contributed uniquely to higher levels of anger and depressed mood. Spirituality was associated with decreased anger and depressed mood. The religion of parents and peers was also associated with decreased anger. Religious participation, on the contrary, did not have a relationship with mental health outcomes. In addition, the negative association between spirituality and anger was stronger among survivors of sexual abuse than nonabused individuals. These results confirm previous research, indicating that survivors of stressful life experiences may experience less religion and spirituality. The results also extend existing knowledge by showing that spirituality may be even more beneficial among sexual abuse survivors, as a protective factor against anger. These findings can help in the minimization of the negative mental health impact of stressful life experiences.

Keywords

sexual abuse family violence/conflict anger depressed mood religion spirituality

Effects of Stressful Life Experiences in Childhood

Stressful life experiences in childhood, such as physical or sexual abuse, can negatively affect survivors’ mental health (Edwards, Holden, Felitti, & Anda, 2003). For example, a large literature has demonstrated the relationship between child sexual abuse (CSA) and an increased risk of psychopathology (Neumann, Houskamp, Pollock, & Briere, 1996; Paolucci, Genuis, & Violato, 2001), such as mood disorders (Molnar, Buka, & Kessler, 2001; Pérez-Fuentes et al., 2013) and anger (Asgeirsdottir, Sigfusdottir, Gudjonsson, & Sigurdsson, 2011; Neumann et al., 1996). These effects can be explained with Agnew’s (1992) strain theory, which posits that adolescents who experience unavoidable strain (such as stressful life events) experience frustration, which is then associated with negative emotions. Given the negative impact of stressful life experiences, identifying factors to counteract or reduce this effect is an important mental health concern. Spirituality and religion may be important factors to reduce the impact of stress. Spirituality refers to a person’s private relationship with a higher power and how much perceived support they experience from God (Good & Willoughby, 2008; Sigfusdottir, Thorlindsson, & Bjarnason, 2007). Religion, on the contrary, refers to participating in religious ceremonies and being part of a community of believers (Good & Willoughby, 2008). Scholars have examined spirituality and religion both as distinct constructs and one factor (then usually referred to as religion/spirituality). Religion and spirituality are potential benefits to mental health, both in general and as a buffer against the effects of stressful life experiences (Fallot & Heckman, 2005; Gall, 2006; Sigfusdottir et al., 2007).

Religion, Spirituality, and Mental Health

Adolescence is a particularly interesting time to examine religion and spirituality because at that age, individuals may experience profound changes in their worldview and even convert their religion (Good & Willoughby, 2008). Religion and spirituality are associated with better mental health (Chandy, Blum, & Resnick, 1996; Frankel & Hewitt, 1994; Good, Willoughby, & Fritjers, 2009; Holder, Coleman, & Wallace, 2010; Ross, 1990; Ryan, Rigby, & King, 1993; Seeman, Dubin, & Seeman, 2003; Van Dyke, Glenwick, Cecero, & Kim, 2009; Yonker, Schnabelrauch, & DeHaan, 2012), particularly for adolescents (Bahr, Maughan, Marcoc, & Li, 1998; Weaver et al., 2002; Wong, Rew, & Slaikeu, 2006). For example, religion and spirituality are associated with decreased depression (Bjorck & Thurman, 2007; Good & Willoughby, 2008; Holder et al., 2010; Koenig & Larson, 2001; Pearce, Little, & Pérez, 2003) and decreased anger (Maddi, Brow, Khoshaba, & Vaitkus, 2006). Religion and spirituality therefore have the potential to strongly contribute to the mental health of individuals.

Two main reasons have been listed to explain why religion/spirituality may positively affect mental health. First, a close personal relationship with God may contribute to a sense of belonging, hope, optimism, sense of purpose, and meaning (Cotton, Zebracki, Rosenthal, Tsevat, & Drotar, 2006; Davis, Kerr, & Kurpius, 2003; Pargament, Koenig, Tarakeshwar, & Hahn, 2001). These factors are related to greater self-esteem, life satisfaction, less depression (Pargament et al., 2001), and less anxiety (Davis et al., 2003). Second, religion and spirituality can connect people to a community of other believers, thereby promoting increased social support, social approval, social capital, and sense of community as well as putting in place social sanctions against risky behavior (Chatters, 2000; Good & Willoughby, 2006; Hill & Pargament, 2008; Smith, 2003; Yonker et al., 2012). These factors are related to improvements in resilience, sense of agency, mental health, and well-being of children and adolescents (Holder et al., 2010; Pargament et al., 1990; Smith, 2003; Yonker et al., 2012). Religion and spirituality may therefore have relationships with improved mental health for a variety of reasons.

Role of Religion and Spirituality in the Relationship Between Stressful Life Experiences and Mental Health

Given the detrimental impact stressful life experiences can have on mental health and the possible benefits of religion and spirituality, scholars have examined whether religion and/or spirituality may act as buffers (Fallot & Heckman, 2005; Gall, 2006; Walker, Reid, O’Neill, & Brown, 2009), for example, as coping mechanisms for stressful life experiences (Lawson, Drebing, Berg, Vincellette, & Penk, 1998; Pérez, Little, & Henrich, 2009). However, the relationship between stressful life experiences, religion, spirituality, and mental health may be complex, partly because of the concepts used. Some scholars use religion/spirituality to refer to the whole category, others focus on the person’s private experience (spirituality) or group memberships, religious ceremonies, and being part of a community (religion; Good & Willoughby, 2008). These aspects may play different roles in the relationship between stressful life experiences and mental health.

For example, a literature review of the relationship between childhood abuse and Axis 1 disorders (such as anxiety and depressive disorders) found religion/spirituality to be a significant moderator of that relationship (Walker et al., 2009). Some studies focusing on religion have found positive effects, such as lower posttraumatic stress disorder (PTSD) symptoms among those who are members of an organized religion and a mediating effect of religious participation between child physical abuse and PTSD symptoms (Elliott, 1994). Similarly, religious service attendance can buffer the harmful effects of stressful life experiences on anxiety and depression (Williams, Larson, Buckler, Heckmann, & Pyle, 1991) and is associated with increased resilience among primary care patients with a history of stressful life experiences (Alim et al., 2008). Other work, however, has not confirmed the benefits of religious service attendance for CSA survivors (Gall, Basque, Damasceno-Scott, & Vardy, 2007), suggesting that type of victimization may also affect the effectiveness of service attendance in terms of mental health. Beyond simple effects of personal religion, research has also identified the importance religious context, such as the religion of parents and peers (PPR). For example, studies have shown that parental religion is protective against risk behavior, such as drug use (Merrill, Salazar, & Gardner, 2001), and is associated with increased prosocial behavior (Bartkowski, Xu, & Levin, 2008) and greater life satisfaction (Varon & Riley, 1999). On the contrary, other studies have not connected parental religiosity to internalizing and externalizing symptoms among preadolescents (Van der Jagt-Jelsma et al., 2011) or found parental religion to moderate the relationship between family conflict and parental depression, on one hand, and adolescent depressive symptoms, on the other hand (Hooper & Newman, 2011). The influence of parental religion on youth well-being is therefore complex. In addition, there is limited research available on the influence of parental and peer religious influences on mental health. For spirituality, the evidence is also mixed, showing that among CSA survivors, spirituality was associated with less depressed mood and an increase in personal growth (Gall et al., 2007), but not among high risk African American primary care patients (Alim et al., 2008). The picture of the relationship between stressful life experiences, mental health, religion, and spirituality is therefore somewhat unclear.

Current Study

Religion and spirituality may be important buffers against the negative impact of stressful life experiences on mental health, but those relationships are complex. For example, aspects of religion and spirituality, such as being part of a religious community, attending religious services, and having a private, spiritual relationship with a higher power, are differentially associated with mental health outcomes (Alim et al., 2008; Elliott, 1994; Walker et al., 2009). In addition, PPR has not been adequately explored in the literature. Because of these mixed findings, we propose examining stressful life experiences, religion (religious attendance and the religion of family and peers) as well as spirituality (perceived support from God), and their impact on mental health (anger and depressed mood) in a large, population survey of adolescents. We also propose looking at two types of stressful life experiences, CSA and family violence/conflict, to examine whether type of victimization is associated to mental health, religion, and spirituality. Because of the social and community aspects of religion, controlling for social support when predicting mental health symptoms is important to discover unique religion effects. Demographic factors are also associated with mental health outcomes and were therefore controlled for in this study. For example, poorer mental health has been associated with economic deprivation (Mishra & Carleton, 2015) and family structure (not living with two biological parents; Turner, Finkelhor, Hamby, & Shattuck, 2013). In addition, this study adds to the literature because most of the past work cited here has been carried out in the United States. The data for this study come from a large population survey in Iceland, which has a small, homogeneous population (around 300,000), most of whom are White of Nordic and Celtic origin. The dominant religion is the Evangelical Lutheran Church of Iceland (around 70% of the population; Statistics Iceland, 2017). In Iceland, the relationship between family violence/conflict, religion, and spirituality has only been examined in the context of delinquency, where anger was found to be a significant mediator between stressful life events and delinquency (e.g., see Sigfusdottir et al., 2007). Given that the Icelandic religious social context is quite different from the United States, it is possible that these relationships will differ from previous work on this topic. Given the previous literature, we put forth the following hypotheses:

Hypothesis 1: Individuals with a history of stressful life experiences (childhood sexual abuse and family violence/conflict) will be lower on religion and spirituality than nonvictimized individuals.

Hypothesis 2: Stressful life experiences will be associated with greater anger and depressed mood.

Hypothesis 3: Religion and spirituality will buffer the negative impact of stressful life experiences on anger and depressed mood.

Method

Participants

Participants for this study were adolescents in Grades 9 and 10 in all secondary schools in Iceland (N = 7,365). They ranged in age from 15 to 16 years (M = 15.51, SD = 0.50) and 50.7% were female. When asked whether they belonged to a religious group, 72.3% of participants reported being part of the Icelandic State Lutheran Church, 9.3% were in other Christian congregations, 0.9% were in a non-Christian congregation, 6.0% were not part of any religious group, and 11.4% were not sure. Recruitment took place in the classroom of the secondary school, and the survey was administered to every student who was in school in a particular date in February 2009. The response rate was 83.5% of all registered students in this age group in Iceland (Gudmundsdottir, Kristjansson, Sigfusdottir, & Sigfusson, 2009). The data for this project therefore come from the majority of the population of adolescents in that age group in Iceland. The information was collected as part of the study Youth in Iceland, a regular survey examining health and well-being of youth in Iceland.

Measures

Demographic variables

Three demographic variables were used: age, gender (0 = boys, 1 = girls) and family structure (0 = living with both parents, 1 = other family types), 69.8% of participants were living with both parents.

Economic deprivation

This was assessed with four questions on how well off financially the parents of participants were: “Your parents are in a bad place financially,” “Your parents cannot afford to have a car,” “Your parents barely have enough money for the most important necessities,” and “Your parents cannot afford to pay for the recreational activity you are interested in.” The scale ranged from 1 = almost never to 5 = almost always and these were added together, creating a scale from 4 to 20 (M = 5.65, SD = 2.57, α = .80). This measure has previously been used on another dataset with Icelandic adolescents and is positive correlated with economic deprivation reported by parents of adolescents (Bernburg, Thorlindsson, & Sigfusdottir, 2009).

Social support

This was measured with 10 questions on how easy it is for adolescents to get warmth and caring, discussions about personal affairs, and personal advice, both from their parents and friends. These ranged from 1 = very difficult to 4 = very easy (Gudjonsson, Sigurdsson, Sigfusdottir, & Asgeirsdottir, 2008). The questions were summed together creating a continuous variable of perceived support that ranged from 10 to 40 (M = 33.60, SD = 5.25, α = .86). The scales of parental and friend support have been used separately in previous research, but here were combined into one, as this was only a control variable (r = .32). Factor analysis showed that the 10 items form one factor.

Sexual abuse

This was assessed with one question: Have you been sexually abused? The responses were coded 0 for no and 1 for yes. Overall, 483 participants (6.6%) reported that they had experienced sexual abuse at some point in their life. Previous work has indicated that for research purposes, one or two item measures can be sensitive and specific screeners of childhood abuse (including sexual abuse; Thombs, Bernstein, Ziegelstein, Bennett, & Walker, 2007) and single item measures of sexual abuse can be sufficient to predict outcomes later in life, such as marital satisfaction (Godbout, Sabourin, & Lussier, 2009).

Family violence/conflict

This was assessed with three questions asking if participants had ever “Witnessed a severe argument between parents,” “Witnessed physical violence at home including an adult,” and “Experienced violence at home, including an adult.” For each of these items, no was coded 0 and yes was coded as 1. These statements were then combined into one variable, with 0 indicating no kind of family violence/conflict and 1 indicating any type of violence/conflict. These items have been used in previous research to measure family conflict/violence (e.g., Asgeirsdottir et al., 2011). Overall, 1,810 participants (24.6%) reported that they had experienced family violence/conflict.

Spirituality

Participants answered how much they agreed with the following six statements: “I believe in God,” “Religion is very important to me,” “I regularly pray to God,” “I regularly read scripture,” “I could seek support from God if needed,” and “I have sought support from God.” The scale ranged from 1 = does not fit well with me to 4 = fits very well with me. These items were added together to create a scale that ranged from 6 to 24 (M = 12.65, SD = 4.71, α = .89). This measure has been previously used in research on Icelandic adolescents (Bjarnason, Thorlindsson, Sigfusdottir, & Welch, 2005). Participants were not specifically instructed to substitute a higher being of their choice other than “God” because the majority of the sample was Christian (less than 1% reporting being a member of another religious group).

Religious participation

Participants were asked how much they agreed with the following statements: “I regularly attend religious services” and “I regularly take part in other religious events.” The scale ranged from 1 = does not fit well with me to 4 = fits very well with me. These two items were then added together and the scale ranged from 2 to 8 (M = 2.95, SD = 1.44, α = .89). These items have been used in previously published work with a similar methodology (Sigfusdottir et al., 2007).

PPR

Participants were asked how religious their mother, father, best friends, and acquaintances were. The scale ranged from 1 = does not fit well with me to 4 = fits very well with me; the four items were added together in a scale that ranged from 4 to 16 (M = 10.89, SD = 3.64, α = .91).

Anger

Five items from the Symptom Checklist (SCL-90) original symptom distress checklist were used to assess anger (Derogatis, Lipman, & Covi, 1973). Each statement ranged from 1 to 4, with higher number indicating more distress. The items were summed together to create a scale from 5 to 20 (M = 8.60, SD = 3.49, α = .84). This measure has previously been used among Icelandic adolescents by the same authors, in studies with similar methodologies but with a different dataset (Asgeirsdottir, Gudjonsson, Sigurdsson, & Sigfusdottir, 2010).

Depressed mood

Eight items from the SCL-90 original symptom distress checklist were used to assess depressed mood (Derogatis, Lipman, Covi, & Rickels, 1971). Each statement ranged from 1 to 4, with higher number indicating more distress. The items were summed together to create a scale from 8 to 32 (M = 12.97, SD = 5.20, α = .88). This measure has also been used among Icelandic adolescents (Asgeirsdottir et al., 2010).

Procedure

These data were collected as part of a cross-sectional survey administered by the Icelandic Centre for Social Research and Analysis, in cooperation with the Privacy and Data Protection Authority in Iceland (Gudmundsdottir et al., 2009). All adolescents in Grades 9 to 10 in all schools in Iceland, who were in school on a certain date in February 2009, were invited to participate. The questionnaire was administered anonymously by teachers who put surveys in blank envelopes. Participants were told that participation was voluntary and that some of the questions could be of a sensitive nature. They got no compensation for participating. Parents were informed that the study was taking place and had the opportunity to prevent their children from completing the questionnaire (passive consent).

Analysis

For this study, three types of analyses were conducted: Pearson’s r was used to calculate correlations between variables of interest. Then, simple t tests were used to compare religious variables by victimization status. Third, hierarchical linear regression was used to predict anger and depressed mood testing for main and interaction effects. We fitted successive models with control variables (demographic information, social support, and economic deprivation), stressful life experiences variables (sexual abuse and family violence/conflict), and religious/spirituality variables (religious participation, spirituality, the religion of parents, and peers), and the final model consisted of interactions between stressful life experiences variables and religious/spirituality variables. The analyses were carried out in the computer program SPSS 24.

Results

Table 1 shows correlations between the variables of interest in this study. Anger was significantly associated to greater sexual abuse, family violence/conflict, being female, and greater economic deprivation. Anger had significant negative relationships with religious participation, spirituality, PPRs, family structure, and social support. Depressed mood had a significant positive correlation with anger, sexual abuse, family violence/conflict, being female, age, and economic deprivation. Depressed mood also had significant negative relationships with religious participation, spirituality, the PPRs, family structure (so that those individuals who do not live with both parents are higher on depressed mood), and social support.

Table 1.

Correlation Table.

	1	2	3	4	5	6	7	8	9	10	11	12	13
1. Depressed mood	—	.54***	.61**	−.03**	−.08***	−.07***	.21***	.24***	.23***	.04***	−.13***	.28***	−.29***
2. Anger		—	.41**	−.04***	−.10***	−.09***	.17***	.24***	.05***	.01	−.10***	.24***	−.25***
3. Anxiety			—	−.01	.02	.03*	.14**	.19**	.25**	.04**	−.07**	.20**	−.15**
4. Religious participation				—	.62***	.28***	.03**	.00	.01	−.05***	.05***	.02	.01
5. Spirituality					—	.50***	−.05***	−.05**	.12***	−.08***	.10***	−.06***	.15***
6. Parent and peer religion						—	−.06***	−.03***	.13***	−.11***	.11***	−.08***	.16***
7. Sexual abuse							—	.27***	.03**	.02	−.13***	.19***	−.16***
8. Family violence/conflict								—	.05***	.02	−.20***	.23***	−.17***
9. Female									—	−.01	−.01	.05***	.25***
10. Age										—	−.02***	.01	.03**
11. Family structure											—	−.24***	.13***
12. Economic deprivation												—	−.28**
13. Social support													—

p < .10. **p < .05. ***p < .001.

Those adolescents with a history of family violence/conflict scored significantly lower on average on religion and spirituality. This was true for both spirituality—had family violence/conflict: M = 12.20, SD = 4.79; no family violence/conflict: M = 12.78, SD = 4.67, t(6,995) = 4.43, p < .001—and PPRs—had family violence/conflict: M = 10.68, SD = 3.53; no family violence/conflict: M = 10.95, SD = 3.66, t(6,964) = 2.62, p = .01. However, there were no differences in religious participation by family violence/conflict status—had family violence/conflict: M = 2.94, SD = 1.51; no family violence/conflict: M = 2.95, SD = 1.42, t(7,141) = 0.06, p = .95. Similar results were observed for sexual abuse, where those who had been sexually abused were on average significantly lower on spirituality—abused: M = 11.74, SD = 5.27; not abused: M = 12.70, SD = 4.67, t(7,117) = 3.94, p < .001—and PPR—abused: M = 9.96, SD = 3.90; not abused: M = 10.93, SD = 3.62, t(7,086) = 5.12, p < .001. However, those who had been sexually abused were higher on religious participation than those not abused—abused: M = 3.12, SD = 1.76; not abused: M = 2.94, SD = 1.42, t(7,269) = −2.51, p = .01. Overall, those with no stressful life experiences were higher on religion and spirituality, except for religious participation, which was higher among sexually abused adolescents, and there was no difference by family violence/conflict.

Anger

Table 2 shows a hierarchical regression model predicting anger in the past week. Stressful life experiences (both sexual abuse and family violence/conflict) variables were associated with greater anger. For the religious variables, spirituality and PPR were significantly associated with less anger but religious participation was not related to anger. For this model, there was one significant interaction, between sexual abuse and spirituality on anger, where spirituality was associated with decreased anger, but that relationship was stronger among those who had experienced sexual abuse (β = –.15, p < .001) than those who had not (β = –.06, p < .001).

Table 2.

Hierarchical Regression Predicting Anger.

	Model 1	Model 2	Model 3	Model 4
Control variables
Age	0.16	0.11	0.06	0.06
Female	0.68***	0.57***	0.57***	0.57***
Family structure	−0.26**	0.02	0.02	0.02
Economic deprivation	0.22***	0.17***	0.17***	0.17***
Social support	−0.16***	−0.13***	−0.13***	−0.13***
Stressful life experiences
Sexual abuse		1.31***	1.31***	1.69**
Family violence/conflict		1.31***	1.31***	1.29***
Religion/spirituality
Religious participation			0.01	0.01
Spirituality			−0.03**	−0.02
PPR			−0.03**	−0.05**
Interactions
Spirituality × Sexual Abuse				−0.13**
Spirituality × Family Violence/Conflict				−0.04
PPR × Sexual Abuse				0.07
PPR × Family Violence/Conflict				0.05
Religious Participation × Sexual Abuse				0.15
Religious Participation × Family Violence/Conflict				0.01
Adjusted R²	.10	.14	.14	.14
F	146.33***	122.06***	10.38***	1.65

Note. PPR = parent and peer religion.

p < .05. ***p < .001.

Depressed Mood

Table 3 shows a hierarchical regression predicting depressed mood where stressful life experiences (both sexual abuse and family violence/conflict) were significantly associated with greater depressed mood. For the religious variables, spirituality was significantly associated with less depressed mood. However, religious participation and the religion of others were not associated with depressed mood when all the other variables had been controlled for. There were no significant interactions between stressful life experiences and religious variables.

Table 3.

Hierarchical Regression Predicting Depressed Mood.

	Model 1	Model 2	Model 3	Model 4
Control variables
Age	0.58**	0.51**	0.47**	0.47**
Female	3.17**	2.95**	2.99**	2.99**
Family structure	−0.58	−0.31*	−0.27**	−0.27*
Economic deprivation	0.33	0.27**	0.27**	0.27**
Social support	−0.32*	−0.30**	−0.29**	−0.29**
Stressful life experiences
Sexual abuse		2.56**	2.56**	2.91*
Family violence/conflict		1.36**	1.35**	1.83**
Religion/spirituality
Religious participation			−0.04	−0.02
Spirituality			−0.04*	−0.03
PPR			−0.01	0.01
Interactions
Spirituality × Sexual Abuse				0.03
Spirituality × Family Violence/Conflict				−0.01
PPR × Sexual Abuse				−0.08
PPR × Family Violence/Conflict				−0.01
Religious Participation × Sexual Abuse				−0.05
Religious Participation × Family Violence/Conflict				−0.08
Adjusted R²	.22	.24	.24	.24
F	352.13**	102.83**	4.54*	0.46

Note. PPR = parent and peer religion.

p < .10. **p < .05. ***p < .001.

Discussion

The purpose of the current study was to examine the relationship between stressful life experiences and mental health and whether religion/spirituality act as buffers against the harmful consequences of stressful life experiences among the population of Icelandic adolescents. Both childhood sexual abuse and family violence/conflict were uniquely associated with an increase in mental health symptoms of depressed mood and anger, similar to previous work (Edwards et al., 2003; Molnar et al., 2001; Neumann et al., 1996; Paolucci et al., 2001; Pérez-Fuentes et al., 2013). The results are also in line with Agnew’s (1992) strain theory, connecting strain with negative emotions. In addition, individuals with victimization histories reported less spirituality and less religion of others, compared with those without stressful life experiences. This is in line with previous research suggesting that individuals with stressful life experiences may struggle with religion and spirituality following their experiences (Cadell, Regehr, & Hemsworth, 2003; Falsetti, Resick, & Davis, 2003; Walker, Reese, Hughes, & Troskie, 2010).

Religion and spirituality had differential relationships with mental health outcomes. For example, greater spirituality was associated with less anger and depressed mood. This is consistent with previous research on the topic (Bjorck & Thurman, 2007; Good & Willoughby, 2008; Holder et al., 2010; Maddi et al., 2006; Pearce et al., 2003). In addition, PPR is significantly connected with less anger, showing the powerful effects of religious context on youth. It is important to recognize that these effects are significant independent of social support, as that had already been controlled for in the analysis. To our knowledge, this is the first study establishing this effect, although other work has found parental religion to protect against drug use (Merrill et al., 2001) and be connected with greater life satisfaction and prosocial behavior (Bartkowski et al., 2008; Varon & Riley, 1999). However, not all studies have identified positive effects of parental religion (Hooper & Newman, 2011; Van der Jagt-Jelsma et al., 2011). We have been unable to locate any research on the relationship between peer religious influence and youth mental health, making this study a unique contribution to the literature. Religious participation, however, was not associated with anger and depressed mood. Overall, these results are in accordance with previous research in the sense that different aspects of religion and spirituality are not uniformly beneficial or detrimental in terms of mental health outcomes (Alim et al., 2008; Elliott, 1994; Gall et al., 2007; Holder et al., 2010; Schnittker, 2001; Walker et al., 2010; Williams et al., 1991).

However, victimization status also plays a role in the relationship between mental health outcomes, religion, and spirituality. Overall, anger had a negative relationship with spirituality, but that effect was significantly stronger for those who had been sexually abused. To our knowledge, this is the first study showing this particular buffering effect in a large population–based study. Previous literature on spirituality as a buffer among trauma survivors has focused on depressed mood, and found spirituality to either be a significant buffer (Gall et al., 2007) or not (Alim et al., 2008). These findings also differ from previous literature on the topic, as the buffering effect was only present for anger, not depressed mood. In addition, we did not detect the buffering effects of religious participation on the relationship between stressful life experiences and mental health symptoms reported in other papers (Alim et al., 2008; Williams et al., 1991).

These analyses also demonstrated the importance of controlling for variables known to be associated with mental health outcomes. For example, girls were more likely than boys to show elevated symptoms of depressed mood, consistent with previous work (Nolen-Hoeksema, 2001; Sigfusdottir, Asgeirsdottir, Sigurdsson, & Gudjonsson, 2008). We also saw the expected effects of social support, which was related to decreased symptoms, which is in line with previous work (Herrenkohl et al., 2016; Stevens et al., 2013).

This study has several limitations. First, in a cross-sectional study, it is impossible to infer causality. For example, we cannot know whether religion and spirituality has led to these mental health outcomes, or whether those who are struggling with psychological symptoms are more likely to seek out religion and spirituality for increased support. Second, the data are based on self-report and no identifying information was collected, so data accuracy cannot be verified. Third, the psychological symptoms measured here were not a clinical assessment or diagnosis. In addition, some items of the spirituality measure used the word “God” without instructing participants to substitute a higher being of their choice when applicable which may have affected the results. Finally, the retrospective nature of the study makes memory biases a concern.

This study has considerable strengths, such as the large population–based sample size and detailed information about the social context. For example, religious variables had unique effects even when controlling for social support in general. This is a significant contribution, especially when considering the social and community dimension of religion (Elliott, 1994; Walker et al., 2010). This study also adds to our knowledge as most of the previous work on this topic has been carried out in the United States. This is important because religion/spirituality exists in diverse ways across the globe and may therefore have different meaning and implications for youth. Diversity is also of interest in Iceland, as the population is relatively homogeneous, with most belonging to the Icelandic State Lutheran Church.

The findings of the current study indicate that in general, adolescent survivors of stressful life experiences of sexual abuse and family violence/conflict are less religious and spiritual than their peers. This may be troubling as spirituality and the religion of others are associated with decreased anger and depressed mood. When it comes to anger, spirituality plays an even larger role among survivors of stressful experiences. Promoting religion and spirituality among youth may therefore be beneficial for their mental health, especially for those with stressful life experiences.

Footnotes

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

Author Biographies

Rannveig Sigurvinsdottir is a postdoctoral research fellow at the Department of Psychology, Reykjavik University. Her research focuses on violence and trauma, such as the impact of sexual violence and intimate partner violence on survivors. She has published work on the impact of postassault disclosures of sexual assault on survivors, the mental health of sexual minority sexual assault survivors, the safety and well-being of survivors of intimate partner violence, and community and legal interventions for trauma victimization.

Bryndis Bjork Asgeirsdottir is an associate professor at the Department of Psychology, Reykjavik University. Her field of research includes stressful life events, trauma, and abuse in the lives of children and adolescents. She has published research on predictors of child abuse, protective factors in the lives of adolescents when facing stressful life events, and pathways from stressful life events to risk behaviors, including suicidal and self-injurious behavior, substance use, and delinquency.

Sarah E. Ullman is a professor of criminology, law, and justice at University of Illinois at Chicago and social psychologist whose research concerns the impact of sexual assault and traumatic life events on women’s health and substance abuse outcomes and rape avoidance/prevention. Her book Talking About Sexual Assault: Society’s Response to Survivors was published by American Psychological Association in 2010 and she is conducting a National Institute on Alcohol Abuse and Alcoholism (NIAAA)–funded longitudinal study of risk and protective factors in sexual assault survivors related to risk of revictimization, mental health, substance abuse, and posttraumatic growth outcomes.

Inga Dora Sigfusdottir is a professor at Reykjavik University. She also serves as a visiting professor at the Institute for Folkhälsovetenskap at Karolinska Institutet in Stockholm and as a research professor in the Department of Health and Behavior Studies at Teachers College, Columbia University in New York. Most of her scientific work can be described as sociological research on youth and adolescents and their health and well-being. Her work has focused on the study of risk and protective factors in the prevention of adolescent delinquency and, more recently, health related behaviour.

References

Agnew

(1992). Foundation for a general strain theory of crime and delinquency. Criminology, 30, 47-87.

Alim

T. N.

Feder

Graves

R. E.

Wang

Weaver

Westphal

Mellman

T. A.

(2008). Trauma, resilience, and recovery in a high-risk African-American population. American Journal of Psychiatry, 165, 1566-1575.

Asgeirsdottir

B. B.

Gudjonsson

G. H.

Sigurdsson

J. F.

Sigfusdottir

I. D.

(2010). Protective processes for depressed mood and anger among sexually abused adolescents: The importance of self-esteem. Personality and Individual Differences, 49, 402-407.

Asgeirsdottir

B. B.

Sigfusdottir

I. D.

Gudjonsson

G. H.

Sigurdsson

J. F.

(2011). Associations between sexual abuse and family conflict/violence, self-injurious behavior, and substance use: The mediating role of depressed mood and anger. Child Abuse & Neglect, 35, 210-219.

Bahr

S. J.

Maughan

S. L.

Marcos

A. C.

(1998). Family, religiosity, and the risk of adolescent drug use. Journal of Marriage and the Family, 979-992.

Bartkowski

J. P.

Levin

M. L.

(2008). Religion and child development: Evidence from the early childhood longitudinal study. Social Science Research, 37, 18-36.

Bernburg

J. G.

Thorlindsson

Sigfusdottir

I. D.

(2009). Relative deprivation and adolescent outcomes in Iceland: A multilevel test. Social Forces, 87, 1223-1250.

Bjarnason

J. G.

Thorlindsson

Sigfusdottir

I. D.

Welch

M. R.

(2005). Familial and religious influences on adolescent alcohol use: A multi-level study of students and school communities. Social Forces, 84(1), 375-390.

Bjorck

J. P.

Thurman

J. W.

(2007). Negative life events, patterns of positive and negative religious coping, and psychological functioning. Journal for the Scientific Study of Religion, 46, 159-167.

10.

Cadell

Regehr

Hemsworth

(2003). Factors contributing to posttraumatic growth: A proposed structural equation model. American Journal of Orthopsychiatry, 73, 279-287.

11.

Chandy

J. M.

Blum

R. W.

Resnick

M. D.

(1996). Female adolescents with a history of sexual abuse risk outcome and protective factors. Journal of Interpersonal Violence, 11, 503-518.

12.

Chatters

L. M.

(2000). Religion and health: Public health research and practice. Annual Review of Public Health, 21, 335-367.

13.

Cotton

Zebracki

Rosenthal

S. L.

Tsevat

Drotar

(2006). Religion/spirituality and adolescent health outcomes: A review. Journal of Adolescent Health, 38, 472-480.

14.

Davis

T. L.

Kerr

B. A.

Kurpius

S. E. R.

(2003). Meaning, purpose, and religiosity in at-risk youth: The relationship between anxiety and spirituality. Journal of Psychology & Theology, 31(4), 356-365.

15.

Derogatis

L. R.

Lipman

R. S.

Covi

(1973). SCL-90: An outpatient psychiatric rating scale—Preliminary report. Psychopharmacology Bulletin, 9, 13-28.

16.

Derogatis

L. R.

Lipman

R. S.

Covi

Rickels

(1971). Neurotic symptom dimensions: As perceived by psychiatrists and patients of various social classes. Archives of General Psychiatry, 24, 454-464.

17.

Edwards

V. J.

Holden

G. W.

Felitti

V. J.

Anda

R. F.

(2003). Relationship between multiple forms of childhood maltreatment and adult mental health in community respondents: Results from the adverse childhood experiences study. American Journal of Psychiatry, 160, 1453-1460.

18.

Elliott

D. M.

(1994). The impact of Christian faith on the prevalence and sequelae of sexual abuse. Journal of Interpersonal Violence, 9, 95-108.

19.

Fallot

R. D.

Heckman

J. P.

(2005). Religious/spiritual coping among women trauma survivors with mental health and substance use disorders. The Journal of Behavioral Health Services & Research, 32, 215-226.

20.

Falsetti

S. A.

Resick

P. A.

Davis

J. L.

(2003). Changes in religious beliefs following trauma. Journal of Traumatic Stress, 16, 391-398.

21.

Finkelhor

Hotaling

G. T.

Lewis

I. A.

Smith

(1989). Sexual abuse and its relationship to later sexual satisfaction, marital status, religion, and attitudes. Journal of Interpersonal Violence, 4, 379-399.

22.

Frankel

B. G.

Hewitt

W. E.

(1994). Religion and well-being among Canadian university students: The role of faith groups on campus. Journal for the Scientific Study of Religion. doi: 10.2307/1386637

23.

Gall

T. L.

(2006). Spirituality and coping with life stress among adult survivors of childhood sexual abuse. Child Abuse & Neglect, 30, 829-844.

24.

Gall

T. L.

Basque

Damasceno-Scott

Vardy

(2007). Spirituality and the current adjustment of adult survivors of childhood sexual abuse. Journal for the Scientific Study of Religion, 46, 101-117.

25.

Godbout

Sabourin

Lussier

(2009). Child sexual abuse and adult romantic adjustment: Comparison of single-and multiple-indicator measures. Journal of Interpersonal Violence, 24, 693-705.

26.

Good

Willoughby

(2006). The role of spirituality versus religiosity in adolescent psychosocial adjustment. Journal of Youth and Adolescence, 35(1), 39-53.

27.

Good

Willoughby

(2008). Adolescence as a sensitive period for spiritual development. Child Development Perspectives, 2(1), 32-37.

28.

Good

Willoughby

Fritjers

(2009). Just another club? The distinctiveness of the relation between religious service attendance and adolescent psychosocial adjustment. Journal of Youth and Adolescence, 38, 1153-1171.

29.

Gudjonsson

G. H.

Sigurdsson

J. F.

Sigfusdottir

I. D.

Asgeirsdottir

B. B.

(2008). False confessions and individual differences: The importance of victimization among youth. Personality and Individual Differences, 45(8), 801-805.

30.

Gudmundsdottir

M. L.

Kristjansson

A. L.

Sigfusdottir

I. D.

Sigfusson

(2009). Young people 2009, Grades 8-10: Education, culture, recreation, sports and future vision of youth in Iceland. Retrieved from http://www.rannsoknir.is/is/utgefid-efni/?search[category][]=225&q=

31.

Herrenkohl

T. I.

Jung

Klika

J. B.

Mason

W. A.

Brown

E. C.

Leeb

R. T.

Herrenkohl

R. C.

(2016). Mediating and moderating effects of social Support in the study of child abuse and adult physical and mental health. American Journal of Orthopsychiatry, 86, 573-583.

32.

Hill

P. C.

Pargament

K. I.

(2008). Advances in the conceptualization and measurement of religion and spirituality: Implications for physical and mental health research. Psychology of Religion and Spirituality, S(1), 3-17.

33.

Holder

M. D.

Coleman

Wallace

J. M.

(2010). Spirituality, religiousness, and happiness in children aged 8–12 years. Journal of Happiness Studies, 11(2), 131-150.

34.

Hooper

L. M.

Newman

C. R.

(2011). Exploring the relations between parent depressive symptoms, family religious involvement, and adolescent depressive symptoms: A test of moderation. Counseling and Values, 55, 210-227.

35.

Koenig

Larson

D. B.

(2001). Religion and mental health: Evidence for an association. International Review of Psychiatry, 13, 67-78.

36.

Lawson

Drebing

Berg

Vincellette

Penk

(1998). The long term impact of child abuse on religious behavior and spirituality in men. Child Abuse & Neglect, 22, 369-380.

37.

Maddi

S. R.

Brow

Khoshaba

D. M.

Vaitkus

(2006). Relationship of hardiness and religiousness to depression and anger. Consulting Psychology Journal: Practice and Research, 58, 148-161.

38.

Merrill

R. M.

Salazar

R. D.

Gardner

N. W.

(2001). Relationship between family religiosity and drug use behavior among youth. Social Behavior and Personality: An International Journal, 29, 347-357.

39.

Mishra

Carleton

R. N.

(2015). Subjective relative deprivation is associated with poorer physical and mental health. Social Science & Medicine, 147, 144-149.

40.

Molnar

B. E.

Buka

S. L.

Kessler

R. C.

(2001). Child sexual abuse and subsequent psychopathology: results from the National Comorbidity Survey. American Journal of Public Health, 91(5), 753.

41.

Neumann

D. A.

Houskamp

B. M.

Pollock

V. E.

Briere

(1996). The long-term sequelae of childhood sexual abuse in women: A meta-analytic review. Child Maltreatment, 1(1), 6-16.

42.

Nolen-Hoeksema

(2001). Gender differences in depression. Current Directions in Psychological Science, 10, 173-176.

43.

Paolucci

E. O.

Genuis

M. L.

Violato

(2001). A meta-analysis of the published research on the effects of child sexual abuse. The Journal of Psychology, 135, 17-36.

44.

Pargament

K. I.

Ensing

D. S.

Falgout

Olsen

Reilly

Van Haitsma

Warren

(1990). God help me:(I): Religious coping efforts as predictors of the outcomes to significant negative life events. American Journal of Community Psychology, 18, 793-824.

45.

Pargament

K. I.

Ishler

Dubow

E. F.

Stanik

Rouiller

Crowe

Royster

B. J.

(1994). Methods of religious coping with the Gulf War: Cross-sectional and longitudinal analyses. Journal for the Scientific Study of Religion, 33, 347-361.

46.

Pargament

K. I.

Koenig

H. G.

Tarakeshwar

Hahn

(2001). Religious struggle as a predictor of mortality among medically ill elderly patients: A 2-year longitudinal study. Archives of Internal Medicine, 161, 1881-1885.

47.

Pearce

M. J.

Little

T. D.

Pérez

J. E.

(2003). Religiousness and depressive symptoms among adolescents. Journal of Clinical Child and Adolescent Psychology, 32, 267-276.

48.

Pérez-Fuentes

Olfson

Villegas

Morcillo

Wang

Blanco

(2013). Prevalence and correlates of child sexual abuse: a national study. Comprehensive Psychiatry, 54(1), 16-27.

49.

Pérez

J. E.

Little

T. D.

Henrich

C. C.

(2009). Spirituality and depressive symptoms in a school-based sample of adolescents: A longitudinal examination of mediated and moderated effects. Journal of Adolescent Health, 44, 380-386.

50.

Ross

C. E.

(1990). Religion and psychological distress. Journal for the Scientific Study of Religion, 236-245.

51.

Ryan

R. M.

Rigby

King

(1993). Two types of religious internalization and their relations to religious orientations and mental health. Journal of Personality and Social Psychology, 65, 586-586.

52.

Schnittker

(2001). When is faith enough? The effects of religious involvement on depression. Journal for the Scientific Study of Religion, 40, 393-411.

53.

Seeman

T. E.

Dubin

L. F.

Seeman

(2003). Religiosity/spirituality and health: A critical review of the evidence for biological pathways. American Psychologist, 58(1), 53-63.

54.

Sigfusdottir

I. D.

Asgeirsdottir

B. B.

Sigurdsson

J. F.

Gudjonsson

G. H.

(2008). Trends in depressive symptoms, anxiety symptoms and visits to healthcare specialists: A national study among Icelandic adolescents. Scandinavian Journal of Public Health, 36, 361-368.

55.

Sigfusdottir

I. D.

Thorlindsson

Bjarnason

(2007). Religion: Soutien divin et tension psychologique. Social Compass, 54, 473-492.

56.

Smith

(2003). Theorizing religious effects among American adolescents. Journal for the Scientific Study of Religion, 42(1), 17-30.

57.

Statistics Iceland. (2017). Religious groups (Trúfélög). Retrieved from https://hagstofa.is/talnaefni/samfelag/menning/trufelog/

58.

Stevens

N. R.

Gerhart

Goldsmith

R. E.

Heath

N. M.

Chesney

S. A.

Hobfoll

S. E.

(2013). Emotion regulation difficulties, low social support, and interpersonal violence mediate the link between childhood abuse and posttraumatic stress symptoms. Behavior Therapy, 44, 152-161.

59.

Thombs

B. D.

Bernstein

D. P.

Ziegelstein

R. C.

Bennett

Walker

E. A.

(2007). A brief two-item screener for detecting a history of physical or sexual abuse in childhood. General Hospital Psychiatry, 29(1), 8-13.

60.

Turner

H. A.

Finkelhor

Hamby

S. L.

Shattuck

(2013). Family structure, victimization, and child mental health in a nationally representative sample. Social Science & Medicine, 87, 39-51.

61.

Van der Jagt-Jelsma

de Vries-Schot

de Jong

Verhulst

F. C.

Ormel

Veenstra

Buitelaar

. (2011). The relationship between parental religiosity and mental health of pre-adolescents in a community sample: The TRAILS study. European Child & Adolescent Psychiatry, 20, 253-260.

62.

Van Dyke

C. J.

Glenwick

D. S.

Cecero

J. J.

Kim

S. K

. (2009). The relationship of religious coping and spirituality to adjustment and psychological distress in urban early adolescents. Mental Health, Religion and Culture, 12(4), 369-383.

63.

Varon

S. R.

Riley

A. W.

(1999). Relationship between maternal church attendance and adolescent mental health and social functioning. Psychiatric Services, 50, 799-805.

64.

Walker

D. F.

Reese

J. B.

Hughes

J. P.

Troskie

M. J.

(2010). Addressing religious and spiritual issues in trauma-focused cognitive behavior therapy for children and adolescents. Professional Psychology: Research and Practice, 41, 174-180.

65.

Walker

D. F.

Reid

H. W.

O’Neill

Brown

(2009). Changes in personal religion/spirituality during and after childhood abuse: A review and synthesis. Psychological Trauma: Theory, Research, Practice, and Policy, 1, 130-145.

66.

Weaver

A. J.

Samford

J. A.

Morgan

V. J.

Larson

D. B.

Koenig

H. G.

Flannelly

K. J.

(2002). A systematic review of research on religion in six primary marriage and family journals: 1995-1999. American Journal of Family Therapy, 30(4), 293-309.

67.

Williams

D. R.

Larson

D. B.

Buckler

R. E.

Heckmann

R. C.

Pyle

C. M.

(1991). Religion and psychological distress in a community sample. Social Science & Medicine, 32(11), 1257-1262.

68.

Wong

Y. J.

Rew

Slaikeu

K. D.

(2006). A systematic review of recent research on adolescent religiosity/spirituality and mental health. Issues in Mental Health Nursing, 27, 161-183.

69.

Yonker

J. E.

Schnabelrauch

C. A.

DeHaan

L. G.

(2012). The relationship between spirituality and religiosity on psychological outcomes in adolescents and emerging adults: A meta-analytic review. Journal of Adolescence, 35, 299-314.