(PS8-D97) Social Cognitive Mediators of Spiritual Well-being on Daily Positive Affect in Patients with Anxiety and Depressive Disorders

Background: Research suggests that despite recent declines in people identifying as “religious” in the U.S., the number of individuals self-identifying as “spiritual” has increased in recent years. Moreover, many patients presenting for treatment continue to identify as spiritual and/or religious, suggesting the need to continue understanding the role of these factors in well-being, alongside other cultural factors. Studies of spiritual well-being (SWB)—a subjective sense of spiritual and existential meaning—have linked it to positive emotional outcomes in the general population. However, less is known about the cognitive pathways that link these processes: whether SWB might operate through a sense of self-efficacy or agency, social connection, or living up to ones moral values. Thus, the aim of this study was to examine (1) the impact of SWB on positive emotion in clinically distressed individuals and (2) how social cognitive factors mediated effects on positive emotions. 

Method: Treatment-seeking p</span>atients identified as religious (22.8%), spiritual but not religious (21.1%), atheist (19.3%), agnostic (15.8%), no affiliation (10.5%), or other self-designation (10.5%). Patients diagnosed via ADIS-5 interview with primary anxiety and/or depressive disorders (N = 66) completed the Spiritual Well-Being Scale at baseline, then completed online experience-sampling diaries for their best and worst daily events over seven days, reporting situation-contingent ratings of self-agency, social connection, and moral values, as well as daily positive affect.  

Results: Multilevel mediation analyses showed, consistent with hypotheses, that spiritual well-being predicted higher subsequently daily positive affect levels directly and via unique indirect effects of agency (unstandardized 95%CI[.008, .013]), social connection [.005, .026], and moral values [.001, .014] during patients’ best daily moments. Moreover, these effects were not limited to individuals endorsing religious affiliation. Findings thus suggest that for some individuals, spirituality may play a role in daily emotional well-being even while they are symptomatic, and may operate via multiple pathways. Implications for cultural adaptation of CBT based on patients’ spirituality will be discussed.