Spiritual Well-Being and Mental Health Outcomes in Adolescents With or Without Inflammatory Bowel Disease

Cotton, Sian; Kudel, Ian; Roberts, Yvonne Humenay; Pallerla, Harini; Tsevat, Joel; Succop, Paul; Yi, Michael S.

doi:10.1016/j.jadohealth.2008.09.013

« Previous Next »Journal of Adolescent Health
Volume 44, Issue 5 , Pages 485-492, May 2009

Spiritual Well-Being and Mental Health Outcomes in Adolescents With or Without Inflammatory Bowel Disease

Sian Cotton, Ph.D.
- Department of Family Medicine, University of Cincinnati Academic Health Center, Cincinnati, Ohio
- Center for the Study of Health, University of Cincinnati Academic Health Center, Cincinnati, Ohio
- Address correspondence to: Sian Cotton, Ph.D., Department of Family Medicine and the Center for the Study of Health, University of Cincinnati Academic Health Center, P.O. Box 670840, Cincinnati, OH 45267.
Ian Kudel, Ph.D.
- Center for the Study of Health, University of Cincinnati Academic Health Center, Cincinnati, Ohio
- Health Services Research and Development, Veterans Affairs Medical Center, Cincinnati, Ohio
Yvonne Humenay Roberts, M.A.
- Department of Psychology, University of Cincinnati, Cincinnati, Ohio
Harini Pallerla, M.S.
- Department of Family Medicine, University of Cincinnati Academic Health Center, Cincinnati, Ohio
Joel Tsevat, M.D., M.P.H.
- Center for the Study of Health, University of Cincinnati Academic Health Center, Cincinnati, Ohio
- Health Services Research and Development, Veterans Affairs Medical Center, Cincinnati, Ohio
- Division of General Internal Medicine, Department of Internal Medicine, University of Cincinnati Academic Health Center, Cincinnati, Ohio
Paul Succop, Ph.D.
- Division of Epidemiology and Biostatistics, Department of Environmental Health,University of Cincinnati Academic Health Center, Cincinnati, Ohio
Michael S. Yi, M.D., M.Sc.
- Center for the Study of Health, University of Cincinnati Academic Health Center, Cincinnati, Ohio
- Division of General Internal Medicine, Department of Internal Medicine, University of Cincinnati Academic Health Center, Cincinnati, Ohio

Received 6 June 2008; accepted 24 September 2008. published online 17 November 2008.

Abstract

Purpose

The purpose of this study was threefold: 1) to describe spiritual well-being (existential and religious well-being) in adolescents with inflammatory bowel disease (IBD) versus healthy peers; 2) to examine associations of spiritual well-being with mental health outcomes (emotional functioning and depressive symptoms); and 3) to assess the differential impact of existential versus religious well-being on mental health.

Methods

A total of 155 adolescents aged 11–19 years from a children's hospital and a university hospital filled out questionnaires including the Spiritual Well-Being Scale, the Children's Depression Inventory–Short Form, and the Pediatric Quality of Life Inventory. Covariates in multivariable models included demographics, disease status, and interactions.

Results

Participants’ mean (SD) age was 15.1 (2.0) years; 80 (52%) were male; and 121 (78%) were of white ethnicity. Levels of existential and religious well-being were similar between adolescents with IBD and healthy peers. In multivariable analyses, existential well-being was associated with mental health (partial R² change = .08–.11, p < .01) above and beyond other characteristics (total R² = .23, p < .01). Presence of disease moderated both the relationship between existential well-being and emotional functioning and that between religious well-being and depressive symptoms: that is, the relationships were stronger in adolescents with IBD as compared with healthy peers. Religious well-being was only marginally significantly associated with mental health after controlling for other factors.

Conclusions

Although both healthy adolescents and those with IBD had high levels of spiritual well-being, having IBD moderated the relationship between spiritual well-being and mental health. Meaning/purpose was related to mental health more than was connectedness to the sacred.