The spiritual health of adolescents is a topic of emerging contemporary importance. Limited numbers of international studies provide evidence about developmental patterns of this aspect of health during the adolescent years. Using multidimensional indicators of spiritual health that have been adapted for use within younger adolescent populations, we therefore: (1) describe aspects of the perceptions of the importance of spiritual health of adolescents by developmental stage and within genders; (2) conduct similar analyses across measures related to specific domains of adolescent spiritual health; (3) relate perceptions of spiritual health to self-perceived personal health status. Cross-sectional surveys were administered to adolescent populations in school settings during 2013-2014. Participants (n=45,967) included eligible and consenting students aged 11-15 years in sampled schools from six European and North American countries. Our primary measures of spiritual health consisted of eight questions in four domains (perceived importance of connections to: self, others, nature, and the transcendent). Socio-demographic factors included age, gender, and country of origin. Self-perceived personal health status was assessed using a simple composite measure. Self-rated importance of spiritual health, both overall and within most questions and domains, declined as young people aged. This declining pattern persisted for both genders and in all countries, and was most notable for the domains of "connections with nature" and "connections with the transcendent". Girls consistently rated their perceptions of the importance of spiritual health higher than boys. Spiritual health and its domains related strongly and consistently with self-perceived personal health status. While limited by the 8-item measure of perceived spiritual health employed, study findings confirm developmental theories proposed from qualitative observation, provide foundational evidence for the planning and targeting of interventions centered on adolescent spiritual health practices, and direction for the study of spiritual health in a general population health survey context.

Adolescent and Child Health Research Group University of Hertfordshire Hatfield UK

Child and Adolescent Health Research Unit University of St Andrews Scotland UK

Department of Criminology and the School of Education Bar Ilan University Ramat Gan Israel

Department of Public Health Sciences Queen's University Kingston Canada K7L 3N6

Faculty of Physical Culture Palacky University Olomouc Czech Republic

Institute of Mother and Child Warsaw Poland

School of Religion Queen's University Kingston Canada

Zobrazit více v PubMed

Benson P.L., Roehlkepartain E.C., Rude S.P. Spiritual development in childhood and adolescence: Toward a field of inquiry. Applied Developmental Science. 2003;7(3):205–213.

Benson P.L., Scales P.C., Syvertsen A.K., Roehlkepartain E.C. Is spiritual development a universal process in the lives of youth? An international exploration. Journal of Positive Psychology. 2012;7(6):453–470.

Bigelow B., Swineheart T. Rethinking Schools; Milwaukee, WI: 2014. A people׳s curriculum for the earth: Teaching climate change and the environmental crisis.

Biegel G.M., Brown K.W., Shapiro S.L., Schubert C. Mindfulness-based stress reduction for the treatment of adolescent psychiatric outpatients: A randomized clinical trial. Journal of Consulting and Clinical Psychology. 2009;77(5):855–866. PubMed

Blaney, B., & Smythe, J. Mindfulness training program. 2014, Retrieved from 〈http://meds.queensu.ca/education/postgraduate/wellness/mbsr〉.

Bone J., Cullen J., Loveridge J. Everyday spirituality: An aspect of the holistic curriculum in action. Contemporary Issues in Early Childhood. 2007;8(4):344–354.

Butterworth G., Harris M. Psychology Press; New York: 2014. Principles of developmental psychology.

Caskey, M. M., & Anfara, V. A., Jr. Research summary: Young adolescents’ developmental characteristics. 2007, Retrieved from 〈http://www.nmsa.org/Research/ResearchSummaries/DevelopmentalCharacteristics/tabid/1414/Default.aspx〉.

CBS . Israel Central Bureau for Statistics; 2009. Social survey 2009—The Jewish population: The place of religion in Israeli public life.

Clements R. An investigation of the status of outdoor play. Contemporary Issues in Early Childhood. 2004;5(1):67–80.

Crompton M. Children, spirituality and religion. In: Milnter P., Carolin B., editors. Time to listen to children: Personal and Professional Communication. Routledge; New York, NY: 1999. pp. 79–93.

Currie, C., Zanotti, C., Morgan, A., Currie, D., de Looze, M., Roberts, C., Samdal, O., Smith, O. R. F., & Barnekow, V. Social determinants of health and well-being among young people: Health behaviour in school-aged children (HBSC study): International report from the 2009/2010 survey. Health Policy for Children and Adolescents, Report No. 6, WHO Regional Office for Europe. 2012, Retrieved from 〈http://www.euro.who.int/en/publications/abstracts/social-determinants-of-health-and-well-being-among-young-people.-health-behaviour-in-school-aged-children-hbsc-study〉.

Damon W., Menon J., Bronk K. The development of purpose during adolescence. Applied Developmental Sciences. 2003;7(3):119–127.

Dhar N., Chaturvedi S., Nandan D. Spiritual health scale 2011: Defining and measuring 4th dimension of health. Indian Journal of Community Medicine. 2011;36(4):275–282. PubMed PMC

Dhar N., Chaturvedi S., Nandan D. Spiritual health, the fourth dimension: A public health perspective. WHO South-East Asia Journal of Public Health. 2013;2(1):3–5. PubMed

Eaude T. National Primary Centre (South West); Bristol: 2003. New perspectives on spiritual development.

Eaude T. Happiness, emotional well-being and mental health: What has children׳s spirituality to offer? International Journal of Children׳s Spirituality. 2009;14(3):185–196.

Elgar F.J., Trites S.J., Boyce W. Social capital reduces socio-economic differences in child health: Evidence from the Canadian health behaviour in school-aged children study. Canadian Journal of Public Health. 2010;101(3):S23–S27. PubMed PMC

Erikson E.H. WW Norton; New York: 1994. Identity: Youth and crisis.

Feudtner C., Haney J., Dimmers M.A. Spiritual care needs of hospitalized children and their families: A national survey of pastoral care providers’ perceptions. Pediatrics. 2003;111(1):e67–e72. PubMed

Fisher J.W. Developing a spiritual health and life-orientation measure for secondary school students. In: Ryan J., Wittwer V., Baird D., editors. Research with a regional/rural focus: Proceedings of the University of Ballarat inaugural annual conference. University of Ballarat, Research and Graduate Studies Office; Ballarat: 1999. pp. 57–63.

Fisher J. Development and application of a spiritual well-being questionnaire called SHALOM. Religions. 2010;1(1):105–121.

Fisher J. The four domains model: Connecting spirituality, health and well-being. Religions. 2011;2(1):17–28.

Fisher J.W., Francis L.J., Johnson P. Assessing spiritual health via four domains of spiritual wellbeing: The SH4DI. Pastoral Psychology. 2000;49(2):133–145. 37.

Francis L.J., Robbins M. Belonging without believing: A study in the social significance of Anglican identity and implicit religion among 13–15 year-old males. Implicit Religion. 2004;7(1):37–54.

Freeman J.G., King M., Pickett W., Craig W., Elgar F., Janssen I., Klinger D. Public Health Agency of Canada; Ottawa: 2011. The health of Canada׳s young people: A mental health focus; p. 194.

Gomez R., Fisher J.W. Domains of spiritual well-being and development and validation of the spiritual well-being questionnaire. Personality and Individual Differences. 2003;35(8):1975–1991.

Gray P. The decline of play and the rise of psychopathology in children and adolescents. American Journal of Play. 2011;3(4):443–463.

Grossman P., Niemann L., Schmidt S., Walach H. Mindfulness-based stress reduction and health benefits: A meta-analysis. Journal of Psychosomatic Research. 2004;57(1):35–43. PubMed

Hay D., Nye R. Fount Paperbacks; London: 1998. The spirit of the child.

Hawks S.R., Hull M.L., Thalman R.L., Richins P.M. Review of spiritual health: Definition, role, and intervention strategies in health promotion. American Journal of Health Promotion. 1995;9(5):371–378. PubMed

Hendricks-Ferguson V. Relationships of age and gender to hope and spiritual well-being among adolescents with cancer. Journal of Pediatric Oncology Nursing. 2006;23(4):189–199. PubMed

Holder M., Coleman B., Wallace J. Spirituality, religiousness, and happiness in children aged 8–12 years. Journal of Happiness Studies. 2008;11(2):131–150.

Houskamp B.M., Fisher L.A., Stuber M.L. Spirituality in children and adolescents: Research findings and implications for clinicians and researchers. Child and Adolescent Psychiatric Clinics of North America. 2004;13(1):221–230. PubMed

Hughes, P. A new day for religion in Canada and Australia? Pointers: Bulletin of the Christian Research Association, 23(1), 2013, 5–6. Retrieved from 〈http://search.informit.com.au/documentSummary;dn=162333001616314;res=IELHSS〉.

Hyland M.E., Wheeler P., Kamble S., Masters K.S. A sense of ׳special connection׳, self-transcendent values and a common factor for religious and non-religious spirituality. Archive for the Psychology of Religion—Archiv Fur Religionspsychologie. 2010;32(3):293–326.

Idler E.L., Benyamini Y. Self-rated health and mortality: A review of twenty-seven community studies. Journal of Health and Social Behavior. 1997;38(1):21–37. PubMed

Jirásek I. Verticality as non-religious spirituality. Implicit Religion. 2013;16(2):191–201.

Kaufman P.I. Humanist spirituality and ecclesial reaction: Thomas More׳s Monstra. Church History. 1987;56(1):25–38.

King P.E., Benson P.L. Spirituality development and adolescent well-being and thriving. In: Roehlkepartain E.C., King P.E., Wagener L., Benson P.L., editors. The handbook of spiritual development in childhood & adolescence. Sage Publications, Inc.; Thousand Oaks, CA: 2006. pp. 384–398.

King P.E., Ramos J., Clardy C. Searching for the sacred: Religion, spirituality, and adolescent development. In: Pargament K.I., Exline J.J., Jones J.W., editors. APA handbook of psychology, religion, and spirituality (Vol. 1): Context, theory, and research. APA; Washington, DC: 2013. pp. 513–528.

Levin J. Is there an association, is it valid, and is it casual? Social Science Medicine. 1994;38(11):1475–1482. PubMed

Lippman L.H., Keith J.D. The demographics of spirituality among youth: International perspectives. In: Roehlkepartain E.C., King P.E., Wagener L., Benson P.L., editors. The handbook of spiritual development in childhood and adolescence. Sage Publications Inc.; Thousand Oaks, CA: 2006. pp. 109–123.

Louv R. Algonquin Books; New York: 2005. Last child in the woods: Saving our children from nature-deficit disorder.

Louv R. Algonquin Books; New York: 2012. The nature principle: Reconnecting with life in a virtual age.

Luo Lu R.G. Culture and conceptions of happiness: Individual oriented and social oriented swb. Journal of Happiness Studies. 2004;5(3):269–291.

Miller J.P., Nakagawa Y., editors. Nurturing our wholeness: Perspectives on spirituality in education. The Foundation for Educational Renewal; Brandon, VT: 2002.

Miller W.R., Thoresen C.E. Spirituality, religion, and health: An emerging research field. American Psychologist. 2003;58(1):24–35. PubMed

Nolan S. In defence of the indefensible: An alternative to John Paley׳s reductionist, atheistic, psychological alternative to spirituality. Nursing Philosophy. 2009;10(3):203–213. PubMed

Ojala M. Regulating worry, promoting hope: How do children, adolescents, and young adults cope with climate change? International Journal of Environmental and Science Education. 2012;7(4):537–561.

Ojala M. Coping with climate change among adolescents: Implications for subjective well-being and environmental engagement. Sustainability. 2013;5(5):2191–2209.

Otake K., Shimai S., Tanaka-Matsumi J. Happy people become happier through kindness: A counting kindness intervention. Journal of Happiness Studies. 2006;7(3):361–375. PubMed PMC

Palmer P. Jossey-Bass; San Francisco, CA: 2009. A hidden wholeness: The journey toward an undivided life.

Pendleton S., Cavalli K., Pargament K., Nasr S. Religious/spiritual coping in childhood cystic fibrosis: A qualitative study. Pediatrics. 2002;109(1):e8. PubMed

Phinney J.S. Ethnic identity in adolescents and adults: review of research. Psychological Bulletin. 1990;108(3):499. PubMed

Piaget J. Intellectual evolution from adolescence to adulthood. Human Development. 1972;15(1):1–12.

Post S.G. Altruism, happiness, and health: It׳s good to be good. International Journal of Behavioral Medicine. 2005;12(2):66–77. PubMed

Rao J.N.K., Scott A.J. The analysis of categorical data from complex sample surveys: Chi-squared tests for goodness of fit and independence in two-way tables. Journal of the American Statistical Association. 1981;76(374):221–230.

Rich Y., Cinamon R.G. Conceptions of spirituality among Israeli Arab and Jewish late adolescents. Journal of Humanistic Psychology. 2007;47(1):7–29.

Roehlkepartain E., King P., Wagener L., Benson P., editors. The handbook of spiritual development in childhood and adolescence. Sage Publications Inc.; Thousand Oaks, CA: 2006.

Rothman K.J., Greenland S., Lash T.L., editors. Modern epidemiology. Lippincott Williams & Wilkins; 2008.

Sallquist J., Eisenberg N., French D., Purwono U., Suryanti T. Indonesian adolescents’ spiritual and religious experiences and their longitudinal relations with socio-emotional functioning. Developmental Psychology. 2010;46(3):699–716. PubMed

Scales P.C., Syvertsen A.K., Benson P.L., Roehlkepartain E.C., Sesma A., Jr. The relation of spiritual development to youth health and well-being: Evidence from a global study. In: Ben-Arieh A., Casas F., Frones I., Korbin J.E., editors. The handbook of child well-being. Springer Netherlands; Dordrecht: 2014. pp. 1101–1135.

Schnell T. Spirituality with and without religion: Differential relationships with personality. Archive for the Psychology of Religion—Archiv Fur Religionspsychologie. 2012;34(1):33–61.

Scholte R.H.J., Van Aken M.A.G. Peer relations in adolescence. In: Jackson S., Goossens L., editors. Handbook of adolescent development. Psychology Press; New York: 2006. pp. 175–199.

Shonin E., Van Gordon W.V., Griffiths M.D. The health benefits of mindfulness-based interventions for children and adolescents. Education and Health. 2012;30(4):95–98. 〈〈http://sheu.org.uk/x/eh304mg.pdf〉〉 Retrieved from.

Simkin D.R., Black N.B. Meditation and mindfulness in clinical practice. Child and Adolescent Psychiatric Clinics in North America. 2014;23(3):487–534. PubMed

Sinats P., Scott D.G., McFerran S., Hittos M., Cragg C., Brooks D., Leblanc T. Writing ourselves into being: Writing as spiritual self-care for adolescent girls, part 1. International Journal of Children׳s Spirituality. 2005;10(1):17–29.

Smith L., Webber R., DeFrain J. Spiritual well-being and its relationship to resilience in young people. Sage Open. 2013:1–13.

Thompson M., Gauntlett-Gilbert J. Mindfulness with children and adolescents: Effective clinical application. Clinical Child Psychology and Psychiatry. 2008;13(3):395–407. PubMed

Udermann B.E. The effect of spirituality on health and healing: A critical review for athletic trainers. Journal of Athletic Training. 2000;35(2):194–197. PubMed PMC

UNICEF. Convention on the rights of the child. 1989, Retrieved from 〈http://www.unicef.org/crc/index_protecting.html〉.

Vader J.P. Spiritual health: The next frontier. European Journal of Public Health. 2006;16(5):457. PubMed

Wallace J. University of British Columbia; BC: 2010. The contributions of spirituality and religious practices to children׳s happiness.

Witvliet C.V.O., Ludwig T.E., Vander Laan K. Granting forgiveness or harboring grudges: Implications for emotion, physiology, and health. Psychological Science. 2001;12:117–123. PubMed

Witvliet C.V.O., McCullough M.E. Forgiveness and health: A review and theoretical exploration of emotion pathways. In: Post S.G., editor. Altruism and health: Perspectives from empirical research. Oxford University Press; Oxford, UK: 2007. pp. 259–276.

Yust K.M., Johnson A.N., Sasso S.E., Roehlkepartain E.C. Traditional wisdom: Creating space for religious reflection on child and adolescent spirituality. Nurturing child and adolescent spirituality: Perspectives from the world׳s religious traditions. 2006:1–14.

Distinguishing between spiritual health and religious involvement as determinants of adolescent health in Canada and the Czech Republic